The Rotterdam Study: 2018 update on objectives,design and main results

The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, otolaryngological, locomotor, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. Since 2016, the cohort is being expanded by persons aged 40 years and over. The findings of the Rotterdam Study have been presented in over 1500 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.     

The Shanghai Women's Asthma and Allergy Study: objectives, design, and recruitment results

The Shanghai Women's Asthma and Allergy Study is the first population-based incidence study designed to assess the associations of dietary antioxidant intake and measures of oxidative stress and antioxidant enzyme activity with development of adult-onset asthma and allergic rhinitis. A total of 65,732 participants in the Shanghai Women's Health Study, an ongoing cohort study in seven districts of Shanghai, People's Republic of China, were recruited to the Shanghai Women's Asthma and Allergy Study from 2003 to 2007. Dietary intake was assessed in the parent study by using a validated and quantitative food frequency questionnaire at baseline recruitment and at the first biennial follow-up survey. Blood and urine samples were collected to measure baseline oxidative stress, antioxidant enzyme activity, and nutrient levels at the baseline survey. Incident asthma and allergic rhinitis were assessed by using a modification of the International Study of Asthma and Allergies in Childhood questionnaire during the biennial in-person survey of the Shanghai Women's Health Study. Diagnosis of asthma was confirmed by either methacholine challenge testing or test of reversibility to beta-agonists. Dietary antioxidant intake, plasma antioxidants, antioxidant enzymes, and urinary isoprostanes, a marker of oxidative stress, were measured prior to disease onset. This paper describes the study objectives, design, population demographics, and recruitment results.     

The Life Journeys Of Young Women Project: objectives, design, and recruitment results

The Life Journeys of Young Women Project is the first population-based study to examine the role of economic uncertainty throughout early adulthood on age at first childbirth. A retrospective cross-sectional component was added to an existing cohort study that is based on a birth cohort of women born during 1973-1975 in Adelaide, South Australia (n ～ 1,000). An event history calendar instrument was used to obtain data regarding a range of life domains including partnering, educational attainment, home ownership, higher education debt, employment, and pregnancies over a 20-year period (sometimes as detailed as at monthly intervals). Interviews were conducted between 2007 and 2009. An analysis framework applying time-varying and time-constant survival analysis techniques within a life-course framework was developed that will guide analyses to examine the role of duration and life-course timing of economic uncertainty on age at first childbirth. This paper discusses study objectives and design, fieldwork procedures, planned statistical analyses, and recruitment outcomes, focusing on novel features that would facilitate analogous epidemiologic research.     

Particulate air pollution and asthma: a review of epidemiological and biological studies

The link between exposure to air pollution and exacerbation of asthma symptoms has been investigated by epidemiological study and by direct biological experimentation. In asthmatics, epidemiological studies generally show a positive correlation between the particulate fraction of air pollution and increased morbidity, although roles for other co-pollutants (for example, ozone) are implicated as well. Direct experimentation using air pollutants, especially particles, to investigate their effects on humans or on animal models of asthma provides corroboration of the epidemiology and has begun to identify the pathophysiological mechanisms involved. We begin this review with an overview of air pollution, followed by a survey of the epidemiological and experimental data regarding air pollution particles and asthma. We finish with a discussion of directions for future research.     

Longitudinal studies: objectives and ethical considerations

Studies discussed in this issue have in common that subjects are followed-up, the majority of studies with data collection on at least two occasions. However the need for follow-up in terms of the study hypotheses should be assessed carefully, because such studies are costly and more difficult to carry-out and analyse than cross-sectional studies. Studies are classified according to the nature of the explanatory and outcome variables, whether fixed for each subject, a transitional age, or a changing measurement or characteristic. The information that can be obtained is discussed for each combination of explanatory and outcome variables. Time trends are also considered. The different requirements of reference ranges are included, and ethical considerations particular to follow-up studies are briefly described.     

The Rotterdam Study: objectives and design update

The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in the Netherlands. The study targets cardiovascular, neurological, ophthalmological and endocrine diseases. As of 2008 about 15,000 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in some 600 research articles and reports (see ). This article gives the reasons for the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.     

Multi-ethnic study of atherosclerosis: objectives and design

The Multi-Ethnic Study of Atherosclerosis was initiated in July 2000 to investigate the prevalence, correlates, and progression of subclinical cardiovascular disease (CVD) in a population-based sample of 6,500 men and women aged 45-84 years. The cohort will be selected from six US field centers. Approximately 38% of the cohort will be White, 28% African-American, 23% Hispanic, and 11% Asian (of Chinese descent). Baseline measurements will include measurement of coronary calcium using computed tomography; measurement of ventricular mass and function using cardiac magnetic resonance imaging; measurement of flow-mediated brachial artery endothelial vasodilation, carotid intimal-medial wall thickness, and distensibility of the carotid arteries using ultrasonography; measurement of peripheral vascular disease using ankle and brachial blood pressures; electrocardiography; and assessments of microalbuminuria, standard CVD risk factors, sociodemographic factors, life habits, and psychosocial factors. Blood samples will be assayed for putative biochemical risk factors and stored for use in nested case-control studies. DNA will be extracted and lymphocytes will be immortalized for genetic studies. Measurement of selected subclinical disease indicators and risk factors will be repeated for the study of progression over 7 years. Participants will be followed through 2008 for identification and characterization of CVD events, including acute myocardial infarction and other coronary heart disease, stroke, peripheral vascular disease, and congestive heart failure; therapeutic interventions for CVD; and mortality.     

