scholarly journals Improvements in the incidence and survival of cancer and cardiovascular but not infectious disease have driven recent mortality improvements in Scotland: nationwide cohort study of linked hospital admission and death records 2001–2016

2019 ◽  
Author(s):  
Paul RHJ Timmers ◽  
Joannes J Kerssens ◽  
Jon W Minton ◽  
Ian Grant ◽  
James F Wilson ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Heart Disease ◽  
Life Expectancy ◽  
Infectious Diseases ◽  
Hospital Admission ◽  
Disease Incidence ◽  
Malignant Neoplasm ◽  
List Type ◽  
Mortality Improvements ◽  
Symptoms And Signs

AbstractObjectivesTo identify the causes and future trends underpinning improvements in life expectancy in Scotland and quantify the relative contributions of disease incidence and survival.DesignPopulation-based study.SettingLinked secondary care and mortality records across Scotland.Participants1,967,130 individuals born between 1905 and 1965, and resident in Scotland throughout 2001–2016.Main outcome measuresHospital admission rates and survival in the five years following admission for 28 diseases, stratified by sex and socioeconomic status.ResultsThe five hospital admission diagnoses associated with the greatest burden of death subsequent to admission were “Influenza and pneumonia”, “Symptoms and signs involving the circulatory and respiratory systems”, “Malignant neoplasm of respiratory and intrathoracic organs”, “Symptoms and signs involving the digestive system and abdomen”, and “General symptoms and signs”. Using disease trends, we modelled a mean mortality hazard ratio of 0.737 (95% CI 0.730–0.745) across decades of birth, equivalent to a life extension of ∼3 years per decade. This improvement was 61% (30%–93%) accounted for by improvements in disease survival after hospitalisation (principally cancer) with the remainder accounted for by a fall in hospitalisation incidence (principally heart disease and cancer). In contrast, deteriorations in the incidence and survival of infectious diseases reduced mortality improvements by 9% (∼3.3 months per decade). Overall, health-driven mortality improvements were slightly greater for men than women (due to greater falls in disease incidence), and generally similar across socioeconomic deciles. We project mortality improvements will continue over the next decade but will slow down by 21% because much of the progress in disease survival has already been achieved.ConclusionMorbidity improvements broadly explain observed improvements in overall mortality, with progress on the prevention and treatment of heart disease and cancer making the most significant contributions. The gaps between men and women’s morbidity and mortality are closing, but the gap between socioeconomic groups is not. A slowing trend in improvements in morbidity may explain the stalling in improvements of period life expectancies observed in recent studies in the UK. However, our modelled slowing of improvements could be offset if we achieve even faster improvements in the major diseases contributing to the burden of death, or if we improve prevention and survival of diseases which have deteriorated recently, such as infectious disease, in the future.Summary boxWhat is already known on this topicLong term improvements in Scottish mortality have slowed down recently, while life expectancy inequalities between socioeconomic classes are increasing.Deaths attributed to ischaemic heart disease and stroke in Scotland have declined in the last two decades.What this study addsGains in life expectancy can largely be attributed to improvements in cancer survival and falls in incidence of cancer and cardiovascular disease.The hospitalisation rate and survival of several infectious diseases have deteriorated, and for urinary infections, this decline has been more rapid in more socioeconomically deprived classes.Improvements in morbidity are projected to slow down, with much progress in survival of heart disease and cancer already achieved, and align with the recently observed slow-down in mortality improvements.

scholarly journals Trends in disease incidence and survival and their effect on mortality in Scotland: nationwide cohort study of linked hospital admission and death records 2001–2016

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034299
Author(s):  
Paul R H J Timmers ◽  
Joannes J Kerssens ◽  
Jon Minton ◽  
Ian Grant ◽  
James F Wilson ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Heart Disease ◽  
Hospital Admission ◽  
Disease Incidence ◽  
Malignant Neoplasm ◽  
Population Based ◽  
Life Extension ◽  
Socioeconomic Groups ◽  
Admission Rates ◽  
Mortality Improvements

