WorldWideScience

Sample records for inadequate epidemiologic evidence

  1. Evidence Report: Risk Factor of Inadequate Nutrition

    Science.gov (United States)

    Smith, Scott M.; Zwart, Sara R.; Heer, Martina

    2015-01-01

    The importance of nutrition in exploration has been documented repeatedly throughout history, where, for example, in the period between Columbus' voyage in 1492 and the invention of the steam engine, scurvy resulted in more sailor deaths than all other causes of death combined. Because nutrients are required for the structure and function of every cell and every system in the body, defining the nutrient requirements for spaceflight and ensuring provision and intake of those nutrients are primary issues for crew health and mission success. Unique aspects of nutrition during space travel include the overarching physiological adaptation to weightlessness, psychological adaptation to extreme and remote environments, and the ability of nutrition and nutrients to serve as countermeasures to ameliorate the negative effects of spaceflight on the human body. Key areas of clinical concern for long-duration spaceflight include loss of body mass (general inadequate food intake), bone and muscle loss, cardiovascular and immune system decrements, increased radiation exposure and oxidative stress, vision and ophthalmic changes, behavior and performance, nutrient supply during extravehicular activity, and general depletion of body nutrient stores because of inadequate food supply, inadequate food intake, increased metabolism, and/or irreversible loss of nutrients. These topics are reviewed herein, based on the current gap structure.

  2. Evidence Report: Risk of Inadequate Human-Computer Interaction

    Science.gov (United States)

    Holden, Kritina; Ezer, Neta; Vos, Gordon

    2013-01-01

    Human-computer interaction (HCI) encompasses all the methods by which humans and computer-based systems communicate, share information, and accomplish tasks. When HCI is poorly designed, crews have difficulty entering, navigating, accessing, and understanding information. HCI has rarely been studied in an operational spaceflight context, and detailed performance data that would support evaluation of HCI have not been collected; thus, we draw much of our evidence from post-spaceflight crew comments, and from other safety-critical domains like ground-based power plants, and aviation. Additionally, there is a concern that any potential or real issues to date may have been masked by the fact that crews have near constant access to ground controllers, who monitor for errors, correct mistakes, and provide additional information needed to complete tasks. We do not know what types of HCI issues might arise without this "safety net". Exploration missions will test this concern, as crews may be operating autonomously due to communication delays and blackouts. Crew survival will be heavily dependent on available electronic information for just-in-time training, procedure execution, and vehicle or system maintenance; hence, the criticality of the Risk of Inadequate HCI. Future work must focus on identifying the most important contributing risk factors, evaluating their contribution to the overall risk, and developing appropriate mitigations. The Risk of Inadequate HCI includes eight core contributing factors based on the Human Factors Analysis and Classification System (HFACS): (1) Requirements, policies, and design processes, (2) Information resources and support, (3) Allocation of attention, (4) Cognitive overload, (5) Environmentally induced perceptual changes, (6) Misperception and misinterpretation of displayed information, (7) Spatial disorientation, and (8) Displays and controls.

  3. 2013 Nutrition Risk Evidence Review Panel. Evidence Review for: The Risk Factor of Inadequate Nutrition

    Science.gov (United States)

    2014-01-01

    The 2013 Nutrition Risk Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on November 20 - 21, 2013. The SRP reviewed the new Evidence Report for the Risk Factor of Inadequate Nutrition (from here on referred to as the 2013 Nutrition Evidence Report), as well as the Research Plan for this Risk. Overall, the SRP thinks the well-qualified research team has compiled an excellent summary of background information in the 2013 Nutrition Evidence Report. The SRP would like to commend the authors in general and particularly note that while the 2013 Nutrition Evidence Report has been written using a single nutrient approach, the research plan takes a much more integrated and physiologically based approach.

  4. Association Between Cannabis and Psychosis: Epidemiologic Evidence.

    Science.gov (United States)

    Gage, Suzanne H; Hickman, Matthew; Zammit, Stanley

    2016-04-01

    Associations between cannabis use and psychotic outcomes are consistently reported, but establishing causality from observational designs can be problematic. We review the evidence from longitudinal studies that have examined this relationship and discuss the epidemiologic evidence for and against interpreting the findings as causal. We also review the evidence identifying groups at particularly high risk of developing psychosis from using cannabis. Overall, evidence from epidemiologic studies provides strong enough evidence to warrant a public health message that cannabis use can increase the risk of psychotic disorders. However, further studies are required to determine the magnitude of this effect, to determine the effect of different strains of cannabis on risk, and to identify high-risk groups particularly susceptible to the effects of cannabis on psychosis. We also discuss complementary epidemiologic methods that can help address these questions. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  5. Saccharin/cyclamates: epidemiological evidence.

    Science.gov (United States)

    Armstrong, B K

    1985-01-01

    Adequate data on the carcinogenicity of saccharin and cyclamate to humans are available only for the urinary bladder. In the studies available, exposure to saccharin and to cyclamate cannot be distinguished readily. Descriptive studies have shown no evidence of time trends in bladder cancer that can be related to use of saccharin or cyclamate. Likewise, studies of diabetics, who have used more saccharin and cyclamate than other people, have shown no evidence of an increased risk of bladder cancer. This association, however, is probably confounded negatively by cigarette smoking. Thirteen case-control studies have addressed the relationship of saccharin and cyclamate intake to bladder cancer in individuals. While statistically significant positive associations have been observed, a similar number of significant negative associations has also been observed. Studies of the dose-response relationships have also shown no consistent pattern. Studies of saccharin and cyclamate use with smoking habits have shown no consistent interaction with heavy smoking, as might be expected from a promotional effect. In some studies, however, an increased risk with saccharin and cyclamate use has been observed in female non-smokers--a group otherwise at low risk for bladder cancer.

  6. Linking anthropological analysis and epidemiological evidence ...

    African Journals Online (AJOL)

    transmission in Acholiland, this paper jointly analyses the historical and political context of the Acholi people and the war, the epidemiologic evidence of HIV prevalence .... the Acholi (Finnström, 2003). It was during this period of time that the rigid concept of an Acholi tribe was developed by the British (Atkinson, 1989).

  7. Inadequate Evidence for Multiple Intelligences, Mozart Effect, and Emotional Intelligence Theories

    Science.gov (United States)

    Waterhouse, Lynn

    2006-01-01

    I (Waterhouse, 2006) argued that, because multiple intelligences, the Mozart effect, and emotional intelligence theories have inadequate empirical support and are not consistent with cognitive neuroscience findings, these theories should not be applied in education. Proponents countered that their theories had sufficient empirical support, were…

  8. Cognitive Dissonance, Confirmatory Bias and Inadequate Information Processing: Evidence from Experimental Auctions

    OpenAIRE

    Cao, Ying; Just, David R.; Wansink, Brian

    2014-01-01

    Using psychological terms such as cognitive dissonance and confirmation bias, this study reveals how individual consumers inadequately process (food safety) information, pay limited attention to signals, and make purchase decisions that are bias towards their initial choices. While it is expected that reading extra information about potential risk associated with the food decreases consumers' willingness to pay (WTP), the magnitude of the impact varies across individuals. In general, consumer...

  9. Cancer chemoprevention by dietary phytochemicals: Epidemiological evidence.

    Science.gov (United States)

    Baena Ruiz, Raúl; Salinas Hernández, Pedro

    2016-12-01

    In recent years, natural compounds called "phytochemicals", which are present in fruits, vegetables, and plants, have received special attention due to their potential to interfere with tumour formation and development. Many of these phytochemicals are being used in chemoprevention strategies. However, the scientific evidence regarding the modification of cancer risk continues to be debated. The aim of this paper is to review the current scientific evidence and the most relevant epidemiological studies regarding the consumption or use of phytochemicals and their effects on the incidence of cancer. A search for relevant articles was conducted in EMBASE and PubMed-NCBI through to May 2016 to identify potential interactions between the consumption or use of phytochemicals and cancer risk. The use or consumption of carotenoids, such as lycopene, alpha-carotene, and betacarotene, leads to a reduction in the risk of cancer, such as breast and prostate tumours. For breast cancer, beta-carotene even reduces the risk of recurrence. The use or consumption of soybean isoflavones has led to a reduction in the risk of lung, prostate, colon (in women only), and breast cancers, although this has depended on menopausal and oestrogen receptor status. The use or consumption of isothiocyanates and indole-3-carbinol also seems to reduce the risk of cancer, such as breast, stomach, colorectal, or prostate tumours. The adoption of a diet rich in phytochemicals is associated with a modification of cancer risk. However, the scientific data supporting its use come mainly from in vitro and in vivo studies (especially in animal models). The epidemiological evidence is inconclusive for many of these phytochemicals, so further studies are needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Insulin resistance and cancer: epidemiological evidence.

    Science.gov (United States)

    Tsugane, Shoichiro; Inoue, Manami

    2010-05-01

    Over the last 60 years, Japanese people have experienced a rapid and drastic change in lifestyle, including diet. Suspicions have been raised that so-called 'Westernization', characterized by a high-calorie diet and physical inactivity, is associated with increasing trends in the incidence of cancer of the colon, liver, pancreas, prostate, and breast, as well as type 2 diabetes. Epidemiological evidence from our prospective study, the Japan Public Health Center-based Prospective (JPHC) study, and systematic literature reviews generally support the idea that factors related to diabetes or insulin resistance are associated with an increased risk of colon (mostly in men), liver, and pancreatic cancers. These cancers are inversely associated with physical activity and coffee consumption, which are known to decrease the risk of type 2 diabetes. The suggested mechanism of these effects is that insulin resistance and the resulting chronic hyperinsulinemia and increase in bioavailable insulin-like growth factor 1 (IGF1) stimulate tumor growth. In contrast, associations with diabetes are less clear for cancer of the colon in women, and breast and prostate, which are known to be related to sex hormones. The effect of insulin resistance or body fat on sex-hormone production and bioavailability may modify their carcinogenic effect differently from cancers of the colon in men, and liver and pancreas. In conclusion, there is substantial evidence to show that cancers of the colon, liver, and pancreas are associated with insulin resistance, and that these cancers can be prevented by increasing physical activity, and possibly coffee consumption.

  11. Inadequate housing in Ghana

    Directory of Open Access Journals (Sweden)

    Franklin Obeng-Odoom

    2011-01-01

    Full Text Available Two themes are evident in housing research in Ghana. One involves the study of how to increase the number of dwellings to correct the overall housing deficit, and the other focuses on how to improve housing for slum dwellers. Between these two extremes, there is relatively little research on why the existing buildings are poorly maintained. This paper is based on a review of existing studies on inadequate housing. It synthesises the evidence on the possible reasons for this neglect, makes a case for better maintenance and analyses possible ways of reversing the problem of inadequate housing.

  12. Cancer risk of air pollution: epidemiological evidence.

    OpenAIRE

    Hemminki, K; Pershagen, G

    1994-01-01

    Epidemiological studies on the effect of urban air pollution on lung cancer were surveyed. Overall, the studies from many countries point to a smoking-adjusted risk in urban areas over countryside areas that is higher by a factor of up to 1.5. The extent to which urban air pollution contributes to this excess remains unknown. Studies on diesel-exposed occupational groups show that urban air pollution may have a causative role in lung cancer. Model calculations on unit risk factors of known hu...

  13. Review paper: epidemiology, evidence-based medicine, and public health.

    Science.gov (United States)

    Tang, Jin-Ling; Griffiths, Sian

    2009-07-01

    This article reviews the relation between evidence-based medicine and epidemiology and the recent evolution of the former. The meaning of evidence and the international efforts to collect, summarize, and disseminate findings from scientific research that are relevant for medical decision making are discussed. Evidence, current resources, and people's values, all play a role in making evidence-based medical decisions. This also has important implications for public health practice. However, decision making differs considerably between clinical care of individual patients and public health decision and policies that normally apply to populations. Although more closely related to epidemiology than clinical medicine, public health should also adopt a more systematic approach to evidence-based practice.

  14. Brazilians' experiences with iron fortification: evidence of effectiveness for reducing inadequate iron intakes with fortified flour policy.

    Science.gov (United States)

    Vieira, Diva Aliete Dos Santos; Steluti, Josiane; Verly, Eliseu; Marchioni, Dirce Maria; Fisberg, Regina Mara

    2017-02-01

    To assess Fe intake, calculate the prevalence of inadequate Fe intake and identify food contributors to Fe intake during 2003 and 2008 in a population-based study, reflecting before and after the mandatory fortification of flour with Fe. Two cross-sectional population-based studies conducted in 2003 and 2008. Dietary intake was evaluated by 24 h recall and the Software for Intake Distribution Estimation (PC-SIDE) was used to estimate within-person variance and prevalence of inadequate Fe intake. The statistical analysis was conducted considering the complex survey design. São Paulo, Brazil. Adolescents, adults and elderly adults of both sexes, interviewed in 2003 (n 2386) and 2008 (n 1661). The Fe intake mean increased in all populations in the post-fortification period. A reduction of over 90 % was observed in the prevalence of inadequate Fe intake among men for all age groups analysed. When evaluating women, despite the substantial reduction (over 63 %), prevalence of inadequate Fe intake remained high (34 %) in those aged 19-50 years. Major food contributors to Fe intake before fortification were beans, beef, vegetables and dairy. There was an alteration in the contributors in the post-fortification period, with bread, beef, beans and biscuits as main contributors. The mandatory fortification with Fe significantly furthered the reduction in the prevalence of inadequacy, except among women of reproductive age, and changed the main contributors to this nutrient in the studied population. Therefore, monitoring of Fe addition in flour is essential to assess compliance to the fortified flour policy and to guarantee a safe Fe intake for all the population.

  15. Particulate matter and heart disease: Evidence from epidemiological studies

    International Nuclear Information System (INIS)

    Peters, Annette

    2005-01-01

    The association between particulate matter and heart disease was noted in the mid-nineties of last century when the epidemiological evidence for an association between air pollution and hospital admissions due to cardiovascular disease accumulated and first hypotheses regarding the pathomechanism were formulated. Nowadays, epidemiological studies have demonstrated coherent associations between daily changes in concentrations of ambient particles and cardiovascular disease mortality, hospital admission, disease exacerbation in patients with cardiovascular disease and early physiological responses in healthy individuals consistent with a risk factor profile deterioration. In addition, evidence was found that annual average PM 2.5 exposures are associated with increased risks for mortality caused by ischemic heart disease and dysrhythmia. Thereby, evidence is suggesting not only a short-term exacerbation of cardiovascular disease by ambient particle concentrations but also a potential role of particles in defining patients' vulnerability to acute coronary events. While this concept is consistent with the current understanding of the factors defining patients' vulnerability, the mechanisms and the time-scales on which the particle-induced vulnerability might operate are unknown

  16. Checklist for One Health Epidemiological Reporting of Evidence (COHERE

    Directory of Open Access Journals (Sweden)

    Meghan F. Davis

    2017-12-01

    Full Text Available One Health is defined as the intersection and integration of knowledge regarding humans, animals, and the environment, yet as the One Health scientific literature expands, there is considerable heterogeneity of approach and quality of reporting in One Health studies. In addition, many researchers who publish such studies do not include or integrate data from all three domains of human, animal, and environmental health. This points to a critical need to unify guidelines for One Health studies. This report details the Checklist for One Health Epidemiological Reporting of Evidence (COHERE to guide the design and publication format of future One Health studies. COHERE was developed by a core writing team and international expert review group that represents multiple disciplines, including human medicine, veterinary medicine, public health, allied professionals, clinical laboratory science, epidemiology, the social sciences, ecohealth and environmental health. The twin aims of the COHERE standards are to 1 improve the quality of reporting of observational or interventional epidemiological studies that collect and integrate data from humans, animals and/or vectors, and their environments; and 2 promote the concept that One Health studies should integrate knowledge from these three domains. The 19 standards in the COHERE checklist address descriptions of human populations, animal populations, environmental assessment, spatial and temporal relationships of data from the three domains, integration of analyses and interpretation, and inclusion of expertise in the research team from disciplines related to human health, animal health, and environmental health.

  17. The Epidemiologic Evidence Linking Autoimmune Diseases and Psychosis

    DEFF Research Database (Denmark)

    Benros, Michael E; Eaton, William W; Mortensen, Preben B

    2014-01-01

    This review summarizes the epidemiologic evidence linking autoimmune diseases and psychosis. The associations between autoimmune diseases and psychosis have been studied for more than a half century, but research has intensified within the last decades, since psychosis has been associated...... with genetic markers of the immune system and with excess autoreactivity and other immune alterations. A range of psychiatric disorders, including psychosis, have been observed to occur more frequently in some autoimmune diseases, such as systemic lupus erythematosus and multiple sclerosis. Many autoimmune......, there is some evidence of associations of psychosis with a family history of autoimmune disorders and vice versa. Additionally, several autoimmune diseases, individually and in aggregate, have been identified as raising the risk for psychotic disorders in longitudinal studies. The associations have been...

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

    Science.gov (United States)

    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

  19. Trichloroethylene: Mechanistic, epidemiologic and other supporting evidence of carcinogenic hazard.

    Science.gov (United States)

    Rusyn, Ivan; Chiu, Weihsueh A; Lash, Lawrence H; Kromhout, Hans; Hansen, Johnni; Guyton, Kathryn Z

    2014-01-01

    The chlorinated solvent trichloroethylene (TCE) is a ubiquitous environmental pollutant. The carcinogenic hazard of TCE was the subject of a 2012 evaluation by a Working Group of the International Agency for Research on Cancer (IARC). Information on exposures, relevant data from epidemiologic studies, bioassays in experimental animals, and toxicity and mechanism of action studies was used to conclude that TCE is carcinogenic to humans (Group 1). This article summarizes the key evidence forming the scientific bases for the IARC classification. Exposure to TCE from environmental sources (including hazardous waste sites and contaminated water) is common throughout the world. While workplace use of TCE has been declining, occupational exposures remain of concern, especially in developing countries. The strongest human evidence is from studies of occupational TCE exposure and kidney cancer. Positive, although less consistent, associations were reported for liver cancer and non-Hodgkin lymphoma. TCE is carcinogenic at multiple sites in multiple species and strains of experimental animals. The mechanistic evidence includes extensive data on the toxicokinetics and genotoxicity of TCE and its metabolites. Together, available evidence provided a cohesive database supporting the human cancer hazard of TCE, particularly in the kidney. For other target sites of carcinogenicity, mechanistic and other data were found to be more limited. Important sources of susceptibility to TCE toxicity and carcinogenicity were also reviewed by the Working Group. In all, consideration of the multiple evidence streams presented herein informed the IARC conclusions regarding the carcinogenicity of TCE. © 2013.

  20. Trichloroethylene: Mechanistic, Epidemiologic and Other Supporting Evidence of Carcinogenic Hazard

    Science.gov (United States)

    Rusyn, Ivan; Chiu, Weihsueh A.; Lash, Lawrence H.; Kromhout, Hans; Hansen, Johnni; Guyton, Kathryn Z.

    2013-01-01

    The chlorinated solvent trichloroethylene (TCE) is a ubiquitous environmental pollutant. The carcinogenic hazard of TCE was the subject of a 2012 evaluation by a Working Group of the International Agency for Research on Cancer (IARC). Information on exposures, relevant data from epidemiologic studies, bioassays in experimental animals, and toxicity and mechanism of action studies was used to conclude that TCE is carcinogenic to humans (Group 1). This article summarizes the key evidence forming the scientific bases for the IARC classification. Exposure to TCE from environmental sources (including from hazardous waste sites and contaminated water) is common throughout the world. While workplace use of TCE has been declining, occupational exposures remain of concern, especially in developing countries. Strongest human evidence is from studies of occupational TCE exposure and kidney cancer. Positive, although less consistent, associations were reported for liver cancer and non-Hodgkin's lymphoma. TCE is carcinogenic at multiple sites in multiple species and strains of experimental animals. The mechanistic evidence includes extensive data on the toxicokinetics and genotoxicity of TCE and its metabolites. Together, available evidence provided a cohesive database supporting the human cancer hazard of TCE, particularly in the kidney. For other target sites of carcinogenicity, mechanistic and other data were found to be more limited. Important sources of susceptibility to TCE toxicity and carcinogenicity were also reviewed by the Working Group. In all, consideration of the multiple evidence streams presented herein informed the IARC conclusions regarding the carcinogenicity of TCE. PMID:23973663

  1. Epidemiology and etiology of Parkinson's disease: a review of the evidence.

    Science.gov (United States)

    Wirdefeldt, Karin; Adami, Hans-Olov; Cole, Philip; Trichopoulos, Dimitrios; Mandel, Jack

    2011-06-01

    The etiology of Parkinson's disease (PD) is not well understood but likely to involve both genetic and environmental factors. Incidence and prevalence estimates vary to a large extent-at least partly due to methodological differences between studies-but are consistently higher in men than in women. Several genes that cause familial as well as sporadic PD have been identified and familial aggregation studies support a genetic component. Despite a vast literature on lifestyle and environmental possible risk or protection factors, consistent findings are few. There is compelling evidence for protective effects of smoking and coffee, but the biologic mechanisms for these possibly causal relations are poorly understood. Uric acid also seems to be associated with lower PD risk. Evidence that one or several pesticides increase PD risk is suggestive but further research is needed to identify specific compounds that may play a causal role. Evidence is limited on the role of metals, other chemicals and magnetic fields. Important methodological limitations include crude classification of exposure, low frequency and intensity of exposure, inadequate sample size, potential for confounding, retrospective study designs and lack of consistent diagnostic criteria for PD. Studies that assessed possible shared etiological components between PD and other diseases show that REM sleep behavior disorder and mental illness increase PD risk and that PD patients have lower cancer risk, but methodological concerns exist. Future epidemiologic studies of PD should be large, include detailed quantifications of exposure, and collect information on environmental exposures as well as genetic polymorphisms.

  2. Inflammation in the development of lung cancer: epidemiological evidence.

    Science.gov (United States)

    Engels, Eric A

    2008-04-01

    The lung is a site for repeated or chronic inflammatory insults. Epidemiologic research has provided evidence to support the hypothesis that tissue damage caused by inflammation can initiate or promote the development of lung cancer, possibly in conjunction with tobacco use. For example, some studies suggest an increased risk of lung cancer among persons with lung infections, such as tuberculosis, bacterial pneumonia, or inflammatory lung diseases. Elevated serum levels of C-reactive protein, an inflammation marker, are associated with heightened lung cancer risk. Recent studies also demonstrate increased lung cancer risk among immunosuppressed individuals infected with HIV. Other research indicates an association between genetic polymorphisms in the inflammation pathway, which might modulate the inflammatory response and lung cancer risk.

  3. Cancer prevention by green tea: evidence from epidemiologic studies1234

    Science.gov (United States)

    2013-01-01

    In contrast to the consistent results of an inhibitory effect of green tea extracts and tea polyphenols on the development and growth of carcinogen-induced tumors in experimental animal models, results from human studies are mixed. Both observational and intervention studies have provided evidence in support of a protective role of green tea intake in the development of oral–digestive tract cancer or an inhibitory role of oral supplementation of green tea extract on a precancerous lesion of oral cavity. Evidence in support of green tea intake against the development of liver cancer risk is limited and inconsistent. An inverse association between green tea intake and lung cancer risk has been observed among never smokers but not among smokers. Although observational studies do not support a beneficial role of tea intake against the development of prostate cancer, several phase 2 clinical trials have shown an inhibitory effect of green tea extract against the progression of prostate premalignant lesions to malignant tumors. Prospective epidemiologic studies so far have not provided evidence for a protective effect of green tea consumption on breast cancer development. Current data neither confirm nor refute a definitive cancer-preventive role of green tea intake. Large randomized intervention trials on the efficacy of green tea polyphenols or extracts are required before a recommendation for green tea consumption for cancer prevention should be made. PMID:24172305

  4. Hypertension, serum lipids and cancer risk: A review of epidemiological evidence

    Directory of Open Access Journals (Sweden)

    Ričardas Radišauskas

    2016-01-01

    Full Text Available Although the association between blood pressure, serum lipids and cancer risk has been investigated, the results are controversial. The aim of this literature review was to examine the epidemiological evidence and provide overview of the association between blood pressure, serum lipids and cancer risk. The arterial hypertension is closely linked with renal cell cancer development. Risk of renal cell cancer was 2–4 times higher for persons with arterial hypertension, independently of sex. In some studies arterial hypertension as one of the components of the metabolic syndrome, was associated with a higher risk of colorectal, prostate cancer and malignant melanoma. Studies suggest that a higher total serum cholesterol level is linked with higher risk of colorectum, colon, prostate and testicular cancer and lower risk of stomach, liver and hematopoietic and lymphoid tissues cancer. There was positive association between serum triglycerides and esophageal, colorectal, lung, renal, thyroid cancer. Given that hypertension is a common risk factor worldwide and its control remains inadequate, our analysis supports the relevance of public health programs aimed at reducing hypertension to reduce the incidence of a number of cancers including renal cell cancer. Effective cholesterol control may lower the risk of cancer, but further studies with longer follow-up and repeated measurements of cholesterol and other lipids are needed.

  5. Empirical Evidence of Study Design Biases in Randomized Trials: Systematic Review of Meta-Epidemiological Studies.

    Directory of Open Access Journals (Sweden)

    Matthew J Page

    Full Text Available To synthesise evidence on the average bias and heterogeneity associated with reported methodological features of randomized trials.Systematic review of meta-epidemiological studies.We retrieved eligible studies included in a recent AHRQ-EPC review on this topic (latest search September 2012, and searched Ovid MEDLINE and Ovid EMBASE for studies indexed from Jan 2012-May 2015. Data were extracted by one author and verified by another. We combined estimates of average bias (e.g. ratio of odds ratios (ROR or difference in standardised mean differences (dSMD in meta-analyses using the random-effects model. Analyses were stratified by type of outcome ("mortality" versus "other objective" versus "subjective". Direction of effect was standardised so that ROR < 1 and dSMD < 0 denotes a larger intervention effect estimate in trials with an inadequate or unclear (versus adequate characteristic.We included 24 studies. The available evidence suggests that intervention effect estimates may be exaggerated in trials with inadequate/unclear (versus adequate sequence generation (ROR 0.93, 95% CI 0.86 to 0.99; 7 studies and allocation concealment (ROR 0.90, 95% CI 0.84 to 0.97; 7 studies. For these characteristics, the average bias appeared to be larger in trials of subjective outcomes compared with other objective outcomes. Also, intervention effects for subjective outcomes appear to be exaggerated in trials with lack of/unclear blinding of participants (versus blinding (dSMD -0.37, 95% CI -0.77 to 0.04; 2 studies, lack of/unclear blinding of outcome assessors (ROR 0.64, 95% CI 0.43 to 0.96; 1 study and lack of/unclear double blinding (ROR 0.77, 95% CI 0.61 to 0.93; 1 study. The influence of other characteristics (e.g. unblinded trial personnel, attrition is unclear.Certain characteristics of randomized trials may exaggerate intervention effect estimates. The average bias appears to be greatest in trials of subjective outcomes. More research on several

  6. Ergonomics and epidemiology in evidence based health prevention

    DEFF Research Database (Denmark)

    Jensen, Olaf Chresten

    2009-01-01

    According to the definitions, ergonomics is a natural part of the health and safety activity but it has its own research methods and causal models. Public health, occupational and clinical medicines are closely related to epidemiology and differ from ergonomics by using a disease model with a wide...... success of health effects from the clinical trials could not be obtained. It is argued that the ergonomics design, Integration and Implementation can be strengthened by adapting the epidemiological methods and causal models. The ergonomics can then contribute to a common development of public health...

  7. Systematic reviews of epidemiology in diabetes: finding the evidence

    Directory of Open Access Journals (Sweden)

    Waugh Norman

    2005-01-01

    Full Text Available Abstract Background Methodological research to support searching for those doing systematic reviews of epidemiological studies is a relatively neglected area. Our aim was to determine how many databases it is necessary to search to ensure a comprehensive coverage of the literature in diabetes epidemiology, with the aim of examining the efficiency of searching in support of systematic reviews of the epidemiology of diabetes Methods Three approaches were used. First, we defined a set of English language diabetes journals and examined their coverage in bibliographic databases. Second, we searched extensively for diabetes epidemiology articles (in all languages to determine which are the most useful databases; and third, we analysed the scattering of these articles to determine the core journals in the area. Results The overlap between MEDLINE and Embase for diabetes journals was 59%. A search for diabetes epidemiology articles across both MEDLINE and Embase, showed that MEDLINE alone retrieved about 94% of the total articles. Searching for diabetes epidemiology studies beyond MEDLINE and Embase retrieved no additional English language journal articles. The only diabetes epidemiology studies found by searching beyond MEDLINE and Embase were found in LILACS, and were Spanish or Portuguese language studies from Latin America; no additional English language studies were found. Only 30% of the meeting abstracts were converted to full publication after three years. One third of journal articles were published in just six journals, with Diabetes Care contributing 14.3% of the articles, followed by Diabetic Medicine (5.0%; Diabetes Research & Clinical Practice (4.1%; Diabetologia (4.0%; Diabetes & Metabolism (2.4% and Diabetes (2.0%. Conclusions Our results show that when searching for articles on diabetes epidemiology, MEDLINE and Embase would suffice for English language papers, with LILACS giving some additional non-English articles from Latin America

  8. Epidemiological evidence of listeriosis in guinea pigs fed with ...

    African Journals Online (AJOL)

    Listeria monocytogenes is a bacterium that infects livestock and humans. We report the first outbreak of invasive listeriosis caused by L. monocytogenes in a guinea pig breeding colony. Eighty to 100% mortality rate was recorded in the colony of 80 guinea pigs within four weeks outbreak. On epidemiologic investigation ...

  9. Trichloroethylene: Mechanistic, epidemiologic and other supporting evidence of carcinogenic hazard

    NARCIS (Netherlands)

    Rusyn, Ivan; Chiu, Weihsueh A.; Lash, Lawrence H.; Kromhout, Hans; Hansen, Johnni; Guyton, Kathryn Z.

    2014-01-01

    The chlorinated solvent trichloroethylene (TCE) is a ubiquitous environmental pollutant. The carcinogenic hazard of TCE was the subject of a 2012 evaluation by a Working Group of the International Agency for Research on Cancer (IARC). Information on exposures, relevant data from epidemiologic

  10. Green tea and the risk of gastric cancer: Epidemiological evidence

    Science.gov (United States)

    Hou, I-Chun; Amarnani, Saral; Chong, Mok T; Bishayee, Anupam

    2013-01-01

    Gastric cancer (GC) is one of the leading causes of cancer death in the world. Numerous efforts are being made to find chemoprotective agents able to reduce its risk. Amongst these, green tea has been reported to have a protective effect against stomach cancer. This article aims to critically evaluate all epidemiological studies reporting an association between green tea consumption and GC risk. MEDLINE, EBSCOHOST and Google Scholar were used to search for clinical trials of green tea and its correlation to stomach cancer. Studies include cohort and case-control studies. Outcome of interests are inverse association, no association, and positive association. Seventeen epidemiologic studies were reviewed. Eleven studies were conducted in Japan, five in China, and one with Japanese descendent in Hawaii. Ten case-control studies and seven cohort studies were included. The relative risks or odds ratio of GC for the highest level of green tea consumption was compared. Seven studies suggested no association, eight an inverse association, and one a positive association. One study had shown a significantly lowered GC risk when tea was served warm to cold. Another study also showed a significantly risk with lukewarm tea. All studies that analyzed men and women separately have suggested a reduced risk in women than in men, albeit no significant difference. This review demonstrates that there is insufficient information to support green tea consumption reduces the risk of GC. More studies on the subject matter are warranted. PMID:23840110

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

    Science.gov (United States)

    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

  12. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study

    DEFF Research Database (Denmark)

    Wood, L.; Egger, M.; Gluud, L.L.

    2008-01-01

    OBJECTIVE: To examine whether the association of inadequate or unclear allocation concealment and lack of blinding with biased estimates of intervention effects varies with the nature of the intervention or outcome. DESIGN: Combined analysis of data from three meta-epidemiological studies based o...

  13. Evidence and causality assessment in environmental epidemiology: methodological aspects

    International Nuclear Information System (INIS)

    Valleron, A.J.

    2000-01-01

    There are usually three major steps in the study of the possible impact of environmental factors on health: 1) to demonstrate that there is an association between exposure to the factor and the disease under study; 2) to demonstrate that this association is causal; 3) to evaluate the health benefit that could be obtained by removing the source of exposure. Statistical methods are commonly assumed to provide an objective way of achieving these three steps. This paper reviews some of the conditions that have to be met to allow proper interpretations and to avoid some of the controversies that are often found in health-environment studies. First, it should be remembered that the so-called P value which is used to qualify 'statistically significant' associations between risk factors and diseases does not give any indication of the probability that this association is actual, while far too often it is believed that it does. The probability that an association between an environmental factor and a disease is real could, however, be estimated by using Bayesian methods. These methods require that the a priori probabilities be stated, which is difficult to do in practice. Some directions to overcome this difficulty are presented. Second, the analysis of causality cannot be carried out on statistical grounds alone and the so-called 'causality criteria' are of limited practical interest. Definition of what is a cause, and upon which conditions a candidate factor of a disease can be considered as a cause, deserves much research effort, and careful consideration of the huge literature (mostly outside of the epidemiological field, for example in logic) which is devoted to this subject. Finally, the measurement of the role of a factor in a disease is very often assessed through the use of 'attributable fraction' or 'attributable mortality'. This should be done only when it is demonstrated that the considered factor is causal. Moreover, the interpretation of attributable fractions

  14. The genetic epidemiology of diverticulosis and diverticular disease: Emerging evidence

    Science.gov (United States)

    Reichert, Matthias C

    2015-01-01

    Diverticular disease (DD) is one of the most prevalent gastrointestinal disorders. The pathogenesis of diverticulosis and DD is controversially discussed. Current studies call the traditional concept of a fibre-deficient diet causing the development of diverticula into question. Data from two recent twin studies have provided conclusive evidence for a strong genetic component to diverticulosis. Although genomewide association studies have provided new insights into the polygenic architecture of human diseases, genomic research in diverticulosis and DD has just been started. This is an astonishing fact given the high morbidity and mortality of the disease, as well as the substantial economic burden on health care systems. For this review, we provide an update of the molecular pathobiology and summarise recent evidence supporting the hypothesis that distinct, yet unidentified genetic variants contribute to the development of diverticulosis and DD. PMID:26535118

  15. [Job strain and cardiovascular diseases: epidemiologic evidence and prevention].

    Science.gov (United States)

    Ferrario, M M

    2012-01-01

    The present contribution wishes to draw attention to major evidences from more recent studies on the relationship between job strain (JS) and cardiovascular diseases (CVD). In particular the demand-control model and the effort-reward imbalance models will be reviewed. Different outcomes are considered: first hypertension, second coronary heart disease (CHD), third atherosclerosis progression, and finally stroke. All these results are in favor of the association between JS and CVD, but with relevant discrepancies in different socio-cultural contest, in different gender groups, indifferent socio-occupational strata. A recent meta-analysis considering prospective cohort studies attribute to people with high JS a 50% increment in risk of CHD in men. Evidences are scares per women. Many limitations in study design contributes to explain some of the discrepancies in the results obtained so far. Promising first results have been reported for studies exploring the interaction between JS and genetic connotes on blood pressure values. More researchers are needed. Based on the actually available evidences, it is time anyhow to start promotion activities at the workplace to improve Individual coping as well as improve the work climate, contrasting major stressor related to work organization and relationships.

  16. Environmental chemicals and DNA methylation in adults: a systematic review of the epidemiologic evidence

    Science.gov (United States)

    Current evidence supports the notion that environmental exposures are associated with DNA-methylation and expression changes that can impact human health. Our objective was to conduct a systematic review of epidemiologic studies evaluating the association between environmental chemicals with DNA met...

  17. Shift work and the risk of ischemic heart disease - a systematic review of the epidemiologic evidence

    DEFF Research Database (Denmark)

    Frost, P.; Kolstad, H.A.; Bonde, Jens Peter

    2009-01-01

    Objective The objective of this review was to evaluate the epidemiologic evidence for a causal relation between shift work and ischemic heart disease. Methods We conducted a systematic search until the end of March 2008 for studies providing information on the relative risk of ischemic heart...

  18. Inadequate pain relief and large functional loss among patients with knee osteoarthritis: evidence from a prospective multinational longitudinal study of osteoarthritis real-world therapies.

    Science.gov (United States)

    Conaghan, Philip G; Peloso, Paul M; Everett, Sharlette V; Rajagopalan, Srinivasan; Black, Christopher M; Mavros, Panagiotis; Arden, Nigel K; Phillips, Ceri J; Rannou, François; van de Laar, Mart A F J; Moore, R Andrew; Taylor, Stephanie D

    2015-02-01

    To estimate the prevalence of inadequate pain relief (IPR) among patients with symptomatic knee OA prescribed analgesic therapy and to characterize patients with IPR. Patients ≥50 years old with physician-diagnosed knee OA who had taken topical or oral pain medication for at least 14 days were recruited for this prospective non-interventional study in six European countries. Pain and function were assessed using the Brief Pain Inventory (BPI) and the WOMAC; quality of life (QoL) was assessed using the 12-item short form. IPR was defined as an average pain score of >4 out of 10 on BPI question 5. Of 1187 patients enrolled, 68% were female and the mean age was 68 years (s.d. 9); 639 (54%) met the definition of IPR. Patient responses for the BPI average pain question were well correlated with responses on the WOMAC pain subscale (Spearman r = 0.64, P < 0.001). In multivariate logistic regression, patients with IPR had greater odds of being female [adjusted odds ratio (adjOR) 1.90 (95% CI 1.46, 2.48)] and having OA in both knees [adjOR 1.48 (95% CI 1.15, 1.90)], higher BMI, longer OA duration, depression or diabetes. Patients with IPR (vs non-IPR) were more likely to have worse QoL, greater function loss and greater pain interference. IPR is common among patients with knee OA requiring analgesics and is associated with large functional loss and impaired QoL. Patients at particular risk of IPR, as characterized in this study, may require greater attention towards their analgesic treatment options. https://clinicaltrials.gov/ (NCT01294696). © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology.

  19. Cruciferous Vegetables and Human Cancer Risk: Epidemiologic Evidence and Mechanistic Basis

    OpenAIRE

    Higdon, Jane V.; Delage, Barbara; Williams, David E.; Dashwood, Roderick H.

    2007-01-01

    Cruciferous vegetables are a rich source of glucosinolates and their hydrolysis products, including indoles and isothiocyanates, and high intake of cruciferous vegetables has been associated with lower risk of lung and colorectal cancer in some epidemiological studies. Glucosinolate hydrolysis products alter the metabolism or activity of sex hormones in ways that could inhibit the development of hormone-sensitive cancers, but evidence of an inverse association between cruciferous vegetable in...

  20. Sleep Duration and the Risk of Diabetes Mellitus: Epidemiologic Evidence and Pathophysiologic Insights

    Science.gov (United States)

    Zizi, Ferdinand; Brown, Clinton D.; Ogedegbe, Gbenga; Boutin-Foster, Carla; McFarlane, Samy I.

    2010-01-01

    Evidence from well-defined cohort studies has shown that short sleep, through sleep fragmentation caused by obstructive sleep apnea (OSA) or behavioral sleep curtailment because of lifestyle choices, is associated with increased incidence of diabetes. In this report, we review epidemiologic and clinical data suggesting that OSA is involved in the pathogenesis of altered glucose metabolism. Evidence suggesting increased risk of developing diabetes resulting from curtailed sleep duration is also considered. Proposed mechanisms explaining associations between short sleep and diabetes are examined and clinical management of OSA among patients with diabetes is discussed. PMID:20425066

  1. [Asbestos and harmful health effects: from denial theories to epidemiological evidence].

    Science.gov (United States)

    di Orio, Ferdinando; Zazzara, Francesca

    2013-01-01

    The recent episode involving Eternit, a factory in Casale Monferrato (Turin, Italy), culminated in February 2012 with a guilty verdict for the owners of the factory. The indiscriminate use of asbestos, however, continues worldwide, despite evidence of increased risk for conditions such as asbestosis and malignant pleural mesothelioma. In this study we investigate the relationship between epidemiological evidence and denial theories, over the decades and until the present time. Many countries in the world still promote the use of asbestos, with a view to profit and globalization but at the expense of public health.

  2. Best Practices for Gauging Evidence of Causality in Air Pollution Epidemiology.

    Science.gov (United States)

    Dominici, Francesca; Zigler, Corwin

    2017-12-15

    The contentious political climate surrounding air pollution regulations has brought some researchers and policy-makers to argue that evidence of causality is necessary before implementing more stringent regulations. Recently, investigators in an increasing number of air pollution studies have purported to have used "causal analysis," generating the impression that studies not explicitly labeled as such are merely "associational" and therefore less rigorous. Using 3 prominent air pollution studies as examples, we review good practices for how to critically evaluate the extent to which an air pollution study provides evidence of causality. We argue that evidence of causality should be gauged by a critical evaluation of design decisions such as 1) what actions or exposure levels are being compared, 2) whether an adequate comparison group was constructed, and 3) how closely these design decisions approximate an idealized randomized study. We argue that air pollution studies that are more scientifically rigorous in terms of the decisions made to approximate a randomized experiment are more likely to provide evidence of causality and should be prioritized among the body of evidence for regulatory review accordingly. Our considerations, although presented in the context of air pollution epidemiology, can be broadly applied to other fields of epidemiology. © The Author(s) 2017. 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.

  3. Review: Epidemiological evidence of groundwater contribution to global enteric disease, 1948-2015

    Science.gov (United States)

    Murphy, Heather M.; Prioleau, Morgan D.; Borchardt, Mark A.; Hynds, Paul D.

    2017-06-01

    Globally, approximately 2.2 billion people rely on groundwater for daily consumption. It is widely accepted that groundwater is more pristine than surface water but while this assumption is frequently the case, groundwater is not ubiquitously free of contaminants; accordingly, this presumption can result in an unfounded and potentially hazardous sense of security among owners, operators and users. The current paper presents a review of published literature providing epidemiological evidence of the contribution of groundwater to global human enteric infection. An emphasis is placed on enteric pathogens transmitted via the faecal-oral route, and specifically those associated with acute gastrointestinal illness (AGI). The review identified 649 published groundwater outbreaks globally between 1948 and 2013 and several epidemiological studies that show there is an increased risk of AGI associated with the consumption of untreated groundwater. The review identified that the following five pathogens were responsible for most outbreaks: norovirus, Campylobacter, Shigella, Hepatitis A and Giardia. Crudely, the authors estimate that between 35.2 and 59.4 million cases of AGI per year globally could be attributable to the consumption of groundwater. Although groundwater is frequently presumed to be a microbiologically safe source of water for consumption, this review demonstrates that consumers served by an untreated groundwater supply remain at risk to enteric disease. The authors conclude that collaboration between microbiologists, hydrogeologists and epidemiologists is needed to better understand pathogen occurrence, persistence, detection and transport in groundwater as well as build stronger epidemiological evidence documenting the true magnitude of disease associated with groundwater globally.

  4. Updating the Evidence for Physical Activity: Summative Reviews of the Epidemiological Evidence, Prevalence, and Interventions to Promote "Active Aging".

    Science.gov (United States)

    Bauman, Adrian; Merom, Dafna; Bull, Fiona C; Buchner, David M; Fiatarone Singh, Maria A

    2016-04-01

    There is a global imperative to increase awareness of the emerging evidence on physical activity (PA) among older adults. "Healthy aging" has traditionally focused on preventing chronic disease, but greater efforts are required to reduce frailty and dependency and to maintain independent physical and cognitive function and mental health and well-being. This integrated review updates the epidemiological data on PA, summarizes the existing evidence-based PA guidelines, describes the global magnitude of inactivity, and finally describes the rationale for action. The first section updates the epidemiological evidence for reduced cardiometabolic risk, reduced risks of falls, the burgeoning new evidence on improved cognitive function and functional capacity, and reduced risk of depression, anxiety, and dementia. This is followed by a summary of population prevalence studies among older adults. Finally, we present a "review of reviews" of PA interventions delivered from community or population settings, followed by a consideration of interventions among the "oldest-old," where efforts are needed to increase resistance (strength) training and balance. This review identifies the global importance of considering "active aging" beyond the established benefits attributed to noncommunicable disease prevention alone. Innovative population-level efforts are required to address physical inactivity, prevent loss of muscle strength, and maintain balance in older adults. Specific investment in healthy aging requires global policy support from the World Health Organization and is implemented at the national and regional levels, in order to reduce the burden of disease and disability among older adults. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Clinical intuition versus statistics: different modes of tacit knowledge in clinical epidemiology and evidence-based medicine.

    Science.gov (United States)

    Braude, Hillel D

    2009-01-01

    Despite its phenomenal success since its inception in the early nineteen-nineties, the evidence-based medicine movement has not succeeded in shaking off an epistemological critique derived from the experiential or tacit dimensions of clinical reasoning about particular individuals. This critique claims that the evidence-based medicine model does not take account of tacit knowing as developed by the philosopher Michael Polanyi. However, the epistemology of evidence-based medicine is premised on the elimination of the tacit dimension from clinical judgment. This is demonstrated through analyzing the dichotomy between clinical and statistical intuition in evidence-based medicine's epistemology of clinical reasoning. I argue that clinical epidemiology presents a more nuanced epistemological model for the application of statistical epidemiology to the clinical context. Polanyi's theory of tacit knowing is compatible with the model of clinical reasoning associated with clinical epidemiology, but not evidence-based medicine.

  6. Genetic-epidemiological evidence for the role of acetaldehyde in cancers related to alcohol drinking.

    Science.gov (United States)

    Eriksson, C J Peter

    2015-01-01

    Alcohol drinking increases the risk for a number of cancers. Currently, the highest risk (Group 1) concerns oral cavity, pharynx, larynx, esophagus, liver, colorectum, and female breast, as assessed by the International Agency for Research on Cancer (IARC). Alcohol and other beverage constituents, their metabolic effects, and alcohol-related unhealthy lifestyles have been suggested as etiological factors. The aim of the present survey is to evaluate the carcinogenic role of acetaldehyde in alcohol-related cancers, with special emphasis on the genetic-epidemiological evidence. Acetaldehyde, as a constituent of alcoholic beverages, and microbial and endogenous alcohol oxidation well explain why alcohol-related cancers primarily occur in the digestive tracts and other tissues with active alcohol and acetaldehyde metabolism. Genetic-epidemiological research has brought compelling evidence for the causality of acetaldehyde in alcohol-related cancers. Thus, IARC recently categorized alcohol-drinking-related acetaldehyde to Group 1 for head and neck and esophageal cancers. This is probably just the tip of the iceberg, since more recent epidemiological studies have also shown significant positive associations between the aldehyde dehydrogenase ALDH2 (rs671)*2 allele (encoding inactive enzyme causing high acetaldehyde elevations) and gastric, colorectal, lung, and hepatocellular cancers. However, a number of the current studies lack the appropriate matching or stratification of alcohol drinking in the case-control comparisons, which has led to erroneous interpretations of the data. Future studies should consider these aspects more thoroughly. The polymorphism phenotypes (flushing and nausea) may provide valuable tools for future successful health education in the prevention of alcohol-drinking-related cancers.

  7. Low quality evidence of epidemiological observational studies on leishmaniasis in Brazil.

    Science.gov (United States)

    Trentini, Bruno; Steindel, Mário; Marlow, Mariel A

    2014-01-01

    Brazil has implemented systematic control methods for leishmaniasis for the past 30 years, despite an increase in cases and continued spread of the disease to new regions. A lack high quality evidence from epidemiological observational studies impedes the development of novel control methods to prevent disease transmission among the population. Here, we have evaluated the quality of observational studies on leishmaniasis conducted in Brazil to highlight this issue. For this systematic review, all publications on leishmaniasis conducted in Brazil from January 1st, 2002 to December 31st, 2012 were screened via Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to select observational studies involving human subjects. The 283 included studies, representing only 14.1% of articles screened, were then further evaluated for quality of epidemiological methods and study design based on the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) checklists. Over half of these studies were descriptive or case reports (53.4%, 151), followed by cross-sectional (20.8%, n = 59), case-control (8.5%, n = 24), and cohort (6.0%, n = 17). Study design was not stated in 46.6% (n = 181) and incorrectly stated in 17.5% (n = 24). Comparison groups were utilized in just 39.6% (n = 112) of the publications, and only 13.4% (n = 38) employed healthy controls. Majority of studies were performed at the city-level (62.9%, n = 178), in contrast with two (0.7%) studies performed at the national-level. Coauthorship networks showed the number of author collaborations rapidly decreased after three collaborations, with 70.9% (n = 659/929) of coauthors publishing only one article during the study period. A review of epidemiological research in Brazil revealed a major lack of quality and evidence. While certain indicators suggested research methods may have improved in the last two years, an emphasis on observational research which employs

  8. Low quality evidence of epidemiological observational studies on leishmaniasis in Brazil.

    Directory of Open Access Journals (Sweden)

    Bruno Trentini

    Full Text Available Brazil has implemented systematic control methods for leishmaniasis for the past 30 years, despite an increase in cases and continued spread of the disease to new regions. A lack high quality evidence from epidemiological observational studies impedes the development of novel control methods to prevent disease transmission among the population. Here, we have evaluated the quality of observational studies on leishmaniasis conducted in Brazil to highlight this issue.For this systematic review, all publications on leishmaniasis conducted in Brazil from January 1st, 2002 to December 31st, 2012 were screened via Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA checklist to select observational studies involving human subjects. The 283 included studies, representing only 14.1% of articles screened, were then further evaluated for quality of epidemiological methods and study design based on the STROBE (Strengthening the Reporting of Observational studies in Epidemiology checklists. Over half of these studies were descriptive or case reports (53.4%, 151, followed by cross-sectional (20.8%, n = 59, case-control (8.5%, n = 24, and cohort (6.0%, n = 17. Study design was not stated in 46.6% (n = 181 and incorrectly stated in 17.5% (n = 24. Comparison groups were utilized in just 39.6% (n = 112 of the publications, and only 13.4% (n = 38 employed healthy controls. Majority of studies were performed at the city-level (62.9%, n = 178, in contrast with two (0.7% studies performed at the national-level. Coauthorship networks showed the number of author collaborations rapidly decreased after three collaborations, with 70.9% (n = 659/929 of coauthors publishing only one article during the study period.A review of epidemiological research in Brazil revealed a major lack of quality and evidence. While certain indicators suggested research methods may have improved in the last two years, an emphasis on observational research which employs

  9. Consequences of Inadequate Physical Activity

    Centers for Disease Control (CDC) Podcasts

    2018-03-27

    Listen as CDC Epidemiologist Susan Carlson, PhD, talks about her research, which estimates the percentage of US deaths attributed to inadequate levels of physical activity.  Created: 3/27/2018 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/27/2018.

  10. Radiologists' responses to inadequate referrals

    International Nuclear Information System (INIS)

    Lysdahl, Kristin Bakke; Hofmann, Bjoern Morten; Espeland, Ansgar

    2010-01-01

    To investigate radiologists' responses to inadequate imaging referrals. A survey was mailed to Norwegian radiologists; 69% responded. They graded the frequencies of actions related to referrals with ambiguous indications or inappropriate examination choices and the contribution of factors preventing and not preventing an examination of doubtful usefulness from being performed as requested. Ninety-five percent (344/361) reported daily or weekly actions related to inadequate referrals. Actions differed among subspecialties. The most frequent were contacting the referrer to clarify the clinical problem and checking test results/information in the medical records. Both actions were more frequent among registrars than specialists and among hospital radiologists than institute radiologists. Institute radiologists were more likely to ask the patient for additional information and to examine the patient clinically. Factors rated as contributing most to prevent doubtful examinations were high risk of serious complications/side effects, high radiation dose and low patient age. Factors facilitating doubtful examinations included respect for the referrer's judgment, patient/next-of-kin wants the examination, patient has arrived, unreachable referrer, and time pressure. In summary, radiologists facing inadequate referrals considered patient safety and sought more information. Vetting referrals on arrival, easier access to referring clinicians, and time for radiologists to handle inadequate referrals may contribute to improved use of imaging. (orig.)

  11. Patients' perceptions of their heart attack and recovery: the influence of epidemiological "evidence" and personal experience.

    Science.gov (United States)

    Wiles, R

    1998-06-01

    Secondary prevention of heart disease is widely viewed as likely to be more successful and cost effective than primary prevention. However, people's willingness to adopt lifestyle change is a complex issue in which people's perceptions of disease causation and risk as well as a range of socio-economic factors are important. This paper reports on a qualitative study of people following heart attack which examines their understandings of heart attack and the salience that lifestyle advice has in the light of these understandings. In-depth, qualitative interviews were conducted with 25 people recovering from heart attack. Each person was interviewed twice: at around two weeks and five months following their heart attack. The study found that information about recovery provided by health professionals was based on a simplified version of epidemiological evidence. This information played a central role in people's understandings about the nature of heart attack and their future risk in the early weeks following heart attack. However, as interviewees came to terms with the shock of the event, they tended to lose their trust in "official" accounts of cause and recovery and evidence from lay epidemiology that contradicted official accounts tended to emerge. This evidence encouraged interviewees to question the explanatory power of official accounts and to view the adoption of long-term lifestyle change as an action that would not guarantee protection from a further heart attack. This was true whether or not people's experiences of recovery reflected those "predicted" by health professionals although those awaiting further surgery or tests tended to maintain trust in official accounts over a longer period. It is concluded that the failure of official accounts to acknowledge the random nature of the occurrence of heart attack, the severity of heart attack and the level of recovery from heart attack is a central feature in people's reluctance to view lifestyle change as a

  12. Solvents and Parkinson disease: A systematic review of toxicological and epidemiological evidence

    Energy Technology Data Exchange (ETDEWEB)

    Lock, Edward A., E-mail: e.lock@ljmu.ac.uk [Liverpool John Moores University, School of Pharmacy and Biomolecular Sciences, Byrom Street, Liverpool (United Kingdom); Zhang, Jing [University of Washington, Department of Pathology, School of Medicine, Seattle, WA (United States); Checkoway, Harvey [University of Washington, Department of Environmental and Occupational Health Sciences, Seattle, WA (United States)

    2013-02-01

    Parkinson disease (PD) is a debilitating neurodegenerative motor disorder, with its motor symptoms largely attributable to loss of dopaminergic neurons in the substantia nigra. The causes of PD remain poorly understood, although environmental toxicants may play etiologic roles. Solvents are widespread neurotoxicants present in the workplace and ambient environment. Case reports of parkinsonism, including PD, have been associated with exposures to various solvents, most notably trichloroethylene (TCE). Animal toxicology studies have been conducted on various organic solvents, with some, including TCE, demonstrating potential for inducing nigral system damage. However, a confirmed animal model of solvent-induced PD has not been developed. Numerous epidemiologic studies have investigated potential links between solvents and PD, yielding mostly null or weak associations. An exception is a recent study of twins indicating possible etiologic relations with TCE and other chlorinated solvents, although findings were based on small numbers, and dose–response gradients were not observed. At present, there is no consistent evidence from either the toxicological or epidemiologic perspective that any specific solvent or class of solvents is a cause of PD. Future toxicological research that addresses mechanisms of nigral damage from TCE and its metabolites, with exposure routes and doses relevant to human exposures, is recommended. Improvements in epidemiologic research, especially with regard to quantitative characterization of long-term exposures to specific solvents, are needed to advance scientific knowledge on this topic. -- Highlights: ► The potential for organic solvents to cause Parkinson's disease has been reviewed. ► Twins study suggests etiologic relations with chlorinated solvents and Parkinson's. ► Animal studies with TCE showed potential to cause damage to dopaminergic neurons. ► Need to determine if effects in animals are relevant to human

  13. Solvents and Parkinson disease: A systematic review of toxicological and epidemiological evidence

    International Nuclear Information System (INIS)

    Lock, Edward A.; Zhang, Jing; Checkoway, Harvey

    2013-01-01

    Parkinson disease (PD) is a debilitating neurodegenerative motor disorder, with its motor symptoms largely attributable to loss of dopaminergic neurons in the substantia nigra. The causes of PD remain poorly understood, although environmental toxicants may play etiologic roles. Solvents are widespread neurotoxicants present in the workplace and ambient environment. Case reports of parkinsonism, including PD, have been associated with exposures to various solvents, most notably trichloroethylene (TCE). Animal toxicology studies have been conducted on various organic solvents, with some, including TCE, demonstrating potential for inducing nigral system damage. However, a confirmed animal model of solvent-induced PD has not been developed. Numerous epidemiologic studies have investigated potential links between solvents and PD, yielding mostly null or weak associations. An exception is a recent study of twins indicating possible etiologic relations with TCE and other chlorinated solvents, although findings were based on small numbers, and dose–response gradients were not observed. At present, there is no consistent evidence from either the toxicological or epidemiologic perspective that any specific solvent or class of solvents is a cause of PD. Future toxicological research that addresses mechanisms of nigral damage from TCE and its metabolites, with exposure routes and doses relevant to human exposures, is recommended. Improvements in epidemiologic research, especially with regard to quantitative characterization of long-term exposures to specific solvents, are needed to advance scientific knowledge on this topic. -- Highlights: ► The potential for organic solvents to cause Parkinson's disease has been reviewed. ► Twins study suggests etiologic relations with chlorinated solvents and Parkinson's. ► Animal studies with TCE showed potential to cause damage to dopaminergic neurons. ► Need to determine if effects in animals are relevant to human exposure

  14. No evidence for involvement of sheep in the epidemiology of cattle virulent epizootic hemorrhagic disease virus.

    Science.gov (United States)

    Kedmi, M; Levi, S; Galon, N; Bomborov, V; Yadin, H; Batten, C; Klement, E

    2011-03-24

    Epizootic hemorrhagic disease virus (EHDV) is an Orbivirus. While not previously considered as an important disease in cattle, several EHDV serotypes (EHDV-6 and 7) have recently been implicated in disease outbreaks. The involvement of sheep in the epidemiology of EHDV is still not understood. In this study we compared the prevalence of antibodies to EHDV and bluetongue virus (BTV) in sheep to their prevalence in cattle after an outbreak of EHDV that occurred in Israel during 2006. Sixty-six sheep and lambs scattered in seven herds were compared to 114 cows and calves scattered in 13 dairy cattle herds, matched to the sheep herds by location. While antibody prevalence to EHDV was high in cattle (35.2% within the outbreak zone) no evidence of exposure to EHDV was found in sheep (p<0.0001). Antibodies to BTV were apparent in both cattle and sheep though in the former it was significantly higher (63.2%, 16.7% respectively, p<0.0001), suggesting higher exposure of cattle to biting Culicoides midges. Taken together, these results imply that sheep have a negligible role in the epidemiology of EHDV. Copyright © 2010 Elsevier B.V. All rights reserved.

  15. Essential evidence for guiding health system priorities and policies: anticipating epidemiological transition in Africa.

    Science.gov (United States)

    Byass, Peter; de Savigny, Don; Lopez, Alan D

    2014-01-01

    Despite indications that infection-related mortality in sub-Saharan Africa may be decreasing and the burden of non-communicable diseases increasing, the overwhelming reality is that health information systems across most of sub-Saharan Africa remain too weak to track epidemiological transition in a meaningful and effective way. We propose a minimum dataset as the basis of a functional health information system in countries where health information is lacking. This would involve continuous monitoring of cause-specific mortality through routine civil registration, regular documentation of exposure to leading risk factors, and monitoring effective coverage of key preventive and curative interventions in the health sector. Consideration must be given as to how these minimum data requirements can be effectively integrated within national health information systems, what methods and tools are needed, and ensuring that ethical and political issues are addressed. A more strategic approach to health information systems in sub-Saharan African countries, along these lines, is essential if epidemiological changes are to be tracked effectively for the benefit of local health planners and policy makers. African countries have a unique opportunity to capitalize on modern information and communications technology in order to achieve this. Methodological standards need to be established and political momentum fostered so that the African continent's health status can be reliably tracked. This will greatly strengthen the evidence base for health policies and facilitate the effective delivery of services.

  16. Essential evidence for guiding health system priorities and policies: anticipating epidemiological transition in Africa

    Directory of Open Access Journals (Sweden)

    Peter Byass

    2014-05-01

    Full Text Available Background: Despite indications that infection-related mortality in sub-Saharan Africa may be decreasing and the burden of non-communicable diseases increasing, the overwhelming reality is that health information systems across most of sub-Saharan Africa remain too weak to track epidemiological transition in a meaningful and effective way. Proposals: We propose a minimum dataset as the basis of a functional health information system in countries where health information is lacking. This would involve continuous monitoring of cause-specific mortality through routine civil registration, regular documentation of exposure to leading risk factors, and monitoring effective coverage of key preventive and curative interventions in the health sector. Consideration must be given as to how these minimum data requirements can be effectively integrated within national health information systems, what methods and tools are needed, and ensuring that ethical and political issues are addressed. A more strategic approach to health information systems in sub-Saharan African countries, along these lines, is essential if epidemiological changes are to be tracked effectively for the benefit of local health planners and policy makers. Conclusion: African countries have a unique opportunity to capitalize on modern information and communications technology in order to achieve this. Methodological standards need to be established and political momentum fostered so that the African continent's health status can be reliably tracked. This will greatly strengthen the evidence base for health policies and facilitate the effective delivery of services.

  17. Folic acid and colorectal cancer prevention: molecular mechanisms and epidemiological evidence (Review).

    Science.gov (United States)

    Ströhle, Alexander; Wolters, Maike; Hahn, Andreas

    2005-06-01

    Epidemiological studies suggest that a diet rich in fruits and vegetables protects against colorectal cancer. This effect may result from their high levels of folic acid (pteroylglutamic acid). Folic acid holds a key position in DNA synthesis and mitosis as well as DNA methylation and regulation of gene expression. Folic acid deficiency has been associated with site- and gene specific DNA hypo- and hypermethylation. Furthermore thymidylate synthesis is restricted by folic acid deficiency which causes misincorporation of nucleotides and DNA strand breaks. Much epidemiological evidence supports the hypothesis that insufficient folic acid supply favors the development of colorectal tumors, particularly prospective studies have supported this connection. However, the data from case-control studies are less consistent. Functional polymorphisms in folate-metabolizing genes, especially the methylenetetrahydrofolate reductase (MTHFR) are capable of modifying the risk of colorectal cancer. Observational studies show that individuals with the homozygote genotype for the MTHFR (677C-->T) polymorphism are at higher risk when folic acid supply is low. Currently there are only few human intervention trials which show that folic acid can modify and inhibit the development of colorectal tumors. Additional studies are required in order to determine whether folic acid will be a useful agent in colorectal cancer prevention.

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

    Directory of Open Access Journals (Sweden)

    Kyong Hye Joung

    2015-01-01

    Full Text Available 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.

  19. Asbestos exposure and health hazards: a global emergency, Epidemiological evidence and denial theories

    Directory of Open Access Journals (Sweden)

    Francesca Zazzara

    2013-01-01

    Full Text Available On June 3rd 2013, in Turin, Italy, the Swiss industrialist Schmidheiny has been sentenced to 18 years imprisonment for intentional disaster for 3,000 asbestos-linked tumours in Italian workers at cement multinational Eternit. The indiscriminate use of asbestos, however, continues worldwide. Although many studies have shown that asbestos is associated with an increased risk of mortality and morbidity, denial theories were spread over time, showing how the logic of profit governs the production of asbestos. We examined the history of the epidemiological evidence of asbestos related risks and, second, the main sources of exposure in Italy and in the world, occupational, non-occupational, and post-disaster exposure (as occurred after L’Aquila earthquake in April 2009. The theme of inequality and social justice is ever so alarming in the fight against asbestos and its lobbies.

  20. Asbestos exposure and health hazards: a global emergency, Epidemiological evidence and denial theories

    Directory of Open Access Journals (Sweden)

    Francesca Zazzara

    2013-11-01

    Full Text Available On June 3rd 2013, in Turin, Italy, the Swiss industrialist Schmidheiny has been sentenced to 18 years imprisonment for intentional disaster for 3,000 asbestos-linked tumours in Italian workers at cement multinational Eternit. The indiscriminate use of asbestos, however, continues worldwide. Although many studies have shown that asbestos is associated with an increased risk of mortality and morbidity, denial theories were spread over time, showing how the logic of profit governs the production of asbestos. We examined the history of the epidemiological evidence of asbestos related risks and, second, the main sources of exposure in Italy and in the world, occupational, non-occupational, and post-disaster exposure (as occurred after L’Aquila earthquake in April 2009. The theme of inequality and social justice is ever so alarming in the fight against asbestos and its lobbies.

  1. The Link Between Inadequate Sleep and Obesity in Young Adults.

    Science.gov (United States)

    Vargas, Perla A

    2016-03-01

    The prevalence of obesity has increased dramatically over the past decade. Although an imbalance between caloric intake and physical activity is considered a key factor responsible for the increase, there is emerging evidence suggesting that other factors may be important contributors to weight gain, including inadequate sleep. Overall research evidence suggests that inadequate sleep is associated with obesity. Importantly, the strength and trajectory of the association seem to be influenced by multiple factors including age. Although limited, the emerging evidence suggests young adults might be at the center of a "perfect health storm," exposing them to the highest risk for obesity and inadequate sleep. Unfortunately, the methods necessary for elucidating the complex relationship between sleep and obesity are lacking. Uncovering the underlying factors and trajectories between inadequate sleep and weight gain in different populations may help to identify the windows of susceptibility and to design targeted interventions to prevent the negative impact of obesity and related diseases.

  2. 3.2 million stillbirths: epidemiology and overview of the evidence review.

    Science.gov (United States)

    Lawn, Joy E; Yakoob, Mohammad Yawar; Haws, Rachel A; Soomro, Tanya; Darmstadt, Gary L; Bhutta, Zulfiqar A

    2009-05-07

    More than 3.2 million stillbirths occur globally each year, yet stillbirths are largely invisible in global data tracking, policy dialogue and programme implementation. This mismatch of burden to action is due to a number of factors that keep stillbirths hidden, notably a lack of data and a lack of consensus on priority interventions, but also to social taboos that reduce the visibility of stillbirths and the associated family mourning. Whilst there are estimates of the numbers of stillbirths, to date there has been no systematic global analysis of the causes of stillbirths. The multiple classifications systems in use are often complex and are primarily focused on high-income countries. We review available data and propose a programmatic classification that is feasible and comparable across settings. We undertook a comprehensive global review of available information on stillbirths in order to 1) identify studies that evaluated risk factors and interventions to reduce stillbirths, 2) evaluate the level of evidence for interventions, 3) place the available evidence for interventions in a health systems context to guide programme implementation, and 4) elucidate key implementation, monitoring, and research gaps. This first paper in the series outlines issues in stillbirth data availability and quality, the global epidemiology of stillbirths, and describes the methodology and framework used for the review of interventions and strategies.

  3. [Physical activity, physical fitness, and overweight in children and adolescents: evidence from epidemiologic studies].

    Science.gov (United States)

    Ortega, Francisco B; Ruiz, Jonatan R; Castillo, Manuel J

    2013-10-01

    Physical activity and fitness play a significant role in prevention of overweight and obesity in children and adolescents. Current understanding and evidence from epidemiologic studies provide useful insights to better understand how they relate to each other and how to develop future intervention strategies. This paper summarizes the most relevant information from cross-sectional and longitudinal studies on the relationships between physical activity, physical fitness, and overweight in early life. According to current scientific evidence: (i) High levels of physical activity during childhood and adolescence, particularly vigorous physical activity, are associated to lower total and central adiposity at this age and later in life; (ii) the level of physical fitness, especially aerobic fitness, is inversely related to current and future adiposity levels; (iii) overweight children and adolescents with a high fitness level have a healthier cardiovascular profile than their overweight, low fit peers and a similar profile to their normal weight, low fit peers. This suggests that high fitness levels may counteract the negative consequences attributed to body fat. These findings suggest that increasing physical fitness in overweight children and adolescents may have many positive effects on health, including lower body fat levels. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  4. Gastric cancer and allium vegetable intake: a critical review of the experimental and epidemiologic evidence.

    Science.gov (United States)

    Guercio, Valentina; Galeone, Carlotta; Turati, Federica; La Vecchia, Carlo

    2014-01-01

    There are suggestions of an anticancerogenic effect of allium vegetables and their associated organosulfur components against several cancer types, including gastric cancer, but the issue remains open to discussion and quantification. The present critical review discussed the history, the health properties, the chemistry, the anticancerogenic evidences from experimental studies, and the anticancer mechanisms of allium vegetables. We also summarized findings from epidemiological studies concerning the association between different types of allium vegetables and gastric cancer risk, published up to date. Available data, derived mainly from case-control studies, suggested a favorable role of high intakes of allium vegetables, mainly garlic and onion, in the etiology of gastric cancer. In particular, of 10 studies, 7 suggested a favorable role of high intake of total allium vegetables and gastric cancer. All 14 studies on garlic and most studies on onion (more than 80%) reported a beneficial role of these allium types against gastric cancer. However several limitations, including possible publication bias and the difficulty to establish a dose-risk relationship, suggest caution in the interpretation. Evidences on other types of allium vegetables, as well as on the influence of different gastric cancer anatomical and histological types, are less consistent.

