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Yamaoka K, Suzuki M, Inoue M, Ishikawa H, Tango T. Spatial clustering of suicide mortality and associated community characteristics in Kanagawa prefecture, Japan, 2011-2017. BMC Psychiatry 2020; 20:74. [PMID: 32070316 PMCID: PMC7029524 DOI: 10.1186/s12888-020-2479-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 01/31/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Suicide mortality is high in Japan and early interventional strategies to solve that problem are needed. An accurate evaluation of the regional status of current suicide mortality would be useful for community interventions. A few studies in Kanagawa prefecture, located next to Tokyo and with the second largest population in Japan, have identified spatial clusters of suicide mortality at regional levels. This study examined spatial clustering and clustering over time of such events using spatial data from regional statistics on suicide deaths. METHODS Data were obtained from regional statistics (58 regions in Kanagawa prefecture) of the National Vital Statistics of Japan from 2011 to 2017. The standardized mortality ratio (SMR) and Empirical Bayes estimator for the SMR (EBSMR) were used as measures. Spatial clusters were examined by Kulldorff's circular spatial scan statistic, Tango-Takahashi's flexible spatial scan statistic and Tango's test. Linear regression and conditional autoregressive (CAR) models were used not only to adjust for covariates but also to estimate regional effects. The analyses were conducted for each year, inclusive. RESULTS Among male suicide deaths, being unemployed (50%) was most frequently related to suicide while among female health problem (50%) were frequent. Spatial clusters with significance detected by FlexScan, SatScan and Tango's test were few and varied somewhat according to the method used. Spatial clusters were detected in some regions including Kawasaki ward after adjustment by covariates. By the linear regression models, selected variables with significance were different between the sexes. For males, unemployment, family size, and proportion of higher education were detected for several of the years studied while for females, family size and divorce rate were detected over this period. These variables were also observed by the CAR model with 5 covariates. Regional effects were much clearer by considering the spatial parameter for both males and females and especially, Kawasaki ward was detected as a high risk region in many years. CONCLUSION The present results detected some spatial clustering of suicide deaths within certain regions. Factors related to suicide deaths were also indicated. These results would provide important information in policy making for suicide prevention.
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Affiliation(s)
- Kazue Yamaoka
- Teikyo University Graduate School of Public Health, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
| | - Masako Suzuki
- grid.264706.10000 0000 9239 9995Teikyo University Graduate School of Public Health, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605 Japan
| | - Mariko Inoue
- grid.264706.10000 0000 9239 9995Teikyo University Graduate School of Public Health, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605 Japan
| | - Hirono Ishikawa
- grid.264706.10000 0000 9239 9995Teikyo University Graduate School of Public Health, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605 Japan
| | - Toshiro Tango
- grid.264706.10000 0000 9239 9995Teikyo University Graduate School of Public Health, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605 Japan ,Center for Medical Statistics, Tokyo, Japan
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The association between internal migration and pulmonary tuberculosis in China, 2005-2015: a spatial analysis. Infect Dis Poverty 2020; 9:5. [PMID: 32063228 PMCID: PMC7025414 DOI: 10.1186/s40249-020-0621-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/07/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Internal migration places individuals at high risk of contracting tuberculosis (TB). However, there is a scarcity of national-level spatial analyses regarding the association between TB and internal migration in China. In our research, we aimed to explore the spatial variation in cases of sputum smear-positive pulmonary TB (SS + PTB) in China; and the associations between SS + PTB, internal migration, socioeconomic factors, and demographic factors in the country between 2005 and 2015. METHODS Reported cases of SS + PTB were obtained from the national PTB surveillance system database; cases were obtained at the provincial level. Internal migration data were extracted from the national population sampling survey and the census. Spatial autocorrelations were explored using the global Moran's statistic and local indicators of spatial association. The spatial temporal analysis was performed using Kulldorff's scan statistic. Fixed effects regression was used to explore the association between SS + PTB and internal migration. RESULTS A total of 4 708 563 SS + PTB cases were reported in China between 2005 and 2015, of which 3 376 011 (71.7%) were male and 1 332 552 (28.3%) were female. There was a trend towards decreasing rates of SS + PTB notifications between 2005 and 2015. The result of global spatial autocorrelation indicated that there were significant spatial correlations between SS + PTB rate and internal migration each year (2005-2015). Spatial clustering of SS + PTB cases was mainly located in central and southern China and overlapped with the clusters of emigration. The proportions of emigrants and immigrants were significantly associated with SS + PTB. Per capita GDP and education level were negatively associated with SS + PTB. The internal migration flow maps indicated that migrants preferred neighboring provinces, with most migrating for work or business. CONCLUSIONS This study found a significant spatial autocorrelation between SS + PTB and internal migration. Both emigration and immigration were statistically associated with SS + PTB, and the association with emigration was stronger than that for immigration. Further, we found that SS + PTB clusters overlapped with emigration clusters, and the internal migration flow maps suggested that migrants from SS + PTB clusters may influence the TB epidemic characteristics of neighboring provinces. These findings can help stakeholders to implement effective PTB control strategies for areas at high risk of PTB and those with high rates of internal migrants.
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Joseph AC, Fuentes M, Wheeler DC. The impact of population mobility on estimates of environmental exposure effects in a case-control study. Stat Med 2020; 39:1610-1622. [PMID: 32059071 DOI: 10.1002/sim.8501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/20/2019] [Accepted: 10/28/2019] [Indexed: 12/12/2022]
Abstract
In many studies of environmental risk factors for disease, researchers use the location at diagnosis as a geographic reference for environmental exposures. However, many environmental pollutants change continuously over space and time. The dynamic characteristics of these pollutants coupled with population mobility in the United States suggest that for diseases with long latencies like cancer, historic exposures may be more relevant than exposure at the time of diagnosis. In this article, we evaluated to what extent the commonly used assumption of no population mobility results in increased bias in the estimates of the relationship between environmental exposures and long-latency health outcomes disease in a case-control study. We conducted a simulation study using the residential histories of a random sample from the National Institutes of Health-AARP (formerly American Association of Retired Persons) Diet and Health Study. We simulated case-control status based on subject exposure and true exposure effects that varied temporally. We compared estimates from models using only subject location at diagnosis to estimates where subjects were assumed to be mobile. Ignoring population mobility resulted in underestimates of subject exposure, with largest deviations observed at time points further away from study enrollment. In general, the effect of population mobility on the bias of the estimates of the relationship between the exposure and the outcome was more prominent with exposures that showed substantial spatial and temporal variability. Based on our results, we recommend using residential histories when environmental exposures and disease latencies span a long enough time period that mobility is important.
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Affiliation(s)
- Anny-Claude Joseph
- Department of Mathematical Sciences, United States Military Academy, West Point, NY
| | - Montserrat Fuentes
- Office of the Executive Vice President and Provost, University of Iowa, Iowa City, IA
| | - David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia
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Edwin P, Azage M. Geographical Variations and Factors Associated with Childhood Diarrhea in Tanzania: A National Population Based Survey 2015-16. Ethiop J Health Sci 2020; 29:513-524. [PMID: 31447525 PMCID: PMC6689700 DOI: 10.4314/ejhs.v29i4.13] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Diarrhea remains the leading cause of morbidity and mortality among under 5 children in low- and middle-income countries. In Tanzania, diarrhea remains one of the major public health problems. This study aimed to investigate spatial variations and the factors correlated with diarrhea in under five children. Methods This is a secondary data analysis using data from the population-based cross section Tanzanian Demographic and Health Survey 2015–16 data. Spatial analysis was done using the Bernoulli model from SaTScan™ software, and a generalized linear mixed model was used to identify the factors associated with childhood diarrhea. Results The overall reported prevalence of childhood diarrhea for the under five children in Tanzania was 12.1% (95%CI 11.3%–12.9%). The SaTScan spatial statics analysis revealed that diarrhea in children was not random. The odds of diarrhea were 7.35 times higher (AOR= 7.35; 95%CI: 5.29, 10.22) among children in the 6–11 months age group compared to children within the 48–59 months of age. As mother's age increased, the risk of diarrhea for the under five children decreased whereas the highest risk of diarrhea was observed in the two rich income brackets richer (AOR=1.70, 95%CI=1.30, 2.22), and richest (AOR= 1.05, 95%CI=1, 1.09). The odds of diarrhea were 1.25 times higher (AOR=1.25, 95%CI=1.06, 1.46) among children with unsafe stool disposal compared to those with safe disposal. Conclusion The socio-demographic factors associated with diarrhea among children were mother's age in years, current age of the child, wealth index and child stool disposal.
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Affiliation(s)
- Paul Edwin
- University of Dodoma, Department of Statistics, United Republic of Tanzania
| | - Muluken Azage
- Bahir Dar university - Public health, College of Medicine and Health Sciences, Bahir Dar university, Bahir Dar, Ethiopia
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105
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León-Gómez BB, Gotsens M, Marí-Dell'Olmo M, Domínguez-Berjón MF, Luque-Fernandez MÁ, Martin U, Rodríguez-Sanz M, Pérez G. Bayesian smoothed small-areas analysis of urban inequalities in fertility across 1999-2013. FERTILITY RESEARCH AND PRACTICE 2020; 5:17. [PMID: 31890237 PMCID: PMC6925428 DOI: 10.1186/s40738-019-0066-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/08/2019] [Indexed: 11/23/2022]
Abstract
Background Since the 2008 economic crisis in Spain, overall fertility has continued to decrease, while urban inequalities have increased. There is a general lack of studies of fertility patterns in small-areas of Spanish cities. We explored the effects of the economic crisis on fertility during three time periods in urban settings in Spain. Methods We studied the distribution of fertility rates among women (15–49 years) from Spain and low-middle income countries (LIC) who were living in 13 Spanish cities. We mapped fertility and the MEDEA socioeconomic deprivation index in small-areas, and analyzed age-related trends in fertility rates. We performed an ecological regression analysis of fertility and the deprivation index in two pre-crisis periods (1999–2003 and 2004–2008) and one crisis period (2009–2013). Fertility rates were calculated and smoothed using the hierarchical Bayesian model (BYM). Results Higher fertility was generally associated with socioeconomic deprivation, with adjustment for the mothers’ age and nationality. While Spanish citizens tended to delay childbearing throughout the three study periods, fertility increased among Spanish adolescents from deprived urban areas during the economic crisis. There was a general decline in fertility among immigrants after the crisis, especially in southern cities. Overall, fertility appeared to be stable, with higher fertility in more deprived areas. Conclusion Increased unemployment and changes to government family policies may have contributed to delayed childbearing in Spain. For immigrants, more restrictive immigration policies may have played a crucial role in decreasing fertility rates. Reforming such policies will be key for better reproductive rights and improved fertility rates across all population cohorts in Spain.