ObjectivesIdentify causes and future trends underpinning Scottish mortality improvements and quantify the relative contributions of disease incidence and survival.DesignPopulation-based study.SettingLinked secondary care and mortality records across Scotland.Participants1 967 130 individuals born between 1905 and 1965 and resident in Scotland from 2001 to 2016.Main outcome measuresHospital admission rates and survival within 5 years postadmission for 28 diseases, stratified by sex and socioeconomic status.Results‘Influenza and pneumonia’, ‘Symptoms and signs involving circulatory and respiratory systems’ and ‘Malignant neoplasm of respiratory and intrathoracic organs’ were the hospital diagnosis groupings associated with most excess deaths, being both common and linked to high postadmission mortality. Using disease trends, we modelled a mean mortality HR of 0.737 (95% CI 0.730 to 0.745) from one decade of birth to the next, equivalent to a life extension of ~3 years per decade. This improvement was 61% (30%–93%) accounted for by improved disease survival after hospitalisation (principally cancer) with the remainder accounted for by lowered hospitalisation incidence (principally heart disease and cancer). In contrast, deteriorations in infectious disease incidence and survival increased mortality by 9% (~3.3 months per decade). Disease-driven mortality improvements were slightly greater for men than women (due to greater falls in disease incidence), and generally similar across socioeconomic deciles. We project mortality improvements will continue over the next decade but slow by 21% because much progress in disease survival has already been achieved.ConclusionMorbidity improvements broadly explain observed mortality improvements, with progress on prevention and treatment of heart disease and cancer contributing the most. The male–female health gaps are closing, but those between socioeconomic groups are not. Slowing improvements in morbidity may explain recent stalling in improvements of UK period life expectancies. However, these could be offset if we accelerate improvements in the diseases accounting for most deaths and counteract recent deteriorations in infectious disease.

scholarly journals Discrepancy between Clinical and Postmortem Diagnosis of Dogs in a Veterinary Medical Teaching Hospital

2017 ◽  
Vol 45 (1) ◽  
pp. 5
Author(s):  
William Torres Blanca ◽  
Lygia Fernandes Gundim ◽  
Thaís De Almeida Moreira ◽  
Taís Meziara Wilson ◽  
Alessandra Aparecida Medeiros-Ronchi
Keyword(s):  
Infectious Disease ◽  
Heart Disease ◽  
Infectious Diseases ◽  
Cause Of Death ◽  
Systemic Disease ◽  
Human Study ◽  
Malignant Neoplasms ◽  
Neoplastic Disease ◽  
Postmortem Diagnosis ◽  
Discrepancy Rate