  5. Cruciferous vegetables and human cancer risk: epidemiologic evidence and mechanistic basis.

    Science.gov (United States)

    Higdon, Jane V; Delage, Barbara; Williams, David E; Dashwood, Roderick H

    2007-03-01

    Cruciferous vegetables are a rich source of glucosinolates and their hydrolysis products, including indoles and isothiocyanates, and high intake of cruciferous vegetables has been associated with lower risk of lung and colorectal cancer in some epidemiological studies. Glucosinolate hydrolysis products alter the metabolism or activity of sex hormones in ways that could inhibit the development of hormone-sensitive cancers, but evidence of an inverse association between cruciferous vegetable intake and breast or prostate cancer in humans is limited and inconsistent. Organizations such as the National Cancer Institute recommend the consumption of five to nine servings of fruits and vegetables daily, but separate recommendations for cruciferous vegetables have not been established. Isothiocyanates and indoles derived from the hydrolysis of glucosinolates, such as sulforaphane and indole-3-carbinol (I3C), have been implicated in a variety of anticarcinogenic mechanisms, but deleterious effects also have been reported in some experimental protocols, including tumor promotion over prolonged periods of exposure. Epidemiological studies indicate that human exposure to isothiocyanates and indoles through cruciferous vegetable consumption may decrease cancer risk, but the protective effects may be influenced by individual genetic variation (polymorphisms) in the metabolism and elimination of isothiocyanates from the body. Cooking procedures also affect the bioavailability and intake of glucosinolates and their derivatives. Supplementation with I3C or the related dimer 3,3'-diindolylmethane (DIM) alters urinary estrogen metabolite profiles in women, but the effects of I3C and DIM on breast cancer risk are not known. Small preliminary trials in humans suggest that I3C supplementation may be beneficial in treating conditions related to human papilloma virus infection, such as cervical intraepithelial neoplasia and recurrent respiratory papillomatosis, but larger randomized

  6. An evidence-based analysis of epidemiologic associations between lymphatic and hematopoietic cancers and occupational exposure to gasoline.

    Science.gov (United States)

    Keenan, J J; Gaffney, S; Gross, S A; Ronk, C J; Paustenbach, D J; Galbraith, D; Kerger, B D

    2013-10-01

    The presence of benzene in motor gasoline has been a health concern for potential increased risk of acute myelogenous leukemia and perhaps other lymphatic/hematopoietic cancers for approximately 40 years. Because of the widespread and increasing use of gasoline by consumers and the high exposure potential of occupational cohorts, a thorough understanding of this issue is important. The current study utilizes an evidence-based approach to examine whether or not the available epidemiologic studies demonstrate a strong and consistent association between occupational exposure to gasoline and lymphatic/hematopoietic cancers. Among 67 epidemiologic studies initially identified, 54 were ranked according to specific criteria relating to the relevance and robustness of each study for answering the research question. The 30 highest-ranked studies were sorted into three tiers of evidence and were analyzed for strength, specificity, consistency, temporality, dose-response trends and coherence. Meta statistics were also calculated for each general and specific lymphatic/hematopoietic cancer category with adequate data. The evidence-based analysis did not confirm any strong and consistent association between occupational exposure to gasoline and lymphatic/hematopoietic cancers based on the epidemiologic studies available to date. These epidemiologic findings, combined with the evidence showing relatively low occupational benzene vapor exposures associated with gasoline formulations during the last three decades, suggest that current motor gasoline formulations are not associated with increased lymphatic/hematopoietic cancer risks related to benzene.

  7. [Inadequate treatment of affective disorders].

    Science.gov (United States)

    Bergsholm, P; Martinsen, E W; Holsten, F; Neckelmann, D; Aarre, T F

    1992-08-30

    Inadequate treatment of mood (affective) disorders is related to the mind/body dualism, desinformation about methods of treatment, the stigma of psychiatry, low funding of psychiatric research, low educational priority, and slow acquisition of new knowledge of psychiatry. The "respectable minority rule" has often been accepted without regard to the international expertise, and the consequences of undertreatment have not been weighed against the benefits of optimal treatment. The risk of chronicity increases with delayed treatment, and inadequately treated affective disorders are a leading cause of suicide. During the past 20 years the increase in suicide mortality in Norway has been the second largest in the world. Severe mood disorders are often misclassified as schizophrenia or other non-affective psychoses. Atypical mood disorders, notably rapid cycling and bipolar mixed states, are often diagnosed as personality, adjustment, conduct, attention deficit, or anxiety disorders, and even mental retardation. Neuroleptic drugs may suppress the most disturbing features of mood disorders, a fact often misinterpreted as supporting the diagnosis of a schizophrenia-like disorder. Treatment with neuroleptics is not sufficient, however, and serious side effects may often occur. The consequences are too often social break-down and post-depression syndrome.

  8. The burden, epidemiology, costs and treatment for Duchenne muscular dystrophy: an evidence review.

    Science.gov (United States)

    Ryder, S; Leadley, R M; Armstrong, N; Westwood, M; de Kock, S; Butt, T; Jain, M; Kleijnen, J

    2017-04-26

    Duchenne Muscular Dystrophy (DMD) is a rapidly progressive, lethal neuromuscular disorder, present from birth, which occurs almost exclusively in males. We have reviewed contemporary evidence of burden, epidemiology, illness costs and treatment patterns of DMD. This systematic review adhered to published methods with information also sought from the web and contacting registries. Searches were carried out from 2005 to June 2015. The population of interest was individuals with clearly defined DMD or their carers. Nine thousand eight hundred fifty titles were retrieved from searches. Fifty-eight studies were reviewed with three assessed as high, 33 as medium and 22 as low quality. We found two studies reporting birth and four reporting point prevalence, three reporting mortality, 41 reporting severity and/or progression, 18 reporting treatment patterns, 12 reporting quality of life, two reporting utility measures, three reporting costs of illness and three treatment guidelines. Birth prevalence ranged from 15.9 to 19.5 per 100,000 live births. Point prevalence per 100,000 males was for France, USA, UK and Canada, 10.9, 1.9, 2.2 and 6.1 respectively. A study of adult DMD patients at a centre in France found median survival for those born between 1970 and 1994 was 40.95 years compared to 25.77 years for those born between 1955 and 1969. Loss of ambulation occurred at a median age of 12 and ventilation starts at about 20 years. There was international variation in use of corticosteroids, scoliosis surgery, ventilation and physiotherapy. The economic cost of DMD climbs dramatically with disease progression - rising as much as 5.7 fold from the early ambulatory phase to the non-ambulatory phase in Germany. This is the first systematic review of treatment, progression, severity and quality of life in DMD. It also provides the most recent description of the burden, epidemiology, illness costs and treatment patterns in DMD. There are evidence gaps, particularly in

  9. Environmental and Genetic Contributors to Hypospadias: A Review of the Epidemiologic Evidence

    Science.gov (United States)

    Carmichael, Suzan L.; Shaw, Gary M.; Lammer, Edward J.

    2012-01-01

    This review evaluates current knowledge related to trends in the prevalence of hypospadias, the association of hypospadias with endocrine-disrupting exposures, and the potential contribution of genetic susceptibility to its etiology. The review focuses on epidemiologic evidence. Increasing prevalence of hypospadias has been observed, but such increases tend to be localized to specific regions or time periods. Thus, generalized statements that hypospadias is increasing are unsupported. Due to limitations of study designs and inconsistent results, firm conclusions cannot be made regarding the association of endocrine-disrupting exposures with hypospadias. Studies with more rigorous study designs (e.g., larger and more detailed phenotypes) and exposure assessment that encompasses more breadth as well as depth (e.g., specific endocrine-related chemicals) will be critical to make better inferences about these important environmental exposures. Many candidate genes for hypospadias have been identified, but few of them have been examined to an extent that enables solid conclusions. Further studies are needed that include larger sample sizes, comparison groups that are more representative of the populations from which the cases were derived, phenotype-specific analyses, and more extensive exploration of variants. In conclusion, examining the associations of environmental and genetic factors with hypospadias remain important areas of inquiry, although our actual understanding of their contribution to hypospadias risk in humans is currently limited. PMID:22678668

  10. Epidemiological evidence of higher susceptibility to vCJD in the young

    Directory of Open Access Journals (Sweden)

    Valleron Alain-Jacques

    2004-08-01

    Full Text Available Abstract Background The strikingly young age of new variant Creutzfeldt-Jacob disease (vCJD cases remains unexplained. Age dependent susceptibility to infection has been put forward, but differential dietary exposure to contaminated food products in the UK population according to age and sex during the bovine spongiform encephalopathy (BSE epidemic may provide a simpler explanation. Methods Using recently published estimates of dietary exposure in mathematical models of the epidemiology of the new variant Creutzfeldt Jacob disease (vCJD, we examine whether the age characteristics of vCJD cases may be reproduced. Results The susceptibility/exposure risk function has likely peaked in adolescents and was followed by a sharp decrease with age, evocative of the profile of exposure to bovine material consumption according to age. However, assuming that the risk of contamination was proportional to exposure, with no age dependent susceptibility, the model failed to reproduce the observed age characteristics of the vCJD cases: The predicted cumulated proportion of cases over 40 years was 48%, in strong disagreement with the observed 10%. Incorporating age dependent susceptibility led to a cumulated proportion of cases over 40 years old of 12%. Conclusions This analysis provides evidence that differential dietary exposure alone fails to explain the pattern of age in vCJD cases. Decreasing age related susceptibility is required to reproduce the characteristics of the age distribution of vCJD cases.

  11. Joint effects of climate variability and socioecological factors on dengue transmission: epidemiological evidence.

    Science.gov (United States)

    Akter, Rokeya; Hu, Wenbiao; Naish, Suchithra; Banu, Shahera; Tong, Shilu

    2017-06-01

    To assess the epidemiological evidence on the joint effects of climate variability and socioecological factors on dengue transmission. Following PRISMA guidelines, a detailed literature search was conducted in PubMed, Web of Science and Scopus. Peer-reviewed, freely available and full-text articles, considering both climate and socioecological factors in relation to dengue, published in English from January 1993 to October 2015 were included in this review. Twenty studies have met the inclusion criteria and assessed the impact of both climatic and socioecological factors on dengue dynamics. Among those, four studies have further investigated the relative importance of climate variability and socioecological factors on dengue transmission. A few studies also developed predictive models including both climatic and socioecological factors. Due to insufficient data, methodological issues and contextual variability of the studies, it is hard to draw conclusion on the joint effects of climate variability and socioecological factors on dengue transmission. Future research should take into account socioecological factors in combination with climate variables for a better understanding of the complex nature of dengue transmission as well as for improving the predictive capability of dengue forecasting models, to develop effective and reliable early warning systems. © 2017 John Wiley & Sons Ltd.

  12. Interstitial cystitis/painful bladder syndrome: epidemiology, pathophysiology and evidence-based treatment options.

    Science.gov (United States)

    Davis, N F; Brady, C M; Creagh, T

    2014-04-01

    Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic debilitating condition that can have a severely negative impact on a patient's quality of life. Its prevalence ranges from 52 to 500/100,000 in females compared to 8-41/100,000 in males, and its incidence is increasing globally. Treatment algorithms are sub-classified into behavioural, pharmacological, intravesical, interventional and surgical therapies. Short-term (i.e. <1 year) cure rates range from 50% to 75% for non-/minimally-invasive therapies, but repeat administration of a therapeutic agent is required. Although definitive surgical intervention is associated with greater long-term cure rates (≥80%); significant short- and long-term adverse effects occur more frequently. Clinicians are likely to experience increasing numbers of patients with IC/PBS as more is understood about its pathophysiology and evolving epidemiology. Therefore urogynaecologists should familiarise themselves with appropriate diagnostic criteria and evidence based therapies to optimise clinical outcomes in this patient cohort. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. "Gum bug, leave my heart alone!"--epidemiologic and mechanistic evidence linking periodontal infections and atherosclerosis.

    Science.gov (United States)

    Kebschull, M; Demmer, R T; Papapanou, P N

    2010-09-01

    Evidence from epidemiologic studies suggests that periodontal infections are independently associated with subclinical and clinical atherosclerotic vascular disease. Although the strength of the reported associations is modest, the consistency of the data across diverse populations and a variety of exposure and outcome variables suggests that the findings are not spurious or attributable only to the effects of confounders. Analysis of limited data from interventional studies suggests that periodontal treatment generally results in favorable effects on subclinical markers of atherosclerosis, although such analysis also indicates considerable heterogeneity in responses. Experimental mechanistic in vitro and in vivo studies have established the plausibility of a link between periodontal infections and atherogenesis, and have identified biological pathways by which these effects may be mediated. However, the utilized models are mostly mono-infections of host cells by a limited number of 'model' periodontal pathogens, and therefore may not adequately portray human periodontitis as a polymicrobial, biofilm-mediated disease. Future research must identify in vivo pathways in humans that may (i) lead to periodontitis-induced atherogenesis, or (ii) result in treatment-induced reduction of atherosclerosis risk. Data from these studies will be essential for determining whether periodontal interventions have a role in the primary or secondary prevention of atherosclerosis.

  14. The vasopressin system: new insights for patients with kidney diseases: Epidemiological evidence and therapeutic perspectives.

    Science.gov (United States)

    Clark, W F; Devuyst, O; Roussel, R

    2017-10-01

    People with chronic kidney disease (CKD) are at risk of severe outcomes, such as end-stage renal disease or cardiovascular disease, and CKD is a globally increasing health burden with a high personal and economic cost. Despite major progresses in prevention and therapeutics in last decades, research is still needed to reverse this epidemic trend. The regulation of water balance and the state of activation of the vasopressin system have emerged as factors tightly associated with kidney health, in the general population but also in specific conditions; among them, various stages of CKD, diabetes and autosomal dominant polycystic kidney disease (ADPKD). Basic science findings and also epidemiological evidence have justified important efforts towards interventional studies supporting causality, and opening therapeutic avenues. On the basis of recent clinical data, the blockade of V2 vasopressin receptors using tolvaptan in patients with rapidly progressing ADPKD has been granted in several countries, and a long-term randomized trial evaluating the effect of an increase in water intake in patients with CKD is on-going. © 2017 The Association for the Publication of the Journal of Internal Medicine.

  15. Dementia in western Europe: epidemiological evidence and implications for policy making.

    Science.gov (United States)

    Wu, Yu-Tzu; Fratiglioni, Laura; Matthews, Fiona E; Lobo, Antonio; Breteler, Monique M B; Skoog, Ingmar; Brayne, Carol

    2016-01-01

    Dementia is receiving increasing attention from governments and politicians. Epidemiological research based on western European populations done 20 years ago provided key initial evidence for dementia policy making, but these estimates are now out of date because of changes in life expectancy, living conditions, and health profiles. To assess whether dementia occurrence has changed during the past 20-30 years, investigators of five different studies done in western Europe (Sweden [Stockholm and Gothenburg], the Netherlands [Rotterdam], the UK [England], and Spain [Zaragoza]) have compared dementia occurrence using consistent research methods between two timepoints in well-defined geographical areas. Findings from four of the five studies showed non-significant changes in overall dementia occurrence. The only significant reduction in overall prevalence was found in the study done in the UK, powered and designed explicitly from its outset to detect change across generations (decrease in prevalence of 22%; p=0.003). Findings from the study done in Zaragoza (Spain) showed a significant reduction in dementia prevalence in men (43%; p=0.0002). The studies estimating incidence done in Stockholm and Rotterdam reported non-significant reductions. Such reductions could be the outcomes from earlier population-level investments such as improved education and living conditions, and better prevention and treatment of vascular and chronic conditions. This evidence suggests that attention to optimum health early in life might benefit cognitive health late in life. Policy planning and future research should be balanced across primary (policies reducing risk and increasing cognitive reserve), secondary (early detection and screening), and tertiary (once dementia is present) prevention. Each has their place, but upstream primary prevention has the largest effect on reduction of later dementia occurrence and disability. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Epidemiological evidence for beta-carotene in prevention of cancer and cardiovascular disease

    NARCIS (Netherlands)

    Poppel, G. van

    1996-01-01

    Objective and conclusions: This article gives an overview of observational and experimental epidemiological studies relating β-carotene to risk of cancer and cardiovascular disease. Observational epidemiological studies have consistently shown that a diet rich in β-carotenerich fruits and vegetables

  17. [Hormonal contraception as a risk factor for developing cervical cancer: biological, epidemiological and immunological evidence].

    Science.gov (United States)

    Castro Romero, Julieta Ivone; Hernández Girón, Carlos; Madrid Marina, Vicente

    2011-09-01

    Cervical cancer has been extensively studied, as well as the various risk factors for that cancer. One such factor is the prolonged use of hormonal contraceptives. To report the biological, immunological and epidemiological findings arising from the use of oral contraceptives and their relation to cervical cancer. Retrospective study based on information published in national and international literature. Controversy persists between the epidemiological data and experimental biological association between hormonal contraceptives and cancer induced by HPV. It is important to consider the biological findings because in Mexico the use of hormonal contraceptives is very broad and the number of cases of cervical cancer and only extensive epidemiological studies will clarify this controversy.

  18. Empirical Evidence of Study Design Biases in Randomized Trials: Systematic Review of Meta-Epidemiological Studies

    Science.gov (United States)

    Page, Matthew J.; Higgins, Julian P. T.; Clayton, Gemma; Sterne, Jonathan A. C.; Hróbjartsson, Asbjørn; Savović, Jelena

    2016-01-01

    Objective To synthesise evidence on the average bias and heterogeneity associated with reported methodological features of randomized trials. Design Systematic review of meta-epidemiological studies. Methods We retrieved eligible studies included in a recent AHRQ-EPC review on this topic (latest search September 2012), and searched Ovid MEDLINE and Ovid EMBASE for studies indexed from Jan 2012-May 2015. Data were extracted by one author and verified by another. We combined estimates of average bias (e.g. ratio of odds ratios (ROR) or difference in standardised mean differences (dSMD)) in meta-analyses using the random-effects model. Analyses were stratified by type of outcome (“mortality” versus “other objective” versus “subjective”). Direction of effect was standardised so that ROR ROR 0.93, 95% CI 0.86 to 0.99; 7 studies) and allocation concealment (ROR 0.90, 95% CI 0.84 to 0.97; 7 studies). For these characteristics, the average bias appeared to be larger in trials of subjective outcomes compared with other objective outcomes. Also, intervention effects for subjective outcomes appear to be exaggerated in trials with lack of/unclear blinding of participants (versus blinding) (dSMD -0.37, 95% CI -0.77 to 0.04; 2 studies), lack of/unclear blinding of outcome assessors (ROR 0.64, 95% CI 0.43 to 0.96; 1 study) and lack of/unclear double blinding (ROR 0.77, 95% CI 0.61 to 0.93; 1 study). The influence of other characteristics (e.g. unblinded trial personnel, attrition) is unclear. Conclusions Certain characteristics of randomized trials may exaggerate intervention effect estimates. The average bias appears to be greatest in trials of subjective outcomes. More research on several characteristics, particularly attrition and selective reporting, is needed. PMID:27398997

  19. Epidemiological evidence for the risk of cancer from diagnostic X-rays

    International Nuclear Information System (INIS)

    Berrington, A.

    2001-01-01

    The magnitude of the risk of cancer following exposure to a single moderate or high dose of ionising radiation has been studied extensively and is quite well understood. The size of the risk of cancer from diagnostic X-rays, which are low dose, fractionated exposures and constitute the largest man-made source of radiation exposure, is much more uncertain. The aim of this thesis is to evaluate the risk of cancer to radiologists and to the population from exposure to diagnostic X-rays using various epidemiological methods. The effect of fractionated radiation exposure was investigated in a cohort of 2698 British radiologists who first registered with a radiological society after 1921. There was no evidence of an overall excess risk of cancer mortality. However, there was evidence of an increasing trend in cancer mortality with time since registration with the society (p=0.0002), such that those who had first registered more than 40 years previously had a 41% (95% Cl: 3% to 90%) excess risk compared to cancer mortality rates for all medical practitioners. Indirect estimates of the risk of cancer from diagnostic X-rays to the population were calculated with lifetable methods. Using data on the current annual frequency of diagnostic X-ray exposures to the population, estimated organ doses from these X-rays and models for the risk of cancer from the Japanese atomic bomb survivors, it was estimated that 1.5% of the lifetime risk of cancer in the U.K. population could be attributable to diagnostic X-ray exposures. In fourteen other developed countries estimates ranged from 1.6% in Finland to 8.6% in Japan. Several published case-control studies of leukaemia, brain and parotid gland tumours and thyroid cancer demonstrated significant excess risks with self-reported exposures to diagnostic X-rays. Analysis of original data from a case-control study of thyroid cancer in Kuwait also found a significant trend in risk with estimated thyroid dose from self-reported upper-body X

  20. “Gum Bug, Leave My Heart Alone!”—Epidemiologic and Mechanistic Evidence Linking Periodontal Infections and Atherosclerosis

    OpenAIRE

    Kebschull, M.; Demmer, R.T.; Papapanou, P.N.

    2010-01-01

    Evidence from epidemiologic studies suggests that periodontal infections are independently associated with subclinical and clinical atherosclerotic vascular disease. Although the strength of the reported associations is modest, the consistency of the data across diverse populations and a variety of exposure and outcome variables suggests that the findings are not spurious or attributable only to the effects of confounders. Analysis of limited data from interventional studies suggests that per...

  1. Analysis of inadequate cervical smears using Shewhart control charts

    Directory of Open Access Journals (Sweden)

    Wall Michael K

    2004-06-01

    Full Text Available Abstract Background Inadequate cervical smears cannot be analysed, can cause distress to women, are a financial burden to the NHS and may lead to further unnecessary procedures being undertaken. Furthermore, the proportion of inadequate smears is known to vary widely amongst providers. This study investigates this variation using Shewhart's theory of variation and control charts, and suggests strategies for addressing this. Methods Cervical cytology data, from six laboratories, serving 100 general practices in a former UK Health Authority area were obtained for the years 2000 and 2001. Control charts of the proportion of inadequate smears were plotted for all general practices, for the six laboratories and for the practices stratified by laboratory. The relationship between proportion of inadequate smears and the proportion of negative, borderline, mild, moderate or severe dyskaryosis as well as the positive predictive value of a smear in each laboratory was also investigated. Results There was wide variation in the proportion of inadequate smears with 23% of practices showing evidence of special cause variation and four of the six laboratories showing evidence of special cause variation. There was no evidence of a clinically important association between high rates of inadequate smears and better detection of dyskaryosis (R2 = 0.082. Conclusions The proportion of inadequate smears is influenced by two distinct sources of variation – general practices and cytology laboratories, which are classified by the control chart methodology as either being consistent with common or special cause variation. This guidance from the control chart methodology appears to be useful in delivering the aim of continual improvement.

  2. Epidemiologic changes and economic burden of hypertension in Latin America: evidence from Mexico.

    Science.gov (United States)

    Arredondo, Armando; Zúñiga, Alexis

    2006-06-01

    Costs of health services for hypertension and the financial consequences of epidemiologic changes in this disease are important concerns for health systems in Latin America. We conducted longitudinal analyses of the economic impact of the epidemiologic changes on health care services for hypertension in the Mexican health care system. The cost evaluation method used was based on costing technique by production function and consensus techniques. To estimate the epidemiologic changes and financial consequences for the period 2005 to 2007, three probabilistic models were constructed according to the Box-Jenkins technique. If changes are not implemented in prevention programs to reduce the effects of current risk factors, there will be increases in the number of patients with hypertension as well as in the financial burden to treat the disease. The amount allocated for hypertension in 2007, which will be 6% to 8% of the total health budget, is US$ 2,486,145,132. Of these, US$ 1,178,725,132 will be direct costs and US$ 1,307,420,000 will be indirect costs. Regarding epidemiologic changes for 2005 v 2007 (P insured populations. If the risk factors and different health programs remain as they currently are, the economic impact of expected epidemiologic changes on the social security system will be particularly strong. Another relevant financial factor is the appearance of internal competition in the allocation of financial resources among the main providers of health services for hypertension; this factor becomes even more complicated within each provider.

  3. Reducing Cancer Burden in the Population: An Overview of Epidemiologic Evidence to Support Policies, Systems, and Environmental Changes.

    Science.gov (United States)

    Platz, Elizabeth A

    2017-01-01

    "Reducing Cancer Burden in the Population: Epidemiologic Evidence to Support Policies, Systems, and Environmental Changes" is a compilation of 11 reviews addressing aspects of primary prevention of cancer (early life factors, vitamin D, and periodontal disease and the oral microbiome); primary and secondary prevention (in the transgender population); surveillance following secondary prevention (personalizing follow-up of patients diagnosed with an adenoma based on colorectal cancer risk); tertiary prevention (physical activity as an adjuvant to cancer treatment, measurement of patient-reported physical functioning in cancer treatment trials, and implementation of palliative care recommendations); and all 3 (changing epidemiology of oral cancers). Authors discuss policies, systems, and environment (PSE) changes that may be supported by epidemiologic evidence, for example, how existing public health and clinical policies and guidelines targeting noncancer outcomes may indirectly reduce cancer burden and how some cancer control policies could be refined to enhance effectiveness. Authors also discuss where systems and environment changes are necessary to ensure routine implementation of up-to-date, evidence-based policies and guidelines. Two other articles discuss infrastructure to support identification of existing and emerging cancer problems that could be reduced or avoided, including by PSE changes. These frameworks may guide impactful cancer research relevant to cancer centers' catchment areas, as well as cancer control efforts in countries where noncommunicable diseases including cancer are on the rise. The weight of the evidence of these reviews supports opportunities for PSE changes and infrastructure that could reduce the cancer burden in populations. © The Author 2017. 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.

  4. Insulin treatment and breast cancer risk; A systematic review of in vitro, animal and epidemiological evidence

    NARCIS (Netherlands)

    Bronsveld, Heleen K.; Ter Braak, Bas; Karlstad, Øystein; Vestergaard, Peter; Starup-Linde, Jakob; Bazelier, Marloes T.; de Bruin, Marieke; De Boer, Anthonius; Siezen, Christine L.E.; Van De Water, Bob; Van Der Laan, Jan Willem; Schmidt, Marjanka K.

    2015-01-01

    Background: In 2009, the concern has been raised that insulin analogues, especially insulin glargine, might increase risk of (breast) cancer. Many in vitro and epidemiological and some animal studies have been performed, but there is still no clarity on this issue. Objectives: The aim of this study

  5. Short sleep duration and dietary intake: epidemiologic evidence, mechanisms, and health implications

    Science.gov (United States)

    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 a...

  6. Short sleep duration and dietary intake: epidemiological evidence, mechanisms, and health implications

    Science.gov (United States)

    Links between short sleep duration and obesity, type 2 diabetes, hypertension, and cardiovascular disease may be mechanistically mediated through changes in dietary intake. This review aims to provide an overview of recent epidemiologic studies on the relationships between habitual short sleep durat...

  7. Evidence, illness, and causation: an epidemiological perspective on the Russo-Williamson Thesis.

    Science.gov (United States)

    Fiorentino, Alexander R; Dammann, Olaf

    2015-12-01

    According to the Russo-Williamson Thesis, causal claims in the health sciences need to be supported by both difference-making and mechanistic evidence. In this article, we attempt to determine whether Evidence-based Medicine (EBM) can be improved through the consideration of mechanistic evidence. We discuss the practical composition and function of each RWT evidence type and propose that exposure-outcome evidence (previously known as difference-making evidence) provides associations that can be explained through a hypothesis of causation, while mechanistic evidence provides finer-grained associations and knowledge of entities that ultimately explains a causal hypothesis. We suggest that mechanistic evidence holds untapped potential to add value to the assessment of evidence quality in EBM and propose initial recommendations for the integration of mechanistic and exposure-outcome evidence to improve EBM by robustly leveraging available evidence in support of good medical decisions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Hormonal contraceptive use and female-to-male HIV transmission: a systematic review of the epidemiologic evidence.

    Science.gov (United States)

    Polis, Chelsea B; Phillips, Sharon J; Curtis, Kathryn M

    2013-02-20

    To systematically review epidemiologic evidence assessing whether hormonal contraception alters the risk of HIV transmission from an HIV-positive woman to an HIV-negative male partner. Systematic review. We included articles published or in press through December 15, 2011. We assessed studies with direct evidence on hormonal contraception use and HIV transmission, and summarized studies with indirect evidence related to genital or plasma viral load. : One study provided direct evidence on oral contraceptive pills (OCPs) or injectable contraception and female-to-male HIV transmission; both injectables [Cox-adjusted hazard ratio (adjHR) 1.95, 95% confidence interval (CI) 1.06-3.58; marginal structural model (MSM) adjusted odds ratio (adjOR) 3.01, 95% CI 1.47-6.16] and OCPs (Cox adjHR 2.09, 95% CI 0.75-5.84; MSM adjOR 2.35, 95% CI 0.79-6.95) generated elevated point estimates, but only estimates for injectables were significant. Findings from 11 indirect studies assessing various hormonal contraception methods and viral genital shedding or setpoint were mixed, and seven of eight studies indicated no adverse effect of various hormonal contraception methods on plasma viral load. The only direct study on OCPs or injectable contraception and female-to-male HIV transmission suggests increased risk with the use of injectables. Given the potential for confounding in observational data, the paucity of direct evidence on this subject, and mixed indirect evidence, additional evidence is needed.

  9. Ergonomics and epidemiology in evidence based health prevention

    DEFF Research Database (Denmark)

    Jensen, Olaf Chresten

    2009-01-01

    According to the definitions, ergonomics is a natural part of the health and safety activity but it has its own research methods and causal models. Public health, occupational and clinical medicines are closely related to epidemiology and differ from ergonomics by using a disease model with a wide...... for patients or for persons with pre-conditions of diseases like pre-hypertension and pre-diabetes and for the most vulnerable parts of the populations....

  10. Environmental lead and children's intelligence: a systematic review of the epidemiological evidence.

    OpenAIRE

    Pocock, S. J.; Smith, M.; Baghurst, P.

    1994-01-01

    OBJECTIVE--To quantify the magnitude of the relation between full scale IQ in children aged 5 or more and their body burden of lead. DESIGN--A systematic review of 26 epidemiological studies since 1979: prospective studies of birth cohorts, cross sectional studies of blood lead, and cross sectional studies of tooth lead. SETTING--General populations of children > or = 5 years. MAIN OUTCOME MEASURES--For each study, the regression coefficient of IQ on lead, after adjustment for confounders whe...

  11. Homocyst(e)ine and cardiovascular disease: a critical review of the epidemiologic evidence.

    Science.gov (United States)

    Eikelboom, J W; Lonn, E; Genest, J; Hankey, G; Yusuf, S

    1999-09-07

    To review epidemiologic studies on the association between homocyst(e)ine level and risk for cardiovascular disease and the potential benefits of homocysteine-decreasing therapies. Computerized and manual searches of the literature on total homocysteine levels and cardiovascular disease. Prospective studies and major retrospective epidemiologic studies evaluating the association between homocyst(e)ine levels and cardiovascular disease and the association between blood levels or dietary intake of folate, vitamin B6, and vitamin B12 and cardiovascular disease. Relevant data on patient population, plasma homocyst(e)ine levels, duration of follow-up, and main results were extracted from studies that met the inclusion criteria. The designs and results of studies included in this review are summarized. A formal meta-analysis was not performed because the studies were heterogeneous in method and design. Results of epidemiologic studies suggest that moderately elevated plasma or serum homocyst(e)ine levels are prevalent in the general population and are associated with an increased risk for cardiovascular disease, independent of classic cardiovascular risk factors. Simple, inexpensive, nontoxic therapy with folic acid, vitamin B6, and vitamin B12 reduces plasma homocyst(e)ine levels. Although the association between homocyst(e)ine levels and cardiovascular disease is generally strong and biologically plausible, the data from the prospective studies are less consistent. In addition, epidemiologic observations of an association between hyperhomocyst(e)inemia and cardiovascular risk do not prove the existence of a causal relation. Therefore, the effectiveness of folate, vitamin B6, and vitamin B12 in reducing cardiovascular morbidity and mortality requires rigorous testing in randomized clinical trials. Several such trials are under way; their results may greatly affect cardiovascular morbidity and mortality, given the simplicity and low cost of vitamin therapy.

  12. [Endocrine disruptors : Evidence from epidemiological studies necessitates a critical review of model systems].

    Science.gov (United States)

    Hoffmann, M; Gebauer, S; Nüchter, M; Baber, R; Ried, J; von Bergen, M; Kiess, W

    2017-06-01

    Endocrine disruptive chemicals (EDCs) cause adverse health effects through interaction with endocrine systems. They are classified by chemical structure, effects on specific endocrine systems, bioaccumulation, persistence in the environment, or clinically observable effects. For research of the complex mechanisms of action in the human body, only in vitro model systems have so far been available, that have insufficient high-throughput capacity, which makes risk evaluation more difficult. In addition, in industrial nations, living people are often exposed to mixtures of substances, with various effects. The clinical importance of epigenetic changes caused by the action of EDCs during vulnerable phases of development is currently unclear. Epidemiological studies are criticized because reproducibility is not always guaranteed. Nevertheless, they remain the method of choice for the development and analysis of suitable model systems. Positive associations, in spite of sometimes conflicting results, are key in the selection of factors that can then be analysed in model systems in an unbiased way. This article depicts the mainly positive epidemiological findings for EDC-caused effects in the fields of growth and metabolism, neurocognitive development and sexual development and reproduction. As a result, there is a need for closer linkage between epidemiological studies and mechanistic research into model systems, especially focusing on the interaction of different EDCs and the consequences of prenatal and early life exposure.

  13. Defining the Term "Overuse": An Evidence-Based Review of Sport Epidemiology Literature.

    Science.gov (United States)

    Neil, Elizabeth R; Winkelmann, Zachary K; Edler, Jessica R

    2018-02-06

    Reference:  Roos KG, Marshall SW. Definition and usage of the term "overuse injury" in the US high school and collegiate sport epidemiology literature: a systematic review. Sports Med. 2014;44(3):405-421.   What is the current context of the term overuse in the epidemiologic sports injury literature?   The authors performed a database search of PubMed and SPORTDiscus. The Boolean phrases athletics AND injury and overuse OR epidemiology were searched.   Studies were included in the review based on the following criteria: (1) epidemiologic in nature, (2) involved US high school or collegiate athletes, and (3) published in English between 1996 and 2012. In addition, a study was classified as epidemiologic in nature if appropriate exposure data were collected in order to calculate injury incidence rates. One reviewer initially read the titles or abstracts of the studies to determine their relevance for the systematic review. Studies were excluded if they (1) were biomechanical or anatomical in nature, (2) were clinical in nature, or (3) assessed the effectiveness of an intervention.   The reviewer extracted statistics and definitions of the word and phrase overuse and no contact. The reviewer adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines as much as possible.   A total of 5182 titles of articles were initially identified in the databases searched. Then 232 studies were read to determine if they included overuse statistics. A total of 35 articles were included in the final review. Two main surveillance programs were used in these studies, with the authors of 12 articles (n = 12/35, 34.3%) using data from the High School Reporting Information Online (RIO) and the authors of 13 articles (n = 13/35, 37.1%) using data from the National Collegiate Athletic Association's Injury Surveillance System (ISS). One group (n = 1/35, 2.9%) used both surveillance systems, whereas 9 groups (n = 9/35, 25.7%) used other

  14. Endocrine Disrupting Chemicals and Endometrial Cancer: An Overview of Recent Laboratory Evidence and Epidemiological Studies

    Science.gov (United States)

    Mallozzi, Maddalena; Leone, Chiara; Manurita, Francesca; Bellati, Filippo; Caserta, Donatella

    2017-01-01

    Background: Although exposure to endocrine disruptor compounds (EDCs) has been suggested as a contributing factor to a range of women’s health disorders including infertility, polycystic ovaries and the early onset of puberty, considerable challenges remain in attributing cause and effect on gynaecological cancer. Until recently, there were relatively few epidemiological studies examining the relationship between EDCs and endometrial cancer, however, in the last years the number of these studies has increased. Methods: A systematic MEDLINE (PubMed) search was performed and relevant articles published in the last 23 years (from 1992 to 2016) were selected. Results: Human studies and animal experiments are confirming a carcinogenic effect due to the EDC exposure and its carcinogenesis process result to be complex, multifactorial and long standing, thus, it is extremely difficult to obtain the epidemiological proof of a carcinogenic effect of EDCs for the high number of confusing factors. Conclusions: The carcinogenic effects of endocrine disruptors are plausible, although additional studies are needed to clarify their mechanisms and responsible entities. Neverthless, to reduce endocrine disruptors (ED) exposure is mandatory to implement necessary measures to limit exposure, particularly during those periods of life most vulnerable to the impact of oncogenic environmental causes, such as embryonic period and puberty. PMID:28327540

  15. Properly Interpreting the Epidemiologic Evidence about the Health Effects of Industrial Wind Turbines on Nearby Residents

    Science.gov (United States)

    Phillips, Carl V.

    2011-01-01

    There is overwhelming evidence that wind turbines cause serious health problems in nearby residents, usually stress-disorder-type diseases, at a nontrivial rate. The bulk of the evidence takes the form of thousands of adverse event reports. There is also a small amount of systematically gathered data. The adverse event reports provide compelling…

  16. Dietary Nitrate Lowers Blood Pressure: Epidemiological, Pre-clinical Experimental and Clinical Trial Evidence.

    Science.gov (United States)

    Gee, Lorna C; Ahluwalia, Amrita

    2016-02-01

    Nitric oxide (NO), a potent vasodilator critical in maintaining vascular homeostasis, can reduce blood pressure in vivo. Loss of constitutive NO generation, for example as a result of endothelial dysfunction, occurs in many pathological conditions, including hypertension, and contributes to disease pathology. Attempts to therapeutically deliver NO via organic nitrates (e.g. glyceryl trinitrate, GTN) to reduce blood pressure in hypertensives have been largely unsuccessful. However, in recent years inorganic (or 'dietary') nitrate has been identified as a potential solution for NO delivery through its sequential chemical reduction via the enterosalivary circuit. With dietary nitrate found in abundance in vegetables this review discusses epidemiological, pre-clinical and clinical data supporting the idea that dietary nitrate could represent a cheap and effective dietary intervention capable of reducing blood pressure and thereby improving cardiovascular health.

  17. Epidemiologic Evidence to Guide the Understanding and Prevention of Gun Violence.

    Science.gov (United States)

    Webster, Daniel W; Cerdá, Magdalena; Wintemute, Garen J; Cook, Philip J

    2016-01-01

    Gunfire from assaults, suicides, and unintentional shootings exacts an enormous burden on public health globally. The epidemiologic reviews in this special issue enhance our understanding of various forms of gun violence, inform interventions, and help chart directions for future research. The available science, however, is limited to answer many important questions necessary for mounting successful efforts to reduce gun violence. Certain data are lacking, and there are numerous analytical challenges to deriving unbiased estimates of policy impacts. Significant investments in research over the long term are warranted to answer questions central to successful prevention of gun violence. © The Author 2016. 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.

  18. Bridging the data gaps in the epidemiology of hepatitis C virus infection in Malaysia using multi-parameter evidence synthesis.

    Science.gov (United States)

    McDonald, Scott A; Mohamed, Rosmawati; Dahlui, Maznah; Naning, Herlianna; Kamarulzaman, Adeeba

    2014-11-07

    Collecting adequate information on key epidemiological indicators is a prerequisite to informing a public health response to reduce the impact of hepatitis C virus (HCV) infection in Malaysia. Our goal was to overcome the acute data shortage typical of low/middle income countries using statistical modelling to estimate the national HCV prevalence and the distribution over transmission pathways as of the end of 2009. Multi-parameter evidence synthesis methods were applied to combine all available relevant data sources - both direct and indirect - that inform the epidemiological parameters of interest. An estimated 454,000 (95% credible interval [CrI]: 392,000 to 535,000) HCV antibody-positive individuals were living in Malaysia in 2009; this represents 2.5% (95% CrI: 2.2-3.0%) of the population aged 15-64 years. Among males of Malay ethnicity, for 77% (95% CrI: 69-85%) the route of probable transmission was active or a previous history of injecting drugs. The corresponding proportions were smaller for male Chinese and Indian/other ethnic groups (40% and 71%, respectively). The estimated prevalence in females of all ethnicities was 1% (95% CrI: 0.6 to 1.4%); 92% (95% CrI: 88 to 95%) of infections were attributable to non-drug injecting routes of transmission. The prevalent number of persons living with HCV infection in Malaysia is estimated to be very high. Low/middle income countries often lack a comprehensive evidence base; however, evidence synthesis methods can assist in filling the data gaps required for the development of effective policy to address the future public health and economic burden due to HCV.

  19. Review of epidemiological evidence for reproductive and hormonal factors in relation to the risk of epithelial ovarian malignancies.

    Science.gov (United States)

    Riman, Tomas; Nilsson, Staffan; Persson, Ingemar R

    2004-09-01

    Ovarian cancer is the leading cause of mortality related to gynecologic malignancies in Sweden but there is no current screening program. Based upon epidemiological research there is evidence that certain reproductive factors are associated with ovarian cancer risk. Most studies generally indicate that each childbirth incurs a 15-20% risk reduction. Women who have used oral contraceptives for 5 years or longer experience about half the risk of ovarian cancer compared with never users. Breastfeeding seems to be protective while age at menarche and at menopause are less consistent risk predictors. Tubal ligation and hysterectomy seem to reduce ovarian cancer risk by up to 80%. Although some studies found endometriosis, polycystic ovarian syndrome (PCOS) and pelvic inflammatory disease (PID) to be positively related to ovarian cancer, the role of these factors is not yet established. Most recent studies observed an approximately 50% ovarian cancer risk increase among ever users of hormone replacement therapy (HRT) compared with never users, and the risk increased further with long-term use. There is less information concerning separate estrogen and progestin effects of HRT and ovarian cancer risk. Although the cause of ovarian cancer remains obscure, hypotheses relating to "incessant" ovulation, excessive gonadotropin secretion, retrograde carcinogen transportation, apoptosis and estrogen/progestin imbalance have been invoked as etiological explanations. All these hypotheses find various epidemiological support. The aim of this review is to summarize the epidemiological findings on reproductive factors and ovarian cancer risk. These findings are considered in the context of etiologic hypotheses and some new research areas are suggested.

  20. Cosmetic talc as a risk factor for pleural mesothelioma: a weight of evidence evaluation of the epidemiology.

    Science.gov (United States)

    Finley, Brent L; Benson, Stacey M; Marsh, Gary M

    2017-03-01

    Due to some historical (and inaccurate) reports that asbestos might be present in some cosmetic talc products, questions are occasionally raised regarding the potential pleural mesothelioma risks associated with cosmetic talc products. Our objective was to determine the incidence of pleural mesothelioma of individuals exposed to cosmetic talc. We conducted a systematic review of the epidemiological literature for cosmetic talc miners and millers and found three occupational cohort studies that evaluated pleural mesothelioma incidence in workers in Italy, Norway, France, and Austria. We conducted a second literature review to evaluate the incidence and mortality of pleural mesothelioma among patients who received talc pleurodesis treatments before 1965 and found retrospective clinical studies including over 300 patients with follow-up ranging from 14 to 40 years. There were no mesotheliomas reported in any of the cosmetic talc miner and miller cohorts. A pooled analysis of data from the cohort mortality studies indicated that four mesothelioma deaths would have been expected from the 90,022 person-years of observation, and this was associated with 84% and 67% statistical power to observe a 3-fold or 2.5-fold increase in pleural mesothelioma mortality, respectively. None of the patients who received talc pleurodesis treatments developed mesothelioma. We conclude that there is no epidemiological evidence to support the hypothesis that exposure to cosmetic talc is associated with the development of pleural mesothelioma.

  1. Essential problems in the interpretation of epidemiologic evidence for an association between mobile phone use and brain tumours

    Science.gov (United States)

    Kundi, Michael

    2010-11-01

    Due to the close proximity of a mobile phone to the head when placing a call, concerns have been raised that exposure from microwaves during mobile phone use may exert adverse health effects and, in particular, may increase the risk of brain tumours. In response to these concerns epidemiological studies have been conducted, most applying the case-control design. While epidemiology can provide decisive evidence for an association between an exposure and a disease fundamental problems arise if exposure is short compared to the natural history of the disease. For brain tumours latencies of decades have been implicated making special considerations about potential effects of exposures necessary that commence during an already growing tumour. It is shown that measures of disease risk like odds ratios and relative risks can under such circumstances not be interpreted as indicators of a long term effect on incidences in the exposed population. Besides this problem, the issues of a suitable exposure metric and the selection of endpoints are unresolved. It is shown that the solution of these problems affords knowledge about the mechanism of action by which exposure increases the risk of manifest disease.

  2. Organochlorine pesticides and prostate cancer, Is there an association? A meta-analysis of epidemiological evidence.

    Science.gov (United States)

    Lewis-Mikhael, Anne-Mary; Olmedo-Requena, Rocío; Martínez-Ruiz, Virginia; Bueno-Cavanillas, Aurora; Jiménez-Moleón, José Juan

    2015-10-01

    The results of epidemiological studies about exposure to organochlorine pesticides (OCPs) and risk of prostate cancer (PC) are inconclusive. We conducted a meta-analysis to evaluate the association between exposure to specific OCPs and PC. We searched PubMed, Scopus, and Web of science databases for case-control and cohort studies published till March 2015 that provided data about exposure to OCPs and PC. We also contacted authors and hand-searched references of the included articles. We calculated pooled estimates using random effects model and explored heterogeneity between studies. We systematically reviewed 15 articles and based our meta-analysis on 10 articles covering nine case-control studies and a large prospective cohort study. Pooled estimates of PC for highest versus lowest exposed category to p,p'-DDE was 1.02 (0.69-1.35), I (2) = 12.7 %, p = 0.333, trans-nonachlor, 0.88 (0.45-1.31), I (2) = 0.00 %, p = 0.892, oxychlordane, 0.91 (0.46-1.35), hexachlorobenzene, 0.88 (0.18-1.57), I (2) = 36.0 %, p = 0.210 from combining results of studies that applied serum OCPs measurements among the general population. For DDT, stratifying studies by exposed population revealed homogeneity, pooled estimate for serum level measurement for the highest exposed versus the lowest exposed of the general population was 0.81 (0.95-1.26), I (2) = 0.00 %, p = 0.400, and for occupational exposure 1.30 (0.94-1.67), I (2) = 13.4 %, p = 0.315. A positive but also insignificant association was obtained for pooling results for high exposure to lindane among farmers and pesticide applicators, 1.56 (0.82-2.29), I (2) = 41.7 %, p = 0.180. The existing epidemiological data do not support the hypothesis that exposure to specific OCPs is associated with an increased incidence of PC in the general population.

  3. Association of Dioxin and Other Persistent Organic Pollutants (POPs) with Diabetes: Epidemiological Evidence and New Mechanisms of Beta Cell Dysfunction

    Science.gov (United States)

    De Tata, Vincenzo

    2014-01-01

    The worldwide explosion of the rates of diabetes and other metabolic diseases in the last few decades cannot be fully explained only by changes in the prevalence of classical lifestyle-related risk factors, such as physical inactivity and poor diet. For this reason, it has been recently proposed that other “nontraditional” risk factors could contribute to the diabetes epidemics. In particular, an increasing number of reports indicate that chronic exposure to and accumulation of a low concentration of environmental pollutants (especially the so-called persistent organic pollutants (POPs)) within the body might be associated with diabetogenesis. In this review, the epidemiological evidence suggesting a relationship between dioxin and other POPs exposure and diabetes incidence will be summarized, and some recent developments on the possible underlying mechanisms, with particular reference to dioxin, will be presented and discussed. PMID:24802877

  4. Relationship between bread consumption, body weight, and abdominal fat distribution: evidence from epidemiological studies.

    Science.gov (United States)

    Bautista-Castaño, Inmaculada; Serra-Majem, Lluis

    2012-04-01

    A long-standing belief held by the general public is that bread fattens. This encourages many people to restrict, or even eliminate, bread from their diet. The present review was conducted to assess whether or not eating patterns that include bread are associated with overall obesity or excess abdominal adiposity, whether in the general population or in subjects undergoing obesity management. The literature search included articles published over the past 30 years that focused on dietary patterns that included bread (refined or whole-grain) and their association with ponderal status and abdominal fat distribution. A total of 38 epidemiological studies fulfilled the inclusion criteria (22 cross-sectional, 11 prospective cohort, and five intervention). The results indicate that dietary patterns that include whole-grain bread do not positively influence weight gain and may be beneficial to ponderal status. With respect to dietary patterns that include refined bread, the majority of cross-sectional studies indicate beneficial effects, while most of the well-designed cohort studies demonstrate a possible relationship with excess abdominal fat. Because differences in the study designs make it difficult to form definitive conclusions, more studies are needed that focus specifically on bread consumption, within different dietary patterns, and its influence on ponderal status. © 2012 International Life Sciences Institute.

  5. Dietary patterns and colorectal adenoma and cancer risk: a review of the epidemiological evidence.

    Science.gov (United States)

    Miller, Paige E; Lesko, Samuel M; Muscat, Joshua E; Lazarus, Philip; Hartman, Terryl J

    2010-01-01

    A number of studies exploring associations between individual dietary components and colorectal adenoma or cancer risk have yielded conflicting results. The study of food-based dietary patterns in relation to chronic disease risk represents an alternative approach to the evaluation of single dietary exposures in epidemiological investigations. Results from prospective cohort and population-based case-control studies examining associations between dietary patterns and colorectal cancer or adenoma risk were evaluated and described in this review. Despite notable differences in population characteristics, study design, and methods used for characterizing dietary patterns across the different studies, two general dietary patterns were found to modestly predict colorectal adenoma and cancer risk. A healthier pattern consisting of greater intakes of fruits and vegetables, and lower intakes of red and processed meat, appeared protective against colorectal adenoma and cancer incidence. Findings also suggest that a less healthy pattern characterized by higher intakes of red and processed meat, as well as potatoes and refined carbohydrates, may increase risk. Continued research efforts are needed to evaluate the cumulative and interactive effects of numerous dietary exposures on colorectal cancer risk.

  6. [Caffeine as a preventive drug for Parkinson's disease: epidemiologic evidence and experimental support].

    Science.gov (United States)

    Góngora-Alfaro, José Luis

    Prospective epidemiologic studies performed in large cohorts of men (total: 374,003 subjects) agree in which the risk of suffering Parkinson's disease diminishes progressively as the consumption of coffee and other caffeinated beverages increases. In the case of women (total: 345,184 subjects) the protective effect of caffeine is only observed in menopausal women which do not receive estrogen replacement therapy. Studies with models of acute parkinsonism in rodents have shown that caffeine reduces the loss of nigrostriatal dopaminergic neurons induced with the neurotoxins 6-hidroxidopamine and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, effect that seems to be mediated through blockade of A(2A) adenosine receptors. Recently, it was shown that male rats treated with moderate doses of caffeine (5 mg/kg/day) during six months, followed by a withdrawal period of at least two weeks, developed a greater resistance to the catalepsy induced with the dopaminergic antagonist haloperidol, which was possibly mediated by an increase of dopaminergic transmission in the corpus striatum. More studies are needed to demonstrate unequivocally that caffeine prevents the degeneration of dopaminergic neurons in animal models of moderate, chronic, and progressive parkinsonism, since it could lead to the discovery of more effective drugs for the prevention of aging-related degenerative diseases of the central nervous system.

  7. Vitamin-D concentrations, cardiovascular risk and events - a review of epidemiological evidence.

    Science.gov (United States)

    Grübler, Martin Robert; März, Winfried; Pilz, Stefan; Grammer, Tanja B; Trummer, Christian; Müllner, Christian; Schwetz, Verena; Pandis, Marlene; Verheyen, Nicolas; Tomaschitz, Andreas; Fiordelisi, Antonella; Laudisio, Daniela; Cipolletta, Ersilia; Iaccarino, Guido

    2017-06-01

    Vitamin D has long been established as an elemental factor of bone physiology. Beyond mineral metabolism, the expression of the vitamin D receptor has been identified throughout the cardiovascular (CV) system. Experimental studies showed beneficial effects of vitamin D on heart and vessels, but vitamin D intoxication in animals also led to hypercalcemia and vascular calcification. Our knowledge has been extended by epidemiological studies that showed that 25-hydroxyvitamin D (25(OH)D) levels are inversely associated with an increased CV risk itself, but also with established CV risk factors, such as arterial hypertension, endothelial dysfunction and atherosclerosis. Conversely, randomized controlled trials could not document significant and consistent effects of vitamin D supplementation on CV risk or events. Potential explanations may lie in differences in reference ranges or the possibility that low vitamin D in CV disease is only an epiphenomenon. In the latter case, the key question is why low 25(OH)D levels are such a strong predictor of health. While we wait for new data, the current conclusion is that vitamin D is a strong risk marker for CV risk factors and for CV diseases itself.

  8. Impact of Bisphenol A on the Cardiovascular System — Epidemiological and Experimental Evidence and Molecular Mechanisms

    Directory of Open Access Journals (Sweden)

    Xiaoqian Gao

    2014-08-01

    Full Text Available Bisphenol A (BPA is a ubiquitous plasticizing agent used in the manufacturing of polycarbonate plastics and epoxy resins. There is well-documented and broad human exposure to BPA. The potential risk that BPA poses to the human health has attracted much attention from regulatory agencies and the general public, and has been extensively studied. An emerging and rapidly growing area in the study of BPA’s toxicity is its impact on the cardiovascular (CV system. Recent epidemiological studies have shown that higher urinary BPA concentration in humans is associated with various types of CV diseases, including angina, hypertension, heart attack and coronary and peripheral arterial disease. Experimental studies have demonstrated that acute BPA exposure promotes the development of arrhythmias in female rodent hearts. Chronic exposure to BPA has been shown to result in cardiac remodeling, atherosclerosis, and altered blood pressure in rodents. The underlying mechanisms may involve alteration of cardiac Ca2+ handling, ion channel inhibition/activation, oxidative stress, and genome/transcriptome modifications. In this review, we discuss these recent findings that point to the potential CV toxicity of BPA, and highlight the knowledge gaps in this growing research area.

  9. Epidemiology of parainfluenza infection in England and Wales, 1998-2013: any evidence of change?

    Science.gov (United States)

    Zhao, H; Harris, R J; Ellis, J; Donati, M; Pebody, R G

    2017-04-01

    Human parainfluenza virus (HPIV) infections are one of the commonest causes of upper and lower respiratory tract infections. In order to determine if there have been any recent changes in HPIV epidemiology in England and Wales, laboratory surveillance data between 1998 and 2013 were analysed. The UK national laboratory surveillance database, LabBase, and the newly established laboratory-based virological surveillance system, the Respiratory DataMart System (RDMS), were used. Descriptive analysis was performed to examine the distribution of cases by year, age, sex and serotype, and to examine the overall temporal trend using the χ 2 test. A random-effects model was also employed to model the number of cases. Sixty-eight per cent of all HPIV detections were due to HPIV type 3 (HPIV-3). HPIV-3 infections were detected all year round but peaked annually between March and June. HPIV-1 and HPIV-2 circulated at lower levels accounting for 20% and 8%, respectively, peaking during the last quarter of the year with a biennial cycle. HPIV-4 was detected in smaller numbers, accounting for only 4% and also mainly observed in the last quarter of the year. However, in recent years, HPIV-4 detection has been reported much more commonly with an increase from 0% in 1998 to 3·7% in 2013. Although an overall higher proportion of HPIV infection was reported in infants (43·0%), a long-term decreasing trend in proportion in infants was observed. An increase was also observed in older age groups. Continuous surveillance will be important in tracking any future changes.

  10. Environmental Chemical Exposures and Autism Spectrum Disorders: A Review of the Epidemiological Evidence

    Science.gov (United States)

    Kalkbrenner, Amy E.; Schmidt, Rebecca J.; Penlesky, Annie C.

    2016-01-01

    In the past decade, the number of epidemiological publications addressing environmental chemical exposures and autism has grown tremendously. These studies are important because it is now understood that environmental factors play a larger role in causing autism than previously thought and because they address modifiable risk factors that may open up avenues for the primary prevention of the disability associated with autism. In this review, we covered studies of autism and estimates of exposure to tobacco, air pollutants, volatile organic compounds and solvents, metals (from air, occupation, diet, dental amalgams, and thimerosal-containing vaccines), pesticides, and organic endocrine-disrupting compounds such as flame retardants, non-stick chemicals, phthalates, and bisphenol A. We included studies that had individual-level data on autism, exposure measures pertaining to pregnancy or the 1st year of life, valid comparison groups, control for confounders, and adequate sample sizes. Despite the inherent error in the measurement of many of these environmental exposures, which is likely to attenuate observed associations, some environmental exposures showed associations with autism, especially traffic-related air pollutants, some metals, and several pesticides, with suggestive trends for some volatile organic compounds (e.g., methylene chloride, trichloroethylene, and styrene) and phthalates. Whether any of these play a causal role requires further study. Given the limited scope of these publications, other environmental chemicals cannot be ruled out, but have not yet been adequately studied. Future research that addresses these and additional environmental chemicals, including their most common routes of exposures, with accurate exposure measurement pertaining to several developmental windows, is essential to guide efforts for the prevention of the neurodevelopmental damage that manifests in autism symptoms. PMID:25199954

  11. Specific phobia in older adults: evidence from the national epidemiologic survey on alcohol and related conditions.

    Science.gov (United States)

    Chou, Kee-Lee

    2009-05-01

    This study aims to investigate: 1) the association of specific phobia with childhood parental loss and recent stressful life events; 2) the coexistence of specific phobia and major depressive disorders (MDDs); and 3) the impact of specific phobia on medical conditions, obesity, health service utilization, and health-related quality of life. Cross-sectional observational study. The National Epidemiologic Survey on Alcohol and Related Conditions (2001-2002), a national representative survey of the noninstitutionized U.S. household population. The 8,205 respondents aged 65 and above. Specific phobia was assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition version. Demographic characteristics, psychosocial risk factors, psychiatric disorders, health-related quality of life, obesity, medical conditions, and health service utilization were measured. The current and lifetime prevalence of specific phobia were 4.51% and 6.05%, respectively. Multivariate analyses revealed that specific phobia was more common among younger age groups, women, and those who reported stressful life events but less common among foreign-born individuals. In addition, MDD was significantly related to lifetime specific phobia. Specific phobia was also significantly related to a lower health-related quality of life and two medical conditions. Our prevalence rates of specific phobia in the elderly are at the lower end of the ranges identified in the previous studies. The correlation between specific phobia and MDD raises further questions about the nature of specific phobia in the elderly. This study supports the notion that specific phobia has a strong impact on the quality of life in old age.

  12. Anxiety and risk of type 2 diabetes: evidence from the Baltimore Epidemiologic Catchment Area Study.

    Science.gov (United States)

    Edwards, Lauren E; Mezuk, Briana

    2012-12-01

    Depression is increasingly recognized as a risk factor for type 2 diabetes, and is also commonly comorbid with anxiety. However, few studies have examined whether anxiety is predictive of diabetes risk. The objectives of this study are to examine the prospective relationship between anxiety disorders (generalized anxiety disorder, panic disorder, social phobia, and agoraphobia) and risk of type 2 diabetes over an 11-year period, and to investigate the association between anxiety and risk of diabetes-related complications among those with prevalent type 2 diabetes. Data come from the 1993/6 and 2004/5 waves of the Baltimore Epidemiologic Catchment Area Study (N=1920), a population-based prospective cohort. Anxiety disorders were assessed using the Diagnostic Interview Schedule. The prospective association between anxiety and incident type 2 diabetes was evaluated using a series of nested multivariable logistic regression models. At baseline, 315 participants (21.8%) had an anxiety disorder. The relationship between anxiety and risk of developing type 2 diabetes was not statistically significant after controlling for demographic characteristics (Odds Ratio (OR): 1.28, 95% Confidence Interval (CI): 0.75, 2.18). There was no relationship between anxiety and diabetes risk after controlling for health behaviors and depression status (OR: 1.00, 95% CI: 0.53, 1.89). There was no significant relationship between anxiety and development of diabetes-related complications among those with prevalent type 2 diabetes (OR: 2.02, 95% CI: 0.61, 6.74). Anxiety disorders are not associated with increased risk of type 2 diabetes or risk of diabetes complications among those who have diabetes. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Human rhinovirus infections in rural Thailand: epidemiological evidence for rhinovirus as both pathogen and bystander.

    Directory of Open Access Journals (Sweden)

    Alicia M Fry

    Full Text Available BACKGROUND: We describe human rhinovirus (HRV detections in SaKaeo province, Thailand. METHODS: From September 1, 2003-August 31, 2005, we tested hospitalized patients with acute lower respiratory illness and outpatient controls without fever or respiratory symptoms for HRVs with polymerase chain reaction and molecularly-typed select HRVs. We compared HRV detection among hospitalized patients and controls and estimated enrollment adjusted incidence. RESULTS: HRVs were detected in 315 (16% of 1919 hospitalized patients and 27 (9.6% of 280 controls. Children had the highest frequency of HRV detections (hospitalized: <1 year: 29%, 1-4 year: 29%, ≥ 65 years: 9%; controls: <1 year: 24%, 1-4 year: 14%, ≥ 65 years: 2.8%. Enrollment adjusted hospitalized HRV detection rates were highest among persons aged <1 year (1038/100,000 persons/year, 1-4 years (457, and ≥ 65 years (71. All three HRV species were identified, HRV-A was the most common species in most age groups including children aged <1 year (61% and all adult age groups. HRV-C was the most common species in the 1-4 year (51% and 5-19 year age groups (54%. Compared to controls, hospitalized adults (≥ 19 years and children were more likely to have HRV detections (odds ratio [OR]: 4.8, 95% confidence interval [CI]: 1.5, 15.8; OR: 2.0, CI: 1.2, 3.3, respectively and hospitalized children were more likely to have HRV-A (OR 1.7, CI: 0.8, 3.5 or HVR-C (OR 2.7, CI: 1.2, 5.9 detection. CONCLUSIONS: HRV rates were high among hospitalized children and the elderly but asymptomatic children also had substantial HRV detection. HRV (all species, and HRV-A and HRV-C detections were epidemiologically-associated with hospitalized illness. Treatment or prevention modalities effective against HRV could reduce hospitalizations due to HRV in Thailand.

  14. Italian retail gasoline activities: inadequate distribution network

    International Nuclear Information System (INIS)

    Verde, Stefano

    2005-01-01

    It is common belief that competition in the Italian retail gasoline activities is hindered by oil companies' collusive behaviour. However, when developing a broader analysis of the sector, low efficiency and scarce competition could results as the consequences coming from an inadequate distribution network and from the recognition of international markets and focal point [it

  15. Barriers to Mammography among Inadequately Screened Women

    Science.gov (United States)

    Stoll, Carolyn R. T.; Roberts, Summer; Cheng, Meng-Ru; Crayton, Eloise V.; Jackson, Sherrill; Politi, Mary C.

    2015-01-01

    Mammography use has increased over the past 20 years, yet more than 30% of women remain inadequately screened. Structural barriers can deter individuals from screening, however, cognitive, emotional, and communication barriers may also prevent mammography use. This study sought to identify the impact of number and type of barriers on mammography…

  16. Radiologists' responses to inadequate referrals

    Energy Technology Data Exchange (ETDEWEB)

    Lysdahl, Kristin Bakke [Oslo University College, Faculty of Health Sciences, Oslo (Norway); University of Oslo, Section for Medical Ethics, Faculty of Medicine, P.O. Box 1130, Blindern, Oslo (Norway); Hofmann, Bjoern Morten [University of Oslo, Section for Medical Ethics, Faculty of Medicine, P.O. Box 1130, Blindern, Oslo (Norway); Gjoevik University College, Faculty of Health Care and Nursing, Gjoevik (Norway); Espeland, Ansgar [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Section for Radiology, Department of Surgical Sciences, Bergen (Norway)

    2010-05-15

    To investigate radiologists' responses to inadequate imaging referrals. A survey was mailed to Norwegian radiologists; 69% responded. They graded the frequencies of actions related to referrals with ambiguous indications or inappropriate examination choices and the contribution of factors preventing and not preventing an examination of doubtful usefulness from being performed as requested. Ninety-five percent (344/361) reported daily or weekly actions related to inadequate referrals. Actions differed among subspecialties. The most frequent were contacting the referrer to clarify the clinical problem and checking test results/information in the medical records. Both actions were more frequent among registrars than specialists and among hospital radiologists than institute radiologists. Institute radiologists were more likely to ask the patient for additional information and to examine the patient clinically. Factors rated as contributing most to prevent doubtful examinations were high risk of serious complications/side effects, high radiation dose and low patient age. Factors facilitating doubtful examinations included respect for the referrer's judgment, patient/next-of-kin wants the examination, patient has arrived, unreachable referrer, and time pressure. In summary, radiologists facing inadequate referrals considered patient safety and sought more information. Vetting referrals on arrival, easier access to referring clinicians, and time for radiologists to handle inadequate referrals may contribute to improved use of imaging. (orig.)

  17. Financial incentives are inadequate for most companies

    Indian Academy of Sciences (India)

    Financial incentives are inadequate for most companies. market far less lucrative than for other diseases, which results in chronic underinvestment; reduced investment in TB drug R&D,. Pfizer withdrawal from TB R&D; AstraZeneca abandon TB R&D & close site; Novartis pull out; 4/22 Big Pharma producing antibacterials ...

  18. Green tea for the prevention of cancer: evidence of field epidemiology

    Directory of Open Access Journals (Sweden)

    Min Zhang

    2012-10-01

    Full Text Available Background: Tea is derived from the leaf of Camellia sinensis, a natural beverage widely consumed around the world. Geological and botanical evidence suggests that the tea plant originated from China. Varying methods of processing tea leaves lead to green tea, black tea, or Oolong tea, which differ in their concentrations of polyphenols. Green tea polyphenols appear to have anti-tumorigenic properties, and form 30-40% of the dry weight of green tea compared with only 3-10% of black tea. Numerous studies in multiple animal models and different cancer cell lines have demonstrated the anti-tumorigenesis by green tea polyphenols. Despite the consistency of laboratory results, evidence of this effect occuring in humans has been inconclusive to date.Objective: To investigate if green tea consumption was associated with longer survival rates in ovarian cancer patients, and a lower risk of ovarian, breast, and colorectal cancer, in addition toadult leukemiaMethods: We have conducted one prospective cohort study in ovarian cancer patients, and fivecase-control studies in ovarian, breast, and colorectal cancers, and leukemia over the past decade. Tea consumption was measured using a structured questionnaire by face-to-face interviews. The validity and reliability of the questionnaire was assessed in a preliminary study, and then evaluated by a test–retest. Cox proportional hazards regression models were used to obtain hazard ratios(HRs, 95% confidence intervals(95% CIs, and were adjusted for age at diagnosis, locality, body mass index(BMI, parity, International Federation of Gynecology and Obstetrics(IFGO stage, histologic grade of differentiation, cytology of ascites, residual tumour, and chemotherapeutic status. Odds ratios(ORs and 95% CIs were obtained using logistic regression analyses, which accounted for demographic, lifestyle, hormonal and family cancer factors, and potential confounders.Functional Foods in Health and Disease 2012, 2

  19. [Epidemiological evidence of possible musculoskeletal, cardiovascular and neoplastic effects in professional drivers].

    Science.gov (United States)

    Murgia, N; Dell'Omo, M; Gambelunghe, A; Folletti, I; Muzi, G; Abbritti, G

    2012-01-01

    The road and rail transport sector, since the several work tipology and risk factors for workers safety and health, is an area where assessing exposure effects is very difficult. Muscoskeletal cardiovascular and neoplastic diseases are the disorders more frequently associated to professional drivers. The role of professional driving is rather well-defined in low back pain occurence, correlated to whole body vibration exposure. Professional drivers are at higher risk of ischemic cardiovascular diseases, but it is not clear whether the risk is attributable just to the occupational exposures or also to their life-style risk factors. Evidence of an excess of risk for lung, genito-urinary and hemolymphopoietic cancer is clear in the scientific literature for professional drivers. Anyway the lack in the control of confounding factors, in exposure assessment force to be very cautious in results interpretation.

  20. Identical twins in forensic genetics - Epidemiology and risk based estimation of weight of evidence.

    Science.gov (United States)

    Tvedebrink, Torben; Morling, Niels

    2015-12-01

    The increase in the number of forensic genetic loci used for identification purposes results in infinitesimal random match probabilities. These probabilities are computed under assumptions made for rather simple population genetic models. Often, the forensic expert reports likelihood ratios, where the alternative hypothesis is assumed not to encompass close relatives. However, this approach implies that important factors present in real human populations are discarded. This approach may be very unfavourable to the defendant. In this paper, we discuss some important aspects concerning the closest familial relationship, i.e., identical (monozygotic) twins, when reporting the weight of evidence. This can be done even when the suspect has no knowledge of an identical twin or when official records hold no twin information about the suspect. The derived expressions are not original as several authors previously have published results accounting for close familial relationships. However, we revisit the discussion to increase the awareness among forensic genetic practitioners and include new information on medical and societal factors to assess the risk of not considering a monozygotic twin as the true perpetrator. If accounting for a monozygotic twin in the weight of evidence, it implies that the likelihood ratio is truncated at a maximal value depending on the prevalence of monozygotic twins and the societal efficiency of recognising a monozygotic twin. If a monozygotic twin is considered as an alternative proposition, then data relevant for the Danish society suggests that the threshold of likelihood ratios should approximately be between 150,000 and 2,000,000 in order to take the risk of an unrecognised identical, monozygotic twin into consideration. In other societies, the threshold of the likelihood ratio in crime cases may reach other, often lower, values depending on the recognition of monozygotic twins and the age of the suspect. In general, more strictly kept

  1. Adult attention deficit hyperactivity symptoms and psychosis: Epidemiological evidence from a population survey in England.