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Affiliation(s)
- Brenda Biaani León-Gómez
- 1Sistemes d'Informació Sanitària, Agència de Salut Pública de Barcelona, Barcelona, Spain.,2Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Mercè Gotsens
- 1Sistemes d'Informació Sanitària, Agència de Salut Pública de Barcelona, Barcelona, Spain.,3Institut de Recerca Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,4Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marc Marí-Dell'Olmo
- 5Qualitat i Intervenció Ambiental, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | | | - Miguel Ángel Luque-Fernandez
- 7Faculty of Epidemiology and Population Health, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Unai Martin
- 8Departamento de Sociología 2, Universidad del País Vasco UPV/EHU, Leoia, Bizkaia Spain
| | - Maica Rodríguez-Sanz
- 9Recerca, Docència i Comunicació, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Gloria Pérez
- 1Sistemes d'Informació Sanitària, Agència de Salut Pública de Barcelona, Barcelona, Spain.,2Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,3Institut de Recerca Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Demoury C, De Schutter H, Faes C, Carbonnelle S, Fierens S, Molenberghs G, Van Damme N, Van Bladel L, Van Nieuwenhuyse A, Vleminckx C. Thyroid cancer incidence near nuclear sites in Belgium: An ecological study at small geographical level. Int J Cancer 2019; 146:3034-3043. [PMID: 31745983 PMCID: PMC7187213 DOI: 10.1002/ijc.32796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/18/2019] [Accepted: 10/22/2019] [Indexed: 12/12/2022]
Abstract
In Belgium, variations in thyroid cancer incidence were observed around the major nuclear sites. The present ecological study investigates whether there is an excess incidence of thyroid cancer among people living in the vicinity of the four nuclear sites at the smallest Belgian geographical level. Rate ratios were obtained from a Bayesian hierarchical model for areas of varying sizes around the nuclear sites. Focused hypothesis tests and generalized additive models were performed to test the hypothesis of a gradient in thyroid cancer incidence with increasing levels of surrogate exposures. No evidence was found for more incident cases of thyroid cancer near the two nuclear power plants. Regarding the two industrial and research nuclear sites, no evidence for a higher incidence in the vicinity of Mol‐Dessel was observed, whereas a slightly nonsignificant higher incidence was found in the close vicinity of Fleurus. In addition, significant gradients for thyroid cancer incidence were observed with the different types of surrogate exposure considered in the 20 km area around the site of Fleurus (decreasing distance, increasing wind direction frequency and increasing exposure to estimated hypothetical radioactive discharges of iodine‐131). In the investigation at the smallest Belgian geographical level, variations in thyroid cancer incidence were found around the Belgian nuclear sites. Significant exposure–response relationships were also observed for the site of Fleurus. Further investigations into these findings could be useful to allow inferring causal relationships on the origin of variations in incidence and to provide information at the individual level. What's new? Potential cancer risk associated with living near nuclear installations has long been a public concern. In Belgium, a previous study found a higher incidence around the two nuclear sites with research and industrial activities, but not around the two nuclear power plants. Exposure misclassification due to the large geographical scale could not be excluded, however. The present study, which uses data available at the smallest Belgian geographical level, confirms the previously‐described incidence patterns around the nuclear power plants and for one of the research and industrial sites. There was a significant exposure‐response relationship for the latter. This finding is valuable for thyroid cancer etiology.
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107
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Lessons Learned From the Environmental Public Health Tracking Sub-County Data Pilot Project. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2019; 24:E20-E27. [PMID: 29227419 DOI: 10.1097/phh.0000000000000686] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Small area data are key to better understanding the complex relationships between environmental health, health outcomes, and risk factors at a local level. In 2014, the Centers for Disease Control and Prevention's National Environmental Public Health Tracking Program (Tracking Program) conducted the Sub-County Data Pilot Project with grantees to consider integration of sub-county data into the National Environmental Public Health Tracking Network (Tracking Network). DESIGN The Tracking Program and grantees developed sub-county-level data for several data sets during this pilot project, working to standardize processes for submitting data and creating required geographies. Grantees documented challenges they encountered during the pilot project and documented decisions. RESULTS This article covers the challenges revealed during the project. It includes insights into geocoding, aggregation, population estimates, and data stability and provides recommendations for moving forward. CONCLUSION National standards for generating, analyzing, and sharing sub-county data should be established to build a system of sub-county data that allow for comparison of outcomes, geographies, and time. Increasing the availability and accessibility of small area data will not only enhance the Tracking Network's capabilities but also contribute to an improved understanding of environmental health and informed decision making at a local level.
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108
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Greenough PG, Nelson EL. Beyond mapping: a case for geospatial analytics in humanitarian health. Confl Health 2019; 13:50. [PMID: 31719842 PMCID: PMC6839210 DOI: 10.1186/s13031-019-0234-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 10/04/2019] [Indexed: 12/02/2022] Open
Abstract
The humanitarian sector is increasingly adopting geospatial data to support operations. However, the utilization of these data in the humanitarian health arena is predominantly in thematic map format, thereby limiting the full insight and utility of geospatial information. Geospatial analytics, in contrast, including pattern analysis, interpolation, and predictive modeling, have tremendous potential within the field of humanitarian health. This paper explores a variety of historical and contemporary geospatial applications in the public health and humanitarian fields and argues for greater integration of geospatial analysis into humanitarian health research and programming. From remote sensing to create sampling frames, to spatial interpolation for environmental exposure analysis, and multi-objective optimization algorithms for humanitarian logistics, spatial analysis has transformed epistemological paradigms, research methods and programming landscapes across diverse disciplines. The field of humanitarian health, which is inextricably bounded by geography and resource limitations, should leverage the unique capacities of spatial methods and strategically integrate geospatial analytics into research and programming not only to fortify the academic legitimacy and professionalization of the field but also to improve operational efficiency and mitigation strategies.
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Affiliation(s)
- P Gregg Greenough
- 1Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA.,2Harvard Humanitarian Initiative, 14 Story Street, Cambridge, MA 02138 USA.,3Department of Emergency Medicine, Harvard Medical School, Boston, MA 02115 USA
| | - Erica L Nelson
- 2Harvard Humanitarian Initiative, 14 Story Street, Cambridge, MA 02138 USA.,3Department of Emergency Medicine, Harvard Medical School, Boston, MA 02115 USA
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Aturinde A, Rose N, Farnaghi M, Maiga G, Pilesjö P, Mansourian A. Establishing spatially-enabled health registry systems using implicit spatial data pools: case study - Uganda. BMC Med Inform Decis Mak 2019; 19:215. [PMID: 31703685 PMCID: PMC6842149 DOI: 10.1186/s12911-019-0949-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 10/24/2019] [Indexed: 12/04/2022] Open
Abstract
Background Spatial epidemiological analyses primarily depend on spatially-indexed medical records. Some countries have devised ways of capturing patient-specific spatial details using ZIP codes, postcodes or personal numbers, which are geocoded. However, for most resource-constrained African countries, the absence of a means to capture patient resident location as well as inexistence of spatial data infrastructures makes capturing of patient-level spatial data unattainable. Methods This paper proposes and demonstrates a creative low-cost solution to address the issue. The solution is based on using interoperable web services to capture fine-scale locational information from existing “spatial data pools” and link them to the patients’ information. Results Based on a case study in Uganda, the paper presents the idea and develops a prototype for a spatially-enabled health registry system that allows for fine-level spatial epidemiological analyses. Conclusion It has been shown and discussed that the proposed solution is feasible for implementation and the collected spatially-indexed data can be used in spatial epidemiological analyses to identify hotspot areas with elevated disease incidence rates, link health outcomes to environmental exposures, and generally improve healthcare planning and provisioning.
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Affiliation(s)
- Augustus Aturinde
- GIS Centre, Department of Physical Geography and Ecosystem Science, Lund University, Sölvegatan 12, 223 62, Lund, Sweden
| | - Nakasi Rose
- College of Computing and Information Science, Makerere University, Kampala, Uganda
| | - Mahdi Farnaghi
- GIS Centre, Department of Physical Geography and Ecosystem Science, Lund University, Sölvegatan 12, 223 62, Lund, Sweden
| | - Gilbert Maiga
- College of Computing and Information Science, Makerere University, Kampala, Uganda
| | - Petter Pilesjö
- GIS Centre, Department of Physical Geography and Ecosystem Science, Lund University, Sölvegatan 12, 223 62, Lund, Sweden
| | - Ali Mansourian
- GIS Centre, Department of Physical Geography and Ecosystem Science, Lund University, Sölvegatan 12, 223 62, Lund, Sweden.
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Revisiting John Snow to Meet the Challenge of Nontuberculous Mycobacterial Lung Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214250. [PMID: 31683836 PMCID: PMC6862550 DOI: 10.3390/ijerph16214250] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 01/09/2023]
Abstract
Nontuberculous mycobacteria (NTM) are ubiquitous components of the soil and surface water microbiome. Disparities by sex, age, and geography demonstrate that both host and environmental factors are key determinants of NTM disease in populations, which predominates in the form of chronic pulmonary disease. As the incidence of NTM pulmonary disease rises across the United States, it becomes increasingly evident that addressing this emerging human health issue requires a bold, multi-disciplinary research framework that incorporates host risk factors for NTM pulmonary disease alongside the determinants of NTM residence in the environment. Such a framework should include the assessment of environmental characteristics promoting NTM growth in soil and surface water, detailed evaluations of water distribution systems, direct sampling of water sources for NTM contamination and species diversity, and studies of host and bacterial factors involved in NTM pathogenesis. This comprehensive approach can identify intervention points to interrupt the transmission of pathogenic NTM species from the environment to the susceptible host and to reduce NTM pulmonary disease incidence.
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111
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Schmeltz MT, Marcotullio PJ. Examination of Human Health Impacts Due to Adverse Climate Events Through the Use of Vulnerability Mapping: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173091. [PMID: 31454901 PMCID: PMC6747256 DOI: 10.3390/ijerph16173091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/21/2019] [Accepted: 08/21/2019] [Indexed: 12/29/2022]
Abstract
Government officials, health professionals, and other decision makers are tasked with characterizing vulnerability and understanding how populations experience risks associated with exposure to climate-related hazards. Spatial analyses of vulnerable locations have given rise to climate change vulnerability mapping. While not a new concept, the spatial analyses of specific health outcomes remain limited. This review explores different methodologies and data that are used to assess vulnerability and map population health impacts to climate hazards. The review retrieved scholarly articles and governmental reports concerning vulnerability mapping of human health to the impacts of climate change in the United States, published in the last decade. After review, 37 studies were selected for inclusion. Climate-related exposures were distributed across four main categories, including: high ambient temperatures; flood hazards; vector-borne diseases; and wildfires. A number of different methodologies and measures were used to assess health vulnerability to climate-related hazards, including heat vulnerability indices and regression analyses. Vulnerability maps should exemplify how variables measuring the sensitivity and adaptive capacity of different populations help to determine the potential for climate-related hazards to have an effect on human health. Recommendations address methodologies, data gaps, and communication to assist researchers and stakeholders in directing adaptations to their most efficient and effective use.
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Affiliation(s)
- Michael T Schmeltz
- Department of Health Sciences, California State University, East Bay, Hayward, CA 94542, USA.
| | - Peter J Marcotullio
- Department of Geography, Hunter College, City University of New York (CUNY), New York, NY 10065, USA
- City University of New York Institute for Sustainable Cities, New York, NY 10065, USA
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112
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Khairat S, Haithcoat T, Liu S, Zaman T, Edson B, Gianforcaro R, Shyu CR. Advancing health equity and access using telemedicine: a geospatial assessment. J Am Med Inform Assoc 2019; 26:796-805. [PMID: 31340022 PMCID: PMC6696489 DOI: 10.1093/jamia/ocz108] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/29/2019] [Accepted: 06/01/2019] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Health disparity affects both urban and rural residents, with evidence showing that rural residents have significantly lower health status than urban residents. Health equity is the commitment to reducing disparities in health and in its determinants, including social determinants. OBJECTIVE This article evaluates the reach and context of a virtual urgent care (VUC) program on health equity and accessibility with a focus on the rural underserved population. MATERIALS AND METHODS We studied a total of 5343 patient activation records and 2195 unique encounters collected from a VUC during the first 4 quarters of operation. Zip codes served as the analysis unit and geospatial analysis and informatics quantified the results. RESULTS The reach and context were assessed using a mean accumulated score based on 11 health equity and accessibility determinants calculated for each zip code. Results were compared among VUC users, North Carolina (NC), rural NC, and urban NC averages. CONCLUSIONS The study concluded that patients facing inequities from rural areas were enabled better healthcare access by utilizing the VUC. Through geospatial analysis, recommendations are outlined to help improve healthcare access to rural underserved populations.
