1.

H 0 : μ2−μ1=0

H 1 : μ 2−μ1 ≠ 0

Ho: There is no significance difference in the means number of days to regain lost weight as a result of
Difference types of milk consumed
H 1 : not H 0
n1=20 n2 =20

x 1=13.1 x 2=9.9

δ 1=SD 1=5.3 δ 2=SD 2=3.7

α =5 %
x 1−x 2−(μ2−μ1 )
T . S=t=

√ δ 21 δ 22
+
n1 n2
13.1−9.9−0 3.2 3.2
¿ ¿ ¿

√ √ √
2 2
5.3 3.7 28.09 13.69 41.72
+ +
20 20 20 20 20

3.2 3.2
¿ ¿ tcal¿ 2.2140
√2.089 1.445

ttap P-Value = 5%, n1+n2-2

= 5%, df=20+20-2
=5%, df=38
=2.024
Since ttab >tcal we reject the HO and concluded that; There is significance difference in the means number of
days to regain lost weight as a result of difference types of milk consumed
2.a γ ij =μi + α i + ε ij
γ ij=Response
µ= Grand Mean
α=effect of I th treatment
ε ij=Random error
ANOVA

Source of Variation Degree of Sum of Square Mean sum of F ratio

Freedom Square
Treatment t−1 Σ t2 SSt Ms t
−cf t−1
r Ms c

Error(residual) n−t∨t ( r −1 ) SST −SSt SSe

n−t
Total n−1 Σxij 2−cf

Ho: There is no significant difference among the four varieties of Maize that rep 5 times

H1: There is a significance difference among the four varieties of Maize that rep 5 times

Maize 1 2 3 4 5 Total
variety
Type 1 1.18 1.09 1.94 1.85 -0.11 5.95
Type 2 1.26 1.35 2.66 2.39 0.29 5.29 7.95
Type 3 1.36 1.27 2.99 2.90 0.38 8.90
Type 4 1.66 1.75 3.21 3.30 -0.07 9.85
Total 5.46 5.46 8.14 10.44 0.49 29.99 32.65
10.14

rβ+ Tt+G
X = ( r−1 ) ( t−1 ) X=missing value

5 ( 8.14 ) + 4 ( 5.29 )−29.99

=
( 5−1 ) ( 4−1 )
40.7+21.16−32 31.89
= (4 ) (3)
=
12
= 2.6558 ≃ 2.66

1st step correcting factor (CF)

2 2 2
G G 32.65 1066.023
cf = = = = = 53.30115 ≃ 53.301
n rt 4 X 5 20

2nd Degree of freedom

DfT =n−1=20−1=19
 Dft =t−1=4−1=3
Dfr=r−1=5−1=4
Dfe=( t−1 ) ( r−1 )= ( 4−1 ) ( 5−1 )= ( 3 )( 4 )=12
3rd. Sum of Square
t r
SST =∑ . ∑ x2ij
i=1 j=1

¿ 1.18 +1.092 +1.942 +…+ 0.072−53.301

2

¿ 9.7787+16,2819+ 20.957+27.0171−53.301
¿ 74.0347−53,301
¿ 20.7337
4

∑ t2
i=1
SSt= −cf
r
2 2 2 2
5.95 +7.95 + 8.90 + 9.85
¿ −53.301
5
274.8375
¿ −53.301
5
¿ 54.9675−53.301
¿ 1.66665

∑ r2
i=1
SSr= −cf
t
2 2 2 2 2
5.46 + 5.46 +10.8 + 10.44 +0.49
¿ −53,301
4
285.4969
¿ −53.301
4
¿ 71.3742−53.301
¿ 18.0732

SSe=SST −SSt −SSr

¿ 20.7337−1.6665−18.0732
¿ 0.994
Step 4: Mean Sum of Square

SSt 1.6665 1.6665

Mst= ¿ ¿ ¿ 0.5555
t−1 4−1 3
SSr 18.0732 18.0732
Msr= ¿ ¿ ¿ 4.5183
r−1 5−1 4
SSe 0.994 0.994
Mse= ¿ ¿ = 0.0828
( t−1 ) ( r−1 ) ( 4−1 ) ( 5−1 ) 12

