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Publisher: Oxford University Press   (Total: 370 journals)

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Showing 1 - 200 of 370 Journals sorted alphabetically
Acta Biochimica et Biophysica Sinica     Hybrid Journal   (Followers: 6, SJR: 0.881, h-index: 38)
Adaptation     Hybrid Journal   (Followers: 8, SJR: 0.111, h-index: 4)
Aesthetic Surgery J.     Hybrid Journal   (Followers: 6, SJR: 1.538, h-index: 35)
African Affairs     Hybrid Journal   (Followers: 57, SJR: 1.512, h-index: 46)
Age and Ageing     Hybrid Journal   (Followers: 81, SJR: 1.611, h-index: 107)
Alcohol and Alcoholism     Hybrid Journal   (Followers: 14, SJR: 0.935, h-index: 80)
American Entomologist     Full-text available via subscription   (Followers: 6)
American Historical Review     Hybrid Journal   (Followers: 125, SJR: 0.652, h-index: 43)
American J. of Agricultural Economics     Hybrid Journal   (Followers: 41, SJR: 1.441, h-index: 77)
American J. of Epidemiology     Hybrid Journal   (Followers: 151, SJR: 3.047, h-index: 201)
American J. of Hypertension     Hybrid Journal   (Followers: 18, SJR: 1.397, h-index: 111)
American J. of Jurisprudence     Hybrid Journal   (Followers: 15)
American journal of legal history     Full-text available via subscription   (Followers: 4, SJR: 0.151, h-index: 7)
American Law and Economics Review     Hybrid Journal   (Followers: 26, SJR: 0.824, h-index: 23)
American Literary History     Hybrid Journal   (Followers: 12, SJR: 0.185, h-index: 22)
Analysis     Hybrid Journal   (Followers: 24)
Annals of Botany     Hybrid Journal   (Followers: 35, SJR: 1.912, h-index: 124)
Annals of Occupational Hygiene     Hybrid Journal   (Followers: 26, SJR: 0.837, h-index: 57)
Annals of Oncology     Hybrid Journal   (Followers: 48, SJR: 4.362, h-index: 173)
Annals of the Entomological Society of America     Full-text available via subscription   (Followers: 8, SJR: 0.642, h-index: 53)
Annals of Work Exposures and Health     Hybrid Journal  
AoB Plants     Open Access   (Followers: 4, SJR: 0.78, h-index: 10)
Applied Economic Perspectives and Policy     Hybrid Journal   (Followers: 19, SJR: 0.884, h-index: 31)
Applied Linguistics     Hybrid Journal   (Followers: 51, SJR: 1.749, h-index: 63)
Applied Mathematics Research eXpress     Hybrid Journal   (Followers: 1, SJR: 0.779, h-index: 11)
Arbitration Intl.     Full-text available via subscription   (Followers: 19)
Arbitration Law Reports and Review     Hybrid Journal   (Followers: 12)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 26, SJR: 0.96, h-index: 71)
Aristotelian Society Supplementary Volume     Hybrid Journal   (Followers: 2, SJR: 0.102, h-index: 20)
Arthropod Management Tests     Hybrid Journal   (Followers: 2)
Astronomy & Geophysics     Hybrid Journal   (Followers: 47, SJR: 0.144, h-index: 15)
Behavioral Ecology     Hybrid Journal   (Followers: 46, SJR: 1.698, h-index: 92)
Bioinformatics     Hybrid Journal   (Followers: 231, SJR: 4.643, h-index: 271)
Biology Methods and Protocols     Hybrid Journal  
Biology of Reproduction     Full-text available via subscription   (Followers: 9, SJR: 1.646, h-index: 149)
Biometrika     Hybrid Journal   (Followers: 19, SJR: 2.801, h-index: 90)
BioScience     Hybrid Journal   (Followers: 28, SJR: 2.374, h-index: 154)
Bioscience Horizons : The National Undergraduate Research J.     Open Access   (Followers: 1, SJR: 0.213, h-index: 9)
Biostatistics     Hybrid Journal   (Followers: 16, SJR: 1.955, h-index: 55)
BJA : British J. of Anaesthesia     Hybrid Journal   (Followers: 134, SJR: 2.314, h-index: 133)
BJA Education     Hybrid Journal   (Followers: 65, SJR: 0.272, h-index: 20)
Brain     Hybrid Journal   (Followers: 61, SJR: 6.097, h-index: 264)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 45, SJR: 4.086, h-index: 73)
Briefings in Functional Genomics     Hybrid Journal   (Followers: 4, SJR: 1.771, h-index: 50)
British J. for the Philosophy of Science     Hybrid Journal   (Followers: 33, SJR: 1.267, h-index: 38)
British J. of Aesthetics     Hybrid Journal   (Followers: 25, SJR: 0.217, h-index: 18)
British J. of Criminology     Hybrid Journal   (Followers: 502, SJR: 1.373, h-index: 62)
British J. of Social Work     Hybrid Journal   (Followers: 80, SJR: 0.771, h-index: 53)
British Medical Bulletin     Hybrid Journal   (Followers: 7, SJR: 1.391, h-index: 84)
British Yearbook of Intl. Law     Hybrid Journal   (Followers: 26)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 3, SJR: 1.474, h-index: 31)
Cambridge J. of Economics     Hybrid Journal   (Followers: 54, SJR: 0.957, h-index: 59)
Cambridge J. of Regions, Economy and Society     Hybrid Journal   (Followers: 9, SJR: 1.067, h-index: 22)
Cambridge Quarterly     Hybrid Journal   (Followers: 10, SJR: 0.1, h-index: 7)
Capital Markets Law J.     Hybrid Journal  
Carcinogenesis     Hybrid Journal   (Followers: 2, SJR: 2.439, h-index: 167)
Cardiovascular Research     Hybrid Journal   (Followers: 11, SJR: 2.897, h-index: 175)
Cerebral Cortex     Hybrid Journal   (Followers: 39, SJR: 4.827, h-index: 192)
CESifo Economic Studies     Hybrid Journal   (Followers: 16, SJR: 0.501, h-index: 19)
Chemical Senses     Hybrid Journal   (Followers: 1, SJR: 1.436, h-index: 76)
Children and Schools     Hybrid Journal   (Followers: 6, SJR: 0.211, h-index: 18)
Chinese J. of Comparative Law     Hybrid Journal   (Followers: 3)
Chinese J. of Intl. Law     Hybrid Journal   (Followers: 19, SJR: 0.737, h-index: 11)
Chinese J. of Intl. Politics     Hybrid Journal   (Followers: 8, SJR: 1.238, h-index: 15)
Christian Bioethics: Non-Ecumenical Studies in Medical Morality     Hybrid Journal   (Followers: 11, SJR: 0.191, h-index: 8)
Classical Receptions J.     Hybrid Journal   (Followers: 17, SJR: 0.1, h-index: 3)
Clinical Infectious Diseases     Hybrid Journal   (Followers: 59, SJR: 4.742, h-index: 261)
Clinical Kidney J.     Open Access   (Followers: 4, SJR: 0.338, h-index: 19)
Community Development J.     Hybrid Journal   (Followers: 24, SJR: 0.47, h-index: 28)
Computer J.     Hybrid Journal   (Followers: 8, SJR: 0.371, h-index: 47)
Conservation Physiology     Open Access   (Followers: 2)
Contemporary Women's Writing     Hybrid Journal   (Followers: 11, SJR: 0.111, h-index: 3)
Contributions to Political Economy     Hybrid Journal   (Followers: 6, SJR: 0.313, h-index: 10)
Critical Values     Full-text available via subscription  
Current Legal Problems     Hybrid Journal   (Followers: 25)
Current Zoology     Full-text available via subscription   (SJR: 0.999, h-index: 20)
Database : The J. of Biological Databases and Curation     Open Access   (Followers: 11, SJR: 1.068, h-index: 24)
Digital Scholarship in the Humanities     Hybrid Journal   (Followers: 12)
Diplomatic History     Hybrid Journal   (Followers: 18, SJR: 0.296, h-index: 22)
DNA Research     Open Access   (Followers: 4, SJR: 2.42, h-index: 77)
Dynamics and Statistics of the Climate System     Open Access   (Followers: 3)
Early Music     Hybrid Journal   (Followers: 13, SJR: 0.124, h-index: 11)
Economic Policy     Hybrid Journal   (Followers: 52, SJR: 2.052, h-index: 52)
ELT J.     Hybrid Journal   (Followers: 25, SJR: 1.26, h-index: 23)
English Historical Review     Hybrid Journal   (Followers: 46, SJR: 0.311, h-index: 10)
English: J. of the English Association     Hybrid Journal   (Followers: 12, SJR: 0.144, h-index: 3)
Environmental Entomology     Full-text available via subscription   (Followers: 11, SJR: 0.791, h-index: 66)
Environmental Epigenetics     Open Access   (Followers: 1)
Environmental History     Hybrid Journal   (Followers: 25, SJR: 0.197, h-index: 25)
EP-Europace     Hybrid Journal   (Followers: 2, SJR: 2.201, h-index: 71)
Epidemiologic Reviews     Hybrid Journal   (Followers: 9, SJR: 3.917, h-index: 81)
ESHRE Monographs     Hybrid Journal  
Essays in Criticism     Hybrid Journal   (Followers: 15, SJR: 0.1, h-index: 6)
European Heart J.     Hybrid Journal   (Followers: 47, SJR: 6.997, h-index: 227)
European Heart J. - Cardiovascular Imaging     Hybrid Journal   (Followers: 9, SJR: 2.044, h-index: 58)
European Heart J. - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 1)
European Heart J. - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart J. Supplements     Hybrid Journal   (Followers: 8, SJR: 0.152, h-index: 31)
European J. of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 7, SJR: 1.568, h-index: 104)
European J. of Intl. Law     Hybrid Journal   (Followers: 147, SJR: 0.722, h-index: 38)
European J. of Orthodontics     Hybrid Journal   (Followers: 4, SJR: 1.09, h-index: 60)
European J. of Public Health     Hybrid Journal   (Followers: 22, SJR: 1.284, h-index: 64)
