New developments in exposure assessment: the impact on the practice of health risk assessment and epidemiological studies.

PubMed

Nieuwenhuijsen, Mark; Paustenbach, Dennis; Duarte-Davidson, Raquel

2006-12-01

The field of exposure assessment has matured significantly over the past 10-15 years. Dozens of studies have measured the concentrations of numerous chemicals in many media to which humans are exposed. Others have catalogued the various exposure pathways and identified typical values which can be used in the exposure calculations for the general population such as amount of water or soil ingested per day or the percent of a chemical than can pass through the skin. In addition, studies of the duration of exposure for many tasks (e.g. showering, jogging, working in the office) have been conducted which allow for more general descriptions of the likely range of exposures. All of this information, as well as the development of new and better models (e.g. air dispersion or groundwater models), allow for better estimates of exposure. In addition to identifying better exposure factors, and better mathematical models for predicting the aerial distribution of chemicals, the conduct of simulation studies and dose-reconstruction studies can offer extraordinary opportunities for filling in data gaps regarding historical exposures which are critical to improving the power of epidemiology studies. The use of probabilistic techniques such as Monte Carlo analysis and Bayesian statistics have revolutionized the practice of exposure assessment and has greatly enhanced the quality of the risk characterization. Lastly, the field of epidemiology is about to undergo a sea change with respect to the exposure component because each year better environmental and exposure models, statistical techniques and new biological monitoring techniques are being introduced. This paper reviews these techniques and discusses where additional research is likely to pay a significant dividend. Exposure assessment techniques are now available which can significantly improve the quality of epidemiology and health risk assessment studies and vastly improve their usefulness. As more quantitative exposure components can now be incorporated into these studies, they can be better used to identify safe levels of exposure using customary risk assessment methodologies. Examples are drawn from both environmental and occupational studies illustrating how these techniques have been used to better understand exposure to specific chemicals. Some thoughts are also presented on what lessons have been learned about conducting exposure assessment for health risk assessments and epidemiological studies.

The big data potential of epidemiological studies for criminology and forensics.

PubMed

DeLisi, Matt

2018-07-01

Big data, the analysis of original datasets with large samples ranging from ∼30,000 to one million participants to mine unexplored data, has been under-utilized in criminology. However, there have been recent calls for greater synthesis between epidemiology and criminology and a small number of scholars have utilized epidemiological studies that were designed to measure alcohol and substance use to harvest behavioral and psychiatric measures that relate to the study of crime. These studies have been helpful in producing knowledge about the most serious, violent, and chronic offenders, but applications to more pathological forensic populations is lagging. Unfortunately, big data relating to crime and justice are restricted and limited to criminal justice purposes and not easily available to the research community. Thus, the study of criminal and forensic populations is limited in terms of data volume, velocity, and variety. Additional forays into epidemiology, increased use of available online judicial and correctional data, and unknown new frontiers are needed to bring criminology up to speed in the big data arena. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Biomarkers of Dietary Polyphenols in Cancer Studies: Current Evidence and Beyond.

PubMed

Wang, Jincheng; Tang, Lili; Wang, Jia-Sheng

2015-01-01

Polyphenols, commonly contained in fruits and vegetables, have long been associated with a protective role against multiple diseases and adverse health effects. Generally, in vitro and animal experiments have provided strong positive evidence, whereas evidence from in vivo and human epidemiological studies is not strong enough. Most epidemiological studies to date use food frequency questionnaire based dietary intake estimations, which inevitably incur imprecision. Biomarkers of polyphenol have the potential to complement and enhance current studies. This review performed a literature search of all epidemiological studies or controlled clinical/intervention trials which employed biomarkers of exposure for polyphenols to help assess their anticarcinogenic role, using studies on green tea polyphenols as a study model. Currently, studies on this topic are still limited; breast cancer and prostate cancer were the only widely studied cancer types. Isoflavone is the only widely studied polyphenol. In addition to associations between polyphenols and cancer risks, factors such as host genetic susceptibility, epigenetic modification, and gut microbiome patterns may also impact on the protective roles of polyphenols. More evidence should be collected by utilizing biomarkers of exposure for polyphenols in future epidemiological studies before a clear conclusion can be made.

Epidemiology of whooping cough & typing of Bordetella pertussis.

PubMed

Hegerle, Nicolas; Guiso, Nicole

2013-11-01

Bordetella pertussis is a Gram-negative human-restricted bacterium that evolved from the broad-range mammalian pathogen, Bordetella bronchiseptica. It causes whooping cough or pertussis in humans, which is the most prevalent vaccine-preventable disease worldwide. The introduction of the pertussis whole-cell vaccination for young children, followed by the introduction of the pertussis acellular vaccination (along with booster vaccination) for older age groups, has affected the bacterial population and epidemiology of the disease. B. pertussis is relatively monomorphic worldwide, but nevertheless, different countries are facing different epidemiological evolutions of the disease. Although it is tempting to link vaccine-driven phenotypic and genotypic evolution of the bacterium to epidemiology, many other factors should be considered and surveillance needs to continue, in addition to studies investigating the impact of current clinical isolates on vaccine efficacy.

A critical look at descriptive epidemiology of sexual dysfunction in Asia compared to the rest of the world - a call for evidence-based data

PubMed Central

2013-01-01

Recently evidence-based medicine has been applied to comparative epidemiological papers regarding sexual dysfunction that have appeared in the literature. This review is intended to focus the readers on a validated and standardized methodological evidence-based process for preparing such articles. It reviews four key articles that have been published in the English language that have obtained a high evidence-based score for reliability that have included descriptive epidemiology of sexual dysfunctions in men and women in Asia compared to the rest of the world. These four papers are analyzed in detail in order to provide stress of what constitutes evidence-based studies in descriptive epidemiology for sexual function. As can be seen there has not yet been a perfect article that compares the prevalence of sexual function in Asia compared to the rest of the world since there are key methodological problems in the collection of the data. In addition, there is a paucity of incidence studies for sexual dysfunction in Asian populations. The readers are encouraged to use this data in preparation of future descriptive epidemiological studies that involve Asian countries. PMID:26816724

A critical look at descriptive epidemiology of sexual dysfunction in Asia compared to the rest of the world - a call for evidence-based data.

PubMed

Lewis, Ronald W

2013-03-01

Recently evidence-based medicine has been applied to comparative epidemiological papers regarding sexual dysfunction that have appeared in the literature. This review is intended to focus the readers on a validated and standardized methodological evidence-based process for preparing such articles. It reviews four key articles that have been published in the English language that have obtained a high evidence-based score for reliability that have included descriptive epidemiology of sexual dysfunctions in men and women in Asia compared to the rest of the world. These four papers are analyzed in detail in order to provide stress of what constitutes evidence-based studies in descriptive epidemiology for sexual function. As can be seen there has not yet been a perfect article that compares the prevalence of sexual function in Asia compared to the rest of the world since there are key methodological problems in the collection of the data. In addition, there is a paucity of incidence studies for sexual dysfunction in Asian populations. The readers are encouraged to use this data in preparation of future descriptive epidemiological studies that involve Asian countries.

Competencies for master and doctoral students in epidemiology: what is important, what is unimportant, and where is there room for improvement?

PubMed

Brunner Huber, Larissa R; Fennie, Kristopher; Patterson, Holly

2015-06-01

In 2008, members of the American College of Epidemiology's Education Committee began work on a project to facilitate discussion on identifying domains and core competencies for epidemiologic training at the master and doctoral levels. Two online surveys were created and participants (N = 183; n = 147 [established epidemiologists] and n = 36 [recent graduates]) rated the importance of 19 domains and 66 competencies. A total of 17 competencies were viewed as important or very important for individuals earning various master- or doctoral-level degrees in epidemiology, whereas eight competencies were reported as being unimportant for all individuals earning graduate degrees in epidemiology. Twenty additional competencies were viewed as important or very important only for individuals receiving doctoral training. In addition, recent master-level graduates identified nine domains in which they felt less prepared, and recent doctoral-level graduates identified two such domains. Additional research is warranted to ensure that all epidemiologists receive sufficient training in identified areas. Copyright © 2015 Elsevier Inc. All rights reserved.

Neurodevelopmental Disorders in Children with Severe to Profound Sensorineural Hearing Loss: A Clinical Study

ERIC Educational Resources Information Center

Chilosi, Anna M.; Comparini, Alessandro; Scusa, Maria F.; Berrettini, Stefano; Forli, Francesca; Battini, Roberta; Cipriani, Paola; Cioni, Giovanni

2010-01-01

Aim: The effects of sensorineural hearing loss (SNHL) are often complicated by additional disabilities, but the epidemiology of associated disorders is not clearly defined. The aim of this study was to evaluate the frequency and type of additional neurodevelopmental disabilities in a sample of children with SNHL and to investigate the relation…

New pieces of the Trichinella puzzle.

PubMed

Pozio, Edoardo; Zarlenga, Dante S

2013-11-01

Contrary to our understanding of just a few decades ago, the genus Trichinella now consists of a complex assemblage of no less than nine different species and three additional genotypes whose taxonomic status remains in flux. New data and methodologies have allowed advancements in detection and differentiation at the population level which in turn have demonstrably advanced epidemiological, immunological and genetic investigations. In like manner, molecular and genetic studies have permitted us to hypothesise biohistorical events leading to the worldwide dissemination of this genus, and to begin crystalising the evolution of Trichinella on a macro scale. The identification of species in countries and continents otherwise considered Trichinella-free has raised questions regarding host adaptation and associations, and advanced important findings on the biogeographical histories of its members. Using past reviews as a backdrop, we have ventured to present an up-to-date assessment of the taxonomy, phylogenetic relationships and epidemiology of the genus Trichinella with additional insights on host species, survival strategies in nature and the shortcomings of our current understanding of the epidemiology of the genus. In addition, we have begun compiling information available to date on genomics, proteomics, transcriptomics and population studies of consequence in the hope we can build on this in years to come. Copyright © 2013 Australian Society for Parasitology Inc. All rights reserved.

Development of a data-mining algorithm to identify ages at reproductive milestones in electronic medical records.

PubMed

Malinowski, Jennifer; Farber-Eger, Eric; Crawford, Dana C

2014-01-01

Electronic medical records (EMRs) are becoming more widely implemented following directives from the federal government and incentives for supplemental reimbursements for Medicare and Medicaid claims. Replete with rich phenotypic data, EMRs offer a unique opportunity for clinicians and researchers to identify potential research cohorts and perform epidemiologic studies. Notable limitations to the traditional epidemiologic study include cost, time to complete the study, and limited ancestral diversity; EMR-based epidemiologic studies offer an alternative. The Epidemiologic Architecture for Genes Linked to Environment (EAGLE) Study, as part of the Population Architecture using Genomics and Epidemiology (PAGE) I Study, has genotyped more than 15,000 patients of diverse ancestry in BioVU, the Vanderbilt University Medical Center's biorepository linked to the EMR (EAGLE BioVU). We report here the development and performance of data-mining techniques used to identify the age at menarche (AM) and age at menopause (AAM), important milestones in the reproductive lifespan, in women from EAGLE BioVU for genetic association studies. In addition, we demonstrate the ability to discriminate age at naturally-occurring menopause (ANM) from medically-induced menopause. Unusual timing of these events may indicate underlying pathologies and increased risk for some complex diseases and cancer; however, they are not consistently recorded in the EMR. Our algorithm offers a mechanism by which to extract these data for clinical and research goals.

Alzheimer’s Disease and Environmental Exposure to Lead: The Epidemiologic Evidence and Potential Role of Epigenetics

PubMed Central

Bakulski, Kelly M.; Rozek, Laura S.; Dolinoy, Dana C.; Paulson, Henry L.; Hu, Howard

2013-01-01

Several lines of evidence indicate that the etiology of late-onset Alzheimer’s disease (LOAD) is complex, with significant contributions from both genes and environmental factors. Recent research suggests the importance of epigenetic mechanisms in defining the relationship between environmental exposures and LOAD. In epidemiologic studies of adults, cumulative lifetime lead (Pb) exposure has been associated with accelerated declines in cognition. In addition, research in animal models suggests a causal association between Pb exposure during early life, epigenetics, and LOAD. There are multiple challenges to human epidemiologic research evaluating the relationship between epigenetics, LOAD, and Pb exposure. Epidemiologic studies are not well-suited to accommodate the long latency period between exposures during early life and onset of Alzheimer’s disease. There is also a lack of validated circulating epigenetics biomarkers and retrospective biomarkers of Pb exposure. Members of our research group have shown bone Pb is an accurate measurement of historical Pb exposure in adults, offering an avenue for future epidemiologic studies. However, this would not address the risk of LOAD attributable to early-life Pb exposures. Future studies that use a cohort design to measure both Pb exposure and validated epigenetic biomarkers of LOAD will be useful to clarify this important relationship. PMID:22272628

New developments in epidemiology, diagnosis, and treatment of fascioliasis.

PubMed

Cabada, Miguel M; White, A Clinton

2012-10-01

This review focuses on the recent developments in the epidemiology, burden of disease, diagnostic tests, and treatment of fascioliasis. Recent epidemiologic data suggest that either the endemic areas are expanding or disease is being recognized in areas where it was not previously observed. In addition, recent data highlight the effects of fascioliasis on childhood anemia and nutrition. Diagnosis remains problematic, but newer diagnostic tests including antibody, antigen, and DNA detection tests may facilitate earlier diagnosis. Recent studies suggest that point-of-care testing may soon be possible. Treatment with triclabendazole is effective, but resistance is emerging in livestock and may pose a threat for patients. Fascioliasis continues to emerge as an important neglected disease, with new studies highlighting the under-recognized burden of disease. Further studies are needed on burden of disease, improved diagnosis, and alternative to triclabendazole treatment.

Use of GeneXpert Remnants for Drug Resistance Profiling and Molecular Epidemiology of Tuberculosis in Libreville, Gabon.

PubMed

Alame-Emane, Amel Kévin; Pierre-Audigier, Catherine; Aboumegone-Biyogo, Oriane Cordelia; Nzoghe-Mveang, Amandine; Cadet-Daniel, Véronique; Sola, Christophe; Djoba-Siawaya, Joël Fleury; Gicquel, Brigitte; Takiff, Howard E

2017-07-01

Multidrug-resistant (MDR) and extensively drug resistant (XDR) strains of Mycobacterium tuberculosis pose major problems for global health. The GeneXpert MTB/RIF (Xpert) assay rapidly detects resistance to rifampin (RIF r ), but for detection of the additional resistance that defines MDR-TB (MDR tuberculosis) and XDR-TB, and for molecular epidemiology, specimen cultures and a biosafe infrastructure are generally required. We sought to determine whether the remnants of sputa prepared for the Xpert assay could be used directly to find mutations associated with drug resistance and to study molecular epidemiology, thus providing precise characterization of MDR-TB cases in countries lacking biosafety level 3 (BSL3) facilities for M. tuberculosis cultures. After sputa were processed and run on the Xpert instrument, the leftovers of the samples prepared for the Xpert assay were used for PCR amplification and sequencing or for a line probe assay to detect mutations associated with resistance to additional drugs, as well as for molecular epidemiology with spoligotyping and selective mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) typing. Of 130 sputum samples from Gabon tested with the Xpert assay, 124 yielded interpretable results; 21 (17%) of these were determined to be RIF r Amplification and sequencing or a line probe assay of the Xpert remnants confirmed 18/21 samples as MDR, corresponding to 12/116 (9.5%) new and 6/8 (75%) previously treated TB patients. Spoligotyping and MIRU typing with hypervariable loci identified an MDR Beijing strain present in five samples. We conclude that the remnants of samples processed for the Xpert assay can be used in PCRs to find mutations associated with the resistance to the additional drugs that defines MDR and XDR-TB and to study molecular epidemiology without the need for culturing or a biosafe infrastructure. Copyright © 2017 Alame-Emane et al.

Linking Meteorology, Air Quality Models and Observations to ...

EPA Pesticide Factsheets

Epidemiologic studies are critical in establishing the association between exposure to air pollutants and adverse health effects. Results of epidemiologic studies are used by U.S. EPA in developing air quality standards to protect the public from the health effects of air pollutants. A major challenge in environmental epidemiology is adequate exposure characterization. Numerous health studies have used measurements from a few central-site ambient monitors to characterize air pollution exposures. Relying solely on central-site ambient monitors does not account for the spatial-heterogeneity of ambient air pollution patterns, the temporal variability in ambient concentrations, nor the influence of infiltration and indoor sources. Central-site monitoring becomes even more problematic for certain air pollutants that exhibit significant spatial heterogeneity. Statistical interpolation techniques and passive monitoring methods can provide additional spatial resolution in ambient concentration estimates. In addition, spatio-temporal models, which integrate GIS data and other factors, such as meteorology, have also been developed to produce more resolved estimates of ambient concentrations. Models, such as the Community Multi-Scale Air Quality (CMAQ) model, estimate ambient concentrations by combining information on meteorology, source emissions, and chemical-fate and transport. Hybrid modeling approaches, which integrate regional scale models with local scale dispersion

Quantitative Serum Nuclear Magnetic Resonance Metabolomics in Large-Scale Epidemiology: A Primer on -Omic Technologies

PubMed Central

Kangas, Antti J; Soininen, Pasi; Lawlor, Debbie A; Davey Smith, George; Ala-Korpela, Mika

2017-01-01

Abstract Detailed metabolic profiling in large-scale epidemiologic studies has uncovered novel biomarkers for cardiometabolic diseases and clarified the molecular associations of established risk factors. A quantitative metabolomics platform based on nuclear magnetic resonance spectroscopy has found widespread use, already profiling over 400,000 blood samples. Over 200 metabolic measures are quantified per sample; in addition to many biomarkers routinely used in epidemiology, the method simultaneously provides fine-grained lipoprotein subclass profiling and quantification of circulating fatty acids, amino acids, gluconeogenesis-related metabolites, and many other molecules from multiple metabolic pathways. Here we focus on applications of magnetic resonance metabolomics for quantifying circulating biomarkers in large-scale epidemiology. We highlight the molecular characterization of risk factors, use of Mendelian randomization, and the key issues of study design and analyses of metabolic profiling for epidemiology. We also detail how integration of metabolic profiling data with genetics can enhance drug development. We discuss why quantitative metabolic profiling is becoming widespread in epidemiology and biobanking. Although large-scale applications of metabolic profiling are still novel, it seems likely that comprehensive biomarker data will contribute to etiologic understanding of various diseases and abilities to predict disease risks, with the potential to translate into multiple clinical settings. PMID:29106475

A Fantastic Epidemiology Journey: from China to Africa and back

Cancer.gov

Dr. Ann Hsing is a professor of medicine at Stanford University and a co-leader of the Population Sciences Program at Stanford Cancer Institute. She is also a professor in the Department of Health Research and Policy (epidemiology, by courtesy) and a faculty fellow for the Center for Innovation in Global Health. In addition, she chairs the Pacific Rim Alliance for Population Health at Stanford’s Center for Population Health Sciences. Prior to joining Stanford School of Medicine, Dr. Hsing served four years as Chief Scientific Officer at the Cancer Prevention Institute of California and 22 years as an intramural scientist (tenured senior investigator) at the Division of Cancer Epidemiology and Genetics, National Cancer Institute. Dr. Hsing received her PhD in epidemiology from the Johns Hopkins University and is widely recognized as a leading expert in the epidemiology of prostate and hepatobiliary cancer, as well as hormonal carcinogenesis and molecular epidemiology. She has authored more than 280 peer-reviewed articles and mentored over 60 pre- and post-doctoral fellows and junior scholars. At Stanford, she leads the Liver Cancer Working Group and the LDCT Screening Group, and serves as the principal investigator (PI) for wellness cohort studies in China, Taiwan, and Singapore as well as liver cancer studies in the Bay area, Taiwan, Mongolia, and Africa.

Overview of the Epidemiology of Lower Urinary Tract Dysfunction in South Korea

PubMed Central

2016-01-01

This review assessed the epidemiology of voiding dysfunctions in South Korea. Comprehensive understanding of this epidemiology is crucial because the senior population and the social burden are increasing because of voiding dysfunctions is growing. We searched the medical records using several terms related to voiding dysfunction: benign prostatic hyperplasia, urinary incontinence, lower urinary tract symptoms, overactive bladder, and nocturia. We then estimated the prevalence of voiding dysfunctions in South Korea; our data were comparable with those from other countries, with slight differences. The ranges of incidences varied widely between studies, mostly because investigators defined disorders differently. Voiding dysfunction greatly affects healthcare costs and individual quality of life; therefore, more proper and valuable epidemiologic data are needed. In addition, efforts to unify the definitions of various voiding dysfunctions and progress in investigational methodologies using multimedia are warranted. PMID:27377940

16 CFR 1000.26 - Directorate for Epidemiology.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... In addition, staff in the Hazard Analysis Division design special studies, design and analyze data from experiments for testing of consumer products, and provide statistical expertise and advice to...

16 CFR 1000.26 - Directorate for Epidemiology.

Code of Federal Regulations, 2012 CFR

2012-01-01

.... In addition, staff in the Hazard Analysis Division design special studies, design and analyze data from experiments for testing of consumer products, and provide statistical expertise and advice to...

16 CFR 1000.26 - Directorate for Epidemiology.

Code of Federal Regulations, 2014 CFR

2014-01-01

.... In addition, staff in the Hazard Analysis Division design special studies, design and analyze data from experiments for testing of consumer products, and provide statistical expertise and advice to...

Epidemiology of hepatitis C virus in Iran.

PubMed

Taherkhani, Reza; Farshadpour, Fatemeh

2015-10-14

In Iran, the prevalence of hepatitis C virus (HCV) infection is relatively low according to the population-based epidemiological studies. However, the epidemiology of HCV is changing and the rate of HCV infection is increasing due to the growth in the number of injecting drug users in the society. In addition, a shift has occurred in the distribution pattern of HCV genotypes among HCV-infected patients in Iran. Genotype 1a is the most prevalent genotype in Iran, but in recent years, an increase in the frequency of 3a and a decrease in 1a and 1b have been reported. These variations in the epidemiology of HCV reflect differences in the routes of transmission, status of public health, lifestyles, and risk factors in different groups and geographic regions of Iran. Health policy makers should consider these differences to establish better strategies for control and prevention of HCV infection. Therefore, this review was conducted to present a clear view regarding the current epidemiology of HCV infection in Iran.

Epidemiology of hepatitis C virus in Iran

PubMed Central

Taherkhani, Reza; Farshadpour, Fatemeh

2015-01-01

In Iran, the prevalence of hepatitis C virus (HCV) infection is relatively low according to the population-based epidemiological studies. However, the epidemiology of HCV is changing and the rate of HCV infection is increasing due to the growth in the number of injecting drug users in the society. In addition, a shift has occurred in the distribution pattern of HCV genotypes among HCV-infected patients in Iran. Genotype 1a is the most prevalent genotype in Iran, but in recent years, an increase in the frequency of 3a and a decrease in 1a and 1b have been reported. These variations in the epidemiology of HCV reflect differences in the routes of transmission, status of public health, lifestyles, and risk factors in different groups and geographic regions of Iran. Health policy makers should consider these differences to establish better strategies for control and prevention of HCV infection. Therefore, this review was conducted to present a clear view regarding the current epidemiology of HCV infection in Iran. PMID:26478671

16 CFR § 1000.26 - Directorate for Epidemiology.

Code of Federal Regulations, 2013 CFR

2013-01-01

.... In addition, staff in the Hazard Analysis Division design special studies, design and analyze data from experiments for testing of consumer products, and provide statistical expertise and advice to...

Epidemiology of Injuries and Prevention Strategies in Competitive Swimmers

PubMed Central

Wanivenhaus, Florian; Fox, Alice J. S.; Chaudhury, Salma; Rodeo, Scott A.

2012-01-01

Context: Competitive swimmers are predisposed to musculoskeletal injuries of the upper limb, knee, and spine. This review discusses the epidemiology of these injuries, in addition to prevention strategies that may assist the physician in formulating rehabilitation programs for the swimmer following an injury. Evidence Acquisition: A literature search was performed by a review of Google Scholar, OVID, and PubMed articles published from 1972 to 2011. Results: This study highlights the epidemiology of injuries common to competitive swimmers and provides prevention strategies for the sports health professional. Conclusions: An understanding of swimming biomechanics and typical injuries in swimming aids in early recognition of injury, initiation of treatment, and design of optimal prevention and rehabilitation strategies. PMID:23016094

Local health department epidemiologic capacity: a stratified cross-sectional assessment describing the quantity, education, training, and perceived competencies of epidemiologic staff.

PubMed

O'Keefe, Kaitlin A; Shafir, Shira C; Shoaf, Kimberley I

2013-01-01

Local health departments (LHDs) must have sufficient numbers of staff functioning in an epidemiologic role with proper education, training, and skills to protect the health of communities they serve. This pilot study was designed to describe the composition, training, and competency level of LHD staff and examine the hypothesis that potential disparities exist between LHDs serving different sized populations. Cross-sectional surveys were conducted with directors and epidemiologic staff from a sample of 100 LHDs serving jurisdictions of varied sizes. Questionnaires included inquiries regarding staff composition, education, training, and measures of competency modeled on previously conducted studies by the Council of State and Territorial Epidemiologists. Number of epidemiologic staff, academic degree distribution, epidemiologic training, and both director and staff confidence in task competencies were calculated for each LHD size strata. Disparities in measurements were observed in LHDs serving different sized populations. LHDs serving small populations reported a smaller average number of epidemiologic staff than those serving larger jurisdictions. As size of population served increased, percentages of staff and directors holding bachelors' and masters' degrees increased, while those holding RN degrees decreased. A higher degree of perceived competency of staff in most task categories was reported in LHDs serving larger populations. LHDs serving smaller populations reported fewer epidemiologic staff, therefore might benefit from additional resources. Differences observed in staff education, training, and competencies suggest that enhanced epidemiologic training might be particularly needed in LHDs serving smaller populations. RESULTS can be used as a baseline for future research aimed at identifying areas where training and personnel resources might be particularly needed to increase the capabilities of LHDs.

Use of job-exposure matrices to estimate occupational exposure to pesticides: A review.

PubMed

Carles, Camille; Bouvier, Ghislaine; Lebailly, Pierre; Baldi, Isabelle

2017-03-01

The health effects of pesticides have been extensively studied in epidemiology, mainly in agricultural populations. However, pesticide exposure assessment remains a key methodological issue for epidemiological studies. Besides self-reported information, expert assessment or metrology, job-exposure matrices still appear to be an interesting tool. We reviewed all existing matrices assessing occupational exposure to pesticides in epidemiological studies and described the exposure parameters they included. We identified two types of matrices, (i) generic ones that are generally used in case-control studies and document broad categories of pesticides in a large range of jobs, and (ii) specific matrices, developed for use in agricultural cohorts, that generally provide exposure metrics at the active ingredient level. The various applications of these matrices in epidemiological studies have proven that they are valuable tools to assess pesticide exposure. Specific matrices are particularly promising for use in agricultural cohorts. However, results obtained with matrices have rarely been compared with those obtained with other tools. In addition, the external validity of the given estimates has not been adequately discussed. Yet, matrices would help in reducing misclassification and in quantifying cumulated exposures, to improve knowledge about the chronic health effects of pesticides.

Evaluating Evidence for Association of Human Bladder Cancer with Drinking-Water Chlorination Disinfection By-Products.

PubMed

Hrudey, Steve E; Backer, Lorraine C; Humpage, Andrew R; Krasner, Stuart W; Michaud, Dominique S; Moore, Lee E; Singer, Philip C; Stanford, Benjamin D

2015-01-01

Exposure to chlorination disinfection by-products (CxDBPs) is prevalent in populations using chlorination-based methods to disinfect public water supplies. Multifaceted research has been directed for decades to identify, characterize, and understand the toxicology of these compounds, control and minimize their formation, and conduct epidemiologic studies related to exposure. Urinary bladder cancer has been the health risk most consistently associated with CxDBPs in epidemiologic studies. An international workshop was held to (1) discuss the qualitative strengths and limitations that inform the association between bladder cancer and CxDBPs in the context of possible causation, (2) identify knowledge gaps for this topic in relation to chlorine/chloramine-based disinfection practice(s) in the United States, and (3) assess the evidence for informing risk management. Epidemiological evidence linking exposures to CxDBPs in drinking water to human bladder cancer risk provides insight into causality. However, because of imprecise, inaccurate, or incomplete estimation of CxDBPs levels in epidemiologic studies, translation from hazard identification directly to risk management and regulatory policy for CxDBPs can be challenging. Quantitative risk estimates derived from toxicological risk assessment for CxDBPs currently cannot be reconciled with those from epidemiologic studies, notwithstanding the complexities involved, making regulatory interpretation difficult. Evidence presented here has both strengths and limitations that require additional studies to resolve and improve the understanding of exposure response relationships. Replication of epidemiologic findings in independent populations with further elaboration of exposure assessment is needed to strengthen the knowledge base needed to better inform effective regulatory approaches.

Evaluating Evidence for Association of Human Bladder Cancer with Drinking-Water Chlorination Disinfection By-Products

PubMed Central

Hrudey, Steve E.; Backer, Lorraine C.; Humpage, Andrew R.; Krasner, Stuart W.; Michaud, Dominique S.; Moore, Lee E.; Singer, Philip C.; Stanford, Benjamin D.

2015-01-01

Exposure to chlorination disinfection by-products (CxDBPs) is prevalent in populations using chlorination-based methods to disinfect public water supplies. Multifaceted research has been directed for decades to identify, characterize, and understand the toxicology of these compounds, control and minimize their formation, and conduct epidemiologic studies related to exposure. Urinary bladder cancer has been the health risk most consistently associated with CxDBPs in epidemiologic studies. An international workshop was held to (1) discuss the qualitative strengths and limitations that inform the association between bladder cancer and CxDBPs in the context of possible causation, (2) identify knowledge gaps for this topic in relation to chlorine/chloramine-based disinfection practice(s) in the United States, and (3) assess the evidence for informing risk management. Epidemiological evidence linking exposures to CxDBPs in drinking water to human bladder cancer risk provides insight into causality. However, because of imprecise, inaccurate, or incomplete estimation of CxDBPs levels in epidemiologic studies, translation from hazard identification directly to risk management and regulatory policy for CxDBPs can be challenging. Quantitative risk estimates derived from toxicological risk assessment for CxDBPs currently cannot be reconciled with those from epidemiologic studies, notwithstanding the complexities involved, making regulatory interpretation difficult. Evidence presented here has both strengths and limitations that require additional studies to resolve and improve the understanding of exposure response relationships. Replication of epidemiologic findings in independent populations with further elaboration of exposure assessment is needed to strengthen the knowledge base needed to better inform effective regulatory approaches. PMID:26309063

Epidemiology of Dengue Disease in the Philippines (2000–2011): A Systematic Literature Review

PubMed Central

Bravo, Lulu; Roque, Vito G.; Brett, Jeremy; Dizon, Ruby; L'Azou, Maïna

2014-01-01

This literature analysis describes the available dengue epidemiology data in the Philippines between 2000 and 2011. Of 253 relevant data sources identified, 34, including additional epidemiology data provided by the National Epidemiology Center, Department of Health, Philippines, were reviewed. There were 14 publications in peer reviewed journals, and 17 surveillance reports/sources, which provided variable information from the passive reporting system and show broad trends in dengue incidence, including age group predominance and disease severity. The peer reviewed studies focused on clinical severity of cases, some revealed data on circulating serotypes and genotypes and on the seroepidemiology of dengue including incidence rates for infection and apparent disease. Gaps in the data were identified, and include the absence incidence rates stratified by age, dengue serotype and genotype distribution, disease severity data, sex distribution data, and seroprevalence data. Protocol registration PROSPERO CRD42012002292 PMID:25375119

Paper vs. electrons. Epidemiologic publishing in a changing world.

PubMed

Rothenberg; Frank; Fitzmaurice

2000-10-01

PURPOSE: To present the parallel histories of epidemiologic and electronic publishing and consider positive and negative factors that might affect their amalgam.METHODS: We performed a quantitative assessment of the arc of epidemiologic publication from 1966-1999, using major self-designated epidemiologic journals as a sample, and of scholarly electronic publication from 1991-1997, based on current literature review. We use an online, paperless journal as a case study, and review selected information-technology opinion in the area.RESULTS: By traditional standards, growth in epidemiologic publication has been considerable, with the addition of six new journals since 1966. In contrast, scholarly electronic publication for the period 1991-1997 grew from 27 to 2459 journals (not all exclusively online). Positive features of electronic publishing include flexibility, shortened time to publication, freedom from fixed publication date, diversity in presentation, and instant linkage to relevant material. A case study of a new online journal illustrates the substantive power of the medium. Negative factors include restriction (or unrestricted expansion) of the audience, the potential for hasty peer review, pitfalls in establishing credibility, an emphasis on style over content, technologic dependence, and additions to the information explosion. Relative cost and archiving are still debated. In assessing the pros and cons, it is important to distinguish electronic mechanisms that facilitate publication from electronic publishing, and to appreciate the difference between moving an existing journal to the electronic medium, and creating a new online journal.CONCLUSIONS: The movement from print to internet is probably inexorable, but a headlong rush may be ill-advised. Several models for dual publishing now exist, with the expectation that many, including the journals that serve epidemiology, will do so. The ultimate configuration is difficult to predict, but likely to be shaped in large measure by market forces, technologic advances and to a lesser extent, by habit and aesthetics.

Clostridium difficile infection: Early history, diagnosis and molecular strain typing methods.

PubMed

Rodriguez, C; Van Broeck, J; Taminiau, B; Delmée, M; Daube, G

2016-08-01

Recognised as the leading cause of nosocomial antibiotic-associated diarrhoea, the incidence of Clostridium difficile infection (CDI) remains high despite efforts to improve prevention and reduce the spread of the bacterium in healthcare settings. In the last decade, many studies have focused on the epidemiology and rapid diagnosis of CDI. In addition, different typing methods have been developed for epidemiological studies. This review explores the history of C. difficile and the current scope of the infection. The variety of available laboratory tests for CDI diagnosis and strain typing methods are also examined. Copyright © 2016 Elsevier Ltd. All rights reserved.

Population Neuroscience: Dementia Epidemiology Serving Precision Medicine and Population Health.

PubMed

Ganguli, Mary; Albanese, Emiliano; Seshadri, Sudha; Bennett, David A; Lyketsos, Constantine; Kukull, Walter A; Skoog, Ingmar; Hendrie, Hugh C

2018-01-01

Over recent decades, epidemiology has made significant contributions to our understanding of dementia, translating scientific discoveries into population health. Here, we propose reframing dementia epidemiology as "population neuroscience," blending techniques and models from contemporary neuroscience with those of epidemiology and biostatistics. On the basis of emerging evidence and newer paradigms and methods, population neuroscience will minimize the bias typical of traditional clinical research, identify the relatively homogenous subgroups that comprise the general population, and investigate broader and denser phenotypes of dementia and cognitive impairment. Long-term follow-up of sufficiently large study cohorts will allow the identification of cohort effects and critical windows of exposure. Molecular epidemiology and omics will allow us to unravel the key distinctions within and among subgroups and better understand individuals' risk profiles. Interventional epidemiology will allow us to identify the different subgroups that respond to different treatment/prevention strategies. These strategies will inform precision medicine. In addition, insights into interactions between disease biology, personal and environmental factors, and social determinants of health will allow us to measure and track disease in communities and improve population health. By placing neuroscience within a real-world context, population neuroscience can fulfill its potential to serve both precision medicine and population health.

Epidemiology of chronic hepatitis B virus in Ireland using routinely collected surveillance and administrative data, 2004-2014.

PubMed

van Gemert, Caroline E; Murphy, Niamh; Mitchell, Tara A; Hellard, Margaret E; Thornton, Thornton

2017-12-09

Ireland has a low prevalence of chronic hepatitis B virus (HBV) infection; however, there are limited recently published epidemiological data. This study aimed to describe the epidemiology of chronic HBV in Ireland between 2004 and 2014 using routine surveillance data and identify and interrogate additional data sources in Ireland to complement the interpretation of HBV surveillance data. Routinely collected passive surveillance data of notified cases of HBV infection were collated for 2004-2014. Additional data sources relating to primary liver cancer and cirrhosis were collated, including hospital discharge data (2005-2013), diagnoses of primary liver cancer (2004-2013), and deaths (2007-2014). Publicly available immigration (2004-2014) data were also collated. Between 2004 and 2014, a total of 7463 notifications of HBV were made in Ireland; the majority (91%) were classified as chronic cases. Notifications peaked in 2008 and decreased until 2013. Hospital discharges, new cancer registrations, and deaths from primary liver cancer and hospital discharges from cirrhosis have increased each year. The epidemiology of HBV in Ireland mirrors immigration patterns. Without a coordinated screening and care programme for priority populations, particularly for immigrants from high prevalence countries, it is likely that hospitalisations and deaths from HBV-attributable cirrhosis and primary liver cancer will continue to rise, with considerable associated public health expense.

[Serotype and phage type distribution of human Salmonella strains isolated in Spain, 1997-2001].

PubMed

Echeita, María Aurora; Aladueña, Ana María; Díez, Rosa; Arroyo, Margarita; Cerdán, Francisca; Gutiérrez, Rafaela; de la Fuente, Manuela; González-Sanz, Rubén; Herrera-León, Silvia; Usera, Miguel Angel

2005-03-01

Salmonellosis is one of the most frequent causes of gastroenteritis in Spain. Serotyping is the gold standard epidemiological marker for subdividing Salmonella spp. strains. A small number of serotypes are very frequently isolated, reducing the discriminatory power of serotyping. Thus, to increase our knowledge of Salmonella spp. epidemiology, additional epidemiological markers, such as phage typing, should be used for this purpose. Salmonella spp. strains of human origin sent to the Laboratorio Nacional de Referencia de Salmonella y Shigella (LNRSSE, Spanish Reference Laboratory for Salmonella and Shigella) between 1997 and 2001 were serotyped using conventional agglutination methods, and Enteritidis, Typhimurium, Hadar, Virchow and Typhi serotypes were additionally phage typed according to internationally-developed schemes. A total of 30,856 Salmonella spp. strains, isolated in the majority of Spanish Autonomous Communities, were analyzed. Enteritidis (51%) and Typhimurium (24%) were the most frequently isolated serotypes. The following were the most frequent serotype/phage type combinations: Enteritidis/PT1 (18%), Enteritidis/PT4 (15%), Enteritidis/PT6a (5%), Typhimurium/DT104 (5%) and Enteritidis/PT6 (3%). The serotype Enteritidis/PT1 showed the greatest increase over the period studied, from 11.61% in 1997 to 24.74% in 2001. A hierarchical typing approach for Salmonella spp., using serotyping coupled with phage typing allowed a higher level of discrimination among Salmonella serotypes. Application of this approach in epidemiological studies could be highly useful for early characterization of related strains.

Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany - a mathematical modelling study.

PubMed

Horn, Johannes; Damm, Oliver; Greiner, Wolfgang; Hengel, Hartmut; Kretzschmar, Mirjam E; Siedler, Anette; Ultsch, Bernhard; Weidemann, Felix; Wichmann, Ole; Karch, André; Mikolajczyk, Rafael T

2018-01-09

Epidemiological studies suggest that reduced exposure to varicella might lead to an increased risk for herpes zoster (HZ). Reduction of exposure to varicella is a consequence of varicella vaccination but also of demographic changes. We analyzed how the combination of vaccination programs and demographic dynamics will affect the epidemiology of varicella and HZ in Germany over the next 50 years. We used a deterministic dynamic compartmental model to assess the impact of different varicella and HZ vaccination strategies on varicella and HZ epidemiology in three demographic scenarios, namely the projected population for Germany, the projected population additionally accounting for increased immigration as observed in 2015/2016, and a stationary population. Projected demographic changes alone result in an increase of annual HZ cases by 18.3% and a decrease of varicella cases by 45.7% between 1990 and 2060. Independently of the demographic scenario, varicella vaccination reduces the cumulative number of varicella cases until 2060 by approximately 70%, but also increases HZ cases by 10%. Unlike the currently licensed live attenuated HZ vaccine, the new subunit vaccine candidate might completely counteract this effect. Relative vaccine effects were consistent across all demographic scenarios. Demographic dynamics will be a major determinant of HZ epidemiology in the next 50 years. While stationary population models are appropriate for assessing vaccination impact, models incorporating realistic population structures allow a direct comparison to surveillance data and can thus provide additional input for immunization decision-making and resource planning.

Potential Health Effects from Groundwater Pollution.

ERIC Educational Resources Information Center

Goyer, Robert A.

1985-01-01

Discusses the growing awareness of potential toxicological effects of synthetic organic chemicals contaminating groundwater. Problems concerning pesticides, chlorination, epidemiologic studies, cancer, nephrotoxicity, and considerations of risk are addressed. Additional research in this area is advocated. (DH)

Epidemiological bases and molecular mechanisms linking obesity, diabetes, and cancer.

PubMed

Gutiérrez-Salmerón, María; Chocarro-Calvo, Ana; García-Martínez, José Manuel; de la Vieja, Antonio; García-Jiménez, Custodia

2017-02-01

The association between diabetes and cancer was hypothesized almost one century ago. Today, a vast number of epidemiological studies support that obese and diabetic populations are more likely to experience tissue-specific cancers, but the underlying molecular mechanisms remain unknown. Obesity, diabetes, and cancer share many hormonal, immune, and metabolic changes that may account for the relationship between diabetes and cancer. In addition, antidiabetic treatments may have an impact on the occurrence and course of some cancers. Moreover, some anticancer treatments may induce diabetes. These observations aroused a great controversy because of the ethical implications and the associated commercial interests. We report an epidemiological update from a mechanistic perspective that suggests the existence of many common and differential individual mechanisms linking obesity and type 1 and 2 diabetes mellitus to certain cancers. The challenge today is to identify the molecular links responsible for this association. Classification of cancers by their molecular signatures may facilitate future mechanistic and epidemiological studies. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

A Review of Epidemiological Research on Adverse Neurological Effects of Exposure to Ambient Air Pollution

PubMed Central

Xu, Xiaohui; Ha, Sandie Uyen; Basnet, Rakshya

2016-01-01

There is a growing body of epidemiological research reporting the neurological effects of ambient air pollution. We examined current evidence, identified the strengths and weaknesses of published epidemiological studies, and suggest future directions for research in this area. Studies were identified through a systematic search of online scientific databases, in addition to a manual search of the reference lists from the identified papers. Despite being a relatively new area of investigation, overall, there is mounting evidence implicating adverse effects of air pollution on neurobehavioral function in both adults and children. Further research is needed to expand our understanding of these relationships, including improvement in the accuracy of exposure assessments; focusing on specific toxicants and their relationships to specific health endpoints, such as neurodevelopmental disorders and neurodegenerative diseases; investigating the combined neurological effects of multiple air pollutants; and further exploration of genetic susceptibility for neurotoxicity of air pollution. In order to achieve these goals collaborative efforts are needed from multidisciplinary teams, including experts in toxicology, biostatistics, geographical science, epidemiology, and neurology. PMID:27547751

Tele-electrocardiography in the epidemiological 'Study of Health in Pomerania' (SHIP).

PubMed

Alte, Dietrich; Völzke, Henry; Robinson, Daniel M; Kleine, Volker; Grabe, Hans Jörgen; John, Ulrich; Felix, Stephan B

2006-01-01

We have evaluated a portable electrocardiogram (ECG) card in the large population-based epidemiological 'Study of Health in Pomerania' (SHIP). In all, 7008 men and women (20-79 years) were randomly selected from population registries and 4310 subjects participated. Participants used an ECG card for four weeks and recorded two ECGs daily. The participants were also encouraged to record additional ECGs in the case of symptomatic arrhythmias, chest pain or dizziness. The ECGs were sent via telephone. Acrobat (.pdf) files arrived at the study centre via email. Arrhythmias were analysed by visual ECG inspection. Seventy-one per cent of the participants sent at least 80% of the requested ECGs for four weeks. There were few problems (about 70) in the total of 38,162 ECGs transmitted. Overall, 94% of all ECGs were rated as 'good'. Physicians required about 1.5 h to read approximately 100 ECGs daily. The functionality and ergonomics of ECG cards appear to be sufficiently developed for large-scale use in epidemiological studies.

Outbreak investigations--a perspective.

PubMed Central

Reingold, A. L.

1998-01-01

Outbreak investigations, an important and challenging component of epidemiology and public health, can help identify the source of ongoing outbreaks and prevent additional cases. Even when an outbreak is over, a thorough epidemiologic and environmental investigation often can increase our knowledge of a given disease and prevent future outbreaks. Finally, outbreak investigations provide epidemiologic training and foster cooperation between the clinical and public health communities. PMID:9452395

Designing Epidemiology Studies to Determine the Incidence and Prevalence of Encapsulating Peritoneal Sclerosis (EPS).

PubMed

Nitsch, Dorothea; Davenport, Andrew

2015-12-01

The reported incidence and prevalence of encapsulating peritoneal sclerosis (EPS) varies markedly between North America, Europe, Japan, and Australia. Although this could reflect differences in clinical practice patterns and access to transplantation as there is no current test for early detection, and some patients may present many years after discontinuation of peritoneal dialysis (PD), there are concerns about under-reporting, particularly for those with milder forms. Currently, only PD vintage has been identified as a significant risk factor for developing EPS, although some patients can develop EPS within months of starting PD. As such, there is a need for epidemiological studies to determine the incidence and prevalence of EPS to allow for patient education and counselling in terms of dialysis modality choice and length of treatment. In addition, carefully designed epidemiological studies could potentially allow for the identification of risk factors and bio-markers that could then be used to identify patients at increased risk of developing EPS in the future. Typically, studies to date have been underpowered with inadequate longitudinal follow-up. We review the different types of epidemiological studies and provide information as to the number of patients to be recruited and the duration of follow-up required to determine the incidence and prevalence of EPS. Copyright © 2015 International Society for Peritoneal Dialysis.

THE INFLUENCE OF A NOISE BARRIER AND VEGETATION ON AIR QUALITY NEAR A ROADWAY

EPA Science Inventory

A growing number of epidemiological studies conducted throughout the world have identified an increase in occurrence of adverse health effects for populations residing, working or attending school near major roadways. In addition, several air quality studies have identified incr...

Recent trends in the epidemiology of inflammatory bowel diseases: Up or down?

PubMed Central

Lakatos, Peter Laszlo

2006-01-01

Inflammatory bowel disease (IBD) is traditionally considered to be common in the Western world, and its incidence has sharply increased since the early 1950s. In contrast, until the last decade, low prevalence and incidence rates have been reported from other parts of the world including Eastern Europe, South America, Asia and the Pacific region. Recent trends indicate a change in the epidemiology of IBD with previously low incidence areas now reporting a progressive rise in the incidence, while in West European and North American countries the figures have stabilized or slightly increased, with decreasing incidence rates for ulcerative colitis. Some of these changes may represent differences in diagnostic practices and increasing awareness of the disease. The quality of studies is also variable. Additional epidemiologic studies are needed to better define the burden of illness, explore the mechanism of association with environmental factors, and identify new risk factors. PMID:17036379

Data that empower: The success and promise of CF patient registries.

PubMed

Fink, Aliza K; Loeffler, Deena R; Marshall, Bruce C; Goss, Christopher H; Morgan, Wayne J

2017-11-01

In this article, we describe existing CF registries with a focus on US registry data collected through the CF Foundation Patient Registry (CFFPR) and the Epidemiologic Study of CF (ESCF); highlight what registries have taught us regarding epidemiology of CF; showcase the impact of registries on research and clinical care; and discuss future directions. This manuscript complements the plenary address given by Dr Wayne Morgan at the 2016 North American CF Conference by summarizing the key points from the presentation and providing additional detail and information. © 2017 Wiley Periodicals, Inc.

Marginal regression approach for additive hazards models with clustered current status data.

PubMed

Su, Pei-Fang; Chi, Yunchan

2014-01-15

Current status data arise naturally from tumorigenicity experiments, epidemiology studies, biomedicine, econometrics and demographic and sociology studies. Moreover, clustered current status data may occur with animals from the same litter in tumorigenicity experiments or with subjects from the same family in epidemiology studies. Because the only information extracted from current status data is whether the survival times are before or after the monitoring or censoring times, the nonparametric maximum likelihood estimator of survival function converges at a rate of n(1/3) to a complicated limiting distribution. Hence, semiparametric regression models such as the additive hazards model have been extended for independent current status data to derive the test statistics, whose distributions converge at a rate of n(1/2) , for testing the regression parameters. However, a straightforward application of these statistical methods to clustered current status data is not appropriate because intracluster correlation needs to be taken into account. Therefore, this paper proposes two estimating functions for estimating the parameters in the additive hazards model for clustered current status data. The comparative results from simulation studies are presented, and the application of the proposed estimating functions to one real data set is illustrated. Copyright © 2013 John Wiley & Sons, Ltd.

A Systematic Review of the Epidemiology of Echinococcosis in Domestic and Wild Animals

PubMed Central

Otero-Abad, Belen; Torgerson, Paul R.

2013-01-01

Background Human echinococcosis is a neglected zoonosis caused by parasites of the genus Echinococcus. The most frequent clinical forms of echinococcosis, cystic echinococcosis (CE) and alveolar echinococcosis (AE), are responsible for a substantial health and economic burden, particularly to low-income societies. Quantitative epidemiology can provide important information to improve the understanding of parasite transmission and hence is an important part of efforts to control this disease. The purpose of this review is to give an insight on factors associated with echinococcosis in animal hosts by summarising significant results reported from epidemiological studies identified through a systematic search. Methodology and Principal Findings The systematic search was conducted mainly in electronic databases but a few additional records were obtained from other sources. Retrieved entries were examined in order to identify available peer-reviewed epidemiological studies that found significant risk factors for infection using associative statistical methods. One hundred studies met the eligibility criteria and were suitable for data extraction. Epidemiological factors associated with increased risk of E. granulosus infection in dogs included feeding with raw viscera, possibility of scavenging dead animals, lack of anthelmintic treatment and owners' poor health education and indicators of poverty. Key factors associated with E. granulosus infection in intermediate hosts were related to the hosts' age and the intensity of environmental contamination with parasite eggs. E. multilocularis transmission dynamics in animal hosts depended on the interaction of several ecological factors, such as hosts' population densities, host-prey interactions, landscape characteristics, climate conditions and human-related activities. Conclusions/Significance Results derived from epidemiological studies provide a better understanding of the behavioural, biological and ecological factors involved in the transmission of this parasite and hence can aid in the design of more effective control strategies. PMID:23755310

Mycobacterium avium Subspecies paratuberculosis: Human Exposure through Environmental and Domestic Aerosols

PubMed Central

Rhodes, Glenn; Richardson, Hollian; Hermon-Taylor, John; Weightman, Andrew; Higham, Andrew; Pickup, Roger

2014-01-01

Mycobacterium avium subspecies paratuberculosis (Map) causes Johne’s disease in animals and is significantly associated with Crohn’s disease (CD) in humans. Our previous studies have shown Map to be present in U.K. rivers due to land deposition from chronic livestock infection and runoff driven by rainfall. The epidemiology of CD in Cardiff showed a significant association with the River Taff, in which Map can be detected on a regular basis. We have previously hypothesized that aerosols from the river might influence the epidemiology of CD. In this preliminary study, we detected Map by quantitative PCR in one of five aerosol samples collected above the River Taff. In addition, we examined domestic showers from different regions in the U.K. and detected Map in three out of 30 independent samples. In detecting Map in river aerosols and those from domestic showers, this is the first study to provide evidence that aerosols are an exposure route for Map to humans and may play a role in the epidemiology of CD. PMID:25438013

Oral Health and the Oral Microbiome in Pancreatic Cancer: An Overview of Epidemiological Studies.

PubMed

Bracci, Paige M

The aim was to provide a cohesive overview of epidemiological studies of periodontal disease, oral microbiome profiles, and pancreatic cancer risk. A PubMed search of articles published in English through July 2017 with additional review of bibliographies of identified articles. Risk estimates for periodontal disease associated with pancreatic cancer consistently ranged from 1.5 to 2, aligning with a meta-analysis summary relative risk of 1.74. Analyses of antibodies to pathogenic and/or commensal oral bacteria in prediagnostic blood provided evidence that some oral bacteria and oral microbial diversity may be related to pancreatic cancer. Overall, the data present a plausible but complex relationship among pancreatic cancer, the oral microbiome, periodontal disease, and other risk factors that might be explained by systemic effects on immune and inflammatory processes. Larger comprehensive studies that examine serially collected epidemiological/clinical data and blood, tissue, and various microbial samples are needed to definitively determine how and whether oral health-related factors contribute to pancreatic cancer risk.

An assessment of the possible extent of confounding in epidemiological studies of lung cancer risk among roofers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mundt, D.J.; van Wijngaarden, E.; Mundt, K.A.

2007-07-01

We evaluated the likelihood and extent to which the observed increased risk of lung cancer may be due to confounding (a mixing of effects of multiple exposures) by co-exposure to other potential carcinogens present in roofing or to lifestyle variables. We conducted a review of the epidemiological and industrial hygiene literature of asphalt-exposed workers. Peer-reviewed epidemiological studies of asphalt fumes, related occupational exposures, and confounding factors were identified from MEDLINE (1966 early 2004). Industrial hygiene studies of asphalt workers were identified through MEDLINE, publicly available government documents, and asphalt industry documents. Using well established statistical methods, we quantified the extentmore » to which lung cancer relative risk estimates among roofers reflect confounding from other exposures, using different prevalence and risk scenarios. The relative risk of lung cancer varied from 1.2 to 5.0 in 13 epidemiological studies of roofers; most studies reported a relative risk between 1.2 and 1.4. Smoking, asbestos and coal tar were the most likely confounders, but the prevalence of these factors varied over time. The results of the study indicate that much of the observed risk reported in epidemiological studies of cancer among roofers is well within the range of what may have resulted from confounding by reasonable and expected levels of smoking, asbestos or coal tar. This may be particularly true for those studies that did not adjust for these confounders and where the exposure was defined as employment in the roofing industry. In addition to poorly defined asphalt exposure, uncontrolled confounding cannot reliably be ruled out in studies of lung cancer among asphalt-exposed roofers. Therefore, it is not possible to conclude whether roofers are at increased risk of lung cancer due to asphalt exposure.« less

Using Accelerometers to Measure Physical Activity in Large-Scale Epidemiologic Studies: Issues and Challenges

PubMed Central

Lee, I-Min; Shiroma, Eric J

2013-01-01

Background Current guidelines for aerobic activity require that adults carry out ≥150 minutes/week of moderate-intensity physical activity, with a large body of epidemiologic evidence showing this level of activity to decrease the incidence of many chronic diseases. Less is known about whether light-intensity activities also have such benefits, and whether sedentary behavior is an independent predictor of increased risks of these chronic diseases, as imprecise assessments of these behaviours and cross-sectional study designs have limited knowledge to date. Methods Recent technological advances in assessment methods have made the use of movement sensors, such as the accelerometer, feasible for use in longitudinal, large-scale epidemiologic studies. Several such studies are collecting sensor-assessed, objective measures of physical activity with the aim of relating these to the development of clinical endpoints. This is a relatively new area of research; thus, in this paper, we use the Women’s Health Study (WHS) as a case study to illustrate challenges related to data collection, data processing, and analyses of the vast amount of data collected. Results The WHS plans to collect 7 days of accelerometer-assessed physical activity and sedentary behavior in ~18,000 women aged ≥62 years. Several logistical challenges exist in collecting data; nonetheless as of 31 August 2013, 11,590 women have already provided some data. Additionally, the WHS experience on data reduction and data analyses can help inform other similar large-scale epidemiologic studies. Conclusions Important data on the health effects of light-intensity activity and sedentary behaviour will emerge from large-scale epidemiologic studies collecting objective assessments of these behaviours. PMID:24297837

EVALUATION OF ANEUPLOIDY AND DNA DAMAGE IN HUMAN SPERMATOZOA: APPLICATIONS IN FIELD STUDIES

EPA Science Inventory

With the goal of incorporating measures of sperm nuclear integrity in an epidemiology study, semen samples from young Czech men were analyzed for sperm anueploidy and sperm chromatin structure in addition to routine measures of sperm production and quality. The exposure in ques...

Use of benzodiazepine and risk of cancer: A meta-analysis of observational studies.

PubMed

Kim, Hong-Bae; Myung, Seung-Kwon; Park, Yon Chul; Park, Byoungjin

2017-02-01

Several observational epidemiological studies have reported inconsistent results on the association between the use of benzodiazepine and the risk of cancer. We investigated the association by using a meta-analysis. We searched PubMed, EMBASE, and the bibliographies of relevant articles to locate additional publications in January 2016. Three evaluators independently reviewed and selected eligible studies based on predetermined selection criteria. Of 796 articles meeting our initial criteria, a total of 22 observational epidemiological studies with 18 case-control studies and 4 cohort studies were included in the final analysis. Benzodiazepine use was significantly associated with an increased risk of cancer (odds ratio [OR] or relative risk [RR] 1.19; 95% confidence interval 1.16-1.21) in a random-effects meta-analysis of all studies. Subgroup meta-analyses by various factors such as study design, type of case-control study, study region, and methodological quality of study showed consistent findings. Also, a significant dose-response relationship was observed between the use of benzodiazepine and the risk of cancer (p for trend <0.01). The current meta-analysis of observational epidemiological studies suggests that benzodiazepine use is associated with an increased risk of cancer. © 2016 UICC.

Phthalates and other additives in plastics: human exposure and associated health outcomes

PubMed Central

Meeker, John D.; Sathyanarayana, Sheela; Swan, Shanna H.

2009-01-01

Concern exists over whether additives in plastics to which most people are exposed, such as phthalates, bisphenol A or polybrominated diphenyl ethers, may cause harm to human health by altering endocrine function or through other biological mechanisms. Human data are limited compared with the large body of experimental evidence documenting reproductive or developmental toxicity in relation to these compounds. Here, we discuss the current state of human evidence, as well as future research trends and needs. Because exposure assessment is often a major weakness in epidemiological studies, and in utero exposures to reproductive or developmental toxicants are important, we also provide original data on maternal exposure to phthalates during and after pregnancy (n = 242). Phthalate metabolite concentrations in urine showed weak correlations between pre- and post-natal samples, though the strength of the relationship increased when duration between the two samples decreased. Phthalate metabolite levels also tended to be higher in post-natal samples. In conclusion, there is a great need for more human studies of adverse health effects associated with plastic additives. Recent advances in the measurement of exposure biomarkers hold much promise in improving the epidemiological data, but their utility must be understood to facilitate appropriate study design. PMID:19528058

Estimation of a partially linear additive model for data from an outcome-dependent sampling design with a continuous outcome

PubMed Central

Tan, Ziwen; Qin, Guoyou; Zhou, Haibo

2016-01-01

Outcome-dependent sampling (ODS) designs have been well recognized as a cost-effective way to enhance study efficiency in both statistical literature and biomedical and epidemiologic studies. A partially linear additive model (PLAM) is widely applied in real problems because it allows for a flexible specification of the dependence of the response on some covariates in a linear fashion and other covariates in a nonlinear non-parametric fashion. Motivated by an epidemiological study investigating the effect of prenatal polychlorinated biphenyls exposure on children's intelligence quotient (IQ) at age 7 years, we propose a PLAM in this article to investigate a more flexible non-parametric inference on the relationships among the response and covariates under the ODS scheme. We propose the estimation method and establish the asymptotic properties of the proposed estimator. Simulation studies are conducted to show the improved efficiency of the proposed ODS estimator for PLAM compared with that from a traditional simple random sampling design with the same sample size. The data of the above-mentioned study is analyzed to illustrate the proposed method. PMID:27006375

The epidemiological modelling of dysthymia: application for the Global Burden of Disease Study 2010.

PubMed

Charlson, Fiona J; Ferrari, Alize J; Flaxman, Abraham D; Whiteford, Harvey A

2013-10-01

In order to capture the differences in burden between the subtypes of depression, the Global Burden of Disease 2010 Study for the first time estimated the burden of dysthymia and major depressive disorder separately from the previously used umbrella term 'unipolar depression'. A global summary of epidemiological parameters are necessary inputs in burden of disease calculations for 21 world regions, males and females and for the year 1990, 2005 and 2010. This paper reports findings from a systematic review of global epidemiological data and the subsequent development of an internally consistent epidemiological model of dysthymia. A systematic search was conducted to identify data sources for the prevalence, incidence, remission and excess-mortality of dysthymia using Medline, PsycINFO and EMBASE electronic databases and grey literature. DisMod-MR, a Bayesian meta-regression tool, was used to check the epidemiological parameters for internal consistency and to predict estimates for world regions with no or few data. The systematic review identified 38 studies meeting inclusion criteria which provided 147 data points for 30 countries in 13 of 21 world regions. Prevalence increases in the early ages, peaking at around 50 years. Females have higher prevalence of dysthymia than males. Global pooled prevalence remained constant across time points at 1.55% (95%CI 1.50-1.60). There was very little regional variation in prevalence estimates. There were eight GBD world regions for which we found no data for which DisMod-MR had to impute estimates. The addition of internally consistent epidemiological estimates by world region, age, sex and year for dysthymia contributed to a more comprehensive estimate of mental health burden in GBD 2010. © 2013 Elsevier B.V. All rights reserved.

Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI): an extension of the STROBE statement for neonatal infection research.

PubMed

Fitchett, Elizabeth J A; Seale, Anna C; Vergnano, Stefania; Sharland, Michael; Heath, Paul T; Saha, Samir K; Agarwal, Ramesh; Ayede, Adejumoke I; Bhutta, Zulfiqar A; Black, Robert; Bojang, Kalifa; Campbell, Harry; Cousens, Simon; Darmstadt, Gary L; Madhi, Shabir A; Meulen, Ajoke Sobanjo-Ter; Modi, Neena; Patterson, Janna; Qazi, Shamim; Schrag, Stephanie J; Stoll, Barbara J; Wall, Stephen N; Wammanda, Robinson D; Lawn, Joy E

2016-10-01

Neonatal infections are estimated to account for a quarter of the 2·8 million annual neonatal deaths, as well as approximately 3% of all disability-adjusted life-years. Despite this burden, few data are available on incidence, aetiology, and outcomes, particularly regarding impairment. We aimed to develop guidelines for improved scientific reporting of observational neonatal infection studies, to increase comparability and to strengthen research in this area. This checklist, Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE- NI), is an extension of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. STROBE-NI was developed following systematic reviews of published literature (1996-2015), compilation of more than 130 potential reporting recommendations, and circulation of a survey to relevant professionals worldwide, eliciting responses from 147 professionals from 37 countries. An international consensus meeting of 18 participants (with expertise in infectious diseases, neonatology, microbiology, epidemiology, and statistics) identified priority recommendations for reporting, additional to the STROBE statement. Implementation of these STROBE-NI recommendations, and linked checklist, aims to improve scientific reporting of neonatal infection studies, increasing data utility and allowing meta-analyses and pathogen-specific burden estimates to inform global policy and new interventions, including maternal vaccines. Copyright © 2016 Elsevier Ltd. All rights reserved.

Integration of DNA sample collection into a multi-site birth defects case-control study.

PubMed

Rasmussen, Sonja A; Lammer, Edward J; Shaw, Gary M; Finnell, Richard H; McGehee, Robert E; Gallagher, Margaret; Romitti, Paul A; Murray, Jeffrey C

2002-10-01

Advances in quantitative analysis and molecular genotyping have provided unprecedented opportunities to add biological sampling and genetic information to epidemiologic studies. The purpose of this article is to describe the incorporation of DNA sample collection into the National Birth Defects Prevention Study (NBDPS), an ongoing case-control study in an eight-state consortium with a primary goal to identify risk factors for birth defects. Babies with birth defects are identified through birth defects surveillance systems in the eight participating centers. Cases are infants with one or more of over 30 major birth defects. Controls are infants without defects from the same geographic area. Epidemiologic information is collected through an hour-long interview with mothers of both cases and controls. We added the collection of buccal cytobrush DNA samples for case-infants, control-infants, and their parents to this study. We describe here the methods by which the samples have been collected and processed, establishment of a centralized resource for DNA banking, and quality control, database management, access, informed consent, and confidentiality issues. Biological sampling and genetic analyses are important components to epidemiologic studies of birth defects aimed at identifying risk factors. The DNA specimens collected in this study can be used for detection of mutations, study of polymorphic variants that confer differential susceptibility to teratogens, and examination of interactions among genetic risk factors. Information on the methods used and issues faced by the NBDPS may be of value to others considering the addition of DNA sampling to epidemiologic studies.

Phylogenetic analysis accounting for age-dependent death and sampling with applications to epidemics.

PubMed

Lambert, Amaury; Alexander, Helen K; Stadler, Tanja

2014-07-07

The reconstruction of phylogenetic trees based on viral genetic sequence data sequentially sampled from an epidemic provides estimates of the past transmission dynamics, by fitting epidemiological models to these trees. To our knowledge, none of the epidemiological models currently used in phylogenetics can account for recovery rates and sampling rates dependent on the time elapsed since transmission, i.e. age of infection. Here we introduce an epidemiological model where infectives leave the epidemic, by either recovery or sampling, after some random time which may follow an arbitrary distribution. We derive an expression for the likelihood of the phylogenetic tree of sampled infectives under our general epidemiological model. The analytic concept developed in this paper will facilitate inference of past epidemiological dynamics and provide an analytical framework for performing very efficient simulations of phylogenetic trees under our model. The main idea of our analytic study is that the non-Markovian epidemiological model giving rise to phylogenetic trees growing vertically as time goes by can be represented by a Markovian "coalescent point process" growing horizontally by the sequential addition of pairs of coalescence and sampling times. As examples, we discuss two special cases of our general model, described in terms of influenza and HIV epidemics. Though phrased in epidemiological terms, our framework can also be used for instance to fit macroevolutionary models to phylogenies of extant and extinct species, accounting for general species lifetime distributions. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Cost estimation of an epidemiological surveillance network for animal diseases in Central Africa: a case study of the Chad network].

PubMed

Ouagal, M; Berkvens, D; Hendrikx, P; Fecher-Bourgeois, F; Saegerman, C

2012-12-01

In sub-Saharan Africa, most epidemiological surveillance networks for animal diseases were temporarily funded by foreign aid. It should be possible for national public funds to ensure the sustainability of such decision support tools. Taking the epidemiological surveillance network for animal diseases in Chad (REPIMAT) as an example, this study aims to estimate the network's cost by identifying the various costs and expenditures for each level of intervention. The network cost was estimated on the basis of an analysis of the operational organisation of REPIMAT, additional data collected in surveys and interviews with network field workers and a market price listing for Chad. These costs were then compared with those of other epidemiological surveillance networks in West Africa. The study results indicate that REPIMAT costs account for 3% of the State budget allocated to the Ministry of Livestock. In Chad in general, as in other West African countries, fixed costs outweigh variable costs at every level of intervention. The cost of surveillance principally depends on what is needed for surveillance at the local level (monitoring stations) and at the intermediate level (official livestock sectors and regional livestock delegations) and on the cost of the necessary equipment. In African countries, the cost of surveillance per square kilometre depends on livestock density.

Current approaches used in epidemiologic studies to examine short-term multipollutant air pollution exposures.

PubMed

Davalos, Angel D; Luben, Thomas J; Herring, Amy H; Sacks, Jason D

2017-02-01

Air pollution epidemiology traditionally focuses on the relationship between individual air pollutants and health outcomes (e.g., mortality). To account for potential copollutant confounding, individual pollutant associations are often estimated by adjusting or controlling for other pollutants in the mixture. Recently, the need to characterize the relationship between health outcomes and the larger multipollutant mixture has been emphasized in an attempt to better protect public health and inform more sustainable air quality management decisions. New and innovative statistical methods to examine multipollutant exposures were identified through a broad literature search, with a specific focus on those statistical approaches currently used in epidemiologic studies of short-term exposures to criteria air pollutants (i.e., particulate matter, carbon monoxide, sulfur dioxide, nitrogen dioxide, and ozone). Five broad classes of statistical approaches were identified for examining associations between short-term multipollutant exposures and health outcomes, specifically additive main effects, effect measure modification, unsupervised dimension reduction, supervised dimension reduction, and nonparametric methods. These approaches are characterized including advantages and limitations in different epidemiologic scenarios. By highlighting the characteristics of various studies in which multipollutant statistical methods have been used, this review provides epidemiologists and biostatisticians with a resource to aid in the selection of the most optimal statistical method to use when examining multipollutant exposures. Published by Elsevier Inc.

Diagnosis of Hepatitis A Virus Infection: a Molecular Approach

PubMed Central

Nainan, Omana V.; Xia, Guoliang; Vaughan, Gilberto; Margolis, Harold S.

2006-01-01

Current serologic tests provide the foundation for diagnosis of hepatitis A and hepatitis A virus (HAV) infection. Recent advances in methods to identify and characterize nucleic acid markers of viral infections have provided the foundation for the field of molecular epidemiology and increased our knowledge of the molecular biology and epidemiology of HAV. Although HAV is primarily shed in feces, there is a strong viremic phase during infection which has allowed easy access to virus isolates and the use of molecular markers to determine their genetic relatedness. Molecular epidemiologic studies have provided new information on the types and extent of HAV infection and transmission in the United States. In addition, these new diagnostic methods have provided tools for the rapid detection of food-borne HAV transmission and identification of the potential source of the food contamination. PMID:16418523

Artificial sweetener use among children: epidemiology, recommendations, metabolic outcomes, and future directions

PubMed Central

Sylvetsky, Allison; Rother, Kristina I.; Brown, Rebecca

2011-01-01

Synopsis This review summarizes the existing literature pertaining to the epidemiology and current recommendations for pediatric artificial sweetener use and presents the results of studies investigating metabolic responses to artificial sweeteners among children. Observational and interventional studies testing the effects of artificial sweeteners on body weight, short-term satiety, glycemia, and glucoregulatory hormones are described. In addition, this review touches on the growing body of literature about taste, craving, and addiction to sweet taste. Gaining an understanding of the research previously conducted and the gaps that remain will inform future clinical and translational research, in order to develop evidence-based recommendations for artificial sweetener use in the prevention and treatment of pediatric obesity. PMID:22093863

The epidemiology of lion lentivirus infection among a population of free-ranging lions (Panthera leo) in the Kruger National Park, South Africa.

PubMed

Adams, H; van Vuuren, M; Bosman, A-M; Keet, D; New, J; Kennedy, M

2009-09-01

Feline immunodeficiency virus is a lentivirus of domestic cats that causes significant lifelong infection. Infection with this or similar lentiviruses has been detected in several nondomestic feline species, including African lions (Panthera leo). Although lion lentivirus (FIVple) infection is endemic in certain lion populations in eastern and southern Africa, little is known about its pathogenic effects or its epidemiological impact in free-ranging lions. This report describes the epidemiological investigation of lentivirus positivity of free-ranging lions in the Kruger National Park, South Africa. A nested polymerase chain reaction assay for virus detection was performed on all whole blood samples collected. In addition, serum samples were tested for cross-reactive antibodies to domestic feline lentivirus antigens and to puma lentivirus synthetic envelope peptide antigen. The results were analysed in conjunction with epidemiological data to provide a descriptive epidemiological study on lion lentivirus infection in a free-ranging population of lions. The overall prevalence of lentivirus infection was 69%, with a prevalence of 41% in the north of the park, and 80% in the south. Adult males had the highest prevalence when combining the factors of sex and age: 94%. The lowest prevalences were found among juveniles, with male juveniles at 29%. Adults were 5.58 times more likely to test positive for FIVple than juveniles, with adult males being 35 times more likely to be test positive for FIVple compared with juvenile males. This research represents the 1st epidemiological study of the lion lentivirus among free-ranging lions in the Kruger National Park.

Prediction of Postpartum Social Support and Symptoms of Depression in Pregnant Adolescents: A Pilot Study

ERIC Educational Resources Information Center

Logsdon, M. Cynthia; Cross, Rene; Williams, Beverly; Simpson, Theresa

2004-01-01

Many pregnant adolescents remain in school, creating unique challenges for professionals to meet their educational and health needs. In this descriptive pilot study of pregnant adolescents (n = 26), 68% demonstrated symptoms of depression as measured by the Center for Epidemiologic Studies Depression Scale (CES-D). In addition, there was an…

Whole genome sequencing options for bacterial strain typing and epidemiologic analysis based on single nucleotide polymorphism versus gene-by-gene-based approaches.

PubMed

Schürch, A C; Arredondo-Alonso, S; Willems, R J L; Goering, R V

2018-04-01

Whole genome sequence (WGS)-based strain typing finds increasing use in the epidemiologic analysis of bacterial pathogens in both public health as well as more localized infection control settings. This minireview describes methodologic approaches that have been explored for WGS-based epidemiologic analysis and considers the challenges and pitfalls of data interpretation. Personal collection of relevant publications. When applying WGS to study the molecular epidemiology of bacterial pathogens, genomic variability between strains is translated into measures of distance by determining single nucleotide polymorphisms in core genome alignments or by indexing allelic variation in hundreds to thousands of core genes, assigning types to unique allelic profiles. Interpreting isolate relatedness from these distances is highly organism specific, and attempts to establish species-specific cutoffs are unlikely to be generally applicable. In cases where single nucleotide polymorphism or core gene typing do not provide the resolution necessary for accurate assessment of the epidemiology of bacterial pathogens, inclusion of accessory gene or plasmid sequences may provide the additional required discrimination. As with all epidemiologic analysis, realizing the full potential of the revolutionary advances in WGS-based approaches requires understanding and dealing with issues related to the fundamental steps of data generation and interpretation. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Ophthalmic epidemiology in Europe: the "European Eye Epidemiology" (E3) consortium.

