4^th International Conference on Epidemiology and Public Health October 03-05, 2016 London, UK

Biography:

In 2001 Cristina Stasi graduated in Medicine and Surgery at the Catholic University of “Sacro Cuore”, Rome. In 2006 she specialized in Gastroenterology at the University of Pisa. From 2006 to 2009 she took part in clinical research projects at the University Hospital “Careggi”, Florence. At the same time she improved her knowledge in Study Design, Management of Clinical Research Project, Statistics, Epidemiology. In 2013 she received her PhD in Experimental and Clinical Medicine from the University of Florence. She published more than 40 papers in reputed international journals and she has been serving as an editorial board member of some international journals.

Abstract:

Introduction. Ansaldi et al. (2005) showed an anti-Hepatitis C virus (HCV) antibody prevalence of 2.7% in the Italian population. Aim of this study was to evaluate this prevalence in Tuscan population that was know and unknown to the Tuscan Regional Health Service in 2014. Methods. To evaluate people infected with HCV known to the Regional Health Service we used the Tuscany Health administrative data. We identified people with a Hepatitis C exention code (070.54), resident in Tuscany. Through the universal code attribuited to each resident, these patients were matched with hospital admission codes, identified by the International Classification of Diseases, Ninth Revision (ICD-9) Clinical Modification (such as “acute hepatitis” ICD9-CM: 070.41 and 070.51; “chronic hepatitis” 070.44 and 070.54; “hepatocellular carcinoma” 155.0; “cirrhosis” 571.5), with codes for dispensing drugs to patients by local and hospital pharmacies (Ribavirin J05AB04). Individuals were considered only once. To evaluate HCV population unknown to Regional Health Service we used the Capture-Recapture analysis.

Results. Living people as at 12.31.2014 with HCV exention codes were 14.810. Patients treated with Pegilated interferon+Ribavirin in the last 10 years were 6635. The total hospital admission in the last 15 years was 18,773. After data linkage the total number was 29.437.

After applying the Capture-Recapture analysis the number of unkown HCV infected people was 29.963. Therefore the total number of chronic HCV infected people was 56,940.

Conclusion. Tuscan administrative data were in line with the serological prevalence of some research studies and they outlined the high prevalence of chronic HCV infection.

Biography:

Syamantak Mani Tripathi is an Assistant Professor in the Department of Veterinary Pharmacology and Toxicology, College of Veterinary Science and Animal Husbandry, Chhattisharh Kamdhenu Vishwavidalya, Durg-491001 (Chhattisgarh) India. He has over six years experience with hand-on applications including teams of researchers and technicians in the Pharmacology & Toxicology and Biotechnology division. His training and experience also includes applied animal investigation skills as a research scholar in the field of pesticide induced immunotoxicology and safety pharmacology studies. He has worked in multiple successful research projects funded by Indian Council of Agricultural Research and Department of Biotechnology, Government of India, supporting clinical development and leading to strong regulatory submissions for pesticides uses in agriculture. His research program is focused on the study of immune response to pesticide and xenobiotics in avian model. He received his Bachelor’s in Veterinary Science and Animal Husbandry from Jawaharlal Nehru Krishi Vishwavidyalaya, Jabalpur (MP), India; Master’s of Veterinary Pharmacology from Anand Agricultural University, Anand (Gujarat), India and his Ph.D. in Veterinary Pharmacology and Toxicology from the Nanaji Deshmukh Veterinary Science University at Jabalpur (MP), India. His academic work was focused on “Immuno-genotoxicity of organophosphorous insecticide ‘acephate’ in white leghorn birds”. His work contributes towards understanding the molecular mechanism of acephate toxicity in avian model; studying interleukin gene(s) associated with immunity and development of test series to study immunotoxicity. Memberships he has include the Indian Society of Toxicology, Indian Society of Veterinary Pharmacology and Toxicology.