Background: The postmortem examination offers the opportunity to study the processes involved in disease. Although a portion of veterinary medical professionals and students consider the necropsy as a diagnostic tool of purely academic interest, it can provide valuable assistance in formulating health strategies in order to prevent and control animal diseases. The number of necropsies performed in general is higher in universities where the cost is subsidized. In veterinary medicine, studies intended to assess the frequency of necropsy and the discrepancy between clinical and postmortem diagnosis of dogs are rare. The main purpose of the necropsy is to discover the cause of death of dogs, by defining a possible etiology and pathogenesis in order to reach a diagnosis.Material, Methods & Results: We used medical records and necropsy records to define the clinical and postmortem diagnosis, respectively. Data relating to deaths was recorded as the number of euthanized dogs and natural deaths in 2014. From the information cause of death, these were categorized as infectious disease, cardiac, gastrointestinal, renal, pulmonary, neurological, metabolic or endocrine disease, neoplastic disease, trauma, or systemic disease. We used the Binomial discrepancy in the comparison of the rates between different years and also to verify the association between discrepancy and the correlation between clinical and postmortem diagnosis of dogs with euthanasia and natural death, with statistical significance (P < 0.05). In 2009, 56.81% (25/44) of cases included in the study had a concordance between the clinical and postmortem diagnosis, while 43.19% (19/44) were discordant. In 2014, it was observed that 71.70% (76/106) of the diagnosis was confirmed with the necropsy, while 28.30% (30/106) were discordant. The disagreement rate was higher in 2009 (P < 0.05) and there was a reduction of 14.89% in the disagreement rate between 2009 and 2014. Regarding the cause of death, infectious diseases, gastrointestinal disease, and heart disease were the categories in which the discrepancy was higher. It was found that in the group of dogs euthanized, the discrepancy rate was lower compared with the group of dogs that had anatural death (P < 0.05).Discussion: The disagreement rate can be considered high when compared with a veterinary study and similar to those observed in a human study. Decrease in the discrepancy rate in the years, as observed by other authors, that can be attributed to improvements and expansion of diagnostic services of the hospital and better training of veterinarians. The difficulty in determining the etiology of infectious diseases is associated with lack of specific diagnostic tests and the high cost of available tests, which often is not bank rolled by the tutor. Dogs in this study were rarely submitted to diagnostics tests such as electrocardiogram or echocardiogram which explains the high discordance in the diagnosis of heart disease. Distemper is an infectious disease of great importance regarding euthanized animals, especially in cases that progress to central nervous system injuries with extremely poor prognosis and wind up having euthanasia indication. Another common cause of domestic animals euthanasia indication is the occurrence malignant neoplasms, which depends on the progression of the disease and psychological and social conditions of the owner. The results generated herein suggests that infectious, gastrointestinal and cardiac diseases origin tend to have a greater discordance between clinical and postmortem diagnosis, however this rate is decreasing due to improved infrastructure of veterinary centers with better professionals qualification.

scholarly journals Re-emerging Infectious Disease (RED) Alert tool

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Maneesha Chitanvis ◽  
Ashlynn Daughton ◽  
Forest M Altherr ◽  
Geoffery Fairchild ◽  
William Rosenberger ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Infectious Diseases ◽  
Disease Incidence ◽  
Emerging Infectious Disease ◽  
Control Measures ◽  
Public Health Response ◽  
Incidence Trends ◽  
Effective Public Health ◽  
Emergence Event

Objective: Although relying on verbal definitions of "re-emergence", descriptions that classify a “re-emergence” event as any significant recurrence of a disease that had previously been under public health control, and subjective interpretations of these events is currently the conventional practice, this has the potential to hinder effective public health responses. Defining re-emergence in this manner offers limited ability for ad hoc analysis of prevention and control measures and facilitates non-reproducible assessments of public health events of potentially high consequence. Re-emerging infectious disease alert (RED Alert) is a decision-support tool designed to address this issue by enhancing situational awareness by providing spatiotemporal context through disease incidence pattern analysis following an event that may represent a local (country-level) re-emergence. The tool’s analytics also provide users with the associated causes (socioeconomic indicators) related to the event, and guide hypothesis-generation regarding the global scenario.Introduction: Definitions of “re-emerging infectious diseases” typically encompass any disease occurrence that was a historic public health threat, declined dramatically, and has since presented itself again as a significant health problem. Examples include antimicrobial resistance leading to resurgence of tuberculosis, or measles re-appearing in previously protected communities. While the language of this verbal definition of “re-emergence” is sensitive enough to capture most epidemiologically relevant resurgences, its qualitative nature obfuscates the ability to quantitatively classify disease re-emergence events as such.Methods: Our tool automatically computes historic disease incidence and performs trend analyses to help elucidate events which a user may considered a true re-emergence in a subset of pertinent infectious diseases (measles, cholera, yellow fever, and dengue). The tool outputs data visualizations that illustrate incidence trends in diverse and informative ways. Additionally, we categorize location and incidence-specific indicators for re-emergence to provide users with associated indicators as well as justifications and documentation to guide users’ next steps. Additionally, the tool also houses interactive maps to facilitate global hypothesis-generation.Results: These outputs provide historic trend pattern analyses as well as contextualization of the user’s situation with similar locations. The tool also broadens users' understanding of the given situation by providing related indicators of the likely re-emergence, as well as the ability to investigate re-emergence factors of global relevance through spatial analysis and data visualization.Conclusions: The inability to categorically name a re-emergence event as such is due to lack of standardization and/or availability of reproducible, data-based evidence, and hinders timely and effective public health response and planning. While the tool will not explicitly call out a user scenario as categorically re-emergent or not, by providing users with context in both time and space, RED Alert aims to empower users with data and analytics in order to substantially enhance their contextual awareness; thus, better enabling them to formulate plans of action regarding re-emerging infectious disease threats at both the country and global level.