PubMed

Delcourt, Cécile; Korobelnik, Jean-François; Buitendijk, Gabriëlle H S; Foster, Paul J; Hammond, Christopher J; Piermarocchi, Stefano; Peto, Tunde; Jansonius, Nomdo; Mirshahi, Alireza; Hogg, Ruth E; Bretillon, Lionel; Topouzis, Fotis; Deak, Gabor; Grauslund, Jakob; Broe, Rebecca; Souied, Eric H; Creuzot-Garcher, Catherine; Sahel, José; Daien, Vincent; Lehtimäki, Terho; Hense, Hans-Werner; Prokofyeva, Elena; Oexle, Konrad; Rahi, Jugnoo S; Cumberland, Phillippa M; Schmitz-Valckenberg, Steffen; Fauser, Sascha; Bertelsen, Geir; Hoyng, Carel; Bergen, Arthur; Silva, Rufino; Wolf, Sebastian; Lotery, Andrew; Chakravarthy, Usha; Fletcher, Astrid; Klaver, Caroline C W

2016-02-01

The European Eye Epidemiology (E3) consortium is a recently formed consortium of 29 groups from 12 European countries. It already comprises 21 population-based studies and 20 other studies (case-control, cases only, randomized trials), providing ophthalmological data on approximately 170,000 European participants. The aim of the consortium is to promote and sustain collaboration and sharing of data and knowledge in the field of ophthalmic epidemiology in Europe, with particular focus on the harmonization of methods for future research, estimation and projection of frequency and impact of visual outcomes in European populations (including temporal trends and European subregions), identification of risk factors and pathways for eye diseases (lifestyle, vascular and metabolic factors, genetics, epigenetics and biomarkers) and development and validation of prediction models for eye diseases. Coordinating these existing data will allow a detailed study of the risk factors and consequences of eye diseases and visual impairment, including study of international geographical variation which is not possible in individual studies. It is expected that collaborative work on these existing data will provide additional knowledge, despite the fact that the risk factors and the methods for collecting them differ somewhat among the participating studies. Most studies also include biobanks of various biological samples, which will enable identification of biomarkers to detect and predict occurrence and progression of eye diseases. This article outlines the rationale of the consortium, its design and presents a summary of the methodology.

Ambient and household air pollution: complex triggers of disease

PubMed Central

Farmer, Stephen A.; Nelin, Timothy D.; Falvo, Michael J.

2014-01-01

Concentrations of outdoor air pollution are on the rise, particularly due to rapid urbanization worldwide. Alternatively, poor ventilation, cigarette smoke, and other toxic chemicals contribute to rising concentrations of indoor air pollution. The World Health Organization recently reported that deaths attributable to indoor and outdoor air pollutant exposure are more than double what was originally documented. Epidemiological, clinical, and animal data have demonstrated a clear connection between rising concentrations of air pollution (both indoor and outdoor) and a host of adverse health effects. During the past five years, animal, clinical, and epidemiological studies have explored the adverse health effects associated with exposure to both indoor and outdoor air pollutants throughout the various stages of life. This review provides a summary of the detrimental effects of air pollution through examination of current animal, clinical, and epidemiological studies and exposure during three different periods: maternal (in utero), early life, and adulthood. Additionally, we recommend future lines of research while suggesting conceivable strategies to curb exposure to indoor and outdoor air pollutants. PMID:24929855

Vitamin D and Colorectal Cancer: Molecular, Epidemiological, and Clinical Evidence

PubMed Central

Dou, Ruoxu; Ng, Kimmie; Giovannucci, Edward L.; Manson, JoAnn E.; Qian, Zhi Rong; Ogino, Shuji

2016-01-01

In many cells throughout the body, vitamin D is converted into its active form calcitriol, and binds to vitamin D receptor (VDR), which functions as a transcription factor to regulate various biological processes including cellular differentiation and immune response. Vitamin D metabolizing enzymes (including CYP24A1 and CYP27B1) and VDR play major roles in exerting and regulating effects of vitamin D. Preclinical and epidemiological studies provide evidence for anticancer effects of vitamin D (in particular, against colorectal cancer), though clinical trials have yet to prove its benefit. Additionally, molecular pathological epidemiology research can provide insights into the interaction of vitamin D with tumour molecular and immunity status. Other future research directions include genome-wide research on VDR transcriptional targets, gene-environment interaction analyses, and clinical trials on vitamin D efficacy in colorectal cancer patients. Here we review the literature on vitamin D and colorectal cancer from both mechanistic and population studies, and discuss the links and controversies within and between the two parts of evidence. PMID:27245104

Skeletal effects of plant products other than soy

USDA-ARS?s Scientific Manuscript database

In addition to the extensive literature on the effects of soy feeding on skeletal parameters and bone turnover, there are a significant number of epidemiological studies suggesting a positive link between bone mineral density (BMD) and overall fruit and vegetable consumption. There is also evidence ...

Energy Expenditure of Selected Household Activities during Pregnancy

ERIC Educational Resources Information Center

Chasan-Taber, Lisa; Freedson, Patty S.; Roberts, Dawn E.; Schmidt, Michael D.; Fragala, Maren S.

2007-01-01

Accurately measuring pregnancy physical activity is critical to assess the percentage of pregnant women meeting the American College of Obstetricians and Gynecologists (ACOG) guidelines. In addition, valid assessment of pregnancy physical activity is important for epidemiologic studies assessing the relationship between physical activity and…

EFFECTS OF RESIDUAL OIL FLY ASH ON CARDIAC, PULMONARY, AND THERMOREGULATORY PARAMETERS IN RATS

EPA Science Inventory

Epidemiological studies have associated ambient levels of particulate matter (PM) with the incidence of cardiopulmonary morbidity and mortality. Additionally, elevated levels of PM have been associated with reduced lung function. More recent published data have suggested a relati...

Molecular epidemiology of echoviruses 11 and 30 in Russia: different properties of genotypes within an enterovirus serotype.

PubMed

Yarmolskaya, Maria S; Shumilina, Elena Yu; Ivanova, Olga E; Drexler, Jan Felix; Lukashev, Alexander N

2015-03-01

Over 100 known enterovirus serotypes differ in their epidemiological and pathogenic properties. Much less is known about variation of these features on a sub-serotype level, such as genotypes. Echovirus 11 (E11) and E30 are amongst the most frequent causative agents of aseptic meningitis. We studied the molecular epidemiology of these pathogens to evaluate potential epidemiological and pathogenic dissimilarities of their genotypes. The complete VP1 genome region was sequenced for 97 E11 and 62 E30 isolates collected in Russia from 2008 to 2012, and they were studied in comparison with all 140 E11 and 432 E30 sequences available in GenBank. A geographic pattern of genotype prevalence was observed for both types. Russian E11 isolates belonged mainly to A genotype, which is common in Asia, and D5, which is predominant in Europe. For E30, genotype III by classification of Ke et al. (2011), also termed genotype a by Bailly et al. (2009), was endemic in Russia from 2003 to 2012, while it was not detected in Europe and North America during this time. The E30 genotypes VI-B, VI-G, and VI-H (e, f and h) were regularly introduced from different countries, became predominant and vanished after no more than 4years. In addition to geographic patterns, E11 genotypes also differed by isolation source. Genotype A2 viruses were significantly more often found in sewage, compared to genotype D5 that was isolated from both sewage and human samples. In addition, there was evidence of a different capacity for international transfers among E11 GtA subclusters. Copyright © 2015 Elsevier B.V. All rights reserved.

[Health examination in future at the era of low tuberculosis incidence--from contacts examination toward active epidemiological studies].

PubMed

Maeda, Hideo; Shirai, Chika

2013-03-01

Japan is still "intermediate burden" country as medium-incidence of tuberculosis (TB). But the incidence of TB varies by public health units. The priority for TB control would be lowering in the areas where the incidence of TB is relatively low. In addition, younger age groups get low prevalence of TB infection than elderly persons. As a result, fewer experiences for TB diagnosis and treatment in the hospital and the medical facility would cause the delay in the detection of TB patients which eventually cause outbreaks. Although there are differences in population density and population mobility between urban and rural areas, the socially economic vulnerable patients and foreign patients are the common risks. Any public health units' policies of TB should correspond to the individual situation. At the era of low tuberculosis incidence, the infection risk is to be "From ubiquitous to the uneven distribution". This makes TB detection much more difficult. At this symposium, each speaker presented the case for actually experienced with QFT test and/or VNTR analysis. They mainly focused on the paradigm shift in TB control which is indispensable for resolving the gaps in regional differences and the differences in diagnostic capability. Although the cases in this symposium were not for the low incidence situation, the pioneering approaches presented here would boost the future application of QFT and VNTR analysis nationwide. The discussions also partially covered the technical infrastructure for molecular epidemiology which covers the whole country. By making full use of QFT test and VNTR analysis as a contact screening tool, we can appropriately understand the risk of TB infection in the region from a buildup of bacteria and patient information. Now is the time to prepare for. Active surveillance of TB by this way would clarify the risk of the disease and lead to the advocacy essential for the resolution. 1. Current situation and challenge of contact survey by using QFT test in Tokyo: Hideo MAEDA (Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government). 2. Contact investigation of a tuberculosis outbreak: Kenichi MIYAMOTO (Takaido Community Health Center). We have experienced a TB outbreak in integrated junior and senior high school in Tokyo. Index patient was a student with persistent respiratory symptoms for six months before diagnosis of sputum smear-positive TB. Public health center started contact investigation immediately. QFT-positive rates were high in close contacts, especially in classmates. Additionally, a student outside of contact investigation was diagnosed as TB and considered to be infected from the first patient by VNTR analysis. Therefore, public health center expanded QFT-tests to all students and teachers in this school. Finally, 9 students and 2 teachers in this school were diagnosed as sputum smear-negative TB by contact investigation. 3. Utilization of molecular epidemiological procedure in contact investigation in Kyoto City: Masahiro ITO (Public Health Center of Kyoto City) Molecular epidemiological procedure using VNTR analysis has been used for contact investigation of tuberculosis since January 2011 in Kyoto City. One hundred forty four strains of Mycobacterium tuberculosis from patients with tuberculosis were investigated and 130 strains were fully analyzed. Fourteen clusters were found and the number of strains included in the cluster was ranged from two to 11. Epidemiological relationship between patients in one cluster was found, however, significant relationship in another clusters was not demonstrated. It was suggested that VNTR analysis is useful for molecular epidemiological analysis of tuberculosis. 4. The population based molecular epidemiological studies and QFT test in a contact examination: Riyo FUJIYAMA, Keisuke MATSUBAYASHI, Setsuko MIZUSHIRI, Junko HIGUCHIL Chika SHIRAI, Yuko KATAGAMI, Mieko CHIHARA, Akihiro IJICHI (Kobe City Public Health Center), Kentaro ARIKAWA, Noriko NAKANISHI, Tomotada IWAMOTO (Kobe Institute of Health). The population based molecular epidemiological studies should be made good use of contacts examination. In future, we expect the tuberculosis molecular epdimiological study improve search for the process of tuberculosis infection. The QFT positive rates correlated well with closeness of contact. QFT test is considered useful for diagnosing tuberculosis infection. However, in the judgment of tuberculosis infection, we should consider the total result of contact investigation not only QFT test but also the contact situation. 5. Insights into the TB epidemiology through population based molecular epidemiological studies: Tomotada IWAMOTO (Kobe Institute of Health) The population based molecular epidemiological studies unveiled the transmission dynamics of tuberculosis at bacterial clone level. This provides scientific evidences for achieving better TB control programs. In the advanced stage of the tuberculosis molecular epidemiological study, we expect to change the current geno-typing based molecular epidemiology to whole genome-typing based molecular epidemiology on the basis of the rapid innovation of next-generation sequencing technology.

Identifying a National Death Index Match

PubMed Central

Burchett, Bruce M.; Blazer, Dan G.

2009-01-01

Data from the National Death Index (NDI) are frequently used to determine survival status in epidemiologic or clinical studies. On the basis of selected information submitted by the investigator, NDI returns a file containing a set of candidate matches. Although NDI deems some matches as perfect, multiple candidate matches may be available for other cases. Working across data from the Duke University site of the Established Populations for Epidemiologic Studies of the Elderly (EPESE), NDI, and the Social Security Death Index (SSDI), the authors found that, for this Established Populations for Epidemiologic Studies of the Elderly cohort of 1,896 cases born before 1922 and alive as of January 1, 1999, a match on Social Security number plus additional personal information (specific combinations of last name, first name, month of birth, day of birth) resulted in agreement between NDI and Social Security Death Index dates of death 94.7% of the time, while comparable agreement was found for only 12.3% of candidate decedents who did not have the required combination of information. Thus, an easy to apply algorithm facilitates accurate identification of NDI matches. PMID:19567777

Vitamin D and colorectal cancer: molecular, epidemiological and clinical evidence.

PubMed

Dou, Ruoxu; Ng, Kimmie; Giovannucci, Edward L; Manson, JoAnn E; Qian, Zhi Rong; Ogino, Shuji

2016-05-01

In many cells throughout the body, vitamin D is converted into its active form calcitriol and binds to the vitamin D receptor (VDR), which functions as a transcription factor to regulate various biological processes including cellular differentiation and immune response. Vitamin D-metabolising enzymes (including CYP24A1 and CYP27B1) and VDR play major roles in exerting and regulating the effects of vitamin D. Preclinical and epidemiological studies have provided evidence for anti-cancer effects of vitamin D (particularly against colorectal cancer), although clinical trials have yet to prove its benefit. In addition, molecular pathological epidemiology research can provide insights into the interaction of vitamin D with tumour molecular and immunity status. Other future research directions include genome-wide research on VDR transcriptional targets, gene-environment interaction analyses and clinical trials on vitamin D efficacy in colorectal cancer patients. In this study, we review the literature on vitamin D and colorectal cancer from both mechanistic and population studies and discuss the links and controversies within and between the two parts of evidence.

Measuring taste impairment in epidemiologic studies: the Beaver Dam Offspring Study.

PubMed

Cruickshanks, K J; Schubert, C R; Snyder, D J; Bartoshuk, L M; Huang, G H; Klein, B E K; Klein, R; Nieto, F J; Pankow, J S; Tweed, T S; Krantz, E M; Moy, G S

2009-07-01

Taste or gustatory function may play an important role in determining diet and nutritional status and therefore indirectly impact health. Yet there have been few attempts to study the spectrum of taste function and dysfunction in human populations. Epidemiologic studies are needed to understand the impact of taste function and dysfunction on public health, to identify modifiable risk factors, and to develop and test strategies to prevent clinically significant dysfunction. However, measuring taste function in epidemiologic studies is challenging and requires repeatable, efficient methods that can measure change over time. Insights gained from translating laboratory-based methods to a population-based study, the Beaver Dam Offspring Study (BOSS) will be shared. In this study, a generalized labeled magnitude scale (gLMS) method was used to measure taste intensity of filter paper disks saturated with salt, sucrose, citric acid, quinine, or 6-n-propylthiouracil, and a gLMS measure of taste preferences was administered. In addition, a portable, inexpensive camera system to capture digital images of fungiform papillae and a masked grading system to measure the density of fungiform papillae were developed. Adult children of participants in the population-based Epidemiology of Hearing Loss Study in Beaver Dam, Wisconsin, are eligible for this ongoing study. The parents were residents of Beaver Dam and 43-84 years of age in 1987-1988; offspring ranged in age from 21-84 years in 2005-2008. Methods will be described in detail and preliminary results about the distributions of taste function in the BOSS cohort will be presented.

State of the Art Review: Depression, Stress, Anxiety, and Cardiovascular Disease

PubMed Central

Edmondson, Donald; Kronish, Ian M.

2015-01-01

The notion that psychological states can influence physical health is hardly new, and perhaps nowhere has the mind-body connection been better studied than in cardiovascular disease (CVD). Recently, large prospective epidemiologic studies and smaller basic science studies have firmly established a connection between CVD and several psychological conditions, including depression, chronic psychological stress, posttraumatic stress disorder (PTSD), and anxiety. In addition, numerous clinical trials have been conducted to attempt to prevent or lessen the impact of these conditions on cardiovascular health. In this article, we review studies connecting depression, stress/PTSD, and anxiety to CVD, focusing on findings from the last 5 years. For each mental health condition, we first examine the epidemiologic evidence establishing a link with CVD. We then describe studies of potential underlying mechanisms and finally discuss treatment trials and directions for future research. PMID:25911639

Toxicology and Epidemiology: Improving the Science with a Framework for Combining Toxicological and Epidemiological Evidence to Establish Causal Inference

PubMed Central

Adami, Hans-Olov; Berry, Sir Colin L.; Breckenridge, Charles B.; Smith, Lewis L.; Swenberg, James A.; Trichopoulos, Dimitrios; Weiss, Noel S.; Pastoor, Timothy P.

2011-01-01

Historically, toxicology has played a significant role in verifying conclusions drawn on the basis of epidemiological findings. Agents that were suggested to have a role in human diseases have been tested in animals to firmly establish a causative link. Bacterial pathogens are perhaps the oldest examples, and tobacco smoke and lung cancer and asbestos and mesothelioma provide two more recent examples. With the advent of toxicity testing guidelines and protocols, toxicology took on a role that was intended to anticipate or predict potential adverse effects in humans, and epidemiology, in many cases, served a role in verifying or negating these toxicological predictions. The coupled role of epidemiology and toxicology in discerning human health effects by environmental agents is obvious, but there is currently no systematic and transparent way to bring the data and analysis of the two disciplines together in a way that provides a unified view on an adverse causal relationship between an agent and a disease. In working to advance the interaction between the fields of toxicology and epidemiology, we propose here a five-step “Epid-Tox” process that would focus on: (1) collection of all relevant studies, (2) assessment of their quality, (3) evaluation of the weight of evidence, (4) assignment of a scalable conclusion, and (5) placement on a causal relationship grid. The causal relationship grid provides a clear view of how epidemiological and toxicological data intersect, permits straightforward conclusions with regard to a causal relationship between agent and effect, and can show how additional data can influence conclusions of causality. PMID:21561883

Effects of Radiation Exposure From Cardiac Imaging: How Good Are the Data?

PubMed Central

Einstein, Andrew J.

2012-01-01

Concerns about medical exposure to ionizing radiation have become heightened in recent years due to rapid growth in procedure volumes and the high radiation doses incurred from some procedures. This article summarizes the evidence base undergirding concerns about radiation exposure in cardiac imaging. After classifying radiation effects, explaining terminology used to quantify the radiation received by patients, and describing typical doses from cardiac imaging procedures, I address the major epidemiological studies having bearing on radiation effects at doses comparable to those received by patients undergoing cardiac imaging. These include studies of atomic bomb survivors, nuclear industry workers, and children exposed in utero to x-rays, all of which have evidenced increased cancer risks at low doses. Additional higher dose epidemiological studies of cohorts exposed to radiation in the context of medical treatment are described and found to be generally compatible with these cardiac-dose-level studies, albeit with exceptions. Using risk projection models developed by the US National Academies that incorporate these data and reflect several evidence-based assumptions, cancer risk from cardiac imaging can be estimated and compared to benefits from imaging. Several ongoing epidemiological studies will provide better understanding of radiation-associated cancer risks. PMID:22300689

Epidemiological study air disaster in Amsterdam (ESADA): study design.

PubMed

Slottje, Pauline; Huizink, Anja C; Twisk, Jos W R; Witteveen, Anke B; van der Ploeg, Henk M; Bramsen, Inge; Smidt, Nynke; Bijlsma, Joost A; Bouter, Lex M; van Mechelen, Willem; Smid, Tjabe

2005-05-30

In 1992, a cargo aircraft crashed into apartment buildings in Amsterdam, killing 43 victims and destroying 266 apartments. In the aftermath there were speculations about the cause of the crash, potential exposures to hazardous materials due to the disaster and the health consequences. Starting in 2000, the Epidemiological Study Air Disaster in Amsterdam (ESADA) aimed to assess the long-term health effects of occupational exposure to this disaster on professional assistance workers. Epidemiological study among all the exposed professional fire-fighters and police officers who performed disaster-related task(s), and hangar workers who sorted the wreckage of the aircraft, as well as reference groups of their non-exposed colleagues who did not perform any disaster-related tasks. The study took place, on average, 8.5 years after the disaster. Questionnaires were used to assess details on occupational exposure to the disaster. Health measures comprised laboratory assessments in urine, blood and saliva, as well as self-reported current health measures, including health-related quality of life, and various physical and psychological symptoms. In this paper we describe and discuss the design of the ESADA. The ESADA will provide additional scientific knowledge on the long-term health effects of technological disasters on professional workers.

EPIDEMIOLOGY STUDY OF BIRTH DEFECTS AND DISINFECTION BYPRODUCTS (DBPS)

EPA Science Inventory

Birth defects are the leading cause of infant mortality in the US, accounting for more than 20% of all infant deaths. In addition, birth defects are the fifth leading cause of years of potential life lost and contribute substantially to childhood morbidity and long-term disabilit...

EPIDEMIOLOGY STUDY OF BIRTH DEFECTS AND DISINFECTION BYPRODUCTS

EPA Science Inventory

Birth defects are the leading cause of infant mortality in the US, accounting for more than 20% of all infant deaths. In addition, birth defects are the fifth leading cause of years of potential lief life lost and contribute substantially to childhood morbidity and long-term disa...

Comparison of four molecular methods to type Salmonella Enteritidis strains.

PubMed

Campioni, Fábio; Pitondo-Silva, André; Bergamini, Alzira M M; Falcão, Juliana P

2015-05-01

This study compared the pulsed-field gel electrophoresis (PFGE), enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR), multilocus variable-number of tanden-repeat analysis (MLVA), and multilocus sequence typing (MLST) methods for typing 188 Salmonella Enteritidis strains from different sources isolated over a 24-year period in Brazil. PFGE and ERIC-PCR were more efficient than MLVA for subtyping the strains. However, MLVA provided additional epidemiological information for those strains. In addition, MLST showed the Brazilian strains as belonging to the main clonal complex of S. Enteritidis, CC11, and provided the first report of two new STs in the S. enterica database but could not properly subtype the strains. Our results showed that the use of PFGE or ERIC-PCR together with MLVA is suitable to efficiently subtype S. Enteritidis strains and provide important epidemiological information. © 2015 APMIS. Published by John Wiley & Sons Ltd.

[Identification and sampling of people with migration background for epidemiological studies in Germany].

PubMed

Reiss, K; Makarova, N; Spallek, J; Zeeb, H; Razum, O

2013-06-01

In 2009, 19.6% of the population of Germany either had migrated themselves or were the offspring of people with migration experience. Migrants differ from the autochthonous German population in terms of health status, health awareness and health behaviour. To further investigate the health situation of migrants in Germany, epidemiological studies are needed. Such studies can employ existing databases which provide detailed information on migration status. Otherwise, onomastic or toponomastic procedures can be applied to identify people with migration background. If migrants have to be recruited into an epidemiological study, this can be done register-based (e. g., data from registration offices or telephone lists), based on residential location (random-route or random-walk procedure), via snowball sampling (e. g., through key persons) or via settings (e. g., school entry examination). An oversampling of people with migration background is not sufficient to avoid systematic bias in the sample due to non-participation. Additional measures have to be taken to increase access and raise participation rates. Personal contacting, multilingual instruments, multilingual interviewers and extensive public relations increase access and willingness to participate. Empirical evidence on 'successful' recruitment strategies for studies with migrants is still lacking in epidemiology and health sciences in Germany. The choice of the recruitment strategy as well as the measures to raise accessibility and willingness to participate depend on the available resources, the research question and the specific migrant target group. © Georg Thieme Verlag KG Stuttgart · New York.

Relations between Suicidal Ideation and Dimensions of Depressive Symptoms in High-School Students

ERIC Educational Resources Information Center

Chabrol, Henri; Rodgers, Rachel; Rousseau, Amelie

2007-01-01

The aim of the study was to evaluate the link between the different dimensions of depressive symptoms and suicidal ideation in adolescents. A sample of 1057 adolescents completed the CES-D (Center for Epidemiological Studies Depression Scale) and three additional items measuring suicidal ideation. The four dimensions of depressive symptoms on the…

Epidemiological changes in the histological subtypes of 35,018 non-small-cell lung cancer cases in Brazil.

PubMed

Costa, Guilherme; Thuler, Luiz Claudio Santos; Ferreira, Carlos Gil

2016-07-01

Regarding the fatality rates stemming from various existing forms of cancers worldwide, lung cancer (LC) is ranked as the main cause of death amongst those who suffer from cancer. Although the epidemiological, clinical, and histological profile of patients with this type of cancer is largely unknown, Brazil has made tremendous efforts to generate data for supporting healthcare policies concerning lung cancer. Taking these factors into account, this study aims to analyse the epidemiological, clinical, and histological profiles of patients with non-small-cell lung cancer (NSCLC) in Brazil. For this study, a cross-sectional epidemiological study was conducted to nationally analyse patient's data within the cancer hospital registries found in the National Cancer Institute (INCA) and the São Paulo Cancer Foundation (FOSP) between 2000 and 2011. A total of 35,018 patients diagnosed with NSCLC in Brazil between 2000 and 2011 were analysed. The analysis demonstrated the occurrence of an epidemiological shift, related to the most prevalent histological type of NSCLC in the study population from 2003. The shift resulted in a higher percentage of adenocarcinoma (43.3%) over squamous cell carcinoma (36.5%). Additionally, there was a significant increase in both the number of cases of LC in women and in the rates of patients diagnosed with metastatic disease. The use of filtered cigarettes since the 60's and the increase in the number of LC cases in women, were one of the causes for the switch in the histological profile of NSCLC in Brazil. Consequently, adenocarcinoma is now the predominant type of cancer detected. Late diagnosis is a hallmark sign. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Unexplained sudden death, focussing on genetics and family phenotyping.

PubMed

Raju, Hariharan; Behr, Elijah R

2013-01-01

Unexplained sudden death and the sudden arrhythmic death syndrome (SADS) affect a small but significant proportion of young and apparently healthy individuals. This review revisits the causes underlying such deaths and the investigational strategies that identify surviving family who may be at risk. Recent epidemiological data is available from case series or government records. The yield from familial cardiological evaluation for inherited conditions has been supported by additional small series. The greatest advance has come with molecular autopsy studies, which have utilized various methodologies and candidate genes to investigate SADS cases and their families. The latest research replicates and extends the existing knowledge regarding epidemiology and familial evaluation of SADS, whilst genetic studies support a role for the molecular autopsy.

When is it time to get married? Or when should the assay user and the assay developer collaborate?

PubMed Central

Swan, S H; Lasley, B L

1991-01-01

Hormone assays are being developed in the laboratory to detect specific molecular markers in nonclinical populations. Epidemiology is increasingly using these assays to improve the precision with which disease processes and exposures can be defined. This growing body of molecular epidemiology requires a high degree of cooperation between the assay developer and the assay user. We draw on our experience in using a sensitive hormone assay for the detection of early pregnancy via urinary human chorionic gonadotropin to illustrate these points. We conclude that this collaborative effort, in addition to making this study possible, has provided unexpected rewards. PMID:1954925

Environmental Chemicals and Type 2 Diabetes: An Updated Systematic Review of the Epidemiologic Evidence

PubMed Central

Kuo, Chin-Chi; Moon, Katherine; Thayer, Kristina A.; Navas-Acien, Ana

2015-01-01

The burden of diabetes is increasing globally. Identifying novel preventable risk factors is an urgent need. In 2011, the U.S. National Toxicological Program (NTP) conducted a workshop to evaluate the epidemiologic and experimental evidence on the relationship of environmental chemicals with obesity, diabetes and metabolic syndrome. Although the evidence was insufficient to establish causality, the NTP workshop review identified an overall positive association between some environmental chemicals and diabetes. In this systematic review, our objective was to summarize the epidemiological research published since the NTP workshop. We identified a total of 29 articles (7 on arsenic, 3 on cadmium, 2 on mercury, 11 on persistent organic pollutants, 3 on phthalates and 4 on bisphenol A) including 7 prospective studies. Considering consistency, temporality, strength, dose-response, and biological plausibility (confounding), we concluded that the evidence is suggestive but not sufficient for a relationship between arsenic and persistent organic pollutants, and insufficient for mercury, phthalates and bisphenol A. For cadmium the epidemiologic evidence does not seem to suggest an association with diabetes. Important research questions include the need of additional prospective studies and the evaluation of the dose-response relationship, the role of joint exposures, and effect modification with other comorbidities and genetic variants. PMID:24114039

Prostate cancer and toxicity from critical use exemptions of methyl bromide: Environmental protection helps protect against human health risks

PubMed Central

2012-01-01

Background Although ozone-depleting methyl bromide was destined for phase-out by 2005, it is still widely applied as a consequence of various critical-use-exemptions and mandatory international regulations aiming to restrict the spread of pests and alien species (e.g. in globalized transport and storage). The withdrawal of methyl bromide because of its environmental risk could fortuitously help in the containment of its human toxicity. Methods We performed a systematic review of the literature, including in vitro toxicological and epidemiological studies of occupational and community exposure to the halogenated hydrocarbon pesticide methyl bromide. We focused on toxic (especially chronic) or carcinogenic effects from the use of methyl bromide, on biomonitoring data and reference values. Eligible epidemiological studies were subjected to meta-analysis. Results Out of the 542 peer reviewed publications between 1990-2011, we found only 91 referring to toxicity of methyl bromide and 29 using the term "carcinogenic", "neoplastic" or "mutagenic". Several studies provide new additional data pertaining to the mechanistic aspects of methyl bromide toxicity. Few studies have performed a detailed exposure assessment including biomonitoring. Three evaluated epidemiological studies assessed a possible association between cancer and methyl bromide. Overall, exposure to methyl bromide is associated with an increased risk of prostate cancer OR, 1.21; 95% CI (0,98-1.49), P = 0.076. Two epidemiological studies have analyzed environmental, non-occupational exposure to methyl bromide providing evidence for its health risk to the general public. None of the epidemiological studies addressed its use as a fumigant in freight containers, although recent field and case reports do refer to its toxic effects associated with its use in shipping and storage. Conclusions Both the epidemiological evidence and toxicological data suggest a possible link between methyl bromide exposure and serious health problems, including prostate cancer risk from occupational and community exposure. The environmental risks of methyl bromide are not in doubt, but also its health risks, especially for genetically predisposed subjects, should not be underestimated. PMID:22284215

Placental transmission of human parvovirus 4 in newborns with hydrops, Taiwan.

PubMed

Chen, Mao-Yuan; Yang, Shiu-Ju; Hung, Chien-Ching

2011-10-01

In studying the epidemiology of parvovirus 4 (PARV4) in Taiwan, we detected DNA in plasma of 3 mothers and their newborns with hydrops. In 1 additional case, only the mother had PARV4 DNA. Our findings demonstrate that PARV4 can be transmitted through the placenta.

An Overview of Exposure Assessment Models Used by the U.S. Environmental Protection Agency

EPA Science Inventory

Models are often used in addition to or in lieu of monitoring data to estimate environmental concentrations and exposures for use in risk assessments or epidemiological studies, and to support regulatory standards and voluntary programs (Jayjock et al., 2007; US EPA, 1989, 1992)....

Exploring multiple trajectories of causality: collaboration between Anthropology and Epidemiology in the 1982 birth cohort, Pelotas, Southern Brazil

PubMed Central

Béhague, Dominique P; Gonçalves, Helen

2009-01-01

OBJECTIVE: Although the relationship between epidemiology and anthropology has a long history, it has generally been comprised of the integration of quantitative and qualitative methods. Only recently have the two fields begun to converge along theoretical lines, leading to a growing mutual interest in explaining rather than simply describing phenomena. This paper aimed to illustrate how ethnographic analyses can be used to assist with the in-depth and theoretically-imbued interpretation of epidemiological results. METHODS: The anthropological analysis presented in this paper used ethnographic data collected as part of the ongoing 1982 birth cohort study, between 1997 and 2007 in Pelotas, Southern Brazil. Analyses were framed according to the results presented in two of the epidemiological articles published in this series on the determinants of mental morbidity and age of sexual initiation. RESULTS AND CONCLUSIONS: The ethnographic results show that statistical associations consist of multiple pathways of influence and causality that generally correspond to the unique experiences of specific subgroups. In exploring these pathways, the paper highlights the importance of an additional set of mediating factors that account for epidemiological results; these include the awareness and experience of inequities, the role of violence in everyday life, traumatic life events, increasing social isolation and emotional introversion as a response to life's difficulties, and differing approaches towards socio-psychological maturation. Theoretical and methodological collaboration between anthropology and epidemiology is important for public health, as it has positively modified both fields. PMID:19142353

[Exploring multiple trajectories of causality: collaboration between Anthropology and Epidemiology in the 1982 birth cohort, Pelotas, Southern Brazil].

PubMed

Béhague, Dominique P; Gonçalves, Helen

2008-12-01

Although the relationship between epidemiology and anthropology has a long history, it has generally been comprised of the integration of quantitative and qualitative methods. Only recently have the two fields begun to converge along theoretical lines, leading to a growing mutual interest in explaining rather than simply describing phenomena. This paper aimed to illustrate how ethnographic analyses can be used to assist with the in-depth and theoretically-imbued interpretation of epidemiological results. The anthropological analysis presented in this paper used ethnographic data collected as part of the ongoing 1982 birth cohort study, between 1997 and 2007 in Pelotas, Southern Brazil. Analyses were framed according to the results presented in two of the epidemiological articles published in this series on the determinants of mental morbidity and age of sexual initiation. The ethnographic results show that statistical associations consist of multiple pathways of influence and causality that generally correspond to the unique experiences of specific subgroups. In exploring these pathways, the paper highlights the importance of an additional set of mediating factors that account for epidemiological results; these include the awareness and experience of inequities, the role of violence in everyday life, traumatic life events, increasing social isolation and emotional introversion as a response to life's difficulties, and differing approaches towards socio-psychological maturation. Theoretical and methodological collaboration between anthropology and epidemiology is important for public health, as it has positively modified both fields.

Problems and Benefits Reported by Stroke Family Caregivers: Results from a Prospective Epidemiological Study

PubMed Central

Haley, William E.; Allen, Jessica Y.; Grant, Joan S.; Clay, Olivio J.; Perkins, Martinique; Roth, David L.

2009-01-01

Background and Purpose Stroke symptoms can be very stressful for family caregivers, but most knowledge about the prevalence and stressfulness of stroke-related patient problems is derived from convenience samples. In addition, little is known about perceived benefits of the stroke caregiving experience. The purpose of this study was to determine the prevalence and stressfulness of stroke-related problems, and perceived benefits of caregiving, as reported by an epidemiologically-derived sample of caregivers of stroke survivors. Methods Stroke survivors (N=75) from a prospective epidemiological study of stroke, the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, and their family caregivers were followed. Caregivers were given a comprehensive telephone interview 8 to 12 months after the stroke, using measures of stroke patient problems, caregiver appraisals of the stressfulness of these problems, and perceived benefits of caregiving. Results Caregivers rated patient problems with mood (depression, loneliness and anxiety), memory, and physical care (bowel control), as the most stressful, but reported prevalence of these problems was lower than those reported previously in studies using clinical samples. Caregivers also reported many benefits from caregiving, with over 90% reporting that caregiving enabled them to appreciate life more. Conclusions Epidemiologically based studies of stroke caregiving provide a unique picture of caregiver strains and benefits compared with clinical studies, which tend to over-represent more impaired patients. Support for caregivers should include interventions to aid their coping with highly stressful mood, physical care, and cognitive problems of stroke patients, but should also attend to perceived benefits of caregiving. PMID:19407230

Methods and Processes of Developing the Strengthening the Reporting of Observational Studies in Epidemiology-Veterinary (STROBE-Vet) Statement.

PubMed

Sargeant, J M; O'Connor, A M; Dohoo, I R; Erb, H N; Cevallos, M; Egger, M; Ersbøll, A K; Martin, S W; Nielsen, L R; Pearl, D L; Pfeiffer, D U; Sanchez, J; Torrence, M E; Vigre, H; Waldner, C; Ward, M P

2016-12-01

Reporting of observational studies in veterinary research presents challenges that often are not addressed in published reporting guidelines. Our objective was to develop an extension of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement that addresses unique reporting requirements for observational studies in veterinary medicine related to health, production, welfare, and food safety. We conducted a consensus meeting with 17 experts in Mississauga, Canada. Experts completed a premeeting survey about whether items in the STROBE statement should be modified or added to address unique issues related to observational studies in animal species with health, production, welfare, or food safety outcomes. During the meeting, each STROBE item was discussed to determine whether or not rewording was recommended, and whether additions were warranted. Anonymous voting was used to determine consensus. Six items required no modifications or additions. Modifications or additions were made to the STROBE items 1 (title and abstract), 3 (objectives), 5 (setting), 6 (participants), 7 (variables), 8 (data sources and measurement), 9 (bias), 10 (study size), 12 (statistical methods), 13 (participants), 14 (descriptive data), 15 (outcome data), 16 (main results), 17 (other analyses), 19 (limitations), and 22 (funding). The methods and processes used were similar to those used for other extensions of the STROBE statement. The use of this STROBE statement extension should improve reporting of observational studies in veterinary research by recognizing unique features of observational studies involving food-producing and companion animals, products of animal origin, aquaculture, and wildlife.

Salmonella epidemiology: A whirlwind of change.

PubMed

Besser, John M

2018-05-01

The field of infectious disease epidemiology for Salmonella and other enteric pathogens is undergoing some of the most profound changes since the time of Kauffman and White. Rapid advances in "big data" technologies such as genomics and metagenomics are making it possible to monitor and control salmonellosis in new and exciting ways. Epidemiological methods are becoming increasingly robust through the routine use of standardized hypothesis-generating questionnaires, iterative open-ended interviewing, informational trace-backs and new modeling techniques for describing the attribution of disease to food sources. In addition, Salmonella epidemiology is facing important challenges and new opportunities due to the rapid adoption of culture independent diagnostic test panels by clinical laboratories. Where is this unprecedented wave of change taking us? This chapter will examine emerging trends in Salmonella epidemiology, and take a peek into the not-so-distant future. Published by Elsevier Ltd.

Mind the Scales: Harnessing Spatial Big Data for Infectious Disease Surveillance and Inference

PubMed Central

Lee, Elizabeth C.; Asher, Jason M.; Goldlust, Sandra; Kraemer, John D.; Lawson, Andrew B.; Bansal, Shweta

2016-01-01

Spatial big data have the velocity, volume, and variety of big data sources and contain additional geographic information. Digital data sources, such as medical claims, mobile phone call data records, and geographically tagged tweets, have entered infectious diseases epidemiology as novel sources of data to complement traditional infectious disease surveillance. In this work, we provide examples of how spatial big data have been used thus far in epidemiological analyses and describe opportunities for these sources to improve disease-mitigation strategies and public health coordination. In addition, we consider the technical, practical, and ethical challenges with the use of spatial big data in infectious disease surveillance and inference. Finally, we discuss the implications of the rising use of spatial big data in epidemiology to health risk communication, and public health policy recommendations and coordination across scales. PMID:28830109

Cardiovascular effects of environmental noise: research in Germany.

PubMed

Maschke, Christian

2011-01-01

Research on systematic noise effects started in Germany back in the fifties with basic experimental studies on humans. As a result, noise was classified as a non-specific stressor, which could cause an ergotropic activation of the complete organism. In the light of this background research a hypothesis was proposed that long-term noise exposure could have an adverse effect on health. This hypothesis was further supported by animal studies. Since the sixties, the adverse effects of chronic road traffic noise exposure were further examined in humans with the help of epidemiological studies. More epidemiological aircraft noise studies followed in the 1970s and thereafter. The sample size was increased, relevant confounding factors were taken into account, and the exposure and health outcomes were investigated objectively and with higher quality measures. To date, more than 20 German epidemiological traffic noise studies have focused on noise-induced health effects, mainly on the cardiovascular system. In particular, the newer German noise studies demonstrate a clear association between residential exposure to traffic noise (particularly night noise) and cardiovascular outcomes. Nevertheless, additional research is needed, particularly on vulnerable groups and multiple noise exposures. The epidemiological findings have still not been fully considered in German regulations, particularly for aircraft noise. The findings, however, were taken into account in national recommendations. The Federal Environment Agency recommends noise rating levels of 65 dB(A) for the day and 55 dB(A) for the night, as a short-term goal. In the medium term, noise rating levels of 60 / 50 (day, night) should be reached and noise rating levels of 55 / 45 in the long run.

An overview of molecular epidemiology of hepatitis B virus (HBV) in India.

PubMed

Datta, Sibnarayan

2008-12-19

Hepatitis B virus (HBV) is one of the major global public health problems. In India, HBsAg prevalence among general population ranges from 2% to 8%, placing India in intermediate HBV endemicity zone and the number of HBV carriers is estimated to be 50 million, forming the second largest global pool of chronic HBV infections. India is a vast country, comprised of multiracial communities with wide variations in ethnicity and cultural patterns, which is attributable to its geographical location, gene influx due to invasion and/or anthropological migrations in the past. Moreover, recent increase in trade, trafficking and use of illicit drugs has also considerably influenced the epidemiology of HBV, specifically in the eastern and north eastern parts of India. However, data on the molecular epidemiology of HBV in India is scanty. HBV genotypes A and D have been well documented from different parts of mainland India. Interestingly, in addition to genotypes A and D, genotype C having high nucleotide similarity with south East Asian subgenotype Cs/C1 strain, have been detected exclusively from eastern Indian HBV carriers, suggesting a recent introduction. Thus, compared to other parts of India, the molecular epidemiology of HBV is naturally distinct in eastern India. Very recently, taking the advantage of circulation of three distinct HBV genotypes within the population of eastern India, different aspects of HBV molecular epidemiology was studied that revealed very interesting results. In this study, the clinical significance of HBV genotypes, core promoter and precore mutations, possible routes of introduction of HBV genotype C in eastern India, the clinical implications of x gene variability, prevalence of the AFB1 induced p53 gene codon 249 mutation, the transmission potentiality of HBV among asymptomatic/inactive or occult HBV carriers and the genetic variability of HBV persisting in the PBL was investigated. In this manuscript, the information available on the molecular epidemiology of HBV in India has been reviewed and the results of studies among the eastern Indian population have been summarised.

Toxicology of microcystins with reference to cases of human intoxications and epidemiological investigations of exposures to cyanobacteria and cyanotoxins.

PubMed

Svirčev, Zorica; Drobac, Damjana; Tokodi, Nada; Mijović, Biljana; Codd, Geoffrey A; Meriluoto, Jussi

2017-02-01

Blooms of cyanobacteria have been documented throughout history, all over the world. Mass populations of these organisms typically present hazards to human health and are known for the production of a wide range of highly toxic metabolites-cyanotoxins, of which among the most common and most investigated are the microcystins. The toxicity of the family of microcystin congeners to animal and cell models has received much attention; however, less is known about their negative effects on human health, whether via acute or chronic exposure. Useful information may be acquired through epidemiological studies since they can contribute to knowledge of the relationships between cyanotoxins and human health in environmental settings. The aim of this review is to compile and evaluate the available published reports and epidemiological investigations of human health incidents associated with exposure to mass populations of cyanobacteria from throughout the world and to identify the occurrence and likely role of microcystins in these events. After an initial screening of 134 publications, 42 publications (25 on the chronic and 17 on the acute effects of cyanotoxins) describing 33 cases of poisonings by cyanobacterial toxins in 11 countries were reviewed. The countries were Australia, China, Sri Lanka, Namibia, Serbia, Sweden, UK, Portugal, Brazil, USA, and Canada. At least 36 publications link cyanobacteria/cyanotoxins including microcystins to adverse human health effects. The studies were published between 1960 and 2016. Although the scattered epidemiological evidence does not provide a definitive conclusion, it can serve as additional information for the medical assessment of the role of microcystins in cancer development and other human health problems. This paper discusses the major cases of cyanotoxin poisonings as well as the strengths, weaknesses, and importance of the performed epidemiological research. This study also proposes some recommendations for future epidemiological work.

Circular epidemiology.

PubMed

Kuller, L H

1999-11-01

Circular epidemiology can be defined as the continuation of specific types of epidemiologic studies beyond the point of reasonable doubt of the true existence of an important association or the absence of such an association. Circular epidemiology is an extreme example of studies of the consistency of associations. A basic problem for epidemiology is the lack of a systematic approach to acquiring new knowledge to reach a goal of improving public health and preventive medicine. For epidemiologists, research support unfortunately is biased toward the continued study of already proven hypotheses. Circular epidemiology, however, freezes at one point in the evolution of epidemiologic studies, failing to move from descriptive to analytical case-control and longitudinal studies, for example, to experimental, clinical trials. Good epidemiology journals are filled with very well-conducted epidemiologic studies that primarily repeat the obvious or are variations on the theme.

Are Exposures to Multiple Frequencies the Key to Future Radiofrequency Research?

PubMed Central

Sienkiewicz, Zenon; Calderón, Carolina; Broom, Kerry A.; Addison, Darren; Gavard, Amélie; Lundberg, Louise; Maslanyj, Myron

2017-01-01

There is an extensive literature investigating possible effects of exposure to radiofrequency (RF) electromagnetic fields associated with mobile phone technologies. This has not identified any public health risks with any degree of certainty. Some epidemiological studies have observed associations between heavy users of mobile phones and some types of cancer, but animal studies do not support this association, although a few studies have reported increased tumor yields. However, there is a crucial difference between epidemiology studies and laboratory work in terms of signals investigated: most people are exposed to a complex mixture of frequencies and signals at varying intensities, whereas the majority of animal studies have been performed using a single frequency or intensity. Whether this might explain the differences in outcome will be discussed, and whether there is a need for additional laboratory investigations that reproduce more accurately realistic exposure conditions will be considered. PMID:29276705

Molecular typing and epidemiology profiles of human adenovirus infection among paediatric patients with severe acute respiratory infection in China.

PubMed

Li, Yamin; Zhou, Weimin; Zhao, Yanjie; Wang, Yanqun; Xie, Zhengde; Lou, Yongliang; Tan, Wenjie

2015-01-01

Human adenoviruses (HAdVs) have been recognised as pathogens that cause a broad spectrum of diseases. The studies on HAdV infection among children with severe acute respiratory infection (SARI) are limited. To investigate the prevalence, epidemiology, and genotype of HAdV among children with SARI in China. Nasopharyngeal aspirates (NPAs) or induced sputum (IS) was collected from hospitalised children with SARIs in Beijing (representing Northern China; n = 259) and Zhejiang Province (representing Eastern China; n = 293) from 2007 to 2010. The prevalence of HAdV was screened by polymerase chain reaction (PCR), followed by sequence typing of PCR fragments that targeted the second half of the hexon gene. In addition, co-infection with other human respiratory viruses, related epidemiological profiles and clinical presentations were investigated. In total, 76 (13.8%) of 552 SARI patients were positive for HAdV, and the infection rates of HAdV in Northern and Eastern China were 20.1% (n = 52) and 8.2% (n = 24), respectively. HAdV co-infection with other respiratory viruses was frequent (infection rates: Northern China, 90.4%; Eastern China, 70.8%). The peak seasons for HAdV-B infection was winter and spring. Additionally, members of multiple species (Human mastadenovirus B, C, D and E) were circulating among paediatric patients with SARI, of which HAdV-B (34/52; 65.4%) and HAdV-C (20/24, 83.3%) were the most predominant in Northern and Eastern China, respectively. These findings provide a benchmark for future epidemiology and prevention strategies for HAdV.

Critical Appraisal Skills Among Canadian Obstetrics and Gynaecology Residents: How Do They Fare?

PubMed

Bougie, Olga; Posner, Glenn; Black, Amanda Y

2015-07-01

Evidence-based medicine has become the standard of care in clinical practice. In this study, our objectives were to (1) determine the type of epidemiology and/or biostatistical training being given in Canadian obstetrics and gynaecology post-graduate programs, (2) determine obstetrics and gynaecology residents' level of confidence with critical appraisal, and (3) assess knowledge of fundamental biostatistical and epidemiological principles among Canadian obstetrics and gynaecology trainees. During a national standardized in-training examination, all Canadian obstetrics and gynaecology residents were invited to complete an anonymous cross-sectional survey to determine their levels of confidence with critical appraisal. Fifteen critical appraisal questions were integrated into the standardized examination to assess critical appraisal skills objectively. Primary outcomes were the residents' level of confidence interpreting biostatistical results and applying research findings to clinical practice, their desire for more biostatistics/epidemiological training in residency, and their performance on knowledge questions. A total of 301 of 355 residents completed the survey (response rate=84.8%). Most (76.7%) had little/no confidence interpreting research statistics. Confidence was significantly higher in those with increased seniority (OR=1.93), in those who had taken a previous epidemiology/statistics course (OR=2.65), and in those who had prior publications (OR=1.82). Many (68%) had little/no confidence applying research findings to clinical practice. Confidence increased significantly with increasing training year (P<0.001) and with formal epidemiology training during residency (OR=2.01). The mean score of the 355 residents on the knowledge assessment questions was 69.8%. Increasing seniority was associated with improved overall test performance (P=0.02). Poorer performance topics included analytical study method (9.9%), study design (36.9%), and sample size (42.0%). Most (84.4%) wanted more epidemiology teaching. Canadian obstetrics and gynaecology residents may have the biostatistical and epidemiological knowledge to interpret results published in the literature, but lack confidence applying these skills in clinical settings. Most residents want additional training in these areas, and residency programs should include training in formal curriculums to improve their confidence and prepare them for a lifelong practice of evidence-based medicine.

[Epidemiology of occupational skin cancer due to UV-irradiation].

PubMed

Diepgen, T L; Drexler, H; Schmitt, J

2012-10-01

Skin cancer induced by occupational UV-irradiation is not an official occupational disease number in the appendix of the German ordinance on occupational diseases (Berufskrankheitenverordnung (BKV) but can be recognized as a "virtually" occupational disease according to § 9 (2) of the 7th book of the German Social Code (SGB VII). Epidemiological studies have demonstrated a positive, statistically significant and relevant association between occupational UV-irradiation and the risk of squamous cell carcinoma (SCC) and actinic keratoses (AK). Outdoor workers have on average a 100% higher risk to develop SCC compared to the general population. Therefore, the prerequisites for a new occupational disease are fulfilled and SCC and AK should be reported as an occupational disease if an additional 40% occupationally-related UV-irradiation is documented and the clinical criteria are typical for work- related skin cancer. Epidemiologic evidence also indicates a significant association between work-related UV-irradiation and basal cell carcinoma (BCC) risk: however the results are less consistent and the association is weaker than with SCC. There is an urgent need for further studies in outdoor workers on BCC and lentigo maligna melanoma.

Analysis of Spatiotemporal Characteristics of Pandemic SARS Spread in Mainland China.

PubMed

Cao, Chunxiang; Chen, Wei; Zheng, Sheng; Zhao, Jian; Wang, Jinfeng; Cao, Wuchun

2016-01-01

Severe acute respiratory syndrome (SARS) is one of the most severe emerging infectious diseases of the 21st century so far. SARS caused a pandemic that spread throughout mainland China for 7 months, infecting 5318 persons in 194 administrative regions. Using detailed mainland China epidemiological data, we study spatiotemporal aspects of this person-to-person contagious disease and simulate its spatiotemporal transmission dynamics via the Bayesian Maximum Entropy (BME) method. The BME reveals that SARS outbreaks show autocorrelation within certain spatial and temporal distances. We use BME to fit a theoretical covariance model that has a sine hole spatial component and exponential temporal component and obtain the weights of geographical and temporal autocorrelation factors. Using the covariance model, SARS dynamics were estimated and simulated under the most probable conditions. Our study suggests that SARS transmission varies in its epidemiological characteristics and SARS outbreak distributions exhibit palpable clusters on both spatial and temporal scales. In addition, the BME modelling demonstrates that SARS transmission features are affected by spatial heterogeneity, so we analyze potential causes. This may benefit epidemiological control of pandemic infectious diseases.

Genetic determinants in head and neck squamous cell carcinoma and their influence on global personalized medicine

PubMed Central

Michmerhuizen, Nicole L.; Birkeland, Andrew C.; Bradford, Carol R.; Brenner, J. Chad

2016-01-01

While sequencing studies have provided an improved understanding of the genetic landscape of head and neck squamous cell carcinomas (HNSCC), there remains a significant lack of genetic data derived from non-Caucasian cohorts. Additionally, there is wide variation in HNSCC incidence and mortality worldwide both between and within various geographic regions. These epidemiologic differences are in part accounted for by varying exposure to environmental risk factors such as tobacco, alcohol, high risk human papilloma viruses and betel quid. However, inherent genetic factors may also play an important role in this variability. As limited sequencing data is available for many populations, the involvement of unique genetic factors in HNSCC pathogenesis from epidemiologically diverse groups is unknown. Here, we review current knowledge about the epidemiologic, environmental, and genetic variation in HNSCC cohorts globally and discuss future studies necessary to further our understanding of these differences. Long-term, a more complete understanding of the genetic drivers found in diverse HNSCC cohorts may help the development of personalized medicine protocols for patients with rare or complex genetic events. PMID:27551333

Analysis of Spatiotemporal Characteristics of Pandemic SARS Spread in Mainland China

PubMed Central

Cao, Chunxiang; Zheng, Sheng; Zhao, Jian; Wang, Jinfeng; Cao, Wuchun

2016-01-01

Severe acute respiratory syndrome (SARS) is one of the most severe emerging infectious diseases of the 21st century so far. SARS caused a pandemic that spread throughout mainland China for 7 months, infecting 5318 persons in 194 administrative regions. Using detailed mainland China epidemiological data, we study spatiotemporal aspects of this person-to-person contagious disease and simulate its spatiotemporal transmission dynamics via the Bayesian Maximum Entropy (BME) method. The BME reveals that SARS outbreaks show autocorrelation within certain spatial and temporal distances. We use BME to fit a theoretical covariance model that has a sine hole spatial component and exponential temporal component and obtain the weights of geographical and temporal autocorrelation factors. Using the covariance model, SARS dynamics were estimated and simulated under the most probable conditions. Our study suggests that SARS transmission varies in its epidemiological characteristics and SARS outbreak distributions exhibit palpable clusters on both spatial and temporal scales. In addition, the BME modelling demonstrates that SARS transmission features are affected by spatial heterogeneity, so we analyze potential causes. This may benefit epidemiological control of pandemic infectious diseases. PMID:27597972

Dynamics of Diabetes and Obesity: Epidemiological Perspective

PubMed Central

Boles, Annette; Kandimalla, Ramesh; Reddy, P. Hemachandra

2017-01-01

The purpose of this review article is to understand the current literature on obesity, diabetes and therapeutic avenues across the world. Diabetes is a chronic lifestyle condition that affects millions of people worldwide and it is a major health concern in our society. Diabetes and obesity are associated with various conditions, including non-modifiable and modifiable risk factors. Early detectable markers are not well established to detect pre-diabetes and as a result, it becomes diabetes. Several published epidemiological studies were assessed and the findings were summarized. Resources from published studies were used to identify criteria used for pre-diabetes, the role of diet in pre-diabetics and potential risks and characteristics associated with pre-diabetes. Preventive strategies are needed to combat diabetes. Individuals diagnosed with pre-diabetes need detailed education, need to fully understand the risk factors and have the ability to manage diabetes. Interventions exist that include chronic disease self-management programs, lifestyle interventions and pharmacological strategies. Obesity plays a large role in causing pre-diabetes and diabetes. Critical analysis of existing epidemiological research data suggests that additional research is needed to determine the efficacy of interventions. PMID:28130199

Epidemiological Review of Injury in Pre-Professional Ballet Dancers.

PubMed

Caine, Dennis; Goodwin, Brett J; Caine, Caroline G; Bergeron, Glen

2015-12-01

The objective of this study was to provide an epidemiological review of the literature concerning ballet injuries affecting pre-professional ballet dancers. The literature search was limited to published peer-reviewed reports and involved an extensive examination of Scopus, SPORTDiscus, and CINAHL. The following search terms were used in various combinations: ballet, injury, epidemiology, risk factor, pre-professional, and intervention. Additional citations were located using the ancestry approach. Unlike some other athletic activities that have been the focus of recent intervention research, there is a paucity of intervention and translational research in pre-professional ballet, and sample sizes have often been small and have not accounted for the multivariate nature of ballet injury. Exposure-based injury rates in this population appear similar to those reported for professional ballet dancers and female gymnasts. A preponderance of injuries affect the lower extremity of these dancers, with sprains and strains being the most frequent type of injury reported. The majority of injuries appear to be overuse in nature. Injury risk factors have been tested in multiple studies and indicate a variety of potential injury predictors that may provide useful guidance for future research.

[Extranodal lymphomas in adults in Szabolcs-Szatmár-Bereg county, Hungary. Analysis of 30 years' epidemiologic data].

PubMed

Jakó, János; Szerafin, László

2015-01-18

In their previous work, the authors reported 27-year' findings on the epidemiology of extranodal lymphomas in Szabolcs-Szatmár-Bereg county, Hungary. There are no other studies on this topic available in Hungary. The aim of this study was to analyse in detail the epidemiologic data of patients with non-Hodgkin's lymphoma who were recorded in the leukaemia/lymphoma registry of Szabolcs-Szatmár-Bereg county during a 30-year period, to compare the main epidemiologic features of the extranodal and nodal forms, and compare the results with data reported in the international literature. Between January 1, 1983 and December 31, 2012, 1123 adult patients with newly diagnosed non-Hodgkin's lymphoma were recorded in the leukaemia/lymphoma registry of Szabolcs-Szatmár-Bereg county. Of those, 347 patients suffered from extranodal, and 776 patients from nodal form of non-Hodgkin's lymphoma. The authors compared the incidence of the extranodal and nodal forms, the age and sex distribution of patients, the ratio of B- and T-cell, as well as the indolent and aggressive forms, the geographic distribution and the association with carcinomas. In addition, they studied the occurrence of familial appearance and the localisation of extranodal forms. The occurrence of non-Hodgkin's lymphomas indicated an increasing tendency in their county. This tendency was true for both the extranodal and nodal forms, but it was more remarkable in the extranodal form of lymphomas. They found no substantial difference between the main epidemiologic features of the two forms. The gastrointestinal tract was the most frequent site of presentation for extranodal lymphomas. These observations are in line with data reported in the international literature. The data are essentially similar to those published in populations from Western European countries and the United States.

1995 Annual epidemiologic surveillance report for Pantex Plant

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

This report provides a summary of epidemiologic surveillance data collected from the Pantex Plant from January 1, 1995 through December 31,1995. The data were collected by a coordinator at Pantex and submitted to the Epidemiologic Surveillance Data Center,located at Oak Ridge Institute for Science and Education, where quality control procedures and data analyses were carried out. The data presented apply only to Pantex. The main sections of the report are the same as in previous years; the 1995 report provides additional information describing the work force by age and occupational groups.

Epidemiologic study of residential proximity to transmission lines and childhood cancer in California: description of design, epidemiologic methods and study population

PubMed Central

Kheifets, Leeka; Crespi, Catherine M; Hooper, Chris; Oksuzyan, Sona; Cockburn, Myles; Ly, Thomas; Mezei, Gabor

2015-01-01

We conducted a large epidemiologic case-control study in California to examine the association between childhood cancer risk and distance from the home address at birth to the nearest high-voltage overhead transmission line as a replication of the study of Draper et al. in the United Kingdom. We present a detailed description of the study design, methods of case ascertainment, control selection, exposure assessment and data analysis plan. A total of 5788 childhood leukemia cases and 3308 childhood central nervous system cancer cases (included for comparison) and matched controls were available for analysis. Birth and diagnosis addresses of cases and birth addresses of controls were geocoded. Distance from the home to nearby overhead transmission lines was ascertained on the basis of the electric power companies’ geographic information system (GIS) databases, additional Google Earth aerial evaluation and site visits to selected residences. We evaluated distances to power lines up to 2000 m and included consideration of lower voltages (60–69 kV). Distance measures based on GIS and Google Earth evaluation showed close agreement (Pearson correlation >0.99). Our three-tiered approach to exposure assessment allowed us to achieve high specificity, which is crucial for studies of rare diseases with low exposure prevalence. PMID:24045429

The promise of molecular epidemiology in defining the association between radiation and cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Neta, R.

2000-07-01

Molecular epidemiology involves the inclusion in epidemiologic studies of biologic measurements made at a genetic and molecular level and aims to improve the current knowledge of disease etiology and risk. One of the goals of molecular epidemiology studies of cancer is to determine the role of environmental and genetic factors in initiation and progression of malignancies and to use this knowledge to develop preventive strategies. This approach promises extraordinary opportunities for revolutionizing the practice of medicine and reducing risk. However, this will be accompanied by the need to address and resolve many challenges, such as ensuring the appropriate interpretation ofmore » molecular testing and resolving associated ethical, legal, and social issues. Traditional epidemiologic approaches determined that exposure to ionizing radiation poses significantly increased risk of leukemia and several other types of cancer. Such studies provided the basis for setting exposure standards to protect the public and the workforce from potentially adverse effects of ionizing radiation. These standards were set by using modeling approaches to extrapolate from the biological effects observed in high-dose radiation studies to predicted, but mostly immeasurable, effects at low radiation doses. It is anticipated that the addition of the molecular parameters to the population-based studies will help identify the genes and pathways characteristic of cancers due to radiation exposure of individuals, as well as identify susceptible or resistant subpopulations. In turn, the information about the molecular mechanisms should aid to improve risk assessment. While studies on radiogenic concerns are currently limited to only a few candidate genes, the exponential growth of scientific knowledge and technology promises expansion of knowledge about identity of participating genes and pathways in the future. This article is meant to provide an introductory overview of recent advances in understanding of carcinogenesis at the molecular level, with an emphasis of the aspects that may be of use in establishing the association between radiation and cancer.« less

TCDD and cancer: A critical review of epidemiologic studies

PubMed Central

Boffetta, Paolo; Mundt, Kenneth A; Adami, Hans-Olov; Cole, Philip; Mandel, Jack S

2011-01-01

The authors reviewed the epidemiologic studies on exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and cancer risk, published since the last full-scale review made by the International Agency for Research on Cancer Monographs program in 1997. The update of a cohort of US herbicide producers generated negative results overall; the internal analysis provided evidence of an increased “all-cancer” risk in the highest exposure category, with a statistically significant exposure-response association in some of the many analyses performed.The update of a similar Dutch cohort did not confirm the previously observed association with TCDD exposure. The updated surveillance of the Seveso population provided evidence of increased all-cancer mortality 15-20 years after exposure among those living in the most contaminated area but might also reflect random variation, as overall excesses in the most recent follow-up were not observed. Corresponding data on cancer incidence offer little support to the mortality results. Updated results from cohort studies of Vietnam veterans potentially exposed to TCDD did not consistently suggest an increased risk of cancer. Results of additional, smaller studies of other occupational groups potentially exposed to TCDD, and of community-based case-control studies, did not provide consistent evidence of an increased cancer risk. In conclusion, recent epidemiological evidence falls far short of conclusively demonstrating a causal link between TCDD exposure and cancer risk in humans. The emphasis on results for overall cancer risk—rather than risk for specific neoplasms—is notjustified on epidemiologic grounds and is nota reason for ignoring the weaknesses of the available evidence. PMID:21718216

Mitochondrial genome sequencing reveals potential origins of the scabies mite Sarcoptes scabiei infesting two iconic Australian marsupials.

PubMed

Fraser, Tamieka A; Shao, Renfu; Fountain-Jones, Nicholas M; Charleston, Michael; Martin, Alynn; Whiteley, Pam; Holme, Roz; Carver, Scott; Polkinghorne, Adam

2017-11-28

Debilitating skin infestations caused by the mite, Sarcoptes scabiei, have a profound impact on human and animal health globally. In Australia, this impact is evident across different segments of Australian society, with a growing recognition that it can contribute to rapid declines of native Australian marsupials. Cross-host transmission has been suggested to play a significant role in the epidemiology and origin of mite infestations in different species but a chronic lack of genetic resources has made further inferences difficult. To investigate the origins and molecular epidemiology of S. scabiei in Australian wildlife, we sequenced the mitochondrial genomes of S. scabiei from diseased wombats (Vombatus ursinus) and koalas (Phascolarctos cinereus) spanning New South Wales, Victoria and Tasmania, and compared them with the recently sequenced mitochondrial genome sequences of S. scabiei from humans. We found unique S. scabiei haplotypes among individual wombat and koala hosts with high sequence similarity (99.1% - 100%). Phylogenetic analysis of near full-length mitochondrial genomes revealed three clades of S. scabiei (one human and two marsupial), with no apparent geographic or host species pattern, suggestive of multiple introductions. The availability of additional mitochondrial gene sequences also enabled a re-evaluation of a range of putative molecular markers of S. scabiei, revealing that cox1 is the most informative gene for molecular epidemiological investigations. Utilising this gene target, we provide additional evidence to support cross-host transmission between different animal hosts. Our results suggest a history of parasite invasion through colonisation of Australia from hosts across the globe and the potential for cross-host transmission being a common feature of the epidemiology of this neglected pathogen. If this is the case, comparable patterns may exist elsewhere in the 'New World'. This work provides a basis for expanded molecular studies into mange epidemiology in humans and animals in Australia and other geographic regions.

The use of genetic markers in the molecular epidemiology of histoplasmosis: a systematic review.

PubMed

Damasceno, L S; Leitão, T M J S; Taylor, M L; Muniz, M M; Zancopé-Oliveira, R M

2016-01-01

Histoplasmosis is a systemic mycosis caused by Histoplasma capsulatum, a dimorphic fungal pathogen that can infect both humans and animals. This disease has worldwide distribution and affects mainly immunocompromised individuals. In the environment, H. capsulatum grows as mold but undergoes a morphologic transition to the yeast morphotype under special conditions. Molecular techniques are important tools to conduct epidemiologic investigations for fungal detection, identification of infection sources, and determination of different fungal genotypes associated to a particular disease symptom. In this study, we performed a systematic review in the PubMed database to improve the understanding about the molecular epidemiology of histoplasmosis. This search was restricted to English and Spanish articles. We included a combination of specific keywords: molecular typing [OR] genetic diversity [OR] polymorphism [AND] H. capsulatum; molecular epidemiology [AND] histoplasmosis; and molecular epidemiology [AND] Histoplasma. In addition, we used the specific terms: histoplasmosis [AND] outbreaks. Non-English or non-Spanish articles, dead links, and duplicate results were excluded from the review. The results reached show that the main methods used for molecular typing of H. capsulatum were: restriction fragment length polymorphism, random amplified polymorphic DNA, microsatellites polymorphism, sequencing of internal transcribed spacers region, and multilocus sequence typing. Different genetic profiles were identified among H. capsulatum isolates, which can be grouped according to their source, geographical origin, and clinical manifestations.

Placental Transmission of Human Parvovirus 4 in Newborns with Hydrops, Taiwan

PubMed Central

Yang, Shiu-Ju; Hung, Chien-Ching

2011-01-01

In studying the epidemiology of parvovirus 4 (PARV4) in Taiwan, we detected DNA in plasma of 3 mothers and their newborns with hydrops. In 1 additional case, only the mother had PARV4 DNA. Our findings demonstrate that PARV4 can be transmitted through the placenta. PMID:22000381

Inverse association between gluthathione peroxidase activity and both selenium-binding protein 1 levels and gleason score in human prostate tissue

USDA-ARS?s Scientific Manuscript database

BACKGROUND. Data from human epidemiological studies, cultured mammalian cells, and animal models have supported a potentially beneficial role of selenium (Se) in prostate cancer prevention. In addition, Se-containing proteins including members of the gutathione peroxidase (GPx) family and Selenium-B...

Work Stress and Altered Biomarkers: A Synthesis of Findings Based on the Effort-Reward Imbalance Model.

PubMed

Siegrist, Johannes; Li, Jian

2017-11-10

While epidemiological studies provide statistical evidence on associations of exposures such as stressful work with elevated risks of stress-related disorders (e.g., coronary heart disease or depression), additional information on biological pathways and biomarkers underlying these associations is required. In this contribution, we summarize the current state of the art on research findings linking stressful work, in terms of an established theoretical model-effort-reward imbalance-with a broad range of biomarkers. Based on structured electronic literature search and recent available systematic reviews, our synthesis of findings indicates that associations of work stress with heart rate variability, altered blood lipids, and risk of metabolic syndrome are rather consistent and robust. Significant relationships with blood pressure, heart rate, altered immune function and inflammation, cortisol release, and haemostatic biomarkers were also observed, but due to conflicting findings additional data will be needed to reach a firm conclusion. This narrative review of empirical evidence supports the argument that the biomarkers under study can act as mediators of epidemiologically established associations of work stress, as measured by effort-reward imbalance, with incident stress-related disorders.

Maternal arsenic exposure and birth outcomes: A comprehensive review of the epidemiologic literature focused on drinking water

PubMed Central

Bloom, Michael S.; Surdu, Simona; Neamtiu, Iulia A.; Gurzau, Eugen S.

2015-01-01

Inorganic arsenic (iAs) is a human toxicant to which populations may be exposed through consumption of geogenically contaminated groundwater. A growing body of experimental literature corroborates the reproductive toxicity of iAs; however, the results of human studies are inconsistent. Therefore, we conducted a comprehensive review of epidemiologic studies focused on drinking water iAs exposure and birth outcomes to assess the evidence for causality and to make recommendations for future study. We reviewed 18 English language papers assessing birth weight, gestational age, and birth size. Thirteen of the studies were conducted among populations with frequent exposure to high-level groundwater iAs contamination (>10 μg/L) and five studies were conducted in areas without recognized contamination. Most studies comprised small samples and used cross-sectional designs, often with ecologic exposure assessment strategies, although several large prospective investigations and studies with individual-level measurements were also reported. We conclude that: 1) the epidemiologic evidence for an increased risk of low birth weight (<2,500 grams) is insufficient, although there exists limited evidence for birth weight decreases; 2) the evidence for increased preterm delivery is insufficient; and, 3) there exists minimal evidence for decreased birth size. In further investigation of birth weight and size, we recommend incorporation of individual susceptibility measures using appropriate biomarkers, with collection timed to windows of vulnerability and speciated arsenic analysis, as well as consideration of populations exposed primarily to drinking water iAs contamination <10 μg/L. Given the large potential public health impact, additional, high quality epidemiologic studies are necessary to more definitively assess the risk. PMID:24713268

Maternal arsenic exposure and birth outcomes: a comprehensive review of the epidemiologic literature focused on drinking water.

PubMed

Bloom, Michael S; Surdu, Simona; Neamtiu, Iulia A; Gurzau, Eugen S

2014-09-01

Inorganic arsenic (iAs) is a human toxicant to which populations may be exposed through consumption of geogenically contaminated groundwater. A growing body of experimental literature corroborates the reproductive toxicity of iAs; however, the results of human studies are inconsistent. Therefore, we conducted a comprehensive review of epidemiologic studies focused on drinking water iAs exposure and birth outcomes to assess the evidence for causality and to make recommendations for future study. We reviewed 18 English language papers assessing birth weight, gestational age, and birth size. Thirteen of the studies were conducted among populations with frequent exposure to high-level groundwater iAs contamination (>10 μg/L) and five studies were conducted in areas without recognized contamination. Most studies comprised small samples and used cross-sectional designs, often with ecologic exposure assessment strategies, although several large prospective investigations and studies with individual-level measurements were also reported. We conclude that: (1) the epidemiologic evidence for an increased risk of low birth weight (<2500 g) is insufficient, although there exists limited evidence for birth weight decreases; (2) the evidence for increased preterm delivery is insufficient; and, (3) there exists minimal evidence for decreased birth size. In further investigation of birth weight and size, we recommend incorporation of individual susceptibility measures using appropriate biomarkers, with collection timed to windows of vulnerability and speciated arsenic analysis, as well as consideration of populations exposed primarily to drinking water iAs contamination <10 μg/L. Given the large potential public health impact, additional, high quality epidemiologic studies are necessary to more definitively assess the risk. Copyright © 2014 Elsevier GmbH. All rights reserved.

Genomic Epidemiology of Tuberculosis.

PubMed

Comas, Iñaki

2017-01-01

The application of next generation sequencing technologies has opened the door to a new molecular epidemiology of tuberculosis, in which we can now look at transmission at a resolution not possible before. At the same time, new technical and analytical challenges have appeared, and we are still exploring the wider potential of this new technology. Whole genome sequencing in tuberculosis still requires bacterial cultures. Thus, although whole genome sequencing has revolutionized the interpretation of transmission patterns, it is not yet ready to be applied at the point-of-care. In this chapter, I will review the promises and challenges of genomic epidemiology, as well as some of the new questions that have arisen from the use of this new technology. In addition, I will examine the role of molecular epidemiology within the general frame of global tuberculosis control and how genomic epidemiology can contribute towards the elimination of the disease.

Epidemiology as discourse: the politics of development institutions in the Epidemiological Profile of El Salvador

PubMed Central

Aviles, L

2001-01-01

STUDY OBJECTIVE—To determine the ways in which institutions devoted to international development influence epidemiological studies.
DESIGN—This article takes a descriptive epidemiological study of El Salvador, Epidemiological Profile, conducted in 1994 by the US Agency for International Development, as a case study. The methods include discourse analysis in order to uncover the ideological basis of the report and its characteristics as a discourse of development.
SETTING—El Salvador.
RESULTS—The Epidemiological Profile theoretical basis, the epidemiological transition theory, embodies the ethnocentrism of a "colonizer's model of the world." This report follows the logic of a discourse of development by depoliticising development, creating abnormalities, and relying on the development consulting industry. The epidemiological transition theory serves as an ideology that legitimises and dissimulates the international order.
CONCLUSIONS—Even descriptive epidemiological assessments or epidemiological profiles are imbued with theoretical assumptions shaped by the institutional setting under which epidemiological investigations are conducted.


Keywords: El Salvador; politics PMID:11160170

Effects of radiation exposure from cardiac imaging: how good are the data?