European Review of Agricultural Economics     Hybrid Journal   (Followers: 12, SJR: 1.549, h-index: 42)
European Review of Economic History     Hybrid Journal   (Followers: 26, SJR: 0.628, h-index: 24)
European Sociological Review     Hybrid Journal   (Followers: 37, SJR: 2.061, h-index: 53)
Evolution, Medicine, and Public Health     Open Access   (Followers: 11)
Family Practice     Hybrid Journal   (Followers: 13, SJR: 1.048, h-index: 77)
Fems Microbiology Ecology     Hybrid Journal   (Followers: 8, SJR: 1.687, h-index: 115)
Fems Microbiology Letters     Hybrid Journal   (Followers: 20, SJR: 1.126, h-index: 118)
Fems Microbiology Reviews     Hybrid Journal   (Followers: 25, SJR: 7.587, h-index: 150)
Fems Yeast Research     Hybrid Journal   (Followers: 13, SJR: 1.213, h-index: 66)
Foreign Policy Analysis     Hybrid Journal   (Followers: 21, SJR: 0.859, h-index: 10)
Forestry: An Intl. J. of Forest Research     Hybrid Journal   (Followers: 16, SJR: 0.903, h-index: 44)
Forum for Modern Language Studies     Hybrid Journal   (Followers: 6, SJR: 0.108, h-index: 6)
French History     Hybrid Journal   (Followers: 30, SJR: 0.123, h-index: 10)
French Studies     Hybrid Journal   (Followers: 19, SJR: 0.119, h-index: 7)
French Studies Bulletin     Hybrid Journal   (Followers: 10, SJR: 0.102, h-index: 3)
Gastroenterology Report     Open Access   (Followers: 2)
Genome Biology and Evolution     Open Access   (Followers: 10, SJR: 3.22, h-index: 39)
Geophysical J. Intl.     Hybrid Journal   (Followers: 31, SJR: 1.839, h-index: 119)
German History     Hybrid Journal   (Followers: 25, SJR: 0.437, h-index: 13)
GigaScience     Open Access   (Followers: 3)
Global Summitry     Hybrid Journal  
Glycobiology     Hybrid Journal   (Followers: 14, SJR: 1.692, h-index: 101)
Health and Social Work     Hybrid Journal   (Followers: 45, SJR: 0.505, h-index: 40)
Health Education Research     Hybrid Journal   (Followers: 12, SJR: 0.814, h-index: 80)
Health Policy and Planning     Hybrid Journal   (Followers: 21, SJR: 1.628, h-index: 66)
Health Promotion Intl.     Hybrid Journal   (Followers: 20, SJR: 0.664, h-index: 60)
History Workshop J.     Hybrid Journal   (Followers: 27, SJR: 0.313, h-index: 20)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 23, SJR: 0.115, h-index: 13)
Human Molecular Genetics     Hybrid Journal   (Followers: 9, SJR: 4.288, h-index: 233)
Human Reproduction     Hybrid Journal   (Followers: 76, SJR: 2.271, h-index: 179)
Human Reproduction Update     Hybrid Journal   (Followers: 16, SJR: 4.678, h-index: 128)
Human Rights Law Review     Hybrid Journal   (Followers: 58, SJR: 0.7, h-index: 21)
ICES J. of Marine Science: J. du Conseil     Hybrid Journal   (Followers: 54, SJR: 1.233, h-index: 88)
ICSID Review     Hybrid Journal   (Followers: 9)
ILAR J.     Hybrid Journal   (Followers: 1, SJR: 1.099, h-index: 51)
IMA J. of Applied Mathematics     Hybrid Journal   (SJR: 0.329, h-index: 26)
IMA J. of Management Mathematics     Hybrid Journal   (Followers: 2, SJR: 0.351, h-index: 20)
IMA J. of Mathematical Control and Information     Hybrid Journal   (Followers: 2, SJR: 0.661, h-index: 28)
IMA J. of Numerical Analysis - advance access     Hybrid Journal   (SJR: 2.032, h-index: 44)
Industrial and Corporate Change     Hybrid Journal   (Followers: 8, SJR: 1.37, h-index: 81)
Industrial Law J.     Hybrid Journal   (Followers: 29, SJR: 0.184, h-index: 15)
Information and Inference     Free  
Integrative and Comparative Biology     Hybrid Journal   (Followers: 8, SJR: 1.911, h-index: 90)
Interacting with Computers     Hybrid Journal   (Followers: 10, SJR: 0.529, h-index: 59)
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 4, SJR: 0.743, h-index: 35)
Intl. Affairs     Hybrid Journal   (Followers: 51, SJR: 1.264, h-index: 53)
Intl. Data Privacy Law     Hybrid Journal   (Followers: 26)
Intl. Health     Hybrid Journal   (Followers: 4, SJR: 0.835, h-index: 15)
Intl. Immunology     Hybrid Journal   (Followers: 3, SJR: 1.613, h-index: 111)
Intl. J. for Quality in Health Care     Hybrid Journal   (Followers: 32, SJR: 1.593, h-index: 69)
Intl. J. of Constitutional Law     Hybrid Journal   (Followers: 59, SJR: 0.613, h-index: 19)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 121, SJR: 4.381, h-index: 145)
Intl. J. of Law and Information Technology     Hybrid Journal   (Followers: 3, SJR: 0.247, h-index: 8)
Intl. J. of Law, Policy and the Family     Hybrid Journal   (Followers: 28, SJR: 0.307, h-index: 15)
Intl. J. of Lexicography     Hybrid Journal   (Followers: 8, SJR: 0.404, h-index: 18)
Intl. J. of Low-Carbon Technologies     Open Access   (Followers: 1, SJR: 0.457, h-index: 12)
Intl. J. of Neuropsychopharmacology     Open Access   (Followers: 3, SJR: 1.69, h-index: 79)
Intl. J. of Public Opinion Research     Hybrid Journal   (Followers: 8, SJR: 0.906, h-index: 33)
Intl. J. of Refugee Law     Hybrid Journal   (Followers: 32, SJR: 0.231, h-index: 21)
Intl. J. of Transitional Justice     Hybrid Journal   (Followers: 13, SJR: 0.833, h-index: 12)
Intl. Mathematics Research Notices     Hybrid Journal   (Followers: 1, SJR: 2.052, h-index: 42)
Intl. Political Sociology     Hybrid Journal   (Followers: 26, SJR: 1.339, h-index: 19)
Intl. Relations of the Asia-Pacific     Hybrid Journal   (Followers: 17, SJR: 0.539, h-index: 17)
Intl. Studies Perspectives     Hybrid Journal   (Followers: 7, SJR: 0.998, h-index: 28)
Intl. Studies Quarterly     Hybrid Journal   (Followers: 36, SJR: 2.184, h-index: 68)
Intl. Studies Review     Hybrid Journal   (Followers: 17, SJR: 0.783, h-index: 38)
ISLE: Interdisciplinary Studies in Literature and Environment     Hybrid Journal   (Followers: 1, SJR: 0.155, h-index: 4)
ITNOW     Hybrid Journal   (Followers: 2, SJR: 0.102, h-index: 4)
J. of African Economies     Hybrid Journal   (Followers: 15, SJR: 0.647, h-index: 30)
J. of American History     Hybrid Journal   (Followers: 39, SJR: 0.286, h-index: 34)
J. of Analytical Toxicology     Hybrid Journal   (Followers: 13, SJR: 1.038, h-index: 60)
J. of Antimicrobial Chemotherapy     Hybrid Journal   (Followers: 19, SJR: 2.157, h-index: 149)
J. of Antitrust Enforcement     Hybrid Journal   (Followers: 1)
J. of Applied Poultry Research     Hybrid Journal   (Followers: 3, SJR: 0.563, h-index: 43)
J. of Biochemistry     Hybrid Journal   (Followers: 44, SJR: 1.341, h-index: 96)
J. of Chromatographic Science     Hybrid Journal   (Followers: 16, SJR: 0.448, h-index: 42)
J. of Church and State     Hybrid Journal   (Followers: 11, SJR: 0.167, h-index: 11)
J. of Competition Law and Economics     Hybrid Journal   (Followers: 34, SJR: 0.442, h-index: 16)
J. of Complex Networks     Hybrid Journal   (Followers: 1, SJR: 1.165, h-index: 5)
J. of Conflict and Security Law     Hybrid Journal   (Followers: 11, SJR: 0.196, h-index: 15)
J. of Consumer Research     Full-text available via subscription   (Followers: 40, SJR: 4.896, h-index: 121)
J. of Crohn's and Colitis     Hybrid Journal   (Followers: 9, SJR: 1.543, h-index: 37)
J. of Cybersecurity     Hybrid Journal   (Followers: 3)
J. of Deaf Studies and Deaf Education     Hybrid Journal   (Followers: 8, SJR: 0.69, h-index: 36)
J. of Design History     Hybrid Journal   (Followers: 15, SJR: 0.166, h-index: 14)
J. of Economic Entomology     Full-text available via subscription   (Followers: 6, SJR: 0.894, h-index: 76)
J. of Economic Geography     Hybrid Journal   (Followers: 34, SJR: 2.909, h-index: 69)
J. of Environmental Law     Hybrid Journal   (Followers: 23, SJR: 0.457, h-index: 20)
J. of European Competition Law & Practice     Hybrid Journal   (Followers: 19)
J. of Experimental Botany     Hybrid Journal   (Followers: 14, SJR: 2.798, h-index: 163)
J. of Financial Econometrics     Hybrid Journal   (Followers: 21, SJR: 1.314, h-index: 27)
J. of Global Security Studies     Hybrid Journal   (Followers: 2)
J. of Heredity     Hybrid Journal   (Followers: 3, SJR: 1.024, h-index: 76)
J. of Hindu Studies     Hybrid Journal   (Followers: 7, SJR: 0.186, h-index: 3)
J. of Hip Preservation Surgery     Open Access  
J. of Human Rights Practice     Hybrid Journal   (Followers: 20, SJR: 0.399, h-index: 10)
J. of Infectious Diseases     Hybrid Journal   (Followers: 40, SJR: 4, h-index: 209)
J. of Insect Science     Open Access   (Followers: 9, SJR: 0.388, h-index: 31)

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Journal Cover International Journal of Epidemiology
  [SJR: 4.381]   [H-I: 145]   [121 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0300-5771 - ISSN (Online) 1464-3685
   Published by Oxford University Press Homepage  [370 journals]
  • Epidemiology in the age of sustainable development
    • Authors: Sachs J.
