Epidemiology Commons^™

Validating Estimates Of Prevalence Of Non-Communicable Diseases Based On Household Surveys: The Symptomatic Diagnosis Study, Spencer L. James, Minerva Romero, Dolores Ramírez-Villalobos, Sara Gómez

Dartmouth Scholarship

Easy-to-collect epidemiological information is critical for the more accurate estimation of the prevalence and burden of different non-communicable diseases around the world. Current measurement is restricted by limitations in existing measurement systems in the developing world and the lack of biometry tests for non-communicable diseases. Diagnosis based on self-reported signs and symptoms (“Symptomatic Diagnosis,” or SD) analyzed with computer-based algorithms may be a promising method for collecting timely and reliable information on non-communicable disease prevalence. The objective of this study was to develop and assess the performance of a symptom-based questionnaire to estimate prevalence of non-communicable diseases in low-resource areas.

Health Disparities Among Racial And Ethnic Minority Firefighters, Walker Sc Poston, Christopher K. Haddock, Sara A. Jahnke, Nattinee Jitnarin, Rena Sue Day, I David Daniels

Journal of Health Disparities Research and Practice

ABSTRACT

Background: Racial/ethnic minorities are substantially underrepresented in the fire service and this situation is unique when compared to similarly mentally and physically demanding and hazardous occupations such as the military and law enforcement. There is little systematic research to provide greater clarity about this significant disparity. The purpose of this study is to examine physical and behavioral health issues of racial/ethnic minority firefighters when compared to their white, non-Hispanic counterparts and potentially identify areas for future research that might assist in improving their substantial underrepresentation.

Materials and Methods: We report the results of a secondary analysis of data combining …

Cohort Of Birth Modifies The Association Between Fto Genotype And Bmi, James Niels Rosenquist, Steven F. Lehrer, A. James O'Malley, Alan M. Zaslavsky, Jordan W. Smoller, Nicholas A. Christakis

Dartmouth Scholarship

A substantial body of research has explored the relative roles of genetic and environmental factors on phenotype expression in humans. Recent research has also sought to identify gene-environment (or g-by-e) interactions, with mixed success. One potential reason for these mixed results may relate to the fact that genetic effects might be modified by changes in the environment over time. For example, the noted rise of obesity in the United States in the latter part of the 20th century might reflect an interaction between genetic variation and changing environmental conditions that together affect the penetrance of genetic influences. To evaluate this …

The Relationship Between Cancer Incidence, Stage, And Poverty In The United States, Francis P. Boscoe, Kevin A. Henry, Recinda L. Sherman, Christopher J. Johnson

Epidemiology & Biostatistics Faculty Scholarship

We extend a prior analysis on the relation between poverty and cancer incidence in a sample of 2.90 million cancers diagnosed in 16 U.S. states plus Los Angeles over the 2005-2009 period by additionally considering stage at diagnosis. Recognizing that higher relative disparities are often found among less-common cancer sites, our analysis incorporated both relative and absolute measures of disparities. Fourteen of the 21 cancer sites analyzed were found to have significant variation by stage; in each instance, diagnosis at distant stage was more likely among residents of high-poverty areas. If the incidence rates found in the lowest-poverty areas for …

Public Domain Small-Area Cancer Incidence Data For New York State, 2005-2009, Francis P. Boscoe, Thomas O. Talbot, Martin Kulldorff

Epidemiology & Biostatistics Faculty Scholarship

There has long been a demand for cancer incidence data at a fine geographic resolution for use in etiologic hypothesis generation and testing, methodological evaluation, and teaching. In this paper we describe a public domain data set containing data for 23 anatomic sites of cancer diagnosed in New York State between 2005 and 2009 at the level of the census block group. The data set includes 524,503 tumors distributed across 13,823 block groups with an average population of about 1,400. In addition, the data have been linked with race and ethnicity and with socioeconomic indicators such as income, educational attainment, …

The Relationship Of Female Physical Attractiveness To Body Fatness, Guanlin Wang, Kurosh Djafarian, Chima A. Egedigwe, Asmaa El Hamdouchi, Robert Ojiambo, Harris Ramuth, Sandra Johanna Wallner-Liebmann, Sonja Lackner, Adama Diouf, Justina Sauciuvenaite, Catherine Hambly, Lobke M. Vaanholt, Mark D. Faries, John R. Speakman