PubMed

Einstein, Andrew J

2012-02-07

Concerns about medical exposure to ionizing radiation have become heightened in recent years as a result of rapid growth in procedure volumes and the high radiation doses incurred from some procedures. This paper summarizes the evidence base undergirding concerns about radiation exposure in cardiac imaging. After classifying radiation effects, explaining terminology used to quantify the radiation received by patients, and describing typical doses from cardiac imaging procedures, this paper will address the major epidemiological studies having bearing on radiation effects at doses comparable to those received by patients undergoing cardiac imaging. These include studies of atomic bomb survivors, nuclear industry workers, and children exposed in utero to x-rays, all of which have evidenced increased cancer risks at low doses. Additional higher-dose epidemiological studies of cohorts exposed to radiation in the context of medical treatment are described and found to be generally compatible with these cardiac dose-level studies, albeit with exceptions. Using risk projection models developed by the U.S. National Academies that incorporate these data and reflect several evidence-based assumptions, cancer risk from cardiac imaging can be estimated and compared with the benefits from imaging. Several ongoing epidemiological studies will provide better understanding of radiation-associated cancer risks. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Mind the Scales: Harnessing Spatial Big Data for Infectious Disease Surveillance and Inference.

PubMed

Lee, Elizabeth C; Asher, Jason M; Goldlust, Sandra; Kraemer, John D; Lawson, Andrew B; Bansal, Shweta

2016-12-01

Spatial big data have the velocity, volume, and variety of big data sources and contain additional geographic information. Digital data sources, such as medical claims, mobile phone call data records, and geographically tagged tweets, have entered infectious diseases epidemiology as novel sources of data to complement traditional infectious disease surveillance. In this work, we provide examples of how spatial big data have been used thus far in epidemiological analyses and describe opportunities for these sources to improve disease-mitigation strategies and public health coordination. In addition, we consider the technical, practical, and ethical challenges with the use of spatial big data in infectious disease surveillance and inference. Finally, we discuss the implications of the rising use of spatial big data in epidemiology to health risk communication, and public health policy recommendations and coordination across scales. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

The Molecular and Spatial Epidemiology of Typhoid Fever in Rural Cambodia.

PubMed

Pham Thanh, Duy; Thompson, Corinne N; Rabaa, Maia A; Sona, Soeng; Sopheary, Sun; Kumar, Varun; Moore, Catrin; Tran Vu Thieu, Nga; Wijedoru, Lalith; Holt, Kathryn E; Wong, Vanessa; Pickard, Derek; Thwaites, Guy E; Day, Nicholas; Dougan, Gordon; Turner, Paul; Parry, Christopher M; Baker, Stephen

2016-06-01

Typhoid fever, caused by the bacterium Salmonella Typhi, is an endemic cause of febrile disease in Cambodia. The aim of this study was to better understand the epidemiology of pediatric typhoid fever in Cambodia. We accessed routine blood culture data from Angkor Hospital for Children (AHC) in Siem Reap province between 2007 and 2014, and performed whole genome sequencing (WGS) on the isolated bacteria to characterize the S. Typhi population. The resulting phylogenetic information was combined with conventional epidemiological approaches to investigate the spatiotemporal distribution of S. Typhi and population-level risk factors for reported disease. During the study period, there were 262 cases of typhoid within a 100 km radius of AHC, with a median patient age of 8.2 years (IQR: 5.1-11.5 years). The majority of infections occurred during the rainy season, and commune incidences as high as 11.36/1,000 in children aged <15 years were observed over the study period. A population-based risk factor analysis found that access to water within households and increasing distance from Tonle Sap Lake were protective. Spatial mapping and WGS provided additional resolution for these findings, and confirmed that proximity to the lake was associated with discrete spatiotemporal disease clusters. We confirmed the dominance of MDR H58 S. Typhi in this population, and found substantial evidence of diversification (at least seven sublineages) within this single lineage. We conclude that there is a substantial burden of pediatric typhoid fever in rural communes in Cambodia. Our data provide a platform for additional population-based typhoid fever studies in this location, and suggest that this would be a suitable setting in which to introduce a school-based vaccination programme with Vi conjugate vaccines.

The Molecular and Spatial Epidemiology of Typhoid Fever in Rural Cambodia

PubMed Central

Rabaa, Maia A; Sona, Soeng; Sopheary, Sun; Kumar, Varun; Moore, Catrin; Tran Vu Thieu, Nga; Wijedoru, Lalith; Holt, Kathryn E.; Wong, Vanessa; Pickard, Derek; Thwaites, Guy E.; Day, Nicholas; Dougan, Gordon; Turner, Paul; Parry, Christopher M.; Baker, Stephen

2016-01-01

Typhoid fever, caused by the bacterium Salmonella Typhi, is an endemic cause of febrile disease in Cambodia. The aim of this study was to better understand the epidemiology of pediatric typhoid fever in Cambodia. We accessed routine blood culture data from Angkor Hospital for Children (AHC) in Siem Reap province between 2007 and 2014, and performed whole genome sequencing (WGS) on the isolated bacteria to characterize the S. Typhi population. The resulting phylogenetic information was combined with conventional epidemiological approaches to investigate the spatiotemporal distribution of S. Typhi and population-level risk factors for reported disease. During the study period, there were 262 cases of typhoid within a 100 km radius of AHC, with a median patient age of 8.2 years (IQR: 5.1–11.5 years). The majority of infections occurred during the rainy season, and commune incidences as high as 11.36/1,000 in children aged <15 years were observed over the study period. A population-based risk factor analysis found that access to water within households and increasing distance from Tonle Sap Lake were protective. Spatial mapping and WGS provided additional resolution for these findings, and confirmed that proximity to the lake was associated with discrete spatiotemporal disease clusters. We confirmed the dominance of MDR H58 S. Typhi in this population, and found substantial evidence of diversification (at least seven sublineages) within this single lineage. We conclude that there is a substantial burden of pediatric typhoid fever in rural communes in Cambodia. Our data provide a platform for additional population-based typhoid fever studies in this location, and suggest that this would be a suitable setting in which to introduce a school-based vaccination programme with Vi conjugate vaccines. PMID:27331909

NASA Remote Sensing Data for Epidemiological Studies

NASA Technical Reports Server (NTRS)

Maynard, Nancy G.; Vicente, G. A.

2002-01-01

In response to the need for improved observations of environmental factors to better understand the links between human health and the environment, NASA has established a new program to significantly improve the utilization of NASA's diverse array of data, information, and observations of the Earth for health applications. This initiative, lead by Goddard Space Flight Center (GSFC) has the following goals: (1) To encourage interdisciplinary research on the relationships between environmental parameters (e.g., rainfall, vegetation) and health, (2) Develop practical early warning systems, (3) Create a unique system for the exchange of Earth science and health data, (4) Provide an investigator field support system for customers and partners, (5) Facilitate a system for observation, identification, and surveillance of parameters relevant to environment and health issues. The NASA Environment and Health Program is conducting several interdisciplinary projects to examine applications of remote sensing data and information to a variety of health issues, including studies on malaria, Rift Valley Fever, St. Louis Encephalitis, Dengue Fever, Ebola, African Dust and health, meningitis, asthma, and filariasis. In addition, the NASA program is creating a user-friendly data system to help provide the public health community with easy and timely access to space-based environmental data for epidemiological studies. This NASA data system is being designed to bring land, atmosphere, water and ocean satellite data/products to users not familiar with satellite data/products, but who are knowledgeable in the Geographic Information Systems (GIS) environment. This paper discusses the most recent results of the interdisciplinary environment-health research projects and provides an analysis of the usefulness of the satellite data to epidemiological studies. In addition, there will be a summary of presently-available NASA Earth science data and a description of how it may be obtained.

Homozygous familial hypercholesterolemia (HoFH) in Germany: an epidemiological survey.

PubMed

Walzer, S; Travers, K; Rieder, S; Erazo-Fischer, E; Matusiewicz, D

2013-01-01

In Europe a disease is recognized as rare if less than 1 in 2000 people suffer from the specific disease. In patients with familial homozygous hypercholesterolemia (HoFH) the accumulation of low-density lipoprotein cholesterol (LDL-C) leads to generalized atherosclerosis due to an insufficient functioning of the LDL-C receptors. Patients die early sometimes even in the mid-30s, from myocardial infarction or stroke. For the German population, insufficient epidemiological evidence exists. A systematic literature search in EMBASE and Medline was performed in conjunction with a targeted manual search for epidemiological HoFH studies. Additionally a nationwide survey was conducted in Germany in all identified apheresis- and lipid centers. The purpose of the survey was the validation of the systematic literature search results based on empirical (practice) data. In total 961 publications were found, 874 were excluded based on pre-defined exclusion criteria leaving only 87 for further review. After review of the identified abstracts (n = 87) 23 publications were identified as epidemiological studies. Only one publication was found which reported a prevalence of 1:1,000,000. The qualitative survey among 187 physicians in Germany also revealed a low prevalence: 95 HoFH patients were identified in 35 centers. The estimated frequency of homozygous familial hypercholesterolemia patients in Germany is around 95 (1:860,000) and the disease should be recognized as rare according to the definition of the European Medical Agency.

The epidemiological information system of the French national electricity and gas company: the SI-EPI project.

PubMed

Goldberg, M; Chevalier, A; Imbernon, E; Coing, F; Pons, H

1996-01-01

SI-EPI is epidemiological information system set up in 1978 in the national electricity and gas company, Electricité de France-Gaz de France (EDF-GDF). The worker population comprises about 150,000 individuals, involved in production, transmission and distribution of energy. SI-EPI was developed by the epidemiologists of the Occupational Health Department (180 physicians), and of the Sécurité Sociale Department (120 physicians). Several data bases constitute SI-EPI. The population data base contains demographic, socioeconomic and professional data about each worker. The health data base is an exhaustive register of sick leave, accidents, permanent disabilities, compensated diseases, causes of death and cancer incidence among active workers. The Occupational Exposure and Working Conditions data base includes the MATEX job-exposure matrix (30 potentially carcinogenic agents) and FINDEX files which record data obtained from the systematic individual surveillance of workers. The GAZEL cohort data base concerns a sample of more than 20,000 volunteer workers, followed since 1989; in addition to data from the data bases, it contains information collected from other different sources, including self-questionnaires. Numerous epidemiological studies based on SI-EPI data have been conducted by in-house epidemiologists as well as by external research groups. They include mortality and morbidity studies and address various topics and health problems. Their results are used for internal information, as well as for epidemiological research purposes.

Epidemiology for the nuclear medicine technologist.

PubMed

Bolus, N E

2001-09-01

The purpose of this article is to introduce the nuclear medicine technologist to the field of epidemiology. There are many applications of epidemiology in nuclear medicine, including research studies that deal with the causes of disease or ways to prevent disease from occurring and investigating the possible effects of ionizing radiation on occupational workers and the general public. One use of an epidemiologic study is to suggest ways to reduce the occurrence of a disease. After reading this article, the nuclear medicine technologist will be familiar with: a) the history and underlying assumptions of epidemiology, b) types of epidemiologic studies, c) what is a valid statistical association for an epidemiologic study, d) proper judgment of cause and effect relationships, e) definitions of epidemiologic terms, and f) an example of a nuclear medicine research study.

Double jeopardy: interaction effects of marital and poverty status on the risk of mortality.

PubMed

Smith, K R; Waitzman, N J

1994-08-01

The purpose of this paper is to examine the hypothesis that marital and poverty status interact in their effects on mortality risks beyond their main effects. This study examines the epidemiological bases for applying an additive rather than a multiplicative specification when testing for interaction between two discrete risk factors. We specifically predict that risks associated with being nonmarried and with being poor interact to produce mortality risks that are greater than each risk acting independently. The analysis is based on men and women who were ages 25-74 during the 1971-1975 National Health and Nutrition Examination Survey I (NHANES I) and who were traced successfully in the NHANES I Epidemiologic Follow-Up Study in 1982-1984. Overall, being both poor and nonmarried places nonelderly (ages 25-64) men, but not women, at risk of mortality greater than that expected from the main effects. This study shows that for all-cause mortality, marital and poverty status interact for men but less so for women; these findings exist when interaction is assessed with either a multiplicative or an additive standard. This difference is most pronounced for poor, widowed men and (to a lesser degree) poor, divorced men. For violent/accidental deaths among men, the interaction effects are large on the basis of an additive model. Weak main and interaction effects were detected for the elderly (age 65+).

Interview with Alexander Cohen.

PubMed

Cohen, Alexander Ander

2017-05-01

Ander Cohen speaks to Adam Price-Evans, Commissioning Editor of Future Cardiology: Alexander (Ander) Cohen MBBS (Hons), MSc, MD, FRACP is a vascular physician and epidemiologist at Guy's and St Thomas' Hospital, King's College (London, UK). He graduated with honors in medicine and honors in surgery from the University of Melbourne, Australia, and became a fellow of the Royal Australasian College of Physicians in 1990. He was awarded an MSc in Epidemiology from the London School of Hygiene and Tropical Medicine, University of London in 1991 with a thesis on the metabolic syndrome in South-Asian populations. In 1998, he was awarded an MD with a thesis on the epidemiology of venous thromboembolism and thromboprophylaxis. In addition to his clinical work, he is involved in designing, managing and analyzing clinical trials from Phase I to IV. He is the Chairman and a member of many international steering committees for multicenter trials, epidemiological and pharmacoeconomic studies, and was previously the Director of Clinical Research and an Epidemiologist in Thrombosis Research at King's College Hospital.

Degradability of creatinine under sewer conditions affects its potential to be used as biomarker in sewage epidemiology.

PubMed

Thai, Phong K; O'Brien, Jake; Jiang, Guangming; Gernjak, Wolfgang; Yuan, Zhiguo; Eaglesham, Geoff; Mueller, Jochen F

2014-05-15

Creatinine was proposed to be used as a population normalising factor in sewage epidemiology but its stability in the sewer system has not been assessed. This study thus aimed to evaluate the fate of creatinine under different sewer conditions using laboratory sewer reactors. The results showed that while creatinine was stable in wastewater only, it degraded quickly in reactors with the presence of sewer biofilms. The degradation followed first order kinetics with significantly higher rate in rising main condition than in gravity sewer condition. Additionally, daily loads of creatinine were determined in wastewater samples collected on Census day from 10 wastewater treatment plants around Australia. The measured loads of creatinine from those samples were much lower than expected and did not correlate with the populations across the sampled treatment plants. The results suggested that creatinine may not be a suitable biomarker for population normalisation purpose in sewage epidemiology, especially in sewer catchment with high percentage of rising mains. Copyright © 2014 Elsevier Ltd. All rights reserved.

Comparison of normal tissue dose calculation methods for epidemiological studies of radiotherapy patients.

PubMed

Mille, Matthew M; Jung, Jae Won; Lee, Choonik; Kuzmin, Gleb A; Lee, Choonsik

2018-06-01

Radiation dosimetry is an essential input for epidemiological studies of radiotherapy patients aimed at quantifying the dose-response relationship of late-term morbidity and mortality. Individualised organ dose must be estimated for all tissues of interest located in-field, near-field, or out-of-field. Whereas conventional measurement approaches are limited to points in water or anthropomorphic phantoms, computational approaches using patient images or human phantoms offer greater flexibility and can provide more detailed three-dimensional dose information. In the current study, we systematically compared four different dose calculation algorithms so that dosimetrists and epidemiologists can better understand the advantages and limitations of the various approaches at their disposal. The four dose calculations algorithms considered were as follows: the (1) Analytical Anisotropic Algorithm (AAA) and (2) Acuros XB algorithm (Acuros XB), as implemented in the Eclipse treatment planning system (TPS); (3) a Monte Carlo radiation transport code, EGSnrc; and (4) an accelerated Monte Carlo code, the x-ray Voxel Monte Carlo (XVMC). The four algorithms were compared in terms of their accuracy and appropriateness in the context of dose reconstruction for epidemiological investigations. Accuracy in peripheral dose was evaluated first by benchmarking the calculated dose profiles against measurements in a homogeneous water phantom. Additional simulations in a heterogeneous cylinder phantom evaluated the performance of the algorithms in the presence of tissue heterogeneity. In general, we found that the algorithms contained within the commercial TPS (AAA and Acuros XB) were fast and accurate in-field or near-field, but not acceptable out-of-field. Therefore, the TPS is best suited for epidemiological studies involving large cohorts and where the organs of interest are located in-field or partially in-field. The EGSnrc and XVMC codes showed excellent agreement with measurements both in-field and out-of-field. The EGSnrc code was the most accurate dosimetry approach, but was too slow to be used for large-scale epidemiological cohorts. The XVMC code showed similar accuracy to EGSnrc, but was significantly faster, and thus epidemiological applications seem feasible, especially when the organs of interest reside far away from the field edge.

A systematic critical review of epidemiological studies on public health concerns of municipal solid waste handling.

PubMed

Ncube, France; Ncube, Esper Jacobeth; Voyi, Kuku

2017-03-01

The ultimate aim of this review was to summarise the epidemiological evidence on the association between municipal solid waste management operations and health risks to populations residing near landfills and incinerators, waste workers and recyclers. To accomplish this, the sub-aims of this review article were to (1) examine the health risks posed by municipal solid waste management activities, (2) determine the strengths and gaps of available literature on health risks from municipal waste management operations and (3) suggest possible research needs for future studies. The article reviewed epidemiological literature on public health concerns of municipal solid waste handling published in the period 1995-2014. The PubMed and MEDLINE computerised literature searches were employed to identify the relevant papers using the keywords solid waste, waste management, health risks, recycling, landfills and incinerators. Additionally, all references of potential papers were examined to determine more articles that met the inclusion criteria. A total of 379 papers were identified, but after intensive screening only 72 met the inclusion criteria and were reviewed. Of these studies, 33 were on adverse health effects in communities living near waste dumpsites or incinerators, 24 on municipal solid waste workers and 15 on informal waste recyclers. Reviewed studies were unable to demonstrate a causal or non-causal relationship due to various limitations. In light of the above findings, our review concludes that overall epidemiological evidence in reviewed articles is inadequate mainly due to methodological limitations and future research needs to develop tools capable of demonstrating causal or non-causal relationships between specific waste management operations and adverse health endpoints.

Epidemiology of periodontal diseases in Indian population since last decade

PubMed Central

Chandra, Anuja; Yadav, Om Prakash; Narula, Sugandha; Dutta, Angel

2016-01-01

Objective: India suffers lot of disparities in terms of oral health care and 95% of the Indian population suffers from periodontal disease. The aim of this review is to estimate the risk factors responsible for periodontal diseases as well as prevalence for the same in the last decade to make an attempt to develop a strategy to improve formulation of an effective oral health care policy in India. Materials and Methods: Keywords such as “prevalence of periodontal diseases,” “epidemiology,” “periodontitis in India,” and “oral hygiene status in India” were searched for appropriate studies to obtain a bibliographic database. The references of selected articles and relevant reviews were searched for any missed publications that included studies conducted in India estimating periodontal diseases with adequate sample size. Clinical parameters, sample size, and findings for each study were tabulated from 2006 to 2015 (till September 15, 2015) in chronological order to observe the prevalence as well as epidemiology of periodontal disease in India. Results: The projection of periodontal disease is disturbing. In addition, the majority of studies done have used the Community Periodontal Index of Treatment Needs (CPITN) as its epidemiological tool that can grossly underestimate the presence of deep pockets. Conclusion: Current knowledge has shown that periodontitis does not present a linear progression and is not age-dependent. Moreover, its distribution and severity are strongly influenced by host susceptibility and risk factors. A structured all-inclusive survey of all districts of the states is a prerequisite for the constitution of an apt and cogent health care policy in our country. PMID:27114945

Gene-Environment Interactions in Schizophrenia: Review of Epidemiological Findings and Future Directions

PubMed Central

van Os, Jim; Rutten, Bart PF; Poulton, Richie

2008-01-01

Concern is building about high rates of schizophrenia in large cities, and among immigrants, cannabis users, and traumatized individuals, some of which likely reflects the causal influence of environmental exposures. This, in combination with very slow progress in the area of molecular genetics, has generated interest in more complicated models of schizophrenia etiology that explicitly posit gene-environment interactions (EU-GEI. European Network of Schizophrenia Networks for the Study of Gene Environment Interactions. Schizophrenia aetiology: do gene-environment interactions hold the key? [published online ahead of print April 25, 2008] Schizophr Res; S0920-9964(08) 00170–9). Although findings of epidemiological gene-environment interaction (G × E) studies are suggestive of widespread gene-environment interactions in the etiology of schizophrenia, numerous challenges remain. For example, attempts to identify gene-environment interactions cannot be equated with molecular genetic studies with a few putative environmental variables “thrown in”: G × E is a multidisciplinary exercise involving epidemiology, psychology, psychiatry, neuroscience, neuroimaging, pharmacology, biostatistics, and genetics. Epidemiological G × E studies using indirect measures of genetic risk in genetically sensitive designs have the advantage that they are able to model the net, albeit nonspecific, genetic load. In studies using direct molecular measures of genetic variation, a hypothesis-driven approach postulating synergistic effects between genes and environment impacting on a final common pathway, such as “sensitization” of mesolimbic dopamine neurotransmission, while simplistic, may provide initial focus and protection against the numerous false-positive and false-negative results that these investigations engender. Experimental ecogenetic approaches with randomized assignment may help to overcome some of the limitations of observational studies and allow for the additional elucidation of underlying mechanisms using a combination of functional enviromics and functional genomics. PMID:18791076

Recruitment and Participation of Recreational Runners in a Large Epidemiological and Genetic Research Study: Retrospective Data Analysis

PubMed Central

Manzanero, Silvia; Kozlovskaia, Maria; Vlahovich, Nicole

2018-01-01

Background With the increasing capacity for remote collection of both data and samples for medical research, a thorough assessment is needed to determine the association of population characteristics and recruitment methodologies with response rates. Objective The aim of this research was to assess population representativeness in a two-stage study of health and injury in recreational runners, which consisted of an epidemiological arm and genetic analysis. Methods The cost and success of various classical and internet-based methods were analyzed, and demographic representativeness was assessed for recruitment to the epidemiological survey, reported willingness to participate in the genetic arm of the study, actual participation, sample return, and approval for biobank storage. Results A total of 4965 valid responses were received, of which 1664 were deemed eligible for genetic analysis. Younger age showed a negative association with initial recruitment rate, expressed willingness to participate in genetic analysis, and actual participation. Additionally, female sex was associated with higher initial recruitment rates, and ethnic origin impacted willingness to participate in the genetic analysis (all P<.001). Conclusions The sharp decline in retention through the different stages of the study in young respondents suggests the necessity to develop specific recruitment and retention strategies when investigating a young, physically active population. PMID:29792293

10 CFR 602.5 - Epidemiology and Other Health Studies Financial Assistance Program.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Epidemiology and Other Health Studies Financial Assistance... AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.5 Epidemiology and Other Health Studies... toxic substances; (5) Epidemiology and other health studies relating to energy production, transmission...

10 CFR 602.5 - Epidemiology and Other Health Studies Financial Assistance Program.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Epidemiology and Other Health Studies Financial Assistance... AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.5 Epidemiology and Other Health Studies... toxic substances; (5) Epidemiology and other health studies relating to energy production, transmission...

10 CFR 602.5 - Epidemiology and Other Health Studies Financial Assistance Program.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Epidemiology and Other Health Studies Financial Assistance... AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.5 Epidemiology and Other Health Studies... toxic substances; (5) Epidemiology and other health studies relating to energy production, transmission...

10 CFR 602.5 - Epidemiology and Other Health Studies Financial Assistance Program.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Epidemiology and Other Health Studies Financial Assistance... AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.5 Epidemiology and Other Health Studies... toxic substances; (5) Epidemiology and other health studies relating to energy production, transmission...

Artificial Sweeteners: A systematic review of metabolic effects in youth

PubMed Central

Brown, Rebecca J.; De Banate, Mary Ann; Rother, Kristina I.

2010-01-01

Epidemiological data have demonstrated an association between artificial sweetener use and weight gain. Evidence of a causal relationship linking artificial sweetener use to weight gain and other metabolic health effects is limited. However, recent animal studies provide intriguing information that supports an active metabolic role of artificial sweeteners. This systematic review examines the current literature on artificial sweetener consumption in children and its health effects. Eighteen studies were identified. Data from large, epidemiologic studies support the existence of an association between artificially-sweetened beverage consumption and weight gain in children. Randomized controlled trials in children are very limited, and do not clearly demonstrate either beneficial or adverse metabolic effects of artificial sweeteners. Presently, there is no strong clinical evidence for causality regarding artificial sweetener use and metabolic health effects, but it is important to examine possible contributions of these common food additives to the global rise in pediatric obesity and diabetes. PMID:20078374

Artificial sweeteners: a systematic review of metabolic effects in youth.

PubMed

Brown, Rebecca J; de Banate, Mary Ann; Rother, Kristina I

2010-08-01

Epidemiological data have demonstrated an association between artificial sweetener use and weight gain. Evidence of a causal relationship linking artificial sweetener use to weight gain and other metabolic health effects is limited. However, recent animal studies provide intriguing information that supports an active metabolic role of artificial sweeteners. This systematic review examines the current literature on artificial sweetener consumption in children and its health effects. Eighteen studies were identified. Data from large, epidemiologic studies support the existence of an association between artificially-sweetened beverage consumption and weight gain in children. Randomized controlled trials in children are very limited, and do not clearly demonstrate either beneficial or adverse metabolic effects of artificial sweeteners. Presently, there is no strong clinical evidence for causality regarding artificial sweetener use and metabolic health effects, but it is important to examine possible contributions of these common food additives to the global rise in pediatric obesity and diabetes.

Salmonella diversity and burden in cows on and culled from dairy farms in the Texas High Plains

USDA-ARS?s Scientific Manuscript database

The objective of this study was to further characterize the epidemiology of Salmonella carried by dairy cows culled from herds in the Texas High Plains and marketed for human consumption. Feces were collected from 706 animals culled from a convenience sample of 9 dairies. In addition, individually...

Epidemiology: Informing Clinical Practice and Research on Language Disorders in Children.

ERIC Educational Resources Information Center

Lubker, Bobbie Boyd; Tomblin, J. Bruce

1998-01-01

Describes the discipline of epidemiology and the application of epidemiologic methods to the study of children's language disorders. Epidemiology is described as the study of the distributions and determinants of disease, disorders, disabilities, and desirable health events in populations. Common epidemiologic research designs are discussed.…

Case definition and classification of leukodystrophies and leukoencephalopathies.

PubMed

Vanderver, Adeline; Prust, Morgan; Tonduti, Davide; Mochel, Fanny; Hussey, Heather M; Helman, Guy; Garbern, James; Eichler, Florian; Labauge, Pierre; Aubourg, Patrick; Rodriguez, Diana; Patterson, Marc C; Van Hove, Johan L K; Schmidt, Johanna; Wolf, Nicole I; Boespflug-Tanguy, Odile; Schiffmann, Raphael; van der Knaap, Marjo S

2015-04-01

An approved definition of the term leukodystrophy does not currently exist. The lack of a precise case definition hampers efforts to study the epidemiology and the relevance of genetic white matter disorders to public health. Thirteen experts at multiple institutions participated in iterative consensus building surveys to achieve definition and classification of disorders as leukodystrophies using a modified Delphi approach. A case definition for the leukodystrophies was achieved, and a total of 30 disorders were classified under this definition. In addition, a separate set of disorders with heritable white matter abnormalities but not meeting criteria for leukodystrophy, due to presumed primary neuronal involvement and prominent systemic manifestations, was classified as genetic leukoencephalopathies (gLE). A case definition of leukodystrophies and classification of heritable white matter disorders will permit more detailed epidemiologic studies of these disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

19-VNTR loci used in genotyping Chinese clinical Mycobacterium tuberculosis complex strains and in association with spoligotyping.

PubMed

Jiang, Yi; Liu, Hai-can; Zheng, Huajun; Dou, Xiangfeng; Tang, Biao; Zhao, Xiu-qin; Zhu, Yongqiang; Lu, Bing; Wang, Shengyue; Dong, Hai-yan; Zhang, Yuan-yuan; Zhao, Guoping; Wan, Kanglin

2013-07-01

Recently, tandem repeat typing has emerged as a rapid and easy method for the molecular epidemiology of the Mycobacterium tuberculosis (M. tuberculosis) complex. In this study, a collection of 19 VNTRs incorporating 15 previously described loci and 4 newly evaluated markers were used to genotype 206 Chinese M. tuberculosis isolates and 9 BCG strains. The discriminatory power was evaluated and compared with that obtained by Spoligotyping. It turned out that 15-locus VNTR could be very useful in M. tuberculosis complex strains genotyping in China. The 4 newly evaluated loci were proved informative and could be useful for future epidemiology studies, especially in Beijing family strains. In addition, a unique pattern of the latter 4 loci were found in Chinese BCG strains. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

ADHD in the Arab World: A Review of Epidemiologic Studies

ERIC Educational Resources Information Center

Farah, Lynn G.; Fayyad, John A.; Eapen, Valsamma; Cassir,Youmna; Salamoun, Mariana M.; Tabet, Caroline C.; Mneimneh, Zeina N.; Karam, Elie G.

2009-01-01

Objective: Epidemiological studies on psychiatric disorders are quite rare in the Arab World. This article reviews epidemiological studies on ADHD in all the Arab countries. Method: All epidemiological studies on ADHD conducted from 1966 through th present were reviewed. Samples were drawn from the general community, primary care clinical…

An epidemiologic review of marijuana and cancer: an update

PubMed Central

Huang, Yu-Hui Jenny; Zhang, Zuo-Feng; Tashkin, Donald P.; Feng, Bingjian; Straif, Kurt; Hashibe, Mia

2014-01-01

Marijuana use is legal in two states and additional states are considering legalization. Approximately 18 million Americans are current marijuana users. There is currently no consensus on whether marijuana use is associated with cancer risk. Our objective is to review the epidemiologic studies on this possible association. We identified 34 epidemiologic studies on upper aerodigestive tract cancers (n=11), lung cancer (n=6), testicular cancer (n=3), childhood cancers (n=6), all cancers (n=1), anal cancer (n=1), penile cancer (n=1), non-Hodgkin's lymphoma (n=2), malignant primary gliomas(n=1), bladder cancer (n=1), and Kaposi's sarcoma (n=1). Studies on head and neck cancer reported increased and decreased risks, possibly because there is no association, or because risks differ by HPV status or geographic differences. The lung cancer studies largely appear not to support an association with marijuana use, possibly because of the smaller amounts of marijuana regularly smoked compared to tobacco. Three testicular cancer case-control studies reported increased risks with marijuana use (summary odds ratios 1.56 (95%CI=1.09-2.23) for higher frequency; 1.50 (95%=1.08-2.09) for ≥10 years). For other cancer sites, there is still insufficient data to make any conclusions. Considering that marijuana use may change due to legalization, well-designed studies on marijuana use and cancer are warranted. PMID:25587109

Are "further studies" really needed? If so, which ones?

PubMed

Olshan, Andrew F

2008-07-01

The association between residential radon exposure and the risk of childhood leukemia reported in this issue of Epidemiology may-or may not-justify further studies to confirm this finding. Such decisions could benefit from a more systematic approach than researchers ordinarily use. Furthermore, when considering the possibility of replication studies, epidemiologists need a new strategy-one that explores more explicitly the improvements and the additional study features that would be required to produce a more meaningful answer.

Systematic Review of the Exposure Assessment and Epidemiology of High-Frequency Voltage Transients

PubMed Central

de Vocht, Frank; Olsen, Robert G.

2016-01-01

Conclusions of epidemiological studies describing adverse health effects as a result of exposure to electromagnetic fields are not unanimous and often contradictory. It has been proposed that an explanation could be that high-frequency voltage transients [dirty electricity (DE)] which are superimposed on 50/60-Hz fields, but are generally not measured, are the real causal agent. DE has been linked to many different health and wellbeing effects, and on the basis of this, an industry selling measurement and filtering equipment is growing. We reviewed the available peer-reviewed evidence for DE as a causal agent for adverse human health effects. A literature search was performed in the Cochrane Library, PubMed, Web of Science, Google Scholar, and additional publications were obtained from reference lists and from the gray literature. This search resulted in 25 publications; 16 included primary epidemiological and/or exposure data. All studies were reviewed by both authors independently, and including a re-review of studies included in a review of data available up to July 31, 2009 by one of the authors. DE has been measured differently in different studies and comparison data are not available. There is no evidence for 50 Graham/Stetzer (GS) units as a safety threshold being anything more than arbitrary. The epidemiological evidence on human health effects of DE is primarily based on, often re-used, case descriptions. Quantitative evidence relies on self-reporting in non-blinded interventions, ecological associations, and one cross-sectional cohort study of cancer risk, which does not point to DE as the causal agent. The available evidence for DE as an exposure affecting human health at present does not stand up to scientific scrutiny. PMID:27066469

Subtype-independent near full-length HIV-1 genome sequencing and assembly to be used in large molecular epidemiological studies and clinical management.

PubMed

Grossmann, Sebastian; Nowak, Piotr; Neogi, Ujjwal

2015-01-01

HIV-1 near full-length genome (HIV-NFLG) sequencing from plasma is an attractive multidimensional tool to apply in large-scale population-based molecular epidemiological studies. It also enables genotypic resistance testing (GRT) for all drug target sites allowing effective intervention strategies for control and prevention in high-risk population groups. Thus, the main objective of this study was to develop a simplified subtype-independent, cost- and labour-efficient HIV-NFLG protocol that can be used in clinical management as well as in molecular epidemiological studies. Plasma samples (n=30) were obtained from HIV-1B (n=10), HIV-1C (n=10), CRF01_AE (n=5) and CRF01_AG (n=5) infected individuals with minimum viral load >1120 copies/ml. The amplification was performed with two large amplicons of 5.5 kb and 3.7 kb, sequenced with 17 primers to obtain HIV-NFLG. GRT was validated against ViroSeq™ HIV-1 Genotyping System. After excluding four plasma samples with low-quality RNA, a total of 26 samples were attempted. Among them, NFLG was obtained from 24 (92%) samples with the lowest viral load being 3000 copies/ml. High (>99%) concordance was observed between HIV-NFLG and ViroSeq™ when determining the drug resistance mutations (DRMs). The N384I connection mutation was additionally detected by NFLG in two samples. Our high efficiency subtype-independent HIV-NFLG is a simple and promising approach to be used in large-scale molecular epidemiological studies. It will facilitate the understanding of the HIV-1 pandemic population dynamics and outline effective intervention strategies. Furthermore, it can potentially be applicable in clinical management of drug resistance by evaluating DRMs against all available antiretrovirals in a single assay.

Development and application of Human Genome Epidemiology

NASA Astrophysics Data System (ADS)

Xu, Jingwen

2017-12-01

Epidemiology is a science that studies distribution of diseases and health in population and its influencing factors, it also studies how to prevent and cure disease and promote health strategies and measures. Epidemiology has developed rapidly in recent years and it is an intercross subject with various other disciplines to form a series of branch disciplines such as Genetic epidemiology, molecular epidemiology, drug epidemiology and tumor epidemiology. With the implementation and completion of Human Genome Project (HGP), Human Genome Epidemiology (HuGE) has emerged at this historic moment. In this review, the development of Human Genome Epidemiology, research content, the construction and structure of relevant network, research standards, as well as the existing results and problems are briefly outlined.

Integrating remote sensing and spatially explicit epidemiological modeling

NASA Astrophysics Data System (ADS)

Finger, Flavio; Knox, Allyn; Bertuzzo, Enrico; Mari, Lorenzo; Bompangue, Didier; Gatto, Marino; Rinaldo, Andrea

2015-04-01

Spatially explicit epidemiological models are a crucial tool for the prediction of epidemiological patterns in time and space as well as for the allocation of health care resources. In addition they can provide valuable information about epidemiological processes and allow for the identification of environmental drivers of the disease spread. Most epidemiological models rely on environmental data as inputs. They can either be measured in the field by the means of conventional instruments or using remote sensing techniques to measure suitable proxies of the variables of interest. The later benefit from several advantages over conventional methods, including data availability, which can be an issue especially in developing, and spatial as well as temporal resolution of the data, which is particularly crucial for spatially explicit models. Here we present the case study of a spatially explicit, semi-mechanistic model applied to recurring cholera outbreaks in the Lake Kivu area (Democratic Republic of the Congo). The model describes the cholera incidence in eight health zones on the shore of the lake. Remotely sensed datasets of chlorophyll a concentration in the lake, precipitation and indices of global climate anomalies are used as environmental drivers. Human mobility and its effect on the disease spread is also taken into account. Several model configurations are tested on a data set of reported cases. The best models, accounting for different environmental drivers, and selected using the Akaike information criterion, are formally compared via cross validation. The best performing model accounts for seasonality, El Niño Southern Oscillation, precipitation and human mobility.

Alzheimer’s disease is not “brain aging”: neuropathological, genetic, and epidemiological human studies

PubMed Central

Head, Elizabeth; Schmitt, Frederick A.; Davis, Paulina R.; Neltner, Janna H.; Jicha, Gregory A.; Abner, Erin L.; Smith, Charles D.; Van Eldik, Linda J.; Kryscio, Richard J.; Scheff, Stephen W.

2011-01-01

Human studies are reviewed concerning whether “aging”-related mechanisms contribute to Alzheimer’s disease (AD) pathogenesis. AD is defined by specific neuropathology: neuritic amyloid plaques and neocortical neurofibrillary tangles. AD pathology is driven by genetic factors related not to aging per se, but instead to the amyloid precursor protein (APP). In contrast to genes involved in APP-related mechanisms, there is no firm connection between genes implicated in human “accelerated aging” diseases (progerias) and AD. The epidemiology of AD in advanced age is highly relevant but deceptively challenging to address given the low autopsy rates in most countries. In extreme old age, brain diseases other than AD approximate AD prevalence while the impact of AD pathology appears to peak by age 95 and decline thereafter. Many distinct brain diseases other than AD afflict older human brains and contribute to cognitive impairment. Additional prevalent pathologies include cerebrovascular disease and hippocampal sclerosis, both high-morbidity brain diseases that appear to peak in incidence later than AD chronologically. Because of these common brain diseases of extreme old age, the epidemiology differs between clinical “dementia” and the subset of dementia cases with AD pathology. Additional aging-associated mechanisms for cognitive decline such as diabetes and synapse loss have been linked to AD and these hypotheses are discussed. Criteria are proposed to define an “aging-linked” disease, and AD fails all of these criteria. In conclusion, it may be most fruitful to focus attention on specific pathways involved in AD rather than attributing it to an inevitable consequence of aging. PMID:21516511

Health effects of carbon-containing particulate matter: focus on sources and recent research program results.

PubMed

Rohr, Annette; McDonald, Jacob

2016-02-01

Air pollution is a complex mixture of gas-, vapor-, and particulate-phase materials comprised of inorganic and organic species. Many of these components have been associated with adverse health effects in epidemiological and toxicological studies, including a broad spectrum of carbonaceous atmospheric components. This paper reviews recent literature on the health impacts of organic aerosols, with a focus on specific sources of organic material; it is not intended to be a comprehensive review of all the available literature. Specific emission sources reviewed include engine emissions, wood/biomass combustion emissions, biogenic emissions and secondary organic aerosol (SOA), resuspended road dust, tire and brake wear, and cooking emissions. In addition, recent findings from large toxicological and epidemiological research programs are reviewed in the context of organic PM, including SPHERES, NPACT, NERC, ACES, and TERESA. A review of the extant literature suggests that there are clear health impacts from emissions containing carbon-containing PM, but difficulty remains in apportioning responses to certain groupings of carbonaceous materials, such as organic and elemental carbon, condensed and gas phases, and primary and secondary material. More focused epidemiological and toxicological studies, including increased characterization of organic materials, would increase understanding of this issue.

Human leptospirosis in Croatia: current status of epidemiology and clinical characteristics.

PubMed

Topic, Mirjana Balen; Habus, Josipa; Milas, Zoran; Tosev, Elvira Celjuska; Stritof, Zrinka; Turk, Nenad

2010-03-01

This study presents the current status of human leptospirosis in Croatia from an epidemiological and clinical viewpoint. Data from annual reports of the Croatian Institute for Public Health as well as archives of the University Hospital for Infectious Diseases 'Dr Fran Mihaljevic' (UHID) in Zagreb were used in this retrospective cohort analysis. The mean yearly incidence of leptospirosis from 1990 to 2007 was 1.83/100 000 inhabitants, with an incidence >2.5/100 000 inhabitants recorded approximately every 3-4 years, making Croatia one of the countries with the highest incidence of human leptospirosis in Europe. In addition to the majority of sporadic cases, two minor outbreaks were recorded. The clinical burden and more detailed epidemiology of 130 patients hospitalised at UHID in the period 1997-2007 were also studied. Clinical presentations were as expected, with an overall case fatality rate (CFR) of 0.77%. The most commonly established infective serovars were Australis followed by Saxkoebing and Grippotyphosa. In comparison with previous periods, the mean yearly number of patients with leptospirosis hospitalised at UHID decreased, but among them a rather higher rate of patients with Weil's disease and a higher CFR was observed.

Performance of six diagnostic tests to screen for Chagas disease in blood banks andprevalence of Trypanosoma cruzi infection among donors with inconclusive serologyscreening based on the analysis of epidemiological variables.

PubMed

Pereira, Gilberto de Araujo; Louzada-Neto, Francisco; Barbosa, Valdirene de Fátima; Ferreira-Silva, Márcia Maria; de Moraes-Souza, Helio

2012-01-01

The frequent occurrence of inconclusive serology in blood banks and the absence of a gold standard test for Chagas'disease led us to examine the efficacy of the blood culture test and five commercial tests (ELISA, IIF, HAI, c-ELISA, rec-ELISA) used in screening blood donors for Chagas disease, as well as to investigate the prevalence of Trypanosoma cruzi infection among donors with inconclusive serology screening in respect to some epidemiological variables. To obtain estimates of interest we considered a Bayesian latent class model with inclusion of covariates from the logit link. A better performance was observed with some categories of epidemiological variables. In addition, all pairs of tests (excluding the blood culture test) presented as good alternatives for both screening (sensitivity > 99.96% in parallel testing) and for confirmation (specificity > 99.93% in serial testing) of Chagas disease. The prevalence of 13.30% observed in the stratum of donors with inconclusive serology, means that probably most of these are non-reactive serology. In addition, depending on the level of specific epidemiological variables, the absence of infection can be predicted with a probability of 100% in this group from the pairs of tests using parallel testing. The epidemiological variables can lead to improved test results and thus assist in the clarification of inconclusive serology screening results. Moreover, all combinations of pairs using the five commercial tests are good alternatives to confirm results.

History, epidemiology and diagnostics of dengue in the American and Brazilian contexts: a review.

PubMed

Salles, Tiago Souza; da Encarnação Sá-Guimarães, Thayane; de Alvarenga, Evelyn Seam Lima; Guimarães-Ribeiro, Victor; de Meneses, Marcelo Damião Ferreira; de Castro-Salles, Patricia Faria; Dos Santos, Carlucio Rocha; do Amaral Melo, Ana Claudia; Soares, Marcia Regina; Ferreira, Davis Fernandes; Moreira, Monica Ferreira

2018-04-24

Dengue virus (DENV), an arbovirus transmitted by mosquitoes, has become a major threat to American human life, reaching approximately 23 million cases from 1980 to 2017. Brazil is among the countries most affected by this terrible viral disease, with 13.6 million cases. DENV has four different serotypes, DENV1-4, which show a broad clinical spectrum. Dengue creates a staggering epidemiological and economic burden for endemic countries. Without a specific therapy and with a commercial vaccine that presents some problems relative to its full effectiveness, initiatives to improve vector control strategies, early disease diagnostics and the development of vaccines and antiviral drugs are priorities. In this study, we present the probable origins of dengue in America and the trajectories of its spread. Overall, dengue diagnostics are costly, making the monitoring of dengue epidemiology more difficult and affecting physicians' therapeutic decisions regarding dengue patients, especially in developing countries. This review also highlights some recent and important findings regarding dengue in Brazil and the Americas. We also summarize the existing DENV polymerase chain reaction (PCR) diagnostic tests to provide an improved reference since these tests are useful and accurate at discriminating DENV from other flaviviruses that co-circulate in the Americas. Additionally, these DENV PCR assays ensure virus serotyping, enabling epidemiologic monitoring.

Leishmaniasis Disease

MedlinePlus

... Leishmaniasis General Information Leishmaniasis FAQs Epidemiology & Risk Factors Biology Disease Diagnosis Treatment Prevention & Control Resources for Health Professionals Publications Additional Resources Get ...

Environmental Metals and Cardiovascular Disease in Adults: A Systematic Review beyond Lead and Cadmium

PubMed Central

Nigra, Anne E; Ruiz-Hernandez, Adrian; Redon, Josep; Navas-Acien, Ana; Tellez-Plaza, Maria

2018-01-01

Published systematic reviews concluded that there is moderate to strong evidence to infer a potential role of lead and cadmium, widespread metal exposures, as cardiovascular risk factors. For other non-essential metals, the evidence has not been appraised systematically. Our objective was to systematically review epidemiologic studies on the association between cardiovascular disease in adults and the environmental metals antimony, barium, chromium, nickel, tungsten, uranium, and vanadium. We identified a total of 4 articles on antimony, 1 on barium, 5 on chromium, 1 on nickel, 4 on tungsten, 1 on uranium and 0 on vanadium. We concluded that the current evidence is not sufficient to inform on the cardiovascular role of these metals because the small number of studies. Few experimental studies have also evaluated the role of these metals in cardiovascular outcomes. Additional epidemiologic and experimental studies, including prospective cohort studies, are needed to understand the role of metals, including exposure to metal mixtures, in cardiovascular disease development. PMID:27783356

Interpreting Epidemiological Evidence in the Presence of Multiple Endpoints: An Alternative Analytic Approach using the 9-Year Follow-up of the Seychelles Child Development Study

PubMed Central

van Wijngaarden, Edwin; Myers, Gary J.; Thurston, Sally W.; Shamlaye, Conrad F.; Davidson, Philip W.

2012-01-01

Purpose The potential for ill-informed causal inference is a major concern in published longitudinal studies evaluating impaired neurological function in children prenatally exposed to background levels of methyl mercury (MeHg). These studies evaluate a large number of developmental tests. We propose an alternative analysis strategy that reduces the number of comparisons tested in these studies. Methods Using data from the 9-year follow-up of 643 children in the Seychelles Child Development Study (SCDS), we grouped 18 individual endpoints into one overall ordinal outcome variable as well as by developmental domains. Subsequently, ordinal logistic regression analyses were performed. Results We did not find an association between prenatal MeHg exposure and developmental outcomes at 9 years of age. Conclusion Our proposed framework is more likely to result in a balanced interpretation of a posteriori associations. In addition, this new strategy should facilitate the use of complex epidemiological data in quantitative risk assessment. PMID:19205720

Interpreting epidemiological evidence in the presence of multiple endpoints: an alternative analytic approach using the 9-year follow-up of the Seychelles child development study.

PubMed

van Wijngaarden, Edwin; Myers, Gary J; Thurston, Sally W; Shamlaye, Conrad F; Davidson, Philip W

2009-08-01

The potential for ill-informed causal inference is a major concern in published longitudinal studies evaluating impaired neurological function in children prenatally exposed to background levels of methyl mercury (MeHg). These studies evaluate a large number of developmental tests. We propose an alternative analysis strategy that reduces the number of comparisons tested in these studies. Using data from the 9-year follow-up of 643 children in the Seychelles child development study, we grouped 18 individual endpoints into one overall ordinal outcome variable as well as by developmental domains. Subsequently, ordinal logistic regression analyses were performed. We did not find an association between prenatal MeHg exposure and developmental outcomes at 9 years of age. Our proposed framework is more likely to result in a balanced interpretation of a posteriori associations. In addition, this new strategy should facilitate the use of complex epidemiological data in quantitative risk assessment.

Guidelines for Good Epidemiology Practices for Occupational and Environmental Epidemiologic Research. The Chemical Manufacturers Association's Epidemiology Task Group.

PubMed

1991-12-01

The Guidelines for Good Epidemiology Practices (GEPs) for Occupational and Environmental Epidemiologic Research address the conduct of studies generally undertaken to answer questions about human health in relationship to the work place or the environment. The GEPs propose minimum practices and procedures that should be considered to help ensure the quality and integrity of data used in epidemiologic research and to provide adequate documentation of the research methods. The GEPs address the process of conducting individual epidemiologic studies and do not prescribe specific research methods. The Guidelines for Good Epidemiology Practices propose minimum practices and procedures in the following areas: I. Organization and Personnel II. Facilities, Resource Commitment, and Contractors III. Protocol IV. Review and Approval V. Study Conduct VI. Communication VII. Archiving VIII. Quality Assurance Although the Guidelines for Good Epidemiology Practices will not guarantee good epidemiology, they do provide a useful framework for ensuring that all research issues are adequately addressed. This framework is proposed as a first step in improving epidemiologic research practices through adherence to sound scientific research principles. Appendices provide an overview of standard operating procedures, a glossary of terms used in the Guidelines, and suggested references on occupational epidemiology methods.

Learning styles and preferences for live and distance education: an example of a specialisation course in epidemiology.

PubMed

Groenwold, Rolf H H; Knol, Mirjam J

2013-07-02

Distance learning through the internet is increasingly popular in higher education. However, it is unknown how participants in epidemiology courses value live vs. distance education. All participants of a 5-day specialisation course in epidemiology were asked to keep a diary on the number of hours they spent on course activities (both live and distance education). Attendance was not compulsory during the course and participants were therefore also asked for the reasons to attend live education (lectures and practicals). In addition, the relation between participants' learning styles (Index of Learning Styles) and their participation in live and distance education was studied. All 54 (100%) participants in the course completed the questionnaire on attendance and 46 (85%) completed the questionnaire on learning styles. The number of hours attending live education was negatively correlated with the number of hours going studying distance learning materials (Pearson correlation -0.5; p < 0.001). The most important reasons to attend live education was to stay focused during lectures (50%), and to ask questions during practicals (50%). A lack of time was the most important reason not to attend lectures (52%) or practicals (61%). Learning styles were not association with the number of hours spent on live or distance education. Distance learning may play an important role in epidemiology courses, since it allows participants to study whenever and wherever they prefer, which provides the opportunity to combine courses with clinical duties. An important requirement for distance learning education appears to be the possibility to ask questions and to interact with instructors.

Methodological considerations in observational comparative effectiveness research for implantable medical devices: an epidemiologic perspective.

PubMed

Jalbert, Jessica J; Ritchey, Mary Elizabeth; Mi, Xiaojuan; Chen, Chih-Ying; Hammill, Bradley G; Curtis, Lesley H; Setoguchi, Soko

2014-11-01

Medical devices play a vital role in diagnosing, treating, and preventing diseases and are an integral part of the health-care system. Many devices, including implantable medical devices, enter the market through a regulatory pathway that was not designed to assure safety and effectiveness. Several recent studies and high-profile device recalls have demonstrated the need for well-designed, valid postmarketing studies of medical devices. Medical device epidemiology is a relatively new field compared with pharmacoepidemiology, which for decades has been developed to assess the safety and effectiveness of medications. Many methodological considerations in pharmacoepidemiology apply to medical device epidemiology. Fundamental differences in mechanisms of action and use and in how exposure data are captured mean that comparative effectiveness studies of medical devices often necessitate additional and different considerations. In this paper, we discuss some of the most salient issues encountered in conducting comparative effectiveness research on implantable devices. We discuss special methodological considerations regarding the use of data sources, exposure and outcome definitions, timing of exposure, and sources of bias. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Characteristics of psoriasis in Greece: an epidemiological study of a population in a sunny Mediterranean climate.

PubMed

Rigopoulos, Dimitris; Gregoriou, Stamatis; Katrinaki, Aimilia; Korfitis, Chrysovalantis; Larios, Giorgos; Stamou, Christos; Mourellou, Olympia; Petridis, Athanasios; Rallis, Efstathios; Sotiriadis, Dimitris; Katsambas, Andreas D; Antoniou, Christina

2010-01-01

Psoriasis is a chronic inflammatory skin disease with important socioeconomic consequences. Data on psoriasis prevalence in Greece is scarce and circumstantially reported. The aim of this study was the recording of psoriatic patients' demographic data, clinical characteristics of the disease, and exacerbating factors. Seven hundred and eighty four patients were enrolled in 6 centres (4 in Athens and 2 in Thessaloniki) in a multicenter epidemiologic prospective study. The mean age of patients was 43.2 (standard deviation, SD 17.44) years (median 42 years), while the men: women ratio was 1.8:1. Additionally, 35% of patients reported a positive family history of psoriasis. The mean age of patients at the first episode of psoriasis was 31.3 (SD 16.39) years (median 28 years). Psoriasis vulgaris was the most common form of psoriasis in the population participating in this study. Flares of psoriasis occurred 2.6 times per year on average. The patients considered stress as the main cause for psoriasis exacerbation. Most frequent target points of psoriasis included elbows, legs, scalp and knees. The most common symptoms reported were scaling, and itching. On average, patients visited dermatologists 2.4 times per year for issues related to psoriasis. This study provides epidemiological information regarding psoriasis in Greece. Results of this survey could assist in delineation of patient profiles, and improve communication between doctors and patients.

Current misconception 3: that subgroup-specific trial mortality results often provide a good basis for individualising patient care

PubMed Central

Peto, R

2011-01-01

Misconceptions and ill-founded theories can arise in all areas of science. However, the apparent accessibility of many epidemiology findings and popular interest in the subject can lead to additional misunderstandings. The article below is the third in an occasional series of short editorials highlighting some current misinterpretations of epidemiological findings. Invited authors will be given wide scope in judging the prevalence of the misconception under discussion. We hope that this series will prove instructive to cancer researchers in other disciplines as well as to students of epidemiology. Adrian L Harris and Leo Kinlen PMID:21448174

FDA Escherichia coli Identification (FDA-ECID) Microarray: a Pangenome Molecular Toolbox for Serotyping, Virulence Profiling, Molecular Epidemiology, and Phylogeny

PubMed Central

Patel, Isha R.; Gangiredla, Jayanthi; Lacher, David W.; Mammel, Mark K.; Jackson, Scott A.; Lampel, Keith A.

2016-01-01

ABSTRACT Most Escherichia coli strains are nonpathogenic. However, for clinical diagnosis and food safety analysis, current identification methods for pathogenic E. coli either are time-consuming and/or provide limited information. Here, we utilized a custom DNA microarray with informative genetic features extracted from 368 sequence sets for rapid and high-throughput pathogen identification. The FDA Escherichia coli Identification (FDA-ECID) platform contains three sets of molecularly informative features that together stratify strain identification and relatedness. First, 53 known flagellin alleles, 103 alleles of wzx and wzy, and 5 alleles of wzm provide molecular serotyping utility. Second, 41,932 probe sets representing the pan-genome of E. coli provide strain-level gene content information. Third, approximately 125,000 single nucleotide polymorphisms (SNPs) of available whole-genome sequences (WGS) were distilled to 9,984 SNPs capable of recapitulating the E. coli phylogeny. We analyzed 103 diverse E. coli strains with available WGS data, including those associated with past foodborne illnesses, to determine robustness and accuracy. The array was able to accurately identify the molecular O and H serotypes, potentially correcting serological failures and providing better resolution for H-nontypeable/nonmotile phenotypes. In addition, molecular risk assessment was possible with key virulence marker identifications. Epidemiologically, each strain had a unique comparative genomic fingerprint that was extended to an additional 507 food and clinical isolates. Finally, a 99.7% phylogenetic concordance was established between microarray analysis and WGS using SNP-level data for advanced genome typing. Our study demonstrates FDA-ECID as a powerful tool for epidemiology and molecular risk assessment with the capacity to profile the global landscape and diversity of E. coli. IMPORTANCE This study describes a robust, state-of-the-art platform developed from available whole-genome sequences of E. coli and Shigella spp. by distilling useful signatures for epidemiology and molecular risk assessment into one assay. The FDA-ECID microarray contains features that enable comprehensive molecular serotyping and virulence profiling along with genome-scale genotyping and SNP analysis. Hence, it is a molecular toolbox that stratifies strain identification and pathogenic potential in the contexts of epidemiology and phylogeny. We applied this tool to strains from food, environmental, and clinical sources, resulting in significantly greater phylogenetic and strain-specific resolution than previously reported for available typing methods. PMID:27037122

Clinical and epidemiological features of leishmaniasis in northwestern-Argentina through a retrospective analysis of recent cases.

PubMed

García Bustos, María F; González-Prieto, Gabriela; Ramos, Federico; Mora, María C; Hashiguchi, Yoshihisa; Parodi, Cecilia; Basombrío, Miguel A; Moreno, Sonia; Monroig, Sibila; Beckar, Josefina; Jaime, Daniela; Sajama, Jesús; Yeo, Matthew; Marco, Jorge D; Locatelli, Fabricio M; Barrio, Alejandra

2016-02-01

Leishmaniasis is a parasitic disease caused by hemoflagellates of the genus Leishmania and is transmitted to humans by the bite of infected phlebotomine sandflies. Depending on the Leishmania species, the disease has different clinical forms including cutaneous, mucocutaneous, and visceral manifestations. Previous studies performed in endemic zones of northwestern-Argentina, during epidemic outbreaks, have been important for detecting patients suffering from the acute phase of the disease, but have not given a complete representation of the clinical and epidemiological features in the region. Furthermore, due to the resurgence of leishmaniasis worldwide and in particular the large increase of international tourism to the region, it seems pertinent to update the current epidemiological and clinical profile of leishmaniasis in northwestern-Argentina. Here we present a retrospective analysis of 95 Leishmania positive cases, presenting between 2000 and 2014. Patients were derived from hospitals and diagnosed in our lab at the University of Salta, located in a non-endemic area in Salta, Argentina. We detected numerous extensive mucocutaneous cases (34/95, 35.8%) distinct from mucosal affected patients, some instances originating in locations with no previously reported human cases. Additionally patients suffering from concomitant diseases, besides leishmaniasis, were assessed. These included Chagas disease, syphilis, deep mycoses, tuberculosis, toxoplasmosis and intestinal parasitosis. This study updates the clinical and epidemiological features of leishmaniasis in northwestern-Argentina, and discusses the implications and management strategy for patients who acquire the disease in this region. Copyright © 2015 Elsevier B.V. All rights reserved.

Strengthening the Reporting of Observational Studies in Epidemiology—Nutritional Epidemiology (STROBE-nut): An Extension of the STROBE Statement

PubMed Central

Hawwash, Dana; Ocké, Marga C.; Berg, Christina; Forsum, Elisabet; Sonestedt, Emily; Wirfält, Elisabet; Åkesson, Agneta; Kolsteren, Patrick; Byrnes, Graham; De Keyzer, Willem; Van Camp, John; Slimani, Nadia; Cevallos, Myriam; Egger, Matthias; Huybrechts, Inge

2016-01-01

Background Concerns have been raised about the quality of reporting in nutritional epidemiology. Research reporting guidelines such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement can improve quality of reporting in observational studies. Herein, we propose recommendations for reporting nutritional epidemiology and dietary assessment research by extending the STROBE statement into Strengthening the Reporting of Observational Studies in Epidemiology—Nutritional Epidemiology (STROBE-nut). Methods and Findings Recommendations for the reporting of nutritional epidemiology and dietary assessment research were developed following a systematic and consultative process, coordinated by a multidisciplinary group of 21 experts. Consensus on reporting guidelines was reached through a three-round Delphi consultation process with 53 external experts. In total, 24 recommendations for nutritional epidemiology were added to the STROBE checklist. Conclusion When used appropriately, reporting guidelines for nutritional epidemiology can contribute to improve reporting of observational studies with a focus on diet and health. PMID:27270749

Who Seeks "Cita Con El Doctor"? Twelve Years of Spanish-Language Radio Program Targeting U.S. Latinos

ERIC Educational Resources Information Center

Ramirez, A. Susana; Graff, Kaitlin; Nelson, David; Galica, Kasia; Leyva, Bryan; Banegas, Mateo; Huerta, Elmer

2015-01-01

Purpose: Spanish-dominant Latinos make up 13% of the U.S. population, and this group is poorer and faces multiple threats to health compared with the general population. Additionally, Spanish speakers face challenges accessing health information that is often not available in Spanish. This study provides a descriptive epidemiology of a unique,…

The epidemiology and surveillance response to pandemic influenza A (H1N1) among local health departments in the San Francisco Bay Area.

PubMed

Enanoria, Wayne T A; Crawley, Adam W; Tseng, Winston; Furnish, Jasmine; Balido, Jeannie; Aragón, Tomás J

2013-03-27

Public health surveillance and epidemiologic investigations are critical public health functions for identifying threats to the health of a community. Very little is known about how these functions are conducted at the local level. The purpose of the Epidemiology Networks in Action (EpiNet) Study was to describe the epidemiology and surveillance response to the 2009 pandemic influenza A (H1N1) by city and county health departments in the San Francisco Bay Area in California. The study also documented lessons learned from the response in order to strengthen future public health preparedness and response planning efforts in the region. In order to characterize the epidemiology and surveillance response, we conducted key informant interviews with public health professionals from twelve local health departments in the San Francisco Bay Area. In order to contextualize aspects of organizational response and performance, we recruited two types of key informants: public health professionals who were involved with the epidemiology and surveillance response for each jurisdiction, as well as the health officer or his/her designee responsible for H1N1 response activities. Information about the organization, data sources for situation awareness, decision-making, and issues related to surge capacity, continuity of operations, and sustainability were collected during the key informant interviews. Content and interpretive analyses were conducted using ATLAS.ti software. The study found that disease investigations were important in the first months of the pandemic, often requiring additional staff support and sometimes forcing other public health activities to be put on hold. We also found that while the Incident Command System (ICS) was used by all participating agencies to manage the response, the manner in which it was implemented and utilized varied. Each local health department (LHD) in the study collected epidemiologic data from a variety of sources, but only case reports (including hospitalized and fatal cases) and laboratory testing data were used by all organizations. While almost every LHD attempted to collect school absenteeism data, many respondents reported problems in collecting and analyzing these data. Laboratory capacity to test influenza specimens often aided an LHD's ability to conduct disease investigations and implement control measures, but the ability to test specimens varied across the region and even well-equipped laboratories exceeded their capacity. As a whole, the health jurisdictions in the region communicated regularly about key decision-making (continued on next page) (continued from previous page) related to the response, and prior regional collaboration on pandemic influenza planning helped to prepare the region for the novel H1N1 influenza pandemic. The study did find, however, that many respondents (including the majority of epidemiologists interviewed) desired an increase in regional communication about epidemiology and surveillance issues. The study collected information about the epidemiology and surveillance response among LHDs in the San Francisco Bay Area that has implications for public health preparedness and emergency response training, public health best practices, regional public health collaboration, and a perceived need for information sharing.

The epidemiology and surveillance response to pandemic influenza A (H1N1) among local health departments in the San Francisco Bay Area

PubMed Central

2013-01-01

Background Public health surveillance and epidemiologic investigations are critical public health functions for identifying threats to the health of a community. Very little is known about how these functions are conducted at the local level. The purpose of the Epidemiology Networks in Action (EpiNet) Study was to describe the epidemiology and surveillance response to the 2009 pandemic influenza A (H1N1) by city and county health departments in the San Francisco Bay Area in California. The study also documented lessons learned from the response in order to strengthen future public health preparedness and response planning efforts in the region. Methods In order to characterize the epidemiology and surveillance response, we conducted key informant interviews with public health professionals from twelve local health departments in the San Francisco Bay Area. In order to contextualize aspects of organizational response and performance, we recruited two types of key informants: public health professionals who were involved with the epidemiology and surveillance response for each jurisdiction, as well as the health officer or his/her designee responsible for H1N1 response activities. Information about the organization, data sources for situation awareness, decision-making, and issues related to surge capacity, continuity of operations, and sustainability were collected during the key informant interviews. Content and interpretive analyses were conducted using ATLAS.ti software. Results The study found that disease investigations were important in the first months of the pandemic, often requiring additional staff support and sometimes forcing other public health activities to be put on hold. We also found that while the Incident Command System (ICS) was used by all participating agencies to manage the response, the manner in which it was implemented and utilized varied. Each local health department (LHD) in the study collected epidemiologic data from a variety of sources, but only case reports (including hospitalized and fatal cases) and laboratory testing data were used by all organizations. While almost every LHD attempted to collect school absenteeism data, many respondents reported problems in collecting and analyzing these data. Laboratory capacity to test influenza specimens often aided an LHD’s ability to conduct disease investigations and implement control measures, but the ability to test specimens varied across the region and even well-equipped laboratories exceeded their capacity. As a whole, the health jurisdictions in the region communicated regularly about key decision-making (continued on next page) (continued from previous page) related to the response, and prior regional collaboration on pandemic influenza planning helped to prepare the region for the novel H1N1 influenza pandemic. The study did find, however, that many respondents (including the majority of epidemiologists interviewed) desired an increase in regional communication about epidemiology and surveillance issues. Conclusion The study collected information about the epidemiology and surveillance response among LHDs in the San Francisco Bay Area that has implications for public health preparedness and emergency response training, public health best practices, regional public health collaboration, and a perceived need for information sharing. PMID:23530722

Incidence and Clinical Features of Rare Cutaneous Malignancies in Olmsted County, Minnesota, 2000 to 2010.

PubMed

Tolkachjov, Stanislav N; Schmitt, Adam R; Muzic, John G; Weaver, Amy L; Baum, Christian L

2017-01-01

The incidence of rare cutaneous malignancies is unknown. Current estimates of rare cutaneous malignancy incidences are based on broad epidemiologic data or single institution experiences, not population-based data. To determine the incidence of several rare nonmelanoma skin cancers. The authors conducted a retrospective chart review of a population-based cohort between the years 2000 and 2010. Residents of Olmsted County, Minnesota, who were diagnosed with a biopsy-proven nonmelanoma skin cancer-excluding basal cell carcinoma and squamous cell carcinoma-were included in this study. The primary outcome was tumor incidence. Additionally, the authors extracted patient demographics, tumor characteristics, treatment modalities, and outcomes. The age-adjusted and sex-adjusted incidences per 100,000 persons of multiple rare cutaneous malignancies were: atypical fibroxanthoma (1.8), sebaceous carcinoma (0.8), dermatofibrosarcoma protuberans (0.4), microcystic adnexal carcinoma (0.7), eccrine carcinoma (0.4), eccrine porocarcinoma (0.2), and leiomyosarcoma (0.2). The authors report population-based incidences and clinical characteristics for these rare cutaneous malignancies. The immune status and smoking status of patients and the treatment and outcomes of these tumors are reported. Additional studies in a broader population are needed to further define the epidemiology and outcomes of these malignancies.

Work Stress and Altered Biomarkers: A Synthesis of Findings Based on the Effort–Reward Imbalance Model

PubMed Central

Siegrist, Johannes; Li, Jian

2017-01-01

While epidemiological studies provide statistical evidence on associations of exposures such as stressful work with elevated risks of stress-related disorders (e.g., coronary heart disease or depression), additional information on biological pathways and biomarkers underlying these associations is required. In this contribution, we summarize the current state of the art on research findings linking stressful work, in terms of an established theoretical model—effort-reward imbalance—with a broad range of biomarkers. Based on structured electronic literature search and recent available systematic reviews, our synthesis of findings indicates that associations of work stress with heart rate variability, altered blood lipids, and risk of metabolic syndrome are rather consistent and robust. Significant relationships with blood pressure, heart rate, altered immune function and inflammation, cortisol release, and haemostatic biomarkers were also observed, but due to conflicting findings additional data will be needed to reach a firm conclusion. This narrative review of empirical evidence supports the argument that the biomarkers under study can act as mediators of epidemiologically established associations of work stress, as measured by effort–reward imbalance, with incident stress-related disorders. PMID:29125555

SEMIPARAMETRIC ADDITIVE RISKS REGRESSION FOR TWO-STAGE DESIGN SURVIVAL STUDIES

PubMed Central

Li, Gang; Wu, Tong Tong

2011-01-01

In this article we study a semiparametric additive risks model (McKeague and Sasieni (1994)) for two-stage design survival data where accurate information is available only on second stage subjects, a subset of the first stage study. We derive two-stage estimators by combining data from both stages. Large sample inferences are developed. As a by-product, we also obtain asymptotic properties of the single stage estimators of McKeague and Sasieni (1994) when the semiparametric additive risks model is misspecified. The proposed two-stage estimators are shown to be asymptotically more efficient than the second stage estimators. They also demonstrate smaller bias and variance for finite samples. The developed methods are illustrated using small intestine cancer data from the SEER (Surveillance, Epidemiology, and End Results) Program. PMID:21931467

Predicting outcome of status epilepticus.

PubMed

Leitinger, M; Kalss, G; Rohracher, A; Pilz, G; Novak, H; Höfler, J; Deak, I; Kuchukhidze, G; Dobesberger, J; Wakonig, A; Trinka, E

2015-08-01

Status epilepticus (SE) is a frequent neurological emergency complicated by high mortality and often poor functional outcome in survivors. The aim of this study was to review available clinical scores to predict outcome. Literature review. PubMed Search terms were "score", "outcome", and "status epilepticus" (April 9th 2015). Publications with abstracts available in English, no other language restrictions, or any restrictions concerning investigated patients were included. Two scores were identified: "Status Epilepticus Severity Score--STESS" and "Epidemiology based Mortality score in SE--EMSE". A comprehensive comparison of test parameters concerning performance, options, and limitations was performed. Epidemiology based Mortality score in SE allows detailed individualization of risk factors and is significantly superior to STESS in a retrospective explorative study. In particular, EMSE is very good at detection of good and bad outcome, whereas STESS detecting bad outcome is limited by a ceiling effect and uncertainty of correct cutoff value. Epidemiology based Mortality score in SE can be adapted to different regions in the world and to advances in medicine, as new data emerge. In addition, we designed a reporting standard for status epilepticus to enhance acquisition and communication of outcome relevant data. A data acquisition sheet used from patient admission in emergency room, from the EEG lab to intensive care unit, is provided for optimized data collection. Status Epilepticus Severity Score is easy to perform and predicts bad outcome, but has a low predictive value for good outcomes. Epidemiology based Mortality score in SE is superior to STESS in predicting good or bad outcome but needs marginally more time to perform. Epidemiology based Mortality score in SE may prove very useful for risk stratification in interventional studies and is recommended for individual outcome prediction. Prospective validation in different cohorts is needed for EMSE, whereas STESS needs further validation in cohorts with a wider range of etiologies. This article is part of a Special Issue entitled "Status Epilepticus". Copyright © 2015. Published by Elsevier Inc.

Clinical laboratory assessments for Mycoplasma genitalium in a high-prevalence sexually-transmitted infection community reveal epidemiologic dichotomies with Trichomonas vaginalis.

PubMed

Munson, Erik; Munson, Kimber L; Schell, Ronald F

2017-02-01

Mycoplasma genitalium is an emerging agent of sexually-transmitted infection and is responsible for clinically-significant genital tract disease in both females and males. Similar to scenarios recently experienced with the urogenital flagellate Trichomonas vaginalis, an evolving molecular diagnostic reference standard based on transcription-mediated amplification allows for accurate detection of the organism, plus additional insight into disease epidemiology. Areas covered. The basis for this article includes primary peer-reviewed literature plus compilations of data derived from routine clinical laboratory screening of females and males for agents of sexually-transmitted infection. Introductory laboratory and epidemiologic data related to T. vaginalis provides not only a foreshadowing to the dichotomies inherent to M. genitalium prevalence but also advocacy of a common non-invasive specimen source that could be used to screen females for both agents. This review also documents increased prevalence rates of M. genitalium in both females and males by way of transcription-mediated amplification. Expert commentary. Molecular detection of M. genitalium should be a consideration in the development of comprehensive sexually-transmitted infection screening programs for both females and males. Transcription-mediated amplification has additionally identified novel facets of M. genitalium and T. vaginalis epidemiology that warrant further investigation.

Cognitive Effects of Air Pollution Exposures and Potential Mechanistic Underpinnings

PubMed Central

Allen, J.L.; Klocke, C.; Morris-Schaffer, K.; Conrad, K.; Sobolewski, M.; Cory-Slechta, D.A.

2017-01-01

Purpose of review This review sought to address the potential for air pollutants to impair cognition and mechanisms by which that might occur. Recent findings Air pollution has been associated with deficits in cognitive functions across a wide range of epidemiological studies, both with developmental and adult exposures. Studies in animal models are significantly more limited in number, with somewhat inconsistent findings to date for measures of learning, but show more consistent impairments for short term memory. Potential contributory mechanisms include oxidative stress/inflammation, altered levels of dopamine and/or glutamate and changes in synaptic plasticity/structure. Summary Epidemiological studies are consistent with adverse effects of air pollutants on cognition, but additional studies and better phenotypic characterization are needed for animal models, including more precise delineation of specific components of cognition that are affected, as well as definitions of critical exposure periods for such effects and the components of air pollution responsible. This would permit development of more circumscribed hypotheses as to potential behavioral and neurobiological mechanisms. PMID:28435996

Methods and Processes of Developing the Strengthening the Reporting of Observational Studies in Epidemiology - Veterinary (STROBE-Vet) Statement.

