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1.
J Altern Complement Med ; 27(2): 184-191, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33332217

RESUMO

Objectives: The specific aims are: 1) To characterize the health, wellness, and lifestyle of graduate and undergraduate students, and how these characteristics change over time; 2) To evaluate associations between lifestyle factors and gut microbiota populations and diversity; and 3) To evaluate associations between stress and stress management practices with sleep habits, quality of life, and overall health. Design: The International Cohort on Lifestyle Determinants of Health (INCLD Health) longitudinal cohort study is designed to assess health behaviors and lifestyle practices amongst adults studying complementary and integrative health (CIH) and higher-education students more generally after at least one to six years of exposure to CIH education. INCLD Health will adhere to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. Settings/Location: Colleges and universities with a CIH focus or interest with the flagship site being the National University of Natural Medicine. Participants: Adults currently enrolled in a college or university with a CIH focus or interest. Outcome Measures: Study visits will be conducted at baseline, 6 months, then every 12 months until the end of each participants' degree program. Measures include anthropometrics; serum and salivary biomarkers of cardiovascular risk, reproductive hormones, and cortisol; nutritional intake measured by a digital food frequency questionnaire; sequencing of fecal microbiota; plus validated questionnaires investigating mood, perceived stress, stress management practices, physical activity, sleep, and wellness. Conclusions: The INCLD Health Study, approved by the NUNM IRB in late 2018, will enroll a unique cohort of adults to characterize the use of CIH practices in relation to short- and long-term health. Our study design provides a breadth of information that could be implemented at multiple sites internationally allowing for comparisons across diverse student cohorts with relatively low cost and personnel.


Assuntos
Terapias Complementares , Projetos de Pesquisa Epidemiológica , Inquéritos Epidemiológicos , Estilo de Vida , Estudos Longitudinais , Adolescente , Adulto , Doenças Cardiovasculares , Feminino , Microbioma Gastrointestinal , Comportamentos Relacionados com a Saúde , Humanos , Internacionalidade , Masculino , Estado Nutricional , Aceitação pelo Paciente de Cuidados de Saúde , Estudantes , Adulto Jovem
2.
PLoS One ; 15(10): e0238871, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33021978

RESUMO

BACKGROUND: Age-period-cohort (APC) models are often used to decompose health trends into period- and cohort-based sources, but their use in epidemiology and population sciences remains contentious. Central to the contention are researchers' failures to 1) clearly state their analytic assumptions and/or 2) thoroughly evaluate model results. These failures often produce varying conclusions across APC studies and generate confusion about APC methods. Consequently, scholarly exchanges about APC methods usually result in strong disagreements that rarely offer practical advice to users or readers of APC methods. METHODS: We use research guidelines to help practitioners of APC methods articulate their analytic assumptions and validate their results. To demonstrate the usefulness of the guidelines, we apply them to a 2015 American Journal of Epidemiology study about trends in black-white differences in U.S. heart disease mortality. RESULTS: The application of the guidelines highlights two important findings. On the one hand, some APC methods produce inconsistent results that are highly sensitive to researcher manipulation. On the other hand, other APC methods estimate results that are robust to researcher manipulation and consistent across APC models. CONCLUSIONS: The exercise shows the simplicity and effectiveness of the guidelines in resolving disagreements over APC results. The cautious use of APC models can generate results that are consistent across methods and robust to researcher manipulation. If followed, the guidelines can likely reduce the chance of publishing variable and conflicting results across APC studies.


Assuntos
Estudos de Coortes , Modelos Estatísticos , Projetos de Pesquisa , Adulto , Afro-Americanos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Projetos de Pesquisa Epidemiológica , Grupo com Ancestrais do Continente Europeu , Feminino , Cardiopatias/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Fatores Raciais/estatística & dados numéricos , Projetos de Pesquisa/estatística & dados numéricos , Estados Unidos/epidemiologia
3.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1145-1150, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741185

RESUMO

Minimizing the burden on study subjects and assessing the general dietary nutritional status as accurately as possible are the basis of a nutritional epidemiological cohort study in the general population. While introducing the main dietary nutrition assessment methods, this paper manly describes the basic contents and principles for the development of food frequency questionnaire, and briefly illustrates the problems and solutions for the development of area specific food frequency questionnaires by taking the example of Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort study. Finally, discusses preliminarily the necessity and possibility of developing a national food frequency questionnaire.


