Annals of Epidemiology RSS feed: Articles in Press. Annals of Epidemiology is a peer reviewed, international journal devoted to epidemiologic research and methodological development. The journal emphasizes the application of epidemiologic methods to issues that affect the distribution and determinants of human illness in diverse contexts. Its primary focus is on chronic and acute conditions of diverse etiologies and of major importance to clinical medicine, public health, and health care delivery. Annals encourages the use of epidemiology in a multidisciplinary approach to understanding disease etiology. Review articles, reports from U.S. Federal and International sources, Editorials, Commentaries, Brief Communications, Letters to the Editor, Book Reviews, and selected papers from major symposia are also published. 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Annals of Epidemiology1047-27972010-01-29 © 2010 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.annalsofepidemiology.org/article/PIIS1047279709003718/abstract?rss=yesPurpose: The purpose of this study was to determine whether proportional cancer incidence is greater among Gulf War veterans compared with non-Gulf War veterans.Methods: Files obtained from the Defense Manpower Data Center included data for 621,902 veterans who were deployed to the Persian Gulf during the 1990 to 1991 Gulf War (August 2, 1990, to March 1, 1991) and 746,248 non-Gulf War veteran controls. Identification of veterans who received a cancer diagnosis between 1991 and 2006 was accomplished through record linkage of the Defense Manpower Data Center dataset with files from 28 state cancer registries and the Department of Veterans Affairs Central Cancer Registry. By the use of logistic regression, proportional incidence ratios adjusted for demographic and military characteristics were calculated by comparing the proportion of a specific cancer among all cancers in the Gulf War veterans to the proportion of that specific cancer among all cancers in the non-Gulf War veterans.Results: Only lung cancer showed a statistically significant relative excess among Gulf War veterans compared with non-Gulf War veterans (adjusted proportional incidence ratios, 1.15; 95% confidence interval, 1.03−1.29). When adjusted for race, age, and sex, the overall proportion of cancers among Gulf War and non-Gulf War veterans was similar (odds ratio, 0.99; 95% CI, 0.96−1.02).Conclusions: With the exception of lung cancer, there is little evidence of excess risk of cancer associated with Gulf War deployment. A follow-up study is warranted to confirm this finding and to evaluate the role of greater smoking rates among deployed personnel.Investigating the Risk of Cancer in 1990-1991 US Gulf War Veterans With the Use of State Cancer Registry Data - Corrected ProofHeather A. Young, Jessica D. Maillard, Paul H. Levine, Samuel J. Simmens, Clare M. Mahan, Han K. Kang10.1016/j.annepidem.2009.11.012Annals of Epidemiology (2010)2010-01-29Annals of Epidemiology2010-01-29http://www.annalsofepidemiology.org/article/PIIS1047279709003627/abstract?rss=yesPurpose: Homeopathy and Bach® Flower Remedy (BFR) therapy, historically-related over-the-counter complementary healing modalities classified as nutritional supplements by the FDA, are compared with regard to indications, dosage philosophies, associated procedures, reported outcomes, safety profiles, and the possible operation of the placebo effect.Methods: Original data and published research reports, including case studies, retrospective meta-analyses, and double-blind clinical trials are compiled and evaluated for both healing systems.Results: Homeopathy and BFR therapy both feature highly diluted natural medicinal substances, flexible dosage schedules tailored to individual patients, and energy-based healing action. They differ with respect to practitioner training and certification, number and types of medicinal source materials, remedy combinations and applications, and potential toxicity or other side-effects.Conclusions: Extensive testing has produced mixed or equivocal results regarding the efficacy of both of these health care systems. While a variety of positive outcomes have been frequently recorded with Homoeopathy and BFR treatments, it is likely that the placebo effect operates to a significant extent in both approaches.When Less Is Better: A Comparison of Bach® Flower Remedies and Homeopathy - Corrected ProofRobert A. Halberstein, Alicia Sirkin, Maria M. Ojeda-vaz10.1016/j.annepidem.2009.11.006Annals of Epidemiology (2010)2010-01-25Annals of Epidemiology2010-01-25http://www.annalsofepidemiology.org/article/PIIS1047279709003706/abstract?rss=yesPurpose: Criminal victimization produces enormous personal and societal costs, yet few investigations have systematically examined substance use and psychiatric disorders of crime victims. Our objectives were to (i) examine the prevalence and patterns of criminal victimization in the United States and (ii) their associations with specific substance use disorders, prevalent psychiatric conditions, and violent and nonviolent antisocial behaviors in controlled multivariate analyses.Methods: Data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of US residents 18 years of age and older (N=43,093). Interviews conducted between 2001 and 2002 included measures of past-year criminal victimization and Diagnostic and Statistical Manual of Mental Disorders, IV mood, anxiety, substance use, and personality disorders.Results: More than 1-in-25 adults in the United States (4.1%) reported past-year criminal victimization. Respondents who reported lower levels of income, lived in urban areas, and were separated or divorced were at significantly heightened risk for criminal victimization. Persons reporting various forms of violent and nonviolent antisocial behavior also were more likely to be victims of crime. In controlled multivariate analyses, crime victims evidenced significantly increased rates of alcohol, cocaine, and opioid use disorders. Paranoid personality disorder, major depressive disorder, and a family history of antisocial behavior were also significantly associated with past-year criminal victimization.Conclusion: Criminal victimization is prevalent in the United States and associated with significant psychiatric comorbidities and behavioral dysfunction. Poor, unmarried persons living in urban areas who have family histories of antisocial conduct and personal histories of specific substance use and psychiatric disorders are at substantially elevated risk for criminal victimization.Criminal Victimization and Comorbid Substance Use and Psychiatric Disorders in the United States: Results from the NESARC - Corrected ProofMichael G. Vaughn, Qiang Fu, Matt Delisi, Kevin M. Beaver, Brian E. Perron, Matthew O. Howard10.1016/j.annepidem.2009.11.011Annals of Epidemiology (2010)2010-01-25Annals of Epidemiology2010-01-25http://www.annalsofepidemiology.org/article/PIIS1047279709003585/abstract?rss=yesPurpose: This study tests hypotheses of one-, two-, three-, and four-factor models of metabolic syndrome (MetS) components and assesses the consistency and fit of the factor models 10 years later using confirmatory factor analysis in a large biracial sample of men and women.Methods: With the use of data from the baseline and year-10 exams of the Coronary Artery Risk Development in Young Adults Study, confirmatory factor analysis was performed overall and for race- and sex-specific groups for one-, two-, three-, and four-factor MetS models in 3403 white and black men and women at baseline and in 2532 white and black men and women 10 years later. Metabolic risk variables used in the factor analysis were insulin resistance (HOMA-IR), fasting glucose, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, systolic and diastolic blood pressure, waist circumference, waist-hip ratio, triceps skinfolds, and uric acid.Results: Three- and four-factor models of MetS achieved excellent fits of the data, ranging from 0.92 to 0.96 for race- and sex-specific models and from the baseline to year-10 exams.Conclusions: The results suggest that MetS factors are consistent across time and race-sex groups. When investigating the MetS, it is necessary to evaluate race-sex groups.Factor Analysis of Metabolic Syndrome Components in the Coronary Artery Risk Development in Young Adults (CARDIA) Study: Examination of Factors by Race-Sex Groups and Across Time - Corrected ProofT. Freeman Ferguson, Ellen Funkhouser, Jeffrey Roseman10.1016/j.annepidem.2009.11.002Annals of Epidemiology (2010)2010-01-13Annals of Epidemiology2010-01-13http://www.annalsofepidemiology.org/article/PIIS1047279709003597/abstract?rss=yesPurpose: Partnership formation and dissolution rates are primary determinants of sexually transmitted infection (STI) transmission dynamics.Methods: The authors used data on persons' lifetime sexual experiences from a 2003–2004 random digit dialing survey of Seattle residents aged 18–39 years (N=1,194) to estimate age- and gender-specific partnership formation and dissolution rates. Partnership start and end dates were used to estimate participants' ages at the start of each partnership and partnership durations, and partnerships not enumerated in the survey were imputed.Results: Partnership formation peaked