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Structural competency is an emerging paradigm for both the training of health professionals and the creation of a common language addressing structural processes that determine health disparities. However, its application to the field of epidemiological design and research is absent. Based on our previous proposal of a tool for Structural and Intercultural Competency in Epidemiological Studies, the SICES guidelines, in this article we analyse the possibilities and challenges of a 'structural turn' in epidemiology. In terms of possibilities, we recognise the value of paradigms from multiple parts of the world, such as social and sociocultural epidemiology, critical epidemiology and collective health, in facilitating a structural turn in epidemiological studies. In this framework, structural competency would provide a new angle by focusing not only on what to research (e.g. inequalities), but with what skills and attitudes (e.g. cultural and epistemic humility). The challenges lie in the inclusion of reflexivity and a comprehensive view in the context of a positivist epidemiology oriented towards obtaining evidence from a biomedical, but not social, perspective.

This study evaluated the self-perception of adolescents' oral health and their oral conditions and the need for treatment in relation to dental caries. An epidemiological survey was carried out in the municipality of Belém, Pará, Brazil, in 2018. The sample consisted of 200 students, aged 11 to 16 years old, from a full-time public school. The data were collected through a questionnaire where their self-perception of their oral health was assessed and an intra-oral examination was carried out to assess oral health conditions in relation to dental caries, using the Dental Caries Index and need for treatment (ICDNT). The data analysis was based on the Chi-square test, and when the npq <5 restriction occurred, Fisher's exact test was applied. The comparison between quantitative variables was performed using the Student's t test. The average DMFT index was 3.57, with only 17% of the studied population free of caries. The carious component was the one with the greatest significance (3.14) and the need for treatment with the highest prevalence was the restoration of one face (47.5%). A percentage of 88.5% of the adolescents evaluated answered that they did not take a toothbrush to school. The studied sample had a moderate prevalence of caries compared to the parameters recommended by the WHO, but above the standard obtained in the national survey carried out in 2010. Therefore, it is necessary to implement measures aimed at improving the quality of oral health of these adolescents and a full-time system would be a ideal for implementing good habits and routines for the adolescent’s oral health.

This study evaluated the self-perception of adolescents' oral health and their oral conditions and the need for treatment in relation to dental caries. An epidemiological survey was carried out in the municipality of Belém, Pará, Brazil, in 2018. The sample consisted of 200 students, aged 11 to 16 years old, from a full-time public school. The data were collected through a questionnaire where their self-perception of their oral health was assessed and an intra-oral examination was carried out to assess oral health conditions in relation to dental caries, using the Dental Caries Index and need for treatment (ICDNT). The data analysis was based on the Chi-square test, and when the npq <5 restriction occurred, Fisher's exact test was applied. The comparison between quantitative variables was performed using the Student's t test. The average DMFT index was 3.57, with only 17% of the studied population free of caries. The carious component was the one with the greatest significance (3.14) and the need for treatment with the highest prevalence was the restoration of one face (47.5%). A percentage of 88.5% of the adolescents evaluated answered that they did not take a toothbrush to school. The studied sample had a moderate prevalence of caries compared to the parameters recommended by the WHO, but above the standard obtained in the national survey carried out in 2010. Therefore, it is necessary to implement measures aimed at improving the quality of oral health of these adolescents and a full-time system would be a ideal for implementing good habits and routines for the adolescent’s oral health.

This study evaluated the self-perception of adolescents' oral health and their oral conditions and the need for treatment in relation to dental caries. An epidemiological survey was carried out in the municipality of Belém, Pará, Brazil, in 2018. The sample consisted of 200 students, aged 11 to 16 years old, from a full-time public school. The data were collected through a questionnaire where their self-perception of their oral health was assessed and an intra-oral examination was carried out to assess oral health conditions in relation to dental caries, using the Dental Caries Index and need for treatment (ICDNT). The data analysis was based on the Chi-square test, and when the npq <5 restriction occurred, Fisher's exact test was applied. The comparison between quantitative variables was performed using the Student's t test. The average DMFT index was 3.57, with only 17% of the studied population free of caries. The carious component was the one with the greatest significance (3.14) and the need for treatment with the highest prevalence was the restoration of one face (47.5%). A percentage of 88.5% of the adolescents evaluated answered that they did not take a toothbrush to school. The studied sample had a moderate prevalence of caries compared to the parameters recommended by the WHO, but above the standard obtained in the national survey carried out in 2010. Therefore, it is necessary to implement measures aimed at improving the quality of oral health of these adolescents and a full-time system would be a ideal for implementing good habits and routines for the adolescent’s oral health.

