Day 2 :
Keynote Forum
Henry Völzke
University Medicine Greifswald, Germany
Keynote: Reference values and therapeutic cut-offs - epidemiologists can help reduce confusion of clinicians
Time : 09:30-10:10
Biography:
Henry Volzke is Professor for Clinical-Epidemiological Research with basic training as Certified Internist. He has been involved in research projects funded by the European Union, the German Research Foundation and numerous other public and private funding bodies and is member of several large national and international research consortia. His broad research interests cover common population-relevant diseases including thyroid and other endocrine disorders, cardiovascular, metabolic and gastrointestinal diseases. In PubMed, he is listed with more than 620 publications in international peer-reviewed journals. He is PI of the Studies of Health in Pomerania and the Northeast German part of the German National Cohort as well as Co-PI of the GANI_MED project and the Greifswald site of the German Centre for Cardiovascular Research. He coordinates the H2020 funded EUthyroid Consortium. He is past President of the German Society for Epidemiology (DGEpi) e.V and the German Representative in the Iodine Global Network
Abstract:
It is a common error in thinking of clinicians to hope that a reference value could help finding the right treatment decision. In general, reference values are nothing else than distribution markers of a clinical test among a healthy reference population, as analysed from cross-sectional studies. The value distribution is highly dependent on factors affecting the population and the selection of the reference population. The question that can be answered by analysing reference intervals is only the question on what is high or low or, more in general, what is usual in a given population. Values outside a reference range indicate that there is a high probability that the patient is not “healthy”, which may require further diagnostic work-up.
Reference values, however, are not sufficient to decide upon treatment initiation. Valid answers to the question on whether high or low values should be treated or not require 1) clinical information on symptoms, co-morbidities and other diagnostic findings and/or 2) longitudinal studies on outcomes related on a given baseline level.
Current epidemiology increasingly comprises large-scale population studies with comprehensive information from medical examinations. These studies offer optimal conditions for reference and cut-off value analyses by 1) results generalizable to the population under investigation, 2) validity in selecting reference populations by not only considering clinical diseases but also subclinical disorders to define health, and 3) high precision by large study populations. Comprehensive statistical methods such as quintile regression allows establishing individual reference values by considering physiological factors influencing test values including, for example, sex, age, body weight and height.
Recent Publications
1. Chaker L, Korevaar TIM, Rizopoulos D, Collet TH, Völzke H, Hofman A, Rodondi N, Cappola AR, Peeters RP, Franco OH. Defining optimal health range for thyroid function based on the risk of cardiovascular disease. J Clin Endocrinol Metab 2017; in press
2. Chaker L, Baumgartner C, den Elzen WP, Collet TH, Ikram MA, Blum MR, Dehghan A, Drechsler C, Luben RN, Portegies ML, Iervasi G, Medici M, Stott DJ, Dullaart RP, Ford I, Bremner A, Newman AB, Wanner C, Sgarbi JA, Dörr M, Longstreth WT Jr, Psaty BM, Ferrucci L, Maciel RM, Westendorp RG, Jukema JW, Ceresini G, Imaizumi M, Hofman A, Bakker SJ, Franklyn JA, Khaw KT, Bauer DC, Walsh JP, Razvi S, Gussekloo J, Völzke H, Franco OH, Cappola AR, Rodondi N, Peeters RP; Thyroid Studies Collaboration. Thyroid function within the reference range and the risk of stroke: an individual participant data analysis. J Clin Endocrinol Metab 2016; 101:4270-82.
3. Ittermann T, Khattak RM, Nauck M, Cordova CM, Völzke H. Shift of the TSH reference range with improved iodine supply in Northeast Germany. Eur J Endocrinol 2015; 172(3):261-7.
4. Mensel B, Quadrat A, Schneider T, Kühn JP, Dörr M, Völzke H, Lieb W, Hegenscheid K, Lorbeer R. MRI-based determination of reference values of thoracic aortic wall thickness in a general population. Eur Radiol. 2014;24:2038-44.
5. Völzke H, Schmidt CO, Baumeister SE, Ittermann T, Fung G, Krafczyk-Korth J, Hoffmann W, Schwab M, Meyer zu Schwabedissen HE, Dörr M, Felix SB, Lieb W, Kroemer HK. Personalized cardiovascular medicine: concepts and methodological considerations. Nat Rev Cardiol. 2013 Jun;10(6):308-16.
Keynote Forum
Carolina M Borges
The College of New Jersey, USA
Keynote: Individual social capital and the use of health services among elderly in a developing context
Biography:
Abstract:
Statement of the Problem: The way we connect to each other can affect our health status and other health related outcomes. Broadly, social capital refers to the characteristics that emerge from social connections among individuals in a given society that can be used for a common goal. Health related outcomes have been linked to lack in Social Capital such as high mortality rates, poor mental health, low well-being, poor oral health, poor maternal health weak adherence to health promotion policies, and obesity prevention.
Methodology & Theoretical Orientation: This cross-sectional study sought to test the association between social capital, health status, and use of health services, among Brazilian non-institutionalized elderly living in an industrialized area. Sample was composed by 2,052 respondents aged 60 or older, living in Sete Lagoas county in 2012 (Jan-Jul). Social Capital (SC) was measured by The World Bank Integrated Questionnaire (SC-IQ) dichotomized in “low Social Capital” and “high Social Capital”. Use of health services (11 variables), health status, community engagement, familiar functionality, and social demographics were assessed.
Findings: Out of total respondents, 68.6% belonged to the group of low social capital. Lack in social capital was associated to poor health status (69.5%), > medical treatment (70.7%). When controlled, Low SC increased chances to medical appointment within 6 months [OR=1.78; 95%IC=1.22-2.60], decreased chances to be assisted by Public Health Family Program [OR=0.77; 95%IC=0.59-0.99], of community engagement [OR=0.12; 95%IC=0.09-0.15], and good familiar functionality [OR=0.56; 95%IC=0.36-0.86].
Conclusion & Significance: Individual Social Capital affected health status and the pattern that elderly used health service in this population.Recent Publications
1. Carolina M Borges, Silvia Spivakovsky. Adjusted protocol for dental extractions in oncology patients taking anti-resorptive drugs may reduce occurrence of medication-related osteonecrosis of the jaw. Evidence-Based Dentistry 2016, 17:14–15.
2. Ana Cristina V Campos, Carolina M Borges, Andréa Maria D Vargas, Viviane Elisangela Gomes, Simone D Lucas and Efigênia F Ferreira. Measuring social capital through multivariate analyses for the IQ-SC. BMC Research Notes 2015, 8:11.
3. Chalub LL, Borges CM, Ferreira RC, Haddad JP, Ferreira EF, Vargas AM. Association between social determinants of health and functional dentition in 35-year-old to 44-year-old Brazilian adults: a population-based analytical study. Community Dental of Oral Epidemiology 2014, Dec; 42(6):503-16.
4. Borges CM, Campos ACV, Vargas AM, Ferreira EF. Tooth loss profile among adults according to social capital, socioeconomic and demographic characteristics. Ciência & Saúde Coletiva 2014, 19(6):1849-1858.
5. CAMPOS, ANA CRISTINA VIANA; Borges CM; LELES, CLÁUDIO RODRIGUES; LUCAS, SIMONE DUTRA; FERREIRA, EFIGÊNIA F. Social capital and quality of life in adolescent apprentices in Brazil: An exploratory study. Health (Irvine), v. 05, p. 973-980, 2013.
Keynote Forum
Flores, R. A
Flores, R. A |National University of Santiago del Estero| Argentina
Keynote: Control and follow up for 7 years and 9 months of patients with arterial hypertension in the Community of the National University of Santiago del Estero, Argentina. Flores, R. A
Time : 10:50-11:30
Biography:
Roberto Antonio Flores has been Graduated from the National University of Tucuman, Argentina as Medical Doctor, with the specialties including Internal Medicine, Social and Community Medicine. He did diploma in Cardiology from the National University of Tucuman and Medical Clinic National Academy of Medicine Argentina. Later on he obtained his post-graduation from National University of Cuyo with subjects Pharmacology & Biology and then started working at The Nurses School, Faculty of Humanities, Social Sciences and Health, National University of Santiago del Estero, Argentina where he has continued his research. Presently he has been working at the at the Regional Hospital Dr. Ramon Carrillo, Santiago del Estero City.
Abstract:
Abstract
Introduction: The intention of this work was to obtain complementary information regarding patients suffering from Hypertension, and to observe as the presence of some risk factors for cardiovascular disease, impacts on the tension figures of said hypertensive patients of the Community of the National University Of Santiago del Estero.
Objectives: General: To control and follow up the hypertensive population and investigate the presence of some risk factors for cardiovascular disease.
Specific:
1. Describe the hypertensive population of the University Community of the National University of Santiago del Estero.
2. Demonstrate how the presence of some risk factors for cardiovascular diseases, such as obesity, sedentary lifestyle, smoking, impact on the tension figures in the hypertensive population of the University Community of the National University of Santiago del Estero.
Development: This is a quantitative, descriptive and cross-sectional study, which began in December 2008, recording blood pressure figures and controlling for risk factors and their modifications in the Primary Care Unit of health. The variables studied were age, sex, obesity, sedentary lifestyle, smoking habits. At the beginning of the study, patients were advised to perform walks of at least 30 minutes daily, to continue with a hyposclic and hypolipid diet.
Outcome: Total visits were 6314.1 times per month during the 7 years and 9 months of the study. There were 6314 controls of blood pressure, and weight, and questioned about smoking and physical activity. Tension figures averaged at the start of the study were 150/90 mm Hg, at the end was 135/80 mm Hg in 40% of hypertensive patients, during the first 5 years, at the end of the study 134/78 mm Hg In 40% of patients.
Depending on the age: 20 - 29: 06, 30-39: 22, 40-49: 07, 50-59: 11, 60-69: 18, 70-79: 01, 80-89: 01, with a total of 66 hypertensive patients, these figures were at the beginning of the study. Sixty patients were terminated, two men and two women retired, two men died.
