Epidemiology and Public Health

Epidemiology and Public Health

  • Where we can get a current epidemiological status of obesity and insulin resistance?
    Is there any specific site for current epidemiological status?
  • Avi Biswas added an answer:
    Do you know what the recommendation is for physical activity and sedentary behavior to health?
    We know that there are many determinants and barriers to physical activity. Among them are the extrinsic factors such as environmental, socioeconomics, and sociopolitical as intrinsic motivation, self-perception, self-efficacy and level of knowledge.
    My questions are: Are people becoming inactive due to lack of knowledge of practical recommendations for physical activity, as well as the volume and intensity to achieve health benefits? Would an intervention program based on the recommendations of health would increase levels of physical activity?
    Avi Biswas · University of Toronto

    Inactivity and sedentary behaviour are totally different constructs. One (Inactivity) is the failure to be physically active and the prevailing behavioural literature suggests that this has more to do with intention - ie. if your intend to be active, this is is usually a strong motivator to do that behaviour. You can read up more on the theories articulating this Transtheoretical model and the Social Cognitive Theory.

    Sedentary behaviour, it has been argued, relies more on habit than intention and has different behavioural constructs - as such, needs to be targeted differently in terms of interventions. 

    A great discussion paper summarizing the different between the two and the theories that define them is by Dr. Stuart Biddle: http://sporttudomany.hu/Hirlevel/pdf/10/Fit_or_Sit.pdf

  • M. Ricky Ramadhian added an answer:
    Can we use mean+/-standard error instead of mean+/-standard deviation when data is non-parametric?
    I measured cytokines through ELISA in humans, but my values were very skewed since I got huge standard deviation which was nearly 2 fold larger than my mean value.
    Shall I use mean+/-standard error instead of mean+/-standard deviation when data is non-parametric?
    M. Ricky Ramadhian · Lampung University

    how about this data if we have data like this?

  • Greger Lindberg added an answer:
    What impact will labeling obesity as a disease have on primary prevention of childhood obesity?
    The American Medical Association has now joined other organizations in deeming obesity a disease (not just a condition or syndrome). There is hand-wringing about proliferation of pharmaceuticals, surgery, and other medical treatments. What about prevention, and specifically, primary prevention for children? Is there applicable evidence for other diseases to inform us of what to expect for prevention and public health efforts around childhood obesity?
    Greger Lindberg · Karolinska Institutet

    Weight essentially reflects energy intake minus energy expenditure. I think it is wrong to focus on energy intake. We should direct our attention to energy expenditure. A sedentary lifestyle in itself is a strong risk factor for disease and also for obesity. Concentrating on energy intake is rather useless if we do nothing to increase energy expenditure. The latter is probably also much easier to change whereas changing energy intake has at best a short-term but marginal effect on weight.

  • Masimalai Palaniyandi added an answer:
    What is the forward elimination method, SPSS- forward selection or backward elimination?

    Data was analysed by SPSS software and the authors mentioned that in the multivariate logistic regression analysis they used forward elimination method

    Masimalai Palaniyandi · Vector Control Research Centre, Pondicherry, India

    Dear friend Yan Chen,

    The both backward and frontward selection or removal methods are used to find the influence of potential confounders (independent variables) and statistical significance on the dependant variables. it is built in or with in Linear Multivariate regression model to see the stepwise regression analysis to see the influence of single variable and multiple variables and also compound variables or factors.


  • Javad Amani added an answer:
    How we can find the Cut off score of the Scale tool?
    Suppose I have a Questionnaire for a Stress assessment that contains 30 questions, each question has 5 answers (0- no stress, 1-mild stress, 2- moderate , 3-High stress, 4- Severe stress). The Total score of the 30 question varies from 0 - 120.