    Science.gov (United States)

    Marwaha, Steven; Thompson, Andrew; Bebbington, Paul; Singh, Swaran P; Freeman, Daniel; Winsper, Catherine; Broome, Matthew R

    2015-09-30

    Despite both having some shared features, evidence linking psychosis and adult attention deficit hyperactivity disorder (ADHD) is sparse and inconsistent. Hypotheses tested were (1) adult ADHD symptoms are associated with auditory hallucinations, paranoid ideation and psychosis (2) links between ADHD symptoms and psychosis are mediated by prescribed ADHD medications, use of illicit drugs, and dysphoric mood. The Adult Psychiatric Morbidity Survey 2007 (N=7403) provided data for regression and multiple mediation analyses. ADHD symptoms were coded from the ADHD Self-Report Scale (ASRS). Higher ASRS total score was significantly associated with psychosis, paranoid ideation and auditory hallucinations despite controlling for socio-demographic variables, verbal IQ, autism spectrum disorder traits, childhood conduct problems, hypomanic and dysphoric mood. An ASRS score indicating probable ADHD diagnosis was also significantly associated with psychosis. The link between higher ADHD symptoms and psychosis, paranoia and auditory hallucinations was significantly mediated by dysphoric mood, but not by use of amphetamine, cocaine or cannabis. In conclusion, higher levels of adult ADHD symptoms and psychosis are linked and dysphoric mood may form part of the mechanism. Our analyses contradict the traditional clinical view that the main explanation for people with ADHD symptoms developing psychosis is illicit drugs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Systematic review of the epidemiological evidence comparing lung cancer risk in smokers of mentholated and unmentholated cigarettes

    Directory of Open Access Journals (Sweden)

    Lee Peter N

    2011-04-01

    Full Text Available Abstract Background US mentholated cigarette sales have increased considerably over 50 years. Preference for mentholated cigarettes is markedly higher in Black people. While menthol itself is not genotoxic or carcinogenic, its acute respiratory effects might affect inhalation of cigarette smoke. This possibility seems consistent with the higher lung cancer risk in Black men, despite Black people smoking less and starting smoking later than White people. Despite experimental data suggesting similar carcinogenicity of mentholated and non-mentholated cigarettes, the lack of convincing evidence that mentholation increases puffing, inhalation or smoke uptake, and the similarity of lung cancer rates in Black and White females, a review of cigarette mentholation and lung cancer is timely given current regulatory interest in the topic. Methods Epidemiological studies comparing lung cancer risk in mentholated and non-mentholated cigarette smokers were identified from MedLine and other sources. Study details were extracted and strengths and weaknesses assessed. Relative risk estimates were extracted, or derived, for ever mentholated use and for long-term use, overall and by gender, race, and current/ever smoking, and meta-analyses conducted. Results Eight generally good quality studies were identified, with valid cases and controls, and appropriate adjustment for age, gender, race and smoking. The studies afforded good power to detect possible effects. However, only one study presented results by histological type, none adjusted for occupation or diet, and some provided no results by length of mentholated cigarette use. The data do not suggest any effect of mentholation on lung cancer risk. Adjusted relative risk estimates for ever use vary from 0.81 to 1.12, giving a combined estimate of 0.93 (95% confidence interval 0.84-1.02, n = 8, with no increase in males (1.01, 0.84-1.22, n = 5, females (0.80, 0.67-0.95, n = 5, White people (0.87, 0.75-1.03, n = 4

  3. The Sero-epidemiology of Coxiella burnetii in Humans and Cattle, Western Kenya: Evidence from a Cross-Sectional Study.

    Science.gov (United States)

    Wardrop, Nicola A; Thomas, Lian F; Cook, Elizabeth A J; de Glanville, William A; Atkinson, Peter M; Wamae, Claire N; Fèvre, Eric M

    2016-10-01

    Evidence suggests that the intracellular bacterial pathogen Coxiella burnetii (which causes Q fever) is widespread, with a near global distribution. While there has been increasing attention to Q fever epidemiology in high-income settings, a recent systematic review highlighted significant gaps in our understanding of the prevalence, spatial distribution and risk factors for Q fever infection across Africa. This research aimed to provide a One Health assessment of Q fever epidemiology in parts of Western and Nyanza Provinces, Western Kenya, in cattle and humans. A cross-sectional survey was conducted: serum samples from 2049 humans and 955 cattle in 416 homesteads were analysed for C. burnetii antibodies. Questionnaires covering demographic, socio-economic and husbandry information were also administered. These data were linked to environmental datasets based on geographical locations (e.g., land cover). Correlation and spatial-cross correlation analyses were applied to assess the potential link between cattle and human seroprevalence. Multilevel regression analysis was used to assess the relationships between a range of socio-economic, demographic and environmental factors and sero-positivity in both humans and animals. The overall sero-prevalence of C. burnetii was 2.5% in humans and 10.5% in cattle, but we found no evidence of correlation between cattle and human seroprevalence either within households, or when incorporating spatial proximity to other households in the survey. Multilevel modelling indicated the importance of several factors for exposure to the organism. Cattle obtained from market (as opposed to those bred in their homestead) and those residing in areas with lower precipitation levels had the highest sero-prevalence. For humans, the youngest age group had the highest odds of seropositivity, variations were observed between ethnic groups, and frequent livestock contact (specifically grazing and dealing with abortion material) was also a risk

  4. Systematic review of the epidemiological evidence comparing lung cancer risk in smokers of mentholated and unmentholated cigarettes

    Science.gov (United States)

    2011-01-01

    Background US mentholated cigarette sales have increased considerably over 50 years. Preference for mentholated cigarettes is markedly higher in Black people. While menthol itself is not genotoxic or carcinogenic, its acute respiratory effects might affect inhalation of cigarette smoke. This possibility seems consistent with the higher lung cancer risk in Black men, despite Black people smoking less and starting smoking later than White people. Despite experimental data suggesting similar carcinogenicity of mentholated and non-mentholated cigarettes, the lack of convincing evidence that mentholation increases puffing, inhalation or smoke uptake, and the similarity of lung cancer rates in Black and White females, a review of cigarette mentholation and lung cancer is timely given current regulatory interest in the topic. Methods Epidemiological studies comparing lung cancer risk in mentholated and non-mentholated cigarette smokers were identified from MedLine and other sources. Study details were extracted and strengths and weaknesses assessed. Relative risk estimates were extracted, or derived, for ever mentholated use and for long-term use, overall and by gender, race, and current/ever smoking, and meta-analyses conducted. Results Eight generally good quality studies were identified, with valid cases and controls, and appropriate adjustment for age, gender, race and smoking. The studies afforded good power to detect possible effects. However, only one study presented results by histological type, none adjusted for occupation or diet, and some provided no results by length of mentholated cigarette use. The data do not suggest any effect of mentholation on lung cancer risk. Adjusted relative risk estimates for ever use vary from 0.81 to 1.12, giving a combined estimate of 0.93 (95% confidence interval 0.84-1.02, n = 8), with no increase in males (1.01, 0.84-1.22, n = 5), females (0.80, 0.67-0.95, n = 5), White people (0.87, 0.75-1.03, n = 4) or Black people (0.90, 0

  5. The Sero-epidemiology of Coxiella burnetii in Humans and Cattle, Western Kenya: Evidence from a Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Nicola A Wardrop

    2016-10-01

    Full Text Available Evidence suggests that the intracellular bacterial pathogen Coxiella burnetii (which causes Q fever is widespread, with a near global distribution. While there has been increasing attention to Q fever epidemiology in high-income settings, a recent systematic review highlighted significant gaps in our understanding of the prevalence, spatial distribution and risk factors for Q fever infection across Africa. This research aimed to provide a One Health assessment of Q fever epidemiology in parts of Western and Nyanza Provinces, Western Kenya, in cattle and humans. A cross-sectional survey was conducted: serum samples from 2049 humans and 955 cattle in 416 homesteads were analysed for C. burnetii antibodies. Questionnaires covering demographic, socio-economic and husbandry information were also administered. These data were linked to environmental datasets based on geographical locations (e.g., land cover. Correlation and spatial-cross correlation analyses were applied to assess the potential link between cattle and human seroprevalence. Multilevel regression analysis was used to assess the relationships between a range of socio-economic, demographic and environmental factors and sero-positivity in both humans and animals. The overall sero-prevalence of C. burnetii was 2.5% in humans and 10.5% in cattle, but we found no evidence of correlation between cattle and human seroprevalence either within households, or when incorporating spatial proximity to other households in the survey. Multilevel modelling indicated the importance of several factors for exposure to the organism. Cattle obtained from market (as opposed to those bred in their homestead and those residing in areas with lower precipitation levels had the highest sero-prevalence. For humans, the youngest age group had the highest odds of seropositivity, variations were observed between ethnic groups, and frequent livestock contact (specifically grazing and dealing with abortion material was

  6. Trichloroethylene and Cancer: Systematic and Quantitative Review of Epidemiologic Evidence for Identifying Hazards

    Directory of Open Access Journals (Sweden)

    Cheryl Siegel Scott

    2011-11-01

    Full Text Available We conducted a meta-analysis focusing on studies with high potential for trichloroethylene (TCE exposure to provide quantitative evaluations of the evidence for associations between TCE exposure and kidney, liver, and non-Hodgkin lymphoma (NHL cancers. A systematic review documenting essential design features, exposure assessment approaches, statistical analyses, and potential sources of confounding and bias identified twenty-four cohort and case-control studies on TCE and the three cancers of interest with high potential for exposure, including five recently published case-control studies of kidney cancer or NHL. Fixed- and random-effects models were fitted to the data on overall exposure and on the highest exposure group. Sensitivity analyses examined the influence of individual studies and of alternative risk estimate selections. For overall TCE exposure and kidney cancer, the summary relative risk (RRm estimate from the random effects model was 1.27 (95% CI: 1.13, 1.43, with a higher RRm for the highest exposure groups (1.58, 95% CI: 1.28, 1.96. The RRm estimates were not overly sensitive to alternative risk estimate selections or to removal of an individual study. There was no apparent heterogeneity or publication bias. For NHL, RRm estimates for overall exposure and for the highest exposure group, respectively, were 1.23 (95% CI: 1.07, 1.42 and 1.43 (95% CI: 1.13, 1.82 and, for liver cancer, 1.29 (95% CI: 1.07, 1.56 and 1.28 (95% CI: 0.93, 1.77. Our findings provide strong support for a causal association between TCE exposure and kidney cancer. The support is strong but less robust for NHL, where issues of study heterogeneity, potential publication bias, and weaker exposure-response results contribute uncertainty, and more limited for liver cancer, where only cohort studies with small numbers of cases were available.

  7. The Association between Ambient Air Pollution and Allergic Rhinitis: Further Epidemiological Evidence from Changchun, Northeastern China.

    Science.gov (United States)

    Teng, Bo; Zhang, Xuelei; Yi, Chunhui; Zhang, Yan; Ye, Shufeng; Wang, Yafang; Tong, Daniel Q; Lu, Binfeng

    2017-02-23

    With the continuous rapid urbanization process over the last three decades, outdoors air pollution has become a progressively more serious public health hazard in China. To investigate the possible associations, lag effects and seasonal differences of urban air quality on respiratory health (allergic rhinitis) in Changchun, a city in Northeastern China, we carried out a time-series analysis of the incidents of allergic rhinitis (AR) from 2013 to 2015. Environmental monitoring showed that PM 2.5 and PM 10 were the major air pollutants in Changchun, followed by SO₂, NO₂ and O₃. The results also demonstrated that the daily concentrations of air pollutants had obvious seasonal differences. PM 10 had higher daily mean concentrations in spring (May, dust storms), autumn (October, straw burning) and winter (November to April, coal burning). The mean daily number of outpatient AR visits in the warm season was higher than in the cold season. The prevalence of allergic rhinitis was significantly associated with PM 2.5 , PM 10 , SO₂ and NO₂, and the increased mobility was 10.2% (95% CI, 5.5%-15.1%), 4.9% (95% CI, 0.8%-9.2%), 8.5% (95% CI, -1.8%-19.8%) and 11.1% (95% CI, 5.8%-16.5%) for exposure to each 1-Standard Deviation (1-SD) increase of pollutant, respectively. Weakly or no significant associations were observed for CO and O₃. As for lag effects, the highest Relative Risks (RRs) of AR from SO₂, NO₂, PM 10 and PM 2.5 were on the same day, and the highest RR from CO was on day 4 (L4). The results also indicated that the concentration of air pollutants might contribute to the development of AR. To summarize, this study provides further evidence of the significant association between ambient particulate pollutants (PM 2.5 and PM 10 , which are usually present in high concentrations) and the prevalence of respiratory effects (allergic rhinitis) in the city of Changchun, located in Northeastern China. Environmental control and public health strategies should be

  8. The Association between Ambient Air Pollution and Allergic Rhinitis: Further Epidemiological Evidence from Changchun, Northeastern China

    Directory of Open Access Journals (Sweden)

    Bo Teng

    2017-02-01

    Full Text Available With the continuous rapid urbanization process over the last three decades, outdoors air pollution has become a progressively more serious public health hazard in China. To investigate the possible associations, lag effects and seasonal differences of urban air quality on respiratory health (allergic rhinitis in Changchun, a city in Northeastern China, we carried out a time-series analysis of the incidents of allergic rhinitis (AR from 2013 to 2015. Environmental monitoring showed that PM2.5 and PM10 were the major air pollutants in Changchun, followed by SO2, NO2 and O3. The results also demonstrated that the daily concentrations of air pollutants had obvious seasonal differences. PM10 had higher daily mean concentrations in spring (May, dust storms, autumn (October, straw burning and winter (November to April, coal burning. The mean daily number of outpatient AR visits in the warm season was higher than in the cold season. The prevalence of allergic rhinitis was significantly associated with PM2.5, PM10, SO2 and NO2, and the increased mobility was 10.2% (95% CI, 5.5%–15.1%, 4.9% (95% CI, 0.8%–9.2%, 8.5% (95% CI, −1.8%–19.8% and 11.1% (95% CI, 5.8%–16.5% for exposure to each 1-Standard Deviation (1-SD increase of pollutant, respectively. Weakly or no significant associations were observed for CO and O3. As for lag effects, the highest Relative Risks (RRs of AR from SO2, NO2, PM10 and PM2.5 were on the same day, and the highest RR from CO was on day 4 (L4. The results also indicated that the concentration of air pollutants might contribute to the development of AR. To summarize, this study provides further evidence of the significant association between ambient particulate pollutants (PM2.5 and PM10, which are usually present in high concentrations and the prevalence of respiratory effects (allergic rhinitis in the city of Changchun, located in Northeastern China. Environmental control and public health strategies should be enforced to

  9. The Association between Ambient Air Pollution and Allergic Rhinitis: Further Epidemiological Evidence from Changchun, Northeastern China

    Science.gov (United States)

    Teng, Bo; Zhang, Xuelei; Yi, Chunhui; Zhang, Yan; Ye, Shufeng; Wang, Yafang; Tong, Daniel Q.; Lu, Binfeng

    2017-01-01

    With the continuous rapid urbanization process over the last three decades, outdoors air pollution has become a progressively more serious public health hazard in China. To investigate the possible associations, lag effects and seasonal differences of urban air quality on respiratory health (allergic rhinitis) in Changchun, a city in Northeastern China, we carried out a time-series analysis of the incidents of allergic rhinitis (AR) from 2013 to 2015. Environmental monitoring showed that PM2.5 and PM10 were the major air pollutants in Changchun, followed by SO2, NO2 and O3. The results also demonstrated that the daily concentrations of air pollutants had obvious seasonal differences. PM10 had higher daily mean concentrations in spring (May, dust storms), autumn (October, straw burning) and winter (November to April, coal burning). The mean daily number of outpatient AR visits in the warm season was higher than in the cold season. The prevalence of allergic rhinitis was significantly associated with PM2.5, PM10, SO2 and NO2, and the increased mobility was 10.2% (95% CI, 5.5%–15.1%), 4.9% (95% CI, 0.8%–9.2%), 8.5% (95% CI, −1.8%–19.8%) and 11.1% (95% CI, 5.8%–16.5%) for exposure to each 1-Standard Deviation (1-SD) increase of pollutant, respectively. Weakly or no significant associations were observed for CO and O3. As for lag effects, the highest Relative Risks (RRs) of AR from SO2, NO2, PM10 and PM2.5 were on the same day, and the highest RR from CO was on day 4 (L4). The results also indicated that the concentration of air pollutants might contribute to the development of AR. To summarize, this study provides further evidence of the significant association between ambient particulate pollutants (PM2.5 and PM10, which are usually present in high concentrations) and the prevalence of respiratory effects (allergic rhinitis) in the city of Changchun, located in Northeastern China. Environmental control and public health strategies should be enforced to

  10. Are Organic Food Labels Inadequate? Evidence from Consumers in Australia

    OpenAIRE

    Joanna Henryks; David Pearson; Tatiana Anisimova; Parves Sultan

    2015-01-01

    The organic sector is one of the fastest growing food markets in the developed world, with a significant number of consumers continuing to prioritise these products that are perceived to be healthier and more sustainably sourced. The body of existing research has identified that very few consumers are dedicated organic food buyers hence most are purchasing it only some of the time. The most commonly identified barriers to purchasing more are associated with price premiums and limited availabi...

  11. Inadequate Empirical Antibiotic Therapy in Hospital Acquired Pneumonia.

    Science.gov (United States)

    Dahal, S; Rijal, B P; Yogi, K N; Sherchand, J B; Parajuli, K; Parajuli, N; Pokhrel, B M

    2015-01-01

    Inadequate empirical antibiotic therapy for HAP is a common phenomena and one of the indicators of the poor stewardship. This study intended to analyze the efficacy of empirical antibiotics in the light of microbiological data in HAP cases. Suspected cases of HAP were followed for clinico-bacterial evidence, antimicrobial resistance and pre and post culture antibiotic use. The study was taken from February,2014 to July 2014 in department of Microbiology and department of Respiratory medicine prospectively. Data was analyzed by Microsoft Office Excel 2007. Out of 758 cases investigated, 77(10 %) cases were HAP, 65(84%) of them were culture positive and 48(74 %) were late in onset. In early onset cases, isolates were Acinetobacter 10(42%), Escherichia coli 5(21%), S.aureus 4(17%), Klebsiella 1(4%) and Pseudomonas 1(4%). From the late onset cases Acinetobacter 15(28%), Klebsiella 17(32%) and Pseudomonas 13(24%) were isolated. All Acinetobacter, 78% Klebsiella and 36% Pseudomonas isolates were multi drug resistant. Empirical therapies were inadequate in 12(70%) of early onset cases and 44(92%) of late onset type. Cephalosporins were used in 7(41%) of early onset infections but found to be adequate only in 2(12%) cases. Polymyxins were avoided empirically but after cultures were used in 9(19%) cases. Empirical antibiotics were vastly inadequate, more frequently so in late onset infections. Use of cephalosporins empirically in early onset infections and avoiding empirical use of polymyxin antibiotics in late onset infections contributed largely to the findings. Inadequate empirical regimen is a real time feedback for a practitioner to update his knowledge on the local microbiological trends.

  12. The epidemiology of self-defense gun use: evidence from the National Crime Victimization Surveys 2007-2011.

    Science.gov (United States)

    Hemenway, David; Solnick, Sara J

    2015-10-01

    To describe the epidemiology of self-defense gun use (SDGU) and the relative effectiveness of SDGU in preventing injury and property loss. Data come from the National Crime Victimization Survey for 2007-2011, focusing on personal contact crimes. For property loss, we examined incidents where the intent was to steal property. Multivariate analyses controlled for age, gender of offender and victim, if offender had a gun, urbanicity, and thirteen types of self-protective action. Of over 14,000 incidents in which the victim was present, 127 (0.9%) involved a SDGU. SDGU was more common among males, in rural areas, away from home, against male offenders and against offenders with a gun. After any protective action, 4.2% of victims were injured; after SDGU, 4.1% of victims were injured. In property crimes, 55.9% of victims who took protective action lost property, 38.5 of SDGU victims lost property, and 34.9% of victims who used a weapon other than a gun lost property. Compared to other protective actions, the National Crime Victimization Surveys provide little evidence that SDGU is uniquely beneficial in reducing the likelihood of injury or property loss. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Evidence of inadequate docosahexaenoic acid status in Brazilian pregnant and lactating women Evidencia de estado inadecuado del ácido docosahexaenóico en gestantes y nutrices brasileras Evidência de estado inadequado do ácido docosahexaenóico em gestantes e nutrizes brasileiras

    Directory of Open Access Journals (Sweden)

    Alexandre G Torres

    2009-04-01

    Full Text Available Recently published data concerning dietary intake of fat and food sources of (n-3 long-chain polyunsaturated fatty acids (LCPUFA in Brazil are reviewed together with data on biochemical indices of PUFA status during pregnancy and lactation and PUFA composition of breast milk in Brazilian adolescents and adults. Potential inadequacies of docosahexaenoic acid (DHA status among Brazilian pregnant and lactating women have not yet been thoroughly evaluated. The data reviewed show that dietary intake of food sources of n-3 LCPUFA is low and possibly deficient in Brazil, and that biochemical indices of maternal DHA status and breast milk DHA content are low compared to the international literature. These data indicate inadequate DHA status among Brazilian women during pregnancy and lactation, but this evidence needs confirmation through comprehensive and specific population-based studies.Son revisadas informaciones publicadas recientemente sobre la ingestión de tipos de grasas alimenticias y fuentes de alimentos de ácidos grasos poli-insaturados de cadena larga (AGPI-CL n-3 en Brasil, junto con índices bioquímicos del estado nutricional para AGPI en gestantes y nutrices y la composición en AGPI en la leche de mujeres brasileras adultas y adolescentes. Posibles inadecuaciones del estado nutricional del ácido docosahexaenóico (DHA en las gestantes y nutrices brasileras aún no fueron investigadas con amplitud y profundidad suficientes en Brasil. Los datos considerados muestran que la ingestión dietética de fuentes de alimentos de AGPI-CL n-3 en Brasil y baja e insuficiente. Así mismo, los índices bioquímicos del estado nutricional materno para el DHA y la proporción de DHA en la leche de mujeres brasileras adultas y adolescentes son bajos, cuando se comparan con datos internacionales. Estos datos indican posible estado inadecuado para el DHA en gestantes y nutrices brasileras, pero estas evidencias merecen confirmación por medio de estudios

  14. Systematic review with meta-analysis of the epidemiological evidence in the 1900s relating smoking to lung cancer

    Science.gov (United States)

    2012-01-01

    Background Smoking is a known lung cancer cause, but no detailed quantitative systematic review exists. We summarize evidence for various indices. Methods Papers published before 2000 describing epidemiological studies involving 100+ lung cancer cases were obtained from Medline and other sources. Studies were classified as principal, or subsidiary where cases overlapped with principal studies. Data were extracted on design, exposures, histological types and confounder adjustment. RRs/ORs and 95% CIs were extracted for ever, current and ex smoking of cigarettes, pipes and cigars and indices of cigarette type and dose–response. Meta-analyses and meta-regressions investigated how relationships varied by study and RR characteristics, mainly for outcomes exactly or closely equivalent to all lung cancer, squamous cell carcinoma (“squamous”) and adenocarcinoma (“adeno”). Results 287 studies (20 subsidiary) were identified. Although RR estimates were markedly heterogeneous, the meta-analyses demonstrated a relationship of smoking with lung cancer risk, clearly seen for ever smoking (random-effects RR 5.50, CI 5.07-5.96) current smoking (8.43, 7.63-9.31), ex smoking (4.30, 3.93-4.71) and pipe/cigar only smoking (2.92, 2.38-3.57). It was stronger for squamous (current smoking RR 16.91, 13.14-21.76) than adeno (4.21, 3.32-5.34), and evident in both sexes (RRs somewhat higher in males), all continents (RRs highest for North America and lowest for Asia, particularly China), and both study types (RRs higher for prospective studies). Relationships were somewhat stronger in later starting and larger studies. RR estimates were similar in cigarette only and mixed smokers, and similar in smokers of pipes/cigars only, pipes only and cigars only. Exceptionally no increase in adeno risk was seen for pipe/cigar only smokers (0.93, 0.62-1.40). RRs were unrelated to mentholation, and higher for non-filter and handrolled cigarettes. RRs increased with amount smoked, duration

  15. Systematic review with meta-analysis of the epidemiological evidence in the 1900s relating smoking to lung cancer

    Directory of Open Access Journals (Sweden)

    Lee Peter N

    2012-09-01

    Full Text Available Abstract Background Smoking is a known lung cancer cause, but no detailed quantitative systematic review exists. We summarize evidence for various indices. Methods Papers published before 2000 describing epidemiological studies involving 100+ lung cancer cases were obtained from Medline and other sources. Studies were classified as principal, or subsidiary where cases overlapped with principal studies. Data were extracted on design, exposures, histological types and confounder adjustment. RRs/ORs and 95% CIs were extracted for ever, current and ex smoking of cigarettes, pipes and cigars and indices of cigarette type and dose–response. Meta-analyses and meta-regressions investigated how relationships varied by study and RR characteristics, mainly for outcomes exactly or closely equivalent to all lung cancer, squamous cell carcinoma (“squamous” and adenocarcinoma (“adeno”. Results 287 studies (20 subsidiary were identified. Although RR estimates were markedly heterogeneous, the meta-analyses demonstrated a relationship of smoking with lung cancer risk, clearly seen for ever smoking (random-effects RR 5.50, CI 5.07-5.96 current smoking (8.43, 7.63-9.31, ex smoking (4.30, 3.93-4.71 and pipe/cigar only smoking (2.92, 2.38-3.57. It was stronger for squamous (current smoking RR 16.91, 13.14-21.76 than adeno (4.21, 3.32-5.34, and evident in both sexes (RRs somewhat higher in males, all continents (RRs highest for North America and lowest for Asia, particularly China, and both study types (RRs higher for prospective studies. Relationships were somewhat stronger in later starting and larger studies. RR estimates were similar in cigarette only and mixed smokers, and similar in smokers of pipes/cigars only, pipes only and cigars only. Exceptionally no increase in adeno risk was seen for pipe/cigar only smokers (0.93, 0.62-1.40. RRs were unrelated to mentholation, and higher for non-filter and handrolled cigarettes. RRs increased with amount smoked

  16. Epidemiological studies that ignore mechanism of disease causation are flawed and mechanistic evidence demonstrates that vaccines cause autism

    OpenAIRE

    Arumugham, Vinu

    2017-01-01

    Since vaccinologists are themselves ignorant of vaccine mechanisms, how can we expect epidemiologists to understand the mechanisms? So most epidemiological studies ignore mechanism of adverse event causation. If you ignore mechanism, you cannot design the study with appropriate controls. So the results of such epidemiological studies have to be discarded due to confounding. Proven mechanism involved in cow's milk contaminated vaccines causing folate receptor antibody related autism is des...

  17. The role of olive oil in disease prevention: a focus on the recent epidemiological evidence from cohort studies and dietary intervention trials.

    Science.gov (United States)

    Buckland, Genevieve; Gonzalez, Carlos A

    2015-04-01

    Consumption of olive oil within the Mediterranean diet has been long known to have many health benefits. However, only over the last decade has epidemiological research confirmed its protective role against developing several chronic diseases. The objective of this review was to give an overview of the state of art epidemiological evidence concerning the relationship between olive oil and key public health outcomes including mortality, CVD, diabetes, metabolic syndrome (MetS), obesity and cancer, with a particular focus on recent results from cohort studies and dietary intervention trials. Recent epidemiological research has shown that regular consumption of olive oil is associated with increased longevity. This benefit is partly due to the olive oil's unequivocal cardio-protective role. There is converging evidence on the benefits of olive oil for preventing several CVD risk factors, including diabetes, MetS and obesity. Olive oil is also implicated in preventing certain cancers, with the most promising findings for breast and digestive tract cancers, although the data are still not entirely consistent and mainly from case-control studies. These health benefits are supported by strong mechanistic evidence from experimental studies, demonstrating that specific components of olive oil have antihypertensive, antithrombotic, antioxidant, antiinflammatory and anticarcinogenic action. Despite the accumulating epidemiological research, there is still a lack of consistent results from high-quality studies for many health outcomes (i.e. certain cancers and metabolism-related disorders). Further research is mandatory, above all from prospective studies and randomised dietary intervention trials when feasible, to confirm some of the still potential health benefits.

  18. Systematic review with meta-analysis of the epidemiological evidence relating smoking to COPD, chronic bronchitis and emphysema

    Science.gov (United States)

    2011-01-01

    Background Smoking is a known cause of the outcomes COPD, chronic bronchitis (CB) and emphysema, but no previous systematic review exists. We summarize evidence for various smoking indices. Methods Based on MEDLINE searches and other sources we obtained papers published to 2006 describing epidemiological studies relating incidence or prevalence of these outcomes to smoking. Studies in children or adolescents, or in populations at high respiratory disease risk or with co-existing diseases were excluded. Study-specific data were extracted on design, exposures and outcomes considered, and confounder adjustment. For each outcome RRs/ORs and 95% CIs were extracted for ever, current and ex smoking and various dose response indices, and meta-analyses and meta-regressions conducted to determine how relationships were modified by various study and RR characteristics. Results Of 218 studies identified, 133 provide data for COPD, 101 for CB and 28 for emphysema. RR estimates are markedly heterogeneous. Based on random-effects meta-analyses of most-adjusted RR/ORs, estimates are elevated for ever smoking (COPD 2.89, CI 2.63-3.17, n = 129 RRs; CB 2.69, 2.50-2.90, n = 114; emphysema 4.51, 3.38-6.02, n = 28), current smoking (COPD 3.51, 3.08-3.99; CB 3.41, 3.13-3.72; emphysema 4.87, 2.83-8.41) and ex smoking (COPD 2.35, 2.11-2.63; CB 1.63, 1.50-1.78; emphysema 3.52, 2.51-4.94). For COPD, RRs are higher for males, for studies conducted in North America, for cigarette smoking rather than any product smoking, and where the unexposed base is never smoking any product, and are markedly lower when asthma is included in the COPD definition. Variations by sex, continent, smoking product and unexposed group are in the same direction for CB, but less clearly demonstrated. For all outcomes RRs are higher when based on mortality, and for COPD are markedly lower when based on lung function. For all outcomes, risk increases with amount smoked and pack-years. Limited data show risk decreases

  19. 9 CFR 417.6 - Inadequate HACCP Systems.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Inadequate HACCP Systems. 417.6... ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS § 417.6 Inadequate HACCP Systems. A HACCP system may be found to be inadequate if: (a) The HACCP plan in operation does not meet the requirements set forth in...

  20. Health care costs and financial consequences of epidemiological changes in chronic diseases in Latin America: evidence from Mexico.

    Science.gov (United States)

    Arredondo, A; Zúñiga, A; Parada, I

    2005-08-01

    To determine the costs of health services and the financial consequences of changes in the epidemiological profile of chronic diseases in Latin America. We conducted longitudinal analyses of costs and of the economic impact of the epidemiological transition in healthcare services for diabetes and hypertension in the Mexican health system. The study population included both the insured and uninsured populations. The cost-evaluation method was based on the instrumentation and consensus techniques. To estimate the epidemiological changes and financial consequences for 2004-2006, six models were constructed according to the Box-Jenkins technique, using confidence intervals of 95% and the Box-Pierce test. Costs ranged from US$613 to US$887 for diabetes, and from US$485 to US$622 for hypertension. Regarding epidemiological changes for 2004 compared with 2006, an increase is expected in both cases, although results predict a greater increase for diabetes, 10-15% in all three institutions (Phealth services required by insured and uninsured populations, the greater increase (17%) will be for the insured population (Psystem will be particularly strong. Another relevant financial factor is the appearance of internal competition in the use and allocation of financial resources among the main providers in the health services; this factor becomes even more complicated within each provider. In effect, within each institution, hypertension and diabetes programmes must compete for resources with other programmes for chronic and infectious diseases.

  1. Inadequate Nutritional Status of Hospitalized Cancer Patients

    Directory of Open Access Journals (Sweden)

    Ali Alkan

    2017-03-01

    Full Text Available Objective: In oncology practice, nutrition and also metabolic activity are essential to support the nutritional status and prevent malignant cachexia. It is important to evaluate the patients and plan the maneuvers at the start of the therapy. The primary objective of the study is to define the nutritional status of hospitalized patients and the factors affecting it in order to define the most susceptible patients and maneuvers for better nutritional support. Methods: Patients hospitalized in oncology clinic for therapy were evaluated for food intake and nutritional status through structured interviews. The clinical properties, medical therapies, elements of nutritional support were noted and predictors of inadequate nutritional status (INS were analyzed. Results: Four hundred twenty three patients, between 16-82 years old (median: 52 were evaluated. Nearly half of the patients (185, 43% reported a better appetite at home than in hospital and declared that hospitalization is an important cause of loss of appetite (140/185, 75.6%. Presence of nausea/vomiting (N/V, depression, age less than 65 and use of non-steroidal anti-inflammatory drugs (NSAIDs were associated with increased risk of INS in hospitalized cancer patients. On the contrary, steroid medication showed a positive impact on nutritional status of cancer patients. Conclusion: N/V, younger age, presence of depression and NSAIDs medication were associated with INS in hospitalized cancer patients. Clinicians should pay more attention to this group of patients. In addition, unnecessary hospitalizations and medications that may disturb oral intake must be avoided. Corticosteroids are important tools for managing anorexia and INS.

  2. Inadequate control of world's radioactive sources

    International Nuclear Information System (INIS)

    2002-01-01

    The radioactive materials needed to build a 'dirty bomb' can be found in almost any country in the world, and more than 100 countries may have inadequate control and monitoring programs necessary to prevent or even detect the theft of these materials. The IAEA points out that while radioactive sources number in the millions, only a small percentage have enough strength to cause serious radiological harm. It is these powerful sources that need to be focused on as a priority. In a significant recent development, the IAEA, working in collaboration with the United States Department of Energy (DOE) and the Russian Federation's Ministry for Atomic Energy (MINATOM), have established a tripartite working group on 'Securing and Managing Radioactive Sources'. Through its program to help countries improve their national infrastructures for radiation safety and security, the IAEA has found that more than 100 countries may have no minimum infrastructure in place to properly control radiation sources. However, many IAEA Member States - in Africa, Asia, Latin America, and Europe - are making progress through an IAEA project to strengthen their capabilities to control and regulate radioactive sources. The IAEA is also concerned about the over 50 countries that are not IAEA Member States (there are 134), as they do not benefit from IAEA assistance and are likely to have no regulatory infrastructure. The IAEA has been active in lending its expertise to search out and secure orphaned sources in several countries. More than 70 States have joined with the IAEA to collect and share information on trafficking incidents and other unauthorized movements of radioactive sources and other radioactive materials. The IAEA and its Member States are working hard to raise levels of radiation safety and security, especially focusing on countries known to have urgent needs. The IAEA has taken the leading role in the United Nations system in establishing standards of safety, the most significant of

  3. Peroxisome Proliferator-Activated Receptors as Mediators of Phthalate-Induced Effects in the Male and Female Reproductive Tract: Epidemiological and Experimental Evidence

    Directory of Open Access Journals (Sweden)

    Giuseppe Latini

    2008-01-01

    Full Text Available There is growing evidence that male as well as female reproductive function has been declining in human and wildlife populations over the last 40 years. Several factors such as lifestyle or environmental xenobiotics other than genetic factors may play a role in determining adverse effects on reproductive health. Among the environmental xenobiotics phthalates, a family of man-made pollutants are suspected to interfere with the function of the endocrine system and therefore to be endocrine disruptors. The definition of endocrine disruption is today extended to broader endocrine regulations, and includes activation of metabolic sensors, such as the peroxisome proliferator-activated receptors (PPARs. Toxicological studies have shown that phthalates can activate a subset of PPARs. Here, we analyze the epidemiological and experimental evidence linking phthalate exposure to both PPAR activation and adverse effects on male and female reproductive health.

  4. Mesothelioma incidence surveillance systems and claims for workers’ compensation. Epidemiological evidence and prospects for an integrated framework

    Science.gov (United States)

    2012-01-01

    Background Malignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos (mainly occupational). In Italy a large proportion of workers are protected from occupational diseases by public insurance and an epidemiological surveillance system for incident mesothelioma cases. Methods We set up an individual linkage between the Italian national mesothelioma register (ReNaM) and the Italian workers’ compensation authority (INAIL) archives. Logistic regression models were used to identify and test explanatory variables. Results We extracted 3270 mesothelioma cases with occupational origins from the ReNaM, matching them with 1625 subjects in INAIL (49.7%); 91.2% (1,482) of the claims received compensation. The risk of not seeking compensation is significantly higher for women and the elderly. Claims have increased significantly in recent years and there is a clear geographical gradient (northern and more developed regions having higher claims rates). The highest rates of compensation claims were after work known to involve asbestos. Conclusions Our data illustrate the importance of documentation and dissemination of all asbestos exposure modalities. Strategies focused on structural and systematic interaction between epidemiological surveillance and insurance systems are needed. PMID:22545679

  5. Mesothelioma incidence surveillance systems and claims for workers’ compensation. Epidemiological evidence and prospects for an integrated framework

    Directory of Open Access Journals (Sweden)

    Marinaccio Alessandro

    2012-07-01

    Full Text Available Abstract Background Malignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos (mainly occupational. In Italy a large proportion of workers are protected from occupational diseases by public insurance and an epidemiological surveillance system for incident mesothelioma cases. Methods We set up an individual linkage between the Italian national mesothelioma register (ReNaM and the Italian workers’ compensation authority (INAIL archives. Logistic regression models were used to identify and test explanatory variables. Results We extracted 3270 mesothelioma cases with occupational origins from the ReNaM, matching them with 1625 subjects in INAIL (49.7%; 91.2% (1,482 of the claims received compensation. The risk of not seeking compensation is significantly higher for women and the elderly. Claims have increased significantly in recent years and there is a clear geographical gradient (northern and more developed regions having higher claims rates. The highest rates of compensation claims were after work known to involve asbestos. Conclusions Our data illustrate the importance of documentation and dissemination of all asbestos exposure modalities. Strategies focused on structural and systematic interaction between epidemiological surveillance and insurance systems are needed.

  6. Profesi Epidemiologi

    Directory of Open Access Journals (Sweden)

    Buchari Lapau

    2011-01-01

    Full Text Available Makalah ini pertama kali menjelaskan perlu adanya profesi kesehatan masyarakat dalam rangka pembangunan kesehatan. Lalu dijelaskan apa profesi itu dan standar keberadaan profesi, atas dasar mana dapat ditetapkan bahwa pelayanan epidemiologi merupakan salah satu profesi. Dalam rangka pembinaan profesi kesehatan masyarakat, IAKMI dan APTKMI telah membentuk Majelis Kolegium Kesehatan Masyarakat Indonesia (MKKMI yang terdiri atas 8 kolegium antara lain Kolegium Epidemiologi, yang telah menyusun Standar Profesi Epidemiologi yang terdiri atas beberapa standar. Masing-masing standar dijelaskan mulai dari kurikulum, standar pelayanan epidmiologi, profil epidemiolog kesehatan, peran epidemiolog kesehatan, fungsi epidemiolog kesehatan, standar kompetensi epidemiologi, dan standar pendidikan profesi epidemiologi.

  7. Soviet civil defense is inadequate and meaningless

    International Nuclear Information System (INIS)

    Kaplan, F.M.

    1985-01-01

    In this paper, the author argues that Soviet civil defense plans exist primarily on paper and are used to pacify the Soviet people, not as plans to survive and prevail in a nuclear confrontation with the U.S. The author describes how the Soviet people have little faith in the civil defense programs. They don't believe they can survive an attack. Furthermore, he says the Soviets have never staged an evacuation exercise in any major city nor, even in smaller towns, has an entire community been evacuated. The author says there are numerous problems with the shelter programs as well. Very few existing shelters have any food stocks, only a few more have any water. There is little evidence that Soviet leaders have planned their economy with civil defense in mind. Nor - given the blatant inadequacies of Soviet civil defense programs, the marked vulnerabilities of the Soviet economy, and the intrinsic limitation and uncertainties about civil defense generally - is there much basis for claiming that Soviet leaders, even in desperate straits, would risk war with the United States while counting on civil defense measures to limit the damage wreaked on the Soviet Union

  8. Integration of Epidemiological Evidence in a Decision Support Model for the Control of Campylobacter in Poultry Production

    DEFF Research Database (Denmark)

    Garcia Clavero, Ana Belén; Madsen, Anders L.; Vigre, Håkan

    2013-01-01

    The control of human Campylobacteriosis is a priority in public health agendas all over the world. Poultry is considered a significant risk factor for human infections with Campylobacter and risk assessment models indicate that the successful implementation of Campylobacter control strategies...... in poultry will translate on a reduction of human Campylobacteriosis cases. Efficient control strategies implemented during primary production will reduce the risk of Campylobacter introduction in chicken houses and/or decrease Campylobacter concentration in infected chickens and their products. Consequently...... managers in specific decisions related to vaccination of commercial broilers for the control of Campylobacter. Epidemiological considerations and other crucial aspects including challenges associated with the quantitative part of the models are discussed in this manuscript. The outcome of the PGMs...

  9. Use of the Medicare database in epidemiologic and health services research: a valuable source of real-world evidence on the older and disabled populations in the US

    Directory of Open Access Journals (Sweden)

    Mues KE

    2017-05-01

    Full Text Available Katherine E Mues,1 Alexander Liede,1 Jiannong Liu,2 James B Wetmore,2 Rebecca Zaha,1 Brian D Bradbury,1 Allan J Collins,2 David T Gilbertson2 1Center for Observational Research, Amgen Inc., Thousand Oaks and San Francisco, CA, 2Chronic Disease Research Group, Minneapolis, MN, USA Abstract: Medicare is the federal health insurance program for individuals in the US who are aged ≥65 years, select individuals with disabilities aged <65 years, and individuals with end-stage renal disease. The Centers for Medicare and Medicaid Services grants researchers access to Medicare administrative claims databases for epidemiologic and health outcomes research. The data cover beneficiaries’ encounters with the health care system and receipt of therapeutic interventions, including medications, procedures, and services. Medicare data have been used to describe patterns of morbidity and mortality, describe burden of disease, compare effectiveness of pharmacologic therapies, examine cost of care, evaluate the effects of provider practices on the delivery of care and patient outcomes, and explore the health impacts of important Medicare policy changes. Considering that the vast majority of US citizens ≥65 years of age have Medicare insurance, analyses of Medicare data are now essential for understanding the provision of health care among older individuals in the US and are critical for providing real-world evidence to guide decision makers. This review is designed to provide researchers with a summary of Medicare data, including the types of data that are captured, and how they may be used in epidemiologic and health outcomes research. We highlight strengths, limitations, and key considerations when designing a study using Medicare data. Additionally, we illustrate the potential impact that Centers for Medicare and Medicaid Services policy changes may have on data collection, coding, and ultimately on findings derived from the data. Keywords: Medicare

  10. Fruits and vegetables: updating the epidemiologic evidence for the WCRF/AICR lifestyle recommendations for cancer prevention.

    Science.gov (United States)

    Norat, Teresa; Aune, Dagfinn; Chan, Doris; Romaguera, Dora

    2014-01-01

    The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) current dietary recommendations for cancer prevention include "eating at least five portions/servings of a variety of non-starchy vegetables and or fruits every day". The most recent report coordinated by WCRF/AICR (2007) concluded that the evidence of a protective effect of fruits and vegetables on cancer was either "probable"-mouth, pharynx and larynx, oesophagus stomach, lung- or "limited suggestive"-nasopharynx, lung, colorectum, ovary, endometrium, pancreas, liver-. In a previous report published by WCRF/AICR in 1997, the evidence of the association of fruits and vegetables with cancer risk was considered convincing. This judgement was based mainly on the results of case-control studies. The association of fruit and vegetable intake and the risk of colorectal, breast and pancreatic cancer was re-examined in the Continuous Update Project (CUP) and the results were quantitatively summarised in meta-analyses. The CUP, with more data available, has confirmed the conclusion of the WCRF/AICR second expert report that there is no convincing evidence that fruits and vegetables play a role on cancer aetiology. On the other hand, evidence that is more consistent has been collected in the CUP about the role of dietary fibre and colorectal cancer. The evidence on the role of dietary fibre in colorectal cancer aetiology has been recently upgraded by the CUP expert panel from probable to convincing.

  11. Risk factors and study designs used in research of youths ’ suicide behaviour — An epidemiological discussion with focus on level of evidence

    DEFF Research Database (Denmark)

    Christiansen, Erik; Stenager, Elsebeth; Bilenberg, Niels

    2014-01-01

    to level of evidence (LoE). Methods: We searched PubMed and psycINFO in order to identify relevant individual studies. Results: We included 36 studies of children and youth on suicidal behaviour and ideation-many rank low on LoE. For suicide, cohort design was often used, and mental illness (depression......Introduction: Many different epidemiology study designs have been used to analyse risk factors for suicide behaviour. The purpose of this study was to obtain an insight into the current study design used in research on youths' risk factors for suicide behaviour and to rank the studies according......, substance abuse and severity of mental illness) was the most common risk factor. Cohort studies are ranked 2b, which is high according to LoE. For suicide attempts, survey was often used, and psychopathology, substance abuse and being exposed to suicidal behaviour were the most common risk factors...

  12. Bayesian evidence and epidemiological implications of environmental contamination from acute respiratory infection in long-term care facilities.

    Science.gov (United States)

    Diaz-Decaro, J D; Launer, B; Mckinnell, J A; Singh, R; Dutciuc, T D; Green, N M; Bolaris, M; Huang, S S; Miller, L G

    2018-04-10

    Skilled nursing home facilities (SNFs) house a vulnerable population frequently exposed to respiratory pathogens. Our study aims to gain a better understanding of the transmission of nursing home-acquired viral respiratory infections in non-epidemic settings. Symptomatic surveillance was performed in three SNFs for residents exhibiting acute respiratory symptoms. Environmental surveillance of five high-touch areas was performed to assess possible transmission. All resident and environmental samples were screened using a commercial multiplex polymerase chain reaction platform. Bayesian methods were used to evaluate environmental contamination. Among nursing home residents with respiratory symptoms, 19% had a detectable viral pathogen (parainfluenza-3, rhinovirus/enterovirus, RSV, or influenza B). Environmental contamination was found in 20% of total room surface swabs of symptomatic residents. Environmental and resident results were all concordant. Target period prevalence among symptomatic residents ranged from 5.5 to 13.3% depending on target. Bayesian analysis quantifies the probability of environmental shedding due to parainfluenza-3 as 92.4% (95% CI: 86.8-95.8%) and due to rhinovirus/enterovirus as 65.6% (95% CI: 57.9-72.5%). Our findings confirm that non-epidemic viral infections are common among SNF residents exhibiting acute respiratory symptoms and that environmental contamination may facilitate further spread with considerable epidemiological implications. Findings further emphasise the importance of environmental infection control for viral respiratory pathogens in long-term care facilities.

  13. Major depression as a risk factor for high blood pressure: epidemiologic evidence from a national longitudinal study.

    Science.gov (United States)

    Patten, Scott B; Williams, Jeanne V A; Lavorato, Dina H; Campbell, Norman R C; Eliasziw, Michael; Campbell, Tavis S

    2009-04-01

    To determine whether major depression (MD) leads to an increased risk of new-onset high blood pressure diagnoses. The data source was the Canadian National Population Health Survey (NPHS). The NPHS included a short-form version of the Composite International Diagnostic Interview (CIDI-SF) to assess MD and collected self-report data about professionally diagnosed high blood pressure and the use of antihypertensive medications. The analysis included 12,270 respondents who did not report high blood pressure or the use of antihypertensive medications at a baseline interview conducted in 1994. Proportional hazards models were used to compare the incidence of high blood pressure in respondents with and without MD during 10 years of subsequent follow-up. After adjustment for age, the risk of developing high blood pressure was elevated in those with MD. The hazard ratio was 1.6 (95% Confidence Interval = 1.2-2.1), p = .001, indicating a 60% increase in risk. Adjustment for additional covariates did not alter the association. MD may be a risk factor for new-onset high blood pressure. Epidemiologic data cannot definitely confirm a causal role, and the association may be due to shared etiologic factors. However, the increased risk may warrant closer monitoring of blood pressure in people with depressive disorders.

  14. Burden of bacterial resistance among neonatal infections in low income countries: how convincing is the epidemiological evidence?

    Science.gov (United States)

    Huynh, Bich-Tram; Padget, Michael; Garin, Benoit; Herindrainy, Perlinot; Kermorvant-Duchemin, Elsa; Watier, Laurence; Guillemot, Didier; Delarocque-Astagneau, Elisabeth

    2015-03-15

    Antibiotic resistance is a threat in developing countries (DCs) because of the high burden of bacterial disease and the presence of risk factors for its emergence and spread. This threat is of particular concern for neonates in DCs where over one-third of neonatal deaths may be attributable to severe infections and factors such as malnutrition and HIV infection may increase the risk of death. Additional, undocumented deaths due to severe infection may also occur due to the high frequency of at-home births in DCs. We conducted a systematic review of studies published after 2000 on community-acquired invasive bacterial infections and antibiotic resistance among neonates in DCs. Twenty-one articles met all inclusion criteria and were included in the final analysis. Ninety percent of studies recruited participants at large or university hospitals. The majority of studies were conducted in Sub-Saharan Africa (n=10) and the Indian subcontinent (n=8). Neonatal infection incidence ranged from 2.9 (95% CI 1.9-4.2) to 24 (95% CI 21.8-25.7) for 1000 live births. The three most common bacterial isolates in neonatal sepsis were Staphylococcus aureus, Escherichia coli, and Klebsiella. Information on antibiotic resistance was sparse and often relied on few isolates. The majority of resistance studies were conducted prior to 2008. No conclusions could be drawn on Enterobacteriaceae resistance to third generation cephalosporins or methicillin resistance among Staphylococcus aureus. Available data were found insufficient to draw a true, recent, and accurate picture of antibiotic resistance in DCs among severe bacterial infection in neonates, particularly at the community level. Existing neonatal sepsis treatment guidelines may no longer be appropriate, and these data are needed as the basis for updated guidelines. Reliable microbiological and epidemiological data at the community level are needed in DCs to combat the global challenge of antibiotic resistance especially among

  15. Evidence of diversity among epidemiologically related carbapenemase-producing Acinetobacter baumannii strains belonging to international clonal lineage II.

    Science.gov (United States)

    Minandri, Fabrizia; D'Arezzo, Silvia; Antunes, Luísa C S; Pourcel, Christine; Principe, Luigi; Petrosillo, Nicola; Visca, Paolo

    2012-03-01

    Carbapenem-resistant Acinetobacter baumannii strains belonging to international clonal lineage II (ICL-II) have become predominant in intensive care units (ICUs) throughout Italy. Between 2005 and 2009, the carbapenem-hydrolyzing class D β-lactamase (CHDL) bla(OXA-23) gene became more prevalent than bla(OXA-58) among epidemic ICL-II strains showing extensive genetic similarity. These findings posed the question of whether CHDL gene replacement occurred in the homogeneous ICL-II population or a new OXA-23 clone(s) emerged and spread in ICUs. In this study, the changes in the ICL-II A. baumannii population and CHDL gene carriage were investigated in 30 genetically related isolates collected during the bla(OXA-58)-to-bla(OXA-23) transition period. Pulsotyping, randomly amplified polymorphic DNA (RAPD) analysis, and multilocus sequence typing (MLST) results were combined with multilocus variable-number tandem-repeat (VNTR) analysis (MLVA-8), siderotyping, and plasmid profiling to improve genotype-based discrimination between isolates. Pulsotyping, RAPD analysis, and MLST clustered isolates into a single type. MLVA-8 identified 19 types that clustered into three complexes. All OXA-23-producing isolates formed a single complex, while OXA-58 producers were split into two complexes. Southern blot analysis of the physical localization and genetic context of the CHDL genes showed that bla(OXA-58) was invariably located on plasmids, while bla(OXA-23) was present within Tn2006 on the chromosome or both the chromosome and plasmids. These data indicate that the apparently homogeneous population of CHDL-producing ICL-II strains was composed of several independent strains and that, between 2005 and 2009, distinct OXA-23 producers displaced the preexisting OXA-58 producers. Thus, MLVA-8 appears to be a suitable tool not only for investigating A. baumannii population structure but also for high-resolution epidemiological typing.

  16. Demographic and epidemiologic characterization of transfusion recipients from four US regions: evidence from the REDS-III recipient database.

    Science.gov (United States)

    Karafin, Matthew S; Bruhn, Roberta; Westlake, Matt; Sullivan, Marian T; Bialkowski, Walter; Edgren, Gustaf; Roubinian, Nareg H; Hauser, Ronald G; Kor, Daryl J; Fleischmann, Debra; Gottschall, Jerome L; Murphy, Edward L; Triulzi, Darrell J

    2017-12-01

    Blood transfusion is one of the most common medical procedures during hospitalization in the United States. To understand the benefits of transfusion while mitigating potential risks, a multicenter database containing detailed information on transfusion incidence and recipient outcomes would facilitate research. The Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) program has developed a comprehensive transfusion recipient database utilizing data from hospital electronic health records at 12 participating hospitals in four geographic regions. Inpatient and outpatient data on transfusion recipients from January 1, 2013 to December 31, 2014 included patient age, sex, ethnicity, primary diagnosis, type of blood product provided, issue location, pretransfusion and post-transfusion hemoglobin (Hgb), and hospital outcomes. Transfusion incidence per encounter was calculated by blood product and various patient characteristics. During the 2-year study period, 80,362 (12.5%) inpatient encounters involved transfusion. Among inpatients, the most commonly transfused blood products were red blood cells (RBCs; 10.9% of encounters), followed by platelets (3.2%) and plasma (2.9%). Among patients who received transfusions, the median number of RBC units was one, the pretransfusion Hgb level was 7.6 g/dL, and the Hgb increment per unit was 1.4 g/dL. Encounter mortality increased with patient age, the number of units transfused, and the use of platelet or plasma products. The most commonly reported transfusion reaction was febrile nonhemolytic. The database contains comprehensive data regarding transfusion use and patient outcomes. The current report describes an evaluation of the first 2 years of a planned, 4-year, linked blood donor-component-recipient database, which represents a critical new resource for transfusion medicine researchers. © 2017 AABB.

  17. Near-highway pollutants in motor vehicle exhaust: A review of epidemiologic evidence of cardiac and pulmonary health risks

    Directory of Open Access Journals (Sweden)

    Durant John L

    2007-08-01

    Full Text Available Abstract There is growing evidence of a distinct set of freshly-emitted air pollutants downwind from major highways, motorways, and freeways that include elevated levels of ultrafine particulates (UFP, black carbon (BC, oxides of nitrogen (NOx, and carbon monoxide (CO. People living or otherwise spending substantial time within about 200 m of highways are exposed to these pollutants more so than persons living at a greater distance, even compared to living on busy urban streets. Evidence of the health hazards of these pollutants arises from studies that assess proximity to highways, actual exposure to the pollutants, or both. Taken as a whole, the health studies show elevated risk for development of asthma and reduced lung function in children who live near major highways. Studies of particulate matter (PM that show associations with cardiac and pulmonary mortality also appear to indicate increasing risk as smaller geographic areas are studied, suggesting localized sources that likely include major highways. Although less work has tested the association between lung cancer and highways, the existing studies suggest an association as well. While the evidence is substantial for a link between near-highway exposures and adverse health outcomes, considerable work remains to understand the exact nature and magnitude of the risks.

  18. Arsenic in drinking water and urinary tract cancers: a systematic review of 30 years of epidemiological evidence.

    Science.gov (United States)

    Saint-Jacques, Nathalie; Parker, Louise; Brown, Patrick; Dummer, Trevor Jb

    2014-06-02

    Arsenic in drinking water is a public health issue affecting hundreds of millions of people worldwide. This review summarizes 30 years of epidemiological studies on arsenic exposure in drinking water and the risk of bladder or kidney cancer, quantifying these risks using a meta-analytical framework. Forty studies met the selection criteria. Seventeen provided point estimates of arsenic concentrations in drinking water and were used in a meta-analysis of bladder cancer incidence (7 studies) and mortality (10 studies) and kidney cancer mortality (2 studies). Risk estimates for incidence and mortality were analyzed separately using Generalized Linear Models. Predicted risks for bladder cancer incidence were estimated at 10, 50 and 150 μg/L arsenic in drinking water. Bootstrap randomizations were used to assess robustness of effect size. Twenty-eight studies observed an association between arsenic in drinking water and bladder cancer. Ten studies showed an association with kidney cancer, although of lower magnitude than that for bladder cancer. The meta-analyses showed the predicted risks for bladder cancer incidence were 2.7 [1.2-4.1]; 4.2 [2.1-6.3] and; 5.8 [2.9-8.7] for drinking water arsenic levels of 10, 50, and 150 μg/L, respectively. Bootstrapped randomizations confirmed this increased risk, but, lowering the effect size to 1.4 [0.35-4.0], 2.3 [0.59-6.4], and 3.1 [0.80-8.9]. The latter suggests that with exposures to 50 μg/L, there was an 83% probability for elevated incidence of bladder cancer; and a 74% probability for elevated mortality. For both bladder and kidney cancers, mortality rates at 150 ug/L were about 30% greater than those at 10 μg/L. Arsenic in drinking water is associated with an increased risk of bladder and kidney cancers, although at lower levels (water may double the risk of bladder cancer, or at the very least, increase it by about 40%. With the large number of people exposed to these arsenic concentrations worldwide the public health

  19. Arsenic in drinking water and urinary tract cancers: a systematic review of 30 years of epidemiological evidence

    Science.gov (United States)

    2014-01-01

    Background Arsenic in drinking water is a public health issue affecting hundreds of millions of people worldwide. This review summarizes 30 years of epidemiological studies on arsenic exposure in drinking water and the risk of bladder or kidney cancer, quantifying these risks using a meta-analytical framework. Methods Forty studies met the selection criteria. Seventeen provided point estimates of arsenic concentrations in drinking water and were used in a meta-analysis of bladder cancer incidence (7 studies) and mortality (10 studies) and kidney cancer mortality (2 studies). Risk estimates for incidence and mortality were analyzed separately using Generalized Linear Models. Predicted risks for bladder cancer incidence were estimated at 10, 50 and 150 μg/L arsenic in drinking water. Bootstrap randomizations were used to assess robustness of effect size. Results Twenty-eight studies observed an association between arsenic in drinking water and bladder cancer. Ten studies showed an association with kidney cancer, although of lower magnitude than that for bladder cancer. The meta-analyses showed the predicted risks for bladder cancer incidence were 2.7 [1.2–4.1]; 4.2 [2.1–6.3] and; 5.8 [2.9–8.7] for drinking water arsenic levels of 10, 50, and 150 μg/L, respectively. Bootstrapped randomizations confirmed this increased risk, but, lowering the effect size to 1.4 [0.35–4.0], 2.3 [0.59–6.4], and 3.1 [0.80–8.9]. The latter suggests that with exposures to 50 μg/L, there was an 83% probability for elevated incidence of bladder cancer; and a 74% probability for elevated mortality. For both bladder and kidney cancers, mortality rates at 150 ug/L were about 30% greater than those at 10 μg/L. Conclusion Arsenic in drinking water is associated with an increased risk of bladder and kidney cancers, although at lower levels (water may double the risk of bladder cancer, or at the very least, increase it by about 40%. With the large number of people exposed to these

  20. Evident?

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind......Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind...

  1. Teaching evidence-based medicine to undergraduate medical students: a course integrating ethics, audit, management and clinical epidemiology.

    Science.gov (United States)

    Rhodes, Martin; Ashcroft, Richard; Atun, Rifat A; Freeman, George K; Jamrozik, Konrad

    2006-06-01

    A six-week full time course for third-year undergraduate medical students at Imperial College uniquely links evidence-based medicine (EBM) with ethics and the management of change in health services. It is mounted jointly by the Medical and Business Schools and features an experiential approach. Small teams of students use a problem-based strategy to address practical issues identified from a range of clinical placements in primary and secondary care settings. The majority of these junior clinical students achieve important objectives for learning about teamwork, critical appraisal, applied ethics and health care organisations. Their work often influences the care received by patients in the host clinical units. We discuss the strengths of the course in relation to other accounts of programmes in EBM. We give examples of recurring experiences from successive cohorts and discuss assessment issues and how our multi-phasic evaluation informs evolution of the course and the potential for future developments.

  2. Epidemiology and Radiation Protection

    International Nuclear Information System (INIS)

    1987-01-01

    Epidemiology aims at providing direct evidence of the long term health effects in humans due to potentially dangerous exposures to various nuisance agents, including ionising radiation. Inappropriate interpretation and use of the results of epidemiological studies may result in inaccurate assessments of the risks associated with radiation exposure. This report presents the proceedings of a Workshop organised by the NEA to create an opportunity for epidemiologists and radiation protection specialists to exchange their experiences and views on the problems of methodology in epidemiological research and on the application of its results to the assessment of radiation risks

  3. Influence of aspirin and non-aspirin NSAID use on ovarian and endometrial cancer: Summary of epidemiologic evidence of cancer risk and prognosis.

    Science.gov (United States)

    Verdoodt, F; Kjaer, S K; Friis, S

    2017-06-01

    Increasing evidence supports a role for aspirin use in reducing the incidence and mortality of several cancer types. This has spurred a new wave of interest in this widely used drug. In this review, we present and evaluate the epidemiologic evidence of the association between the use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) and the incidence and prognosis of ovarian and endometrial cancer. The evidence of a preventive effect of NSAID use on risk of ovarian or endometrial cancer is based primarily on results from observational studies and, consequently, is only suggestive. Overall, observational studies indicate modest reductions in risk of ovarian and endometrial cancer with aspirin use, whereas the results for non-aspirin NSAID use are equivocal. The strongest inverse associations have been reported for long-term consistent aspirin use, notably among subgroups of users (e.g., those with high body mass index). Few studies have evaluated the influence of NSAID use on the mortality of ovarian or endometrial cancer, and substantial heterogeneity of study characteristics and results preclude any conclusions. Additional studies of aspirin and non-aspirin NSAID use and ovarian or endometrial cancer risk and prognosis are warranted. In the present review, we discuss the importance of comprehensive exposure definitions (i.e., duration, timing, consistency and intensity/dose) and evaluation of potential effect modification according to user characteristics, with the aim of identifying women who may experience the largest benefit of aspirin or non-aspirin NSAID use on risk or prognosis of ovarian and endometrial cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Issues in epidemiological studies of radiofrequency workers

    International Nuclear Information System (INIS)

    Hocking, B.

    1985-01-01

    The paper reviews some of the issues in a proposed epidemiological study of radiofrequency workers. First a few other epidemiological studies are discussed to illustrate some of the common problems such as inadequate definition of effects and/or exposure. Then technical problems in determining dosage and responses as well as study design are reviewed, and finally the administrative aspects of ethics, industrial relations and costs are considered

  5. Environmental stressors and cardio-metabolic disease: part I-epidemiologic evidence supporting a role for noise and air pollution and effects of mitigation strategies.

    Science.gov (United States)

    Münzel, Thomas; Sørensen, Mette; Gori, Tommaso; Schmidt, Frank P; Rao, Xiaoquan; Brook, Jeffrey; Chen, Lung Chi; Brook, Robert D; Rajagopalan, Sanjay

    2017-02-21

    Traffic noise and air pollution together represent the two most important environmental risk factors in urbanized societies. The first of this two-part review discusses the epidemiologic evidence in support of the existence of an association between these risk factors with cardiovascular and metabolic disease. While independent effects of these risk factors have now clearly been shown, recent studies also suggest that the two exposures may interact with each other and with traditional risk factors such as hypertension and type 2 diabetes. From a societal and policy perspective, the health effects of both air pollution and traffic noise are observed for exposures well below the thresholds currently accepted as being safe. Current gaps in knowledge, effects of intervention and their impact on cardiovascular disease, will be discussed in the last section of this review. Increased awareness of the societal burden posed by these novel risk factors and acknowledgement in traditional risk factor guidelines may intensify the efforts required for effective legislation to reduce air pollution and noise. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions please email: journals.permissions@oup.com.

  6. Lifestyle, Diet, and Colorectal Cancer Risk According to (Epi)genetic Instability: Current Evidence and Future Directions of Molecular Pathological Epidemiology.

    Science.gov (United States)

    Hughes, Laura A E; Simons, Colinda C J M; van den Brandt, Piet A; van Engeland, Manon; Weijenberg, Matty P

    2017-01-01

    In this review, we describe molecular pathological epidemiology (MPE) studies from around the world that have studied diet and/or lifestyle factors in relation to molecular markers of (epi)genetic pathways in colorectal cancer (CRC), and explore future perspectives in this realm of research. The main focus of this review is diet and lifestyle factors for which there is evidence for an association with CRC as identified by the World Cancer Research Fund reports. In addition, we review promising hypotheses, that warrant consideration in future studies. Associations between molecular characteristics of CRC have been published in relation to smoking, alcohol consumption; body mass index (BMI); waist:hip ratio; adult attained height; physical activity; early life energy restriction; dietary acrylamide, fiber, fat, methyl donors, omega 3 fatty acids; meat, including total protein, processed meat, and heme iron; and fruit and vegetable intake. MPE studies help identify where associations between diet, lifestyle, and CRC risk may otherwise be masked and also shed light on how timing of exposure can influence etiology. Sample size is often an issue, but this may be addressed in the future by pooling data.

  7. Doenças periodontais causam doenças cardiovasculares? Análise das evidências epidemiológicas Does periodontal disease cause cardiovascular disease? Analysis of epidemiological evidence

    Directory of Open Access Journals (Sweden)

    Joana Cunha-Cruz

    2003-04-01

    Full Text Available Este artigo é uma análise de estudos epidemiológicos que avaliaram a doença periodontal como causa de doenças cardiovasculares. Foram identificados 35 estudos por meio de busca manual nos volumes especiais de resumos do periódico Journal of Dental Research; de busca nos bancos de dados eletrônicos MEDLINE, LILACS e ISI; e da inspeção de bibliografias dos artigos identificados. Os critérios de inclusão foram: artigos em qualquer idioma publicados entre 1989 e 2000, que relataram a ausência ou presença de associação entre doenças periodontais e doenças cardiovasculares. As evidências disponíveis ainda são esparsas e suas interpretações são limitadas por potenciais vieses e situação de confusão. Os estudos analisados, tanto separadamente quanto juntos, não fornecem evidência epidemiológica convincente para uma associação causal entre doenças periodontais e doenças cardiovasculares. Entretanto, a possibilidade das doenças bucais causarem doenças cardiovasculares ainda não pode ser descartada. Até que dados adequados estejam disponíveis, não se deve considerar as doenças periodontais ou qualquer outra infecção bucal como causa de doenças cardiovasculares.This article reports a critical analysis of epidemiologic studies that evaluated periodontal disease as a cause of cardiovascular disease. Thirty-five studies were identified through a manual search of the special abstracts volumes of the Journal of Dental Research, as well as an electronic search on MEDLINE, LILACS, and ISI and inspection of the articles' bibliographies. Inclusion criteria were: articles in any language published between 1989 and 2000 reporting the presence or absence of an association between periodontal and cardiovascular diseases. Available studies are scarce, and interpretations are limited by potential bias and confounding. The studies analyzed (whether separately or jointly fail to provide convincing epidemiologic evidence for a

  8. Big Five personality traits may inform public health policy and preventive medicine: Evidence from a cross-sectional and a prospective longitudinal epidemiologic study in a Swiss community.

    Science.gov (United States)

    Hengartner, Michael P; Kawohl, Wolfram; Haker, Helene; Rössler, Wulf; Ajdacic-Gross, Vladeta

    2016-05-01

    Some evidence documents the importance of personality assessments for health research and practise. However, no study has opted to test whether a short self-report personality inventory may comprehensively inform health policy. Data were taken from a population-based epidemiologic survey in Zurich, Switzerland, conducted from 2010-2012. A short form of the Big Five Inventory was completed by n=1155 participants (54.4% women; mean age=29.6 years), while health-related outcomes were taken from a comprehensive semi-structured clinical interview. A convenience subsample averaging n=171 participants additionally provided laboratory measures and n=133 were subsequently followed-up at least once over a maximal period of 6 months. Personality traits, in particular high neuroticism and low conscientiousness, related significantly to poor environmental resources such as low social support (R(2)=0.071), health-impairing behaviours such as cannabis use (R(2)=0.071), and psychopathology, including negative affect (R(2)=0.269) and various mental disorders (R(2)=0.060-0.195). The proportion of total variance explained was R(2)=0.339 in persons with three or more mental disorders. Personality significantly related to some laboratory measures including total cholesterol (R(2)=0.095) and C-Reactive Protein (R(2)=0.062). Finally, personality prospectively predicted global psychopathological distress and vegetative symptoms over a 6-month observation period. Personality relates consistently to poor socio-environmental resources, health-impairing behaviours and psychopathology. We also found some evidence for an association with metabolic and immune functions that are assumed to influence health. A short personality inventory could provide valuable information for preventive medicine when used as a means to screen entire populations for distinct risk exposure, in particular with respect to psychopathology. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. No molecular epidemiological evidence supporting household transmission of zoonotic Giardia duodenalis and Cryptosporidium spp. from pet dogs and cats in the province of Álava, Northern Spain.