Abstract:

Acephate and its metabolite methamidophos are common organophosphorus insecticide used for crop protection. High uses of acephate and methamidophos have induced health issues and environmental pollution. Their undesired presence in the environment is creating Ecotoxicology and may harm human health. It is therefore essential to detect the presence of acephate even in trace level its effect on environmental and public health. This study aimed to investigate the toxic effects of long-term, low-dose acephate administration on white Leghorn birds. A total of 150 white Leghorn birds was randomly assigned to different groups: control; vehicle control; low-dose acephate (21.3 mg kg−1bw−1); middle-dose acephate (28.4 mg kg−1 bw−1); and high-dose acephate (42.6 mg kg−1 bw−1). The birds continuously received acephate via drinking water for 24 weeks. Bird blood plasma samples were collected at different time points to measure haemato-biochemical and immunological profiles. Liver, bursa of Fabricius and spleen tissues were subjected to histopathological examination. There was a significant decrease in the live body weight and total leukocyte count, anti-Newcastle Disease Virus (NDV) antibody titer, serum total protein (TP), serum globulin, serum albumin and organ:body weight ratios of immune organs. The delayed type hypersensitivity response to 2,4-dinitro-1-chlorobenzene (DNCB) was significantly reduced. Histopathologically, bursa and spleen showed mild depletion of lymphocytes. Furthermore, DNA fragmentation assay was performed and detected a ladder pattern (180 bp) in DNA. These results provided a basis for concern over farm workers being overexposed during application. Workers exposed to acephate (n=150) were drawn from a population of vegetable and fruit farmers of about 50 districts of Madhya Pradesh, India. They were interviewed on symptoms and personal protection, and their erythrocyte acetylcholinesterase (AChE) activity was determined during both spraying and nonspraying periods. AChE activities during spraying and nonspraying period were comparable. The prevalence of cough, headache, abdominal pain, excessive sweating, nausea, excessive salivation, diarrhea, and vomiting differed non-significantly between spraying and nonspraying periods. There was no suggestion of decreased AChE in exposed subjects who complained of acephate related symptoms compared to symptomless exposed subjects. Use of gloves, long boots, head cover and face cover was significantly associated with AChE activity. No marked AChE depression was found during spraying season, which may explain the lack of association between symptoms and AChE. The fact that only moderately toxic acephate was used may indicate that toxicity was not sufficiently high to cause depression. Experience, however, suggests that occupational poisoning remains a potential serious danger in vegetable and fruit cultivation in India. It was concluded that subchronic acephate exposure at medium and high concentrations may affect immune responses in avian species and human health.

Biography:

Anya P G F Vieira-Meyer has completed her PhD in 2005 from the University of Toronto, She is currently a visiting scholar at the University of California in Berkeley (until May 2016). She is a senior researcher at Fundação Oswaldo Cruz (FIOCRUZ) – Brazil, as well as the Coordenator of the Family Health Master Program. She has published more than 40 papers in reputed journals and has been serving as an scientific editor for the Revista Brasileira em Promoção da Saúde journal.

Abstract:

The Brazilian National Programme for Improving Access and Quality of Primary Care (PMAQ-AB) was established by the Ministry of Health (MOH) in 2011. Its main objective is to encourage the expansion of access and improvement of primary care quality and create patterns comparable in national, regional and local levels - in order to allow greater transparency and effectiveness of government actions. As part of the program, an external evaluation is performed by the Higher Education Institutions (HEIs), focusing on primary health care teams, oral health teams, and family health support teams. Two cycles have already taken place (2012 and 2014). In order to give continuity to these evaluative actions in Brazilian health primary care, the MOH is inducing the 3rd program cycle, which includes a multicenter external evaluation in 2016. With respect to methodology, this is an investigation (survey), with application of a single national survey and will take as a parameter what was applied in the previous PMAQ-AB cycles. The questionnaire will be organized into 03 major modules: infrastructure conditions; teams work process and care organization; users satisfaction and perception of services. We intend to present the methodology, as well as describe the advantages, disdvantages and chanleges of such endevour from the perspective of Universidade Federal do Rio Grande do Norte (UFRN) -paired up with Fundacao Oswaldo Cruz Ceara and other RENASF partners-, which is one of the HEIs working with the MOH, for the external evaluation of PMAQ-AB. A total of 3,856 teams will be evaluated by UFRN.