scholarly journals Area deprivation and notifiable infectious diseases in Germany: A longitudinal small-area analysis

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Rohleder ◽  
C Stock ◽  
W Maier ◽  
K Bozorgmehr
Keyword(s):  
Infectious Disease ◽  
Infectious Diseases ◽  
Viral Hepatitis ◽  
Disease Incidence ◽  
Gastrointestinal Diseases ◽  
Bayesian Regression ◽  
Area Deprivation ◽  
High Deprivation ◽  
Vector Borne ◽  
Deprived Areas

Abstract Background Socioeconomic inequalities may affect the infectious disease incidence. We studied the association between area deprivation and incidence of notifiable infectious diseases in Germany to understand spatio-temporal patterns and the effects of societal factors on disease epidemiology. Methods Using national surveillance data of 401 districts from 2001 to 2017, we examined the incidence of infectious diseases using spatiotemporal Bayesian regression models. We analyzed eight disease classes: blood-borne viral hepatitis, gastrointestinal, vaccine preventable, vector-borne, zoonotic, other bacterial, other infectious, and overall burden of infectious diseases. As explanatory factors we considered area deprivation (measured by the German Index of Multiple Deprivation), fraction of non-nationals, sex, age, and spatiotemporal effects. Results A risk gradient across deprivation quintiles was observed for the overall burden of infectious diseases. The relative risk (RR) for gastrointestinal diseases in areas with medium and high deprivation relative to low deprivation was 1.65 (95%-credible interval [CrI] 1.01-2.54) and 2.64 (1.22-4.98), respectively. The RR for vector-borne diseases was 1.89 (1.27-2.73) in districts with high deprivation compared to areas with low deprivation. Lower risks in highly deprived areas relative to low deprived areas were identified in vaccine-preventable diseases (RR = 0.39; 0.14-0.88) and zoonoses (RR = 0.69; 0.48-0.96). For blood-borne viral hepatitis, other bacterial, and other infectious diseases no association with area deprivation was observed. Spatial risks of infections were predominantly concentrated in eastern parts of Germany and changed marginally over time. Conclusions The risks of infections tend to be higher in more deprived areas and in eastern parts of Germany, but they varied by class of disease. Our results can guide measures of infectious disease control and prevention by considering spatial risks and deprivation. Key messages Area deprivation has both positive and inverse associations with the incidences of infectious diseases in Germany. Regions with increased risks may benefit from targeted public health measures. Spatial risks of infections tended to be higher in eastern regions of Germany. Disparities in the incidence of infectious diseases may be still present between western and eastern Germany.

scholarly journals Geographical patterns of proportionate mortality for the most common causes of death in Brazil

1992 ◽  
Vol 26 (6) ◽  
pp. 424-430 ◽  
Author(s):  
Rosely Sichieri ◽  
Cecilia A. de Lolio ◽  
Valmir R. Correia ◽  
James E. Everhart
Keyword(s):  
Breast Cancer ◽  
Infectious Disease ◽  
Heart Disease ◽  
Linear Regression ◽  
Infectious Diseases ◽  
Ischaemic Heart Disease ◽  
Chronic Diseases ◽  
Heart Diseases ◽  
Economic Variables ◽  
Socio Economic Variables