      PubDate: 2017-04-20
  • Associations of parity-related reproductive histories with ER± and HER2±
           receptor-specific breast cancer aetiology
    • Authors: Anderson W; Pfeiffer R, Wohlfahrt J, et al.
      Abstract: <span class="paragraphSection">First published online: 5 November 2016, <span style="font-style:italic;">Int J Epidemiol</span>, 2016, doi: <strong><a href="article.aspx'volume=&page="><span></span></a></strong></span>
      PubDate: 2017-03-29
  • Epidemiology in an age of anger and complaint
    • Authors: Leeder S.
      Abstract: <span class="paragraphSection">Unlike those sciences and scholarship that thrive within the controlled environment of laboratories or quiet, IT-enabled reading rooms (formerly libraries), epidemiology lacks the luxury of monastic isolation in which to develop its wisdom. When practised consistently with the discipline’s etymology, epidemiologists deal daily with communities and populations—‘science of the people for the people’.</span>
      PubDate: 2017-02-28
  • Farewell to the Editors of the International Journal of Epidemiology: an
    • Authors: .
      PubDate: 2017-02-28
  • Why population-based data are crucial to achieving the Sustainable
           Development Goals
    • Authors: Sankoh O .
      Abstract: <span class="paragraphSection">In September 2015, the member countries of the United Nations signed up to 17 Sustainable Development Goals (SDGs). The goals contain a total of 169 specific targets which governments have committed to meeting by 2030. With their aim of eliminating poverty, protecting the planet and ensuring prosperity for all, the SDGs lay out the agenda for international development over the next 15 years.<a href="#dyx010-B1" class="reflinks"><sup>1</sup></a></span>
      PubDate: 2017-02-15
  • Genetics for population and public health
    • Authors: Hopper J.
      Abstract: <span class="paragraphSection">Epidemiologists and public health practitioners are somewhat wary of genetics, and for good reason. The historical catch phrases ‘nature versus nurture’, or ‘genes versus environment’, have created a culture clash. These simplistic views are built around an inherent assumption of genetic determinism, and the belief that the causes of diseases can be partitioned into two or three groups: genetic, environmental and perhaps ‘stochastic’<a href="#dyx008-B1" class="reflinks"><sup>1</sup></a> (which, to my mind, can’t be genetic and just represents lack of knowledge about the environment). When it comes to public or population health, this thinking hasn’t translated into anything useful except fuel for debates.</span>
      PubDate: 2017-02-15
  • Commentary: transgenerational effects of parental death—a life
           history perspective
    • Authors: Hõrak P.
      Abstract: <span class="paragraphSection">Living beings do not, through natural selection, pass on their genes randomly. Scientists in different disciplines have distinct views about the relevance of evolutionary approaches when explaining medical and epidemiological issues. Vågerö and Rajaleid,<a href="#dyw368-B1" class="reflinks"><sup>1</sup></a> studying an association between a parent’s death while their children were young with prematurity and low birthweight in the third generation, have tested the epigenetic hypothesis that childhood trauma might trigger a sex-specific male-line transgenerational effect. Their main finding is that parental (G1) death during (G2) childhood predicts G3 prematurity and lower birthweight. They conclude that this is compatible with the epigenetic hypothesis. They consider it unlikely, since most G1 deaths were fathers, that G3 offspring birthweights are genetically linked to G2 parental loss in childhood.</span>
      PubDate: 2017-02-15
  • Transgenerational response and life history theory: a response to Peeter
    • Authors: Vågerö D; Rajaleid K.
      Abstract: <span class="paragraphSection">We are grateful to Peeter Hõrak for his careful reading of our paper on the transgenerational response to childhood trauma.<a href="#dyw369-B1" class="reflinks"><sup>1</sup></a> We reported<a href="#dyw369-B2" class="reflinks"><sup>2</sup></a> that grandparental (generation 1, G1) death during generation 2 (G2) childhood predicted birthweight and prematurity in generation 3 (G3). The major point in Hõrak’s response is that our results can be explained by ‘life history theory’, derived from evolutionary biology or evolutionary ecology. Our major conclusion, that the observed transgenerational response along the male line may well be epigenetic and triggered during the slow growth period, is hardly touched on by Hõrak. Finally, Hõrak states that human population data, like ours, can be used to test theories derived from evolutionary biology, such as life history theory. We disagree on Hõrak’s first point but agree on the last. All three points are elaborated below.</span>
      PubDate: 2017-02-15
  • Bicycle injuries and helmet use: a systematic review and meta-analysis
    • Authors: Olivier J; Creighton P.
      Abstract: <span class="paragraphSection">In the originally published version of this article, in Table 1, the study size for Otte and Wiese should have been given as  4245 instead of 245. Additionally, the last Dinh et al reference (#91) should have been 254 for the study size. This has now been corrected.</span>
      PubDate: 2017-01-18
  • Dissidents and dietary sodium: concerns about the commentary by
           O’Donnell et al.
    • Authors: Campbell N.
      Abstract: <span class="paragraphSection">O’Donnell <span style="font-style:italic;">et al.</span> claim that there are few individuals with extreme perspectives on both sides of the sodium controversy and that there are ‘few areas in public health that elicit more strident, polemic interpretations of the research literature’.<a href="#dyw292-B1" class="reflinks"><sup>1</sup></a> Yet numerous independent health and scientific organizations have reviewed the totality of evidence and have reached very consistent recommendations to reduce dietary sodium.<a href="#dyw292-B2" class="reflinks"><sup>2</sup></a> Further, mainstream health practitioners and scientists, including the World Health Organization, have strongly supported reductions in dietary sodium.<a href="#dyw292-B3" class="reflinks"><sup>3–5</sup></a> In Canada, where O’Donnell and his co-authors have academic affiliations, 26 national health and scientific organizations endorsed a position to reduce dietary sodium to < 2300 mg/day, the federal and provincial governments set a target to reduce dietary sodium to 2300 mg/day by the end of 2016 and leaders of organizations representing most health care professionals and about 70% of the Canadian population supported a regulatory approach to reducing dietary sodium: Hypertension Canada [<a href=""></a>], accessed 30 March 2016; and Consumer Science in the Public Interest [<a href=""></a>], accessed 30 March 2016.<a href="#dyw292-B6" class="reflinks"><sup>6</sup></a> The Canadian Hypertension Education Program recommends considering reducing dietary sodium to 2000 mg/day to reduce blood pressure.<a href="#dyw292-B7" class="reflinks"><sup>7</sup></a> High levels of support are seen in many other countries.<a href="#dyw292-B4" class="reflinks"><sup>4</sup></a> World Action of Salt and Health, an organization of scientists and health professionals concerned about excess dietary sodium, has over 500 members from 95 countries [<a href=""></a>], accessed 31 March 2016. There are similar local networks of concerned scientists in other areas of the world [ALASS, <a href=""></a>], (accessed 31 March 2016).<a href="#dyw292-B4" class="reflinks"><sup>4</sup></a> Most national hypertension organizations and the World Hypertension League and the International Society of Hypertension support dietary sodium reduction.<a href="#dyw292-B8" class="reflinks"><sup>8</sup></a><sup>,</sup><a href="#dyw292-B9" class="reflinks"><sup>9</sup></a> Consumers International (an umbrella organization of 240 national civil society organizations in 120 countries) supports reductions in dietary sodium as a key project [<a href=""> y-projects/salt-reduction/</a>], (accessed 1 April 2016). I am not aware of any credible health, scientific or civil society organization that supports the views expressed in O’Donnell’s commentary or those of other dissenting scientists.<a href="#dyw292-B1" class="reflinks"><sup>1</sup></a> The debate is generated by a small but highly vocal group of dissenting scientists advocating against mainstream science and public health.</span>
      PubDate: 2016-12-30
  • Low sodium intake and cardiovascular health: an unanswered question.
           Response to: Letter from Dr N. Campbell, ‘Dissidents and dietary sodium.
           Concerns about the commentary by O’Donnell et al. ’
    • Authors: O’Donnell M; Mente A, Yusuf S.