    Science.gov (United States)

    de Lucio, Aida; Bailo, Begoña; Aguilera, María; Cardona, Guillermo A; Fernández-Crespo, Juan C; Carmena, David

    2017-06-01

    The role of pet dogs and cats as suitable source of human infections by the diarrheagenic protozoan parasites Giardia duodenalis and Cryptosporidium spp. has been a topic of intense debate for long time and still remains a largely unsolved problem. In this cross-sectional molecular epidemiological survey we attempted to investigate whether zoonotic (or zooanthroponotic) disease transmission was occurring among humans and domestic dogs and cats sharing the same spatial and temporal setting in both rural and urban areas of the province of Álava, Northern Spain. A total of 268 (including 179 human, 55 canine, and 34 feline) individual faecal specimens were obtained from 63 family households during February-March and November-December 2014. Detection of G. duodenalis cysts and Cryptosporidium spp. oocysts was achieved by direct fluorescence microscopy (DFAT) and PCR-based methods targeting the small subunit (SSU) ribosomal RNA gene of the parasites. Giardia-positive isolates were subsequently sub-genotyped at the glutamate dehydrogenase (GDH) and β-giardin (BG) genes. Overall, G. duodenalis infections were identified in 3.4% (6/179) of humans, 29% (16/55) of dogs, and 5.9% (2/34) of cats, respectively. Cryptosporidium spp. infections were detected in 1.1% (2/179) of humans, 5.5% (3/55) of dogs, and 8.8% (3/34) of cats, respectively. Simultaneous infections in human and canine/feline hosts by G. duodenalis or Cryptosporidium spp. were only demonstrated in a single household in which a cat and its owner tested positive for Cryptosporidium by DFAT, but this result could not be confirmed by SSU-PCR. Infections were homogeneously distributed among the studied human or animal populations irrespectively of their sex, age group, or geographical region of origin. Inadequate washing of raw vegetables and fruits was the only risk factor significantly associated to a higher likelihood of having human giardiosis/cryptosporidiosis. Molecular characterization of G. duodenalis

  10. The impact of inadequate wastewater treatment on the receiving ...

    African Journals Online (AJOL)

    The impact of inadequate wastewater treatment on the receiving water bodies – Case study: Buffalo City and Nkokonbe Municipalities of the Eastern Cape ... into their respective receiving water bodies (Tembisa Dam, the Nahoon and Eastern Beach which are part of the Indian Ocean; the Tyume River and the Kat River).

  11. The impact of inadequate wastewater treatment on the receiving ...

    African Journals Online (AJOL)

    7950 = Water SA (on-line). 687. The impact of inadequate wastewater treatment on the receiving water bodies – Case study: Buffalo City and. Nkokonbe Municipalities of the Eastern Cape Province. MNB Momba1*, AN Osode2 and M Sibewu1.

  12. Inadequate cerebral oxygen delivery and central fatigue during strenuous exercise

    DEFF Research Database (Denmark)

    Nybo, Lars; Rasmussen, Peter

    2007-01-01

    Under resting conditions, the brain is protected against hypoxia because cerebral blood flow increases when the arterial oxygen tension becomes low. However, during strenuous exercise, hyperventilation lowers the arterial carbon dioxide tension and blunts the increase in cerebral blood flow, which...... can lead to an inadequate oxygen delivery to the brain and contribute to the development of fatigue....

  13. Inadequate Information in Laboratory Test Requisition in a Tertiary ...

    African Journals Online (AJOL)

    Aim: Laboratory investigations are important aspect of patient management and inadequate information or errors arising from the process of filling out laboratory Request Forms can impact significantly on the quality of laboratory result and ultimately on patient care. Objectives: This study examined the pattern of deficiencies ...

  14. Inadequate sleep and muscle strength: Implications for resistance training.

    Science.gov (United States)

    Knowles, Olivia E; Drinkwater, Eric J; Urwin, Charles S; Lamon, Séverine; Aisbett, Brad

    2018-02-02

    Inadequate sleep (e.g., an insufficient duration of sleep per night) can reduce physical performance and has been linked to adverse metabolic health outcomes. Resistance exercise is an effective means to maintain and improve physical capacity and metabolic health, however, the outcomes for populations who may perform resistance exercise during periods of inadequate sleep are unknown. The primary aim of this systematic review was to evaluate the effect of sleep deprivation (i.e. no sleep) and sleep restriction (i.e. a reduced sleep duration) on resistance exercise performance. A secondary aim was to explore the effects on hormonal indicators or markers of muscle protein metabolism. A systematic search of five electronic databases was conducted with terms related to three combined concepts: inadequate sleep; resistance exercise; performance and physiological outcomes. Study quality and biases were assessed using the Effective Public Health Practice Project quality assessment tool. Seventeen studies met the inclusion criteria and were rated as 'moderate' or 'weak' for global quality. Sleep deprivation had little effect on muscle strength during resistance exercise. In contrast, consecutive nights of sleep restriction could reduce the force output of multi-joint, but not single-joint movements. Results were conflicting regarding hormonal responses to resistance training. Inadequate sleep impairs maximal muscle strength in compound movements when performed without specific interventions designed to increase motivation. Strategies to assist groups facing inadequate sleep to effectively perform resistance training may include supplementing their motivation by training in groups or ingesting caffeine; or training prior to prolonged periods of wakefulness. Copyright © 2018. Published by Elsevier Ltd.

  15. Mendelian randomization in nutritional epidemiology

    OpenAIRE

    Qi, Lu

    2009-01-01

    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 o...

  16. Coccidioidomycosis: epidemiology

    Directory of Open Access Journals (Sweden)

    Brown J

    2013-06-01

    Full Text Available Jennifer Brown,1 Kaitlin Benedict,2 Benjamin J Park,2 George R Thompson III1,31Department of Internal Medicine, Division of Infectious Diseases, University of California, Davis Medical Center, Sacramento, CA, USA; 2Mycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA; 3Department of Medical Microbiology and Immunology, One Shields Avenue, Tupper Hall, Coccidioidomycosis Serology Laboratory, University of California, Davis, CA, USAAbstract: Coccidioidomycosis consists of a spectrum of disease, ranging from a mild, self-limited, febrile illness to severe, life-threatening infection. It is caused by the soil-dwelling fungi, Coccidioides immitis and C. posadasii, which are present in diverse endemic areas. Climate changes and environmental factors affect the Coccidioides lifecycle and influence infection rates. The incidence of coccidioidomycosis has risen substantially over the past two decades. The vast majority of Coccidioides infections occur in the endemic zones, such as California, Arizona, Mexico, and Central America. Infections occurring outside those zones appear to be increasingly common, and pose unique clinical and public health challenges. It has long been known that elderly persons, pregnant women, and members of certain ethnic groups are at risk for severe or disseminated coccidioidomycosis. In recent years, it has become evident that persons with immunodeficiency diseases, diabetics, transplant recipients, and prisoners are also particularly vulnerable.Keywords: coccidioidomycosis, Coccidioides, epidemiology, incidence, risk factors, geography

  17. Tea and cancer prevention: an evaluation of the epidemiologic literature.

    Science.gov (United States)

    Kohlmeier, L; Weterings, K G; Steck, S; Kok, F J

    1997-01-01

    Animal and in vitro studies provide evidence of an anticarcinogenic potential of active ingredients in teas. This review encompasses epidemiologic studies of stomach, colon, and lung cancer as well as the evidence of a relationship between tea drinking and cancer at large in humans. Cohort studies do not suggest a protective role for tea drinking in the total risk of cancer. Site-specific studies reveal a more complex picture. The epidemiologic studies on tea drinking and stomach cancer do not justify claims of a cancer-protective effect. A protective effect of green tea on the development of colon cancer is suggested. The evidence regarding black tea is less clear, with some indication of a risk of colon or rectal cancer associated with regular use of black tea. The studies on tea and lung cancer also suggest an increased risk with increased tea consumption. The range and crude categorization of tea consumption, choice of control groups, and inadequate control for confounding might have obscured possible relationships. From the limited studies that suggest a favorable effect from tea, it is likely that benefits are restricted to high intakes in high-risk populations.

  18. Inadequate vocal hygiene habits associated with the presence of self-reported voice symptoms in telemarketers.

    Science.gov (United States)

    Fuentes-López, Eduardo; Fuente, Adrian; Contreras, Karem V

    2017-12-18

    The aim of this study is to determine possible associations between vocal hygiene habits and self-reported vocal symptoms in telemarketers. A cross-sectional study that included 79 operators from call centres in Chile was carried out. Their vocal hygiene habits and self-reported symptoms were investigated using a validated and reliable questionnaire created for the purposes of this study. Forty-five percent of telemarketers reported having one or more vocal symptoms. Among them, 16.46% reported that their voices tense up when talking and 10.13% needed to clear their throat to make their voices clearer. Five percent mentioned that they always talk without taking a break and 40.51% reported using their voices in noisy environments. The number of working hours per day and inadequate vocal hygiene habits were associated with the presence of self-reported symptoms. Additionally, an interaction between the use of the voice in noisy environments and not taking breaks during the day was observed. Finally, the frequency of inadequate vocal hygiene habits was associated with the number of symptoms reported. Using the voice in noisy environments and talking without taking breaks were both associated with the presence of specific vocal symptoms. This study provides some evidence about the interaction between these two inadequate vocal hygiene habits that potentiates vocal symptoms.

  19. Perfil clínico e epidemiológico das queimaduras: evidências para o cuidado de enfermagem = Profile of clinical and epidemiological burns: evidence for nursing care

    Directory of Open Access Journals (Sweden)

    Costa, Gabriela Oliveira Parentes da

    2015-01-01

    Full Text Available Objetivo: Analisar as evidências científicas disponíveis acerca dos cuidados de enfermagem a pacientes internados por queimaduras. Materiais e Métodos: Trata-se de uma revisão integrativa da literatura. O período da coleta foi de setembro de 2014 a janeiro de 2015, por meio das bases de dados LILACS/SciELO; IBECS; MEDLINE e recorte temporal de 2002 a 2014. A amostra final foi de 18 artigos. Para avaliação da qualidade metodológica dos mesmos aplicou-se as recomendações STROBE (Strengthening the reporting of observational studies in epidemiology. Os dados foram analisados de forma descritiva. Resultados: Para melhor organização os resultados foram agrupados em duas categorias analíticas; segundo as recomendações STROBE 55,5% foram classificados como A e 44,4% B; quanto ao nível de evidencia 72,2% tiveram nível 4; 55,5% dos estudos correspondem a publicações entre 2011 e 2014. Os indivíduos do sexo masculino foram os que mais se envolveram em queimaduras e as causas prevalentes foram contatos acidentais com líquidos quentes e manejo de álcool. A maioria ocorreu em ambiente doméstico, atingindo principalmente os membros superiores. No cotidiano os enfermeiros lidam com cuidados físicos e emocionais. Alguns profissionais relataram dificuldades em lidar com a dor do paciente, principalmente, durante o banho e curativo, procedimentos rotineiros na unidade de queimados. Conclusão: Mesmo com as dificuldades enfrentadas a equipe de enfermagem deve sistematizar a assistência usando de artifícios científicos e tecnologias que contribuam para melhoria do cuidado prestado

  20. Deferasirox pharmacokinetics in patients with adequate versus inadequate response

    Science.gov (United States)

    Chirnomas, Deborah; Smith, Amber Lynn; Braunstein, Jennifer; Finkelstein, Yaron; Pereira, Luis; Bergmann, Anke K.; Grant, Frederick D.; Paley, Carole; Shannon, Michael

    2009-01-01

    Tens of thousands of transfusion-dependent (eg, thalassemia) patients worldwide suffer from chronic iron overload and its potentially fatal complications. The oral iron chelator deferasirox has become commercially available in many countries since 2006. Although this alternative to parenteral deferoxamine has been a major advance for patients with transfusional hemosiderosis, a proportion of patients have suboptimal response to the maximum approved doses (30 mg/kg per day), and do not achieve negative iron balance. We performed a prospective study of oral deferasirox pharmacokinetics (PK), comparing 10 transfused patients with inadequate deferasirox response (rising ferritin trend or rising liver iron on deferasirox doses > 30 mg/kg per day) with control transfusion-dependent patients (n = 5) with adequate response. Subjects were admitted for 4 assessments: deferoxamine infusion and urinary iron measurement to assess readily chelatable iron; quantitative hepatobiliary scintigraphy to assess hepatic uptake and excretion of chelate; a 24-hour deferasirox PK study following a single 35-mg/kg dose of oral deferasirox; and pharmacogenomic analysis. Patients with inadequate response to deferasirox had significantly lower systemic drug exposure compared with control patients (P deferasirox must be determined. This trial has been registered at http://www.clinicaltrials.gov under identifier NCT00749515. PMID:19724055

  1. Early Cannabis Use and Estimated Risk of Later Onset of Depression Spells : Epidemiologic Evidence From the Population-based World Health Organization World Mental Health Survey Initiative

    NARCIS (Netherlands)

    de Graaf, R.; Radovanovic, M.; van Laar, M.; Fairman, B.; Degenhardt, L.; Aguilar-Gaxiola, S.; Bruffaerts, R.; De Girolamo, G.; Fayyad, J.; Gureje, O.; Haro, J.M.; Huang, Y.Q.; Kostychenko, S.; Lepine, J.P.; Matschinger, H.; Mora, M.E.M.; Neumark, Y.; Ormel, J.; Posada-Villa, J.; Stein, D.J.; Tachimori, H.; Wells, J.E.; Anthony, J.C.

    2010-01-01

    Early-onset cannabis use is widespread in many countries and might cause later onset of depression. Sound epidemiologic data across countries are missing. The authors estimated the suspected causal association that links early-onset (age <17 years) cannabis use with later-onset (age >= 17 years)

  2. Gynaekologisk epidemiologi

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind

    2006-01-01

    Epidemiological research has good possibilities in Denmark due to the fact that all people have a personal PIN code and due to our many National health registers. In gynaecology the National Register of Patients, the Birth Registry, IVF-registry, Cancer Registry and latest the National Prescription...... Database offer unique possibilities of linking exposure data with many clinical outcomes. Danish epidemiology has contributed with morbidity analyses on children concieved by in vitro fertilisation, pharmacoepidemiological studies on short and long term effects of oral contraceptives and hormone therapy...

  3. Gynaekologisk epidemiologi

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind

    2006-01-01

    Database offer unique possibilities of linking exposure data with many clinical outcomes. Danish epidemiology has contributed with morbidity analyses on children concieved by in vitro fertilisation, pharmacoepidemiological studies on short and long term effects of oral contraceptives and hormone therapy......Epidemiological research has good possibilities in Denmark due to the fact that all people have a personal PIN code and due to our many National health registers. In gynaecology the National Register of Patients, the Birth Registry, IVF-registry, Cancer Registry and latest the National Prescription...

  4. Defining localities of inadequate treatment for childhood asthma: A GIS approach

    Directory of Open Access Journals (Sweden)

    Pliskin Joseph S

    2006-01-01

    Full Text Available Abstract Background The use of Geographic Information Systems (GIS has great potential for the management of chronic disease and the analysis of clinical and administrative health care data. Asthma is a chronic disease associated with substantial morbidity, mortality, and health care use. Epidemiologic data from all over the world show an increasing prevalence of asthma morbidity and mortality despite the availability of effective treatment. These facts led to the emergence of strategies developed to improve the quality of asthma care. The objective To develop an efficient tool for quality assurance and chronic disease management using a Geographic Information System (GIS. Geographic location The southern region of Israel. January 1998 – October 2000. Databases Administrative claims data of the largest HMO in Israel: drug dispensing registry, demographic data, Emergency Room visits, and hospitalization data bases. Methods We created a list of six markers for inadequate pharmaceutical treatment of childhood asthma from the Israeli clinical guidelines. We used this list to search the drug dispensing registry to identify asthmatic children who received inadequate treatment and to assess their health care utilization and bad outcomes: emergency room visits and hospitalizations. Using GIS we created thematic maps on which we located the clinics with a high percentage of children for whom the treatment provided was not in adherence with the clinical guidelines. Results 81% of the children were found to have at least one marker for inadequate treatment; 17.5% were found to have more than one marker. Children with markers were found to have statistically significant higher rates of Emergency Room visits, hospitalizations and longer length of stay in hospital compared with children without markers. The maps show in a robust way which clinics provided treatment not in accord with the clinical guidelines. Those clinics have high rates of Emergency Room

  5. [The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies

    DEFF Research Database (Denmark)

    Elm, E. von; Altman, D.G.; Egger, M.

    2008-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed rec...

  6. Internet addiction: reappraisal of an increasingly inadequate concept.

    Science.gov (United States)

    Starcevic, Vladan; Aboujaoude, Elias

    2017-02-01

    This article re-examines the popular concept of Internet addiction, discusses the key problems associated with it, and proposes possible alternatives. The concept of Internet addiction is inadequate for several reasons. Addiction may be a correct designation only for the minority of individuals who meet the general criteria for addiction, and it needs to be better demarcated from various patterns of excessive or abnormal use. Addiction to the Internet as a medium does not exist, although the Internet as a medium may play an important role in making some behaviors addictive. The Internet can no longer be separated from other potentially overused media, such as text messaging and gaming platforms. Internet addiction is conceptually too heterogeneous because it pertains to a variety of very different behaviors. Internet addiction should be replaced by terms that refer to the specific behaviors (eg, gaming, gambling, or sexual activity), regardless of whether these are performed online or offline.

  7. Inadequate doses of hemodialysis. Predisposing factors, causes and prevention

    Directory of Open Access Journals (Sweden)

    Pehuén Fernández

    2017-04-01

    Full Text Available Patients receiving sub-optimal dose of hemodialysis have increased morbidity and mortality. The objectives of this study were to identify predisposing factors and causes of inadequate dialysis, and to design a practical algorithm for the management of these patients. A cross-sectional study was conducted. Ninety patients in chronic hemodialysis at Hospital Privado Universitario de Córdoba were included, during September 2015. Twenty two received sub-optimal dose of hemodialysis. Those with urea distribution volume (V greater than 40 l (72 kg body weight approximately are 11 times more likely (OR = 11.6; CI 95% = 3.2 to 51.7, p < 0.0001 to receive an inadequate dose of hemodialysis, than those with a smaller V. This situation is more frequent in men (OR = 3.5; 95% CI 1.01-15.8; p = 0.0292. V greater than 40 l was the only independent predictor of sub-dialysis in the multivariate analysis (OR = 10.3; 95% CI 2.8-37; p < 0.0004. The main cause of suboptimal dialysis was receiving a lower blood flow (Qb than the prescribed (336.4 ± 45.8 ml/min vs. 402.3 ± 28.8 ml/min respectively, p < 0.0001 (n = 18. Other causes were identified: shorter duration of the session (n = 2, vascular access recirculation (n = 1, and error in the samples (n = 1. In conclusion, the only independent predisposing factor found in this study for sub-optimal dialysis is V greater than 40 l. The main cause was receiving a slower Qb than prescribed. From these findings, an algorithm for the management of these patients was developed

  8. Critical review of the epidemiological literature on occupational exposure to perchloroethylene and cancer.

    Science.gov (United States)

    Mundt, Kenneth A; Birk, Thomas; Burch, Margaret T

    2003-09-01

    Of an estimated 500,000 workers in the USA potentially exposed to perchloroethylene (PCE), the largest share is employed in the dry-cleaning industry. PCE, a non-flammable solvent, has commercial applications as a chemical intermediate, metal degreaser and, since the 1950s, primary solvent in the dry-cleaning industry. The International Agency for Research on Cancer (IARC) currently finds sufficient evidence to designate PCE as carcinogenic in animals, with limited evidence in humans. With regard to occupational exposure through dry-cleaning, PCE is considered to be possibly carcinogenic to humans. This review was conducted to assess the current epidemiological literature on PCE and specific cancers. A comprehensive search was conducted to identify all available epidemiological literature pertaining to the carcinogenic effects of PCE. Forty-four papers that provided reasonable data on up to 17 cancer sites were critically reviewed in the context of the available background literature for each cancer site and were assessed on the basis of specified methodological and scientific quality criteria. While all the epidemiological studies selected for review investigated similar exposure-health outcome relationships, there was a broad diversity of proxy measurements of exposure to PCE, as well as numerous specific cancer outcomes of interest. The widespread lack of valid exposure measurements or other adequate indicators of potential for exposure were consistent limitations. We found no evidence of an association between breast, prostate, skin or brain cancer and exposure to PCE. A relationship between PCE and cancer of the following sites was considered unlikely: oral cavity, liver, pancreas, cervix lung. Scientific evidence was inadequate for laryngeal, kidney, esophageal and bladder cancers. The current epidemiological evidence does not support a conclusion that occupational exposure to PCE is a risk factor for cancer of any specific site. Priority areas in which

  9. Epidemiological causality.

    Science.gov (United States)

    Morabia, Alfredo

    2005-01-01

    Epidemiological methods, which combine population thinking and group comparisons, can primarily identify causes of disease in populations. There is therefore a tension between our intuitive notion of a cause, which we want to be deterministic and invariant at the individual level, and the epidemiological notion of causes, which are invariant only at the population level. Epidemiologists have given heretofore a pragmatic solution to this tension. Causal inference in epidemiology consists in checking the logical coherence of a causality statement and determining whether what has been found grossly contradicts what we think we already know: how strong is the association? Is there a dose-response relationship? Does the cause precede the effect? Is the effect biologically plausible? Etc. This approach to causal inference can be traced back to the English philosophers David Hume and John Stuart Mill. On the other hand, the mode of establishing causality, devised by Jakob Henle and Robert Koch, which has been fruitful in bacteriology, requires that in every instance the effect invariably follows the cause (e.g., inoculation of Koch bacillus and tuberculosis). This is incompatible with epidemiological causality which has to deal with probabilistic effects (e.g., smoking and lung cancer), and is therefore invariant only for the population.

  10. Initial treatment of severe malaria in children is inadequate – a study ...

    African Journals Online (AJOL)

    -medicated at home. Initial consultations are at primary local health facilities where less effective drugs are prescribed at inadequate dosages. Recommended ACTs were also often prescribed at inadequate dosages. Education in the use of ...

  11. Newcastle disease virus outbreaks: vaccine mismatch or inadequate application?

    Science.gov (United States)

    Dortmans, Jos C F M; Peeters, Ben P H; Koch, Guus

    2012-11-09

    Newcastle disease (ND) is one of the most important diseases of poultry, and may cause devastating losses in the poultry industry worldwide. Its causative agent is Newcastle disease virus (NDV), also known as avian paramyxovirus type 1. Many countries maintain a stringent vaccination policy against ND, but there are indications that ND outbreaks can still occur despite intensive vaccination. It has been argued that this may be due to antigenic divergence between the vaccine strains and circulating field strains. Here we present the complete genome sequence of a highly virulent genotype VII virus (NL/93) obtained from vaccinated poultry during an outbreak of ND in the Netherlands in 1992-1993. Using this strain, we investigated whether the identified genetic evolution of NDV is accompanied by antigenic evolution. In this study we show that a live vaccine that is antigenically adapted to match the genotype VII NL/93 outbreak strain does not provide increased protection compared to a classic genotype II live vaccine. When challenged with the NL/93 strain, chickens vaccinated with a classic vaccine were completely protected against clinical disease and mortality and virus shedding was significantly reduced, even with a supposedly suboptimal vaccine dose. These results suggest that it is not antigenic variation but rather poor flock immunity due to inadequate vaccination practices that may be responsible for outbreaks and spreading of virulent NDV field strains. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. The evolution of the epidemiological landscape of head and neck cancer in Italy: Is there evidence for an increase in the incidence of potentially HPV-related carcinomas?

    Directory of Open Access Journals (Sweden)

    Paolo Boscolo-Rizzo

    Full Text Available The current study aimed to investigate the incidence and survival patterns of HNSCCs arising from different anatomic sites, potentially related (the oropharynx or unrelated (the oral cavity, the larynx/hypopharynx to HPV, to provide clues on possible growing impact of HPV in the epidemiology of HNSCC in Italy. Epidemiological data were retrieved from ten long-term Cancer Registries covering a population of 7.8 million inhabitants. Trends were described by means of the estimated annual percent change (APC stratified by age and gender, and compared between HPV-related and HPV-unrelated anatomical sites. The data regarding 28,295 HNSCCs diagnosed in Italy between 1988 and 2012 were analyzed. In males, the incidence rate (IR of cancers arising from sites unrelated to HPV infection significantly decreased in all age groups (APC:-3.31 for larynx/hypopharynx; APC:-1.77 for oral cavity, whereas stable IR were observed for cancers arising from sites related to HPV infection. In females, IR for cancers from HPV-related sites increased significantly over the observed period; the largest increment was noted in those over 60 (APC:2.92% who also showed a significantly lower number of HNSCCs from the larynx/hypopharynx (APC:- 0.84 and a significantly higher number of oral cavity tumors (APC = 2.15. The five-year relative survival remained largely unchanged in the patients with laryngeal/hypopharyngeal SCC and, conversely, significantly improved in the patients with SCC at HPV-related sites. The trends observed suggest a potential increasing impact of HPV infection on the epidemiology of HNSCC in Italy, but to a lesser extent and with a different pattern from that observed in other Western countries.

  13. The evolution of the epidemiological landscape of head and neck cancer in Italy: Is there evidence for an increase in the incidence of potentially HPV-related carcinomas?

    Science.gov (United States)

    Boscolo-Rizzo, Paolo; Zorzi, Manuel; Del Mistro, Annarosa; Da Mosto, Maria Cristina; Tirelli, Giancarlo; Buzzoni, Carlotta; Rugge, Massimo; Polesel, Jerry; Guzzinati, Stefano

    2018-01-01

    The current study aimed to investigate the incidence and survival patterns of HNSCCs arising from different anatomic sites, potentially related (the oropharynx) or unrelated (the oral cavity, the larynx/hypopharynx) to HPV, to provide clues on possible growing impact of HPV in the epidemiology of HNSCC in Italy. Epidemiological data were retrieved from ten long-term Cancer Registries covering a population of 7.8 million inhabitants. Trends were described by means of the estimated annual percent change (APC) stratified by age and gender, and compared between HPV-related and HPV-unrelated anatomical sites. The data regarding 28,295 HNSCCs diagnosed in Italy between 1988 and 2012 were analyzed. In males, the incidence rate (IR) of cancers arising from sites unrelated to HPV infection significantly decreased in all age groups (APC:-3.31 for larynx/hypopharynx; APC:-1.77 for oral cavity), whereas stable IR were observed for cancers arising from sites related to HPV infection. In females, IR for cancers from HPV-related sites increased significantly over the observed period; the largest increment was noted in those over 60 (APC:2.92%) who also showed a significantly lower number of HNSCCs from the larynx/hypopharynx (APC:- 0.84) and a significantly higher number of oral cavity tumors (APC = 2.15). The five-year relative survival remained largely unchanged in the patients with laryngeal/hypopharyngeal SCC and, conversely, significantly improved in the patients with SCC at HPV-related sites. The trends observed suggest a potential increasing impact of HPV infection on the epidemiology of HNSCC in Italy, but to a lesser extent and with a different pattern from that observed in other Western countries.

  14. Pure animal phobia is more specific than other specific phobias: epidemiological evidence from the Zurich Study, the ZInEP and the PsyCoLaus.

    Science.gov (United States)

    Ajdacic-Gross, Vladeta; Rodgers, Stephanie; Müller, Mario; Hengartner, Michael P; Aleksandrowicz, Aleksandra; Kawohl, Wolfram; Heekeren, Karsten; Rössler, Wulf; Angst, Jules; Castelao, Enrique; Vandeleur, Caroline; Preisig, Martin

    2016-09-01

    Interest in subtypes of mental disorders is growing in parallel with continuing research progress in psychiatry. The aim of this study was to examine pure animal phobia in contrast to other specific phobias and a mixed subtype. Data from three representative Swiss community samples were analysed: PsyCoLaus (n = 3720), the ZInEP Epidemiology Survey (n = 1500) and the Zurich Study (n = 591). Pure animal phobia and mixed animal/other specific phobias consistently displayed a low age at onset of first symptoms (8-12 years) and clear preponderance of females (OR > 3). Meanwhile, other specific phobias started up to 10 years later and displayed almost a balanced sex ratio. Pure animal phobia showed no associations with any included risk factors and comorbid disorders, in contrast to numerous associations found in the mixed subtype and in other specific phobias. Across the whole range of epidemiological parameters examined in three different samples, pure animal phobia seems to represent a different entity compared to other specific phobias. The etiopathogenetic mechanisms and risk factors associated with pure animal phobias appear less clear than ever.

  15. Metabolic regulation during sport events: factual interpretations and inadequate allegations

    Directory of Open Access Journals (Sweden)

    Jacques Remy Poortmans

    2013-09-01

    Full Text Available Different fuels are available to generate ATP for muscle activities during sport events. Glycogen from striated muscles and liver stores may be converted to lactic acid or almost completely oxidized to carbon dioxide (CO2, triacylglycerol within the muscle itself and fatty acids from adipose tissue could be converted to CO2 in acting muscles, some free amino acids can be released within the muscle itself and from intestinal stores to sustain the amount of ATP generation indispensable for muscle contraction. All single biochemical reactions, but one, need one or several enzymes to activate the conversion of a substrate into a product. The energy transformation in biochemical reactions is led by application of so-called free energy. Reversible and non-reversible reactions within a metabolic pathway are dependent on specific enzymes near or far from equilibrium. Allosteric enzymes are regulatory enzymes that provide the direction in the pathway. A regulatory enzyme is either activated or inhibited by small regulators (ligands. A reversible substrate cycle between A and B is catalyzed by two enzymes with different fluxes. The need of ATP production for muscle contraction is under the leadership of regulatory enzymes and available substrate stores. The improvement of adapted metabolic reactions under sport training depends on the appropriate increase of regulatory enzymes within the glycolytic and oxidative pathways. The amount of some specific enzymes is increased by training in order to improve the maximum activity of the metabolic pathway. Unfortunately, several publications do not precisely implicate the appropriate enzyme(s to explain or reject the adaptation induced by the training schedule. A few examples will illustrate the factual interpretation and the inadequate allegation.

  16. The association of xerostomia and inadequate intake in older adults.

    Science.gov (United States)

    Rhodus, N L; Brown, J

    1990-12-01

    Recent studies indicate that nearly one in five older adults has xerostomia (dry mouth). Salivary gland dysfunction and/or inadequate saliva increases the difficulty of these older adults in obtaining proper nutrition. Problems in lubricating, masticating, tolerating, tasting, and swallowing food contribute notably to the complex physiological and psychological manifestations of aging. To our knowledge, the literature has not demonstrated an association between xerostomia and malnutrition in the elderly. We randomly selected 67 older adults from institutionalized and free-living geriatric populations. Nutritional intake analysis was performed on both groups of study subjects, who were found to have xerostomia by use of sialometry, and on control subjects matched for age, sex, and physical status. Intake of total energy, protein, dietary fiber, total fat, saturated fat, cholesterol, sodium, potassium, vitamin A, vitamin C, thiamin, riboflavin, vitamin B-6, calcium, iron, and zinc was compared with the 1989 Recommended Dietary Allowances. Subjects' intakes were also compared with that of a control group. Medical systemic information and number and types of medications were compared among the groups. Statistical analysis of the data indicated significant (p less than .001) inadequacies in the nutritional intake patterns of institutionalized and free-living older adults with xerostomia. Subjects with xerostomia (more than 75% of the free-living and institutionalized seniors) had significant deficiencies of fiber, potassium, vitamin B-6, iron, calcium, and zinc. Taste and food perception were significantly reduced in the elders with xerostomia. Our study indicates the potential contribution of xerostomia to the high prevalence of geriatric malnutrition in the United States.

  17. Inadequate pain relief among patients with primary knee osteoarthritis.

    Science.gov (United States)

    Laires, Pedro A; Laíns, Jorge; Miranda, Luís C; Cernadas, Rui; Rajagopalan, Srini; Taylor, Stephanie D; Silva, José C

    Despite the widespread treatments for osteoarthritis (OA), data on treatment patterns, adequacy of pain relief, and quality of life are limited. The prospective multinational Survey of Osteoarthritis Real World Therapies (SORT) was designed to investigate these aspects. To analyze the characteristics and the patient reported outcomes of the Portuguese dataset of SORT at the start of observation. Patients ≥50 years with primary knee OA who were receiving oral or topical analgesics were eligible. Patients were enrolled from seven healthcare centers in Portugal between January and December 2011. Pain and function were evaluated using the Brief Pain Inventory (BPI) and WOMAC. Quality of life was assessed using the 12-Item Short Form Health Survey (SF-12). Inadequate pain relief (IPR) was defined as a score >4/10 on item 5 of the BPI. Overall, 197 patients were analyzed. The median age was 67.0 years and 78.2% were female. Mean duration of knee OA was 6.2 years. IPR was reported by 51.3% of patients. Female gender (adjusted odds ratio - OR 2.15 [95%CI 1.1, 4.5]), diabetes (OR 3.1 [95%CI 1.3, 7.7]) and depression (OR 2.24 [95%CI 1.2, 4.3]) were associated with higher risk of IPR. Patients with IPR reported worst outcomes in all dimensions of WOMAC (p<0.001) and in all eight domains and summary components of SF-12 (p<0.001). Our findings indicate that improvements are needed in the management of pain in knee OA in order to achieve better outcomes in terms of pain relief, function and quality of life. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  18. Evidence-based decision-making in infectious diseases epidemiology, prevention and control: matching research questions to study designs and quality appraisal tools

    NARCIS (Netherlands)

    Harder, Thomas; Takla, Anja; Rehfuess, Eva; Sánchez-Vivar, Alex; Matysiak-Klose, Dorothea; Eckmanns, Tim; Krause, Gérard; de Carvalho Gomes, Helena; Jansen, Andreas; Ellis, Simon; Forland, Frode; James, Roberta; Meerpohl, Joerg J.; Morgan, Antony; Schünemann, Holger; Zuiderent-Jerak, Teun; Wichmann, Ole

    2014-01-01

    The Project on a Framework for Rating Evidence in Public Health (PRECEPT) was initiated and is being funded by the European Centre for Disease Prevention and Control (ECDC) to define a methodology for evaluating and grading evidence and strength of recommendations in the field of public health, with

  19. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel

    NARCIS (Netherlands)

    Ference, Brian A.; Ginsberg, Henry N.; Graham, Ian; Ray, Kausik K.; Packard, Chris J.; Bruckert, Eric; Hegele, Robert A.; Krauss, Ronald M.; Raal, Frederick J.; Schunkert, Heribert; Watts, Gerald F.; Boren, Jan; Fazio, Sergio; Horton, Jay D.; Masana, Luis; Nicholls, Stephen J.; Nordestgaard, Borge G.; van de Sluis, Bart; Taskinen, Marja-Riitta; Tokgozoglu, Lale; Landmesser, Ulf; Laufs, Ulrich; Wiklund, Olov; Stock, Jane K.; Chapman, M. John; Catapano, Alberico L.

    2017-01-01

    Aims: To appraise the clinical and genetic evidence that low-density lipoproteins (LDLs) cause atherosclerotic cardiovascular disease (ASCVD). Methods and results: We assessed whether the association between LDL and ASCVD fulfils the criteria for causality by evaluating the totality of evidence from

  20. Evidence Report, Risk of Inadequate Design of Human and Automation/Robotic Integration

    Science.gov (United States)

    Zumbado, Jennifer Rochlis; Billman, Dorrit; Feary, Mike; Green, Collin

    2011-01-01

    The success of future exploration missions depends, even more than today, on effective integration of humans and technology (automation and robotics). This will not emerge by chance, but by design. Both crew and ground personnel will need to do more demanding tasks in more difficult conditions, amplifying the costs of poor design and the benefits of good design. This report has looked at the importance of good design and the risks from poor design from several perspectives: 1) If the relevant functions needed for a mission are not identified, then designs of technology and its use by humans are unlikely to be effective: critical functions will be missing and irrelevant functions will mislead or drain attention. 2) If functions are not distributed effectively among the (multiple) participating humans and automation/robotic systems, later design choices can do little to repair this: additional unnecessary coordination work may be introduced, workload may be redistributed to create problems, limited human attentional resources may be wasted, and the capabilities of both humans and technology underused. 3) If the design does not promote accurate understanding of the capabilities of the technology, the operators will not use the technology effectively: the system may be switched off in conditions where it would be effective, or used for tasks or in contexts where its effectiveness may be very limited. 4) If an ineffective interaction design is implemented and put into use, a wide range of problems can ensue. Many involve lack of transparency into the system: operators may be unable or find it very difficult to determine a) the current state and changes of state of the automation or robot, b) the current state and changes in state of the system being controlled or acted on, and c) what actions by human or by system had what effects. 5) If the human interfaces for operation and control of robotic agents are not designed to accommodate the unique points of view and operating environments of both the human and the robotic agent, then effective human-robot coordination cannot be achieved.

  1. Food intolerance and allergy: increased incidence or contemporary inadequate diets?

    NARCIS (Netherlands)

    Skypala, Isabel; Vlieg-Boerstra, Berber

    2014-01-01

    The role of nutrients in the study of allergic disease has been studied for many years, but recent evidence suggests that it is the quality and variety of the whole diet which affects the development of food allergy. This review seeks to understand whether food allergy prevalence is increasing and

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

    Science.gov (United States)

    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

  3. Mathematical epidemiology

    CERN Document Server

    Driessche, Pauline; Wu, Jianhong

    2008-01-01

    Based on lecture notes of two summer schools with a mixed audience from mathematical sciences, epidemiology and public health, this volume offers a comprehensive introduction to basic ideas and techniques in modeling infectious diseases, for the comparison of strategies to plan for an anticipated epidemic or pandemic, and to deal with a disease outbreak in real time. It covers detailed case studies for diseases including pandemic influenza, West Nile virus, and childhood diseases. Models for other diseases including Severe Acute Respiratory Syndrome, fox rabies, and sexually transmitted infections are included as applications. Its chapters are coherent and complementary independent units. In order to accustom students to look at the current literature and to experience different perspectives, no attempt has been made to achieve united writing style or unified notation. Notes on some mathematical background (calculus, matrix algebra, differential equations, and probability) have been prepared and may be downlo...

  4. Early cannabis use and estimated risk of later onset of depression spells: Epidemiologic evidence from the population-based World Health Organization World Mental Health Survey Initiative.

    Science.gov (United States)

    de Graaf, Ron; Radovanovic, Mirjana; van Laar, Margriet; Fairman, Brian; Degenhardt, Louisa; Aguilar-Gaxiola, Sergio; Bruffaerts, Ronny; de Girolamo, Giovanni; Fayyad, John; Gureje, Oye; Haro, Josep Maria; Huang, Yueqin; Kostychenko, Stanislav; Lépine, Jean-Pierre; Matschinger, Herbert; Mora, Maria Elena Medina; Neumark, Yehuda; Ormel, Johan; Posada-Villa, Jose; Stein, Dan J; Tachimori, Hisateru; Wells, J Elisabeth; Anthony, James C

    2010-07-15

    Early-onset cannabis use is widespread in many countries and might cause later onset of depression. Sound epidemiologic data across countries are missing. The authors estimated the suspected causal association that links early-onset (age cannabis use with later-onset (age > or =17 years) risk of a depression spell, using data on 85,088 subjects from 17 countries participating in the population-based World Health Organization World Mental Health Survey Initiative (2001-2005). In all surveys, multistage household probability samples were evaluated with a fully structured diagnostic interview for assessment of psychiatric conditions. The association between early-onset cannabis use and later risk of a depression spell was studied using conditional logistic regression with local area matching of cases and controls, controlling for sex, age, tobacco use, and other mental health problems. The overall association was modest (controlled for sex and age, risk ratio = 1.5, 95% confidence interval: 1.4, 1.7), was statistically robust in 5 countries, and showed no sex difference. The association did not change appreciably with statistical adjustment for mental health problems, except for childhood conduct problems, which reduced the association to nonsignificance. This study did not allow differentiation of levels of cannabis use; this issue deserves consideration in future research.

  5. Food intolerance and allergy: increased incidence or contemporary inadequate diets?

    Science.gov (United States)

    Skypala, Isabel; Vlieg-Boerstra, Berber

    2014-09-01

    The role of nutrients in the study of allergic disease has been studied for many years, but recent evidence suggests that it is the quality and variety of the whole diet which affects the development of food allergy. This review seeks to understand whether food allergy prevalence is increasing and the role of diet in the development of the disease. New data on the European and global prevalence of food allergy suggest that both reported and actual rates are increasing. Recent findings from studies in infants and children indicated that a Western diet could enhance the development of allergic disease, possibly due to an effect on the homeostasis of the gut microbiome, impacting the immune status of individuals. With overall prevalence rates for food allergy increasing, it is important to ascertain the relevance of dietary influences. Attention has shifted from single-nutrient prevention studies to evaluation of the effect of different dietary patterns on allergic outcomes. Evidence suggests that introduction of complementary foods should not be delayed, and the diversity of the diet in early life is important. The increasingly processed nature of the Western diet, in combination with influences on the gut microbiome, may contribute to the rising prevalence of allergic disease, including food allergy.

  6. Molecular epidemiology of Salmonella enterica serovar typhimurium isolates from cattle in hokkaido, Japan: evidence of clonal replacement and characterization of the disseminated clone.

    Science.gov (United States)

    Tamamura, Yukino; Uchida, Ikuo; Tanaka, Kiyoshi; Okazaki, Hizuru; Tezuka, Satoru; Hanyu, Hideki; Kataoka, Natsumi; Makino, Sou-Ichi; Kishima, Masato; Kubota, Takayuki; Kanno, Toru; Hatama, Shinichi; Ishihara, Ryoko; Hata, Eiji; Yamada, Hironari; Nakaoka, Yuuji; Akiba, Masato

    2011-03-01

    The molecular epidemiology of 545 Salmonella enterica serovar Typhimurium isolates collected between 1977 and 2009 from cattle in Hokkaido, Japan, was investigated using pulsed-field gel electrophoresis (PFGE). Nine main clusters were identified from 116 PFGE patterns. Cluster I comprised 248 isolates, 243 of which possessed a sequence specific to definitive phage type 104 (DT104) or U302. The cluster I isolates were dominant in 1993 to 2003, but their numbers declined beginning in 2004. Beginning in 2002, an increase was observed in the number of cluster VII isolates, consisting of 21 PFGE patterns comprising 165 isolates. A total of 116 isolates representative of the 116 PFGE profiles were analyzed by multilocus variable-number tandem-repeat analysis (MLVA). Other than two drug-sensitive isolates, 19 isolates within cluster VII were classified in the same cluster by MLVA. Among the cluster VII isolates, an antibiotic resistance type showing resistance to ampicillin, chloramphenicol, streptomycin, sulfonamides, tetracycline, kanamycin, cefazolin, and sulfamethoxazole-trimethoprim and a resistance type showing resistance to ampicillin, streptomycin, sulfonamides, tetracycline, and kanamycin were found in 23 and 125 isolates, respectively. In the 19 isolates representative of cluster VII, the bla(TEM-1) gene was found on a Salmonella serotype Typhimurium virulence plasmid, which was transferred to Escherichia coli by electroporation along with resistance to two to four other antimicrobials. Genomic analysis by subtractive hybridization and plasmid analysis suggested that the bla(TEM-1)-carrying virulence plasmid has a mosaic structure composed of elements of different origin. These results indicate an emerging multidrug-resistant S. Typhimurium clone carrying a virulence-resistance plasmid among cattle in Hokkaido, Japan.

  7. Molecular Epidemiology of Salmonella enterica Serovar Typhimurium Isolates from Cattle in Hokkaido, Japan: Evidence of Clonal Replacement and Characterization of the Disseminated Clone▿ †

    Science.gov (United States)

    Tamamura, Yukino; Uchida, Ikuo; Tanaka, Kiyoshi; Okazaki, Hizuru; Tezuka, Satoru; Hanyu, Hideki; Kataoka, Natsumi; Makino, Sou-ichi; Kishima, Masato; Kubota, Takayuki; Kanno, Toru; Hatama, Shinichi; Ishihara, Ryoko; Hata, Eiji; Yamada, Hironari; Nakaoka, Yuuji; Akiba, Masato

    2011-01-01

    The molecular epidemiology of 545 Salmonella enterica serovar Typhimurium isolates collected between 1977 and 2009 from cattle in Hokkaido, Japan, was investigated using pulsed-field gel electrophoresis (PFGE). Nine main clusters were identified from 116 PFGE patterns. Cluster I comprised 248 isolates, 243 of which possessed a sequence specific to definitive phage type 104 (DT104) or U302. The cluster I isolates were dominant in 1993 to 2003, but their numbers declined beginning in 2004. Beginning in 2002, an increase was observed in the number of cluster VII isolates, consisting of 21 PFGE patterns comprising 165 isolates. A total of 116 isolates representative of the 116 PFGE profiles were analyzed by multilocus variable-number tandem-repeat analysis (MLVA). Other than two drug-sensitive isolates, 19 isolates within cluster VII were classified in the same cluster by MLVA. Among the cluster VII isolates, an antibiotic resistance type showing resistance to ampicillin, chloramphenicol, streptomycin, sulfonamides, tetracycline, kanamycin, cefazolin, and sulfamethoxazole-trimethoprim and a resistance type showing resistance to ampicillin, streptomycin, sulfonamides, tetracycline, and kanamycin were found in 23 and 125 isolates, respectively. In the 19 isolates representative of cluster VII, the blaTEM-1 gene was found on a Salmonella serotype Typhimurium virulence plasmid, which was transferred to Escherichia coli by electroporation along with resistance to two to four other antimicrobials. Genomic analysis by subtractive hybridization and plasmid analysis suggested that the blaTEM-1-carrying virulence plasmid has a mosaic structure composed of elements of different origin. These results indicate an emerging multidrug-resistant S. Typhimurium clone carrying a virulence-resistance plasmid among cattle in Hokkaido, Japan. PMID:21239560

  8. Significantly increased risk of cancer in diabetes mellitus patients: A meta‐analysis of epidemiological evidence in Asians and non‐Asians

    OpenAIRE

    Noto, Hiroshi; Tsujimoto, Tetsuro; Noda, Mitsuhiko

    2011-01-01

    Abstract Aims/Introduction:  Emerging evidence from observational studies suggests that diabetes mellitus affects the cancer risk. However, whether there are differences in the magnitude of the influence of diabetes among ethnic groups is unknown. Materials and Methods:  We searched MEDLINE and the Cochrane Library for pertinent articles that had been published as of 4 April 2011, and included them in a meta‐analysis of the risk of all‐cancer mortality and incidence in diabetic subjects. Resu...

  9. Two bite mark cases with inadequate scale references.

    Science.gov (United States)

    Bernstein, M L

    1985-07-01

    Most literature addressing comparisons between epidermal bite marks and the perpetrator's bite pattern mandates fastidious coordination between the size of the compared reproductions. While ideal, this is not possible in every case and inability to control this variable in selected cases may not necessarily invalidate the comparison. The first case involves a known perpetrator. All photographic measurements were recorded with acceptable techniques to discover a serious discrepancy in arch size. The second case was degraded by the absence of a ruler in a tangentially made photograph of a bite mark. In both cases, the weight of the conclusions were lessened by these problems but the impartial handling of the evidence and explanation of discrepancies offered credibility to the analyses. Both cases illustrate that a technical infraction in processing and recording bite marks, though serious, need not automatically preempt the analysis.

  10. Epidemiology of scabies.

    Science.gov (United States)

    Fuller, L Claire

    2013-04-01

    Scabies is a common skin infestation globally, particularly in the developing world. With the launch of the International Alliance for the Control of Scabies (IACS) in 2012, this review aims to present the recent evidence of the current epidemiological situation for scabies across the globe. Mindful of the fact that the downstream complications of scabies infestations, pyoderma, streptococcal glomerulonephritis and subsequent chronic renal impairment and rheumatic fever, have been recognized as being more significant to global health than previously acknowledged, the review focusses also on the epidemiological evidence from developing countries. Scabies occurrence rates vary in the recent literature from 2.71 per 1000 to 46%. Although it is responsible for larger disease burdens and complications such as pyoderma and renal and heart disease in the tropics, scabies outbreaks in the developed world amongst vulnerable communities and health institutions contribute a significant cost to the health services managing them. Scabies remains common across the world, but is such a health issue in the developing world that the suggestion that it be considered a neglected tropical disease is a pertinent one. Standardized diagnostic criteria and even a point-of-care diagnostic test would be a major contribution to the understanding of this epidemic.

  11. Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System

    Science.gov (United States)

    Douglas, Grace L.; Cooper, Maya; Bermudez-Aguirre, Daniela; Sirmons, Takiyah

    2016-01-01

    evidence for the Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System and the gaps in relation to exploration, as identified by the NASA Human Research Program (HRP). The research reviewed here indicates strategies to establish methods, technologies, and requirements that increase food stability, support adequate nutrition, quality, and variety, enable supplementation with grow-pick-and-eat salad crops, ensure safety, and reduce resource use. Obtaining the evidence to establish an adequate food system is essential, as the resources allocated to the food system may be defined based on the data relating nutritional stability and food quality requirements to crew performance and health.

  12. [The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies

    DEFF Research Database (Denmark)

    Elm, E. von; Altman, D.G.; Egger, M.

    2008-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed......, researchers, and journal editors to draft a che-cklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop...... and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case...

  13. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement

    DEFF Research Database (Denmark)

    von Elm, Erik; Altman, Douglas G; Egger, Matthias

    2014-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed......, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop...... and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case...

  14. Gout as a risk factor for osteoporosis: epidemiologic evidence from a population-based longitudinal study involving 108,060 individuals.

    Science.gov (United States)

    Kok, V C; Horng, J-T; Wang, M N; Chen, Z-Y; Kuo, J-T; Hung, G-D

    2018-04-01

    Is gout a risk factor for future osteoporosis? This large population-based study comprising two matched groups of individuals with and without gout demonstrates that patients with gout have a 20% increase in the risk of developing osteoporosis in future through an 8-year follow-up. To examine if gout is associated with an increased risk of osteoporosis. We conducted a nationwide population-based retrospective matched-cohort study. Two matched cohorts (n = 36,458 with gout and 71,602 without gout) assembled and recruited from the Longitudinal Health Insurance Dataset containing 1 million subjects. Exclusion criteria were missing data, age < 20 years, short follow-up period, and pre-existing osteoporosis. Both cohorts were followed up until incident osteoporosis, death, or the end of the study. Person-year data and incidence rates were evaluated. A multivariable Cox model was used to derive an adjusted hazard ratio (aHR) after controlling for socioeconomic proxy, geographical difference, glucocorticoid and allopurinol exposure, various prespecified medical conditions, and comorbidities. Men comprised 72.8% of the cohorts. With a follow-up of 183,729 and 359,900 person-years for the gout and non-gout cohorts, 517 and 811 incidents of osteoporosis occurred, respectively, after excluding osteoporosis incidents in the first 3 years of follow-up. The cumulative incidence of osteoporosis was statistically higher in the gout cohort than in the non-gout cohort, at 3.3 versus 2.1% (P = 0.0036, log-rank). Our Cox model showed a 1.2-fold increase in the incidence of osteoporosis in the gout cohort, with an aHR of 1.2 (95% confidence interval, 1.06-1.35). This first population-based epidemiologic study supports the hypothesis that compared with individuals without gout; those with gout have a modest increase in the risk of developing osteoporosis in future.

  15. Cross-national differences in clinically significant cannabis problems: epidemiologic evidence from 'cannabis-only' smokers in the United States, Mexico, and Colombia.

    Science.gov (United States)

    Fiestas, Fabian; Radovanovic, Mirjana; Martins, Silvia S; Medina-Mora, Maria E; Posada-Villa, Jose; Anthony, James C

    2010-03-23

    Epidemiological studies show wide variability in the occurrence of cannabis smoking and related disorders across countries. This study aims to estimate cross-national variation in cannabis users' experience of clinically significant cannabis-related problems in three countries of the Americas, with a focus on cannabis users who may have tried alcohol or tobacco, but who have not used cocaine, heroin, LSD, or other internationally regulated drugs. Data are from the World Mental Health Surveys Initiative and the National Latino and Asian American Study, with probability samples in Mexico (n = 4426), Colombia (n = 5,782) and the United States (USA; n = 8,228). The samples included 212 'cannabis only' users in Mexico, 260 in Colombia and 1,724 in the USA. Conditional GLM with GEE and 'exact' methods were used to estimate variation in the occurrence of clinically significant problems in cannabis only (CO) users across these surveyed populations. The experience of cannabis-related problems was quite infrequent among CO users in these countries, with weighted frequencies ranging from 1% to 5% across survey populations, and with no appreciable cross-national variation in general. CO users in Colombia proved to be an exception. As compared to CO users in the USA, the Colombia smokers were more likely to have experienced cannabis-associated 'social problems' (odds ratio, OR = 3.0; 95% CI = 1.4, 6.3; p = 0.004) and 'legal problems' (OR = 9.7; 95% CI = 2.7, 35.2; p = 0.001). This study's most remarkable finding may be the similarity in occurrence of cannabis-related problems in this cross-national comparison within the Americas. Wide cross-national variations in estimated population-level cumulative incidence of cannabis use disorders may be traced to large differences in cannabis smoking prevalence, rather than qualitative differences in cannabis experiences. More research is needed to identify conditions that might make cannabis-related social and legal problems more

  16. Cross-national differences in clinically significant cannabis problems: epidemiologic evidence from 'cannabis-only' smokers in the United States, Mexico, and Colombia

    Directory of Open Access Journals (Sweden)

    Posada-Villa Jose

    2010-03-01

    Full Text Available Abstract Background Epidemiological studies show wide variability in the occurrence of cannabis smoking and related disorders across countries. This study aims to estimate cross-national variation in cannabis users' experience of clinically significant cannabis-related problems in three countries of the Americas, with a focus on cannabis users who may have tried alcohol or tobacco, but who have not used cocaine, heroin, LSD, or other internationally regulated drugs. Methods Data are from the World Mental Health Surveys Initiative and the National Latino and Asian American Study, with probability samples in Mexico (n = 4426, Colombia (n = 5,782 and the United States (USA; n = 8,228. The samples included 212 'cannabis only' users in Mexico, 260 in Colombia and 1,724 in the USA. Conditional GLM with GEE and 'exact' methods were used to estimate variation in the occurrence of clinically significant problems in cannabis only (CO users across these surveyed populations. Results The experience of cannabis-related problems was quite infrequent among CO users in these countries, with weighted frequencies ranging from 1% to 5% across survey populations, and with no appreciable cross-national variation in general. CO users in Colombia proved to be an exception. As compared to CO users in the USA, the Colombia smokers were more likely to have experienced cannabis-associated 'social problems' (odds ratio, OR = 3.0; 95% CI = 1.4, 6.3; p = 0.004 and 'legal problems' (OR = 9.7; 95% CI = 2.7, 35.2; p = 0.001. Conclusions This study's most remarkable finding may be the similarity in occurrence of cannabis-related problems in this cross-national comparison within the Americas. Wide cross-national variations in estimated population-level cumulative incidence of cannabis use disorders may be traced to large differences in cannabis smoking prevalence, rather than qualitative differences in cannabis experiences. More research is needed to identify conditions that

  17. Vitamins Associated with Brain Aging, Mild Cognitive Impairment, and Alzheimer Disease: Biomarkers, Epidemiological and Experimental Evidence, Plausible Mechanisms, and Knowledge Gaps.

    Science.gov (United States)

    Fenech, Michael

    2017-11-01

    The key to preventing brain aging, mild cognitive impairment (MCI), and Alzheimer disease (AD) via vitamin intake is first to understand molecular mechanisms, then to deduce relevant biomarkers, and subsequently to test the level of evidence for the impact of vitamins in the relevant pathways and their modulation of dementia risk. This narrative review infers information on mechanisms from gene and metabolic defects associated with MCI and AD, and assesses the role of vitamins using recent results from animal and human studies. Current evidence suggests that all known vitamins and some "quasi-vitamins" are involved as cofactors or influence ≥1 of the 6 key sets of pathways or pathologies associated with MCI or AD, relating to 1 ) 1-carbon metabolism, 2 ) DNA damage and repair, 3 ) mitochondrial function and glucose metabolism, 4 ) lipid and phospholipid metabolism and myelination, 5 ) neurotransmitter synthesis and synaptogenesis, and 6 ) amyloidosis and Tau protein phosphorylation. The contemporary level of evidence for each of the vitamins varies considerably, but it is notable that B vitamins are involved as cofactors in all of the core pathways or pathologies and, together with vitamins C and E, are consistently associated with a protective role against dementia. Outcomes from recent studies indicate that the efficacy and safety of supplementation with vitamins to prevent MCI and the early stages of AD will most likely depend on 1 ) which pathways are defective, 2 ) which vitamins are deficient and could correct the relevant metabolic defects, and 3 ) the modulating impact of nutrient-nutrient and nutrient-genotype interaction. More focus on a precision nutrition approach is required to realize the full potential of vitamin therapy in preventing dementia and to avoid causing harm. © 2017 American Society for Nutrition.

  18. [Eco-epidemiology: towards epidemiology of complexity].

    Science.gov (United States)

    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.

  19. Inadequate humidification of respiratory gases during mechanical ventilation of the newborn.

    Science.gov (United States)

    Tarnow-Mordi, W O; Sutton, P; Wilkinson, A R

    1986-01-01

    Proximal airway humidity was measured during mechanical ventilation in 14 infants using an electronic hygrometer. Values below recommended minimum humidity of adult inspired gas were recorded on 251 of 396 occasions. Inadequate humidification, largely due to inadequate proximal airway temperature, is commoner than recognised in infants receiving mechanical ventilation. PMID:3740912

  20. Inadequate humidification of respiratory gases during mechanical ventilation of the newborn.

    OpenAIRE

    Tarnow-Mordi, W O; Sutton, P; Wilkinson, A R

    1986-01-01

    Proximal airway humidity was measured during mechanical ventilation in 14 infants using an electronic hygrometer. Values below recommended minimum humidity of adult inspired gas were recorded on 251 of 396 occasions. Inadequate humidification, largely due to inadequate proximal airway temperature, is commoner than recognised in infants receiving mechanical ventilation.

  1. Linkage analysis: Inadequate for detecting susceptibility loci in complex disorders?

    Energy Technology Data Exchange (ETDEWEB)

    Field, L.L.; Nagatomi, J. [Univ. of Calgary, Alberta (Canada)

    1994-09-01

    Insulin-dependent diabetes mellitus (IDDM) may provide valuable clues about approaches to detecting susceptibility loci in other oligogenic disorders. Numerous studies have demonstrated significant association between IDDM and a VNTR in the 5{prime} flanking region of the insulin (INS) gene. Paradoxically, all attempts to demonstrate linkage of IDDM to this VNTR have failed. Lack of linkage has been attributed to insufficient marker locus information, genetic heterogeneity, or high frequency of the IDDM-predisposing allele in the general population. Tyrosine hydroxylase (TH) is located 2.7 kb from INS on the 5` side of the VNTR and shows linkage disequilibrium with INS region loci. We typed a highly polymorphic microsatellite within TH in 176 multiplex families, and performed parametric (lod score) linkage analysis using various intermediate reduced penetrance models for IDDM (including rare and common disease allele frequencies), as well as non-parametric (affected sib pair) linkage analysis. The scores significantly reject linkage for recombination values of .05 or less, excluding the entire 19 kb region containing TH, the 5{prime} VNTR, the INS gene, and IGF2 on the 3{prime} side of INS. Non-parametric linkage analysis also provided no significant evidence for linkage (mean TH allele sharing 52.5%, P=.12). These results have important implications for efforts to locate genes predisposing to complex disorders, strongly suggesting that regions which are significantly excluded by linkage methods may nevertheless contain predisposing genes readily detectable by association methods. We advocate that investigators routinely perform association analyses in addition to linkage analyses.

  2. Public health safety and environment in inadequate hospital and healthcare settings: a review.

    Science.gov (United States)

    Baguma, D

    2017-03-01

    Public health safety and environmental management are concerns that pose challenges worldwide. This paper briefly assesses a selected impact of the environment on public health. The study used an assessment of environmental mechanism to analyse the underlying different pathways in which the health sector is affected in inadequate hospital and health care settings. We reviewed the limited available evidence of the association between the health sector and the environment, and the likely pathways through which the environment influences health. The paper also models the use of private health care as a function of costs and benefits relative to public care and no care. The need to enhancing policies to improve the administration of health services, strengthening interventions on environment using international agreements, like Rio Conventions, including measures to control hospital-related infection, planning for human resources and infrastructure construction development have linkage to improve environment care and public health. The present study findings partly also demonstrate the influence of demand for health on the environment. The list of possible interventions includes enhancing policies to improve the administration of health services, strengthening Rio Conventions implementation on environmental concerns, control of environmental hazards and public health. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  3. Studies in using a universal exchange and inference language for evidence based medicine. Semi-automated learning and reasoning for PICO methodology, systematic review, and environmental epidemiology.

    Science.gov (United States)

    Robson, Barry

    2016-12-01

    The Q-UEL language of XML-like tags and the associated software applications are providing a valuable toolkit for Evidence Based Medicine (EBM). In this paper the already existing applications, data bases, and tags are brought together with new ones. The particular Q-UEL embodiment used here is the BioIngine. The main challenge is one of bringing together the methods of symbolic reasoning and calculative probabilistic inference that underlie EBM and medical decision making. Some space is taken to review this background. The unification is greatly facilitated by Q-UEL's roots in the notation and algebra of Dirac, and by extending Q-UEL into the Wolfram programming environment. Further, the overall problem of integration is also a relatively simple one because of the nature of Q-UEL as a language for interoperability in healthcare and biomedicine, while the notion of workflow is facilitated because of the EBM best practice known as PICO. What remains difficult is achieving a high degree of overall automation because of a well-known difficulty in capturing human expertise in computers: the Feigenbaum bottleneck. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Human immunodeficiency virus, AIDS, and drug consumption in South America and the Caribbean: epidemiological evidence and initiatives to curb the epidemic.

    Science.gov (United States)

    Hacker, Mariana A; Malta, Monica; Enriquez, Melissa; Bastos, Francisco I

    2005-01-01

    The paper reviews data on drug use in relation to the spread of human immunodeficiency virus and AIDS in South America and the Caribbean. Information was gathered by thoroughly reviewing major bibliographic databanks, web sites of international institutions and regional networks working with substance misuse or human immunodeficiency virus and AIDS, and abstracts from conferences and meetings. Although some gaps remain, a growing body of evidence documents the significant role of injected cocaine in the Brazilian and Southern Cone epidemics. The Caribbean and the Andean areas have thus far been spared in large part from the spread of injection drug use and its consequences, but the situation has been changing in Southern Cone countries towards a higher prevalence of harmful injection habits. Additional challenges have been posed by the increasing availability of heroin in the Andean Area and the abuse of crack cocaine and its impact on the sexual transmission of human immunodeficiency virus in many cities. Harm reduction strategies have been established in most areas of Brazil and are gaining momentum in Argentina. Other countries in the Region still face serious limitations due to restrictive legislation and lack of broader support. Greater participation of Latin American and Caribbean countries in research protocols and continued debate on both successful and failed experiences should be encouraged in order to minimize existing barriers to the full adoption of effective measures to curb the human immunodeficiency virus and AIDS epidemic in this Region.

  5. The significance of inadequate transcranial Doppler studies in children with sickle cell disease.

    Directory of Open Access Journals (Sweden)

    Simon Greenwood

    Full Text Available Sickle cell disease (SCD is a common cause of cerebrovascular disease in childhood. Primary stroke prevention is effective using transcranial Doppler (TCD scans to measure intracranial blood velocities, and regular blood transfusions or hydroxycarbamide when these are abnormal. Inadequate TCD scans occur when it is not possible to measure velocities in all the main arteries. We have investigated the prevalence and significance of this in a retrospective audit of 3915 TCD scans in 1191 children, performed between 2008 and 2015. 79% scans were normal, 6.4% conditional, 2.8% abnormal and 12% inadequate. 21.6% of 1191 patients had an inadequate scan at least once. The median age of first inadequate scan was 3.3 years (0.7-19.4, with a U-shaped frequency distribution with age: 28% aged 2-3 years, 3.5% age 10 years, 25% age 16 years. In young children reduced compliance was the main reason for inadequate TCDs, whereas in older children it was due to a poor temporal ultrasound window. The prevalence of inadequate TCD was 8% in the main Vascular Laboratory at King's College Hospital and significantly higher at 16% in the outreach clinics (P<0.0001, probably due to the use of a portable ultrasound machine. Inadequate TCD scans were not associated with underlying cerebrovascular disease.

  6. Morbidity in the marshes: using spatial epidemiology to investigate skeletal evidence for Malaria in Anglo-Saxon England (AD 410-1050).

    Science.gov (United States)

    Gowland, R L; Western, A G

    2012-02-01

    Concerns over climate change and its potential impact on infectious disease prevalence have contributed to a resurging interest in malaria in the past. A wealth of historical evidence indicates that malaria, specifically Plasmodium vivax, was endemic in the wetlands of England from the 16th century onwards. While it is thought that malaria was introduced to Britain during the Roman occupation (AD first to fifth centuries), the lack of written mortality records prior to the post-medieval period makes it difficult to evaluate either the presence or impact of the disease. The analysis of human skeletal remains from archaeological contexts is the only potential means of examining P. vivax in the past. Malaria does not result in unequivocal pathological lesions in the human skeleton; however, it results in hemolytic anemia, which can contribute to the skeletal condition cribra orbitalia. Using geographical information systems (GIS), we conducted a spatial analysis of the prevalence of cribra orbitalia from 46 sites (5,802 individuals) in relation to geographical variables, historically recorded distribution patterns of indigenous malaria and the habitat of its mosquito vector Anopheles atroparvus. Overall, those individuals living in low-lying and Fenland regions exhibited higher levels of cribra orbitalia than those in nonmarshy locales. No corresponding relationship existed with enamel hypoplasia. We conclude that P. vivax malaria, in conjunction with other comorbidities, is likely to be responsible for the pattern observed. Studies of climate and infectious disease in the past are important for modeling future health in relation to climate change predictions. Copyright © 2011 Wiley Periodicals, Inc.

  7. Predictors of Inadequate Inpatient Colonoscopy Preparation and Its Association with Hospital Length of Stay and Costs.

    Science.gov (United States)

    Yadlapati, Rena; Johnston, Elyse R; Gregory, Dyanna L; Ciolino, Jody D; Cooper, Andrew; Keswani, Rajesh N

    2015-11-01

    Adequate bowel preparation is essential to safe and effective inpatient colonoscopy. Predictors of poor inpatient colonoscopy preparation and the economic impacts of inadequate inpatient preparations are not defined. The aims of this study were to (1) determine risk factors for inadequate inpatient bowel preparations, and (2) examine the association between inadequate inpatient bowel preparation and hospital length of stay (LOS) and costs. We performed a retrospective cohort study of adult patients undergoing inpatient colonoscopy preparation over 12 months (1/1/2013-12/31/2013). Of 524 identified patients, 22.3% had an inadequate preparation. A multiple logistic regression model identified the following potential predictors of inadequate bowel preparation: lower income (OR 1.11; 95% CI 1.04, 1.22), opiate or tricyclic antidepressant (TCA) use (OR 1.55; 0.98, 2.46), and afternoon colonoscopy (OR 1.66; 1.07, 2.59); as well as American Society of Anesthesiologists (ASA) class ≥3 (OR 1.15; 1.05, 1.25) and symptoms of nausea/vomiting (OR 1.14; 1.04, 1.25) when a fair preparation was considered inadequate. Inadequate bowel preparation was associated with significantly increased hospital LOS (model relative mean estimate 1.25; 95% CI 1.03, 1.51) and hospital costs (estimate 1.31; 1.03, 1.67) when compared to adequate preparations. The rate of inadequate inpatient bowel preparations is high and associated with a significant increase in hospital LOS and costs. We identified five potential predictors of inadequate inpatient preparation: lower socioeconomic class, opiate/TCA use, afternoon colonoscopies, ASA class ≥3, and pre-preparation nausea/vomiting; these data should guide future initiatives to improve the quality of inpatient bowel preparations.

  8. Behaviorally inadequate

    DEFF Research Database (Denmark)

    Kasperbauer, Tyler Joshua

    2014-01-01

    According to situationism in psychology, behavior is primarily influenced by external situational factors rather than internal traits or motivations such as virtues. Environmental ethicists wish to promote pro-environmental behaviors capable of providing adequate protection for the environment......, but situationist critiques suggest that character traits, and environmental virtues, are not as behaviorally robust as is typically supposed. Their views present a dilemma. Because ethicists cannot rely on virtues to produce pro-environmental behaviors, the only real way of salvaging environmental virtue theory...... positive results. However, because endorsing behaviorally ineffective virtues, for whatever reason, entails that environmental ethicists are abandoning the goal of helping and protecting the environment, environmental ethicists should consider looking elsewhere than virtues and focus instead on the role...

  9. Epidemiology of exercise and sleep*

    OpenAIRE

    Youngstedt, Shawn D; Kline, Christopher E

    2006-01-01

    Although exercise is widely believed to improve sleep, experimental evidence has found acute and chronic exercise to exert only modest effects on subsequent sleep. However, these studies are limited in that they have primarily used good sleepers (floor/ceiling effects). In contrast to experimental studies, epidemiologic studies have consistently reported significant positive associations between self-reported exercise habits and better self-reported sleep. This association has been confirmed ...

  10. Ehrlichiosis: Statistics and Epidemiology

    Science.gov (United States)

    ... a tick Diseases transmitted by ticks Statistics and Epidemiology Recommend on Facebook Tweet Share Compartir On This ... Holman RC, McQuiston JH, Krebs JW, Swerdlow DL. Epidemiology of human ehrlichiosis and anaplasmosis in the United ...

  11. Anaplasmosis: Statistics and Epidemiology

    Science.gov (United States)

    ... a tick Diseases transmitted by ticks Statistics and Epidemiology Recommend on Facebook Tweet Share Compartir On This ... Holman RC, McQuiston JH, Krebs JW, Swerdlow DL. Epidemiology of human ehrlichiosis and anaplasmosis in the United ...

  12. International Lymphoma Epidemiology Consortium

    Science.gov (United States)

    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.

