Medicine and Health Sciences Commons^™

Evaluations Of The Effectiveness Of A Web-Based Graduate Epidemiology Course, Molly A. Rose, Anthony J. Frisby, Michael D. Hamlin, Susan S. Jones

Anthony J Frisby, PhD

An online epidemiology course was developed, implemented, and evaluated for graduate nursing students through the collaborative efforts of nursing faculty and information, education, and instructional design staff of the library at a health sciences university. This epidemiology course is a core curriculum course for graduate nursing students. The course was piloted with 14 students (one student in Romania); the initial online offering ran concurrently with a traditional classroom section. Extensive evaluation data were collected and analyzed to compare the effectiveness of the classroom and distance-learning formats. Areas of evaluation included objective measures, such as midterm and final examination scores and …

Small Individual Loans And Mental Health: A Randomized Controlled Trial Among South African Adults, Lia C. H. Fernald, Rita Hamad, Dean Karlan, Emily J. Ozer, Jonathan Zinman

Dartmouth Scholarship

Background: In the developing world, access to small, individual loans has been variously hailed as a poverty-alleviation tool – in the context of "microcredit" – but has also been criticized as "usury" and harmful to vulnerable borrowers. Prior studies have assessed effects of access to credit on traditional economic outcomes for poor borrowers, but effects on mental health have been largely ignored.

Methods: Applicants who had previously been rejected (n = 257) for a loan (200% annual percentage rate – APR) from a lender in South Africa were randomly assigned to a "second-look" that encouraged loan officers to approve their …

Childhood Lymphohematopoietic Cancer Incidence And Hazardous Air Pollutants In Southeast Texas, 1995–2004, Kristina W. Whitworth, Elaine Symanski, Ann L. Coker

CRVAW Faculty Journal Articles

BACKGROUND: Cancer is the second leading cause of death among U.S. children with few known risk factors. There is increasing interest in the role of air pollutants, including benzene and 1,3-butadiene, in the etiology of childhood cancers.

OBJECTIVE: Our goal was to assess whether census tracts with the highest benzene or 1,3-butadiene ambient air levels have increased childhood lymphohematopoietic cancer incidence.

METHODS: Our ecologic analysis included 977 cases of childhood lymphohematopoietic cancer diagnosed from 1995–2004. We obtained the U.S. Environmental Protection Agency’s 1999 modeled estimates of benzene and 1,3-butadiene for 886 census tracts surrounding Houston, Texas. We ran Poisson regression …

Cardiorespiratory Fitness As A Predictor Of Fatal And Nonfatal Stroke In Asymptomatic Women And Men, Steven P. Hooker, Xuemei Sui, Natalie Colabianchi, John E. Vena, James N. Laditka, Michael J. Lamonte, Steven N. Blair

Faculty Publications

Background and Purpose - Prospective data on the association between cardiorespiratory fitness (CRF) and stroke are largely limited to studies in men or do not separately examine risks for fatal and nonfatal stroke. This study examined the association between CRF and fatal and nonfatal stroke in a large cohort of asymptomatic women and men.

Methods - A total of 46,405 men and 15,282 women without known myocardial infarction or stroke at baseline completed a maximal treadmill exercise test between 1970 and 2001. CRF was grouped as quartiles of the sex-specific distribution of maximal metabolic equivalents achieved. Mortality follow-up was through …

Chinese Journals: A Guide For Epidemiologists, Isaac Chun-Hai Fung

Isaac Chun-Hai Fung

Chinese journals in epidemiology, preventive medicine and public health contain much that is of potential international interest. However, few non-Chinese speakers are acquainted with this literature. This article therefore provides an overview of the contemporary scene in Chinese biomedical journal publication, Chinese bibliographic databases and Chinese journals in epidemiology, preventive medicine and public health. The challenge of switching to English as the medium of publication, the development of publishing bibliometric data from Chinese databases, the prospect of an Open Access publication model in China, the issue of language bias in literature reviews and the quality of Chinese journals are discussed. …

Does Language Matter? A Case Study Of Epidemiological And Public Health Journals, Databases And Professional Education In French, German And Italian, Iacopo Baussano, Patrick Brzoska, Ugo Fedeli, Claudia Larouche, Oliver Razum, Isaac Chun-Hai Fung