PubMed

Sargeant, J M; O'Connor, A M; Dohoo, I R; Erb, H N; Cevallos, M; Egger, M; Ersbøll, A K; Martin, S W; Nielsen, L R; Pearl, D L; Pfeiffer, D U; Sanchez, J; Torrence, M E; Vigre, H; Waldner, C; Ward, M P

2016-11-01

Reporting of observational studies in veterinary research presents challenges that often are not addressed in published reporting guidelines. To develop an extension of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement that addresses unique reporting requirements for observational studies in veterinary medicine related to health, production, welfare, and food safety. Consensus meeting of experts. Mississauga, Canada. Seventeen experts from North America, Europe, and Australia. Experts completed a pre-meeting survey about whether items in the STROBE statement should be modified or added to address unique issues related to observational studies in animal species with health, production, welfare, or food safety outcomes. During the meeting, each STROBE item was discussed to determine whether or not rewording was recommended and whether additions were warranted. Anonymous voting was used to determine consensus. Six items required no modifications or additions. Modifications or additions were made to the STROBE items 1 (title and abstract), 3 (objectives), 5 (setting), 6 (participants), 7 (variables), 8 (data sources/measurement), 9 (bias), 10 (study size), 12 (statistical methods), 13 (participants), 14 (descriptive data), 15 (outcome data), 16 (main results), 17 (other analyses), 19 (limitations), and 22 (funding). The methods and processes used were similar to those used for other extensions of the STROBE statement. The use of this STROBE statement extension should improve reporting of observational studies in veterinary research by recognizing unique features of observational studies involving food-producing and companion animals, products of animal origin, aquaculture, and wildlife. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

An outbreak of hantavirus pulmonary syndrome, Chile, 1997.

PubMed Central

Toro, J.; Vega, J. D.; Khan, A. S.; Mills, J. N.; Padula, P.; Terry, W.; Yadón, Z.; Valderrama, R.; Ellis, B. A.; Pavletic, C.; Cerda, R.; Zaki, S.; Shieh, W. J.; Meyer, R.; Tapia, M.; Mansilla, C.; Baro, M.; Vergara, J. A.; Concha, M.; Calderon, G.; Enria, D.; Peters, C. J.; Ksiazek, T. G.

1998-01-01

An outbreak of 25 cases of Andes virus-associated hantavirus pulmonary syndrome (HPS) was recognized in southern Chile from July 1997 through January 1998. In addition to the HPS patients, three persons with mild hantaviral disease and one person with asymptomatic acute infection were identified. Epidemiologic studies suggested person-to-person transmission in two of three family clusters. Ecologic studies showed very high densities of several species of sigmodontine rodents in the area. PMID:9866751

Dissecting effects of complex mixtures: who's afraid of informative priors?

PubMed

Thomas, Duncan C; Witte, John S; Greenland, Sander

2007-03-01

Epidemiologic studies commonly investigate multiple correlated exposures, which are difficult to analyze appropriately. Hierarchical modeling provides a promising approach for analyzing such data by adding a higher-level structure or prior model for the exposure effects. This prior model can incorporate additional information on similarities among the correlated exposures and can be parametric, semiparametric, or nonparametric. We discuss the implications of applying these models and argue for their expanded use in epidemiology. While a prior model adds assumptions to the conventional (first-stage) model, all statistical methods (including conventional methods) make strong intrinsic assumptions about the processes that generated the data. One should thus balance prior modeling assumptions against assumptions of validity, and use sensitivity analyses to understand their implications. In doing so - and by directly incorporating into our analyses information from other studies or allied fields - we can improve our ability to distinguish true causes of disease from noise and bias.

Molecular epidemiology for vector research on leishmaniasis.

PubMed

Kato, Hirotomo; Gomez, Eduardo A; Cáceres, Abraham G; Uezato, Hiroshi; Mimori, Tatsuyuki; Hashiguchi, Yoshihisa

2010-03-01

Leishmaniasis is a protozoan disease caused by the genus Leishmania transmitted by female phlebotomine sand flies. Surveillance of the prevalence of Leishmania and responsive vector species in endemic and surrounding areas is important for predicting the risk and expansion of the disease. Molecular biological methods are now widely applied to epidemiological studies of infectious diseases including leishmaniasis. These techniques are used to detect natural infections of sand fly vectors with Leishmania protozoa and are becoming powerful tools due to their sensitivity and specificity. Recently, genetic analyses have been performed on sand fly species and genotyping using PCR-RFLP has been applied to the sand fly taxonomy. In addition, a molecular mass screening method has been established that enables both sand fly species and natural leishmanial infections to be identified simultaneously in hundreds of sand flies with limited effort. This paper reviews recent advances in the study of sand flies, vectors of leishmaniasis, using molecular biological approaches.

[Based on the incidence of Creutzfeldt-Jakob disease in the Lanzarote healthcare area. Description of two definitive cases].

PubMed

Hernández-Ramos, F J; Martínez Martín, M; Esteban Robayna, M; Jensen Toll, F; Palacios Llopis, S

2005-01-01

We present two cases who have been diagnosed of definitive Creutzfeldt-Jakob disease in the health area of Lanzarote in the period January 2002 to January 2004. The two cases are presented with clinical description, complementary tests -- including electroencephalogram, 14-3-3 protein determination -- study of the prionic protein gene, and histopathologic findings. In this article, we try to show the importance of trying to reach a definitive diagnosis with the histopathologic study once there is clinical suspicion (a diagnosis that is probable or possible). In addition our cases show that communication between the clinical and the epidemiological coordinator of the regional community and the National Center of Epidemiology is very important. We refer to the clear growth in the incidence of the disease in the population of Lanzarote in the period above mentioned. Finally, we discuss whether this growth is or is not an isolated event.

Molecular Epidemiology for Vector Research on Leishmaniasis

PubMed Central

Kato, Hirotomo; Gomez, Eduardo A; Cáceres, Abraham G; Uezato, Hiroshi; Mimori, Tatsuyuki; Hashiguchi, Yoshihisa

2010-01-01

Leishmaniasis is a protozoan disease caused by the genus Leishmania transmitted by female phlebotomine sand flies. Surveillance of the prevalence of Leishmania and responsive vector species in endemic and surrounding areas is important for predicting the risk and expansion of the disease. Molecular biological methods are now widely applied to epidemiological studies of infectious diseases including leishmaniasis. These techniques are used to detect natural infections of sand fly vectors with Leishmania protozoa and are becoming powerful tools due to their sensitivity and specificity. Recently, genetic analyses have been performed on sand fly species and genotyping using PCR-RFLP has been applied to the sand fly taxonomy. In addition, a molecular mass screening method has been established that enables both sand fly species and natural leishmanial infections to be identified simultaneously in hundreds of sand flies with limited effort. This paper reviews recent advances in the study of sand flies, vectors of leishmaniasis, using molecular biological approaches. PMID:20617005

Modification in the diet can induce beneficial effects against breast cancer

PubMed Central

Aragón, Felix; Perdigón, Gabriela; de Moreno de LeBlanc, Alejandra

2014-01-01

The population tends to consume foods that in addition to their nutritional values can offer some benefits to their health. There are many epidemiological evidences and research studies in animal models suggesting that diet plays an important role in breast cancer prevention or progression. This review summarized some of the relevant researches about nutrition and cancer during the last years, especially in breast cancer. The analysis of probiotics and fermented products containing lactic acid bacteria in cancer prevention and/or treatment was especially discussed. It was observed that a balance of fatty acids similar to those of traditional Mediterranean diet, the consumption of fruits and vegetables, dietary fiber intake, vitamin supplementation are, along with the intake of probiotic products, the most extensively studied by the negative association to breast cancer risk. The consumption of probiotics and fermented products containing lactic acid bacteria was associated to reduce breast cancer risk in some epidemiological studies. The use of animal models showed the modulation of the host’s immune response as one of the important effects associated to the benefices observed with most probiotics. However; future assays in human are very important before the medical community can accept the addition of probiotic or fermented milks containing lactic acid bacteria as supplements for cancer patients. PMID:25114859

Spatial analysis of lung, colorectal, and breast cancer on Cape Cod: An application of generalized additive models to case-control data

PubMed Central

Vieira, Verónica; Webster, Thomas; Weinberg, Janice; Aschengrau, Ann; Ozonoff, David

2005-01-01

Background The availability of geographic information from cancer and birth defect registries has increased public demands for investigation of perceived disease clusters. Many neighborhood-level cluster investigations are methodologically problematic, while maps made from registry data often ignore latency and many known risk factors. Population-based case-control and cohort studies provide a stronger foundation for spatial epidemiology because potential confounders and disease latency can be addressed. Methods We investigated the association between residence and colorectal, lung, and breast cancer on upper Cape Cod, Massachusetts (USA) using extensive data on covariates and residential history from two case-control studies for 1983–1993. We generated maps using generalized additive models, smoothing on longitude and latitude while adjusting for covariates. The resulting continuous surface estimates disease rates relative to the whole study area. We used permutation tests to examine the overall importance of location in the model and identify areas of increased and decreased risk. Results Maps of colorectal cancer were relatively flat. Assuming 15 years of latency, lung cancer was significantly elevated just northeast of the Massachusetts Military Reservation, although the result did not hold when we restricted to residences of longest duration. Earlier non-spatial epidemiology had found a weak association between lung cancer and proximity to gun and mortar positions on the reservation. Breast cancer hot spots tended to increase in magnitude as we increased latency and adjusted for covariates, indicating that confounders were partly hiding these areas. Significant breast cancer hot spots were located near known groundwater plumes and the Massachusetts Military Reservation. Discussion Spatial epidemiology of population-based case-control studies addresses many methodological criticisms of cluster studies and generates new exposure hypotheses. Our results provide evidence for spatial clustering of breast cancer on upper Cape Cod. The analysis suggests further investigation of the potential association between breast cancer and pollution plumes based on detailed exposure modeling. PMID:15955253

Spatial analysis of lung, colorectal, and breast cancer on Cape Cod: an application of generalized additive models to case-control data.

PubMed

Vieira, Verónica; Webster, Thomas; Weinberg, Janice; Aschengrau, Ann; Ozonoff, David

2005-06-14

The availability of geographic information from cancer and birth defect registries has increased public demands for investigation of perceived disease clusters. Many neighborhood-level cluster investigations are methodologically problematic, while maps made from registry data often ignore latency and many known risk factors. Population-based case-control and cohort studies provide a stronger foundation for spatial epidemiology because potential confounders and disease latency can be addressed. We investigated the association between residence and colorectal, lung, and breast cancer on upper Cape Cod, Massachusetts (USA) using extensive data on covariates and residential history from two case-control studies for 1983-1993. We generated maps using generalized additive models, smoothing on longitude and latitude while adjusting for covariates. The resulting continuous surface estimates disease rates relative to the whole study area. We used permutation tests to examine the overall importance of location in the model and identify areas of increased and decreased risk. Maps of colorectal cancer were relatively flat. Assuming 15 years of latency, lung cancer was significantly elevated just northeast of the Massachusetts Military Reservation, although the result did not hold when we restricted to residences of longest duration. Earlier non-spatial epidemiology had found a weak association between lung cancer and proximity to gun and mortar positions on the reservation. Breast cancer hot spots tended to increase in magnitude as we increased latency and adjusted for covariates, indicating that confounders were partly hiding these areas. Significant breast cancer hot spots were located near known groundwater plumes and the Massachusetts Military Reservation. Spatial epidemiology of population-based case-control studies addresses many methodological criticisms of cluster studies and generates new exposure hypotheses. Our results provide evidence for spatial clustering of breast cancer on upper Cape Cod. The analysis suggests further investigation of the potential association between breast cancer and pollution plumes based on detailed exposure modeling.

Recruitment and Participation of Recreational Runners in a Large Epidemiological and Genetic Research Study: Retrospective Data Analysis.

PubMed

Manzanero, Silvia; Kozlovskaia, Maria; Vlahovich, Nicole; Hughes, David C

2018-05-23

With the increasing capacity for remote collection of both data and samples for medical research, a thorough assessment is needed to determine the association of population characteristics and recruitment methodologies with response rates. The aim of this research was to assess population representativeness in a two-stage study of health and injury in recreational runners, which consisted of an epidemiological arm and genetic analysis. The cost and success of various classical and internet-based methods were analyzed, and demographic representativeness was assessed for recruitment to the epidemiological survey, reported willingness to participate in the genetic arm of the study, actual participation, sample return, and approval for biobank storage. A total of 4965 valid responses were received, of which 1664 were deemed eligible for genetic analysis. Younger age showed a negative association with initial recruitment rate, expressed willingness to participate in genetic analysis, and actual participation. Additionally, female sex was associated with higher initial recruitment rates, and ethnic origin impacted willingness to participate in the genetic analysis (all P<.001). The sharp decline in retention through the different stages of the study in young respondents suggests the necessity to develop specific recruitment and retention strategies when investigating a young, physically active population. ©Silvia Manzanero, Maria Kozlovskaia, Nicole Vlahovich, David C Hughes. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 23.05.2018.

Snippets from the past: the evolution of Wade Hampton Frost's epidemiology as viewed from the American Journal of Hygiene/Epidemiology.

PubMed

Morabia, Alfredo

2013-10-01

Wade Hampton Frost, who was a Professor of Epidemiology at Johns Hopkins University from 1919 to 1938, spurred the development of epidemiologic methods. His 6 publications in the American Journal of Hygiene, which later became the American Journal of Epidemiology, comprise a 1928 Cutter lecture on a theory of epidemics, a survey-based study of tonsillectomy and immunity to Corynebacterium diphtheriae (1931), 2 papers from a longitudinal study of the incidence of minor respiratory diseases (1933 and 1935), an attack rate ratio analysis of the decline of diphtheria in Baltimore (1936), and a 1936 lecture on the age, time, and cohort analysis of tuberculosis mortality. These 6 American Journal of Hygiene /American Journal of Epidemiology papers attest that Frost's personal evolution mirrored that of the emerging "early" epidemiology: The scope of epidemiology extended beyond the study of epidemics of acute infectious diseases, and rigorous comparative study designs and their associated quantitative methods came to light.

Snippets From the Past: The Evolution of Wade Hampton Frost's Epidemiology as Viewed From the American Journal of Hygiene/Epidemiology

PubMed Central

Morabia, Alfredo

2013-01-01

Wade Hampton Frost, who was a Professor of Epidemiology at Johns Hopkins University from 1919 to 1938, spurred the development of epidemiologic methods. His 6 publications in the American Journal of Hygiene, which later became the American Journal of Epidemiology, comprise a 1928 Cutter lecture on a theory of epidemics, a survey-based study of tonsillectomy and immunity to Corynebacterium diphtheriae (1931), 2 papers from a longitudinal study of the incidence of minor respiratory diseases (1933 and 1935), an attack rate ratio analysis of the decline of diphtheria in Baltimore (1936), and a 1936 lecture on the age, time, and cohort analysis of tuberculosis mortality. These 6 American Journal of Hygiene /American Journal of Epidemiology papers attest that Frost's personal evolution mirrored that of the emerging “early” epidemiology: The scope of epidemiology extended beyond the study of epidemics of acute infectious diseases, and rigorous comparative study designs and their associated quantitative methods came to light. PMID:24022889

Application of latent semantic analysis for open-ended responses in a large, epidemiologic study

PubMed Central

2011-01-01

Background The Millennium Cohort Study is a longitudinal cohort study designed in the late 1990s to evaluate how military service may affect long-term health. The purpose of this investigation was to examine characteristics of Millennium Cohort Study participants who responded to the open-ended question, and to identify and investigate the most commonly reported areas of concern. Methods Participants who responded during the 2001-2003 and 2004-2006 questionnaire cycles were included in this study (n = 108,129). To perform these analyses, Latent Semantic Analysis (LSA) was applied to a broad open-ended question asking the participant if there were any additional health concerns. Multivariable logistic regression was performed to examine the adjusted odds of responding to the open-text field, and cluster analysis was executed to understand the major areas of concern for participants providing open-ended responses. Results Participants who provided information in the open-ended text field (n = 27,916), had significantly lower self-reported general health compared with those who did not provide information in the open-ended text field. The bulk of responses concerned a finite number of topics, most notably illness/injury, exposure, and exercise. Conclusion These findings suggest generalized topic areas, as well as identify subgroups who are more likely to provide additional information in their response that may add insight into future epidemiologic and military research. PMID:21974837

HIV in Young Men Who Have Sex with Men: A Review of Epidemiology, Risk, and Protector Factors, and Interventions

PubMed Central

Mustanski, Brian S.; Newcomb, Michael E.; Bois, Steve Nicholas Du; Garcia, Steve C.; Grov, Christian

2012-01-01

Epidemiological studies have found that young men who have sex with men (YMSM) represent the majority of young people infected with HIV annually in the U.S. Further, they are one of the few risk groups to show an increase in the rate of infections in recent years. In addition to these disparities in prevalence and infection rates, there is an inequity in prevention and intervention research on this population. The purpose of this article is to review the existing YMSM literature on HIV epidemiology, correlates of risk, and intervention research. We conclude that promising future directions for basic research include a focus on multiple clustering health issues, processes that promote resiliency, the role of family influences, and the development of parsimonious models of risk. In terms of intervention research, we suggest that promising future directions include Internet-based intervention delivery, integration of biomedical and behavioral approaches, and interventions that go beyond the individual level to address partnership, structural, community, and network factors. PMID:21409715

The association between type 2 diabetes mellitus and women cancer: the epidemiological evidences and putative mechanisms.

PubMed

Joung, Kyong Hye; Jeong, Jae-Wook; Ku, Bon Jeong

2015-01-01

Type 2 diabetes mellitus (T2DM), a chronic disease increasing rapidly worldwide, is well established as an important risk factor for various types of cancer. Although many factors impact the development of T2DM and cancer including sex, age, ethnicity, obesity, diet, physical activity levels, and environmental exposure, many epidemiological and experimental studies are gradually contributing to knowledge regarding the interrelationship between DM and cancer. The insulin resistance, hyperinsulinemia, and chronic inflammation associated with diabetes mellitus are all associated strongly with cancer. The changes in bioavailable ovarian steroid hormone that occur in diabetes mellitus (the increasing levels of estrogen and androgen and the decreasing level of progesterone) are also considered potentially carcinogenic conditions for the breast, endometrium, and ovaries in women. In addition, the interaction among insulin, insulin-like growth factors (IGFs), and ovarian steroid hormones, such as estrogen and progesterone, could act synergistically during cancer development. Here, we review the cancer-related mechanisms in T2DM, the epidemiological evidence linking T2DM and cancers in women, and the role of antidiabetic medication in these cancers.

The Association between Type 2 Diabetes Mellitus and Women Cancer: The Epidemiological Evidences and Putative Mechanisms

PubMed Central

2015-01-01

Type 2 diabetes mellitus (T2DM), a chronic disease increasing rapidly worldwide, is well established as an important risk factor for various types of cancer. Although many factors impact the development of T2DM and cancer including sex, age, ethnicity, obesity, diet, physical activity levels, and environmental exposure, many epidemiological and experimental studies are gradually contributing to knowledge regarding the interrelationship between DM and cancer. The insulin resistance, hyperinsulinemia, and chronic inflammation associated with diabetes mellitus are all associated strongly with cancer. The changes in bioavailable ovarian steroid hormone that occur in diabetes mellitus (the increasing levels of estrogen and androgen and the decreasing level of progesterone) are also considered potentially carcinogenic conditions for the breast, endometrium, and ovaries in women. In addition, the interaction among insulin, insulin-like growth factors (IGFs), and ovarian steroid hormones, such as estrogen and progesterone, could act synergistically during cancer development. Here, we review the cancer-related mechanisms in T2DM, the epidemiological evidence linking T2DM and cancers in women, and the role of antidiabetic medication in these cancers. PMID:25866823

Epidemiology of eating disorders, eating disordered behaviour, and body image disturbance in males: a narrative review.

PubMed

Mitchison, Deborah; Mond, Jonathan

2015-01-01

Challenges to epidemiological studies of eating and related body image disturbance disorders in males include, in addition to low base rates and the predominance of residual diagnostic categories, the female-centric nature of current classification schemes and the consequent lack of appropriate assessment instruments. In this narrative review, we summarise epidemiological data regarding the prevalence and correlates of eating disorders, related body image disturbance disorders, and eating disorder features in males. Attention is focused on disorders most likely to be observed among males, such as muscle dysmorphia and muscularity-oriented excessive exercise. It is argued that, given the multiple challenges involved in research of this kind, a focus on features is more likely to advance the field than a focus on diagnoses. In terms of correlates, we focus on impairment and help-seeking, since these issues are most relevant in informing public health burden, service provision, and related issues. We end with some thoughts about current gaps in the knowledge base and directions for future research that we consider to be most promising.

Arsenic metabolism and cancer risk: A meta-analysis.

PubMed

Gamboa-Loira, Brenda; Cebrián, Mariano E; Franco-Marina, Francisco; López-Carrillo, Lizbeth

2017-07-01

To describe the studies that have reported association measures between risk of cancer and the percentage distribution of urinary inorganic arsenic (iAs) metabolites by anatomical site, in non-ecological epidemiological studies. Studies were identified in the PubMed database in the period from 1990 to 2015. Inclusion criteria were: non-ecological epidemiological study, with histologically confirmed cancer cases, reporting the percentage distribution of inorganic arsenic (iAs), monomethylated (MMA) and dimethylated (DMA) metabolites, as well as association measures with confidence intervals (CI) between cancer and %iAs and/or %MMA and/or %DMA. A descriptive meta-analysis was performed by the method of the inverse of the variance for the fixed effects model and the DerSimonian and Laird's method for the random effects model. Heterogeneity was tested using the Q statistic and stratifying for epidemiological design and total As in urine. The possibility of publication bias was assessed through Begg's test. A total of 13 eligible studies were found, most of them were performed in Taiwan and focused on skin and bladder cancer. The positive association between %MMA and various types of cancer was consistent, in contrast to the negative relationship between %DMA and cancer that was inconsistent. The summary risk of bladder (OR=1.79; 95% CI: 1.42, 2.26, n=4 studies) and lung (OR=2.44; 95% CI: 1.57, 3.80, n=2 studies) cancer increased significantly with increasing %MMA, without statistical heterogeneity. In contrast, lung cancer risk was inversely related to %DMA (OR=0.58; 95% CI: 0.36, 0.93, n=2 studies), also without significant heterogeneity. These results were similar after stratifying by epidemiological design and total As in urine. No evidence of publication bias was found. These findings provide additional support that methylation needs to be taken into account when assessing the potential iAs carcinogenicity risk. Copyright © 2017. Published by Elsevier Inc.

Feasibility of epidemiological monitoring for a proposed coal-fired power plant, Ivanpah, California.

PubMed

Goldsmith, J R; Spivey, G H; Coulson, A H

1984-01-27

The authors were asked to determine the feasibility of conducting epidemiologic monitoring for adverse health impact of emissions from the proposed Ivanpah Coal-Fired Power Plant. The study was required by the licensing agency, and specifically concerned health effects on the surrounding community. No potential occupational effects were considered. The area of concern was limited by the licensing agency to a circle of 50 mile radius around the Ivanpah site. The proposed power plant will be capable of generating 1500 megawatts of electricity utilizing low sulfur western coal. It is designed with stack heights of 500 feet for good dispersion and is planned to be outfitted with the best available stack emission control equipment. To establish whether an epidemiologic study is feasible, one must determine: (1) the size of the population which potentially would be exposed; (2) the pollutants to which that population might be exposed and the expected level of exposure and (3) the known or expected health effects of these pollutants and the frequency of such health outcomes. In addition, as in any epidemiologic study, the choice of a proper comparison group, the acceptability of a study to the population to be monitored and costs of the study in relation to available resources must also be taken into account. The population residing within 20 miles of the site consists of approximately 1,500 people at the present time. This population is not expected to increase significantly, although there is the possibility of growth of a "company town" surrounding the plant. Such an event would clearly alter the feasibility of conducting an epidemiologic study. Air quality modeling was used to predict the exposures to the population from various emissions from the proposed generating station. It was based on worst-case assumptions of wind speed, direction, atmospheric stability and percent sulfur-content coal. While a great many pollutants may result from coal burning, the levels of all pollutants, with the possible exception of ozone, are expected to be much lower than existing standards allow and therefore of little practical concern in the communities near Ivanpah. Since ozone is not a primary pollutant but is of secondary origin, its concentration, given the appropriate conditions, could increase with distance from the plant. None of the expected health outcomes occurs with sufficient frequency to allow the detection, with a reasonable degree of statistical certainty, of any reasonably expected increase in frequency in an epidemiologic study of a population as small as that which is associated with the Ivanpah site.(ABSTRACT TRUNCATED AT 400 WORDS)

Descriptive Epidemiology of Bovine Tuberculosis in Michigan (1975–2010): Lessons Learned

PubMed Central

Okafor, Chika C.; Grooms, Daniel L.; Bruning-Fann, Colleen S.; Averill, James J.; Kaneene, John B.

2011-01-01

Despite ongoing eradication efforts, bovine tuberculosis (BTB) remains a challenge in Michigan livestock and wildlife. The objectives of this study were to (1) review the epidemiology of BTB in Michigan cattle, privately owned cervids, and wildlife between 1975 and 2010 and (2) identify important lessons learned from the review and eradication strategies. BTB information was accessed from the Michigan BTB Eradication Project agencies. Cattle herds (49), privately owned deer herds (4), and wild white-tailed deer (668) were found infected with BTB during the review period. BTB has occurred primarily in counties located at the northern portion of the state's Lower Peninsula. Currently used BTB eradication strategies have successfully controlled BTB spread. However additional changes in BTB surveillance, prevention, and eradication strategies could improve eradication efforts. PMID:21776355

A small jab - a big effect: nonspecific immunomodulation by vaccines.

PubMed

Benn, Christine S; Netea, Mihai G; Selin, Liisa K; Aaby, Peter

2013-09-01

Recent epidemiological studies have shown that, in addition to disease-specific effects, vaccines against infectious diseases have nonspecific effects on the ability of the immune system to handle other pathogens. For instance, in randomized trials tuberculosis and measles vaccines are associated with a substantial reduction in overall child mortality, which cannot be explained by prevention of the target disease. New research suggests that the nonspecific effects of vaccines are related to cross-reactivity of the adaptive immune system with unrelated pathogens, and to training of the innate immune system through epigenetic reprogramming. Hence, epidemiological findings are backed by immunological data. This generates a new understanding of the immune system and about how it can be modulated by vaccines to impact the general resistance to disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

Privacy Act of 1974; altered system of records--PHS. Notification of altered system of records: 09-30-0036, "Alcohol, Drug Abuse, and Mental Health Epidemiologic and Biometric Research Data, HHS/ADAMHA/OA".

PubMed

1984-10-23

In accordance with the requirements of the Privacy Act, the Public Health Service (OHS) is publishing a notice of proposal to alter the system of records in the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA), National Institute of Mental Health (NIMH), entitled, "Mental Health Epidemiologic and Biometric Research Data, HHS/ADAMHA/NIMH," to create an umbrella system of records to include epidemiologic and biometric research data in the areas of alcohol and drug abuse in addition to data already collected and maintained for mental health research. The system is to be retitled, "Alcohol, Drug Abuse, and Mental Health Epidemiologic and Biometric Research Data, HHS/ADAMHA/OA." PHS invites interested persons to submit comments on the proposed alteration on or before November 23, 1984.

Guidance on radiation dose limits for the lens of the eye: overview of the recommendations in NCRP Commentary No. 26.

PubMed

Dauer, Lawrence T; Ainsbury, Elizabeth A; Dynlacht, Joseph; Hoel, David; Klein, Barbara E K; Mayer, Donald; Prescott, Christina R; Thornton, Raymond H; Vano, Eliseo; Woloschak, Gayle E; Flannery, Cynthia M; Goldstein, Lee E; Hamada, Nobuyuki; Tran, Phung K; Grissom, Michael P; Blakely, Eleanor A

2017-10-01

This review summarizes the conclusions and recommendations of the new National Council on Radiation Protection and Measurements (NCRP) Commentary No. 26 guidance on radiation dose limits for the lens of the eye. The NCRP addressed radiation protection principles in respect to the lens of the eye, discussed the current understanding of eye biology and lens effects, reviewed and evaluated epidemiology, and assessed exposed populations with the potential for significant radiation exposures to the lens while suggesting monitoring and protection practices. Radiation-induced damage to the lens of the eye can include the loss of clarity resulting in opacification or clouding several years after exposure. The impact is highly dependent on the type of radiation, how the exposure of the lens was delivered, the genetic susceptibilities of the individual exposed, and the location of the opacity relative to the visual axis of the individual. The preponderance of epidemiological evidence suggests that lens damage could occur at lower doses than previously considered and the NCRP has determined that it is prudent to reduce the recommended annual lens of the eye occupational dose limit from an equivalent dose of 150 mSv to an absorbed dose of 50 mGy. Significant additional research is still needed in the following areas: comprehensive evaluation of the overall effects of ionizing radiation on the eye, dosimetry methodology and dose-sparing optimization techniques, additional high quality epidemiology studies, and a basic understanding of the mechanisms of cataract development.

The impact of medicinal drugs on traffic safety: a systematic review of epidemiological studies.

PubMed

Orriols, Ludivine; Salmi, Louis-Rachid; Philip, Pierre; Moore, Nicholas; Delorme, Bernard; Castot, Anne; Lagarde, Emmanuel

2009-08-01

To evaluate the quality of epidemiological research into effects of medicinal drugs on traffic safety and the current knowledge in this area. The bibliographic search was done in Medline electronic database using the keywords: ((accident* or crash*) and traffic and drug*) leading to 1141 references. Additional references were retrieved from the Safetylit website and the reference lists of selected studies. Original articles published in English or French, between 1 April 1979 and 31 July 2008, were considered for inclusion. We excluded descriptive studies, studies limited to alcohol or illicit drug involvement and investigations of injuries other than from traffic crashes. Studies based on laboratory tests, driving simulators or on-the-road driving tests were also excluded. Eligible studies had to evaluate the causal relationship between the use of medicinal drugs and the risk of traffic crashes. Study quality was assessed by two independent experts, according to a grid adapted from the strengthening the reporting of observational studies in epidemiology (STROBE) statement. Twenty two studies of variable methodological quality were included. Definition of drug exposure varied across studies and depended on the data sources. Potential confounding due to the interaction between the effects of the medicinal drug and disease-related symptoms was often not controlled. The risk of motor-vehicle crashes related to benzodiazepines has been amply studied and demonstrated. Results for other medicinal drugs remain controversial. There is a need for large studies, investigating the role of individual substances in the risk of road traffic crashes. Copyright 2009 John Wiley & Sons, Ltd.

Los Alamos National Laboratory: A guide to records series supporting epidemiologic studies conducted for the Department of Energy

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1997-01-01

The purpose of this guide is to describe each series of records that pertains to the epidemiologic studies conducted by the Epidemiology Section of the Occupational Medicine Group (ESH-2) at the Department of Energy`s (DOE) Los Alamos National Laboratory (LANL) in Los Alamos, New Mexico. The records described in this guide relate to occupational studies performed by the Epidemiology Section, including those pertaining to workers at LANL, Mound Plant, Oak Ridge Reservation, Pantex Plant, Rocky Flats Plant, and Savannah River Site. Also included are descriptions of other health-related records generated or collected by the Epidemiology Section and a small setmore » of records collected by the Industrial Hygiene and Safety Group. This guide is not designed to describe the universe of records generated by LANL which may be used for epidemiologic studies of the LANL work force. History Associates Incorporated (HAI) prepared this guide as part of its work as the support services contractor for DOE`s Epidemiologic Records Inventory Project. This introduction briefly describes the Epidemiologic Records Inventory Project, HAI`s role in the project, the history of LANL the history and functions of LANL`s Health Division and Epidemiology Section, and the various epidemiologic studies performed by the Epidemiology Section. It provides information on the methodology that HAI used to inventory and describe records housed in the offices of the LANL Epidemiology Section in Technical Area 59 and at the LANL Records Center. Other topics include the methodology used to produce the guide, the arrangement of the detailed record series descriptions, and information concerning access to records repositories.« less

Becoming the Framingham Study 1947–1950

PubMed Central

Oppenheimer, Gerald M.

2005-01-01

In the epidemiological imagination, the Framingham Heart Study has attained iconic status, both as the prototype of the cohort study and as a result of its scientific success. When the Public Health Service launched the study in 1947, epidemiological knowledge of coronary heart disease was poor, and epidemiology primarily involved the study of infectious disease. In constructing their investigation, Framingham’s initiators had to invent new approaches to epidemiological research. These scientific goals were heavily influenced by the contending institutional and personal interests buffeting the study. The study passed through vicissitudes and stages during its earliest years as its organizers grappled to define its relationship to medicine, epidemiology, and the local community. PMID:15798116

Clostridium difficile in the Military Population

DTIC Science & Technology

2016-08-05

association between race and infection . This is similar to the Buchner and associates case- control study; which noted an increase in occurrence of C...sustained within a hospital , additional persons infected with C. difficile are needed10. Acute appendicitis ranking first among diagnoses for hospitalized ...Buchner AM, Sonnenberg A. Epidemiology of Clostridium difficile infection in a large population of hospitalized US military veterans. Dig Dis Sci

Overview of Epidemiology, Genetics, Birth Defects, and Chromosome Abnormalities Associated With CDH

PubMed Central

Pober, Barbara R.

2010-01-01

Congenital diaphragmatic hernia (CDH) is a common and well-studied birth defect. The etiology of most cases remains unknown but increasing evidence points to genetic causation. The data supporting genetic etiologies which are detailed below include the association of CDH with recurring chromosome abnormalities, the existence of CDH-multiplex families, and the co-occurrence of CDH with additional congenital malformations. PMID:17436298

1995 annual epidemiologic surveillance report for Hanford Site

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1995-12-31

The US Department of Energy`s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. A number of DOE sites participate in the Epidemiologic Surveillance Program. This program monitors illnesses and health conditions that result in an absence of five or more consecutive workdays, occupational injuries and illnesses, disabilities and deaths among current workers. This report provides a summary of epidemiologic surveillance data collected from the Hanford Site from January 1, 1995 through December 31, 1995. The data were collected bymore » a coordinator at Hanford and submitted to the Epidemiologic Surveillance Data Center, located at Oak Ridge Institute for Science and Education, where quality control procedures and data analyses were carried out. The information in the main body of the report provides a descriptive analysis of the data collected from the site, and the appendices provides additional detail. The report also contains an expanded Glossary and an Explanation of Diagnostic Categories which gives examples of health conditions in each of the diagnostic categories.« less

[Eco-epidemiology: towards epidemiology of complexity].

PubMed

Bizouarn, Philippe

2016-05-01

In order to solve public health problems posed by the epidemiology of risk factors centered on the individual and neglecting the causal processes linking the risk factors with the health outcomes, Mervyn Susser proposed a multilevel epidemiology called eco-epidemiology, addressing the interdependence of individuals and their connection with molecular, individual, societal, environmental levels of organization participating in the causal disease processes. The aim of this epidemiology is to integrate more than a level of organization in design, analysis and interpretation of health problems. After presenting the main criticisms of risk-factor epidemiology focused on the individual, we will try to show how eco-epidemiology and its development could help to understand the need for a broader and integrative epidemiology, in which studies designed to identify risk factors would be balanced by studies designed to answer other questions equally vital to public health. © 2016 médecine/sciences – Inserm.

Uric Acid, Hyperuricemia and Vascular Diseases

PubMed Central

Jin, Ming; Yang, Fan; Yang, Irene; Yin, Ying; Luo, Jin Jun; Wang, Hong; Yang, Xiao-Feng

2011-01-01

Uric acid is the product of purine metabolism. It is known that hyperuricemia, defined as high levels of blood uric acid, is the major etiological factor of gout. A number of epidemiological reports have increasingly linked hyperuricemia with cardiovascular and neurological diseases. Studies highlighting the pathogenic mechanisms of uric acid point to an inflammatory response as the primary mechanism for inducing gout and possibly contributing to uric acid's vascular effects. Monosodium urate (MSU) crystals induce an inflammatory reaction, which are recognized by Toll-like receptors (TLRs). These TLRs then activate NALP3 inflammasome. MSU also triggers neutrophil activation and further produces immune mediators, which lead to a proinflammatory response. In addition, soluble uric acid can also mediate the generation of free radicals and function as a pro-oxidant. This review summarizes the epidemiological studies of hyperuricemia and cardiovascular disease, takes a brief look at hyperuricemia and its role in neurological diseases, and highlights the studies of the advanced pathological mechanisms of uric acid and inflammation. PMID:22201767

Phylogenetic studies of transmission dynamics in generalized HIV epidemics: An essential tool where the burden is greatest?

PubMed Central

Dennis, Ann M.; Herbeck, Joshua T.; Brown, Andrew Leigh; Kellam, Paul; de Oliveira, Tulio; Pillay, Deenan; Fraser, Christophe; Cohen, Myron S.

2014-01-01

Efficient and effective HIV prevention measures for generalized epidemics in sub-Saharan Africa have not yet been validated at the population-level. Design and impact evaluation of such measures requires fine-scale understanding of local HIV transmission dynamics. The novel tools of HIV phylogenetics and molecular epidemiology may elucidate these transmission dynamics. Such methods have been incorporated into studies of concentrated HIV epidemics to identify proximate and determinant traits associated with ongoing transmission. However, applying similar phylogenetic analyses to generalized epidemics, including the design and evaluation of prevention trials, presents additional challenges. Here we review the scope of these methods and present examples of their use in concentrated epidemics in the context of prevention. Next, we describe the current uses for phylogenetics in generalized epidemics, and discuss their promise for elucidating transmission patterns and informing prevention trials. Finally, we review logistic and technical challenges inherent to large-scale molecular epidemiological studies of generalized epidemics, and suggest potential solutions. PMID:24977473

Learning styles and preferences for live and distance education: an example of a specialisation course in epidemiology

PubMed Central

2013-01-01

Background Distance learning through the internet is increasingly popular in higher education. However, it is unknown how participants in epidemiology courses value live vs. distance education. Methods All participants of a 5-day specialisation course in epidemiology were asked to keep a diary on the number of hours they spent on course activities (both live and distance education). Attendance was not compulsory during the course and participants were therefore also asked for the reasons to attend live education (lectures and practicals). In addition, the relation between participants’ learning styles (Index of Learning Styles) and their participation in live and distance education was studied. Results All 54 (100%) participants in the course completed the questionnaire on attendance and 46 (85%) completed the questionnaire on learning styles. The number of hours attending live education was negatively correlated with the number of hours going studying distance learning materials (Pearson correlation −0.5; p < 0.001). The most important reasons to attend live education was to stay focused during lectures (50%), and to ask questions during practicals (50%). A lack of time was the most important reason not to attend lectures (52%) or practicals (61%). Learning styles were not association with the number of hours spent on live or distance education. Conclusion Distance learning may play an important role in epidemiology courses, since it allows participants to study whenever and wherever they prefer, which provides the opportunity to combine courses with clinical duties. An important requirement for distance learning education appears to be the possibility to ask questions and to interact with instructors. PMID:23819522

Cohort profile: the Western Australian Sleep Health Study.

PubMed

Mukherjee, Sutapa; Hillman, David; Lee, Jessica; Fedson, Annette; Simpson, Laila; Ward, Kim; Love, Gregory; Edwards, Cass; Szegner, Bernadett; Palmer, Lyle John

2012-03-01

Epidemiologic and genetic studies of obstructive sleep apnoea (OSA) are limited by a lack of large-scale, well-characterized OSA cohorts. These studies require large sample size to provide adequate power to detect differences between groups. This study describes the development of such a cohort (The Western Australian Sleep Health Study) in OSA patients of Caucasian-European origin attending the only public sleep clinic in Western Australia (WA). The main aim of the study is to phenotype 4,000 OSA patients in order to define the genetics of OSA and its co-morbidities. Almost all underwent laboratory-based attended polysomnography (PSG). Currently complete data (questionnaire, biochemistry, DNA, and PSG) has been obtained on over 3,000 individuals and will reach the target of 4,000 individuals by the end of 2010. In a separate but related study, we have developed a sleep study database containing data from all patients who have undergone PSG at the sleep laboratory since its inception in 1988 until the present day (over 30,000 PSG studies representing data from approximately 20,000 individuals). In addition, data from both cohorts have been linked prospectively to statutory health data collected by the WA Department of Health. This study will be the largest sleep clinic cohort database internationally with access to genetic and epidemiological data. It is unique among sleep clinic cohorts because of its size, the breadth of data collected and the ability to link prospectively to statutory health data. It will be a major tool to comprehensively assess genetic and epidemiologic factors determining OSA and its co-morbidities.

Epidemiology of complementary alternative medicine for asthma and allergy in Europe and Germany.

PubMed

Schäfer, Torsten

2004-08-01

To describe and discuss the epidemiologic characteristics and determinants of the use of complementary alternative medicine (CAM) from a European, particularly German, perspective. An unrestricted literature search using the keywords alternative, allergy, complementary, epidemiology, and medicine was performed in PubMed (National Library of Medicine). In addition, background literature and the opinion of the author contributed to the article. European studies that provided data on the epidemiology of the use of CAM were selected and discussed in more detail. Approximately 30% of patients with allergies report experiences with CAM in Europe. In selected in-patient populations, the prevalence reaches 50%. Users of CAM tend to be younger women with a higher educational background. Furthermore, users and nonusers differ in terms of psychomedical characteristics, such as health locus of control or health-related quality of life. Although a larger number of different CAM modalities are provided, only a few techniques account for the majority of use (eg, acupuncture, homeopathy, herbalism, bioresonance, autologous blood injection). The use of CAM is associated with considerable costs, reaching an estimated amount of 0.9 billion Euro (approximately 1 billion US dollars) in Germany. CAM is widely used by the public to treat allergies. National peculiarities concerning the individual methods, providers, or reimbursement must be considered. The economic and public health implications should be discussed in context with the limited evidence of efficacy.

Genotyping of Mycobacterium tuberculosis: application in epidemiologic studies

PubMed Central

Kato-Maeda, Midori; Metcalfe, John Z.; Flores, Laura

2014-01-01

Genotyping is used to track specific isolates of Mycobacterium tuberculosis in a community. It has been successfully used in epidemiologic research (termed ‘molecular epidemiology’) to study the transmission dynamics of TB. In this article, we review the genetic markers used in molecular epidemiologic studies including the use of whole-genome sequencing technology. We also review the public health application of molecular epidemiologic tools. PMID:21366420

Risk factors for age-related maculopathy.

PubMed

Connell, Paul P; Keane, Pearse A; O'Neill, Evelyn C; Altaie, Rasha W; Loane, Edward; Neelam, Kumari; Nolan, John M; Beatty, Stephen

2009-01-01

Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.

Examination of Different Exposure Metrics in an Epidemiological Study

EPA Science Inventory

Epidemiological studies of air pollution have traditionally relied upon measurements of ambient concentration from central-site monitoring stations as surrogates of population exposures. However, depending on the epidemiological study design, this approach may introduce exposure...

The "Pathological Gambling and Epidemiology" (PAGE) study program: design and fieldwork.

PubMed

Meyer, Christian; Bischof, Anja; Westram, Anja; Jeske, Christine; de Brito, Susanna; Glorius, Sonja; Schön, Daniela; Porz, Sarah; Gürtler, Diana; Kastirke, Nadin; Hayer, Tobias; Jacobi, Frank; Lucht, Michael; Premper, Volker; Gilberg, Reiner; Hess, Doris; Bischof, Gallus; John, Ulrich; Rumpf, Hans-Jürgen

2015-03-01

The German federal states initiated the "Pathological Gambling and Epidemiology" (PAGE) program to evaluate the public health relevance of pathological gambling. The aim of PAGE was to estimate the prevalence of pathological gambling and cover the heterogenic presentation in the population with respect to comorbid substance use and mental disorders, risk and protective factors, course aspects, treatment utilization, triggering and maintenance factors of remission, and biological markers. This paper describes the methodological details of the study and reports basic prevalence data. Two sampling frames (landline and mobile telephone numbers) were used to generate a random sample from the general population consisting of 15,023 individuals (ages 14 to 64) completing a telephone interview. Additionally, high-risk populations have been approached in gambling locations, via media announcements, outpatient addiction services, debt counselors, probation assistants, self-help groups and specialized inpatient treatment facilities. The assessment included two steps: (1) a diagnostic interview comprising the gambling section of the Composite International Diagnostic Interview (CIDI) for case finding; (2) an in-depth clinical interview with participants reporting gambling problems. The in-depth clinical interview was completed by 594 participants, who were recruited from the general or high-risk populations. The program provides a rich epidemiological database which is available as a scientific use file. Copyright © 2015 John Wiley & Sons, Ltd.

Epidemiology of mild traumatic brain injury and neurodegenerative disease

PubMed Central

Gardner, Raquel C.; Yaffe, Kristine

2015-01-01

Every year an estimated 42 million people worldwide suffer a mild traumatic brain injury (MTBI) or concussion. More severe traumatic brain injury (TBI) is a well-established risk factor for a variety of neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis (ALS). Recently, large epidemiological studies have additionally identified MTBI as a risk factor for dementia. The role of MTBI in risk of PD or ALS is less well established. Repetitive MTBI and repetitive sub-concussive head trauma has been linked to increased risk for a variety of neurodegenerative diseases including chronic traumatic encephalopathy (CTE). CTE is a unique neurodegenerative tauopathy first described in boxers but more recently described in a variety of contact sport athletes, military veterans, and civilians exposed to repetitive MTBI. Studies of repetitive MTBI and CTE have been limited by referral bias, lack of consensus clinical criteria for CTE, challenges of quantifying MTBI exposure, and potential for confounding. The prevalence of CTE is unknown and the amount of MTBI or sub-concussive trauma exposure necessary to produce CTE is unclear. This review will summarize the current literature regarding the epidemiology of MTBI, post-TBI dementia and Parkinson's disease, and CTE while highlighting methodological challenges and critical future directions of research in this field. PMID:25748121

Use of FEV1 in Cystic Fibrosis Epidemiologic Studies and Clinical Trials: A Statistical Perspective for the Clinical Researcher

PubMed Central

Szczesniak, Rhonda; Heltshe, Sonya L.; Stanojevic, Sanja; Mayer-Hamblett, Nicole

2017-01-01

Background Forced expiratory volume in 1 second (FEV1) is an established marker of cystic fibrosis (CF) disease progression that is used to capture clinical course and evaluate therapeutic efficacy. The research community has established FEV1 surveillance data through a variety of observational data sources such as patient registries, and there is a growing pipeline of new CF therapies demonstrated to be efficacious in clinical trials by establishing improvements in FEV1. Results In this review, we summarize from a statistical perspective the clinical relevance of FEV1 based on its association with morbidity and mortality in CF, its role in epidemiologic studies of disease progression and comparative effectiveness, and its utility in clinical trials. In addition, we identify opportunities to advance epidemiologic research and the clinical development pipeline through further statistical considerations. Conclusions Our understanding of CF disease course, therapeutics, and clinical care has evolved immensely in the past decades, in large part due to the thoughtful application of rigorous research methods and meaningful clinical endpoints such as FEV1. A continued commitment to conduct research that minimizes the potential for bias, maximizes the limited patient population, and harmonizes approaches to FEV1 analysis while maintaining clinical relevance, will facilitate further opportunities to advance CF care. PMID:28117136

Epidemiological survey of swine influenza A virus in the wild boar population of two Italian provinces.

PubMed

Foni, Emanuela; Garbarino, Chiara; Chiapponi, Chiara; Baioni, Laura; Zanni, Irene; Cordioli, Paolo

2013-12-01

An epidemiological survey was carried out in order to obtain a better understanding of the role of wild boars in the epidemiology of the influenza virus. The samples were submitted to Real-Time PCR testing for gene M of the swine influenza virus (SIV), and virus isolation was performed from the positive PCR samples. Genome sequence analysis was performed on the isolates. Additionally, 1,977 boar sera samples were analyzed using ELISA and hemoagglutination inhibition. Over recent years, the wild boar population has greatly increased in Italy, including in areas of high-density industrial pig farming, where the influenza virus is widespread. From July to December 2012, wild boar lung samples were collected in the Parma and Piacenza area, in the Emilia Romagna region. 354 wild boar lung samples were collected. Wild-boar influenza A virus infection should be studied more broadly in order to obtain a better understanding of the epidemiological role played by this species. Three SIV strains were isolated out of 12 samples that resulted positive using PCR analysis and they were identified as avian-like SIV subtype H1N1. Phylogenetic analysis of the sequences obtained from isolate A/wild boar/291320/2012 showed that it clustered with recent Italian avian-like H1N1 SIVs isolated from domestic pigs. Sixty-eight sera samples showed a positive titer to the isolate A/wild boar/291320/2012. This study suggests that SIV actively circulates in the wild boar population in the investigated. area. © 2013 Blackwell Publishing Ltd.

Male circumcision and HIV prevention: current knowledge and future research directions.

PubMed

Bailey, R C; Plummer, F A; Moses, S

2001-11-01

Over the past decade, numerous epidemiological studies have reported a significant association between lack of male circumcision and risk for HIV infection, leading to recommendations for male circumcision to be added to the armamentarium of effective HIV prevention strategies. We review the epidemiological data from studies that have investigated this association, including ecological, cross-sectional/case-control, and prospective studies. We discuss problematic issues in interpreting the epidemiological data, including the presence of other sexually transmitted infections, age of circumcision, and potential confounders such as religion, cultural practices, and genital hygiene. In addition, we review studies of biological mechanisms by which the presence of the foreskin may increase HIV susceptibility, data on risks associated with the circumcision procedure, and available data on the acceptability and feasibility of introducing male circumcision in societies where it is traditionally not practised. Although the evidence in support of male circumcision as an effective HIV prevention measure is compelling, residual confounding in observational studies cannot be excluded. Taken together with concerns over the potential disinhibiting effect of male circumcision on risk behaviour, and safety of the circumcision procedure, randomised trials of male circumcision to prevent HIV infection are recommended. An individual's choice to undergo male circumcision or a community's decision to promote the practice should be made in the light of the best available scientific evidence. More knowledge is required to assist individuals and communities in making those decisions. We conclude with recommendations for future research.

[Air pollution and cardiovascular toxicity: known risks].

PubMed

Kostrzewa, A; Filleul, L; Eilstein, D; Harrabi, I; Tessier, J F

2004-03-01

Review of studies about epidemiological and physiopathological knowledge of ambient air particles short-term cardio-vascular effects. CURRENTS AND STRONG POINTS: Many studies, in contrasted countries for pollution's sources, meteorological conditions or socio-demographical characteristics, have shown health effects due to ambient air particles. After having studied mainly the respiratory effects of particulate air pollution, epidemiologists are now interested in the cardio-vascular effects of ambient air particles. In fact, serious effects seem to exist in fragile people which can get to emergency department visits, hospitalisation and even death. In addition, studies have shown less serious effects, but likely to be frequent (cardiac symptoms, and stoppages for cardio-vascular causes, notably). The exact mechanism by which particles have cardio-vascular adverse health effects is unknown, but experimental and epidemiological studies have led to several hypotheses: local pulmonary effects seem to be followed by systemic effects, which would be responsible for effects on the electrical activity of the heart through cardiac autonomic dysfunction and effects on the blood supply to the heart. The objective of this work is to summarise epidemiological and physiopathological knowledge about the cardio-vascular effects of ambient air particles. To evaluate the real importance of cardio-vascular effects due to particulate air pollution and to identify their exact mechanism, a more precise knowledge of detailed causes of deaths and hospitalisations and a better knowledge of less serious effects, but likely to be frequent, is necessary. Equally, a detailed identification of fragile people is essential for developing preventive actions.

Epidemiology and risk factors for drug allergy

PubMed Central

Thong, Bernard Y-H; Tan, Teck-Choon

2011-01-01

The aim of this review was to describe the current evidence-based knowledge of the epidemiology, prevalence, incidence, risk factors and genetic associations of drug allergy. Articles published between 1966 and 2010 were identified in MEDLINE using the key words adult, adverse drug reaction reporting systems, age factors, anaphylactoid, anaphylaxis, anaesthetics, antibiotics, child, drug allergy, drug eruptions, ethnic groups, hypersensitivity, neuromuscular depolarizing agents, neuromuscular nondepolarizing agents, sex factors, Stevens Johnson syndrome and toxic epidermal necrolysis. Additional studies were identified from article reference lists. Relevant, peer-reviewed original research articles, case series and reviews were considered for review. Current epidemiological studies on adverse drug reactions (ADRs) have used different definitions for ADR-related terminology, often do not differentiate immunologically and non-immunologically mediated drug hypersensitivity, study different study populations (different ethnicities, inpatients or outpatients, adults or children), utilize different methodologies (spontaneous vs. non-spontaneous reporting, cohort vs. case-control studies), different methods of assessing drug imputability and different methods of data analyses. Potentially life-threatening severe cutaneous adverse reactions (SCAR) are associated with a high risk of morbidity and mortality. HLA associations for SCAR associated with allopurinol, carbamazepine and abacavir have been reported with the potential for clinical use in screening prior to prescription. Identification of risk factors for drug allergy and appropriate genetic screening of at-risk ethnic groups may improve the outcomes of drug-specific SCAR. Research and collaboration are necessary for the generation of clinically-relevant, translational pharmacoepidemiological and pharmacogenomic knowledge, and success of health outcomes research and policies on drug allergies. PMID:21480948

Review and evaluation of innovative technologies for measuring diet in nutritional epidemiology.

PubMed

Illner, A-K; Freisling, H; Boeing, H; Huybrechts, I; Crispim, S P; Slimani, N

2012-08-01

The use of innovative technologies is deemed to improve dietary assessment in various research settings. However, their relative merits in nutritional epidemiological studies, which require accurate quantitative estimates of the usual intake at individual level, still need to be evaluated. To report on the inventory of available innovative technologies for dietary assessment and to critically evaluate their strengths and weaknesses as compared with the conventional methodologies (i.e. Food Frequency Questionnaires, food records, 24-hour dietary recalls) used in epidemiological studies. A list of currently available technologies was identified from English-language journals, using PubMed and Web of Science. The search criteria were principally based on the date of publication (between 1995 and 2011) and pre-defined search keywords. Six main groups of innovative technologies were identified ('Personal Digital Assistant-', 'Mobile-phone-', 'Interactive computer-', 'Web-', 'Camera- and tape-recorder-' and 'Scan- and sensor-based' technologies). Compared with the conventional food records, Personal Digital Assistant and mobile phone devices seem to improve the recording through the possibility for 'real-time' recording at eating events, but their validity to estimate individual dietary intakes was low to moderate. In 24-hour dietary recalls, there is still limited knowledge regarding the accuracy of fully automated approaches; and methodological problems, such as the inaccuracy in self-reported portion sizes might be more critical than in interview-based applications. In contrast, measurement errors in innovative web-based and in conventional paper-based Food Frequency Questionnaires are most likely similar, suggesting that the underlying methodology is unchanged by the technology. Most of the new technologies in dietary assessment were seen to have overlapping methodological features with the conventional methods predominantly used for nutritional epidemiology. Their main potential to enhance dietary assessment is through more cost- and time-effective, less laborious ways of data collection and higher subject acceptance, though their integration in epidemiological studies would need additional considerations, such as the study objectives, the target population and the financial resources available. However, even in innovative technologies, the inherent individual bias related to self-reported dietary intake will not be resolved. More research is therefore crucial to investigate the validity of innovative dietary assessment technologies.

Mycobacterium tuberculosis infection in cattle from the Eastern Cape Province of South Africa.

PubMed

Hlokwe, Tiny Motlatso; Said, Halima; Gcebe, Nomakorinte

2017-10-10

Mycobacterium tuberculosis is the main causative agent of tuberculosis (TB) in human and Mycobacterium bovis commonly causes tuberculosis in animals. Transmission of tuberculosis caused by both pathogens can occur from human to animals and vice versa. In the current study, M. tuberculosis, as confirmed by polymerase chain reaction (PCR) using primers targeting 3 regions of difference (RD4, RD9 and RD12) on the genomes, was isolated from cattle originating from two epidemiologically unrelated farms in the Eastern Cape (E.C) Province of South Africa. Although the isolates were genotyped with variable number of tandem repeat (VNTR) typing, no detailed epidemiological investigation was carried out on the respective farms to unequivocally confirm or link humans as sources of TB transmission to cattle, a move that would have embraced the 'One Health' concept. In addition, strain comparison with human M. tuberculosis in the database from the E.C Province and other provinces in the country did not reveal any match. This is the first report of cases of M. tuberculosis infection in cattle in South Africa. The VNTR profiles of the M. tuberculosis strains identified in the current study will form the basis for creating M. tuberculosis VNTR database for animals including cattle for future epidemiological studies. Our findings however, call for urgent reinforcement of collaborative efforts between the veterinary and the public health services of the country.

Early Environmental Origins of Neurodegenerative Disease in Later Life

PubMed Central

Landrigan, Philip J.; Sonawane, Babasaheb; Butler, Robert N.; Trasande, Leonardo; Callan, Richard; Droller, Daniel

2005-01-01

Parkinson disease (PD) and Alzheimer disease (AD), the two most common neurodegenerative disorders in American adults, are of purely genetic origin in a minority of cases and appear in most instances to arise through interactions among genetic and environmental factors. In this article we hypothesize that environmental exposures in early life may be of particular etiologic importance and review evidence for the early environmental origins of neurodegeneration. For PD the first recognized environmental cause, MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine), was identified in epidemiologic studies of drug abusers. Chemicals experimentally linked to PD include the insecticide rotenone and the herbicides paraquat and maneb; interaction has been observed between paraquat and maneb. In epidemiologic studies, manganese has been linked to parkinsonism. In dementia, lead is associated with increased risk in chronically exposed workers. Exposures of children in early life to lead, polychlorinated biphenyls, and methylmercury have been followed by persistent decrements in intelligence that may presage dementia. To discover new environmental causes of AD and PD, and to characterize relevant gene–environment interactions, we recommend that a large, prospective genetic and epidemiologic study be undertaken that will follow thousands of children from conception (or before) to old age. Additional approaches to etiologic discovery include establishing incidence registries for AD and PD, conducting targeted investigations in high-risk populations, and improving testing of the potential neurologic toxicity of chemicals. PMID:16140633

Occupational epidemiology and work related inequalities in health: a gender perspective for two complementary approaches to work and health research

PubMed Central

Artazcoz, Lucía; Borrell, Carme; Cortès, Imma; Escribà‐Agüir, Vicenta; Cascant, Lorena

2007-01-01

Objectives To provide a framework for epidemiological research on work and health that combines classic occupational epidemiology and the consideration of work in a structural perspective focused on gender inequalities in health. Methods Gaps and limitations in classic occupational epidemiology, when considered from a gender perspective, are described. Limitations in research on work related gender inequalities in health are identified. Finally, some recommendations for future research are proposed. Results Classic occupational epidemiology has paid less attention to women's problems than men's. Research into work related gender inequalities in health has rarely considered either social class or the impact of family demands on men's health. In addition, it has rarely taken into account the potential interactions between gender, social class, employment status and family roles and the differences in social determinants of health according to the health indicator analysed. Conclusions Occupational epidemiology should consider the role of sex and gender in examining exposures and associated health problems. Variables should be used that capture the specific work environments and health conditions of both sexes. The analysis of work and health from a gender perspective should take into account the complex interactions between gender, family roles, employment status and social class. PMID:18000116

Association between media use in adolescence and depression in young adulthood: a longitudinal study.

PubMed

Primack, Brian A; Swanier, Brandi; Georgiopoulos, Anna M; Land, Stephanie R; Fine, Michael J

2009-02-01

Although certain media exposures have been linked to the presence of psychiatric conditions, few studies have investigated the association between media exposure and depression. To assess the longitudinal association between media exposure in adolescence and depression in young adulthood in a nationally representative sample. Longitudinal cohort study. We used the National Longitudinal Survey of Adolescent Health (Add Health) to investigate the relationship between electronic media exposure in 4142 adolescents who were not depressed at baseline and subsequent development of depression after 7 years of follow-up. Main Outcome Measure Depression at follow-up assessed using the 9-item Center for Epidemiologic Studies-Depression Scale. Of the 4142 participants (47.5% female and 67.0% white) who were not depressed at baseline and who underwent follow-up assessment, 308 (7.4%) reported symptoms consistent with depression at follow-up. Controlling for all covariates including baseline Center for Epidemiologic Studies-Depression Scale score, those reporting more television use had significantly greater odds of developing depression (odds ratio [95% confidence interval], 1.08 [1.01-1.16]) for each additional hour of daily television use. In addition, those reporting more total media exposure had significantly greater odds of developing depression (1.05 [1.0004-1.10]) for each additional hour of daily use. We did not find a consistent relationship between development of depressive symptoms and exposure to videocassettes, computer games, or radio. Compared with young men, young women were less likely to develop depression given the same total media exposure (odds ratio for interaction term, 0.93 [0.88-0.99]). Television exposure and total media exposure in adolescence are associated with increased odds of depressive symptoms in young adulthood, especially in young men.

A Systematic Bayesian Integration of Epidemiological and Genetic Data

PubMed Central

Lau, Max S. Y.; Marion, Glenn; Streftaris, George; Gibson, Gavin

2015-01-01

Genetic sequence data on pathogens have great potential to inform inference of their transmission dynamics ultimately leading to better disease control. Where genetic change and disease transmission occur on comparable timescales additional information can be inferred via the joint analysis of such genetic sequence data and epidemiological observations based on clinical symptoms and diagnostic tests. Although recently introduced approaches represent substantial progress, for computational reasons they approximate genuine joint inference of disease dynamics and genetic change in the pathogen population, capturing partially the joint epidemiological-evolutionary dynamics. Improved methods are needed to fully integrate such genetic data with epidemiological observations, for achieving a more robust inference of the transmission tree and other key epidemiological parameters such as latent periods. Here, building on current literature, a novel Bayesian framework is proposed that infers simultaneously and explicitly the transmission tree and unobserved transmitted pathogen sequences. Our framework facilitates the use of realistic likelihood functions and enables systematic and genuine joint inference of the epidemiological-evolutionary process from partially observed outbreaks. Using simulated data it is shown that this approach is able to infer accurately joint epidemiological-evolutionary dynamics, even when pathogen sequences and epidemiological data are incomplete, and when sequences are available for only a fraction of exposures. These results also characterise and quantify the value of incomplete and partial sequence data, which has important implications for sampling design, and demonstrate the abilities of the introduced method to identify multiple clusters within an outbreak. The framework is used to analyse an outbreak of foot-and-mouth disease in the UK, enhancing current understanding of its transmission dynamics and evolutionary process. PMID:26599399

Sex-specific associations of serum uric acid with metabolic syndrome in Chinese rural population: The RuralDiab study.

PubMed

Zhang, Honglei; Li, Yuqian; Mao, Zhenxing; Liu, Xiaotian; Zhang, Xia; Yang, Kaili; Liu, Ruihua; Qian, Xinling; Zhang, Haiqing; Jiang, Jingjing; Zhang, Gongyuan; Wang, Chongjian

2018-05-01

We explored the association between serum uric acid (SUA) and metabolic syndrome (MetS) in Chinese rural adults. A total of 16,577 subjects (6354 men and 10,223 women) were from the RuralDiab study. SUA concentration was measured by the enzymatic colorimetric method. A meta-analysis including 12 eligible studies focused on SUA and MetS was preformed to confirm the findings of the cross-sectional study. After adjustment for age, educational level, and other covariates, the odds ratio (ORs) for MetS increased smoothly with the increasing SUA concentration in both sexes (P for no-linear trend > 0.05). The adjusted ORs of MetS comparing the fourth and firstly quartiles were 3.11 [95% CI: 2.58-3.74] in men and 3.64 [95% CI: 3.22-4.11] in women (P trend  < 0.001). In continuous analysis, each 1 mg/dl increment in SUA concentration was significantly associated with a 41% increased risk of MetS in men and 62% in women. The meta-analysis validated the positive association between SUA and MetS (pooled OR: Men, 1.80 [95% CI: 1.57-2.07]; Women, 2.46 [95% CI: 1.95-3.12]). SUA concentration was positively with the prevalence of MetS in Chinese rural population, and more studies are needed to explore the mechanisms of the relationship. WHAT IS ALREADY KNOWN ON THIS TOPIC?: Previous studies have explored the association between serum uric acid and metabolic syndrome, but evidence on the strength and consistency of the association remains uncertain and limited, especially in rural population. In addition, the epidemiological research and meta-analysis on the association have not been reported. WHAT DOES THIS STUDY ADD?: The results of this study showed that serum uric acid was significantly associated with metabolic syndrome and its components in Chinese rural population. Furthermore, the findings demonstrated that the significant associations varied across sex. In addition, the results of epidemiological research were similar with the meta-analysis, which demonstrates the credible of the results of the epidemiology research. Copyright © 2018 Elsevier B.V. All rights reserved.

Combined Application of Study Design and Case-Based Learning Comprehensive Model in Epidemiology Teaching

ERIC Educational Resources Information Center

Shi, Xiuquan; Zhou, Yanna; Wang, Haiyan; Wang, Tao; Nie, Chan; Shi, Shangpeng

2017-01-01

This paper aims to conduct the SD-CBL (study design with the case based learning, SD-CBL) in Epidemiology teaching and evaluate its effect. Students from five classes were recruited, and a combined comprehensive teaching model of SD-CBL was used in the "Injury Epidemiology" chapter, while other chapters in "Epidemiology"…

Depression in dementia: epidemiology, mechanisms, and treatment.

PubMed

Enache, Daniela; Winblad, Bengt; Aarsland, Dag

2011-11-01

Depression in people with dementia has important implications, such as reduced quality of life of patients and carers, and is associated with increased costs and reduced cognition. Here, we review recent studies of the epidemiology, course, mechanisms and treatment of depression in people with dementia. Depression is both a risk factor and a prodrome of Alzheimer's disease. Depression is a common occurrence in all types of dementias and at all disease stages, including in mild cognitive impairment (MCI). Many studies have explored whether depression in MCI increased the conversion rate to dementia, but findings are inconsistent. Studies of the mechanisms are relatively few and findings inconsistent, but inflammatory, trophic and cerebrovascular factors may contribute, in addition to monoamine deficiency and severity of plaques and tangle pathology. Studies of antidepressants for depression in dementia are inconclusive, with several negative findings reported in recent large studies, suggesting that antidepressant may not confer benefit over placebo. Depression is a common risk factor, prodrome, and accompanying symptom of people with Alzheimer's dementia. The mechanisms are unknown, and there is little evidence of effective therapies.

Epidemiological characteristics of hand-foot-and-mouth disease in China, 2008-2012

PubMed Central

Sun, Junling; Wu, Joseph T; Chang, Zhaorui; Liu, Fengfeng; Fang, Vicky J; Zheng, Yingdong; Cowling, Benjamin J; Varma, Jay K; Farrar, Jeremy J; Leung, Gabriel M; Yu, Hongjie

2014-01-01

Summary Background Hand–foot–and–mouth disease (HFMD) is a common childhood illness caused by enteroviruses. Increasingly it imposes a substantial disease burden throughout East and Southeast Asia. To better inform vaccine and other interventions, we characterized the epidemiology of HFMD in China based on enhanced surveillance. Methods We extracted epidemiological, clinical and laboratory data from reported HFMD cases during 2008–2012 and compiled climatic, geographic and demographic information. All analyses were stratified by age, disease severity, laboratory confirmation status and enterovirus subtype. Findings The surveillance registry captured 7,200,092 probable HFMD cases (annualized incidence, 1·2 per 1,000), of whom 3·7% were laboratory–confirmed and 0·03% died. Incidence and mortality were highest in children aged 12–23 months (in 2012: 38·2 cases per 1,000 and 1·5 death per 100,000). Median durations from onset to diagnosis and death were 1·5 days and 3·5 days respectively. The risk of cardiopulmonary or neurological complications was 1·1% and the severe-case fatality risk was 3·0%, with >90% of deaths associated with enterovirus 71. HFMD peaked annually in June in the North, whereas Southern China experienced semi-annual outbreaks in May and September/October. Geographic differences in seasonal patterns were weakly associated with climate and demographic factors (variance explained 8-23% and 3–19%, respectively). Interpretation This is the largest population-based study to date of the epidemiology of HFMD. Future mitigation policies should take full account of the heterogeneities of disease burden identified. Additional epidemiologic and serologic studies are warranted to elucidate local HFMD dynamics and immunity patterns and optimize interventions. Funding China–US Collaborative Program on Emerging and Re-emerging Infectious Diseases; World Health Organization; The Li Ka Shing Oxford Global Health Programme and Wellcome Trust; Harvard Center for Communicable Disease Dynamics; Health and Medical Research Fund, Government of the Hong Kong Special Administrative Region. PMID:24485991

Current practice of epidemiology in Africa: highlights of the 3rd conference of the African epidemiological association and 1st conference of the Cameroon society of epidemiology, Yaoundé, Cameroon, 2014

PubMed Central

Nkwescheu, Armand Seraphin; Fokam, Joseph; Tchendjou, Patrice; Nji, Akindeh; Ngouakam, Hermann; Andre, Bita Fouda; Joelle, Sobngwi; Uzochukwu, Benjamin; Akinroye, Kingsley; Mbacham, Wilfred; Colizzi, Vittorio; Leke, Rose; Victora, Cesar

2015-01-01

As the study of disease occurrence and health indicators in human populations, Epidemiology is a dynamic field that evolves with time and geographical context. In order to update African health workers on current epidemiological practices and to draw awareness of early career epidemiologists on concepts and opportunities in the field, the 3rd African Epidemiology Association and the 1st Cameroon Society of Epidemiology Conference was organized in June 2-6, 2014 at the Yaoundé Mont Febe Hotel, in Cameroon. Under the theme«Practice of Epidemiology in Africa: Stakes, Challenges and Perspectives», the conference attracted close to five hundred guest and participants from all continents. The two main programs were the pre-conference course for capacity building of African Early Career epidemiologists, and the conference itself, providing a forum for scientific exchanges on recent epidemiological concepts, encouraging the use of epidemiological methods in studying large disease burden and neglected tropical diseases; and highlighting existing opportunities. PMID:26523191

Current practice of epidemiology in Africa: highlights of the 3rd conference of the African epidemiological association and 1st conference of the Cameroon society of epidemiology, Yaoundé, Cameroon, 2014.

PubMed

Nkwescheu, Armand Seraphin; Fokam, Joseph; Tchendjou, Patrice; Nji, Akindeh; Ngouakam, Hermann; Andre, Bita Fouda; Joelle, Sobngwi; Uzochukwu, Benjamin; Akinroye, Kingsley; Mbacham, Wilfred; Colizzi, Vittorio; Leke, Rose; Victora, Cesar

2015-01-01

As the study of disease occurrence and health indicators in human populations, Epidemiology is a dynamic field that evolves with time and geographical context. In order to update African health workers on current epidemiological practices and to draw awareness of early career epidemiologists on concepts and opportunities in the field, the 3(rd) African Epidemiology Association and the 1st Cameroon Society of Epidemiology Conference was organized in June 2-6, 2014 at the Yaoundé Mont Febe Hotel, in Cameroon. Under the theme«Practice of Epidemiology in Africa: Stakes, Challenges and Perspectives», the conference attracted close to five hundred guest and participants from all continents. The two main programs were the pre-conference course for capacity building of African Early Career epidemiologists, and the conference itself, providing a forum for scientific exchanges on recent epidemiological concepts, encouraging the use of epidemiological methods in studying large disease burden and neglected tropical diseases; and highlighting existing opportunities.

[Scientific, practical and educational aspects of clinical epidemiology].

PubMed

Briko, N I

2012-01-01

This article defines clinical epidemiology and describes its goal and objectives. The author claims that clinical epidemiology is a section of epidemiology which underlies the development of evidence-based standards for diagnostics, treatment and prevention and helps to select the appropriate algorithm for each clinical case. The study provides a comprehensive overview of the relationship between clinical epidemiology and evidence-based medicine. Epidemiological research is shown to be methodological basis of clinical epidemiology and evidence-based medicine with randomized controlled trials being the "gold standard" for obtaining reliable data. The key stages in the history of clinical epidemiology are discussed and further development of clinical epidemiology and the integration of courses on clinical epidemiology in education is outlined for progress in medical research and health care practice.

A molecular epidemiological survey of Babesia, Hepatozoon, Ehrlichia and Anaplasma infections of dogs in Japan

PubMed Central

KUBO, Shotaro; TATENO, Morihiro; ICHIKAWA, Yasuaki; ENDO, Yasuyuki

2015-01-01

Tick-borne diseases are often encountered in canine clinical practice. In the present study, a molecular epidemiological survey of dogs in Japan was conducted to understand the prevalence and geographical distribution of Babesia spp., Hepatozoon spp., Ehrlichia spp. and Anaplasma spp. Pathogen-derived DNA in blood samples obtained from 722 dogs with a history of exposure to ticks and/or fleas was examined by PCR. The prevalence of Babesia gibsoni, Babesia odocoilei-like species, Hepatozoon canis and Ehrlichia spp./Anaplasma spp. was 2.4% (16/722), 0.1% (1/722), 2.5% (18/722) and 1.5% (11/722), respectively. While B. gibsoni and Ehrlichia spp./Anaplasma spp. were detected in the western part of Japan, H. canis was detected in Tohoku area in addition to western and central parts of Japan. PMID:25947226

Overview of Recent Marine and Freshwater Recreational Epidemiology Studies and Their Findings

EPA Science Inventory

Overview of Recent Marine and Freshwater Recreational Epidemiology Studies and Their Findings Timothy J. Wade, Elizabeth A. Sams, Rich Haugland, Alfred P. Dufour The National Epidemiologic and Environmental Assessment of Recreational Water Study was conducted to address aspects...

hprt mutant frequencies, nonpulmonary malignancies, and domestic radon exposure: "postmortem" analysis of an interesting hypothesis.

