• Title/Summary/Keyword: epidemiology

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CLINICAL AND POPULATION EPIDEMIOLOGY: BEYOND SIBLING RIVALRY?

  • Naylor C. David;Basinski Antoni;Abrams Howard B.;Detsky Allan S.
    • 대한예방의학회:학술대회논문집
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    • 1994.02b
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    • pp.7-11
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    • 1994
  • Twenty years ago, the American Journal of Epidemiology published David Sackett's brief description of. clinical epidemiology and its practitioners [1]. This commentary was a useful focal point for an emerging discipline. By 1983, with clinical epidemiology already thriving in many academic medical centres, Walter Holland called into question both the term, 'clinical epidemiology', and the nature of the discipline [2]. More recently, clinical epidemiology has drawn strong criticism from John Last, a noted academician whose contributions include the editorship of the Maxcy-Rosenau Textbook of Public Health. Writing in the Journal of Public Health Policy in 1988 [3], Last referred to the 'uncritical enthusiasm' for clinical epidemiology in medical schools as 'a danger to health', and staked. a claim to the term 'epidemiology' as appropriate only to the description of what classical or population epidemiologists do. Faced with such views, practitioners and proponents of clinical epidemiology can respond in three ways. They can ignore the criticism, and go on about their business. They can reaffirm their differences and resort to defensive rhetoric. Or, the critique can become an opportunity for reflection about the nature of clinical epidemiology and its relations with sister disciplines in modem medical schools. The latter course is followed here by four physicians who-despite diverse backgrounds and interests-all consider their work to be in the field of clinical epidemiology.

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Perspectives of Preventive Medicine: Focused on Epidemiology (예방의학의 발전방향: 역학분야)

  • Choi, Jin-Su
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.3
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    • pp.190-194
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    • 2006
  • Epidemiology is the key element of public health and preventive medicine. Reversely, public health and social equity are the basic ground for epidemiologists. Current progress in the various fields of epidemiologic study in Korea calls for the increased participation of the trained epidemiologists. Expanding epidemiologic concepts to the wide spectrum of health and medical programs, active participation to the diversified health service fields and strengthening the role of epidemiology in the social and political decision making should be included in the perspectives of epidemiology in Korea. The future of epidemiology is certainly depend on the efforts of present epidemologists.

Differentiated Thyroid Carcinoma Risk Factors in French Polynesia

  • Xhaard, Constance;Ren, Yan;Clero, Enora;Maillard, Stephane;Brindel, Pauline;Rachedi, Frederique;Boissin, Jean-Louis;Sebbag, Joseph;Shan, Larrys;Bost-Bezeaud, Frederique;Petitdidier, Patrick;Drozdovitch, Vladimir;Doyon, Francoise;Rubino, Carole;de Vathaire, Florent
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2675-2680
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    • 2014
  • Background: To investigate differentiated thyroid cancer risk factors in natives of French Polynesia is of interest because of the very high incidence of this cancer in the archipelago. Materials and Methods: To assess the role of various potential risk factors of thyroid cancer in the natives of French Polynesia we performed a case-control study. The study included almost all the French Polynesians diagnosed with differentiated thyroid carcinoma between 1981 and 2003 (n=229) and 373 French Polynesian control individuals from the general population without cancer. Results: Thyroid radiation dose received from nuclear fallout before the age of 15, a personal history of neck or/and head medical irradiation, obesity, tallness, large number of children, an artificial menopause, a familial history of thyroid cancer, a low dietary iodine intake, and having a spring as the main source of drinking water were found to be significant risk factors. No roles of smoking habits, alcohol consumption, iodine containing drugs, and exposure to pesticides were evidenced. Conclusions: Except for smoking, differentiated thyroid carcinoma risk factors in natives of French Polynesia are similar to those in other populations. Our finding on the role of having a spring as a drinking water origin is coherent with some other studies and could be due to geological factors.

Lack of Association between Fingernail Selenium and Thyroid Cancer Risk: A Case-Control Study in French Polynesia

  • Ren, Yan;Kitahara, Cari Meinhold;de Gonzalez, Amy Berrington;Clero, Enora;Brindel, Pauline;Maillard, Stephane;Cote, Suzanne;Dewailly, Eric;Rachedi, Frederique;Boissin, Jean-Louis;Sebbag, Joseph;Shan, Larrys;Bost-Bezeaud, Frederique;Petitdidier, Patrick;Xhaard, Constance;Rubino, Carole;de Vathaire, Florent
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5187-5194
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    • 2014
  • Background: Numerous studies have suggested that selenium deficiency may be associated with an increased risk for several types of cancer, but few have focused on thyroid cancer. Materials and Methods: We examined the association between post-diagnostic fingernail selenium levels and differentiated thyroid cancer risk in a French Polynesian matched case-control study. Conditional logistic regression models were used to estimate odds ratios and 95% confidence intervals. Results: The median selenium concentration among controls was $0.76{\mu}g/g$. Significantly, we found no association between fingernail selenium levels and thyroid cancer risk after conditioning on year of birth and sex and additionally adjusting for date of birth (highest versus lowest quartile: odds-ratio=1.12, 95% confidence interval: 0.66-1.90; p-trend=0.30). After additional adjustment for other covariates, this association remained non-significant (p-trend=0.60). When restricting the analysis to thyroid cancer of 10 mm or more, selenium in nails was non-significantly positively linked to thyroid cancer risk (p-trend=0.09). Although no significant interaction was evidenced between iodine in nails and selenium in nails effect (p=0.70), a non-significant (p-trend =0.10) positive association between selenium and thyroid cancer risk was seen in patients with less than 3 ppm of iodine in nails. The highest fingernail selenium concentration in French Polynesia was in the Marquises Islands ($M=0.87{\mu}g/g$) and in the Tuamotu-Gambier Archipelago ($M=0.86{\mu}g/g$). Conclusions: Our results do not support, among individuals with sufficient levels of selenium, that greater long-term exposure to selenium may reduce thyroid cancer risk. Because these findings are based on post-diagnostic measures, studies with prediagnostic selenium are needed for corroboration.

Epidemiology and Social Epidemiology (역학과 사회역학)

  • Song, Yun-Mi
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.3
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    • pp.237-240
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    • 2005
  • Social epidemiology is a sub-discipline of epidemiology explicitly investigating social determinants of population distributions of health, disease, and well-being. Persistent pattern of social inequalities in health in spite of the broad improvement in the physical environment over the last centuries necessitated the development of this field as an approach to understand disease etiology that incorporates social experiences as more direct determinant of health. Social epidemiology incorporates theories, measurement tools, and techniques from a wide variety of other social sciences. A population perspective, the social context of behavior, contextual multilevel analysis, a developmental and life-course perspective, and general susceptibility to disease are the most important guiding concepts in social epidemiology.