      Abstract: <span class="paragraphSection"><span style="font-style:italic;">‘An error does not become truth by reason of multiplied propagation, nor does the truth become error because nobody will see it’ [Mahatma Gandhi , All Men Are Brothers (2005 edition), Continuum - ISBN: 9780826417398].</span></span>
      PubDate: 2016-12-30
  • Multilevel regression modelling to investigate variation in disease
           prevalence across locations
    • Authors: Weinmayr G; Dreyhaupt J, Jaensch A, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div>In this article, we show how to investigate the role of individual (personal) risk factors in outcome prevalence in multicentre studies with multilevel modelling. The variation in outcome prevalence is modelled by introducing a random intercept. In the next step, the empty model is compared with the model containing the risk factor(s). Because the outcome is dichotomous, this comparison can only be carried out after having rescaled the models’ parameter values to the variance of an underlying continuous variable. We illustrate this approach with data from Phase Two of the International Study of Asthma and Allergies in Childhood (ISAAC) and provide a corresponding Stata do-file.</span>
      PubDate: 2016-11-16
  • Gestational age at birth and academic performance: population-based cohort
    • Authors: Abel K; Heuvelman H, Wicks S, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> Numerous studies suggest pre-term birth is associated with cognitive deficit. However, less is known about cognitive outcomes following post-term birth, or the influence of weight variations within term or post-term populations. We examined associations between gestational age (GA) and school performance, by weight-for-GA, focusing on extremely pre- and post-term births.<strong>Method:</strong> Record linkage study of Swedish children born 1973–94 (<span style="font-style:italic;">n = </span>2 008 102) with a nested sibling comparison (<span style="font-style:italic;">n = </span>439 629). We used restricted cubic regression splines to examine associations between GA and the grade achieved on leaving secondary education, comparing siblings to allow stronger causal inference with regard to associations between GA and school performance.<strong>Results:</strong> Grade averages of both pre- and post-term children were below those of full-term counterparts and lower for those born small-for-GA. The adjusted grades of extremely pre-term children (at 24 completed weeks), while improving in later study periods, were lower by 0.43 standard deviations (95% confidence interval 0.38–0.49), corresponding with a 21-point reduction (19 to 24) on a 240-point scale. Reductions for extremely post-term children (at 45 completed weeks) were lesser [–0.15 standard deviation (–0.17 to –0.13) or –8 points (–9 to –7)]. Among matched siblings, we observed weaker residual effects of pre-term and post-term GA on school performance.<strong>Conclusions:</strong> There may be independent effects of fetal maturation and fetal growth on school performance. Associations among matched siblings, although attenuated, remained consistent with causal effects of pre- and post-term birth on school performance.</span>
      PubDate: 2016-11-06
  • Associations of parity-related reproductive histories with ER± and HER2±
           receptor-specific breast cancer aetiology
    • Authors: Anderson W; Pfeiffer R, Wohlfahrt J, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> Associations of reproductive history with breast cancer risk differ by oestrogen receptor (ER±) status and possibly by the joint expression of ER and the human epidermal growth factor receptor-2 (ER±/HER2±). However, large sample sizes are needed to establish ER-specific risks by HER2± expression.<strong>Methods:</strong> We linked a cancer registry covering nearly 95% of the primary breast cancer diagnoses in Denmark with a research parity database to assess associations for parity, number of live births and age at first live birth (AFLB) with receptor-specific risk. Relative risks (RRs) for associations were estimated with Poisson regression models.<strong>Results:</strong> With nearly 31 million women-years of follow-up, 45 786 Danish women aged 20–84 years developed invasive breast cancer during 1992–2011. ER± expression was available for the entire study period and HER2± after 2006. Of the breast cancers with known ER expression, 79% were ER+. Most breast cancers with known ER and HER2 were HER2– (90% of ER+ cancers and 65% of ER– cancers). RRs differed by ER± expression for all reproductive variables (<span style="font-style:italic;">p</span>-homogeneity < 0.001). Associations were stronger for ER+ than ER– cancers and for those diagnosed before age 50. Parity and early [not later] AFLB showed a protective association with ER+/HER2– and risk association with ER–/HER2– cancers.<strong>Conclusion:</strong> Associations of reproductive history with breast cancer risk varied among Danish women by ER± and ER±/HER2± expression and age-at-diagnosis, consistent with receptor-specific and age-related etiological heterogeneity. Further stratification by HER2 status demonstrated dual (or opposite) effects for ER+/HER2– and ER–/HER2– cancers.</span>
      PubDate: 2016-11-05
  • Foundations of Epidemiology
    • Authors: Villalonga-Olives E.
      Abstract: <span class="paragraphSection"><strong>Lilienfeld’s Foundations of Epidemiology</strong>. 4th edition. SchneiderDona and LilienfeldDavid E.. Oxford, UK: Oxford University Press, 2015</span>
      PubDate: 2016-10-31
  • Psychopathology of children of genocide survivors: a systematic review on
           the impact of genocide on their children`s psychopathology from five
    • Authors: Lindert J; Knobler H, Kawachi I, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background</strong>: The health consequences of genocides on children of survivors are increasingly discussed but conclusions have been conflicting.<strong>Methods:</strong> We systematically reviewed studies from five electronic databases (EMBASE, PILOTS, PUBMED, PsycINFO, Web of Science), which used a quantitative study design and included: (i) exposure to the genocides of Armenians in Nazi Germany, Cambodia, Rwanda and Bosnia; (ii) mental health outcomes; (iii) validated instruments; (iv) statistical tests of associations. Study quality was appraised using a quality assessment tool for genocide studies. PRISMA reporting guidelines were followed.<strong>Results:</strong> From 3352 retrieved records, 20 studies with a total of 4793 participants involving 2431 children of survivors and 2362 controls met the eligibility criteria. Studies were conducted in seven countries: Australia, Canada, Italy, Israel, Norway, Rwanda and the USAs over the past seven decades, using the Genocide Studies Quality Assessment Tool. Data from the high quality studies provide no consistent evidence that children of genocide survivors are more likely to have mental health problems than comparators who were not children of genocide survivors.<strong>Conclusions:</strong> Methodological characteristics were associated with findings: studies investigating random samples of genocide survivors did not find an impact of genocides on health of children of survivors. Potential confounders (e.g. recent life events, poverty) need further investigation. Future studies of the impact of genocides on mental health should report using a standardized structure, such as the quality tool used here.</span>
      PubDate: 2016-10-25
  • The effects of age on crash risk associated with driver distraction
    • Authors: Guo F; Klauer S, Fang Y, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> Driver distraction is a major contributing factor to crashes, which are the leading cause of death for the US population under 35 years of age. The prevalence of secondary-task engagement and its impacts on distraction and crashes may vary substantially by driver age.<strong>Methods:</strong> Driving performance and behaviour data were collected continuously using multiple cameras and sensors <span style="font-style:italic;">in situ</span> for 3542 participant drivers recruited for up to 3 years for the Second Strategic Highway Research Program Naturalistic Driving Study. Secondary-task engagement at the onset of crashes and during normal driving segments was identified from videos. A case–cohort approach was used to estimate the crash odds ratios associated with, and the prevalence of, secondary tasks for four age groups: 16–20, 21–29, 30–64 and 65–98 years of age. Only severe crashes (property damage and higher severity) were included in the analysis.<strong>Results:</strong> Secondary-task-induced distraction posed a consistently higher threat for drivers younger than 30 and above 65 when compared with middle-aged drivers, although senior drivers engaged in secondary tasks much less frequently than their younger counterparts. Secondary tasks with high visual–manual demand (e.g. visual–manual tasks performed on cell phones) affected drivers of all ages. Certain secondary tasks, such as operation of in-vehicle devices and talking/singing, increased the risk for only certain age groups.<strong>Conclusions:</strong> Teenaged, young adult drivers and senior drivers are more adversely impacted by secondary-task engagement than middle-aged drivers. Visual–manual distractions impact drivers of all ages, whereas cognitive distraction may have a larger impact on young drivers.</span>
      PubDate: 2016-10-14
  • Parenthood and the risk of cardiovascular diseases among 0.5 million men
           and women: findings from the China Kadoorie Biobank
    • Authors: Peters S; Yang L, Guo Y, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> Women’s parity has been associated with risk of cardiovascular disease (CVD). It is unclear, however, whether it reflects biological effects of childbearing or uncontrolled socio-economic and lifestyle factors associated with childrearing. We assessed the association between number of children and incident CVD outcomes separately in women and men.<strong>Methods:</strong> In 2004–08, the nationwide China Kadoorie Biobank recruited 0.5 million individuals aged 30–79 years from 10 diverse regions. During 7 years of follow-up, 24 432 incident cases of coronary heart disease (CHD) and 35 736 of stroke were recorded among 489 762 individuals without prior CVD. Multivariable Cox regression models were used to estimate sex-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for CHD and stroke associated with number of children.<strong>Results:</strong> Overall, 98% of all participants had children and the mean number of children declined progressively from four in older participants to one or two in younger participants. Compared with childless women, women with children had an increased risk of CHD, but not of stroke [HR (95% CI): 1.14 (1.00; 1.30) and 1.03 (0.92; 1.16)]. Corresponding results for men were 1.20 (1.06; 1.35) and 1.13 (1.03; 1.24), respectively. In individuals with children, there was a log-linear association between number of children and CVD outcomes; in women, each additional child was associated with adjusted HRs of 1.02 (1.01; 1.04) for CHD and 1.02 (1.01; 1.03) for stroke, similar in magnitude to that in men [1.03 (1.01; 1.04) for CHD and 1.02 (1.01; 1.03) for stroke].<strong>Conclusion:</strong> In Chinese adults, the association between the number of children and risk of CHD and stroke was similar between men and women, suggesting that factors associated with parenthood and childrearing are more likely to affect the risk of CVD outcomes than factors associated with childbearing.</span>
      PubDate: 2016-09-19
  • Two cheers for a small giant' Why we need better ways of seeing data:
           A commentary on: ‘Rising morbidity and mortality in midlife among White
           non-Hispanic Americans in the 21st century’
    • Authors: Minton J; Green M, McCartney G, et al.