at age 19 at 0.9 (95% confidence interval [CI]: 0.76–1.04) partnerships per year and decreased to 0.1 to 0.2 after age 30 for women and peaked at age 20 at 1.4 (95% CI: 1.08–1.64) and declined to 0.5 after age 30 for men. Nearly one fourth (23.7%) of partnerships ended within 1 week and more than one half (51.2%) ended within 12 weeks. Most (63.5%) individuals 30 to 39 years of age had not formed a new sexual partnership in the past 3 years.Conclusion: A large proportion of the heterosexual population is no longer at substantial STI risk by their early 30s, but similar analyses among high-risk populations may give insight into reasons for the profound disparities in STI rates across populations.Age- and Gender-Specific Estimates of Partnership Formation and Dissolution Rates in the Seattle Sex Survey - Corrected ProofSara J. Nelson, James P. Hughes, Betsy Foxman, Sevgi O. Aral, King K. Holmes, Peter J. White, Matthew R. Golden10.1016/j.annepidem.2009.11.003Annals of Epidemiology (2010)2010-01-13Annals of Epidemiology2010-01-13http://www.annalsofepidemiology.org/article/PIIS1047279709003676/abstract?rss=yesPurpose: The objective of this study was to examine the associations between paternal age and birth defects of unknown etiologies while carefully controlling for maternal age.Methods: By using 1997 to 2004 data from the National Birth Defects Prevention Study, we fit logistic regression models with paternal and maternal age as continuous variables while adjusting for demographic and other factors.Results: Elevated odds ratios (ORs) for each year increase in paternal age were found for cleft palate (OR. 1.02, 95% confidence interval [95% CI], 1.00–1.04), diaphragmatic hernia (OR, 1.04; 95% CI, 1.02–1.06), right ventricular outflow tract obstruction (OR, 1.03; 95% CI, 1.01–1.04), and pulmonary valve stenosis (OR, 1.02, 95% CI, 1.01–1.04). At younger paternal ages, each year increase in paternal age correlated with increased odds of having offspring with encephalocele, cataract, esophageal atresia, anomalous pulmonary venous return, and coarctation of the aorta, but these increased odds were not observed at older paternal ages. The effect of paternal age was modified by maternal age for gastroschisis, omphalocele, spina bifida, all orofacial clefts, and septal heart defects.Conclusions: Our findings suggest that paternal age may be a risk factor for some multifactorial birth defects.Association of Paternal Age and Risk for Major Congenital Anomalies From the National Birth Defects Prevention Study, 1997 to 2004 - Corrected ProofRidgely Fisk Green, Owen Devine, Krista S. Crider, Richard S. Olney, Natalie Archer, Andrew F. Olshan, Stuart K. Shapira, The National Birth Defects Prevention Study10.1016/j.annepidem.2009.10.009Annals of Epidemiology (2010)2010-01-07Annals of Epidemiology2010-01-07http://www.annalsofepidemiology.org/article/PIIS1047279709003639/abstract?rss=yesPurpose: Asthma includes immunological components that may share mechanisms with autoimmune diseases. We analyzed the subsequent occurrence of any of 22 autoimmune and related conditions in hospitalized asthma patients.Methods: A nationwide study was conducted in Sweden on subsequent diseases of asthma patients on the basis of the Hospital Discharge Register. Standardized incidence ratios (SIRs) were calculated for subsequent autoimmune diseases.Results: A total of 4006 patients were hospitalized for an autoimmune condition after last hospitalization for asthma. The SIRs were increased for 11 subsequent autoimmune conditions, diagnosed at least 5 years after asthma. The highest SIRs were noted for polyarteritis nodosa (4.29) and Addison disease (3.62). SIRs for these diseases and others, including the most common autoimmune disease rheumatoid arthritis, were increased even when the follow-up was started 5 years after the last asthma hospitalization. Addison disease and Crohn disease were increased in asthma patients hospitalized at various ages, whereas young asthma patients presented with celiac disease and immune thrombocytopenic purpura.Conclusions: Hospitalized asthma patients presented with a number of subsequent autoimmune and related diseases. Although we were unable to exclude the effects of environmental factors, the data suggest that shared genetic factors or gene-environment interactions may explain coexistence of some of these diseases.Subsequent Autoimmune or Related Disease in Asthma Patients: Clustering of Diseases or Medical Care? - Corrected ProofKari Hemminki, Xinjun Li, Jan Sundquist, Kristina Sundquist10.1016/j.annepidem.2009.11.007Annals of Epidemiology (2009)2009-12-28Annals of Epidemiology2009-12-28