Assuntos
Inquéritos sobre Dietas/métodos , Avaliação Nutricional , China/epidemiologia , Estudos de Coortes , Projetos de Pesquisa Epidemiológica , Humanos
4.
Am J Trop Med Hyg ; 103(4): 1364-1366, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32828137

RESUMO

As the global COVID-19 pandemic continues, unabated and clinical trials demonstrate limited effective pharmaceutical interventions, there is a pressing need to accelerate treatment evaluations. Among options for accelerated development is the evaluation of drug combinations in the absence of prior monotherapy data. This approach is appealing for a number of reasons. First, combining two or more drugs with related or complementary therapeutic effects permits a multipronged approach addressing the variable pathways of the disease. Second, if an individual component of a combination offers a therapeutic effect, then in the absence of antagonism, a trial of combination therapy should still detect individual efficacy. Third, this strategy is time saving. Rather than taking a stepwise approach to evaluating monotherapies, this strategy begins with testing all relevant therapeutic options. Finally, given the severity of the current pandemic and the absence of treatment options, the likelihood of detecting a treatment effect with combination therapy maintains scientific enthusiasm for evaluating repurposed treatments. Antiviral combination selection can be facilitated by insights regarding SARS-CoV-2 pathophysiology and cell cycle dynamics, supported by infectious disease and clinical pharmacology expert advice. We describe a clinical evaluation strategy using adaptive combination platform trials to rapidly test combination therapies to treat COVID-19.


Assuntos
Antivirais/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Quimioterapia Combinada/métodos , Projetos de Pesquisa Epidemiológica , Pandemias , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Betacoronavirus/efeitos dos fármacos , Betacoronavirus/imunologia , Betacoronavirus/patogenicidade , Ensaios Clínicos como Assunto , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Combinação de Medicamentos , Reposicionamento de Medicamentos/métodos , Humanos , Interferon beta-1b/uso terapêutico , Lopinavir/uso terapêutico , Pneumonia Viral/imunologia , Pneumonia Viral/virologia , Ribavirina/uso terapêutico , Ritonavir/uso terapêutico
5.
Epidemiology ; 31(6): 836-843, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32841988

RESUMO

Testing of symptomatic persons for infection with severe acute respiratory syndrome coronavirus-2 is occurring worldwide. We propose two types of case-control studies that can be carried out jointly in test settings for symptomatic persons. The first, the test-negative case-control design (TND) is the easiest to implement; it only requires collecting information about potential risk factors for Coronavirus Disease 2019 (COVID-19) from the tested symptomatic persons. The second, standard case-control studies with population controls, requires the collection of data on one or more population controls for each person who is tested in the test facilities, so that test-positives and test-negatives can each be compared with population controls. The TND will detect differences in risk factors between symptomatic persons who have COVID-19 (test-positives) and those who have other respiratory infections (test-negatives). However, risk factors with effect sizes of equal magnitude for both COVID-19 and other respiratory infections will not be identified by the TND. Therefore, we discuss how to add population controls to compare with the test-positives and the test-negatives, yielding two additional case-control studies. We describe two options for population control groups: one composed of accompanying persons to the test facilities, the other drawn from existing country-wide healthcare databases. We also describe other possibilities for population controls. Combining the TND with population controls yields a triangulation approach that distinguishes between exposures that are risk factors for both COVID-19 and other respiratory infections, and exposures that are risk factors for just COVID-19. This combined design can be applied to future epidemics, but also to study causes of nonepidemic disease.


Assuntos
Estudos de Casos e Controles , Grupos Controle , Infecções por Coronavirus/epidemiologia , Projetos de Pesquisa Epidemiológica , Pneumonia Viral/epidemiologia , Betacoronavirus , Causalidade , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Infecções Respiratórias/epidemiologia , Fatores de Risco
7.
Am J Epidemiol ; 189(10): 1037-1041, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32602548

RESUMO

Increasing diverse engagement in the Society for Epidemiologic Research (SER) will positively impact the field of epidemiology. As the largest and longest-running epidemiologic society in North America, SER has long been a pioneer in promoting diversity and inclusion. A recent survey of SER members, however, showed there is still room for improving diversity, inclusion, representation, and participation in the Society. In this commentary, as members of both the SER and the Johns Hopkins Bloomberg School of Public Health Department of Epidemiology's Inclusion, Diversity, Equity, Anti-Racism, and Science (Epi IDEAS) Working Group, we recommend 4 goals for the SER Annual Meeting and beyond: 1) convene epidemiologic researchers with diverse backgrounds and ideas; 2) promote an inclusive environment at the SER Annual Meeting; 3) develop, compile, and disseminate best practices to honor diversity in epidemiologic research; and 4) increase prioritization of health disparities research and methods. We also suggest strategies for achieving these goals so that SER can better include, support, and elevate members from historically disadvantaged groups. While our recommendations are tailored specifically to SER, the greater epidemiologic and academic communities could benefit from adopting these goals and strategies within their professional societies and conferences.