      PubDate: 2016-09-16
  • Father’s environment before conception and asthma risk in his children:
           a multi-generation analysis of the Respiratory Health In Northern Europe
    • Authors: Svanes C; Koplin J, Skulstad S, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> Whereas it is generally accepted that maternal environment plays a key role in child health, emerging evidence suggests that paternal environment before conception also impacts child health. We aimed to investigate the association between children’s asthma risk and parental smoking and welding exposures prior to conception.<strong>Methods:</strong> In a longitudinal, multi-country study, parents of 24 168 offspring aged 2–51 years provided information on their life-course smoking habits, occupational exposure to welding and metal fumes, and offspring’s asthma before/after age 10 years and hay fever. Logistic regressions investigated the relevant associations controlled for age, study centre, parental characteristics (age, asthma, education) and clustering by family.<strong>Results:</strong> Non-allergic early-onset asthma (asthma without hay fever, present in 5.8%) was more common in the offspring with fathers who smoked before conception {odds ratio [OR] = 1.68 [95% confidence interval (CI) = 1.18–2.41]}, whereas mothers’ smoking before conception did not predict offspring asthma. The risk was highest if father started smoking before age 15 years [3.24 (1.67–6.27)], even if he stopped more than 5 years before conception [2.68 (1.17–6.13)]. Fathers’ pre-conception welding was independently associated with non-allergic asthma in his offspring [1.80 (1.29–2.50)]. There was no effect if the father started welding or smoking after birth. The associations were consistent across countries.<strong>Conclusions:</strong> Environmental exposures in young men appear to influence the respiratory health of their offspring born many years later. Influences during susceptible stages of spermatocyte development might be important and needs further investigation in humans. We hypothesize that protecting young men from harmful exposures may lead to improved respiratory health in future generations.</span>
      PubDate: 2016-08-25
  • The association of parental education with childhood undernutrition in
           low- and middle-income countries: comparing the role of paternal and
           maternal education
    • Authors: Vollmer S; Bommer C, Krishna A, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> Most existing research on the association of parental education with childhood undernutrition focuses on maternal education and often ignores paternal education. We systematically investigate differences in maternal and paternal education and their association with childhood undernutrition.<strong>Methods:</strong> One hundred and eighty Demographic and Health Surveys from 62 countries performed between 1990 and 2014 were analysed. We used linear-probability models to predict childhood undernutrition prevalences, measured as stunting, underweight and wasting, for all combinations of maternal and paternal attainment in school. Models were adjusted for demographic and socio-economic covariates for the child, mother and household, country-level fixed effects and clustering. Additional specifications adjust for local area characteristics instead of country fixed effects.<strong>Results:</strong> Both higher maternal and paternal education levels are associated with lower childhood undernutrition. In regressions adjusted for child age and sex as well as country-level fixed effects, the association is stronger for maternal education than for paternal education when their combined level of education is held constant. In the fully adjusted models, the observed differences in predicted undernutrition prevalences are strongly attenuated, suggesting a similar importance of maternal and paternal education. These findings are confirmed by the analysis of composite schooling indicators.<strong>Conclusions:</strong> We find that paternal education is similarly important for reducing childhood undernutrition as maternal education and should therefore receive increased attention in the literature.</span>
      PubDate: 2016-08-08
  • Exercise interventions and prevention of fall-related fractures in older
           people: a meta-analysis of randomized controlled trials
    • Authors: Zhao R; Feng F, Wang X.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> This meta-analysis aimed to determine whether exercise interventions were effective in preventing fall-related fractures in older people. The treatment effects on rate of falls, leg strength and balance were also examined.<strong>Methods</strong> An electronic database search was conducted in PubMed, EMBASE, the Cochrane library and PEDro up to 1 September 2015. Randomized controlled trials (RCTs) that conducted exercise interventions and reported fall-related fracture data in older people were included. The primary outcome was the treatment effects on fall-related fractures determined by relative risk (RR) and 95% confidence interval (CI). The treatment effects on falls, leg strength and balance were also reported using rate ratio (RaR) with 95% CI and standardized mean difference (SMD) with 95% CI, respectively. Random effects models were used for meta-analysis.<strong>Results:</strong> Fifteen studies including 3136 participants met the inclusion criteria. Exercise had a beneficial effect on reduction of fall-related fractures, with pooled estimates of RR 0.604 (95% CI 0.453 - 0.840, <span style="font-style:italic;">P</span> = 0.003, I<sup>2 </sup>= 0%). The rate of falls (RaR 0.856, 95% CI 0.778 – 0.941, <span style="font-style:italic;">P</span> = 0.001, I<sup>2 </sup>= 45%) and leg strength (SMD 0.613, 95% CI 0.119 - 1.107, <span style="font-style:italic;">P</span> = 0.015, I<sup>2 </sup>= 76.7%) were also potentially affected by exercise interventions. These only had a marginally beneficial effect on balance (SMD 0.468, 95% CI −0.011 – 0.947, <span style="font-style:italic;">P</span> = 0.055, I<sup>2 </sup>= 93.6%).<strong>Conclusions:</strong> Our findings implied that exercise interventions were effective in preventing fall-related fractures and reducing risk factors of fall-related fractures in older people.</span>
      PubDate: 2016-07-27
  • Usefulness of overnight pulse oximeter as the sleep assessment tool to
           assess the 6-year risk of road traffic collision: evidence from the Taiwan
           Bus Driver Cohort Study
    • Authors: Wu W; Tsai S, Liao H, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> In order to support health service organizations in arranging a system for prevention of road traffic collisions (RTC), it is important to study the usefulness of sleep assessment tools. A cohort study was used to evaluate the effectiveness of subjective and objective sleep assessment tools to assess for the 6-year risk of both first RTC event only and recurrent RTC events.<strong>Methods:</strong> The Taiwan Bus Driver Cohort Study (TBDCS) recruited 1650 professional drivers from a large bus company in Taiwan in 2005. The subjects were interviewed in person, completed the sleep assessment questionnaires and had an overnight pulse oximeter survey. Moreover, this cohort of drivers was linked to the National Traffic Accident Database (NTAD) and researchers found 139 new RTC events from 2005 to 2010. Primary outcomes were traffic collisions from NTAD, nocturnal oxygen desaturation index (ODI) from pulse oximeter, Pittsburg sleeping quality score, Epworth daytime sleepiness score, Snore Outcomes Survey score and working patterns from questionnaires. A Cox proportional hazards model and an extended Cox regression model for repeated events were performed to estimate the hazard ratio for RTC.<strong>Results:</strong> The RTC drivers had increased ODI4 levels (5.77 ± 4.72 vs 4.99 ± 6.68 events/h; <span style="font-style:italic;">P</span> = 0.008) and ODI3 levels (8.68 ± 6.79 vs 7.42 ± 7.94 events/h; <span style="font-style:italic;">P</span> = 0.007) in comparison with non-RTC drivers. These results were consistent regardless of whether ODI was evaluated as a continuous or a categorical variable. ODI4 and ODI3 levels increased the 6-year RTC risks among professional drivers even after adjusting for age, education, history of cardiovascular disease, caffeine intake, sleeping pills used, bus driving experience and shift modes. Moreover, there was an increased trend for ODI between the stratification of the number of RTCs in comparison with the non-RTC group. In the extended Cox regression models for repeated RTC events with the Anderson and Gill intensity model and Prentice-Williams-Petersen model, measurement of ODI increased hazards of the subsequent RTC events.<strong>Conclusion:</strong> This study showed that an increase in the 6-year risk of RTC was associated with objective measurement of ODI for a sign of sleep-disordered breathing (SDB), but was not associated with self-reported sleeping quality or daytime sleepiness. Therefore, the overnight pulse oximeter is an effective sleep assessment tool for assessing the risk of RTC. Further research should be conducted regarding measures to prevent against SDB among professional drivers.</span>
      PubDate: 2016-07-27
  • Bicycle injuries and helmet use: a systematic review and meta-analysis
    • Authors: Olivier J; Creighton P.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> The research literature was systematically reviewed and results were summarized from studies assessing bicycle helmet effectiveness to mitigate head, serious head, face, neck and fatal head injury in a crash or fall.<strong>Methods:</strong> Four electronic databases (MEDLINE, EMBASE, COMPENDEX and SCOPUS) were searched for relevant, peer-reviewed articles in English. Included studies reported medically diagnosed head, face and neck injuries where helmet use was known. Non-approved helmets were excluded where possible. Summary odds ratios (OR) were obtained using multivariate meta-regression models stratified by injury type and severity. Time trends and publication bias were assessed.<strong>Results:</strong> A total of 43 studies met inclusion criteria and 40 studies were included in the meta-analysis with data from over 64 000 injured cyclists. For cyclists involved in a crash or fall, helmet use was associated with odds reductions for head (OR = 0.49, 95% confidence interval (CI): 0.42–0.57), serious head (OR = 0.31, 95% CI: 0.25–0.37), face (OR = 0.67, 95% CI: 0.56–0.81) and fatal head injury (OR = 0.35, 95% CI: 0.14–0.88). No clear evidence of an association between helmet use and neck injury was found (OR = 0.96, 95% CI: 0.74–1.25). There was no evidence of time trends or publication bias.<strong>Conclusions:</strong> Bicycle helmet use was associated with reduced odds of head injury, serious head injury, facial injury and fatal head injury. The reduction was greater for serious or fatal head injury. Neck injury was rare and not associated with helmet use. These results support the use of strategies to increase the uptake of bicycle helmets as part of a comprehensive cycling safety plan.</span>
      PubDate: 2016-07-21
  • Cohort Profile: The Birmingham Chronic Obstructive Pulmonary Disease
           (COPD) Cohort Study
    • Authors: Adab P; Fitzmaurice D, Dickens A, et al.
      PubDate: 2016-07-04
  • Cohort Profile: The Australian Gulf War Veterans’ Health Study
    • Authors: Ikin J; Kelsall H, McKenzie D, et al.