Mortality due to chronic diseases has been increasing in all regions of Brazil with corresponding decreases in mortality from infectious diseases. The geographical variation in proportionate mortality for chronic diseases for 17 Brazilian state capitals for the year 1985 and their association with socio-economic variables and infectious disease was studied. Calculations were made of correlation coefficients of proportionate mortality for adults of 30 years or above due to ischaemic heart disease, stroke and cancer of the lung, the breast and stomach with 3 socio-economic variables, race, and mortality due to infectious disease. Linear regression analysis included as independent variables the % of illiteracy, % of whites, % of houses with piped water, mean income, age group, sex, and % of deaths caused by infectious disease. The dependent variables were the % of deaths due to each one of the chronic diseases studied by age-sex group. Chronic diseases were an important cause of death in all regions of Brazil. Ischaemic heart diseases, stroke and malignant neoplasms accounted for more than 34% of the mortality in each of the 17 capitals studied. Proportionate cause-specific mortality varied markedly among state capitals. Ranges were 6.3-19.5% for ischaemic heart diseases, 8.3-25.4% for stroke, 2.3-10.4% for infections and 12.2-21.5% for malignant neoplasm. Infectious disease mortality had the highest (p < 0.001) correlation with all the four socio-economic variables studied and ischaemic heart disease showed the second highest correlation (p < 0.05). Higher socio-economic level was related to a lower % of infectious diseases and a higher % of ischaemic heart diseases. Mortality due to breast cancer and stroke was not associated with socio-economic variables. Multivariate linear regression models explained 59% of the variance among state capitals for mortality due to ischaemic heart disease, 50% for stroke, 28% for lung cancer, 24% for breast cancer and 40% for stomach cancer. There were major differences in the proportionate mortality due to chronic diseases among the capitals which could not be accounted for by the social and environmental factors and by the mortality due to infectious disease.

scholarly journals Występowanie chorób zakaźnych w Wielkopolsce w latach 1945-1953 w świetle dokumentów Archiwum Państwowego w Poznaniu

2016 ◽  
Vol 3 ◽  
pp. 113-143
Author(s):  
Lucyna Błażejczyk-Majka
Keyword(s):  
Infectious Disease ◽  
Mortality Rate ◽  
Infectious Diseases ◽  
Incidence Rate ◽  
Disease Incidence ◽  
Historical Context ◽  
National Archive ◽  
Regional Government ◽  
Department Of Health ◽  
Work Camps

Wojna niesie ze sobą bezmiar cierpień, zniszczeń i śmierci. Ci którzy przeżyli musieli zmierzyć się z następującymi po niej chorobami. W latach 40. i 50. lekarze powiatowi przekazywali do Wydziału Zdrowia Urzędu Wojewódzkiego w Poznaniu raporty dotyczące zachorowalności na choroby zakaźnie. Artykuł oparty jest na prezentacji i porównaniu raportów z roku 1946 z analogicznymi raportami z 1953 r. Na tej podstawie podjęto próbę wyjaśnienia większej liczby zachorowań na choroby zakaźne na określonych obszarach Wielkopolski w kontekście historycznym tego okresu. W odniesieniu do roku 1946 dane dotyczą 23 powiatów. Dane dla roku 1953 obejmują 26 powiatów. Ze względu na porównywalność informacji w artykule uwzględniono jedynie dane dla powiatów ziemskich. Typowymi chorobami dla tego okresu okazały się: tyfus, gruźlica i dyfteryt, ale także dużą śmiertelność przypisać można wyczerpaniu, brudowi i niedożywieniu przemieszczających się wówczas mas ludności. Z przeprowadzonych analiz wynika, że najsilniejszy związek występuje pomiędzy chorobami zakaźnymi a umiejscowieniem obozów jenieckich i obozów pracy oraz strumieniami ludności przepływającej przez punkty etapowe PUR. Incidence rate of infectious diseases in Greater Poland in the years 1945–1953 according to the documents of the National Archive in Poznań The war brings infinite suffering, death and destruction. Those who survive it have to deal with diseases that follow. In the 1940s and 1950s, county doctors wrote reports on infectious disease incidence for the Department of Health of the Regional Government in Poznań. The article comprises the presentation and comparison of parallel reports from the years 1946 and 1953. Based on that, it makes an attempt to explain the higher incidence rate of infectious diseases in some parts of Greater Poland based on the historical context of this period. For the year 1946, the data describe 23 counties. Data for the year 1953 include 26 counties. Due to the comparability of information, the article includes data only for rural counties. Typical diseases of the period were typhoid, tuberculosis and diphtheria, but the high mortality rate can also be explained by exhaustion, poor hygiene and malnutrition among the migrating masses of people. The analyses conducted indicate that the strongest relationship can be observed between infectious diseases and the location of prisoners’ and work camps and the migration of people going through the stage points of the National Repatriates Office.

