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Akron, OH, United States

Lee B.Y.,University of Pittsburgh | Brown S.T.,University of Pittsburgh | Bailey R.R.,University of Pittsburgh | Zimmerman R.K.,University of Pittsburgh | And 9 more authors.
Health Affairs

When influenza vaccines are in short supply, allocating vaccines equitably among different jurisdictions can be challenging. But justice is not the only reason to ensure that poorer counties have the same access to influenza vaccines as do wealthier ones. Using a detailed computer simulation model of the Washington, D.C., metropolitan region, we found that limiting or delaying vaccination of residents of poorer counties could raise the total number of influenza infections and the number of new infections per day at the peak of an epidemic throughout the region-even in the wealthier counties that had received more timely and abundant vaccine access. Among other underlying reasons, poorer counties tend to have high-density populations and more children and other higher-risk people per household, resulting in more interactions and both increased transmission of influenza and greater risk for worse influenza outcomes. Thus, policy makers across the country, in poor and wealthy areas alike, have an incentive to ensure that poorer residents have equal access to vaccines. © 2011 Project HOPE-The People-to-People Health Foundation, Inc. Source

Brasky T.M.,Ohio State University | Rodabough R.J.,Fred Hutchinson Cancer Research Center | Liu J.,Fred Hutchinson Cancer Research Center | Kurta M.L.,Office of Epidemiology and Biostatistics | And 7 more authors.
American Journal of Clinical Nutrition

Background: Inflammation may be important in endometrial cancer development. Long-chain ω-3 (n-3) polyunsaturated fatty acids (LCω-3PUFAs) may reduce inflammation and, therefore, reduce cancer risk. Because body mass is associated with both inflammation and endometrial cancer risk, it may modify the association of fat intake on risk. Objective: We examined whether intakes of LCω-3PUFAs were associated with endometrial cancer risk overall and stratified by body size and histologic subtype. Design: Women were n = 87,360 participants of the Women's Health Initiative Observational Study and Clinical Trials who were aged 50-79 y, had an intact uterus, and completed a baseline foodfrequency questionnaire. After 13 y of follow-up, n = 1253 incident invasive endometrial cancers were identified. Cox regression models were used to estimate HRs and 95% CIs for the association of intakes of individual ω-3 fatty acids and fish with endometrial cancer risk. Results: Intakes of individual LCω-3PUFAs were associated with 15-23% linear reductions in endometrial cancer risk. In women with body mass index (BMI; in kg/m2) <25, those in the upper compared with lowest quintiles of total LCω-3PUFA intake (sum of eicosapentaenoic, docosapentaenoic, and docosahexaenoic acids) had significantly reduced endometrial cancer risk (HR: 0.59; 95% CI: 0.40, 0.82; P-trend = 0.001), whereas there was little evidence of an association in overweight or obese women. The reduction in risk observed in normal-weight women was further specific to type I cancers. Conclusions: Long-chain ω-3 intake was associated with reduced endometrial cancer risk only in normal-weight women. Additional studies that use biomarkers of ω-3 intake are needed to more accurately estimate their effects on endometrial cancer risk. © 2015 American Society for Nutrition. Source

Lee J.,Kent State University | Lee J.,Henan University | Alnasrallah M.,Kent State University | Wong D.,George Mason University | And 4 more authors.
ISPRS International Journal of Geo-Information

The prevalence of obesity has increased dramatically in recent decades. It is an important public health issue as it causes many other chronic health conditions, such as hypertension, cardiovascular diseases, and type II diabetics. Obesity affects life expectancy and even the quality of lives. Eventually, it increases social costs in many ways due to increasing costs of health care and workplace absenteeism. Using the spatial patterns of obesity prevalence as an example; we show how different geographic units can reveal different degrees of detail in results of analysis. We used both census tracts and census block groups as units of geographic analysis. In addition; to reveal how different geographic scales may impact on the analytic results; we applied geographically weighted regression to model the relationships between obesity rates (dependent variable) and three independent variables; including education attainment; unemployment rates; and median family income. Though not including an exhaustive list of explanatory variables; this regression model provides an example for revealing the impacts of geographic scales on analysis of health data. With obesity data based on reported heights and weights on driver's licenses in Summit County, Ohio, we demonstrated that geographically weighted regression reveals varying spatial trends between dependent and independent variables that conventional regression models such as ordinary least squares regression cannot. Most importantly, analyses carried out with different geographic scales do show very different results. With these findings, we suggest that, while possible, smaller geographic units be used to allow better understanding of the studies phenomena. © 2014 by the authors; licensee MDPI, Basel, Switzerland. Source

Torso L.M.,Office of Epidemiology and Biostatistics | Voorhees R.E.,Office of Epidemiology and Biostatistics | Forest S.A.,Office of Epidemiology and Biostatistics | Gordon A.Z.,Office of Epidemiology and Biostatistics | And 9 more authors.
Journal of Food Protection

Escherichia coli O157:H7 is a common cause of foodborne illness in the United States. Beef ground at establishments regulated by the U.S. Department of Agriculture, Food Safety and Inspection Service is routinely tested for E. Coli O157:H7. Prior to December 2013, boxed beef product (wholesale cuts of beef, such as beef loin, packaged into bags and boxed for shipping) was not always tested for this pathogen. Downstream processors or retailers may grind the product; and, if the ground beef is not cooked to the recommended temperature, pathogens on the exterior of the beef introduced to the interior through grinding may survive. On 18 October 2013, the Allegheny County Health Department identified two E. Coli O157:H7 cases, both of whom were food handlers at restaurant A, a restaurant that ground locally produced boxed beef for hamburgers on site. Case finding was conducted through public messaging, employee surveys, and disease surveillance. All potential cases were interviewed using a standard questionnaire. A confirmed case was defined as laboratory-confirmed E. Coli O157:H7 with exposure to restaurant A. A probable case was defined as a patient with compatible symptoms and exposure to restaurant A but without laboratory confirmation. All human and food isolates were characterized by pulsed-field gel electrophoresis and multilocus variable-number tandem repeat analysis. The analysis identified 14 confirmed and 10 probable cases of E. Coli; 18 nonintact ground beef samples tested positive for E. Coli O157:H7. Nine confirmed cases were restaurant A employees. All confirmed cases recalled eating a restaurant A hamburger in the 10 days before illness onset; most cases reported consuming medium to rare hamburgers. Multiple pulsed-field gel electrophoresis and multilocus variable-number tandem repeat analysis patterns were identified among both the human and ground beef isolates, and the patient isolates matched those found in ground beef samples. Restaurant A voluntarily closed for 1.5 days, changed beef suppliers, ceased grinding beef in-house, and has had no new cases since reopening. Source

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