According to sex: Men: 41, 62.12% of the total population. Women: 25, 37.87% of the total population.
Number of obese: 57, which represents 86.36% of the total sample at the beginning of the study. At the end of 26, they reduced their weight, thanks to the programmed physical activity and the hyposódic and hypolipid diet.
Number of sedentarians: 66, representing 100% of the total sample, at the beginning of the study, at the end of 26 performed scheduled physical activities.
Number of smokers: 18, representing 27.27% of the total sample, at the beginning of the study. They completed 17, 1 died, the 2 who proposed to reduce the amount of cigarettes daily achieved their goal, smoking only 10 of 20 cigarettes a day, and 12 of 40 cigarettes a day.
It was recorded that 01 patient suffers from Cardiometabolic Syndrome. There are 04 patients suffering from type 2 diabetes. One patient suffers from hyperthyroidism. One patient had acute myocardial infarction with posterior stenting and pacemaker placement, 01 suffering from osteoporosis and osteoporosis. Only 40% of hypertensive patients usually follow the treatment.
Conclusions: It was demonstrated that when hypertensive patients perform physical activities and lose weight, it is possible to reduce tension figures.
Smoking is a toxic habit that denotes a great psychic dependence for those who suffer from it, which is why patients were advised of psychological consultations and controls that would help overcome this addiction.
- Epidemiology and Public Health Nursing
Location: Paris
Chair
Jean Caron
McGill University, Montreal Canada
Co-Chair
Wolfgang Seger
Health Advisory Board, Germany
Session Introduction
Edward S Peters
Louisiana State University Health Sciences Center, USA
Title: Mental health among a cohort of women in coastal Louisiana affected by the deep-water horizon oil spill
Biography:
Edward S Peters is Professor and Chair of the LSU School of Public Health’s Epidemiology Program and Director of the School’s Epidemiology Data Center. His research interests focus on using classic and molecular epidemiologic tools to examine molecular and biologic heterogeneity and susceptibility of chronic diseases. More recently this research has begun including aspects of social epidemiology to examine how the effects of social determinants of health influence disparate disease outcomes through a transdisciplinary perspective. He is the Co-PI of the Women’s and Their Children’s Health Study that was established to examine the health effects from the Deepwater Horizon Oil Spill. He has active research projects in oral, ovarian, and prostate cancer. In addition, through his work in the Louisiana Tumour Registry he works on efforts to improve cancer surveillance for HPV related cancers, bioinformatics and molecular pathology.
Abstract:
Statement of the Problem: The Deepwater Horizon Oil Spill (DHOS) was the largest accidental marine oil spill in the history of the US petroleum industry, dwarfing all prior oil tanker spills in magnitude and impact on the environment and causing extensive damage to marine and wildlife habitats. It contaminated over 1,000 miles of beach and marsh shoreline from Texas to Florida and threatened the viability of the northern Gulf’s commercial fishing and tourism industries. The Women and Their Children’s Health study was established to examine health effects from the DHOS among a cohort of 2800 women and 650 children in Louisiana. Psychological sequelae are among the most pronounced effects in populations following exposure to oil spills. Women in particular represent a vulnerable yet influential population but have remained relatively understudied with respect to the DHOS.
Methodology: A baseline telephone interview in 2012, obtained data on physical/mental health and exposure to the oil spill. A follow-up interview was completed in 2016. Exposure to the DHOS was assessed measuring an individual’s physical and economic experience of the spill. Generalized linear models were fit to estimate the association between DHOS exposure and mental health outcomes among the adult women cross-sectionally at baseline then subsequently over time.
Findings: We observe that this population has experienced numerous traumatic events in their lifetime; further the DHOS exposure is associated with increased severity of depression, stress and PTSD symptoms.
Conclusion & Significance: Although additional work is necessary to disentangle this single event from other natural disasters and traumatic events that have occurred in this population, this technologic disaster has had long-lasting negative effects on the psychological well-being of a vulnerable community. Our findings support the adverse impact of disaster exposures on mental health symptoms in women and identify potential targets for post-disaster mitigation.
Recent Publications (minimum 5)
1. Peters ES, Rung AL, Bronson MH, et al. The Women and Their Children’s Health (WaTCH) study: methods and design of a prospective cohort study in Louisiana to examine the health effects from the BP oil spill. BMJ Open. 2017 Jul 10;7(7):e014887.
2. Gaston SA, Volaufova J, Peters ES, Ferguson TF, Robinson WT, Nugent N, Trapido EJ, Rung AL. Individual-level exposure to disaster, neighborhood environmental characteristics, and their independent and combined associations with depressive symptoms in women. Soc Psychiatry Psychiatr Epidemiol. 2017 Jun 27.
3. Rung AL, Gaston S, Robinson WT, Trapido EJ, Peters ES. Untangling the disaster-depression knot: The role of social ties after Deepwater Horizon. Soc Sci Med. 2017 Mar;177:19-26. doi: 10.1016/j.socscimed.2017.01.041.
4. Gaston SA, Nugent N, Peters ES, Ferguson TF, Trapido EJ, Robinson WT, Rung AL. Exploring Heterogeneity and Correlates of Depressive Symptoms in the Women and Their Children’s Health (WaTCH) Study. Journal of Affective Disorders. 2016.
5. Sullivan SM, Peters ES, Trapido EJ, Oral E, Scribner RA, Rung AL. Assessing mediation of behavioral and stress pathways in the association between neighborhood environments and obesity outcomes. Prev Med Rep. 4:248-55, 2016
Mayvor Ström
Primary Health Care, Sweden
Title: Callers’ perceptions of receiving advice via a medical care help line
Time : 12:00-12:30
Biography:
Mayvor Ström completed PhD at the Sahlgrenska Academy in 2009 in Sweden and a trained nurse/midwife in service with Master degree in Environmental Medicine. Mayvor Ström have spent a lot of time in telephone contact with patients during my almost 40-year career. Mayvor Ström thinks that the daily care meeting is a crucial and very important part of overall care. Caring meeting by phone has many dimensions, as power perspective, patient perspective, and of course the staff perspective.
Abstract:
Background: Telephone consultations with specially trained nurses are becoming an increasingly common form of care.
Aim: To describe patients’ perceptions of receiving advice via a medical care help line.
Results: The patients perceived the help line as a professional, reliable and easily accessible asset in everyday life, that self-care is promoted through personal advice and that the help line is a partner with whom one can discuss reflections and feelings. It is also a kind of “back up”. The advice service is perceived as satisfactory when the nurse is calm, friendly, confirming and shows respect. Compliance and acceptance are enhanced when patients feel involved in the decision-making process. The fact that the service is easily accessible is perceived as simple and time-saving.
Conclusions: Seen from the patient’s perspective, the telephone contact with the help line is a simple, easily accessible and secure alternative that is appreciated and used. Caring encounters gave rise to feelings, influenced by the agreement between one’s own needs and expectations, the encounter between human beings and the care provided. More in-depth studies are needed focusing on the patient’s perspective and characterises of the caring encounter over the telephone.
Relevance to Clinical Nursing: Improved understanding of the patient’s perspective on the care provided leads to increased staff satisfaction and motivation. Care encounters by phone are common today for nurses and their well-being at work is beneficial for both them and the care they provide and thereby for the patients.
Alma Sorberg Wallin
Karolinska Institute, Sweden
Title: Suicide attempt in adulthood predicted by childhood cognitive ability and academic performance: a cohort study of 26000 women and men
Time : 12:30-13:00
Biography:
Alma Sorberg Wallin has a background in Clinical Psychology and completed her PhD in Social Epidemiology at the Karolinska Institute in Stockholm, Sweden, in 2015. She is currently working as Postdoctoral Researcher in a project on origins of educational gradients in health. He is a Managing Editor of the European Journal of Public Health. Her main interests are in Psychiatric Epidemiology and Suicidology.
Abstract:
Suicidal behaviour is of public health importance, and is increasing in young populations. Academic performance in youth measured in Grade Point Average (GPA), predicts suicide attempt but the mechanisms are not known. It has been suggested that general cognitive ability might underlie the association. We followed 26,315 Swedish women and men in the population-representative evaluation through follow-up cohorts, up to maximum 46 years of age, for a first suicide attempt in recorded in the national inpatient register. Associations between GPA at age 16, IQ measured in school at age 13 and suicide attempt were investigated in Cox regression and mediation analyses, with control for potential confounders including socioeconomic position. There was a clear graded association between lower GPA and subsequent suicide attempt. With control for potential confounders, those in the lowest GPA quartile had a near five-fold risk (HR 4.9, 95% CI 3.7-6.7) compared to those in the highest quartile. In a mediation analysis, the association between GPA and suicide attempt was robust while the association between IQ and suicide attempt was fully mediated by GPA. To conclude, academic performance in compulsory school was a robust predictor of suicide attempt past young adulthood. Rather than IQ accounting for the association, the association between IQ and suicide attempt was mediated by academic performance, highlighting the role of academic performance in long-term suicidal risk. Future studies should further investigate the key mechanisms in this association, and if interventions to improve academic performance have a long-term preventive effect on suicidal behaviour.
Sarah Donovan
University of Otago, New Zealand
Title: Hidden burdens for women and girls: why is menstrual management not on the public health agenda in OECD countries?
Time : 13:00-13:30
Biography:
Sarah Donovan is a sociologist with a focus on the social determinants of health. She has also worked as a midwife. Her doctoral research (2010, Victoria University of Wellington) focused on prenatal screening for Down Syndrome in New Zealand, and investigated women's experience of prenatal screening decisions, and the relationship of this experience to principles of individual choice and informed consent. Current research focuses on menstrual pain, and cost of menstrual products as a barrier to school attendance. She currently teaches in the postgraduate Diploma of Public Health at the University of Otago, New Zealand.