PubMed

Ruttenber, A J; Harrison, L T; Baron, A; McClure, D; Glanz, J; Quillin, R; O'Neill, J P; Sullivan, L; Campbell, J; Nicklas, J A

2001-01-01

The hypothesis that exposure to domestic radon raises the risk for leukemia and other nonpulmonary cancers has been proposed and tested in a number of epidemiologic studies over the past decade. During this period, interest in this hypothesis was heightened by evidence of increased frequencies of mutations at the hypoxanthine guanine phosphoribosyl transferase (hprt) gene in persons exposed to domestic radon (Bridges BA et al. [1991]: Lancet 337:1187-1189). An extension of this study (Cole J et al. [lsqb[1996]: Radiat Res 145:61-69) and two independent studies (Albering HJ et al. [1992[: Lancet 340:739; Albering HJ et al. [1994[: Lancet 344:750-751) found that hprt mutant frequency was not correlated with domestic radon exposure, and two well-designed epidemiologic studies showed no evidence of a relation between radon exposure and leukemia in children or adults. In this report, we present additional data from a study of Colorado high school students showing no correlation between domestic radon exposure and hprt mutant frequency. We use reanalyses of previous studies of radon and hprt mutant frequency to identify problems with this assay as a biomarker for domestic radon exposure and to illustrate difficulties in interpreting the statistical data. We also show with analyses of combined data sets that there is no support for the hypothesis that domestic radon exposure elevates hprt mutant frequency. Taken together, the scientific evidence provides a useful example of the problems associated with analyzing and interpreting data that link environmental exposures, biomarkers, and diseases in epidemiologic studies. Copyright 2001 Wiley-Liss, Inc.

Is frequency of tooth brushing a risk factor for periodontitis? A systematic review and meta-analysis.

PubMed

Zimmermann, Heiko; Zimmermann, Nils; Hagenfeld, Daniel; Veile, Annette; Kim, Ti-Sun; Becher, Heiko

2015-04-01

The epidemiology of periodontitis regarding oral-hygiene practices particularly the frequency of tooth brushing has been the subject of relatively few dedicated studies. This paper provides a systematic review of available relevant epidemiological studies and a meta-analysis of the effect of tooth brushing frequency on periodontitis. To review and to quantify the risk for periodontitis associated with frequency of tooth brushing. Systematic literature search was conducted in nine online resources (PUBMED, ISI and 7 additional databases). Related and cross-referencing publications were reviewed. Papers published until end of March 2013 reporting associations between tooth brushing frequency and periodontitis were considered. A meta-analysis was performed to quantify this association. Fourteen studies were identified. The test of heterogeneity for cross-sectional studies was not significant (P = 0.31). A fixed-effects model yielded a significant overall odds ratio estimate of 1.41 (95%CI: 1.25-1.58, P < 0.0001) for infrequent compared to frequent tooth brushing. For all fourteen studies, there was a slight indication for heterogeneity (I² = 48%, P = 0.02) and the corresponding result with a random-effects model was 1.44 (95%CI: 1.21-1.71, P < 0.0001). There are relatively few studies evaluating the association between tooth brushing frequency and periodontitis. A clear effect was observed, indicating that infrequent tooth brushing was associated with severe forms of periodontal disease. Further epidemiological studies are needed to precisely estimate the effect of key risk factors for periodontitis and their interaction effects. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Injuries in Competitive Dragon Boating.

PubMed

Mukherjee, Swarup; Leong, Hin Fong; Chen, Simin; Foo, Yong Xiang Wayne; Pek, Hong Kiat

2014-11-01

Dragon boating is a fast-growing team water sport and involves forceful repetitive motions that predispose athletes to overuse injuries. Despite the rising popularity of the sport, there is a lack of studies on injury epidemiology in dragon boating. To investigate the injury epidemiology in competitive dragon boating athletes. Descriptive epidemiological study. A total of 95 dragon boaters (49 males, 46 females) representing their respective universities took part in this study. Data were collected retrospectively using a reliable and valid self-report questionnaire. The study period was from August 2012 to July 2013. A total of 104 musculoskeletal injuries were reported (3.82 injuries/1000 athlete-exposures), 99% of which occurred during training. The most commonly injured regions were the lower back (22.1%), shoulder (21.1%), and wrist (17.3%). The majority of injuries were due to overuse (56.3%), and incomplete muscle-tendon strain was the most prevalent type of injury (50.5%). The time loss from injuries varied. In addition, a significant majority of the dragon boating athletes incurred nonmusculoskeletal injuries, with abrasions (90.5%), blisters (78.9%), and sunburns (72.6%) being the most common. Competitive dragon boating has a moderately high injury incidence, and there seems to be a direct relationship between exposure time and injury rate. A majority of the injuries are overuse in nature, and the body parts most actively involved in paddling movement are at higher risk of injuries. The high incidence of nonmusculoskeletal injuries in dragon boaters suggested that these injuries are likely outcomes of participation in the sport.

[Biological markers in epidemiology: concepts, applications, perspectives (part I)].

PubMed

Hoffmann, W; Latza, U; Ahrens, W; Greiser, K H; Kroke, A; Nieters, A; Schulze, M B; Steiner, M; Terschüren, C; Wjst, M

2002-02-01

The inclusion of biomarkers in epidemiological research provides new possibilities for exposure assessment and the study of early structural or functional changes and pre-clinical stages of diseases. At the same time issues of validity, reliability, and quality control as well as logistics require special attention. Usually epidemiological studies become more expensive with regard to time and cost. Interdisciplinary collaboration between epidemiology, basic research, and laboratory research is crucial. A prerequisite for this collaboration are agreements on definitions, methods and procedures. The definition of "biomarker" and a description of previous uses of biomarkers in epidemiological studies are presented in the first part of this paper. The second part addresses genetic markers and markers of individual sensitivity and susceptibility. We will end with a discussion about the possible future of biomarkers in epidemiology.

Advances in spatial epidemiology and geographic information systems.

PubMed

Kirby, Russell S; Delmelle, Eric; Eberth, Jan M

2017-01-01

The field of spatial epidemiology has evolved rapidly in the past 2 decades. This study serves as a brief introduction to spatial epidemiology and the use of geographic information systems in applied research in epidemiology. We highlight technical developments and highlight opportunities to apply spatial analytic methods in epidemiologic research, focusing on methodologies involving geocoding, distance estimation, residential mobility, record linkage and data integration, spatial and spatio-temporal clustering, small area estimation, and Bayesian applications to disease mapping. The articles included in this issue incorporate many of these methods into their study designs and analytical frameworks. It is our hope that these studies will spur further development and utilization of spatial analysis and geographic information systems in epidemiologic research. Copyright © 2016 Elsevier Inc. All rights reserved.

Sequencing Strategies for Population and Cancer Epidemiology Studies (SeqSPACE) Webinar Series

Cancer.gov

The Sequencing Strategies for Population and Cancer Epidemiology Studies (SeqSPACE) Webinar Series provides an opportunity for our grantees and other interested individuals to share lessons learned and practical information regarding the application of next generation sequencing to cancer epidemiology studies.

The Biomonitoring, Environmental Epidemiology, and Short-Lived Chemicals (BEES-C) Instrument for Assessing Study Quality

EPA Science Inventory

Environmental epidemiology studies can be an effective means to assess impacts on human health from exposure to environmental stressors. Exposure scenarios are often extremely complex and proper assessment is critical for interpreting epidemiological study results. Biomarkers are...

Challenges and Opportunities for Occupational Epidemiology in the Twenty-first Century.

PubMed

Stayner, L T; Collins, J J; Guo, Y L; Heederik, D; Kogevinas, M; Steenland, K; Wesseling, C; Demers, P A

2017-09-01

There are many opportunities and challenges for conducting occupational epidemiologic studies today. In this paper, we summarize the discussion of a symposium held at the Epidemiology in Occupational Health (EPICOH) conference, Chicago 2014, on challenges for occupational epidemiology in the twenty-first century. The increasing number of publications and attendance at our conferences suggests that worldwide interest in occupational epidemiology has been growing. There are clearly abundant opportunities for new research in occupational epidemiology. Areas ripe for further work include developing improved methods for exposure assessment, statistical analysis, studying migrant workers and other vulnerable populations, the use of biomarkers, and new hazards. Several major challenges are also discussed such as the rapidly changing nature and location of work, lack of funding, and political/legal conflicts. As long as work exists there will be occupational diseases that demand our attention, and a need for epidemiologic studies designed to characterize these risks and to support the development of preventive strategies. Despite the challenges and given the important past contribution in this field, we are optimistic about the importance and continued vitality of the research field of occupational epidemiology.

Frequency and longitudinal trends of household care product use

NASA Astrophysics Data System (ADS)

Moran, Rebecca E.; Bennett, Deborah H.; Tancredi, Daniel J.; Wu, Xiangmei (May); Ritz, Beate; Hertz-Picciotto, Irva

2012-08-01

The use of household cleaning products and air fresheners exposes people to a variety of chemicals, including some that have been shown to be irritants, potential carcinogens and endocrine disrupting compounds. In addition, some react with ambient ozone infiltrating to the indoor environment to form potentially toxic secondary pollutants. Although realistic estimates of usage patterns are necessary for modeling potential exposures in risk assessments, few studies have documented cleaning habits and product usage to characterize how they vary between households and over time. In addition, understanding within-household temporal variability of use is important to assess the reliability of exposure questionnaires used in epidemiological surveys and improve the cost-efficiency of data collection. In the SUPERB (Study of Use of Products and Exposure-Related Behavior) study, frequencies of use of eight types of household cleaning products and air fresheners and the performance of different types of cleaning tasks are collected in three annual telephone and six quarterly web-based surveys. All-purpose and glass cleaners were the products most frequently used among all products surveyed. Use frequencies differed by demographic and other household characteristics for some products. Product usage was internally consistent, with over 75% of pairwise cross-sectional correlations between product types statistically significantly different from zero. In addition, each product type was correlated with at least one cleaning habit. Frequency of cleaning product use and performing cleaning tasks did not vary by season. An examination of intra-household variability showed moderately to highly consistent usage patterns over time, with lower temporal consistency observed among products used more frequently, such as all-purpose cleaners. Frequency of household care product usage was consistent enough that in epidemiologic studies, participants can be classified, for example, into three categories on the basis of a single assessment, with only minimal misclassification.

Epidemiological studies of cognitive impairment and dementia across Eastern and Middle European countries (epidemiology of dementia in Eastern and Middle European Countries).

PubMed

Kiejna, A; Frydecka, D; Adamowski, T; Bickel, H; Reynish, E; Prince, M; Caracciolo, B; Fratiglioni, L; Georges, J

2011-02-01

To determine the availability and the consistency of prevalence findings of epidemiological studies on cognitive impairment and dementia conducted in Eastern and Middle Europe. We adopted a stepwise multimethod study approach consisting of iterative literature searches for epidemiological articles published between 1990 and 2006 and subsequent data analyses of published material, reanalyses of existing accessible epidemiological data sets and expert inquiries in Eastern and Middle European countries. Systematic computer-assisted searches used the keywords: "dementia", "Alzheimer", "cognitive impairment", "incidence", "prevalence", "epidemiology" in combination with the name of the relevant countries or "Europe" in English and Polish language. We supplemented the literature search with a review of the references in the articles that were identified during the initial search. We were able to find few regional and country-specific epidemiological studies of various kinds (population-based, cohort, cross-sectional studies) and conducted on different restricted population groups of patients (from neurological units, out-patients units, residential homes). No studies were identified from most of the countries taken under consideration and the ones we found were characterized by an immense diversity with a considerable degree of clinical and methodological variations. The few studies that there are suggest prevalence rates of dementia in Eastern Europe similar to those in Western Europe. There is strong need for epidemiological studies in Eastern and Middle Europe, as well as for greater coordination and standardization of methods to improve the quality and comparability of epidemiological data to determine the prevalences' rates of dementia in all the EU countries. Copyright © 2010 John Wiley & Sons, Ltd.

[Biology and culture: a dimension of collaboration between anthropology and epidemiology].

PubMed

Song, Leiming; Wang, Ning

2016-01-01

Biology is the important basis of epidemiological study. Based on biology, psychology, social and cultural factors can influence human's health and disease incidence. The medical mode has changed from "biomedical mode" to "bio-psycho-social medical model" , but culture factor was neglected somewhat during this process, so paying attention to culture factor in anthropologic study and using it as biologic basis in epidemiologic study might be a dimension of collaboration between of anthropology and epidemiology.

Transmembrane domain dependent inhibitory function of FcγRIIB.

PubMed

Wang, Junyi; Li, Zongyu; Xu, Liling; Yang, Hengwen; Liu, Wanli

2018-03-01

FcγRIIB, the only inhibitory IgG Fc receptor, functions to suppress the hyper-activation of immune cells. Numerous studies have illustrated its inhibitory function through the ITIM motif in the cytoplasmic tail of FcγRIIB. However, later studies revealed that in addition to the ITIM, the transmembrane (TM) domain of FcγRIIB is also indispensable for its inhibitory function. Indeed, recent epidemiological studies revealed that a non-synonymous single nucleotide polymorphism (rs1050501) within the TM domain of FcγRIIB, responsible for the I232T substitution, is associated with the susceptibility to systemic lupus erythematosus (SLE). In this review, we will summarize these epidemiological and functional studies of FcγRIIB-I232T in the past few years, and will further discuss the mechanisms accounting for the functional loss of FcγRIIB-I232T. Our review will help the reader gain a deeper understanding of the importance of the TM domain in mediating the inhibitory function of FcγRIIB and may provide insights to a new therapeutic target for the associated diseases.

Dietary salt intake and risk of gastric cancer.

PubMed

D'Elia, Lanfranco; Galletti, Ferruccio; Strazzullo, Pasquale

2014-01-01

Humans began to use large amounts of salt for the main purpose of food preservation approximately 5,000 years ago and, although since then advanced technologies have been developed allowing drastic reduction in the use of salt for food storage, excess dietary salt intake remains very common. Gastric cancer is a common neoplasia, and dietary factors, including salt consumption, are considered relevant to its causation. A number of experimental studies supported the cocarcinogenic effect of salt through synergic action with Helicobacter pylori infection, in addition to some independent effects such as increase in the rate of cell proliferation and of endogenous mutations. Many epidemiological studies analyzed the relationship between excess salt intake and risk of gastric cancer. Both cross-sectional and prospective studies indicated a possibly dose-dependent positive association. In particular, a comprehensive meta-analysis of longitudinal studies detected a strong adverse effect of total salt intake and salt-rich foods on the risk of gastric cancer in the general population. Altogether, the epidemiological, clinical, and experimental evidence supports the possibility of a substantial reduction in the rates of gastric cancer through progressive reduction in population salt intake.

A review of mortality associated with elongate mineral particle (EMP) exposure in occupational epidemiology studies of gold, talc, and taconite mining.

PubMed

Mandel, Jeffrey H; Alexander, Bruce H; Ramachandran, Gurumurthy

2016-12-01

Mining of gold, taconite, and talc may involve exposure to elongate mineral particles (EMP). The involved EMPs are typically non-asbestiform, include dimensions that regulatory definitions exclude, and have been less studied. A review of the literature was undertaken for this exposure and occupational epidemiological studies that occur in gold, talc, and taconite mining. Quantitative EMP exposure information in these industries is incomplete. However, there are consistent findings of pneumoconiosis in each of these types of mining. A recent case-control study suggests a possible association between this exposure and mesothelioma. Lung cancer is inconsistently reported in these industries and is an unlikely outcome of non-asbestiform EMP exposure. There is evidence of cardiovascular mortality excess across all of these types of mining. Non-malignant respiratory disease and cardiovascular mortality have been consistently increased in these industries. Further investigation, including additional insights for the role of non-asbestiform EMP, is warranted. Am. J. Ind. Med. 59:1047-1060, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

The epidemiology of injury among surfers, kite surfers and personal watercraft riders: wind and waves.

PubMed

Pikora, Terri J; Braham, Rebecca; Mills, Christina

2012-01-01

The objective of this review was to summarize the epidemiological literature for surfboard riding (surfing), kite surfing and personal watercraft (PWC) riding injuries and describe the incidence and nature of these injuries, common risk factors, and strategies for prevention. The databases searched for relevant publications included Medline, ScienceDirect, ProQuest International, PubMed, Academic Search Premier as well as Google Scholar to identify additional, non-indexed studies. Overall, there was a lack of good quality descriptive studies for these three sports and many of the studies reviewed involved the use of administrative datasets or case-series designs. Among the few studies to provide incidence estimates, there were inconsistencies in how injury was defined, the inclusion criteria, and the reporting of incidence rates, making comparisons within and between the sports difficult. While the reported incidence rates were generally low, head and lower extremity injuries were common across all three sports. Only two studies reported evidence for postulated risk factors. Bigger waves and surfing over rock or reef sea floor increased the risk of injury among competitive surfers, while older age and having more experience increased the risk of significant injuries among recreational surfers. No evaluations of preventative measures were identified. This review demonstrates the need for well-designed epidemiological research, especially studies that focus on the accurate measurement and description of incidence, nature, severity and circumstances of injuries. Once this has occurred, interventions targeted at reducing the incidence of injuries among these sports can be designed, implemented and evaluated. Copyright © 2012 S. Karger AG, Basel.

U.S. EPA health assessment for diesel engine exhaust: a review.

PubMed

Ris, Charles

2007-01-01

In 2002 the U.S. Environmental Protection Agency (EPA) released a Health assessment Document for Diesel Engine Exhaust. The objective of this assessment was to examine the possible health hazards associated with exposure to diesel engine exhaust (DE). The assessment concludes that long-term inhalation exposure is likely to pose a lung cancer hazard to humans as inferred from epidemiologic and certain animal studies. Estimation of cancer potency from available epidemiology studies was not attempted because of the absence of a confident cancer dose-response and animal studies were not judged appropriate for cancer potency estimation. A noncancer chronic human health hazard is inferred from rodent studies which show dose-dependent inflammation and histopathology in the rat lung. For these noncancer effects a safe exposure concentration for humans was estimated. Short-term exposures were noted to cause irritation and inflammatory symptoms of a transient nature, these being highly variable across an exposed population. The assessment also indicates that there is emerging evidence for the exacerbation of existing allergies and asthma symptoms; however, as of 2002 the data were inadequate for quantitative dose-response analysis. The assessment conclusions are based on studies that used exposures from engines built prior to the mid 1990s. More recent engines without high-efficiency particle traps would be expected to have exhaust emissions with similar characteristics. With additional cancer epidemiology studies expected in 2007-2008, and a growing body of evidence for allergenicity and cardiovascular effects, future health assessments will have an expanded health effects data base to evaluate.

An Interactive, Web-based High Performance Modeling Environment for Computational Epidemiology.

PubMed

Deodhar, Suruchi; Bisset, Keith R; Chen, Jiangzhuo; Ma, Yifei; Marathe, Madhav V

2014-07-01

We present an integrated interactive modeling environment to support public health epidemiology. The environment combines a high resolution individual-based model with a user-friendly web-based interface that allows analysts to access the models and the analytics back-end remotely from a desktop or a mobile device. The environment is based on a loosely-coupled service-oriented-architecture that allows analysts to explore various counter factual scenarios. As the modeling tools for public health epidemiology are getting more sophisticated, it is becoming increasingly hard for non-computational scientists to effectively use the systems that incorporate such models. Thus an important design consideration for an integrated modeling environment is to improve ease of use such that experimental simulations can be driven by the users. This is achieved by designing intuitive and user-friendly interfaces that allow users to design and analyze a computational experiment and steer the experiment based on the state of the system. A key feature of a system that supports this design goal is the ability to start, stop, pause and roll-back the disease propagation and intervention application process interactively. An analyst can access the state of the system at any point in time and formulate dynamic interventions based on additional information obtained through state assessment. In addition, the environment provides automated services for experiment set-up and management, thus reducing the overall time for conducting end-to-end experimental studies. We illustrate the applicability of the system by describing computational experiments based on realistic pandemic planning scenarios. The experiments are designed to demonstrate the system's capability and enhanced user productivity.

An Interactive, Web-based High Performance Modeling Environment for Computational Epidemiology

PubMed Central

Deodhar, Suruchi; Bisset, Keith R.; Chen, Jiangzhuo; Ma, Yifei; Marathe, Madhav V.

2014-01-01

We present an integrated interactive modeling environment to support public health epidemiology. The environment combines a high resolution individual-based model with a user-friendly web-based interface that allows analysts to access the models and the analytics back-end remotely from a desktop or a mobile device. The environment is based on a loosely-coupled service-oriented-architecture that allows analysts to explore various counter factual scenarios. As the modeling tools for public health epidemiology are getting more sophisticated, it is becoming increasingly hard for non-computational scientists to effectively use the systems that incorporate such models. Thus an important design consideration for an integrated modeling environment is to improve ease of use such that experimental simulations can be driven by the users. This is achieved by designing intuitive and user-friendly interfaces that allow users to design and analyze a computational experiment and steer the experiment based on the state of the system. A key feature of a system that supports this design goal is the ability to start, stop, pause and roll-back the disease propagation and intervention application process interactively. An analyst can access the state of the system at any point in time and formulate dynamic interventions based on additional information obtained through state assessment. In addition, the environment provides automated services for experiment set-up and management, thus reducing the overall time for conducting end-to-end experimental studies. We illustrate the applicability of the system by describing computational experiments based on realistic pandemic planning scenarios. The experiments are designed to demonstrate the system's capability and enhanced user productivity. PMID:25530914

Epidemiologic survey of Kawasaki disease in Inner Mongolia, China, between 2001 and 2013

PubMed Central

Zhang, Xiaomei; Liang, Yanyan; Feng, Wanyu; Su, Xuewen; Zhu, Hua

2016-01-01

The epidemiologic features of Kawasaki disease (KD) in the Inner Mongolia Autonomous Region of China has not been previously determined, to the best of our knowledge. Therefore, the aim of the present study was to investigate the epidemiology of KD in Inner Mongolia. Clinical data from 518 patients treated for KD in Inner Mongolia between January 2001 and December 2013 were analyzed. The results indicated that the mean annual incidence rate was 3.55±2.96 per 100,000 children under the age of 5 years between 2001 and 2013. The age at diagnosis ranged between 49 days and 14 years, while the disease occurred more frequently in the spring and summer. In addition, the incidence of coronary artery lesion (CAL) was reported to be 40.2% in the present survey. KD patients in the Han Chinese ethnic group were more likely to be complicated by CAL, whereas patients with incidence of KD in July were less likely to be complicated by CAL. In conclusion, the incidence of KD was observed to be increasing in Inner Mongolia, while the ethnic group and month of onset may be associated with the incidence of CAL in KD patients. PMID:27446347

Systematic review of pancreatic cancer epidemiology in Asia-Pacific Region: major patterns in GLOBACON 2012

PubMed Central

Pourhoseingholi, Mohamad Amin; Ashtari, Sara; Hajizadeh, Nastaran; Fazeli, Zeinab; Zali, Mohammad Reza

2017-01-01

Pancreatic cancer is one of the deadliest cancers with short-term survival rates. Trends for pancreatic cancer incidence and mortality varied considerably in the world. To date, the causes of pancreatic cancer are not known sufficiently, although certain risk factors have been identified such as, smoking, obesity, life style, diabetes mellitus, alcohol, dietary factors and chronic pancreatitis. Since there are no current screening recommendations for pancreatic cancer, primary prevention is very important. Therefore, up-to-date statistics on pancreatic cancer occurrence and outcome are essential for the primary prevention of this disease. Due to the lack of information on epidemiology of pancreatic cancer in most Asian countries, and limited of statistics and registration system in this area, we conducted a systematic review study to evaluate the most recent data concerning epidemiology of pancreatic cancer in Asia-Pacific region. In this review we focused on collected recent data on incidence, mortality, survival and risk factors of pancreatic cancer in this region. In addition, we reviewed and used the data of GLOBOCAN 2012 in this paper to complete the information as a source of compiling pancreatic cancer incidence and mortality rate. PMID:29379588

Is the Linear No-Threshold Dose-Response Paradigm Still Necessary for the Assessment of Health Effects of Low Dose Radiation?

PubMed Central

2016-01-01

Inevitable human exposure to ionizing radiation from man-made sources has been increased with the proceeding of human civilization and consequently public concerns focus on the possible risk to human health. Moreover, Fukushima nuclear power plant accidents after the 2011 East-Japan earthquake and tsunami has brought the great fear and anxiety for the exposure of radiation at low levels, even much lower levels similar to natural background. Health effects of low dose radiation less than 100 mSv have been debated whether they are beneficial or detrimental because sample sizes were not large enough to allow epidemiological detection of excess effects and there was lack of consistency among the available experimental data. We have reviewed an extensive literature on the low dose radiation effects in both radiation biology and epidemiology, and highlighted some of the controversies therein. This article could provide a reasonable view of utilizing radiation for human life and responding to the public questions about radiation risk. In addition, it suggests the necessity of integrated studies of radiobiology and epidemiology at the national level in order to collect more systematic and profound information about health effects of low dose radiation. PMID:26908982

[Operative treatment of traumatic fractures of the thoracic and lumbar spinal column. Part I: epidemiology].

PubMed

Reinhold, M; Knop, C; Beisse, R; Audigé, L; Kandziora, F; Pizanis, A; Pranzl, R; Gercek, E; Schultheiss, M; Weckbach, A; Bühren, V; Blauth, M

2009-01-01

The Spine Study Group (AG WS) of the German Trauma Association (DGU) has now been in existence for more than a decade. Its main objective is the evaluation and optimization of the operative treatment for traumatic spinal injuries. The authors present the results of the second prospective internet-based multicenter study (MCS II) of the AG WS in three consecutive parts: epidemiology, surgical treatment and radiologic findings and follow-up results. The aim of the study was to update and review the state-of-the art for treatment of spinal fractures for thoracic and lumbar spine (T1-L5) injuries in German-speaking countries: which lesions will be treated with which procedure and what differences can be found in the course of treatment and the clinical and radiological outcome? This present first part of the study outlines the new study design and concept of an internet-based data collection system. The epidemiologic findings and characteristics of the three major treatment subgroups of the study collective will be presented: operative treatment (OP), non-operative treatment (KONS), and patients receiving a kyphoplasty and/or vertebroplasty without additional instrumentation (PLASTIE). A total of 865 patients (OP n=733, KONS n=52, PLASTIE n=69, other n=7) from 8 German and Austrian trauma centers were included. The main causes of accidents in the OP subgroup were motor vehicle accidents 27.1% and trivial falls 15.8% (KONS 55.8%, PLASTIE 66.7%). The Magerl/AO classification scheme was used and 548 (63.3%) compression fractures (type A), 181 (20.9%) distraction injuries (type B), and 136 (15.7%) rotational injuries (type C) were diagnosed. Of the fractures 68.8% were located at the thoracolumbar junction (T11-L2). Type B and type C injuries carried a higher risk for concomitant injuries, neurological deficits and additional vertebral fractures. The average initial VAS spine score, representing the status before the trauma, varied between treatment subgroups (OP 80, KONS 75, PLASTIE 72) and declined with increasing patient age (p<0.01).

Traumatic brain injury may not increase the risk of Alzheimer disease.

PubMed

Weiner, Michael W; Crane, Paul K; Montine, Thomas J; Bennett, David A; Veitch, Dallas P

2017-10-31

Traumatic brain injury (TBI) commonly occurs in civilian and military populations. Some epidemiologic studies previously have associated TBI with an increased risk of Alzheimer disease (AD). Recent clinicopathologic and biomarker studies have failed to confirm the relationship of TBI to the development of AD dementia or pathologic changes, and suggest that other neurodegenerative processes might be linked to TBI. Additional studies are required to determine the long-term consequences of TBI. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Proposal for a definition of lifelong premature ejaculation based on epidemiological stopwatch data.

PubMed

Waldinger, Marcel D; Zwinderman, Aeilko H; Olivier, Berend; Schweitzer, Dave H

2005-07-01

Consensus on a definition of premature ejaculation has not yet been reached because of debates based on subjective authority opinions and nonstandardized assessment methods to measure ejaculation time and ejaculation control. To provide a definition for lifelong premature ejaculation that is based on epidemiological evidence including the neurobiological and psychological approach. We used the 0.5 and 2.5 percentiles as accepted standards of disease definition in a skewed distribution. We applied these percentiles in a stopwatch-determined intravaginal ejaculation latency time (IELT) distribution of 491 nonselected men from five different countries. The practical consequences of 0.5% and 2.5% cutoff points for disease definition were taken into consideration by reviewing current knowledge of feelings of control and satisfaction in relation to ejaculatory performance of the general male population. Literature arguments to be used in a proposed consensus on a definition of premature ejaculation. The stopwatch-determined IELT distribution is positively skewed. The 0.5 percentile equates to an IELT of 0.9 minute and the 2.5 percentile an IELT of 1.3 minutes. However, there are no available data in the literature on feelings of control or satisfaction in relation to ejaculatory latency time in the general male population. Random male cohort studies are needed to end all speculation on this subject. Exact stopwatch time assessment of IELT in a multinational study led us to propose that all men with an IELT of less than 1 minute (belonging to the 0.5 percentile) have "definite" premature ejaculation, while men with IELTs between 1 and 1.5 minutes (between 0.5 and 2.5 percentile) have "probable" premature ejaculation. Severity of premature ejaculation (nonsymptomatic, mild, moderate, severe) should be defined in terms of associated psychological problems. We define lifelong premature ejaculation as a neurobiological dysfunction with an unacceptable increase of risk to develop sexual and psychological problems anywhere in a lifetime. By defining premature ejaculation from an authority-defined disorder into a dysfunction based on epidemiological evidence it is possible to establish consensus based on epidemiological evidence. Additional epidemiological stopwatch studies are needed for a final decision of IELT values at both percentile cutoff points.

Alcohol drinking and esophageal cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population.

PubMed

Oze, Isao; Matsuo, Keitaro; Wakai, Kenji; Nagata, Chisato; Mizoue, Tetsuya; Tanaka, Keitaro; Tsuji, Ichiro; Sasazuki, Shizuka; Inoue, Manami; Tsugane, Shoichiro

2011-05-01

Although alcohol drinking is considered as an important risk factor for esophageal cancer, the magnitude of the association might be varied among geographic areas. Therefore, we reviewed epidemiologic studies on the association between alcohol drinking and esophageal cancer among the Japanese population. Original data were obtained from MEDLINE, searched using PubMed or from searches of the Ichushi database, complemented with manual searches. Evaluation of associations was based on the strength of evidence ('convincing', 'probable', 'possible' or 'insufficient') and the magnitude of association ('strong', 'moderate', 'weak' or 'no association'), together with biological plausibility as previously evaluated by the International Agency of Research on Cancer. We identified four cohort studies and nine case-control studies. All cohort studies and case-control studies showed strong positive associations between esophageal cancer and alcohol drinking. All cohort studies and six case-control studies showed that alcohol drinking had the dose- or frequency-response relationships with esophageal cancer. In addition, four case-control studies showed that acetaldehyde dehydrogenase Glu504Lys polymorphism had strong effect modification with alcohol drinking. We conclude that there is convincing evidence that alcohol drinking increases the risk of esophageal cancer in the Japanese population.

Radiofrequency exposure on fast patrol boats in the Royal Norwegian Navy--an approach to a dose assessment.

PubMed

Baste, Valborg; Mild, Kjell Hansson; Moen, Bente E

2010-07-01

Epidemiological studies related to radiofrequency (RF) electromagnetic fields (EMF) have mainly used crude proxies for exposure, such as job titles, distance to, or use of different equipment emitting RF EMF. The Royal Norwegian Navy (RNoN) has measured RF field emitted from high-frequency antennas and radars on several spots where the crew would most likely be located aboard fast patrol boats (FPB). These boats are small, with short distance between the crew and the equipment emitting RF field. We have described the measured RF exposure aboard FPB and suggested different methods for calculations of total exposure and annual dose. Linear and spatial average in addition to percentage of ICNIRP and squared deviation of ICNIRP has been used. The methods will form the basis of a job exposure matrix where relative differences in exposure between groups of crew members can be used in further epidemiological studies of reproductive health. 2010 Wiley-Liss, Inc.

Epidemiology of soy and cancer: perspectives and directions.

PubMed

Persky, V; Van Horn, L

1995-03-01

Previous epidemiologic studies of the effects of soy protein on cancer risk have been limited by small variations in soy intake, inability to separate soy from other dietary variables and difficulties inherent in relating dietary intake to the development of cancer several decades later. As a result, although existing data suggest that soy protein may be protective for cancer risk, results are overall inconclusive. There is also evidence that soy products may affect risk factors for cancer, such as endogenous hormone levels. Preliminary data from our group indicate that young Adventist women who are vegetarians with high soy intake and a lower risk of breast cancer may have higher levels of an adrenal androgen, dehydroepiandrosterone sulfate. Other groups have noted that soy protein may be associated with alterations in the regulation and binding of ovarian hormones. Additional studies examining effects of soy protein on risk factors for cancer would help, not only in delineating mechanisms of cancer development, but also in designing dietary programs aimed at cancer prevention.

[Relevance of parasitological examinations for the clinical course, epidemiology and prevention of alveolar echinococcosis - experiences of more than two decades in Austria].

PubMed

Auer, Herbert

2006-01-01

Alveolar echinococcosis has been known in Austria since 1854. At the beginning of the 20th century the Austrian researcher on echinococcosis, Adolf Posselt, has realized already the enormous medical relevance of serological tests for the diagnosis of alveolar echinococcosis as well as for preventive purposes. Since the beginning of the 1980ies a long-term study about the epidemiology and serodiagnosis of alveolar echinococcosis has started in the Department of Medical Parasitology of the Clinical Institute of Hygiene and Medical Microbiology of the University of Vienna. Today a highly sensitive enzyme-linked immunosorbent assay as well as a highly specific westernblot system are available for the serological diagnosis of human alveolar echinococcosis cases, for the serological monitoring of the disease as well as for seroepidemiological and preventive medical studies. In addition, molecular biological tools for the detection of E. multilocularis (as well as E. granulosus strain) specific DNA in surgical resected and bioptic materials complete our diagnostic spectrum of methods.

Epidemiology of radiation-induced cancer.

PubMed Central

Radford, E P

1983-01-01

The epidemiology of radiation-induced cancer is important for theoretical and practical insights that these studies give to human cancer in general and because we have more evidence from radiation-exposed populations than for any other environmental carcinogen. On theoretical and experimental grounds, the linear no-threshold dose-response relationship is a reasonable basis for extrapolating effects to low doses. Leukemia is frequently the earliest observed radiogenic cancer but is now considered to be of minor importance, because the radiation effect dies out after 25 or 30 years, whereas solid tumors induced by radiation develop later and the increased cancer risk evidently persists for the remaining lifetime. Current estimates of the risk of particular cancers from radiation exposure cannot be fully evaluated until the population under study have been followed at least 40 or 50 years after exposure. Recent evidence indicates that for lung cancer induction, combination of cigarette smoking and radiation exposure leads to risks that are not multiplicative but rather nearly additive. PMID:6653538

Molecular Epidemiology of Influenza A/H3N2 Viruses Circulating in Mexico from 2003 to 2012

PubMed Central

Escalera-Zamudio, Marina; Nelson, Martha I.; Cobián Güemes, Ana Georgina; López-Martínez, Irma; Cruz-Ortiz, Natividad; Iguala-Vidales, Miguel; García, Elvia Rodríguez; Barrera-Badillo, Gisela; Díaz-Quiñonez, Jose Alberto; López, Susana; Arias, Carlos F.; Isa, Pavel

2014-01-01

In this work, nineteen influenza A/H3N2 viruses isolated in Mexico between 2003 and 2012 were studied. Our findings show that different human A/H3N2 viral lineages co-circulate within a same season and can also persist locally in between different influenza seasons, increasing the chance for genetic reassortment events. A novel minor cluster was also identified, named here as Korea, that circulated worldwide during 2003. Frequently, phylogenetic characterization did not correlate with the determined antigenic identity, supporting the need for the use of molecular evolutionary tools additionally to antigenic data for the surveillance and characterization of viral diversity during each flu season. This work represents the first long-term molecular epidemiology study of influenza A/H3N2 viruses in Mexico based on the complete genomic sequences and contributes to the monitoring of evolutionary trends of A/H3N2 influenza viruses within North and Central America. PMID:25075517

Effects of Vegetables on Cardiovascular Diseases and Related Mechanisms

PubMed Central

Tang, Guo-Yi; Meng, Xiao; Li, Ya; Zhao, Cai-Ning; Liu, Qing

2017-01-01

Epidemiological studies have shown that vegetable consumption is inversely related to the risk of cardiovascular diseases. Moreover, research has indicated that many vegetables like potatoes, soybeans, sesame, tomatoes, dioscorea, onions, celery, broccoli, lettuce and asparagus showed great potential in preventing and treating cardiovascular diseases, and vitamins, essential elements, dietary fibers, botanic proteins and phytochemicals were bioactive components. The cardioprotective effects of vegetables might involve antioxidation; anti-inflammation; anti-platelet; regulating blood pressure, blood glucose, and lipid profile; attenuating myocardial damage; and modulating relevant enzyme activities, gene expression, and signaling pathways as well as some other biomarkers associated to cardiovascular diseases. In addition, several vegetables and their bioactive components have been proven to protect against cardiovascular diseases in clinical trials. In this review, we analyze and summarize the effects of vegetables on cardiovascular diseases based on epidemiological studies, experimental research, and clinical trials, which are significant to the application of vegetables in prevention and treatment of cardiovascular diseases. PMID:28796173

Challenges associated with post-deployment screening for mild traumatic brain injury in military personnel.

PubMed

Iverson, Grant L; Langlois, Jean A; McCrea, Michael A; Kelly, James P

2009-11-01

There is ongoing debate regarding the epidemiology of mild traumatic brain injury (MTBI) in military personnel. Accurate and timely estimates of the incidence of brain injury and the prevalence of long-term problems associated with brain injuries among active duty service members and veterans are essential for (a) operational planning, and (b) to allocate sufficient resources for rehabilitation and ongoing services and supports. The purpose of this article is to discuss challenges associated with post-deployment screening for MTBI. Multiple screening methods have been used in military, Veterans Affairs, and independent studies, which complicate cross-study comparisons of the resulting epidemiological data. We believe that post-deployment screening is important and necessary--but no screening methodology will be flawless, and false positives and false negatives are inevitable. Additional research is necessary to refine the sequential screening methodology, with the goal of minimizing false negatives during initial post-deployment screening and minimizing false positives during follow-up evaluations.

Advances in studies of disease-navigating webs: Sarcoptes scabiei as a case study

PubMed Central

2014-01-01

The discipline of epidemiology is the study of the patterns, causes and effects of health and disease conditions in defined anima populations. It is the key to evidence-based medicine, which is one of the cornerstones of public health. One of the important facets of epidemiology is disease-navigating webs (disease-NW) through which zoonotic and multi-host parasites in general move from one host to another. Epidemiology in this context includes (i) classical epidemiological approaches based on the statistical analysis of disease prevalence and distribution and, more recently, (ii) genetic approaches with approximations of disease-agent population genetics. Both approaches, classical epidemiology and population genetics, are useful for studying disease-NW. However, both have strengths and weaknesses when applied separately, which, unfortunately, is too often current practice. In this paper, we use Sarcoptes scabiei mite epidemiology as a case study to show how important an integrated approach can be in understanding disease-NW and subsequent disease control. PMID:24406101

Psychiatric epidemiology in India.

PubMed

Math, Suresh Bada; Chandrashekar, C R; Bhugra, Dinesh

2007-09-01

Epidemiological studies report prevalence rates for psychiatric disorders from 9.5 to 370/1000 populations in India. This review critically evaluates the prevalence rate of mental disorders as reported in Indian epidemiological studies. Extensive search of PubMed, NeuroMed and MEDLARS using search terms "psychiatry" and "epidemiology" was done. Manual search of literature was also done. Retrieved articles were systematically selected using inclusion and exclusion criteria. Only sixteen prevalence studies fulfilled the study criteria. Most of the epidemiological studies done in India neglected anxiety disorders, substance dependence disorders, co-morbidity and dual diagnosis. The use of poor sensitive screening instruments, single informant and systematic underreporting has added to the discrepancy in the prevalence rate. The prevalence of mental disorders reported in epidemiological surveys can be considered lower estimates rather than accurate reflections of the true prevalence in the population. Researchers have focused on broad non-specific, non-modifiable risk factors, such as age, gender and social class. Future research focused on the general population, longitudinal (prospective), multi-centre, co-morbid studies, assessment of disability, functioning, family burden and quality of life studies involving a clinical service providing approach, is required.

Epidemiologic evidence for asthma and exposure to air toxics: linkages between occupational, indoor, and community air pollution research.

PubMed Central

Delfino, Ralph J

2002-01-01

Outdoor ambient air pollutant exposures in communities are relevant to the acute exacerbation and possibly the onset of asthma. However, the complexity of pollutant mixtures and etiologic heterogeneity of asthma has made it difficult to identify causal components in those mixtures. Occupational exposures associated with asthma may yield clues to causal components in ambient air pollution because such exposures are often identifiable as single-chemical agents (e.g., metal compounds). However, translating occupational to community exposure-response relationships is limited. Of the air toxics found to cause occupational asthma, only formaldehyde has been frequently investigated in epidemiologic studies of allergic respiratory responses to indoor air, where general consistency can be shown despite lower ambient exposures. The specific volatile organic compounds (VOCs) identified in association with occupational asthma are generally not the same as those in studies showing respiratory effects of VOC mixtures on nonoccupational adult and pediatric asthma. In addition, experimental evidence indicates that airborne polycyclic aromatic hydrocarbon (PAH) exposures linked to diesel exhaust particles (DEPs) have proinflammatory effects on airways, but there is insufficient supporting evidence from the occupational literature of effects of DEPs on asthma or lung function. In contrast, nonoccupational epidemiologic studies have frequently shown associations between allergic responses or asthma with exposures to ambient air pollutant mixtures with PAH components, including black smoke, high home or school traffic density (particularly truck traffic), and environmental tobacco smoke. Other particle-phase and gaseous co-pollutants are likely causal in these associations as well. Epidemiologic research on the relationship of both asthma onset and exacerbation to air pollution is needed to disentangle effects of air toxics from monitored criteria air pollutants such as particle mass. Community studies should focus on air toxics expected to have adverse respiratory effects based on biological mechanisms, particularly irritant and immunological pathways to asthma onset and exacerbation. PMID:12194890

Changes in Depression, Health Anxiety, and Pain Catastrophizing Between Enrollment and 1 Month After a Radius Fracture.

PubMed

Golkari, Sina; Teunis, Teun; Ring, David; Vranceanu, Ana-Maria

2015-01-01

To test the difference in symptoms of (1) depression, (2) health anxiety, and (3) catastrophic thinking between 1 and 6 weeks after injury to the radius. In total, 69 adult patients with a minimally displaced radial head or distal radius fracture were prospectively enrolled. After diagnosis, we recorded demographic variables, 11-point ordinal numerical pain score, and agreement with "no pain, no gain"; Disabilities of the Arms, Shoulder, and Hand (DASH) questionnaire; Center for Epidemiologic Studies Depression Scale; the Whiteley Index; and the Pain Catastrophizing Scale. In total, 55 patients (80%) returned after 1 month to reevaluate pain, Disabilities of the Arms, Shoulder, and Hand, Center for Epidemiologic Studies Depression, Whiteley Index, and Pain Catastrophizing Scale scores. Center for Epidemiologic Studies Depression scores decreased by an average of 5 ± 9 points (p < 0.001), and Pain Catastrophizing Scale scores decreased by 2 ± 6 points (p = 0.0041). In multivariable analysis, decrease in Center for Epidemiologic Studies Depression was associated with not having an additional pain condition, more days elapsed between injury and final evaluation, and stronger agreement with "no pain, no gain" (adjusted R(2) = 0.26, p = 0.0006). An increase in Whiteley scores was associated with fewer years of education (R = -0.34, p = 0.012). Changes in Pain Catastrophizing Scale scores were associated with marital status (single -1.7 ± 4.3 vs married -4.6 ± 6.0 vs separated 0.55 ± 6.2, p = 0.040). Symptoms of depression and catastrophic thinking, but not health anxiety, improved during recovery after injury. If psychologic measures are used as a screening tool to predict outcome after treatment, one should account for a patient's disease phase. Prognostic level I. Copyright © 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Epidemiology of Overuse and Acute Injuries Among Competitive Collegiate Athletes

PubMed Central

Yang, Jingzhen; Tibbetts, Abigail S.; Covassin, Tracey; Cheng, Gang; Nayar, Saloni; Heiden, Erin

2012-01-01

Context: Although overuse injuries are gaining attention, epidemiologic studies on overuse injuries in male and female collegiate athletes are lacking. (70.7%) acute injuries were reported. The overall injury rate was Objective: To report the epidemiology of overuse injuries sustained by collegiate athletes and to compare the rates of overuse and acute injuries. Design: Descriptive epidemiology study. Setting: A National Collegiate Athletic Association Division I university. Patients or Other Participants: A total of 1317 reported injuries sustained by 573 male and female athletes in 16 collegiate sports teams during the 2005–2008 seasons. Main Outcome Measure(s): The injury and athlete-exposure (AE) data were obtained from the Sports Injury Monitoring System. An injury was coded as either overuse or acute based on the nature of injury. Injury rate was calculated as the total number of overuse (or acute) injuries during the study period divided by the total number of AEs during the same period. Results: A total of 386 (29.3%) overuse injuries and 931 63.1 per 10000 AEs. The rate ratio (RR) of acute versus overuse injuries was 2.34 (95% confidence interval [CI] = 2.05, 2.67). Football had the highest RR (RR = 8.35, 95% CI = 5.38, 12.97), and women's rowing had the lowest (RR = 0.75, 95% CI = 0.51, 1.10). Men had a higher acute injury rate than women (49.8 versus 38.6 per 10000 AEs). Female athletes had a higher rate of overuse injury than male athletes (24.6 versus 13.2 per 10000 AEs). More than half of the overuse injuries (50.8%) resulted in no time loss from sport. Conclusions: Additional studies are needed to examine why female athletes are at greater risk for overuse injuries and identify the best practices for prevention and rehabilitation of overuse injuries. PMID:22488286

Trends in employer postings for epidemiology jobs: an analysis of PublicHealthJobs.net data from 2003 to 2016.

PubMed

Frankenfeld, Cara L

2017-09-01

To analyze public health job posting data to help objectively inform epidemiology faculty and students about skills sought by employers. Raw data from PublicHealthJobs.net database (January 2003-October 2016) was data-mined and analyzed (n = 25,308 job postings). There were 3985 jobs that were classified with an epidemiology designation, either as the only designation or co-occurring with another designation. Frequencies and percentages were calculated for job type, industry, location, degree requirements, CPH credential, and specialized skills. The majority of recent postings (January 2014-October 2016) were for full-time positions (60.8%). The highest proportion of recent job industries was education/academic/research (44.3%), state government (17.5%), and nonprofit/NGO (16.3%). A masters-level degree was listed in 71.4% of postings, frequently co-occurring with other degree levels. Epidemiology as the only job class was listed in 1765 postings (45.3%). Most characteristics of epidemiology job postings did not appreciably change over the time period, but there were some specialized skill differences. This analysis illustrates how employment sites can be used to identify employer preferences in epidemiology hires. There may be some skills that are beneficial additions to public health curricula or that job-seeking future epidemiologists may wish to enhance during their training. Copyright © 2017 Elsevier Inc. All rights reserved.

Phocomelia: a worldwide descriptive epidemiologic study in a large series of cases from the International Clearinghouse for Birth Defects Surveillance and Research, and overview of the literature.

PubMed

Bermejo-Sánchez, Eva; Cuevas, Lourdes; Amar, Emmanuelle; Bianca, Sebastiano; Bianchi, Fabrizio; Botto, Lorenzo D; Canfield, Mark A; Castilla, Eduardo E; Clementi, Maurizio; Cocchi, Guido; Landau, Danielle; Leoncini, Emanuele; Li, Zhu; Lowry, R Brian; Mastroiacovo, Pierpaolo; Mutchinick, Osvaldo M; Rissmann, Anke; Ritvanen, Annukka; Scarano, Gioacchino; Siffel, Csaba; Szabova, Elena; Martínez-Frías, María-Luisa

2011-11-15

Epidemiologic data on phocomelia are scarce. This study presents an epidemiologic analysis of the largest series of phocomelia cases known to date. Data were provided by 19 birth defect surveillance programs, all members of the International Clearinghouse for Birth Defects Surveillance and Research. Depending on the program, data corresponded to a period from 1968 through 2006. A total of 22,740,933 live births, stillbirths and, for some programs, elective terminations of pregnancy for fetal anomaly (ETOPFA) were monitored. After a detailed review of clinical data, only true phocomelia cases were included. Descriptive data are presented and additional analyses compared isolated cases with those with multiple congenital anomalies (MCA), excluding syndromes. We also briefly compared congenital anomalies associated with nonsyndromic phocomelia with those presented with amelia, another rare severe congenital limb defect. A total of 141 phocomelia cases registered gave an overall total prevalence of 0.62 per 100,000 births (95% confidence interval: 0.52-0.73). Three programs (Australia Victoria, South America ECLAMC, Italy North East) had significantly different prevalence estimates. Most cases (53.2%) had isolated phocomelia, while 9.9% had syndromes. Most nonsyndromic cases were monomelic (55.9%), with an excess of left (64.9%) and upper limb (64.9%) involvement. Most nonsyndromic cases (66.9%) were live births; most isolated cases (57.9%) weighed more than 2,499 g; most MCA (60.7%) weighed less than 2,500 g, and were more likely stillbirths (30.8%) or ETOPFA (15.4%) than isolated cases. The most common associated defects were musculoskeletal, cardiac, and intestinal. Epidemiological differences between phocomelia and amelia highlighted possible differences in their causes. Copyright © 2011 Wiley Periodicals, Inc.

Phocomelia: A Worldwide Descriptive Epidemiologic Study in a Large Series of Cases From the International Clearinghouse for Birth Defects Surveillance and Research, and Overview of the Literature

PubMed Central

Bermejo-Sánchez, Eva; Cuevas, Lourdes; Amar, Emmanuelle; Bianca, Sebastiano; Bianchi, Fabrizio; Botto, Lorenzo D.; Canfield, Mark A.; Castilla, Eduardo E.; Clementi, Maurizio; Cocchi, Guido; Landau, Danielle; Leoncini, Emanuele; Li, Zhu; Lowry, R. Brian; Mastroiacovo, Pierpaolo; Mutchinick, Osvaldo M.; Rissmann, Anke; Ritvanen, Annukka; Scarano, Gioacchino; Siffel, Csaba; Szabova, Elena; Martínez-Frías, María-Luisa

2015-01-01

Epidemiologic data on phocomelia are scarce. This study presents an epidemiologic analysis of the largest series of phocomelia cases known to date. Data were provided by 19 birth defect surveillance programs, all members of the International Clearinghouse for Birth Defects Surveillance and Research. Depending on the program, data corresponded to a period from 1968 through 2006. A total of 22,740,933 live births, stillbirths and, for some programs, elective terminations of pregnancy for fetal anomaly (ETOPFA) were monitored. After a detailed review of clinical data, only true phocomelia cases were included. Descriptive data are presented and additional analyses compared isolated cases with those with multiple congenital anomalies (MCA), excluding syndromes. We also briefly compared congenital anomalies associated with nonsyndromic phocomelia with those presented with amelia, another rare severe congenital limb defect. A total of 141 phocomelia cases registered gave an overall total prevalence of 0.62 per 100,000 births (95% confidence interval: 0.52–0.73). Three programs (Australia Victoria, South America ECLAMC, Italy North East) had significantly different prevalence estimates. Most cases (53.2%) had isolated phocomelia, while 9.9% had syndromes. Most nonsyndromic cases were monomelic (55.9%), with an excess of left (64.9%) and upper limb (64.9%) involvement. Most nonsyndromic cases (66.9%) were live births; most isolated cases (57.9%) weighed more than 2,499 g; most MCA (60.7%) weighed less than 2,500 g, and were more likely stillbirths (30.8%) or ETOPFA (15.4%) than isolated cases. The most common associated defects were musculoskeletal, cardiac, and intestinal. Epidemiological differences between phocomelia and amelia highlighted possible differences in their causes. PMID:22002800

Ecological and epidemiological status of species of the Phlebotomus perniciosus complex (Diptera: Psychodidae, Phlebotominae) in Morocco.

PubMed

Zarrouk, Asmae; Kahime, Kholoud; Boussaa, Samia; Belqat, Boutaïna

2016-03-01

Leishmania infantum (Kinetoplastida: Trypanosomatidae) infection is transmitted by an infected female sand fly (Diptera: Psychodidae, Phlebotominae) of the subgenus Larroussius: Phlebotomus ariasi, Phlebotomus perniciosus, and Phlebotomus longicuspis in the Mediterranean basin. In Morocco, the vectorial role of P. ariasi was demonstrated, while that of P. longicuspis and P. perniciosus is not elucidated. In addition, Moroccan P. longicuspis and P. perniciosus populations present a higher morphologic and genetic variability. It was classified as P. perniciosus complex, including typical (PN) and atypical (PNA) morphs of P. perniciosus, P. longicuspis sensu stricto (LCss), and a sibling species of P. longicuspis (LCx). With the aim to study the ecological and epidemiological status of P. perniciosus complex species in Morocco, entomological surveys were carried out during three entomological seasons (2012, 2013, and 2014). We collected a total of 6298 specimens from 81 localities of northern, central, and southern Morocco. After describing the geographical distribution of P. perniciosus complex trough Morocco according to many variables (altitude, latitude, and longitude), we discuss the resulting epidemiological implications of its species. Our results highlight the geographical distribution of the two morphs of P. perniciosus through Morocco: PN is limited to the north, while PNA is widespread in northern, central, and southern Morocco. In terms of vectorial role, we hypothesize the potential involvement of PN, LCss, and LCx, at least, with P. ariasi, in the epidemiological cycle of L. infantum in Morocco.

A community-based study to examine the epidemiology of human cystic echinococcosis in Rio Negro Province, Argentina.

PubMed

Bingham, Glenda M; Budke, Christine M; Larrieu, Edmundo; Del Carpio, Mario; Mujica, Guillermo; Slater, Margaret R; Moguillansky, Sergio

2014-08-01

Although cystic echinococcosis (CE) is an important public health problem in Rio Negro Province, current epidemiological data for CE, in this region of Argentina, are not available. Therefore, a community-based study, which incorporated diagnostic imaging and a questionnaire, was conducted in Ingeniero Jacobacci, a small town in southern Rio Negro Province. This study sought to assess the prevalence of human CE, in the study population, and to evaluate epidemiologic factors associated with CE transmission within the study area. Of the 560 individuals who volunteered to participate in the study, 189 (34%) were children and 371 (66%) were adults. All study participants were screened for CE using abdominal ultrasound scanning, with CE-positive or suspect individuals also receiving thoracic radiographs. The overall prevalence of CE was 7.1% (40/560), with 1.6% (3/189) of children, and 10% (37/371) of adults diagnosed as CE-positive. Although 92.5% (37/40) of the CE-positive individuals had only hepatic lesions, two participants had both hepatic and pulmonary lesions, and one participant had a single renal lesion. Approximately 92% (340/371) of the adult study participants completed the questionnaire, which was used to identify factors associated with an increased risk for human infection. Age, level of education, dog ownership, and contact with sheep were found to be significantly associated with CE status. This study demonstrated that CE continues to be highly endemic in this region of Rio Negro Province, Argentina. In addition, community-based ultrasound screening surveys are a noninvasive, effective approach to case detection at the community level. Copyright © 2014 Elsevier B.V. All rights reserved.

Adaptation of Chain Event Graphs for use with Case-Control Studies in Epidemiology.

PubMed

Keeble, Claire; Thwaites, Peter Adam; Barber, Stuart; Law, Graham Richard; Baxter, Paul David

2017-09-26

Case-control studies are used in epidemiology to try to uncover the causes of diseases, but are a retrospective study design known to suffer from non-participation and recall bias, which may explain their decreased popularity in recent years. Traditional analyses report usually only the odds ratio for given exposures and the binary disease status. Chain event graphs are a graphical representation of a statistical model derived from event trees which have been developed in artificial intelligence and statistics, and only recently introduced to the epidemiology literature. They are a modern Bayesian technique which enable prior knowledge to be incorporated into the data analysis using the agglomerative hierarchical clustering algorithm, used to form a suitable chain event graph. Additionally, they can account for missing data and be used to explore missingness mechanisms. Here we adapt the chain event graph framework to suit scenarios often encountered in case-control studies, to strengthen this study design which is time and financially efficient. We demonstrate eight adaptations to the graphs, which consist of two suitable for full case-control study analysis, four which can be used in interim analyses to explore biases, and two which aim to improve the ease and accuracy of analyses. The adaptations are illustrated with complete, reproducible, fully-interpreted examples, including the event tree and chain event graph. Chain event graphs are used here for the first time to summarise non-participation, data collection techniques, data reliability, and disease severity in case-control studies. We demonstrate how these features of a case-control study can be incorporated into the analysis to provide further insight, which can help to identify potential biases and lead to more accurate study results.

Injuries in Competitive Dragon Boating

PubMed Central

Mukherjee, Swarup; Leong, Hin Fong; Chen, Simin; Foo, Yong Xiang Wayne; Pek, Hong Kiat

2014-01-01

Background: Dragon boating is a fast-growing team water sport and involves forceful repetitive motions that predispose athletes to overuse injuries. Despite the rising popularity of the sport, there is a lack of studies on injury epidemiology in dragon boating. Purpose: To investigate the injury epidemiology in competitive dragon boating athletes. Study Design: Descriptive epidemiological study. Methods: A total of 95 dragon boaters (49 males, 46 females) representing their respective universities took part in this study. Data were collected retrospectively using a reliable and valid self-report questionnaire. The study period was from August 2012 to July 2013. Results: A total of 104 musculoskeletal injuries were reported (3.82 injuries/1000 athlete-exposures), 99% of which occurred during training. The most commonly injured regions were the lower back (22.1%), shoulder (21.1%), and wrist (17.3%). The majority of injuries were due to overuse (56.3%), and incomplete muscle-tendon strain was the most prevalent type of injury (50.5%). The time loss from injuries varied. In addition, a significant majority of the dragon boating athletes incurred nonmusculoskeletal injuries, with abrasions (90.5%), blisters (78.9%), and sunburns (72.6%) being the most common. Conclusion: Competitive dragon boating has a moderately high injury incidence, and there seems to be a direct relationship between exposure time and injury rate. A majority of the injuries are overuse in nature, and the body parts most actively involved in paddling movement are at higher risk of injuries. The high incidence of nonmusculoskeletal injuries in dragon boaters suggested that these injuries are likely outcomes of participation in the sport. PMID:26535280

Quantitative exposure metrics for sleep disturbance and their association with breast cancer risk.

PubMed

Girschik, Jennifer; Fritschi, Lin; Erren, Thomas C; Heyworth, Jane

2013-05-01

It has been acknowledged by those in the field of sleep epidemiology that the current measures of sleep used in many epidemiological studies do not adequately capture the complexity and variability of sleep. A number of ways to improve the measurement of sleep have been proposed. This study aimed to assess the relationship between novel 'sleep disturbance' metrics, as expanded measures of sleep, and breast cancer risk. Data for this study were derived from a population-based case-control study conducted in Western Australia between 2009 and 2011. Participants completed a self-administered questionnaire that included questions about demographic, reproductive, and lifestyle factors in addition to questions on sleep. Four metrics of exposure to sleep disturbance (cumulative, average, duration, and peak) were developed. Unconditional logistic regression was used to examine the association between metrics of sleep disturbance and breast cancer risk. There was no evidence to support an association between any of the sleep disturbance metrics and breast cancer risk. Compared with the reference group of unexposed women, the fully adjusted ORs for cumulative sleep disturbance (harm) metric were as follows: 1st tertile 0.90 (95 % CI: 0.72-1.13); OR for the 2nd tertile 1.04 (95 % CI: 0.84-1.29); and OR for the 3rd tertile 1.02 (95 % CI: 0.82-1.27). This study found no association between several metrics of sleep disturbance and risk of breast cancer. Our experience with developing metrics of sleep disturbance may be of use to others in sleep epidemiology wishing to expand their scope of sleep measurement.

Epidemiology and risk factors for drug allergy.

PubMed

Thong, Bernard Y-H; Tan, Teck-Choon

2011-05-01

The aim of this review was to describe the current evidence-based knowledge of the epidemiology, prevalence, incidence, risk factors and genetic associations of drug allergy. Articles published between 1966 and 2010 were identified in MEDLINE using the key words adult, adverse drug reaction reporting systems, age factors, anaphylactoid, anaphylaxis, anaesthetics, antibiotics, child, drug allergy, drug eruptions, ethnic groups, hypersensitivity, neuromuscular depolarizing agents, neuromuscular nondepolarizing agents, sex factors, Stevens Johnson syndrome and toxic epidermal necrolysis. Additional studies were identified from article reference lists. Relevant, peer-reviewed original research articles, case series and reviews were considered for review. Current epidemiological studies on adverse drug reactions (ADRs) have used different definitions for ADR-related terminology, often do not differentiate immunologically and non-immunologically mediated drug hypersensitivity, study different study populations (different ethnicities, inpatients or outpatients, adults or children), utilize different methodologies (spontaneous vs. non-spontaneous reporting, cohort vs. case-control studies), different methods of assessing drug imputability and different methods of data analyses. Potentially life-threatening severe cutaneous adverse reactions (SCAR) are associated with a high risk of morbidity and mortality. HLA associations for SCAR associated with allopurinol, carbamazepine and abacavir have been reported with the potential for clinical use in screening prior to prescription. Identification of risk factors for drug allergy and appropriate genetic screening of at-risk ethnic groups may improve the outcomes of drug-specific SCAR. Research and collaboration are necessary for the generation of clinically-relevant, translational pharmacoepidemiological and pharmacogenomic knowledge, and success of health outcomes research and policies on drug allergies. © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.

Comprehensive personal RF-EMF exposure map and its potential use in epidemiological studies.

PubMed

Gonzalez-Rubio, Jesus; Najera, Alberto; Arribas, Enrique

2016-08-01

In recent years, numerous epidemiological studies, which deal with the potential effects of mobile phone antennas on health, have almost exclusively focused on their distance to mobile phone base stations. Although it is known that this is not the best approach to the problem, this situation occurs due to the numerous difficulties when determining the personal exposure to the radiofrequency electromagnetic fields (RF-EMF). However, due to the rise of personal exposimeters, the evolution of spatial statistics, the development of geographical information systems and the use of powerful software, new alternatives are available to deal with these epidemiological studies and thus overcome the aforementioned difficulties. Using these tools, this paper presents a lattice map of personal RF-EMF exposure from exterior mobile phone base stations, covering the entire 110 administrative regions in the city of Albacete (Spain). For this purpose, we used a personal exposimeter, Satimo EME Spy 140 model, performing measurements every 4s The exposimeter was located inside the plastic basket of a bicycle, whose versatility permitted the access to all the zones of the city. Once the exposure map was prepared, its relation with the known antenna locations was studied. The 64 mobile telephone antennas of the city were also georeferenced; the randomness of both variables (exposure and antennas) were studied by means of the Moran's I test. Results showed that the distribution of the antennas follows a grouped pattern (p<0.001), while the distribution of the average exposure values have a random distribution (p=0.618). In addition, we showed two Spearman correlation studies: the first between the average exposure values and the number of mobile telephone antennas per administrative region, and the second, also considering the antennas of the neighbouring regions. No substantial correlation was detected in either of the two cases. This study also reveals the weaknesses of the epidemiological studies, which only take into account the distance to the antennas, which would provide a new approach to the problem. By precisely knowing the resident population of each administrative region of the city, this proves to be highly useful to rely on a prepared aggregate data map based on the mean exposure values to RF-EMF in these sections. The displayed map would permit the execution of more accurate epidemiological studies, since it would be possible to compare the exposure measurements with the incidence data of a disease. Copyright © 2016 Elsevier Inc. All rights reserved.

TIME-INTEGRATED EXPOSURE MEASURES TO IMPROVE THE PREDICTIVE POWER OF EXPOSURE CLASSIFICATION FOR EPIDEMIOLOGIC STUDIES

EPA Science Inventory

Accurate exposure classification tools are required to link exposure with health effects in epidemiological studies. Although long-term integrated exposure measurements are a critical component of exposure assessment, the ability to include these measurements into epidemiologic...

Epidemiological evidence in forensic pharmacovigilance.

PubMed

Persaud, Nav; Healy, David

2012-01-01

Until recently epidemiological evidence was not regarded as helpful in determining cause and effect. It generated associations that then had to be explained in terms of bio-mechanisms and applied to individual patients. A series of legal cases surrounding possible birth defects triggered by doxylamine (Bendectin) and connective tissue disorders linked to breast implants made it clear that in some instances epidemiological evidence might have a more important role, but the pendulum swung too far so that epidemiological evidence has in recent decades been given an unwarranted primacy, partly perhaps because it suits the interests of certain stakeholders. Older and more recent epidemiological studies on doxylamine and other antihistamines are reviewed to bring out the ambiguities and pitfalls of an undue reliance on epidemiological studies.

ESTIMATING RESIDENTIAL EXPOSURE TO DRINKING WATER ARSENIC IN INNER MONGOLIA, CHINA FOR EPIDEMIOLOGIC STUDIES

EPA Science Inventory

ESTIMATING RESIDENTIAL EXPOSURE TO DRINKING WATER ARSENIC IN INNER MONGOLIA, CHINA FOR EPIDEMIOLOGIC STUDIES

Richard Kwok1, Pauline Mendola1 Zhixiong Ning2, Zhiyi Liu2 and Judy Mumford1

1) Epidemiology and Biomarkers Branch, Human Studies Division, NHEERL, US EPA, R...

Epidemiology and statistics at the Nordic School of Public Health: Teaching and research 1979-2014.

PubMed

Eriksson, Bo

2015-08-01

The Nordic School of Public Health (NHV) was jointly founded in 1953 by the Nordic countries. Until 1979, the school provided ad hoc courses on public health topics, using external teachers drawn mainly from the Nordic countries. At the time, the permanent staff of the school was small. In 1979, it began a Master's degree programme and a few academic positions were established and filled, to support these courses. The programme included four main areas: Epidemiology, Social Medicine, Environmental Health and Health Services Administration. Epidemiology was compulsory in all Master of Public Health (MPH) exams, but there were a handful of optional courses that could be substituted for the other subjects.This paper tells the story of Epidemiology at NHV from about 1980, up until closure of the school in 2014. The original MPH model ran until 1995. Nursing Science entered NHV from about 1985 and worked mainly with qualitative research that often focused on individual patients. The new methods attracted nurses, midwives, psychologists and other groups that previously had been less represented in NHV. Being quantitative and population oriented, Epidemiology lost its unique position as a mandatory subject for the MPH examination. In addition the 'New Public Health' proposed by the World Health Organisation (WHO) that advocated health promotion and the philosophy of salutogenesis became a challenge for the programme in epidemiology: pathogenesis no longer was of primary interest. From 1995, the MPH format changed repeatedly and a DrPH programme was begun. For the last 8 years of its existence, NHV offered a reasonably comprehensive, basic course in Epidemiology.Throughout the years, epidemiology training and research at NHV were very traditional. In being a relatively free institution in terms of academic choices, NHV should have contributed to the development and innovation of epidemiology in public health. For several reasons, this did not happen. © 2015 the Nordic Societies of Public Health.

The potential impact of epidemiology on the prevention of occupational disease

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wegman, D.H.

1992-07-01

This presentation reviews occupational epidemiology as a foundation for workplace disease prevention activities. By examining descriptive, etiologic and intervention occupational epidemiology studies, a range of opportunities are illustrated where epidemiology has played, or could play a principal role in guiding preventive efforts. Descriptive studies presented include ones based on vital records, on epidemic investigations, cross-sectional surveys, and surveillance. Etiologic studies review the largely successful development of knowledge for lung cancer and asbestos exposure for pulmonary effects of isocyanate exposures. However, attention is also directed to the need for etiologic studies of work environment risks for both cardiovascular and musculoskeletal disease.more » Finally importance is placed on the too infrequent epidemiologic studies of intervention. Historical examples of control of large risks from nickel cancers and silicosis are balanced with more recent examples of successes at reducing smaller risks of cardiovascular disease and oil acne. Throughout, emphasis is placed on the importance of reintegrating the academic discipline of epidemiology into the application of study findings to prevention of workplace risks.67 references.« less

Defining Chronic Cough: A Systematic Review of the Epidemiological Literature

PubMed Central

Song, Woo-Jung; Chang, Yoon-Seok; Faruqi, Shoaib; Kang, Min-Koo; Kim, Ju-Young; Kang, Min-Gyu; Kim, Sujeong; Jo, Eun-Jung; Lee, Seung-Eun; Kim, Min-Hye; Plevkova, Jana; Park, Heung-Woo

2016-01-01

Purpose Recent evidence suggests a global burden of chronic cough in general populations. However, the definitions vary greatly among epidemiological studies, and none have been validated for clinical relevance. We aimed to examine previous epidemiological definitions in detail and explore the operational characteristics. Methods A systematic review was conducted for epidemiological surveys that reported the prevalence of chronic cough in general adult populations during the years 1980 to 2013. A literature search was performed on Pubmed and Embase without language restriction. Epidemiological definitions for chronic cough were classified according to their components, such as cutoff duration. Meta-analyses were performed for the male-to-female ratio of chronic cough prevalence to explore operational characteristics of epidemiological definitions. Results A total of 70 studies were included in the systematic review. The most common epidemiological definition was identified as 'cough ≥3 months' duration without specification of phlegm (n=50); however, it conflicted with the cutoff duration in current clinical guidelines (cough ≥8 weeks). Meta-analyses were performed for the male-to-female ratio of chronic cough among 28 studies that reported sex-specific prevalence using the most common definition. The pooled male-to-female odds ratio was 1.26 (95% confidence interval 0.92-1.73) with significant heterogeneity (I2=96%, P<0.001), which was in contrast to clinical observations of female predominance from specialist clinics. Subgroup analyses did not reverse the ratio or reduce the heterogeneity. Conclusions This study identified major issues in defining chronic cough in future epidemiological studies. The conflict between epidemiological and clinical diagnostic criteria needs to be resolved. The unexpected difference in the gender predominance between the community and clinics warrants further studies. Clinical validation of the existing definition is required. PMID:26739408

Epidemiology, quality and reporting characteristics of meta-analyses of observational studies published in Chinese journals.

PubMed

Zhang, Zhe-wen; Cheng, Juan; Liu, Zhuan; Ma, Ji-chun; Li, Jin-long; Wang, Jing; Yang, Ke-hu

2015-12-07

The aim of this study was to examine the epidemiological and reporting characteristics as well as the methodological quality of meta-analyses (MAs) of observational studies published in Chinese journals. 5 Chinese databases were searched for MAs of observational studies published from January 1978 to May 2014. Data were extracted into Excel spreadsheets, and Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Assessment of Multiple Systematic Reviews (AMSTAR) checklists were used to assess reporting characteristics and methodological quality, respectively. A total of 607 MAs were included. Only 52.2% of the MAs assessed the quality of the included primary studies, and the retrieval information was not comprehensive in more than half (85.8%) of the MAs. In addition, 50 (8.2%) MAs did not search any Chinese databases, while 126 (20.8%) studies did not search any English databases. Approximately 41.2% of the MAs did not describe the statistical methods in sufficient details, and most (95.5%) MAs did not report on conflicts of interest. However, compared with the before publication of the MOOSE Checklist, the quality of reporting improved significantly for 20 subitems after publication of the MOOSE Checklist, and 7 items of the included MAs demonstrated significant improvement after publication of the AMSTAR Checklist (p<0.05). Although many MAs of observational studies have been published in Chinese journals, the reporting quality is questionable. Thus, there is an urgent need to increase the use of reporting guidelines and methodological tools in China; we recommend that Chinese journals adopt the MOOSE and AMSTAR criteria. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Lupus vulgaris and tuberculosis verrucosa cutis (TBVC)--a clinical, pathological and epidemiological study of 71 cases.

PubMed

Padmavathy, L; Lakshmana Rao, L; Pari, T; Ethirajan, N; Krishnaswamy, B

2008-10-01

The epidemiological aspects and diagnostic problems encountered in a rural set up are largely unknown. The present study on cutaneous tuberculosis encompassing clinical, pathological and epidemiological aspects was undertaken at Rajah Muthiah Medical college and Hospital (RMMC&H), a teaching hospital mainly catering to the health needs of a predominantly rural population from villages and hamlets around Chidambaram, a taluq headquarters, located in Cuddalore district ofTamil Nadu. During the period of study, 5744 cases (82%) of pulmonary tuberculosis and 1261 (18%) of extra-pulmonary tuberculosis were encountered. Cutaneous tuberculosis accounted for 117 (1.67%) of tuberculosis cases. Of the seventy-one patients with cutaneous tuberculosis, 39 had lupus vulgaris and 32 with TBVC. Lupus vulgaris was more prevalent with male pre-ponderance. The maximum incidence was seen in the second decade of life. Both LV and TBVC showed a male pre-ponderance, M:F ratio being 3:2 and 2:1 in LV and TBVC respectively. A majority of patients with LV (27 cases; 69.2%) and TBVC (31 cases; 96.8%) manifested with a single site of involvement. Lower extremities were more commonly involved among patients hailing from poor economic strata who were not habituated to the use of footwear while working out doors. Over crowding was also a contributing factor. The relationships between BCG vaccination and Mantoux test with cutaneous tuberculosis, association with pulmonary tuberculosis in addition to the underlying predisposing socio-economic factors are discussed.

Nutritional status and epidemiological profile of elderly people.