This study evaluated the self-perception of adolescents' oral health and their oral conditions and the need for treatment in relation to dental caries. An epidemiological survey was carried out in the municipality of Belém, Pará, Brazil, in 2018. The sample consisted of 200 students, aged 11 to 16 years old, from a full-time public school. The data were collected through a questionnaire where their self-perception of their oral health was assessed and an intra-oral examination was carried out to assess oral health conditions in relation to dental caries, using the Dental Caries Index and need for treatment (ICDNT). The data analysis was based on the Chi-square test, and when the npq <5 restriction occurred, Fisher's exact test was applied. The comparison between quantitative variables was performed using the Student's t test. The average DMFT index was 3.57, with only 17% of the studied population free of caries. The carious component was the one with the greatest significance (3.14) and the need for treatment with the highest prevalence was the restoration of one face (47.5%). A percentage of 88.5% of the adolescents evaluated answered that they did not take a toothbrush to school. The studied sample had a moderate prevalence of caries compared to the parameters recommended by the WHO, but above the standard obtained in the national survey carried out in 2010. Therefore, it is necessary to implement measures aimed at improving the quality of oral health of these adolescents and a full-time system would be a ideal for implementing good habits and routines for the adolescent’s oral health.

This study evaluated the self-perception of adolescents' oral health and their oral conditions and the need for treatment in relation to dental caries. An epidemiological survey was carried out in the municipality of Belém, Pará, Brazil, in 2018. The sample consisted of 200 students, aged 11 to 16 years old, from a full-time public school. The data were collected through a questionnaire where their self-perception of their oral health was assessed and an intra-oral examination was carried out to assess oral health conditions in relation to dental caries, using the Dental Caries Index and need for treatment (ICDNT). The data analysis was based on the Chi-square test, and when the npq <5 restriction occurred, Fisher's exact test was applied. The comparison between quantitative variables was performed using the Student's t test. The average DMFT index was 3.57, with only 17% of the studied population free of caries. The carious component was the one with the greatest significance (3.14) and the need for treatment with the highest prevalence was the restoration of one face (47.5%). A percentage of 88.5% of the adolescents evaluated answered that they did not take a toothbrush to school. The studied sample had a moderate prevalence of caries compared to the parameters recommended by the WHO, but above the standard obtained in the national survey carried out in 2010. Therefore, it is necessary to implement measures aimed at improving the quality of oral health of these adolescents and a full-time system would be a ideal for implementing good habits and routines for the adolescent’s oral health.

The year 2020 celebrated the tenth anniversary of the recognition of the Mediterranean Diet as Intangible Cultural Heritage of Humanity by the UNESCO Intergovernmental Committee. This event represented a milestone in the history of nutrition, as the Mediterranean diet was the first traditional food practice to receive such award. Since then, a lot has been discussed not only on the beneficial aspects of the Mediterranean diet, but also on its complex role as a lifestyle model that includes a set of skills, knowledge and intercultural dialogue. This process ended up with the recognition in 2019 of Mediterranean diet as a possibly universal model of healthy diet from the EAT-Lancet Commission. These concepts were widely debated at the 2019 “Ancel Keys” International Seminar, held in Ascea (Italy) (for more information see: www.mediterraneandietseminar.org) with the aim to stimulate interest and awareness of a young group of participants on the current problems inherent to the effective implementation of the Mediterranean diet. The present article collects the contributions of several lecturers at the Seminar on key issues such as methodological and experimental approach, sustainability, molecular aspects in disease prevention, future exploitation, without neglecting a historical view of the Seven Countries Study. From the Seminar conclusions emerged a still vibrant and modern role of Mediterranean diet. The years to come will see national and international efforts to reduce the barriers that limit adherence to Mediterranean diet in order to plan for multi-factorial and targeted interventions that would guide our populations to a sustainable healthy living.

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness.

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness., Special issue

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness., Special issue

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness., Special issue

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness.

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness.

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness.

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness.

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness.

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness., Special issue

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness.

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness.