    How we can categories the Total score (the range of total score is 0-120) into mild , moderate and severe? Which cut off s should l take for mild, moderate and severe?
    Javad Amani · University of Tabriz

    for likert scale 1 to 2.33 (low), 2.34 to 3.67 (moderate), 3.67 to 5 (high). to do this you should change scoring of your scale from 1 to 5 for each item. then compute the mean of your scale (not sum) and use above method to cut off

  • Ramanathan Krishnan added an answer:
    As a reviewer of a journal, what can/should you do when the author(s) submitted their manuscript simultaneously to two or more journals?
    Yesterday, I comprehensively reviewed a manuscript for a journal. The review took more than 10 hours of my time and I tried to do my best with more than 43 comments. Unfortunately, today I checked the authors' names and noticed that the manuscript has been recently published (with many faults) in another journal. I am EXTREMELY UPSET that these authors submitted their manuscript simultaneously to (at least) two journals. What did/would you do if you were in my shoes?
    Ramanathan Krishnan · French National Centre for Scientific Research

    This is a difficult situation and the answer is not simple. A s one would  qualify this a"much might be siad on bothe sides".

    Since I am a retired person I can speak my mind without any bias. young researchers are assessed by their publications, often by numbers and also by the journals. some journals take more than 6 months even to reply. Their problem is that the referees take time, and or proper referee could noe be found easily. whatever it be the young researcher would lose a year before his paper sees the day light. He gets panicky and  sends his paper to another journal.. I do not sya that I approve of this tactics but i understand. In my active ays I have ben refereeing papers and i know the difficulty involed. you feel vexed that you consider a paper and unfit but another journal publishe dit. So as some others also have expressed it is all in the game. As long as the paper is a copy or contains incoorect information one could tolerate this. further some jourals ared yong to get papers for their journal and they would gladly publsiha a paper without much caring for the quality. So this situation is not new and it existed 40 years ago too. then the choice was limited but now with mushrroming of categories and journals things get complex.

  • Sultan Salah added an answer:
    What type of statistical analysis should be done in a survey study ?
    In a survey done in a large population like about 5000 subjects, how to analyze the results statistically ?

    Input from the statistician will be of immense help in the conduct of the study and will also help in publication of the study in the reputed journal, nowadays there are various ready made software available in the  market . SPSS is widely used in the statistical analysis and accepted by many reputed journals.

  • Jeffrey E. Jarrett added an answer:
    What is the minimum sample size, regardless of total number of population, that can be considered as reliable for performing advanced statistical tests?
    I have 32 patients with tuberculous meningitis, if I determined the sensitivity and specificity of cerebrospinal fluid adenosine deaminase and I got significant results, does it mean the result can be generalized? Can I determine the predictors of mortality from this sample?
    Jeffrey E. Jarrett · University of Rhode Island

    Minimum or optimum sample size is related to your risk of incurring  Type ! and Type 2  errors, the assumed standard deviation of the population and the tolerance level. Read a book of statistics of sampling and you will never ask this question again. The issue was solved many years ago.

  • Muhammad Javed added an answer:
    What is being done in your country with the current increase in dengue infection?
    In my country, dengue cases have increased from around 18000+ in 2012, to 28000+ this year. Deaths due to this viral disease has also increased from 21 to more than 60 this year. How about in your country?
    Muhammad Javed · Hamdard University

    Provincial Governments are actively in mass education of community by media  and on improvement of personal health  due to this companion,  and effective fumigation has resulted in decline of dengue fever this year 

  • Sally Hodges added an answer:
    Are there softwares to manage clinical data?
    I would like to have a software to manage large amounts of clinical data.
  • Kuldeep Dhama added an answer:
    Do Religion and Prayer Benefit Health?
    I need evidence-based medicine or research to back up these statements if someone can cite where the evidence can be found it will be very helpful and greatly appreciated.
    Kuldeep Dhama · Indian Veterinary Research Institute

    Religion and prayers are believed by many and most population of world, accepted by majority, and many beliefs and examples certify their beneficial effects on well being and health