Abstract:
Issues relating to the management of menstrual pain and flow (including access to affordable menstrual products and pain relief) are the main reason for missed school and work for women in girls in any country. However, these barriers to participation in normal daily activities such as work and school have rarely been considered as within the purview of public health.
While inadequate access to health education and menstrual management products is recognized by UNESCO as important cultural and socioeconomic barriers for women and girls in developing countries, it is widely assumed that within OECD countries these basic necessities are readily accessible by all. However, there is evidence that in a context of growing social inequality within high-income countries, significant economic and cultural barriers to satisfactory menstrual management do now exist for women and girls. As a case study, the presenter will discuss recent media coverage and advocacy work on girls missing school in New Zealand due to the unaffordability of pads and tampons, and the inadequate provision of sanitary disposal units in schools. She will also present findings from her recent and on-going qualitative studies investigating the impact of Primary Dysmenorrhea on the lives of New Zealand women and adolescent girls.
This presentation argues that menstrual management should be recognized as a significant health equity issue in OECD countries, warranting further investigation of the extent to which access to menstrual management products and pain relief now varies significantly along socioeconomic lines.
Arti Uniyal
Maulana Azad Medical College, India
Title: Effect of use of mobile phones on sleep and general health of adolescents of age group 16-19 years
Time : 15:10-15:40
Biography:
Arti Uniyal has recently graduated from Maulana Azad Medical College. She performed this research during her third year of medical school with the guidance of Dr. Pragya Sharma of the Department of Community Medicine. At a very young age she developed the quest for research and realized the relevance of this research topic in today’s world. Her research received recognition by the Indian council of Medical Research and she was awarded for the same. She is currently pursuing her internship and continues to gain experience in medical skills as well as dedicatedly involves in more research in the medical field.
Abstract:
Statement of the problem: Today mobile phones have become an indispensable tool because of the countless perks it provides. However, this extensive use has led to exposure to a dangerous level of electromagnetic waves. Adolescents are at an age where good quality sleep, mental and physical wellbeing is of utmost importance. Sadly, to keep up with today’s fast paced, technologically oriented society, they engage in habitual mobile phone use which affects their cognitive function and general wellbeing. Difficulty in “shutting off” leads to various sleep disturbances.
Purpose: The purpose of this study is to address the increasing extent of mobile phone use among adolescents and its effect on their general health and sleep. Less research has been done in this field and holds great significance today.
Methodology & Theoretical Orientation: A cross sectional study was performed under which a total of 225 High School and College students were interviewed in the form of a semi-structured questionnaire assessing their frequency and pattern of mobile use. General health questionnaire–12 and Pittsburgh sleep Quality index questionnaire-9 were included to assess their levels of stress and sleep problems respectively. The students were interviewed after taking a written informed consent and being assured of their confidentiality.
Findings: This study revealed that more than half (~60%) of the adolescents used mobile phones regularly. A significant association was found between the usage hours and physical symptoms reported as well as with calculated levels of distress. Association between poor quality sleep and hours of calling and internet usage was also found.
Conclusion & Significance: This raises an important question of how this overuse can affect our future and how can we make amends. A huge step would be to help our children keep a check on their levels of use and involve in other recreational activities.
Susan C Hu
National Cheng Kung University, Taiwan
Title: Factors associated with the changes in depressive symptoms in older adults: a follow-up study
Time : 15:55-16:25
Biography:
Susan C Hu is an Associate Professor in the Department of Public Health, National Cheng Kung University. Her research interests focus on health behaviour and health promotion, especially for the older adults. Currently, she serves as the PI of Active Aging Project in Taiwan.
Abstract:
Background: Late life depression is an important public health issue. Very limited studies have focused on the changes in depressive symptoms in the elderly. The aims of the study were to examine factors associated with the deterioration or improvement in depressive symptoms in older adults.
Methods: Four waves of the survey “Taiwan Longitudinal Study on Aging” from 1996 to 2007 were used. A total of 5,088 older adults aged 50 and over were selected. Depressive symptoms were measured using a 10-item depression scale (CESD, scores 0-30), dividing into 3 groups: no (0), low (1-9), and high (≥10). The changes in depressive symptoms were composed of 9 situations: no-no, no-low, no-high; low-low, low-high, low-no; high-high, high-low, high-no. Socio-demographic factors, health behaviours, and health status were examined for the changes in depressive symptoms by using Hierarchical Linear Modelling (HLM) method.
Results: There were 52.6% of participants remaining the same depression status, 24.9% in deterioration, and 22.5% in improvement. In deterioration situations, no exercise was associated with no-low status, and female, older age; and poor health were more to be associated with low-high status. In improvement situations, having spouse, being employed, and good health were associated with high-low status; and higher education, good health, without chronic disease and regular exercise were associated with low-no status.
Conclusion: No exercise and poor health were associated with the deterioration in depression, whereas having spouse, being employed, good health, and engaging in regular exercise were related to the improvement in depressive symptoms in older adults.
Key Messages: 1. Little research has showed the changes in depressive symptoms in the elderly. 2. About one fourth of older adults were in deterioration status, whereas more than one-fifth were in improvement status. 3. Exercise, employment and health status were associated with the deterioration or improvement in depressive symptoms in older adults.
Harshdeep Joshi
Punjab Institute of Medical Sciences, India
Title: Impact of feeding practices on health and nutritional status of the children in urban and rural Haryana
Time : 16:30-16:50
Biography:
Harshdeep Joshi has been working as an Assistant Professor in Department of Community Medicine in Punjab Institute of Medical Sciences. She graduated from Jammu and Kashmir and thereafter pursued MD in Community Medicine. Her main area of interest is Mother and Child Health and her thesis topic was “An assessment of Trends in Infant and Young Child feeding Practices among Rural and Urban Mothers of Haryana and its impact on health and nutritional status of the child using newly developed WHO Indicators”. She has presented Seminars on: Pedagogy, Infant feeding practices, Training on Public Health Nutrition, National Population Policy and Revised National Tuberculosis Program. She has also presented at Journal Clubs on various related topics. She has a versatile research work with more than 10 publications to her credit which were published in journals of international repute. Her research work mainly focuses on vitamin D deficiency in women, adolescent health, maternal and child health. She is also a Member of Medical Education Unit in her Institution and has organized CME on Women’s Health. She has also written articles in different newspapers and is a proactive teacher.
Abstract:
Background: Infant feeding practices are directly linked to nutritional status of the child. About 2/3rd of deaths in young children occur due to inappropriate feeding practices.
Aims & Objectives: To study impact of feeding practices on health and nutritional status of the children.
Materials & Methods: It was community based cross-sectional study conducted among 1267 children between age group of 0-24 months in the urban and rural field practice areas of Department of Community Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, District Ambala, Haryana. A self-designed semi structured questionnaire was used to assess mother’s knowledge, trends and determinants of infant and young child feeding practices and this was followed by anthropometry.
Results: In the current study it was observed that 33.1%, 44.1% and 14.4% children were underweight, stunted and wasted respectively. Factors like mother's education, occupation and type of family significantly (p<0.001) influenced nutritional status of the child as 39.8% underweight children belonged to mothers who were educated up to high school only; also 35.7% underweight children were more in category of unemployed mothers. Feeding practices like feeding colostrum, duration of breastfeeding and time of initiation of complimentary feeds significantly (p<0.005) influenced weight and height of the child. Also, exclusively breastfed children had significantly (p<0.001) less episodes of diarrhea as compared to non-breastfed counterparts.
Conclusion: Feeding practices significantly influence health and nutritional status of the child. Therefore, mothers must be correctly educated regarding right feeding practices.
- Epidemiology and Antibiotic Resistance | Infectious Disease | Congenital Heart Disease | Disease control | Etiology
Location: Paris
Chair
Henry Völzke
University Medicine Greifswald, Germany
Co-Chair
Ray M Merrill
Brigham Young University, USA
Session Introduction
Anne Sophie Mariet
Burgundy Franche-Comte University, France
Title: Trends of operating room-based glaucoma procedures in France from 2005 to 2014: a nationwide study
Biography:
Anne-Sophie Mariet is a public health medical doctor and a Ph.D. student in environmental epidemiology and biostatistics. She works in the Biostatistics and Medical Informatics unit of Dijon University Hospital. Her themes of research are the study of the effects of environmental multi-exposure to noise and air pollution on health particularly in the perinatal period, and the utilization of the hospital Medical Information System Program in epidemiology.
Catherine Quantin is the Head of the Biostatistics and Medical Informatics Unit of Dijon Teaching Hospital and a member of the Inserm UMR 1181 Paris team. The Biostatistics and Medical Informatics Unit directed by her, specializes in the statistical analyses of data contained in major medical databases in the field of public health. Her team includes Hospital Practitioners, Analysts, Statisticians and Public Health Researchers. This team is responsible for the collection, coding and statistical analysis of hospital Medical Information System Program (PMSI) data. Its research activities include the development, the comparison and the application of statistical methods and models (notably to identify prognostic factors) to meet the challenges associated with the exploitation of health data. In this context, her team was one of the first to obtain authorization to extract data from the SNIIRAM database (a nationwide centralized administrative database of all health services) for methodological research (pharmaco-epidemiology).
Abstract:
Aim: The aim of this study is to report the trends of operating room-based glaucoma procedures from 2005 to 2014 in France.
Methods: We identified operating room-based glaucoma procedures (trabeculectomies, deep sclerectomies, aqueous shunts and ciliary body destructions) performed in France from 2005 to 2014 by means of billing codes from a national database. Annual rates and incidence of these procedures per 100,000 were analyzed globally and in 3 age groups: 0-14 years, 15-59 years and over 60 years.