Assuntos
Congressos como Assunto , Diversidade Cultural , Epidemiologia/organização & administração , Projetos de Pesquisa Epidemiológica , Humanos
9.
Rev Saude Publica ; 54: 48, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32491093

RESUMO

OBJECTIVE To identify the Brazilian cohorts that started either in the prenatal period or at birth, to describe their characteristics and the explored variables, and to map the cohorts with potential for studies on early determinants on health and the risk of falling ill on later stages of the life cycle. METHODS A scoping review was carried out. The articles were searched in the electronic databases PubMed and Virtual Health Library (VHL). The descriptors used were [((("Child" OR "Child, Preschool" OR "Infant" OR "Infant, Newborn") AND (Cohort Studies" OR "Longitudinal Studies")) AND "Brazil")]. The inclusion criteria were Brazilian cohorts that started the baseline in the prenatal period or at birth and with at least two follow-ups with the participants. In order to meet the concept of LCE, we excluded those cohorts whose follow-ups were restricted to the first year of life, as well as those that did not address biological, behavioral and psychosocial aspects, and cohorts with data collection of a single stage of the life cycle. RESULTS The search step identified 5,010 articles. Eighteen cohorts were selected for descriptive synthesis. The median number of baseline participants was 2,000 individuals and the median age at the last follow-up was 9 years. Sample loss at the last follow-up ranged from 9.2 to 87.5%. Most cohorts monitored two phases of the life cycle (the perinatal period and childhood). The Southern region had the highest number of cohorts. The main variables collected were sociodemographic and environmental aspects of the family, morbidity aspects, nutritional practices and lifestyle. CONCLUSIONS We recommend the continuity of these cohorts, the approach to different social contexts and the performance of follow-ups with participants in different phases of the life cycle for the strengthening and expansion of life course epidemiology analyses in Brazil.


Assuntos
Desenvolvimento Infantil/fisiologia , Estudos de Coortes , Estágios do Ciclo de Vida/fisiologia , Fatores Etários , Brasil , Criança , Pré-Escolar , Projetos de Pesquisa Epidemiológica , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez
10.
Emerg Infect Dis ; 26(9): 1978-1986, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32544053

RESUMO

Serologic studies are crucial for clarifying dynamics of the coronavirus disease pandemic. Past work on serologic studies (e.g., during influenza pandemics) has made relevant contributions, but specific conditions of the current situation require adaptation. Although detection of antibodies to measure exposure, immunity, or both seems straightforward conceptually, numerous challenges exist in terms of sample collection, what the presence of antibodies actually means, and appropriate analysis and interpretation to account for test accuracy and sampling biases. Successful deployment of serologic studies depends on type and performance of serologic tests, population studied, use of adequate study designs, and appropriate analysis and interpretation of data. We highlight key questions that serologic studies can help answer at different times, review strengths and limitations of different assay types and study designs, and discuss methods for rapid sharing and analysis of serologic data to determine global transmission of severe acute respiratory syndrome coronavirus 2.


Assuntos
Betacoronavirus/imunologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/epidemiologia , Projetos de Pesquisa Epidemiológica , Pneumonia Viral/epidemiologia , Estudos Soroepidemiológicos , Anticorpos Antivirais/análise , Infecções por Coronavirus/diagnóstico , Humanos , Pandemias
11.
Med Sci (Paris) ; 36(4): 376-381, 2020 Apr.
Artigo em Francês | MEDLINE | ID: mdl-32356714

RESUMO

While evidence has accumulated about the links between long-term exposure to air pollution and health, little is known about the health effects of airborne metals. In France, the law makes it mandatory to monitor atmospheric concentrations and deposition of some airborne metals, through measurements or modelling. But the available data are either too scarce or irregular, making them difficult to use in large-scale epidemiology: using mosses in the wild offers a welcome alternative. Mosses belong to the few vegetal organisms able to accumulate airborne metals. As such, they have been used for decades in air quality survey networks in Europe. They provide data to assess population exposure to airborne metals and may complement classical research programmes on air pollution epidemiology. As an example, we estimated associations between exposure to airborne metals of anthropogenic origin and increased mortality in France.