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Affiliation(s)
- Saif Khairat
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Timothy Haithcoat
- MU Informatics Institute, University of Missouri, Columbia, Missouri, USA
| | - Songzi Liu
- School of Information and Library Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Tanzila Zaman
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Barbara Edson
- Virtual Care Center, UNC Healthcare, Chapel Hill, North Carolina, USA
| | | | - Chi-Ren Shyu
- MU Informatics Institute, University of Missouri, Columbia, Missouri, USA
- Electrical Engineering and Computer Science Department, University of Missouri, Columbia, Missouri, USA
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113
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Sahar L, Foster SL, Sherman RL, Henry KA, Goldberg DW, Stinchcomb DG, Bauer JE. GIScience and cancer: State of the art and trends for cancer surveillance and epidemiology. Cancer 2019; 125:2544-2560. [PMID: 31145834 PMCID: PMC6625915 DOI: 10.1002/cncr.32052] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/05/2018] [Accepted: 06/25/2018] [Indexed: 12/18/2022]
Abstract
Maps are well recognized as an effective means of presenting and communicating health data, such as cancer incidence and mortality rates. These data can be linked to geographic features like counties or census tracts and their associated attributes for mapping and analysis. Such visualization and analysis provide insights regarding the geographic distribution of cancer and can be important for advancing effective cancer prevention and control programs. Applying a spatial approach allows users to identify location-based patterns and trends related to risk factors, health outcomes, and population health. Geographic information science (GIScience) is the discipline that applies Geographic Information Systems (GIS) and other spatial concepts and methods in research. This review explores the current state and evolution of GIScience in cancer research by addressing fundamental topics and issues regarding spatial data and analysis that need to be considered. GIScience, along with its health-specific application in the spatial epidemiology of cancer, incorporates multiple geographic perspectives pertaining to the individual, the health care infrastructure, and the environment. Challenges addressing these perspectives and the synergies among them can be explored through GIScience methods and associated technologies as integral parts of epidemiologic research, analysis efforts, and solutions. The authors suggest GIScience is a powerful tool for cancer research, bringing additional context to cancer data analysis and potentially informing decision-making and policy, ultimately aimed at reducing the burden of cancer.
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Affiliation(s)
- Liora Sahar
- Geospatial Research, Statistics and Evaluation Center, American Cancer Society, Atlanta, Georgia
| | - Stephanie L. Foster
- Geospatial Research Analysis and Services Program, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Recinda L. Sherman
- Data Use and Research, North American Association of Central Cancer Registries, Springfield, Illinois
| | - Kevin A. Henry
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Daniel W. Goldberg
- Department of Geography, College of Geosciences, Texas A&M University, College Station, Texas
- Department of Computer Science and Engineering, College of Engineering, Texas A&M University, College Station, Texas
| | | | - Joseph E. Bauer
- Statistics and Evaluation Center, American Cancer Society, Atlanta, Georgia
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Spatial Analytics Based on Confidential Data for Strategic Planning in Urban Health Departments. URBAN SCIENCE 2019. [DOI: 10.3390/urbansci3030075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Spatial data analytics can detect patterns of clustering of events in small geographies across an urban region. This study presents and demonstrates a robust research design to study the longitudinal stability of spatial clustering with small case numbers per census tract and assess the clustering changes over time across the urban environment to better inform public health policy making at the community level. We argue this analysis enables the greater efficiency of public health departments, while leveraging existing data and preserving citizen personal privacy. Analysis at the census tract level is conducted in Mecklenburg County, North Carolina, on hypertension during pregnancy compiled from 2011–2014 birth certificates. Data were derived from per year and per multi-year moving counts by aggregating spatially to census tracts and then assessed for clustering using global Moran’s I. With evidence of clustering, local indicators of spatial association are calculated to pinpoint hot spots, while time series data identified hot spot changes. Knowledge regarding the geographical distribution of diseases is essential in public health to define strategies that improve the health of populations and quality of life. Our findings support that spatial aggregation at the census tract level contributes to identifying the location of at-risk “hot spot” communities to refine health programs, while temporal windowing reduces random noise effects on spatial clustering patterns. With tight state budgets limiting health departments’ funds, using geographic analytics provides for a targeted and efficient approach to health resource planning.
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Aturinde A, Farnaghi M, Pilesjö P, Mansourian A. Spatial analysis of HIV-TB co-clustering in Uganda. BMC Infect Dis 2019; 19:612. [PMID: 31299907 PMCID: PMC6625059 DOI: 10.1186/s12879-019-4246-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/30/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) is the leading cause of death for individuals infected with Human immunodeficiency virus (HIV). Conversely, HIV is the most important risk factor in the progression of TB from the latent to the active status. In order to manage this double epidemic situation, an integrated approach that includes HIV management in TB patients was proposed by the World Health Organization and was implemented in Uganda (one of the countries endemic with both diseases). To enable targeted intervention using the integrated approach, areas with high disease prevalence rates for TB and HIV need to be identified first. However, there is no such study in Uganda, addressing the joint spatial patterns of these two diseases. METHODS This study uses global Moran's index, spatial scan statistics and bivariate global and local Moran's indices to investigate the geographical clustering patterns of both diseases, as individuals and as combined. The data used are TB and HIV case data for 2015, 2016 and 2017 obtained from the District Health Information Software 2 system, housed and maintained by the Ministry of Health, Uganda. RESULTS Results from this analysis show that while TB and HIV diseases are highly correlated (55-76%), they exhibit relatively different spatial clustering patterns across Uganda. The joint TB/HIV prevalence shows consistent hotspot clusters around districts surrounding Lake Victoria as well as northern Uganda. These two clusters could be linked to the presence of high HIV prevalence among the fishing communities of Lake Victoria and the presence of refugees and internally displaced people camps, respectively. The consistent cold spot observed in eastern Uganda and around Kasese could be explained by low HIV prevalence in communities with circumcision tradition. CONCLUSIONS This study makes a significant contribution to TB/HIV public health bodies around Uganda by identifying areas with high joint disease burden, in the light of TB/HIV co-infection. It, thus, provides a valuable starting point for an informed and targeted intervention, as a positive step towards a TB and HIV-AIDS free community.
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Affiliation(s)
- Augustus Aturinde
- GIS Centre, Department of Physical Geography and Ecosystem Science, Lund University, SE-221 00 Lund, Sweden
- College of Computing and Information Science, Makerere University, Kampala, Uganda
- Department of Lands and Architectural Studies, Kyambogo University, Kampala, Uganda
| | - Mahdi Farnaghi
- GIS Centre, Department of Physical Geography and Ecosystem Science, Lund University, SE-221 00 Lund, Sweden
| | - Petter Pilesjö
- GIS Centre, Department of Physical Geography and Ecosystem Science, Lund University, SE-221 00 Lund, Sweden
- Centre for Middle Eastern Studies, Lund University, Sölvegatan 10, 223 62 Lund, Sweden
| | - Ali Mansourian
- GIS Centre, Department of Physical Geography and Ecosystem Science, Lund University, SE-221 00 Lund, Sweden
- Centre for Middle Eastern Studies, Lund University, Sölvegatan 10, 223 62 Lund, Sweden
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Wang L, Sun W, Zhou K, Zhang M, Bao P. Spatial Analysis of Built Environment Risk for Respiratory Health and Its Implication for Urban Planning: A Case Study of Shanghai. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081455. [PMID: 31022924 PMCID: PMC6518356 DOI: 10.3390/ijerph16081455] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/10/2019] [Accepted: 04/20/2019] [Indexed: 12/29/2022]
Abstract
Urban planning has been proven and is expected to promote public health by improving the built environment. With a focus on respiratory health, this paper explores the impact of the built environment on the incidence of lung cancer and its planning implications. While the occurrence of lung cancer is a complicated and cumulative process, it would be valuable to discover the potential risks of the built environment. Based on the data of 52,009 lung cancer cases in Shanghai, China from 2009 to 2013, this paper adopts spatial analytical methods to unravel the spatial distribution of lung cancer cases. With the assistance of geographic information system and Geo-Detector, this paper identifies certain built environments that are correlated with the distribution pattern of lung cancer cases in Shanghai, including the percentage of industrial land (which explains 28% of the cases), location factors (11%), and the percentages of cultivated land and green space (6% and 5%, respectively). Based on the quantitative study, this paper facilitates additional consideration and planning intervention measures for respiratory health such as green buffering. It is an ecological study to illustrate correlation that provides approaches for further study to unravel the causality of disease incidence and the built environment.
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Affiliation(s)
- Lan Wang
- College of Architecture and Urban Planning, Tongji University, 1239 Siping Road, Shanghai 200092, China.
| | - Wenyao Sun
- College of Architecture and Urban Planning, Tongji University, 1239 Siping Road, Shanghai 200092, China.
| | - Kaichen Zhou
- College of Architecture and Urban Planning, Tongji University, 1239 Siping Road, Shanghai 200092, China.
| | - Minlu Zhang
- Shanghai Center for Disease Prevention and Control, Shanghai 200336, China.
| | - Pingping Bao
- Shanghai Center for Disease Prevention and Control, Shanghai 200336, China.
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Melero-Alegria JI, Cascon M, Romero A, Vara PP, Barreiro-Perez M, Vicente-Palacios V, Perez-Escanilla F, Hernandez-Hernandez J, Garde B, Cascon S, Martin-Garcia A, Diaz-Pelaez E, de Dios JM, Uribarri A, Jimenez-Candil J, Cruz-Gonzalez I, Blazquez B, Hernandez JM, Sanchez-Pablo C, Santolino I, Ledesma MC, Muriel P, Dorado-Diaz PI, Sanchez PL. SALMANTICOR study. Rationale and design of a population-based study to identify structural heart disease abnormalities: a spatial and machine learning analysis. BMJ Open 2019; 9:e024605. [PMID: 30765403 PMCID: PMC6398793 DOI: 10.1136/bmjopen-2018-024605] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/06/2018] [Accepted: 12/18/2018] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION This study aims to obtain data on the prevalence and incidence of structural heart disease in a population setting and, to analyse and present those data on the application of spatial and machine learning methods that, although known to geography and statistics, need to become used for healthcare research and for political commitment to obtain resources and support effective public health programme implementation. METHODS AND ANALYSIS We will perform a cross-sectional survey of randomly selected residents of Salamanca (Spain). 2400 individuals stratified by age and sex and by place of residence (rural and urban) will be studied. The variables to analyse will be obtained from the clinical history, different surveys including social status, Mediterranean diet, functional capacity, ECG, echocardiogram, VASERA and biochemical as well as genetic analysis. ETHICS AND DISSEMINATION The study has been approved by the ethical committee of the healthcare community. All study participants will sign an informed consent for participation in the study. The results of this study will allow the understanding of the relationship between the different influencing factors and their relative importance weights in the development of structural heart disease. For the first time, a detailed cardiovascular map showing the spatial distribution and a predictive machine learning system of different structural heart diseases and associated risk factors will be created and will be used as a regional policy to establish effective public health programmes to fight heart disease. At least 10 publications in the first-quartile scientific journals are planned. TRIAL REGISTRATION NUMBER NCT03429452.
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Affiliation(s)
- Jose Ignacio Melero-Alegria
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Manuel Cascon
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | - Pedro Pablo Vara
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Manuel Barreiro-Perez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Victor Vicente-Palacios
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | - Jesus Hernandez-Hernandez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Beatriz Garde
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Sara Cascon
- Robleda Primary Care Center, Salamanca, Spain
| | - Ana Martin-Garcia
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Elena Diaz-Pelaez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | - Aitor Uribarri
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Javier Jimenez-Candil
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Ignacio Cruz-Gonzalez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | | | - Clara Sanchez-Pablo
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | | | - Paz Muriel
- Miguel Armijo Primary Care Centre, Salamanca, Spain
| | - P Ignacio Dorado-Diaz
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Pedro L Sanchez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
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Affiliation(s)
- Peng Jia
- Department of Earth Observation Science, Faculty of Geo-information Science and Earth Observation, University of Twente, 7500 Enschede, Netherlands; International Initiative on Spatial Lifecourse Epidemiology (ISLE), Enschede, Netherlands.