Results: The annual rate of trabeculectomies slightly decreased during the study period while the rate for other surgical techniques (deep sclerectomies, aqueous drainage procedures and ciliary body destructions) increased. The rate of glaucoma surgery was 30 procedures per 100,000 inhabitants over the study period (standardized rate on the French population). There were variations over time in the rate of different types of procedures. For example, the annual rate of trabeculectomy decreased slightly during the study period from 15.6 in 2005 to 12.1 procedures per 100,000 inhabitants in 2014. Second, the rate of deep sclerectomies doubled between 2005 and 2006 from 5.3 to 10.4 procedures per 100,000 inhabitants and then declined steadily to reach 7.8 procedures per 100,000 inhabitants in 2014. Finally, the rate of aqueous drainage procedures increased over the period from 0.24 in 2005 to 0.95 procedures per 100,000 inhabitants in 2014 and the rate of ciliary body destructions increased from 1.98 to 3.02 procedures per 100,000 inhabitants during the period.
Conclusion: Trabeculectomy was the most commonly performed operating room-based glaucoma procedure in France from 2005 to 2014. Other modalities such as deep sclerectomies, aqueous drainage procedures and ciliary body destruction gained more acceptance among French ophthalmologists during this ten-year period.
Tea Skaaby
Research Centre for Prevention and Health, Denmark
Title: Investigating the causal effect of smoking on hay fever and asthma: a Mendelian randomization meta-analysis in the carta consortium
Biography:
Tea Skaaby is an experienced Researcher in epidemiological, population-based preventive medicine. Her scientific focus areas are micronutrient deficiencies and other risk factors for chronic diseases incl. cardiovascular disease and cancer. The current study is part of a series of studies intended to investigate whether repeated health examinations with screening of various risk factors in an unselected population can prevent long-term incidence of ischemic heart disease, stroke, diabetes and mortality, etc.
Abstract:
Statement of the Problem Observational studies on smoking and risk of hay fever and asthma have shown inconsistent results. However, observational studies may be biased by confounding and reverse causation. Mendelian randomization uses genetic variants as markers of exposures to examine causal effects.
Methodology & Theoretical Orientation: We examined the causal effect of smoking on hay fever and asthma by using the smoking-associated single nucleotide polymorphism (SNP) rs16969968/rs1051730. We included 231,020 participants from 22 population-based studies.
Findings: Observational analyses showed that current vs never smokers had lower risk of hay fever (odds ratio (OR)=0•68, 95% confidence interval (CI): 0•61, 0•76; p<0•001) and allergic sensitization (OR =0•74, 95% CI: 0•64, 0•86; P<0•001), but similar asthma risk (OR=1•00, 95% CI: 0•91, 1•09; P=0•967). Mendelian randomization analyses in current smokers showed a slightly lower risk of hay fever (OR=0•958, 95% CI: 0•920, 0•998; P=0•041), a lower risk of allergic sensitization (OR=0•92, 95% CI: 0•84, 1•02; P=0•117), but higher risk of asthma (OR=1•06, 95% CI: 1•01, 1•11; p=0•020) per smoking-increasing allele.
Conclusion & Significance: Our results suggest that smoking may be causally related to a higher risk of asthma and a slightly lower risk of hay fever. However, the adverse events associated with smoking limit its clinical significance.
Recent Publications
1. Skaaby T, Jørgensen T, Linneberg A. Effects of invitation to participate in health surveys on the incidence of cardiovascular disease: a randomized general population study. Int J Epidemiol. 2017 Apr 1;46(2):603-611.
2. Skaaby T, Taylor AE, Thuesen BH, Jacobsen RK, Friedrich N, Møllehave LT, Hansen S, Larsen SC, Völker U, Nauck M, Völzke H, Hansen T, Pedersen O, Jørgensen T, Paternoster L, Munafò M, Grarup N, Linneberg A. Estimating the causal effect of body mass index on hay fever, asthma, and lung function using Mendelian randomization. Allergy. 2017 Jul 4 [Epub ahead of print].
3. Skaaby T, Taylor AE, Jacobsen RK, Paternoster L, Thuesen BH, Ahluwalia TS, Larsen SC, Zhou A, Wong A, Gabrielsen ME, Bjørngaard JH, Flexeder C, Männistö S, Hardy R, Kuh D, Barry SJ, Tang Møllehave L, Cerqueira C, Friedrich N, Bonten TN, Noordam R, Mook-Kanamori DO, Taube C, Jessen LE, McConnachie A, Sattar N, Upton MN, McSharry C, Bønnelykke K, Bisgaard H, Schulz H, Strauch K, Meitinger T, Peters A, Grallert H, Nohr EA, Kivimaki M, Kumari M, Völker U, Nauck M, Völzke H, Power C, Hyppönen E, Hansen T, Jørgensen T, Pedersen O, Salomaa V, Grarup N, Langhammer A, Romundstad PR, Skorpen F, Kaprio J, R Munafò M, Linneberg A. Investigating the causal effect of smoking on hay fever and asthma: a Mendelian randomization meta-analysis in the CARTA consortium. Sci Rep. 2017 May 22;7(1):2224.
4. Skaaby T, Husemoen LL, Thuesen BH, Pisinger C, Hannemann A, Jørgensen T, Linneberg A. Longitudinal associations between lifestyle and vitamin D: A general population study with repeated vitamin D measurements. Endocrine. 2016 Feb;51(2):342-50.
5. Skaaby T, Husemoen LL, Thuesen BH, Jeppesen J, Linneberg A. The association of atopy with incidence of ischemic heart disease, stroke, and diabetes. Endocrine. 2015 Mar;48(2):541-50.
Jeonghoon Kim
Seoul Medical Center, South Korea
Title: Factors associated with Secondhand smoke incursion at homes in multiunit housing: Cross sectional study in Seoul, Korea
Biography:
Jeonghoon Kim is working in Department of Environmental Health in Seoul Medical Center in Seoul, South Korea. He is also Ph.D. students in Graduate School of Public Health at Seoul National University and majored in Environmental Health. His study is focused on exposure science. Recently, he is more focused on Second Hand Smoke (SHS) exposure in hospitality venues and multiunit housing.
Abstract:
Second-Hand Smoke (SHS) can seep into living homes from somewhere else in or outside of a building in Multiunit Housing (MUH). The aims of this study were to examine the prevalence of SHS incursion in MUH and to assess relationships between SHS incursion and socio-demographic and home environmental factors in Korea. Population-based samples of 2,600 MUH residents (≥19 years) in Seoul were collected through a web-based panel. The residents completed a questionnaire on socio-demographic factors, smoking status, a frequency of SHS incursion, and home environmental factors. Homes with personal smoke-free rule were determined when residents declared they lived in homes where no one smoked inside. In 2,600 residents, a frequency of SHS incursion was less likely to report residents who were smokers. Non-smoking residents who lived in homes with personal smoke-free rule were included for further analysis (n=1,784). The residents who were experienced for SHS incursion within past 12 months were 74.7%. Multivariable ordinal logistic regression analysis resulted that residents who had more activity time at home, lived with children, supported for the implementation of smoke-free regulation in MUH, lived in homes with smaller home size, lived in homes with natural ventilation with open front doors or open both windows and front door, and lived in homes with higher frequency of natural ventilation were more likely to report SHS incursion at home. Majorities of the non-smoking residents who lived in a home with smoke-free rule were experienced for SHS incursion at home. Activity time at home, living with children, support for the implementation of smoke-free regulation in MUH, home size, methods of natural ventilation, and frequency of natural ventilation was predictors for SHS incursion in MUH. A smoke-free policy in MUH is needed to protect residents from SHS exposure when they are at home.
Recent Publications (minimum 5)
1. Koster B, Brink AL, Clemmensen IH (2013) 'Neighbour smoke'--exposure to secondhand smoke in multiunit dwellings in Denmark in 2010: a cross-sectional study. Tobacco Control. 22(3):190-193.
2. Wilson KM, Torok M, McMillen R, et al (2014). Tobacco smoke incursions in multiunit housing. American Journal of Public Health. 104(8):1445-1453.
3. King BA, Cummings KM, Mahoney MC, Juster HR, Hyland AJ (2012) Multiunit housing residents’ experiences and attitudes toward smoke-free policies. Nicotine & Tobacco Research. 12(6):598-605.
4. Licht AS, King BA, Travers MJ, Rivard C, Hyland AJ (2012) Attitudes, experiences, and acceptance of smoke-free policies among US multiunit housing residents. American Journal of Public Health. 102(10):1868-1871.
5. Kim J, Lee K (2016) Characterization of urinary cotinine in non-smoking residents in smoke-free homes in the Korean National Environmental Health Survey (KoNEHS). BMC Public Health. 16(1):1-8.
Biography:
Anne Sophie Mariet is a Public Health Medical Doctor and a PhD student in Environmental Epidemiology and Biostatistics. She works in the Biostatistics and Medical Informatics unit of Dijon University Hospital. Her themes of research are the study of the effects of environmental multi-exposure to noise and air pollution on health particularly in the perinatal period, and the utilization of the hospital Medical Information System Program in epidemiology.
Abstract:
The objective of this study was to analyze risk factors of preterm birth, hypertensive disorders of pregnancy and small for gestational age in a population of multiple pregnancies in two French urban areas. We included all 249 multiple pregnancies of women who lived in Besancon and in the urban unit of Dijon and delivered in one of the university hospitals of the two cities between 2005 and 2009. A retrospective data collection was conducted in obstetrical records to collect obstetrical history, individual socioeconomic factors, comorbidities during pregnancy, and characteristics of the delivery and newborns. Preterm birth was defined as birth before 36 weeks of gestational age. Small for gestational age was defined as birth weight less than the 10th percentile of birth weight for gestational age in France. Environmental exposures to noise and air pollution (NO2) were modelized at home buildings. A neighborhood socioeconomic index was calculated at the census block groups scale. The associations between potential risk factors and preterm birth, hypertensive disorders of pregnancy and small for gestational age were analyzed by logistic regression models. Preterm birth was observed in 152 pregnancies and hypertensive disorders in 30 pregnancies. Among 506 newborns, 122 were small for gestational age. Preterm birth was associated with infection (p=0.01) and major infant congenital abnormalities (p=0.007). A high pre-pregnancy body mass index was associated with the occurrence of hypertensive disorders during the pregnancy (p=0.002). A small weight for gestational age was less frequent with girls (p=0.04), the absence of pre-existing hypertension (p=0.02), and diabetes (p=0.03). In order to optimize the management of multiple pregnancies, risk factors of adverse pregnancy outcomes should be more precisely identified in this specific population.