Biography:

Caron is associate professor of psychiatry at McGill University and researcher at the Research center of the Douglas Mental Health university Institute. He currently leads the team of Canadian Institute of Health Research (CIHR) in Social and Psychiatric Epidemiology. He is also associate researcher at the Institute of Public Health of the University of Montreal and at the Instituto de Saude Colletiva of the Federal University of Bahia in Brazil.

Abstract:

The aim of this study is to identify predictors of well-being, a positive indicator of mental health. We used data from the Montreal Epidemiological Catchment Area Study, a longitudinal study that focuses on the mental health and well-being of residents in the southwest region of Montreal. The study recruited a randomly selected sample of 2,433 individuals aged 15-65 at baseline. Of them, 1,303 were re-interviewed four years later. Well-being was measured with Personal Well-being Index (Cummins, 2003). Direct interviews gathered self-reported data on: socio-demographics, life events, stress and coping abilities, social support, perceptions of neighbourhoods, working status and income, mental disorders, psychiatric family history and mental health services utilization. Social and built features of environment were determined using Geographic Information System. We employed hierarchical linear regression to identify significant independent predictors of well-being improvement overtime, among the aforementioned baseline variables. We first used forward selection procedure to identify significant variable blocks – groups of variables that had significant overall effects on well-being. We then used backward deletion procedure to eliminate non-significant individual variables. The final model explained 41% of the variance of well-being. Variables from eight blocks were found to be significant predictors of well-being, including socio-demographics, income, stress and coping, social support, mental health status, satisfaction with precise life domains, satisfaction with the physical state, density of the vegetation in the neighbourhood, and average property values in the neighbourhood. Better understanding predictors of well-being will enable the development of more effective mental health promotion programs.

Biography:

Miss Luo completed master’s degree in 2004 from Department of Public Health of National Defense Medical Center. I worked at National Health Research Institutes for 10 years. My main duty was development of EV71 vaccine in Taiwan: epidemiology and disease burden.

Abstract:

Human enteroviruses are classified into four species (A, B, C, and D) and include over 100 serotypes. Except polioviruses and enterovirus A71 (EV71) which frequently cause neurological complications, human enteroviruses usually cause self-limited infections. EV71 was first identified and a large-scale EV71 epidemic was documented in southern Vietnam in 2003 which reported 173 EV71 cases, including 51 with neurological complications and 3 fatal cases. In 2011, a large-scale EV71 epidemic occurred with more than 5,000 inpatients and 32 fatal cases in CH1, HCM. NHRI cooperated with CH1 to establish hospital-based surveillance of enterovirus in HCM City in 2011. Inpatients <0.5 years of age to 17.2, 24.0, 29.4, 58.6 at 0.5-0.9, 1-1.9, 2-2.9, 3-3.9 and 4-4.9 years of age, respectively. Risk of EV71 infections in Vietnam increased after 6 months of age. Vietnamese children in HCM City acquired EV71 infections at an early age and vaccine development in Vietnam should target young children.

Biography:

Ahmad M. Khalil received Ph.D. from the Ohio State University in 1987.  Currently is a Professor at Yarmouk University, Irbid, JORDAN. Earned the professorship in 2000. Director of the Department of Biological Sciences at Yarmouk 2001-2003. Founded the Biotechnology M. Sc. Program at Yarmouk in 2003. In Arabic, authored a book in Radiation Biology, a unit in Molecular Biology, a chapter in Genetics and 35 articles of general interest. Published 40 research papers most of them in International Journals. Developed expertise in investigating the biology of prostate cancer in collaboration with King Abduallah Hospital at Jordan University of Science and Technology (JUST).