PubMed

Gonçalves, Déborah Franco; Tinoco, Adelson Luiz Araújo; Ribeiro, Rita de Cássia Lanes; Martinho, Karina Oliveira; de Mendonça, Erica Toledo; Benfica, Dalilla Tâmara

2012-01-01

We intended to identify and evaluate the association between the socio-demographic and epidemiological characteristics of elderly people with their nutritional characteristics. This is a transversal study PMTI (from the Portuguese name of "Programa Municipal da Terceira Idade"), conducted at Viçosa, MG, Brazil. We analyzed 93 records of elderly people registered since 2006 and who underwent nutritional care. After having analyzed the questionnaire, we performed the descriptive and association analyses in the Epi Info (version 6.04) and Minitab softwares. Of the 93 analyzed records, most elderly people were women (80.4%), with an average of 72 years of age, of which 13.0% were long-lived people. The mean body mass index (BMI) was 27.4 kg/m(2), and 50.5% were overweight. We have found 26.8% elderly patients with hypertension, and 31.6% took antihypertensives. Elderly patients who were overweight are 4.54 times more likely to have arterial hypertension (odds ratio (OR)=4.54; 95% confidence interval (CI)=1.2-2.45). Only 7.5% smoked, 30.1% were alcoholics and 60.2% made physical activities. Inadequacies were found regarding the servings of fruits, dairy products, vegetables and sugars consumed. However, the servings of cereals, leguminous, meat and fat consumed were appropriate. This study showed that the nutritional diagnosis and the epidemiological and socio-demographic studies are critical tools to understand this population group, in addition to being important to the planning of health actions. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Omega-3 fatty acids and dementia

PubMed Central

Cole, Greg M.; Ma, Qiu-Lan; Frautschy, Sally A.

2014-01-01

More than a dozen epidemiological studies have reported that reduced levels or intake of omega-3 fatty acids or fish consumption is associated with increased risk for age-related cognitive decline or dementia such as Alzheimer's disease (AD). Increased dietary consumption or blood levels of docosahexaenoic acid (DHA) appear protective for AD and other dementia in multiple epidemiological studies; however, three studies suggest that the ApoE4 genotype limits protection. DHA is broadly neuroprotective via multiple mechanisms that include neuroprotective DHA metabolites, reduced arachidonic acid metabolites, and increased trophic factors or downstream trophic signal transduction. DHA is also protective against several risk factors for dementia including head trauma, diabetes, and cardiovascular disease. DHA is specifically protective against AD via additional mechanisms: It limits the production and accumulation of the amyloid β peptide toxin that is widely believed to drive the disease; and it also suppresses several signal transduction pathways induced by Aβ, including two major kinases that phosphorylate the microtubule associated protein tau and promote neurofibrillary tangle pathology. Based on the epidemiological and basic research data, expert panels have recommended the need for clinical trials with omega-3 fatty acids, notably DHA, for the prevention or treatment of age-related cognitive decline—with a focus on the most prevalent cause, AD. Clinical trials are underway to prevent and treat AD. Results to-date suggest that DHA may be more effective if it is begun early or used in conjunction with antioxidants. PMID:19523795

Identification, typing, ecology and epidemiology of coagulase negative staphylococci associated with ruminants.

PubMed

Vanderhaeghen, Wannes; Piepers, Sofie; Leroy, Frédéric; Van Coillie, Els; Haesebrouck, Freddy; De Vliegher, Sarne

2015-01-01

Since phenotypic methods to identify coagulase negative staphylococci (CNS) from the milk of ruminants often yield unreliable results, methods for molecular identification based on gene sequencing or fingerprinting techniques have been developed. In addition to culture-based detection of isolates, culture-independent methods may be of interest. On the basis of molecular studies, the five CNS species commonly causing intramammary infections (IMI) are Staphylococcus chromogenes, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus simulans and Staphylococcus xylosus. Current knowledge suggests that S. chromogenes is a bovine-adapted species, with most cases of IMI due to this bacterium being opportunistic. S. haemolyticus also appears to be an opportunistic pathogen, but this bacterium occupies a variety of habitats, the importance of which as a source of IMI remains to be elucidated. S. xylosus appears to be a versatile species, but little is known of its epidemiology. S. epidermidis is considered to be a human-adapted species and most cases of IMI appear to arise from human sources, but the organism is capable of residing in other habitats. S. simulans typically causes contagious IMI, but opportunistic cases also occur and the ecology of this bacterium requires further study. Further studies of the ecology and epidemiology of CNS as a cause of IMI in cattle are required, along with careful attention to classification of these bacteria and the diseases they cause. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Epidemiological transition and cardiovascular risk factors in Tunisia].

PubMed

Ghannem, H; Fredj, A H

1997-09-01

In Tunisia a growing extension of chronic diseases has resulted from the environmental and behavioral changes such as the adoption of new dietary habits, sedentarity habitat, stress of urbanization and work conditions. To illustrate this trend, we undertook a household epidemiologic survey of a representative sample of the adult urban population of Soussa (n = 957) to assess the main cardiovascular risk factors except the lipid profile distribution. This study showed a high prevalence of hypertension (> 160/95 mm Hg): 18.8% with an adjusted rate of 15.6%. History of diabetes 10.2%, obesity (BMI > 30) 27.7% significantly higher in women (34.4%), android obesity 36%, smoking habits 21.5% significantly higher in men (61.4%). With this risk factor profile, Tunisia has to implement a national strategy of primary prevention and heart health promotion in addition to the efforts recently made in secondary prevention of some chronic diseases such as hypertension and diabetes.

Newspaper Coverage of Intimate Partner Violence: Skewing Representations of Risk.

PubMed

Carlyle, Kellie E; Slater, Michael D; Chakroff, Jennifer L

2008-03-01

How media portray intimate partner violence (IPV) has implications for public perceptions and social policy. Therefore, to better understand these portrayals, this study content analyzes a nationally representative sample of newspaper coverage of IPV over a two-year-period and compares this coverage to epidemiological data in order to examine the implications of the discrepancies between coverage and social reality. Stratified media outlets across the country were used to obtain a representative sample of daily newspapers based on their designated market areas, resulting in 395 IPV-related articles. Results show that newspaper framing of IPV tends to be heavily skewed toward episodic framing. In addition, there are significant differences between our data and epidemiological estimates, particularly in the coverage of homicide and use of alcohol and illegal drugs, which may skew public perceptions of risk. Implications for public perceptions and social policy are discussed.

Torque teno virus infection in male commercial sex workers in Surakarta Indonesia

NASA Astrophysics Data System (ADS)

Prasetyo, Afiono Agung; Luvi, Sabrina Damara; Hartono, Sari, Yulia

2017-02-01

The molecular epidemiology data of torque teno virus (TTV) in Indonesia is very rare. This study evaluated the prevalence of TTV in male commercial sex workers, as one of the high risk community for blood borne viruses pathogens in Surakarta, Indonesia. All blood samples collected from male commercial sex workers in Surakarta in 2009-2013 were tested by nested polymerase chain reaction (PCR). The amplified PCR products were molecularly cloned and subjected to sequence analysis. TTV DNA was detected in 80.9% (72/89) samples. Furthermore, the molecular characterization revealed that the most prevalent was genogroup 3, followed by genogroup 2 and l, respectively. TTV was detected in male commercial sex workers in Surakarta with high infection rate. Further investigation about TTV circulation in Indonesian population is needed in order to provide additional information about the genetic variability and TTV epidemiology in Indonesia, especially in the high risk communities.

A survey of the transmission of infectious diseases/infections between wild and domestic ungulates in Europe

PubMed Central

2011-01-01

The domestic animals/wildlife interface is becoming a global issue of growing interest. However, despite studies on wildlife diseases being in expansion, the epidemiological role of wild animals in the transmission of infectious diseases remains unclear most of the time. Multiple diseases affecting livestock have already been identified in wildlife, especially in wild ungulates. The first objective of this paper was to establish a list of infections already reported in European wild ungulates. For each disease/infection, three additional materials develop examples already published, specifying the epidemiological role of the species as assigned by the authors. Furthermore, risk factors associated with interactions between wild and domestic animals and regarding emerging infectious diseases are summarized. Finally, the wildlife surveillance measures implemented in different European countries are presented. New research areas are proposed in order to provide efficient tools to prevent the transmission of diseases between wild ungulates and livestock. PMID:21635726

Comparative review of human and canine osteosarcoma: morphology, epidemiology, prognosis, treatment and genetics.

PubMed

Simpson, Siobhan; Dunning, Mark David; de Brot, Simone; Grau-Roma, Llorenç; Mongan, Nigel Patrick; Rutland, Catrin Sian

2017-10-24

Osteosarcoma (OSA) is a rare cancer in people. However OSA incidence rates in dogs are 27 times higher than in people. Prognosis in both species is relatively poor, with 5 year OSA survival rates in people not having improved in decades. For dogs, 1 year survival rates are only around ~ 45%. Improved and novel treatment regimens are urgently required to improve survival in both humans and dogs with OSA. Utilising information from genetic studies could assist in this in both species, with the higher incidence rates in dogs contributing to the dog population being a good model of human disease. This review compares the clinical characteristics, gross morphology and histopathology, aetiology, epidemiology, and genetics of canine and human OSA. Finally, the current position of canine OSA genetic research is discussed and areas for additional work within the canine population are identified.

Multiple sclerosis epidemiology in Latin America: An updated survey

PubMed Central

Rojas, Juan Ignacio

2017-01-01

Novel epidemiological data have appeared in recent years in Latin America (LATAM). The objective of this study was to perform an updated systematic review of the epidemiology of the disease reported in LATAM. Methods We conducted a systematic review of published epidemiological articles from January 1995 to December 2016. Results Incidence data were found in four studies and ranged from 0.3 to 3 annual cases per 100,000 person-years. Prevalence was reported in 13 studies and ranged from 0.83 to 38.2 cases per 100,000 inhabitants. Two studies showed an increase in prevalence and incidence in the last five years in specific regions. Conclusion The study provides updated information on epidemiological features of MS in the region. The frequency reported is lower compared with some European and North American countries; however, due to recent observations, studies including follow-up assessment of prevalence and incidence should be conducted in the region. PMID:28638628

International Lymphoma Epidemiology Consortium

Cancer.gov

The InterLymph Consortium, or formally the International Consortium of Investigators Working on Non-Hodgkin's Lymphoma Epidemiologic Studies, is an open scientific forum for epidemiologic research in non-Hodgkin's lymphoma.

Spatial analysis for the epidemiological study of cardiovascular diseases: A systematic literature search.

PubMed

Mena, Carlos; Sepúlveda, Cesar; Fuentes, Eduardo; Ormazábal, Yony; Palomo, Iván

2018-05-07

Cardiovascular diseases (CVDs) are the primary cause of death and disability in de world, and the detection of populations at risk as well as localization of vulnerable areas is essential for adequate epidemiological management. Techniques developed for spatial analysis, among them geographical information systems and spatial statistics, such as cluster detection and spatial correlation, are useful for the study of the distribution of the CVDs. These techniques, enabling recognition of events at different geographical levels of study (e.g., rural, deprived neighbourhoods, etc.), make it possible to relate CVDs to factors present in the immediate environment. The systemic literature presented here shows that this group of diseases is clustered with regard to incidence, mortality and hospitalization as well as obesity, smoking, increased glycated haemoglobin levels, hypertension physical activity and age. In addition, acquired variables such as income, residency (rural or urban) and education, contribute to CVD clustering. Both local cluster detection and spatial regression techniques give statistical weight to the findings providing valuable information that can influence response mechanisms in the health services by indicating locations in need of intervention and assignment of available resources.

Thimerosal-containing vaccines and autistic spectrum disorder: a critical review of published original data.

PubMed

Parker, Sarah K; Schwartz, Benjamin; Todd, James; Pickering, Larry K

2004-09-01

The issue of thimerosal-containing vaccines as a possible cause of autistic spectrum disorders (ASD) and neurodevelopmental disorders (NDDs) has been a controversial topic since 1999. Although most practitioners are familiar with the controversy, many are not familiar with the type or quality of evidence in published articles that have addressed this issue. To assess the quality of evidence assessing a potential association between thimerosal-containing vaccines and autism and evaluate whether that evidence suggests accepting or rejecting the hypothesis, we systematically reviewed published articles that report original data pertinent to the potential association between thimerosal-containing vaccines and ASD/NDDs. Articles for analysis were identified in the National Library of Medicine's Medline database using a PubMed search of the English-language literature for articles published between 1966 and 2004, using keywords thimerosal, thiomersal, mercury, methylmercury, or ethylmercury alone and combined with keywords autistic disorder, autistic spectrum disorder, and neurodevelopment. In addition, we used the "related links" option in PubMed and reviewed the reference sections in the identified articles. All original articles that evaluated an association between thimerosal-containing vaccines and ASD/NDDs or pharmacokinetics of ethylmercury in vaccines were included. Twelve publications that met the selection criteria were identified by the literature search: 10 epidemiologic studies and 2 pharmacokinetic studies of ethylmercury. The design and quality of the studies showed significant variation. The preponderance of epidemiologic evidence does not support an association between thimerosal-containing vaccines and ASD. Epidemiologic studies that support an association are of poor quality and cannot be interpreted. Pharmacokinetic studies suggest that the half-life of ethylmercury is significantly shorter when compared with methylmercury. Studies do not demonstrate a link between thimerosal-containing vaccines and ASD, and the pharmacokinetics of ethylmercury make such an association less likely. Epidemiologic studies that support a link demonstrated significant design flaws that invalidate their conclusions. Evidence does not support a change in the standard of practice with regard to administration of thimerosal-containing vaccines in areas of the world where they are used.

Public health and economic impact of seasonal influenza vaccination with quadrivalent influenza vaccines compared to trivalent influenza vaccines in Europe.

PubMed

Uhart, Mathieu; Bricout, Hélène; Clay, Emilie; Largeron, Nathalie

2016-09-01

Influenza B strains represent on average 23% of all circulating strains in Europe and when there is a vaccine mismatch on B strains, additional influenza-related hospitalizations and deaths as well as substantial additional costs are observed. The objective was to estimate the public health and economic impact of seasonal influenza vaccination with quadrivalent influenza vaccines (QIV) compared to trivalent influenza vaccines (TIV) in Europe (EU). Based on data from 5 EU countries (France, Germany, Italy, Spain and UK) during 10 influenza seasons from 2002 to 2013, epidemiological and associated economic outcomes were estimated for each season for the actual scenario where the TIV was used, and for a hypothetical scenario where QIV could have been used instead. By using QIV, this study estimated that for the 5 EU countries, an additional 1.03 million (327.9/100,000 inhabitants) influenza cases, 453,000 (143.9/100,000) general practitioners consultations, 672,000 (213.1/100,000) workdays lost, 24,000 (7.7/100,000) hospitalizations and 10,000 (3.1/100,000) deaths could have been avoided compared to the use of TIV over the 10-seasons-period. This study estimates that QIV can be of economic value since from a societal perspective 15 million Euros would have been saved on general practitioners consultations (14 million Euros from third-party payer perspective), 77 million on hospitalizations (74 million Euros from third-party payer perspective) and 150 million Euros on workdays lost, across the 5 EU countries. In conclusion, the present study estimates that, compared to TIV, QIV may result in a substantial decrease in epidemiological burden and in influenza-related costs.

EPIDEMIOLOGIC STUDIES OF DISINFECTANTS AND DISINFECTANT BY-PRODUCTS

EPA Science Inventory

This article provides a review of the epidemiologic evidence for human health effects that may be associated with the disinfection of drinking water. An epidemiologic study attempts to link human health effects with exposure to a specific agent (e.g., DBCM), agents (e.g., THMs or...

[The institutionalization of epidemiology as a subject at Rio de Janeiro Federal University Medical School].

PubMed

Torres, Carlos Henrique; Czeresnia, Dina

2003-01-01

This article aimed at studying the teaching of epidemiology in medical school undergraduate courses. Medical books have been analyzed in order to understand the constitution of epidemiology as a scientific subject, as well as its relations with medical science and secondary school teaching. The introduction and development of the subject in UFRJ Medical School were studied through the analysis of internal regulations, courses brochures and programs. Professors were interviewed. The analysis revealed that epidemiology concepts spread to health services and practice, as well as to medical research. At UFRJ Medical School, starting at the end of the 1980's, epidemiology teaching began to be emphasized and valued. That was the time when collective health began to develop. Among collective health subjects, both epidemiology and statistics developed the most.

Editorial Commentary: Evaluating the Epidemiology of Shoulder Stabilization Surgery: An Opinion on Causation.

PubMed

Nelson, Bradley

2018-03-01

Epidemiology originates from the Greek words "epi" meaning upon and "demos" meaning people. Hence, epidemiology is the study of what is "upon the people" or the analysis of the patterns of disease in a defined population. Epidemiological studies are important in defining "at-risk" patient populations so research can be directed toward these groups. It is important to understand that epidemiology does not determine causation. However, it is reasonable for clinicians (me) to opine on the reasons for these epidemiological trends. I believe that the major factors responsible for the changing incidence in shoulder stabilization are the use of the arthroscope and the surgical management of the first time dislocator. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Epigenetic Research in Cancer Epidemiology: Trends, Opportunities, and Challenges

PubMed Central

Verma, Mukesh; Rogers, Scott; Divi, Rao L.; Schully, Sheri D.; Nelson, Stefanie; Su, L. Joseph; Ross, Sharon; Pilch, Susan; Winn, Deborah M.; Khoury, Muin J.

2014-01-01

Epigenetics is emerging as an important field in cancer epidemiology that promises to provide insights into gene regulation and facilitate cancer control throughout the cancer care continuum. Increasingly, investigators are incorporating epigenetic analysis into the studies of etiology and outcomes. To understand current progress and trends in the inclusion of epigenetics in cancer epidemiology, we evaluated the published literature and the National Cancer Institute (NCI) supported research grant awards in this field to identify trends in epigenetics research. We present a summary of the epidemiological studies in NCI’s grant portfolio (from January 2005 through December 2012) and in the scientific literature published during the same period, irrespective of support from NCI. Blood cells and tumor tissue were the most commonly used biospecimens in these studies, although buccal cells, cervical cells, sputum, and stool samples also were used. DNA methylation profiling was the focus of the majority of studies, but several studies also measured microRNA profiles. We illustrate here the current status of epidemiologic studies that are evaluating epigenetic changes in large populations. The incorporation of epigenomic assessments in cancer epidemiology studies has and is likely to continue to provide important insights into the field of cancer research. PMID:24326628

[Bibliometric analysis of scientific articles on epidemiological study of burns in China].

PubMed

Cheng, W F; Shen, Z A; Zhao, D X; Li, D W; Shang, Y R

2017-04-20

Objective: To analyze the current status of epidemiological study of burns in China, and to explore the related strategies. Methods: Retrospective or cross-sectional scientific articles in Chinese or English on epidemiological study of burns in China published from January 2005 to December 2015 were systemically retrieved from 4 databases. The databases include PubMed, Embase, China Biology Medicine disc, and Chinese Journals Full - text Database . From the results retrieved, data with regard to publication year, journal distribution, number of institutions participated in the study, affiliation of the first author and its location, and admission time span and age of patients in all the scientific articles were collected. Furthermore, the definition of age range and the grouping method of age of pediatric patients in English articles on epidemiological study of pediatric burns of China were recorded. Data were processed with descriptive statistical analysis. Results: A total of 256 scientific articles conforming to the study criteria were retrieved, among which 214 (83.59%) articles were in Chinese, and 42 (16.41%) articles were in English; 242 (94.53%) articles were retrospective studies, and 14 (5.47%) articles were cross-sectional studies. During the 11 years, the number of the relevant articles was fluctuant on the whole. The scientific articles were published in 130 journals, with 42 English articles in source journals for SCIENCE CITATION INDEX EXPANDED - JOURNAL LIST, accounting for 16.41%, and 116 Chinese articles in Source Journal for Chinese Scientific and Technical Papers, accounting for 45.31%. Totally 215 (83.98%) articles were single-center studies, and 29 (11.33%) articles were multicenter studies which were conducted by three or more centers. The number of affiliations of the first author of articles was 161 in total. The top 10 institutions regarding the article publishing number published 58 articles, accounting for 22.66%. Scientific articles on epidemiological study of burns were retrieved with location of affiliation of the first author in 31 provinces, autonomous regions, and municipalities directly under the Central Government in Mainland China, and also in Taiwan Province and Hong Kong Special Administrative Region, among which Shanghai ranked first with 24 (9.38%) articles published. The admission time span of patients in the articles ranged from 3 months to 47 years, with 120 (46.87%) articles from 3 months to 5 years, 79 (30.86%) articles from 6 to 10 years, and 57 (22.27%) articles more than 10 years, respectively. Regarding the age of patients in the study, 123 articles were on epidemiological study of pediatric burns, and 16 articles on epidemiological study of elderly burns, accounting for 48.05% and 6.25%, respectively. Further analysis of articles on epidemiological study of pediatric burns in English showed that there was no standard definition of age range or unified grouping method of age for pediatric burn patients. Conclusions: The epidemiological study of burns in China has been carried out nationwide, but the number of institutions conducted relevant study is not that much, and multicenter epidemiological studies remain scanty. The quality of the articles needs to be further improved. The epidemiological study of elderly burns is relatively deficient and calls for more attention. The epidemiological study of burns in China lacks regularity or continuity in time scope. There is an urgent need for the guideline on classification method for items of epidemiological study of burns in China so as to standardize the related research.

Development of a pseudo/anonymised primary care research database: Proof-of-concept study.

PubMed

MacRury, Sandra; Finlayson, Jim; Hussey-Wilson, Susan; Holden, Samantha

2016-06-01

General practice records present a comprehensive source of data that could form a variety of anonymised or pseudonymised research databases to aid identification of potential research participants regardless of location. A proof-of-concept study was undertaken to extract data from general practice systems in 15 practices across the region to form pseudo and anonymised research data sets. Two feasibility studies and a disease surveillance study compared numbers of potential study participants and accuracy of disease prevalence, respectively. There was a marked reduction in screening time and increase in numbers of potential study participants identified with the research repository compared with conventional methods. Accurate disease prevalence was established and enhanced with the addition of selective text mining. This study confirms the potential for development of national anonymised research database from general practice records in addition to improving data collection for local or national audits and epidemiological projects. © The Author(s) 2014.

Molecular pathological epidemiology: new developing frontiers of big data science to study etiologies and pathogenesis.

PubMed

Hamada, Tsuyoshi; Keum, NaNa; Nishihara, Reiko; Ogino, Shuji

2017-03-01

Molecular pathological epidemiology (MPE) is an integrative field that utilizes molecular pathology to incorporate interpersonal heterogeneity of a disease process into epidemiology. In each individual, the development and progression of a disease are determined by a unique combination of exogenous and endogenous factors, resulting in different molecular and pathological subtypes of the disease. Based on "the unique disease principle," the primary aim of MPE is to uncover an interactive relationship between a specific environmental exposure and disease subtypes in determining disease incidence and mortality. This MPE approach can provide etiologic and pathogenic insights, potentially contributing to precision medicine for personalized prevention and treatment. Although breast, prostate, lung, and colorectal cancers have been among the most commonly studied diseases, the MPE approach can be used to study any disease. In addition to molecular features, host immune status and microbiome profile likely affect a disease process, and thus serve as informative biomarkers. As such, further integration of several disciplines into MPE has been achieved (e.g., pharmaco-MPE, immuno-MPE, and microbial MPE), to provide novel insights into underlying etiologic mechanisms. With the advent of high-throughput sequencing technologies, available genomic and epigenomic data have expanded dramatically. The MPE approach can also provide a specific risk estimate for each disease subgroup, thereby enhancing the impact of genome-wide association studies on public health. In this article, we present recent progress of MPE, and discuss the importance of accounting for the disease heterogeneity in the era of big-data health science and precision medicine.

Short Sleep Duration and Dietary Intake: Epidemiologic Evidence, Mechanisms, and Health Implications12

PubMed Central

Dashti, Hassan S; Scheer, Frank AJL; Jacques, Paul F; Lamon-Fava, Stefania; Ordovás, José M

2015-01-01

Links between short sleep duration and obesity, type 2 diabetes, hypertension, and cardiovascular disease may be mediated through changes in dietary intake. This review provides an overview of recent epidemiologic studies on the relations between habitual short sleep duration and dietary intake in adults from 16 cross-sectional studies. The studies have observed consistent associations between short sleep duration and higher total energy intake and higher total fat intake, and limited evidence for lower fruit intake, and lower quality diets. Evidence also suggests that short sleepers may have irregular eating behavior deviating from the traditional 3 meals/d to fewer main meals and more frequent, smaller, energy-dense, and highly palatable snacks at night. Although the impact of short sleep duration on dietary intake tends to be small, if chronic, it may contribute to an increased risk of obesity and related chronic disease. Mechanisms mediating the associations between sleep duration and dietary intake are likely to be multifactorial and include differences in the appetite-related hormones leptin and ghrelin, hedonic pathways, extended hours for intake, and altered time of intake. Taking into account these epidemiologic relations and the evidence for causal relations between sleep loss and metabolism and cardiovascular function, health promotion strategies should emphasize improved sleep as an additional factor in health and weight management. Moreover, future sleep interventions in controlled studies and sleep extension trials in chronic short sleepers are imperative for establishing whether there is a causal relation between short sleep duration and changes in dietary intake. PMID:26567190

Nutraceutical Value of Citrus Flavanones and Their Implications in Cardiovascular Disease.

PubMed

Testai, Lara; Calderone, Vincenzo

2017-05-16

Background- Cardiovascular diseases, including myocardial infarction, dyslipidaemia and coronary artery pathology, are a major cause of illness and death in Western countries. Therefore, identifying effective therapeutic approaches and their cellular signalling pathways is a challenging goal for medicine. In this regard, several epidemiological studies demonstrate a relationship between the intake of flavonoid-rich foods and the reduction of cardiovascular risk factors and mortality. In particular, flavonoids present in citrus fruits, such as oranges, bergamots, lemons and grapefruit (95% from flavanones), are emerging for their considerable nutraceutical value. Methods- In this review an examination of literature was performed while considering both epidemiological, clinical and pre-clinical evidence supporting the beneficial role of the flavanone class. We evaluated studies in which citrus fruit juices or single flavanone administration and cardiovascular risk factors were analysed; to identify these studies, an electronic search was conducted in PUBMED for papers fulfilling these criteria and written in English. Results- In addition to epidemiological evidence and clinical studies demonstrating that fruits in the Citrus genus significantly reduce the incidence of cardiovascular disease risk, pre-clinical investigations highlight cellular and subcellular targets that are responsible for these beneficial effects. There has been special attention on evaluating intracellular pathways involved in direct cardiovascular and cardiometabolic effects mediated by naringenin, hesperetin and eriodictyol or their glycosylated derivatives. Conclusions- Although some mechanisms of action remain unclear and bioavailability problems remain to be solved, the current evidence supports the use of a nutraceutical approach with citrus fruits to prevent and cure several aspects of cardiovascular disease.

Sport Injuries Sustained by Athletes with Disability: A Systematic Review.

PubMed

Weiler, Richard; Van Mechelen, Willem; Fuller, Colin; Verhagen, Evert

2016-08-01

Fifteen percent of the world's population live with disability, and many of these individuals choose to play sport. There are barriers to sport participation for athletes with disability and sports injury can greatly impact on daily life, which makes sports injury prevention additionally important. The purpose of this review is to systematically review the definitions, methodologies and injury rates in disability sport, which should assist future identification of risk factors and development of injury prevention strategies. A secondary aim is to highlight the most pressing issues for improvement of the quality of injury epidemiology research for disability sport. A search of NICE, AMED, British Nursing Index, CINAHL, EMBASE and Medline was conducted to identify all publications up to 16 June 2015. Of 489 potentially relevant articles and reference searching, a total of 15 studies were included. Wide study sample heterogeneity prevented data pooling and meta-analysis. Results demonstrated an evolving field of epidemiology, but with wide differences in sports injury definition and with studies focused on short competitions. Background data were generally sparse; there was minimal exposure analysis, and no analysis of injury severity, all of which made comparison of injury risk and injury severity difficult. There is an urgent need for consensus on sports injury definition and methodology in disability sports. The quality of studies is variable, with inconsistent sports injury definitions, methodologies and injury rates, which prevents comparison, conclusions and development of injury prevention strategies. The authors highlight the most pressing issues for improvement of the quality in injury epidemiology research for disability sport.

Molecular pathological epidemiology: new developing frontiers of big data science to study etiologies and pathogenesis

PubMed Central

Hamada, Tsuyoshi; Keum, NaNa; Nishihara, Reiko; Ogino, Shuji

2016-01-01

Molecular pathological epidemiology (MPE) is an integrative field that utilizes molecular pathology to incorporate interpersonal heterogeneity of a disease process into epidemiology. In each individual, the development and progression of a disease are determined by a unique combination of exogenous and endogenous factors, resulting in different molecular and pathological subtypes of the disease. Based on “the unique disease principle,” the primary aim of MPE is to uncover an interactive relationship between a specific environmental exposure and disease subtypes in determining disease incidence and mortality. This MPE approach can provide etiologic and pathogenic insights, potentially contributing to precision medicine for personalized prevention and treatment. Although breast, prostate, lung, and colorectal cancers have been among the most commonly studied diseases, the MPE approach can be used to study any disease. In addition to molecular features, host immune status and microbiome profile likely affect a disease process, and thus serve as informative biomarkers. As such, further integration of several disciplines into MPE has been achieved (e.g., pharmaco-MPE, immuno-MPE, and microbial MPE), to provide novel insights into underlying etiologic mechanisms. With the advent of high-throughput sequencing technologies, available genomic and epigenomic data have expanded dramatically. The MPE approach can also provide a specific risk estimate for each disease subgroup, thereby enhancing the impact of genome-wide association studies on public health. In this article, we present recent progress of MPE, and discuss the importance of accounting for the disease heterogeneity in the era of big-data health science and precision medicine. PMID:27738762

Feasibility of future epidemiological studies on possible health effects of mobile phone base stations.

PubMed

Neubauer, Georg; Feychting, Maria; Hamnerius, Yngve; Kheifets, Leeka; Kuster, Niels; Ruiz, Ignacio; Schüz, Joachim; Uberbacher, Richard; Wiart, Joe; Röösli, Martin

2007-04-01

The increasing deployment of mobile communication base stations led to an increasing demand for epidemiological studies on possible health effects of radio frequency emissions. The methodological challenges of such studies have been critically evaluated by a panel of scientists in the fields of radiofrequency engineering/dosimetry and epidemiology. Strengths and weaknesses of previous studies have been identified. Dosimetric concepts and crucial aspects in exposure assessment were evaluated in terms of epidemiological studies on different types of outcomes. We conclude that in principle base station epidemiological studies are feasible. However, the exposure contributions from all relevant radio frequency sources have to be taken into account. The applied exposure assessment method should be piloted and validated. Short to medium term effects on physiology or health related quality of life are best investigated by cohort studies. For long term effects, groups with a potential for high exposure need to first be identified; for immediate effect, human laboratory studies are the preferred approach. (c) 2006 Wiley-Liss, Inc.

About the Epidemiology and Genomics Research Program

Cancer.gov

Epidemiology is the scientific study of the causes and distribution of disease in populations. NCI-funded epidemiology research is conducted through research at institutions in the United States and internationally.

How does airway exposure of aflatoxin B1 affect serum albumin adduct concentrations? Evidence based on epidemiological study and animal experimentation.

PubMed

Mo, Xianwei; Lai, Hao; Yang, Yang; Xiao, Jun; He, Ke; Liu, Chao; Chen, Jiansi; Lin, Yuan

2014-08-01

Aflatoxin B1 (AFB1) airway inhalation represents an additional route of exposure to this toxin. However, the association between AFB1 inhalation and serum AFB1 albumin adducts remains unclear. The aim of this study was to explore the association between airway exposure to AFB1 and serum AFB1 albumin adduct concentrations via an epidemiological study, as well as in an AFB1 airway exposure animal model. Our epidemiological study was conducted in a sugar factory in the Guangxi Autonomous Region of China. In order to examine fungal contamination, air samples were obtained in the workshop and areas outside the workshop, such as the office and nearby store. Dust samples were also collected from the bagasse warehouse and presser workshop, and were analyzed using an indirect competitive enzyme-linked immunosorbent assay (ELISA). Additionally, blood samples were collected from a total of 121 workshop workers, and a control group (n = 80) was comprised of workers who undertook administrative tasks or other work outside the workshop. The animal experiment was conducted in the laboratory animal center of Guangxi Medical University, where a total of 60 adult male rabbits were involved in this study. By intubation, AFB1 was administered in three groups of rabbits daily, at dose rates of 0.075, 0.05 and 0.025 mg/kg/day for a period of 7 days. Blood samples were collected on day 1, day 3, day 7 and day 21, and the measurements of the AFB1 albumin adducts in the serum were performed by a double antibody sandwich ELISA. The epidemiological study showed that serum albumin adducts were detected in 67 workshop workers (55.37%), and the values ranged 6.4 pg/mg albumin to 212 pg/mg albumin (mean value: 51 ± 4.62 pg/mg albumin). In contrast, serum albumin adducts were detected in only 7 control group participants, with the values ranging from 9 pg AFB1/mg albumin to 59 pg/mg albumin (mean value: 20 ± 13.72 pg/mg albumin). The animal experiment revealed that the rabbits had detectable levels of AFB1 in their serum with a minimum effective dose of 0.05 mg/kg/day; while 11 of 17 (64.71%) rabbits had detectable levels of AFB1 albumin adducts in the high exposure group (0.075 mg/kg/day), and only 5 rabbits (26.32%) had detectable levels of AFB1 albumin adducts in the moderate exposure group (0.05 mg/kg/day). No rabbits had detectable levels of AFB1 albumin adducts in the low exposure group (0.025 mg/kg/day). Our results demonstrated that only exposure to a certain level of AFB1 would result in detectable levels of serum AFB1 albumin adducts. Interventional programs aimed at reducing exposure to AFB1 by inhalation are urgently needed in high-risk populations. Additional large-sample, well-designed randomized controlled trials are needed to further confirm our results.

The Exposure Dimension of Environmental Epidemiology: A Critical but Under-ExploredStudy Quality Issue in Environmental Health

EPA Science Inventory

Epidemiological research plays a critical role in assessing the effects of various chemical, physical, oiological, and social exposures on human health both in the general population and the workplace. However, even epidemiological studies that are specifically designed to test c...

Using a Virtual Population to Authentically Teach Epidemiology and Biostatistics

ERIC Educational Resources Information Center

Dunn, Peter K.; Donnison, Sharn; Cole, Rachel; Bulmer, Michael

2017-01-01

Epidemiology is the study of the distribution of disease in human populations. This means that authentically teaching primary data collection in epidemiology is difficult as students cannot easily access suitable human populations. Using an action research methodology, this paper studied the use of a virtual human population (called "The…

40 CFR 159.170 - Human epidemiological and exposure studies.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Human epidemiological and exposure... Information § 159.170 Human epidemiological and exposure studies. Information must be submitted which concerns... that a correlation may exist between exposure to a pesticide and observed adverse effects in humans...

40 CFR 159.170 - Human epidemiological and exposure studies.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Human epidemiological and exposure... Information § 159.170 Human epidemiological and exposure studies. Information must be submitted which concerns... that a correlation may exist between exposure to a pesticide and observed adverse effects in humans...

40 CFR 159.170 - Human epidemiological and exposure studies.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Human epidemiological and exposure... Information § 159.170 Human epidemiological and exposure studies. Information must be submitted which concerns... that a correlation may exist between exposure to a pesticide and observed adverse effects in humans...

40 CFR 159.170 - Human epidemiological and exposure studies.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Human epidemiological and exposure... Information § 159.170 Human epidemiological and exposure studies. Information must be submitted which concerns... that a correlation may exist between exposure to a pesticide and observed adverse effects in humans...

Measuring food intake in studies of obesity.

PubMed

Lissner, Lauren

2002-12-01

The problem of how to measure habitual food intake in studies of obesity remains an enigma in nutritional research. The existence of obesity-specific underreporting was rather controversial until the advent of the doubly labelled water technique gave credence to previously anecdotal evidence that such a bias does in fact exist. This paper reviews a number of issues relevant to interpreting dietary data in studies involving obesity. Topics covered include: participation biases, normative biases,importance of matching method to study, selective underreporting, and a brief discussion of the potential implications of generalised and selective underreporting in analytical epidemiology. It is concluded that selective underreporting of certain food types by obese individuals would produce consequences in analytical epidemiological studies that are both unpredictable and complex. Since it is becoming increasingly acknowledged that selective reporting error does occur, it is important to emphasise that correction for energy intake is not sufficient to eliminate the biases from this type of error. This is true both for obesity-related selective reporting errors and more universal types of selective underreporting, e.g. foods of low social desirability. Additional research is urgently required to examine the consequences of this type of error.

Is it time to reassess current safety standards for glyphosate-based herbicides?

PubMed Central

Blumberg, Bruce; Antoniou, Michael N; Benbrook, Charles M; Carroll, Lynn; Colborn, Theo; Everett, Lorne G; Hansen, Michael; Landrigan, Philip J; Lanphear, Bruce P; Mesnage, Robin; vom Saal, Frederick S; Welshons, Wade V; Myers, John Peterson

2017-01-01

Use of glyphosate-based herbicides (GBHs) increased ∼100-fold from 1974 to 2014. Additional increases are expected due to widespread emergence of glyphosate-resistant weeds, increased application of GBHs, and preharvest uses of GBHs as desiccants. Current safety assessments rely heavily on studies conducted over 30 years ago. We have considered information on GBH use, exposures, mechanisms of action, toxicity and epidemiology. Human exposures to glyphosate are rising, and a number of in vitro and in vivo studies challenge the basis for the current safety assessment of glyphosate and GBHs. We conclude that current safety standards for GBHs are outdated and may fail to protect public health or the environment. To improve safety standards, the following are urgently needed: (1) human biomonitoring for glyphosate and its metabolites; (2) prioritisation of glyphosate and GBHs for hazard assessments, including toxicological studies that use state-of-the-art approaches; (3) epidemiological studies, especially of occupationally exposed agricultural workers, pregnant women and their children and (4) evaluations of GBHs in commercially used formulations, recognising that herbicide mixtures likely have effects that are not predicted by studying glyphosate alone. PMID:28320775

Can epidemiological studies discern subtle neurological effects due to perinatal exposure to PCBs?

PubMed

Seegal, R F

1996-01-01

What conclusions can be drawn concerning the potential neurological effects of perinatal exposure to either PCBs, or PCBs and other fish-borne contaminants? First, by their very nature epidemiological studies are limited in their ability to detect subtle associations--including possible links between exposure to low levels of environmental contaminants and disease. As stated by Dr. Schantz, both Rogan and the Jacobsons report small changes in motor and cognitive behavior--typically less than one-half of a standard deviation--and only in the most highly exposed children. Given these small changes in CNS function, the substantive criticisms of Paneth (including the Jacobsons' choice to employ a random, rather than matched, control sample and the related fact that fish-eating mothers differed from non-fish-eating mothers on several important characteristics) and similar "generic" concerns raised by Taubes, a critical reader must question both the validity of the findings from the Michigan study and the reasons for discrepancies in results between the Jacobson and Rogan studies. Are the differences in neurobehavioral effects reported by the Jacobsons and colleagues, and Rogan and colleagues, due to the presence of confounders, exposure to different neurotoxicants, or subtle differences in methodologies? At present it is not possible to answer these questions. Nevertheless, certain commonalities exist between the Rogan and Jacobson studies, and most recently, the study conducted by Daly and colleagues in New York. All of these studies report alterations in the Brazelton Neonatal Behavioral Assessment Scale, suggesting that exposure to environmental contaminants (including PCBs) may induce subtle, transient alterations in maturation of the human CNS. Secondly, because contaminated fish contain a large number of putative developmental neurotoxicants (e.g., methyl-mercury, p,p'-DDE, PCBs, and pesticides), I am pessimistic that additional studies of human populations exposed to contaminated aquatic and marine fish and mammals will allow investigators to determine which contaminant(s) may be responsible for the observed association between fish consumption and neurobehavioral deficits. For example, although PCB body burdens have been measured in the majority of the epidemiological studies, PCBs may simply reflect exposure to other fish-borne contaminants. In light of the above statements, future epidemiological studies should focus on highly exposed susceptible populations such as occupationally exposed workers or the aged. Results from these studies would provide important information on the risk of perinatal or adult exposure to PCBs in susceptible populations, although generalization of results obtained in these populations to the general population may be fraught with difficulties. Finally, because of the limitations of epidemiological studies, particularly those studying fish-eating populations, future risk assessments should depend more heavily on laboratory derived data, including studies in nonhuman primates exposed to environmentally relevant mixtures and relevant doses of PCB congeners and other known or suspected neurotoxicants.

[Epidemiology of type 1 diabetes mellitus in children in Spain].

PubMed

Conde Barreiro, S; Rodríguez Rigual, M; Bueno Lozano, G; López Siguero, J P; González Pelegrín, B; Rodrigo Val, M P; Compés Dea, M L

2014-09-01

Epidemiological studies in many regions and countries have contributed to determining the epidemiology of type 1 diabetes (T1DM) in children less than 15 years old. Studies in many regions of Spain have been published, but the national incidence is not really known. A review was made of the publications on the epidemiology of T1DM in Spain, selecting the references on patients less than 15 years old. Many epidemiological studies on T1DM in almost all regions in Spain have been published. The methodology of these studies is heterogeneous, with variations in geographical definition, duration, period of study, limit of age, and data collection. The incidence rates are variable, from 11.5 cases per 100,000/year in Asturias to 27.6 in Castilla-La Mancha. Some studies report the percentage of diabetic ketoacidosis at the time of diagnosis, which is usually in the range of 25-40%. Although there have been various epidemiological studies on T1DM in almost all regions in Spain, the methodology is heterogeneous. The mean incidence of T1DM in children less than 15 years old in Spain, stimated from the selected studies is 17,69 cases per 100,000/year. T1DM registers need to be created and updated, using standardized methodology, to get more reliable data of the epidemiology of T1DM in Spain in the near future. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

A regularized variable selection procedure in additive hazards model with stratified case-cohort design.

PubMed

Ni, Ai; Cai, Jianwen

2018-07-01

Case-cohort designs are commonly used in large epidemiological studies to reduce the cost associated with covariate measurement. In many such studies the number of covariates is very large. An efficient variable selection method is needed for case-cohort studies where the covariates are only observed in a subset of the sample. Current literature on this topic has been focused on the proportional hazards model. However, in many studies the additive hazards model is preferred over the proportional hazards model either because the proportional hazards assumption is violated or the additive hazards model provides more relevent information to the research question. Motivated by one such study, the Atherosclerosis Risk in Communities (ARIC) study, we investigate the properties of a regularized variable selection procedure in stratified case-cohort design under an additive hazards model with a diverging number of parameters. We establish the consistency and asymptotic normality of the penalized estimator and prove its oracle property. Simulation studies are conducted to assess the finite sample performance of the proposed method with a modified cross-validation tuning parameter selection methods. We apply the variable selection procedure to the ARIC study to demonstrate its practical use.

[EFFECTIVENESS OF PREVENTIVE VACCINE PROPHYLAXIS OF CHICKEN POX IN MILITARY COLLECTIVES].

PubMed

Dubodelov, D V; Rybin, V V; Rikhter, V V; Yaroslavtsev, V V; Gritsik, A A; Kazanova, A S; Lavrov, V F; Semenenko, T A; Kuzin, S N

2015-01-01

Study the effectiveness of preventive vaccine prophylaxis of chicken pox in military collectives. In the focus of chicken pox, 200 servicemen of the new addition by conscription were immunized once against chicken pox; 97 servicemen by conscription of the new addition (comparison group) were not vaccinated. Epidemiologic and immunologic effectiveness of conduction of preventive vaccine prophylaxis in chicken pox focus were studied. In the group of 200 soldiers, that were present in the focus of infection and were immunized once against chicken pox, only 2 cases of this disease were registered (10 per thousand). In the comparison group, that consisted of 97 unvaccinated servicemen, chicken pox disease was registered in 7 individuals (72 per thousand). Epidemiologic effectiveness of preventive vaccine prophylaxis of chicken pox amounted to 86%. Immunologic effectiveness of vaccination 2-3 weeks after the immunization was 42%, and 2 months after--44%. Local reactions in the form of hyperemia (up to 1.5 cm) and edema were noted in 10% of the vaccinated at the location of preparation administration; in 1.7%--general reaction in the form of temperature increase to 37.8°C was observed. Post-vaccinal complications in the immunized group were not detected. Preventive vaccination of servicemen allows to minimize the spread of chicken pox, however can not serve as means of complete elimination of the infection from military collectives.

Epidemiology of end-stage renal disease in the countries of the Gulf Cooperation Council: a systematic review.

PubMed

Hassanien, Amal A; Al-Shaikh, Fahdah; Vamos, Eszter P; Yadegarfar, Ghasem; Majeed, Azeem

2012-06-01

To describe the epidemiology of end stage renal disease (ESRD). Mixed-methods systematic review. The countries of the Gulf Cooperation Council (GCC) which consist of Saudi Arabia, the United Arab Emirates, Kuwait, Qatar, Bahrain, and Oman. Defined to have ESRD or patients on regular dialysis for a minimum dialysis period of at least three months. Since many outcomes were reviewed, studies that estimated the incidence and prevalence of ESRD as outcomes should not have defined the study population as ESRD population or patients on regular dialysis. Studies where the study population mainly comprised children or pregnant woman were excluded. The trends of the incidence, prevalence, and mortality rate of ESRD; also, causes of mortality, primary causes and co-morbid conditions associated with ESRD. 44 studies included in this review show that the incidence of ESRD has increased while the prevalence and mortality rate of ESRD in the GCC has not been reported sufficiently. The leading primary causes of ESRD recorded in the countries of the GCC is diabetes with the most prevalent co-morbid conditions being Hypertension and Hepatitis C Virus infection; the most common cause of death was cardiovascular disease and sepsis. This review highlights that the lack of national renal registries data is a critical issue in the countries of the GCC. The available data also do not provide an accurate and updated estimate for relevant outcomes. Additionally, considering the increasing burden of chronic kidney disease (CKD), these results stressed the needs and the importance of preventative strategies for leading causes of ESRD. Furthermore, more studies are needed to describe the epidemiology of ESRD and for assessing the overall quality of renal care.

Epidemiology of end-stage renal disease in the countries of the Gulf Cooperation Council: a systematic review

PubMed Central

Hassanien, Amal A.; Al-Shaikh, Fahdah; Vamos, Eszter P.; Yadegarfar, Ghasem; Majeed, Azeem

2012-01-01

Objectives To describe the epidemiology of end stage renal disease (ESRD). Design Mixed-methods systematic review. Setting The countries of the Gulf Cooperation Council (GCC) which consist of Saudi Arabia, the United Arab Emirates, Kuwait, Qatar, Bahrain, and Oman. Participants Defined to have ESRD or patients on regular dialysis for a minimum dialysis period of at least three months. Since many outcomes were reviewed, studies that estimated the incidence and prevalence of ESRD as outcomes should not have defined the study population as ESRD population or patients on regular dialysis. Studies where the study population mainly comprised children or pregnant woman were excluded. Main outcome measures The trends of the incidence, prevalence, and mortality rate of ESRD; also, causes of mortality, primary causes and co-morbid conditions associated with ESRD. Results 44 studies included in this review show that the incidence of ESRD has increased while the prevalence and mortality rate of ESRD in the GCC has not been reported sufficiently. The leading primary causes of ESRD recorded in the countries of the GCC is diabetes with the most prevalent co-morbid conditions being Hypertension and Hepatitis C Virus infection; the most common cause of death was cardiovascular disease and sepsis. Conclusions This review highlights that the lack of national renal registries data is a critical issue in the countries of the GCC. The available data also do not provide an accurate and updated estimate for relevant outcomes. Additionally, considering the increasing burden of chronic kidney disease (CKD), these results stressed the needs and the importance of preventative strategies for leading causes of ESRD. Furthermore, more studies are needed to describe the epidemiology of ESRD and for assessing the overall quality of renal care. PMID:22768372

The STROBE extensions: protocol for a qualitative assessment of content and a survey of endorsement.

PubMed

Sharp, Melissa K; Utrobičić, Ana; Gómez, Guadalupe; Cobo, Erik; Wager, Elizabeth; Hren, Darko

2017-10-22

The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) Statement was developed in response to inadequate reporting of observational studies. In recent years, several extensions to STROBE have been created to provide more nuanced field-specific guidance for authors. The content and the prevalence of extension endorsement have not yet been assessed. Accordingly, there are two aims: (1) to classify changes made in the extensions to identify strengths and weaknesses of the original STROBE checklist and (2) to determine the prevalence and typology of endorsement by journals in fields related to extensions. Two independent researchers will assess additions in each extension. Additions will be coded as 'field specific' (FS) or 'not field specific' (NFS). FS is defined as particularly relevant information for a single field and guidance provided generally cannot be extrapolated beyond that field. NFS is defined as information that reflects epidemiological or methodological tenets and can be generalised to most, if not all, types of observational research studies. Intraclass correlation will be calculated to measure reviewers' concordance. On disagreement, consensus will be sought. Individual additions will be grouped by STROBE checklist items to identify the frequency and distribution of changes.Journals in fields related to extensions will be identified through National Library of Medicine PubMed Broad Subject Terms, screened for eligibility and further distilled via Ovid MEDLINE® search strategies for observational studies. Text describing endorsement will be extracted from each journal's website. A classification scheme will be created for endorsement types and the prevalence of endorsement will be estimated. Analyses will use NVivo V.11 and SAS University Edition. This study does not require ethical approval as it does not involve human participants. This study has been preregistered on Open Science Framework. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Violent crime in San Antonio, Texas: an application of spatial epidemiological methods.

PubMed

Sparks, Corey S

2011-12-01

Violent crimes are rarely considered a public health problem or investigated using epidemiological methods. But patterns of violent crime and other health conditions are often affected by similar characteristics of the built environment. In this paper, methods and perspectives from spatial epidemiology are used in an analysis of violent crimes in San Antonio, TX. Bayesian statistical methods are used to examine the contextual influence of several aspects of the built environment. Additionally, spatial regression models using Bayesian model specifications are used to examine spatial patterns of violent crime risk. Results indicate that the determinants of violent crime depend on the model specification, but are primarily related to the built environment and neighborhood socioeconomic conditions. Results are discussed within the context of a rapidly growing urban area with a diverse population. Copyright © 2011 Elsevier Ltd. All rights reserved.

Oligonucleotide (GTG)5 as an epidemiological tool in the study of nontuberculous mycobacteria.

PubMed Central

Cilliers, F J; Warren, R M; Hauman, J H; Wiid, I J; van Helden, P D

1997-01-01

Analysis of restriction fragment length polymorphisms in the genome of Mycobacterium tuberculosis (DNA fingerprinting) has proved to be a useful epidemiological tool in the study of tuberculosis within populations or communities. However, to date, no similar method has been developed to study the epidemiology of nontuberculous mycobacteria (NTM). In this communication, we report that a simple oligonucleotide repeat, (GTG)5, can be used to accurately genotype all species and strains of NTM tested. We suggest that this technology is an easily applied and accurate tool which can be used for the study of the epidemiology of NTM. PMID:9163479

Assessing exposure in epidemiologic studies to disinfection by-products in drinking water: report from an international workshop.

PubMed Central

Arbuckle, Tye E; Hrudey, Steve E; Krasner, Stuart W; Nuckols, Jay R; Richardson, Susan D; Singer, Philip; Mendola, Pauline; Dodds, Linda; Weisel, Clifford; Ashley, David L; Froese, Kenneth L; Pegram, Rex A; Schultz, Irvin R; Reif, John; Bachand, Annette M; Benoit, Frank M; Lynberg, Michele; Poole, Charles; Waller, Kirsten

2002-01-01

The inability to accurately assess exposure has been one of the major shortcomings of epidemiologic studies of disinfection by-products (DBPs) in drinking water. A number of contributing factors include a) limited information on the identity, occurrence, toxicity, and pharmacokinetics of the many DBPs that can be formed from chlorine, chloramine, ozone, and chlorine dioxide disinfection; b) the complex chemical interrelationships between DBPs and other parameters within a municipal water distribution system; and c) difficulties obtaining accurate and reliable information on personal activity and water consumption patterns. In May 2000, an international workshop was held to bring together various disciplines to develop better approaches for measuring DBP exposure for epidemiologic studies. The workshop reached consensus about the clear need to involve relevant disciplines (e.g., chemists, engineers, toxicologists, biostatisticians and epidemiologists) as partners in developing epidemiologic studies of DBPs in drinking water. The workshop concluded that greater collaboration of epidemiologists with water utilities and regulators should be encouraged in order to make regulatory monitoring data more useful for epidemiologic studies. Similarly, exposure classification categories in epidemiologic studies should be chosen to make results useful for regulatory or policy decision making. PMID:11834463

Environmental chemicals and preterm birth: Biological mechanisms and the state of the science

PubMed Central

Ferguson, Kelly K.; Chin, Helen B.

2017-01-01

Purpose of review Preterm birth is a significant worldwide health problem of uncertain origins. The extant body of literature examining environmental contaminant exposures in relation to preterm birth is extensive but results remain ambiguous for most organic pollutants, metals and metalloids, and air pollutants. In the present review we examine recent epidemiologic studies investigating these associations, and identify recent advances and the state of the science. Additionally, we highlight biological mechanisms of action in the pathway between chemical exposures and preterm birth, including inflammation, oxidative stress, and endocrine disruption, that deserve more attention in this context. Recent findings Important advances have been made in the study of the environment and preterm birth, particularly in regard to exposure assessment methods, exploration of effect modification by co-morbidities and exposures, and in identification of windows of vulnerability during gestation. There is strong evidence for an association between maternal exposure to some persistent pesticides, lead, and fine particulate matter, but data on other contaminants is sparse and only suggestive trends can be noted with the current data. Summary Beyond replicating current findings, further work must be done to improve understanding of mechanisms underlying the associations observed between environmental chemical exposures and preterm birth. By examining windows of vulnerability, disaggregating preterm birth by phenotypes, and measuring biomarkers of mechanistic pathways in these epidemiologic studies we can improve our ability to detect associations with exposure, provide additional evidence for causality in an observational setting, and identify opportunities for intervention. PMID:28944158

Environmental chemicals and preterm birth: Biological mechanisms and the state of the science.

PubMed

Ferguson, Kelly K; Chin, Helen B

2017-03-01

Preterm birth is a significant worldwide health problem of uncertain origins. The extant body of literature examining environmental contaminant exposures in relation to preterm birth is extensive but results remain ambiguous for most organic pollutants, metals and metalloids, and air pollutants. In the present review we examine recent epidemiologic studies investigating these associations, and identify recent advances and the state of the science. Additionally, we highlight biological mechanisms of action in the pathway between chemical exposures and preterm birth, including inflammation, oxidative stress, and endocrine disruption, that deserve more attention in this context. Important advances have been made in the study of the environment and preterm birth, particularly in regard to exposure assessment methods, exploration of effect modification by co-morbidities and exposures, and in identification of windows of vulnerability during gestation. There is strong evidence for an association between maternal exposure to some persistent pesticides, lead, and fine particulate matter, but data on other contaminants is sparse and only suggestive trends can be noted with the current data. Beyond replicating current findings, further work must be done to improve understanding of mechanisms underlying the associations observed between environmental chemical exposures and preterm birth. By examining windows of vulnerability, disaggregating preterm birth by phenotypes, and measuring biomarkers of mechanistic pathways in these epidemiologic studies we can improve our ability to detect associations with exposure, provide additional evidence for causality in an observational setting, and identify opportunities for intervention.

Bovine tuberculosis slaughter surveillance in the United States 2001–2010: assessment of its traceback investigation function

PubMed Central

2014-01-01

Background The success of tracing cattle to the herd of origin after the detection and confirmation of bovine tuberculosis (TB) lesions in cattle at slaughter is a critical component of the national bovine TB eradication program in the United States (U.S.). The aims of this study were to 1) quantify the number of bovine TB cases identified at slaughter that were successfully traced to their herd of origin in the U.S. during 2001–2010, 2) quantify the number of successful traceback investigations that found additional TB infected animals in the herd of origin or epidemiologically linked herds, and 3) describe the forms of animal identification present on domestic bovine TB cases and their association with traceback success. Results We analyzed 2001–2010 data in which 371 granulomatous lesions were confirmed as bovine TB. From these 114 bovine TB cases, 78 adults (i.e. sexually intact bovines greater than two years of age), and 36 fed (i.e. less than or equal to two years of age) were classified as domestic cattle (U.S. originated). Of these adults and fed cases, 83% and 13% were successfully traced, respectively. Of these traceback investigations, 70% of adult cases and 50% of fed cases identified additional bovine TB infected animals in the herd of origin or an epidemiologically linked herd. We found that the presence of various forms of animal identification on domestic bovine TB cases at slaughter may facilitate successful traceback investigations; however, they do not guarantee it. Conclusions These results provide valuable information with regard to epidemiological traceback investigations and serve as a baseline to aid U.S. officials when assessing the impact of newly implemented strategies as part of the national bovine TB eradication in the U.S. PMID:25123050

Epidemiology of cholera outbreaks and socio-economic characteristics of the communities in the fishing villages of Uganda: 2011-2015.

PubMed

Bwire, Godfrey; Munier, Aline; Ouedraogo, Issaka; Heyerdahl, Leonard; Komakech, Henry; Kagirita, Atek; Wood, Richard; Mhlanga, Raymond; Njanpop-Lafourcade, Berthe; Malimbo, Mugagga; Makumbi, Issa; Wandawa, Jennifer; Gessner, Bradford D; Orach, Christopher Garimoi; Mengel, Martin A

2017-03-01

The communities in fishing villages in the Great Lakes Region of Africa and particularly in Uganda experience recurrent cholera outbreaks that lead to considerable mortality and morbidity. We evaluated cholera epidemiology and population characteristics in the fishing villages of Uganda to better target prevention and control interventions of cholera and contribute to its elimination from those communities. We conducted a prospective study between 2011-15 in fishing villages in Uganda. We collected, reviewed and documented epidemiological and socioeconomic data for 10 cholera outbreaks that occurred in fishing communities located along the African Great Lakes and River Nile in Uganda. These outbreaks caused 1,827 suspected cholera cases and 43 deaths, with a Case-Fatality Ratio (CFR) of 2.4%. Though the communities in the fishing villages make up only 5-10% of the Ugandan population, they bear the biggest burden of cholera contributing 58% and 55% of all reported cases and deaths in Uganda during the study period. The CFR was significantly higher among males than females (3.2% vs. 1.3%, p = 0.02). The outbreaks were seasonal with most cases occurring during the months of April-May. Male children under age of 5 years, and 5-9 years had increased risk. Cholera was endemic in some villages with well-defined "hotspots". Practices predisposing communities to cholera outbreaks included: the use of contaminated lake water, poor sanitation and hygiene. Additional factors were: ignorance, illiteracy, and poverty. Cholera outbreaks were a major cause of morbidity and mortality among the fishing communities in Uganda. In addition to improvements in water, sanitation, and hygiene, oral cholera vaccines could play an important role in the prevention and control of these outbreaks, particularly when targeted to high-risk areas and populations. Promotion and facilitation of access to social services including education and reduction in poverty should contribute to cholera prevention, control and elimination in these communities.

Survival improvement in patients with non-small cell lung cancer between 1983 and 2012: Analysis of the Surveillance, Epidemiology, and End Results database.

PubMed

Wang, Shuncong; Sun, Tiantian; Sun, Huanhuan; Li, Xiaobo; Li, Jie; Zheng, Xiaobin; Mallampati, Saradhi; Sun, Hongliu; Zhou, Xiuling; Zhou, Cuiling; Zhang, Hongyu; Cheng, Zhibin; Ma, Haiqing

2017-05-01

Non-small cell lung cancer is the most common malignancy in males; it constitutes the majority of lung cancer cases and requires massive medical resources. Despite improvements in managing non-small cell lung cancer, long-term survival remains very low. This study evaluated survival improvement in patients with non-small cell lung cancer in each decade between 1983 and 2012 to determine the impact of race, sex, age, and socioeconomic status on the survival rates in these patients. We extracted data on non-small cell lung cancer cases in each decade between 1983 and 2012 from the Surveillance, Epidemiology, and End Results registries. In total, 573,987 patients with non-small cell lung cancer were identified in 18 Surveillance, Epidemiology, and End Results registry regions during this period. The 12-month relative survival rates improved slightly across three decades, from 39.7% to 40.9% to 45.5%, with larger improvement in the last two decades. However, the 5-year-relative survival rates were very low, with 14.3%, 15.5%, and 18.4%, respectively, in three decades, indicating the urgency for novel comprehensive cancer care. In addition, our data demonstrated superiority in survival time among non-small cell lung cancer patients of lower socioeconomic status and White race. Although survival rates of non-small cell lung cancer patients have improved across the three decades, the 5-year-relative survival rates remain very poor. In addition, widening survival disparities among the race, the sex, and various socioeconomic status groups were confirmed. This study will help in predicting future tendencies of incidence and survival of non-small cell lung cancer, will contribute to better clinical trials by balancing survival disparities, and will eventually improve the clinical management of non-small cell lung cancer.

Epidemiology of cholera outbreaks and socio-economic characteristics of the communities in the fishing villages of Uganda: 2011-2015

PubMed Central

Ouedraogo, Issaka; Heyerdahl, Leonard; Komakech, Henry; Kagirita, Atek; Wood, Richard; Mhlanga, Raymond; Njanpop-Lafourcade, Berthe; Malimbo, Mugagga; Makumbi, Issa; Wandawa, Jennifer; Gessner, Bradford D.; Orach, Christopher Garimoi; Mengel, Martin A.

2017-01-01

Background The communities in fishing villages in the Great Lakes Region of Africa and particularly in Uganda experience recurrent cholera outbreaks that lead to considerable mortality and morbidity. We evaluated cholera epidemiology and population characteristics in the fishing villages of Uganda to better target prevention and control interventions of cholera and contribute to its elimination from those communities. Methodology/Principal findings We conducted a prospective study between 2011–15 in fishing villages in Uganda. We collected, reviewed and documented epidemiological and socioeconomic data for 10 cholera outbreaks that occurred in fishing communities located along the African Great Lakes and River Nile in Uganda. These outbreaks caused 1,827 suspected cholera cases and 43 deaths, with a Case-Fatality Ratio (CFR) of 2.4%. Though the communities in the fishing villages make up only 5–10% of the Ugandan population, they bear the biggest burden of cholera contributing 58% and 55% of all reported cases and deaths in Uganda during the study period. The CFR was significantly higher among males than females (3.2% vs. 1.3%, p = 0.02). The outbreaks were seasonal with most cases occurring during the months of April-May. Male children under age of 5 years, and 5–9 years had increased risk. Cholera was endemic in some villages with well-defined “hotspots”. Practices predisposing communities to cholera outbreaks included: the use of contaminated lake water, poor sanitation and hygiene. Additional factors were: ignorance, illiteracy, and poverty. Conclusions/Significance Cholera outbreaks were a major cause of morbidity and mortality among the fishing communities in Uganda. In addition to improvements in water, sanitation, and hygiene, oral cholera vaccines could play an important role in the prevention and control of these outbreaks, particularly when targeted to high-risk areas and populations. Promotion and facilitation of access to social services including education and reduction in poverty should contribute to cholera prevention, control and elimination in these communities. PMID:28288154

An Updated Review of Epidemiologic Studies on the Relationship Between Exposure to Whole-Body Vibration and Low Back Pain

NASA Astrophysics Data System (ADS)

Bovenzi, M.; Hulshof, C. T. J.

1998-08-01

The aim of this paper is to update the information on the epidemiologic evidence of the adverse health effects of whole-body vibration (WBV) on the spinal system by means of a review of the epidemiologic studies published between 1986 and 1996. In a systematic search of epidemiologic studies of low back pain (LBP) disorders and occupations with exposure to WBV, 37 articles were retrieved. The quality of each study was evaluated according to criteria concerning the assessment of vibration exposure, assessment of health effects, and methodology. The epidemiologic studies reaching an adequate score on each of the above mentioned criteria, were included in the final review. A meta-analysis was also conducted in order to combine the results of independent epidemiologic studies. After applying the selection criteria, 16 articles reporting the occurrence of LBP disorders in 19 WBV-exposed occupational groups, reached a sufficient score. The study design was cross-sectional for 13 occupational groups, longitudinal for 5 groups and of case-control type for one group. The main reasons for the exclusion of studies were insufficient quantitative information on WBV exposure and the lack of control groups. The findings of the selected studies and the results of the meta-analysis of both cross-sectional and cohort studies showed that occupational exposure to WBV is associated with an increased risk of LBP, sciatic pain, and degenerative changes in the spinal system, including lumbar intervertebral disc disorders. Owing to the cross-sectional design of the majority of the reviewed studies, this epidemiologic evidence is not sufficient to outline a clear exposure-response relationship between WBV exposure and LBP disorders. Upon comparing the epidemiological studies included in this review with those conducted before 1986, it is concluded that research design and the quality of exposure and health effect data in the field of WBV have improved in the last decade.

Terrorism preparedness in state health departments--United States, 2001-2003.

PubMed

2003-10-31

The anthrax attacks in fall 2001 highlighted the role of infectious disease (ID) epidemiologists in terrorism preparedness and response. Beginning in 2002, state health departments (SHDs) received approximately 1 billion dollars in new federal funding to prepare for and respond to terrorism, infectious disease outbreaks, and other public health threats and emergencies. This funding is being used in part to improve epidemiologic and surveillance capabilities. To determine how states have used a portion of their new funding to increase ID epidemiology capacity, the Iowa Department of Public Health's Center for Acute Disease Epidemiology and the Iowa State University Department of Microbiology conducted two surveys of U.S. state epidemiologists during September 2000-August 2001 and October 2002-June 2003. This report summarizes the results of these surveys, which determined that although the number of SHD epidemiology workers assigned to ID and terrorism preparedness increased by 132%, concerns remained regarding the ability of SHDs to hire qualified personnel. These findings underscore the need to develop additional and more diverse training venues for current and future ID epidemiologists.

The epidemiology of pneumococcal carriage and infections in Malaysia.

PubMed

Le, Cheng-Foh; Jefferies, Johanna M; Yusof, Mohd Yasim Mohd; Sekaran, Shamala Devi; Clarke, Stuart C

2012-06-01

In Malaysia, various aspects of the epidemiology of pneumococcal carriage and disease remain largely unclear due to the lack of supporting data. Although a number of relevant studies have been documented, their individual discrete findings are not sufficient to inform experts on pneumococcal epidemiology at a national level. Therefore, in this review we aim to bring together and systematically evaluate the key information regarding pneumococcal disease epidemiology in Malaysia and provide a comprehensive overview of the data. Major aspects discussed include pneumococcal carriage, disease incidence and prevalence, age factors, invasiveness of pneumococci, serotypes, molecular epidemiology and antibiotic susceptibility. Penicillin resistance is increasingly prevalent and studies suggest that the majority of pneumococcal serotypes causing pneumococcal disease in Malaysia are covered by currently available conjugate vaccines. Continued surveillance is needed to provide a better understanding of pneumococcal epidemiology in Malaysia.

Using Geographic Information Systems for Exposure Assessment in Environmental Epidemiology Studies

PubMed Central

Nuckols, John R.; Ward, Mary H.; Jarup, Lars

2004-01-01

Geographic information systems (GIS) are being used with increasing frequency in environmental epidemiology studies. Reported applications include locating the study population by geocoding addresses (assigning mapping coordinates), using proximity analysis of contaminant source as a surrogate for exposure, and integrating environmental monitoring data into the analysis of the health outcomes. Although most of these studies have been ecologic in design, some have used GIS in estimating environmental levels of a contaminant at the individual level and to design exposure metrics for use in epidemiologic studies. In this article we discuss fundamentals of three scientific disciplines instrumental to using GIS in exposure assessment for epidemiologic studies: geospatial science, environmental science, and epidemiology. We also explore how a GIS can be used to accomplish several steps in the exposure assessment process. These steps include defining the study population, identifying source and potential routes of exposure, estimating environmental levels of target contaminants, and estimating personal exposures. We present and discuss examples for the first three steps. We discuss potential use of GIS and global positioning systems (GPS) in the last step. On the basis of our findings, we conclude that the use of GIS in exposure assessment for environmental epidemiology studies is not only feasible but can enhance the understanding of the association between contaminants in our environment and disease. PMID:15198921

Epidemiological studies on radiation carcinogenesis in human populations following acute exposure: nuclear explosions and medical radiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fabrikant, J.I.

1982-08-01

The present review provides an understanding of our current knowledge of the carcinogenic effect of low-dose radiation in man, and surveys the epidemiological studies of human populations exposed to nuclear explosions and medical radiation. Discussion centers on the contributions of quantitative epidemiology to present knowledge, the reliability of the dose-incidence data, and those relevant epidemiological studies that provide the most useful information for risk estimation of cancer-induction in man. Reference is made to dose-incidence relationships from laboratory animal experiments where they may obtain for problems and difficulties in extrapolation from data obtained at high doses to low doses, and frommore » animal data to the human situation. The paper describes the methods of application of such epidemiological data for estimation of excess risk of radiation-induced cancer in exposed human populations, and discusses the strengths and limitations of epidemiology in guiding radiation protection philosophy and public health policy.« less

Epidemiological studies on radiation carcinogenesis in human populations following acute exposure: nuclear explosions and medical radiation.

PubMed Central

Fabrikant, J. I.

1981-01-01

The present review provides an understanding of our current knowledge of the carcinogenic effect of low-dose radiation in man, and surveys the epidemiological studies of human populations exposed to nuclear explosions and medical radiation. Discussion centers on the contributions of quantitative epidemiology to present knowledge, the reliability of the dose-incidence data, and those relevant epidemiological studies that provide the most useful information for risk estimation of cancer induction in man. Reference is made to dose-incidence relationships from laboratory animal experiments where they may obtain, for problems and difficulties in extrapolation from data obtained at high doses to low doses, and from animal data to the human situation. The paper describes the methods of application of such epidemiological data for estimation of excess risk of radiation-induced cancer in exposed human populations and discusses the strengths and limitations of epidemiology in guiding radiation protection philosophy and public health policy. PMID:7043913

Using Epidemiologic Methods to Test Hypotheses regarding Causal Influences on Child and Adolescent Mental Disorders

ERIC Educational Resources Information Center

Lahey, Benjamin B.; D'Onofrio, Brian M.; Waldman, Irwin D.

2009-01-01

Epidemiology uses strong sampling methods and study designs to test refutable hypotheses regarding the causes of important health, mental health, and social outcomes. Epidemiologic methods are increasingly being used to move developmental psychopathology from studies that catalogue correlates of child and adolescent mental health to designs that…

Charting the course for the future of science in healthcare epidemiology: results of a survey of the membership of the Society of Healthcare Epidemiology of America.

PubMed

Sinaii, Ninet

2010-07-01

To describe the results of a survey of members of the Society for Healthcare Epidemiology of America (SHEA) that (1) measured members' perceptions of gaps in the healthcare epidemiology knowledge base and members' priorities for SHEA research goals, (2) assessed whether members would be willing to participate in consortia to address identified gaps in knowledge, and (3) evaluated the need for training for the next generation of investigators in the field of healthcare epidemiology. Electronic and paper survey of members of SHEA, a professional society formed to advance the science of healthcare epidemiology through research and education. All society members were invited to participate. Of 1,289 SHEA members, 593 (46.0%) responded. Respondents identified the following issues as important for the Research Committee of SHEA: setting the scientific agenda for healthcare epidemiology, developing collaborative infrastructure to conduct research, and developing funding mechanisms for research. Respondents ranked multidrug-resistant gram-negative organisms, antimicrobial stewardship, methicillin-resistant Staphylococcus aureus, adherence to effective hand hygiene guidelines, and Clostridium difficile infections as the most important scientific issues facing the field. Respondents ranked inadequate project funding, lack of protected time for research, and inability to obtain a grant, contract, and/or outside funding as the most significant barriers to conducting research. More than 92% of respondents support creating a SHEA research consortium; more than 40% would participate even if no additional funding were available; nearly 90% identified developing research training as a key function for SHEA. These data provide a road map for the SHEA Research Committee for the next decade.

Portable Functional Neuroimaging as an Environmental Epidemiology Tool: A How-To Guide for the Use of fNIRS in Field Studies.

PubMed

Baker, Joseph M; Rojas-Valverde, Daniel; Gutiérrez, Randall; Winkler, Mirko; Fuhrimann, Samuel; Eskenazi, Brenda; Reiss, Allan L; Mora, Ana M

2017-09-21

The widespread application of functional neuroimaging within the field of environmental epidemiology has the potential to greatly enhance our understanding of how environmental toxicants affect brain function. Because many epidemiological studies take place in remote and frequently changing environments, it is necessary that the primary neuroimaging approach adopted by the epidemiology community be robust to many environments, easy to use, and, preferably, mobile. Here, we outline our use of functional near-infrared spectroscopy (fNIRS) to collect functional brain imaging data from Costa Rican farm workers enrolled in an epidemiological study on the health effects of chronic pesticide exposure. While couched in this perspective, we focus on the methodological considerations that are necessary to conduct a mobile fNIRS study in a diverse range of environments. Thus, this guide is intended to be generalizable to all research scenarios and projects in which fNIRS may be used to collect functional brain imaging data in epidemiological field surveys. https://doi.org/10.1289/EHP2049.

Portable Functional Neuroimaging as an Environmental Epidemiology Tool: A How-To Guide for the Use of fNIRS in Field Studies

PubMed Central

Rojas-Valverde, Daniel; Gutiérrez, Randall; Winkler, Mirko; Fuhrimann, Samuel; Eskenazi, Brenda; Reiss, Allan L.; Mora, Ana M.