Chrissy Bishop
University of Bradford, UK
Title: New insights from reporting congenital anomaly rates using primary care data in a multi-ethnic Born in Bradford (BiB) study
Biography:
Chrissy Bishop worked as an Occupational Therapist for 5 years, during which she developed interests in Public Health and Policy Research. She studied her MSc in Professional Health and Social Care whilst working in the NHS, progressing her interests towards health determinants and epidemiology. She left the NHS to study a second MSc in Epidemiology and Biostatistics at the University of Leeds, during which she was introduced to the Born in Bradford Project. On graduating she was awarded a scholarship to study her PhD with Born in Bradford. Her special interests are pathways through care for children with complex healthcare needs.
Abstract:
Background: In the UK Congenital Anomalies (CA) are a common cause of childhood death and disability; they are the most common cause of infant death for children of Pakistani origin. The CA rate in Bradford is nearly twice the national average. In the present study we linked children with CA in the Born in Bradford study (BiB) to General Practice (GP) data. We have used this routine data to prospectively study late diagnoses of CA and to further describe associations with risk factors for CA.
Methods: We used questionnaire data on 11474 babies from BiB, a prospective birth cohort study of 13857 babies and their families, for which recruitment took place between 2007 and 2011. CA cases were identified by linking cohort babies to GP records, anomalies were classified according to European Surveillance of Congenital Anomalies (EUROCAT) guidelines and coded using ICD-10. Children with one or more CA (n=708), were compared to those without CA (n=10766). We calculated univariate and multivariate risk ratios (RRs) with 95% confidence intervals for various maternal risk factors.
Findings: Use of routinely collected GP data increased the ascertainment of children with CA. At age one, rates for CA were 376 per 10,000 live births but accounted for only 60% of diagnoses. 40% of diagnoses were made after age one, increasing rates to 619 per 10,000 live births to age eight. Consanguinity was found to be a risk factor for anomalies in Pakistani mothers (multivariate RR 1.89, 95% CI 1.51-2.39).
Interpretation: 98% of UK CA registrations occur before age 1 year; our data suggest this is leading to incomplete case ascertainment. National registries should reconsider an age restriction of one for CA case ascertainment. More complete case ascertainment would provide better information for commissioners and allow funding decisions to better reflect clinical requirements.
Tea Skaaby
Research Centre for Prevention and Health, Denmark
Title: Effects of invitation to participate in health surveys on the incidence of cardiovascular disease: a randomised general population study
Biography:
Tea Skaaby is an experienced Researcher in epidemiological, population-based preventive medicine. Her scientific focus areas are micronutrient deficiencies and other risk factors for chronic diseases incl. cardiovascular disease and cancer. The current study is part of a series of studies intended to investigate whether repeated health examinations with screening of various risk factors in an unselected population can prevent long-term incidence of ischemic heart disease, stroke, diabetes and mortality etc.
Abstract:
Statement of the Problem: The effects of health checks on reducing cardiovascular disease morbidity and mortality in the general population have been questioned. There are few randomized studies with long-term follow-up. We used a cohort randomly selected from a general population as a randomized trial to study the effect of repeated general health checks on the 30-year incidence of ischaemic heart disease (IHD), stroke and all-cause mortality.
Methodology & Theoretical Orientation: The study included all persons (n=17 845) aged 30, 40, 50 and 60 years living in 11 municipalities in Copenhagen, the capital of Denmark. An age- and gender-stratified random sample (n=4789) was invited to up to three health checks, from 1982 to 1994 (intervention group). The remaining 12 994 persons were defined as the control group. Complete follow-up on mortality, emigration and fatal and non-fatal IHD and stroke until 31 December 2012 was obtained by linkage to registries.
Findings: There were 3209 and 2190 incident cases of IHD and stroke, respectively, and a total of 6432 deaths during follow-up (mean = 25.2 years). The hazard ratios (HRs) (95% confidence intervals, CIs) for persons in the intervention group versus persons in the control group were as follows: IHD (HR: 0.99, 95% CI: 0.92, 1.07), stroke (HR: 1.14, 95% CI: 1.04, 1.25) and all-cause mortality (HR: 1.03, 95% CI: 0.98, 1.09).
Conclusion & Significance: Repeated general health checks offered to the general population had no beneficial effects on the development of IHD, stroke or all-cause mortality during 30 years of follow-up. An increased incidence of stroke was observed in the group offered health checks.
Isaac M Danat
University of Wolverhampton,UK
Title: Risk factors for abnormal weight in older adults: a community-based cohort study in China
Time : 15:25-15:55
Biography:
Isaac M Danat is a PhD student in Epidemiology and Global Health Research under the supervisor of Dr. Ruoling Chen at the University of Wolverhampton, UK. In 2014 he was awarded Master of Public Health degree (MPH) at University of Wolverhampton after obtaining a MBA at Ahmadu Bello University and a Bachelor of Pharmacy degree at University of Jos, Nigeria. Before entry into the PhD program he worked as a Senior Analyst and a Senior Program Officer, on the Essential Medicine Project, with an international public health NGO “Clinton Health Access Initiative”. His work focuses on obesity research in older population. He was a Speaker at the International Conference for Geriatrics and Gerontological Nursing at London UK, in October 2016. He is a co-author of a paper published in a peer review journal titled “The prevalence and determinants of undetected dementia in the community: A systematic review and a meta-analysis”.
Abstract:
Statement of the Problem: Maintaining normal weight will prevent ill health and prolong life. In the older population, it is also true, but older people have increased risks of obesity, overweight and underweight. Risk factors for these abnormal weights have been less investigated. We set up a cohort study in China to identify the risk factors.
Methods: In 2001-2003 we examined a random sample of 2917 residents aged ≥65 years from Anhui of China, documenting socioeconomic status (SES) and cardiovascular disease risk factors (CVDRFs) and recording blood pressure and physical measurements. In 2007-2009 we re-interviewed 1462 surviving cohort members, measuring body weight and height to calculate Body Mass Index (BMI). We defined participants with BMI≥28 kg/m2 as having obesity, BMI 24-<28 as overweight, BMI 18.5-<24 as normal weight and BMI<18.5 as underweight. We employed a binary logistic regression model to compute age-sex adjusted odds ratios (OR) for risk factors in obesity verse normal weight. ORs were also calculated to identify risk factors in overweight and underweight respectively.
Findings: Of 1462 participants, 1313 had their BMI measured, of which 55.9% had normal weight, 6.5% obesity, 24.4% overweight and 13.3% underweight. There was a significant association of obesity with high SES (e.g. adjusted OR in urban verse rural living was 1.75, 95%CI 1.10-2.79) and CVDRFs (e.g. hypertension 2.55, 1.30-5.01). There was a similar pattern for overweight associated with these risk factors (e.g. hypertension 1.55, 1.05-2.27), while watching TV increased the risk of overweight (1.84, 1.33-2.54). Surprisingly underweight was also related to high SES (e.g. adjusted OR of 1.49, 1.03-2.15 in urban), and inversely associated with baseline depression (0.57, 0.33-0.97) and smoking (0.59, 0.39-0.90).
Conclusion & Significance: Older adults in China have high levels of abnormal weight. Targeting high-risk groups of abnormal weight would likely improve weight management in older adults.
Joelza M A Pires
Federal University of Rio Grande do Sul, Brazil
Title: Adolescents deprived of liberty: subject of rights? Analytical overview under Foundation Care Social-Educational of Rio Grande Do Sul (Brazil) during the period from 2002 to 2014
Biography:
Joelza M. A. Pires, graduated since 1984 in Medicine from Federal University of Bahia (UFBA/1984) and a Master’s Degree in Medical Sciences (Paediatrics) at the Federal University of Rio Grande do Sul (UFRGS/2003). She is completing the doctoral degree in the graduate program in child and adolescent health of UFRGS. She is a specialist in Paediatrics by the Brazilian Society of Paediatrics (SBP). She is a domestic violence expert at the University of Sao Paulo (USP). She is the President of the Foundation of Educational Service of Rio Grande do Sul (FASE/RS) for delinquency juvenile in the management 2011-2015. She has an experience in Social Paediatrics working mainly on the following themes: violence against children and adolescents, sexual abuse and exploitation of children and adolescents, families in situation of vulnerability and social risk, domestic violence, juvenile delinquency, restorative practices, non-violent communication and culture of peace.
Abstract:
Statement of the problem: The teenage offender is the result of a number of factors associated with their vulnerable condition, victim of social exclusion, and although they are not the main perpetrators of violence, relate to her so ambivalent, as victim, as aggressor. There are many risk factors, few responsible for them; In addition to the parental abandonment, father absence, truancy, of street children, drug use and many other violations of human rights. The Fundacao de Atendimento Socioeducativo of Rio Grande do Sul (FASE-RS) is responsible for the implementation of educational measures, applied by Regional Courts of Childhood and Adolescent for offenders teens. The purpose of this study is to describe and analyse the management of FASE-RS, focusing on the fundamental rights of adolescents deprived of liberty and the governmental responsibility of implement, public policies national and State between 2002 to 2014.
Methodology & Theoretical Orientation: Is a qualitative study of organizational-historical exploration using content analysis, interview techniques, analysis of documents and participant observation. As research tool we will use semi-structured interviews with open issues applied in specific social representations: Presidents (managers), judges and prosecutors from childhood.