Faculty Publications

Aspects of the female body may be attractive because they signal evolutionary fitness. Greater body fatness might reflect greater potential to survive famines, but individuals carrying larger fat stores may have poor health and lower fertility in non-famine conditions. A mathematical statistical model using epidemiological data linking fatness to fitness traits, predicted a peaked relationship between fatness and attractiveness (maximum at body mass index (BMI) = 22.8 to 24.8 depending on ethnicity and assumptions). Participants from three Caucasian populations (Austria, Lithuania and the UK), three Asian populations (China, Iran and Mauritius) and four African populations (Kenya, Morocco, Nigeria and Senegal) …

Remote Video Auditing With Real-Time Feedback In An Academic Surgical Suite Improves Safety And Efficiency Metrics: A Cluster Randomised Study, F. J. Overdyk, O. Dowling, S. Newman, D. Glatt, M. Chester, D. Armellino, B. Cole, G. S. Landis, D. Schoenfeld, J. F. Dicapua

Journal Articles

IMPORTANCE: Compliance with the surgical safety checklist during operative procedures has been shown to reduce inhospital mortality and complications but proper execution by the surgical team remains elusive. OBJECTIVE: We evaluated the impact of remote video auditing with real-time provider feedback on checklist compliance during sign-in, time-out and sign-out and case turnover times. DESIGN, SETTING: Prospective, cluster randomised study in a 23-operating room (OR) suite. PARTICIPANTS: Surgeons, anaesthesia providers, nurses and support staff. EXPOSURE: ORs were randomised to receive, or not receive, real-time feedback on safety checklist compliance and efficiency metrics via display boards and text messages, followed by a …

Mining Mobile Datasets To Enable The Fine-Grained Stochastic Simulation Of Ebola Diffusion, Nicholas Vogel, Christopher Theisen, Jonathan P. Leidig, Jerry Scripps, Doug H. Graham, Greg Wolffe

Peer Reviewed Articles

The emergence of Ebola in West Africa is of worldwide public health concern. Successful miti- gation of epidemics requires coordinated, well-planned intervention strategies that are specific to the pathogen, transmission modality, population, and available resources. Modeling and sim- ulation in the field of computational epidemiology provides predictions of expected outcomes that are used by public policy planners in setting response strategies.

Developing up to date models of population structures, daily activities, and movement has proven challenging for developing countries due to limited governmental resources. Recent collaborations (in 2012 and 2014) with telecom providers have given public health researchers access to …

Geographic Trends Of Tobacco-Related Cancers In Cyprus, Evi A. Farazi, Lina Lander, Pavlos Pavlou, Katherine Watkins, Lynne Le, Amr Soliman

Journal Articles: Epidemiology

BACKGROUND: Causal relationships have been previously established between smoking and various cancers. In Cyprus, 39 % of men and 14 % of women reported daily smoking in 2008. The objective of this study was to compare the incidence of tobacco-related cancers to all other cancers by district and rural-urban classification to understand the impact of tobacco in Cyprus.

METHODS: Data on lung, urinary bladder, oral, pharyngeal, head/neck, and laryngeal cancers were obtained from the Cyprus Cancer Registry (1998-2008). There were 3,635 patients with tobacco-related cancers and 18,780 with non-tobacco cancers. Univariate analysis comparing tobacco-related cancers and all other cancers were …

Comparison Of Individual And Pooled Urine Samples For Estimating The Presence And Intensity Of Schistosoma Haematobium Infections At The Population Level, Abraham Degarege, Berhanu Erko, Zeleke Mekonnen, Mengistu Legesse, Yohannes Negash, Jozef Vercruysse, Bruno Levecke

Journal Articles: Epidemiology

BACKGROUND: There is a lack of cost-effective diagnostic strategies to evaluate whether mass drug administration (MDA) programmes to control Schistosoma haematobium progress as anticipated. The purpose of this study is to provide a proof-of-principle for examination of pooled urine samples as a strategy for rapid assessment of presence and intensity of Schistosoma haematobium infections at the population level.