Assuntos
Poluição do Ar/análise , Briófitas/química , Exposição Ambiental/análise , Monitoramento Ambiental/métodos , Monitoramento Epidemiológico , Metais/análise , Poluentes Atmosféricos/análise , Projetos de Pesquisa Epidemiológica , Europa (Continente)/epidemiologia , França/epidemiologia , Saúde/estatística & dados numéricos , Humanos
13.
Eur J Epidemiol ; 35(5): 483-517, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32367290

RESUMO

The Rotterdam Study is an ongoing prospective cohort study that started in 1990 in the city of Rotterdam, The Netherlands. The study aims to unravel etiology, preclinical course, natural history and potential targets for intervention for chronic diseases in mid-life and late-life. The study focuses on cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, otolaryngological, locomotor, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. Since 2016, the cohort is being expanded by persons aged 40 years and over. The findings of the Rotterdam Study have been presented in over 1700 research articles and reports. This article provides an update on the rationale and design of the study. It also presents a summary of the major findings from the preceding 3 years and outlines developments for the coming period.


Assuntos
Doença Crônica/epidemiologia , Expectativa de Vida/tendências , Vigilância da População/métodos , Adulto , Estudos de Coortes , Projetos de Pesquisa Epidemiológica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Estudos Prospectivos , Fatores de Risco
16.
Epidemiol Infect ; 148: e60, 2020 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-32079547

RESUMO

For outbreaks of gastrointestinal disease, rapid identification of the source is crucial to enable public health intervention and prevent further cases. Outbreak investigation comprises analyses of exposure information from cases and, if required, undertaking analytical epidemiological studies. Hypothesis generation has been reliant on empirical knowledge of exposures historically associated with a given pathogen. Epidemiology studies are resource-intensive and prone to bias, one of the reasons being the difficulties in recruiting appropriate controls. For this paper, the information from cases was compared against pre-defined background exposure information. As exemplars, three past outbreaks were used, one of common and two of rare exposures. Information from historical case trawling questionnaires was used to define background exposure having removed any exposures implicated with the outbreak. The case-background approach showed good sensitivity and specificity, identifying correctly all outbreak-related exposures. One additional exposure related to a retailer was identified and four food items where all cases had been exposed. In conclusion, the case-background method, a development of the case-case design, can be used to assist with hypothesis generation or when a case-control study may not be possible to carry out.


Assuntos
Surtos de Doenças , Exposição Ambiental/estatística & dados numéricos , Projetos de Pesquisa Epidemiológica , Gastroenteropatias/epidemiologia , Adulto , Inglaterra , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública , Estudos Retrospectivos , Infecções por Salmonella/epidemiologia , Infecções por Salmonella/transmissão , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-32046266

RESUMO

Epidemiological inquiries study and evaluate the health status of the population. For dental caries, the World Health Organization (WHO) recommends the DMFT and DMFS indexes, which represent the sum of the decayed, missing and filled teeth, divided by the population studied. Traditionally these surveys are conducted using cellulose paper sheet. This study describes the development and presents the field performance of NutriOdonto, a software created for an Oral Health Survey carried out in 2018 and 2019 involving 2578 students from the municipal schools of Palmas/TO, located in the Brazilian Amazon region. This is a descriptive, applied research on the development of a software for the collecting, analysis, management and reproducibility of oral health epidemiological research. A software applied to the collecting, analysis and formation of the database was developed through the information obtained from the questionnaires applied to the participants of the study and the completion of the electronic oral examination form. Recent Information and Communication Technologies (ICT) are intelligently configured to create models and mobile applications (Apps) that can be useful to manage health issues, thus broadening the perspective of service provision in this sector. Some of these mobile devices, tablets and smartphones are being developed to generate information, for collection, recording, storage and analysis of oral health epidemiological research data. NutriOdonto contributed to the rapid collection, recording and storage of information, in the construction of the database and its analysis. Replacing paper forms with electronic forms minimized possible typos, reduced the use of cellulose paper and the financial costs, among other things. This software can contribute to decision making by managers and professionals and to improving the planning and implementation of actions in health promotion and oral disease prevention.