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Geographic and area-level socioeconomic variation in cardiometabolic risk factor distribution: a systematic review of the literature. Int J Health Geogr 2019; 18:1. [PMID: 30621786 PMCID: PMC6323718 DOI: 10.1186/s12942-018-0165-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/31/2018] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION A growing number of publications report variation in the distribution of cardiometabolic risk factors (CMRFs) at different geographic scales. A review of these variations may help inform policy and health service organisation. AIM To review studies reporting variation in the geographic distribution of CMRFs and its association with various proxy measures of area-level socioeconomic disadvantage (ASED) among the adult ( ≥ 18 years) population across the world. METHODS A systematic search for published articles was conducted in four databases (MEDLINE (Ovid), PubMed, Scopus and Web of Science) considering the interdisciplinary nature of the review question. Population-based cross-sectional and cohort studies on geographic variations of one or more biological proxies of CMRFs with/without an analysed contextual association with ASED were included. Two independent reviewers screened the studies and PRISMA guidelines were followed in the study selection and reporting. RESULT A total of 265 studies were retrieved and screened, resulting in 24 eligible studies. The review revealed reports of variation in the distribution of CMRFs, at varying geographic scales, in multiple countries. In addition, consistent associations between ASED and higher prevalence of CMRFs were demonstrated. The reports were mainly from industrialised nations and small area geographic units were frequently used. CONCLUSION Geographic variation in cardiometabolic risk exists across multiple spatial scales and is positively associated with ASED. This association is independent of individual-level factors and provides an imperative for area-based approaches to informing policy and health service organisation. The study protocol is registered in International prospective register of systematic reviews (Register No: CRD42018115294) PROSPERO 2018.
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Toledano MB, Smith RB, Chang I, Douglass M, Elliott P. Cohort Profile: UK COSMOS-a UK cohort for study of environment and health. Int J Epidemiol 2018; 46:775-787. [PMID: 26534947 PMCID: PMC5837533 DOI: 10.1093/ije/dyv203] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2015] [Indexed: 12/28/2022] Open
Affiliation(s)
- Mireille B Toledano
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Rachel B Smith
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Irene Chang
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Margaret Douglass
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Paul Elliott
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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Tewara MA, Mbah-Fongkimeh PN, Dayimu A, Kang F, Xue F. Small-area spatial statistical analysis of malaria clusters and hotspots in Cameroon;2000-2015. BMC Infect Dis 2018; 18:636. [PMID: 30526507 PMCID: PMC6286522 DOI: 10.1186/s12879-018-3534-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/20/2018] [Indexed: 11/10/2022] Open
Abstract
Background Malaria prevalence in Cameroon is a major public health problem both at the regional and urban-rural geographic scale. In 2016, an estimated 1.6 million confirmed cases, and 18,738 cases were reported in health facilities and communities respectively, with about 8000 estimated deaths. Several studies have estimated malaria prevalence in Cameroon using the analytical techniques at the regional scale. We aimed at identifying malaria clusters and hotspots at the urban-rural geographic scale from the Demographic and Health Survey (DHS) data for households between 2000 and 2015 using ArcGIS for intervention programs. Methods To identify malaria hotspots and analyze the pattern of distribution, we used the optimized hotspots toolset and spatial autocorrelation respectively in ArcGIS 10.3 for desktop. We also used Pearson’s Correlation analysis to identify associative environmental factors using the R-software 3.4.1. Results The spatial distribution of malaria showed statistically significant clustered pattern for the year 2000 and 2015 with Moran’s indexes 0.126 (P < 0.001) and 0.187 (P < 0.001) respectively. Meanwhile, the years 2005 and 2010 with Moran’s indexes 0.001 (P = 0.488) and 0.002 (P = 0.318) respectively, had a random malaria distribution pattern. There exist varying degrees of malaria clusters and statistically significant hotspots in the urban-rural areas of the 12 administrative regions. Malaria cases were associated with population density and some environmental covariates; rainfall, enhanced vegetation index and composite lights (P < 0.001). Conclusion This study identified urban-rural areas with high and low malaria clusters and hotspots. Our maps can be used as supportive tools for effective malaria control and elimination, and investments in malaria programs and research, malaria prevention, diagnosis and treatment, surveillance, should pay more attention to urban-rural geographic scale.
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Affiliation(s)
- Marlvin Anemey Tewara
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University Cheeloo College of Medicine , Jinan, 250012, People's Republic of China
| | | | - Alimu Dayimu
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University Cheeloo College of Medicine , Jinan, 250012, People's Republic of China
| | - Fengling Kang
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University Cheeloo College of Medicine , Jinan, 250012, People's Republic of China
| | - Fuzhong Xue
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University Cheeloo College of Medicine , Jinan, 250012, People's Republic of China.
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Piel FB, Parkes BL, Daby H, Hansell AL, Elliott P. The challenge of opt-outs from NHS data: a small-area perspective. J Public Health (Oxf) 2018; 40:e594-e600. [PMID: 29590471 PMCID: PMC6306093 DOI: 10.1093/pubmed/fdy059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 03/06/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Frédéric B Piel
- UK Small-Area Health Statistics Unit, MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, UK
| | - Brandon L Parkes
- UK Small-Area Health Statistics Unit, MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, UK
| | - Hima Daby
- UK Small-Area Health Statistics Unit, MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, UK
| | - Anna L Hansell
- UK Small-Area Health Statistics Unit, MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, UK
| | - Paul Elliott
- UK Small-Area Health Statistics Unit, MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, UK
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Zhen Z, Cao Q, Shao L, Zhang L. Global and Geographically Weighted Quantile Regression for Modeling the Incident Rate of Children's Lead Poisoning in Syracuse, NY, USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2300. [PMID: 30347704 PMCID: PMC6210516 DOI: 10.3390/ijerph15102300] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 10/15/2018] [Accepted: 10/17/2018] [Indexed: 12/16/2022]
Abstract
Objective: The purpose of this study was to explore the full distribution of children's lead poisoning and identify "high risk" locations or areas in the neighborhood of the inner city of Syracuse (NY, USA), using quantile regression models. Methods: Global quantile regression (QR) and geographically weighted quantile regression (GWQR) were applied to model the relationships between children's lead poisoning and three environmental factors at different quantiles (25th, 50th, 75th, and 90th). The response variable was the incident rate of children's blood lead level ≥ 5 µg/dL in each census block, and the three predictor variables included building year, town taxable values, and soil lead concentration. Results: At each quantile, the regression coefficients of both global QR and GWQR models were (1) negative for both building year and town taxable values, indicating that the incident rate of children lead poisoning reduced with newer buildings and/or higher taxable values of the houses; and (2) positive for the soil lead concentration, implying that higher soil lead concentration around the house may cause higher risks of children's lead poisoning. Further, these negative or positive relationships between children's lead poisoning and three environmental factors became stronger for larger quantiles (i.e., higher risks). Conclusions: The GWQR models enabled us to explore the full distribution of children's lead poisoning and identify "high risk" locations or areas in the neighborhood of the inner city of Syracuse, which would provide useful information to assist the government agencies to make better decisions on where and what the lead hazard treatment should focus on.
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Affiliation(s)
- Zhen Zhen
- Department of Forest Management, School of Forestry, Northeast Forestry University, Harbin 150040, Heilongjiang, China.
| | - Qianqian Cao
- Department of Forest and Natural Resources Management, State University of New York College of Environmental Science and Forestry, One Forestry Drive, Syracuse, New York, NY 13210, USA.
| | - Liyang Shao
- Department of Forest and Natural Resources Management, State University of New York College of Environmental Science and Forestry, One Forestry Drive, Syracuse, New York, NY 13210, USA.
| | - Lianjun Zhang
- Department of Forest and Natural Resources Management, State University of New York College of Environmental Science and Forestry, One Forestry Drive, Syracuse, New York, NY 13210, USA.
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Dixit S, Arora NK, Rahman A, Howard NJ, Singh RK, Vaswani M, Das MK, Ahmed F, Mathur P, Tandon N, Dasgupta R, Chaturvedi S, Jethwaney J, Dalpath S, Prashad R, Kumar R, Gupta R, Dube L, Daniel M. Establishing a Demographic, Development and Environmental Geospatial Surveillance Platform in India: Planning and Implementation. JMIR Public Health Surveill 2018; 4:e66. [PMID: 30291101 PMCID: PMC6231830 DOI: 10.2196/publichealth.9749] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 05/11/2018] [Accepted: 06/18/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Inadequate administrative health data, suboptimal public health infrastructure, rapid and unplanned urbanization, environmental degradation, and poor penetration of information technology make the tracking of health and well-being of populations and their social determinants in the developing countries challenging. Technology-integrated comprehensive surveillance platforms have the potential to overcome these gaps. OBJECTIVE This paper provides methodological insights into establishing a geographic information system (GIS)-integrated, comprehensive surveillance platform in rural North India, a resource-constrained setting. METHODS The International Clinical Epidemiology Network Trust International established a comprehensive SOMAARTH Demographic, Development, and Environmental Surveillance Site (DDESS) in rural Palwal, a district in Haryana, North India. The surveillance platform evolved by adopting four major steps: (1) site preparation, (2) data construction, (3) data quality assurance, and (4) data update and maintenance system. Arc GIS 10.3 and QGIS 2.14 software were employed for geospatial data construction. Surveillance data architecture was built upon the geospatial land parcel datasets. Dedicated software (SOMAARTH-1) was developed for handling high volume of longitudinal datasets. The built infrastructure data pertaining to land use, water bodies, roads, railways, community trails, landmarks, water, sanitation and food environment, weather and air quality, and demographic characteristics were constructed in a relational manner. RESULTS The comprehensive surveillance platform encompassed a population of 0.2 million individuals residing in 51 villages over a land mass of 251.7 sq km having 32,662 households and 19,260 nonresidential features (cattle shed, shops, health, education, banking, religious institutions, etc). All land parcels were assigned georeferenced location identification numbers to enable space and time monitoring. Subdivision of villages into sectors helped identify socially homogenous community clusters (418/676, 61.8%, sectors). Water and hygiene parameters of the whole area were mapped on the GIS platform and quantified. Risk of physical exposure to harmful environment (poor water and sanitation indicators) was significantly associated with the caste of individual household (P=.001), and the path was mediated through the socioeconomic status and density of waste spots (liquid and solid) of the sector in which these households were located. Ground-truthing for ascertaining the land parcel level accuracies, community involvement in mapping exercise, and identification of small habitations not recorded in the administrative data were key learnings. CONCLUSIONS The SOMAARTH DDESS experience allowed us to document and explore dynamic relationships, associations, and pathways across multiple levels of the system (ie, individual, household, neighborhood, and village) through a geospatial interface. This could be used for characterization and monitoring of a wide range of proximal and distal determinants of health.