  13. Evaluation of epidemiological studies

    International Nuclear Information System (INIS)

    Breckow, J.

    1995-01-01

    The publication is intended for readers with a professional background in radiation protection who are not experts in the field of epidemiology. The potentials and the limits of epidemiology are shown and concepts and terminology of radioepidemilogic studies as well as epidemiology in general are explained, in order to provide the necessary basis for understanding or performing evaluations of epidemiologic studies. (orig./VHE) [de

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

    Science.gov (United States)

    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.

  15. Linking anthropological analysis and epidemiological evidence ...

    African Journals Online (AJOL)

    For twenty years, a region of northern Uganda known as Acholiland has been heavily affected by war, leading to the formation of internally displaced people's camps, rape, transactional sex and child abductions. While it is clear that the war has had onerous consequences for the health of the Acholi people, the specific ...

  16. Epidemiology of delayed ejaculation.

    Science.gov (United States)

    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.

  17. [The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies].

    Science.gov (United States)

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2008-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed explanation and elaboration document is published separately and is freely available on the websites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE statement will contribute to improving the quality of reporting of observational studies.

  18. [The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies].

    Science.gov (United States)

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2008-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists, researchers, and journal editors to draft a che-cklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed explanation and elaboration document is published separately and is freely available on the websites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE statement will contribute to improving the quality of reporting of observational studies.

  19. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

    Science.gov (United States)

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2014-12-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE statement: guidelines for reporting observational studies.

    Directory of Open Access Journals (Sweden)

    Erik von Elm

    2007-10-01

    Full Text Available Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.

  1. The association between inadequate prenatal care and future healthcare use among offspring in the Bedouin population.

    Science.gov (United States)

    Estis-Deaton, Asia; Sheiner, Eyal; Wainstock, Tamar; Landau, Daniella; Walfisch, Asnat

    2017-12-01

    To evaluate the impact of inadequate prenatal care on long-term morbidity among the offspring of an ethnic minority population. A retrospective population-based cohort analysis was performed among all Bedouin women with singleton pregnancies who delivered in a tertiary medical center in Israel between January 1, 1991, and January 1, 2014. Morbidity was defined as pediatric hospitalization across six distinct disease categories before 18 years of age. The cumulative morbidity rates were compared for offspring born following pregnancies with either inadequate (prenatal care facility) or adequate prenatal care. Overall, 127 396 neonates were included; 19 173 (15.0%) were born following inadequate prenatal care. Pediatric hospitalizations for all morbidities other than cardiovascular ones were less frequent among the inadequate prenatal care group than the adequate prenatal care group (Pprenatal care group, with the exception of cardiovascular disease. Inadequate prenatal care correlated with reduced pediatric hospitalization rates among offspring, possibly owing to a lack of child healthcare service utilization within the Bedouin population. © 2017 International Federation of Gynecology and Obstetrics.

  2. Consequences of Inadequate Staffing Include Missed Care, Potential Failure to Rescue, and Job Stress and Dissatisfaction.

    Science.gov (United States)

    Simpson, Kathleen Rice; Lyndon, Audrey; Ruhl, Catherine

    2016-01-01

    To evaluate responses of registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) to a survey that sought their recommendations for staffing guidelines and their perceptions of the consequences of inadequate nurse staffing. The goal was to use these member data to inform the work of the AWHONN nurse staffing research team. Secondary analysis of responses to the 2010 AWHONN nurse staffing survey. Online. AWHONN members (N = 884). Review of data from an online survey of AWHONN members through the use of thematic analysis for descriptions of the consequences of inadequate nurse staffing during the childbirth process. Three main themes emerged as consequences of inadequate staffing or being short-staffed: Missed Care, Potential for Failure to Rescue, and Job-Related Stress and Dissatisfaction. These themes are consistent with those previously identified in the literature related to inadequate nurse staffing. Based on the responses from participants in the 2010 AWHONN nurse staffing survey, consequences of inadequate staffing can be quite serious and may put patients at risk for preventable harm. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  3. Skull-base Osteomyelitis: a Dreaded Complication after Trivial Fall and Inadequate Management

    Directory of Open Access Journals (Sweden)

    Kundan Mittal

    2015-10-01

    Full Text Available Introduction: Skull-based osteomyelitis is bony infection which generally originates from inadequately treated chronic infection, adjoining tissue infection or after trauma.Case: 11 month female child had a trivial fall while standing near a bucket. The child developed fracture of right clavicle and left orbital swelling which was inadequately treated. This resulted in in spread of infection to adjoining tissues, skull bones, sinuses and brain.Conclusion: Cranial base osteomyelitis is rare but dreaded condition which requires early diagnosis and prompt treatment to avoid mortality and morbidity in form of neurological deficits and permanent disability

  4. Air Pollution and Neuropsychological Development: A Review of the Latest Evidence.

    Science.gov (United States)

    Suades-González, Elisabet; Gascon, Mireia; Guxens, Mònica; Sunyer, Jordi

    2015-10-01

    For the last decade, literature on the detrimental impacts of air pollution on brain, cognition and behavior has exponentially increased. Our aim is to review the latest epidemiologic literature on the association between outdoor air pollution and neuropsychological developmental in children. Two independent researchers searched for published studies between January 1, 2012 and June 12, 2015 in MEDLINE, Web of Science, and Science direct using defined keywords on outdoor air pollution and neuropsychological development. Selection of articles was based on study eligibility criteria. We encountered sufficient evidence of detrimental effects of pre- or postnatal exposure to polycyclic aromatic hydrocarbons on global intelligence quotient. The evidence was also sufficient for the association between pre- or postnatal exposure to fine particulate matter (PM2.5) and autism spectrum disorder, and limited evidence was encountered between nitrogen oxides and autism spectrum disorder. For other exposure-outcome associations reviewed, the evidence was inadequate or insufficient. Although evidence is not yet conclusive and further research is needed, the latest epidemiological studies support the hypothesis that pre- or postnatal exposure to ambient pollution, particularly polycyclic aromatic hydrocarbons, PM2.5, and nitrogen oxides has a negative impact on the neuropsychological development of children. The public health impact of air pollutants cannot be ignored and the precautionary principle should be applied to protect children.

  5. Should the history of epidemiology be taught in epidemiology training programs?

    Science.gov (United States)

    Laskaris, Zoey; Morabia, Alfredo

    2015-01-01

    Currently, there is no evidence concerning the presence of historical content in the epidemiology curricula of the United States and abroad. Similarly, it is not known how epidemiologists view this topic in the context of master's or doctoral level course work. We attempted to fill these knowledge gaps with data from 2 online surveys-Survey I administered to persons in charge of all epidemiology training programs in North America and Survey II to epidemiologists practicing around the world. A substantial minority (39%) of graduate programs in epidemiology in the United States teach a course on the history of the field. In both surveys, the most common reasons selected for teaching such a course were "To build a sense of identity as an epidemiologist" and "As a tool for achieving a deeper understanding into specific methods and concepts." The majority of respondents, from 63 countries, agreed that the history of epidemiology should be included in curricula for graduate students in epidemiology.

  6. Self-esteem, social support, and satisfaction differences in women with adequate and inadequate prenatal care.

    Science.gov (United States)

    Higgins, P; Murray, M L; Williams, E M

    1994-03-01

    This descriptive, retrospective study examined levels of self-esteem, social support, and satisfaction with prenatal care in 193 low-risk postpartal women who obtained adequate and inadequate care. The participants were drawn from a regional medical center and university teaching hospital in New Mexico. A demographic questionnaire, the Coopersmith self-esteem inventory, the personal resource questionnaire part 2, and the prenatal care satisfaction inventory were used for data collection. Significant differences were found in the level of education, income, insurance, and ethnicity between women who received adequate prenatal care and those who received inadequate care. Women who were likely to seek either adequate or inadequate prenatal care were those whose total family income was $10,000 to $19,999 per year and high school graduates. Statistically significant differences were found in self-esteem, social support, and satisfaction between the two groups of women. Strategies to enhance self-esteem and social support have to be developed to reach women at risk for receiving inadequate prenatal care.

  7. Randomized Trial of Once-Daily Fluticasone Furoate in Children with Inadequately Controlled Asthma

    DEFF Research Database (Denmark)

    Oliver, Amanda J.; Covar, Ronina A.; Goldfrad, Caroline H.

    2016-01-01

    Objective To evaluate the dose-response, efficacy, and safety of fluticasone furoate (FF; 25 µg, 50 µg, and 100 µg), administered once daily in the evening during a 12-week treatment period to children with inadequately controlled asthma. Study design This was a Phase IIb, multicenter, stratified...

  8. Wearable Devices for Classification of Inadequate Posture at Work Using Neural Networks.

    Science.gov (United States)

    Barkallah, Eya; Freulard, Johan; Otis, Martin J-D; Ngomo, Suzy; Ayena, Johannes C; Desrosiers, Christian

    2017-09-01

    Inadequate postures adopted by an operator at work are among the most important risk factors in Work-related Musculoskeletal Disorders (WMSDs). Although several studies have focused on inadequate posture, there is limited information on its identification in a work context. The aim of this study is to automatically differentiate between adequate and inadequate postures using two wearable devices (helmet and instrumented insole) with an inertial measurement unit (IMU) and force sensors. From the force sensors located inside the insole, the center of pressure (COP) is computed since it is considered an important parameter in the analysis of posture. In a first step, a set of 60 features is computed with a direct approach, and later reduced to eight via a hybrid feature selection. A neural network is then employed to classify the current posture of a worker, yielding a recognition rate of 90%. In a second step, an innovative graphic approach is proposed to extract three additional features for the classification. This approach represents the main contribution of this study. Combining both approaches improves the recognition rate to 95%. Our results suggest that neural network could be applied successfully for the classification of adequate and inadequate posture.

  9. The Inadequacy of Academic Environment Contributes to Inadequate Teaching and Learning Phenomena

    Science.gov (United States)

    Quasim, Shahla; Arif, Muhammad Shahbaz

    2014-01-01

    This study aims at the inadequacy of academic environment as an indicator contributing to the inadequate teaching and learning situation in Pakistan. The main focus is to look into the low proficiency of students in the subject of English at secondary school level. A comprehensive questionnaire was designed from the literature concerned and The…

  10. 25 CFR 170.811 - What happens if lack of funds results in inadequate maintenance?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What happens if lack of funds results in inadequate maintenance? 170.811 Section 170.811 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.811 What happens if lack of funds...

  11. Do infants with cow's milk protein allergy have inadequate levels of vitamin D?

    Science.gov (United States)

    Silva, Cristiane M; Silva, Silvia A da; Antunes, Margarida M de C; Silva, Gisélia Alves Pontes da; Sarinho, Emanuel Sávio Cavalcanti; Brandt, Katia G

    To verify whether infants with cow's milk protein allergy have inadequate vitamin D levels. This cross-sectional study included 120 children aged 2 years or younger, one group with cow's milk protein allergy and a control group. The children were recruited at the pediatric gastroenterology, allergology, and pediatric outpatient clinics of a university hospital in the Northeast of Brazil. A questionnaire was administered to the caregiver and blood samples were collected for vitamin D quantification. Vitamin D levels <30ng/mL were considered inadequate. Vitamin D level was expressed as mean and standard deviation, and the frequency of the degrees of sufficiency and other variables, as proportions. Infants with cow's milk protein allergy had lower mean vitamin D levels (30.93 vs.35.29ng/mL; p=0.041) and higher deficiency frequency (20.3% vs.8.2; p=0.049) than the healthy controls. Exclusively or predominantly breastfed infants with cow's milk protein allergy had higher frequency of inadequate vitamin D levels (p=0.002). Regardless of sun exposure time, the groups had similar frequencies of inadequate vitamin D levels (p=0.972). Lower vitamin D levels were found in infants with CMPA, especially those who were exclusively or predominantly breastfed, making these infants a possible risk group for vitamin D deficiency. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  12. Sleep deprivation in the last trimester of pregnancy and inadequate vitamin D: Is there a relationship?

    Directory of Open Access Journals (Sweden)

    Suzan Gunduz

    2016-01-01

    Conclusion: Inadequate vitamin D and poor sleep quality are prevalent in pregnant women, but low levels of vitamin D are not associated with poor sleep quality. Further studies with larger sample sizes and studies that include preterm deliveries and special sleep disorders should be performed to understand this issue better.

  13. Epidemiology: second-rate science?

    Science.gov (United States)

    Parascandola, M

    1998-01-01

    In recent years epidemiology has come under increasing criticism in regulatory and public arenas for being "unscientific." The tobacco industry has taken advantage of this, insisting for decades that evidence linking cigarettes and lung cancer falls short of proof. Moreover, many epidemiologists remain unduly skeptical and self-conscious about the status of their own causal claims. This situation persists in part because of a widespread belief that only the laboratory can provide evidence sufficient for scientific proof. Adherents of this view erroneously believe that there is no element of uncertainty or inductive inference in the "direct observation" of the laboratory researcher and that epidemiology provides mere "circumstantial" evidence. The historical roots of this attitude can be traced to philosopher John Stuart Mill and physiologist Claude Bernard and their influence on modern experimental thinking. The author uses the debate over cigarettes and lung cancer to examine ideas of proof in medical science and public health, concluding that inductive inference from a limited sample to a larger population is an element in all empirical science.

  14. The cancer epidemiology of radiation.

    Science.gov (United States)

    Wakeford, Richard

    2004-08-23

    Ionizing radiation has been the subject of intense epidemiological investigation. Studies have demonstrated that exposure to moderate-to-high levels can cause most forms of cancer, leukaemia and cancers of the breast, lung and thyroid being particularly sensitive to induction by radiation, especially at young ages at exposure. Predominant among these studies is the Life Span Study of the cohort of survivors of the atomic bombings of Japan in 1945, but substantial evidence is derived from groups exposed for medical reasons, occupationally or environmentally. Notable among these other groups are underground hard rock miners who inhaled radioactive radon gas and its decay products, large numbers of patients irradiated therapeutically and workers who received high doses in the nuclear weapons programme of the former USSR. The degree of carcinogenic risk arising from low levels of exposure is more contentious, but the available evidence points to an increased risk that is approximately proportional to the dose received. Epidemiological investigations of nonionizing radiation have established ultraviolet radiation as a cause of skin cancer. However, the evidence for a carcinogenic effect of other forms of nonionizing radiation, such as those associated with mobile telephones or electricity transmission lines, is not convincing, although the possibility of a link between childhood leukaemia and extremely low-frequency electromagnetic fields cannot be dismissed entirely.

  15. [Epidemiology and public policies].

    Science.gov (United States)

    Barata, Rita Barradas

    2013-03-01

    The present essay deals with the relation between epidemiology and public policies, highlighting the epidemiology position in the public health field, analyzing the impact of public policies over epidemiological profile and contributions from epidemiology to the lay down, implementation and evaluation of public health policies. In the first title, the essay debates the links between the epidemiology and public health field, the social determinants and political action framework proposed by the WHO's Commission on Social Determinants of Health, and different approaches of health policies. In the second title the essay analyses the reduction of child stunting in Brazil as an example of public policies that impact epidemiological profile. The third title presents three strategic topics for the application of public health policies: reduction of social inequalities in health, health promotion and regulation of products and services that have impact over health. The fourth title discusses the possibilities and difficulties to combine the epidemiological knowledge in the lay down, implementation and evaluation of public policies and, finally, material examples of such relation between epidemiology and public policies are presented.

  16. Epidemiology for Educators.

    Science.gov (United States)

    Landsberger, Betty H.

    The epidemiological approach, as elaborated to accomodate multiple-causation of chronic disease, is suggested as appropriate for the size and the nature of the failure-to-learn problem faced by educators. The epidemiological approach begins with an examination of the health status of an area's population. Major problems are identified with respect…

  17. Nueva evidencia epidemiológica y molecular a favor de la transmisión interhumana para el linaje Sout del hantavirus Andes New epidemiologic and molecular evidence of person to person transmission of hantavirus Andes Sout

    Directory of Open Access Journals (Sweden)

    Diego M. Pinna

    2004-02-01

    Full Text Available A partir de un brote de síndrome pulmonar por hantavirus ocurrido en 1996 en el sur de Argentina un nuevo mecanismo de infección quedó demostrado para el virus Andes (AND: la transmisión viral de persona a persona. La sospecha de ocurrencia de este mecanismo de transmisión ha sido restringida a la zona endémica del linaje AND Sout. Describimos el caso de un paciente (caso A residente en Buenos Aires, que desarrolló una infección por hantavirus sin haber tenido ningún otro riesgo epidemiológico más que el contacto con un caso previo (caso I en un viaje al sur de Argentina. Posteriormente un tercer caso (caso B residente de la provincia de Buenos Aires, desarrolló un síndrome pulmonar por hantavirus (SPH teniendo como antecedente de riesgo varios encuentros con A. La confirmación de la enfermedad en los tres pacientes se realizó mediante diagnóstico serológico y caracterización genética viral. El linaje viral en los tres casos fue el AND Sout siendo idéntica la cepa viral. Entre los hallazgos clínicos del caso A es destacable el gran compromiso general, con síntomas gastrointestinales pero sin evidencia clínica de daño pulmonar. En el presente informe presentamos nueva evidencia para el mecanismo de transmisión interhumana del linaje AND Sout, con las características particulares de haber ocurrido por un contacto ocasional, no repetido, pero prolongado como un viaje en ómnibus de larga distancia y fuera del área endémica.After the Hantavirus Pulmonary Syndrome (HPS outbreak occurred in Southern Argentina (Patagonia in 1996, a new mechanism of hantavirus spread was described for Andes virus (AND: person-to-person transmission. Since then, this mode of transmission has been limited to the endemic area of AND Sout lineage. We report here an HPS case, patient A, with residence in Buenos Aires Province, whose unique epidemiological risk factor was to have shared a trip to Southern Argentina with an already ill person, later

  18. Vaccine epidemiology: A review

    Directory of Open Access Journals (Sweden)

    Chandrakant Lahariya

    2016-01-01

    Full Text Available This review article outlines the key concepts in vaccine epidemiology, such as basic reproductive numbers, force of infection, vaccine efficacy and effectiveness, vaccine failure, herd immunity, herd effect, epidemiological shift, disease modeling, and describes the application of this knowledge both at program levels and in the practice by family physicians, epidemiologists, and pediatricians. A case has been made for increased knowledge and understanding of vaccine epidemiology among key stakeholders including policy makers, immunization program managers, public health experts, pediatricians, family physicians, and other experts/individuals involved in immunization service delivery. It has been argued that knowledge of vaccine epidemiology which is likely to benefit the society through contributions to the informed decision-making and improving vaccination coverage in the low and middle income countries (LMICs. The article ends with suggestions for the provision of systematic training and learning platforms in vaccine epidemiology to save millions of preventable deaths and improve health outcomes through life-course.

  19. Donepezil: A cause of inadequate muscle relaxation and delayed neuromuscular recovery

    Directory of Open Access Journals (Sweden)

    Alka Bhardwaj

    2011-01-01

    Full Text Available A 74-year-old female with diabetes mellitus type II and Alzheimer′s disease, taking donepezil for 4 months was operated for right modified radical mastectomy under general anesthesia. During the procedure a higher dose of non-depolarizing muscle relaxant was required than those recommended for her age yet the muscle relaxation was inadequate intra-operatively. Residual neuromuscular blockade persisted postoperatively, due to the cumulative effect of large doses of non-depolarizing muscle relaxant, needing post-operative ventilatory assistance. After ruling out other causes of resistance to non-depolarizing muscle relaxants, we concluded that acetylcholinesterase inhibitor donepezil was primarily responsible for inadequate muscle relaxation and delayed post-operative neuromuscular recovery.

  20. Role of Sex and the Environment in Moderating Weight Gain Due to Inadequate Sleep.

    Science.gov (United States)

    Coborn, Jamie E; Houser, Monica M; Perez-Leighton, Claudio E; Teske, Jennifer A

    2017-12-01

    The growing prevalence of obesity, inadequate sleep and sleep disorders together with the negative impact of lack of sleep on overall health highlights the need for therapies targeted towards weight gain due to sleep loss. Sex disparities in obesity and sleep disorders are present; yet, the role of sex is inadequately addressed and thus it is unclear whether sensitivity to sleep disruption differs between men and women. Like sex, environmental factors contribute to the development of obesity and poor sleep. The obesogenic environment is characterized by easy access to palatable foods and a low demand for energy expenditure in daily activities. These and other environmental factors are discussed, as they drive altered sleep or their interaction with food choice and intake can promote obesity. We discuss data that suggest differences in sleep patterns and responses to sleep disruption influence sex disparities in weight gain, and that enviromental disturbances alter sleep and interact with features of the obesogenic environment that together promote obesity.

  1. OCCUPATIONAL ACCIDENTS AS INDICATORS OF INADEQUATE WORK CONDITIONS AND WORK ENVIRONMENT

    OpenAIRE

    Petar Babović

    2009-01-01

    Occupational accidents due to inadequate working conditions and work environment present a major problem in highly industrialised countries, as well as in developing ones. Occupational accidents are a regular and accompanying phenomenon in all human activities and one of the main health related and economic problems in modern societies.The aim of this study is the analysis of the connections of unfavourable working conditions and working environment on occupational accidents. Occurrence of oc...

  2. Global trends in dietary micronutrient supplies and estimated prevalence of inadequate intakes.

    Directory of Open Access Journals (Sweden)

    Ty Beal

    Full Text Available Understanding dietary patterns is vital to reducing the number of people experiencing hunger (about 795 million, micronutrient deficiencies (2 billion, and overweight or obesity (2.1 billion. We characterize global trends in dietary quality by estimating micronutrient density of the food supply, prevalence of inadequate intake of 14 micronutrients, and average prevalence of inadequate intake of these micronutrients for all countries between 1961 and 2011. Over this 50-year period, the estimated prevalence of inadequate intakes of micronutrients has declined in all regions due to increased total production of food and/or micronutrient density. This decline has been particularly strong in East and Southeast Asia and weaker in South Asia and sub-Saharan Africa. Sub-Saharan Africa is the only region where dietary micronutrient density has declined over this 50-year period. At the global level, micronutrients with the lowest levels of adequate estimated intake are calcium, iron, vitamin A, and zinc, but there are strong differences between countries and regions. Fortification has reduced the estimated prevalence of inadequate micronutrient intakes in all low-income regions, except South Asia. The food supply in many countries is still far below energy requirements, which suggests a need to increase the availability and accessibility of nutritious foods. Countries where the food energy supply is adequate show a very large variation in dietary quality, and in many of these countries people would benefit from more diverse diets with a greater proportion of micronutrient-dense foods. Dietary quality can be improved through fortification, biofortification, and agricultural diversification, as well as efforts to improve access to and use of micronutrient-dense foods and nutritional knowledge. Reducing poverty and increasing education, especially of women, are integral to sustainably addressing malnutrition.

  3. Global trends in dietary micronutrient supplies and estimated prevalence of inadequate intakes.

    Science.gov (United States)

    Beal, Ty; Massiot, Eric; Arsenault, Joanne E; Smith, Matthew R; Hijmans, Robert J

    2017-01-01

    Understanding dietary patterns is vital to reducing the number of people experiencing hunger (about 795 million), micronutrient deficiencies (2 billion), and overweight or obesity (2.1 billion). We characterize global trends in dietary quality by estimating micronutrient density of the food supply, prevalence of inadequate intake of 14 micronutrients, and average prevalence of inadequate intake of these micronutrients for all countries between 1961 and 2011. Over this 50-year period, the estimated prevalence of inadequate intakes of micronutrients has declined in all regions due to increased total production of food and/or micronutrient density. This decline has been particularly strong in East and Southeast Asia and weaker in South Asia and sub-Saharan Africa. Sub-Saharan Africa is the only region where dietary micronutrient density has declined over this 50-year period. At the global level, micronutrients with the lowest levels of adequate estimated intake are calcium, iron, vitamin A, and zinc, but there are strong differences between countries and regions. Fortification has reduced the estimated prevalence of inadequate micronutrient intakes in all low-income regions, except South Asia. The food supply in many countries is still far below energy requirements, which suggests a need to increase the availability and accessibility of nutritious foods. Countries where the food energy supply is adequate show a very large variation in dietary quality, and in many of these countries people would benefit from more diverse diets with a greater proportion of micronutrient-dense foods. Dietary quality can be improved through fortification, biofortification, and agricultural diversification, as well as efforts to improve access to and use of micronutrient-dense foods and nutritional knowledge. Reducing poverty and increasing education, especially of women, are integral to sustainably addressing malnutrition.

  4. Growth inhibition in rats fed inadequate and incomplete proteins: repercussion on mandibular biomechanics

    OpenAIRE

    Bozzini, Clarisa; Champin, Graciela Monica; Bozzini, Carlos Eduardo Jose; Alippi, Rosa Maria

    2015-01-01

    This study describes the effects of feeding growing rats with a diet containing inadequate and incomplete proteins on both the morphological and the biomechanical properties of the mandible. Female rats aged 30 d were fed freely with one of two diets, control (CD, 301 Cal/100g) and experimental (ED, 359 Cal/100g). CD was a standard laboratory diet, while ED was a synthetic diet containing cornflower supplemented with vitamins and minerals. Both diets had the same physical characteristics. Con...

  5. Inadequate management of pregnancy-associated listeriosis: lessons from four case reports.

    Science.gov (United States)

    Charlier, C; Goffinet, F; Azria, E; Leclercq, A; Lecuit, M

    2014-03-01

    Listeria monocytogenes infection during pregnancy can lead to dramatic fetal or neonatal outcomes. No clinical trial has evaluated treatment options, and retrospective studies of cases are therefore important to define optimal regimens. We report four cases of materno-neonatal listeriosis illustrating inadequate antimicrobial therapy management and discuss recommended treatment options. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  6. WHO - IPHECA: Epidemiological aspects

    International Nuclear Information System (INIS)

    Souchkevitch, G.

    1996-01-01

    In May 1991 the World Health Assembly endorsed the establishment of the International Programme on the Health Effects of the Chernobyl Accident (IPHECA) under the auspices of WHO. Five pilot projects have been carried out within IPHECA in the study territories of Belarus, Russian Federation and Ukraine in a period from 1991 to 1994. This pilot projects dealt with the detection and treatment of leukaemia and related diseases (Haematology Project), thyroid disorders (Thyroid project), brain damage during exposure 'in-utero' (Brain Damage 'in-Utero' project) and with the development of the Chernobyl registries (Epidemiological Registry Project). A fifth pilot project on oral health was performed only in Belarus. Epidemiological investigations have been an important component of all IPHECA pilot projects. Within 'Epidemiological Registry' Project such investigations have been the principal activity. But with respect to other IPHECA projects it was carried out in addition to main objectives relating to medical monitoring, early diagnosis and treatment of specific diseases included in project protocols. To support the epidemiological investigations within IPHECA, WHO supplied 41 computers in Belarus, Russian Federation and Ukraine and provided training for specialists from these countries in internationally recognized centres. The training programmes and host countries were as follows: standardization of epidemiological investigations (United Kingdom), radiation epidemiology (Russia), development of software (United Kingdom), principles of epidemiological investigations (The Czech Republic), cohort investigations (Japan)

  7. Basic concepts of epidemiology

    International Nuclear Information System (INIS)

    Savitz, D.A.

    1984-01-01

    Epidemiology can be defined simply as the science of the distribution and determinants of disease in human populations. As a descriptive tool, epidemiology can aid health care service providers, for example, in allocation of resources. In its analytic capacity, the epidemiologic approach can help identify determinants of disease through the study of human populations. Epidemiology is primarily an observational rather than experimental methodology, with corresponding strengths and limitations. Relative to other approaches for assessing disease etiology and impacts of potential health hazards, epidemiology has a rather unique role that is complementary to, but independent of, both basic biologic sciences and clinical medicine. Experimental biologic sciences such as toxicology and physiology provide critical information on biologic mechanisms of disease required for causal inference. Clinical medicine often serves as the warning system that provides etiologic clues to be pursued through systematic investigation. The advantage of the epidemiologic approach is its reliance on human field experience, that is, the real world. While laboratory experimentation is uniquely well suited to defining potential hazards, it can neither determine whether human populations have actually been affected nor quantify that effect. Building all the complexities of human behavior and external factors into a laboratory study or mathematical model is impossible. By studying the world as it exists, epidemiology examines the integrated, summarized product of the myriad factors influencing health

  8. Epidemiology: Then and Now.

    Science.gov (United States)

    Kuller, Lewis H

    2016-03-01

    Twenty-five years ago, on the 75th anniversary of the Johns Hopkins Bloomberg School of Public Health, I noted that epidemiologic research was moving away from the traditional approaches used to investigate "epidemics" and their close relationship with preventive medicine. Twenty-five years later, the role of epidemiology as an important contribution to human population research, preventive medicine, and public health is under substantial pressure because of the emphasis on "big data," phenomenology, and personalized medical therapies. Epidemiology is the study of epidemics. The primary role of epidemiology is to identify the epidemics and parameters of interest of host, agent, and environment and to generate and test hypotheses in search of causal pathways. Almost all diseases have a specific distribution in relation to time, place, and person and specific "causes" with high effect sizes. Epidemiology then uses such information to develop interventions and test (through clinical trials and natural experiments) their efficacy and effectiveness. Epidemiology is dependent on new technologies to evaluate improved measurements of host (genomics), epigenetics, identification of agents (metabolomics, proteomics), new technology to evaluate both physical and social environment, and modern methods of data collection. Epidemiology does poorly in studying anything other than epidemics and collections of numerators and denominators without specific hypotheses even with improved statistical methodologies. © 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.

  9. Managing inadequate responses to frontline treatment of chronic myeloid leukemia: a case-based review.

    Science.gov (United States)

    Bixby, Dale L

    2013-05-01

    The tyrosine kinase inhibitors (TKIs) imatinib, nilotinib, and dasatinib are the standard of care for treating patients with newly diagnosed chronic-phase chronic myeloid leukemia (CML). Compared with interferon-based treatment, the previous standard of care, imatinib is associated with significantly higher cytogenetic response rates and prolonged overall survival. Nilotinib and dasatinib, both newer and more potent TKIs, significantly improve cytogenetic and molecular response rates compared with imatinib. Despite significant advances in CML treatment enabled by the TKIs, a fraction of patients who receive frontline treatment with a TKI demonstrate inadequate response. The reasons for this vary, but in many cases, inadequate response can be attributed to non-adherence to the treatment regimen, intolerance to the drug, intrinsic or acquired resistance to the drug, or a combination of reasons. More often than not, strategies to improve response necessitate a change in treatment plan, either a dose adjustment or a switch to an alternate drug, particularly in the case of drug intolerance or drug resistance. Improved physician-patient communication and patient education are effective strategies to address issues relating to adherence and intolerance. Because inadequate response to TKI treatment correlates with poor long-term outcomes, it is imperative that patients who experience intolerance or who fail to achieve appropriate responses are carefully evaluated so that appropriate treatment modifications can be made to maximize the likelihood of positive long-term outcome. Copyright © 2012. Published by Elsevier Ltd.

  10. Predictors of inadequate initial echocardiography in suspected Kawasaki disease: Criteria for sedation.

    Science.gov (United States)

    Lorenzoni, Raymond P; Choi, Jaeun; Choueiter, Nadine F; Munjal, Iona M; Katyal, Chhavi; Stern, Kenan W D

    2018-03-09

    Kawasaki disease is the primary cause of acquired pediatric heart disease in developed nations. Timely diagnosis of Kawasaki disease incorporates transthoracic echocardiography for visualization of the coronary arteries. Sedation improves this visualization, but not without risks and resource utilization. To identify potential sedation criteria for suspected Kawasaki disease, we analyzed factors associated with diagnostically inadequate initial transthoracic echocardiography performed without sedation. This retrospective review of patients Kawasaki disease from 2009 to 2015 occurred at a medium-sized urban children's hospital. The primary outcome was diagnostically inadequate transthoracic echocardiography without sedation due to poor visualization of the coronary arteries, determined by review of clinical records. The associations of the primary outcome with demographics, Kawasaki disease type, laboratory data, fever, and antipyretic or intravenous immunoglobulin treatment prior to transthoracic echocardiography were analyzed. In total, 112 patients (44% female, median age 2.1 years, median BSA 0.54 m 2 ) underwent initial transthoracic echocardiography for suspected Kawasaki disease, and 99 were not sedated. Transthoracic echocardiography was diagnostically inadequate in 19 out of these 99 patients (19.2%) and was associated with age ≤ 2.0 years, weight ≤ 10.0 kg, and antipyretic use ≤ 6 hours before transthoracic echocardiography (all P Kawasaki disease. These factors should be considered when deciding which patients to sedate for initial Kawasaki disease transthoracic echocardiography. © 2018 Wiley Periodicals, Inc.

  11. Factors associated with inadequate work ability among women in the clothing industry.

    Science.gov (United States)

    Augusto, Viviane Gontijo; Sampaio, Rosana Ferreira; Ferreira, Fabiane Ribeiro; Kirkwood, Renata Noce; César, Cibele Comini

    2015-01-01

    Work ability depends on a balance between individual resources and work demands. This study evaluated factors that are associated with inadequate work ability among workers in the clothing industry. We conducted a cross-sectional observational study of 306 workers in 40 small and medium-sized enterprises. We assessed work ability, individual resources, physical and psychosocial demands, and aspects of life outside work using a binary logistic regression model with hierarchical data entry. The mean work ability was 42.5 (SD=3.5); when adjusted for age, only 11% of the workers showed inadequate work ability. The final model revealed that smoking, high isometric physical load, and poor physical environmental conditions were the most significant predictors of inadequate work ability. Good working conditions and worker education must be implemented to eliminate factors that can be changed and that have a negative impact on work ability. These initiatives include anti-smoking measures, improved postures at work, and better physical environmental conditions.

  12. Epidemiology of Crohn's Disease.

    Science.gov (United States)

    Sandler, R S; Golden, A L

    1986-04-01

    Although our current understanding is limited, epidemiologic investigation of Crohn's disease holds great promise. Certain aspects of the epidemiology are clear. The incidence of Crohn's disease, which has increased over the past few decades, may have reached a plateau. The disease has its peak onset in early life, with a second peak among the elderly. It is more common in the developed countries and among Jews. Whether the disease is related to occupation, social class, marital status, stress, infection, diet, smoking, and oral contraceptives is less certain. This paper reviews the epidemiology of Crohn's disease and proposes areas in which further research is needed.

  13. Descriptive and analytic epidemiology. Bridges to cancer control

    International Nuclear Information System (INIS)

    Mettlin, C.

    1988-01-01

    Epidemiology serves as a bridge between basic science and cancer control. The two major orientations of epidemiology are descriptive and analytic. The former is useful in assessing the scope and dimensions of the cancer problem and the latter is used to assess environmental and lifestyle sources of cancer risk. A recent development in descriptive epidemiology is the use of functional measures of disease such as lost life expectancy. In analytical epidemiology, there is new or renewed interest in several lifestyle factors including diet and exercise as well as environmental factors such as involuntary tobacco exposure and radon in dwellings. Review of the evidence should consider the strengths and weaknesses of different research procedures. Each method is inconclusive by itself but, the different research designs of epidemiology collectively may represent a hierarchy of proof. Although the roles of many factors remain to be defined, the aggregate epidemiologic data continue to demonstrate the special importance of personal behavior and lifestyle in affecting cancer risk

  14. Relationship between Asthma and Rhinitis: Epidemiologic, Pathophysiologic, and Therapeutic Aspects

    Directory of Open Access Journals (Sweden)

    Bergeron Celine

    2005-06-01

    Full Text Available Abstract Over the last few years, the evidence of links between rhinitis and asthma has been strengthened. This has led to the introduction of the concept of united airway disease. Rhinitis and asthma appear to be interrelated at the epidemiologic level and at the pathophysiologic level. This article reviews current epidemiologic and pathophysiologic evidence of the relationship between rhinitis and asthma and discusses the effect of treatment of one site on the other site.

  15. Epidemiology and the Tobacco Epidemic: How Research on Tobacco and Health Shaped Epidemiology.

    Science.gov (United States)

    Samet, Jonathan M

    2016-03-01

    In this article, I provide a perspective on the tobacco epidemic and epidemiology, describing the impact of the tobacco-caused disease epidemic on the field of epidemiology. Although there is an enormous body of epidemiologic evidence on the associations of smoking with health, little systematic attention has been given to how decades of research have affected epidemiology and its practice. I address the many advances that resulted from epidemiologic research on smoking and health, such as demonstration of the utility of observational designs and important parameters (the odds ratio and the population attributable risk), guidelines for causal inference, and systematic review approaches. I also cover unintended and adverse consequences for the field, including the strategy of doubt creation and the recruitment of epidemiologists by the tobacco industry to serve its mission. The paradigm of evidence-based action for addressing noncommunicable diseases began with the need to address the epidemic of tobacco-caused disease, an imperative for action documented by epidemiologic research. © The Author 2016. 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.

  16. Population Genomics of Francisella tularensis subsp. holarctica and its Implication on the Eco-Epidemiology of Tularemia in Switzerland.

    Science.gov (United States)

    Wittwer, Matthias; Altpeter, Ekkehard; Pilo, Paola; Gygli, Sebastian M; Beuret, Christian; Foucault, Frederic; Ackermann-Gäumann, Rahel; Karrer, Urs; Jacob, Daniela; Grunow, Roland; Schürch, Nadia

    2018-01-01

    Whole genome sequencing (WGS) methods provide new possibilities in the field of molecular epidemiology. This is particularly true for monomorphic organisms where the discriminatory power of traditional methods (e.g., restriction enzyme length polymorphism typing, multi locus sequence typing etc.) is inadequate to elucidate complex disease transmission patterns, as well as resolving the phylogeny at high resolution on a micro-geographic scale. In this study, we present insights into the population structure of Francisella tularensis subsp. holarctica , the causative agent of tularemia in Switzerland. A total of 59 Fth isolates were obtained from castor bean ticks ( Ixodes ricinus) , animals and humans and a high resolution phylogeny was inferred using WGS methods. The majority of the Fth population in Switzerland belongs to the west European B.11 clade and shows an extraordinary genetic diversity underlining the old evolutionary history of the pathogen in the alpine region. Moreover, a new B.11 subclade was identified which was not described so far. The combined analysis of the epidemiological data of human tularemia cases with the whole genome sequences of the 59 isolates provide evidence that ticks play a pivotal role in transmitting Fth to humans and other vertebrates in Switzerland. This is further underlined by the correlation of disease risk estimates with climatic and ecological factors influencing the survival of ticks.

  17. [The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting of observational studies].

    Science.gov (United States)

    von Elm, E; Altman, D G; Egger, M; Pocock, S J; Gøtzsche, P C; Vandenbroucke, J P

    2008-06-01

    Much of biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalizability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. Eighteen items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.

  18. Epidemiology of allergic rhinitis.

    Science.gov (United States)

    Mims, James W

    2014-09-01

    Allergic rhinitis (AR) is the archetypal allergic disease otolaryngologists encounter. Epidemiologic studies inform providers of the association of rhinitis symptoms and allergy test results in the broader population. Understanding the epidemiological characteristics of AR is important for interpreting both rhinitis symptoms and allergy tests. Articles were selected based on literature review through PubMed and personal knowledge of the author. The largest and highest-quality studies were included. The search selection was not standardized. Epidemiological studies demonstrate marked variability globally in the prevalence of both rhinitis symptoms and allergy tests. Self-reported seasonal or perennial rhinitis symptoms significantly overestimate the prevalence of AR defined by a positive history and positive allergy tests. Positive allergy tests are also common in those without self-reported rhinitis symptoms. Interpreting rhinitis symptoms and allergy testing is enhanced by an understanding of the epidemiology of AR. © 2014 ARS-AAOA, LLC.

  19. Epidemiology & Genomics Research Program

    Science.gov (United States)

    The Epidemiology and Genomics Research Program, in the National Cancer Institute's Division of Cancer Control and Population Sciences, funds research in human populations to understand the determinants of cancer occurrence and outcomes.

  20. Cancer Epidemiology Cohorts

    Science.gov (United States)

    Cohort studies are fundamental for epidemiological research by helping researchers better understand the etiology of cancer and provide insights into the key determinants of this disease and its outcomes.

  1. Scabies: an epidemiologic reassessment.

    Science.gov (United States)

    Burkhart, C G

    1983-04-01

    Scabies is a highly contagious parasitic infestation whose exact nature is unknown. A reassessment of epidemiologic data questions accepted ideas such as that scabies is a sexually transmitted disease; 30-year cycles of scabies epidemics exist; changes in the immune status of the host population (herd immunity) are epidemiologically significant; fomite transmission is rare; and blacks are resistant to the mite. Scabies epidemics are due to several factors and improved surveillance is needed before the disease can be better controlled.

  2. Epidemiology of Stone Disease

    OpenAIRE

    Curhan, Gary C.

    2007-01-01

    Epidemiology has improved our understanding and management of stone. These types of studies have quantified changes in patterns and burden of disease, while identification of risk factors has changed clinical practice and provided insight into pathophysiologic processes related to stone formation. Because nephrolithiasis is a complex disease, an understanding of the epidemiology, particularly the interactions among different factors, may help lead to approaches that reduce the risk of stone f...

  3. Inadequate emergence after anesthesia: emergence delirium and hypoactive emergence in the Postanesthesia Care Unit.

    Science.gov (United States)

    Xará, Daniela; Silva, Acácio; Mendonça, Júlia; Abelha, Fernando

    2013-09-01

    To evaluate the frequency, determinants, and outcome of inadequate emergence after elective surgery in the Postanesthesia Care Unit (PACU). Prospective observational study. 12-bed PACU of a tertiary-care hospital in a major metropolitan area. 266 adult patients admitted to the PACU. To evaluate inadequate emergence, the Richmond Agitation and Sedation Scale (RASS) was administered to patients 10 minutes after their admission to the PACU. Demographic data, perioperative variables, and postoperative length of stay (LOS) in the PACU and the hospital were recorded. 40 (15%) patients showed symptoms of inadequate emergence: 17 patients (6.4%) screened positive for emergence delirium and 23 patients (8.6%) showed hypoactive emergence. Determinants of emergence delirium were longer duration of preoperative fasting (P = 0.001), higher visual analog scale (VAS) scores for pain (P = 0.002), and major surgical risk (P = 0.001); these patients had a higher frequency of postoperative delirium (P = 0.017) and had higher nausea VAS score 6 hours after surgery (P = 0.001). Determinants of hypoactive emergence were duration of surgery (P = 0.003), amount of crystalloids administered during surgery (P = 0.002), residual neuromuscular block (P < 0.001), high-risk surgery (P = 0.002), and lower core temperature on PACU admission (P = 0.028); these patients also had more frequent residual neuromuscular block (P < 0.001) postoperative delirium (P < 0.001), and more frequent adverse respiratory events (P = 0.02). Patients with hypoactive emergence had longer PACU and hospital LOS. Preventable determinants for emergence delirium were higher postoperative pain scores and longer fasting times. Hypoactive emergence was associated with longer postoperative PACU and hospital LOSs. © 2013 Elsevier Inc. All rights reserved.

  4. Risk factors for and consequences of inadequate surgical margins in oral squamous cell carcinoma

    DEFF Research Database (Denmark)

    Lawaetz, Mads; Homøe, Preben

    2014-01-01

    OBJECTIVE: The purpose of this study was to examine which factors are associated with inadequate surgical margins and to assess the postoperative consequences. STUDY DESIGN: A retrospective cohort of 110 patients with oral squamous cell carcinoma treated with surgery during a 2-year period...... was examined. Clinical, histopathologic, and operative variables were related to the surgical margin status. Furthermore postoperative treatment data were compared with margin status. RESULTS: Univariate statistically significant associations were found between the tumor site in the floor of mouth, more...

  5. The role of abutment-attachment selection in resolving inadequate interarch distance: a clinical report.

    Science.gov (United States)

    Alsiyabi, Abdullah S; Felton, David A; Cooper, Lyndon F

    2005-09-01

    A critical factor that needs to be evaluated during the diagnosis and treatment planning phase for patients seeking an implant-tissue-supported overdenture or metal-resin implant fixed denture is the presence of adequate interarch distance. The amount of interarch distance is critical to the selection of appropriate implant abutments and attachments for both implant-tissue-supported overdentures and metal-resin implant fixed complete dentures. This clinical report describes a patient with complications related to the failure to diagnose inadequate interarch distance, and the methods used to resolve the patient's chief complaint. A guide for abutment-attachment selection using one commercially available implant system is given.

  6. Forensic Epidemiology in Italy: principles and practice.

    Science.gov (United States)

    Chiesa, Valentina; Odone, Anna; Signorelli, Carlo

    2017-10-23

    Forensic epidemiology (FE) implies the use of epidemiological data in the processes and the involvement of epidemiologists in judicial proceedings. FE is essential for the assessment of causal association between the exposure to specific agents and the occurrence of diseases. In this paper we describe FE principles and applications in the Italian context as in recent years FE emerged increasingly as well as the need of experienced and trained epidemiological experts able to navigate legal proceedings. In the literature, the principles of FE have been widely described by different authors, among them: Kennet Rothman who introduced the definition of cause, Sir Austin Bradford Hill who proposed an analytic framework to assess the causal association, and recently by Sana Loue who described the actual legislation and application of FE in the United States. Despite the legislation varies among different countries epidemiological methods and theories represent the foundation for the application of FE we illustrate in this paper. The association between environmental pollution and disease, mobile phones and cancer, vaccines and autism, asbestos and pleural mesothelioma are all situations that underscore the need for FE investigations in criminal acts. Causal association is a complex process: in real life only in limited cases causal associations are assessed by gathering robust scientific evidence, while cases with doubts and situations where different approaches to questions may lead to discordant arguments to questions may lead to discordant arguments are more frequent. Therefore, during the assessment of causation in civil and criminal matters the choice the epidemiological expert - with his knowledge and expertise - and the evidence from well-designed studies are crucial to fill the gaps between clinical and epidemiological data and the low.

  7. Nonoclusive thrombosis of mechanical mitral valve prosthesis caused by inadequate treatment of anticoagulant therapy resistance

    Directory of Open Access Journals (Sweden)

    Ivanović Branislava

    2008-01-01

    Full Text Available Background. Oral anticoagulants have been used in the prevention of thromboembolic complications for over six decades. A rare, but possible problem in the application of these medications could be resistance to them. Case report. We presented a patient with nonocclusive thrombosis of the mechanical mitral prosthesis due to inadequately treated resistance to peroral anticoagulant therapy. Resistance to oral anticoagulant medications was proven by an increased dosage of warfarin up to 20 mg and, after that, acenokumarol to 15 mg over ten days which did not lead to an increase in the international normalized ratio (INR value over 1.2. On the basis of information that she did not take food rich in vitamin K or medications which could reduce effects of oral anticoagulants, and that she did not have additional illnesses and conditions that could cause an inadequate response to anticoagulant therapy, it was circumstantially concluded that this was a hereditary form of resistance. Because of the existing mechanical prosthetics on the mitral position, low molecular heparin has been introduced into the therapy. The patient reduced it on her own initiative, leading to nonocclusive valvular thrombosis. Conclusion. When associated complications like absolute arrhithmia does not exist, the finding of resistance to oral anticoagulant agents is an indication for the replacement of a mechanical prosthetic with a biological one which has been done in this patients.

  8. Approach to the patients with inadequate response to colchicine in familial Mediterranean fever.

    Science.gov (United States)

    Gül, Ahmet

    2016-04-01

    Familial Mediterranean fever (FMF) is the most common form of monogenic autoinflammatory conditions, and response to colchicine has been considered as one of its distinctive features among other hereditary periodic fever disorders. Prophylactic colchicine has been shown to be effective in the prevention of inflammatory attacks and development of amyloidosis. However, the highest tolerable doses of colchicine may not be adequate enough to manage these goals in approximately 5% of FMF patients. Inadequate response to colchicine in fully compliant FMF patients may be associated with genetic and/or environmental factors affecting disease severity and colchicine bioavailability. Clarification of the molecular pathogenic mechanisms of FMF has revealed that interleukin-1 beta (IL-1β) cytokine is the most likely target to attack, and several case reports and case series have already documented the efficacy and safety of available anti-IL-1 agents, such as anakinra, rilonacept, and canakinumab in those patients inadequately responding to colchicine. Characterization and early identification of those FMF patients with uncontrolled inflammatory activity have become more important after the availability of new treatment options for the prevention of disease-associated complications and permanent damages. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Inadequate Sleep and Exercise Associated with Burnout and Depression Among Medical Students.

    Science.gov (United States)

    Wolf, Megan R; Rosenstock, Jason B

    2017-04-01

    The authors studied whether low levels of exercise or inadequate sleep correlated with higher levels of burnout and depression in medical students. Medical students of all years at the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA, were invited to participate in an anonymous online survey in Fall 2012 and Winter 2013. Validated measures were used to assess exercise, sleep, burnout, and depression. Response rates were 28.7 % at the beginning of the school year and 22.6 % at the middle of the school year. Burnout rates overall were 22.4 % at the beginning of the year and 19.2 % in the middle of the year. Eight percent of students screened positive for depression at the beginning of the year and 9.3 % in the middle of the year. Decreased exercise frequency was significantly correlated with lower professional efficacy. Pathological sleepiness was significantly associated with a higher prevalence of burnout. Inadequate sleep correlated with significantly lower professional efficacy and higher exhaustion scores. Burnout was associated with a positive depression screen. Positive depression screening, pathological sleepiness, and sleeping less than 7 h a night were independent predictors of burnout. Sleep habits, exercise, and a positive depression screen were associated with burnout risk within the medical student population.

  10. Inadequate ventilation for nosocomial tuberculosis prevention in public hospitals in Central Thailand.

    Science.gov (United States)

    Jiamjarasrangsi, W; Bualert, S; Chongthaleong, A; Chaindamporn, A; Udomsantisuk, N; Euasamarnjit, W

    2009-04-01

    Forty-two community and general hospitals in central Thailand. To examine the adequacy of indoor ventilation for nosocomial tuberculosis (TB) prevention in public hospitals in central Thailand. A cross-sectional survey was conducted among 323 patient care and ancillary areas in the target hospitals. Data on indoor ventilation rate were collected by the tracer gas method and reported as air changes per hour (ACH). The adequacy of the measured ventilation rates were then determined by comparison with the international recommended standard values. Indoor ventilation rates were inadequate in almost half of the studied areas (144/323, 44.6%). The inadequacy was particularly serious in the emergency rooms (ERs) and radiological areas, where 73.8% (31/42 each) of the rooms had ACH below the recommended standards. Detailed analysis showed that most of the rooms with natural ventilation had air exchange rates that exceeded the recommended standards, while the opposite was the case for rooms with air-conditioning, particularly the window or wall-mount type. Indoor ventilation in high-risk nosocomial TB areas in public hospitals in Thailand was inadequate due to the installation of air-conditioning systems in modern buildings.

  11. Household Response to Inadequate Sewerage and Garbage Collection Services in Abuja, Nigeria.

    Science.gov (United States)

    Abubakar, Ismaila Rimi

    2017-01-01

    Provision of sanitation and garbage collection services is an important and yet challenging issue in the rapidly growing cities of developing countries, with significant human health and environmental sustainability implications. Although a growing number of studies have investigated the consequences of inadequate delivery of basic urban services in developing countries, few studies have examined how households cope with the problems. Using the Exit, Voice, Loyalty, and Neglect (EVLN) model, this article explores how households respond to inadequate sewerage and garbage collection services in Abuja, Nigeria. Based on a qualitative study, data were gathered from in-depth interviews with sixty households, complemented with personal observation. The findings from grounded analysis indicated that majority (62%) and about half (55%) of the respondents have utilized the informal sector for sewerage services and garbage collection, respectively, to supplement the services provided by the city. While 68% of the respondents reported investing their personal resources to improve the delivery of existing sewerage services, half (53%) have collectively complained to the utility agency and few (22%) have neglected the problems. The paper concludes by discussing the public health and environmental sustainability implications of the findings.

  12. Cervical cancer and human papillomavirus: Epidemiological evidence and perspectives for prevention Cáncer del cérvix y virus del papiloma humano: evidencia epidemiológica y perspectivas para su prevención

    Directory of Open Access Journals (Sweden)

    NUBIA MUÑOZ

    1997-07-01

    Full Text Available Cervical cancer is a major public health problem, as it is the second most common cancer in women world-wide after breast cancer. About 80% of the half a million cases estimated to occur annually in the world, occur in developing countries. The epidemiological evidence linking human papillomavirus (HPV to cervical cancer is reviewed. It is concluded that over 90% of cervical cancers can be attributed to certain HPV types. HPV 16 accounts for the highest proportion (50% followed by HPV 18 (12%, HPV 45 (8% and HPV 31 (5%. The associations with these HPV types are very b and consistent with odds ratios over 15 in all case-control studies in high- and low-risk countries for cervical cancer. However, HPV is not a sufficient cause of this malignancy; certain cofactors are necessary for a proportion of HPV persistent infections to eventually progress to cancer. These include host factors such as histocompatibilidad types and immunological response, hormonal influences and infections with other sexually transmitted agents such as Chlamydia trachomatis. In addition, results from our studies carried out in Spain and Colombia support the hypothesis that male carriers of HPV play an important role in the development of cervical cancer in their wives. The recognition of the central role of HPV in cervical cancer has far-reaching implications for the primary and secondary prevention of this malignancy. Prophylactic and therapeutic HPV vaccines are now under development and HPV typing is being integrated into screening programmes in pilot studies in a few developed countries. In developing countries, well conducted conventional screening programmes remain the best approach for the control of cervical cancer until a safe and efficient HPV vaccine can be used in the general population.El cáncer del cérvix constituye un problema importante de salud pública y es el más común en el mundo, después del de mama. Aproximadamente 80% de los 500 000 casos que se

  13. The epidemiology of irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Canavan C

    2014-02-01

    Full Text Available Caroline Canavan, Joe West, Timothy Card Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK Abstract: Irritable bowel syndrome (IBS is a functional condition of the bowel that is diagnosed using clinical criteria. This paper discusses the nature of the diagnostic process for IBS and how this impacts epidemiological measurements. Depending on the diagnostic criteria employed, IBS affects around 11% of the population globally. Around 30% of people who experience the symptoms of IBS will consult physicians for their IBS symptoms. These people do not have significantly different abdominal symptoms to those who do not consult, but they do have greater levels of anxiety and lower quality of life. Internationally, there is a female predominance in the prevalence of IBS. There is 25% less IBS diagnosed in those over 50 years and there is no association with socioeconomic status. IBS aggregates within families and the genetic and sociological factors potentially underlying this are reviewed. Patients diagnosed with IBS are highly likely to have other functional disease and have more surgery than the general population. There is no evidence that IBS is associated with an increased mortality risk. The epidemiological evidence surrounding these aspects of the natural history is discussed. Keywords: irritable bowel syndrome, epidemiology, prevalence, mortality, natural history

  14. Epidemiological studies on syncope

    DEFF Research Database (Denmark)

    Ruwald, Martin Huth

    2013-01-01

    thesis demonstrated that the ICD-10 discharge diagnosis could reliably identify a cohort of patients admitted for syncope and that the discharge code carried a high number of unexplained cases despite use of numerous tests. The last studies showed that syncope is a common cause for hospital contact......The epidemiology and prognosis of ''fainting'' or syncope has puzzled physicians over the years. Is fainting dangerous? This is a question often asked by the patient--and the answer is ''it depends on a lot of things''. The diverse pathophysiology of syncope and the underlying comorbidites...... of the patients play an essential role. In epidemiology these factors have major impact on the outcome of the patients. Until recently, even the definition of syncope differed from one study to another which has made literature reviews difficult. Traditionally the data on epidemiology of syncope has been taken...

  15. Ophthalmic epidemiology in Europe

    DEFF Research Database (Denmark)

    Delcourt, Cécile; Korobelnik, Jean-François; Buitendijk, Gabriëlle H S

    2016-01-01

    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 Euro......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...

  16. Nuclear accidents and epidemiology

    International Nuclear Information System (INIS)

    1987-01-01

    A consultation on epidemiology related to the Chernobyl accident was held in Copenhagen in May 1987 as a basis for concerted action. This was followed by a joint IAEA/WHO workshop in Vienna, which reviewed appropriate methodologies for possible long-term effects of radiation following nuclear accidents. The reports of these two meetings are included in this volume, and cover the subjects: 1) Epidemiology related to the Chernobyl nuclear accident. 2) Appropriate methodologies for studying possible long-term effects of radiation on individuals exposed in a nuclear accident. Figs and tabs

  17. Inadequate documentation of urinary tract infection symptoms in the medical chart.

    Science.gov (United States)

    Mithoowani, Siraj; Celetti, Steve J; Irfan, Neal; Brooks, Annie; Mertz, Dominik

    2015-11-01

    We evaluated symptom documentation for 312 inpatients with bacteriuria by comparing information found in the chart with that obtained prospectively from the medical and nursing team caring for the patient. There was only moderate agreement (κ = 0.55), and only 77% of symptomatic patients had any symptom documented in the chart. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  18. Inadequate supply of vitamins and DHA in the elderly: implications for brain aging and Alzheimer-type dementia.

    Science.gov (United States)

    Mohajeri, M Hasan; Troesch, Barbara; Weber, Peter

    2015-02-01

    Alzheimer's disease (AD) is the most prevalent, severe, and disabling cause of dementia worldwide. To date, AD therapy is primarily targeted toward palliative treatment of symptoms rather than prevention of disease progression. So far, no pharmacologic interventions have changed the onset or progression of AD and their use is accompanied by side effects. The major obstacle in managing AD and designing therapeutic strategies is the difficulty in retarding neuronal loss in the diseased brain once the pathologic events leading to neuronal death have started. Therefore, a promising alternative strategy is to maintain a healthy neuronal population in the aging brain for as long as possible. One factor evidently important for neuronal health and function is the optimal supply of nutrients necessary for maintaining normal functioning of the brain. Mechanistic studies, epidemiologic analyses, and randomized controlled intervention trials provide insight to the positive effects of docosahexaenoic acid (DHA) and micronutrients such as the vitamin B family, and vitamins E, C, and D, in helping neurons to cope with aging. These nutrients are inexpensive in use, have virtually no side effects when used at recommended doses, are essential for life, have established modes of action, and are broadly accepted by the general public. This review provides some evidence that the use of vitamins and DHA for the aging population in general, and for individuals at risk in particular, is a viable alternative approach to delaying brain aging and for protecting against the onset of AD pathology. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  19. Psychological distress is associated with inadequate dietary intake in Vietnamese marriage immigrant women in Korea.

    Science.gov (United States)

    Hwang, Ji-Yun; Lee, Sang Eun; Kim, Sun Hye; Chung, Hye Won; Kim, Wha Young

    2010-05-01

    Previous studies have reported that the nutritional status of Vietnamese female marriage immigrants in Korea is inadequate. And the mediation of acculturation stress can contribute to problems in their eating practices and dietary intakes. This study examines an association between psychological distress and inadequate dietary intake in Vietnamese female marriage immigrants living in Korea. A cross-sectional study analyzed baseline data (n=570) from the Cohort of Intermarried Women in Korea. Daily nutrient intakes were compared according to the quartiles of distress scores assessed by the Psychological Well-Being Index-Short Form. One-way analysis of variance and chi(2) tests were used to compare eating practices and nutrient intake across quartiles of psychological distress. Subjects in the highest stress scores were more likely to skip breakfast and to change their dietary habits after living in Korea than those in groups with low stress scores. Analyses of the subjects' Mini Dietary Assessments revealed that those with the highest stress scores were less likely to consume milk or dairy products, eat regular meals, or have balanced diets than those with the lowest stress scores. Nutrient intakes were found to be inadequate in the subjects, and those with the highest stress scores showed lower consumptions of energy, carbohydrate, protein, fat, calcium, zinc, thiamin, riboflavin, and folate compared to those with the lowest scores. The prevalence of underweight (body mass index [calculated as kg/m(2)] <18.5) increased from the lowest to highest quartiles of psychological distress scores. Psychological distress in Vietnamese female marriage immigrants living in Korea was negatively associated with dietary intake. These findings can assist dietetics practitioners working with minority immigrants because such information is important in designing appropriate strategies for dietary counseling. A follow-up study should address the underlying mechanisms of the observed

  20. Avoidable waste of research related to inadequate methods in clinical trials.

    Science.gov (United States)

    Yordanov, Youri; Dechartres, Agnes; Porcher, Raphaël; Boutron, Isabelle; Altman, Douglas G; Ravaud, Philippe

    2015-03-24

    To assess the waste of research related to inadequate methods in trials included in Cochrane reviews and to examine to what extent this waste could be avoided. A secondary objective was to perform a simulation study to re-estimate this avoidable waste if all trials were adequately reported. Methodological review and simulation study. Trials included in the meta-analysis of the primary outcome of Cochrane reviews published between April 2012 and March 2013. We collected the risk of bias assessment made by the review authors for each trial. For a random sample of 200 trials with at least one domain at high risk of bias, we re-assessed risk of bias and identified all related methodological problems. For each problem, possible adjustments were proposed that were then validated by an expert panel also evaluating their feasibility (easy or not) and cost. Avoidable waste was defined as trials with at least one domain at high risk of bias for which easy adjustments with no or minor cost could change all domains to low risk. In the simulation study, after extrapolating our re-assessment of risk of bias to all trials, we considered each domain rated as unclear risk of bias as missing data and used multiple imputations to determine whether they were at high or low risk. Of 1286 trials from 205 meta-analyses, 556 (43%) had at least one domain at high risk of bias. Among the sample of 200 of these trials, 142 were confirmed as high risk; in these, we identified 25 types of methodological problem. Adjustments were possible in 136 trials (96%). Easy adjustments with no or minor cost could be applied in 71 trials (50%), resulting in 17 trials (12%) changing to low risk for all domains. So the avoidable waste represented 12% (95% CI 7% to 18%) of trials with at least one domain at high risk. After correcting for incomplete reporting, avoidable waste due to inadequate methods was estimated at 42% (95% CI 36% to 49%). An important burden of wasted research is related to inadequate

  1. Cannabis Epidemiology: A Selective Review

    Science.gov (United States)

    Anthony, James C.; Lopez-Quintero, Catalina; Alshaarawy, Omayma

    2017-01-01

    Background Globally, the most widely used set of compounds among the internationally regulated drugs is cannabis. Objective To review evidence from epidemiological research on cannabis, organized in relation to this field’s five main rubrics: quantity, location, causes, mechanisms, and prevention/control. Method The review covers a selection of evidence from standardized population surveys, official statistics, and governmental reports, as well as published articles and books identified via MEDLINE, Web of Science, and Google Scholar as of July 2016. Results In relation to quantity, an estimated 3% to 5% of the world population is thought to have tried a cannabis product, with at least one fairly recent use, mainly extra-medical and outside boundaries of prescribed use. Among cannabis users in the United States, roughly one in 7–8 has engaged in medical marijuana use. In relation to location, prevalence proportions reveal important variations across countries and between subgroups within countries. Regarding causes and mechanisms of starting to use cannabis, there is no compelling integrative and replicable conceptual model or theoretical formulation. Most studies of mechanisms have focused upon a ‘gateway sequence’ and person-to-person diffusion, with some recent work on disability-adjusted life years. A brief review of cannabis use consequences, as well as prevention and control strategies is also provided. Conclusion At present, we know much about the frequency and occurrence of cannabis use, with too little replicable definitive evidence with respect to the other main rubrics. Given a changing regulatory environment for cannabis products, new institutions such as an independent International Cannabis Products Safety Commission may be required to produce evidence required to weigh benefits versus costs. It is not clear that government sponsored research will be sufficient to meet consumer demand for balanced points of view and truly definitive evidence

  2. Cannabis Epidemiology: A Selective Review.

    Science.gov (United States)

    Anthony, James C; Lopez-Quintero, Catalina; Alshaarawy, Omayma

    2017-01-04

    Globally, the most widely used set of compounds among the internationally regulated drugs is cannabis. To review evidence from epidemiological research on cannabis, organized in relation to this field's five main rubrics: quantity, location, causes, mechanisms, and prevention/ control. The review covers a selection of evidence from standardized population surveys, official statistics, and governmental reports, as well as published articles and books identified via MEDLINE, Web of Science, and Google Scholar as of July 2016. In relation to quantity, an estimated 3% to 5% of the world population is thought to have tried a cannabis product, with at least one fairly recent use, mainly extra-medical and outside boundaries of prescribed use. Among cannabis users in the United States, roughly one in 7-8 has engaged in medical marijuana use. In relation to location, prevalence proportions reveal important variations across countries and between subgroups within countries. Regarding causes and mechanisms of starting to use cannabis, there is no compelling integrative and replicable conceptual model or theoretical formulation. Most studies of mechanisms have focused upon a 'gateway sequence' and person-to-person diffusion, with some recent work on disability-adjusted life years. A brief review of cannabis use consequences, as well as prevention and control strategies is also provided. At present, we know much about the frequency and occurrence of cannabis use, with too little replicable definitive evidence with respect to the other main rubrics. Given a changing regulatory environment for cannabis products, new institutions such as an independent International Cannabis Products Safety Commission may be required to produce evidence required to weigh benefits versus costs. It is not clear that governmentsponsored research will be sufficient to meet consumer demand for balanced points of view and truly definitive evidence. Copyright© Bentham Science Publishers; For any queries

  3. Risk Factors for Inadequate Defibrillation Safety Margins Vary With the Underlying Cardiac Disease: Implications for Selective Testing Strategies

    NARCIS (Netherlands)

    Bonnes, J.L.; Westra, S.W.; Bouwels, L.H.; Boer, M.J. de; Brouwer, M.A.; Smeets, J.L.R.M.

    2016-01-01

    INTRODUCTION: In view of the shift from routine toward no or selective defibrillation testing, optimization of the current risk stratification for inadequate defibrillation safety margins (DSMs) could improve individualized testing decisions. Given the pathophysiological differences in myocardial

  4. Molecular epidemiology of ascariasis

    DEFF Research Database (Denmark)

    Betson, Martha; Halstead, Fennella; Nejsum, Peter

      We are using molecular epidemiology techniques to study the population structure of Ascaris obtained from humans and pigs. Worms were obtained from human hosts on Zanzibar and in Uganda, Bangladesh, Guatemala and Nepal and Ascaris from pigs were collected from in Uganda, Tanzania, Denmark...

  5. Epidemiology of reflex syncope

    NARCIS (Netherlands)

    Colman, N.; Nahm, K.; Ganzeboom, K. S.; Shen, W. K.; Reitsma, J.; Linzer, M.; Wieling, W.; Kaufmann, H.

    2004-01-01

    Cost-effective diagnostic approaches to reflex syncope require knowledge of its frequency and causes in different age groups. For this purpose we reviewed the available literature dealing with the epidemiology of reflex syncope. The incidence pattern of reflex syncope in the general population and

  6. Hepatitis E: Epidemiological forms

    Indian Academy of Sciences (India)

    In these endemic countries, the disease takes two major epidemiological forms. The form that was recognized first was occurrence of large outbreaks affecting several hundred to several thousand cases of acute hepatitis, usually over a short period of a few weeks. However, it was soon realized that the viral agent was also ...

  7. Inflammatory bowel disease epidemiology

    DEFF Research Database (Denmark)

    Burisch, Johan; Munkholm, Pia

    2013-01-01

    The occurrence of inflammatory bowel disease (IBD) is increasing worldwide, yet the reasons remain unknown. New therapeutic approaches have been introduced in medical IBD therapy, but their impact on the natural history of IBD remains uncertain. This review will summarize the recent findings in t...... in the epidemiology of IBD....

  8. Translational Epidemiology in Psychiatry

    Science.gov (United States)

    Weissman, Myrna M.; Brown, Alan S.; Talati, Ardesheer

    2012-01-01

    Translational research generally refers to the application of knowledge generated by advances in basic sciences research translated into new approaches for diagnosis, prevention, and treatment of disease. This direction is called bench-to-bedside. Psychiatry has similarly emphasized the basic sciences as the starting point of translational research. This article introduces the term translational epidemiology for psychiatry research as a bidirectional concept in which the knowledge generated from the bedside or the population can also be translated to the benches of laboratory science. Epidemiologic studies are primarily observational but can generate representative samples, novel designs, and hypotheses that can be translated into more tractable experimental approaches in the clinical and basic sciences. This bedside-to-bench concept has not been explicated in psychiatry, although there are an increasing number of examples in the research literature. This article describes selected epidemiologic designs, providing examples and opportunities for translational research from community surveys and prospective, birth cohort, and family-based designs. Rapid developments in informatics, emphases on large sample collection for genetic and biomarker studies, and interest in personalized medicine—which requires information on relative and absolute risk factors—make this topic timely. The approach described has implications for providing fresh metaphors to communicate complex issues in interdisciplinary collaborations and for training in epidemiology and other sciences in psychiatry. PMID:21646577

  9. Follow-up of abnormal or inadequate test results in the Danish Cervical Cancer Screening Program

    DEFF Research Database (Denmark)

    Kristiansen, Bettina Kjær

    2014-01-01

    Denmark has a higher incidence of cervical cancer than other Nordic countries, although all Danish women (aged 23–65) are screened regularly to identify possible cervical dysplasia or asymptomatic invasive cancer. Annually 40 000 women receives an abnormal or inadequate test result and a follow......-up recommendation. However problems with delayed follow-up may threaten the effectiveness of the Danish Cervical Cancer Screening Program, as 20% of women are delayed and dysplasia potentially can progress into cancer. Delayed follow-up is found in situations where women either consciously or unconsciously postpone...... will be of great importance to the future organisation of cervical and colorectal cancer screening programmes in Denmark, but will also have international interest because of their similar challenges....