Isaac Chun-Hai Fung

Epidemiology and public health are usually context-specific. Journals published in different languages and countries play a role both as sources of data and as channels through which evidence is incorporated into local public health practice. Databases in these languages facilitate access to relevant journals, and professional education in these languages facilitates the growth of native expertise in epidemiology and public health. However, as English has become the lingua franca of scientific communication in the era of globalisation, many journals published in non-English languages face the difficult dilemma of either switching to English and competing internationally, or sticking to the native …

Epidemiology Of Copd Exacerbations, Andrea K. Johnston, David M. Mannino

David M. Mannino

Chapter Opening

Chronic obstructive pulmonary disease (COPD) is expected to be the third cause of death worldwide by the year 2020, behind only cardiovascular disease and cerebrovascular disease (1), and the fifth leading cause of disability-adjusted life years lost (2). In the United States, COPD accounted for 8 million outpatient visits, 1.5 millions emergency department (ED) visits, 726,000 hospitalizations, and 119,000 deaths in 2000, with the number of women dying from COPD surpassing the number of men for the first time (3). In the United Kingdom, COPD exacerbations are now the most common cause of hospital admission (4). Acute exacerbations …

Cancer In American Indian And Alaska Native Young Adults (Ages 20–44 Years): Us, 1999–2004, Hannah K. Weir, Melissa Jim, Loraine D. Marrett, Temeika L. Fairley

Public Health Resources

BACKGROUND. An examination of cancer incidence patterns in American Indians and Alaska Native (AI/AN) young adults may provide insight into their present and future cancer burden.

METHODS. To reduce racial misclassification, incidence data were linked with the Indian Health Service (IHS) patient services database. Age-adjusted cancer incidence rates per 100,000 (AAR) and corresponding rate ratios (RR) for young adults (ages 20-44 years) were compared across IHS regions and for selected cancers within Contract Health Service Delivery Area counties by race (AI/AN vs non-Hispanic whites [NHW]) and sex.

RESULTS. The all-sites cancer incidence rate was lower for AI/ANs …

Gastric Cancer Among American Indians And Alaska Natives In The United States, 1999–2004, Charles Wiggins, David G. Perdue, Jeffrey A. Henderson, Michael G. Bruce, Anne P. Lanier, Janet J. Kelly, Brenda F. Seals, David K. Espey

Public Health Resources

BACKGROUND. Gastric cancer incidence rates for American Indians and Alaska Natives (AI/ANs) historically have exceeded those for non-Hispanic whites (NHWs). Previous reports may have underestimated the true burden of gastric cancer in AI/AN populations because of misclassification of AI/AN race in cancer registries.

METHODS. Population-based cancer registry data from 1999 through 2004 were used to describe gastric cancer incidence in AI/ANs and NHWs in the US. To address misclassification of race, registry data were linked with Indian Health Service administrative records, and analyses were restricted to residents of Contract Health Service Delivery Areas (CHSDA). Disease patterns were assessed …

Known Facts About The Epidemiology Of Porcine Proliferative Enteropathy, Roberto M. C. Guedes

The Thai Journal of Veterinary Medicine

The amount of new information of the last seven years regarding Lawsonia intracellularis sensitivity to antimicrobial drugs, prevention/control based on treatment and vaccination, diagnosis and, finally, genome is amazing. Nevertheless, not much is known about the epidemiology of the disease, mainly regarding the source of infection, resistance of the bacteria in the environment and possible biological vectors that could spread the infection among farms. It was learned that as few as 1,000 to 10,000 bacteria are enough to induce infection and fecal shedding two to three weeks after inoculating susceptible pigs. It was also learned that L. intracellularis organisms can …

Capacity Building Of Biodefense Informatics For Public Health Preparedness And Response In Rural Regions: Epiinfo, Gis, And Data Management Training, Chiehwen Ed Hsu, Francisco Soto Mas

Francisco Soto Mas

Emergency informatics such as data management and geographic information systems applications have become an important training agenda for enhancing health surveillance and risk communication in public health emergencies. The free EpiInfo/Epimap software developed by the CDC offering domain knowledge such as health information management may be particularly useful for preparing nonurban jurisdictions often confronting limited resources in dealing with health emergency events. This article describes the delivery of training workshops to enhance the competencies of health workers in biodefense informatics and discusses its implication for delivering education to rural regions.