Hospital reform project, objectives, implementation, results and training

Face to structural adjustments of the economy, the Tunisian public system of health, confronted with internal inefficiencies and to an inadequate financing, makes the object of a reform targeting teaching hospitals. Its objectives are to institute an autonomy of management and to exploit an integrated system of information that, associated to economic studies, will allow the Government to revise modes of financing of the health sector. This reform has modified the legal structure of university hospitals ending to a management of performances, based on the participation of the intervening, in an environment demarcated by the Government, by contracting multi-annual programs. By its impact, by reactions and surrounding opportunities, its viability and its sustainability are warranted especially if one minimizes potential risks linked to the exercise of the tutelage and to the adaptation to reforms of the other systems, notably the health insurance in order that a project of reform has been adopted and will be put in application soon. The strategy of implementation steady has allowed to reach convincing results to consolidate and to diagnose insufficiencies to fulfill, especially that an adapted extension of this reform is anticipated, to the level of regional hospitals, secondary care level.     

Erfurt Male cohort Study (ERFORT Study). Study design and descriptive results

OBJECTIVES: The main objective of ERFORT Study is to investigate cardiovascular risk factors, life-style related factors and psychosocial factors with regard to total and cause-specific mortality and morbidity. This paper describes the study design, frequency data on cardiovascular and psychosocial factors at baseline survey, and findings of three 5 year follow-up medical examinations. Life status was followed for 30 years. METHODS: The Erfurt Male Cohort Study (ERFORT Study) is a population-based prospective cohort study and has its origin in the WHO initiated feasibility study to acquire experience in multi-factorial intervention programs. The baseline survey in 1973-75 examined a random population-based sample of 1,160 males aged 35-61 years (brutto response rate 74.6%) from the city of Erfurt, East Germany. RESULTS: Standardized and mostly validated methods were applied for a collection of data on cardiovascular risk factors, lifestyle-related and psychosocial factors, blood tests and ECG. Three consecutive follow-up examinations yielded datasets of 907, 740 and 609 subjects' re-examination in 1978-79, 1983-85 and 1988-90. Cardiovascular diseases such as myocardial infarction, angina pectoris, and claudication intermittent approximately doubled within a 15-year follow-up. Prevalence of diabetes strongly increases from 2.8% at baseline to 12.0% at the 15-years follow up. High blood pressure (> or = 160/95 mm Hg) only slightly increased, whereas the antihypertensive treatment increased from 8.7% to 33.6%. CONCLUSIONS: This data set of a German cohort followed for several decades is an outstanding database to answer questions about long-term associations between biological and psychosocial factors and mortality in men.     

The World Organisation for Animal Health and epidemiological modelling: background and objectives

The papers in this issue of the Scientific and Technical Review (the Review) examine uses of modelling as a tool to supportthe formulation of disease control policy and applications of models for various aspects of animal disease management. Different issues in model development and several types of models are described. The experience with modelling during the 2001 foot and mouth disease outbreak in the United Kingdom underlines how models might be appropriately applied by decision-makers when preparing for and dealing with animal health emergencies. This paper outlines the involvement of the World Organisation for Animal Health (OIE) in epidemiological modelling since 2005, with emphasis on the outcome of the 2007 questionnaire survey of model usage among Member Countries, the subsequent OIE General Session resolution and the 2008 epidemiological modelling workshop at the Centers for Epidemiology and Animal Health in the United States. Many of the workshop presentations were developed into the papers that are presented in this issue of the Review.     

The epidemiological contribution to the preparation of field trials for HIV and STI vaccines: objectives and methods of feasibility studies

Feasibility studies are an important component of preparations for efficacy field trials of vaccine candidates, but represent a neglected area in clinical trial literature. These studies are designed to identify cohorts of higher-risk individuals with sufficiently high incidence to support a vaccine trial; to determine the readiness of these individuals to participate in a trial; to develop cost-effective recruitment and retention strategies, educational methods that ensure ethical informed consent, and instruments that accurately assess risk behaviours; to measure incidence rates over time and the effect of risk reduction interventions on incidence; to contribute estimates of incidence and loss to follow-up rates to sample size calculations; to assess the level of acceptability of a future efficacious vaccine in the target population and, in the case of several viruses, to identify circulating subtypes. Feasibility study methods have been largely developed in the context of HIV, but may also be used in the preparation of preventive intervention trials for other STI.     

The Rotterdam Study: 2010 objectives and design update

The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in close to a 1,000 research articles and reports (see www.epib.nl/rotterdamstudy). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.     

The Rotterdam Study: 2014 objectives and design update

The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, oncological, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in over a 1,000 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.     

The Rotterdam Study: 2012 objectives and design update

The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, oncological, and respiratory diseases. As of 2008, 14,926 subjects aged 45?years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in over a 1,000 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy ). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.