  • Amarnath Trivedi added an answer:
    Can anyone suggest a topic on mental illness among the elderly for my Pg thesis?
    I have a plan to do thesis for my public health master's degree on dementia among elderly people in South India. Please suggest a topic which is of public health importance.
    Amarnath Trivedi · Christian Medical College Vellore

    thank you for the suggestions

  • Annette Anderson added an answer:
    Has anyone seen additional cases of invasive Neisseria macacae disease in humans?
    We treated a child with Neisseria macacae bacteraemia. In the literature I can not find any other published cases. Does anyone recall - from their own clinical practice - similar cases?
    Annette Anderson · Universitätsklinikum Freiburg

    Dear Dr. Schouten; we might have found N. macacae in an oral sample from a Sudanese study participant. But it has only been identified by 16S rDNA sequencing and the 16S sequences of N. macacae,  N. mucosa and N. sicca seem very related. The test person was healthy, so the only conclusion you might draw from this is, that N. macacae might have been part of his oral microbial flora.

    Kind regards,

    A. Anderson

  • Elena Kulikalova added an answer:
    What are your reservations with using GIS for health purposes?
    As it turns, GIS is fast gaining ground with more applications every year. The GIS-health nexus has always been a special one, especially with regard to communicable diseases. As technology drives many facets of health care and research, is the use of GIS still lagging behind? I aim to understand why!
    Elena Kulikalova · Irkutsk Antiplague Research Institute of Siberia and the Far East

    GIS is used not still enough and cause of it is a technical complexity of the product, and lack of IT competence in medical researchers knowledge (there is no information how to use GIS). I think, GIS is not only visualization tool, but also is a possibility for analysis like spatial-temporal spreading and density occurrence of infection disease etc. Researcher can try to use soft EpiInfo 7.0 of Centers for Disease Control and Prevention. 

  • Victor Maduabuchi Oguoma added an answer:
    Waist Circumference cut point for sub-Saharan Africans?

    What are the best ways to develop the Waist Circumference cut point for sub-Saharan Africans? I understand that the current clinical definition of obesity for sub-Saharan Africa according to the IDF is by using the European Waist Circumference cut point.

    Victor Maduabuchi Oguoma · Charles Darwin University

    Hi Sean,

    Thanks heaps for your detailed response and suggestion.



  • Jolanta Walusiak-Skorupa added an answer:
    Any good journal for occupational health?
    I am planning to submit a short paper on asbestosis. Is there A good journal on occupational health and diseases that is probably indexed with an impact factor?
    Jolanta Walusiak-Skorupa · Nofer Institute of Occupational Medicine

    International Journal of Occupational Medicine and Environmental Health


  • Rafael Maria Roman added an answer:
    What is the use of reporting the exact p value in a research paper? Is it necessary?
    If it mentioned in the Material and Methods p<0.05 or p<0.01 then is it stupidity to report the exact p values in the tables or does it have any relevance? If it is not significant then what does it matter if it is changed to 0.2 or 0.3 or 0.5 or 0.9 or 0.99?
    Rafael Maria Roman · University of Zulia

    In hypothesis testing, you have two choises, based on the value of alpha or probability of type I error:
    a) Strongly reject the null hypothesis.
    b) You have no evidence to reject the null hypothesis.

    The decision to accept the null hypothesis can only be considered after calculating the probability of the type II error, also called beta.

    Alpha alpha = 0.05 or 0.01; were established for convenience, the current trend is to report the exact value of p in which there are significant differences. This is a never ending point. I think, that the logical interpretation depends on the understanding, based on the evidence of the and practical implications of your decision.