  10. Microbiological changes after periodontal therapy in diabetic patients with inadequate metabolic control

    Directory of Open Access Journals (Sweden)

    Carina Maciel Silva-Boghossian

    2014-05-01

    Full Text Available The present study investigated the effect of non-surgical periodontal treatment (SRP on the composition of the subgingival microbiota of chronic periodontitis (CP in individuals with type 2 diabetes (DM2 with inadequate metabolic control and in systemically healthy (SH individuals. Forty individuals (20 DM2 and 20 SH with CP underwent full-mouth periodontal examination. Subgingival plaque was sampled from 4 deep sites of each individual and tested for mean prevalence and counts of 45 bacterial taxa by the checkerboard method. Clinical and microbiological assessments were performed before and 3 months after SRP. At baseline, those in the DM2 group presented a significantly higher percentage of sites with visible plaque and bleeding on probing compared with those in the SH group (p < 0.01. Those in the DM2 group presented significantly higher levels of C. rectus and P. gingivalis, and lower prevalence of P. micra and S. anginosus, compared with those in the SH group (p ≤ 0.001. At the 3-month visit, both groups showed a significant improvement in all clinical parameters (p < 0.01. Those in the DM2 group showed significantly higher prevalence and/or levels of A. gerencseriae, A. naeslundii I, A. oris, A. odontolyticus, C. sputigena, F. periodonticum, and G. morbillorum compared with those in the SH group (p ≤ 0.001. However, those in the DM2 group showed a significant reduction in the levels of P. intermedia, P. gingivalis, T. forsythia, and T. denticola (p ≤ 0.001 over time. Those in the SRP group showed improved periodontal status and reduced levels of putative periodontal pathogens at 3 months’ evaluation compared with those in the DM2 group with inadequate metabolic control.

  11. Epidemiology of cervical cancer in Colombia

    Directory of Open Access Journals (Sweden)

    Nubia Muñoz

    2014-09-01

    Full Text Available Objective. To describe the incidence, mortality, time trends and prognostic factors for cervical cancer in Cali, Colombia, and to review the molecular epidemiological evidence showing that HPV is the major and necessary cause of cervical cancer and the implications of this discovery for primary and secondary prevention. Materials and methods. Incidence rates of cervical cancer during a 45-year period (1962-2007 were estimated based on the population-based cancer registry of Cali and the mortality statistics from the Municipal Health Secretariat of Cali. Prognostic factors were estimated based on relative survival. Review of the molecular epidemiological evidence linking HPV to cervical cancer was focused on the studies carried out in Cali and in other countries. Results. Incidence rates of squamous cell carcinoma (SCC declined from 120.4 per 100 000 in 1962-1966 to 25.7 in 2003-2007 while those of adenocarcinoma increased from 4.2 to 5.8. Mortality rates for cervical cancer declined from 18.5 in 1984-1988 to 7.0 per 100 000 in 2009-2011. Survival was lower in women over 65 years of age and in clinical stages 3-4. Review of the molecular epidemiological evidence showed that certain types of HPV are the central and necessary cause of cervical cancer. Conclusions. A decline in the incidence and mortality of SCC and an increase in the incidence of adenocarcinoma during a 45-year period was documented in Cali, Colombia

  12. Predictors of an inadequate defibrillation safety margin at ICD implantation: insights from the National Cardiovascular Data Registry.

    Science.gov (United States)

    Hsu, Jonathan C; Marcus, Gregory M; Al-Khatib, Sana M; Wang, Yongfei; Curtis, Jeptha P; Sood, Nitesh; Parker, Matthew W; Kluger, Jeffrey; Lampert, Rachel; Russo, Andrea M

    2014-07-22

    Defibrillation testing is often performed to establish effective arrhythmia termination, but predictors and consequences of an inadequate defibrillation safety margin (DSM) remain largely unknown. The aims of this study were to develop a simple risk score predictive of an inadequate DSM at implantable cardioverter-defibrillator (ICD) implantation and to examine the association of an inadequate DSM with adverse events. A total of 132,477 ICD Registry implantations between 2010 and 2012 were analyzed. Using logistic regression models, factors most predictive of an inadequate DSM (defined as the lowest successful energy tested 3 days (odds ratio: 1.24; 95% confidence interval: 1.19 to 1.30; p < 0.0001), and in-hospital mortality (odds ratio: 1.96; 95% confidence interval: 1.63 to 2.36; p < 0.0001). A simple risk score identified ICD recipients at risk for an inadequate DSM. An inadequate DSM was associated with an increased risk for in-hospital adverse events. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Molecular Epidemiology Investigation of Obesity and Lethal Prostate Cancer

    Science.gov (United States)

    2015-09-01

    compelling evidence linking obesity to aggressive prostate cancer, but the underlying causes of this relationship are unclear. In this study we used whole...1 AWARD NUMBER: W81XWH-14-1-0250 TITLE: Molecular Epidemiology Investigation of Obesity and Lethal Prostate Cancer PRINCIPAL INVESTIGATOR: Ericka...TITLE AND SUBTITLE Molecular Epidemiology Investigation of Obesity and Lethal Prostate Cancer 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0250

  14. Epidemiology of cancer in young persons in West Cumbria

    International Nuclear Information System (INIS)

    Snee, M.P.

    1987-01-01

    A brief report is given of a lecture by Professor Gardner of the MRC in which some of the epidemiological evidence of cancer in young persons in the vicinity of the Sellafield site was reviewed. The studies that the MRC Environmental Epidemiology Unit at Southampton were currently undertaking in relation to Recommendations 1,2 and 3 of the Black Committee 1984 Report were also outlined. Some of the questions put to Professor Gardner after his lecture are briefly discussed. (UK)

  15. Epidemiology as a liberal art: from graduate school to middle school, an unfulfilled agenda.

    Science.gov (United States)

    Bracken, Michael B

    2014-03-01

    Calls by Lilienfeld, Fraser, and others some three decades ago to introduce epidemiology into undergraduate college education remain largely unfulfilled. Consideration of epidemiology as a "liberal art" has also led to exploring possibilities for introducing epidemiology into early education: to high and even middle schools. Adding epidemiology to school curricula should help educate the public to understand science-based evidence concerning the causes and treatments of disease, help inoculate them against a tsunami of biased and fraudulent media messaging, and permit advancing postgraduate education in epidemiology to even higher levels of scholarship. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Epidemiological fallacies of modern psychiatric research.

    Science.gov (United States)

    Newson, Rachel S; Karlsson, Hasse; Tiemeier, Henning

    2011-09-01

    Psychiatric epidemiology is an important cornerstone of research in psychiatry and integral for the treatment and care of people suffering from psychiatric disorders. However, psychiatric epidemiology is a difficult science, which is often beset with methodological problems. In light of this, the current review sought to explore 13 of the common methodological issues in psychiatric epidemiology. Many methodological problems result from misunderstandings. As such, we sought to highlight these problems, provide evidence to counteract the myths surrounding these problems and subsequently provide recommendations to overcome these problems. To highlight and clarify these issues, examples are provided from current psychiatric literature. Areas discussed in the review include problems with: taxonometry of disorders, sole reliance on self-reports, single-question diagnoses, baseline participation rates, measurement of lifetime prevalence, inconsistency of multiple informants, selection of covariates, testing of interactions, correction for multiple testing, the intermittent measurement of disorders during follow-up, evaluation of causal associations, data invalidation related to loss from follow-up and the publication of negative findings. Many methodological myths prevail in the area of epidemiology and this review endeavoured to elucidate and clarify these. This review was developed as a teaching tool for students, clinicians and researchers.

  17. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies

    OpenAIRE

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2014-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study’s generalizability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-contro...

  18. Epidemiology applied to health physics

    International Nuclear Information System (INIS)

    1983-01-01

    The technical program of the mid-year meeting of the Health Physics Society, entitled Epidemiology Applied to Health physics, was developed to meet three objectives: (1) give health physicists a deeper understanding of the basics of epidemiological methods and their use in developing standards, regulations, and criteria and in risk assessment; (2) present current reports on recently completed or on-going epidemiology studies; and (3) encourage greater interaction between the health physics and epidemiology disciplines. Included are studies relating methods in epidemiology to radiation protection standards, risk assessment from exposure to bone-seekers, from occupational exposures in mines, mills and nuclear facilities, and from radioactivity in building materials

  19. Barriers to implementing evidence-based practice in a private ...

    African Journals Online (AJOL)

    , individual perceptions that underpin clinical decision-making, lack of access to information required for EBP, inadequate sources to access evidence, inability to synthesise the literature available, and resistance to change. Barriers related to ...

  20. Epidemiology and ionizing radiations

    International Nuclear Information System (INIS)

    Bourguignon, M.; Masse, R.; Slama, R.; Spira, A.; Timarche, M.; Laurier, D.; Billon, S.; Rogel, A.; Telle Lamberton, M.; Catelinois, O.; Thierry, I.; Grosche, B.; Ron, E.; Vathaire, F. de; Cherie Challine, L.; Donadieu, J.; Pirard, Ph.; Bloch, J.; Setbon, M.

    2004-01-01

    The ionizing radiations have effects on living being. The determinist effects appear since a threshold of absorbed dose of radiation is reached. In return, the stochastic effects of ionizing radiations are these ones whom apparition cannot be described except in terms of probabilities. They are in one hand, cancers and leukemia, on the other hand, lesions of the genome potentially transmissible to the descendants. That is why epidemiology, defined by specialists as the science that studies the frequency and distribution of illness in time and space, the contribution of factors that determine this frequency and this distribution among human populations. This issue gathers and synthesizes the knowledge and examines the difficulties of methodologies. It allows to give its true place to epidemiology. (N.C.)

  1. The leukemias: Epidemiologic aspects

    International Nuclear Information System (INIS)

    Linet, M.S.

    1984-01-01

    Particularly geared to physicians and cancer researchers, this study of the epidemiology and etiology of leukemia analyzes the four major leukemia subtypes in terms of genetic and familial determinant factors and examines the incidence, distribution and frequency of reported leukemia clusters. Linet discusses the connection between other types of malignancies, their treatments, and the subsequent development of leukemia and evaluates the impact on leukemia onset of such environmental factors as radiation therapy, drugs, and occupational hazards

  2. EPIDEMIOLOGY OF PARACOCCIDIOIDOMYCOSIS

    OpenAIRE

    MARTINEZ, Roberto

    2015-01-01

    SUMMARY The epidemiological characteristics of paracoccidioidomycosis were reviewed and updated. The new endemic areas in Brazil were discussed in the section regarding the geographic distribution of the mycosis. Subclinical infection with Paracoccidioides brasiliensis was discussed on the basis of skin test surveys with antigens of the fungus, seroepidemiological studies, and disease cases outside Latin America. Large case series permitted a comparison of the prevalence of the mycosis in dif...

  3. EPIDEMIOLOGY OPPORTUNISTIC MYCOSES

    Directory of Open Access Journals (Sweden)

    V. V. Shkarin

    2017-01-01

    Full Text Available The review touches upon a problem of coinfection caused by several important fungal infections (aspergillus, candida, pneumocystis, cryptococcus and infectious or parasitic diseases. The authors also investigate epidemiologic determinants of such clinical forms of pathologic process. There are a lot of scientific gaps in the studying coinfections concerning mycosis and other infections. Physicians and infection control practitioners sometimes reveal such cases therefore complex characteristics of the coinfections is required.

  4. Racial and Social Class Differences in How Parents Respond to Inadequate Achievement: Consequences for Children's Future Achievement.

    Science.gov (United States)

    Robinson, Keith; Harris, Angel L

    2013-12-01

    Despite numerous studies on parental involvement in children's academic schooling, there is a dearth of knowledge on how parents respond specifically to inadequate academic performance. This study examines whether 1) racial differences exist in parenting philosophy for addressing inadequate achievement, 2) social class has implications for parenting philosophy, and 3) parents' philosophies are consequential for children's academic achievement. Using data from the Child Development Supplement (N=1041) to the Panel Study of Income Dynamics, we sort parents into two categories-those whose parenting repertoires for addressing poor achievement include punitive responses and those whose repertoires do not. We then determine whether racial differences exist between these categories and how various responses within the aforementioned categories are related to students' academic achievement. The findings show that white and black parents have markedly different philosophies on how to respond to inadequate performance, and these differences appear to impact children's achievement in dramatically different ways. Educators and policy makers should pay particular attention to how parents respond to inadequate achievement as imploring parents of inadequately performing students to be more involved without providing them with some guidance might exacerbate the problem.

  5. Effects of inadequate maternal dietary protein:carbohydrate ratios during pregnancy on offspring immunity in pigs

    Directory of Open Access Journals (Sweden)

    Tuchscherer Margret

    2012-11-01

    Full Text Available Abstract Background Inadequate nutrition in utero may retard foetal growth and alter physiological development of offspring. This study investigated the effects of low and high protein diets fed to primiparous German Landrace sows throughout pregnancy on the immune function of their offspring at different ages. Sows were fed diets with adequate (AP, 12.1%; n = 13, low (LP, 6.5%; n = 15, or high (HP, 30%; n = 14 protein content, made isoenergetic by varying carbohydrate levels. Cortisol, total protein and immunoglobulin (IgG, IgM, IgA concentrations were measured in the blood of sows over the course of pregnancy. Cortisol, total protein, immunoglobulins, lymphocyte proliferation, immune cell counts, and cytokines were assessed in the blood of offspring at baseline and under challenging conditions (weaning; lipopolysaccharide (LPS administration. Results In sows, the LP diet increased cortisol (P P P P + cell percentage and the CD4+/CD8+ ratio increased after weaning (P P = 0.09 and HP (P P  Conclusions Our results indicate that both low and high protein:carbohydrate ratios in the diet of pregnant sows can induce short-term as well as long-lasting effects on immune competence in piglets that may have serious consequences for host defence against bacterial pathogens.

  6. Dutch healthcare professionals inadequately perceived if three- and four-year-old preschool children were overweight.

    Science.gov (United States)

    Bocca, Gianni; Corpeleijn, Eva; Broens, Jasper; Stolk, Ronald P; Sauer, Pieter J

    2016-10-01

    We studied whether healthcare professionals adequately perceived if preschool children were overweight and whether this was influenced by their own body mass index (BMI). We sent 716 Dutch healthcare professionals questionnaires containing seven pictures and seven sketches of three- and four-year-old children showing body weights from underweight to morbidly obese. The professionals rated the pictures on a five-point scale from too heavy to too light and chose the sketch that they felt best depicted the child's body shape. They also reported their own height and weight and their BMI was calculated. Of the 716 questionnaires, 346 (48.3%) were returned with complete information and analysed. Healthcare professionals mostly chose sketches that showed children as being lighter than they really were. Depending on their own BMI group, the overweight child was perceived as having a normal weight by 74-79% of the healthcare professionals. The obese children were rated correctly by 44-52% of the professionals, but 14-15% said their weight was normal. The morbidly obese child was adequately assessed by 93-98% of the professionals. Healthcare professionals inadequately perceived whether three- and four-year-old children were overweight and this may have hindered early interventions, leading to overweight children becoming overweight adolescents. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  7. Inadequate child supervision: The role of alcohol outlet density, parent drinking behaviors, and social support.

    Science.gov (United States)

    Freisthler, Bridget; Johnson-Motoyama, Michelle; Kepple, Nancy J

    2014-08-01

    Supervisory neglect, or the failure of a caregiver to appropriately supervise a child, is one of the predominant types of neglectful behaviors, with alcohol use being considered a key antecedent to inadequate supervision of children. The current study builds on previous work by examining the role of parental drinking and alcohol outlet densities while controlling for caregiver and child characteristics. Data were obtained from 3,023 participants via a telephone survey from 50 cities throughout California. The telephone survey included items on neglectful parenting practices, drinking behaviors, and socio-demographic characteristics. Densities of alcohol outlets were measured for each of the 202 zip codes in the study. Multilevel Bernoulli models were used to analyze the relationship between four supervisory neglect parenting practices and individual-level and zip code-level variables. In our study, heavy drinking was only significantly related to one of our four outcome variables (leaving a child where he or she may not be safe). The density of on premise alcohol outlets was positively related to leaving a child home alone when an adult should be present. This study demonstrates that discrete relationships exist between alcohol related variables, social support, and specific supervisory neglect subtypes at the ecological and individual levels.

  8. Increasing Trends in Orthopedic Fellowships Are Not due to Inadequate Residency Training

    Directory of Open Access Journals (Sweden)

    K. A. Almansoori

    2015-01-01

    Full Text Available Orthopedic residents have one of the highest fellowship participation rates among medical specialities and there are growing concerns that inadequate residency training may be contributing to this trend. Therefore, a mixed-exploratory research survey was distributed to all 148 graduating Canadian orthopedic residents to investigate their perceptions and attitudes for pursuing fellowships. A response rate of 33% (n=49 was obtained with the majority of residents undertaking one (27% or two (60% fellowships. Surgical-skill development was reported as the most common motivating factor, followed by employment and marketability; malpractice protection and financial reasons were the least relevant. The overwhelming majority of residents (94%, n=46 felt adequately prepared by their residency training for independent general practice, and 84% (n=41 of respondents did not feel that current fellowship trends were due to poor residency training. Three common themes were expressed in their comments: the growing perceived expectation by healthcare professionals and employers to be fellowship-certified, the integration of fellowship training into the surgical education hierarchy, and the failure of residency training curriculums to accommodate for this trend. In conclusion, Canadian orthopedic residents are confident of their residency training and are increasingly pursuing fellowships to primarily develop their surgical skills and expertise.

  9. The challenge of inadequate achievement in mathematics: Focus on a meta-approach

    Directory of Open Access Journals (Sweden)

    Kobus Maree

    2009-09-01

    Full Text Available As is the case elsewhere in the world, all stakeholders in South Africa are deeply concerned about the level and scope of underachievement in mathematics, not only at Grade 12 level, but, indeed, at University, University of Technology and Further Education and Training levels. These concerns assume a deeper dimension in light of the fact that inadequate achievement in mathematics inevitably will have a ripple effect on the academic situation in any country: inadequate achievement in mathematics precludes learners from applying for admission to sought-after fi elds of study, which, in turn, prevents numerous learners from realising their true potential and, eventually, from being happy and successful in careers that they might otherwise have been able to execute successfully. It goes without saying that inadequate achievement in mathematics will impact negatively on the overall economic situation in any country (even more so in a developing country such as South Africa. Truth being, achievement in mathematics amounts to equipping oneself with survival skills. In this article, the spotlight shifts from a narrow and outdated focus on problems that are associated with inadequate achievement in mathematics to possible solutions for this disconcerting situation and the implied challenge it raises. The focus is thus on three levels that collectively underpin and impact on achievement in mathematics, viz. the macro level, the meso level and the micro level. The macro level refers mainly to the input by the national government (and, by default, the National Department of Education. In the fi rst instance, it is the responsibility of the state to provide adequate schooling facilities for all learners, irrespective of where they fi nd themselves. Furthermore, it is the duty of the state to ensure that every learner has access to basic facilities, including food, water, sanitation and housing. The state (via the National Department of Education is also

  10. Fossil fuel subsidy removal and inadequate public power supply: Implications for businesses

    International Nuclear Information System (INIS)

    Bazilian, Morgan; Onyeji, Ijeoma

    2012-01-01

    We briefly consider the impact of fossil fuel subsidy removal policies in the context of inadequate power supply, with a focus on the implications for businesses. In doing so, we utilize the case of the early 2012 fuel subsidy removal in Nigeria. The rationale for such subsidy-removal policies is typically informed by analysis showing that they lead to an economically inefficient allocation of resources and market distortions, while often failing to meet intended objectives. However, often the realities of infrastructural and institutional deficiencies are not appropriately factored into the decision-making process. Businesses in many developing countries, already impaired by the high cost of power supply deficiencies, become even less competitive on an unsubsidized basis. We find that justifications for removal often do not adequately reflect the specific environments of developing country economies, resulting in poor recommendations – or ineffective policy. - Highlights: ► We consider the impact of fuel subsidy removal in the context of energy poverty. ► Calls for subsidy removal often do not reflect the developing country realities. ► Businesses impaired by power supply deficiencies, become even less competitive.

  11. Epidemiology and risk assessment for radiation

    International Nuclear Information System (INIS)

    Badwe, R.A.

    2014-01-01

    The hazard and exposures from radiation are known with reasonable accuracy. However, at 'low levels' uncertainty persists as to whether the dose response relationship is linear and whether there is a dose threshold, below which there is no risk. Some have proposed that 'low' exposures to radiation may be beneficial, a hypothesis referred to as 'hormesis'. Over recent decades, various expert groups have adopted linear no-threshold dose-response models for radiation and cancer, based on review of epidemiological and biological evidence. The unexpected epidemic of thyroid cancer among children following the Chernobyl disaster was noticed. The research with epidemiological data and knowledge of the radionuclides to which the children were exposed is needed. Currently a debate concerning potential risks of high frequency electromagnetic radiation from mobile phones illustrates another need for further research

  12. Assessing the first wave of epidemiological studies of nanomaterial workers

    International Nuclear Information System (INIS)

    Liou, Saou-Hsing; Tsai, Candace S. J.; Pelclova, Daniela; Schubauer-Berigan, Mary K.; Schulte, Paul A.

    2015-01-01

    The results of early animal studies of engineered nanomaterials (ENMs) and air pollution epidemiology suggest that it is important to assess the health of ENM workers. Initial epidemiological studies of workers’ exposure to ENMs (<100 nm) are reviewed and characterized for their study designs, findings, and limitations. Of the 15 studies, 11 were cross-sectional, 4 were longitudinal (1 was both cross-sectional and longitudinal in design), and 1 was a descriptive pilot study. Generally, the studies used biologic markers as the dependent variables. All 11 cross-sectional studies showed a positive relationship between various biomarkers and ENM exposures. Three of the four longitudinal studies showed a negative relationship; the fourth showed positive findings after a 1-year follow-up. Each study considered exposure to ENMs as the independent variable. Exposure was assessed by mass concentration in 10 studies and by particle count in six studies. Six of them assessed both mass and particle concentrations. Some of the studies had limited exposure data because of inadequate exposure assessment. Generally, exposure levels were not very high in comparison to those in human inhalation chamber studies, but there were some exceptions. Most studies involved a small sample size, from 2 to 258 exposed workers. These studies represent the first wave of epidemiological studies of ENM workers. They are limited by small numbers of participants, inconsistent (and in some cases inadequate) exposure assessments, generally low exposures, and short intervals between exposure and effect. Still, these studies are a foundation for future work; they provide insight into where ENM workers are experiencing potentially adverse effects that might be related to ENM exposures

  13. Assessing the first wave of epidemiological studies of nanomaterial workers

    Energy Technology Data Exchange (ETDEWEB)

    Liou, Saou-Hsing, E-mail: shliou@nhri.org.tw [National Health Research Institutes, National Institute of Environmental Health Sciences (China); Tsai, Candace S. J. [Colorado State University, Department of Environmental and Radiological Health Science (United States); Pelclova, Daniela [Charles University in Prague, Department of Occupational Medicine, First Faculty of Medicine (Czech Republic); Schubauer-Berigan, Mary K.; Schulte, Paul A. [National Institute for Occupational Safety and Health (United States)

    2015-10-15

    The results of early animal studies of engineered nanomaterials (ENMs) and air pollution epidemiology suggest that it is important to assess the health of ENM workers. Initial epidemiological studies of workers’ exposure to ENMs (<100 nm) are reviewed and characterized for their study designs, findings, and limitations. Of the 15 studies, 11 were cross-sectional, 4 were longitudinal (1 was both cross-sectional and longitudinal in design), and 1 was a descriptive pilot study. Generally, the studies used biologic markers as the dependent variables. All 11 cross-sectional studies showed a positive relationship between various biomarkers and ENM exposures. Three of the four longitudinal studies showed a negative relationship; the fourth showed positive findings after a 1-year follow-up. Each study considered exposure to ENMs as the independent variable. Exposure was assessed by mass concentration in 10 studies and by particle count in six studies. Six of them assessed both mass and particle concentrations. Some of the studies had limited exposure data because of inadequate exposure assessment. Generally, exposure levels were not very high in comparison to those in human inhalation chamber studies, but there were some exceptions. Most studies involved a small sample size, from 2 to 258 exposed workers. These studies represent the first wave of epidemiological studies of ENM workers. They are limited by small numbers of participants, inconsistent (and in some cases inadequate) exposure assessments, generally low exposures, and short intervals between exposure and effect. Still, these studies are a foundation for future work; they provide insight into where ENM workers are experiencing potentially adverse effects that might be related to ENM exposures.

  14. High Prevalence of Inadequate Calcium and Iron Intakes by Mexican Population Groups as Assessed by 24-Hour Recalls.

    Science.gov (United States)

    Sánchez-Pimienta, Tania G; López-Olmedo, Nancy; Rodríguez-Ramírez, Sonia; García-Guerra, Armando; Rivera, Juan A; Carriquiry, Alicia L; Villalpando, Salvador

    2016-09-01

    A National Health and Nutrition Survey (ENSANUT) conducted in Mexico in 1999 identified a high prevalence of inadequate mineral intakes in the population by using 24-h recall questionnaires. However, the 1999 survey did not adjust for within-person variance. The 2012 ENSANUT implemented a more up-to-date 24-h recall methodology to estimate usual intake distributions and prevalence of inadequate intakes. We examined the distribution of usual intakes and prevalences of inadequate intakes of calcium, iron, magnesium, and zinc in the Mexican population in groups defined according to sex, rural or urban area, geographic region of residence, and socioeconomic status (SES). We used dietary intake data obtained through the 24-h recall automated multiple-pass method for 10,886 subjects as part of ENSANUT 2012. A second measurement on a nonconsecutive day was obtained for 9% of the sample. Distributions of usual intakes of the 4 minerals were obtained by using the Iowa State University method, and the prevalence of inadequacy was estimated by using the Institute of Medicine's Estimated Average Requirement cutoff. Calcium inadequacy was 25.6% in children aged 1-4 y and 54.5-88.1% in subjects >5 y old. More than 45% of subjects >5 y old had an inadequate intake of iron. Less than 5% of children aged 12 y had inadequate intakes of magnesium, whereas zinc inadequacy ranged from <10% in children aged <12 y to 21.6% in men aged ≥20 y. Few differences were found between rural and urban areas, regions, and tertiles of SES. Intakes of calcium, iron, magnesium, and zinc are inadequate in the Mexican population, especially among adolescents and adults. These results suggest a public health concern that must be addressed. © 2016 American Society for Nutrition.

  15. Estimating the global prevalence of inadequate zinc intake from national food balance sheets: effects of methodological assumptions.

    Directory of Open Access Journals (Sweden)

    K Ryan Wessells

    Full Text Available The prevalence of inadequate zinc intake in a population can be estimated by comparing the zinc content of the food supply with the population's theoretical requirement for zinc. However, assumptions regarding the nutrient composition of foods, zinc requirements, and zinc absorption may affect prevalence estimates. These analyses were conducted to: (1 evaluate the effect of varying methodological assumptions on country-specific estimates of the prevalence of dietary zinc inadequacy and (2 generate a model considered to provide the best estimates.National food balance data were obtained from the Food and Agriculture Organization of the United Nations. Zinc and phytate contents of these foods were estimated from three nutrient composition databases. Zinc absorption was predicted using a mathematical model (Miller equation. Theoretical mean daily per capita physiological and dietary requirements for zinc were calculated using recommendations from the Food and Nutrition Board of the Institute of Medicine and the International Zinc Nutrition Consultative Group. The estimated global prevalence of inadequate zinc intake varied between 12-66%, depending on which methodological assumptions were applied. However, country-specific rank order of the estimated prevalence of inadequate intake was conserved across all models (r = 0.57-0.99, P<0.01. A "best-estimate" model, comprised of zinc and phytate data from a composite nutrient database and IZiNCG physiological requirements for absorbed zinc, estimated the global prevalence of inadequate zinc intake to be 17.3%.Given the multiple sources of uncertainty in this method, caution must be taken in the interpretation of the estimated prevalence figures. However, the results of all models indicate that inadequate zinc intake may be fairly common globally. Inferences regarding the relative likelihood of zinc deficiency as a public health problem in different countries can be drawn based on the country

  16. Risk Factors for Inadequate Defibrillation Safety Margins Vary With the Underlying Cardiac Disease: Implications for Selective Testing Strategies.

    Science.gov (United States)

    Bonnes, Judith L; Westra, Sjoerd W; Bouwels, Leon H R; DE Boer, Menko Jan; Brouwer, Marc A; Smeets, Joep L R M

    2016-05-01

    In view of the shift from routine toward no or selective defibrillation testing, optimization of the current risk stratification for inadequate defibrillation safety margins (DSMs) could improve individualized testing decisions. Given the pathophysiological differences in myocardial substrate between ischemic and nonischemic heart disease (IHD/non-IHD) and the accompanying differences in clinical characteristics, we studied inadequate DSMs and their predictors in relation to the underlying etiology. Cohort of routine defibrillation tests (n = 785) after first implantable cardioverter defibrillator (ICD)-implantations at the Radboud UMC (2005-2014). A defibrillation threshold >25 J was regarded as an inadequate DSM. In total, 4.3% of patients had an inadequate DSM; in IHD 2.5% versus 7.3% in non-IHD (P = 0.002). We identified a group of non-IHD patients at high risk (13-42% inadequate DSM); the remainder of the cohort (>70%) had a risk of only 2% (C-statistic entire cohort 0.74; C-statistic non-IHD 0.82). This was based upon two identified interaction terms: (1) non-IHD and age (aOR 0.94 [95% CI 0.91-0.97]); (2) non-IHD and the indexed left ventricular (LV) internal diastolic diameter (aOR 3.50 [95% CI 2.10-5.82]). The present study on risk stratification for an inadequate DSM not only confirms the importance of making a distinction between IHD and non-IHD, but also shows that risk factors in an entire cohort (LV dilatation, age) may only apply to a subgroup (non-IHD). Appreciation of this concept could favorably affect current risk stratification. If confirmed, our approach may be used to optimize individualized testing decisions in an upcoming era of non-routine testing. © 2016 Wiley Periodicals, Inc.

  17. STI epidemiology in the global older population: emerging challenges.

    Science.gov (United States)

    Minichiello, Victor; Rahman, Saifur; Hawkes, Gail; Pitts, Marian

    2012-07-01

    This paper reviews the evidence concerning the epidemiology of sexually transmitted infections (STIs) with a particular focus on older people. Evidence from North America, Australia, China and Korea clearly shows increasing rates of many STIs in the population group aged 50 years and older. Similar changes are identified in three studies conducted in sub-Saharan Africa. There is a significant lack of detailed epidemiological data from Asia-Pacific and many African countries. There is also a lack of health education and health programmes directed towards older people. It is likely that sexual ageism is the dynamic that underpins this lack of focus and resources for older people.

  18. Widespread Reassortment Shapes the Evolution and Epidemiology of Bluetongue Virus following European Invasion.

    Directory of Open Access Journals (Sweden)

    Kyriaki Nomikou

    2015-08-01

    Full Text Available Genetic exchange by a process of genome-segment 'reassortment' represents an important mechanism for evolutionary change in all viruses with segmented genomes, yet in many cases a detailed understanding of its frequency and biological consequences is lacking. We provide a comprehensive assessment of reassortment in bluetongue virus (BTV, a globally important insect-borne pathogen of livestock, during recent outbreaks in Europe. Full-genome sequences were generated and analysed for over 150 isolates belonging to the different BTV serotypes that have emerged in the region over the last 5 decades. Based on this novel dataset we confirm that reassortment is a frequent process that plays an important and on-going role in evolution of the virus. We found evidence for reassortment in all ten segments without a significant bias towards any particular segment. However, we observed biases in the relative frequency at which particular segments were associated with each other during reassortment. This points to selective constraints possibly caused by functional relationships between individual proteins or genome segments and genome-wide epistatic interactions. Sites under positive selection were more likely to undergo amino acid changes in newly reassorted viruses, providing additional evidence for adaptive dynamics as a consequence of reassortment. We show that the live attenuated vaccines recently used in Europe have repeatedly reassorted with field strains, contributing to their genotypic, and potentially phenotypic, variability. The high degree of plasticity seen in the BTV genome in terms of segment origin suggests that current classification schemes that are based primarily on serotype, which is determined by only a single genome segment, are inadequate. Our work highlights the need for a better understanding of the mechanisms and epidemiological consequences of reassortment in BTV, as well as other segmented RNA viruses.

  19. Epidemiology and trace elements.

    Science.gov (United States)

    Elwood, P C

    1985-08-01

    Basically, epidemiology is the making of measurements of known reproducibility, in a bias-free manner, on representative samples of subjects drawn from defined communities. Epidemiology has become a relatively precise science and its value in medicine is widely appreciated. So too are its limitations: the difficulties in achieving a high response rate, in identifying and controlling confounding factors in the examination of an association, and the ultimate difficulties in distinguishing causation from association. While the value of community-based studies seems to be recognized by those interested in man and his environment, the need for the strict application of epidemiological procedures, and the limitations imposed on conclusions drawn from studies in which these procedures have been compromised, does not seem to be adequately understood. There are certain known links between trace elements in the environment and disease: for example the level of iodine in soil and water and the prevalence of goitre; the level of fluoride in water and the prevalence of dental caries. The investigation of other possible associations is difficult for a number of reasons, including interrelationships between trace elements, confounding of trace element levels (and disease) with social and dietary factors, and the probability that relationships are generally weak. Two conditions in which associations are likely are cardiovascular disease and cancer. Despite research along a number of lines, the relevance of trace elements to cardiovascular disease is not clear, and certainly the apparent association with hardness of domestic water supply seems unlikely to be causal. The same general conclusion seems reasonable for cancer, and although there are a very few well established associations which are likely to be causal, such as exposure to arsenic and skin cancer, the role of trace elements is obscure, and likely to be very small.

  20. Income-related inequalities in inadequate dentition over time in Australia, Brazil and USA adults.

    Science.gov (United States)

    Peres, Marco A; Luzzi, Liana; Peres, Karen G; Sabbah, Wael; Antunes, Jose L; Do, Loc G

    2015-06-01

    To assess changes over time of the absolute and relative household income-related inequalities in inadequate dentition (ID) among Australians, Brazilians and USA adults. This study used nationwide oral health survey data from Australia (n = 1200 in 1999; n = 2729 in 2005), Brazil (n = 13 431 in 2003; n = 9779 in 2010) and USA (n = 2542 in 1999; n = 1596 in 2005). Absolute income inequalities were calculated using Absolute Concentration Index (ACI) and Slope Index of Inequality (SII), while relative inequalities were calculated using Relative Concentration Index (RCI) and Relative Index of Inequality (RII). Prevalence of ID in the studied period dropped from 8.7% to 3.1% in Australia; from 42.1% to 22.4% in Brazil; and remained stable in USA, nearly 8.0%. Absolute income inequalities were highest in Brazil, followed by the USA and Australia; relative inequalities were lower in Brazil than in Australia and the USA. ID was higher among Brazilian females (2010) and for the poorest group in all countries and periods. A remarkable reduction in absolute inequalities were found in Australia [Slope Index of Inequality (SII) and AIC 60%] and in Brazil (SII 25%; ACI 33%) while relative inequalities increased both in Australia (RCI and RII 40%) and in Brazil (RCI 24%; RII 38%). No changes in absolute and relative income inequalities were found in the USA. There were still persistent absolute and relative income inequalities in ID in all examined countries. There has been a reduction in absolute income inequalities in ID but an increase in relative income inequalities. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Inadequate dietary intake of children and adolescents with juvenile idiopathic arthritis and systemic lupus erythematosus.

    Science.gov (United States)

    Caetano, Michelle C; Ortiz, Thaís T; Terreri, Maria Teresa S R L A; Sarni, Roseli O S; Silva, Simone G L; Souza, Fabíola I S; Hilário, Maria Odete E

    2009-01-01

    To evaluate the dietary intake of children and adolescents with juvenile idiopathic arthritis (JIA) and juvenile systemic lupus erythematosus (JSLE) using a 24-hour diet recall and relating it to the patients' clinical and anthropometric characteristics and to the drugs used in their treatment. By means of a cross-sectional study, we assessed the 24-hour diet recalls of outpatients. Their nutritional status was classified according to the CDC (2000). The computer program NutWin UNIFESP-EPM was used for food intake calculation. The Recommended Dietary Allowances and the Brazilian food pyramid were used for quantitative and qualitative analysis. Median age was 12 years for JIA patients and 16.5 years for JSLE patients. Among the JIA patients, 37.5% had active disease, and among the JSLE patients, 68.2% showed Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) > 4. Malnutrition was found in 8.3 and 4.5% of the JIA and JSLE patients, respectively, and obesity was present in 16.7 and 18.2%. For JIA patients, the excessive intake of energy, protein, and lipids was 12.5, 75, and 31.3%, respectively. For JSLE patients, the excessive intake of energy, protein, and lipids was 13.6, 86.4, and 36.4%, respectively. Low intake of iron, zinc, and vitamin A was found in 29.2 and 50, 87.5 and 86.4, and 87.5 and 95.2% of the JIA and JSLE patients, respectively. There was not a significant association between intake, disease activity, and nutritional status. Patients with rheumatic diseases have inadequate dietary intake. There is excessive intake of lipids and proteins and low intake of micronutrients.

  2. Proposed biodiversity conservation areas: gap analysis and spatial prioritization on the inadequately studied Qinghai Plateau, China

    Directory of Open Access Journals (Sweden)

    Renqiang Li

    2018-01-01

    Full Text Available Global biodiversity priorities are primarily addressed through the establishment or expansion of conservation areas (CAs. Spatial prioritization of these CAs can help minimize biodiversity loss by accounting for the uneven distribution of biodiversity and conservation considerations (e.g., accessibility, cost, and biodiversity threats. Furthermore, optimized spatial priorities can help facilitate the judicious use of limited conservation resources by identifying cost effective CA designs. Here, we demonstrate how key species and ecosystems can be incorporated into systematic conservation planning to propose the expansion and addition of new CAs in the biodiversity-unique and data-poor region of Qinghai Plateau, China. We combined species distribution models with a systematic conservation planning tool, MARXAN to identify CAs for biodiversity on Qinghai Plateau. A set of 57 optimal CAs (273,872 km2, 39.3 % of this Province were required to achieve the defined conservation targets in Qinghai Province. We also identified 29 new CAs (139,216 km2, 20% of Qinghai Province outside the existing nature reserve (NRs that are necessary to fully achieve the proposed conservation targets. The conservation importance of these 29 new CAs was also indicated, with 10 labeled as high priority, 11 as medium priority, and 8 as low priority. High priority areas were more abundant in the eastern and southeastern parts of this region. Our results suggest that many species remain inadequately protected within the Qinghai Plateau, with conservation gaps in eastern and northwestern regions. The proposed more representative and effective CAs can provide useful information for adjusting the existing NRs and developing the first National Park in China.

  3. Comparison of Vildagliptin and Pioglitazone in Korean Patients with Type 2 Diabetes Inadequately Controlled with Metformin

    Directory of Open Access Journals (Sweden)

    Jong Ho Kim

    2016-04-01

    Full Text Available BackgroundWe compared the efficacies of vildagliptin (50 mg twice daily relative to pioglitazone (15 mg once daily as an add-on treatment to metformin for reducing glycosylated hemoglobin (HbA1c levels in Korean patients with type 2 diabetes.MethodsThe present study was a multicenter, randomized, active-controlled investigation comparing the effects of vildagliptin and pioglitazone in Korean patients receiving a stable dose of metformin but exhibiting inadequate glycemic control. Each patient underwent a 16-week treatment period with either vildagliptin or pioglitazone as an add-on treatment to metformin.ResultsThe mean changes in HbA1c levels from baseline were –0.94% in the vildagliptin group and –0.6% in the pioglitazone group and the difference between the treatments was below the non-inferiority margin of 0.3%. The mean changes in postprandial plasma glucose (PPG levels were –60.2 mg/dL in the vildagliptin group and –38.2 mg/dL in the pioglitazone group and these values significantly differed (P=0.040. There were significant decreases in the levels of total, low density lipoprotein, high density lipoprotein (HDL, and non-HDL cholesterol in the vildagliptin group but increases in the pioglitazone group. The mean change in body weight was –0.07 kg in the vildagliptin group and 0.69 kg in the pioglitazone group, which were also significantly different (P=0.002.ConclusionAs an add-on to metformin, the efficacy of vildagliptin for the improvement of glycemic control is not inferior to that of pioglitazone in Korean patients with type 2 diabetes. In addition, add-on treatment with vildagliptin had beneficial effects on PPG levels, lipid profiles, and body weight compared to pioglitazone.

  4. Inadequately marketing our brand: Medical student awareness of acute care surgery.

    Science.gov (United States)

    Montgomery, Stephanie C; Privette, Alicia R; Ferguson, Pamela L; Mirdamadi, Meena; Fakhry, Samir M

    2015-11-01

    Despite focused national efforts to promote acute care surgery (ACS), little is known about medical student awareness of ACS as a career choice. The impending shortage of general surgeons emphasizes the need to increase interest in this comprehensive surgical specialty. The goal of this study was to determine whether students would be more likely to consider choosing ACS if they were aware of the specialty and its benefits. A survey was distributed electronically to medical students at our institution, a Level I trauma center with an active ACS service. The survey asked questions regarding specialty choice and factors that were used in making that decision. Also included were questions regarding their familiarity and affinity for ACS. The survey was returned by 518 students. Each medical school year was proportionately represented. Twenty-one percent of the students reported surgery as their career choice; however, women were half as likely to choose surgery as men. When asked to define ACS, 23% of all students gave the correct response. Only 8.9% of the students in the preclinical years correctly defined ACS. Even in the clinical years, 54% were unaware of ACS as a specialty. Students reported that the top factors that influenced their choice were controllable lifestyle, predictable schedule, and a positive medical school role model. When asked to identify what would make ACS appealing, a 50-hour work week was deemed most influential. When given the definition of ACS with approximate pay and on-call hours, 41.5% of the students and 75% of those interested in surgery would be likely to choose ACS as a career. This study highlights that awareness of ACS as a specialty is lacking. This may reflect inadequate marketing of our "brand" both locally and nationally. Focused efforts at familiarizing students with ACS and increased role modeling may increase interest in ACS.

  5. Anemia in ST-Elevation Myocardial Infarction Patients with Markers of Inadequate Bone Marrow Response.

    Science.gov (United States)

    Arbel, Yaron; Milwidsky, Assi; Finkelstein, Ariel; Halkin, Amir; Revivo, Miri; Berliner, Shlomo; Ellis, Martin; Herz, Itzhak; Keren, Gad; Banai, Shmuel

    2015-08-01

    Anemia confers an adverse prognosis in patients with ST-elevation myocardial infarction (STEMI). Several mechanisms have been implicated in the etiology of anemia in this setting, including inflammation, blood loss, and the presence of comorbidities such as renal failure. To evaluate the adequacy of bone marrow response as potentially reflected by elevation in blood and reticulocyte counts. Consecutive men with STEMI who underwent primary percutaneous intervention within 6 hours of symptom onset and who presented to our catheterization laboratory during a 36 month period were included in the study. The cohort was divided into quartiles according to hemoglobin concentration, and differences in clinical and laboratory characteristics between the groups were evaluated. A total of 258 men with STEMI were recruited, 22% of whom suffered from anemia according to the World Health Organization classification (hemoglobin < 13 g/dl). Men in the lowest quartile of hemoglobin concentration presented with significantly lower white blood cell and platelet counts (9.6 ± 2.9 vs. 12.6 ± 3.6 x 103/μl, P < 0.001) and (231 ± 79 vs. 263 ± 8 x 103/μl, P < 0.01), respectively, despite higher inflammatory biomarkers (C-reactive protein and fibrinogen) compared with patients in the upper hemoglobin concentration quartile. Reticulocyte production index was not significantly higher in anemic patients, with a value of 1.8, 1.4, 1.5 and 1.6 in the ascending hemoglobin quartiles, respectively (P = 0.292). Anemic men with STEMI have relatively lower leukocyte and platelet counts as well as a reduced reticulocyte count despite higher inflammatory biomarkers. These findings might suggest inadequate bone marrow response.

  6. Systematic review of epidemiological studies on health effects associated with management of solid waste

    Directory of Open Access Journals (Sweden)

    Lazzarino Antonio I

    2009-12-01

    Full Text Available Abstract Background Management of solid waste (mainly landfills and incineration releases a number of toxic substances, most in small quantities and at extremely low levels. Because of the wide range of pollutants, the different pathways of exposure, long-term low-level exposure, and the potential for synergism among the pollutants, concerns remain about potential health effects but there are many uncertainties involved in the assessment. Our aim was to systematically review the available epidemiological literature on the health effects in the vicinity of landfills and incinerators and among workers at waste processing plants to derive usable excess risk estimates for health impact assessment. Methods We examined the published, peer-reviewed literature addressing health effects of waste management between 1983 and 2008. For each paper, we examined the study design and assessed potential biases in the effect estimates. We evaluated the overall evidence and graded the associated uncertainties. Results In most cases the overall evidence was inadequate to establish a relationship between a specific waste process and health effects; the evidence from occupational studies was not sufficient to make an overall assessment. For community studies, at least for some processes, there was limited evidence of a causal relationship and a few studies were selected for a quantitative evaluation. In particular, for populations living within two kilometres of landfills there was limited evidence of congenital anomalies and low birth weight with excess risk of 2 percent and 6 percent, respectively. The excess risk tended to be higher when sites dealing with toxic wastes were considered. For populations living within three kilometres of old incinerators, there was limited evidence of an increased risk of cancer, with an estimated excess risk of 3.5 percent. The confidence in the evaluation and in the estimated excess risk tended to be higher for specific cancer

  7. Epidemiology of preterm birth.

    Science.gov (United States)

    Purisch, Stephanie E; Gyamfi-Bannerman, Cynthia

    2017-11-01

    Preterm birth is a worldwide epidemic with a global incidence of 15 million per year. Though rates of preterm birth in the United States have declined over the last decade, nearly 1 in 10 babies is still born preterm. The incidence, gestational age, and underlying etiology of preterm birth is highly variable across different racial and ethnic groups and geographic boundaries. In this article, we review the epidemiology of preterm birth in the United States and globally, with a focus on temporal trends and racial, ethnic, and geographic disparities. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Worldwide epidemiology of fibromyalgia.

    Science.gov (United States)

    Queiroz, Luiz Paulo

    2013-08-01

    Studying the epidemiology of fibromyalgia (FM) is very important to understand the impact of this disorder on persons, families and society. The recent modified 2010 classification criteria of the American College of Rheumatology (ACR), without the need of tender points palpation, allows that larger and nationwide surveys may be done, worldwide. This article reviews the prevalence and incidence studies done in the general population, in several countries/continents, the prevalence of FM in special groups/settings, the association of FM with some sociodemographic characteristics of the population, and the comorbidity of FM with others disorders, especially with headaches.

  9. Worldwide Report, Epidemiology, No. 327

    National Research Council Canada - National Science Library

    1983-01-01

    Partial Contents: Epidemiology, Human Diseases, Health, Malaria, AIDS, Homosexual Male, Medical Administration, Rabies, Tuberculosis, Encephalitis Statistics, Gastroenteritie, Mystery Diseases, Children, Epidemics...

  10. Lifesaving emergency obstetric services are inadequate in south-west Ethiopia: a formidable challenge to reducing maternal mortality in Ethiopia

    Science.gov (United States)

    2013-01-01

    Background Most maternal deaths take place during labour and within a few weeks after delivery. The availability and utilization of emergency obstetric care facilities is a key factor in reducing maternal mortality; however, there is limited evidence about how these institutions perform and how many people use emergency obstetric care facilities in rural Ethiopia. We aimed to assess the availability, quality, and utilization of emergency obstetric care services in the Gamo Gofa Zone of south-west Ethiopia. Methods We conducted a retrospective review of three hospitals and 63 health centres in Gamo Gofa. Using a retrospective review, we recorded obstetric services, documents, cards, and registration books of mothers treated and served in the Gamo Gofa Zone health facilities between July 2009 and June 2010. Results There were three basic and two comprehensive emergency obstetric care qualifying facilities for the 1,740,885 people living in Gamo Gofa. The proportion of births attended by skilled attendants in the health facilities was 6.6% of expected births, though the variation was large. Districts with a higher proportion of midwives per capita, hospitals and health centres capable of doing emergency caesarean sections had higher institutional delivery rates. There were 521 caesarean sections (0.8% of 64,413 expected deliveries and 12.3% of 4,231 facility deliveries). We recorded 79 (1.9%) maternal deaths out of 4,231 deliveries and pregnancy-related admissions at institutions, most often because of post-partum haemorrhage (42%), obstructed labour (15%) and puerperal sepsis (15%). Remote districts far from the capital of the Zone had a lower proportion of institutional deliveries (4% of deliveries, much higher than the average 1.9%). Conclusion Based on a population of 1.7 million people, there should be 14 basic and four comprehensive emergency obstetric care (EmOC) facilities in the Zone. Our study found that only three basic and two comprehensive EmOC service

  11. Epidemiology, hunger and development

    Directory of Open Access Journals (Sweden)

    Paulo H. Battaglin Machado

    2008-06-01

    Full Text Available Understanding the relationship between epidemiology and food security implies in disclosing famine causes, the way it is distributed in the society and to which extent it affects the populations. Building up from that perspective, this paper attempts to understand the famine logic throughout the various transitions accomplished in the past decades: epidemiologic, demographic, risk, nutritional and development. The reflexes of the demographic transition that took place in Brazil in the XXth century are related to the population nutritional status standard changes, that is, they shifted from malnutrition high prevalence to a significant increase in obesity. However, the paradox of this situation is due to the fact that most risk factors that bring about diseases of the modern world come from the “excess”, while millions die around the globe because of “deprivation”. The food production alone does not ensure its equitable distribution among the various groups of the society. The access alone does not lead to quality. The choices are made individually, but life style options imply in a set of correlations that go from economy to culture. It means that this field has a collective basis and encompasses environment and development.

  12. Clinical Epidemiology Of Stroke

    Directory of Open Access Journals (Sweden)

    Nagaraja D

    2005-01-01

    Full Text Available Stroke is a huge public health problem because of its high morbidity and disability. The epidemiology of stroke is of relevance to construct practical paradigms to tackle this major health issue in the community. Recent data have shown that about 72-86% of strokes are ischemic, 9-18% are due to hemorrhage (intracerebral of subarachnoid and the rest are undefined. The risk factors for stroke are multiple and combined. At present, stroke is no more considered as unavoidable and untreatable. It is an emergency and specialized units and teams improve outcome and lower costs. Death related to stroke is declining in many countries and in both sexes. This decrease in multifactorial. The detection and more effective treatment of hypertension may play an important factor, as well as the improved medical care and improvement in diagnostic procedures. While stroke incidence appears stable and stroke mortality is slowly declining, the absolute magnitude of stroke is likely to grow over the next 30 years. as the population ages, the absolute number of stroke victims and demands on healthcare and other support systems is likely to increase substantially in the future. Keeping this in perspective, this chapter shall focus on the epidemiology of stroke in the world and in Indian, in particular.

  13. Epidemiology of cancer in children

    International Nuclear Information System (INIS)

    Greenberg, R.S.; Shuster, J.L. Jr.

    1985-01-01

    The epidemiologic features of cancers among children have stimulated abundant descriptive and analytic investigation. The descriptive work has demonstrated consistent differences in the incidence rates of these cancers by anatomic site, age, race, and gender. It is clear that the various forms of cancer during childhood have distinctive patterns of occurrence. To a large extent, the characteristic population distributions of these diseases may represent differences in the underlying etiologic processes. Analytic studies of cancer during childhood have addressed possible genetic and environmental risk factors for these diseases. The demonstration of cancers induced by transplacental exposure to diethylstilbestrol has confirmed the speculation that the prenatal environment may influence subsequent carcinogenesis. Although possible leukemogenic effects of intrauterine diagnostic irradiation remain controversial, the issue may become unimportant clinically as prenatal irradiation is replaced by other diagnostic modalities (194). To date, studies of prenatal ultrasound have provided no evidence of an overall excess of subsequent malignancies. Postnatal exposure to high doses of irradiation is known to produce considerable excesses of leukemias and other cancers. At present, there are insufficient data available to reach a firm conclusion on the possible carcinogenic effects of exposure during childhood to low doses of irradiation, fringe magnetic fields, or chemicals

  14. Cancers in Australia in 2010 attributable to inadequate consumption of fruit, non-starchy vegetables and dietary fibre

    Science.gov (United States)

    Nagle, Christina M; Wilson, Louise F; Hughes, Maria Celia B; Ibiebele, Torukiri I; Miura, Kyoko; Bain, Christopher J; Whiteman, David C; Webb, Penelope M

    2015-01-01

    Objectives To estimate the number and proportion of cancers occurring in Australia in 2010 attributable to consumption deficits in fruit, non-starchy vegetables and dietary fibre. Methods We estimated the population attributable fraction (PAF) for cancers causally associated with inadequate intake of fruit and non-starchy vegetables (oral cavity, pharynx, oesophageal squamous cell carcinoma, stomach, larynx); inadequate intake of fruit (lung); and insufficient intake of fibre (colorectum). We used standard formulae incorporating prevalence of exposure (1995 National Nutrition Survey) and relative risks from independent studies. Results Overall, 1,555 (1.4% of all) and 311 (0.3% of all) cancers were attributable to inadequate intakes of fruit and non-starchy vegetables, respectively. A further 2,609 colorectal cancers (18% of colorectal) were attributable to insufficient fibre intake. If Australians increased their fibre intake by eating the recommended daily intakes of fruit and vegetables, an estimated 1,293 (8.8%) colorectal cancers could be prevented. Conclusions One in six colorectal cancer cases was attributable to inadequate intake of dietary fibre and about 1,800 cancers at other sites were attributable to insufficient fruit and non-starchy vegetable consumption. Implications Increasing the proportion of Australians who consume the recommended intake of fruit, vegetables and fibre could prevent up to 4% of all cancers. PMID:26437726

  15. 20 CFR 411.321 - Under what conditions will SSA terminate an agreement with an EN due to inadequate performance?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Under what conditions will SSA terminate an agreement with an EN due to inadequate performance? 411.321 Section 411.321 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Networks § 411.321 Under...

  16. Safety and efficacy of twice-daily exenatide in Taiwanese patients with inadequately controlled type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Chieh-Hsiang Lu

    2013-03-01

    Conclusion: This subgroup analysis of Taiwanese patients was consistent with the overall study results, which showed that exenatide BID is superior to placebo for improving glycemic control in Asian patients with type 2 diabetes who experienced inadequate glycemic control when using oral antidiabetic therapy.

  17. Loss of integrity of thyroid morphology and function in children born to mothers with inadequately treated Graves' disease

    NARCIS (Netherlands)

    Kempers, Marlies J. E.; van Trotsenburg, A. S. Paul; van Rijn, Rick R.; Smets, Anne M. J. B.; Smit, Bert J.; de Vijlder, Jan J. M.; Vulsma, Thomas

    2007-01-01

    Context: Central congenital hypothyroidism (CH-C) in neonates born to mothers with inadequately treated Graves' disease usually needs T-4 supplementation. The thyroid and its regulatory system have not yet been extensively studied after T-4 withdrawal, until we observed disintegrated thyroid glands

  18. Dialysis Hypotension : A Role for Inadequate Increase in Arginine Vasopressin Levels? A Systematic Literature Review and Meta-Analysis

    NARCIS (Netherlands)

    Ettema, Esmee M.; Zittema, Debbie; Kuipers, Johanna; Gansevoort, Ron T.; Vart, Priya; de Jong, Paul E.; Westerhuis, Ralf; Franssen, Casper F. M.

    2014-01-01

    Background: Intradialytic hypotension is a common complication of hemodialysis (HD). Some studies have suggested that inadequate arginine vasopressin (AVP) increase could play a role in the pathogenesis of intradialytic hypotension. However, AVP levels during HD and its relation to hypotension has

  19. Risk factors for inadequate TB case finding in Rural Western Kenya: a comparison of actively and passively identified TB patients

    NARCIS (Netherlands)

    van't Hoog, Anna H.; Marston, Barbara J.; Ayisi, John G.; Agaya, Janet A.; Muhenje, Odylia; Odeny, Lazarus O.; Hongo, John; Laserson, Kayla F.; Borgdorff, Martien W.

    2013-01-01

    The findings of a prevalence survey conducted in western Kenya, in a population with 14.9% HIV prevalence suggested inadequate case finding. We found a high burden of infectious and largely undiagnosed pulmonary tuberculosis (PTB), that a quarter of the prevalent cases had not yet sought care, and a

  20. Factors explaining inadequate prenatal care utilization by first and second generation non-western women in The Netherlands.

    NARCIS (Netherlands)

    Boerleider, A.W.; Manniën, J.; Wiegers, T.A.; Francke, A.L.; Devillé, W.L.J.M.

    2013-01-01

    Background: In many industrialized western countries non-western women constitute a substantial part of the prenatal care client population. In The Netherlands, these women have also been shown to be more likely to make inadequate use of prenatal care. Explanatory factors for this include, among

  1. Confidence versus Performance as an Indicator of the Presence of Alternative Conceptions and Inadequate Problem-Solving Skills in Mechanics

    Science.gov (United States)

    Potgieter, Marietjie; Malatje, Esther; Gaigher, Estelle; Venter, Elsie

    2010-01-01

    This study investigated the use of performance-confidence relationships to signal the presence of alternative conceptions and inadequate problem-solving skills in mechanics. A group of 33 students entering physics at a South African university participated in the project. The test instrument consisted of 20 items derived from existing standardised…

  2. Inadequate Helmet Fit Increases Concussion Severity in American High School Football Players.

    Science.gov (United States)

    Greenhill, Dustin A; Navo, Paul; Zhao, Huaqing; Torg, Joseph; Comstock, R Dawn; Boden, Barry P

    2016-05-01

    There is limited information on the relationship between football helmet fit and concussion severity. Poor helmet fit may predispose football players to a more severe concussion. Descriptive epidemiology study. Level 3. Data from concussion injury reports were obtained from the National High School Sports-Related Injury Surveillance System over a 9-year period. Symptoms, duration, and helmet parameters (fit, interior padding) were analyzed for all first-time concussions. Data from 4580 concussions were analyzed. Patients who suffered concussions with a helmet that did not fit properly (3.22%), as determined by an athletic trainer, had higher rates of drowsiness (RR, 1.46; P = 0.005), hyperexcitability (RR, 2.38; P = 0.047), and sensitivity to noise (RR, 1.88; P football helmet is a risk factor for a concussion with more symptoms and of longer duration. Concussions of longer duration are also more common in players with an air bladder-lined helmet. Current high school football rules should mandate supervision and maintenance of helmet fit throughout the season, prior to impact. Team physicians, athletic trainers, coaches, and high school officials should ensure proper oversight of helmet fit in high school athletes to decrease concussion severity and duration. © 2016 The Author(s).

  3. Inadequate dietary calcium and vitamin D intakes in renal-transplant recipients in Ireland.

    LENUS (Irish Health Repository)

    Lynch, Irene T

    2012-02-03

    vitamin D intakes in adult renal-transplant patients are in many cases inadequate.

  4. The inadequate liability and compensation regime for damage caused by nuclear activities

    International Nuclear Information System (INIS)

    Dyke, Jon M. Van

    2010-09-01

    The specific obligation to provide restitution and compensation when nuclear activities cause injuries has been recognized repeatedly and is now certainly part of customary international law. But problems remain regarding how to measure damages, how to implement the duty to repair the injuries, and what specific obligations exist to protect neighboring states from transboundary pollution. Although some treaties exist governing liability for harm resulting from nuclear accidents, they are not adequate to protect victims and have not been widely ratified. The failure to require nuclear operators to prepare for damage that may result from accidents constitutes a subsidy to the nuclear industry and makes it difficult to compare the real costs of nuclear energy with the costs of other energy sources. This survey of settled norms and unresolved issues demonstrates that further work is needed to develop a comprehensive and authoritative regime to govern harm from nuclear activities. Although it is clear that both the operators of nuclear facilities and the states that have jurisdiction over them would be responsible to provide restitution and compensation for such harm under a strict liability regime, the types of injuries that must be compensated and the range of damages that must be covered remain subjects of controversy. Although the underlying customary international law principles (the no-harm principle and the polluter-pays principle) are clear, the actual treaties that have been drafted are inadequate and they have not been widely ratified. Victims of damage from nuclear activities would have difficulty finding a neutral tribunal in which to bring their claims and would face procedural obstacles including caps on liabilities and inappropriately short statutes of limitations as well as difficulties regarding proof of damages. The failure to develop a proper regime that would ensure full restitution and compensation for harm resulting from nuclear facilities

  5. Inadequate treatment of ventilator-associated and hospital-acquired pneumonia: Risk factors and impact on outcomes

    Directory of Open Access Journals (Sweden)

    Piskin Nihal

    2012-10-01

    Full Text Available Abstract Background Initial antimicrobial therapy (AB is an important determinant of clinical outcome in patients with severe infections as pneumonia, however well-conducted studies regarding prognostic impact of inadequate initial AB in patients who are not undergoing mechanical ventilation (MV are lacking. In this study we aimed to identify the risk factors for inadequate initial AB and to determine its subsequent impact on outcomes in both ventilator associated pneumonia (VAP and hospital acquired pneumonia (HAP. Methods We retrospectively studied the accuracy of initial AB in patients with pneumonia in a university hospital in Turkey. A total of 218 patients with HAP and 130 patients with VAP were included. For each patient clinical, radiological and microbiological data were collected. Stepwise multivariate logistic regression analysis was used for risk factor analysis. Survival analysis was performed by using Kaplan-Meier method with Log-rank test. Results Sixty six percent of patients in VAP group and 41.3% of patients in HAP group received inadequate initial AB. Multiple logistic regression analysis revealed that the risk factors for inadequate initial AB in HAP patients were; late-onset HAP (OR = 2.35 (95% CI, 1.05-5.22; p = 0.037 and APACHE II score at onset of HAP (OR = 1.06 (95% CI, 1.01-1.12; p = 0.018. In VAP patients; antibiotic usage in the previous three months (OR = 3.16 (95% CI, 1.27-7.81; p = 0.013 and admission to a surgical unit (OR = 2.9 (95% CI, 1.17-7.19; p = 0.022 were found to be independent risk factors for inadequate initial AB. No statistically significant difference in crude hospital mortality and 28-day mortality was observed between the treatment groups in both VAP and HAP. However we showed a significant increase in length of hospital stay, duration of mechanical ventilation and a prolonged clinical resolution in the inadequate AB group in both VAP and HAP. Conclusion Our data

  6. Inadequate treatment of ventilator-associated and hospital-acquired pneumonia: risk factors and impact on outcomes.

    Science.gov (United States)

    Piskin, Nihal; Aydemir, Hande; Oztoprak, Nefise; Akduman, Deniz; Comert, Fusun; Kokturk, Furuzan; Celebi, Guven

    2012-10-24

    Initial antimicrobial therapy (AB) is an important determinant of clinical outcome in patients with severe infections as pneumonia, however well-conducted studies regarding prognostic impact of inadequate initial AB in patients who are not undergoing mechanical ventilation (MV) are lacking. In this study we aimed to identify the risk factors for inadequate initial AB and to determine its subsequent impact on outcomes in both ventilator associated pneumonia (VAP) and hospital acquired pneumonia (HAP). We retrospectively studied the accuracy of initial AB in patients with pneumonia in a university hospital in Turkey. A total of 218 patients with HAP and 130 patients with VAP were included. For each patient clinical, radiological and microbiological data were collected. Stepwise multivariate logistic regression analysis was used for risk factor analysis. Survival analysis was performed by using Kaplan-Meier method with Log-rank test. Sixty six percent of patients in VAP group and 41.3% of patients in HAP group received inadequate initial AB. Multiple logistic regression analysis revealed that the risk factors for inadequate initial AB in HAP patients were; late-onset HAP (OR = 2.35 (95% CI, 1.05-5.22; p = 0.037) and APACHE II score at onset of HAP (OR = 1.06 (95% CI, 1.01-1.12); p = 0.018). In VAP patients; antibiotic usage in the previous three months (OR = 3.16 (95% CI, 1.27-7.81); p = 0.013) and admission to a surgical unit (OR = 2.9 (95% CI, 1.17-7.19); p = 0.022) were found to be independent risk factors for inadequate initial AB. No statistically significant difference in crude hospital mortality and 28-day mortality was observed between the treatment groups in both VAP and HAP. However we showed a significant increase in length of hospital stay, duration of mechanical ventilation and a prolonged clinical resolution in the inadequate AB group in both VAP and HAP. Our data suggests that the risk factors for inadequate initial AB

  7. Evidence and research in rectal cancer.

    NARCIS (Netherlands)

    Valentini, V.; Beets-Tan, R.G.; Borras, J.M.; Krivokapic, Z.; Leer, J.W.H.; Pahlman, L.; Rodel, C.; Schmoll, H.J.; Scott, N.; Velde, C.V.; Verfaillie, C.

    2008-01-01

    The main evidences of epidemiology, diagnostic imaging, pathology, surgery, radiotherapy, chemotherapy and follow-up are reviewed to optimize the routine treatment of rectal cancer according to a multidisciplinary approach. This paper reports on the knowledge shared between different specialists

  8. Predictors of Inadequate Prenatal Care in Methamphetamine-Using Mothers in New Zealand and the United States

    Science.gov (United States)

    LaGasse, Linda L.; Wouldes, Trecia A.; Arria, Amelia M.; Wilcox, Tara; Derauf, Chris; Newman, Elana; Shah, Rizwan; Smith, Lynne M.; Neal, Charles R.; Huestis, Marilyn A.; DellaGrotta, Sheri; Lester, Barry M.

    2013-01-01

    This study compared patterns of prenatal care among mothers who used methamphetamine (MA) during pregnancy and non-using mothers in the US and New Zealand (NZ), and evaluated associations among maternal drug use, child protective services (CPS) referral, and inadequate prenatal care in both countries. The sample consisted of 182 mothers in the MA-Exposed and 196 in the Comparison groups in the US, and 107 mothers in the MA-Exposed and 112 in the Comparison groups in NZ. Positive toxicology results and/or maternal report of MA use during pregnancy were used to identify MA use. Information about sociodemographics, prenatal care and prenatal substance use was collected by maternal interview. MA-use during pregnancy is associated with lower socio-economic status, single marital status, and CPS referral in both NZ and the US. Compared to their non-using counterparts, MA-using mothers in the US had significantly higher rates of inadequate prenatal care. No association was found between inadequate care and MA-use in NZ. In the US, inadequate prenatal care was associated with CPS referral, but not in NZ. Referral to CPS for drug use only composed 40 % of all referrals in the US, but only 15 % of referrals in NZ. In our study population, prenatal MA-use and CPS referral eclipse maternal sociodemographics in explanatory power for inadequate prenatal care. The predominant effect of CPS referral in the US is especially interesting, and should encourage further research on whether the US policy of mandatory reporting discourages drug-using mothers from seeking antenatal care. PMID:22588827

  9. Epidemiological data and radiation risk estimates

    International Nuclear Information System (INIS)

    Cardis, E.

    2002-01-01

    The results of several major epidemiology studies on populations with particular exposure to ionizing radiation should become available during the first years of the 21. century. These studies are expected to provide answers to a number of questions concerning public health and radiation protection. Most of the populations concerned were accidentally exposed to radiation in ex-USSR or elsewhere or in a nuclear industrial context. The results will complete and test information on risk coming from studies among survivors of the Hiroshima and Nagasaki atomic bombs, particularly studies on the effects of low dose exposure and prolonged low-dose exposure, of different types of radiation, and environmental and host-related factors which could modify the risk of radiation-induced effects. These studies are thus important to assess the currently accepted scientific evidence on radiation protection for workers and the general population. In addition, supplementary information on radiation protection could be provided by formal comparisons and analyses combining data from populations with different types of exposure. Finally, in order to provide pertinent information for public health and radiation protection, future epidemiology studies should be targeted and designed to answer specific questions, concerning, for example, the risk for specific populations (children, patients, people with genetic predisposition). An integrated approach, combining epidemiology and studies on the mechanisms of radiation induction should provide particularly pertinent information. (author)

  10. CEDR: Comprehensive Epidemiologic Data Resource

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-01

    The Department of Energy (DOE) and its predecessor agencies have a long history of epidemiologic research programs. The main focus of these programs has been the Health and Mortality Study of the DOE work force. This epidemiologic study began in 1964 with a feasibility study of workers at the Hanford facility. Studies of other populations exposed to radiation have also been supported, including the classic epidemiologic study of radium dial painters and studies of atomic bomb survivors. From a scientific perspective, these epidemiologic research program have been productive, highly credible, and formed the bases for many radiological protection standards. Recently, there has been concern that, although research results were available, the data on which these results were based were not easily obtained by interested investigators outside DOE. Therefore, as part of an effort to integrate and broaden access to its epidemiologic information, the DOE has developed the Comprehensive Epidemiologic Data Resource (CEDR) Program. Included in this effort is the development of a computer information system for accessing the collection of CEDR data and its related descriptive information. The epidemiologic data currently available through the CEDAR Program consist of analytic data sets, working data sets, and their associated documentation files. In general, data sets are the result of epidemiologic studies that have been conducted on various groups of workers at different DOE facilities during the past 30 years.

  11. Meta-analysis in epidemiology

    African Journals Online (AJOL)

    1990-07-21

    Jul 21, 1990 ... sciences.8. •. 9 The term refers to the 'epidemiology of results'. Stated more formally, Jenicek3 has defined meta-analysis as. 'the structured and systematic qualitative and quantitative integration of the ... In reality, most research involves re-search! ... Centre for Epidemiological Research in Southern Mrica,.