Community Based Epidemiological Study Of Chagas Disease In Rural Peru, Paul Walker

Yale Medicine Thesis Digital Library

The purpose of this study was to evaluate the epidemiology of Trypanosoma cruzi infection, to valuate the TESA blot, and to characterize cardiac findings of patients with Chagas disease in a rural setting near Arequipa, Peru. The study site was the town of Quequeña, Peru with a population of 774 with 236 inhabitants under the age of 18 according to the 2005 census conducted by Peru. A fumigation/insect collection campaign was done in December of 2006 to quantify household infestation levels, document housing characteristics, and GPS household locations. Of the 602 people surveyed to be living in Quequeña, blood samples …

Lung Cancer Incidence Among American Indians And Alaska Natives In The United States, 1999–2004, Anne Bliss, Nathaniel Cobb, Teshia Solomon, Kym Cravatt, Melissa A. Jim, Latisha Marshall, Janis Campbell

Public Health Resources

BACKGROUND. Lung cancer incidence rates among American Indians and Alaska Natives (AI/ANs) in the United States have not been described well, primarily because of race misclassification and, until the 1990s, incomplete coverage of their population by cancer registries. Smoking, the predominant cause of lung cancer, is particularly prevalent among this population.

METHODS. Data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age adjusted incidence rates of lung cancer during 1999 through 2004. Cases were linked to Indian Health Service (IHS) registration databases to identify AI/ANs whose race …

Methods For Improving Cancer Surveillance Data In American Indian And Alaska Native Populations, David K. Espey, Charles Wiggins, Melissa A. Jim, Barry A. Miller, Christopher J. Johnson, Tom M. Becker

Public Health Resources

BACKGROUND. The misclassification of race decreases the accuracy of cancer incidence data for American Indians and Alaska Natives (AI/ANs) in some central cancer registries. This article describes the data sources and methods that were used to address this misclassification and to produce the cancer statistics used by most of the articles in this supplement.

METHODS. Records from United States cancer registries were linked with Indian Health Service (IHS) records to identify AI/AN cases that were misclassified as non-AI/AN. Data were available from 47 registries that linked their data with IHS, met quality criteria, and agreed to participate. Analyses …

Prostate Cancer Incidence Among American Indian And Alaska Native Men, Us, 1999–2004, Jeffrey A. Henderson, David K. Espey, Melissa Jim, Robert R. German, Kate M. Shaw, Richard M. Hoffman

Public Health Resources

BACKGROUND. American Indian and Alaska Native (AI/AN) men experience lower incidence of prostate cancer than other race/ethnic populations in the US, but racial misclassification of AI/AN men threatens the validity of these estimates. To the authors’ knowledge, little is known concerning prostate-specific antigen (PSA) testing in AI/AN men.

METHODS. The authors linked cancer registry data with Indian Health Service enrollment records to improve race classification. Analyses comparing cancer incidence rates and stage at diagnosis for AI/AN and non-Hispanic white (NHW) men for 6 geographic regions focused on counties known to have less race misclassification. The authors also used …

Regional Differences In Colorectal Cancer Incidence, Stage, And Subsite Among American Indians And Alaska Natives, 1999–2004, David G. Perdue, Carin Perkins, Jeannette Jackson-Thompson, Steven S. Coughlin, Faruque Ahmed, Donald S. Haverkamp, Melissa Jim

Public Health Resources

BACKGROUND. Colorectal cancer (CRC) is a leading cause of cancer morbidity and mortality for American Indians and Alaska Natives (AI/ANs), but misclassification of race causes underestimates of disease burden.

METHODS. The authors compared regional differences in CRC incidence, stage at diagnosis, and anatomic distribution between AI/ANs and non-Hispanic whites (NHWs). To reduce misclassification, data from the National Program of Cancer Registries; the Surveillance, Epidemiology, and End Results Program; and the Indian Health Service (IHS) were linked. The analysis was limited to the 56% of AI/ AN who live in IHS Contract Health Service Delivery Areas.

RESULTS. From …

Cancer Among American Indians And Alaska Natives In The United States, 1999–2004, Charles Wiggins, David K. Espey, Phyllis A. Wingo, Judith S. Kaur, Robin Taylor Wilson, Judith Swan, Barry A. Miller, Melissa Jim, Janet J. Kelly, Anne P. Lanier

Public Health Resources

BACKGROUND. Cancer incidence rates vary among American Indian and Alaska Native (AI/AN) populations and often differ from rates among non-Hispanic whites (NHWs). However, the misclassification of race for AI/AN cancer cases in central cancer registries may have led to underestimates of the AI/AN cancer burden in previous reports.