METHODS: A total of 640 urine samples were collected from 520 school-aged children (520 at baseline and 120 at follow-up) during a clinical trial that was designed to assess the efficacy of praziquantel against Schistosoma haematobium infections in Ethiopia. Individual and pooled …

Association Between Respiratory Syncytial Virus Activity And Pneumococcal Disease In Infants: A Time Series Analysis Of Us Hospitalization Data., Daniel M. Weinberger, Keith P. Klugman, Claudia A. Steiner, Lone Simonsen, Cécile Viboud

Epidemiology Faculty Publications

BACKGROUND:

The importance of bacterial infections following respiratory syncytial virus (RSV) remains unclear. We evaluated whether variations in RSV epidemic timing and magnitude are associated with variations in pneumococcal disease epidemics and whether changes in pneumococcal disease following the introduction of seven-valent pneumococcal conjugate vaccine (PCV7) were associated with changes in the rate of hospitalizations coded as RSV.

METHODS AND FINDINGS:

We used data from the State Inpatient Databases (Agency for Healthcare Research and Quality), including >700,000 RSV hospitalizations and >16,000 pneumococcal pneumonia hospitalizations in 36 states (1992/1993-2008/2009). Harmonic regression was used to estimate the timing of the average seasonal …

Clinical Presentation Of Patients With Ebola Virus Disease In Conakry, Guinea, Elhadj Ibrahima Bah, Marie-Claire Lamah, Tom Fletcher, Shevin T. Jacob, David Brett-Major, Amadou Alpha Sall, Nahoko Shindo, William A. Fischer, Francois Lamontagne, Sow Mamadou Saliou, Daniel G. Bausch, Barry Moumié, Tim Jagatic, Armand Sprecher, James V. Lawler, Thierry Mayet, Frederique A. Jacquerioz, María F. Méndez Baggi, Constanza Vallenas, Christophe Clement, Simon Mardel, Ousmane Faye, Oumar Faye, Baré Soropogui, Nfaly Magassouba, Lamine Koivogui, Ruxandra Pinto, Robert A. Fowler

Journal Articles: Epidemiology

BACKGROUND: In March 2014, the World Health Organization was notified of an outbreak of Zaire ebolavirus in a remote area of Guinea. The outbreak then spread to the capital, Conakry, and to neighboring countries and has subsequently become the largest epidemic of Ebola virus disease (EVD) to date.

METHODS: From March 25 to April 26, 2014, we performed a study of all patients with laboratory-confirmed EVD in Conakry. Mortality was the primary outcome. Secondary outcomes included patient characteristics, complications, treatments, and comparisons between survivors and nonsurvivors.

RESULTS: Of 80 patients who presented with symptoms, 37 had laboratory-confirmed EVD. Among confirmed …

Calling Science Pseudoscience: Fleck’S Archaeologies Of Fact And Latour’S ‘Biography Of An Investigation’ In Aids Denialism And Homeopathy, Babette Babich

Articles and Chapters in Academic Book Collections

Fleck’s Genesis and Development of a Scientific Fact foregrounds claims traditionally excluded from reception, often regarded as opposed to fact, scientific claims that are increasingly seldom discussed in connection with philosophy of science save as examples of pseudo-science. I am especially concerned with scientists who question the epidemiological link between HIV and AIDS and who are thereby discounted—no matter their credentials, no matter the cogency of their arguments, no matter the sobriety of their statistics—but also with other classic examples of so-called pseudo-science including homeopathy and other sciences, such as cold fusion. The pseudo-science version of the demarcation problem turns …

Serum Cotinine And Chronic Pain: Nhanes 2003-2004, R Constance Wiener

Faculty & Staff Scholarship

Purpose—Tobacco smoke exposure continues to be the leading preventable risk factor for many diseases and has the potential to be a risk factor for chronic pain. The purpose of this study is to determine the relationship of chronic pain with smoking, secondhand smoke exposure and nonsmoking using serum cotinine (and self-report of living with someone who smokes in the home) to identify the tobacco exposure groups. Methods—The National Health and Nutrition Examination Survey (NHANES) 2003–2004 was used for this study. Participants were queried about pain duration and had serum cotinine levels determined during the course of the NHANES examination/survey. Participants, …

A History Of Undergraduate Education For Public Health: From Behind The Scenes To Center Stage., Richard Kenneth Riegelman, Susan Albertine, Randy Wykoff

GW Biostatistics Center

No abstract provided.