  • Tim Sly added an answer:
    What is the difference between written and verbal consent? Which type of study should it be used in?
    Most journals are very particular about written consent. But is it necessary to take written consent in the descriptive studies? Sharing your knowledge and vision about this question will not only help me but also help other researchers.
    Tim Sly · Ryerson University

    It is useful to remind ourselves that in the subject of "informed consent", while the noun is the target, the adjective is often forgotten or given far attention than it deserves.  Written 'consent' may have been given - a scribbled signature obtained - but if under extreme stress, pain, or exhaustion, for instance, can the candidate be considered truly "informed"?  And exactly WHAT was the candidate actually informed about? The actual probability of success/fatality? Or just the opinion of the surgeon that this was the best course of action under the circumstances?     

  • Lekha Pandit added an answer:
    Does anybody use metaxantrone for treatment of multiple sclerosis?
    Lekha Pandit · Nitte University

    Mitoxantrone has a limited role in the treatment of MS in the current scenario.  Apart from the short period that it can be administered, treatment induced leukemia ( even as far as > 5 yrs after treatment) and cardiac toxicity are reasons for not preferring this drug. However in aggressive MS  that has not responded to first line therapy ( for eg. while compliant on Betainterferon , patient develops > 2 severe clinical relapses /yr or has increasing T2 W lesion load or > 2 GAD enhancing lesions) , then there is a limited role for Mitoxantrone to INDUCE Remission , to be followed later by a less toxic first line drug. 

  • Judith N Waudo added an answer:
    Which new technologies are most useful in assessing population dietary intakes?
    Traditional paper-based methods for assessing diet are difficult for people to complete, tend to encourage under-reporting and are expensive to analyse. New technologies, such as web-based or phone-based methods are being developed and look promising. At Leeds University, we are undertaking a review of new technologies to assess diet, and would be interested to hear from any researchers that have methods in development, that are Beta versions, or prototypes that may not be in the scientific literature at present.
    Judith N Waudo · Kenyatta University

    What l have worked on in terms of dietary assessment of a population is to use the 24 hr recall  with standardized household measures for different population groups and supplement this with electronic food photos. The use of dietary diversity score has also been useful and simplier.

  • Can anyone recommend an ebook or paper which provides a guide on how to do meta analysis of epidemiological studies?
    I want to know how meta-analysis of an epidemiological studies are carried out what are steps any book or website which explain ABC of meta analysis or explain it in basic steps.
    Yohannes Woubishet Woldeamanuel · Stanford Medicine

    Hope this paper helps, we have addressed the most important aspects exhaustively. Please feel free to ask if there are areas you wish further clarification. 

    p.s. please consider clicking the green arrow if you find this information helpful. Thanks :)

  • Sheriff Muideen added an answer:
    What is survival analysis? And what are the statistical methods to estimate survival time from data?
    I am conducting a descriptive study on patients with liver transplantation. My mentor asks me to do survival analysis. What is survival analysis? And what are the statistical methods to estimate survival time from data?
    Sheriff Muideen · Walden University

    Survival analysis is generally described as a set of methods employed for analyzing data where the outcome variable is the time until the occurrence of an event of interest. The event cab be death, occurrence of disease, marriage, divorce, etc. In survival analysis, subjects are usually followed over a specific time period, and the focus is on the time (t) at which the event of interest occurs. Various methods used in survival analysis includes: The Kaplan- Meier method, Log-Rank test, Life table method, Cox Model etc. The link bellow may provide you with further insight on the scope of the discuss...hope this helps?  