  12. Cancer Epidemiology Data Repository (CEDR)

    Science.gov (United States)

    In an effort to broaden access and facilitate efficient data sharing, the Epidemiology and Genomics Research Program (EGRP) has created the Cancer Epidemiology Data Repository (CEDR), a centralized, controlled-access database, where Investigators can deposit individual-level de-identified observational cancer datasets.

  13. Conduct Disorder and Oppositional Defiant Disorder in a National Sample: Developmental Epidemiology

    Science.gov (United States)

    Maughan, Barbara; Rowe, Richard; Messer, Julie; Goodman, Robert; Meltzer, Howard

    2004-01-01

    Background: Despite an expanding epidemiological evidence base, uncertainties remain over key aspects of the epidemiology of the "antisocial" disorders in childhood and adolescence. Methods: We used cross-sectional data on a nationally representative sample of 10,438 5-15-year-olds drawn from the 1999 British Child Mental Health Survey…

  14. EPIDEMIOLOGY OF PARACOCCIDIOIDOMYCOSIS.

    Science.gov (United States)

    Martinez, Roberto

    2015-09-01

    The epidemiological characteristics of paracoccidioidomycosis were reviewed and updated. The new endemic areas in Brazil were discussed in the section regarding the geographic distribution of the mycosis. Subclinical infection with Paracoccidioides brasiliensis was discussed on the basis of skin test surveys with antigens of the fungus, seroepidemiological studies, and disease cases outside Latin America. Large case series permitted a comparison of the prevalence of the mycosis in different regions, its estimated incidence and risk factors for the development of the disease. Aspects modulating the expression of the clinical forms of paracoccidioidomycosis are also presented. This review also deals with diseases associated with the mycosis, opportunistic paracoccidioidomycosis, lethality, mortality and infection and disease in animals.

  15. Temporal network epidemiology

    CERN Document Server

    Holme, Petter

    2017-01-01

    This book covers recent developments in epidemic process models and related data on temporally varying networks. It is widely recognized that contact networks are indispensable for describing, understanding, and intervening to stop the spread of infectious diseases in human and animal populations; “network epidemiology” is an umbrella term to describe this research field. More recently, contact networks have been recognized as being highly dynamic. This observation, also supported by an increasing amount of new data, has led to research on temporal networks, a rapidly growing area. Changes in network structure are often informed by epidemic (or other) dynamics, in which case they are referred to as adaptive networks. This volume gathers contributions by prominent authors working in temporal and adaptive network epidemiology, a field essential to understanding infectious diseases in real society.

  16. Epidemiology of Lyme Disease

    Directory of Open Access Journals (Sweden)

    Dennis J White

    1991-01-01

    Full Text Available Investigation of the epidemiology of Lyme disease depends upon information generated from several sources. Human disease surveillance can be conducted by both passive and active means involving physicians, public health agencies and laboratories. Passive and active tick surveillance programs can document the extent of tick-borne activity, identify the geographic range of potential vector species, and determine the relative risk of exposure to Lyme disease in specific areas. Standardized laboratory services can play an important role in providing data. Epidemiologists can gain a better understanding of Lyme disease through the collection of data from such programs. The interpretation of data and provision of information to the medical and general communities are important functions of public health agencies.

  17. [Epidemiology of obesity].

    Science.gov (United States)

    Möhr, M

    1977-05-15

    In the GDR about 20% of the males and 40% of the females were estimated to be obese. In the country obesity is more spread than in the town. Increased disablement of obese persons leads to reduction of the national income. With higher expenses for nutrition the frequency of obestiy increases. Hypophages and hyperphages are differently distributed in persons with normal weight and obese ones, so that the average establishments do not reflect the differentiated situation in nutrition. Obesity correlates with the type of structure; with increasing obesity dominate pyknomorphous tendencies of growth. Also in normal weight pyknomorphous persons have a higher proportion of fat. We should speak of obesity in such a case, when, taking into consideration biological differentiations, the normal proportion of the fat in the body is increased by more than 1/3. For epidemiological serial examinations the degrees of relative weight basing on optimum weight are a favourable basis for the classification of obesity.

  18. Epidemiology of dentin hypersensitivity.

    Science.gov (United States)

    Splieth, Christian H; Tachou, Aikaterini

    2013-03-01

    In contrast to the well-established caries epidemiology, data on dentin hypersensitivity seem to be scarce and contradictory. This review evaluates the available literature on dentin hypersensitivity and assesses its prevalence, distribution, and potential changes. The systematic search was performed to identify and select relevant publications with several key words in electronic databases. In addition, the articles' bibliographies were consulted. Prevalence rates range from 3 to 98 %. This vast range can be explained partly by the differences in the selection criteria for the study sample and also the variety in diagnostic approaches or time frames. Women are slightly more affected than men and an age peak of 30-40 years has been reported. Still, the prevalence of erosions with dentin exposure seems to increase in younger adults, often resulting in hypersensitivity. In older patients, root surfaces are frequently exposed due to periodontal disease which is associated with a high rate of dentin hypersensitivity, especially after periodontal treatment and intensified brushing activity. On the other hand, the number of affected seniors with tooth loss or even edentulism is reduced. About 25-30 % of the adult population report dentin hypersensitivity. Most dentists also consider it to be a relevant problem in their practice, but they request more information on this topic. Maxillary teeth are affected to a higher extent, but the different teeth show very similar rates. Buccal surfaces clearly show the highest prevalence rates. In spite of the advances regarding management of dentin hypersensitivity, it still remains an epidemiologically understudied field. Although great variations have been observed in the prevalence of dentin hypersensitivity, this issue is often observed by dentists and related by patients. However, further studies are necessary to find the cause of this condition and refine its management.

  19. Middle-Class Entrepreneurs and Inadequate Prospects for Social Mobility through Entrepreneurship in Colombia

    OpenAIRE

    Marcela Melendez; Paula Mejia

    2014-01-01

    This paper explores whether Colombia's middle class is a cradle of entrepreneurship that drives innovation and business growth and fosters social mobility. Microeconomic data are used to characterize entrepreneurs by income group and business characteristics. While entrepreneurs appear to enjoy more income mobility than the average worker, it is not clear whether this is true for middle-class entrepreneurs in particular or if it is a result of entrepreneurship. Nor is there evidence that midd...

  20. Epidemiologic studies based on the Chernobyl accident

    International Nuclear Information System (INIS)

    Beebe, G.

    1996-01-01

    There are great opportunities in the post-Chernobyl experience for significant epidemiologic research, perhaps even more in the area of disaster research than in the area of the human health effects of ionizing radiation. But the potential opportunity for learning the effects of radioiodine on the thyroid is very great and has aroused widespread national and international investigative interest. The opportunities for significant epidemiologic research are, however, severely limited currently by the worsening economic situation in Belarus and Ukraine, where the greatest exposure occurred, and by the lack of personnel trained in appropriate methods of study, the lack of modern equipment, the lack of supplies, the poor communication facilities, and the difficulties of accurate dose estimation. the disadvantages may or may not outweigh the obvious advantages of large numbers, the extensive direct thyroidal measurements made shortly after the accident in 1986, the magnitude of the releases of radioiodine, and the retention of the former Soviet system of universal medical care. Both the European Commission (EC) and the World Health Organization (WHO) have been working actively to strengthen the infrastructure of Russia, Belarus, and Ukraine. New scientific knowledge has yet to emerge from the extensive epidemiologic work but information of considerable public health significance has begun to accumulate. The bulk of the thyroid cancer has been shown to be valid by international pathology review; both EC and WHO representatives have declared the increase in thyroid cancer among children to have been caused in large part by Chernobyl. No increase in leukemia has been seen in the general population. The WHO pilot studies have shown no evidence of an increase in psychologic or neurologic complications among those exposed in utero. Ongoing epidemiologic work can be described by review of the inventory that the WHO has begun to maintain and publish. 20 refs., 7 tabs

  1. Extraintestinal manifestations of inflammatory bowel disease: epidemiology, diagnosis, and management

    DEFF Research Database (Denmark)

    Larsen, Signe; Bendtzen, Klaus; Nielsen, Ole Haagen

    2010-01-01

    evidence of treatment was difficult to obtain, and epidemiologic data on the rarer forms of extraintestinal manifestations are scarce. However, updates on the pathophysiology and treatment regimens are given for each of these disorders. This paper offers a current review of original research papers...

  2. Epidemiology of Newcastle disease virus among local chickens of ...

    African Journals Online (AJOL)

    Newcastle disease (ND) is one of the major constraints to poultry in most developing countries. It is a highly contagious and fatal disease caused by a virus of the family Paramyxoviridae. In other to evaluate the evidence of ND among village chicken, an epidemiological survey was carried out between September and ...

  3. Participatory epidemiology: the contribution of participatory research to epidemiology

    Directory of Open Access Journals (Sweden)

    Mario Bach

    2017-02-01

    Full Text Available Abstract Background Epidemiology has contributed in many ways to identifying various risk factors for disease and to promoting population health. However, there is a continuing debate about the ability of epidemiology not only to describe, but also to provide results which can be better translated into public health practice. It has been proposed that participatory research approaches be applied to epidemiology as a way to bridge this gap between description and action. A systematic account of what constitutes participatory epidemiology practice has, however, been lacking. Methods A scoping review was carried out focused on the question of what constitutes participatory approaches to epidemiology for the purpose of demonstrating their potential for advancing epidemiologic research. Relevant databases were searched, including both the published and non-published (grey literature. The 102 identified sources were analyzed in terms of comparing common epidemiologic approaches to participatory counterparts regarding central aspects of the research process. Exemplary studies applying participatory approaches were examined more closely. Results A highly diverse, interdisciplinary body of literature was synthesized, resulting in a framework comprised of seven aspects of the research process: research goal, research question, population, context, data synthesis, research management, and dissemination of findings. The framework specifies how participatory approaches not only differ from, but also how they can enhance common approaches in epidemiology. Finally, recommendations for the further development of participatory approaches are given. These include: enhancing data collection, data analysis, and data validation; advancing capacity building for research at the local level; and developing data synthesis. Conclusion The proposed framework provides a basis for systematically developing the emergent science of participatory epidemiology.

  4. Importance of clinical epidemiology research in studies on respiratory diseases.

    Science.gov (United States)

    Iwanaga, Takashi; Tohda, Yuji

    2013-12-01

    Evidence-based medicine (EBM) has generated great interest since the 1990s and many physicians worldwide have based their clinical practice on this idea. Its underlying concepts include a diverse array of findings from clinical epidemiological research. In western countries, many clinical databases of clinical epidemiology are in circulation. Clinical epidemiological research using these data in western countries constitutes the majority worldwide. However, because race, lifestyle, culture, etc., differ among western countries and Japan, it is difficult to apply the results of clinical epidemiological research obtained in Japan to western countries. Unfortunately, there is no large-scale database for respiratory diseases prevalent in Japan. Many specialists agree with the opinion that it is necessary to collect medical information specific to the Japanese population and analyze the clinical data. KiHAC (Kinki Hokuriku Airway Disease Conference) was established in September 2001 with the aim of generating evidence through clinical epidemiological research for airway diseases by targeting physicians practicing respiratory medicine, pediatrics, and otorhinolaryngology, primarily in the Kinki and Hokuriku regions located in the central to western parts of Japan. As a part of the KiHAC, clinical research societies will attempt to cooperate with each other to make joint research possible and to share and utilize information, in addition to further promoting clinical research in the field of respiratory medicine. Copyright © 2013 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  5. Los efectos agudos de la contaminación del aire en la salud de la población: evidencias de estudios epidemiológicos Acute effects of air pollution on health: evidence from epidemiological studies

    Directory of Open Access Journals (Sweden)

    José Alberto Rosales-Castillo

    2001-12-01

    Full Text Available Objetivo. Sintetizar las evidencias de los efectos en la salud de la población por la exposición a contaminación del aire por ozono y partículas suspendidas. Material y métodos. A partir de las principales publicaciones internacionales y mexicanas, publicadas y referidas hasta junio del año 2000, se realizó un metanálisis para resumir los efectos reportados a través del empleo de modelos de efectos aleatorios. Resultados. Los resultados se expresaron como porcentajes de incremento por 10 unidades de concentración de PM10 (µg/m³ y ozono (ppb. Entre los efectos de PM10 cabe destacar el efecto agudo en la mortalidad (0.96%, hospitalizaciones (1.39%, visitas a salas de urgencias (3.11%, síntomas respiratorios (7.72%, parámetros de función pulmonar (1.42%, para capacidad vital forzada (CVF y días de actividad restringida (7.74%. Los efectos de la exposición a ozono son igualmente significativos. Conclusiones. Estos resultados muestran el gran impacto que las concentraciones de contaminantes del aire podrían tener en la salud de las poblaciones urbanas de las grandes metrópolis. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html Objective. To summarize the evidence of acute health effects from exposure to particulate matter and ozone. Material and Methods. A meta-analysis was performed using random effect models, to summarize the health effects of pollution, published in major international and Mexican journals up to June 2000. Results. Results were given as percent increase in ten units of PM10 (µg/m3 and ozone (ppb. PM10 was found to have an effect on mortality (0.96%, hospital admissions (1.39%, emergency room visits (3.11%, respiratory symptoms (7.72%, pulmonary forced vital capacity (1.42%, and restricted activity days (7.74%. Ozone effects were equally significant. Conclusions. These findings show the great impact that air pollutants may have on the health of populations

  6. Strengthening the reporting of genetic association studies (STREGA): an extension of the strengthening the reporting of observational studies in epidemiology (STROBE) statement.

    Science.gov (United States)

    Little, Julian; Higgins, Julian P T; Ioannidis, John P A; Moher, David; Gagnon, France; von Elm, Erik; Khoury, Muin J; Cohen, Barbara; Davey-Smith, George; Grimshaw, Jeremy; Scheet, Paul; Gwinn, Marta; Williamson, Robin E; Zou, Guang Yong; Hutchings, Kim; Johnson, Candice Y; Tait, Valerie; Wiens, Miriam; Golding, Jean; van Duijn, Cornelia; McLaughlin, John; Paterson, Andrew; Wells, George; Fortier, Isabel; Freedman, Matthew; Zecevic, Maja; King, Richard; Infante-Rivard, Claire; Stewart, Alex F; Birkett, Nick

    2009-06-01

    Making sense of rapidly evolving evidence on genetic associations is crucial to making genuine advances in human genomics and the eventual integration of this information in the practice of medicine and public health. Assessment of the strengths and weaknesses of this evidence, and hence, the ability to synthesize it, has been limited by inadequate reporting of results. The STrengthening the REporting of Genetic Association (STREGA) studies initiative builds on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and provides additions to 12 of the 22 items on the STROBE checklist. The additions concern population stratification, genotyping errors, modeling haplotype variation, Hardy-Weinberg equilibrium, replication, selection of participants, rationale for choice of genes and variants, treatment effects in studying quantitative traits, statistical methods, relatedness, reporting of descriptive and outcome data, and the volume of data issues that are important to consider in genetic association studies. The STREGA recommendations do not prescribe or dictate how a genetic association study should be designed, but seek to enhance the transparency of its reporting, regardless of choices made during design, conduct, or analysis.

  7. Associations between Inadequate Parenting Practices and Behavioral Problems in Children and Adolescents with Attention Deficit Hyperactivity Disorder.

    Science.gov (United States)

    Teixeira, Maria Cristina Triguero Veloz; Marino, Regina Luisa de Freitas; Carreiro, Luiz Renato Rodrigues

    2015-01-01

    Children and adolescents with ADHD present behaviors such as impulsiveness, inattention, and difficulties with personal organization that represent an overload for parents. Moreover, it also increases their level of stress and leads them to resort to inadequate educational strategies. The present study verifies associations between inadequate parenting practices and behavioral profiles of children and adolescents with ADHD. The sample was composed of 22 children with ADHD (age range 6-16 years) and their mothers. Spearman correlation analyses were made with the scores of Parenting Style Inventory (PSI) and Child Behavior Checklist for ages 6-18 (CBCL/6-18). Results indicate statistically significant associations between behavioral problems and the use of punishment practices and negligence. When assessing a child with ADHD, it is important to verify the predominant types of parenting practices that can influence both immediate interventions and the prognosis of the disorder.

  8. An implant-supported removable partial denture on milled bars to compromise the inadequate treatment plan: a clinical report

    OpenAIRE

    Kim, Jee-Hwan; Lee, Jae-Hoon

    2010-01-01

    Presurgical prosthetic treatment planning is critical for the success of the implant prosthesis. Inadequate treatment plan, due to insufficient discussion between prosthodontist, and surgeon, may result in poor prognosis. A 26-year-old male patient was referred for prosthodontic treatment after implant was placed in the area of teeth #17, 16, 22, 25 and 27, without adequate discussion nor the treatment planning between oral surgeon and prosthodontist. It was found that the patient had two hop...

  9. Prevalence and risk factors of inadequate cervical dilation following laminaria insertion in second-trimester abortion--case control study.

    Science.gov (United States)

    Ben-Ami, Ido; Stern, Sharon; Vaknin, Zvi; Smorgick, Noam; Schneider, David; Halperin, Reuvit

    2015-04-01

    The objective was to explore the prevalence of and risk factors for inadequate cervical dilation following insertion of a single set of laminaria in women scheduled for dilation & evacuation (D&E) at 14-24 weeks' gestation. We retrospectively reviewed all cases of women who underwent pregnancy termination by D&E at 14-24 weeks' gestation between January 2003 and December 2013. All cases in which the surgical procedure was cancelled due to failure to achieve adequate cervical dilation after a single set of laminaria inadequate cervical dilation were included. The control group was women who underwent D&E following adequate cervical dilation after a single set of laminaria, and were matched according to gestational week in a ratio of 1:3. The overall dilation failure rate was 3.2%, with 4.0% among the induced-abortion patients and 1.5% among the patients with fetal demise (p=.002). Patients who had inadequate cervical dilation had lower rates of gravidity (p=.002) and previous spontaneous vaginal delivery (plaminaria insertion, namely, previous cesarean section (p=.002) and previous cervical procedure (plaminaria. Women who are scheduled for D&E, and in whom one of these risk factors exists, might benefit from additional interventions to achieve better cervical preparation. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Inadequate vertical bone dimension managed by bone-added osteotome sinus floor elevation (BAOSFE): a literature review and case report.

    Science.gov (United States)

    Kolhatkar, Shilpa; Cabanilla, Leyvee; Bhola, Monish

    2009-05-01

    The purpose of this report is to provide a brief literature review of the bone-added osteotome sinus floor elevation (BAOSFE) procedure and to present a case utilizing this technique. Implant placement in the posterior maxillary region is often compromised due to anatomic limitations. In clinical situations where there is inadequate vertical bone dimension, the BAOSFE technique can be employed to increase bone height and allow placement of implants with an appropriate length dimension. A case of a 60-year-old female with inadequate vertical bone dimension in the area of an extracted #13 is presented. The BAOSFE technique was performed which facilitated the placement of a 3.75 X 13 mm implant. Anatomic limitations such as inadequate vertical bone dimension in the posterior maxillary region may result in placement of shorter implants. Sinus floor elevation (SFE) procedures using a crestal approach such as the BAOSFE, in certain selected cases, can effectively and predictably increase bone height. The BAOSFE technique is an excellent procedure that can overcome limitations associated with the posterior maxillary region.

  11. Inadequate housing among families under investigation for child abuse and neglect: prevalence from a national probability sample.

    Science.gov (United States)

    Fowler, Patrick J; Henry, David B; Schoeny, Michael; Landsverk, John; Chavira, Dina; Taylor, Jeremy J

    2013-09-01

    This study aimed to estimate the prevalence of inadequate housing that threaten out-of-home placement among families under investigation by child welfare. Data came from the National Survey of Child and Adolescent Well-Being, a nationally representative longitudinal survey of child welfare-involved families. Child protective services caseworkers as well as caregivers provided information on families whose child remained in the home after initial investigation (N = 3,867). Multilevel latent class analyses tested the presence of inadequately housed subgroups using 4 housing problem indicators at baseline. Logistic regressions assessed convergent and predictive validity. A two class latent solution best fit the data. Findings indicated that inadequate housing contributed to risk for out-of-home placement in approximately 16 % of intact families under investigation by child protective services. These families were 4 times more likely to need housing services 12 months later. Federal legislation emphasizes integration of social services as necessary to end homelessness. This study demonstrates overlap across public agencies. Enhanced coordination of child welfare and housing services facilitates interventions to prevent and mitigate homelessness.

  12. Epidemiology of Huntington disease.

    Science.gov (United States)

    Kay, Chris; Hayden, Michael R; Leavitt, Blair R

    2017-01-01

    Huntington disease (HD) is an autosomal-dominant neurologic disorder caused by an expanded CAG trinucleotide repeat mutation in patients with characteristic motor signs and specific brain pathology. A repeat of 36 CAG or more can lead to the disease, with increased penetrance and decreased age of onset at longer CAG repeats. The epidemiology of HD thus depends on ascertainment of individuals with the expanded CAG mutation, and on examination of clinical signs to accurately assess disease onset. A larger number of individuals have an expanded CAG repeat than actively manifest the disease due to adult onset in the majority of cases. Because of incomplete penetrance at the lower end of the pathogenic CAG repeat range, the frequency of the expanded CAG repeat in the general population may be higher than previously thought. Genetic differences and changing demographics may account for geographic and ethnic variation in the prevalence of HD between populations and over time. There are gross differences in the prevalence of HD by ancestry, with a much higher rate of the disease in populations of European descent. Molecular studies have elucidated genetic causes for these population-specific differences, possibly resulting from differences in the HD new mutation rate. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Epidemiology of severe trauma.

    Science.gov (United States)

    Alberdi, F; García, I; Atutxa, L; Zabarte, M

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions. Copyright © 2014 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  14. Radiobiology and Epidemiology

    Energy Technology Data Exchange (ETDEWEB)

    Desaintes, C; Holmstock, L

    2001-04-01

    The main objectives of research in the field of radiobiology and epidemiology performed at the Belgian Nuclear Research Centre SCK-CEN are: (1) to study cancer mortality in nuclear workers in Belgium and to co-ordinate the Belgian contribution to the 'International Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry'; (2) to elucidate the molecular basis of individual susceptibility to ionizing radiation in mammalian embryo during the early phases of its development; (3) to assess the genetic risk of maternal exposure to ionizing radiation; (4) to elucidate the cellular mechanisms leading to brain damage after prenatal irradiation; (5) to monitor the early variations of gene expression induced by ionising radiation and cytokines; (6) to evaluate the use of cytokines and natural substances for improving radiotherapy protocols; (6) to advise authorities and to provide the general population with adequate information concerning the health risk arising from radiation exposure. Progress and major achievements in these topical areas in 2000 are reported.

  15. TUBERCULOSIS: EPIDEMIOLOGY AND CONTROL

    Directory of Open Access Journals (Sweden)

    Giorgia Sulis

    2014-10-01

    Full Text Available Tuberculosis (TB is a major public health concern worldwide: despite a regular, although slow, decline in incidence over the last decade, as many as 8.6 million new cases and 1.3 million deaths were estimated to have occurred in 2012. TB is by all means a poverty-related disease, mainly affecting the most vulnerable populations in the poorest countries. The presence of multidrug-resistant strains of M. tuberculosis in most countries, with some where prevalence is high, is among the major challenges for TB control, which may hinder recent achievements especially in some settings. Early TB case detection especially in resource-constrained settings and in marginalized groups remains a challenge, and about 3 million people are estimated to remain undiagnosed or not notified and untreated. The World Health Organization (WHO has recently launched the new global TB strategy for the “post-2015 era” aimed at “ending the global TB epidemic” by 2035, based on the three pillars that emphasize patient-centred TB care and prevention, bold policies and supportive systems, and intensified research and innovation. This paper aims to provide an overview of the global TB epidemiology as well as of the main challenges that must be faced to eliminate the disease as a public health problem everywhere.

  16. Radiobiology and Epidemiology

    International Nuclear Information System (INIS)

    Desaintes, C; Holmstock, L.

    2001-01-01

    The main objectives of research in the field of radiobiology and epidemiology performed at the Belgian Nuclear Research Centre SCK-CEN are: (1) to study cancer mortality in nuclear workers in Belgium and to co-ordinate the Belgian contribution to the 'International Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry'; (2) to elucidate the molecular basis of individual susceptibility to ionizing radiation in mammalian embryo during the early phases of its development; (3) to assess the genetic risk of maternal exposure to ionizing radiation; (4) to elucidate the cellular mechanisms leading to brain damage after prenatal irradiation; (5) to monitor the early variations of gene expression induced by ionising radiation and cytokines; (6) to evaluate the use of cytokines and natural substances for improving radiotherapy protocols; (6) to advise authorities and to provide the general population with adequate information concerning the health risk arising from radiation exposure. Progress and major achievements in these topical areas in 2000 are reported

  17. Epidemiology of Lung Cancer

    Science.gov (United States)

    Brock, Malcolm V.; Ford, Jean G.; Samet, Jonathan M.; Spivack, Simon D.

    2013-01-01

    Background: Ever since a lung cancer epidemic emerged in the mid-1900s, the epidemiology of lung cancer has been intensively investigated to characterize its causes and patterns of occurrence. This report summarizes the key findings of this research. Methods: A detailed literature search provided the basis for a narrative review, identifying and summarizing key reports on population patterns and factors that affect lung cancer risk. Results: Established environmental risk factors for lung cancer include smoking cigarettes and other tobacco products and exposure to secondhand tobacco smoke, occupational lung carcinogens, radiation, and indoor and outdoor air pollution. Cigarette smoking is the predominant cause of lung cancer and the leading worldwide cause of cancer death. Smoking prevalence in developing nations has increased, starting new lung cancer epidemics in these nations. A positive family history and acquired lung disease are examples of host factors that are clinically useful risk indicators. Risk prediction models based on lung cancer risk factors have been developed, but further refinement is needed to provide clinically useful risk stratification. Promising biomarkers of lung cancer risk and early detection have been identified, but none are ready for broad clinical application. Conclusions: Almost all lung cancer deaths are caused by cigarette smoking, underscoring the need for ongoing efforts at tobacco control throughout the world. Further research is needed into the reasons underlying lung cancer disparities, the causes of lung cancer in never smokers, the potential role of HIV in lung carcinogenesis, and the development of biomarkers. PMID:23649439

  18. Epidemiology in a changing world: implications for population-based research on mental disorders.

    Science.gov (United States)

    Cooper, B

    2014-06-01

    Introduction and objectives. Population-based research on mental disorders needs to keep pace with trends in general epidemiology. At present, this requirement is complicated by uncertainty within the parent discipline about its future development. The present study examines proposals for new directions in strategy and methods and considers their significance for psychiatric epidemiology. Method. Narrative review, cross-checked by search of English-language journals of epidemiology for new trends and developments reported in the years from 2000 onwards. Results. The proposals reviewed here are divided into three groups: 1. A new research paradigm of 'eco-epidemiology', which includes both individual risk factors and macro-environmental systems that mediate population levels of health and sickness. 2. Improved 'translation' of research findings - i.e. more rapid and effective implementation of epidemiological evidence into health policy and practice. 3. Adaptation of epidemiology to a globalised economy, with firmer regulation of funding and resources. Conclusions. Each of these proposals has implications for psychiatric epidemiology. Workers in this field, however, are still preoccupied by relatively specific problems of definition, measurement and classification, and so far the current debates in general epidemiology are scarcely reflected. The proposals outlined above call for: • a working model of eco-epidemiology as it relates to psychiatric disorders; • implementation strategies to encourage more active participation in epidemiological research by community health services and caregiver organisations; • international collaborative projects that offer practical benefits in training and service facilities for the countries taking part.

  19. Social justice, epidemiology and health inequalities.

    Science.gov (United States)

    Marmot, Michael

    2017-07-01

    A lifetime spent studying how social determinants of health lead to health inequalities has clarified many issues. First is that social stratification is an appropriate topic of study for epidemiologists. To ignore it would be to ignore a major source of variation in health in society. Not only is the social gradient in health appropriate to study but we have made progress both in understanding its causes and what can be done to address them. Post-modern 'critical theory' raises questions about the social construction of science. Given the attack on science by politicians of bad faith, it is important to recognise that epidemiology and public health have a crucial role to play in providing evidence to improve health of society and reduce inequalities. Evidence gives grounds for optimism that progress can be made both in improving the health of the worst-off in society and narrowing health inequalities. Theoretical debates about 'inequality of what' have been helpful in clarifying theories that drive further gathering of evidence. While it is important to consider alternative explanations of the social gradient in health-principal among them reverse causation-evidence strongly supports social causation. Social action is by its nature political. It is, though, a vital function to provide the evidence that underpins action.

  20. Inadequate Diagnostic Evaluation in Young Patients Registered with a Diagnosis of Dementia

    DEFF Research Database (Denmark)

    Salem, Lise Cronberg; Andersen, Birgitte Bo; Nielsen, T Rune

    2014-01-01

    BACKGROUND: Establishing a diagnosis of dementia in young patients may be complex and have significant implications for the patient. The aim of this study was to evaluate the quality of the diagnostic work-up in young patients diagnosed with dementia in the clinical routine. METHODS: Two hundred...... patients were randomly selected from 891 patients aged ≤65 years registered with a diagnosis of dementia for the first time in 2008 in Danish hospitals, and 159 medical records were available for review. Three raters evaluated their medical records for the completeness of the diagnostic work-up on which...... the diagnosis of dementia had been based, using evidence-based guidelines for the diagnostic evaluation of dementia as reference standards. RESULTS: According to the rater review, only 111 (70%) patients met the clinical criteria for dementia. An acceptable diagnostic work-up including all items of recommended...

  1. Emergency Department Visits for Homelessness or Inadequate Housing in New York City before and after Hurricane Sandy.

    Science.gov (United States)

    Doran, Kelly M; McCormack, Ryan P; Johns, Eileen L; Carr, Brendan G; Smith, Silas W; Goldfrank, Lewis R; Lee, David C

    2016-04-01

    Hurricane Sandy struck New York City on October 29, 2012, causing not only a large amount of physical damage, but also straining people's health and disrupting health care services throughout the city. In prior research, we determined that emergency department (ED) visits from the most vulnerable hurricane evacuation flood zones in New York City increased after Hurricane Sandy for several medical diagnoses, but also for the diagnosis of homelessness. In the current study, we aimed to further explore this increase in ED visits for homelessness after Hurricane Sandy's landfall. We performed an observational before-and-after study using an all-payer claims database of ED visits in New York City to compare the demographic characteristics, insurance status, geographic distribution, and health conditions of ED patients with a primary or secondary ICD-9 diagnosis of homelessness or inadequate housing in the first week after Hurricane Sandy's landfall versus the baseline weekly average in 2012 prior to Hurricane Sandy. We found statistically significant increases in ED visits for diagnosis codes of homelessness or inadequate housing in the week after Hurricane Sandy's landfall. Those accessing the ED for homelessness or inadequate housing were more often elderly and insured by Medicare after versus before the hurricane. Secondary diagnoses among those with a primary ED diagnosis of homelessness or inadequate housing also differed after versus before Hurricane Sandy. These observed differences in the demographic, insurance, and co-existing diagnosis profiles of those with an ED diagnosis of homelessness or inadequate housing before and after Hurricane Sandy suggest that a new population cohort-potentially including those who had lost their homes as a result of storm damage-was accessing the ED for homelessness or other housing issues after the hurricane. Emergency departments may serve important public health and disaster response roles after a hurricane, particularly for

  2. News on Inflation and the Epidemiology of Inflation Expectations

    DEFF Research Database (Denmark)

    Pfajfar, Damjan; Santoro, Emiliano

    2013-01-01

    This paper examines the nexus between news coverage on inflation and households’ inflation expectations. In doing so, we test the epidemiological foundations of the sticky information model (Carroll ). We use both aggregate and household-level data from the Survey Research Center at the University...... of Michigan. We highlight a fundamental disconnection among news on inflation, consumers’ frequency of expectation updating, and the accuracy of their expectations. Our evidence provides at best weak support to the epidemiological framework, as most of the consumers who update their expectations do not revise...

  3. Whole-Genome Sequencing in Epidemiology of Campylobacter jejuni Infections.

    Science.gov (United States)

    Llarena, Ann-Katrin; Taboada, Eduardo; Rossi, Mirko

    2017-05-01

    This review describes the current state of knowledge regarding the application of whole-genome sequencing (WGS) in the epidemiology of Campylobacter jejuni , the leading cause of bacterial gastroenteritis worldwide. We describe how WGS has increased our understanding of the evolutionary and epidemiological dynamics of this pathogen and how WGS has the potential to improve surveillance and outbreak detection. We have identified hurdles to the full implementation of WGS in public health settings. Despite these challenges, we think that ample evidence is available to support the benefits of integrating WGS into the routine monitoring of C. jejuni infections and outbreak investigations. Copyright © 2017 American Society for Microbiology.

  4. Genomic Resources for Cancer Epidemiology

    Science.gov (United States)

    This page provides links to research resources, complied by the Epidemiology and Genomics Research Program, that may be of interest to genetic epidemiologists conducting cancer research, but is not exhaustive.

  5. Metabolomics and Epidemiology Working Group

    Science.gov (United States)

    The Metabolomics and Epidemiology (MetEpi) Working Group promotes metabolomics analyses in population-based studies, as well as advancement in the field of metabolomics for broader biomedical and public health research.

  6. Sociocultural epidemiology: an essential approach.

    Directory of Open Access Journals (Sweden)

    Paul Hersch-Martínez

    2013-09-01

    Full Text Available The necessity of an inclusive epidemiological approach, capable to attend the diverse dimensions involved in health damage as a reflective phenomenon of society is analyzed. The range of perspectives involved requires an inclusive methodological scope and applicative channels, in order to deal with sanitary realities systematically related to culture and social organization. Some constitutive elements of sociocultural epidemiology are underlined, shaping an operative proposal that can enhance the relationship between disciplines and sectors regarding specific outstanding public health problems.

  7. Sociocultural epidemiology: an essential approach.

    OpenAIRE

    Paul Hersch-Martínez

    2013-01-01

    The necessity of an inclusive epidemiological approach, capable to attend the diverse dimensions involved in health damage as a reflective phenomenon of society is analyzed. The range of perspectives involved requires an inclusive methodological scope and applicative channels, in order to deal with sanitary realities systematically related to culture and social organization. Some constitutive elements of sociocultural epidemiology are underlined, shaping an operative proposal that can enhance...

  8. Occupational reproductive epidemiology: Pt. 1

    International Nuclear Information System (INIS)

    Roman, Eve; Doyle, Pat

    1993-01-01

    The authors review the current state of knowledge about possible adverse effects of hazardous paternal workplace exposures on human reproduction is scant. The methodology for studying possible association between occupational exposures and adverse reproductive events is not well developed. More detailed laboratory and epidemiological research is clearly required, and better collaboration between these two disciplines is needed. Associations suggested in the course of epidemiological research need to be tested in the laboratory, and vice versa. (author)

  9. Epidemiology of juvenile violence.

    Science.gov (United States)

    Farrington, D P; Loeber, R

    2000-10-01

    It is difficult to review the epidemiology of juvenile violence because few studies focus specifically on this topic as opposed to childhood aggression or delinquency in general. More research is needed specifically on juvenile violence, which is generally measured using official records or self-reports. Self-report research shows that a substantial fraction of the male juvenile population commits violence, and that very few violent acts are followed by arrests or convictions. Racial differences in violence may be explainable by reference to racial differences in community contexts. There is a great deal of versatility in juvenile violence. Juveniles who commit one type of violent offense also tend to commit other types and nonviolent offenses. Violent offenders tend to be persistent or frequent offenders, and there is little difference between violent offenders and nonviolent but equally frequent offenders. Nevertheless, there is some degree of specialization in violence. More research is needed to investigate whether risk factors exist for violence that are not risk factors for serious nonviolent delinquency (e.g., biologic factors). Violent juveniles tend to have co-occurring problems such as victimization, substance abuse, and school failure. Often, they might be described as multiple-problem youth. There is considerable continuity from childhood aggression to juvenile violence. An early age of onset of violence predicts a large number of violent offenses. The major long-term risk factors for juvenile violence are individual (high impulsiveness and low intelligence, possibly linked to the executive functions of the brain), family (poor supervision, harsh discipline, child physical abuse, a violent parent, large family size, poverty, a broken family), peer delinquency, gang membership, urban residence, and living in a high-crime neighborhood (characterized by gangs, guns, and drugs in the United States). More research is needed on interactions among risk factors

  10. [Epidemiology of gestational syphilis in Fortaleza, Ceará State, Brazil: an uncontrolled disease].

    Science.gov (United States)

    Campos, Ana Luiza de Araujo; Araújo, Maria Alix Leite; Melo, Simone Paes de; Gonçalves, Marcelo Luiz Carvalho

    2010-09-01

    This cross-sectional study investigated the epidemiological profile of pregnant women with positive VDRL in Fortaleza, Ceará State, Brazil, in 2008. The study verified the proportion of pregnant women with syphilis that was classified as treated incorrectly according to Brazilian Ministry of Health guidelines, and assessed the reasons for inadequate treatment. Fifty-eight women who had given birth at five public maternity hospitals were interviewed consecutively following delivery. Data were also recovered from medical files and pregnancy cards. Sociodemographic and obstetric data and information related to the diagnosis and treatment of syphilis in both pregnant women and their partners were analyzed. Only three (5.2%; 95%CI: 1.8%-14.1%) pregnant women had received adequate treatment. The main reason for inadequate treatment was lack of partner treatment (88% of cases; 95%CI: 76.2%-94.4%). Medical care as currently provided does not guarantee the control of gestational syphilis in this sample.

  11. Epidemiological criminology: drug use among African American gang members.

    Science.gov (United States)

    Lanier, Mark M; Pack, Robert P; Akers, Timothy A

    2010-01-01

    Epidemiological methods and public health theories can be tied to theories of crime and delinquency and used to create evidence-based policy. Interdisciplinary theoretical approaches to existing, and emerging, public health and criminal justice problems hold great promise. Differential association theory postulates that close association with delinquent peers leads to an increase in deviant activities such as illicit drug use. Social cognitive theory postulates that health behavior change is driven by the interaction of (a) cognitive states that support a health outcome, (b) the social and contextual environment, (c) and individual action. Combined, these theories can be applied to drug eradication programs as well as other health and crime issues. Focus groups and interviews were performed to identify rates of illicit substance use among incarcerated African American adolescent male gang members and nongang members. The policy recommendations illustrate the convergence of criminological and epidemiological theory under the new paradigm of epidemiological criminology or ''EpiCrim.''

  12. Acute respiratory distress syndrome: epidemiology and management approaches

    Directory of Open Access Journals (Sweden)

    Walkey AJ

    2012-07-01

    Full Text Available Allan J Walkey,1 Ross Summer,1 Vu Ho,1 Philip Alkana21The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA; 2Asthma Research Center, Brigham and Women's Hospital, Boston, MA, USAAbstract: Acute lung injury and the more severe acute respiratory distress syndrome represent a spectrum of lung disease characterized by the sudden onset of inflammatory pulmonary edema secondary to myriad local or systemic insults. The present article provides a review of current evidence in the epidemiology and treatment of acute lung injury and acute respiratory distress syndrome, with a focus on significant knowledge gaps that may be addressed through epidemiologic methods.Keywords: acute lung injury, acute respiratory distress syndrome, review, epidemiology

  13. Inadequate sleep as a contributor to type 2 diabetes in children and adolescents.

    Science.gov (United States)

    Dutil, C; Chaput, J-P

    2017-05-08

    Lack of sleep is a modifiable risk factor for adverse health in humans. Short sleep duration and poor sleep quality are common in the pediatric population; the largest decline in sleep duration over the past decades has been seen in children and adolescents. The objective of the present narrative review was to provide for the first time an overview of the literature on sleep and its association with type 2 diabetes mellitus (T2D) biomarkers in children and adolescents. For this narrative review, 23 studies were retained (21 observational and 2 experimental studies). Notwithstanding the conflicting results found in these studies and despite being attenuated by adiposity level, maturity, sex and age, there is still some compelling evidence for an association between sleep duration (for both objective or subjective measurements of duration) and architecture with one or more T2D biomarkers in children and adolescents. The majority of the studies reviewed did focus on sleep duration and one or more T2D biomarkers in children and adolescents, but sleep architecture, more precisely the suppression of slow wave sleep and rapid eye movement sleep, has also been shown to be associated with insulin resistance. Only two studies looked at sleep quality, and the association between sleep quality and insulin resistance was not independent of level of adiposity. Future experimental studies will help to better understand the mechanisms linking insufficient sleep with T2D. Work also needs to be carried out on finding novel and effective strategies aimed at improving sleep hygiene and health outcomes of children and adolescents.

  14. Contagious equine metritis: artificial reproduction changes the epidemiologic paradigm.

    Science.gov (United States)

    Schulman, Martin Lance; May, Catherine Edith; Keys, Bronwyn; Guthrie, Alan John

    2013-11-29

    Recent CEM outbreak reports reflect a novel epidemiologic manifestation with a markedly different risk association for transmission via artificial reproduction and subsequent to inadvertent importation of unapparent carrier stallions. Artificial breeding has an increased association with horizontal or fomite-associated transmission. Reported risk factors include inadequate biosecurity protocols at centralised breeding facilities associated with stallion management and methods of semen collection, processing and transport. Detection of carriers is based on traditional bacteriology from genital swabs and despite limitations inherent to Taylorella equigenitalis is currently the gold standard applied in all international trade and movement protocols. These limitations are reported to be overcome by PCR assays improving diagnostic sensitivity and specificity, practicality, turn-around times, through-put and cost efficacy. Molecular methods have increased understanding of the Taylorelleae, facilitate epidemiologic surveillance and outbreak control strategies. Validation and international regulatory acceptance of a robust PCR-based assay and the undefined risks in association with cryopreserved semen and embryos are future areas warranting further investigation. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Explanatory factors for first and second-generation non-western women's inadequate prenatal care utilisation: a prospective cohort study.

    Science.gov (United States)

    Boerleider, Agatha W; Manniën, Judith; van Stenus, Cherelle M V; Wiegers, Therese A; Feijen-de Jong, Esther I; Spelten, Evelien R; Devillé, Walter L J M

    2015-04-21

    Little research into non-western women's prenatal care utilisation in industrialised western countries has taken generational differences into account. In this study we examined non-western women's prenatal care utilisation and its explanatory factors according to generational status. Data from 3300 women participating in a prospective cohort of primary midwifery care clients (i.e. women with no complications or no increased risk for complications during pregnancy, childbirth and the puerperium who receive maternity care by autonomous midwives) in the Netherlands (the DELIVER study) was used. Gestational age at entry and the total number of prenatal visits were aggregated into an index. The extent to which potential factors explained non-western women's prenatal care utilisation was assessed by means of blockwise logistic regression analyses and percentage changes in odds ratios. The unadjusted odds of first and second-generation non-western women making inadequate use of prenatal care were 3.26 and 1.96 times greater than for native Dutch women. For the first generation, sociocultural factors explained 43% of inadequate prenatal care utilisation, socioeconomic factors explained 33% and demographic and pregnancy factors explained 29%. For the second generation, sociocultural factors explained 66% of inadequate prenatal care utilisation. Irrespective of generation, strategies to improve utilisation should focus on those with the following sociocultural characteristics (not speaking Dutch at home, no partner or a first-generation non-Dutch partner). For the first generation, strategies should also focus on those with the following demographic, pregnancy and socioeconomic characteristics (aged ≤ 19 or ≥ 36, unplanned pregnancies, poor obstetric histories (extra-uterine pregnancy, molar pregnancy or abortion), a low educational level, below average net household income and no supplementary insurance.

  16. Inadequate prescription of chronic consumption of proton pump inhibitors in a hospital in Mexico: Cross-sectional study

    Directory of Open Access Journals (Sweden)

    Jaime Alberto Sánchez-Cuén

    2013-03-01

    Full Text Available Introduction: PPIs have been an enormous therapeutic advance in acid-related diseases. However, it has been detected an abuse in its consumption. The aim of this study was to determine the frequency of inadequate prescription of chronic use of PPIs in outpatients in a speciality hospital. Material and methods: we performed a cross-sectional descriptive study review. The study population were patients, chronic users of proton pump inhibitors (PPIs, attending outpatient consult in a hospital of government workers. We defined as chronic user of PPIs that patient that takes medication daily for over a year and inappropriate prescription, that one that has not been approved by the clinical guidelines. A simple random sampling was utilized. The following parameters were investigated: diagnosis and prescription of PPIs, time of use, at which level of care PPIs were prescribed (primary care or specialist, self-medication, with or without endoscopy. For the statistical analysis, we used Student's t-test and Chi-square, 95% confidence intervals and significance 0.05 %. Results: we reviewed 153 patients, 40 (26.1 % men and 113 (73.9 % women, mean age 58 ± 11.4 years. The prescription of chronic treatment with PPIs was adequate in 64.7 % of patients and inadequate in 35.3 %. The most common appropriate prescription (31.3 % of chronic use of PPIs was due to gastroesophageal reflux disease. The most common inadequate prescription was absence of diagnosis (22.2 %, polypharmacy without nonsteroidal antiinflammatory drugs (16.6 % and chronic gastritis (16.6 %. History of endoscopy were not statistically significant. Conclusions: the frequency of inappropriate prescriptions of chronic use of PPIs was high, around 35.3 %, similar to those reported in hospitals in developed countries.

  17. Inadequate Riboflavin Intake and Anemia Risk in a Chinese Population: Five-Year Follow Up of the Jiangsu Nutrition Study

    Science.gov (United States)

    Shi, Zumin; Zhen, Shiqi; Wittert, Gary A.; Yuan, Baojun; Zuo, Hui; Taylor, Anne W.

    2014-01-01

    Objectives Riboflavin (vitamin B2) has been shown in animal studies to affect the absorption and metabolism of iron. Cross-sectional population studies show a relationship between riboflavin intake and anemia but prospective population studies are limited. The aim of the study was to determine the relationship between riboflavin intake and the risk of anemia in a Chinese cohort. Method The study used data from 1253 Chinese men and women who participated in two waves of the Jiangsu Nutrition Study (JIN), five years apart, in 2002 and 2007. Riboflavin intake and hemoglobin (Hb) were quantitatively assessed together with dietary patterns, lifestyle, socio-demographic and health-related factors. Results At baseline, 97.2% of participants had inadequate riboflavin intake (below the estimate average requirement). Riboflavin intake was positively associated with anemia at baseline, but low riboflavin intake was associated with an increased risk of anemia at follow-up among those anemic at baseline. In the multivariate model, adjusting for demographic and lifestyle factors and dietary patterns, the relative risk and 95% confidence interval for anemia at follow-up, across quartiles of riboflavin intake were: 1, 0.82(0.54–1.23), 0.56(0.34–0.93), 0.52(0.28–0.98) (p for trend 0.021). There was a significant interaction between riboflavin and iron intake; when riboflavin intake was low, a high iron intake was associated with a lower probability of anemia at follow-up. This association disappeared when riboflavin intake was high. Conclusion Inadequate riboflavin intake is common and increases the risk of anemia in Chinese adults. Given the interaction with iron intake correcting inadequate riboflavin intake may be a priority in the prevention of anemia, and population based measurement and intervention trials are required. PMID:24533156

  18. Inadequate functional health literacy in Spanish as a barrier to cervical cancer screening among immigrant Latinas in New York City.

    Science.gov (United States)

    Garbers, Samantha; Chiasson, Mary Ann

    2004-10-01

    The objective of this study was to examine the association between inadequate functional health literacy in Spanish among low-income Latinas aged 40 and older and cervical cancer screening knowledge and behavior. Spanish-speaking Latinas aged 40-78 of various nationalities (n = 205) participated in a study that included a survey on cervical cancer knowledge and behavior administered in Spanish and the Spanish version of the Test of Functional Health Literacy in Adults. Compared to those with adequate and marginal health literacy, women with inadequate functional health literacy in Spanish were significantly less likely to have ever had a Papanicolaou (Pap) test (odds ratio, 0.12; 95% confidence interval [CI], 0.04-0.37) or in the last three years (odds ratio, 0.35; 95% CI, 0.18-0.68) and were significantly more likely to have had their last Pap test at a local public hospital (odds ratio, 2.43; 95% CI, 1.18-4.97). Even when controlling for other factors, women with inadequate health literacy were 16.7 times less likely (adjusted odds ratio, 0.06; 95% CI, 0.01-0.55) to have ever had a Pap test. Almost half of the population we studied will have difficulty interpreting written medical materials, even in Spanish. When developing efforts to reach women who have not been screened, programs and service providers need to be aware that the women most in need of information about screening may be more likely to be unable to read any written materials provided to them, regardless of the language or level of simplicity of the materials. Programs and strategies need to be implemented to increase screening prevalence and to minimize the identified gaps in regular screening for Latinas who have low health literacy.

  19. Depression, obesity, and smoking were independently associated with inadequate glycemic control in patients with type 1 diabetes.

    Science.gov (United States)

    Melin, Eva O; Thunander, Maria; Svensson, Ralph; Landin-Olsson, Mona; Thulesius, Hans O

    2013-06-01

    The aim of this study was to explore the associations between inadequate glycemic control of diabetes and psychological, anthropometric, and lifestyle variables in a population-based cohort of type 1 diabetes patients. Cross-sectional study. In this study, 292 patients with type 1 diabetes, aged 1859 years, participated. psychological data were assessed by self-report instruments: Hospital Anxiety and Depression Scale and Toronto Alexithymia Scale-20. Anthropometrics, blood analyses, data from medical records, and data from the Swedish National Diabetes Registry were collected. Self-reported depression (adjusted odds ratio (AOR) 4.8), obesity (AOR 4.3), and smoking (AOR 3.0) were independently associated with inadequate glycemic control of diabetes (HbA1c>8.6%). Gender-stratified analyses showed that self-reported depression (AOR 19.8) and obesity (AOR 7.0) in women and smoking in men (AOR 4.2) were associated with HbA1c>8.6%. Alexithymia, antidepressant medication, and physical inactivity were associated with HbA1c>8.6% only in bivariate analyses. Alexithymia, self-rated anxiety, physical inactivity, and absence of abdominal obesity were associated with self-reported depression. Depression was the only psychological factor independently associated with HbA1c>8.6%. The association was of comparable importance as obesity and smoking, well-known risk factors for inadequate glycemic control and diabetes complications. The association between depression and HbA1c>8.6% was particularly strong for women. Alexithymia, which is a relatively stable personality trait, was associated with depression. In the future care of patients with diabetes, psychological aspects should be considered alongside anthropometrics and lifestyle factors in order to achieve the goals for HbA1c.

  20. Circulating sclerostin and estradiol levels are associated with inadequate response to bisphosphonates in postmenopausal women with osteoporosis.

    Science.gov (United States)

    Morales-Santana, Sonia; Díez-Pérez, Adolfo; Olmos, José M; Nogués, Xavier; Sosa, Manuel; Díaz-Curiel, Manuel; Pérez-Castrillón, José L; Pérez-Cano, Ramón; Torrijos, Antonio; Jodar, Esteban; Rio, Luis Del; Caeiro-Rey, José R; Reyes-García, Rebeca; García-Fontana, Beatriz; González-Macías, Jesús; Muñoz-Torres, Manuel

    2015-12-01

    The biological mechanisms associated with an inadequate response to treatment with bisphosphonates are not well known. This study investigates the association between circulating levels of sclerostin and estradiol with an inadequate clinical outcome to bisphosphonate therapy in women with postmenopausal osteoporosis. This case-control study is based on 120 Spanish women with postmenopausal osteoporosis being treated with oral bisphosphonates. Patients were classified as adequate responders (ARs, n=66, mean age 68.2±8 years) without incident fractures during 5 years of treatment, or inadequate responders (IRs, n=54, mean age 67±9 years), with incident fractures between 1 and 5 years of treatment. Bone mineral density (DXA), structural analysis of the proximal femur and structural/fractal analysis of the distal radius were assessed. Sclerostin concentrations were measured by ELISA and 17β-estradiol levels by radioimmunoassay based on ultrasensitive methods. In the ARs group, sclerostin serum levels were significantly lower (p=0.02) and estradiol concentrations significantly higher (p=0.023) than in the IRs group. A logistic regression analysis was performed, including as independent variables in the original model femoral fracture load, 25 hydroxyvitamin D, previus history of fragility fracture, sclerostin and estradiol. Only previous history of fragility fracture (OR 14.04, 95% CI 2.38-82.79, p=0.004) and sclerostin levels (OR 1.11, 95% CI 1.02-1.20, p=0.011), both adjusted by estradiol levels remained associated with IRs. Also, sclerostin concentrations were associated with the index of resistance to compression (IRC) in the fractal analysis of the distal radius, a parameter on bone microstructure. Sclerostin and estradiol levels are associated with the response to bisphosphonate therapy in women with postmenopausal osteoporosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Does periodontal disease cause cardiovascular disease? Analysis of epidemiological evidence

    OpenAIRE

    Cunha-Cruz, Joana; Nadanovsky, Paulo

    2003-01-01

    Este artigo é uma análise de estudos epidemiológicos que avaliaram a doença periodontal como causa de doenças cardiovasculares. Foram identificados 35 estudos por meio de busca manual nos volumes especiais de resumos do periódico Journal of Dental Research; de busca nos bancos de dados eletrônicos MEDLINE, LILACS e ISI; e da inspeção de bibliografias dos artigos identificados. Os critérios de inclusão foram: artigos em qualquer idioma publicados entre 1989 e 2000, que relataram a ausência ou ...

  2. Groundwater and enteric disease: A review of the epidemiological evidence

    Science.gov (United States)

    Globally, approximately 2.2 billion people rely on groundwater for daily consumption. It is widely accepted that groundwater typically represents a more pristine source of water for human consumption than surface water resources. While this assumption is frequently the case, groundwater is not ubiqu...

  3. Impacts of flood on health: epidemiologic evidence from Hanoi, Vietnam

    Directory of Open Access Journals (Sweden)

    Debarati Guha-Sapir

    2011-08-01

    Full Text Available Vietnam is one of the most disaster-prone countries in the world. The country suffers from many kinds of natural disasters, of which the most common and serious one is flooding. Long and heavy rainfall during the last days of October and the first week of November 2008 resulted in a devastating flood unseen for over three decades in the capital city of Hanoi. It caused a substantial health impact on residents in and around the city and compromised the capacity of local health services. The aim of this study is to ascertain the vulnerability and health impacts of the devastating flood in Hanoi by identifying the differences in mortality, injuries, and morbidity patterns (dengue, pink eye, dermatitis, psychological problems, and hypertension between flood affected and non-affected households. A cross-sectional study was carried out involving 871 households in four selected communes (two heavily flood affected and two comparatively less affected from two severely flooded districts of Hanoi. Participants were interviewed and information collected on the social, economic, and health impacts of the devastation within 1 month after the flood. The self-reported number of deaths and injuries reported in this study within 1 month after the heavy rainfall were a bit higher in severely affected communes as compared to that of the less affected communes of our study. The findings showed higher incidences of dengue fever, pink eye, dermatitis, and psychological problems in communes severely affected by flood as compared to that of the controlled communes. For people in flood prone areas (at risk for flooding, flood prevention and mitigation strategies need to be seriously thought through and acted upon, as these people are exposed to greater health problems such as psychological issues and communicable diseases such as pink eye or dermatitis.

  4. Death Associated with Inadequate Reassessment of Venous Thromboembolism Prophylaxis at and after Hospital Discharge.

    Science.gov (United States)

    2015-01-01

    Venous thromboembolism (VTE) prophylaxis, also known as thromboprophylaxis, reduces the risk of deep vein thrombosis, pulmonary embolism, and associated complications, including death, in high-risk patients. VTE prophylaxis is recommended for acutely ill, hospitalized medical patients at risk of thrombosis. Anticoagulants, the pharmacologic agents of choice to prevent VTE, are considered high-alert medications. By definition, therefore, anticoagulants bear a hightened risk of causing significant patient harm when they are used in error. As part of ongoing collaboration with a provincial death investigation service, ISMP Canada received a report of a fatal incident that involved continuation of VTE prophylaxis with enoxaparin for a patient discharge to a long-term care (LTC) facility from an acute care setting. The findings and recommendations from this case are charged to highlight the need to build routine reassessment of VTE prophylaxis into the process for discharging patients from the acute care setting and upon transfer to another facility or to primary care. The incident described in this bulletin highlights the importance of continually reassessing the need for VTE prophylaxis, especially at transitions of care, such as discharge from an acute care setting. Evidence and guidelines confirm the benefits of VTE prophylaxis in certain patients during a hospital stay for an acute illness, but the balance of benefits and risks may become unfavourable once the patient is discharged. Clear documentation from the acute care facility can assist the receiving facility and health-care providers, as well as family caregivers, when determining whether thromboprophylaxis is still warranted. Until clear guidance to continue thromboprophylaxis after acute care is available, health-care organizations and practitioners across the spectrum of care are urged to share and consider the strategies presented in this bulletin to ensure the safe use of VTE prophylaxis and improved

  5. Is epidemiology correcting its vision problem? A perspective on our perspective: 2012 presidential address for American College of Epidemiology.

    Science.gov (United States)

    McKeown, Robert E

    2013-10-01

    Epidemiology, like all disciplines, exists within and is shaped by a culture that frames its ways of understanding. In the last 60 years epidemiology as a discipline and scientific approach has undergone major transition, but remains challenged by vestiges of the limiting frameworks of our origins which shape the way we approach questions, and even the questions we choose to investigate. A part of the current transformation is a reframing of our perspective and a broadening of our methods to encourage creativity and to encompass new types of evidence and new approaches to investigation and interpretation. Epidemiologists are developing innovative ways to approach increasingly complex problems and becoming more open to multi-disciplinary approaches to solving epidemiologic challenges. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Epidemiology of stuttering: 21st century advances.

    Science.gov (United States)

    Yairi, Ehud; Ambrose, Nicoline

    2013-06-01

    Epidemiological advances in stuttering during the current century are reviewed within the perspectives of past knowledge. The review is organized in six sections: (a) onset, (b) incidence, (c) prevalence, (d) developmental paths, (e) genetics and (f) subtypes. It is concluded that: (1) most of the risk for stuttering onset is over by age 5, earlier than has been previously thought, with a male-to-female ratio near onset smaller than what has been thought, (2) there are indications that the lifespan incidence in the general population may be higher than the 5% commonly cited in past work, (3) the average prevalence over the lifespan may be lower than the commonly held 1%, (4) the effects of race, ethnicity, culture, bilingualism, and socioeconomic status on the incidence/prevalence of stuttering remain uncertain, (5) longitudinal, as well as incidence and prevalence studies support high levels of natural recovery from stuttering, (6) advances in biological genetic research have brought within reach the identification of candidate genes that contribute to stuttering in the population at large, (7) subtype-differentiation has attracted growing interest, with most of the accumulated evidence supporting a distinction between persistent and recovered subtypes. Readers will be exposed to a summary presentation of the most recent data concerning basic epidemiological factors in stuttering. Most of these factors also pertain to children's risks for experiencing stuttering onset, as well as risks for persistency. The article also aims to increase awareness of the implications of the information to research, and professional preparation that meets the epidemiology of the disorder. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Epidemiology of a thermonuclear bomb-burst over Nashville, Tennessee: a theoretic study

    International Nuclear Information System (INIS)

    Quinn, R.W.

    1983-01-01

    A thermonuclear bomb explosion over any city in the world would have a devastating effect on the population and environment. For those who survive, with or without injuries, life would become primitive with little or no uncontaminated food or water, and with inadequate housing, fuel, and medical care, resulting in a breakdown of family and interpersonal relationships. This theoretic study of the potential outcome of a thermonuclear bomb-burst over Nashville, Tennessee, discusses epidemiologically the wide range of medical and psychologic effects from the direct trauma of blast and fire, widespread epidemics of otherwise controlled disease, long-term chronic illness, genetic damage, and catastrophic environmental havoc

  8. Epidemiology and management of refractory lupus nephritis.

    Science.gov (United States)

    Pons-Estel, Guillermo J; Serrano, Rosa; Plasín, Miguel A; Espinosa, Gerard; Cervera, Ricard

    2011-09-01

    Although the survival of patients with lupus nephritis (LN) has improved considerably in recent years, refractory LN appears in a substantial proportion of patients and, therefore, treatment of LN remains a real challenge today. We will use the term "refractory" LN, for those cases with none or partial response to first-line therapies. In this sense, numerous epidemiological factors, including racial, socioeconomic, histological and serological parameters, may influence treatment response and, therefore, may have an impact on the outcome of renal involvement. Initial conventional therapy will depend somewhat on these epidemiological factors. If this initial therapy fails, fortunately today we have alternative therapies that include the multitarget therapy and the use of biologics. Published evidence about these therapies is presented in this review. Important terms in the management of LN, such as the definition of complete response, partial response, sustained response and renal flare as well as the discrimination of different types of flare, are also discussed here according to the European consensus statement on the terminology used in the management of lupus glomerulonephritis. Copyright © 2011 Elsevier B.V. All rights reserved.

  9. Inadequate Iodine Intake in Population Groups Defined by Age, Life Stage and Vegetarian Dietary Practice in a Norwegian Convenience Sample.

    Science.gov (United States)

    Brantsæter, Anne Lise; Knutsen, Helle Katrine; Johansen, Nina Cathrine; Nyheim, Kristine Aastad; Erlund, Iris; Meltzer, Helle Margrete; Henjum, Sigrun

    2018-02-17

    Inadequate iodine intake has been identified in populations considered iodine replete for decades. The objective of the current study is to evaluate urinary iodine concentration (UIC) and the probability of adequate iodine intake in subgroups of the Norwegian population defined by age, life stage and vegetarian dietary practice. In a cross-sectional survey, we assessed the probability of adequate iodine intake by two 24-h food diaries and UIC from two fasting morning spot urine samples in 276 participants. The participants included children ( n = 47), adolescents ( n = 46), adults ( n = 71), the elderly ( n = 23), pregnant women ( n = 45), ovo-lacto vegetarians ( n = 25), and vegans ( n = 19). In all participants combined, the median (95% CI) UIC was 101 (90, 110) µg/L, median (25th, 75th percentile) calculated iodine intake was 112 (77, 175) µg/day and median (25th, 75th percentile) estimated usual iodine intake was 101 (75, 150) µg/day. According to WHOs criteria for evaluation of median UIC, iodine intake was inadequate in the elderly, pregnant women, vegans and non-pregnant women of childbearing age. Children had the highest (82%) and vegans the lowest (14%) probability of adequate iodine intake according to reported food and supplement intakes. This study confirms the need for monitoring iodine intake and status in nationally representative study samples in Norway.

  10. Schoolchildren have similar predicted prevalences of inadequate intakes as toddlers in village populations in Egypt, Kenya, and Mexico.

    Science.gov (United States)

    Murphy, S P; Calloway, D H; Beaton, G H

    1995-09-01

    To examine the probability of inadequacy of schoolchild nutrient intakes; to compare the predicted adequacy of schoolchild diets to previously published data for toddler diets and to examine the relative adequacy of the diets of sibling pairs. Food consumption data were measured 2 days per month across approximately one year. Mean nutrient intakes were calculated and compared to international standards using a probability approach. Villages in Egypt, Kenya, and Mexico. 285 school-age children (7-9 years of age) and 255 toddlers (18-30 months of age) including 94 sibling pairs. Within a country, there was a striking similarity between the nutrients predicted to be inadequate in schoolchild and toddler diets across all nutrients except vitamin B12, which was more likely to be inadequate among schoolchildren. Nutrients of concern for both ages in one or more countries included iron, zinc, calcium, riboflavin, and vitamins B12, D, E, and A. For 94 toddler-schoolchild pairs, siblings at high risk of nutrient inadequacy could be identified from an indicator child with a sensitivity of 43-100% and a specificity of 59-100%. Nutrient adequacy tends to be a household characteristic for these two ages of children. Nutritional interventions that target the household have a high probability of benefitting multiple age groups of children.

  11. Inadequate Iodine Intake in Population Groups Defined by Age, Life Stage and Vegetarian Dietary Practice in a Norwegian Convenience Sample

    Directory of Open Access Journals (Sweden)

    Anne Lise Brantsæter

    2018-02-01

    Full Text Available Inadequate iodine intake has been identified in populations considered iodine replete for decades. The objective of the current study is to evaluate urinary iodine concentration (UIC and the probability of adequate iodine intake in subgroups of the Norwegian population defined by age, life stage and vegetarian dietary practice. In a cross-sectional survey, we assessed the probability of adequate iodine intake by two 24-h food diaries and UIC from two fasting morning spot urine samples in 276 participants. The participants included children (n = 47, adolescents (n = 46, adults (n = 71, the elderly (n = 23, pregnant women (n = 45, ovo-lacto vegetarians (n = 25, and vegans (n = 19. In all participants combined, the median (95% CI UIC was 101 (90, 110 µg/L, median (25th, 75th percentile calculated iodine intake was 112 (77, 175 µg/day and median (25th, 75th percentile estimated usual iodine intake was 101 (75, 150 µg/day. According to WHOs criteria for evaluation of median UIC, iodine intake was inadequate in the elderly, pregnant women, vegans and non-pregnant women of childbearing age. Children had the highest (82% and vegans the lowest (14% probability of adequate iodine intake according to reported food and supplement intakes. This study confirms the need for monitoring iodine intake and status in nationally representative study samples in Norway.

  12. Pregabalin for the treatment of patients with generalized anxiety disorder with inadequate treatment response to antidepressants and severe depressive symptoms.

    Science.gov (United States)

    Olivares, José M; Álvarez, Enrique; Carrasco, José L; Pérez Páramo, María; López-Gómez, Vanessa

    2015-09-01

    To evaluate the effectiveness of pregabalin in patients with resistant generalized anxiety disorder (GAD) and severe depressive symptoms, we carried out a post-hoc analysis of a multicenter, prospective, and observational 6-month study. We included patients who were at least 18 years old, fulfilled the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for GAD, showed inadequate responses to previous courses of antidepressant treatment, had Montgomery-Asberg Rating Scale scores of at least 35, had not received pregabalin previously, and were prescribed pregabalin upon entry into this study. We included 1815 patients fulfilling the DSM-IV criteria for GAD, and 133 (7.3%) fulfilled the selection criteria for these analyses. Ninety-seven percent of the patients received pregabalin (mean dose: 222 mg/day) in combination with other psychotropics. The Hamilton Anxiety Scale total score was reduced by a mean of 20.3 points (95% confidence interval, 22.1-18.4) (57.2% reduction) at month 6. Pregabalin also ameliorated comorbid depressive symptoms, with a reduction in the mean score of the Montgomery-Asberg Rating Scale of 22.3 points (95% confidence interval, 24.2-20.4) (56.6% reduction). Our results suggest that pregabalin, as part of a combination regimen with antidepressants and/or benzodiazepines, might be effective for the treatment of patients with GAD who have shown inadequate response to previous antidepressants and have severe depressive symptoms.

  13. Inadequate evaluation and management of threats in Australia's Marine Parks, including the Great Barrier Reef, misdirect Marine conservation.

    Science.gov (United States)

    Kearney, Bob; Farebrother, Graham

    2014-01-01

    The magnificence of the Great Barrier Reef and its worthiness of extraordinary efforts to protect it from whatever threats may arise are unquestioned. Yet almost four decades after the establishment of the Great Barrier Reef Marine Park, Australia's most expensive and intensely researched Marine Protected Area, the health of the Reef is reported to be declining alarmingly. The management of the suite of threats to the health of the reef has clearly been inadequate, even though there have been several notable successes. It is argued that the failure to prioritise correctly all major threats to the reef, coupled with the exaggeration of the benefits of calling the park a protected area and zoning subsets of areas as 'no-take', has distracted attention from adequately addressing the real causes of impact. Australia's marine conservation efforts have been dominated by commitment to a National Representative System of Marine Protected Areas. In so doing, Australia has displaced the internationally accepted primary priority for pursuing effective protection of marine environments with inadequately critical adherence to the principle of having more and bigger marine parks. The continuing decline in the health of the Great Barrier Reef and other Australian coastal areas confirms the limitations of current area management for combating threats to marine ecosystems. There is great need for more critical evaluation of how marine environments can be protected effectively and managed efficiently.

  14. Epidemiological Approaches to Metal Toxicology

    DEFF Research Database (Denmark)

    Grandjean, Philippe; Budtz-Jørgensen, Esben

    2014-01-01

    Epidemiological methods are crucial to extract as much valid information as possible from human metal exposures. Thus, modern epidemiological approaches have elucidated human health effects that were not apparent in the past. At the same time, metal toxicology has served as a useful arena...... for testing and further refining methods for study design and data analysis. In contrast to most organic compounds, metals are not broken down, and many of them are retained in the body for long periods, thereby facilitating exposure assessment. In conjunction with the use of inexpensive metal analytical...... to their propensity to cause chronic or delayed toxicity, epidemiological studies of metal toxicity have focused on a wide variety of organ systems, subtle effects as well as mortality, and differences in susceptibility. Toxic metals often serve as paradigms of environmental and occupational toxicity...