Findings: The current population is around 1367 teenagers, between 12 and 21 years old, fulfilling educational measures in juvenile justice institution. The State shall ensure, with full protection and absolute priority, for all the teenagers, deprived of liberty, the right to life, health, food, education, leisure, professional training, culture, dignity, respect, freedom, family and community living, besides putting them safe from all forms of negligence, discrimination, exploitation, violence, cruelty and oppression (ECA-1990).
Conclusion & Significance: The Government plans do not include in his re-socialization priorities of adolescents deprived of freedom, in disagreement with the law. The final result will be included before October.
Recent Publications
1. Andrés Villaveces; Lisa A. DeRoo (Dec. 2008) Child delinquency and the prophylaxis of crime in early 20th-century Latin America. Rev Panam Salud Publica vol.24 n.6 Washington.
2. Van der Put and de Ruiter (2016). Child maltreatment victimization by type in relation to criminal recidivism in juvenile offenders. BMC Psychiatry 16:24.
3. Rapp L. (Apr.2016).Delinquent-Victim Youth-Adapting a Trauma-Informed Approach for the Juvenile Justice System. J Evid Inf Soc Work. 25:1-6.
4. Simons I, Mulder E, Rigter H, Breuk R, van der Vaart W, Vermeiren R. (2016 Sep). Family-Centered Care in Justice Institutions: A Mixed Methods Study Protocol. 12; 5(3):e177.
5. Synder H, Sickmund M (2011) International Centre for Prison Studies. University of Essex; Juvenile offenders and victims: 2006 national report. Washington, DC: Office of Juvenile Justice and Delinquency Prevention; 2006
Weiju Zhou
University of Wolverhampton, UK
Title: Socioeconomic deprivation and survival in older adults with angina: a community-based cohort study in China
Biography:
BACKGROUND: Over the past 30 years, China has had an increasing number of people with angina alongside a rapid economic development and population aging. China has also seen an increase in the income gap between rich and poor. The association between socioeconomic deprivation (SED) and survival of older adults with angina is unclear.
METHODS: In 2001-2003, we interviewed 1457 people aged ≥ 60 years who had minimal educational levels in Anhui province, China, having characterised socio-demographics and risk factors for cardiovascular disease and documented doctor-diagnosed angina at baseline. One year after baseline, survivors were re-interviewed to document incident angina. The vital status of all cohort members was followed up over five years. A Cox regression model was used to calculate hazards ratio (HR) of mortality in relation to SED.
RESULTS: 131 participants with angina at baseline or at one-year follow up had an increased mortality (23.7%) compared to those without angina (mortality 14.2%). The multivariate adjusted HR in angina patients living in rural areas versus non-angina participants living in urban areas was 8.45 (95%CI 1.93-37.0). Multivariate adjusted HR among angina patients having a low level of education, occupational class or income versus non-angina participants having high levels was 2.41 (1.38-4.22), 2.15 (1.11-4.17) and 2.88 (1.40-5.92) respectively. Within angina patients, an increased HR was significantly observed for patients living in rural versus urban (4.99, 1.09-22.9), but not in those with other indicators of SED.
CONCLUSIONS: In China, reducing surviving inequality in older adults with angina should be addressed in rural areas.
Abstract:
Weiju Zhou is a PhD student in Epidemiology and Global Health Research under the supervisions of Drs Alex Hopkins and Ruoling Chen (DoS) at the University of Wolverhampton (UoW), UK. On obtaining his first-class BSc from UoW in Jun 2016, Weiju started his PhD study. His research interesting areas cover Coronary Heart Disease and Health Inequality. Weiju examines the data of a large cohort of Chinese older adults to address important research questions from the PhD proposal. He has co-authored a paper published in peer-reviewed journal. Mr Zhou is President of the Wolverhampton Chinese Students and Scholars Association, UK.
Natasha F Morris
Monash University, university in Melbourne, Australia
Title: The indigenous Australian malnutrition project: measuring the burden and nature of malnutrition in regional Australian hospitals
Biography:
Natasha F Morris is a PhD Candidate at Baker Heart and Diabetes Institute and Monash University. Her expertise lies in malnutrition screening and aims to improve malnutrition screening and the nutritional health of adult patients. She is keen on completion of her PhD work involving improving the nutritional health for people with chronic disease through early assessment and nutritional intervention. She is a Lecturer at the University of Melbourne, Department of Nursing, and Coordinates Graduate Certificate in Nursing Practice.
Abstract:
Statement of the Problem: Worldwide, many indigenous populations experience poor health due to their vulnerability to socio-economic disadvantage. Indigenous people are more likely than non-indigenous people to have nutrition related diseases, increased morbidity and decreased life expectancy. Malnutrition in hospital patients is a well-recognized problem; however, malnutrition is frequently under recognized or under estimated in vulnerable patients including indigenous people.
Purpose: The purpose of this study was to measure the burden and nature of malnutrition in adult indigenous Australian inpatients in 3 regional hospitals.
Methodology & Theoretical Orientation: A cross-sectional survey was used to measure malnutrition risk using the Malnutrition Screening Tool and Australian Nutrition Tool; and malnutrition using the Subjective Global Assessment. A Population Based Screening Framework was used with the aim of increasing the awareness and recognition of malnutrition in indigenous Australians and to facilitate early nutrition management.
Findings: 608 indigenous and non-indigenous Australians were enrolled in this study. The prevalence of malnutrition in all patients was 46.1% (95% CI 40.1-52.3%). Higher rates of malnutrition were observed in indigenous Australians residing in Central Australia (56.7%, 95% CI 46.7-66.4%) than in the Top End of Australia (40.7%, 95% CI 31.7-50.1%) and Far North Queensland (36.7%, 95% CI 36.7%, 95% CI 23.4-41.7%). Factors independently associated with malnutrition for Indigenous Australians included Central Australian residence and an increased Charles Comorbidity Index. Anthropometric variables including a BMI <18.5 kg/m2 and smaller mid-upper arm circumference were strong predictors of malnutrition for Indigenous Australians.
Conclusion & Significance: This is the first study to measure the burden and nature of malnutrition in indigenous Australians in an inpatient setting. We observed higher rates of malnutrition than previous malnutrition surveys in Australia and the differing nature of malnutrition that we found highlights the need to developing alternative approaches to malnutrition screening and detection in indigenous Australians.
- Epidemiology and Antibiotic Resistance | Infectious Disease | Congenital Heart Disease | Disease control | Etiology
Session Introduction
Marjan Zare
Shiraz University of Medical Sciences, Iran
Title: Space-Time Cluster Analysis of Malaria in Fars Province, Iran
Biography:
Marjan Zare pursued MS in Biostatistics and is a PhD student in Epidemiology. He has expertise in statistical and epidemiological modelling, and has passion in improving health care and public health policies. She has been working for Shiraz Medical School research center for three years and she knows how to work with R, ITSM, CMA, Lisrel, Arc GIS, SaTScan, SPSS, Python language softwares to do ordinary statistical analysis. Also, she is interested in doing micro array analysis using Mega Data in field of genetics; hereby she knows how to work with the related softwares like Plink and Hoploview. The basis of this research is to predict the potential outbreaks in the future using Time-Series data
Abstract:
Background: Cutaneous Leishmaniasis (CL) is an infectious endemic disease in most provinces of Iran, which is among public health problems. CL is prevalent in 88 countries in the world, infecting nearly 12 million individuals. Almost two million new leishmaniasis cases occur yearly, with CL accounting for 1500000 cases. Fars province is known to be an endemic area for CL.
Study objective: The objective of this study is to assess the spatiotemporal trait of CL in Fars province, Iran.
Materials & Methods: Spatiotemporal cluster analysis was done retrospectively to find spatiotemporal clusters of CL cases. Time-series data were recorded from 29201 cases in Fars province, Iran from 2010 to 2015, which were used to verify if the cases were distributed randomly over time and place. Then, subgroup analysis was applied to find significant sub-clusters within large clusters. Spatiotemporal permutation scans statistics in addition to subgroup analysis were implemented using SaTScan software.
Results: This study resulted in statistically significant spatiotemporal clusters of CL (p<0.05). The most likely cluster contained 350 cases from 1 July 2010 to 30 November 2010. Besides, 5 secondary clusters were detected in different periods of time. Finally, statistically significant sub-clusters were found within the three large clusters (p<0.05).
Conclusion: Transmission of CL followed spatiotemporal pattern in Fars province, Iran. This can have an important effect on future studies on prediction and prevention of CL.
Phyu Sin Aye
Open University, UK
Title: International cancer survival gaps and the influence of health systems performance
Biography:
Phyu Sin Aye earned her medical degree from the University of Medicine, Myanmar. She worked at the Department of Medical Research for three years involving in various population-based researches. Her interests are epidemiology, biostatistics, chronic diseases, and health care services. She went on to complete her Master of Public Health at the University of Auckland, New Zealand, with a focus on cancer epidemiology and health services. She is currently a Ph.D. student at the Open University, UK and continues her research on international cancer survival gaps and the association with health systems performance in seeking to improve cancer outcomes.
Abstract:
Findings and discussion: There are statistically significant differences in cancer survival across the world, ranging from 3.4% difference in colon cancer survival to as high as 61.9% difference in rectal cancer survival when one country is compared to the country with a highest global level for each cancer. These values of cancer survival gaps represent room
Marjan Zare
Shiraz University of Medical Sciences, Iran
Title: Spatiotemporal clustering of cutaneous leishmaniasis in Fars province, Iran
Biography:
Marjan Zare pursued MS in Biostatistics and is a PhD student in Epidemiology. He has expertise in statistical and epidemiological modelling, and has passion in improving health care and public health policies. She has been working for Shiraz Medical School research center for three years and she knows how to work with R, ITSM, CMA, Lisrel, Arc GIS, SaTScan, SPSS, Python language softwares to do ordinary statistical analysis. Also, she is interested in doing micro array analysis using Mega Data in field of genetics; hereby she knows how to work with the related softwares like Plink and Hoploview. The basis of this research is to predict the potential outbreaks in the future using Time-Series data
Abstract:
Background: Cutaneous Leishmaniasis (CL) is an infectious endemic disease in most provinces of Iran, which is among public health problems. CL is prevalent in 88 countries in the world, infecting nearly 12 million individuals. Almost two million new leishmaniasis cases occur yearly, with CL accounting for 1500000 cases. Fars province is known to be an endemic area for CL.