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness., Special issue

We thank Dr. Karp for his interest [1] in our paper [2]. We agree on some points, but our theoretical description differs from his in ways leading to important divergences for teaching and practice. We also see a danger of overextending abstract theory (with its inevitable and extensive simplifications) into practice [3], especially when the practical questions are causal but the theory applied lacks an explicit, sound longitudinal causal model to address these questions. As we will explain, a defect in the “study base” theory Dr. Karp adopts as a foundational belief system is that it takes as a foundation a parameter affected by baseline risk factors—including exposure when that has effects on follow-up or disease. It consequently leads to biases and misconceptions of the sort documented elsewhere [4, 5] and below, which require a coherent theory of longitudinal causality to address. Our divergence from Dr. Karp thus raises the issue of the role of theory and methods in research, although matching serves to illustrate our points in a familiar epidemiologic context.

Проведено аналіз захворюваності на різні види лейкемій населення Житомирської області протягом 15 років після аварії на ЧАЕС. Порівнювались показники в радіаційно забруднених та так званих «чистих» районах. Спостерігався певний ріст захворюваності на гострі лейкемії в області в 1990-му році. В подальші роки цей показник стабілізувався та суттєво не відхилявся від рівня. В потерпілих районах показники захворюваності на різні види лейкемій суттєво не відрізнялись від відповідних показників «чистих» районів., Проведен анализ заболеваемости различными видами лейкемий населения Житомирской области в течение 15 лет после аварии на ЧАЭС. Сравнивались показатели в радиационно загрязнённых и так называемых «чистых» районах. Наблюдался определённый рост заболеваемости острыми лейкемиями в области в 1990-м году. В последующие годы этот показатель стабилизировался и существенно не отклонялся от уровня. В пострадавших районах показатели заболеваемости различными видами лейкемий существенно не отличались от соответствующих показателей в «чистых» районах., The authors analyze the sickness rate of various types of leukemia in the Zhytomyr region within 15 years after the Chernobyl accident and compare the indices in the contaminated and so-called «clean areas». In 1990 a certain growth is acute leukemia cases in the region was observed. In the following years this index stabilized and did not differ much from the spontaneous level. In the contaminated areas the indices of sickness rate of various types of leukemia did not essentially differ from the corresponding indices in the «clean areas».

Проведено аналіз захворюваності на різні види лейкемій населення Житомирської області протягом 15 років після аварії на ЧАЕС. Порівнювались показники в радіаційно забруднених та так званих «чистих» районах. Спостерігався певний ріст захворюваності на гострі лейкемії в області в 1990-му році. В подальші роки цей показник стабілізувався та суттєво не відхилявся від рівня. В потерпілих районах показники захворюваності на різні види лейкемій суттєво не відрізнялись від відповідних показників «чистих» районів., Проведен анализ заболеваемости различными видами лейкемий населения Житомирской области в течение 15 лет после аварии на ЧАЭС. Сравнивались показатели в радиационно загрязнённых и так называемых «чистых» районах. Наблюдался определённый рост заболеваемости острыми лейкемиями в области в 1990-м году. В последующие годы этот показатель стабилизировался и существенно не отклонялся от уровня. В пострадавших районах показатели заболеваемости различными видами лейкемий существенно не отличались от соответствующих показателей в «чистых» районах., The authors analyze the sickness rate of various types of leukemia in the Zhytomyr region within 15 years after the Chernobyl accident and compare the indices in the contaminated and so-called «clean areas». In 1990 a certain growth is acute leukemia cases in the region was observed. In the following years this index stabilized and did not differ much from the spontaneous level. In the contaminated areas the indices of sickness rate of various types of leukemia did not essentially differ from the corresponding indices in the «clean areas».

Maximising response is an important issue in epidemiological research. Reciprocation and commitment/consistency are psychological persuasion principles that have been used in many contexts to increase compliance with requests. We attempted to apply both these principles to increase compliance with a survey request by sending a fridge magnet reminder. The aim of this study was to determine whether the magnet improved response.

This article discusses the role of epidemiologic evidence in toxic tort cases, focusing on relative risk. Whether specific causation can be inferred if a relative risk is above 2.0 is discussed. The object is to explore the scientific logic behind intuitions of relative risk.