      PubDate: 2016-07-04
  • Threats to security and ischaemic heart disease deaths: the case of
           homicides in Mexico
    • Authors: Lee E; Bruckner T.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> Ischaemic heart disease (IHD) ranks as the leading cause of death worldwide. Whereas much attention focuses on behavioural and lifestyle factors, less research examines the role of acute, ambient stressors. An unprecedented rise in homicides in Mexico over the past decade and the attendant media coverage and publicity have raised international concern regarding its potential health sequelae. We hypothesize that the rise in homicides in Mexico acts as an ecological threat to security and elevates the risk of both transient ischaemic events and myocardial infarctions, thereby increasing IHD deaths.<strong>Methods:</strong> We applied time-series methods to monthly counts of IHD deaths and homicides in Mexico for 156 months spanning January 2000 to December 2012. Methods controlled for strong temporal patterns in IHD deaths, the unemployment rate and changes in the population size at risk.<strong>Results:</strong> After controlling for trend and seasonality in IHD deaths, a 1-unit increase in the logged count of homicides coincides with a 7% increase in the odds of IHD death in that same month (95% confidence interval: 0.04 — 0.10). Inference remains robust to additional sensitivity checks, including a state-level fixed effects analysis.<strong>Conclusions: </strong>Our findings indicate that the elevated level of homicides in Mexico serves as a population-level stressor that acutely increases the risk of IHD death. This research adds to the growing literature documenting the role of ambient threats, or perceived threats, to security on cardiovascular health.</span>
      PubDate: 2016-06-10
  • Interrupted time series regression for the evaluation of public health
           interventions: a tutorial
    • Authors: Bernal J; Cummins S, Gasparrini A.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div>Interrupted time series (ITS) analysis is a valuable study design for evaluating the effectiveness of population-level health interventions that have been implemented at a clearly defined point in time. It is increasingly being used to evaluate the effectiveness of interventions ranging from clinical therapy to national public health legislation. Whereas the design shares many properties of regression-based approaches in other epidemiological studies, there are a range of unique features of time series data that require additional methodological considerations. In this tutorial we use a worked example to demonstrate a robust approach to ITS analysis using segmented regression. We begin by describing the design and considering when ITS is an appropriate design choice. We then discuss the essential, yet often omitted, step of proposing the impact model a priori. Subsequently, we demonstrate the approach to statistical analysis including the main segmented regression model. Finally we describe the main methodological issues associated with ITS analysis: over-dispersion of time series data, autocorrelation, adjusting for seasonal trends and controlling for time-varying confounders, and we also outline some of the more complex design adaptations that can be used to strengthen the basic ITS design.</span>
      PubDate: 2016-06-08
  • Maelstrom Research guidelines for rigorous retrospective data
    • Authors: Fortier I; Raina P, Van den Heuvel E, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> It is widely accepted and acknowledged that data harmonization is crucial: in its absence, the co-analysis of major tranches of high quality extant data is liable to inefficiency or error. However, despite its widespread practice, no formalized/systematic guidelines exist to ensure high quality retrospective data harmonization.<strong>Methods:</strong> To better understand real-world harmonization practices and facilitate development of formal guidelines, three interrelated initiatives were undertaken between 2006 and 2015. They included a phone survey with 34 major international research initiatives, a series of workshops with experts, and case studies applying the proposed guidelines.<strong>Results:</strong> A wide range of projects use retrospective harmonization to support their research activities but even when appropriate approaches are used, the terminologies, procedures, technologies and methods adopted vary markedly. The generic guidelines outlined in this article delineate the essentials required and describe an interdependent step-by-step approach to harmonization: 0) define the research question, objectives and protocol; 1) assemble pre-existing knowledge and select studies; 2) define targeted variables and evaluate harmonization potential; 3) process data; 4) estimate quality of the harmonized dataset(s) generated; and 5) disseminate and preserve final harmonization products.<strong>Conclusions:</strong> This manuscript provides guidelines aiming to encourage rigorous and effective approaches to harmonization which are comprehensively and transparently documented and straightforward to interpret and implement. This can be seen as a key step towards implementing guiding principles analogous to those that are well recognised as being essential in securing the foundational underpinning of systematic reviews and the meta-analysis of clinical trials.</span>
      PubDate: 2016-06-05
  • Cognitive and emotional outcomes after prolonged education: a
           quasi-experiment on 320 182 Swedish boys
    • Authors: Lager A; Seblova D, Falkstedt D, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> Cognitive and socio-emotional abilities are powerful predictors of death and disease as well as of social and economic outcomes. Education is societies’ main way of promoting these abilities, ideally so that inequalities by socioeconomic background are reduced. However, the extent to which education serves these cognitive, social-emotional and equality objectives is relatively unknown and intensively debated. Drawing on a Swedish school reform that was explicitly designed as a massive quasi-experiment, we assessed differential impact of education on intelligence and emotional control across childhood socioeconomic position. We also assessed initial differences in abilities by childhood socioeconomic position and how well childhood socioeconomic position and abilities predict all-cause mortality.<strong>Methods:</strong> The Swedish comprehensive school reform, rolled out during the 1950s, extended compulsory education from 8 to 9 years in some municipalities whereas others were kept as controls for the sake of evaluation. We followed eight full cohorts of Swedish boys born between 1951 and 1958, who lived in 1017 municipalities with known experimental status (344 336 boys) and whose childhood socioeconomic position was known (320 182 boys). At conscription, intelligence was measured by four subtests and emotional control (calm and efficient responses in various situations) was rated by a military psychologist. Both measures were standardized to have a mean of 100 and standard deviation of 15. All-cause mortality was recorded until 49–56 years of age.<strong>Results:</strong> The reform had an average positive impact on intelligence of 0.75 IQ units (95% confidence interval (CI): 0.54, 0.97; <span style="font-style:italic;">P</span> < 0.0005). The impact on emotional control was negative; −0.50 units (95% CI: −0.72, −0.28; <span style="font-style:italic;">P</span> < 0.0005). Both effects differed by socioeconomic background so that the average IQ difference between sons of high non-manual and unqualified manual workers was reduced from 16.32 to 15.57 units and the difference in emotional control was reduced from 6.50 to 5.63 units. All-cause mortality was predicted by low childhood socioeconomic position [hazard ratio (HR) = 1.15 [95% CI: 1.11, 1.20], <span style="font-style:italic;">P</span> < 0.0005], low intelligence [HR = 1.39 (95% CI: 1.34, 1.44), <span style="font-style:italic;">P</span> < 0.0005] as well as low emotional control [HR = 1.61 (95% CI: 1.55, 1.67), <span style="font-style:italic;">P</span> < 0.0005] in mutually adjusted models.<strong>Conclusions:</strong> Extending compulsory education promoted intelligence but lowered emotional control, and reduced disparities over social background in both. Emotional control was the strongest predictor of all-cause mortality. Our results are in line with the idea that education is important in our efforts to achieve healthy, competent and fair societies, but much more work is needed to understand the links between education and non-cognitive skills.</span>
      PubDate: 2016-06-02
  • Maternal underweight and obesity and risk of orofacial clefts in a large
           international consortium of population-based studies
    • Authors: Kutbi H; Wehby G, Moreno Uribe L, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> Evidence on association of maternal pre-pregnancy weight with risk of orofacial clefts is inconsistent.<strong>Methods:</strong> Six large case-control studies of orofacial clefts from Northern Europe and the USA were included in analyses pooling individual-level data. Cases included 4943 mothers of children with orofacial clefts (cleft lip only: 1135, cleft palate with cleft lip: 2081, cleft palate only: 1727) and controls included 10 592 mothers of unaffected children. Association of orofacial cleft risk with pre-pregnancy maternal weight classified by level of body mass index (BMI, kg/m<sup>2</sup>) was evaluated using logistic regression adjusting for multiple covariates.<strong>Results:</strong> Cleft palate, both alone and with cleft lip (CP+/-CL), was associated with maternal class II+ pre-pregnancy obesity (≥ 35)compared with normal weight [adjusted odds ratio (aOR) = 1.36; 95% confidence interval (CI) = 1.16, 1.58]. CP+/-CL was marginally associated with maternal underweight (aOR = 1.16; 95% CI = 0.98, 1.36). Cleft lip alone was not associated with BMI.<strong>Conclusions:</strong> In this largest population-based study to date, we found an increased risk of cleft palate, with or without cleft lip, in class II+ obese mothers compared with normal-weight mothers; underweight mothers may also have an increased risk, but this requires further study. These results also suggest that extremes of weight may have a specific effect on palatal development.</span>
      PubDate: 2016-05-21
  • Bidirectional association between physical activity and muscular strength
           in older adults: Results from the UK Biobank study
    • Authors: Cooper A; Lamb M, Sharp S, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> The relationship between physical activity and muscular strength has not been examined in detail among older adults. The objective of this study was to examine the associations between physical activity and hand grip strength among adults aged ≥ 60 years.<strong>Methods:</strong> Using data from the UK Biobank study, we included 66 582 men and women with complete baseline data and 6599 with 4.5 years of follow-up data. We used multiple linear regression models to examine the cross-sectional, longitudinal and bidirectional associations between moderate-to-vigorous physical activity (MVPA) and grip strength, adjusting for potential confounding by age, sex, height, weight, health status, education level, smoking status, Townsend deprivation index and retirement status.<strong>Results:</strong> In cross-sectional analyses, grip strength and MVPA were linearly and positively associated with each other. Longitudinally, baseline MVPA was not associated with grip strength at follow-up {difference between quintile [Q] 5 and Q1 = 0.40 [95% confidence interval (CI): -0.14, 0.94]kg}, whereas baseline grip strength was associated with MVPA at follow-up [Q5 vs Q1 = 7.15 (1.18, 13.12) min/day]. People who maintained/increased time spent in MVPA did not experience any benefit in grip strength [0.08 (−0.20, 0.37) kg] whereas those who increased their grip strength spent 3.69 (0.20, 7.17) min/day extra in MVPA.<strong>Conclusion:</strong> Promotion of strength-training activities may enable and maintain participation in regular physical activity among older adults.</span>