F ratio- For treatment For replication (Block)

Mst 0.5555 Msr 4.5183

F ratio= = =6.708 f ratio= = =54.57
Mse 0.0828 Mse 0.0828
For treatment

F tab at α =0.05 , ( t−1 ) ,(t−1)(r−1)

¿ 0.05 , ( 4−1 ) ,( 4−1)(5−1)
¿ 0.05 , 3 ,12
¿ 3.49
For replication

F tab at α =0.05 , ( r −1 ) , ( t−1 ) ( r−1 )

¿ 0.05 , ( 5−1 ) , ( 4−1 ) ( 5−1 )
¿ 0.05 , 4 ,12
¿ 3.26

Source of Degree of Sum of Square Mean sum of Fratio

variation freedom square
Treatment 3 1.667 0.555 6.705
Replication 4 18.073 4.518 54.43
(Block)
Error 12 0.994 0.083 -
Total 19 20.734 - -
We reject the H0 we reject Ho

We reject the H0 and concluded that: There is a significance difference among the four varieties of Maize
that rep 5 times.

5a. Descriptive

Descriptive epidemiology aims to describe the distributions of diseases and determinants. It provides a
way of organizing and analyzing these data to describe the variations in disease frequency among
populations by geographical areas and over time (i.e., person, place, and time).

Descriptive statistics, in short, help describe and understand the features of a specific data set by giving
short summaries about the sample and measures of the data. The most recognized types of descriptive
statistics are measures of center: the mean, median, and mode, which are used at almost all levels of
math and statistics

 Descriptive statistics summarizes or describes the characteristics of a data set.

 Descriptive statistics consists of three basic categories of measures: measures of central tendency,
measures of variability (or spread), and frequency distribution.
 Measures of central tendency describe the center of the data set (mean, median, mode).
 Measures of variability describe the dispersion of the data set (variance, standard deviation).
 Measures of frequency distribution describe the occurrence of data within the data set (count).

b. A case-control
A case-control study is designed to help determine if an exposure is associated with an outcome (i.e.,
disease or condition of interest). In theory, the case-control study can be described simply. First, identify
the cases (a group known to have the outcome) and the controls (a group known to be free of the
outcome). Then, look back in time to learn which subjects in each group had the exposure(s), comparing
the frequency of the exposure in the case group to the control group. By definition, a case-control study is
always retrospective because it starts with an outcome then traces back to investigate exposures. When
the subjects are enrolled in their respective groups, the outcome of each subject is already known by the
investigator. This, and not the fact that the investigator usually makes use of previously collected data, is
what makes case-control studies ‘retrospective’.
Case-Control Studies: Advantages and Disadvantages
Advantages Disadvantages

1.can obtain findings quickly  1. cannot generate incidence data

2.can often be undertaken with minimal
funding
3.efficient for rare diseases
4.can study multiple exposures
5.generally requires few study subjects
2.subject to bias
 3. difficult if record keeping is either inadequate or
4.unreliable
 5. selection of controls can be difficult

A case control study is a retrospective, observational study that compares two existing groups.
Researchers form these groups based on the existence of a condition in the case group and the lack of that
condition in the control group. They evaluate the differences in the histories between these two groups
looking for factors that might cause a disease.