Abstract:

Truck drivers work under conditions that predispose them to a high prevalence of risk factors for the development of Musculoskeletal Disorders (MSD). However, these factors have not been fully evaluated and are not usually considered to be within the scope of health or labor services. An observational cross-sectional study was conducted on 283 long-distance truck drivers and 100 work site controls at the Jordan Petroleum Refinery Company (JPRC) located about 15 miles east of the capital; Amman. All the participants were males with experience at JPRC ranged from 5 to 35 years. The clinical evaluation consisted of an assessment of social habits and demographic data and an evaluation of risk factors for MSD. To test the work-relatedness of the MSD with the risk factors between the two groups, univariate and multivariate analyses were used. 42% of the occupational drivers reported back pain and only 7.2% reported legs pain. These prevalence rates were significantly higher than those found among clerical workers (37.7% and 3.8%, respectively). Elevated incidences of pain in the lumbar vertebrae, shoulder, and knee pain were recorded. Musculoskeletal pain significantly increased by age, weight, sitting posture and overwork. Moreover, surveyed truckers were found to have significant issues affecting their health, such as hemorrhoidectomy (9.84%), thyroidectomy (7.56%), disc surgery (4.37%), and varicosity (3.28%). These findings have potential to help researchers develop interventions to improve the emotional and occupational health of truck drivers, a highly underserved population. In order to cope with the health problems of truck drivers, it is recommended that working conditions among truck drivers be improved.

Biography:

Ruoling Chen joined in the University of Wolverhampton, UK as a Reader in Epidemiology and Public Health and Epidemiology in 2009. He was awarded his PhD from the University of Aberdeen in 1997, after studying medicine and medical statistics in China. His research areas and expertise include epidemiology and global public health. Dr Chen has published widely in these fields. He previously worked at the Universities of Liverpool, Dundee and London (UCL and KCL) as a lecturer, senior lecturer and principle investigator, over the past 20 years. He has been an adjunct Professor at Anhui Medical University since 2003.

Abstract:

Background  China has an increasing incidence rate of stroke due to its population aging, with the largest number of stroke patients in the world. However, incidence and predictors of stroke in older people has not been well studied. We determined incidence and predictors of stroke in older Chinese.

Methods In 2001-03 we interviewed a random sample of 3336 participants aged ≥ 60 years in Anhui, China, having characterized risk factors for stroke. Of them 2852 (89.2%) without stroke were followed-up until 2011,  identifying stroke cases from 3 waves surveys interview and from causes of death. 

Results During the 10-year follow-up, 211 incident stroke cases (12.8/1,000 person-years) were documented. After adjusted for age, sex and rural resident location, hazards ratio of stroke increased with older age (1.97, 95%CI 1.27-3.06  in  participants ≥ 80 years compared to 65-69 years), rural living (1.57, 1.14-2.18), low education  (in illiterate 1.95, 1.17-3.21 vs >=High secondary school), low  occupational class (manual labourer 1.59, 1.01-2.49 vs official/teacher), hypertension (undetected hypertension 1.65, 1.16-2.34, untreated 2.24, 1.29-3.91, treated but uncontrolled 3.30,  2.28-4.78, controlled hypertension 1.33, 0.60-2.95  vs normotensives), diabetes (1.83,1.08-3.09), heart disease (1.50, 1.04-2.16),  and reduced activities of daily living (ADL). However it was not significantly associated with male gender, obesity/overweight, alcohol drinking, smoking status, marital status and depression at baseline. Including all these factors in multivariate analysis, prediction of these factors for incident stroke was not substantially changed, except for diabetes and heart disease showing not significant.

Conclusions The incidence of stroke in older people in China was higher than their counterparts in the West. It is associated with older people’s  low socioeconomic status, poor management of hypertension and low ADL.  These need to be taken into account when implementing intervention programs.

Biography:

Eremeeva received her MD in biochemistry from the Russian National Research MedicalUniversity, her PhD in microbiology from the Gamaleya Research Institute, Moscow, Russia and her ScD in microbiology and cellular biology from the University of the Mediterranean, Marseilles France. Her postdoctoral studies were at the University of Maryland, School of Medicine, Baltimore, USA. She is an Associate Professor and Director of the Core Laboratory at the Jiann-Ping Hsu College of Public Health of the Georgia Southern University. She has published more than 100 peer-reviewed articles, book chapters and conference papers on different aspects of rickettsiae and rickettsial diseases including discovery of emerging pathogens and descriptions of new rickettsioses

Abstract:

Murine typhus is a re-emerging rickettsial disease with a wide-prevalence, most typically in

temperate to tropical seaboard regions. The disease manifests as a febrile illness with an acute onset and mild to severe morbidity, including severe encephalitis and fatalities. Its classic form is associated with a rat flea and rat cycle, although other ectoparasites and animal species are involved in the circulation of the etiologic agent, Rickettsia typhi. The disease was first described in 1913 in Atlanta, GA, and its distribution was progressively widened. Broad application of pesticides and rodenticides was thought to bring the disease under control for several decades in the USA. Use of molecular approaches to ecological studies and clinical diagnosis in the last 20 years revealed continued circulation of R. typhi in different endemic locales, but also provided evidence for at least two other flea-borne rickettsial agents, Rickettsia felis and Rickettsia asemboensis; they are frequently found in fleas and animals formerly thought to be less typical vectors and reservoirs of murine typhus. These findings raised significant concerns and a need for reevaluation of approaches to diagnosis of flea-transmitted rickettsial diseases, better understanding of the ecology and epidemiology of flea-borne rickettsial agents and reassessment of methods used for flea control.This presentation will review the most recent findings related to these issues and discuss the public health implications of the presence of these rickettsial pathogens in areas affected by malaria and

dengue. Because these diseases can present with symptoms of many other infections, it is important to include epidemiological considerations when treating patients with febrile illness of unknown etiology.

Biography:

Mark Nyman completed his MD training at Oral Roberts University, Tulsa OK in 1990 and Residency and Fellowship training in General Internal Medicine at Mayo Clinic College of Medicine, Rochester, MN in 1994.  He has served as a staff physician in the Division of General Internal Medicine at Mayo Clinic since 1994. He has worked in the area of Quality Improvement for more than 20 years including guideline development, guideline implementation and quality measurement. He served on the board of Minnesota Community Measurement for 6 years as well as their Measurement Advisory Reporting Committee for 9 years.

Abstract:

Background: Current publicly reported quality performance measures directly compare primary care to specialty care. Specialists see short-term patients referred due to poor control of their disease who then return to their local provider. Our study looked to determine if outcomes measured in short-term care patients differed from those in long-term care patients and what impact those differences may have on quality performance profiles for specialists.

Methods: Retrospective cohort from a large academic medical Center. Performance was measured as “Optimal Care” - all or none attainment of goals. Patients with short-term care (90 days contact) were evaluated for both specialty and primary care practices during the year 2008.

Results: Patients with short-term care had significantly lower “Optimal Care”: 7.2% vs. 19.7% for optimal diabetes care in endocrinology and 41.3% vs. 53.1% for optimal ischemic vascular disease care in cardiology (p < 0.001).  Combining short and long term care patients lowered overall perceived performance in the specialty practice.

Conclusions: Factors other than quality affect the perceived performance of the specialty practice. Extending current primary care quality measurement to short-term specialty care patients without adjustment produces misleading results.

Biography:

Jee is a professor of the Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, where he teaches epidemiology. His current research is focused on large scaled prospective cohort study for smoking, obesity, metabolic syndrome, CVD and cancer. He developed the Korean Cancer Prevention Study (KCPS) in 2001. The cohort consists of over one million adult Koreans who had a physical examination as part of their care by the national health program.

Abstract:

We used a Mendelian randomization analysis to assess the causal effect of alcohol use on uric acid (UA) in Koreans. The Korean Cancer Prevention Study-II (KCPS) Biobank cohort consisted of 159,844 healthy Korean aged 20 years or older. Clinical data, including UA, alcohol use, and other related confounding variables were collected. Single nucleotide polymorphism rs671 of ALDH2 was genotyped among 2,790 men and 1,271 women in 2016, which was a randomly selected subcohort of KCPS Biobank participants. In Mendelian randomization analysis, the causal risk increase for UA was estimated to be 0.64 mg/dL per alcohol unit (10 g ethanol) per day (95% CI: 0.58-0.70) in men (p=0.046), which was comparable to the observational estimate (Durbin-Wu-Hausman chi-square test P for difference =0.266). The associations did not change after excluding heavy drinkers or the elderly. In women, similar results were shown with no significant association between alcohol use and UA. These novel results provide evidence that alcohol use is causally associated with risk of UA in Koreans and support its role as a risk determinant. This study was funded by a grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI14C2686).