2017-01-01

Summary: The widespread application of functional neuroimaging within the field of environmental epidemiology has the potential to greatly enhance our understanding of how environmental toxicants affect brain function. Because many epidemiological studies take place in remote and frequently changing environments, it is necessary that the primary neuroimaging approach adopted by the epidemiology community be robust to many environments, easy to use, and, preferably, mobile. Here, we outline our use of functional near-infrared spectroscopy (fNIRS) to collect functional brain imaging data from Costa Rican farm workers enrolled in an epidemiological study on the health effects of chronic pesticide exposure. While couched in this perspective, we focus on the methodological considerations that are necessary to conduct a mobile fNIRS study in a diverse range of environments. Thus, this guide is intended to be generalizable to all research scenarios and projects in which fNIRS may be used to collect functional brain imaging data in epidemiological field surveys. https://doi.org/10.1289/EHP2049 PMID:28937962

A systematic review about the epidemiology of primary progressive multiple sclerosis in Latin America and the Caribbean.

PubMed

Rojas, Juan Ignacio; Romano, Marina; Patrucco, Liliana; Cristiano, Edgardo

2018-02-24

Novel epidemiological data has appeared in recent years in Latin America (LATAM) regarding the epidemiology of multiple sclerosis (MS); however, most of this information is related to all MS subtypes, and no specific data was collected regarding the primary progressive form of MS (PPMS). The objective of this study was to perform an updated systematic review of the epidemiology of PPMS in LATAM. We conducted a systematic review of published epidemiological articles of PPMS from January 1997 to June 2017. No incidence data were found regarding PPMS. Differentiated prevalence was reported in 7 studies and ranged from 0.13 to 1.1 cases of PPMS per 100,000 inhabitants. Regarding subtype frequency, PPMS was observed in 10% of affected patients in proportional meta-analysis. No data about mortality were found. The study provides information on discriminated epidemiological features of PPMS in the region. The frequency observed was low in terms of prevalence. Follow up studies considering survival milestones and incidence data could provide a better understanding of the disease in the region. Copyright © 2018. Published by Elsevier B.V.

Characteristics of foodborne outbreaks in which use of analytical epidemiological studies contributed to identification of suspected vehicles, European Union, 2007 to 2011.

PubMed

Schlinkmann, K M; Razum, O; Werber, D

2017-04-01

Foodborne disease outbreaks (FBDOs) occur frequently in Europe. Employing analytical epidemiological study designs increases the likelihood of identifying the suspected vehicle(s), but these studies are rarely applied in FBDO investigations. We used multivariable binary logistic regression analysis to identify characteristics of investigated FBDOs reported to the European Food Safety Authority (2007-2011) that were associated with analytical epidemiological evidence (compared to evidence from microbiological investigations/descriptive epidemiology only). The analysis was restricted to FBDO investigations, where the evidence for the suspected vehicle was considered 'strong', i.e. convincing. The presence of analytical epidemiological evidence was reported in 2012 (50%) of these 4038 outbreaks. In multivariable analysis, increasing outbreak size, number of hospitalizations, causative (i.e. aetiological) agent (whether identified and, if so, which one), and the setting in which these outbreaks occurred (e.g. geographically dispersed outbreaks) were independently associated with presence of analytical evidence. The number of investigations with reported analytical epidemiological evidence was unexpectedly high, likely indicating the need for quality assurance within the European Union foodborne outbreak reporting system, and warranting cautious interpretation of our findings. This first analysis of evidence implicating a food vehicle in FBDOs may help to inform public health authorities on when to use analytical epidemiological study designs.

Evaluation of the Reproductive and Developmental Risks of Caffeine

PubMed Central

Brent, Robert L; Christian, Mildred S; Diener, Robert M

2011-01-01

A risk analysis of in utero caffeine exposure is presented utilizing epidemiological studies and animal studies dealing with congenital malformation, pregnancy loss, and weight reduction. These effects are of interest to teratologists, because animal studies are useful in their evaluation. Many of the epidemiology studies did not evaluate the impact of the “pregnancy signal,” which identifies healthy pregnancies and permits investigators to identify subjects with low pregnancy risks. The spontaneous abortion epidemiology studies were inconsistent and the majority did not consider the confounding introduced by not considering the pregnancy signal. The animal studies do not support the concept that caffeine is an abortafacient for the wide range of human caffeine exposures. Almost all the congenital malformation epidemiology studies were negative. Animal pharmacokinetic studies indicate that the teratogenic plasma level of caffeine has to reach or exceed 60 µg/ml, which is not attainable from ingesting large amounts of caffeine in foods and beverages. No epidemiological study described the “caffeine teratogenic syndrome.” Six of the 17 recent epidemiology studies dealing with the risk of caffeine and fetal weight reduction were negative. Seven of the positive studies had growth reductions that were clinically insignificant and none of the studies cited the animal literature. Analysis of caffeine's reproductive toxicity considers reproducibility and plausibility of clinical, epidemiological, and animal data. Moderate or even high amounts of beverages and foods containing caffeine do not increase the risks of congenital malformations, miscarriage or growth retardation. Pharmacokinetic studies markedly improve the ability to perform the risk analyses. Birth Defects Res (Part B) 92:152–187, 2011. © 2011 Wiley-Liss, Inc. PMID:21370398

Genomic epidemiology of Lineage 4 Mycobacterium tuberculosis subpopulations in New York City and New Jersey, 1999-2009.

PubMed

Brown, Tyler S; Narechania, Apurva; Walker, John R; Planet, Paul J; Bifani, Pablo J; Kolokotronis, Sergios-Orestis; Kreiswirth, Barry N; Mathema, Barun

2016-11-21

Whole genome sequencing (WGS) has rapidly become an important research tool in tuberculosis epidemiology and is likely to replace many existing methods in public health microbiology in the near future. WGS-based methods may be particularly useful in areas with less diverse Mycobacterium tuberculosis populations, such as New York City, where conventional genotyping is often uninformative and field epidemiology often difficult. This study applies four candidate strategies for WGS-based identification of emerging M. tuberculosis subpopulations, employing both phylogenomic and population genetics methods. M. tuberculosis subpopulations in New York City and New Jersey can be distinguished via phylogenomic reconstruction, evidence of demographic expansion and subpopulation-specific signatures of selection, and by determination of subgroup-defining nucleotide substitutions. These methods identified known historical outbreak clusters and previously unidentified subpopulations within relatively monomorphic M. tuberculosis endemic clone groups. Neutrality statistics based on the site frequency spectrum were less useful for identifying M. tuberculosis subpopulations, likely due to the low levels of informative genetic variation in recently diverged isolate groups. In addition, we observed that isolates from New York City endemic clone groups have acquired multiple non-synonymous SNPs in virulence- and growth-associated pathways, and relatively few mutations in drug resistance-associated genes, suggesting that overall pathoadaptive fitness, rather than the acquisition of drug resistance mutations, has played a central role in the evolutionary history and epidemiology of M. tuberculosis subpopulations in New York City. Our results demonstrate that some but not all WGS-based methods are useful for detection of emerging M. tuberculosis clone groups, and support the use of phylogenomic reconstruction in routine tuberculosis laboratory surveillance, particularly in areas with relatively less diverse M. tuberculosis populations. Our study also supports the use of wider-reaching phylogenomic and population genomic methods in tuberculosis public health practice, which can support tuberculosis control activities by identifying genetic polymorphisms contributing to epidemiological success in local M. tuberculosis populations and possibly explain why certain isolate groups are apparently more successful in specific host populations.

Epidemiology of moderate-to-severe penetrating versus closed traumatic brain injury in the Iraq and Afghanistan wars.

PubMed

Orman, Jean A; Geyer, Dennis; Jones, John; Schneider, Eric B; Grafman, Jordan; Pugh, Mary Jo; Dubose, Joseph

2012-12-01

US combat operations in Iraq and Afghanistan have resulted in a greater proportion of service members with head and neck wounds caused by explosions compared with that of previous wars. Although penetrating traumatic brain injury (TBI) is frequently associated with these wounds, the epidemiology of penetrating TBI from these conflicts has not been well described. The Joint Theater Trauma Registry was queried for January 2003 through December 2010 to identify all patients with moderate-to-severe brain injury with a maximum Abbreviated Injury Scale (AIS) score of the head of 3 or greater and a diagnosis of penetrating or closed TBI in accordance with the Department of Defense Traumatic Brain Injury Surveillance definition. The epidemiology of these injuries was examined, including demographics, TBI severity, overall injury severity, and surgical interventions provided. A total of 1,255 TBI patients (774 penetrating, 481 closed) meeting criteria were identified. Penetrating brain injuries were more severe, more likely to be battle related, and less likely to be isolated injuries than a group of moderate-to-severe closed TBIs within the same range of anatomic injury severity. During the 5-year period of the Iraq war with the largest numbers of TBIs (2004-2008), the numbers of penetrating TBIs exceeded closed TBIs by a ratio of 2:1. During the 3-year period of the Afghanistan war with the greatest numbers of TBIs (2008-2010), the ratio of penetrating to closed TBIs was substantially lower, approximately 1.3:1. This study represents the first comprehensive report on the epidemiology of moderate-to-severe penetrating and closed TBIs resulting from the wars in Iraq and Afghanistan using Joint Theater Trauma Registry data. With the maturing theater of conflicts, penetrating TBIs were substantially less predominant compared with closed TBIs. While this finding may reflect changes in the use of protective measures and tactics or improvements in diagnosis of closed TBIs, additional research is needed to identify the reason for this shift and the subsequent effect on outcome after combat-related TBIs. Epidemiologic study, level III.

Evolution of epidemiologic methods and concepts in selected textbooks of the 20th century.

PubMed

Zhang, Fang F; Michaels, Desireé C; Mathema, Barun; Kauchali, Shuaib; Chatterjee, Anjan; Ferris, David C; James, Tamarra M; Knight, Jennifer; Dounel, Matthew; Tawfik, Hebatullah O; Frohlich, Janet A; Kuang, Li; Hoskin, Elena K; Veldman, Frederick J; Baldi, Giulia; Mlisana, Koleka P; Mametja, Lerole D; Diaz, Angela; Khan, Nealia L; Sternfels, Pamela; Sevigny, Jeffery J; Shamam, Asher; Morabia, Alfredo

2004-01-01

Textbooks are an expression of the state of development of a discipline at a given moment in time. By reviewing eight epidemiology textbooks published over the course of a century, we have attempted to trace the evolution of five epidemiologic concepts and methods: study design (cohort studies and case-control studies), confounding, bias, interaction and causal inference. Overall, these eight textbooks can be grouped into three generations. Greenwood (1935) and Hill (first edition 1937; version reviewed 1961)'s textbooks belong to the first generation, "early epidemiology", which comprise early definitions of bias and confounding. The second generation, "classic epidemiology", represented by the textbooks of Morris (first edition 1957; version reviewed 1964), MacMahon & Pugh (first edition 1960; version reviewed 1970), Susser (1973), and Lilienfeld & Lilienfeld (first edition 1976; version reviewed 1980), clarifies the properties of cohort and case-control study designs and the theory of disease causation. Miettinen (1985) and Rothman (1986)'s textbooks belong to a third generation, "modern epidemiology", presenting an integrated perspective on study designs and their measures of outcome, as well as distinguishing and formalizing the concepts of confounding and interaction. Our review demonstrates that epidemiology, as a scientific discipline, is in constant evolution and transformation. It is likely that new methodological tools, able to assess the complexity of the causes of human health, will be proposed in future generations of textbooks.

[Clinical and epidemiologic profile of melanoma patients according to sun exposure of the tumor site].

PubMed

Nagore, E; Botella-Estrada, R; Requena, C; Serra-Guillén, C; Martorell, A; Hueso, L; Llombart, B; Sanmartín, O; Guillén, C

2009-04-01

Melanomas arising in areas with comparable levels of sun exposure have been shown to have similar genetic profiles. The aim of this study was to characterize the clinical features of melanoma patients according to the pattern of sun exposure: chronic, intermittent, or none. From our melanoma database, we selected 789 consecutive patients with melanoma diagnosed in our center since January 2000. Epidemiologic data, phenotype, and personal and family history of cancer were retrieved. The observed frequency of each variable was compared. Most melanoma patients presented tumors on areas exposed intermittently to sunlight. In addition, these patients presented higher numbers of common and atypical melanocytic nevi and the melanoma very frequently arose in a pre-existing nevus. The second largest group was formed by patients with tumors on areas chronically exposed to sun and that had all the clinical lesions (solar lentigines and actinic keratoses) and epidemiological characteristics typical of these areas. Finally, patients with melanomas on areas not exposed to sun were older, as occurred in the group with chronic exposure, and the diagnosis was made at more advanced stages of the disease. There are many patients who did not fit these patterns of melanoma development. Clinical and biological characterization is therefore necessary to determine alternative pathways of development in order to establish specific preventive measures.

[Molecular markers: an important tool in the diagnosis, treatment and epidemiology of invasive aspergillosis].

PubMed

Frías-de León, María Guadalupe; Acosta-Altamirano, Gustavo; Duarte-Escalante, Esperanza; Martínez-Hernández, José Enrique; Martínez-Rivera, María de Los Ángeles; Reyes-Montes, María Del Rocío

2014-01-01

Increase in the incidence of invasive aspergillosis has represented a difficult problem for management of patients with this infection due to its high rate of mortality, limited knowledge concerning its diagnosis, and therapeutic practice. The difficulty in management of patients with aspergillosis initiates with detection of the fungus in the specimens of immunosuppressed patients infected with Aspergillus fumigatus; in addition, difficulty exists in terms of the development of resistance to antifungals as a consequence of their indiscriminate use in prophylactic and therapeutic practice and to ignorance concerning the epidemiological data of aspergillosis. With the aim of resolving these problems, molecular markers is employed at present with specific and accurate results. However, in Mexico, the use of molecular markers has not yet been implemented in the routine of intrahospital laboratories; despite the fact that these molecular markers has been widely referred in the literature, it is necessary for it to validated and standardized to ensure that the results obtained in any laboratory would be reliable and comparable. In the present review, we present an update on the usefulness of molecular markers in accurate identification of A. fumigatus, detection of resistance to antifugal triazoles, and epidemiological studies for establishing the necessary measures for prevention and control of aspergillosis.

Understanding the Epidemiology of Heart Failure to Improve Management Practices: An Asia-Pacific Perspective.

PubMed

Rajadurai, Jeyamalar; Tse, Hung-Fat; Wang, Chao-Hung; Yang, Ning-I; Zhou, Jingmin; Sim, David

2017-04-01

Heart failure (HF) is a major global healthcare problem with an estimated prevalence of approximately 26 million. In Asia-Pacific regions, HF is associated with a significant socioeconomic burden and high rates of hospital admission. Epidemiological data that could help to improve management approaches to address this burden in Asia-Pacific regions are limited, but suggest patients with HF in the Asia-Pacific are younger and have more severe signs and symptoms of HF than those of Western countries. However, local guidelines are based largely on the European Society of Cardiology and American College of Cardiology Foundation/American Heart Association guidelines, which draw their evidence from studies where Western patients form the major demographic and patients from the Asia-Pacific region are underrepresented. Furthermore, regional differences in treatment practices likely affect patient outcomes. In the following review, we examine epidemiological data from existing regional registries, which indicate that these patients represent a distinct subpopulation of patients with HF. In addition, we highlight that patients with HF are under-treated in the region despite the existence of local guidelines. Finally, we provide suggestions on how data can be enriched throughout the region, which may positively affect local guidelines and improve management practices. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Molecular epidemiology demonstrated three emerging clusters of human immunodeficiency virus type 1 subtype B infection in Hong Kong.

PubMed

Leung, Tommy W C; Mak, Darwin; Wong, K H; Wang, Y; Song, Y H; Tsang, D N C; Wong, C; Shao, Y M; Lim, W L

2008-07-01

We conducted a molecular epidemiological study on newly diagnosed human immunodeficiency virus type 1 (HIV-1)-infected patients in Hong Kong to identify the epidemiological linkage of HIV-1 infection in the locality. Reverse transcription polymerase chain reaction (RT-PCR) for HIV-1 was performed on newly diagnosed HIV-1-positive sera collected from January 2002 to December 2006. PCR products correspond to the env C2V3V4 region and gag p17/p24 junction of the HIV-1 genome were nucleotide sequenced. Phylogenetic analyses performed on the acquired nucleotide sequences revealed that CRF01_AE and subtype B were the two dominant HIV-1 subtypes. Analyses also demonstrated the presence of three emerging HIV-1 clusters among the subtype B sequences in Hong Kong. Individual cluster possesses a unique cluster-specific amino acid signature for identification. Data show that one of the clusters (Cluster I) is rapidly expanding. In addition to the unique cluster-specific amino acid signature, the majority of sequences in Cluster I harbor a 6-amino acid insertion at the gag p17/p24 junction in a region that is thought to be closely associated with HIV-1 infectivity.

The clinical picture of juvenile parotitis in a prospective setup.

PubMed

Saarinen, Riitta; Kolho, Kaija-Leena; Davidkin, Irja; Pitkäranta, Anne

2013-02-01

To characterize the features of juvenile parotitis in a prospective setup and epidemiology. All children with parotitis admitted to Helsinki University Central Hospital 2005-2010 were recruited. Clinical characteristics, given treatment, outcome, blood leukocyte count, C-reactive protein, serum amylase and trypsinogen, SPINK-1 genotype and mumps antibodies were recorded. To map the epidemiology, a questionnaire was sent to 1000 randomly selected 13-year-old children. The prospective study included 41 children (aged ≤ 17) with acute parotitis, all in good general condition. Serum amylase, but not trypsinogen, was elevated in majority of the cases (79%) and C-reactive protein in 68%. Eleven (27%) children had an elevated blood leukocyte count. None had acute mumps. Most children recovered well, 51% being treated symptomatically only. Seven children were treated on ward. Seventeen (46%) children had recurrent symptoms. One child (2.4%) had SPINK P55S mutation. According to the epidemiological questionnaire, 1.1% of the respondents (8/728, response rate 73%) reported a verified episode(s) of parotitis. Juvenile parotitis has a frequency close to 1%. In the majority, the general condition is good during the episode. Serum amylase serves as an additional marker for the disease. Parotitis has a tendency to recur in almost half of the cases. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

Determinants of epidemiologic transition in rural Africa: the role of socioeconomic status and drinking water source.

PubMed

Engelaer, Frouke M; Koopman, Jacob J E; van Bodegom, David; Eriksson, Ulrika K; Westendorp, Rudi G J

2014-06-01

Many African countries experience a protracted epidemiologic transition, different from the classical transition in western societies. The factors driving this protracted transition are largely unknown. In northeast Ghana, we studied an ongoing epidemiologic transition and investigated the effects of socioeconomic status and drinking water source on the transition. During a 9-year period, we followed a cohort of almost 30 000 individuals and collected information on mortality and fertility rates. In addition, using the standards set out by the WHO, we obtained the causes of death by verbal autopsy. Individuals were stratified according to their socioeconomic status and the households' use of an improved or unimproved drinking water source. Mortality rates decreased by -5.0% annually (p<0.001) and the main cause of death shifted from infectious to non-infectious diseases (p=0.014). General fertility rates and child-women ratios decreased annually by -12.7% (p<0.001) and -11.9% (p<0.001), respectively. There was no difference in the decline of mortality and fertility depending on socioeconomic status or drinking water source. Factors other than socioeconomic status and drinking water source are responsible for the observed declines in mortality and fertility observed during the protracted epidemiologic transition. Identifying the specific determinants of the ongoing transition is of importance, as they could be targeted in order to further improve public health in rural African countries. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Polyunsaturated fatty acids and suicide risk in mood disorders: A systematic review.

PubMed

Pompili, Maurizio; Longo, Lucia; Dominici, Giovanni; Serafini, Gianluca; Lamis, Dorian A; Sarris, Jerome; Amore, Mario; Girardi, Paolo

2017-03-06

Deficiency of omega-3 polyunsaturated fatty acids (PUFAs) and an alteration between the ratio of omega-3 and omega-6 PUFAs may contribute to the pathogenesis of bipolar disorder and unipolar depression. Recent epidemiological studies have also demonstrated an association between the depletion of PUFAs and suicide. Our aim was to investigate the relationship between PUFAs and suicide; assess whether the depletion of PUFAs may be considered a risk factor for suicidal behavior; in addition to detailing the potential use of PUFAs in clinical practice. We performed a systematic review on PUFAs and suicide in mood disorders, searching MedLine, Excerpta Medica, PsycLit, PsycInfo, and Index Medicus for relevant epidemiological, post-mortem, and clinical studies from January 1997 to September 2016. A total of 20 articles from peer-reviewed journals were identified and selected for this review. The reviewed studies suggest that subjects with psychiatric conditions have a depletion of omega-3 PUFAs compared to control groups. This fatty acid depletion has also been found to contribute to suicidal thoughts and behavior in some cases. However, large epidemiological studies have generally not supported this finding, as the depletion of omega-3 PUFAs was not statistically different between controls and patients diagnosed with a mental illness and/or who engaged in suicidal behavior. Increasing PUFA intake may be relevant in the treatment of depression, however in respect to the prevention of suicide, the data is currently not supportive of this approach. Changes in levels of PUFAs may however be a risk factor to evaluate when assessing for suicide risk. Clinical studies should be conducted to prospectively assess whether prescriptive long-term use of PUFAs in PUFA-deficient people with depression, may have a preventative role in attenuating suicide. Copyright © 2016 Elsevier Inc. All rights reserved.

Epidemiology of Cyclospora Species in Humans in Malatya Province in Turkey.

PubMed

Karaman, Ulku; Daldal, Nilgun; Ozer, Ali; Enginyurt, Ozgur; Erturk, Omer

2015-07-01

Cyclospora species are rare among other Coccidia parasites and can cause recurrent gastroenteritis. Cyclospora spp. can infect reptiles, insects, rodents, and mammals. The present study aimed to determine the epidemiology of Cyclospora spp. in Malatya province and its neighboring provinces. Totally, 2281 stool samples taken from patients with digestive system complaints who referred to the polyclinics affiliated with Inonu University, Faculty of Medicine in Malatya Province and its neighboring provinces, in 2006, and whose stool specimens were submitted to the parasitology department were examined. A questionnaire was developed to determine the epidemiology of Cyclospora spp. in the patients as the dependent variable of the study. All the participants signed an informed written consent. The samples were coated with Entellan™ after staining via acid-fast staining and were examined on an immersion microscope objective. The data are presented as mean, standard deviation, or number/percentage. The chi-square test was used for the statistical analyses. Statistically, a P value < 0.05 was accepted as meaningful. The stool samples were examined via direct microscopic examination and acid-fast staining. Positivity was determined in 129 (5.7%) cases. In the overall assessment of the patients with respect to general body itching, rectal itching, allergy, immunosuppression plus cancer, shortness of breath, ulcerative colitis, diarrhea, abdominal pain, salivation, constipation, nausea, vomiting, growth retardation, and anemia, there was no significant relationship. However, in the statistical evaluations among the positive cases, the difference was found to be significant. The study was conducted in Malatya Province, but patients from the neighboring provinces were also included in the evaluation during the study. Of all the positive cases, 5.6% were those from Malatya Province and its surrounding areas. Additionally, Cyclospora spp. were observed among the patients referring to the polyclinics with digestive system complaints in 8.1% of those from the Adiyaman province and in 6.9% of those from the Kahramanmaraş region. The incidence of Cyclospora cayetanensis may be higher in these regions if an epidemiological study is performed. Consequently, we suggest that Cyclospora spp. be investigated in digestive system disorders, especially in immunosuppressed patients.

Epidemiology of Cyclospora Species in Humans in Malatya Province in Turkey

PubMed Central

Karaman, Ulku; Daldal, Nilgun; Ozer, Ali; Enginyurt, Ozgur; Erturk, Omer

2015-01-01

Background: Cyclospora species are rare among other Coccidia parasites and can cause recurrent gastroenteritis. Cyclospora spp. can infect reptiles, insects, rodents, and mammals. Objectives: The present study aimed to determine the epidemiology of Cyclospora spp. in Malatya province and its neighboring provinces. Patients and Methods: Totally, 2281 stool samples taken from patients with digestive system complaints who referred to the polyclinics affiliated with Inonu University, Faculty of Medicine in Malatya Province and its neighboring provinces, in 2006, and whose stool specimens were submitted to the parasitology department were examined. A questionnaire was developed to determine the epidemiology of Cyclospora spp. in the patients as the dependent variable of the study. All the participants signed an informed written consent. The samples were coated with Entellan™ after staining via acid-fast staining and were examined on an immersion microscope objective. The data are presented as mean, standard deviation, or number/percentage. The chi-square test was used for the statistical analyses. Statistically, a P value < 0.05 was accepted as meaningful. Results: The stool samples were examined via direct microscopic examination and acid-fast staining. Positivity was determined in 129 (5.7%) cases. In the overall assessment of the patients with respect to general body itching, rectal itching, allergy, immunosuppression plus cancer, shortness of breath, ulcerative colitis, diarrhea, abdominal pain, salivation, constipation, nausea, vomiting, growth retardation, and anemia, there was no significant relationship. However, in the statistical evaluations among the positive cases, the difference was found to be significant. Conclusions: The study was conducted in Malatya Province, but patients from the neighboring provinces were also included in the evaluation during the study. Of all the positive cases, 5.6% were those from Malatya Province and its surrounding areas. Additionally, Cyclospora spp. were observed among the patients referring to the polyclinics with digestive system complaints in 8.1% of those from the Adiyaman province and in 6.9% of those from the Kahramanmaraş region. The incidence of Cyclospora cayetanensis may be higher in these regions if an epidemiological study is performed. Consequently, we suggest that Cyclospora spp. be investigated in digestive system disorders, especially in immunosuppressed patients. PMID:26421126

Invited commentary: do-it-yourself modern epidemiology--at last!

PubMed

Morabia, Alfredo

2014-10-01

In this issue of the Journal, Keyes and Galea (Am J Epidemiol. 2014;180(7):661-668) propose "7 foundational steps" for introducing epidemiologic methods and concepts to beginners. Keyes and Galea's credo is that the methododological and conceptual components that comprise epidemiology, today scattered in textbook chapters, come together as an integrated and coherent methodological corpus in the process of designing studies. Thus, they expound, the process of designing studies should be the core of teaching epidemiology. Two aspects of their 7-steps-to-epidemiology, do-it-yourself user manual stand out as novel: 1) the approach, because of its emphasis on modern epidemiology's causal framework of a dynamic population in a steady state evolving across time, and 2) the ambition to teach modern epidemiology in introductory courses, instead of the popular mix of classical and modern epidemiology that is often used today to keep introductory courses simple. Both aspects are of potentially great significance for our discipline. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Using the Center for Epidemiologic Studies Depression Scale to Screen for Depression in Systemic Lupus Erythematosus

PubMed Central

Julian, Laura J.; Gregorich, Steven E.; Tonner, Chris; Yazdany, Jinoos; Trupin, Laura; Criswell, Lindsey A.; Yelin, ED; Katz, Patricia P.

2013-01-01

Objective Identifying persons with systemic lupus erythematosus (SLE) at risk for depression would facilitate the identification and treatment of an important comorbidity conferring additional risk for poor outcomes. The purpose of this study was to determine the utility of a brief screening measure, the Center for Epidemiologic Studies Depression Scale (CES-D), in detecting mood disorders in persons with SLE. Methods This cross-sectional study examined 150 persons with SLE. Screening cut points were empirically derived using threshold selection methods, and receiver operating characteristic curves were estimated. The empirically derived cut points of the CES-D were used as the screening measures and were compared to other commonly used CES-D cut points in addition to other commonly used methods to screen for depression. Diagnoses of major depressive disorder or other mood disorders were determined using a “gold standard” structured clinical interview. Results Of the 150 persons with SLE, 26% of subjects met criteria for any mood disorder and 17% met criteria for major depressive disorder. Optimal threshold estimations suggested a CES-D cut score of 24 and above, which yielded adequate sensitivity and specificity in detecting major depressive disorder (88% and 93%, respectively) and correctly classified 92% of participants. To detect the presence of any mood disorder, a cut score of 20 and above was suggested, yielding sensitivity and specificity of 87% and correctly classifying 87%. Conclusion These results suggest the CES-D may be a useful screening measure to identify patients at risk for depression. PMID:21312347

The Schisto Track: A System for Gathering and Monitoring Epidemiological Surveys by Connecting Geographical Information Systems in Real Time

PubMed Central

2014-01-01

Background Using the Android platform as a notification instrument for diseases and disorders forms a new alternative for computerization of epidemiological studies. Objective The objective of our study was to construct a tool for gathering epidemiological data on schistosomiasis using the Android platform. Methods The developed application (app), named the Schisto Track, is a tool for data capture and analysis that was designed to meet the needs of a traditional epidemiological survey. An initial version of the app was finished and tested in both real situations and simulations for epidemiological surveys. Results The app proved to be a tool capable of automation of activities, with data organization and standardization, easy data recovery (to enable interfacing with other systems), and totally modular architecture. Conclusions The proposed Schisto Track is in line with worldwide trends toward use of smartphones with the Android platform for modeling epidemiological scenarios. PMID:25099881

Using a virtual population to authentically teach epidemiology and biostatistics

NASA Astrophysics Data System (ADS)

Dunn, Peter K.; Donnison, Sharn; Cole, Rachel; Bulmer, Michael

2017-02-01

Epidemiology is the study of the distribution of disease in human populations. This means that authentically teaching primary data collection in epidemiology is difficult as students cannot easily access suitable human populations. Using an action research methodology, this paper studied the use of a virtual human population (called The Island) to enable students to experience many features of authentic primary data collection in epidemiological research. The Island was used in a course introducing epidemiology and biostatistics for students in non-quantitative disciplines. This paper discusses how The Island was introduced into the course, and then evaluates the change. Students were highly engaged, and students and teaching staff responded favourably to the use of The Island, with 70% of students agreeing or strongly agreeing that The Island was easy to use, and 64% agreeing or strongly agreeing that the use of a virtual population was beneficial to their understanding of epidemiology.

Night Shift Work and Risk of Breast Cancer.

PubMed

Hansen, Johnni

2017-09-01

Night work is increasingly common and a necessity in certain sectors of the modern 24-h society. The embedded exposure to light-at-night, which suppresses the nocturnal hormone melatonin with oncostatic properties and circadian disruption, i.e., misalignment between internal and external night and between cells and organs, are suggested as main mechanisms involved in carcinogenesis. In 2007, the International Agency for Research on Cancer (IARC) classified shift work that involves circadian disruption as probably carcinogenic to humans based on limited evidence from eight epidemiologic studies on breast cancer, in addition to sufficient evidence from animal experiments. The aim of this review is a critical update of the IARC evaluation, including subsequent and the most recent epidemiologic evidence on breast cancer risk after night work. After 2007, in total nine new case-control studies, one case-cohort study, and eight cohort studies are published, which triples the number of studies. Further, two previous cohorts have been updated with extended follow-up. The assessment of night shift work is different in all of the 26 existing studies. There is some evidence that high number of consecutive night shifts has impact on the extent of circadian disruption, and thereby increased breast cancer risk, but this information is missing in almost all cohort studies. This in combination with short-term follow-up of aging cohorts may explain why some cohort studies may have null findings. The more recent case-control studies have contributed interesting results concerning breast cancer subtypes in relation to both menopausal status and different hormonal subtypes. The large differences in definitions of both exposure and outcome may contribute to the observed heterogeneity of results from studies of night work and breast cancer, which overall points in the direction of an increased breast cancer risk, in particular after over 20 years of night shifts. Overall, there is a tendency of increased risk of breast cancer either after over 20 years of night shift or after shorter periods with many consecutive shifts. More epidemiologic research using standardized definitions of night work metrics and breast cancer subtypes as well as other cancers is needed in order to improve the epidemiologic evidence in combination with animal models of night work. Also, evidence-based preventive interventions are needed.

The discipline of epidemiology: engaging in the full breadth of population health science.

PubMed

Feldman, Harold I

2018-06-01

This address was delivered by Harold I. Feldman, MD, MSCE, at the Annual Meeting of the American College of Epidemiology in New Orleans, Louisiana, on September 26, 2017. Dr. Feldman is George S. Pepper Professor of Public Health and Preventive Medicine, Professor of Epidemiology and Medicine, and Chair, Department of Biostatistics, Epidemiology, and Informatics at the Perelman School of Medicine at the University of Pennsylvania. He is recognized nationally and internationally for his expertise in kidney disease epidemiology. Dr. Feldman pioneered the integration of epidemiology and renal medicine with his first studies of dialyzer reuse and hemodialysis vascular access morbidity. He is internationally renowned in nephrology and clinical epidemiology and an architect of one of the largest and most successful epidemiological research programs in chronic kidney disease. For over 15 years, he has led NIH's Chronic Renal Insufficiency Cohort Study, placing him at the helm of the "Framingham Study of Renal Disease". It has elucidated the chronic kidney disease-specific relationships of mineral dysmetabolism and cardiovascular complications; dietary sodium and heart failure; novel vascular stiffness metrics and renal disease progression; cardiovascular biomarkers and heart failure; and cognitive decline and renal dysfunction, among others. He has also led the nation's largest trials targeting hemodialysis vascular access morbidity, discovered the benefits of transplantation before dialysis dependence, elucidated racial disparities and the role of genetics in kidney failure, and shaped our understanding of the toxicity from unregulated reuse of medical devices. He is the past President of the American College of Epidemiology and directs one of the nation's largest clinical epidemiology and biostatistics programs. Dr. Feldman has an MD from Boston University and an MSCE from the University of Pennsylvania. He is an elected member of the American Society of Clinical Investigation, the Association of American Physicians, and the American Epidemiological Society. Copyright © 2018 Elsevier Inc. All rights reserved.

A Decade of War: Prospective Trajectories of Posttraumatic Stress Disorder Symptoms Among Deployed US Military Personnel and the Influence of Combat Exposure (Publisher’s Version)

DTIC Science & Technology

2017-09-27

physical health (5) of service mem- bers. In addition, previous research indicates that exposure to combat may increase the likelihood of negative health ... physical , and behavioral health , studies have shown few negative effects of deployment with respect to posttraumatic stress disorder (PTSD) (10...American Journal of Epidemiology Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This

[Effect of physical activity on functional performance].

PubMed

Nikolaus, T

2001-02-01

Epidemiological studies clearly show a connection between physical activity and the occurrence of disabilities in old age. Physical exercise is possible and useful at every age. Numerous intervention trials have shown that training of endurance, strength and coordination has positive effects on the cardiovascular system, the lung, the musculo-skeletal system, metabolism and the immune system in elderly people. Even very frail elderly people can increase their muscle strength and functional capabilities by strength training. Group sessions may improve social interactions and additionally increase the quality of life.

Pre‐historic eating patterns in Latin America and protective effects of plant‐based diets on cardiovascular risk factors

PubMed Central

Acosta Navarro, Julio C; Cárdenas Prado, Silvia M; Cárdenas, Pedro Acosta; Santos, Raul D; Caramelli, Bruno

2010-01-01

In this review, we present the contributions to nutrition science from Latin American native peoples and scientists, appreciated from a historic point of view since pre‐historic times to the modern age. Additionally, we present epidemiological and clinical studies on the area of plant‐based diets and their relation with the prevention and treatment of cardiovascular diseases conducted in recent decades, and we discuss challenges and perspectives regarding aspects of nutrition in the region. PMID:21120310

Epidemiological Study of Mild Traumatic Brain Injury Sequelae Caused by Blast Exposure During Operations Iraqi Freedom and Enduring Freedom

DTIC Science & Technology

2010-10-01

Checklist Military Version (PCL-M) (Weathers et al, 1991), pain using both the McGill Pain Questionnaire short form (MPQ-SF) (Melzak, 1987) and the 11...Thus we spent much time refining our injury situation and experience questionnaires to be as thorough and specific as possible. Additionally, we...chose to add two structured interviews to help cross-validate some of our key diagnostic screening questionnaires . 4. Finalize Data collection

[Application of SAS macro to evaluated multiplicative and additive interaction in logistic and Cox regression in clinical practices].

PubMed

Nie, Z Q; Ou, Y Q; Zhuang, J; Qu, Y J; Mai, J Z; Chen, J M; Liu, X Q

2016-05-01

Conditional logistic regression analysis and unconditional logistic regression analysis are commonly used in case control study, but Cox proportional hazard model is often used in survival data analysis. Most literature only refer to main effect model, however, generalized linear model differs from general linear model, and the interaction was composed of multiplicative interaction and additive interaction. The former is only statistical significant, but the latter has biological significance. In this paper, macros was written by using SAS 9.4 and the contrast ratio, attributable proportion due to interaction and synergy index were calculated while calculating the items of logistic and Cox regression interactions, and the confidence intervals of Wald, delta and profile likelihood were used to evaluate additive interaction for the reference in big data analysis in clinical epidemiology and in analysis of genetic multiplicative and additive interactions.

Assessing the reporting of categorised quantitative variables in observational epidemiological studies.

PubMed

Mabikwa, Onkabetse V; Greenwood, Darren C; Baxter, Paul D; Fleming, Sarah J

2017-03-14

One aspect to consider when reporting results of observational studies in epidemiology is how quantitative risk factors are analysed. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines recommend that researchers describe how they handle quantitative variables when analysing data. For categorised quantitative variables, the authors are required to provide reasons and justifications informing their practice. We investigated and assessed the practices and reporting of categorised quantitative variables in epidemiology. The assessment was based on five medical journals that publish epidemiological research. Observational studies published between April and June 2015 and investigating the relationships between quantitative exposures (or risk factors) and the outcomes were considered for assessment. A standard form was used to collect the data, and the reporting patterns amongst eligible studies were quantified and described. Out of 61 articles assessed for eligibility, 23 observational studies were included in the assessment. Categorisation of quantitative exposures occurred in 61% of these studies and reasons informing the practice were rarely provided. Only one article explained the choice of categorisation in the analysis. Transformation of quantitative exposures into four or five groups was common and dominant amongst studies using equally spaced categories. Dichotomisation was not popular; the practice featured in one article. Overall, the majority (86%) of the studies preferred ordered or arbitrary group categories. Other criterions used to decide categorical boundaries were based on established guidelines such as consensus statements and WHO standards. Categorisation of continuous variables remains a dominant practice in epidemiological studies. The reasons informing the practice of categorisation within published work are limited and remain unknown in most articles. The existing STROBE guidelines could provide stronger recommendations on reporting quantitative risk factors in epidemiology.

[The biobank of the German National Cohort as a resource for epidemiologic research].

PubMed

Wichmann, H-Erich; Hörlein, Andreas; Ahrens, Wolfgang; Nauck, Matthias

2016-03-01

The linkage of high-quality biosamples with detailed data from medical examinations, questionnaires and interviews offers great opportunities for research. This is particularly true for large-scale prospective epidemiological studies with long observation periods, like the German National Cohort (GNC). The modalities of collecting, processing and storing biosamples of high quality and with a high throughput, as well as ethical aspects are described using the GNC as an example. For the GNC, 200,000 randomly selected adults will be recruited by 18 study centres and will be followed up for 20-30 years. In addition to the extensive basic examination protocol, followed by reassessment examinations and follow-up questionnaires, the biorepository is a cornerstone of the GNC. The GNC biorepository will comprise more than 20 million aliquots of plasma, serum, erythrocytes, lymphocytes, urine, saliva, nasal swabs and stool. Preanalytics and aliquoting are performed locally in the study centres and are highly standardised and extensively automated. All samples are stored at - 80 and - 180 °C, respectively. A laboratory information system documents all processing steps and storage locations. Access to data and biosamples will be granted to researchers within and outside Germany after completion of the baseline recruitment (i.e. from 2018 onwards). Experience with already existing epidemiological biobanks shows impressive results, especially with regard to genetic research, as well as post-genomics (e.g. transcriptomics, metabolomics, epigenomics). Previous success stories explain the strongly increased demand for data and biosamples from the population. Thus the GNC will provide an important resource for biomedical research in the future.

A toolkit for measurement error correction, with a focus on nutritional epidemiology

PubMed Central

Keogh, Ruth H; White, Ian R

2014-01-01

Exposure measurement error is a problem in many epidemiological studies, including those using biomarkers and measures of dietary intake. Measurement error typically results in biased estimates of exposure-disease associations, the severity and nature of the bias depending on the form of the error. To correct for the effects of measurement error, information additional to the main study data is required. Ideally, this is a validation sample in which the true exposure is observed. However, in many situations, it is not feasible to observe the true exposure, but there may be available one or more repeated exposure measurements, for example, blood pressure or dietary intake recorded at two time points. The aim of this paper is to provide a toolkit for measurement error correction using repeated measurements. We bring together methods covering classical measurement error and several departures from classical error: systematic, heteroscedastic and differential error. The correction methods considered are regression calibration, which is already widely used in the classical error setting, and moment reconstruction and multiple imputation, which are newer approaches with the ability to handle differential error. We emphasize practical application of the methods in nutritional epidemiology and other fields. We primarily consider continuous exposures in the exposure-outcome model, but we also outline methods for use when continuous exposures are categorized. The methods are illustrated using the data from a study of the association between fibre intake and colorectal cancer, where fibre intake is measured using a diet diary and repeated measures are available for a subset. © 2014 The Authors. PMID:24497385

[Estimates of Attributable Fraction of occupational cancers in the recent epidemiological literature].

PubMed

Merler, Enzo

2009-01-01

The article reviews the estimates of Attributable Fraction (AF) of occupational cancers. Because of their relevance, it starts with a synthesis and a comment on the estimates of avoidable cancers, and among these of cancers due to occupation, as expressed in 1981 by Doll and Peto. The main studies that have brought back into the epidemiological pathway the exercise of producing FA are quoted and the results of the new studies reviewed. The dimension of occupational cancers is of public health importance, because caused by exposures assumed to be avoidable. However, the estimates of AF are prone to uncertainties and limitations. Occupational cancers represent the major killer among deaths due to occupational diseases and injuries and a relevant fraction, especially among males, of total cancers. When related to developed countries, estimates may underestimate the risks, because of the insufficient data on exposures for workers in small firms, the lack of information on exposures in agriculture, the scanty availability of epidemiological studies on cancer risks among women. The trend towards a reduction of employees in industrial activities, the elimination or control of some exposures should suggest, instead, a reduction for occupational cancer. However, the more recent estimates of AF of occupational cancers are still in line with the estimates expressed more that 20 years ago. In developing countries, the estimates of AF are plenty of assumptions. In addition, some characteristics (i.e. the younger age of starting work, the extension of work at older age) suggest the need of better data, whereas information on exposures and events are dramatically lacking.

Crohn's disease in Japan: diagnostic criteria and epidemiology.

PubMed

Yao, T; Matsui, T; Hiwatashi, N

2000-10-01

New diagnostic criteria for Crohn's disease and a review of Japanese epidemiologic studies are presented. New diagnostic criteria for Crohn's disease were established by the Research Committee of Inflammatory Bowel Disease, set up by the Japanese Ministry of Health and Welfare. For a definite diagnosis one of the following three conditions is required: 1) longitudinal ulcer or luminal deformity induced by longitudinal ulcer or cobblestone pattern, 2) intestinal small aphthous ulcerations arranged in a longitudinal fashion for at least three months plus noncaseating granulomas, and 3) multiple small aphthous ulcerations in both the upper and lower digestive tract not necessarily with longitudinal arrangement, for at least three months, plus noncaseating granulomas. Moreover, ulcerative colitis, ischemic enterocolitis, and acute infectious enterocolitis should be excluded. Data from the Japanese Ministry of Health and Welfare, in addition to data collected from two study groups, these being the two largest studies in Japan, are reviewed with regard to epidemiology. The number of patients with Crohn's disease has increased remarkably. The prevalence and the annual incidence of patients with Crohn's disease in Japan were estimated to be approximately 2.9 and 0.6 per 10(5) population in 1986, respectively, and 13.5 and 1.2 per 10(5) population in 1998. Characteristic features of Crohn's disease in Japan are that the male-female ratio exceeds 2, and that there is no second peak of incidence in the age group of 55 to 65 years. Clinically, Crohn's disease with only multiple small aphthous ulcerations, which is the earliest stage of the disease that is diagnosable, was found in 5 percent of patients.

Square2 - A Web Application for Data Monitoring in Epidemiological and Clinical Studies

PubMed

Schmidt, Carsten Oliver; Krabbe, Christine; Schössow, Janka; Albers, Martin; Radke, Dörte; Henke, Jörg

2017-01-01

Valid scientific inferences from epidemiological and clinical studies require high data quality. Data generating departments therefore aim to detect data irregularities as early as possible in order to guide quality management processes. In addition, after the completion of data collections the obtained data quality must be evaluated. This can be challenging in complex studies due to a wide scope of examinations, numerous study variables, multiple examiners, devices, and examination centers. This paper describes a Java EE web application used to monitor and evaluate data quality in institutions with complex and multiple studies, named Square 2 . It uses the Java libraries Apache MyFaces 2, extended by BootsFaces for layout and style. RServe and REngine manage calls to R server processes. All study data and metadata are stored in PostgreSQL. R is the statistics backend and LaTeX is used for the generation of print ready PDF reports. A GUI manages the entire workflow. Square 2 covers all steps in the data monitoring workflow, including the setup of studies and their structure, the handling of metadata for data monitoring purposes, selection of variables, upload of data, statistical analyses, and the generation as well as inspection of quality reports. To take into account data protection issues, Square 2 comprises an extensive user rights and roles concept.

Central line-associated bloodstream infection in a trauma intensive care unit: impact of implementation of Society for Healthcare Epidemiology of America/Infectious Diseases Society of America practice guidelines.

PubMed

Mazi, Waleed; Begum, Zikra; Abdulla, Diaa; Hesham, Ahmed; Maghari, Sami; Assiri, Abdullah; Senok, Abiola

2014-08-01

This study aimed to assess the impact implementation of the basic Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA/IDSA) practice recommendations in reducing central line-associated bloodstream infection (CLABSI) in intensive care units (ICUs). The prospective study was conducted from January 2011-December 2012 at the 23-bed trauma ICU in Saudi Arabia. The basic SHEA/IDSA practice recommendations were introduced and implemented during the year 2012. Laboratory-confirmed CLABSIs were identified, and the antimicrobial susceptibility of isolates was determined. Data were collected and analyzed for benchmarking with the National Healthcare Safety Network. There was a 58% decline in the CLABSI incidence rate from 3.87 to 1.5 per 1,000 central line days in 2011 and 2012, respectively (standardized infection ratio, 0.42; P = .043). Three institutional risk factors were identified and resolved: health care personnel education, removal of nonessential catheters, and use of a catheter cart. Three Klebsiella pneumoniae isolates susceptible only to imipenem, 1 pandrug resistant Acinetobacter baumannii, and 2 Enterococcus faecalis, with 1 isolate resistant to vancomycin, were identified in 2012. The basic SHEA/ISDA practice recommendation is an effective prevention model for the reduction of CLABSIs in the ICU. Additional measures are needed to control the spread of multidrug-resistant organisms. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Point prevalence and epidemiological characteristics of chronic cough in the general adult population

PubMed Central

Kang, Min-Gyu; Song, Woo-Jung; Kim, Hyun-Jung; Won, Ha-Kyeong; Sohn, Kyoung-Hee; Kang, Sung-Yoon; Jo, Eun-Jung; Kim, Min-Hye; Kim, Sae-Hoon; Kim, Sang-Heon; Park, Heung-Woo; Chang, Yoon-Seok; Lee, Byung-Jae; Morice, Alyn H.; Cho, Sang-Heon

2017-01-01

Abstract Cough is frequently self-limiting, but may persist longer in certain individuals. Most of previous studies on the epidemiology of chronic cough have only measured period prevalence, and thus have afforded limited information on the burden and natural course. We aimed to investigate the epidemiology of chronic cough by using a point prevalence measure in a large-scale general population. We analyzed cross-sectional data collected from 18,071 adults who participated in the Korean National Health and Nutrition Examination Survey 2010–2012. Presence and duration of current cough was ascertained by structured questionnaires, and cough was classified into acute (<3 weeks), subacute (3–8 weeks), or chronic cough (≥8 weeks). Demographic and clinical parameters were examined in relation to chronic cough. The point prevalences of acute, subacute, and chronic cough were 2.5 ± 0.2%, 0.8 ± 0.1% and 2.6 ± 0.2%, respectively. The proportion of current cough showed a steep decrease after 1 week of duration. However, 2 peaks in the prevalence of current cough were revealed; cough durations of less than 1 week and longer than 1 year were most common (31.1% and 27.7% of current cough, respectively). Subacute and chronic cough were more prevalent in the elderly (≥65 years); the positive associations with older age were independent of other confounders, including current smoking and comorbidities. This is the first report on the epidemiology of cough using a point prevalence measure in a nationally representative population sample. Our findings indicate a high burden of chronic cough among adults with current cough in the community. The dual-peak of cough duration suggested that the pathophysiology of acute and chronic cough may differ. The preponderance of elderly people in the prevalence of chronic cough warrants further investigation. In addition, more sophistication and validation of tools to define chronic cough will help our understanding of the epidemiology. PMID:28353590

Neurotoxicity in Preclinical Models of Occupational Exposure to Organophosphorus Compounds.

PubMed

Voorhees, Jaymie R; Rohlman, Diane S; Lein, Pamela J; Pieper, Andrew A

2016-01-01

Organophosphorus (OPs) compounds are widely used as insecticides, plasticizers, and fuel additives. These compounds potently inhibit acetylcholinesterase (AChE), the enzyme that inactivates acetylcholine at neuronal synapses, and acute exposure to high OP levels can cause cholinergic crisis in humans and animals. Evidence further suggests that repeated exposure to lower OP levels insufficient to cause cholinergic crisis, frequently encountered in the occupational setting, also pose serious risks to people. For example, multiple epidemiological studies have identified associations between occupational OP exposure and neurodegenerative disease, psychiatric illness, and sensorimotor deficits. Rigorous scientific investigation of the basic science mechanisms underlying these epidemiological findings requires valid preclinical models in which tightly-regulated exposure paradigms can be correlated with neurotoxicity. Here, we review the experimental models of occupational OP exposure currently used in the field. We found that animal studies simulating occupational OP exposures do indeed show evidence of neurotoxicity, and that utilization of these models is helping illuminate the mechanisms underlying OP-induced neurological sequelae. Still, further work is necessary to evaluate exposure levels, protection methods, and treatment strategies, which taken together could serve to modify guidelines for improving workplace conditions globally.

Chronic Pain and Mental Health Disorders: Shared Neural Mechanisms, Epidemiology, and Treatment.

PubMed

Hooten, W Michael

2016-07-01

Chronic pain and mental health disorders are common in the general population, and epidemiological studies suggest that a bidirectional relationship exists between these 2 conditions. The observations from functional imaging studies suggest that this bidirectional relationship is due in part to shared neural mechanisms. In addition to depression, anxiety, and substance use disorders, individuals with chronic pain are at risk of other mental health problems including suicide and cigarette smoking and many have sustained sexual violence. Within the broader biopsychosocial model of pain, the fear-avoidance model explains how behavioral factors affect the temporal course of chronic pain and provides the framework for an array of efficacious behavioral interventions including cognitive-behavioral therapy, acceptance-based therapies, and multidisciplinary pain rehabilitation. Concomitant pain and mental health disorders often complicate pharmacological management, but several drug classes, including serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, and anticonvulsants, have efficacy for both conditions and should be considered first-line treatment agents. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

[Systems epidemiology].

PubMed

Huang, T; Li, L M

2018-05-10

The era of medical big data, translational medicine and precision medicine brings new opportunities for the study of etiology of chronic complex diseases. How to implement evidence-based medicine, translational medicine and precision medicine are the challenges we are facing. Systems epidemiology, a new field of epidemiology, combines medical big data with system biology and examines the statistical model of disease risk, the future risk simulation and prediction using the data at molecular, cellular, population, social and ecological levels. Due to the diversity and complexity of big data sources, the development of study design and analytic methods of systems epidemiology face new challenges and opportunities. This paper summarizes the theoretical basis, concept, objectives, significances, research design and analytic methods of systems epidemiology and its application in the field of public health.

Augmenting epidemiological models with point-of-care diagnostics data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pullum, Laura L.; Ramanathan, Arvind; Nutaro, James J.

Although adoption of newer Point-of-Care (POC) diagnostics is increasing, there is a significant challenge using POC diagnostics data to improve epidemiological models. In this work, we propose a method to process zip-code level POC datasets and apply these processed data to calibrate an epidemiological model. We specifically develop a calibration algorithm using simulated annealing and calibrate a parsimonious equation-based model of modified Susceptible-Infected-Recovered (SIR) dynamics. The results show that parsimonious models are remarkably effective in predicting the dynamics observed in the number of infected patients and our calibration algorithm is sufficiently capable of predicting peak loads observed in POC diagnosticsmore » data while staying within reasonable and empirical parameter ranges reported in the literature. Additionally, we explore the future use of the calibrated values by testing the correlation between peak load and population density from Census data. Our results show that linearity assumptions for the relationships among various factors can be misleading, therefore further data sources and analysis are needed to identify relationships between additional parameters and existing calibrated ones. As a result, calibration approaches such as ours can determine the values of newly added parameters along with existing ones and enable policy-makers to make better multi-scale decisions.« less

Augmenting epidemiological models with point-of-care diagnostics data

DOE PAGES

Pullum, Laura L.; Ramanathan, Arvind; Nutaro, James J.; ...

2016-04-20

Although adoption of newer Point-of-Care (POC) diagnostics is increasing, there is a significant challenge using POC diagnostics data to improve epidemiological models. In this work, we propose a method to process zip-code level POC datasets and apply these processed data to calibrate an epidemiological model. We specifically develop a calibration algorithm using simulated annealing and calibrate a parsimonious equation-based model of modified Susceptible-Infected-Recovered (SIR) dynamics. The results show that parsimonious models are remarkably effective in predicting the dynamics observed in the number of infected patients and our calibration algorithm is sufficiently capable of predicting peak loads observed in POC diagnosticsmore » data while staying within reasonable and empirical parameter ranges reported in the literature. Additionally, we explore the future use of the calibrated values by testing the correlation between peak load and population density from Census data. Our results show that linearity assumptions for the relationships among various factors can be misleading, therefore further data sources and analysis are needed to identify relationships between additional parameters and existing calibrated ones. As a result, calibration approaches such as ours can determine the values of newly added parameters along with existing ones and enable policy-makers to make better multi-scale decisions.« less

Epidemiology of lyme borreliosis.

PubMed

Hubálek, Zdenek

2009-01-01

Lyme borreliosis (LB) is the most frequent ixodid tick-borne human disease in the world, with an estimated 85,500 patients annually (underlying data presented in this review: Europe 65,500, North America 16,500, Asia 3,500, North Africa 10; approximate figures). This chapter summarizes the up-to-date knowledge about facts and factors important in the epidemiology of LB all over the world. Individual sections briefly describe geographic (latitudinal and altitudinal) distribution and incidence rates of LB in individual countries; seasonal distribution of the disease; effects of patients' age, sex, and profession; comparison of urban versus rural settings; weather-related effects on LB incidence; risk factors for LB acquisition by humans; and risk assessment. This chapter finishes by recommending a more thorough epidemiological surveillance for LB, including morbidity notification in some additional countries where it has not yet been fully implemented. Copyright 2009 S. Karger AG, Basel.

Epidemiological Distribution and Subtype Analysis of Premenstrual Dysphoric Disorder Syndromes and Symptoms Based on TCM Theories

PubMed Central

Wang, Haijun; Zhan, Xianghong; Liu, Hongqi; Wang, Xiaoyun; Li, Xia; Wang, Xiaoru; Wu, Jibiao

2017-01-01

We performed an epidemiological investigation of subjects with premenstrual dysphoric disorder (PMDD) to identify the clinical distribution of the major syndromes and symptoms. The pathogenesis of PMDD mainly involves the dysfunction of liver conveyance and dispersion. Excessive liver conveyance and dispersion are associated with liver-qi invasion syndrome, while insufficient liver conveyance and dispersion are expressed as liver-qi depression syndrome. Additionally, a nonconditional logistic regression was performed to analyze the symptomatic features of liver-qi invasion and liver-qi depression. As a result of this analysis, two subtypes of PMDD are proposed, namely, excessive liver conveyance and dispersion (liver-qi invasion syndrome) and insufficient liver conveyance and dispersion (liver-qi depression syndrome). Our findings provide an epidemiological foundation for the clinical diagnosis and treatment of PMDD based on the identification of different types. PMID:28698873

The role of counterfactual theory in causal reasoning.

PubMed

Maldonado, George

2016-10-01

In this commentary I review the fundamentals of counterfactual theory and its role in causal reasoning in epidemiology. I consider if counterfactual theory dictates that causal questions must be framed in terms of well-defined interventions. I conclude that it does not. I hypothesize that the interventionist approach to causal inference in epidemiology stems from elevating the randomized trial design to the gold standard for thinking about causal inference. I suggest that instead the gold standard we should use for thinking about causal inference in epidemiology is the thought experiment that, for example, compares an actual disease frequency under one exposure level with a counterfactual disease frequency under a different exposure level (as discussed in Greenland and Robins (1986) and Maldonado and Greenland (2002)). I also remind us that no method should be termed "causal" unless it addresses the effect of other biases in addition to the problem of confounding. Copyright © 2016 Elsevier Inc. All rights reserved.

Breast Cancer Epidemiology in Puerto Rico

DTIC Science & Technology

2010-06-01

cancer epidemiology. Dr. Rosario took a course on Social Epidemiology at Johns Hopkins Bloomberg School of Public Health Baltimore, MD. June 29 to...July 3, 2009. This course offered an overview of conceptual and methodological approaches relevant to the study of the impact of social factors on...conference call. 2. Training: a. Courses: i. Attended a course on Social Epidemiology at Johns Hopkins Bloomberg School of Public Health

Strengthening the Reporting of Molecular Epidemiology for Infectious Diseases (STROME-ID): an extension of the STROBE statement.

PubMed

Field, Nigel; Cohen, Ted; Struelens, Marc J; Palm, Daniel; Cookson, Barry; Glynn, Judith R; Gallo, Valentina; Ramsay, Mary; Sonnenberg, Pam; Maccannell, Duncan; Charlett, Andre; Egger, Matthias; Green, Jonathan; Vineis, Paolo; Abubakar, Ibrahim

2014-04-01

Molecular data are now widely used in epidemiological studies to investigate the transmission, distribution, biology, and diversity of pathogens. Our objective was to establish recommendations to support good scientific reporting of molecular epidemiological studies to encourage authors to consider specific threats to valid inference. The statement Strengthening the Reporting of Molecular Epidemiology for Infectious Diseases (STROME-ID) builds upon the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative. The STROME-ID statement was developed by a working group of epidemiologists, statisticians, bioinformaticians, virologists, and microbiologists with expertise in control of infection and communicable diseases. The statement focuses on issues relating to the reporting of epidemiological studies of infectious diseases using molecular data that were not addressed by STROBE. STROME-ID addresses terminology, measures of genetic diversity within pathogen populations, laboratory methods, sample collection, use of molecular markers, molecular clocks, timeframe, multiple-strain infections, non-independence of infectious-disease data, missing data, ascertainment bias, consistency between molecular and epidemiological data, and ethical considerations with respect to infectious-disease research. In total, 20 items were added to the 22 item STROBE checklist. When used, the STROME-ID recommendations should advance the quality and transparency of scientific reporting, with clear benefits for evidence reviews and health-policy decision making. Copyright © 2014 Elsevier Ltd. All rights reserved.

Association Between Media Use in Adolescence and Depression in Young Adulthood

PubMed Central

Primack, Brian A.; Swanier, Brandi; Georgiopoulos, Anna M.; Land, Stephanie R.; Fine, Michael J.

2010-01-01

Context Although certain media exposures have been linked to the presence of psychiatric conditions, few studies have investigated the association between media exposure and depression. Objective To assess the longitudinal association between media exposure in adolescence and depression in young adulthood in a nationally representative sample. Design Longitudinal cohort study. Setting and Participants We used the National Longitudinal Survey of Adolescent Health (Add Health) to investigate the relationship between electronic media exposure in 4142 adolescents who were not depressed at baseline and subsequent development of depression after 7 years of follow-up. Main Outcome Measure Depression at follow-up assessed using the 9-item Center for Epidemiologic Studies–Depression Scale. Results Of the 4142 participants (47.5% female and 67.0% white) who were not depressed at baseline and who underwent follow-up assessment, 308 (7.4%) reported symptoms consistent with depression at follow-up. Controlling for all covariates including baseline Center for Epidemiologic Studies–Depression Scale score, those reporting more television use had significantly greater odds of developing depression (odds ratio [95% confidence interval], 1.08 [1.01-1.16]) for each additional hour of daily television use. In addition, those reporting more total media exposure had significantly greater odds of developing depression (1.05 [1.0004-1.10]) for each additional hour of daily use. We did not find a consistent relationship between development of depressive symptoms and exposure to videocassettes, computer games, or radio. Compared with young men, young women were less likely to develop depression given the same total media exposure (odds ratio for interaction term, 0.93 [0.88-0.99]). Conclusion Television exposure and total media exposure in adolescence are associated with increased odds of depressive symptoms in young adulthood, especially in young men. PMID:19188540

Genetics and epidemiology, congenital anomalies and cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Friedman, J.M.

1997-03-01

Many of the basic statistical methods used in epidemiology - regression, analysis of variance, and estimation of relative risk, for example - originally were developed for the genetic analysis of biometric data. The familiarity that many geneticists have with this methodology has helped geneticists to understand and accept genetic epidemiology as a scientific discipline. It worth noting, however, that most of the work in genetic epidemiology during the past decade has been devoted to linkage and other family studies, rather than to population-based investigations of the type that characterize much of mainstream epidemiology. 30 refs., 2 tabs.

Use of Case Studies to Introduce Undergraduate Students to Principles of Food Microbiology, Molecular Biology, and Epidemiology of Food-Borne Disease

ERIC Educational Resources Information Center

Ponder, Monica A.; Sumner, Susan

2009-01-01

Mock outbreaks of infectious disease offer the ability to introduce principles of food microbiology, ecology, and epidemiology to undergraduate students using an inquiry driven process. Students were presented with an epidemiological case study detailing patient history, clinical presentation, and foods recently consumed. The students then had to…

The CDC/Council of state and territorial epidemiologists applied epidemiology fellowship program: evaluation of the first 9 years.

PubMed

Dick, Virginia R; Masters, Amanda E; McConnon, Patrick J; Engel, Jeffrey P; Underwood, Valerie N; Harrison, Robert J

2014-11-01

The Council of State and Territorial Epidemiologists (CSTE) implemented the Applied Epidemiology Fellowship (AEF) in 2003 to train public health professionals in applied epidemiology and strengthen applied epidemiology capacity within public health institutions to address the identified challenges. The CSTE recently evaluated the outcomes of the fellowship across the last 9 years. To review the findings from the outcome evaluation of the first nine classes of AEF alumni with particular attention to how the fellowship affected alumni careers, mentors' careers, host site agency capacity, and competencies of the applied epidemiology workforce. The mixed-methods evaluation used surveys and administrative data. Administrative data were gathered over the past 9 years and the surveys were collected in late 2013 and early 2014. Descriptive statistics and qualitative thematic analysis were conducted in early 2014 to examine the data from more than 130 alumni and 150 mentors. More than half the alumni (67%) indicated the fellowship was essential to their long-term career. In addition, 79% of the mentors indicated that participating in the fellowship had a positive impact on their career. Mentors also indicated significant impacts on host site capacity. A majority (88%) of alumni had worked for at least 1 year or more in government public health environments after the fellowship. Evaluation findings support previous research indicating need for competency-based field-based training programs that include a strong mentoring component. These characteristics in a field-based training program can increase applied epidemiology capacity in various ways. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

An assessment of survey measures used across key epidemiologic studies of United States Gulf War I Era Veterans

PubMed Central

2013-01-01

Over the past two decades, 12 large epidemiologic studies and 2 registries have focused on U.S. veterans of the 1990–1991 Gulf War Era. We conducted a review of these studies’ research tools to identify existing gaps and overlaps of efforts to date, and to advance development of the next generation of Gulf War Era survey tools. Overall, we found that many of the studies used similar instruments. Questions regarding exposures were more similar across studies than other domains, while neurocognitive and psychological tools were the most variable. Many studies focused on self-reported survey results, with a range of validation practices. However, physical exams, biomedical assessments, and specimen storage were not common. This review suggests that while research may be able to pool data from past surveys, future surveys need to consider how their design can yield data comparable with previous surveys. Additionally, data that incorporate recent technologies in specimen and genetic analyses would greatly enhance such survey data. When combined with existing data on deployment-related exposures and post-deployment health conditions, longitudinal follow-up of existing studies within this collaborative framework could represent an important step toward improving the health of veterans. PMID:23302181

Integrating informative priors from experimental research with Bayesian methods: an example from radiation epidemiology.

PubMed

Hamra, Ghassan; Richardson, David; Maclehose, Richard; Wing, Steve

2013-01-01

Informative priors can be a useful tool for epidemiologists to handle problems of sparse data in regression modeling. It is sometimes the case that an investigator is studying a population exposed to two agents, X and Y, where Y is the agent of primary interest. Previous research may suggest that the exposures have different effects on the health outcome of interest, one being more harmful than the other. Such information may be derived from epidemiologic analyses; however, in the case where such evidence is unavailable, knowledge can be drawn from toxicologic studies or other experimental research. Unfortunately, using toxicologic findings to develop informative priors in epidemiologic analyses requires strong assumptions, with no established method for its utilization. We present a method to help bridge the gap between animal and cellular studies and epidemiologic research by specification of an order-constrained prior. We illustrate this approach using an example from radiation epidemiology.

Mendelian randomization in nutritional epidemiology

PubMed Central

Qi, Lu

2013-01-01

Nutritional epidemiology aims to identify dietary and lifestyle causes for human diseases. Causality inference in nutritional epidemiology is largely based on evidence from studies of observational design, and may be distorted by unmeasured or residual confounding and reverse causation. Mendelian randomization is a recently developed methodology that combines genetic and classical epidemiological analysis to infer causality for environmental exposures, based on the principle of Mendel’s law of independent assortment. Mendelian randomization uses genetic variants as proxiesforenvironmentalexposuresofinterest.AssociationsderivedfromMendelian randomization analysis are less likely to be affected by confounding and reverse causation. During the past 5 years, a body of studies examined the causal effects of diet/lifestyle factors and biomarkers on a variety of diseases. The Mendelian randomization approach also holds considerable promise in the study of intrauterine influences on offspring health outcomes. However, the application of Mendelian randomization in nutritional epidemiology has some limitations. PMID:19674341

Gene-environment interactions in cancer epidemiology: a National Cancer Institute Think Tank report.

PubMed

Hutter, Carolyn M; Mechanic, Leah E; Chatterjee, Nilanjan; Kraft, Peter; Gillanders, Elizabeth M

2013-11-01

Cancer risk is determined by a complex interplay of genetic and environmental factors. Genome-wide association studies (GWAS) have identified hundreds of common (minor allele frequency [MAF] > 0.05) and less common (0.01 < MAF < 0.05) genetic variants associated with cancer. The marginal effects of most of these variants have been small (odds ratios: 1.1-1.4). There remain unanswered questions on how best to incorporate the joint effects of genes and environment, including gene-environment (G × E) interactions, into epidemiologic studies of cancer. To help address these questions, and to better inform research priorities and allocation of resources, the National Cancer Institute sponsored a "Gene-Environment Think Tank" on January 10-11, 2012. The objective of the Think Tank was to facilitate discussions on (1) the state of the science, (2) the goals of G × E interaction studies in cancer epidemiology, and (3) opportunities for developing novel study designs and analysis tools. This report summarizes the Think Tank discussion, with a focus on contemporary approaches to the analysis of G × E interactions. Selecting the appropriate methods requires first identifying the relevant scientific question and rationale, with an important distinction made between analyses aiming to characterize the joint effects of putative or established genetic and environmental factors and analyses aiming to discover novel risk factors or novel interaction effects. Other discussion items include measurement error, statistical power, significance, and replication. Additional designs, exposure assessments, and analytical approaches need to be considered as we move from the current small number of success stories to a fuller understanding of the interplay of genetic and environmental factors. © 2013 WILEY PERIODICALS, INC.

Provision of bednets and water filters to delay HIV-1 progression: cost-effectiveness analysis of a Kenyan multisite study.

PubMed

Kern, Eli; Verguet, Stéphane; Yuhas, Krista; Odhiambo, Frederick H; Kahn, James G; Walson, Judd

2013-08-01

To estimate the effectiveness, costs and cost-effectiveness of providing long-lasting insecticide-treated nets (LLINs) and point-of-use water filters to antiretroviral therapy (ART)-naïve HIV-infected adults and their family members, in the context of a multisite study in Kenya of 589 HIV-positive adults followed on average for 1.7 years. The effectiveness, costs and cost-effectiveness of the intervention were estimated using an epidemiologic-cost model. Model epidemiologic inputs were derived from the Kenya multisite study data, local epidemiological data and from the published literature. Model cost inputs were derived from published literature specific to Kenya. Uncertainty in the model estimates was assessed through univariate and multivariate sensitivity analyses. We estimated net cost savings of about US$ 26 000 for the intervention, over 1.7 years. Even when ignoring net cost savings, the intervention was found to be very cost-effective at a cost of US$ 3100 per death averted or US$ 99 per disability-adjusted life year (DALY) averted. The findings were robust to the sensitivity analysis and remained most sensitive to both the duration of ART use and the cost of ART per person-year. The provision of LLINs and water filters to ART-naïve HIV-infected adults in the Kenyan study resulted in substantial net cost savings, due to the delay in the initiation of ART. The addition of an LLIN and a point-of-use water filter to the existing package of care provided to ART-naïve HIV-infected adults could bring substantial cost savings to resource-constrained health systems in low- and middle-income countries. © 2013 Blackwell Publishing Ltd.

Gene-Environment Interactions in Cancer Epidemiology: A National Cancer Institute Think Tank Report

PubMed Central

Hutter, Carolyn M.; Mechanic, Leah E.; Chatterjee, Nilanjan; Kraft, Peter; Gillander, Elizabeth M.

2014-01-01

Cancer risk is determined by a complex interplay of genetic and environmental factors. Genome-wide association studies (GWAS) have identified hundreds of common (minor allele frequency [MAF]>0.05) and less common (0.01

A review of methods used for studying the molecular epidemiology of Brachyspira hyodysenteriae.

PubMed

Zeeh, Friederike; Nathues, Heiko; Frey, Joachim; Muellner, Petra; Fellström, Claes

2017-08-01

Brachyspira (B.) spp. are intestinal spirochaetes isolated from pigs, other mammals, birds and humans. In pigs, seven Brachyspira spp. have been described, i.e. B. hyodysenteriae, B. pilosicoli, B. intermedia, B. murdochii, B. innocens, B. suanatina and B. hampsonii. Brachyspira hyodysenteriae is especially relevant in pigs as it causes swine dysentery and hence considerable economic losses to the pig industry. Furthermore, reduced susceptibility of B. hyodysenteriae to antimicrobials is of increasing concern. The epidemiology of B. hyodysenteriae infections is only partially understood, but different methods for detection, identification and typing have supported recent improvements in knowledge and understanding. In the last years, molecular methods have been increasingly used. Molecular epidemiology links molecular biology with epidemiology, offering unique opportunities to advance the study of diseases. This review is based on papers published in the field of epidemiology and molecular epidemiology of B. hyodysenteriae in pigs. Electronic databases were screened for potentially relevant papers using title and abstract and finally, Barcellos et al. papers were systemically selected and assessed. The review summarises briefly the current knowledge on B. hyodysenteriae epidemiology and elaborates on molecular typing techniques available. Results of the studies are compared and gaps in the knowledge are addressed. Finally, potential areas for future research are proposed. Copyright © 2017 Elsevier B.V. All rights reserved.

A Narrative Review on the Human Health Effects of Ambient Air Pollution in Sub-Saharan Africa: An Urgent Need for Health Effects Studies

PubMed Central

Coker, Eric; Kizito, Samuel

2018-01-01

An important aspect of the new sustainable development goals (SDGs) is a greater emphasis on reducing the health impacts from ambient air pollution in developing countries. Meanwhile, the burden of human disease attributable to ambient air pollution in sub-Saharan Africa is growing, yet estimates of its impact on the region are possibly underestimated due to a lack of air quality monitoring, a paucity of air pollution epidemiological studies, and important population vulnerabilities in the region. The lack of ambient air pollution epidemiologic data in sub-Saharan Africa is also an important global health disparity. Thousands of air pollution health effects studies have been conducted in Europe and North America, rather than in urban areas that have some of the highest measured air pollution levels in world, including urban areas in sub-Saharan Africa. In this paper, we provide a systematic and narrative review of the literature on ambient air pollution epidemiological studies that have been conducted in the region to date. Our review of the literature focuses on epidemiologic studies that measure air pollutants and relate air pollution measurements with various health outcomes. We highlight the gaps in ambient air pollution epidemiological studies conducted in different sub-regions of sub-Saharan Africa and provide methodological recommendations for future environmental epidemiology studies addressing ambient air pollution in the region. PMID:29494501

A Narrative Review on the Human Health Effects of Ambient Air Pollution in Sub-Saharan Africa: An Urgent Need for Health Effects Studies.

PubMed

Coker, Eric; Kizito, Samuel

2018-03-01

An important aspect of the new sustainable development goals (SDGs) is a greater emphasis on reducing the health impacts from ambient air pollution in developing countries. Meanwhile, the burden of human disease attributable to ambient air pollution in sub-Saharan Africa is growing, yet estimates of its impact on the region are possibly underestimated due to a lack of air quality monitoring, a paucity of air pollution epidemiological studies, and important population vulnerabilities in the region. The lack of ambient air pollution epidemiologic data in sub-Saharan Africa is also an important global health disparity. Thousands of air pollution health effects studies have been conducted in Europe and North America, rather than in urban areas that have some of the highest measured air pollution levels in world, including urban areas in sub-Saharan Africa. In this paper, we provide a systematic and narrative review of the literature on ambient air pollution epidemiological studies that have been conducted in the region to date. Our review of the literature focuses on epidemiologic studies that measure air pollutants and relate air pollution measurements with various health outcomes. We highlight the gaps in ambient air pollution epidemiological studies conducted in different sub-regions of sub-Saharan Africa and provide methodological recommendations for future environmental epidemiology studies addressing ambient air pollution in the region.