  • Mingji Zhang added an answer:
    Can anyone recommend a critical appraisal tool for assessing the quality of an observational study?
    NB. I would like to know about the quality of the study rather than how well it was reported (e.g. according to the STROBE checklist).
    Mingji Zhang · Fudan University
    this is a adapted critical appraisal tool for a survey (cross sectional study), by www.cebma.org
  • Eva Hamilton added an answer:
    Is the medical cake properly divided?
    Currently specialization divides medical disciplines into sectors, much like slices of a cake. The results are that (i) patients with multiple morbidities are shunted from one doctor to another to another etc., (ii) it is impossible to have all the necessary specialists in one place unless that place is sufficiently large (and wealthy), (iii) emergency cover is unsustainable in all areas unless certain specialists double for others, (iv) the inevitable consequence is that a specialists, even if perfectly trained and competent, cannot deal with a patient with a malady accorded to a different specialty than his own, (v) specialists leave the simpler aspects of their field to their juniors, as they prefer to deal with the complex, "more interesting" issues (except in private practice). (vi) the system is more and more expensive to run, (vii) specialization leads to further "super-specialization" and further fragmentation of medicine, (viii) the model is exported to LMICs with catastrophic results as they cannot afford nor accommodate such a system, (ix) inevitably medical schools will be pushed to limit training of their students pertaining to their final specialty destination, (x) the specialties are themselves not defined and "turf wars" are created in bordering areas of practice, both in terms of departmental control and patient care.
    There is no proper definition of the generalist, neither in medicine nor surgery. Yet, on the shoulders of this dying breed rests the burden of most "ordinary" patients' treatment worldwide.
    Where therefore are we going? Is it not time to define the "Generalist" as a "Specialist" in his own right, and let him deal with the central part of the cake, leaving the periphery to be divided by the particulate specialists?
    After all, everyone knows that the cherry is usually in the middle of the cake.
    Eva Hamilton · Bournemouth University
    Michael, your question reminds of Ernest Hemingway's (1898-1961) quote:

    "I have noticed that doctors who fail in the practice of medicine have a tendency to seek one another's company and aid in consultation. A doctor who cannot take out your appendix properly will recommend you to a doctor who will be unable to remove your tonsils with success"

  • Rohit P Ojha added an answer:
    What are the text books that you recommend to use in teaching epidemiology in post graduate programs?
    Please keep suggestions to books written in English language.
    Rohit P Ojha · St. Jude Children's Research Hospital
    Similar to a few other respondents, I support the use of "Modern Epidemiology" by Rothman, Greenland, and Lash for doctoral students. In addition, I suggest "Interpreting Epidemiologic Evidence: Strategies for Study Design and Analysis" by Savitz as a standard textbook for graduate and doctoral students.
  • Ana-Maria Ciobotaru added an answer:
    Hello everyone...
    Good to see like minded people on the board discussing public health. I belong to a developing country where public health training is in a nascent stage. So, I keep looking for online courses where I can upgrade my skills. I came across one such course by John Hopkins, which I would like to share with the group. The link is http://globaltobaccocontrol.org/. You can register for the course free of cost and the content is quite good. It would be particularly useful to the guys dealing with dental public health. If anyone knows other good online courses, kindly let me know....
    Ana-Maria Ciobotaru · University of Bucharest
    hy, on this link https://iversity.org/ also are some free courses.
  • Saban Tekin added an answer:
    What is being done in your country concerning compartmentalization of health science studies; to control diseases that involve human and animal hosts?
    The study of health sciences is often compartmentalized: human diseases, live-stock diseases, wild animal diseases. Some of us grew up thinking that doctors were responsible for human health, and vets for animal health.
    But for the past decade, we have had severe diseases that involve both human and animal hosts. In Malaysia, we had the fear of H1N1 or swine flu.
    What is being done in your country or institution concerning this compartmentalization of health science studies? What innovative collaborations are being put in place to control diseases that involve human and animal hosts?
    Saban Tekin · TUBITAK Marmara Research Center
    Yes indeed the study of health sciences is generally compartmentalized in Turkey as you mention. However, stuation is changing that basic life scientist doing interesting an very important studies in health sciences. In addition, colloboration between scientists in health science and life sciences will limit compartmentalisation. In this way the biology of human and animals are well understood to solve problem in health sicences.
    If national and international regulatory and grant organisations promote or force the colloboration of scientists in health and life sciences, this problem will disappear and we will find or reach better solutions of problems sooner than today in health sciences.

About Epidemiology and Public Health

Identifying patterns of health and disease among populations.

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