      PubDate: 2016-05-20
  • Variation in worldwide incidence of amyotrophic lateral sclerosis: a
    • Authors: Marin B; Boumédiene F, Logroscino G, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> To assess the worldwide variation of amyotrophic lateral sclerosis (ALS) incidence, we performed a systematic review and meta-analysis of population-based data published to date.<strong>Methods:</strong> We reviewed Medline and Embase up to June 2015 and included all population-based studies of newly diagnosed ALS cases, using multiple sources for case ascertainment. ALS crude and standardized incidence (on age and sex using the US 2010 population) were calculated. Random effect meta-analysis and meta-regression were performed using the subcontinent as the main study level covariate. Sources of heterogeneity related to the characteristics of the study population and the study methodology were investigated.<strong>Results:</strong> Among 3216 records, 44 studies were selected, covering 45 geographical areas in 11 sub-continents. A total of 13 146 ALS cases and 825 million person-years of follow-up (PYFU) were co-nsidered. The overall pooled worldwide crude ALS incidence was at 1.75 (1.55–1.96)/100 000 PYFU; 1.68 (1.50–1.85)/100 000 PYFU after standardization. Heterogeneity was identified in ALS standardized incidence between North Europe [1.89 (1.46–2.32)/100 000 PYFU] and East Asia [0.83 (0.42–1.24)/100 000 PYFU, China and Japan <span style="font-style:italic;">P</span> = 0.001] or South Asia [0.73 (0.58–0.89)/100 000/PYFU Iran, <span style="font-style:italic;">P</span> = 0.02]. Conversely, homogeneous rates have been reported in populations from Europe, North America and New Zealand [pooled ALS standardized incidence of 1.81 (1.66-1.97)/100 000 PYFU for those areas].<strong>Conclusion:</strong> This review confirms a heterogeneous distribution worldwide of ALS, and sets the scene to sustain a collaborative study involving a wide international consortium to investigate the link between ancestry, environment and ALS incidence.</span>
      PubDate: 2016-05-13
  • Does an elite education benefit health' Findings from the 1970 British
           Cohort Study
    • Authors: Bann D; Hamer M, Parsons S, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> Attending private school or a higher-status university is thought to benefit future earnings and occupational opportunities. We examined whether these measures were beneficially related to health and selected health-related behaviours in midlife.<strong>Methods:</strong> Data were from up to 9799 participants from the 1970 British birth Cohort Study. The high school attended (private, grammar or state) was ascertained at 16 years, and the university attended reported at 42 years [categorised as either higher (Russell Group) or normal-status institutions]. Self-reported health, limiting illness and body mass index (BMI) were reported at 42 years, along with television viewing, take-away meal consumption, physical inactivity, smoking and high risk alcohol drinking. Associations were examined using multiple regression models, adjusted for gender and childhood socioeconomic, health and cognitive measures.<strong>Results:</strong> Private school and higher status university attendance were associated with favourable self-rated health and lower BMI, and beneficially associated with health-related-behaviours. For example, private school attendance was associated with 0.56 [95% confidence interval (CI): 0.48, 0.65] odds of lower self-rated health [odds ratio (OR) for higher-status university: 0.32 (0.27, 0.37)]. Associations were largely attenuated by adjustment for potential confounders, except for those of private schooling and higher-status university attendance with lower BMI and television viewing, and less frequent take-away meal consumption.<strong>Conclusions:</strong> Private school and higher-status university attendance were related to better self-rated health, lower BMI and multiple favourable health behaviours in midlife. Findings suggest that type or status of education may be an important under-researched construct to consider when documenting and understanding socioeconomic inequalities in health.</span>
      PubDate: 2016-05-10
  • Elevated outdoor temperatures and risk of stillbirth
    • Authors: Auger N; Fraser W, Smargiassi A, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> The causes of stillbirth are poorly understood, including whether elevated outdoor temperatures increase risk. We assessed the relationship between elevated ambient temperatures and risk of stillbirth by gestational age and cause of death during warm months in a temperate region.<strong>Methods:</strong> We performed a case-crossover study of 5047 stillbirths in continental Quebec, Canada, between the months of April through September from 1981 to 2011. Using data on maximum daily temperatures adjusted for relative humidity, we estimated associations with stillbirth, comparing temperatures before fetal death with temperatures on adjacent days. The main outcomes were stillbirth according to age of gestation (term, preterm), and cause of death (undetermined, maternal, placenta/cord/membranes, birth asphyxia, congenital anomaly, other).<strong>Results:</strong> Elevated outdoor temperatures the week before the death were more strongly associated with risk of term than preterm stillbirth. Odds of term stillbirth for temperature 28 °C the day before death were 1.16 times greater relative to 20 °C (95% confidence interval, CI 1.02-1.33). Elevated outdoor temperature was associated with stillbirth due to undetermined and maternal causes, but not other causes. Compared with 20 °C, the odds of stillbirth at 28 °C were 1.19 times greater for undetermined causes (95% CI 1.02-1.40) and 1.46 times greater for maternal complications (95% CI 1.03-2.07).<strong>Conclusions:</strong> Elevated outdoor temperatures may be a risk factor for term stillbirth, including stillbirth due to undetermined causes or maternal complications.</span>
      PubDate: 2016-05-07
  • Does childhood trauma influence offspring’s birth
    • Authors: Vågerö D; Rajaleid K.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background</strong>: A recent epigenetic hypothesis postulates that ‘a sex-specific male-line transgenerational effect exists in humans’, which can be triggered by childhood trauma during ‘the slow growth period’ just before puberty. The evidence is based on a few rather small epidemiological studies. We examine what response childhood trauma predicts, if any, in the birth size and prematurity risk of almost 800 000 offspring.<strong>Methods:</strong> Children of parity 1, 2 or 3, born 1976-2002 in Sweden, for whom we could trace both parents and all four grandparents, constituted generation 3 (G3, <span style="font-style:italic;">n</span> = 764 569). Around 5% of their parents, G2, suffered parental (G1) death during their own childhood. The association of such trauma in G2 with G3 prematurity and birthweight was analysed, while controlling for confounders in G1 and G2. We examined whether the slow growth period was extra sensitive to parental loss.<strong>Results:</strong> Parental (G1) death during (G2) childhood predicts premature birth and lower birthweight in the offspring generation (G3). This response is dependent on G2 gender, G2 age at exposure and G3 parity, but not G3 gender.<strong>Conclusions:</strong> The results are compatible with the Pembrey-Bygren hypothesis that trauma exposure during boys’ slow growth period may trigger a transgenerational response; age at trauma exposure among girls seems less important, suggesting a different set of pathways for any transgenerational response. Finally, parental death during childhood was not important for the reproduction of social inequalities in birthweight and premature birth.</span>
      PubDate: 2016-05-04
  • Cohort Profile: The VicGeneration (VicGen) study: An Australian oral
           health birth cohort
    • Authors: Johnson S; Carpenter L, Amezdroz E, et al.
      PubDate: 2016-05-02
  • Usual blood pressure, atrial fibrillation and vascular risk: evidence from
           4.3 million adults
    • Authors: Emdin C; Anderson S, Salimi-Khorshidi G, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> Although elevated blood pressure is associated with an increased risk of atrial fibrillation (AF), it is unclear if this association varies by individual characteristics. Furthermore, the associations between AF and a range of different vascular events are yet to be reliably quantified.<strong>Methods:</strong> Using linked electronic health records, we examined the time to first diagnosis of AF and time to first diagnosis of nine vascular events in a cohort of 4.3 million adults, aged 30 to 90 years, in the UK.<strong>Results</strong>: A 20-mmHg higher usual systolic blood pressure was associated with a higher risk of AF [hazard ratio (HR) 1.21, 95% confidence interval (CI) 1.19, 1.22]. The strength of the association declined with increasing age, from an HR of 1.91 (CI 1.75, 2.09) at age 30-40 to an HR of 1.01 (CI 0.97, 1.04) at age 80-90 years. AF without antithrombotic use at baseline was associated with a greater risk of any vascular event than AF with antithrombotic usage (<span style="font-style:italic;">P</span> interaction < 0.0001). AF without baseline antithrombotic usage was associated with an increased risk of ischaemic heart disease (HR 2.52, CI 2.23, 2.84), heart failure (HR 3.80, CI 3.50, 4.12), ischaemic stroke (HR 2.72, CI 2.19, 3.38), unspecified stroke (HR 2.59, CI 2.25, 2.99), haemorrhagic stroke, chronic kidney disease, peripheral arterial disease and vascular dementia, but not aortic aneurysm.<strong>Conclusions:</strong> The association between elevated blood pressure and AF attenuates with increasing age. AF without antithrombotic usage is associated with an increased risk of eight vascular events.</span>
      PubDate: 2016-04-28
  • The cohort multiple randomized controlled trial design: a valid and
           efficient alternative to pragmatic trials'
    • Authors: van der Velden J; Verkooijen H, Young-Afat D, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div>Randomized controlled trials (RCTs)—the gold standard for evaluating the effects of medical interventions—are notoriously challenging in terms of logistics, planning and costs. The cohort multiple randomized controlled trial approach is designed to facilitate randomized trials for pragmatic evaluation of (new) interventions and is a promising variation from conventional pragmatic RCTs. In this paper, we evaluate methodological challenges of conducting an RCT within a cohort. We argue that equally valid results can be obtained from trials conducted within cohorts as from pragmatic RCTs. However, whether this design is more efficient compared with conducting a pragmatic RCT depends on the amount and nature of non-compliance in the intervention arm.</span>
      PubDate: 2016-04-25
  • Cohort Profile: Melbourne Atopy Cohort study (MACS)
    • Authors: Lowe A; Lodge C, Allen K, et al.