scholarly journals HLA and Infectious Diseases

2009 ◽  
Vol 22 (2) ◽  
pp. 370-385 ◽  
Author(s):  
Jenefer M. Blackwell ◽  
Sarra E. Jamieson ◽  
David Burgner
Keyword(s):  
Infectious Disease ◽  
Infectious Diseases ◽  
Human Leukocyte Antigen ◽  
Molecular Basis ◽  
Selective Pressure ◽  
Human Leukocyte ◽  
Acquired Immunity ◽  
Leukocyte Antigen ◽  
Extreme Variability ◽  
Classical Human Leukocyte Antigen

SUMMARY Following their discovery in the early 1970s, classical human leukocyte antigen (HLA) loci have been the prototypical candidates for genetic susceptibility to infectious disease. Indeed, the original hypothesis for the extreme variability observed at HLA loci (H-2 in mice) was the major selective pressure from infectious diseases. Now that both the human genome and the molecular basis of innate and acquired immunity are understood in greater detail, do the classical HLA loci still stand out as major genes that determine susceptibility to infectious disease? This review looks afresh at the evidence supporting a role for classical HLA loci in susceptibility to infectious disease, examines the limitations of data reported to date, and discusses current advances in methodology and technology that will potentially lead to greater understanding of their role in infectious diseases in the future.

scholarly journals Drivers of Infectious Disease Seasonality: Potential Implications for COVID-19

2021 ◽  
pp. 074873042098732
Author(s):  
N. Kronfeld-Schor ◽  
T. J. Stevenson ◽  
S. Nickbakhsh ◽  
E. S. Schernhammer ◽  
X. C. Dopico ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Infectious Diseases ◽  
Multidisciplinary Approach ◽  
Preliminary Assessment ◽  
Epidemiological Evidence ◽  
Wide Range ◽  
Human Coronaviruses ◽  
Induced Changes ◽  
And Behavior ◽  
Timing Phase

Not 1 year has passed since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19). Since its emergence, great uncertainty has surrounded the potential for COVID-19 to establish as a seasonally recurrent disease. Many infectious diseases, including endemic human coronaviruses, vary across the year. They show a wide range of seasonal waveforms, timing (phase), and amplitudes, which differ depending on the geographical region. Drivers of such patterns are predominantly studied from an epidemiological perspective with a focus on weather and behavior, but complementary insights emerge from physiological studies of seasonality in animals, including humans. Thus, we take a multidisciplinary approach to integrate knowledge from usually distinct fields. First, we review epidemiological evidence of environmental and behavioral drivers of infectious disease seasonality. Subsequently, we take a chronobiological perspective and discuss within-host changes that may affect susceptibility, morbidity, and mortality from infectious diseases. Based on photoperiodic, circannual, and comparative human data, we not only identify promising future avenues but also highlight the need for further studies in animal models. Our preliminary assessment is that host immune seasonality warrants evaluation alongside weather and human behavior as factors that may contribute to COVID-19 seasonality, and that the relative importance of these drivers requires further investigation. A major challenge to predicting seasonality of infectious diseases are rapid, human-induced changes in the hitherto predictable seasonality of our planet, whose influence we review in a final outlook section. We conclude that a proactive multidisciplinary approach is warranted to predict, mitigate, and prevent seasonal infectious diseases in our complex, changing human-earth system.