Background Motor Vehicle Crashes (MVCs) are a major cause of morbidity and mortality worldwide. This thesis explores the potential use of large databases of primary care medical records to investigate the epidemiology of MVCs in the United Kingdom and to supplement the data available from national statistics, which are believed to understate both the number of crashes, and the number of injuries which occur as a result. Methods Details of all individuals enrolled in The Health Improvement Network (THIN) database whose primary care records indicated involvement in a MVC were used to calculate a series of summary measures describing the burden and consequences of MVCs. These were compared with data available from police accident reports and from hospital admissions. Data from THIN were used to conduct a series of studies of the impact of health and healthcare-related factors on the risk of involvement in MVCs. Specifically: a case-control study of the impact of modifiable lifestyle factors on the risk of MVC; case-crossover and self-controlled case-series studies of the effect of exposure to prescribed medications on the risk of MVC; a case-control study investigating the impact of disordered sleep on the risk of MVC; a case-control study of the risk of involvement in MVC among individuals with diabetes relative to the general population; and; a cohort study assessing whether there is evidence to suggest that involvement in a MVC may indicate the presence of undiagnosed disease which may impair driving performance. Results The socio-demographic characteristics of individuals involved in MVCs recorded in THIN differ markedly from those recorded in police accident reports and hospital admissions data. There was no evidence of consistent trends in MVC incidence over time in the three data sources. Differences in data collection methodology and the severity and scope of crashes recorded may account for these variations. Evidence was found of an association between having

Background Motor Vehicle Crashes (MVCs) are a major cause of morbidity and mortality worldwide. This thesis explores the potential use of large databases of primary care medical records to investigate the epidemiology of MVCs in the United Kingdom and to supplement the data available from national statistics, which are believed to understate both the number of crashes, and the number of injuries which occur as a result. Methods Details of all individuals enrolled in The Health Improvement Network (THIN) database whose primary care records indicated involvement in a MVC were used to calculate a series of summary measures describing the burden and consequences of MVCs. These were compared with data available from police accident reports and from hospital admissions. Data from THIN were used to conduct a series of studies of the impact of health and healthcare-related factors on the risk of involvement in MVCs. Specifically: a case-control study of the impact of modifiable lifestyle factors on the risk of MVC; case-crossover and self-controlled case-series studies of the effect of exposure to prescribed medications on the risk of MVC; a case-control study investigating the impact of disordered sleep on the risk of MVC; a case-control study of the risk of involvement in MVC among individuals with diabetes relative to the general population; and; a cohort study assessing whether there is evidence to suggest that involvement in a MVC may indicate the presence of undiagnosed disease which may impair driving performance. Results The socio-demographic characteristics of individuals involved in MVCs recorded in THIN differ markedly from those recorded in police accident reports and hospital admissions data. There was no evidence of consistent trends in MVC incidence over time in the three data sources. Differences in data collection methodology and the severity and scope of crashes recorded may account for these variations. Evidence was found of an association between having

Background For epidemiological research purposes structured data provide identifiable and immediate access to the information that has been recorded, however, many quantitative recordings in electronic medical records are unstructured. This means researchers have to manually identify and extract information of interest. This is costly in terms of time and money and with access to larger amounts of electronically stored data this approach is becoming increasingly impractical. Method Two programmatic methods were developed to extract and classify numeric quantities and identify attributes from unstructured dosage instructions and clinical comments from The Health Improvement Network (THIN) database. Both methods are based on frequently occurring patterns of recording from which models were formed. Dosage instructions: Automated coding was achieved through the interpretation of a representative set of language phrases with identifiable traits. The dosage data table was automatically recoded and assessed for accuracy and coverage of a daily dosage value, then assessed in the context of 146 commonly prescribed medications. Clinical comments: Automated coding was achieved through the identification of a representative set of text and/or Read code qualifications. The model was initially trained on THIN data for a wide range of numeric health indicators, then tested for generalizability using comments from an alternative source and assessed for accuracy, sensitivity, and specificity using a subset of 12 commonly recorded health indicators. Results Dosage instructions: The coverage of a daily dosage value within the dosage data table was increased from 42.1% to 84.8% coverage with an accuracy of 84.6%. For the 146 medications assessed, on a per-unique-instruction basis, the coverage was 79.7% on average with an accuracy of 95.4%. On an all-recorded-instructions basis the weighted coverage was 65.9% on average with an accuracy of 99.3%. Clinical comments: For all 12 of the he