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Affiliation(s)
- Shikha Dixit
- Research, SOMAARTH Demographic, Development and Environmental Surveillance Site, The INCLEN Trust International, New Delhi, India
| | - Narendra K Arora
- Research, Epidemiology, The INCLEN Trust International, New Delhi, India
| | - Atiqur Rahman
- Department of Geography, Faculty of Natural Sciences, Jamia Millia Islamia, New Delhi, India
| | - Natasha J Howard
- Sansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, Australia.,South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Rakesh K Singh
- Research, SOMAARTH Demographic, Development and Environmental Surveillance Site, The INCLEN Trust International, New Delhi, India
| | - Mayur Vaswani
- Research, SOMAARTH Demographic, Development and Environmental Surveillance Site, The INCLEN Trust International, New Delhi, India
| | - Manoja K Das
- Research, SOMAARTH Demographic, Development and Environmental Surveillance Site, The INCLEN Trust International, New Delhi, India
| | | | - Prashant Mathur
- National Cancer Registry Program, National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bangalore, India
| | - Nikhil Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajib Dasgupta
- Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
| | - Sanjay Chaturvedi
- Department of Community Medicine, University College of Medical Sciences, University of Delhi, New Delhi, India
| | - Jaishri Jethwaney
- Department of Research, Indian Council for Social Science Research, New Delhi, India
| | | | - Rajendra Prashad
- Office of Chief Medical Officer, Department of Health, Palwal, India
| | - Rakesh Kumar
- Indian Council of Medical Research, New Delhi, India
| | | | - Laurette Dube
- McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Mark Daniel
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australia.,Department of Medicine, St. Vincent's Hospital, The University of Melbourne, Melbourne, Australia
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Paireau J, Pelat C, Caserio-Schönemann C, Pontais I, Le Strat Y, Lévy-Bruhl D, Cauchemez S. Mapping influenza activity in emergency departments in France using Bayesian model-based geostatistics. Influenza Other Respir Viruses 2018; 12:772-779. [PMID: 30055089 PMCID: PMC6185885 DOI: 10.1111/irv.12599] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/09/2018] [Accepted: 07/18/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Maps of influenza activity are important tools to monitor influenza epidemics and inform policymakers. In France, the availability of a high-quality data set from the Oscour® surveillance network, covering 92% of hospital emergency department (ED) visits, offers new opportunities for disease mapping. Traditional geostatistical mapping methods such as Kriging ignore underlying population sizes, are not suited to non-Gaussian data and do not account for uncertainty in parameter estimates. OBJECTIVE Our objective was to create reliable weekly interpolated maps of influenza activity in the ED setting, to inform Santé publique France (the French national public health agency) and local healthcare authorities. METHODS We used Oscour® data of ED visits covering the 2016-2017 influenza season. We developed a Bayesian model-based geostatistical approach, a class of generalized linear mixed models, with a multivariate normal random field as a spatially autocorrelated random effect. Using R-INLA, we developed an algorithm to create maps of the proportion of influenza-coded cases among all coded visits. We compared our results with maps obtained by Kriging. RESULTS Over the study period, 45 565 (0.82%) visits were coded as influenza cases. Maps resulting from the model are presented for each week, displaying the posterior mean of the influenza proportion and its associated uncertainty. Our model performed better than Kriging. CONCLUSIONS Our model allows producing smoothed maps where the random noise has been properly removed to reveal the spatial risk surface. The algorithm was incorporated into the national surveillance system to produce maps in real time and could be applied to other diseases.
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Affiliation(s)
- Juliette Paireau
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France.,Centre National de la Recherche Scientifique, UMR2000: Génomique évolutive, modélisation et santé (GEMS), Paris, France.,Center of Bioinformatics, Biostatistics and Integrative Biology, Institut Pasteur, Paris, France
| | - Camille Pelat
- Santé publique France, French National Public Health Agency, Saint-Maurice, France
| | | | - Isabelle Pontais
- Santé publique France, French National Public Health Agency, Saint-Maurice, France
| | - Yann Le Strat
- Santé publique France, French National Public Health Agency, Saint-Maurice, France
| | - Daniel Lévy-Bruhl
- Santé publique France, French National Public Health Agency, Saint-Maurice, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France.,Centre National de la Recherche Scientifique, UMR2000: Génomique évolutive, modélisation et santé (GEMS), Paris, France.,Center of Bioinformatics, Biostatistics and Integrative Biology, Institut Pasteur, Paris, France
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127
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Svechkina A, Dubnov J, Portnov BA. Environmental risk factors associated with low birth weight: The case study of the Haifa Bay Area in Israel. ENVIRONMENTAL RESEARCH 2018; 165:337-348. [PMID: 29778968 DOI: 10.1016/j.envres.2018.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/15/2018] [Accepted: 05/07/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Low birth weight (LBW) is known to be associated with infant mortality and postnatal health complications. Previous studies revealed strong relationships between LBW rate and several socio-demographic factors, including ethnicity, maternal age, and family income. However, studies of association between LBW rate and environmental risk factors remain infrequent. STUDY METHODS We retrieved a geo-referenced data set, containing 7216 individual records of children born in 2015 in the Haifa Bay Area in Israel. Using this dataset, we analysed factors affecting LBW prevalence by applying two alternative techniques: analysis of LBW rates in small census area (SCAs) and more recently developed double kernel density (DKD) relative risk (RR) estimates. RESULTS In the SCA models, LBW rate was found to be associated with proximity to petrochemical industries (B=-0.26, 95%CI=-0.30, -0.22), road density (B=0.05, 95%CI=0.02, 0.08), distance to the seashore (B=0.17, 95%CI=0.14, 0.22), PM2.5 (B=0.06, 95%CI=0.04, 0.09) and NOx (B=0.10, 95%CI=0.06, 0.13) exposure estimates. Although similar factors emerged in the DKD models as well, in most cases, the effects of these factors in the latter models were found to be stronger: proximity to petrochemical industries (B=-0.48, 95%CI= -0.51, -0.30), road density (B=0.05, 95%CI=0.02, 0.08), distance to the seashore (B=0.24, 95%CI=0.21, 0.27), PM2.5 (B=0.08, 95%CI=0.05, 0.10) and NOx (B=0.20, 95%CI=0.17, 0.23) exposure estimates. In addition, elevation above the sea level was found to be statistically significant in spatial dependence models estimated for both DKD and SCA rates (P < 0.01). CONCLUSION The analysis revealed an excess LBW rate in residential areas located close to petrochemical industries and a protective effect of seashore proximity and elevation above the sea level on the LBW rate. We attribute the latter finding to the moderating effect of elevated seashore locations on outdoor temperatures during the hot summer season.
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Affiliation(s)
- Alina Svechkina
- Department of Natural Resources and Environmental Management, Faculty of Management, University of Haifa, Mount Carmel, Haifa 3498838, Israel
| | - Jonathan Dubnov
- School of Public Health, Faculty of Welfare and Health Sciences, University of Haifa, Mount Carmel, Haifa 3498838, Israel
| | - Boris A Portnov
- Department of Natural Resources and Environmental Management, Faculty of Management, University of Haifa, Mount Carmel, Haifa 3498838, Israel.
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128
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Soomro N, Redrup D, Evens C, Strasiotto LP, Singh S, Lyle D, Singh H, Ferdinands RED, Sanders R. Injury rate and patterns of Sydney grade cricketers: a prospective study of injuries in 408 cricketers. Postgrad Med J 2018; 94:425-431. [DOI: 10.1136/postgradmedj-2018-135861] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 06/29/2018] [Accepted: 07/03/2018] [Indexed: 01/12/2023]
Abstract
BackgroundThe grade cricket competition, also known as premier cricket, supplies players to the state and national teams in Australia. The players involved are generally high-performing amateur (subelite) club cricketers. However, to date, there is no study on the injury epidemiology of Australian grade cricket.AimTo conduct injury surveillance across all teams playing Sydney Grade Cricket (SGC) competition during the 2015–2016 season.MethodsA cohort study was conducted to track injuries in 408 male cricketers in 20 teams playing SGC competition. Players were tracked through the MyCricket website’s scorebook every week. Cricket New South Wales physiotherapists were alerted if there were changes to the playing XI from the last game. If any changes were made due to injury, then an injury incident was registered.ResultsDuring the course of the season, a total of 86 injuries were registered from 65 players, resulting in a loss of 385 weeks of play. The overall injury incidence rate was 35.54 injuries/10 000 playing hours with an average weekly injury prevalence of 4.06%. Lower back injuries (20%) were the most common injuries followed by foot (14%), hand (13.75%), knee (7.5%) and calf (7.5%). Linear regression analysis showed that the likelihood of injury increased as the mean age of the teams increased (R=0.5, p<0.05).ConclusionThe injury rate in SGC is lower than that reported at elite level. However, the high rate of lower back injuries (20%) highlights an area of concern in this cohort. High workloads or inadequate physical conditioning may contribute to such injuries. This study sets the foundation for understanding injury epidemiology in grade cricket and examines the links between injury and performance, these results may assist coaches and administrators to develop and implement cricket-specific injury prevention programmes.
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129
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Pernet F, Fuhrmann M, Petton B, Mazurié J, Bouget JF, Fleury E, Daigle G, Gernez P. Determination of risk factors for herpesvirus outbreak in oysters using a broad-scale spatial epidemiology framework. Sci Rep 2018; 8:10869. [PMID: 30022088 PMCID: PMC6052024 DOI: 10.1038/s41598-018-29238-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 07/06/2018] [Indexed: 11/09/2022] Open
Abstract
Marine diseases have major impacts on ecosystems and economic consequences for aquaculture and fisheries. Understanding origin, spread and risk factors of disease is crucial for management, but data in the ocean are limited compared to the terrestrial environment. Here we investigated how the marine environment drives the spread of viral disease outbreak affecting The Pacific oyster worldwide by using a spatial epidemiology framework. We collected environmental and oyster health data at 46 sites spread over an area of 300 km2 along an inshore-offshore gradient during an epizootic event and conducted risk analysis. We found that disease broke out in the intertidal farming area and spread seaward. Mortalities and virus detection were observed in oysters placed 2 km from the farming areas, but oysters of almost all sites were subclinically infected. Increasing food quantity and quality, growth rate and energy reserves of oyster were associated with a lower risk of mortality offshore whereas increasing turbidity, a proxy of the concentration of suspended particulate matter, and terrestrial inputs, inferred from fatty acid composition of oysters, were associated with a higher risk of mortality. Offshore farming and maintenance of good ecological status of coastal waters are options to limit disease risk in oysters.
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Affiliation(s)
- Fabrice Pernet
- Ifremer, Unité de Physiologie Fonctionnelle des Organisme Marins, LEMAR UMR 6539, Technopole de Brest-Iroise, Plouzané, France.
| | - Marine Fuhrmann
- Ifremer, Unité de Physiologie Fonctionnelle des Organisme Marins, LEMAR UMR 6539, Technopole de Brest-Iroise, Plouzané, France
| | - Bruno Petton
- Ifremer, Unité de Physiologie Fonctionnelle des Organisme Marins, LEMAR UMR 6539, Presqu'île du vivier, Argenton, France
| | - Joseph Mazurié
- Ifremer, Unité Littorale, Laboratoire Environnement Ressource du Morbihan Pays-de-la-Loire, 12 Rue des Résistants, La Trinité-sur-Mer, France
| | - Jean-François Bouget
- Ifremer, Unité Littorale, Laboratoire Environnement Ressource du Morbihan Pays-de-la-Loire, 12 Rue des Résistants, La Trinité-sur-Mer, France
| | - Elodie Fleury
- Ifremer, Unité de Physiologie Fonctionnelle des Organisme Marins, LEMAR UMR 6539, Technopole de Brest-Iroise, Plouzané, France
| | - Gaétan Daigle
- Université Laval, Département de mathématiques et de statistique, Pavillon Alexandre-Vachon, Québec, QC, Canada
| | - Pierre Gernez
- Mer Molécules Santé (EA 2160), Université de Nantes, Nantes, France
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Auld SC, Shah NS, Cohen T, Martinson NA, Gandhi NR. Where is tuberculosis transmission happening? Insights from the literature, new tools to study transmission and implications for the elimination of tuberculosis. Respirology 2018; 23:10.1111/resp.13333. [PMID: 29869818 PMCID: PMC6281783 DOI: 10.1111/resp.13333] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 05/14/2018] [Accepted: 05/20/2018] [Indexed: 12/12/2022]
Abstract
More than 10 million new cases of tuberculosis (TB) are diagnosed worldwide each year. The majority of these cases occur in low- and middle-income countries where the TB epidemic is predominantly driven by transmission. Efforts to 'end TB' will depend upon our ability to halt ongoing transmission. However, recent studies of new approaches to interrupt transmission have demonstrated inconsistent effects on reducing population-level TB incidence. TB transmission occurs across a wide range of settings, that include households and hospitals, but also community-based settings. While home-based contact investigations and infection control programmes in hospitals and clinics have a successful track record as TB control activities, there is a gap in our knowledge of where, and between whom, community-based transmission of TB occurs. Novel tools, including molecular epidemiology, geospatial analyses and ventilation studies, provide hope for improving our understanding of transmission in countries where the burden of TB is greatest. By integrating these diverse and innovative tools, we can enhance our ability to identify transmission events by documenting the opportunity for transmission-through either an epidemiologic or geospatial connection-alongside genomic evidence for transmission, based upon genetically similar TB strains. A greater understanding of locations and patterns of transmission will translate into meaningful improvements in our current TB control activities by informing targeted, evidence-based public health interventions.