Assuntos
Computadores de Mão , Análise de Dados , Inquéritos de Saúde Bucal , Projetos de Pesquisa Epidemiológica , Indicadores Básicos de Saúde , Aplicativos Móveis , Saúde Bucal , Brasil , Criança , Estudos Transversais , Diagnóstico Bucal , Feminino , Nível de Saúde , Humanos , Masculino , Reprodutibilidade dos Testes , Software
18.
Br J Sports Med ; 54(7): 372-389, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32071062

RESUMO

Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport-specific or setting-specific consensus statements on sports injury (and, eventually, illness) epidemiology to date. Our objective was to further strengthen consistency in data collection, injury definitions and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension. The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups and a 3-day consensus meeting in October 2019. This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems; severity of health problems; capturing and reporting athlete exposure; expressing risk; burden of health problems; study population characteristics and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE Extension-the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS). The IOC encourages ongoing in- and out-of-competition surveillance programmes and studies to describe injury and illness trends and patterns, understand their causes and develop measures to protect the health of the athlete. Implementation of the methods outlined in this statement will advance consistency in data collection and research reporting.


Assuntos
Traumatismos em Atletas/epidemiologia , Lista de Checagem , Projetos de Pesquisa Epidemiológica , Medicina Esportiva/estatística & dados numéricos , Traumatismos em Atletas/classificação , Doença/classificação , Humanos , Medicina Esportiva/classificação
19.
Dtsch Med Wochenschr ; 145(1): 47-55, 2020 01.
Artigo em Alemão | MEDLINE | ID: mdl-31914469

RESUMO

Education of medical students requires teaching students how to navigate in the broad field of medical research. The objective of this article is to provide an overview about medical research and to show how to denote a medical study in a concise fashion. Medical research can be classified into categories according to the object of investigation. Examples for medical research categories are therapeutic, diagnostic and prognostic studies, epidemiological studies, animal and in vitro studies etc. Each research category uses a specific set of study types with names such as cross-sectional study, case-control study etc. The article describes the principles of the study types. Together, research category and study type briefly describe the design of a medical study.


Assuntos
Pesquisa Biomédica/educação , Educação Médica , Projetos de Pesquisa Epidemiológica , Humanos , Estudantes de Medicina
20.
Diabetes Care ; 43(2): 265-271, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31959642

RESUMO

Prevailing dietary guidelines have widely recommended diets relatively low in red and processed meats and high in minimally processed plant foods for the prevention of chronic diseases. However, an ad hoc research group called the Nutritional Recommendations (NutriRECS) consortium recently issued "new dietary guidelines" encouraging individuals to continue their current meat consumption habits due to "low certainty" of the evidence, difficulty of altering meat eaters' habits and preferences, and the lack of need to consider environmental impacts of red meat consumption. These recommendations are not justified, in large part because of the flawed methodologies used to review and grade nutritional evidence. The evidence evaluation was largely based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria, which are primarily designed to grade the strength of evidence for clinical interventions especially pharmacotherapy. However, the infeasibility for conducting large, long-term randomized clinical trials on most dietary, lifestyle, and environmental exposures makes the criteria inappropriate in these areas. A separate research group proposed a modified and validated system for rating the meta-evidence on nutritional studies (NutriGRADE) to address several limitations of the GRADE criteria. Applying NutriGRADE, the evidence on the positive association between red and processed meats and type 2 diabetes was rated to be of "high quality," while the evidence on the association between red and processed meats and mortality was rated to be of "moderate quality." Another important limitation is that inadequate attention was paid to what might be replacing red meat, be it plant-based proteins, refined carbohydrates, or other foods. In summary, the red/processed meat recommendations by NutriRECS suffer from important methodological limitations and involve misinterpretations of nutritional evidence. To improve human and planetary health, dietary guidelines should continue to emphasize dietary patterns low in red and processed meats and high in minimally processed plant foods such as fruits and vegetables, whole grains, nuts, and legumes.


Assuntos
Diabetes Mellitus Tipo 2/etiologia , Dieta/efeitos adversos , Comportamento Alimentar/fisiologia , Carne/efeitos adversos , Carne Vermelha/efeitos adversos , Diabetes Mellitus Tipo 2/epidemiologia , Dieta/estatística & dados numéricos , Projetos de Pesquisa Epidemiológica , Manipulação de Alimentos/estatística & dados numéricos , Preferências Alimentares/fisiologia , Frutas/fisiologia , Humanos , Nozes/fisiologia , Estudos Observacionais como Assunto/normas , Estudos Observacionais como Assunto/estatística & dados numéricos , Fatores de Risco , Verduras/fisiologia , Grãos Integrais/fisiologia
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