Recurrent respiratory papillomatosis: a longitudinal study comparing severity associated with human papilloma viral types 6 and 11 and other risk factors in a large pediatric population.

PubMed

Wiatrak, Brian J; Wiatrak, Deborah W; Broker, Thomas R; Lewis, Linda

2004-11-01

A database was developed for prospective, longitudinal study of recurrent respiratory papillomatosis (RRP) in a large population of pediatric patients. Data recorded for each patient included epidemiological factors, human papilloma virus (HPV) type, clinical course, staged severity of disease at each surgical intervention, and frequency of surgical intervention. The study hypothesizes that patients with HPV type 11 (HPV-11) and patients younger than 3 years of age at diagnosis are at risk for more aggressive and extensive disease. The 10-year prospective epidemiological study used disease staging for each patient with an original scoring system. Severity scores were updated at each surgical procedure. Parents of children with RRP referred to the authors' hospital completed a detailed epidemiological questionnaire at the initial visit or at the first return visit after the study began. At the first endoscopic debridement after study enrollment, tissue was obtained and submitted for HPV typing using polymerase chain reaction techniques and in situ hybridization. Staging of disease severity was performed in real time at each endoscopic procedure using an RRP scoring system developed by one of the authors (B.J.W.). The frequency of endoscopic operative debridement was recorded for each patient. Information in the database was analyzed to identify statistically significant relationships between extent of disease and/or HPV type, patient age at diagnosis, and selected epidemiological factors. The study may represent the first longitudinal prospective analysis of a large pediatric RRP population. Fifty-eight of the 73 patients in the study underwent HPV typing. Patients infected with HPV-11 were significantly more likely to have higher severity scores, require more frequent surgical intervention, and require adjuvant therapy to control disease progression. In addition, patients with HPV-11 RRP were significantly more likely to develop tracheal disease, to require tracheotomy, and to develop pulmonary disease. Patients receiving a diagnosis of RRP before 3 years of age had significantly higher severity scores, higher frequencies of surgical intervention, and greater likelihood of requiring adjuvant medical therapy. Patients with Medicaid insurance had significantly higher severity scores and required more frequent surgical debridement. Birth by cesarean section appeared to be a significant risk factor for more severe disease and necessity of more frequent surgical intervention. Statistical analysis of the relationships among epidemiological factors, HPV type, and clinical course revealed that patients with HPV-11 and patients younger than 3 years of age at RRP diagnosis are prone to develop more aggressive disease as represented by higher severity scores at endoscopic debridement, more frequent operative debridement procedures per year, a greater requirement for adjuvant therapy, and greater likelihood of tracheal disease with tracheotomy.

Design and descriptive epidemiology of the Infectious Diseases of East African Livestock (IDEAL) project, a longitudinal calf cohort study in western Kenya

PubMed Central

2013-01-01

Background There is a widely recognised lack of baseline epidemiological data on the dynamics and impacts of infectious cattle diseases in east Africa. The Infectious Diseases of East African Livestock (IDEAL) project is an epidemiological study of cattle health in western Kenya with the aim of providing baseline epidemiological data, investigating the impact of different infections on key responses such as growth, mortality and morbidity, the additive and/or multiplicative effects of co-infections, and the influence of management and genetic factors. A longitudinal cohort study of newborn calves was conducted in western Kenya between 2007-2009. Calves were randomly selected from all those reported in a 2 stage clustered sampling strategy. Calves were recruited between 3 and 7 days old. A team of veterinarians and animal health assistants carried out 5-weekly, clinical and postmortem visits. Blood and tissue samples were collected in association with all visits and screened using a range of laboratory based diagnostic methods for over 100 different pathogens or infectious exposures. Results The study followed the 548 calves over the first 51 weeks of life or until death and when they were reported clinically ill. The cohort experienced a high all cause mortality rate of 16% with at least 13% of these due to infectious diseases. Only 307 (6%) of routine visits were classified as clinical episodes, with a further 216 reported by farmers. 54% of calves reached one year without a reported clinical episode. Mortality was mainly to east coast fever, haemonchosis, and heartwater. Over 50 pathogens were detected in this population with exposure to a further 6 viruses and bacteria. Conclusion The IDEAL study has demonstrated that it is possible to mount population based longitudinal animal studies. The results quantify for the first time in an animal population the high diversity of pathogens a population may have to deal with and the levels of co-infections with key pathogens such as Theileria parva. This study highlights the need to develop new systems based approaches to study pathogens in their natural settings to understand the impacts of co-infections on clinical outcomes and to develop new evidence based interventions that are relevant. PMID:24000820

Design and descriptive epidemiology of the Infectious Diseases of East African Livestock (IDEAL) project, a longitudinal calf cohort study in western Kenya.

PubMed

de Clare Bronsvoort, Barend Mark; Thumbi, Samuel Mwangi; Poole, Elizabeth Jane; Kiara, Henry; Auguet, Olga Tosas; Handel, Ian Graham; Jennings, Amy; Conradie, Ilana; Mbole-Kariuki, Mary Ndila; Toye, Philip G; Hanotte, Olivier; Coetzer, J A W; Woolhouse, Mark E J

2013-08-30

There is a widely recognised lack of baseline epidemiological data on the dynamics and impacts of infectious cattle diseases in east Africa. The Infectious Diseases of East African Livestock (IDEAL) project is an epidemiological study of cattle health in western Kenya with the aim of providing baseline epidemiological data, investigating the impact of different infections on key responses such as growth, mortality and morbidity, the additive and/or multiplicative effects of co-infections, and the influence of management and genetic factors.A longitudinal cohort study of newborn calves was conducted in western Kenya between 2007-2009. Calves were randomly selected from all those reported in a 2 stage clustered sampling strategy. Calves were recruited between 3 and 7 days old. A team of veterinarians and animal health assistants carried out 5-weekly, clinical and postmortem visits. Blood and tissue samples were collected in association with all visits and screened using a range of laboratory based diagnostic methods for over 100 different pathogens or infectious exposures. The study followed the 548 calves over the first 51 weeks of life or until death and when they were reported clinically ill. The cohort experienced a high all cause mortality rate of 16% with at least 13% of these due to infectious diseases. Only 307 (6%) of routine visits were classified as clinical episodes, with a further 216 reported by farmers. 54% of calves reached one year without a reported clinical episode. Mortality was mainly to east coast fever, haemonchosis, and heartwater. Over 50 pathogens were detected in this population with exposure to a further 6 viruses and bacteria. The IDEAL study has demonstrated that it is possible to mount population based longitudinal animal studies. The results quantify for the first time in an animal population the high diversity of pathogens a population may have to deal with and the levels of co-infections with key pathogens such as Theileria parva. This study highlights the need to develop new systems based approaches to study pathogens in their natural settings to understand the impacts of co-infections on clinical outcomes and to develop new evidence based interventions that are relevant.

A Conversation with Allen J. Wilcox

PubMed Central

Jukic, Anne Marie Z.

2017-01-01

Allen James Wilcox was born on 30 September 1946 in Columbus, Ohio. He studied medicine at the University of Michigan, graduating in 1973, and after a rotating internship completed a master’s degree in maternal and child health (1976) and a PhD in epidemiology (1979) at the University of North Carolina in Chapel Hill. After graduation, he went to work at the National Institute of Environmental Health Sciences (NIEHS, one of the US National Institutes of Health) in Durham, North Carolina, where he has spent his career. He developed a research program in reproductive and perinatal epidemiology, a relatively unexplored area at the time. His studies include the Early Pregnancy Study, which documented the extent of subclinical pregnancy loss in humans and established the fertile days of a woman’s menstrual cycle. He served as Chief of the Epidemiology Branch from 1991 to 2001, and as Editor-in-Chief of the journal EPIDEMIOLOGY from 2001 to 2014. His textbook, Fertility and Pregnancy – An Epidemiologic Perspective, was published by Oxford University Press in 2010. He was elected to the American Epidemiological Society in 1989, and served as its president in 2003. He also served as president of the Society of Pediatric and Perinatal Epidemiological Research (1996) and the president of the Society of Epidemiological Research (1998). He holds adjunct teaching appointments at the University of North Carolina, Harvard University, and the University of Bergen (Norway), which awarded him an honorary doctoral degree in 2008. PMID:27482869

Selenium and Human Health: Witnessing a Copernican Revolution?

PubMed

Jablonska, Ewa; Vinceti, Marco

2015-01-01

In humans, selenium was hypothesized to lower the risk of several chronic diseases, mainly due to the antioxidant activity of selenium-containing proteins. Recent epidemiologic and laboratory studies, however, are changing our perception of the biological effects of this nutritionally essential trace element. We reviewed the most recent epidemiologic and biochemical literature on selenium, synthesizing the findings from these studies into a unifying view. Randomized trials have shown that selenium did not protect against cancer and other chronic diseases, but even increased the risk of specific neoplasms such as advanced prostate cancer and skin cancer, in addition to type 2 diabetes. Biochemical studies indicate that selenium may exert a broad pattern of toxic effects at unexpectedly low concentrations. Furthermore, its upregulation of antioxidant proteins (selenium-dependent and selenium-independent) may be a manifestation of self-induced oxidative stress. In conclusion, toxic effects of selenium species occur at lower concentrations than previously believed. Those effects may include a large range of proteomic changes and adverse health effects in humans. Since the effects of environmental exposure to this element on human health still remain partially unknown, but are potentially serious, the toxicity of selenium exposure should be further investigated and considered as a public health priority.

Evolution, epidemiology, and population genetics of black flies (Diptera: Simuliidae).

PubMed

Adler, Peter H; Cheke, Robert A; Post, Rory J

2010-10-01

More than 2000 species of black flies feed on vertebrate blood; 1.5% of all species are vectors of pathogens that cause human diseases. Of nine simuliid-borne animal diseases, only two, mansonellosis and onchocerciasis, afflict humans. Onchocerciasis is a debilitating disease infecting an estimated 40 million people in Africa, Latin America, and Yemen, whereas mansonellosis is a mild disease in the Neotropics. Cytogenetic studies of natural populations of more than 500 species of black flies have revealed that the classic morphospecies of taxonomists is typically a complex of two or more reproductively isolated entities, or sibling (cryptic) species. Most vectors of human pathogens are sibling species, each ecologically unique in traits such as breeding habitats, dispersal capabilities, and degree of vector competence. We review the evolution of black flies, the cytogenetics that have revealed about 260 cytologically distinct entities, the molecular studies that continue to expose additional hidden biodiversity, and a case study of the epidemiology of the Simulium damnosum complex, the largest species complex of blood-feeding arthropods on Earth and the premier group of black flies responsible for human onchocerciasis. Copyright 2010 Elsevier B.V. All rights reserved.

[Pre- and perinatal risk factors in autism spectrum disorder and attention deficit/hyperactivity disorder].

PubMed

Schmitz, Johanna C; Cholemkery, Hannah; Medda, Juliane; Freitag, Christine M

2017-01-01

Epidemiological studies indicate the relevance of pre- and perinatal risk factors for the genesis of attention deficit/hyperactivity disorder and autism spectrum disorder. This study compares potential risk factors in a clinical sample of children with ADHD, ASD, the combination of both diseases, ADHD and oppositional defiant or conduct disorder (ADHD & ODD/CD) and examined whether the existence of additional risk factors promotes the occurrence of combined diseases. We compared the pre- and perinatal risk factors of 341 patients (299 boys, 42 girls) from a clinical population, differentiating between children with ADHD (n=80), ASD (n=122), ADHD & ASD (n=55), or ADHD & ODD/CD (n=84). We observed a higher rate of maternal smoking, a higher rate of migration, and lower parental education among the children with ADHD & ODD/CD compared to those with ASD or ADHD. The rate of migration background was higher among the children with ASD compared to children with ADHD. Miscarriage was a specific risk factor for ADHD & ASD. Numerous risk factors described in epidemiological studies occurred only rarely in our clinical sample. The distribution of most risk factors was comparable between the examined diseases.

Epidemiological evidence of type 2 diabetes mellitus, metabolic syndrome, and cardiovascular disease in Japan.

PubMed

Saito, Isao

2012-01-01

Although epidemiological studies in the US and Europe have confirmed that type 2 diabetes mellitus (DM) is associated with an increased risk of cardiovascular disease (CVD) events, evidence is limited in Japan. Earlier studies in Japan showed that hypertension has a major effect on atherosclerosis in relatively lean subjects, with type 2 DM contributing more to CVD events, because of a decline in blood pressure levels in both sexes and an increase in body mass index in men. Recent cohort studies in Japan using baseline assessments carried out during the 1990s have confirmed that type 2 DM is associated with an increased risk of coronary heart disease (CHD) and all types of stroke, except hemorrhagic stroke. In addition, the metabolic syndrome, a constellation of metabolic risk factors, was shown to predict CVD events in Japanese people, independent of the presence or absence of obesity. The strong association of type 2 DM with CHD (hazard ratio: 1.5-4) and ischemic stroke (hazard ratio: 2-4) events was confirmed in Japanese adults. Individuals with impaired glucose tolerance or impaired fasting glucose were also shown to have an increased risk of a CHD event, but not a stroke.

Molecular diagnosis of toxoplasmosis in immunocompromised patients.

PubMed

Robert-Gangneux, Florence; Belaz, Sorya

2016-08-01

Toxoplasmosis in immunocompromised patients is associated with a high mortality rate. Molecular techniques are important tools to diagnose acute disease in immunocompromised patients, but there are various methods with variable efficiency. Some of them have been validated for the diagnosis of congenital toxoplasmosis, but the impact of their use has not been evaluated in immunocompromised patients. Toxoplasmosis is of increasing importance in non-HIV immunocompromised patients. In addition, the picture of disease shows greater severity in South America, both in immunocompetent study participants and in congenitally infected infants. These epidemiological differences could influence the sensitivity of diagnostic methods. This review analyzes recent data on molecular diagnosis and compares them with older ones, in light of progress gained in molecular techniques and of recent epidemiological findings. Most recent studies were conducted in South America and used PCR targeting the B1 gene. PCR on blood could allow diagnosing a significant proportion of patients with ocular toxoplasmosis in Brazil. Quantitative PCR methods with specific probes should be used to improve sensitivity and warrant specificity. Performance of quantitative PCR targeting the repeated 529 bp sequence for the diagnosis of toxoplasmosis in immunocompromised patients needs evaluation in field studies in South America and in western countries.

Evaluating uncertainty to strengthen epidemiologic data for use in human health risk assessments

EPA Science Inventory

Background: There is a recognized need to improve the application of epidemiologic data in human health risk assessment especially for understanding and characterizing risks from environmental and occupational exposures. While most epidemiologic studies result in uncertainty, tec...

MOLECULAR EPIDEMIOLOGICAL STUDIES ON TWO CYCLOSPORIASIS OUTBREAKS IN VANCOUVER, BRITISH COLUMBIA

EPA Science Inventory

Two cyclosporiasis outbreaks in Vancouver, British Columbia (BC) were investigated using molegular epidemiology. The cause of the 1999 outbreak has not been identiifed whereas the 2001 oubreak has been linked epidemiologically to the consumption of Thai basil. The internal tran...

[Magnesium disorder in metabolic bone diseases].

PubMed

Ishii, Akira; Imanishi, Yasuo

2012-08-01

Magnesium is abundantly distributed among the body. The half of the magnesium exists in the bone. In addition, magnesium is the second most abundant intracellular cation in vertebrates and essential for maintaining physiological function of the cells. Epidemiologic studies have demonstrated that magnesium deficiency is a risk factor for osteoporosis. The mechanism of bone fragility caused by magnesium deficiency has been intensely studied using animal models of magnesium deficiency. Magnesium deficiency causes decreased osteoblastic function and increased number of osteoclasts. Magnesium deficiency also accelerates mineralization in bone. These observations suggest that disturbed bone metabolic turnover and mineralization causes bone fragility.

Maternal obesity during pregnancy and cardiovascular development and disease in the offspring.

PubMed

Gaillard, Romy

2015-11-01

Maternal obesity during pregnancy is an important public health problem in Western countries. Currently, obesity prevalence rates in pregnant women are estimated to be as high as 30%. In addition, approximately 40% of women gain an excessive amount of weight during pregnancy in Western countries. An accumulating body of evidence suggests a long-term impact of maternal obesity and excessive weight gain during pregnancy on adiposity, cardiovascular and metabolic related health outcomes in the offspring in fetal life, childhood and adulthood. In this review, we discuss results from recent studies, potential underlying mechanisms and challenges for future epidemiological studies.

Simple neck pain questions used in surveys, evaluated in relation to health outcomes: a cohort study

PubMed Central

2012-01-01

Background The high prevalence of pain reported in many epidemiological studies, and the degree to which this prevalence reflects severe pain is under discussion in the literature. The aim of the present study was to evaluate use of the simple neck pain questions commonly included in large epidemiological survey studies with respect to aspects of health. We investigated if and how an increase in number of days with pain is associated with reduction in health outcomes. Methods A cohort of university students (baseline age 19–25 years) were recruited in 2002 and followed annually for 4 years. The baseline response rate was 69% which resulted in 1200 respondents (627 women, 573 men). Participants were asked about present and past pain and perceptions of their general health, sleep disturbance, stress and energy levels, and general performance. The data were analyzed using a mixed model for repeated measurements and a random intercept logistic model. Results When reporting present pain, participants also reported lower prevalence of very good health, higher stress and sleep disturbance scores and lower energy score. Among those with current neck pain, additional questions characterizing the pain such as duration (categorized), additional pain sites and decreased general performance were associated with lower probability of very good health and higher amounts of sleep disturbance. Knowing about the presence or not of pain explains more of the variation in health between individuals, than within individuals. Conclusion This study of young university students has demonstrated that simple neck pain survey questions capture features of pain that affect aspects of health such as perceived general health, sleep disturbance, mood in terms of stress and energy. Simple pain questions are more useful for group descriptions than for describing or following pain in an individual. PMID:23102060

Simple neck pain questions used in surveys, evaluated in relation to health outcomes: a cohort study.

PubMed

Grimby-Ekman, Anna; Hagberg, Mats

2012-10-26

The high prevalence of pain reported in many epidemiological studies, and the degree to which this prevalence reflects severe pain is under discussion in the literature. The aim of the present study was to evaluate use of the simple neck pain questions commonly included in large epidemiological survey studies with respect to aspects of health. We investigated if and how an increase in number of days with pain is associated with reduction in health outcomes. A cohort of university students (baseline age 19-25 years) were recruited in 2002 and followed annually for 4 years. The baseline response rate was 69% which resulted in 1200 respondents (627 women, 573 men). Participants were asked about present and past pain and perceptions of their general health, sleep disturbance, stress and energy levels, and general performance. The data were analyzed using a mixed model for repeated measurements and a random intercept logistic model. When reporting present pain, participants also reported lower prevalence of very good health, higher stress and sleep disturbance scores and lower energy score. Among those with current neck pain, additional questions characterizing the pain such as duration (categorized), additional pain sites and decreased general performance were associated with lower probability of very good health and higher amounts of sleep disturbance. Knowing about the presence or not of pain explains more of the variation in health between individuals, than within individuals. This study of young university students has demonstrated that simple neck pain survey questions capture features of pain that affect aspects of health such as perceived general health, sleep disturbance, mood in terms of stress and energy. Simple pain questions are more useful for group descriptions than for describing or following pain in an individual.

Molecular Epidemiology Investigation of Obesity and Lethal Prostate Cancer

DTIC Science & Technology

2015-09-01

research progress at monthly Patho-epidemiology Group meetings and Prostate Cancer Epidemiology Group meetings throughout the year. She was an active...report on the aspirin component of the ongoing Physicians’ Health Study. Steering Committee of the Physicians’ Health Study Research Group . N Engl J...PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT: Approved for Public

Epidemiology of Pediatric Convulsive Status Epilepticus With Fever in the Emergency Department: A Cohort Study of 381 Consecutive Cases.

PubMed

Hayakawa, Itaru; Miyama, Sahoko; Inoue, Nobuaki; Sakakibara, Hiroshi; Hataya, Hiroshi; Terakawa, Toshiro

2016-09-01

Pediatric convulsive status epilepticus with fever is common in the emergency setting but leads to severe neurological sequelae in some patients. To explore the epidemiology of convulsive status epilepticus with fever, a retrospective cohort covering all convulsive status epilepticus cases with fever seen in the emergency department of a tertiary care children's hospital were consecutively collected. Of the 381 consecutive cases gathered, 81.6% were due to prolonged febrile seizure, 6.6% to encephalopathy/encephalitis, 0.8% to meningitis, and 7.6% to epilepsy. In addition, seizures were significantly longer in encephalopathy/encephalitis cases than in prolonged febrile seizure cases (log rank test, P < .001). These results provide for the first time the pretest probability of final diagnoses in children with convulsive status epilepticus with fever in the emergency setting, and will help optimize the management of pediatric patients presenting to the emergency department with convulsive status epilepticus with fever. © The Author(s) 2016.

The epidemiology of premature ejaculation.

PubMed

Saitz, Theodore Robert; Serefoglu, Ege Can

2016-08-01

Vast advances have occurred over the past decade with regards to understanding the epidemiology, pathophysiology and management of premature ejaculation (PE); however, we still have much to learn about this common sexual problem. As a standardized evidence-based definition of PE has only recently been established, the reported prevalence rates of PE prior to this definition have been difficult to interpret. As a result, a large range of conflicting prevalence rates have been reported. In addition to the lack of a standardized definition and operational criteria, the method of recruitment for study participation and method of data collection have obviously contributed to the broad range of reported prevalence rates. The new criteria and classification of PE will allow for continued research into the diverse phenomenology, etiology and pathogenesis of the disease to be conducted. While the absolute pathophysiology and true prevalence of PE remains unclear, developing a better understanding of the true prevalence of the disease will allow for the completion of more accurate analysis and treatment of the disease.

Genotyping of Mycobacterium tuberculosis with additional markers enhances accuracy in epidemiological studies.

PubMed Central

Warren, R; Richardson, M; Sampson, S; Hauman, J H; Beyers, N; Donald, P R; van Helden, P D

1996-01-01

Two highly polymorphic Mycobacterium tuberculosis genomic domains, characterized by hybridization to the oligonucleotide (GTG)5, were identified as potential DNA fingerprinting probes. These domains were cloned [pMTB484(1) and pMTB484(2K4), respectively] and shown to be useful for genotype analysis by Southern blotting. These probes were used to genotype geographically linked strains of M. tuberculosis previously shown to have identical IS6110 fingerprints. Subsequent DNA fingerprints generated with MTB484(1) and MTB484(2K4) showed a high degree of polymorphism, allowing subclassification of IS6110-defined clusters into composites of smaller clusters and unique strains. Correlation of the molecular data with patient interviews and clinical records confirmed the sensitivity of these probes, as contacts were established only within subclusters. These findings demonstrate the requirement for multiple probes to accurately classify M. tuberculosis strains, even those with high copy numbers of IS6110. The enhanced accuracy of strain typing should, in turn, further our understanding of the epidemiology of tuberculosis. PMID:8862588

Epidemiology of delayed ejaculation

PubMed Central

Di Sante, Stefania; Mollaioli, Daniele; Gravina, Giovanni Luca; Ciocca, Giacomo; Limoncin, Erika; Carosa, Eleonora; Lenzi, Andrea

2016-01-01

A large body of literature on diminished ejaculatory disorders has been generated without the use of a clear diagnostic definition. Many studies have not distinguished between the orgasm and ejaculation disorders leading to doubtful results. Delayed ejaculation (DE) is one of the diminished ejaculatory disorders, which range from varying delays in ejaculatory latency to a complete inability to ejaculate. The present review is aimed at providing a comprehensive overview of the current knowledge on the definition and epidemiology of diminished ejaculatory disorders. We focus on the acquired diseases, such as benign prostatic hyperplasia (BPH) and specific drug regimens that may cause an iatrogenic form of ejaculatory disorder. In addition, the impact of aging is discussed since the prevalence of DE appears to be moderately but positively related to age. Finally, we also focus on the importance of the hormonal milieu on male ejaculation. To date, evidence on the endocrine control of ejaculation is derived from small clinical trials, but the evidence suggests that hormones modulate the ejaculatory process by altering its overall latency. PMID:27652226

Epidemiology of delayed ejaculation.

PubMed

Di Sante, Stefania; Mollaioli, Daniele; Gravina, Giovanni Luca; Ciocca, Giacomo; Limoncin, Erika; Carosa, Eleonora; Lenzi, Andrea; Jannini, Emmanuele A

2016-08-01

A large body of literature on diminished ejaculatory disorders has been generated without the use of a clear diagnostic definition. Many studies have not distinguished between the orgasm and ejaculation disorders leading to doubtful results. Delayed ejaculation (DE) is one of the diminished ejaculatory disorders, which range from varying delays in ejaculatory latency to a complete inability to ejaculate. The present review is aimed at providing a comprehensive overview of the current knowledge on the definition and epidemiology of diminished ejaculatory disorders. We focus on the acquired diseases, such as benign prostatic hyperplasia (BPH) and specific drug regimens that may cause an iatrogenic form of ejaculatory disorder. In addition, the impact of aging is discussed since the prevalence of DE appears to be moderately but positively related to age. Finally, we also focus on the importance of the hormonal milieu on male ejaculation. To date, evidence on the endocrine control of ejaculation is derived from small clinical trials, but the evidence suggests that hormones modulate the ejaculatory process by altering its overall latency.

Mapping epidemiology's past to inform its future: metaknowledge analysis of epidemiologic topics in leading journals, 1974-2013.

PubMed

Trinquart, Ludovic; Galea, Sandro

2015-07-15

An empiric perspective on what epidemiology has studied over time might inform discussions about future directions for the discipline. We aimed to identify the main areas of epidemiologic inquiry and determine how they evolved over time in 5 high-impact epidemiologic journals. We analyzed the titles and abstracts of 20,895 articles that were published between 1974 and 2013. In 5 time periods that reflected approximately equal numbers of articles, we identified the main topics by clustering terms based on co-occurrence. Infectious disease and cardiovascular disease epidemiology were the prevailing topics over the 5 periods. Cancer epidemiology was a major topic from 1974 to 2001 but disappeared thereafter. Nutritional epidemiology gained relative importance from 1974 to 2013. Environmental epidemiology appeared during 1996-2001 and continued to be important, whereas 2 clusters related to methodology and meta-analysis in genetics appeared during 2008-2013. Several areas of epidemiology, including injury or psychiatric epidemiology, did not make an appearance as major topics at any time. In an ancillary analysis of 6 high-impact general medicine journals, we found patterns of epidemiologic articles that were overall consistent with the findings in epidemiologic journals. This metaknowledge investigation allowed identification of the dominant topics in and conversely those that were absent from 5 major epidemiologic journals. We discuss implications for the field. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Strengthening the reliability and credibility of observational epidemiology studies by creating an Observational Studies Register.

PubMed

Swaen, Gerard M H; Carmichael, Neil; Doe, John

2011-05-01

To evaluate the need for the creation of a system in which observational epidemiology studies are registered; an Observational Studies Register (OSR). The current scientific process for observational epidemiology studies is described. Next, a parallel is made with the clinical trials area, where the creation of clinical trial registers has greatly restored and improved their credibility and reliability. Next, the advantages and disadvantages of an OSR are compared. The advantages of an OSR outweigh its disadvantages. The creation of an OSR, similar to the existing Clinical Trials Registers, will improve the assessment of publication bias and will provide an opportunity to compare the original study protocol with the results reported in the publication. Reliability, credibility, and transparency of observational epidemiology studies are strengthened by the creation of an OSR. We propose a structured, collaborative, and coordinated approach for observational epidemiology studies that can provide solutions for existing weaknesses and will strengthen credibility and reliability, similar to the approach currently used in clinical trials, where Clinical Trials Registers have played a key role in strengthening their scientific value. Copyright © 2011 Elsevier Inc. All rights reserved.

Male reproductive disorders, diseases, and costs of exposure to endocrine-disrupting chemicals in the European Union.

PubMed

Hauser, Russ; Skakkebaek, Niels E; Hass, Ulla; Toppari, Jorma; Juul, Anders; Andersson, Anna Maria; Kortenkamp, Andreas; Heindel, Jerrold J; Trasande, Leonardo

2015-04-01

Increasing evidence suggests that endocrine-disrupting chemicals (EDCs) contribute to male reproductive diseases and disorders. To estimate the incidence/prevalence of selected male reproductive disorders/diseases and associated economic costs that can be reasonably attributed to specific EDC exposures in the European Union (EU). An expert panel evaluated evidence for probability of causation using the Intergovernmental Panel on Climate Change weight-of-evidence characterization. Exposure-response relationships and reference levels were evaluated, and biomarker data were organized from carefully identified studies from the peer-reviewed literature to represent European exposure and approximate burden of disease as it occurred in 2010. The cost-of-illness estimation utilized multiple peer-reviewed sources. The expert panel identified low epidemiological and strong toxicological evidence for male infertility attributable to phthalate exposure, with a 40-69% probability of causing 618,000 additional assisted reproductive technology procedures, costing €4.71 billion annually. Low epidemiological and strong toxicological evidence was also identified for cryptorchidism due to prenatal polybrominated diphenyl ether exposure, resulting in a 40-69% probability that 4615 cases result, at a cost of €130 million (sensitivity analysis, €117-130 million). A much more modest (0-19%) probability of causation in testicular cancer by polybrominated diphenyl ethers was identified due to very low epidemiological and weak toxicological evidence, with 6830 potential cases annually and costs of €848 million annually (sensitivity analysis, €313-848 million). The panel assigned 40-69% probability of lower T concentrations in 55- to 64-year-old men due to phthalate exposure, with 24 800 associated deaths annually and lost economic productivity of €7.96 billion. EDCs may contribute substantially to male reproductive disorders and diseases, with nearly €15 billion annual associated costs in the EU. These estimates represent only a few EDCs for which there were sufficient epidemiological studies and those with the highest probability of causation. These public health costs should be considered as the EU contemplates regulatory action on EDCs.

Pulsotype Diversity of Clostridium botulinum Strains Containing Serotypes A and/or B Genes

PubMed Central

Halpin, Jessica L.; Joseph, Lavin; Dykes, Janet K.; McCroskey, Loretta; Smith, Elise; Toney, Denise; Stroika, Steven; Hise, Kelley; Maslanka, Susan; Lúquez, Carolina

2017-01-01

Clostridium botulinum strains are prevalent in the environment and produce a potent neurotoxin that causes botulism, a rare but serious paralytic disease. In 2010, a national PulseNet database was established to curate C. botulinum pulsotypes and facilitate epidemiological investigations, particularly for serotypes A and B strains frequently associated with botulism cases in the United States. Between 2010 and 2014 we performed pulsed-field gel electrophoresis (PFGE) using a PulseNet protocol, uploaded the resulting PFGE patterns into a national database, and analyzed data according to PulseNet criteria (UPGMA clustering, Dice coefficient, 1.5% position tolerance, and 1.5% optimization). A retrospective data analysis was undertaken on 349 entries comprised of type A and B strains isolated from foodborne and infant cases to determine epidemiological relevance, resolution of the method, and the diversity of the database. Most studies to date on the pulsotype diversity of C. botulinum have encompassed very small sets of isolates; this study, with over 300 isolates, is more comprehensive than any published to date. Epidemiologically linked isolates had indistinguishable patterns, except in four instances and there were no obvious geographic trends noted. Simpson’s Index of Diversity (D) has historically been used to demonstrate species diversity and abundance within a group, and is considered a standard descriptor for PFGE databases. Simpson’s Index was calculated for each restriction endonuclease (SmaI, XhoI), the pattern combination SmaI-XhoI, as well as for each toxin serotype. The D values indicate that both enzymes provided better resolution for serotype B isolates than serotype A. XhoI as the secondary enzyme provided little additional discrimination for C. botulinum. SmaI patterns can be used to exclude unrelated isolates during a foodborne outbreak, but pulsotypes should always be considered concurrently with available epidemiological data. PMID:28692343

Performance improvement and implementation science: infection prevention competencies for current and future role development.

PubMed

Hanchett, Marilyn

2012-05-01

The Association for Professionals in Infection Control and Epidemiology, Inc, developed its first model of infection preventionist (IP) competency in 2011. The model is based on the principles of patient safety, professional and practice standards, and core competencies identified through research conducted by the Certification Board of Infection Control and Epidemiology, Inc. In addition, the model highlights 4 domains that are predicted to be key areas for future competency development. Performance improvement (PI) and implementation represent 1 of the 4 forward-focused domains. Concurrently, the inclusion of implementation science (IS) in the competency model is consistent with the research goals established by the Association for Professionals in Infection Control and Epidemiology, Inc, in its 2020 strategic plan. This article explains the importance of PI and IS and describes their relevance to the current and future IP role development. Significant challenges such as role delineation and compression are discussed. The need for the IP to acquire new competencies at integrating, as well as differentiating, PI and IS are explored in terms of emerging issues and trends. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Installation Restoration Program. Phase 2. Confirmation/Quantification. Stage 1. Reese Air Force Base, Lubbock, Texas. Volume 2. Appendices

DTIC Science & Technology

1988-04-01

epidemiological studies ; pending resolution of essentiality in human diet; EPA has not regulated arsenic as a carcinogen in drinking water 3ICadmium B1...Probable human carcinogen based upon sufficient evidence in epidemiological studies ; not regulated as a carcinogen in drinking water because there is...Carcinogenic in animal studies ; because of the extensive negative epidemiological evidence, EPA has proposed to regu- late lead in drinking water based on

Exercise and prostate cancer: From basic science to clinical applications.

PubMed

Campos, Christian; Sotomayor, Paula; Jerez, Daniel; González, Javier; Schmidt, Camila B; Schmidt, Katharina; Banzer, Winfried; Godoy, Alejandro S

2018-06-01

Prostate cancer (PCa) is a disease of increasing medical significance worldwide. In developed countries, PCa is the most common non-skin cancer in men, and one of the leading causes of cancer-related deaths. Exercise is one of the environmental factors that have been shown to influence cancer risk. Moreover, systemic reviews and meta-analysis have suggested that total physical activity is related to a decrease in the risk of developing PCa. In addition, epidemiological studies have shown that exercise, after diagnosis, has benefits regarding PCa development, and positive outcome in patients under treatment. The standard treatment for locally advanced or metastatic PCa is Androgen deprivation therapy (ADT). ADT produces diverse side effects, including loss of libido, changes in body composition (increase abdominal fat), and reduced muscle mass, and muscle tone. Analysis of numerous research publications showed that aerobic and/or resistance training improve patient's physical condition, such us, cardiorespiratory fitness, muscle strength, physical function, body composition, and fatigue. Therefore, exercise might counteract several ADT treatment-induced side effects. In addition of the aforementioned benefits, epidemiological, and in vitro studies have shown that exercise might decrease PCa development. Thus, physical activity might attenuate the risk of PCa and supervised exercise intervention might improve deleterious effects of cancer treatment, such as ADT side effects. This review article provides evidence indicating that exercise could complement, and potentiate, the current standard treatments for advanced PCa, probably by creating an unfavorable microenvironment that can negatively affect tumor development, and progression. © 2018 Wiley Periodicals, Inc.

[Prevalence of hepatitis B virus infection in patients suffering from acute and chronic liver disease in three public hospitals in Durango, Mexico].

PubMed

Alvarado-Esquivel, Cosme; Arellano-Santos, Claudia Verónica; Salazar-Arana, José Luis; Mercado-Suárez, Miguel Francisco

2006-01-01

We carried out an observational, descriptive, and retrospective epidemiological study in order to determine the prevalence of hepatitis B virus infection (HBV) in patients with acute and chronic liver disease in three public hospitals of Durango, Mexico. Sixty five adult patients were included in the study. Fifty eight (89%) were inpatients and 7 were outpatients. Twenty three patients suffered from acute hepatitis, 10 chronic hepatitis, 29 liver cirrhosis, 2 hepatocellular carcinoma, and I fulminant hepatitis. A questionnaire was administered to all participants that included sociodemographic and epidemiological data. In addition, serum samples were analyzed for hepatitis B surface antigen (HBsAg) by an immunoassay (A UZYME Monoclonal), manufactured by ABBOTT Diagnostics (North Chicago, IL, USA). Out of the 65 patients, 2 (3%) were positive for HBsAg. Of the two positive cases, one had chronic hepatitis and other liver cirrhosis. Both positive cases had histories of blood transfusion, surgery, and alcohol abuse. In addition, one of them had a history of acupuncture. Previous traveling (within Mexico, abroad or both) was more frequently observed in HBsAg positive patients than in HBsAg negative patients (p <0.05). We concluded that the prevalence of HBV infection in patients with liver disease in the city of Durango is low. This prevalence is comparable or lower than the one reported in other Mexican cities, and lower than other countries.

Sex differences in prevalence and comorbidity of alcohol and drug use disorders: results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions.

PubMed

Goldstein, Risë B; Dawson, Deborah A; Chou, S Patricia; Grant, Bridget F

2012-11-01

The present study examined sex differences in lifetime Axis I and II psychiatric comorbidity of DSM-IV alcohol use disorders (AUDs) and drug use disorders (DUDs) among general population U.S. adults. Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, Wave 2 lifetime prevalences of each disorder comorbid with alcohol abuse, alcohol dependence, drug abuse, and drug dependence were compared between men and women. Sex-specific associations of alcohol, any drug, and cannabis- and cocaine-specific abuse and dependence with each comorbid disorder were examined using logistic regression, first with adjustment for sociodemographic variables and then with additional adjustment for all other psychiatric disorders. Prevalences of most comorbid disorders differed significantly by sex among respondents with each AUD and DUD. However, after adjustment for sociodemographic characteristics and additional co-occurring psychiatric diagnoses, there were few sex differences in unique comorbid associations of specific AUDs and DUDs with specific psychiatric disorders. Rates of psychiatric disorders comorbid with AUDs and DUDs indicate large burdens of morbidity in both sexes, highlighting the need for careful assessment and appropriate treatment of both substance use and mental health disorders. The unique comorbid associations with AUDs and DUDs identified in this study further indicate the need for prospective etiological research to characterize these associations, their underlying mechanisms, and the possible sex specificity of those mechanisms.

Sex Differences in Prevalence and Comorbidity of Alcohol and Drug Use Disorders: Results From Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Goldstein, Risë B.; Dawson, Deborah A.; Chou, S. Patricia; Grant, Bridget F.

2012-01-01

Objective: The present study examined sex differences in lifetime Axis I and II psychiatric comorbidity of DSM-IV alcohol use disorders (AUDs) and drug use disorders (DUDs) among general population U.S. adults. Method: Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, Wave 2 lifetime prevalences of each disorder comorbid with alcohol abuse, alcohol dependence, drug abuse, and drug dependence were compared between men and women. Sex-specific associations of alcohol, any drug, and cannabis- and cocaine-specific abuse and dependence with each comorbid disorder were examined using logistic regression, first with adjustment for sociodemographic variables and then with additional adjustment for all other psychiatric disorders. Results: Prevalences of most comorbid disorders differed significantly by sex among respondents with each AUD and DUD. However, after adjustment for sociodemographic characteristics and additional co-occurring psychiatric diagnoses, there were few sex differences in unique comorbid associations of specific AUDs and DUDs with specific psychiatric disorders. Conclusions: Rates of psychiatric disorders comorbid with AUDs and DUDs indicate large burdens of morbidity in both sexes, highlighting the need for careful assessment and appropriate treatment of both substance use and mental health disorders. The unique comorbid associations with AUDs and DUDs identified in this study further indicate the need for prospective etiological research to characterize these associations, their underlying mechanisms, and the possible sex specificity of those mechanisms. PMID:23036212

Sequencing and annotation of mitochondrial genomes from individual parasitic helminths.

PubMed

Jex, Aaron R; Littlewood, D Timothy; Gasser, Robin B

2015-01-01

Mitochondrial (mt) genomics has significant implications in a range of fundamental areas of parasitology, including evolution, systematics, and population genetics as well as explorations of mt biochemistry, physiology, and function. Mt genomes also provide a rich source of markers to aid molecular epidemiological and ecological studies of key parasites. However, there is still a paucity of information on mt genomes for many metazoan organisms, particularly parasitic helminths, which has often related to challenges linked to sequencing from tiny amounts of material. The advent of next-generation sequencing (NGS) technologies has paved the way for low cost, high-throughput mt genomic research, but there have been obstacles, particularly in relation to post-sequencing assembly and analyses of large datasets. In this chapter, we describe protocols for the efficient amplification and sequencing of mt genomes from small portions of individual helminths, and highlight the utility of NGS platforms to expedite mt genomics. In addition, we recommend approaches for manual or semi-automated bioinformatic annotation and analyses to overcome the bioinformatic "bottleneck" to research in this area. Taken together, these approaches have demonstrated applicability to a range of parasites and provide prospects for using complete mt genomic sequence datasets for large-scale molecular systematic and epidemiological studies. In addition, these methods have broader utility and might be readily adapted to a range of other medium-sized molecular regions (i.e., 10-100 kb), including large genomic operons, and other organellar (e.g., plastid) and viral genomes.

iDNA screening: Disease vectors as vertebrate samplers.

PubMed

Kocher, Arthur; de Thoisy, Benoit; Catzeflis, François; Valière, Sophie; Bañuls, Anne-Laure; Murienne, Jérôme

2017-11-01

In the current context of global change and human-induced biodiversity decline, there is an urgent need for developing sampling approaches able to accurately describe the state of biodiversity. Traditional surveys of vertebrate fauna involve time-consuming and skill-demanding field methods. Recently, the use of DNA derived from invertebrate parasites (leeches and blowflies) was suggested as a new tool for vertebrate diversity assessment. Bloodmeal analyses of arthropod disease vectors have long been performed to describe their feeding behaviour, for epidemiological purposes. On the other hand, this existing expertise has not yet been applied to investigate vertebrate fauna per se. Here, we evaluate the usefulness of hematophagous dipterans as vertebrate samplers. Blood-fed sand flies and mosquitoes were collected in Amazonian forest sites and analysed using high-throughput sequencing of short mitochondrial markers. Bloodmeal identifications highlighted contrasting ecological features and feeding behaviour among dipteran species, which allowed unveiling arboreal and terrestrial mammals of various body size, as well as birds, lizards and amphibians. Additionally, lower vertebrate diversity was found in sites undergoing higher levels of human-induced perturbation. These results suggest that, in addition to providing precious information on disease vector host use, dipteran bloodmeal analyses may represent a useful tool in the study of vertebrate communities. Although further effort is required to validate the approach and consider its application to large-scale studies, this first work opens up promising perspectives for biodiversity monitoring and eco-epidemiology. © 2017 John Wiley & Sons Ltd.

Is it time to reassess current safety standards for glyphosate-based herbicides?

PubMed

Vandenberg, Laura N; Blumberg, Bruce; Antoniou, Michael N; Benbrook, Charles M; Carroll, Lynn; Colborn, Theo; Everett, Lorne G; Hansen, Michael; Landrigan, Philip J; Lanphear, Bruce P; Mesnage, Robin; Vom Saal, Frederick S; Welshons, Wade V; Myers, John Peterson

2017-06-01

Use of glyphosate-based herbicides (GBHs) increased ∼100-fold from 1974 to 2014. Additional increases are expected due to widespread emergence of glyphosate-resistant weeds, increased application of GBHs, and preharvest uses of GBHs as desiccants. Current safety assessments rely heavily on studies conducted over 30 years ago. We have considered information on GBH use, exposures, mechanisms of action, toxicity and epidemiology. Human exposures to glyphosate are rising, and a number of in vitro and in vivo studies challenge the basis for the current safety assessment of glyphosate and GBHs. We conclude that current safety standards for GBHs are outdated and may fail to protect public health or the environment. To improve safety standards, the following are urgently needed: (1) human biomonitoring for glyphosate and its metabolites; (2) prioritisation of glyphosate and GBHs for hazard assessments, including toxicological studies that use state-of-the-art approaches; (3) epidemiological studies, especially of occupationally exposed agricultural workers, pregnant women and their children and (4) evaluations of GBHs in commercially used formulations, recognising that herbicide mixtures likely have effects that are not predicted by studying glyphosate alone. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Current Practices in Teaching Introductory Epidemiology: How We Got Here, Where to Go

PubMed Central

Keyes, Katherine M.; Galea, Sandro

2014-01-01

The number of students and disciplines requiring basic instruction in epidemiologic methods is growing. As a field, we now have a lexicon of epidemiologic terminology and particular methods that have developed and become canonical through the historical development of the field. Yet, many of our basic concepts remain elusive to some students, particularly those not pursuing a career in epidemiology. Further, disagreement and redundancy across basic terms limit their utility in teaching epidemiology. Many approaches to teaching epidemiology generally start with labeling key concepts and then move on to explain them. We submit that an approach grounded not in labels but in foundational concepts may offer a useful adjunct to introductory epidemiology education. We propose 7 foundational steps in conducting an epidemiologic study and provide examples of how these steps can be operationalized, using simple graphics that articulate how populations are defined, samples are selected, and individuals are followed to count cases. A reorganization of introductory epidemiology around core first principles may be an effective way forward for educating the next generation of public health scientists. PMID:25190677

The perfect food and the filth disease: milk-borne typhoid and epidemiological practice in late Victorian Britain.

PubMed

Steere-Williams, Jacob

2010-10-01

This article explores the initial set of epidemiological investigations in Victorian Britain that linked typhoid fever to milk from dairy cattle. Because Victorian epidemiologists first recognized the milk-borne route in outbreaks of typhoid fever, these investigations served as a model for later studies of milk-borne scarlet fever, diphtheria, and perhaps tuberculosis. By focusing on epidemiological practices conducted by Medical Inspectors at the Medical Department of the Local Government Board and Medical Officers of Health, I show that Victorian epidemiology was committed to field-based, observational methods that defined the professional nature of the discipline and its theories and practices. Epidemiological investigations of milk-borne typhoid heated up several important public health debates in the second half of the nineteenth century, and demonstrate how Victorian epidemiology was not solely wedded to examining population studies using statistical methods, as historians have typically argued, but also relied on observational case-tracing in individuals, animals, and even environments.

Nervios and dysphoria in Mexican American widows.

PubMed

Kay, M; Portillo, C

1989-01-01

One hundred widows participating in experimental research entitled Efficacy of Support Groups for Mexican American Widows were studied to learn how they express the loss of their husbands. Mourning practices, acknowledged symptoms of dysphoria, and somatic reactions were studied to learn if the syndrome of nervios subsumes their reaction to bereavement. In addition, their responses to instruments designed to measure depression, the Spanish version of the Beck Depression Inventory and the Center for Epidemiologic Studies Depression Scale, were examined for correlation with nervios and relationships to Mexican American acculturation. Nervios seems to be a manifestation of dysphoria rather than a specific syndrome for these women.

Genome-wide association study of colorectal cancer identifies six new susceptibility loci.

PubMed

Schumacher, Fredrick R; Schmit, Stephanie L; Jiao, Shuo; Edlund, Christopher K; Wang, Hansong; Zhang, Ben; Hsu, Li; Huang, Shu-Chen; Fischer, Christopher P; Harju, John F; Idos, Gregory E; Lejbkowicz, Flavio; Manion, Frank J; McDonnell, Kevin; McNeil, Caroline E; Melas, Marilena; Rennert, Hedy S; Shi, Wei; Thomas, Duncan C; Van Den Berg, David J; Hutter, Carolyn M; Aragaki, Aaron K; Butterbach, Katja; Caan, Bette J; Carlson, Christopher S; Chanock, Stephen J; Curtis, Keith R; Fuchs, Charles S; Gala, Manish; Giovannucc, Edward L; Giocannucci, Edward L; Gogarten, Stephanie M; Hayes, Richard B; Henderson, Brian; Hunter, David J; Jackson, Rebecca D; Kolonel, Laurence N; Kooperberg, Charles; Küry, Sébastien; Kury, Sebastian; LaCroix, Andrea; Laurie, Cathy C; Laurie, Cecelia A; Lemire, Mathieu; Lemire, Mathiew; Levine, David; Ma, Jing; Makar, Karen W; Qu, Conghui; Taverna, Darin; Ulrich, Cornelia M; Wu, Kana; Kono, Suminori; West, Dee W; Berndt, Sonja I; Bezieau, Stéphane; Brenner, Hermann; Campbell, Peter T; Chan, Andrew T; Chang-Claude, Jenny; Coetzee, Gerhard A; Conti, David V; Duggan, David; Figueiredo, Jane C; Fortini, Barbara K; Gallinger, Steven J; Gauderman, W James; Giles, Graham; Green, Roger; Haile, Robert; Harrison, Tabitha A; Hoffmeister, Michael; Hopper, John L; Hudson, Thomas J; Jacobs, Eric; Iwasaki, Motoki; Jee, Sun Ha; Jenkins, Mark; Jia, Wei-Hua; Joshi, Amit; Li, Li; Lindor, Noralene M; Matsuo, Keitaro; Moreno, Victor; Mukherjee, Bhramar; Newcomb, Polly A; Potter, John D; Raskin, Leon; Rennert, Gad; Rosse, Stephanie; Severi, Gianluca; Schoen, Robert E; Seminara, Daniela; Shu, Xiao-Ou; Slattery, Martha L; Tsugane, Shoichiro; White, Emily; Xiang, Yong-Bing; Zanke, Brent W; Zheng, Wei; Le Marchand, Loic; Casey, Graham; Gruber, Stephen B; Peters, Ulrike

2015-07-07

Genetic susceptibility to colorectal cancer is caused by rare pathogenic mutations and common genetic variants that contribute to familial risk. Here we report the results of a two-stage association study with 18,299 cases of colorectal cancer and 19,656 controls, with follow-up of the most statistically significant genetic loci in 4,725 cases and 9,969 controls from two Asian consortia. We describe six new susceptibility loci reaching a genome-wide threshold of P<5.0E-08. These findings provide additional insight into the underlying biological mechanisms of colorectal cancer and demonstrate the scientific value of large consortia-based genetic epidemiology studies.

[Molecular-genetic characterization of shiga-toxin producing Escherichia coli isolated during a food-borne outbreak in St. Petersburg in 2013].

PubMed

Onishchenko, G G; Dyatlov, I A; Svetoch, E A; Volozhantsev, N V; Bannov, V A; Kartsev, N N; Borzenkov, V N; Fursova, N K; Shemyakin, I G; Bogun, A G; Kislichkina, A A; Popova, A V; Myakinina, V P; Teimurazov, M G; Polosenko, O V; Kaftyreva, L A; Makarova, M A; Matveeva, Z N; Grechaninova, T A; Grigor'eva, N S; Kicha, E V; Zabalueva, G V; Kutasova, T B; Korzhaev, Yu N; Bashketova, N S; Bushmanova, O N; Stalevskaya, A V; Tchinjeria, I G; Zhebrun, F B

2015-01-01

Shiga toxin-producing Escherichia coli (STEC) food-borne infections are reported worldwide and represent a serious problem for public healthcare. In the Russian Federation there is little information on epidemiology and etiology of STEC-infections as well as on molecular-genetic peculiarities of STEC pathogens. Our aim was to describe a food-borne outbreak as hemorrhagic colitis (HC) along with hemolytic uremic syndrome (HUS), enterocolitis, and acute gastroenteritis in children in St. Petersburg in 2013. Epidemiological, microbiological, molecular-genetic and bioinformatic methods were applied. Objects to study were clinical specimens, milk and food samples, as well as STEC strains isolated during the outbreak. The outbreak of food-borne infection was found to be caused by STEC-contaminated raw milk as confirmed by epidemiological analysis, detection of STEC DNA and isolation of relevant pathogens in milk and sick children fecal specimens. The whole-genome sequencing revealed two groups ofpathogens, E. coli O157:H7 and E. coli O101:H33 among collected strains. Group I strains were attributed to the previously known sequence type ST24, while group II strains belonged to the previously non-described sequence type ST145. In strain genomes of both groups there were identified nucleotide sequences of VT2-like prophage carrying stx2c gene, plasmid enterohemolysin gene, and gene of the STEC main adhesion factor intimin. Gene of intimin gamma was identified in E. coli O157:H7 strains and intimin iota 2 in E. coli O101:H33 strains. The latter previously was identified only in enteropathogenic E. coli (EPEC) strains. The additional knowledge of epidemiology and biology of STEC pathogens would assist clinicians and epidemiologists in diagnosing, treating and preventing hemorrhagic colitis.

Changing molecular epidemiology and high rates of mupirocin resistance among meticillin-resistant Staphylococcus aureus in Singaporean hospitals.

PubMed

Hon, Pei Yun; Koh, Tse Hsien; Tan, Thean Yen; Krishnan, Prabha; Leong, Janice Wai-Yeng; Jureen, Roland; Chan, Joey; Tee, Nancy Wen-Sim; Murugesh, Jagadeesan; Chan, Kian Sing; Hsu, Li Yang

2014-03-01

A prospective cross-sectional study was performed to determine the continuing shift in the molecular epidemiology of meticillin-resistant Staphylococcus aureus (MRSA) in Singapore. In total, 666 MRSA isolates from screening cultures performed between 7 and 20 January 2013 were obtained from all seven public sector hospitals in Singapore and were subjected to molecular typing using multilocus variable-number tandem-repeat fingerprinting with confirmatory multilocus sequencing typing for clustered isolates. Isolates were also tested for the presence of the orfX-ACME insert and the high-level mupirocin resistance gene ileS-2. The major circulating clones in Singaporean hospitals were ST22 (63.2%), ST45 (18.9%) and ST239 (10.7%). The orfX-ACME insert was only found in ST239 isolates (31/71, 43.7%), but ileS-2 was found in 207 (31.1%) of the MRSA isolates, varying between 10.0% and 47.8% among the hospitals. In conclusion, the molecular epidemiology of MRSA in Singaporean hospitals has continued to change, with ST45 now replacing ST239 in addition to the ongoing replacement of the latter by ST22. Although a greater proportion of ST239 isolates carry the orfX-ACME insert, the actual clinical impact may be marginal as ST239 MRSA continues to decline. Finally, high-level mupirocin resistance rates are remarkably high in local healthcare-associated MRSA, with implications for MRSA decolonisation and infection prevention. Further surveillance is required to monitor the changing epidemiological trends. Copyright © 2013 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

[Evaluation of tuberculosis transmission routes in an outbreak among young adults for developing an effective method for contact investigations].

PubMed

Toyota, Makoto

2012-12-01

To evaluate the various transmission routes of tuberculosis in an outbreak among young adults in order to develop an effective method for contact investigations. We reviewed the records of 21 tuberculosis patients involved in an outbreak of tuberculosis; the records were collected by conventional epidemiological studies. Mycobacterium tuberculosis isolates were genotyped using IS6110-based restriction fragment length polymorphism (RFLP). The index patient was a 26-year-old man whose 32-year-old brother was identified as the source patient of tuberculosis through a contact investigation. Investigation of their contacts led to the identification of 10 tuberculosis patients. Further, 5 more patients with only casual contact with the index or source patients developed tuberculosis 18-25 months after identification of the index patient. The RFLP analysis of strains obtained from these 5 patients as well as the index and source patients revealed an identical pattern. Further, 4 persons, among those who had epidemiological links with some of the above-mentioned 5 patients, developed tuberculosis 22-34 months after identification of the index patient. All 21 patients were relatively young. In total, 15 strains obtained from these patients were sent for the RFLP analysis, all of which showed an identical pattern. The epidemiological links were categorized into a household environment, an entertainment area, a university, a music band, and a construction site. Molecular epidemiology can provide insights into the process of tuberculosis transmission, which may otherwise go unrecognized by conventional contact investigations. Additionally, it can play an important role in identifying places of tuberculosis outbreaks and routes of transmission in a contact investigation.

An animated depiction of major depression epidemiology.

PubMed

Patten, Scott B

2007-06-08

Epidemiologic estimates are now available for a variety of parameters related to major depression epidemiology (incidence, prevalence, etc.). These estimates are potentially useful for policy and planning purposes, but it is first necessary that they be synthesized into a coherent picture of the epidemiology of the condition. Several attempts to do so have been made using mathematical modeling procedures. However, this information is not easy to communicate to users of epidemiological data (clinicians, administrators, policy makers). In this study, up-to-date data on major depression epidemiology were integrated using a discrete event simulation model. The mathematical model was animated in Virtual Reality Modeling Language (VRML) to create a visual, rather than mathematical, depiction of the epidemiology. Consistent with existing literature, the model highlights potential advantages of population health strategies that emphasize access to effective long-term treatment. The paper contains a web-link to the animation. Visual animation of epidemiological results may be an effective knowledge translation tool. In clinical practice, such animations could potentially assist with patient education and enhanced long-term compliance.

Alarums false, alarums real: challenges and threats to the future of epidemiology.

PubMed

Bracken, M B

1998-02-01

A review of recent threats and challenges to epidemiology suggests that some represent an opportunity to advance the discipline while others are a major threat to conducting epidemiologic work. Two issues are identified which should advance the publication and conduct of epidemiologic research. Three are discussed that exemplify current threats. Epidemiologists have a role in helping journalists improve the communication of risk information in the media. Methodological advances for studies of rare exposure being related to rare disease should reduce the frequency of conflicting results in the epidemiologic literature. Three significant external forces that threaten epidemiologic research are identified. These are: unbridled discovery during litigation as exemplified by Bendectin, breast implants and cellular telephones; over zealous privacy laws; and the negative impact of managed care on epidemiologic research. The American College of Epidemiology has a major role to play in protecting the profession from some of the real threats that face it, and in helping meet the challenges.

Human exposure to chemical mixtures: Challenges for the integration of toxicology with epidemiology data in risk assessment.

PubMed

Hernández, Antonio F; Tsatsakis, Aristidis M

2017-05-01

Little is known about the potential adverse effects from longterm exposure to complex mixtures at low doses, close to health-based reference values. Traditional chemical-specific risk assessment based on animal testing may be insufficient and the lack of toxicological studies on chemical mixtures remains a major regulatory challenge. Hence, new methodologies on cumulative risk assessment are being developed but still present major limitations. Evaluation of chemical mixture effects requires an integrated and systematic approach and close collaboration across different scientific fields, particularly toxicology, epidemiology, exposure science, risk assessment and statistics for a proper integration of data from all these disciplines. Well designed and conducted epidemiological studies can take advantage of this new paradigm and can provide insight to support the correlation between humans low-dose exposures and diseases, thus avoiding the uncertainty associated with extrapolation across species. In this regard, human epidemiology studies may play a significant role in the new vision of toxicity testing. However, this type of information has not been fully considered in risk assessment, mainly due to the inherent limitations of epidemiologic studies. An integrated approach of in vivo, in vitro and in silico data, together with systematic reviews or meta-analysis of high quality epidemiological studies will improve the robustness of risk assessment of chemical mixtures and will provide a stronger basis for regulatory decisions. The ultimate goal is that experimental and mechanistic data can lend support and biological plausibility to the human epidemiological observations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Hunner's Ulcers

MedlinePlus

... Epidemiology (RICE) Study Boston Area Community Health (BACH) Survey ICA Pilot Research Program Funding Opportunities Clinical Trial ... Epidemiology (RICE) Study Boston Area Community Health (BACH) Survey ICA Pilot Research Program Funding Opportunities Clinical Trial ...

Bladder Retraining

MedlinePlus

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Epidemiological Studies to Support the Development of Next Generation Influenza Vaccines.

PubMed

Petrie, Joshua G; Gordon, Aubree

2018-03-26

The National Institute of Allergy and Infectious Diseases recently published a strategic plan for the development of a universal influenza vaccine. This plan focuses on improving understanding of influenza infection, the development of influenza immunity, and rational design of new vaccines. Epidemiological studies such as prospective, longitudinal cohort studies are essential to the completion of these objectives. In this review, we discuss the contributions of epidemiological studies to our current knowledge of vaccines and correlates of immunity, and how they can contribute to the development and evaluation of the next generation of influenza vaccines. These studies have been critical in monitoring the effectiveness of current influenza vaccines, identifying issues such as low vaccine effectiveness, reduced effectiveness among those who receive repeated vaccination, and issues related to egg adaptation during the manufacturing process. Epidemiological studies have also identified population-level correlates of protection that can inform the design and development of next generation influenza vaccines. Going forward, there is an enduring need for epidemiological studies to continue advancing knowledge of correlates of protection and the development of immunity, to evaluate and monitor the effectiveness of next generation influenza vaccines, and to inform recommendations for their use.

Molecular Studies of HTLV-1 Infection in Newly Recognized High Risk Population

DTIC Science & Technology

1993-07-10

showing similar sequence to African Isolates. 14. SUBJECT TERMS 15. NUMBER OF PAGES HTLV-I, Epidemiology , Polymerase, Virus, Aids, Biotechnology, RAD... Epidemiologic and molecular studies of both viruses have identified several themes underlying the leukemogenic process. Leukemia is a rare consequence...form. Key words EPIDEMIOLOGIC AND MOLECULAR CIARACTERIZATION 1st OF HTLV-I INFEXTION IN ISRAEL SYehuda L. Danon, el Kilim, and Joseph Rosenblatt

Relevance of improved epidemiological knowledge to sustainable control of Haemonchus contortus in Nigeria.

PubMed

Bolajoko, M B; Morgan, E R

2012-12-01

Nigeria experiences losses in small ruminant production as a result of a high prevalence of infection with Haemonchus contortus, but there have been very few investigative studies into the epidemiology of H. contortus in Nigeria, particularly in the south and western parts of the country. For successful planning and execution of control of hemonchosis in Nigeria, there is a need for insight into the epidemiology of free-living stages under the prevailing local conditions and models for climatic and environmental factors that control the risk of hemonchosis and distribution of H. contortus. In this review, we assess previous studies on the epidemiology of H. contortus in Nigeria, evaluate the present climatic and epidemiological situation, and highlight areas that require further investigative studies. The goal is to identify factors that underpin better control strategies and holistic integrated farm-management practice. Previous studies on H. contortus provided important information for formulation of control strategies and development toward integrated parasite management. However, this review has revealed the need for holistic evaluation of the current epidemiology and prevalence of H. contortus in Nigeria, particularly in relation to climate change. Accurate information is needed to build useful predictive models of the population dynamics of all free-living stages, particularly the L3.

The justification of studies in genetic epidemiology - political scaling in China Medical City.

PubMed

Sleeboom-Faulkner, Margaret

2018-04-01

Genetic epidemiology examines the role of genetic factors in determining health and disease in families and in populations to help addressing health problems in a responsible manner. This paper uses a case study of genetic epidemiology in Taizhou, China, to explore ways in which anthropology can contribute to the validation of studies in genetic epidemiology. It does so, first, by identifying potential overgeneralizations of data, often due to mismatching scale and, second, by examining it's embedding in political, historical and local contexts. The example of the longitudinal cohort study in Taizhou illustrates dimensions of such 'political scaling'. Political scaling is a notion used here to refer to the effects of scaling biases in relation to the justification of research in terms of relevance, reach and research ethics. The justification of a project on genetic epidemiology involves presenting a maximum of benefits and a minimum of burden for the population. To facilitate the delineation of political scaling, an analytical distinction between donating and benefiting communities was made using the notions of 'scaling of relevance', 'scaling of reach' and 'scaling of ethics'. Political scaling results at least partly from factors external to research. By situating political scaling in the context of historical, political and local discourses, anthropologists can play a complementary role in genetic epidemiology.

Men and IC

MedlinePlus

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IC Associated Conditions

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General IC Symptoms

MedlinePlus

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Children and IC

MedlinePlus

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NIEHS' David Rall

ERIC Educational Resources Information Center

Environmental Science and Technology, 1974

1974-01-01

According to Rall, director of NIEHS, the agency is supporting environmental research in the areas of occupational health, epidemiological, carcinogenic and biochemical toxicology, air pollution, food additives and nutrition. Rall's concern is that environmentalists have become sidetracked by the problems of esthetics and wildlife toxicity and…

INTEGRATING EPIDEMIOLOGY AND TOXICOLOGY IN NEUROTOXICITY RISK ASSESSMENT.

EPA Science Inventory

Neurotoxicity risk assessments depend on the best available scientific information, including data from animal toxicity, human experimental studies and human epidemiology studies. There are several factors to consider when evaluating the comparability of data from studies. Reg...

Epidemiological Trends of Dengue Disease in Colombia (2000-2011): A Systematic Review

PubMed Central

Villar, Luis Angel; Rojas, Diana Patricia; Besada-Lombana, Sandra; Sarti, Elsa

2015-01-01

A systematic literature review was conducted to describe the epidemiology of dengue disease in Colombia. Searches of published literature in epidemiological studies of dengue disease encompassing the terms “dengue”, “epidemiology,” and “Colombia” were conducted. Studies in English or Spanish published between 1 January 2000 and 23 February 2012 were included. The searches identified 225 relevant citations, 30 of which fulfilled the inclusion criteria defined in the review protocol. The epidemiology of dengue disease in Colombia was characterized by a stable “baseline” annual number of dengue fever cases, with major outbreaks in 2001–2003 and 2010. The geographical spread of dengue disease cases showed a steady increase, with most of the country affected by the 2010 outbreak. The majority of dengue disease recorded during the review period was among those <15 years of age. Gaps identified in epidemiological knowledge regarding dengue disease in Colombia may provide several avenues for future research, namely studies of asymptomatic dengue virus infection, primary versus secondary infections, and under-reporting of the disease. Improved understanding of the factors that determine disease expression and enable improvement in disease control and management is also important. PMID:25790245

The National Heart, Lung, and Blood Institute retrovirus epidemiology donor studies (Retrovirus Epidemiology Donor Study and Retrovirus Epidemiology Donor Study-II): twenty years of research to advance blood product safety and availability.

PubMed

Kleinman, Steven; King, Melissa R; Busch, Michael P; Murphy, Edward L; Glynn, Simone A

2012-10-01

The Retrovirus Epidemiology Donor Study (REDS), conducted from 1989 to 2001, and the REDS-II, conducted from 2004 to 2012, were National Heart, Lung, and Blood Institute-funded, multicenter programs focused on improving blood safety and availability in the United States. The REDS-II also included international study sites in Brazil and China. The 3 major research domains of REDS/REDS-II have been infectious disease risk evaluation, blood donation availability, and blood donor characterization. Both programs have made significant contributions to transfusion medicine research methodology by the use of mathematical modeling, large-scale donor surveys, innovative methods of repository sample storage, and establishing an infrastructure that responded to potential emerging blood safety threats such as xenotropic murine leukemia virus-related virus. Blood safety studies have included protocols evaluating epidemiologic and/or laboratory aspects of human immunodeficiency virus, human T-lymphotropic virus 1/2, hepatitis C virus, hepatitis B virus, West Nile virus, cytomegalovirus, human herpesvirus 8, parvovirus B19, malaria, Creutzfeldt-Jakob disease, influenza, and Trypanosoma cruzi infections. Other analyses have characterized blood donor demographics, motivations to donate, factors influencing donor return, behavioral risk factors, donors' perception of the blood donation screening process, and aspects of donor deferral. In REDS-II, 2 large-scale blood donor protocols examined iron deficiency in donors and the prevalence of leukocyte antibodies. This review describes the major study results from over 150 peer-reviewed articles published by these 2 REDS programs. In 2011, a new 7-year program, the Recipient Epidemiology and Donor Evaluation Study-III, was launched. The Recipient Epidemiology and Donor Evaluation Study-III expands beyond donor-based research to include studies of blood transfusion recipients in the hospital setting and adds a third country, South Africa, to the international program. Copyright © 2012 Elsevier Inc. All rights reserved.

WINPEPI updated: computer programs for epidemiologists, and their teaching potential

PubMed Central

2011-01-01

Background The WINPEPI computer programs for epidemiologists are designed for use in practice and research in the health field and as learning or teaching aids. The programs are free, and can be downloaded from the Internet. Numerous additions have been made in recent years. Implementation There are now seven WINPEPI programs: DESCRIBE, for use in descriptive epidemiology; COMPARE2, for use in comparisons of two independent groups or samples; PAIRSetc, for use in comparisons of paired and other matched observations; LOGISTIC, for logistic regression analysis; POISSON, for Poisson regression analysis; WHATIS, a "ready reckoner" utility program; and ETCETERA, for miscellaneous other procedures. The programs now contain 122 modules, each of which provides a number, sometimes a large number, of statistical procedures. The programs are accompanied by a Finder that indicates which modules are appropriate for different purposes. The manuals explain the uses, limitations and applicability of the procedures, and furnish formulae and references. Conclusions WINPEPI is a handy resource for a wide variety of statistical routines used by epidemiologists. Because of its ready availability, portability, ease of use, and versatility, WINPEPI has a considerable potential as a learning and teaching aid, both with respect to practical procedures in the planning and analysis of epidemiological studies, and with respect to important epidemiological concepts. It can also be used as an aid in the teaching of general basic statistics. PMID:21288353

Epidemiology and vectors of Dracunculus medinensis in northwest Burkina Faso, West Africa.

PubMed

Steib, K; Mayer, P

1988-04-01

The epidemiology of the guinea worm, Dracunculus medinensis, was studied in the dry savanna zone of West Africa. The monthly incidence data collected over a period of four years showed peak transmission occurring in June and July at the beginning of the rainy season. The different types of local water sources (i.e. wells, periodic streams, seasonal cattle waterings, natural ponds and man-made ponds) were examined for infected cyclopoid copepods. Small hand-dug ponds or water-holes situated in the fields proved to be the most important sites of transmission. While the domestic water supply is obtained from draw-wells in the villages throughout the year, the villagers take additional drinking water from these ponds during the planting season when farm activities require long stays in the fields. Four cyclopoid species were found for the first time acting as natural intermediate hosts of D. medinensis. Thermocyclops inopinus was the most frequently infected cyclopoid, and small man-made ponds are the preferred habitats of this species. Occurrence of T. inopinus is confined to the first half of the rainy season, coinciding with peak transmission. The epidemiology of dracunculiasis in dry and humid regions of West Africa is compared with regard to seasonality. The use of protective water filters proved to be the only adequate method for guinea worm control in the project area.

Health effects of uranium: new research findings.

PubMed

Brugge, Doug; Buchner, Virginia

2011-01-01

Recent plans for a nuclear renaissance in both established and emerging economies have prompted increased interest in uranium mining. With the potential for more uranium mining worldwide and a growth in the literature on the toxicology and epidemiology of uranium and uranium mining, we found it timely to review the current state of knowledge. Here, we present a review of the health effects of uranium mining, with an emphasis on newer findings (2005-2011). Uranium mining can contaminate air, water, and soil. The chemical toxicity of the metal constitutes the primary environmental health hazard, with the radioactivity of uranium a secondary concern. The update of the toxicologic evidence on uranium adds to the established findings regarding nephrotoxicity, genotoxicity, and developmental defects. Additional novel toxicologic findings, including some at the molecular level, are now emerging that raise the biological plausibility of adverse effects on the brain, on reproduction, including estrogenic effects, on gene expression, and on uranium metabolism. Historically, most epidemiology on uranium mining has focused on mine workers and radon exposure. Although that situation is still overwhelmingly true, a smaller emerging literature has begun to form around environmental exposure in residential areas near uranium mining and processing facilities. We present and critique such studies. Clearly, more epidemiologic research is needed to contribute to causal inference. As much damage is irreversible, and possibly cumulative, present efforts must be vigorous to limit environmental uranium contamination and exposure.

Diversity and Antifungal Drug Susceptibility of Cryptococcus Isolates in Thailand.

PubMed

Worasilchai, Navaporn; Tangwattanachuleeporn, Marut; Meesilpavikkai, Kornvalee; Folba, Claudia; Kangogo, Mourine; Groß, Uwe; Weig, Michael; Bader, Oliver; Chindamporn, Ariya

2017-08-01

Yeasts of the Cryptococcus species complex are the causative agent of cryptococcosis, especially in human immunodeficiency virus (HIV) positive individuals. Cerebral or disseminated cryptococcosis has a very high mortality rate worldwide, including in Thailand. Additionally, an increasing rate of antifungal drug resistant cryptococcal isolates has been reported in several neighboring countries, complicating therapeutic approaches. To understand the situation of this infection in Thailand, we retrospectively investigated the molecular epidemiology and antifungal drug resistance in a collection of 74 clinical, 52 environmental and two veterinary isolates using the URA5-RFLP for typing and the EUCAST guideline for susceptibility testing. Where no EUCAST breakpoints (AMB and 5FC) were available, CLSI epidemiologic cutoff values were used for interpretation. Cryptococcal molecular type diversity showed most isolates were C. grubii, molecular type VNI. One clinical isolate was C. deuterogattii (mol. type VGII) and another C. grubii (mol. type VNII). One strain from environment was classified as C. grubii (mol. type VNII). No resistant strains were detected in this retrospective study for either of the antimycotics tested; however, monitoring of the epidemiology of Cryptococcus species in infected patients in Thailand needs to be continued to detect emergence of resistance. © The Author 2016. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Epidemiological review of Toxoplasma gondii infection in humans and animals in Portugal.

PubMed

Lopes, A P; Dubey, J P; Dardé, M-L; Cardoso, L

2014-11-01

Toxoplasmosis is a worldwide zoonosis. However, data from Portugal are limited and a considerable part of the literature is in Portuguese. Currently, the rate of congenital infection in Portugal is unknown, and almost nothing is known of sequelae of congenital toxoplasmosis. There is no recent general population-based serological survey of Toxoplasma gondii in humans in Portugal. In addition, there is little information on genetic characteristics of T. gondii in animals and humans. In the present paper, we review prevalence, clinical spectrum and epidemiology of T. gondii in humans and animals in Portugal. This knowledge should be useful to biologists, public health workers, physicians and veterinarians.