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Affiliation(s)
- Sara C Auld
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - N Sarita Shah
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Division of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ted Cohen
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Neil A Martinson
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Neel R Gandhi
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
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131
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Boo G, Leyk S, Brunsdon C, Graf R, Pospischil A, Fabrikant SI. The importance of regional models in assessing canine cancer incidences in Switzerland. PLoS One 2018; 13:e0195970. [PMID: 29652921 PMCID: PMC5898743 DOI: 10.1371/journal.pone.0195970] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/03/2018] [Indexed: 12/29/2022] Open
Abstract
Fitting canine cancer incidences through a conventional regression model assumes constant statistical relationships across the study area in estimating the model coefficients. However, it is often more realistic to consider that these relationships may vary over space. Such a condition, known as spatial non-stationarity, implies that the model coefficients need to be estimated locally. In these kinds of local models, the geographic scale, or spatial extent, employed for coefficient estimation may also have a pervasive influence. This is because important variations in the local model coefficients across geographic scales may impact the understanding of local relationships. In this study, we fitted canine cancer incidences across Swiss municipal units through multiple regional models. We computed diagnostic summaries across the different regional models, and contrasted them with the diagnostics of the conventional regression model, using value-by-alpha maps and scalograms. The results of this comparative assessment enabled us to identify variations in the goodness-of-fit and coefficient estimates. We detected spatially non-stationary relationships, in particular, for the variables related to biological risk factors. These variations in the model coefficients were more important at small geographic scales, making a case for the need to model canine cancer incidences locally in contrast to more conventional global approaches. However, we contend that prior to undertaking local modeling efforts, a deeper understanding of the effects of geographic scale is needed to better characterize and identify local model relationships.
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Affiliation(s)
- Gianluca Boo
- Department of Geography, University of Zurich, Zurich, Switzerland
- Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology in Zurich, Zurich, Switzerland
| | - Stefan Leyk
- Department of Geography, University of Colorado, Boulder, Colorado, United States of America
| | | | - Ramona Graf
- Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology in Zurich, Zurich, Switzerland
| | - Andreas Pospischil
- Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology in Zurich, Zurich, Switzerland
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132
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Huque MH, Anderson C, Walton R, Woolford S, Ryan L. Smooth individual level covariates adjustment in disease mapping. Biom J 2018; 60:597-615. [PMID: 29577405 DOI: 10.1002/bimj.201700143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 12/03/2017] [Accepted: 02/11/2018] [Indexed: 11/10/2022]
Abstract
Spatial models for disease mapping should ideally account for covariates measured both at individual and area levels. The newly available "indiCAR" model fits the popular conditional autoregresssive (CAR) model by accommodating both individual and group level covariates while adjusting for spatial correlation in the disease rates. This algorithm has been shown to be effective but assumes log-linear associations between individual level covariates and outcome. In many studies, the relationship between individual level covariates and the outcome may be non-log-linear, and methods to track such nonlinearity between individual level covariate and outcome in spatial regression modeling are not well developed. In this paper, we propose a new algorithm, smooth-indiCAR, to fit an extension to the popular conditional autoregresssive model that can accommodate both linear and nonlinear individual level covariate effects while adjusting for group level covariates and spatial correlation in the disease rates. In this formulation, the effect of a continuous individual level covariate is accommodated via penalized splines. We describe a two-step estimation procedure to obtain reliable estimates of individual and group level covariate effects where both individual and group level covariate effects are estimated separately. This distributed computing framework enhances its application in the Big Data domain with a large number of individual/group level covariates. We evaluate the performance of smooth-indiCAR through simulation. Our results indicate that the smooth-indiCAR method provides reliable estimates of all regression and random effect parameters. We illustrate our proposed methodology with an analysis of data on neutropenia admissions in New South Wales (NSW), Australia.
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Affiliation(s)
- Md Hamidul Huque
- Murdoch Childrens Research Institute, Parkville, VIC, 3052, Australia.,School of Mathematical and Physical Sciences, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.,Australian Research Council Centre of Excellence for Mathematical and Statistical Frontiers, NSW, 2015, Australia
| | - Craig Anderson
- School of Mathematical and Physical Sciences, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.,Australian Research Council Centre of Excellence for Mathematical and Statistical Frontiers, NSW, 2015, Australia
| | | | - Samuel Woolford
- Department of Mathematical Sciences, Bentley University, Waltham, MA, 02452, USA
| | - Louise Ryan
- School of Mathematical and Physical Sciences, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.,Australian Research Council Centre of Excellence for Mathematical and Statistical Frontiers, NSW, 2015, Australia
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133
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Development of Framework for Aggregation and Visualization of Three-Dimensional (3D) Spatial Data. BIG DATA AND COGNITIVE COMPUTING 2018. [DOI: 10.3390/bdcc2020009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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134
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Ayubi E, Barati M, Dabbagh Moghaddam A, Reza Khoshdel A. Spatial modeling of cutaneous leishmaniasis in Iranian army units during 2014-2017 using a hierarchical Bayesian method and the spatial scan statistic. Epidemiol Health 2018; 40:e2018032. [PMID: 30056641 PMCID: PMC6186865 DOI: 10.4178/epih.e2018032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 07/13/2018] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This study aimed to map the incidence of cutaneous leishmaniasis (CL) in Iranian army units (IAUs) and to identify possible spatial clusters. METHODS This ecological study investigated incident cases of CL between 2014 and 2017. CL data were extracted from the CL registry maintained by the deputy of health of AJA University of Medical Sciences. The standardized incidence ratio (SIR) of CL was computed with a Besag, York, and Mollié model. The purely spatial scan statistic was employed to detect the most likely highand low-rate clusters and to obtain the observed-to-expected (O/E) ratio for each detected cluster. The statistical significance of the clusters was assessed using the log likelihood ratio (LLR) test and Monte Carlo hypothesis testing. RESULTS A total of 1,144 new CL cases occurred in IAUs from 2014 to 2017, with an incidence rate of 260 per 100,000. Isfahan and Khuzestan Provinces were found to have more CL cases than expected in all studied years (SIR>1), while Kermanshah, Kerman, and Fars Provinces were observed to have been high-risk areas in only some years of the study period. The most significant CL cluster was in Kermanshah Province (O/E, 67.88; LLR, 1,200.62; p<0.001), followed by clusters in Isfahan Province (O/E, 6.02; LLR, 513.24; p<0.001) and Khuzestan Province (O/E, 2.35; LLR, 73.71; p<0.001), while low-rate clusters were located in the northeast areas, including Razavi Khorasan, North Khorasan, Semnan, and Golestan Provinces (O/E, 0.03; LLR, 95.11; p<0.001). CONCLUSIONS This study identified high-risk areas for CL. These findings have public health implications and should be considered when planning control interventions among IAUs.
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Affiliation(s)
- Erfan Ayubi
- Modern Epidemiology Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Mohammad Barati
- Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Arasb Dabbagh Moghaddam
- Department of Preventive Medicine, Deputy of Health, AJA University of Medical Sciences, Tehran, Iran
| | - Ali Reza Khoshdel
- Modern Epidemiology Research Center, AJA University of Medical Sciences, Tehran, Iran
- Correspondence: Ali Reza Khoshdel Modern Epidemiology Research Center, AJA University of Medical Sciences, Fatemi St., Shahid Etemadzadeh St., Tehran 1411718541, Iran E-mail:
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135
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A spatial analysis of dietary patterns in a large representative population in the north of The Netherlands - the Lifelines cohort study. Int J Behav Nutr Phys Act 2017; 14:166. [PMID: 29212502 PMCID: PMC5719934 DOI: 10.1186/s12966-017-0622-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 11/22/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Diet is an important modifiable risk factor for chronic diseases. In the search for effective strategies to improve dietary patterns in order to promote healthy ageing, new approaches considering contextual factors in public health medicine are warranted. The aim of this study is to examine the spatial clustering of dietary patterns in a large representative sample of adults. METHODS Dietary patterns were defined on the basis of a 111 item Food Frequency Questionnaire among n = 117,570 adults using principal components analysis. We quantified the spatial clustering of dietary pattern scores at the neighborhood level using the Global Moran's I spatial statistic, taking into consideration individual demographic and (neighborhood) socioeconomic indicators. RESULTS Four dietary patterns explaining 27% of the variance in dietary data were extracted in this population and named the "bread and cookies" pattern, the "snack" pattern, the "meat and alcohol" pattern and the "vegetable, fruit and fish" pattern. Significant spatial clustering of high (hot spot) and low (cold spot) dietary pattern scores was found for all four dietary patterns irrespective of age and gender differences. Educational attainment and neighborhood income explained the global clustering to some extent, although clustering at smaller regional scales persisted. CONCLUSION The significant region-specific hot and cold spots of the four dietary patterns illustrate the existence of regional "food cultures" and underscore the need for interventions targeted at the sub-national level in order to tackle unhealthy dietary behavior and to stimulate people to make healthy dietary choices.
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Montero-Oleas N, Núñez-González S, Simancas-Racines D. The remarkable geographical pattern of gastric cancer mortality in Ecuador. Cancer Epidemiol 2017; 51:92-97. [DOI: 10.1016/j.canep.2017.10.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/19/2017] [Accepted: 10/26/2017] [Indexed: 12/23/2022]
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137
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Möglichkeiten der Regionalisierung von Gesundheitsindikatoren mit Small-Area-Estimation. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 60:1429-1439. [DOI: 10.1007/s00103-017-2649-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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138
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A generic method for improving the spatial interoperability of medical and ecological databases. Int J Health Geogr 2017; 16:36. [PMID: 28974262 PMCID: PMC5627422 DOI: 10.1186/s12942-017-0109-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 09/25/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The availability of big data in healthcare and the intensive development of data reuse and georeferencing have opened up perspectives for health spatial analysis. However, fine-scale spatial studies of ecological and medical databases are limited by the change of support problem and thus a lack of spatial unit interoperability. The use of spatial disaggregation methods to solve this problem introduces errors into the spatial estimations. Here, we present a generic, two-step method for merging medical and ecological databases that avoids the use of spatial disaggregation methods, while maximizing the spatial resolution. METHODS Firstly, a mapping table is created after one or more transition matrices have been defined. The latter link the spatial units of the original databases to the spatial units of the final database. Secondly, the mapping table is validated by (1) comparing the covariates contained in the two original databases, and (2) checking the spatial validity with a spatial continuity criterion and a spatial resolution index. RESULTS We used our novel method to merge a medical database (the French national diagnosis-related group database, containing 5644 spatial units) with an ecological database (produced by the French National Institute of Statistics and Economic Studies, and containing with 36,594 spatial units). The mapping table yielded 5632 final spatial units. The mapping table's validity was evaluated by comparing the number of births in the medical database and the ecological databases in each final spatial unit. The median [interquartile range] relative difference was 2.3% [0; 5.7]. The spatial continuity criterion was low (2.4%), and the spatial resolution index was greater than for most French administrative areas. CONCLUSIONS Our innovative approach improves interoperability between medical and ecological databases and facilitates fine-scale spatial analyses. We have shown that disaggregation models and large aggregation techniques are not necessarily the best ways to tackle the change of support problem.