scholarly journals Application of 3D bioprinting in the prevention and the therapy for human diseases

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Hee-Gyeong Yi ◽  
Hyeonji Kim ◽  
Junyoung Kwon ◽  
Yeong-Jin Choi ◽  
Jinah Jang ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Infectious Diseases ◽  
Rapid Development ◽  
In Vitro Models ◽  
Delivery Systems ◽  
Advanced Technology ◽  
3D Bioprinting ◽  
Disease Research ◽  
Infectious Disease Research

AbstractRapid development of vaccines and therapeutics is necessary to tackle the emergence of new pathogens and infectious diseases. To speed up the drug discovery process, the conventional development pipeline can be retooled by introducing advanced in vitro models as alternatives to conventional infectious disease models and by employing advanced technology for the production of medicine and cell/drug delivery systems. In this regard, layer-by-layer construction with a 3D bioprinting system or other technologies provides a beneficial method for developing highly biomimetic and reliable in vitro models for infectious disease research. In addition, the high flexibility and versatility of 3D bioprinting offer advantages in the effective production of vaccines, therapeutics, and relevant delivery systems. Herein, we discuss the potential of 3D bioprinting technologies for the control of infectious diseases. We also suggest that 3D bioprinting in infectious disease research and drug development could be a significant platform technology for the rapid and automated production of tissue/organ models and medicines in the near future.

scholarly journals Association between home insulation and hospital admission rates: retrospective cohort study using linked data from a national intervention programme

BMJ ◽  
2020 ◽  
pp. m4571 ◽  
Author(s):  
Caroline Fyfe ◽  
Lucy Telfar ◽  
Barnard ◽  
Philippa Howden-Chapman ◽  
Jeroen Douwes
Keyword(s):  
Cohort Study ◽  
Heart Disease ◽  
Confidence Interval ◽  
Hospital Admission ◽  
Retrospective Cohort ◽  
Rate Ratio ◽  
Hospital Admissions ◽  
Relative Rate ◽  
Intervention Programme ◽  
Admission Rates

Abstract Objectives To investigate whether retrofitting insulation into homes can reduce cold associated hospital admission rates among residents and to identify whether the effect varies between different groups within the population and by type of insulation. Design A quasi-experimental retrospective cohort study using linked datasets to evaluate a national intervention programme. Participants 994 317 residents of 204 405 houses who received an insulation subsidy through the Energy Efficiency and Conservation Authority Warm-up New Zealand: Heat Smart retrofit programme between July 2009 and June 2014. Main outcome measure A difference-in-difference approach was used to compare the change in hospital admissions of the study population post-insulation with the change in hospital admissions of the control population that did not receive the intervention over the same two timeframes. Relative rate ratios were used to compare the two groups. Results 234 873 hospital admissions occurred during the study period. Hospital admission rates after the intervention increased in the intervention and control groups for all population categories and conditions with the exception of acute hospital admissions among Pacific Peoples (rate ratio 0.94, 95% confidence interval 0.90 to 0.98), asthma (0.92, 0.86 to 0.99), cardiovascular disease (0.90, 0.88 to 0.93), and ischaemic heart disease for adults older than 65 years (0.79, 0.74 to 0.84). Post-intervention increases were, however, significantly lower (11%) in the intervention group compared with the control group (relative rate ratio 0.89, 95% confidence interval 0.88 to 0.90), representing 9.26 (95% confidence interval 9.05 to 9.47) fewer hospital admissions per 1000 in the intervention population. Effects were more pronounced for respiratory disease (0.85, 0.81 to 0.90), asthma in all age groups (0.80, 0.70 to 0.90), and ischaemic heart disease in those older than 65 years (0.75, 0.66 to 0.83). Conclusion This study showed that a national home insulation intervention was associated with reduced hospital admissions, supporting previous research, which found an improvement in self-reported health.

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