Scaling Down To Scale Up: A Health Economic Analysis Of Integrating Point-Of-Care Syphilis Testing Into Antenatal Care In Zambia During Pilot And National Rollout Implementation., Katharine D. Shelley, Éimhín M. Ansbro, Alexander Tshaka Ncube, Sedona Sweeney, Colette Fleischer, Grace Tembo Mumba, Michelle M. Gill, Susan Strasser, Rosanna W. Peeling, Fern Terris-Prestholt

GW Biostatistics Center

Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, …

Treatment-Induced Changes In Plasma Adiponectin Do Not Reduce Urinary Albumin Excretion In The Diabetes Prevention Program Cohort., Kieren J. Mather, Qing Pan, William C. Knowler, Tohru Funahashi, George A. Bray, Et Al.

GW Biostatistics Center

BACKGROUND AND OBJECTIVES: Molecular data suggests that adiponectin may directly regulate urinary albumin excretion. In the Diabetes Prevention Program (DPP) we measured adiponectin and albuminuria before and after intervention, and we previously reported increases in adiponectin with interventions. Here we have used the DPP dataset to test the hypothesis that treatment-related increases in adiponectin may reduce albuminuria in obesity.

DESIGN, SETTING, PARTICIPANTS AND METHODS: We evaluated cross-sectional correlations between plasma adiponectin and urinary albumin excretion at baseline, and the relationship of treatment-related changes in adiponectin and albuminuria. Baseline and follow-up urine albumin to creatinine ratios (ACR (albumin to creatinine ratio)) …

The Cost-Effectiveness Of Diabetes Prevention: Results From The Diabetes Prevention Program And The Diabetes Prevention Program Outcomes Study, William H. Herman

GW Biostatistics Center

Background

The Diabetes Prevention Program (DPP) was a randomized, controlled clinical trial. It demonstrated that among high-risk individuals with impaired glucose tolerance, diabetes incidence was reduced by 58 % with lifestyle intervention and 31 % with metformin compared to placebo. During the Diabetes Prevention Program Outcomes Study (DPPOS), all DPP participants were unmasked to their treatment assignments, the original lifestyle intervention group was offered additional lifestyle support, the metformin group continued metformin, and all three groups were offered a group-implemented lifestyle intervention. Over the 10 years of combined DPP/DPPOS follow-up, diabetes incidence was reduced by 34 % in the lifestyle …

Skin Collagen Advanced Glycation Endproducts (Ages) And The Long-Term Progression Of Sub-Clinical Cardiovascular Disease In Type 1 Diabetes, Vincent M. Monnier, Wanjie Sun, Xiaoyu Gao, David R. Sell, Patricia Cleary, John M. Lachin, Saul Genuth, The Dcct/Edic Research Group

GW Biostatistics Center

BACKGROUND:

We recently reported strong associations between eight skin collagen AGEs and two solubility markers from skin biopsies obtained at DCCT study closeout and the long-term progression of microvascular disease in EDIC, despite adjustment for mean glycemia. Herein we investigated the hypothesis that some of these AGEs (fluorescence to be reported elsewhere) correlate with long-term subclinical cardiovascular disease (CVD) measurements, i.e. coronary artery calcium score (CAC) at EDIC year 7-9 (n = 187), change of carotid intima-media thickness (IMT) from EDIC year 1 to year 6 and 12 (n = 127), and cardiac MRI outcomes at EDIC year 15-16 (n …

Quality Control Measures Over 30 Years In A Multicenter Clinical Study: Results From The Diabetes Control And Complications Trial / Epidemiology Of Diabetes Interventions And Complications (Dcct/Edic) Study., Gayle M Lorenzi, Barbara H Braffett, Valerie L Arends, Ronald P Danis, Lisa Diminick, Kandace A Klumpp, Anthony D Morrison, Elsayed Z Soliman, Michael W Steffes, Patricia A Cleary

GW Biostatistics Center

No abstract provided.