Biography:

Jia-yin Dai is a professor of ecotoxicology at the Institute of Zoology. He obtained a Ph. D in 1999 from Nanjing University, China, and carried out postdoctoral research work from 2001 to 2005 at the Weill Medical College of Cornell University, USA. He is the director of the Key Laboratory of Animal Ecology and Conservation Biology, and an editorial board member of Integrative Zoology. He has published more than 100 papers in reputed journals and is also the recipient of the NSFC “Distinguished Young Scholars” award and the CAS “One Hundred Talent Program” award.

Abstract:

Per- and polyfluoroalkyl substances (PFASs) can cross the placental barrier. However, little is known about the predictors of placental transfer efficiency. We aimed to explore whether placental transfer efficiency (based on the ratio of cord to maternal sera concentrations) is affected by maternal demographic and physiologic factors. PFAS concentrations were analyzed in matched samples of maternal sera in all 3 trimesters and umbilical cord sera (N = 100) from the prospective Healthy Baby Cohort (HBC), China in 2012-2014. Linear regression was used to estimate associations of transfer efficiencies with predictors. Aside from traditional PFASs, a novel PFAS named F-53B was detected for the first time in pregnant women and the fetus. Strongest correlations between cord PFAS levels and maternal levels were observed for maternal sera sampled in 3rd trimester followed by samples taken in 2rd and 1st trimester. Higher transfer efficiencies of PFASs were associated with older maternal age, higher educational attainment and lower glomerular filtration rate (GFR). Of interest, cord sera albumin was a positive predictor for higher transfer efficiency, whereas maternal serum albumin tended to reduce transfer efficiency. Our results suggested an ubiquitous exposure to F-53B in Chinese pregnant women and their fetus. PFAS levels in maternal serum sampled in 3rd trimester gave better estimates of PFAS fetal exposure, as represented by cord serum levels. Physiological predictors for placental transfer of PFASs were observed for the first time in a Chinese birth cohort. GFR and serum albumin may play critical roles in the PFAS placental transfer.

Biography:

Ruoling Chen joined in the University of Wolverhampton, UK as a Reader in Epidemiology and Public Health and Epidemiology in 2009. He was awarded his PhD from the University of Aberdeen in 1997, after studying medicine and medical statistics in China. His research areas and expertise include epidemiology and global public health. Dr Chen has published widely in these fields. He previously worked at the Universities of Liverpool, Dundee and London (UCL and KCL) as a lecturer, senior lecturer and principle investigator, over the past 20 years. He has been an adjunct Professor at Anhui Medical University since 2003.

Abstract:

The aim of this presentation is to assess the association of eating fish with risk of dementia by a systematic literature review and a new study. We examined a random sample of 6981 participants aged >=60 years in China for health survey in 2007-2011.  After adjustment for age, sex, province, urban-rural areas, education, smoking and stroke, odds ratio (OR) for dementia in 5453 participants (dementia rate 4.33%) who had any fish consumption over the past 2 years was 0.73 (95%CI 0.64-0.99) in comparison to 1528 never eating fish (dementia rate 5.89%). Adjusted OR was 0.79 (0.49-1.29) in participants eating fish once a week, 0.59 (0.38-0.90) in eating fish more than twice a week, and 0.76 (0.55-1.04) in eating >= daily. Searching Medline and 4 other electronic databases up to February 2016 we identified and 11 articles for review. Two of 11 articles did not include data on the association, while 9 others included 15 studied populations; 4 demonstrated a significant association of fish eating (or high verse low consumptions) with reduced risk of dementia (around 20% to 66%), 9 showed a non-statistically reduced risk, and 2 exhibited no association (or increased risk). Pooled data from 16 studied populations, including the older Chinese showed a relative risk (RR) of dementia in people eating, fishing was 0.80 (0.73-0.87). Pooled dose-response data showed a RR of 0.85 (0.73-0.98), 0.79 (0.72-0.86) and 0.73 (0.59-0.92) from low, middle to high consumption of fish. Increasing fish consumption in the population may help prevent dementia in the world.