      PubDate: 2016-04-21
  • Take a Stand!–a multi-component intervention aimed at reducing sitting
           time among office workers–a cluster randomized trial
    • Authors: Danquah I; Kloster S, Holtermann A, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> Prolonged sitting time has been associated with adverse health outcomes. Interventions at work may contribute to reduced sitting. The objective was to test if a multicomponent work-based intervention can reduce sitting time and the number of prolonged sitting periods (> 30 min), increase the number of sit-to-stand transitions and decrease waist circumference and body fat percentage among office workers. Primary outcomes were: change in sitting time, prolonged sitting periods and sit-to-stand transitions at follow-up 1 month later.<strong>Methods:</strong> At four workplaces, 19 offices (317 workers in total) were cluster randomized for intervention or control. The intervention included the appointment of local ambassadors, management support, environmental changes, a lecture and a workshop. Sitting time was measured using an ActiGraph GT3X+ fixed on the thigh. Data were processed using Acti4 software providing data on time spent sitting, standing and doing other activities. Control participants were instructed to behave as usual. Follow-up measurements were obtained after 1 and 3 months.<strong>Results:</strong> At 1 and 3 months, total sitting time was 71 (<span style="font-style:italic;">P</span> < 0.001) and 48 min (<span style="font-style:italic;">P</span> < 0.001) lower per 8-h workday in the intervention group compared with the control group. At 1 month, the number of prolonged sitting periods was lower (-0.79/8-h workday, <span style="font-style:italic;">P</span> < 0.001) and sit-to-stand transitions were higher (+14%/sitting hour, <span style="font-style:italic;">P</span> = 0.001) in the intervention compared with the control group. After 3 months, trends persisted. The body fat percentage was lower by 0.61 percentage points (<span style="font-style:italic;">P</span> = 0.011) in the intervention group compared with the control group after 3 months.<strong>Conclusions:</strong> The multicomponent workplace-based intervention was effective in reducing sitting time, prolonged sitting periods and body fat percentage, and in increasing the number of sit-to-stand transitions.</span>
      PubDate: 2016-04-19
  • The effects of waterpipe tobacco smoking on health outcomes: an updated
           systematic review and meta-analysis
    • Authors: Waziry R; Jawad M, Ballout R, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background and aims:</strong> A systematic review conducted in 2008 found significant associations between waterpipe tobacco smoking and lung cancer, respiratory disease, periodontal disease and low birthweight. Since then, a number of relevant studies have been published. The objective of this study was to update the systematic review on the effects of waterpipe tobacco smoking on health outcomes.<strong>Methods:</strong> In May 2015 we electronically searched the following databases with no date restrictions: MEDLINE, EMBASE and the ISI Web of Science using a detailed search strategy with no language restrictions. We also screened the references' lists of the included studies. We included cohort, case-control and cross-sectional studies, and excluded case reports, conference abstracts, editorials and reviews. We excluded studies not conducted in humans, assessing physiological outcomes, not distinguishing waterpipe tobacco smoking from other forms of smoking or not reporting association measures. We assessed risk of bias for each included study and conducted meta-analyses for each of the outcomes of interest.<strong>Results:</strong> We identified 50 eligible studies. We found that waterpipe tobacco smoking was significantly associated with: respiratory diseases [COPD; odds ratio (OR) = 3.18, 95% confidence interval CI = 1.25, 8.08; bronchitis OR = 2.37, 95% CI = 1.49, 3.77; passive waterpipe smoking and wheeze OR) = 1.97, 95% CI = 1.28, 3.04]; oral cancer OR = 4.17, 95% CI = 2.53, 6.89; lung cancer OR = 2.12, 95% CI = 1.32, 3.42; low birthweight (OR = 2.39, 95% CI = 1.32, 4.32); metabolic syndrome (OR 1.63–1.95, 95% CI = 1.25, 2.45); cardiovascular disease (OR = 1.67, 95% CI = 1.25, 2.24); and mental health (OR 1.30–2.4, 95% CI = 1.20, 2.80). Waterpipe tobacco smoking was not significantly associated with: oesophageal cancer (OR = 4.14, 95% CI = 0.93, 18.46); worse quality of life scores [standardized mean difference (SMD) = −0.16, 95% CI = −0.66, 0.34]; gastric carcinoma (OR = 2.16, 95% CI = 0.72, 6.47); bladder cancer (OR = 1.25, 95% CI = 0.99, 1.57); prostate cancer (OR = 7.00, 95% CI = 0.90, 56.90); hepatitis C infection (OR = 0.98, 95%0.80, 1.21); periodontal disease (OR = 3.00, 5.00); gastro-oesophageal reflux disease (OR = 1.25, 95% CI = 1.01, 1.56); nasopharyngeal carcinoma (OR = 0.49, 95% CI = 0.20, 1.23); bladder cancer (OR = 1.25, 95% CI = 0.99, 1.57); infertility (OR = 2.50, 95% CI = 1.00, 6.30); and mortality (OR = 1.15, 95% CI = 0.93, 1.43).<strong>Conclusions:</strong> There is accumulating evidence about the association of waterpipe tobacco smoking with a growing number of health outcomes.</span>
      PubDate: 2016-04-13
  • Perinatal microbial exposure may influence aortic intima-media thickness
           in early infancy
    • Authors: McCloskey K; Vuillermin P, Carlin J, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> The maternal and infant microbiome may influence infant cardiovascular risk through immune programming. The maternal vagino-enteric microbiome is often sampled for group B streptococcus (GBS) colonization during pregnancy. Our aim was to investigate the association between maternal GBS colonization, intrapartum antibiotics, antenatal pet exposure and infant aortic intima-media thickness (aIMT), an intermediate vascular phenotype, and whether this association varied by mode of delivery.<strong>Methods:</strong> The Barwon Infant Study is a population-derived pre-birth cohort. Perinatal data were collected on participants. Women were tested for vagino-enteric group B streptococcus (GBS) colonization during third trimester. Six-week infant aIMT was measured by trans-abdominal ultrasound. Adjustment for confounders included maternal age, pre-pregnancy body mass index (BMI), smoking, socioeconomic status, gestational diabetes, length of gestation, infant sex, birthweight and aortic internal diameter.<strong>Results:</strong> Data were available on 835 mother-infant pairs. Of these, 574 (69%) women delivered vaginally; of those, 129 (22%) were GBS-colonized; and of these women, 111 (86%) received prophylactic intrapartum antibiotics. An association between maternal GBS colonization and infant aIMT was observed among those delivered vaginally (β = 19.5 µm, 95% CI 9.5, 29.4; <span style="font-style:italic;">P</span> < 0.0001) but not by Caesarean section (<span style="font-style:italic;">P</span> for interaction = 0.02). A similar pattern was seen for intrapartum antibiotics. There was a negative association between antenatal pet exposure and aIMT observed in those delivered vaginally.<strong>Conclusion:</strong> Maternal GBS colonization and intrapartum antibiotics were associated with increased infant aIMT in those delivered vaginally, whereas antenatal pet exposure was associated with decreased aIMT. These data suggest that differences in early life microbial experience may contribute to an increased cardiovascular risk.</span>
      PubDate: 2016-04-07
  • Systematic correlation of environmental exposure and physiological and
           self-reported behaviour factors with leukocyte telomere length
    • Authors: Patel C; Manrai A, Corona E, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> It is hypothesized that environmental exposures and behaviour influence telomere length, an indicator of cellular ageing. We systematically associated 461 indicators of environmental exposures, physiology and self-reported behaviour with telomere length in data from the US National Health and Nutrition Examination Survey (NHANES) in 1999–2002. Further, we tested whether factors identified in the NHANES participants are also correlated with gene expression of telomere length modifying genes.<strong>Methods:</strong> We correlated 461 environmental exposures, behaviours and clinical variables with telomere length, using survey-weighted linear regression, adjusting for sex, age, age squared, race/ethnicity, poverty level, education and born outside the USA, and estimated the false discovery rate to adjust for multiple hypotheses. We conducted a secondary analysis to investigate the correlation between identified environmental variables and gene expression levels of telomere-associated genes in publicly available gene expression samples.<strong>Results:</strong> After correlating 461 variables with telomere length, we found 22 variables significantly associated with telomere length after adjustment for multiple hypotheses. Of these varaibales, 14 were associated with longer telomeres, including biomarkers of polychlorinated biphenyls([PCBs; 0.1 to 0.2 standard deviation (SD) increase for 1 SD increase in PCB level, <span style="font-style:italic;">P</span> < 0.002] and a form of vitamin A, retinyl stearate. Eight variables associated with shorter telomeres, including biomarkers of cadmium, C-reactive protein and lack of physical activity. We could not conclude that PCBs are correlated with gene expression of telomere-associated genes.<strong>Conclusions:</strong> Both environmental exposures and chronic disease-related risk factors may play a role in telomere length. Our secondary analysis found no evidence of association between PCBs/smoking and gene expression of telomere-associated genes. All correlations between exposures, behaviours and clinical factors and changes in telomere length will require further investigation regarding biological influence of exposure.</span>
      PubDate: 2016-04-07
  • Cohort Profile: The Wenchuan Earthquake Adolescent Health Cohort Study
    • Authors: Fan F; Zhou Y, Mo L, et al.
      PubDate: 2016-04-04
  • Cohort Profile: The Health Outcomes and Measures of the Environment (HOME)
    • Authors: Braun J; Kalloo G, Chen A, et al.
      PubDate: 2016-03-22
  • Leisure-time physical inactivity and association with body mass index: a
           Finnish Twin Study with a 35-year follow-up
    • Authors: Piirtola M; Kaprio J, Waller K, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> We investigated the stability and change of leisure-time physical inactivity in adult men and women during a 35-year follow-up. We also analysed the impact of long-term physical inactivity on the development of body mass index (BMI).<strong>Methods</strong>: In this population-based cohort study, 5254 Finnish twin individuals (59% women) participated in four surveys in 1975, 1981, 1990 and 2011. Mean age at baseline was 23.9 years. Individual long-term leisure-time physical activity (LTPA) was categorized into seven classes varying from ‘persistently inactive’ to ‘persistently active’. We used the multivariate multilevel mixed-effects linear regression model and paired-sample t-test in the analyses. Co-twin control design was used for examining within-pair associations.<strong>Results</strong>: Of men 11%, and of women 8%, were persistently inactive. Among both sexes, the mean BMI slope trajectories were steeper among the persistently inactive and those who became inactive than among those who were persistently active. Overall, the inactive participants gained 1.4 kg/m<sup>2</sup> [95% confidence interval (CI) 1.2 to 1.7] more in weight than did the active participants from 1975 to 2011. Among twin pairs discordant for LTPA, the corresponding difference was 1.4 kg/m<sup>2</sup> (95% CI 0.83 to 2.0) in dizygotic pairs and 0.68 kg/m<sup>2</sup> (95% CI 0.05 to1.3) in monozygotic pairs.<strong>Conclusions:</strong> Over a 35-year time span from young adulthood, persistently inactive participants and those who had become inactive had greater weight increases than those who were persistently active. This association was also found in twin-pair analyses, although attenuated in monozygotic pairs. This may support the importance of LTPA in weight management, although further causal inference is required.</span>
      PubDate: 2016-03-12
  • Nut consumption and total and cause-specific mortality: results from the
           Golestan Cohort Study
    • Authors: Eslamparast T; Sharafkhah M, Poustchi H, et al.
      Abstract: <span class="paragraphSection"><div class="boxTitle"> </div><strong>Background:</strong> A number of prospective studies have observed inverse associations between nut consumption and chronic diseases. However, these studies have predominantly been conducted in Western countries, where nut consumption tends to be more common among individuals with healthier lifestyles. It is important to examine the association in other parts of the world, and particularly among populations with different patterns of disease, socioeconomic status, lifestyles and disease risk factors. Our objective was to examine the association between nut consumption and mortality in a population whose nut consumption does not track with a healthy lifestyle.<strong>Methods:</strong> We examined the association between nut consumption and all-cause and cause-specific mortality in the 50 045 participants of the Golestan Cohort Study. Participants were aged 40 and older at baseline in 2004, and have been actively followed since that time. Dietary data were collected using a validated semi-quantitative food frequency questionnaire that was administered at baseline.<strong>Results:</strong> During 349 677 person-years of follow-up, 3981 cohort participants died, including 1732 women and 2249 men. Nut consumption was associated inversely with all-cause mortality. The pooled multivariate adjusted hazard ratios for death among participants who ate nuts, as compared with those who did not, were 0.89 [95% confidence interval (CI), 0.82-0.95] for the consumption of less than one serving of nuts per week, 0.75 (95% CI, 0.67-0.85) for one to less than three servings per week and 0.71 (95% CI, 0.58-0.86) for three or more servings per week (<span style="font-style:italic;">P</span> < 0.001 for trend). Among specific causes, significant inverse associations were observed between nut consumption and deaths due to cardiovascular disease, all cancers and gastrointestinal cancers.<strong>Conclusions:</strong> This study provides evidence for an inverse association between nut consumption and mortality in a developing country, where nut consumption does not track with a healthy lifestyle. Further work is needed to establish the underlying mechanisms responsible for this association.</span>
      PubDate: 2016-02-14
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