Study objective: The objective of this study is to assess the spatiotemporal trait of CL in Fars province, Iran.
Materials & Methods: Spatiotemporal cluster analysis was done retrospectively to find spatiotemporal clusters of CL cases. Time-series data were recorded from 29201 cases in Fars province, Iran from 2010 to 2015, which were used to verify if the cases were distributed randomly over time and place. Then, subgroup analysis was applied to find significant sub-clusters within large clusters. Spatiotemporal permutation scans statistics in addition to subgroup analysis were implemented using SaTScan software.
Results: This study resulted in statistically significant spatiotemporal clusters of CL (p<0.05). The most likely cluster contained 350 cases from 1 July 2010 to 30 November 2010. Besides, 5 secondary clusters were detected in different periods of time. Finally, statistically significant sub-clusters were found within the three large clusters (p<0.05).
Conclusion: Transmission of CL followed spatiotemporal pattern in Fars province, Iran. This can have an important effect on future studies on prediction and prevention of CL.
Jing Wang
Center for Disease Control and Prevention, China
Title: Occupational group’s workplace social capital and mental health: connections in employee’s work ability
Biography:
Jing Wang, Chief Physician, has her expertise in health education and promotion and passion in improving the health and wellbeing. During more than 20 years, in her career as Director of the Department of Health Education and Promotion in Shanghai Pudong CDC, she organized and participated in various research projects of a national and provincial level.
Abstract:
Background: There are a variety of factors from work and daily life who affect the physical and mental health of occupational groups, then affect their work ability. Social capital as a characteristic of social life includes network, norms and trust. Researchers have reported that social capital is an important social factor that affects health, but the impact mechanism is not very clear at present. The purpose of this study is to explore and clarify the connections between workplace social capital and the physical and mental health of employees and work ability, and to provide new directions and strategies for Occupational Health Promotion and Workplace Health Management. Methods: 3988 employees from 14 workplaces in Pudong New Area were investigated with professional scale questionnaire through stratified cluster sampling. We used the structural equation modeling to examine the associations between worker’s basic information, occupational characteristics, physical and mental health, workplace social capital and work ability. Results: Worker’s basic information, the physical and mental health and the level of workplace social capital are the direct influencing factors of work ability, and the employee's self-rated health and mental health level are the most important factors. In addition, employee’s workplace social capital directly affects their mental health. Conclusions: Workplace social capital is an important factor in employee’s health and work ability. Policies and measures for raising workplace social capital would help improve employee’s mental health level and their work ability. The study provides an important research direction for Occupational Health Promotion and Workplace Health Management, also it provided a strong evidence for the measures of improving the team cohesion to increase enterprise productivity.
Xianfeng Zhou
Center for Disease Control and Prevention, China
Title: Optimal haemoglobin A1c cutoff value for diabetes mellitus and pre-diabetes in Pudong new area, Shanghai, China
Biography:
Xianfeng Zhou has her expertise in disease surveillance and passion in chronic disease prevention and control. She and her project team built a cohort based on the community and contained ten thousand people in Pudong New Area. Since 2013, she and her project team carried out a follow-up survey every three year to observe the incidence and prevalence of chronic diseases such as hypertension, diabetes, chronic obstructive pulmonary disease and the dynamic change trend of risk factors related to chronic diseases. At the same time, they built Biobank. She is focused on the study of internal and external environmental exposure factors of chronic disease, further provide data support for chronic disease prevention and control in Pudong New Area.
Abstract:
Introduction: The latest China Guideline for Type 2 diabetes mellitus (T2DM) in 2013 didn’t recommend HbA1c for diagnosis of diabetes and pre-diabetes. It requires considerable research to evaluate HbA1c diagnostic threshold for diagnosis of hyperglycaemia.
Materials & Methods: We included 7909 subjects aged ≥15 without known diabetes from the baseline of Pudong community cohort in 2013. Participants took oral glucose tolerance test (OGTT) and HbA1c assay. Receiver operating characteristic curve determined the HbA1c threshold in the diagnosis of hyperglycaemia.
Results: The optimal HbA1C threshold for diagnosing newly diagnosed diabetes (NDD) and pre-diabetes in this population was 6.0% (AUC=0.798, 95%CI: 0.779-0.818, P<0.001) and 5.6% (AUC=0.655, 95%CI: 0.638-0.671, P=0.008). The sensitivity (pre-diabetes: 51.78%, NDD: 63.60%) and specificity (pre-diabetes: 72.63%, NDD: 84.86%) of pre-diabetes was lower than NDD. The AUC of HbA1c for diagnosing NDD and pre-diabetes in subjects <60 years was larger than older (≥60 years) subjects (NDD: P=0.002, pre-diabetes: P=0.02). There were 13.81% and 14.34% of participants would be newly detected as NDD and pre-diabetes via HbA1c criteria; meanwhile almost 3.20% and 15.52% diagnosed as NDD and pre-diabetes by OGTT criteria would be missed diagnosis.
Conclusions: The optimal HbA1c thresholds for NDD and pre-diabetes were lower than ADA criteria. HbA1c and OGTT are discordant for diagnosis of hyperglycaemia. It is necessary to carefully consider whether choose HbA1c as a diagnostic criterion or combine two diagnostic standards. Age-specific diagnostic thresholds should be considered when HbA1c was recommended as diagnostic standard.
Jung Eun Yoo and Hye Soon Park
Seoul National University Hospital, South Korea
Title: Relationship between parental hypertension and cardio metabolic risk factors in adolescents
Biography:
Jung Eun Yoo has her expertise in evaluation and passion in improving the health and wellbeing. She always tries to provide a personalized healthcare for each patient, including prevention and early diagnosis of diseases resulting from one's lifestyle problems, degenerative illnesses, and cancers. In addition, she offers professional help for patients and their family's well-being, including matters related to nutrition, exercise, smoking and drinking, stress, and aging
Abstract:
This study aimed to investigate the relationship between parental hypertension and cardiometabolic risk factors in adolescents. We analysed data of 554 adolescents aged 13–19 years from Korean National Health and Nutrition Examination Survey 2013. The associations between parental hypertension and cardiometabolic abnormalities in adolescents were evaluated through multivariate logistic regression. Parental hypertension was noted in 16.2% of subjects. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for overweight (OR 2.08, 95% CI 1.01–4.28) and obesity (OR 2.11, 95% CI 1.09–4.07) were significantly higher in subjects with parental hypertension. The adjusted ORs for abdominal obesity (OR 2.36, 95% CI 1.01–5.56), high blood pressure (OR 3.05, 95% CI 1.19–7.78), and elevated alanine transaminase defined as >35 IU/L (OR 2.86, 95% CI 1.03–7.95) were significantly higher in subjects with parental hypertension. Prevention of cardiometabolic risk factors should be reinforced in offspring of hypertensive parents.
Haeyong Pak
National Health Insurance Service Ilsan Hospital, South Korea
Title: Health impact assessment by income level due to heatwave
Biography:
Haeyong Pak has his expertise in health evaluation and air pollution in Public Health and Environmental. He was a Practitioner of Health Impact Assessment for four years at KEI (Korea Environmental Institute). He is currently studying health insurance policies at the National Health Insurance Service Ilsan Hospital. His recent areas of interest include artificial intelligence and climate change modeling clinical trials.
Abstract:
Health impact of high temperature has been reported since the early 20th century. In South Korea, it is reported that mortality increases with temperature above city-specific thresholds during the hot season in Seoul. However, the health impact of high temperature according to vulnerability on morbidity has been inconclusive in South Korea. The goal of this analysis was to examine health impact of high temperature, according to vulnerability on morbidity in summer (May-September) Seoul, South Korea, from 2003 to 2013. To examine the distributed lag effects, we fitted a constrained distributed lag model that included lagged exposure variables as covariates, applying a function of days of lag according to B-spline bases. In our study, morbidity data are episode data based on patients, with applying the episode of care in National Health Insurance Service – National Sample Cohort (2002~2013). We examined heat stroke in two age categories: all ages and those over age 65, low level of income, high region of deprivation. The summer temperature thresholds were 26.1°C in Seoul. A 1°C increase in temperatures above morbidity-specific thresholds was associated with increase in heat stroke episode counts for all ages, and for those over age 65 of 35.86% and 50.05%, 44.56% and 52.42% for low level of income, 42.28% and 62.62% for high region of deprivation. Associations were stronger for low level of income and high region of deprivation in heat stroke, to a lesser extent, total group. Our study found that high temperature was associated increased risk of heat stroke, according to vulnerability in Seoul. Consequentially, evidence of this study has the potential to inform public health efforts, such as heat warning systems for differential high temperature according to vulnerability.
Wan Chen Hsu
National Cheng Kung University, Taiwan
Title: The relationship between retirement planning and quality of life among the middle-aged and older retirees in Taiwan
Biography:
Wan Chen Hsu is a full-time Research Assistant in the Department of Public Health, National Cheng Kung University. Before studying at the graduate school, she is interested in studying the health issues of older population which made her chose this topic about mobility of caregivers as her research.
Abstract:
Introduction: Retirement leads to many impacts on the middle-aged and older adults, such as role change, social relationship, a lot of free time and financial planning. Previous studies showed that well-retirement planning would lower the anxiety and improve quality of life. However, fewer studies explore the association between retirement planning and quality of life in Asia countries. Hence, this research aimed to examine the relationship between retirement planning and quality of life for the middle and older adults in Taiwan.