  15. Epidemiología de campo y epidemiología social Field epidemiology and social epidemiology

    Directory of Open Access Journals (Sweden)

    Javier Segura del Pozo

    2006-03-01

    Full Text Available Mediante la comparación de la epidemiología de campo y la epidemiología social, se pretende reflexionar sobre los imaginarios no explícitos que operan en ambos ámbitos, necesariamente convergentes, sobre los obstáculos de la práctica epidemiológica actual para alcanzar su función social y sobre la necesidad de cambiar las bases epistemológicas, metodológicas y prácticas que operan en la epidemiología, empezando por la formación del epidemiólogo de campo. La epidemiología de campo tiende a la acción sin marco teórico. La epidemiología social, por el contrario, tiende a los desarrollos teóricos (reflexión e investigación sobre los determinantes sociales alejados de la acción, debido a los limitantes para cambiar las políticas públicas. Otras diferencias se sitúan en el nivel de intervención (micro/macroespacios, el objeto de intervención (control del brote frente a control de las desigualdades y en la forma de articular la comunicación con la sociedad. Se asemejan en la preocupación por el método, la predominancia de una orientación positivista y condicionada por la estadística, aunque en proceso de cierta apertura epistemológica, la tensión experimentada entre relacionarse con un mundo virtual de bases de datos o con la sociedad real, su situación en la periferia del sistema político-social-institucional-profesional y por estar abocadas a la frustración profesional. Finalmente, se formulan 10 interrogantes a los epidemiólogos de campo sobre su práctica actual, a través de los cuales se podría evaluar si están realizando una epidemiología social, y se sugieren cambios para introducir en la formación y práctica del epidemiólogo.Comparing field epidemiology and social epidemiology, we pretend to think about the no explicit images and meanings operating in both necessary convergent fields, about the obstacles present in epidemiological practice to fulfil its social function and about the necessity of

  16. The risk and consequences of clinical miscoding due to inadequate medical documentation: a case study of the impact on health services funding.

    Science.gov (United States)

    Cheng, Ping; Gilchrist, Annette; Robinson, Kerin M; Paul, Lindsay

    As coded clinical data are used in a variety of areas (e.g. health services funding, epidemiology, health sciences research), coding errors have the potential to produce far-reaching consequences. In this study the causes and consequences of miscoding were reviewed. In particular, the impact of miscoding due to inadequate medical documentation on hospital funding was examined. Appropriate reimbursement of hospital revenue in the casemix-based (output-based) funding system in the state of Victoria, Australia relies upon accurate, comprehensive, and timely clinical coding. In order to assess the reliability of these data in a Melbourne tertiary hospital, this study aimed to: (a) measure discrepancies in clinical code assignment; (b) identify resultant Diagnosis Related Group (DRG) changes; (c) identify revenue shifts associated with the DRG changes; (d) identify the underlying causes of coding error and DRG change; and (e) recommend strategies to address the aforementioned. An internal audit was conducted on 752 surgical inpatient discharges from the hospital within a six-month period. In a blind audit, each episode was re-coded. Comparisons were made between the original codes and the auditor-assigned codes, and coding errors were grouped and statistically analysed by categories. Changes in DRGs and weighted inlier-equivalent separations (WIES) were compared and analysed, and underlying factors were identified. Approximately 16% of the 752 cases audited reflected a DRG change, equating to a significant revenue increase of nearly AU$575,300. Fifty-six percent of DRG change cases were due to documentation issues. Incorrect selection or coding of the principal diagnosis accounted for a further 13% of the DRG changes, and missing additional diagnosis codes for 29%. The most significant of the factors underlying coding error and DRG change was poor quality of documentation. It was concluded that the auditing process plays a critical role in the identification of causes

  17. Molecular epidemiology of human rhinoviruses

    OpenAIRE

    Savolainen-Kopra, Carita

    2006-01-01

    The first part of this work investigates the molecular epidemiology of a human enterovirus (HEV), echovirus 30 (E-30). This project is part of a series of studies performed in our research team analyzing the molecular epidemiology of HEV-B viruses. A total of 129 virus strains had been isolated in different parts of Europe. The sequence analysis was performed in three different genomic regions: 420 nucleotides (nt) in the VP4/VP2 capsid protein coding region, the entire VP1 capsid protein cod...

  18. Nephrogenic systemic fibrosis: epidemiology update

    DEFF Research Database (Denmark)

    Marckmann, P.

    2008-01-01

    Purpose of review The aim of this article is to outline the history of nephrogenic systemic fibrosis, a new and serious disease of patients with renal failure, and to give an update on its aetiology and prevalence. Recent findings Epidemiological and histochemical studies demonstrated that gadoli......Purpose of review The aim of this article is to outline the history of nephrogenic systemic fibrosis, a new and serious disease of patients with renal failure, and to give an update on its aetiology and prevalence. Recent findings Epidemiological and histochemical studies demonstrated...

  19. Epidemiology, Molecular Epidemiology and Evolution of Bovine Respiratory Syncytial Virus

    Directory of Open Access Journals (Sweden)

    Gilberto Vaughan

    2012-11-01

    Full Text Available The bovine respiratory syncytial virus (BRSV is an enveloped, negative sense, single-stranded RNA virus belonging to the pneumovirus genus within the family Paramyxoviridae. BRSV has been recognized as a major cause of respiratory disease in young calves since the early 1970s. The analysis of BRSV infection was originally hampered by its characteristic lability and poor growth in vitro. However, the advent of numerous immunological and molecular methods has facilitated the study of BRSV enormously. The knowledge gained from these studies has also provided the opportunity to develop safe, stable, attenuated virus vaccine candidates. Nonetheless, many aspects of the epidemiology, molecular epidemiology and evolution of the virus are still not fully understood. The natural course of infection is rather complex and further complicates diagnosis, treatment and the implementation of preventive measures aimed to control the disease. Therefore, understanding the mechanisms by which BRSV is able to establish infection is needed to prevent viral and disease spread. This review discusses important information regarding the epidemiology and molecular epidemiology of BRSV worldwide, and it highlights the importance of viral evolution in virus transmission.

  20. Epidemiology of youth suicide and suicidal behavior.

    Science.gov (United States)

    Cash, Scottye J; Bridge, Jeffrey A

    2009-10-01

    Suicide is the third leading cause of death among young people in the U.S. and represents a significant public health problem worldwide. This review focuses on recent developments in our understanding of the epidemiology and risk factors for adolescent suicide and suicidal behavior. The suicide rate among children and adolescents in the U.S. has increased dramatically in recent years and has been accompanied by substantial changes in the leading methods of youth suicide, especially among young girls. Much work is currently underway to elucidate the relationships between psychopathology, substance use, child abuse, bullying, internet use, and youth suicidal behavior. Recent evidence also suggests sex-specific and moderating roles of sex in influencing risk for suicide and suicidal behavior. Empirical research into the causal mechanisms underlying youth suicide and suicidal behavior is needed to inform early identification and prevention efforts.

  1. The Epidemiology of Obesity: A Big Picture

    Science.gov (United States)

    Hruby, Adela; Hu, Frank B.

    2016-01-01

    The epidemic of overweight and obesity presents a major challenge to chronic disease prevention and health across the life course around the world. Fueled by economic growth, industrialization, mechanized transport, urbanization, an increasingly sedentary lifestyle, and a nutritional transition to processed foods and high calorie diets over the last 30 years, many countries have witnessed the prevalence of obesity in its citizens double, and even quadruple. Rising prevalence of childhood obesity, in particular, forebodes a staggering burden of disease in individuals and healthcare systems in the decades to come. A complex, multifactorial disease, with genetic, behavioral, socioeconomic, and environmental origins, obesity raises risk of debilitating morbidity and mortality. Relying primarily on epidemiologic evidence published within the last decade, this non-exhaustive review discusses the extent of the obesity epidemic, its risk factors—known and novel—, sequelae, and economic impact across the globe. PMID:25471927

  2. Hvad er epidemiologi og hvad er cancerepidemiologi?

    DEFF Research Database (Denmark)

    Olsen, Jørn; Storm, Hans-Henrik

    2002-01-01

    What is epidemiology and what is cancer epidemiology? Ugeskr Læger 2002; 164: 2871-6. We have the world's oldest cancer registry in Denmark. We also have a cancer society that has invested substantial funds in epidemiology, which have been well used by highly skilled cancer epidemiologists....... This is the formula for success. Cancer epidemiology, which is now conducted at the highest international level in Denmark, is a subdiscipline within epidemiology, and most of its activities are related to public health problems. Clinical cancer epidemiology is, however, a field which will grow in the next decades...

  3. Epidemiology, costs, and the economic burden of fibromyalgia

    OpenAIRE

    Spaeth, Michael

    2009-01-01

    The assumption that fibromyalgia is associated with a major impact on the utilization of both healthcare and nonhealthcare resources has not been thoroughly supported by evidence-based data. Despite the differences between healthcare and sociopolitical systems in various countries, more recent results from epidemiological research now clearly demonstrate the socioeconomic burden of fibromyalgia and its comorbidities. The costs of the disease, calculated in single studies and countries, allow ...

  4. Epidemiologic Insights into Stone Disease as a Systemic Disorder

    Science.gov (United States)

    Curhan, Gary C.

    2007-04-01

    Examining the epidemiology of stone disease can provide insight into etiology. There is a growing body of evidence that stone disease is not simply a disorder of the kidney. In fact, nephrolithiasis is clearly a systemic disorder. Conditions associated with stone disease include the classic ones such as inflammatory bowel disease and primary hyperparathyroidism. More recent studies have demonstrated strong associations with obesity, gout, diabetes and hypertension. Future studies will help uncover the underlying common pathophysiologic abnormalities.

  5. Epidemiological methods: a brief review

    International Nuclear Information System (INIS)

    Winkelstein, W. Jr.

    1983-01-01

    Epidemiology, the study of disease distributions in populations and the factors which influence these distributions, is an observational science, i.e., its data base consists of measurements made on free living individuals characterized by presence or absence of disease states and putative risk factors. Epidemiological studies are usually classified as descriptive or analytical. Descriptive studies are primarily used for planning and evaluating health programs or to generate etiological hypotheses. Analytical studies are primarily used for testing etiological hypotheses. Analytical studies are designed either as cohort investigations in which populations with and without a putative risk factor are followed through time to ascertain their differential incidence of disease, or case-control investigations in which the history of exposure to a putative risk factor is compared among persons with a disease and appropriate controls free of disease. Both descriptive and analytical epidemiological studies have been applied to health physics problems. Examples of such problems and the epidemiological methods used to explore them will be presented

  6. Epidemiologic issues in interstitial cystitis

    NARCIS (Netherlands)

    Parsons, J. Kellogg; Kurth, Karlheinz; Sant, Grannum R.

    2007-01-01

    As a result of variations in disease definition and diagnostic criteria for interstitial cystitis (IC), the performance of epidemiologic studies has been challenging. Initial prevalence studies used physician-confirmed diagnoses of IC; more recent studies, which have incorporated the use of patient

  7. Epidemiology in public health practice

    NARCIS (Netherlands)

    Haveman-Nies, A.; Jansen, M.; Oers, van J.A.M.; Veer, van 't P.

    2017-01-01

    Over the past decades, epidemiology has made a relevant contribution to public health by identifying health problems and analysing their determinants. Recent developments call for new and applied methods to support the planning, implementation and evaluation of public health policies and programmes.

  8. Epidemiology in public health practice

    NARCIS (Netherlands)

    Haveman-Nies, A.; Jansen, S.; Oers, van H.; Veer, van 't P.

    2010-01-01

    Over the past decades, epidemiology has made a relevant contribution to public health by identifying health problems and analysing their determinants. However, recent developments call for new and applied methods to support the planning, implementation and evaluation of public health policies and

  9. Glossary for econometrics and epidemiology.

    Science.gov (United States)

    Gunasekara, F Imlach; Carter, K; Blakely, T

    2008-10-01

    Epidemiologists and econometricians are often interested in similar topics-socioeconomic position and health outcomes-but the different languages that epidemiologists and economists use to interpret and discuss their results can create a barrier to mutual communication. This glossary defines key terms used in econometrics and epidemiology to assist in bridging this gap.

  10. Brain Tumor Epidemiology Consortium (BTEC)

    Science.gov (United States)

    The Brain Tumor Epidemiology Consortium is an open scientific forum organized to foster the development of multi-center, international and inter-disciplinary collaborations that will lead to a better understanding of the etiology, outcomes, and prevention of brain tumors.

  11. Epidemiology of subtypes of depression

    DEFF Research Database (Denmark)

    Kessing, L V

    2007-01-01

    OBJECTIVE: There is a general clinical impression that depression differs qualitatively from non-depressive conditions, and that it can be identified as a categorical entity. In contrast, epidemiological studies support the view that depression is dynamic in nature and develops on a continuous sc...... of more severe and substantial illness such as melancholia....

  12. Nephrogenic systemic fibrosis: epidemiology update

    DEFF Research Database (Denmark)

    Marckmann, P.

    2008-01-01

    Purpose of review The aim of this article is to outline the history of nephrogenic systemic fibrosis, a new and serious disease of patients with renal failure, and to give an update on its aetiology and prevalence. Recent findings Epidemiological and histochemical studies demonstrated that gadoli...

  13. Epidemiology of acute wrist trauma

    DEFF Research Database (Denmark)

    Larsen, C F; Lauritsen, Jens

    1993-01-01

    Epidemiological data on wrist injuries in a population can be used for planning by applying them to criteria for care and thus deriving estimates of provisions for care according to currently desirable standards. In a 1-year study all patients > or = 15 years with acute wrist trauma and treated...

  14. Radiation epidemiology: Past and present

    International Nuclear Information System (INIS)

    Boice, J.D. Jr.

    1997-01-01

    Major advancements in radiation epidemiology have occurred during the last several years in studies of atomic bomb survivors, patients given medical radiation, and radiation workers, including underground miners. Risks associated with the Chernobyl accident, indoor radon and childhood exposure to I-131 have yet to be elucidated. Situations in the former Soviet Union around Chelyabinsk, a nuclear installation in the southern Urals, and in the Altai, which received radioactive fallout from weapons testing at Semipalatinsk, Kazakhstan, have the potential to provide information on the effects of chronic radiation exposure. Since Roentgen's discovery of x-rays just 100 years ago, a tremendous amount of knowledge has been accumulated about human health effects following irradiation. The 1994 UNSCEAR report contains the latest compilation and synthesis of radiation epidemiology. This overview will cover epidemiology from a radiation perspective. The different types of study methodologies will be described, followed by a kaleidoscope coverage of past and present studies; ending with some remaining questions in radiation epidemiology. This should set the stage for future chapters, and stimulate thinking about implications of the new data on radiation cancer risks

  15. [Epidemiology of prostate cancer].

    Science.gov (United States)

    Becker, N

    2011-11-01

    Since a number of years, prostate cancer has been the most frequent cancer site among men in Germany and has replaced lung cancer as the leading position. Among the most frequent cancer sites, it is the one with the lowest available knowledge about etiology. Smoking and alcohol apparently do not play a role. Regarding food intake, indications exist for a protective association to tomatoes or lycopene consumption and a protective association was also seen with high physical activity, while risk seems to be elevated in obese men. Associations to hormonal factors have been observed and are under consideration. Trials with potential chemopreventive agents have been unsuccessful so far. For early detection, digital rectal examination has been part of the German statutory early detection program" from the very beginning in 1971 and the test for prostate specific antigen (PSA) is being used in the framework of the so-called individual health services, both without scientific evidence of effectiveness. The available data show that the progression of prostate cancer to the leading male cancer site was chiefly driven by the unstructured introduction of the PSA test as a screening tool. Cynically addressed, the figures indicate that the most efficient known preventive intervention was not to attend screening. This delicate situation should, however, not discourage from further examinations of prostate cancer screening. Recent results including the European randomized prostate cancer screening study (ERSPC) indicated that intelligently structured screening, possibly even using the PSA test, might be effective. Before routine application the novel approaches also have to be scrutinized in a research setting.

  16. [Epidemiology of shoulder dystocia].

    Science.gov (United States)

    Deneux-Tharaux, C; Delorme, P

    2015-12-01

    To synthetize the available evidence regarding the incidence and risk factors of shoulder dystocia (SD). Consultation of the Medline database, and of national guidelines. Shoulder dystocia is defined as a vaginal delivery that requires additional obstetric manoeuvres to deliver the foetus after the head has delivered and gentle traction has failed. With this definition, the incidence of SD in population-based studies is about 0.5-1% of vaginal deliveries. Many risk factors have been described but most associations are not independent, or have not been constantly found. The 2 characteristics consistently found as independent risk factors for SD in the literature are previous SD (incidence of SD of about 10% in parturients with previous SD) and foetal macrosomia. Maternal diabetes and obesity also are associated with a higher risk of SD (2 to 4 folds) but these associations may be completely explained by foetal macrosomia. However, even factors independently and constantly associated with SD do not allow a valid prediction of SD because they are not discriminant; 50 to 70% of SD cases occur in their absence, and the great majority of deliveries when they are present is not associated with SD. Shoulder dystocia is defined by the need for additional obstetric manoeuvres to deliver the foetus after the head has delivered and gentle traction has failed, and complicates 0.5-1% of vaginal deliveries. Its main risk factors are previous SD and macrosomia, but they are poorly predictive. SD remains a non-predictable obstetrics emergency. Knowledge of SD risk factors should increase the vigilance of clinicians in at-risk contexts. Copyright © 2015. Published by Elsevier Masson SAS.

  17. Ionizing radiation biomarkers for potential use in epidemiological studies

    International Nuclear Information System (INIS)

    Pernot, Eileen; Cardis, Elisabeth; Hall, Janet; Baatout, Sarah; El Saghire, Houssein; Mohammed Abderrafi Benotmane; Roel Quintens; Blanchardon, Eric; Bouffler, Simon; Gomolka, Maria; Guertler, Anne; Kreuzer, Michaela; Harms-Ringdahl, Mats; Jeggo, Penny; Laurier, Dominique; Lindholm, Carita; Mkacher, Radhia; Sabatier, Laure; Tapio, Soile; De Vathaire, Florent

    2012-01-01

    Ionizing radiation is a known human carcinogen that can induce a variety of biological effects depending on the physical nature, duration, doses and dose-rates of exposure. However, the magnitude of health risks at low doses and dose-rates (below 100 mSv and/or 0.1 mSv min -1 ) remains controversial due to a lack of direct human evidence. It is anticipated that significant insights will emerge from the integration of epidemiological and biological research, made possible by molecular epidemiology studies incorporating biomarkers and bioassays. A number of these have been used to investigate exposure, effects and susceptibility to ionizing radiation, albeit often at higher doses and dose rates, with each reflecting time-limited cellular or physiological alterations. This review summarises the multidisciplinary work undertaken in the framework of the European project DoReMi (Low Dose Research towards Multidisciplinary Integration) to identify the most appropriate biomarkers for use in population studies. In addition to logistical and ethical considerations for conducting large-scale epidemiological studies, we discuss the relevance of their use for assessing the effects of low dose ionizing radiation exposure at the cellular and physiological level. We also propose a temporal classification of biomarkers that may be relevant for molecular epidemiology studies which need to take into account the time elapsed since exposure. Finally, the integration of biology with epidemiology requires careful planning and enhanced discussions between the epidemiology, biology and dosimetry communities in order to determine the most important questions to be addressed in light of pragmatic considerations including the appropriate population to be investigated (occupationally, environmentally or medically exposed), and study design. The consideration of the logistics of biological sample collection, processing and storing and the choice of biomarker or bioassay, as well as awareness of

  18. Mitochondrial DNA and Cancer Epidemiology Workshop

    Science.gov (United States)

    A workshop to review the state-of-the science in the mitochondrial DNA field and its use in cancer epidemiology, and to develop a concept for a research initiative on mitochondrial DNA and cancer epidemiology.

  19. Development and application of Human Genome Epidemiology

    Science.gov (United States)

    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.

  20. Rocky Mountain Spotted Fever: Statistics and Epidemiology

    Science.gov (United States)

    ... tick Diseases transmitted by ticks More Statistics and Epidemiology Recommend on Facebook Tweet Share Compartir Rocky Mountain ... lower case fatality rate observed in recent decades. Epidemiology Figure 1 – Reported incidence and case fatality of ...

  1. About the Epidemiology and Genomics Research Program

    Science.gov (United States)

    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.

  2. Travel epidemiology: the Saudi perspective.

    Science.gov (United States)

    Memish, Ziad A; Venkatesh, S; Ahmed, Qanta A

    2003-02-01

    The Kingdom of Saudi Arabia occupies four-fifths of the Arabian Peninsula, with a land area of 2 million square kilometres. Saudi Arabia holds a unique position in the Islamic world, as the custodian of the two holiest places of Islam, in Mecca and Medina. Annually, some 2 million Muslims from over 140 countries embark on Hajj. This extraordinary en masse migration is a unique forum for the study of travel epidemiology since the Hajj carries various health risks, both communicable and non-communicable, often on a colossal scale. Non-communicable hazards of the Hajj include stampede and motor vehicle trauma, fire-related burn injuries and accidental hand injury during animal slaughter. Communicable hazards in the form of outbreaks of multiple infectious diseases have been reported repeatedly, during and following the Hajj. Meningococcal meningitis, gastroenteritis, hepatitis A, B and C, and various zoonotic diseases comprise some of the possible infectious hazards at the Hajj. Many of these infectious and non-infectious hazards can be avoided or averted by adopting appropriate prophylactic measures. Physicians and health personnel must be aware of these risks to appropriately educate, immunize and prepare these travellers facing the unique epidemiological challenges of Hajj in an effort to minimize untoward effects. Travel epidemiology related to the Hajj is a new and exciting area, which offers valuable insights to the travel specialist. The sheer scale of numbers affords a rare view of migration medicine in action. As data is continually gathered and both national and international policy making is tailored to vital insights gained through travel epidemiology, the Hajj will be continually safeguarded. Practitioners will gain from findings of travel related epidemiological changes in evolution at the Hajj: the impact of vaccinating policies, infection control policies and public health are afforded a real-world laboratory setting at each annual Hajj, allowing us to

  3. Effect of adjunct metformin treatment in patients with type-1 diabetes and persistent inadequate glycaemic control. A randomized study

    DEFF Research Database (Denmark)

    Lund, S.S.; Tarnow, L.; Astrup, A.S.

    2008-01-01

    BACKGROUND: Despite intensive insulin treatment, many patients with type-1 diabetes (T1DM) have longstanding inadequate glycaemic control. Metformin is an oral hypoglycaemic agent that improves insulin action in patients with type-2 diabetes. We investigated the effect of a one-year treatment...... with metformin versus placebo in patients with T1DM and persistent poor glycaemic control. METHODOLOGY/PRINCIPAL FINDINGS: One hundred patients with T1DM, preserved hypoglycaemic awareness and HaemoglobinA(1c) (HbA(1c)) > or = 8.5% during the year before enrolment entered a one-month run-in on placebo treatment....... Thereafter, patients were randomized (baseline) to treatment with either metformin (1 g twice daily) or placebo for 12 months (double-masked). Patients continued ongoing insulin therapy and their usual outpatient clinical care. The primary outcome measure was change in HbA(1c) after one year of treatment...

  4. A survey of breakfast-skipping and inadequate breakfast-eating among young schoolchildren in Nova Scotia.

    Science.gov (United States)

    McIntyre, L

    1993-01-01

    The prevalence of breakfast-skipping and inadequate breakfast-eating among schoolchildren in Nova Scotia was determined by surveying 2,500 children in Grades 1 to 3 in 25 randomly selected schools. Breakfast-skipping was measured on two occasions using a validated survey instrument administered by videotaped child entertainers. 4.8% of children came to school without eating or drinking anything on the morning of testing. Breakfast omission was significantly related to grade with 6.1% of Grade 1 children skipping breakfast compared with 3.2% in Grade 3. Boys were significantly more likely to skip breakfast than girls but the absolute differences were small. 86% of children consumed a breakfast including two food groups; 56% three food groups. Adequacy of consumption was poorer in lower grades but did not vary by other sociodemographic variables. Breakfast omission in Nova Scotia children attending Grades 1, 2 or 3 does not warrant a provincial public health response.

  5. TG13 current terminology, etiology, and epidemiology of acute cholangitis and cholecystitis

    NARCIS (Netherlands)

    Kimura, Yasutoshi; Takada, Tadahiro; Strasberg, Steven M.; Pitt, Henry A.; Gouma, Dirk J.; Garden, O. James; Büchler, Markus W.; Windsor, John A.; Mayumi, Toshihiko; Yoshida, Masahiro; Miura, Fumihiko; Higuchi, Ryota; Gabata, Toshifumi; Hata, Jiro; Gomi, Harumi; Dervenis, Christos; Lau, Wan-Yee; Belli, Giulio; Kim, Myung-Hwan; Hilvano, Serafin C.; Yamashita, Yuichi

    2013-01-01

    While referring to the evidence adopted in the Tokyo Guidelines 2007 (TG07) as well as subsequently obtained evidence, further discussion took place on terminology, etiology, and epidemiological data. In particular, new findings have accumulated on the occurrence of symptoms in patients with

  6. The Effect of Inadequate Initial Empiric Antimicrobial Treatment on Mortality in Critically Ill Patients with Bloodstream Infections: A Multi-Centre Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Rachel D Savage

    Full Text Available Hospital mortality rates are elevated in critically ill patients with bloodstream infections. Given that mortality may be even higher if appropriate treatment is delayed, we sought to determine the effect of inadequate initial empiric treatment on mortality in these patients. A retrospective cohort study was conducted across 13 intensive care units in Canada. We defined inadequate initial empiric treatment as not receiving at least one dose of an antimicrobial to which the causative pathogen(s was susceptible within one day of initial blood culture. We evaluated the association between inadequate initial treatment and hospital mortality using a random effects multivariable logistic regression model. Among 1,190 patients (1,097 had bacteremia and 93 had candidemia, 476 (40% died and 266 (22% received inadequate initial treatment. Candidemic patients more often had inadequate initial empiric therapy (64.5% versus 18.8%, as well as longer delays to final culture results (4 vs 3 days and appropriate therapy (2 vs 0 days. After adjustment, there was no detectable association between inadequate initial treatment and mortality among bacteremic patients (Odds Ratio (OR: 1.02, 95% Confidence Interval (CI 0.70-1.48; however, candidemic patients receiving inadequate treatment had nearly three times the odds of death (OR: 2.89, 95% CI: 1.05-7.99. Inadequate initial empiric antimicrobial treatment was not associated with increased mortality in bacteremic patients, but was an important risk factor in the subgroup of candidemic patients. Further research is warranted to improve early diagnostic and risk prediction methods in candidemic patients.

  7. Distinguishing the impacts of inadequate prey and vessel traffic on an endangered killer whale (Orcinus orca population.

    Directory of Open Access Journals (Sweden)

    Katherine L Ayres

    Full Text Available Managing endangered species often involves evaluating the relative impacts of multiple anthropogenic and ecological pressures. This challenge is particularly formidable for cetaceans, which spend the majority of their time underwater. Noninvasive physiological approaches can be especially informative in this regard. We used a combination of fecal thyroid (T3 and glucocorticoid (GC hormone measures to assess two threats influencing the endangered southern resident killer whales (SRKW; Orcinus orca that frequent the inland waters of British Columbia, Canada and Washington, U.S.A. Glucocorticoids increase in response to nutritional and psychological stress, whereas thyroid hormone declines in response to nutritional stress but is unaffected by psychological stress. The inadequate prey hypothesis argues that the killer whales have become prey limited due to reductions of their dominant prey, Chinook salmon (Oncorhynchus tshawytscha. The vessel impact hypothesis argues that high numbers of vessels in close proximity to the whales cause disturbance via psychological stress and/or impaired foraging ability. The GC and T3 measures supported the inadequate prey hypothesis. In particular, GC concentrations were negatively correlated with short-term changes in prey availability. Whereas, T3 concentrations varied by date and year in a manner that corresponded with more long-term prey availability. Physiological correlations with prey overshadowed any impacts of vessels since GCs were lowest during the peak in vessel abundance, which also coincided with the peak in salmon availability. Our results suggest that identification and recovery of strategic salmon populations in the SRKW diet are important to effectively promote SRKW recovery.

  8. Capillary Blood Ketone Levels as an Indicator of Inadequate Breast Milk Intake in the Early Neonatal Period.

    Science.gov (United States)

    Futatani, Takeshi; Shimao, Ayako; Ina, Shihomi; Higashiyama, Hiroyuki; Fujita, Shuhei; Ueno, Kazuyuki; Igarashi, Noboru; Hatasaki, Kiyoshi

    2017-12-01

    To determine the utility of capillary blood ketone levels as an indicator of inadequate intake of breast milk in the early postnatal period. Levels of capillary blood beta-hydroxybutyrate (βOHB), the main ketone body in the blood, were measured with a bedside ketone meter in 585 full-term neonates aged 48-95 hours who were breastfed exclusively. Relationships between weight-loss percentage, blood sodium, glucose, pH, partial pressure of carbon dioxide, base-deficit levels, and βOHB levels were investigated. The diagnostic accuracy of βOHB for predicting excessive weight loss (weight loss ≥10% of birth weight) and hypernatremic dehydration (blood sodium level ≥150 mEq/L) was determined. βOHB levels were correlated positively with weight-loss percentage and blood sodium levels and were correlated negatively with blood glucose levels. The diagnostic accuracy of βOHB was 0.846 (optimal cut off, 1.55 mmol/L; sensitivity, 80.9%, specificity, 74.0%) for predicting excessive weight loss and 0.868 (optimal cut off, 1.85 mmol/L; sensitivity, 94.3%; specificity, 69.9%) for predicting hypernatremic dehydration according to the area under the receiver operating characteristic curve. Multiple logistic analysis revealed that βOHB and weight loss percentage were the only independent predictors of hypernatremic dehydration. Increases in βOHB levels also were associated with worsening metabolic acidosis and hypocapnia. High βOHB levels were associated with inadequate intake of breast milk in the early postnatal period. The use of bedside capillary blood ketone levels may be clinically useful as an indicator of dehydration, energy depletion, and acid-base imbalance in breastfeeding infants in the early postnatal period. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Autosomal Recessive Polycystic Kidney Disease and Epidemiologic Factors

    Directory of Open Access Journals (Sweden)

    Parsa Yousefichaijan

    2017-01-01

    Full Text Available Background Autosomal recessive polycystic kidney disease (ARPKD is a heterogeneous inherited disorder most commonly seen in childhood. The presentation is usually a palpable large mass in the flank or abdomen appearing at infancy or birth, leading to electrolyte abnormalities, pulmonary hypoplasia, oligohydramnious and the Potter’s syndrome. The survival rate of this disease is 70%. Multiple mutations of the polycystic kidney and hepatic disease 1 (PKHD1 are known that can cause ARPKD. On the other hand, mutations in PKHD1 have also been identified in about 30% of children with congenital hepatic fibrosis (the Caroli’s syndrome without any evidence of kidney involvement. Based on this evidence, not everyone with PKHD1 mutations will present with ARPKD. Recent studies have shown that nongenetic factors, including environmental exposures had a significant effect on manifestations of ARPKD. The present study aimed at investigating the possible link between ARPKD and its epidemiologic factors, hypothesizing that these epidemiologic conditions would influence the incidence of ARPKD. Objectives The present study aimed at evaluating a possible link between the ARPKD and its epidemiologic factors. Methods In this case-control study, children with ARPKD referred to Amirkabir hospital in Arak city, Iran, were compared with noninfected children. Examinations, interviews, and questionnaires were performed to collect data and the disease was diagnosed by a physician. Results The results of this study showed no significant relationship between epidemiological factors such as age, place of residence for families, sex, family education/occupation/ income, body mass index, stunted growth, slow growth, good growth, milk intake, water intake, failure to thrive and ARPKD. Conclusions Based on our findings, epidemiological factors did not have a significant effect on the occurrence of ARPKD.

  10. The Epidemiology of Hand, Foot and Mouth Disease in Asia

    Science.gov (United States)

    Koh, Wee Ming; Bogich, Tiffany; Siegel, Karen; Jin, Jing; Chong, Elizabeth Y.; Tan, Chong Yew; Chen, Mark IC; Horby, Peter

    2016-01-01

    Context: Hand, foot and mouth disease (HFMD) is a widespread pediatric disease caused primarily by human enterovirus 71 (EV-A71) and Coxsackievirus A16 (CV-A16). Objective: This study reports a systematic review of the epidemiology of HFMD in Asia. Data Sources: PubMed, Web of Science and Google Scholar were searched up to December 2014. Study Selection: Two reviewers independently assessed studies for epidemiologic and serologic information about prevalence and incidence of HFMD against predetermined inclusion/exclusion criteria. Data Extraction: Two reviewers extracted answers for 8 specific research questions on HFMD epidemiology. The results are checked by 3 others. Results: HFMD is found to be seasonal in temperate Asia with a summer peak and in subtropical Asia with spring and fall peaks, but not in tropical Asia; evidence of a climatic role was identified for temperate Japan. Risk factors for HFMD include hygiene, age, gender and social contacts, but most studies were underpowered to adjust rigorously for confounding variables. Both community-level and school-level transmission have been implicated, but their relative importance for HFMD is inconclusive. Epidemiologic indices are poorly understood: No supporting quantitative evidence was found for the incubation period of EV-A71; the symptomatic rate of EV-A71/Coxsackievirus A16 infection was from 10% to 71% in 4 studies; while the basic reproduction number was between 1.1 and 5.5 in 3 studies. The uncertainty in these estimates inhibits their use for further analysis. Limitations: Diversity of study designs complicates attempts to identify features of HFMD epidemiology. Conclusions: Knowledge on HFMD remains insufficient to guide interventions such as the incorporation of an EV-A71 vaccine in pediatric vaccination schedules. Research is urgently needed to fill these gaps. PMID:27273688

  11. The evolving epidemiology of inflammatory bowel disease.

    LENUS (Irish Health Repository)

    Shanahan, Fergus

    2009-07-01

    Epidemiologic studies in inflammatory bowel disease (IBD) include assessments of disease burden and evolving patterns of disease presentation. Although it is hoped that sound epidemiologic studies provide aetiological clues, traditional risk factor-based epidemiology has provided limited insights into either Crohn\\'s disease or ulcerative colitis etiopathogenesis. In this update, we will summarize how the changing epidemiology of IBD associated with modernization can be reconciled with current concepts of disease mechanisms and will discuss studies of clinically significant comorbidity in IBD.

  12. 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.

    Science.gov (United States)

    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.

  13. The epidemiology, antibiograms and predictors of mortality among critically-ill patients with central line-associated bloodstream infections.

    Science.gov (United States)

    Kuo, Shin-Huei; Lin, Wei-Ru; Lin, Jun-You; Huang, Chung-Hao; Jao, Ya-Ting; Yang, Pei-Wen; Tsai, Jong-Rung; Wang, Wen-Hung; Chen, Yen-Hsu; Hung, Ching-Tzu; Lu, Po-Liang

    2017-09-06

    For high risk of central line-associated bloodstream infections (CLABSIs) in patients of intensive care units (ICUs) and scarcely epidemiology and therapeutic recommendations in Asia, we aimed to evaluate the annual change in epidemiology, antibiogram, and risk factors for 14-day mortality. A retrospective study of ICUs patients with CLABSIs at a medical center in Taiwan (2010-2016), where central line care bundle implemented since 2014, by reviewing clinical data, pathogens, and the antibiogram. Gram-negative bacteria (59.3%) were main microorganisms of CLABSIs, and 9.0% of all GNB were MDROs. Acinetobacter spp., Enterobacter spp., and Stenotrophomonas maltophilia were the most frequently isolated. In multivariate analysis, malignancy, inadequate empirical antimicrobial therapy, inadequate definite antimicrobial therapy, and infection by fungi or multidrug-resistant organisms (MDROs) were associated with 14-day mortality (all p empirical drugs in the hospital setting when GNB is predominant for CLABSI. Significant decreasing susceptibility of ampicillin/sulbactam in Enterobacter spp. (36.7%-0.0%), and ampicillin/sulbactam (12.5%-0.0%), ceftazidime (100.0%-52.9%), and tigecycline (87.5%-35.3%) in Serratia marcescens. We identified Gram-negative bacteria as leading pathogens of CLABSIs in a Taiwan medical center, and good compliance to care bundle is associated with reduced CLABSI incidence rate. Malignancy, infection by MDROs or fungi, inadequate empirical or definite antimicrobial therapy are significant factors for 14-day mortality. Copyright © 2017. Published by Elsevier B.V.

  14. Has epidemiology become infatuated with methods? A historical perspective on the place of methods during the classical (1945-1965) phase of epidemiology.

    Science.gov (United States)

    Morabia, Alfredo

    2015-03-18

    Before World War II, epidemiology was a small discipline, practiced by a handful of people working mostly in the United Kingdom and in the United States. Today it is practiced by tens of thousands of people on all continents. Between 1945 and 1965, during what is known as its "classical" phase, epidemiology became recognized as a major academic discipline in medicine and public health. On the basis of a review of the historical evidence, this article examines to which extent classical epidemiology has been a golden age of an action-driven, problem-solving science, in which epidemiologists were less concerned with the sophistication of their methods than with the societal consequences of their work. It also discusses whether the paucity of methods stymied or boosted classical epidemiology's ability to convince political and financial agencies about the need to intervene in order to improve the health of the people.

  15. Challenges in understanding the epidemiology of acquired brain injury in India

    Directory of Open Access Journals (Sweden)

    Suresh Kumar Kamalakannan

    2015-01-01

    Full Text Available An acquired brain injury (ABI is an injury to the brain, which is not hereditary, congenital, degenerative, or induced by birth trauma. In India, rapid urbanization, economic growth and changes in lifestyle have led to a tremendous increase in the incidence of ABI, so much so that it is being referred to as a ′silent epidemic′. Unlike developed countries, there is no well-established system for collecting and managing information on various diseases in India. Thus it is a daunting task to obtain reliable information about acquired brain injury. In the course of conducting a systematic review on the epidemiology of ABI in India, we recognized several challenges which hampered our effort. Inadequate case definition, lack of centralized reporting mechanisms, lack of population based studies, absence of standardized survey protocols and inadequate mortality statistics are some of the major obstacles. Following a standard case definition, linking multiple hospital-based registries, initiating a state or nationwide population-based registry, conducting population-based studies that are methodologically robust and introducing centralized, standard reporting mechanisms for ABI, are some of the strategies that could help facilitate a thorough investigation into the epidemiology and understanding of ABI. This may help improve policies on prevention and management of acquired brain injury in India.

  16. Cost-utility evaluation of vortioxetine in patients with Major Depressive Disorder experiencing inadequate response to alternative antidepressants in the United Kingdom.

    Science.gov (United States)

    Young, A H; Evitt, L; Brignone, M; Diamand, F; Atsou, K; Campbell, R; Cure, S; Danchenko, N

    2017-08-15

    Patients frequently require several lines of therapy for treatment of major depressive episodes. This economic analysis details the management of patients who responded inadequately due to lack of efficacy or intolerability to two previous antidepressants in the UK. The model included a decision tree and a Markov component. Health states considered in the decision tree were remission, response, no response, withdrawal due to adverse events, relapse, recovery, and recurrence. The time horizon was 24 months. Patients were on third-line treatment for up to a 3-month acute phase and a 6-month maintenance phase. As third-line efficacy data were not available, inputs were calculated by adjusting original second-line data to third-line based on proportionate reductions observed in STAR*D. Equivalent efficacy was assumed for all comparators. Healthcare resource use and utilities were based on UK estimates. Vortioxetine was a cost-effective treatment option at a threshold of £20,000/QALY vs. escitalopram, citalopram, sertraline, and was associated with more health benefits, less costs (was dominant) versus relevant third-line comparators venlafaxine and duloxetine. Agomelatine was found not to be a cost-effective option. The 22-month maintenance phase treatment scenario results were similar to the 6-month base case. Third-line efficacy data were not available. This highlights the need for studies in patients receiving third-line treatment. This model provides an overview for the management of patients receiving third-line treatment where limited evidence currently exists. Vortioxetine, with its novel mechanism of action, is expected to be a dominant treatment option versus relevant comparators in the UK. Copyright © 2017. Published by Elsevier B.V.

  17. [Growth and trends in scientific production in epidemiology in Brazil].

    Science.gov (United States)

    Barreto, Mauricio L

    2006-08-01

    To analyze the growth of epidemiological research in Brazil in comparison to the total number of indexed publications worldwide and from several Latin American and Caribbean countries. A Boolean combination of epidemiological key words was used to search the MEDLINE/PubMed database for articles published between 1985 and 2004. These articles were divided into 4 time periods: 1985-9, 1990-4, 1995-9, and 2000-4. Of the total 211,727 articles identified in the MEDLINE/PubMed database, 1,952 (0.9%) were related to Brazil. The number of articles increased 12-fold throughout the period (from 91 to 1,096), and more than doubled (0.54% to 1.1%) if considered in relation to the total number of indexed articles. This growth was accompanied by diversification of the subjects addressed. The fields of infectious diseases and mother-child health, which predominated during the first period (74%), represented only a minority of articles in the last period. There was a noteworthy increase in the Brazilian output when compared to that of other Latin American and Caribbean countries. Our results corroborate previous evidence of the intense growth of epidemiological research in Brazil in the last two decades. This growth was more intense than mean growth worldwide, and much greater than that found in other Latin American countries. Therefore, Brazilian scientific output in the epidemiology field is showing a growth pattern similar to that of other scientific areas in the country.

  18. "Epidemiological criminology": coming full circle.

    Science.gov (United States)

    Akers, Timothy A; Lanier, Mark M

    2009-03-01

    Members of the public health and criminal justice disciplines often work with marginalized populations: people at high risk of drug use, health problems, incarceration, and other difficulties. As these fields increasingly overlap, distinctions between them are blurred, as numerous research reports and funding trends document. However, explicit theoretical and methodological linkages between the 2 disciplines remain rare. A new paradigm that links methods and statistical models of public health with those of their criminal justice counterparts is needed, as are increased linkages between epidemiological analogies, theories, and models and the corresponding tools of criminology. We outline disciplinary commonalities and distinctions, present policy examples that integrate similarities, and propose "epidemiological criminology" as a bridging framework.

  19. Linking healthcare associated norovirus outbreaks: a molecular epidemiologic method for investigating transmission

    Directory of Open Access Journals (Sweden)

    Andrews Nick

    2006-07-01

    Full Text Available Abstract Background Noroviruses are highly infectious pathogens that cause gastroenteritis in the community and in semi-closed institutions such as hospitals. During outbreaks, multiple units within a hospital are often affected, and a major question for control programs is: are the affected units part of the same outbreak or are they unrelated transmission events? In practice, investigators often assume a transmission link based on epidemiological observations, rather than a systematic approach to tracing transmission. Here, we present a combined molecular and statistical method for assessing: 1 whether observed clusters provide evidence of local transmission and 2 the probability that anecdotally|linked outbreaks truly shared a transmission event. Methods 76 healthcare associated outbreaks were observed in an active and prospective surveillance scheme of 15 hospitals in the county of Avon, England from April 2002 to March 2003. Viral RNA from 64 out of 76 specimens from distinct outbreaks was amplified by reverse transcription-PCR and was sequenced in the polymerase (ORF 1 and capsid (ORF 2 regions. The genetic diversity, at the nucleotide level, was analysed in relation to the epidemiological patterns. Results Two out of four genetic and epidemiological clusters of outbreaks were unlikely to have occurred by chance alone, thus suggesting local transmission. There was anecdotal epidemiological evidence of a transmission link among 5 outbreaks pairs. By combining this epidemiological observation with viral sequence data, the evidence of a link remained convincing in 3 of these pairs. These results are sensitive to prior beliefs of the strength of epidemiological evidence especially when the outbreak strains are common in the background population. Conclusion The evidence suggests that transmission between hospitals units does occur. Using the proposed criteria, certain hypothesized transmission links between outbreaks were supported while

  20. EPIDEMIOLOGICAL EVALUATION OF COLORECTAL CANCER

    OpenAIRE

    B. Shafayan M. Keyhani

    2003-01-01

    This study was carried out to analyze certain epidemiological variations in Iranian patients with colorectal cancer. (CRC): From March 1981 up to March 1993, 103 patients were analyzed retrospectively for age, gender, marital state, job, nutritional habits, presenting symptoms and histopathological features. Most of the patients with colorectal cancer were male, age range 20-75 (mean 56), 25.4 percent were long-term smokers and bleeding was the most common symptom. The rectum was the most com...

  1. Viral marketing as epidemiological model

    OpenAIRE

    Rodrigues, Helena Sofia; Fonseca, Manuel José

    2015-01-01

    In epidemiology, an epidemic is defined as the spread of an infectious disease to a large number of people in a given population within a short period of time. In the marketing context, a message is viral when it is broadly sent and received by the target market through person-to-person transmission. This specific marketing communication strategy is commonly referred as viral marketing. Due to this similarity between an epidemic and the viral marketing process and because the understanding of...

  2. Epidemiologic perspectives in radiation carcinogenesis

    International Nuclear Information System (INIS)

    Jablon, S.

    1984-01-01

    Epidemiological studies can tell much about carcinogenic effects at large doses, but not at small. To embark on large, long-term, expensive follow-up studies to learn something of scientific value about the effects of low doses-an average of three rads, say - is to waste time, effort, and money. It would be a fruitless effort even if the only problem to overcome was sampling variability - but it is not

  3. Social network visualization in epidemiology

    OpenAIRE

    James H. Fowler; Nicholas A. Christakis

    2009-01-01

    Epidemiological investigations and interventions are increasingly focusing on social networks. Two aspects of social networks are relevant in this regard: the structure of networks and the function of networks. A better understanding of the processes that determine how networks form and how they operate with respect to the spread of behavior holds promise for improving public health. Visualizing social networks is a key to both research and interventions. Network images supplement statistical...

  4. EPIDEMIOLOGY OF PEDIATRIC SPORTS INJURIES: INDIVIDUAL SPORTS

    Directory of Open Access Journals (Sweden)

    Dennis J. Caine

    2005-06-01

    Full Text Available The objective of the book is to review comprehensively what is known about the distribution and determinants of injury rates in a variety of individual sports, and to suggest injury prevention measures and guidelines for further research. This book provides comprehensive compilation and critical analysis of epidemiological data over children's individual sports: including equestrian, gymnastics, martial arts, skiing and snowboarding, tennis, track and field, and wrestling. This book encourages coaches and sports administrators to discuss rules, equipment standards, techniques, and athlete conditioning programs. In turn, they can inform parents about the risks and how they can help their children avoid or limit injury in sports. A common, uniform strategy and evidence-based approach to organizing and interpreting the literature is used in all chapters. All the sports-specific chapters are laid out with the same basic headings, so that it is easy for the reader to find common information across chapters. Chapter headings are: 1 Epidemiology of children's individual sports injuries, 2 Equestrian injuries, 2 Gymnastics injuries, 3 Martial arts injuries, 4 Skiing and snowboard injuries, 5 Tennis injuries, 6 Track and field injuries, 7 Wrestling injuries, 8 Injury prevention and future research. Chapter headings include: i Incidence of injury, ii Injury characteristics, iii Injury severity, iv njury risk factors, v Suggestions for injury prevention, vi Suggestions for further research. In each sports-specific chapter, an epidemiological picture has been systematically developed from the data available in prospective cohort, retrospective cohort, case-control, and cross-sectional studies. The tables are numerous, helpful and very useful. The book provides a very useful resource for sport scientist, pediatricians, family practitioners and healthcare professionals in the field of child and adolescent injury and prevention The readers are going to

  5. Risk factors for inadequate TB case finding in Rural Western Kenya: a comparison of actively and passively identified TB patients.

    Directory of Open Access Journals (Sweden)

    Anna H Van't Hoog

    Full Text Available The findings of a prevalence survey conducted in western Kenya, in a population with 14.9% HIV prevalence suggested inadequate case finding. We found a high burden of infectious and largely undiagnosed pulmonary tuberculosis (PTB, that a quarter of the prevalent cases had not yet sought care, and a low case detection rate.We aimed to identify factors associated with inadequate case finding among adults with PTB in this population by comparing characteristics of 194 PTB patients diagnosed in a health facility after self-report, i.e., through passive case detection, with 88 patients identified through active case detection during the prevalence survey. We examined associations between method of case detection and patient characteristics, including HIV-status, socio-demographic variables and disease severity in univariable and multivariable logistic regression analyses.HIV-infection was associated with faster passive case detection in univariable analysis (crude OR 3.5, 95% confidence interval (CI 2.0-5.9, but in multivariable logistic regression this was largely explained by the presence of cough, illness and clinically diagnosed smear-negative TB (adjusted OR (aOR HIV 1.8, 95% CI 0.85-3.7. Among the HIV-uninfected passive case detection was less successful in older patients aOR 0.76, 95%CI 0.60-0.97 per 10 years increase, and women (aOR 0.27, 95%CI 0.10-0.73. Reported current or past alcohol use reduced passive case detection in both groups (0.42, 95% CI 0.23-0.79. Among smear-positive patients median durations of cough were 4.0 and 6.9 months in HIV-infected and uninfected patients, respectively.HIV-uninfected patients with infectious TB who were older, female, relatively less ill, or had a cough of a shorter duration were less likely found through passive case detection. In addition to intensified case finding in HIV-infected persons, increasing the suspicion of TB among HIV-uninfected women and the elderly are needed to improve TB case

  6. Epidemiology of brain tumors in childhood--a review

    International Nuclear Information System (INIS)

    Baldwin, Rachel Tobias; Preston-Martin, Susan

    2004-01-01

    Malignant brain tumors are the leading cause of cancer death among children and the second most common type of pediatric cancer. Despite several decades of epidemiologic investigation, the etiology of childhood brain tumors (CBT) is still largely unknown. A few genetic syndromes and ionizing radiation are established risk factors. Many environmental exposures and infectious agents have been suspected of playing a role in the development of CBT. This review, based on a search of the medical literature through August 2003, summarizes the epidemiologic evidence to date. The types of exposures discussed include ionizing radiation, N-nitroso compounds (NOC), pesticides, tobacco smoke, electromagnetic frequencies (EMF), infectious agents, medications, and parental occupational exposures. We have chosen to focus on perinatal exposures and review some of the recent evidence indicating that such exposures may play a significant role in the causation of CBT. The scientific community is rapidly learning more about the molecular mechanisms by which carcinogenesis occurs and how the brain develops. We believe that advances in genetic and molecular biologic technology, including improved histologic subtyping of tumors, will be of huge importance in the future of epidemiologic research and will lead to a more comprehensive understanding of CBT etiology. We discuss some of the early findings using these technologies

  7. An epidemiological examination of the subluxation construct using Hill's criteria of causation

    Directory of Open Access Journals (Sweden)

    Wyatt Lawrence H

    2009-12-01

    Full Text Available Abstract Background Chiropractors claim to locate, analyze and diagnose a putative spinal lesion known as subluxation and apply the mode of spinal manipulation (adjustment for the correction of this lesion. Aim The purpose of this examination is to review the current evidence on the epidemiology of the subluxation construct and to evaluate the subluxation by applying epidemiologic criteria for it's significance as a causal factor. Methods The databases of PubMed, Cinahl, and Mantis were searched for studies using the keywords subluxation, epidemiology, manipulation, dose-response, temporality, odds ratio, relative risk, biological plausibility, coherence, and analogy. Results The criteria for causation in epidemiology are strength (strength of association, consistency, specificity, temporality (temporal sequence, dose response, experimental evidence, biological plausibility, coherence, and analogy. Applied to the subluxation all of these criteria remain for the most part unfulfilled. Conclusion There is a significant lack of evidence to fulfill the basic criteria of causation. This lack of crucial supportive epidemiologic evidence prohibits the accurate promulgation of the chiropractic subluxation.

  8. Pre-bisection of a single skin biopsy does not produce technically inadequate specimens for direct immunofluorescence: a review of 3450 specimens.

    Science.gov (United States)

    Loh, Ern; Armstrong, April W; Fung, Maxwell A

    2014-11-01

    Evaluation of a potential immunobullous disorder typically requires two pieces of tissue obtained by skin biopsy: one placed in formalin for conventional microscopy and a second placed in a different transport medium suitable for direct immunofluorescence (DIF) testing. Clinical practice in this area is not standardized, with dermatologists either obtaining two biopsies or dividing (pre-bisecting) a single biopsy. Some DIF specimens are technically inadequate for interpretation of subepidermal imunobullous disorders because the basement membrane zone is not intact, but it is unknown whether pre-bisecting the tissue increases the risk of compromising the specimen. To investigate whether technically inadequate DIF specimens are associated with pre-bisection. DIF specimens were consecutively sampled from a single referral center and identified as whole (non-bisected) biopsy specimens or pre-bisected biopsy specimens. The proportion of inadequate specimens was calculated for both groups. A total of 3450 specimens were included. The percentage of inadequate specimens was 5.072% (153/3016) for whole (non-bisected) specimens and 5.299% for pre-bisected specimens. This difference was not significant (chi square, p = 0.84). The study was sufficiently powered to detect a relative risk of 1.685. Pre-bisection of a single skin biopsy does not significantly increase the risk of a technically inadequate specimen for direct immunofluorescence testing. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Inadequate calcium intake is highly prevalent in Korean children and adolescents: the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2010.

    Science.gov (United States)

    Im, Jong Geun; Kim, Shin Hye; Lee, Gyeong-Yoon; Joung, Hyojee; Park, Mi-Jung

    2014-11-01

    The present study aimed to assess the adequacy of Ca intake and major food sources of Ca in Korean children and adolescents. A cross-sectional study. Data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2007-2010. We analysed the daily Ca intake, major food sources of Ca and the prevalence of inadequate Ca intake in the study population. Ca intake was categorized as inadequate when the participant's daily Ca intake was less than the Estimated Average Requirement. Subject The study population consisted of 7233 children and adolescents (3973 boys, 3260 girls; aged 1-18 years). Mean Ca intake was 510·2 mg/d in boys and 431·7 mg/d in girls. Overall, 75·0 % of adolescents (boys 71·6 %, girls 79·1 %) had inadequate Ca intake. The prevalence of inadequate Ca intake increased significantly from toddlers (45-55 %) to adolescents (78-86 %) in both genders. The highest ranked food sources for Ca were dairy products (35·0 %), followed by vegetables (17·3 %), grains (11·3 %) and seafood (9·9 %). Ca intake from dairy products decreased significantly from 57 % in toddlers to 30 % in adolescents, while Ca intakes from other foods increased with age. Inadequate Ca intake is highly prevalent and increased with age in Korean children and adolescents. It should be emphasized to encourage children and adolescents to eat more Ca-rich products to meet their Ca needs.

  10. Excessive homework, inadequate sleep, physical inactivity and screen viewing time are major contributors to high paediatric obesity.

    Science.gov (United States)

    Ren, Hong; Zhou, Zhixiong; Liu, Wenxi Kevin; Wang, Xiujiang; Yin, Zenong

    2017-01-01

    This study examined the relationships between energy balance-related behaviours (EBRBs) outside school hours and obesity in Chinese primary school students. We also explored the influence of gender on those relationships. The study sample was a cross-sectional cohort of 5032 Chinese children who were enrolled in grades 1-6 in primary schools in five Chinese cities and whose mean ages ranged from seven years and three months to 11.9 years. The children's parents completed a survey on their child's height, weight and EBRBs outside school hours. The response rate was 97%, and the reported rates of overweight and obesity were 13.6% and 13.8%, respectively. The obesity rates were higher in boys and lower grade children. Most EBRBs varied between boys and girls and with increased grade levels. The amount of time spent on academic-related activities, screen viewing, outdoor activities and sleep was mostly associated with obesity on weekdays and varied by gender. Rate of obesity was alarmingly high in the primary school Chinese children in this cohort, especially in younger children. Excessive time spent on academic-related activities outside school hours, inadequate sleep, physical inactivity and higher levels of screen viewing were major contributors to obesity in these Chinese children. ©2016 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  11. Inadequate Models of Adolescent Substance Use Prevention: Looking for Options to Promote Pro-Social Change and Engagement.

    Science.gov (United States)

    Ostaszewski, Krzysztof

    2015-01-01

    In the adolescent substance use prevention two competing models can be found: negative and positive. The negative model is entirely focused on risks and problems that young people should avoid. The positive model goes beyond that problem-oriented perspective and calls for positive youth growth and development. Both models of prevention seems to be inadequate to address effectively the challenging problem of adolescent substance use associated consequences. Both models are in fact flawed, but in different ways. Old, negative model neglects the power of individual strengths and ecological developmental assets, while new, positive model is often instrumentally used by politicians and other stakeholders for completely different goals than an informed, science-based prevention. As a result many substance use prevention programs implemented at schools and in communities are neither theoretically nor empirically informed. In order to address these flaws, the model of balanced prevention was outlined. It posits that triple well informed efforts are needed to achieve both specific substance use prevention goals and youth personal/social development. These efforts include protection building, risks reducing and individual assets development support. The proposed model is an ongoing work in progress. It can be considered as an encouragement for international dialogue to build a balanced conceptual foundation for adolescent substance use prevention.

  12. A new positive pressure ventilation delivery system: its impact on lung ventilation studies that are technically inadequate or non diagnostic

    International Nuclear Information System (INIS)

    Bui, C.; Leiper, C.; Lee, K.; Saunders, C.; Dixson, H.; Elison, B.; Bennett, G.; Gibian, T.; Rutland, J.; Tse, V.; Elzein, H.; Babicheva, R.

    2000-01-01

    Full text: The objective of this study was to evaluate the efficacy and safety of an improved Positive Pressure Ventilation Delivery System (PVDS) in the investigation of Pulmonary Embolism (PE). The major component of PVDS is a commercially available, self-inflating 1.6L Hudson Resuscitator Bag, filled with either oxygen or air (if the patient has CO 2 retention), which is squeezed by the operator to push Technegas from the Technegas Generator Chamber to the patient via the Patient Administration Set synchronously with patient inspiration. 27 spontaneously breathing in-patients (12 males, 15 females, age range 64-89, 21 with chronic airflow limitation), whose conventional lung ventilation images were technically inadequate or non diagnostic, were re-scanned using PVDS within four days after the conventional ventilation study. Randomised blinded visual interpretation of conventional ventilation/perfusion scan vs. PVDS-assisted ventilation/perfusion scan was performed by consensus reading with two experienced observers. In conclusion PVDS was safe and well tolerated. PVDS improved the image quality of the lung ventilation scans in this cohort of patients. This technique has the potential to improve the accuracy of lung scanning in patients with severe lung disease. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  13. Initial dose of vancomycin based on body weight and creatinine clearance to minimize inadequate trough levels in Japanese adults.

    Science.gov (United States)

    Maki, N; Ohkuchi, A; Tashiro, Y; Kim, M R; Le, M; Sakamoto, T; Matsubara, S; Hakamata, Y

    2012-10-01

    Our aims were to elucidate the factors that affected vancomycin (VCM) serum trough levels and to find the optimal initial dose based on creatinine clearance (CrCl) and body weight (BW) to minimize inadequate trough levels in a retrospective observational study among Japanese adults. One hundred and six inpatients, in whom VCM trough levels were measured after completing the third dosing, were consecutively recruited into our study in a tertiary hospital. We considered the frequency of initial VCM total daily dose, CrCl, and BW were independent risk factors of VCM trough levels. In patients with CrCl ≥30 and level of ≥20 mcg/mL, regardless of BW. In patients with CrCl ≥50 mL/min, 2 g/day yielded low frequencies of a trough level of initial total daily dose may be 1 g/day in patients with CrCl ≥30 and <50 mL/min regardless of BW and 2 g/day in patients weighing <55 kg with CrCl ≥50 mL/min among Japanese adults.

  14. IDegLira Versus Alternative Intensification Strategies in Patients with Type 2 Diabetes Inadequately Controlled on Basal Insulin Therapy

    DEFF Research Database (Denmark)

    Freemantle, Nick; Mamdani, Muhammad; Vilsbøll, Tina

    2015-01-01

    glycated hemoglobin (HbA1c) and other outcomes. METHODS: A pooled analysis of five completed Novo Nordisk randomized clinical trials in patients with type 2 diabetes inadequately controlled on basal insulin was used to compare indirectly IDegLira (N = 199) with: addition of liraglutide to basal insulin (N...... = 225) [glucagon-like peptide-1 receptor agonist (GLP-1RA) add-on strategy]; basal-bolus (BB) insulin [insulin glargine (IGlar) + insulin aspart] (N = 56); or up-titration of IGlar (N = 329). A supplementary analysis was performed with the BB arm including patients who received IGlar or IDeg as basal...... of study, differences between IDegLira and BB or up-titrated IGlar, respectively, were as follows: reduction in HbA1c -0.30%, 95% confidence interval (-0.58; -0.01) and -0.65% (-0.83; -0.47); change in body weight -6.89 kg (-7.92; -5.86) and -4.04 kg (-4.69; -3.40) all in favor of IDegLira. Confirmed...

  15. Negative energy balance secondary to inadequate dietary intake of patients on the waiting list for liver transplantation.

    Science.gov (United States)

    Ferreira, Lívia Garcia; Ferreira Martins, Aline Isabel; Cunha, Carolina Elisa; Anastácio, Lucilene Rezende; Lima, Agnaldo Soares; Correia, Maria Isabel Toulson Davisson

    2013-10-01

    The aim of this study was to evaluate the energy balance (EB) of patients on the waiting list for liver transplantation, using total energy expenditure (TEE) assessment and total caloric intake (TCI). We analyzed nutrient adequacy and factors associated with it. EB was obtained by subtracting the TCI (obtained by 3-d food record) from TEE, which was measured as resting energy expenditure and physical activity factor calculation. Socioeconomic and clinical data also were evaluated. Univariate and multiple linear regressions were used (P 0.05). Women, less-educated patients, those with ascites, and those who were malnourished presented with lower TCI (P Liver Disease scores were associated with EB (P fiber (94.5%) inadequacies also were high. The percentage of adequate intake was less than 10% for vitamins B5 and D, calcium, folic acid, and potassium, and higher percentages of adequate intake (>80%) were found for iron and vitamins B1 and B12. Moreover, 54.8% and 16.4% of the patients had excessive sodium and cholesterol intakes, respectively. Negative EB was highly prevalent among patients on the waiting list for liver transplantation, and was associated with the severity of liver disease. Negative EB was primarily affected by low food intake. The food intake data were characterized by low overall energy and protein intake and inadequate composition of the patient's diet plan, which tended to be characterized by specific nutrient deficiencies and excesses. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. What causes treatment failure - the patient, primary care, secondary care or inadequate interaction in the health services?

    Directory of Open Access Journals (Sweden)

    Lange Ove

    2011-05-01

    Full Text Available Abstract Background Optimal treatment gives complete relief of symptoms of many disorders. But even if such treatment is available, some patients have persisting complaints. One disorder, from which the patients should achieve complete relief of symptoms with medical or surgical treatment, is gastroesophageal reflux disease (GERD. Despite the fact that such treatment is cheap, safe and easily available; some patients have persistent complaints after contact with the health services. This study evaluates the causes of treatment failure. Methods Twelve patients with GERD and persistent complaints had a semi-structured interview which focused on the patients' evaluation of treatment failure. The interviews were taped, transcribed and evaluated by 18 physicians, (six general practitioners, six gastroenterologists and six gastrointestinal surgeons who completed a questionnaire for each patient. The questionnaires were scored, and the relative responsibility for the failure was attributed to the patient, primary care, secondary care and interaction in the health services. Results Failing interaction in the health services was the most important cause of treatment failure, followed by failure in primary care, secondary care and the patient himself; the relative responsibilities were 35%, 28%, 27% and 10% respectively. There was satisfactory agreement about the causes between doctors with different specialities, but significant inter-individual differences between the doctors. The causes of the failures differed between the patients. Conclusions Treatment failure is a complex problem. Inadequate interaction in the health services seems to be important. Improved communication between parts of the health services and with the patients are areas of improvement.

  17. Global epidemiology of mental disorders: what are we missing?

    Directory of Open Access Journals (Sweden)

    Amanda J Baxter

    Full Text Available BACKGROUND: Population-based studies provide the understanding of health-need required for effective public health policy and service-planning. Mental disorders are an important but, until recently, neglected agenda in global health. This paper reviews the coverage and limitations in global epidemiological data for mental disorders and suggests strategies to strengthen the data. METHODS: Systematic reviews were conducted for population-based epidemiological studies in mental disorders to inform new estimates for the global burden of disease study. Estimates of population coverage were calculated, adjusted for study parameters (age, gender and sampling frames to quantify regional coverage. RESULTS: Of the 77,000 data sources identified, fewer than 1% could be used for deriving national estimates of prevalence, incidence, remission, and mortality in mental disorders. The two major limitations were (1 highly variable regional coverage, and (2 important methodological issues that prevented synthesis across studies, including the use of varying case definitions, the selection of samples not allowing generalization, lack of standardized indicators, and incomplete reporting. North America and Australasia had the most complete prevalence data for mental disorders while coverage was highly variable across Europe, Latin America, and Asia Pacific, and poor in other regions of Asia and Africa. Nationally-representative data for incidence, remission, and mortality were sparse across most of the world. DISCUSSION: Recent calls to action for global mental health were predicated on the high prevalence and disability of mental disorders. However, the global picture of disorders is inadequate for planning. Global data coverage is not commensurate with other important health problems, and for most of the world's population, mental disorders are invisible and remain a low priority.

  18. Global Epidemiology of Mental Disorders: What Are We Missing?

    Science.gov (United States)

    Baxter, Amanda J.; Patton, George; Scott, Kate M.; Degenhardt, Louisa; Whiteford, Harvey A.

    2013-01-01

    Background Population-based studies provide the understanding of health-need required for effective public health policy and service-planning. Mental disorders are an important but, until recently, neglected agenda in global health. This paper reviews the coverage and limitations in global epidemiological data for mental disorders and suggests strategies to strengthen the data. Methods Systematic reviews were conducted for population-based epidemiological studies in mental disorders to inform new estimates for the global burden of disease study. Estimates of population coverage were calculated, adjusted for study parameters (age, gender and sampling frames) to quantify regional coverage. Results Of the 77,000 data sources identified, fewer than 1% could be used for deriving national estimates of prevalence, incidence, remission, and mortality in mental disorders. The two major limitations were (1) highly variable regional coverage, and (2) important methodological issues that prevented synthesis across studies, including the use of varying case definitions, the selection of samples not allowing generalization, lack of standardized indicators, and incomplete reporting. North America and Australasia had the most complete prevalence data for mental disorders while coverage was highly variable across Europe, Latin America, and Asia Pacific, and poor in other regions of Asia and Africa. Nationally-representative data for incidence, remission, and mortality were sparse across most of the world. Discussion Recent calls to action for global mental health were predicated on the high prevalence and disability of mental disorders. However, the global picture of disorders is inadequate for planning. Global data coverage is not commensurate with other important health problems, and for most of the world's population, mental disorders are invisible and remain a low priority. PMID:23826081

  19. Global epidemiology of mental disorders: what are we missing?

    Science.gov (United States)

    Baxter, Amanda J; Patton, George; Scott, Kate M; Degenhardt, Louisa; Whiteford, Harvey A

    2013-01-01

    Population-based studies provide the understanding of health-need required for effective public health policy and service-planning. Mental disorders are an important but, until recently, neglected agenda in global health. This paper reviews the coverage and limitations in global epidemiological data for mental disorders and suggests strategies to strengthen the data. Systematic reviews were conducted for population-based epidemiological studies in mental disorders to inform new estimates for the global burden of disease study. Estimates of population coverage were calculated, adjusted for study parameters (age, gender and sampling frames) to quantify regional coverage. Of the 77,000 data sources identified, fewer than 1% could be used for deriving national estimates of prevalence, incidence, remission, and mortality in mental disorders. The two major limitations were (1) highly variable regional coverage, and (2) important methodological issues that prevented synthesis across studies, including the use of varying case definitions, the selection of samples not allowing generalization, lack of standardized indicators, and incomplete reporting. North America and Australasia had the most complete prevalence data for mental disorders while coverage was highly variable across Europe, Latin America, and Asia Pacific, and poor in other regions of Asia and Africa. Nationally-representative data for incidence, remission, and mortality were sparse across most of the world. Recent calls to action for global mental health were predicated on the high prevalence and disability of mental disorders. However, the global picture of disorders is inadequate for planning. Global data coverage is not commensurate with other important health problems, and for most of the world's population, mental disorders are invisible and remain a low priority.

  20. Epidemiology of Zika virus, 1947–2007

    Science.gov (United States)

    Posen, H Joshua; Keystone, Jay S; Gubbay, Jonathan B; Morris, Shaun K

    2016-01-01

    Introduction Since 1947, Zika virus has been identified sporadically in humans in Africa and Asia; however, clinically consequential Zika virus disease had not been documented prior to the current outbreak in the Americas. Considering 6 decades have passed since the first identification of the virus, it is perhaps unexpected that Zika virus was recognised only recently as capable of causing disease epidemics. Substantial work on understanding the epidemiology of Zika virus has been conducted since the virus' first outbreak in 2007 in Micronesia; however, there has been little study of the earlier data on Zika virus. Methods A systematic literature search was conducted to identify evidence of Zika virus infection in humans from 1947 to 2007. Data extracted included seroprevalence of Zika virus infection, age distributions of positive test results and serologic test modalities used. Country-level and age-specific seroprevalence was calculated. Estimates of seroprevalence by different serologic test modalities were compared. Results 12 026 citations were retrieved by the literature search, and 76 articles were included in this review. Evidence of Zika virus infection in humans was found in 29 countries in Africa, 8 countries in Asia and 1 country in Europe. Country-level seroprevalence of Zika virus infection ranged from 0.4% to 53.3%. Seroprevalence of Zika virus infection was found to increase across the lifespan; 15–40% of reproductive-age individuals may have been previously infected. No significant difference was found between estimates of seroprevalence by different serologic test modalities. Discussion Zika virus has likely been endemic for decades in certain regions of the world; however, the majority of reproductive-age individuals have likely not been infected. Historical evidence of Zika virus infection exists regardless of the serologic test modality used. PMID:28588942