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139
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Heidi E B, Wangshu M, Mohammed K, Clarisse T, Jian L, Daoqin T. Spatial scale in environmental risk mapping: A Valley fever case study. J Public Health Res 2017; 6:886. [PMID: 29071255 PMCID: PMC5641658 DOI: 10.4081/jphr.2017.886] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 08/07/2017] [Indexed: 11/23/2022] Open
Abstract
Background Valley fever is a fungal infection occurring in desert regions of the U.S. and Central and South America. Environmental risk mapping for this disease is hampered by challenges with detection, case reporting, and diagnostics as well as challenges common to spatial data handling. Design and methods. Using 12,349 individual cases in Arizona from 2006 to 2009, we analyzed risk factors at both the individual and area levels. Results. Risk factors including elderly population, income status, soil organic carbon, and density of residential area were found to be positively associated with residence of Valley fever cases. A negative association was observed for distance to desert and pasture/hay land cover. The association between incidence and two land cover variables (shrub and cultivated crop lands) varied depending on the spatial scale of the analysis. Conclusions The consistence of age, income, population density, and proximity to natural areas supports that these are important predictors of Valley fever risk. However, the inconsistency of the land cover variables across scales highlights the importance of how scale is treated in risk mapping. Significance for public health With the increasing use of spatially explicit data in public health comes uncertainty related to spatial resolution, data compatibility at different scales, and appropriate model selection. Using soil-borne Valley fever, we quantify how risk mapping changes by scale and provide advice on how to assess and explore uncertainty within an analysis.
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Affiliation(s)
- Brown Heidi E
- College of Public Health, University of Arizona, Tucson, AZ
| | - Mu Wangshu
- School of Geography and Development, University of Arizona, Tucson, AZ
| | - Khan Mohammed
- Office of Infectious Disease Services, Infectious Disease Epidemiology and Surveillance, Arizona Department of Health, Phoenix, AZ
| | - Tsang Clarisse
- Office of Infectious Disease Services, Infectious Disease Epidemiology and Surveillance, Arizona Department of Health, Phoenix, AZ
| | - Liu Jian
- Department of Engineering, University of Arizona, Tucson, AZ, USA
| | - Tong Daoqin
- School of Geography and Development, University of Arizona, Tucson, AZ
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140
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Wong KLM, Benova L, Campbell OMR. A look back on how far to walk: Systematic review and meta-analysis of physical access to skilled care for childbirth in Sub-Saharan Africa. PLoS One 2017; 12:e0184432. [PMID: 28910302 PMCID: PMC5598961 DOI: 10.1371/journal.pone.0184432] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 08/18/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To (i) summarize the methods undertaken to measure physical accessibility as the spatial separation between women and health services, and (ii) establish the extent to which distance to skilled care for childbirth affects utilization in Sub-Saharan Africa. METHOD We defined spatial separation as the distance/travel time between women and skilled care services. The use of skilled care at birth referred to either the location or attendant of childbirth. The main criterion for inclusion was any quantification of the relationship between spatial separation and use of skilled care at birth. The approaches undertaken to measure distance/travel time were summarized in a narrative format. We obtained pooled adjusted odds ratios (aOR) from studies that controlled for financial means, education and (perceived) need of care in a meta-analysis. RESULTS 57 articles were included (40 studied distance and 25 travel time), in which distance/travel time were found predominately self-reported or estimated in a geographic information system based on geographic coordinates. Approaches of distance/travel time measurement were generally poorly detailed, especially for self-reported data. Crucial features such as start point of origin and the mode of transportation for travel time were most often unspecified. Meta-analysis showed that increased distance to maternity care had an inverse association with utilization (n = 10, pooled aOR = 0.90/1km, 95%CI = 0.85-0.94). Distance from a hospital for rural women showed an even more pronounced effect on utilization (n = 2, pooled aOR = 0.58/1km increase, 95%CI = 0.31,1.09). The effect of spatial separation appears to level off beyond critical point when utilization was generally low. CONCLUSION Although the reporting and measurements of spatial separation in low-resource settings needs further development, we found evidence that a lack of geographic access impedes use. Utilization is conditioned on access, researchers and policy makers should therefore prioritize quality data for the evidence-base to ensure that women everywhere have the potential to access obstetric care.
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Affiliation(s)
- Kerry L. M. Wong
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Lenka Benova
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Oona M. R. Campbell
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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141
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Patterson MT, Grossman RL. Detecting Spatial Patterns of Disease in Large Collections of Electronic Medical Records Using Neighbor-Based Bootstrapping. BIG DATA 2017; 5:213-224. [PMID: 28933946 PMCID: PMC5647508 DOI: 10.1089/big.2017.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We introduce a method called neighbor-based bootstrapping (NB2) that can be used to quantify the geospatial variation of a variable. We applied this method to an analysis of the incidence rates of disease from electronic medical record data (International Classification of Diseases, Ninth Revision codes) for ∼100 million individuals in the United States over a period of 8 years. We considered the incidence rate of disease in each county and its geospatially contiguous neighbors and rank ordered diseases in terms of their degree of geospatial variation as quantified by the NB2 method. We show that this method yields results in good agreement with established methods for detecting spatial autocorrelation (Moran's I method and kriging). Moreover, the NB2 method can be tuned to identify both large area and small area geospatial variations. This method also applies more generally in any parameter space that can be partitioned to consist of regions and their neighbors.
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Affiliation(s)
- Maria T. Patterson
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois
| | - Robert L. Grossman
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois
- Computation Institute, University of Chicago, Chicago, Illinois
- Section of Computational Biomedicine and Biomedical Data Science, Department of Medicine, University of Chicago, Chicago, Illinois
- Institute for Genomics and Systems Biology, University of Chicago, Chicago, Illinois
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142
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Shao L, Zhang L, Zhen Z. Exploring spatially varying relationships between children's lead poisoning and environmental factors. Ann N Y Acad Sci 2017; 1404:49-60. [PMID: 28833191 DOI: 10.1111/nyas.13453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 07/06/2017] [Accepted: 07/19/2017] [Indexed: 01/21/2023]
Abstract
Children's lead poisoning continues to compromise children's health and development, particularly in the inner cities of the United States. We applied a global Poisson model, a Poisson with random effects model, and a geographically weighted Poisson regression (GWPR) model to deal with the spatial dependence and heterogeneity of the number of children's lead poisoning cases in Syracuse, New York. We used three environmental factors-the building year (i.e., the year of construction) of houses, the town taxable value of houses, and the soil lead concentration-averaged at the census block level to explore the spatially varying relationships between children's lead poisoning and environmental factors. The results indicated that GWPR not only produced better model fitting and reduced the spatial dependence and heterogeneity in the model residuals but also improved the model predictions for the spatial clusters, or hot spots, of children's lead poisoning across inner city neighborhoods. Furthermore, the spatially varying model coefficients and their associated statistical tests were visualized using geographical information system maps to show the high-risk areas for the impacts of the environmental factors on the response variable. This information can provide valuable insights for public health agencies to make better decisions on lead hazard intervention, mitigation, and control programs.
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Affiliation(s)
- Liyang Shao
- Department of Forest and Natural Resources Management, State University of New York College of Environmental Science and Forestry, Syracuse, New York
| | - Lianjun Zhang
- Department of Forest and Natural Resources Management, State University of New York College of Environmental Science and Forestry, Syracuse, New York
| | - Zhen Zhen
- School of Forestry, Northeast Forestry University (NEFU), Harbin, Heilongjiang, People's Republic of China
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143
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Moura-Correa MJ, Pinheiro RDC, Carvalho LVBD, Menezes MAC, Nussbaumer L, Jacobina AJR, Nobre LCDC. Roteiro de inspeção sanitária de ambientes e processos de trabalho em postos de revenda de combustíveis: análise de usos e aplicações no estado de Santa Catarina. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2017. [DOI: 10.1590/2317-6369000127315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Introdução: o Roteiro de inspeção sanitária de ambientes e processos de trabalho em postos de revenda de combustíveis (RIAT-PRC) é utilizado para fins de vigilância em saúde pelo Centro de Referência em Saúde do Trabalhador (Cerest). Objetivo: descrever os usos e aplicações do RIAT-PRC a partir da experiência da vigilância em saúde do trabalhador do estado de Santa Catarina. Método: relato descritivo e analítico do instrumento RIAT-PRC e da avaliação de sua qualidade e uso no estado de Santa Catarina, no período de 2010 a 2014. Resultados: o roteiro foi aplicado em 459 PRC, com bom grau de preenchimento no geral. A aplicação do instrumento permitiu identificar baixa realização de monitoramentos biológicos e ambientais por parte das empresas. Também permitiu o acompanhamento das condições de trabalho e de saúde dos trabalhadores ao longo do tempo, bem como a possibilidade de identificar fatores e situações de risco nos ambientes de trabalho. Conclusão: o RIAT-PRC mostrou factibilidade para vigilância e para subsídio de estudos sobre exposição ao benzeno em PRC. Evidenciou-se a necessidade de aprimorar a capacitação das equipes técnicas para a efetiva vigilância da exposição ao benzeno e a outros agentes químicos presentes nos PRC.
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144
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Panczak R, Moser A, Held L, Jones PA, Rühli FJ, Staub K. A tall order: Small area mapping and modelling of adult height among Swiss male conscripts. ECONOMICS AND HUMAN BIOLOGY 2017; 26:61-69. [PMID: 28284175 DOI: 10.1016/j.ehb.2017.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 01/10/2017] [Accepted: 01/11/2017] [Indexed: 06/06/2023]
Abstract
Adult height reflects an individual's socio-economic background and offers insights into the well-being of populations. Height is linked to various health outcomes such as morbidity and mortality and has consequences on the societal level. The aim of this study was to describe small-area variation of height and associated factors among young men in Switzerland. Data from 175,916 conscripts (aged between 18.50 and 20.50 years) was collected between 2005 and 2011, which represented approximately 90% of the corresponding birth cohorts. These were analysed using Gaussian hierarchical models in a Bayesian framework to investigate the spatial pattern of mean height across postcodes. The models varied both in random effects and degree of adjustment (professional status, area-based socioeconomic position, and language region). We found a strong spatial structure for mean height across postcodes. The range of height differences between mean postcode level estimates was 3.40cm according to the best fitting model, with the shorter conscripts coming from the Italian and French speaking parts of Switzerland. There were positive socioeconomic gradients in height at both individual and area-based levels. Spatial patterns for height persisted after adjustment for individual factors, but not when language region was included. Socio-economic position and cultural/natural boundaries such as language borders and mountain passes are shaping patterns of height for Swiss conscripts. Small area mapping of height contributes to the understanding of its cofactors.
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Affiliation(s)
- Radoslaw Panczak
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland; Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, CH-3012 Bern, Switzerland
| | - André Moser
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, CH-3012 Bern, Switzerland; Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, CH-3012 Bern, Switzerland
| | - Leonhard Held
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, CH-8001 Zurich, Switzerland
| | - Philip A Jones
- Department of Geography, Swansea University, Wallace Building, Singleton Park, Swansea SA2 8PP, UK
| | - Frank J Rühli
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland
| | - Kaspar Staub
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland.