Methods: This study analysed 3141 samples aged 50-74 years old from “Retirement planning on life adaptation and health status of post retirement” database in Taiwan. These participants received pension from Public Insurance or Labor Insurance. Pre-retirement planning was grouped into 4 types: (1) no planning, (2) plan 1-2 items, (3) plan 3-5 items, (4) plan 6 and above items. Quality of life was measured by SF-12 and summarize to PCS (Physical Component Summary,) and MCS (Mental Component Summary). Descriptive statistics, Chi-Square, T-test and multiple regressions were used in this study.
Result: Results showed that 68% retiree had no retirement planning, 11.1% retiree planned 1-2 items, 11.1% retiree planned 3-5 items, and 9.8% retiree planned 6 and above items. In MCS score, prepare 3-5 items retirement planning and 6 and above items were significantly higher than no planning (β=1.07 and 1.51, respectively). However, pre-retirement planning showed no relationship in PCS score.
Discussion: According to the result, pre-retirement planning of retirees presented better mental health and displayed a dose-response relationship between items of pre-retirement planning and mental health scores. It is suggested that workplace should offer more kinds of pre-retirement planning but not only financial planning to improve life adaptation of retirement life.
Tomoko Tachibana
National Institute of Public Health, Japan
Title: Promoting evidence-based health and welfare policies for people with disabilities: a proposed “definition of health†for a care-focused mature society
Biography:
Tomoko Tachibana has her expertise in research and passion in improving the health and wellbeing. Her research on regional models for progressing toward establishment of a “Disability Registry,” using the Clinical Efficacy Database creates new pathways for improving health and welfare policies for people with disabilities. She has been building this model over years of experience in clinical medicine, research, evaluation, teaching and administration in a hospital, public health centres and an education institution. For supporting independent decision-making and activities by people with disabilities, and putting into practice evidence-based health and welfare policies for them, she has been advancing research to promote accumulation and utilization of epidemiological evidence data which are needed for policy evaluation, cooperation between medicine and welfare, etc. The National Institute of Public Health, whose mission is to carry out human resources development and to conduct research in public health, was established in 2002, integrating the (former) National Institute of Public Health, National Institute of Health Services Management, etc.
Abstract:
Background and aim: Disease structure has been changing in many countries, and the global burden is shifting to non-infectious diseases. Due to the growing ratio of the aged population in Japan, medical and social security systems need to be transformed from “cure” to “support”. The definition of “health” in care-focused mature societies is discussed based on Japan’s current health policies.
Methods: Evidence-based public health policies were compared between cancer and trauma (injuries, damage, and sequelae).
Findings: Public health policy for cancer follows the Cancer Control Act. Evidence such as survival rates is useful not only for health care providers and policymakers but also for cancer patients in executing the right to self-determination in promoting health. Meanwhile, evidence about long-term outcomes of trauma in Japan is overwhelmingly lacking, although the incidence of trauma is estimated to be comparable to that of neoplasms in the 2014 National Patient Survey. We have proposed to review health and welfare policies for people with disabilities from the viewpoint of longitudinal epidemiological studies that understand disease conditions from the viewpoint of the people concerned as ordinary citizens by redefining the prognoses of trauma as “the outcomes of acquired disability”. To realize this review in the community-based integrated care system, we focus on the database of diagnoses, treatments, treatment effects, etc. of patients visiting medical institutions, and intend to develop a disability registry.
Interpretation: Developing this registry utilizing clinical effect information is expected to enhance quality as evidence in health and welfare policies for people with disabilities. In care-focused mature societies such as Japan, the following concept needs to be included in the definition of health: Taking into consideration the disease burden, and various other “social, physical and psychological problems,” health pertains to maintaining the patient’s quality of life, enabling his/her control over his/her own life, offering things that he/she can do him/herself, and fostering his/her self-actualization
Yan Ping Lin
National Cheng Kung University, Taiwan
Title: The factors of pre-retirement planning among middle-aged and older adults in Taiwan
Biography:
Yan Ping Lin is a full-time Research Assistant in the Department of Public Health, National Cheng Kung University. Her past research has focused on the relationship between MSM groups, drug users and AIDS when she was an undergraduate student in Kaohsiung Medical University. As a Graduate Student in National Cheng Kung University, she has involved in research of health issues related to the older population, especially in the relationship between working transition and health.
Abstract:
Introduction: Past studies indicated that pre-retirement planning is helpful to release anxiety and adapt retired life of retirees. However, few studies examined the factors of pre-retirement planning among middle-aged and older adults. Therefore, the aim of this study is to find out the factors affecting middle-aged and older adults to prepare pre-retirement planning.
Methods: This study used a nationally representative dataset from “Retirement Planning, Life Adaptation and Health Status Survey”. This survey of 3141 retirees aged 50-74 years in Taiwan. Pre-retirement planning was designed with 20 items and could be grouped as five types. If retirees answered any one of these 20 items, they were categorized as pre-retirement planners, else as non-preretirement planners. The effect factors of pre-retirement planning were investigated in three dimensions: social demographic characteristics, work condition before retirement, and lifestyle. Descriptive statistics, chi-square test, T test, and logistic regression analysis were used in this study.
Results: In this study, more than half of the participants were male and 32% of participants prepared pre-retirement planning before retirement (the average number of planning items was 4.29±2.95). A majority type that participants planned before retirement was “Health promotion and leisure” (77%). Compared with the group of non-preretirement planners, participants who had pre-retirement planning were significantly associated with age, skill level of pre-retirement occupation, occupation types of pre-retirement, working pressure of pre-retirement, working time controlled by yourself, company provide information of retirement planning, drinking, exercise, and perceived health. Especially, information provided by company is the most effective factors of pre-retirement planning (OR= 3.09, 95%C.I.=3.09-5.39).
Discussion: According to the result, “Information provided by company” was the most important reason affect people to prepare pre-retirement planning. Therefore, future interventions and policies should assist companies to provide more kinds of information about pre-retirement planning and establish pre-retirement planning courses.
Yu-Mi Lee
Kyungpook National University, Republic of Korea
Title: Persistent organic pollutants impair insulin secretory function of pancreatic beta-cells: human and in vitro evidence
Biography:
Yu-Mi Lee is an Assistant Professor in the Department of Preventive Medicine, School of Medicine, Kyungpook National University. He was a Clinical Fellow in Kyungpook National University from 2013 to 2015. He took residency training in Kyungpook National University from 2010 to 2013 and also took MD training at Kyungpook National University from 2003 to 2009.
Abstract:
Persistent organic pollutants (POPs), especially organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) have emerged as a new risk factor of type 2 diabetes (T2D). We evaluated whether chronic exposure to low-dose POPs affects insulin secretory function of beta-cells in humans and in vitro cells. Serum concentrations of OCPs and PCBs were measured in 200 non-diabetic adults. Mathematical-model-based insulin secretion indices were estimated using a 2-hour 7-sample oral glucose tolerance test. Insulin secretion by INS1E beta-cells was measured after 48-hour treatment with 3 OCPs or a PCB mixture. Static second-phase insulin secretion significantly decreased with increasing serum concentrations of OCPs. Adjusted means were 63.2, 39.3, 44.1, 39.3, 39.7, and 22.3 across six categories of a summary measure of OCPs (Ptrend = 0.02). Dynamic first-phase insulin secretion remarkably decreased only among insulin-sensitive individuals with increasing concentrations of OCPs (Ptrend = 0.02); the insulin levels among subjects with high OCPs were about 30% of those with low OCPs. Compared to OCPs, PCBs showed weaker associations. The decreased insulin secretion by INS1E beta-cells was observed for even 1 pM OCPs. Our data from human subjects and in vitro cell experiments suggest that chronic exposure to low-dose POPs, especially OCPs, can induce pancreatic beta-cell dysfunction.
Z Abidli
Ibn Tofail University, Morocco
Title: Epidemiological studies of poisoning by pesticides in Morocco
Biography:
Z Abidli is a PhD candidate in the Biology Department at Ibn Tofail University in Morocco. He has recently obtained a Master's degree in Human Neurocognition and Population Health. He also serves as an active member of the Genetics and Biometry Laboratory. He took part in multiple congresses as a Poster Presenter, including the 6th International Congress on Toxicology in Marrakech and the National Congress on Pharmacovigilance in Rabat. He is currently conducting a research on risk management of anti-tuberculosis drug and the objective is to decrease the side effects of drug treatment.
Abstract:
In Morocco, a first assessment of the extent of pesticides poisoning, although not exhaustive, is made possible by the Moroccan Anti-poisoning and Pharmacovigilance Center (MAPPC). This work aims to study the epidemiological characteristics of volunteers poisoned by pesticides and to analyse their impact on human health. This is a retrospective study of all cases of pesticide poisoning reported in Morocco between 2008 and 2014, compiled by the MAPPC. The data carriers used in this study are the Toxicovigilance sheets and the medical records that are set up for Toxicological Information. The methodology used is based on the descriptive statistics and the Principal Component Analysis (PCA). During the study period, the MAPPC had collected 2690 cases of poisoning by pesticides, this type of poisoning mainly affects adults (61.97% of cases) and 68% of addicts are female, with a sex ratio of 2, (P<0.001). However, suspect products are insecticides with about 55.86% cases of poisoning, the majority of which presented in a moderate condition (Grade 2) with 32.10%. The central and peripheral nervous system is the lead of the systems affected with 52.66% of cases, with a specific lethality of 7.5% (the number of deaths being 6 subjects). Patients presented several neurological signs including Convulsions and clonic seizures, Obnubilations, Agitation, Headache, and Coma respectively with 17.61%; 10.56%; 7.75%; 7.04%; 6.34% of cases. The principal component analysis makes it possible to distinguish two large groups, the male ones with different signs according to the period of poisoning, in winter with signs like nausea of asthenia and they generally are adults. The second group consists essentially of intoxicated children who usually show signs of vomiting, chills especially in spring and autumn. According to our results, pesticide poisoning is responsible for serious neurological effects, which should prompt us to implement regulations on the sale of pesticides in order to reduce the poisoning rate in Morocco.