Medical and epidemiological researchers frequently use case-control studies to identify potential risk
factors for diseases and other medical conditions. In this context, scientists create the case and control
groups based on the presence and absence of the condition, respectively. The researchers strive to create
otherwise similar groups outside the condition and the risk factors they’re explicitly evaluating.
By evaluating differences in exposure to risk factors between the case and control groups, researchers can
learn which factors are associated with the medical condition.
For example, medical researchers study disease X and use a case-control study design to identify risk
factors. They create two groups using available medical records from hospitals. Individuals with disease X
are in the case group, while those without it are in the control group. If the case group has more exposure
to a risk factor than the control group, that exposure is a potential cause for disease X. However, case-
control studies establish only correlation and not causation. Be aware of spurious correlations!
c. Cohort
The term “cohort” in modern epidemiology refers to “a group of people with defined characteristics who
are followed up to determine the incidence of, or mortality from, some specific disease, all causes of
death, or some other outcome.” A cohort study observes people as two or more groups, from exposure to
outcome. A key feature of the cohort study design is that subjects are followed up over time. It begins
with subjects who are exposed and not exposed to a factor and then evaluates the subsequent occurrence
of an outcome. Unlike cross-sectional studies, which are often used to determine prevalence, cohort
studies are used to study incidence, causes, and prognosis.
In clinical research, cohort studies are appropriate when there is evidence to suggest an association
between an exposure and an outcome, and the time interval between exposure and the development of
outcome is reasonable. Cohort studies are the design of choice for determining the incidence and natural
history of a condition. Due to their longitudinal design feature, one can look at disease progression and
natural history. Cohort studies allow us to calculate the incidence rate, cumulative incidence, relative
risk, and hazard ratio. Causality cannot be established definitively through a cohort study. Nevertheless,
cohort studies are useful to provide evidence that suggests causality and information regarding the
strength of the association between the risk factors and the outcome.

d. Cross-sectional
Cross-sectional studies are observational studies that analyze data from a population at a single point in
time. They are often used to measure the prevalence of health outcomes, understand determinants of
health, and describe features of a population. Unlike other types of observational studies, cross-sectional
studies do not follow individuals up over time. They are usually inexpensive and easy to conduct. They are
useful for establishing preliminary evidence in planning a future advanced study. This article reviews the
essential characteristics, describes strengths and weaknesses, discusses methodological issues, and gives
our recommendations on design and statistical analysis for cross-sectional studies in pulmonary and
critical care medicine. A list of considerations for reviewers is also provided.

e. Intervention
Intervention studies are considered to provide the most reliable evidence in epidemiological research.
Intervention studies can generally be considered as either preventative or therapeutic [1].

Therapeutic trials are conducted among individuals with a particular disease to assess the effectiveness of
an agent or procedure to diminish symptoms, prevent recurrence, or reduce mortality from the disease.

Preventative trials are conducted to evaluate whether an agent or procedure reduces the risk of
developing a particular disease among individuals free from that disease at the beginning of the trial, for
example, vaccine trials. Preventative trials may be conducted among individuals or among entire
communities

Types of experimental interventions may include:

- Therapeutic agents
- Prophylactic agents
- Diagnostic agents
- Surgical procedures
- Health service strategies
Characteristics of an intervention study

* A distinguishing characteristic of an intervention study is that the intervention (the preventative or

therapeutic measure) being tested is allocated by the investigator to a group of two or more study
subjects (individuals, households, communities).
* Subjects are followed prospectively to compare the intervention vs. the control (standard treatment, no
treatment or placebo).
4a. calculate the standardized mortality ratio for civil servants

Age Group Total Population of Deaths In Specific Deaths Expected Deaths of

(Years) Population c/Servants Population Rate C/S
15-19 94,963 29,128 53 53/94963= 0.0006 0.0006*29128=16.2567
20-24 107,584 26,921 76 0.0007 19.0177
25-29 106,753 22,578 99 0.0009 20.9383
30-34 92,847 18,656 139 0.0015 27.9296
35-39 99,909 14,630 237 0.0024 34.7047
40-44 98,979 10,689 346 0.0035 37.3654
45-49 85,477 9,588 501 0.0059 56.1974
50-54 74,229 10,108 609 0.0082 82.9295
55-59 50,550 8,963 593 0.011c 105.1446
Total 811,291 151,261 2653 0.0354 400.4839

Total number of deaths∈ a specific age group

Note: Age specific death rate =
Population of that age group
Expected death of c/servants = Population of c/Servants in a specific age group x Age specific death rate

Total nuber of observed deaths of civil servants

Standardized Mortality Ratio = x100
Number of expected deaths
42
=
400.4839
x100

=0.1049x100
=10.487
 =10%
Therefore since 0.1049 <1 or 10% < 100%, we concluded that: The result above
indicate that, there were fewer than expected deaths in the population of civil
servants in that certain community in Nigeria.