METHODS. Cases diagnosed during 1999 through 2004 were identified from population- based cancer registries in the United States. Age-adjusted rates were calculated for the 25 most common sites for AI/ANs and NHWs. To minimize the misclassification of race, cancer registry records were linked with patient registration files from the Indian …

Breast Cancer Incidence Among American Indian And Alaska Native Women: Us, 1999–2004, Phyllis A. Wingo, Jessica King, Judith Swan, Steven S. Coughlin, Judith S. Kaur, Julie A. Erb-Alvarez, Jeannette Jackson-Thompson, Teshia G. Arambula Solomon

Public Health Resources

BACKGROUND. Breast cancer is a leading cause of cancer morbidity and mortality among American Indian and Alaska Native (AI/AN) women. Although published studies have suggested that breast cancer rates among AI/AN women are lower than those among other racial and ethnic populations, accurate determinations of the breast cancer burden have been hampered by misclassification of AI/AN race.

METHODS. Cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age-adjusted rates for the diagnosis years 1999 through 2004. Several steps were taken to reduce the misclassification of …

Epidemiology Of Tropical Theileriosis In The Cappadocia Region, Abdullah İnci̇, Anil İça, Alparslan Yildirim, Zati̇ Vatansever, Ayşe Çakmak, Hasan Albasan, Yücel Çam, Ayhan Atasever, Önder Düzlü

Turkish Journal of Veterinary & Animal Sciences

A total of 554 cattle from the Cappadocia region were divided into 5 different groups according to vaccination and were examined for Theileria annulata by microscope and indirect fluorescence antibody test (IFAT). The sampled cattle were checked for tick infestation. The prevalence of T. annulata was 60.5% by microscopic examination and 67.5% by IFAT. According to the microscopic examination, the prevalence of T. annulata was significantly (P < 0.001) higher in the unvaccinated group. The seropositivity according to IFAT was significantly (P < 0.001) lower in the unvaccinated group. The morbidity was significantly (P < 0.001) higher in the unvaccinated, semi-grazed, pure breed, and >2 years age groups. The mortality was significantly higher in the unvaccinated (P < 0.001), semi-grazed (P < 0.05), pure breed (P < 0.05), and female (P < 0.001) groups. A total of 1585 tick specimens belonging to the genera Hyalomma, Rhipicephalus, Dermacentor, Boophilus, and Ornithodorus were detected in 21.48% of examined cattle. The developing forms of T. annulata were determined in the H. anatolicum anatolicum ticks microscopically. Out of 554 cattle, 156 (27.61%) were diagnosed with acute tropical theileriosis. Out of these 156 cattle, 86 (56.21%) died due to the disease.

Physical Activity And Blood Pressure In Childhood: Findings From A Population-Based Study, Sam D. Leary, Andy R. Ness, George Davey Smith, Calum Mattocks, Kevin Deere, Steven N. Blair, Chris J. Riddoch

Faculty Publications

The pathological processes associated with development of cardiovascular disease begin early in life. For example, elevated blood pressure (BP) can be seen in childhood and tracks into adulthood. The relationship between physical activity (PA) and BP in adults is well-established, but findings in children have been inconsistent, with few studies measuring PA mechanically. Children aged 11 to 12 years were recruited from the Avon Longitudinal Study of Parents and Children. 5505 had systolic and diastolic BP measurements, plus valid (at least 10 hours for at least 3 days) accelerometer measures of PA; total PA recorded as average counts per minute …

Use Of Accelerometers In A Large Field-Based Study Of Children: Protocols, Design Issues, And Effects On Precision, Calum Mattocks, Andy R. Ness, Sam D. Leary, Kate Tilling, Steven N. Blair, Julian Shield, Kevin Deere, Joanne Saunders, Joanne Krikby, George Davey Smith, Jonathan Wells, Nicholas Wareham, John J. Reilly, Chris J. Riddoch

Faculty Publications

Background: Objective methods can improve accuracy of physical activity measurement in field studies but uncertainties remain about their use.

Methods: Children age 11 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), were asked to wear a uni-axial accelerometer (MTI Actigraph) for 7 days.

Results: Of 7159 children who attended for assessment, 5595 (78%) provided valid measures. The reliability coefficient for 3 days of recording was .7 and the power to detect a difference of 0.07 SDs (P ≤ .05) was > 90%. Measures tended to be higher on the first day of recording (17 counts/min; 95% CI, …