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145
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Pearce DC, McCaw JM, McVernon J, Mathews JD. Influenza as a trigger for cardiovascular disease: An investigation of serotype, subtype and geographic location. ENVIRONMENTAL RESEARCH 2017; 156:688-696. [PMID: 28477579 DOI: 10.1016/j.envres.2017.04.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 04/20/2017] [Accepted: 04/20/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Seasonal peaks of influenza and cardiovascular disease tend to coincide. Many excess deaths may be triggered by influenza, and the severity of this effect may vary with the virulence of the circulating influenza strain and host susceptibility. We aimed to explore the association between hospital admissions for influenza and/or pneumonia (IP) and acute myocardial infarction (AMI) or ischaemic heart disease (IHD) in Queensland, Australia, taking into account temporal and spatial variation of influenza virus type and subtype in 2007, 2008 and 2009. METHODS This ecological study at Statistical Subdivision level (SSD, n=38) used linked patient-level data. For each study year, Standardized Morbidity Ratios (SMRs) were calculated for hospital admissions with diagnoses of IP, AMI and IHD. We investigated the associations between IP and AMI or IHD using spatial autoregressive modelling, adjusting for socio-demographic factors. RESULTS Spatial autocorrelation was detected in SMRs, possibly reflecting underlying social and behavioural risk factors, but consistent with infectious disease spread. SMRs for IP were consistently predictive of SMRs for AMI and IHD when adjusted for socioeconomic status, population density and per cent Indigenous population (coefficient: 0.707, 95% confidence interval (CI): 0.318 - 1.096; 0.553, 0.222 - 0.884; 0.598, 0.307 - 0.888 and 1.017, 0.711 - 1.323; 0.650, 0.342 - 0.958; 1.031, 0.827 - 1.236) in 2007, 2008 and 2009, respectively. CONCLUSIONS This ecological study provides further evidence that severe respiratory infections may trigger the onset of cardiovascular events, implicating the influenza virus as a contributing factor.
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Affiliation(s)
- D C Pearce
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 3, 207 Bouverie Street, The University of Melbourne, Victoria 3010, Australia; Faculty of Science & Technology, Federation University Australia, University Drive, Mt Helen, Victoria 3350, Australia.
| | - J M McCaw
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 3, 207 Bouverie Street, The University of Melbourne, Victoria 3010, Australia; Modelling and Simulation, Infection and Immunity Theme, Murdoch Childrens Research Institute, 9th floor, The Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia; School of Mathematics and Statistics, Level 3, Old Geology South, The University of Melbourne, Victoria 3010, Australia.
| | - J McVernon
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 3, 207 Bouverie Street, The University of Melbourne, Victoria 3010, Australia; Modelling and Simulation, Infection and Immunity Theme, Murdoch Childrens Research Institute, 9th floor, The Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia.
| | - J D Mathews
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 3, 207 Bouverie Street, The University of Melbourne, Victoria 3010, Australia.
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146
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Rifaie F, Maharani T, Hamidy A. Where did Venomous Snakes Strike? A Spatial Statistical Analysis of Snakebite Cases in Bondowoso Regency, Indonesia. HAYATI JOURNAL OF BIOSCIENCES 2017. [DOI: 10.1016/j.hjb.2017.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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147
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Lothrop N, Hussaini K, Billheimer D, Beamer P. Community-level characteristics and environmental factors of child respiratory illnesses in Southern Arizona. BMC Public Health 2017; 17:516. [PMID: 28545417 PMCID: PMC5445507 DOI: 10.1186/s12889-017-4424-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 05/15/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Lower respiratory illnesses (LRIs) and asthma are common diseases in children <5 years of age. Few studies have investigated the relationships between multiple, home-based social and environmental risk factors and asthma and LRIs in children. Of those that have, none have focused exclusively on children <5 years of age, who are more physiologically vulnerable and spend more time at home compared to older children. Further, no studies have done so at the community level. METHODS We modeled relationships between emergency department visits and hospitalization rates for asthma and LRIs for children <5 years and geographic risk factors, including socio-economic and housing characteristics, ambient air pollution levels, and population density in Maricopa and Pima Counties, Arizona, from 2005 to 2009. We used a generalized linear model with a negative binomial observation distribution and an offset for the population of very young children in each tract. To reduce multicollinearity among predictors, socio-economic characteristics, and ambient air pollutant levels were combined into unit-less indices using the principal components analysis (PCA). Housing characteristics variables did not exhibit moderate-to-high correlations and thus were not included in PCA. Spatial autocorrelation among regression model residuals was assessed with the Global Moran's I test. RESULTS Following the regression analyses, almost all predictors were significantly related to at least one disease outcome. Lower socio-economic status (SES) and reduced population density were associated with asthma hospitalization rates and both LRI outcomes (p values <0.001). After adjusting for differences between counties, Pima County residence was associated with lower asthma and LRI hospitalization rates. No spatial autocorrelation was found among multiple regression model residuals (p values >0.05). CONCLUSIONS Our study revealed complex, multi-factorial associations between predictors and outcomes. Findings indicate that many rural areas with lower SES have distinct factors for childhood respiratory diseases that require further investigation. County-wide differences in maternal characteristics or agricultural land uses (not tested here) may also play a role in Pima County residence protecting against hospitalizations, when compared to Maricopa County. By better understanding this and other relationships, more focused public health interventions at the community level could be developed to reduce and better control these diseases in children <5 years, who are more physiologically vulnerable.
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Affiliation(s)
- Nathan Lothrop
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., PO 245210, Tucson, AZ 85724 USA
| | - Khaleel Hussaini
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., PO 245210, Tucson, AZ 85724 USA
- Biomedical Informatics, College of Medicine, University of Arizona, Tucson, AZ 85724 USA
| | - Dean Billheimer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., PO 245210, Tucson, AZ 85724 USA
- BIO5 Institute, University of Arizona, Tucson, AZ 85724 USA
| | - Paloma Beamer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., PO 245210, Tucson, AZ 85724 USA
- BIO5 Institute, University of Arizona, Tucson, AZ 85724 USA
- Arizona Respiratory Center, University of Arizona, Tucson, AZ 85724 USA
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148
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Kronenfeld BJ, Wong DWS. Visualizing statistical significance of disease clusters using cartograms. Int J Health Geogr 2017; 16:19. [PMID: 28506288 PMCID: PMC5433035 DOI: 10.1186/s12942-017-0093-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/02/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health officials and epidemiological researchers often use maps of disease rates to identify potential disease clusters. Because these maps exaggerate the prominence of low-density districts and hide potential clusters in urban (high-density) areas, many researchers have used density-equalizing maps (cartograms) as a basis for epidemiological mapping. However, we do not have existing guidelines for visual assessment of statistical uncertainty. To address this shortcoming, we develop techniques for visual determination of statistical significance of clusters spanning one or more districts on a cartogram. We developed the techniques within a geovisual analytics framework that does not rely on automated significance testing, and can therefore facilitate visual analysis to detect clusters that automated techniques might miss. RESULTS On a cartogram of the at-risk population, the statistical significance of a disease cluster is determinate from the rate, area and shape of the cluster under standard hypothesis testing scenarios. We develop formulae to determine, for a given rate, the area required for statistical significance of a priori and a posteriori designated regions under certain test assumptions. Uniquely, our approach enables dynamic inference of aggregate regions formed by combining individual districts. The method is implemented in interactive tools that provide choropleth mapping, automated legend construction and dynamic search tools to facilitate cluster detection and assessment of the validity of tested assumptions. A case study of leukemia incidence analysis in California demonstrates the ability to visually distinguish between statistically significant and insignificant regions. CONCLUSION The proposed geovisual analytics approach enables intuitive visual assessment of statistical significance of arbitrarily defined regions on a cartogram. Our research prompts a broader discussion of the role of geovisual exploratory analyses in disease mapping and the appropriate framework for visually assessing the statistical significance of spatial clusters.
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Affiliation(s)
- Barry J Kronenfeld
- Department of Geology and Geography, Eastern Illinois University, 600 Lincoln Avenue, Charleston, IL, 61920-3099, USA
| | - David W S Wong
- Geography and Geoinformation Science, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
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149
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Scripcaru G, Mateus C, Nunes C. A decade of adverse drug events in Portuguese hospitals: space-time clustering and spatial variation in temporal trends. BMC Pharmacol Toxicol 2017; 18:34. [PMID: 28486949 PMCID: PMC5424420 DOI: 10.1186/s40360-017-0140-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 05/01/2017] [Indexed: 12/04/2022] Open
Abstract
Background The aim of this study is to identify the distribution by municipalities of adverse drug events (ADE) in Portugal, including adverse drug reactions (ADR) and accidental poisoning by drugs (AP), on municipality/years ADE rate clustering. Also we identify areas with different trends in time. Methods We used a national dataset of public hospital discharges in Continental Portugal from 2004 to 2013. Events were identified based on codes: from E930 to E949.9 (ADR) and from E850 to E858.9 (AP). Space-time clustering and spatial variation in temporal trends methods were applied in three different time-periods: globally, by year and grouped in 2 classes (periods of 5 years). Results A total of 9,320,076 patients were discharged within this period, with 133,688 patients (1.46%) having at least one ADE, 4% of them related with AP. Critical space-time identified clusters (p < 0.001) were the municipalities from Lisbon metropolitan area and Centro region area. The global rate increased at a 7.8% mean annual percentage change, with high space-time heterogeneity and variation in time trends clusters (p < 0.001). For whole period, 2004–2013, all clusters presented increasing trends. However when analyzed by period of 5 years we identified two clusters with decreasing trends in time in 2004–2008. Conclusion The impact of ADE is huge, with widely variations within country and in time, and represents an increasing challenge. Future research using individual and contextual risk factors are urgently needed to understand this spatiotemporal variability in order to promote local tailored and updated actions of prevention.
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Affiliation(s)
- Gianina Scripcaru
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Av Padre Cruz, 1600-560, Lisbon, Portugal.,AMGEN Biofarmaceutica, Lisbon, Portugal
| | - Ceu Mateus
- Health Economics Group Division of Health Research, Lancaster University, Lancaster, UK
| | - Carla Nunes
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Av Padre Cruz, 1600-560, Lisbon, Portugal. .,Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal.
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150
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Stevens JR, Al Masud A, Suyundikov A. A comparison of multiple testing adjustment methods with block-correlation positively-dependent tests. PLoS One 2017; 12:e0176124. [PMID: 28453517 PMCID: PMC5409054 DOI: 10.1371/journal.pone.0176124] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 04/05/2017] [Indexed: 01/08/2023] Open
Abstract
In high dimensional data analysis (such as gene expression, spatial epidemiology, or brain imaging studies), we often test thousands or more hypotheses simultaneously. As the number of tests increases, the chance of observing some statistically significant tests is very high even when all null hypotheses are true. Consequently, we could reach incorrect conclusions regarding the hypotheses. Researchers frequently use multiplicity adjustment methods to control type I error rates-primarily the family-wise error rate (FWER) or the false discovery rate (FDR)-while still desiring high statistical power. In practice, such studies may have dependent test statistics (or p-values) as tests can be dependent on each other. However, some commonly-used multiplicity adjustment methods assume independent tests. We perform a simulation study comparing several of the most common adjustment methods involved in multiple hypothesis testing, under varying degrees of block-correlation positive dependence among tests.
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Affiliation(s)
- John R. Stevens
- Department of Mathematics and Statistics, Utah State University, 3900 Old Main Hill, Logan, UT 84322-3900, United States of America
- * E-mail:
| | - Abdullah Al Masud
- Department of Mathematics and Statistics, Utah State University, 3900 Old Main Hill, Logan, UT 84322-3900, United States of America
- Department of Biostatistics, Indiana University Fairbanks School of Public Health and Indiana University School of Medicine, Indianapolis, IN 46202, United States of America
| | - Anvar Suyundikov
- Department of Mathematics and Statistics, Utah State University, 3900 Old Main Hill, Logan, UT 84322-3900, United States of America
- BioStat Solutions, Inc., 5280 Corporate Drive, Suite C200, Frederick, MD 21703, United States of America
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