5. Data
Period ---------------------------------------------------------------2000(366)
Bed compliment -------------------------------------------------418
Discharges---------------------------------------------------------16,860
Deaths-------------------------------------------------------------500
Referred----------------------------------------------------------150
Internal transfer ----------------------------------------------1,450
Inpatient days (OBD) ----------------------------------------142,221

i. Average daily bed occupancy (ADBO)

Total patient days( occupied bed days)
ADBO =
number of days ∈the period under review
142,221
= 366

= 388.58 or 389 beds

ii. Percentages of occupancy (% occ )
Occupied Bed Days
% occ = Available Bed Days x 100 Note =Bed Compliment =Available Bed
 142,221
= 418 x 366 x 100

142,22100
= 152,988

= 92.96 or 93%
iii. Mean stay per patient (MS)

Occupied Bed Days

MS = Discharges∧death

142,221
= 16,860

= 8.4354 or 8days

iv. Turn Over Interval (TOI)

Available Bed Days−Occupied Bed Days
TOI = Discharges∧deaths

418 x 366−142,221
= 16,860

152,988−142,221
= 16,860

10,767
= 16,860

= 0.6386 or 1 day.

V. proportion of death to discharges for the period. (PDD)

deaths
PDD = Discharges∧deaths x100

500
= 16,860 x 100

= 2.9656 or 3%
Therefore proportion of discharges to deaths 100 - 2.9656 =97.0344 or 97%.
Another method
If discharges not by deaths = discharges – deaths = 16,860- 500=16,360
Proportion of discharges to deaths (PDD)
discharges not by deaths
PDD = Discharges∧deaths
x100

16360
= 16860 x100

= 0.970344x100
= 97.0344 or 97%

6.
Bed compliment ---------------------------------------------200
Bed occupancy rate -----------------------------------------85%
Period-----------------------------------------------------------2019 (365)
Mean length of stay-----------------------------------------9 days
Death -----------------------------------------------------------220
Period-----------------------------------------------------------2020(366)
Mean stay -----------------------------------------------------9-2=7 days
Discharged-----------------------------------------------------?

a. Total discharges and Deaths

Using percentage of occupancy (% of occ)
occupied Bed Days
% of occ = Available Bed Days ∗100 Let occupied Bed Days=x
x
85 = 200∗365 ∗100
 x 100
85 = 73000 cross multiply

X100 = 85* 73000

x 100 85∗730 00
= 100 = 1 00

62050 00
x= 100

X = 62050

⇒ Occupied Bed Days = 62050days

Mean length of stay (MLS)

occupied Bed Days
MLS = Discharge∧Death

62050
9= x
let discharges and deaths =x

9x 62050
=¿
9 9

X = 6894.44

⟹ Discharges and Death = 6894pts.

b. Average patient treated per bed or through put (TP)

Total Discharges∧death
TP = Available bed

6894
= 200
 = 34.47
~ 34 pts/bed

c. vacant bed days (VBD)

VBD =available bed days – occupied bed days
= (200*365) – 62050
= 73000 – 62050
= 10950 days

d. Turn Over Interval (TOI)

Available bed days−occupied bed days
TOI = Total Discharge∧death
73000−62050
= 6894
10950
= 6894

= 1.5883
~ 2days
e. If mean stay =7days in 2020 how many patients will be discharged
occupied bed days
Using % occ = available bed days ∗100 Let occupied bed days = x

x
= 200∗366 ∗100

100 x
85 = 73200

100 x 85∗73200
100
= 100

62220 00
X= 100
X = 62,220
⟹Occupied bed days = 62220

Mean length of stay (MLS)

 occupied Bed Days
MLS = Discharge∧Death

62,220
7= x
let discharges and deaths =x

7X 62,220
¿
7 7

X = 8,888.57143
DISCHARGES AND DEATH=8,888.57143
IF deaths =220
Discharged = discharges and deaths –deaths
= 8,888.57143-220
=8,668.57143
= 8,669pts