Frontiers in epidemiology最新文献

{"title":"Global, regional, and national burden of multiple myeloma from 1990 to 2021 and projections for 2040: a systematic analysis for the global burden of disease 2021 study.","authors":"Yuying Wei, Wenjuan Gao, Shuai Wang, Qizhao Li, Shuqian Xu","doi":"10.3389/fepid.2025.1568688","DOIUrl":"10.3389/fepid.2025.1568688","url":null,"abstract":"<p><strong>Background: </strong>Multiple myeloma (MM) is a malignant hematologic disorder characterized by the abnormal clonal proliferation of bone marrow plasma cells and excessive production of immunoglobulins, often leading to severe organ damage. Due to its high incidence, recurrence, and death rates, MM poses a significant burden on individuals and global healthcare systems. This study leverages the latest data from the Global Burden of Disease Study 2021 (GBD 2021) to analyze the epidemiological trends of MM and propose effective preventive strategies.</p><p><strong>Methods: </strong>Using data from GBD 2021, we analyzed the age-standardized incidence rate (ASIR), death rate (ASDR), and disability-adjusted life years (DALYs) of MM, evaluating temporal trends through estimated annual percentage change (EAPC). Pearson correlation analysis was employed to explore the relationship between age-standardized rates (ASRs) and the Sociodemographic Index (SDI). Additionally, frontier analysis was conducted. Finally, Bayesian age-period-cohort models were utilized to predict the trends of MM ASRs through 2040.</p><p><strong>Results: </strong>In 2021, the global number of new MM cases was 148,755 (95% UI: 131,780.4-162,049.2), with 116,359.6 deaths (95% UI: 103,078.6-128,470.6) and 2,595,595 DALYs (95% UI: 2,270,483.6-2,889,968.2). Age-standardized rates increased with age. Between 1990 and 2021, the global burden of MM exhibited a consistent upward trend across all populations, with males and older adults bearing the highest burden. The analysis demonstrated a positive correlation between ASRs and the SDI. Frontier analysis indicated regions with medium-to-high SDI have the greatest potential for reducing ASRs. Among all risk factors, high body mass index (BMI) was identified as the most significant contributor to MM. Projections suggest that by 2040, the global burden of MM may experience a decline.</p><p><strong>Conclusion: </strong>Driven by population aging and advancements in diagnostic capabilities, the global burden of multiple myeloma continues to rise. Targeted prevention and treatment strategies, particularly for elderly and high-risk populations, are essential to alleviate the disease burden and improve patient outcomes.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"5 ","pages":"1568688"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hygiene and sanitation public health risks in illicit alcohol production and retail in Zambia.","authors":"Musawa Mukupa, Cosmas Zyambo, Masauso Moses Phiri, Richard Zulu, Tulani Francis L Matenga, Kumbulani Mabanti, Anna Hainze, Ahmed Ogwell, William DeJong, Dhally M Menda, Angela Rizzo, Fastone Goma, Tom Achoki","doi":"10.3389/fepid.2025.1461874","DOIUrl":"https://doi.org/10.3389/fepid.2025.1461874","url":null,"abstract":"<p><strong>Introduction: </strong>Illicit alcohol, existing outside legal frameworks, lacks safety standards and may contain harmful substances. In Africa, the illicit alcohol market is pervasive, contributing to significant public health challenges. The state in Zambia may not be so different where abuse of alcohol was associated to unintended injuries, suicidal ideation and physical fights that in some cases lead to death. This mirrors these challenges; according to the Zambia Stepwise Survey for Non-Communicable Diseases (NCDs) Risk Factors (2017), 21.7% of adults consume alcohol, with urban areas experiencing higher rates of illicit production.</p><p><strong>Aim: </strong>The study aimed to assess the public health risk implications associated with the production and retail of illicit alcohol based on the hygiene and sanitation of these premises. A quantitative approach was employed in Livingstone, Lusaka, and Ndola.</p><p><strong>Methods: </strong>We employed a quantitative approach was conducted in Livingstone, Lusaka, and Ndola. A hygiene and sanitation observation tool obtained from the Lusaka City Council was adapted and utilized to evaluate the conditions of these premises.</p><p><strong>Results: </strong>The study found that Livingstone exhibited the highest rate of unavailability of water supply at illicit alcohol production sites, with 18% lacking access to water, while Lusaka had 13% without water supply of the zones selected, all sites in Ndola had water supply.</p><p><strong>Conclusion: </strong>Given the growing trend of consuming illicit alcohol in such unsanitary environments, urgent interventions are warranted. The study recommends the implementation of enforcement of regulations, including regular inspections and enhanced enforcement mechanisms, to ensure hygienic and sanitary production practices.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"5 ","pages":"1461874"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neighborhood disorder and depressive symptoms in Jamaican adults: the mediating roles of neighborhood crime and safety problems and collective efficacy.","authors":"C Cunningham-Myrie, T Moore, J Wiggan, N Younger-Coleman, S McFarlane, G Gordon-Strachan, D Francis, N Bennett, I Govia, M Tulloch-Reid, T S Ferguson, W Aiken, A Grant, T Davidson, K Webster-Kerr, R Wilks, K P Theall","doi":"10.3389/fepid.2025.1467838","DOIUrl":"https://doi.org/10.3389/fepid.2025.1467838","url":null,"abstract":"<p><strong>Background: </strong>Neighborhood disorder has been found to be associated with worse mental health outcomes, such as depression. This study examined the association between perceived neighborhood disorder on depressive symptoms in a nationally representative sample of Jamaican adults, and whether any association was mediated by perception of neighbourhood crime and safety problems or collective efficacy (CE).</p><p><strong>Methods: </strong>Secondary analysis was conducted on the Jamaica Health and Lifestyle Survey (JHLS III). The JHLS III, a cross-sectional nationally representative survey, was administered to 2,807 individuals aged 15 years and older in Jamaica and completed in 2017. Regression analyses were performed to identify associations between perceived neighborhood disorder and depressive symptoms and mediation analyses to examine the roles of perceived neighborhood crime and safety problems and CE in the pathway between perceived neighbourhood disorder and depressive symptomatology.</p><p><strong>Results: </strong>The odds of depressive symptomatology were 1.55 (95% CI = 1.14, 2.10) times as high among respondents living in neighborhoods perceived as having high disorder compared to those with low disorder. Partial mediation by perceived neighborhood crime and safety problems and low CE in the disorder-depressive symptomatology relation was observed. Twelve percent and 7% of the association between neighbourhood disorder and depressive symptoms were explained through perceived neighborhood crime and safety problems and low CE, respectively. In serial mediation analysis the association between perceived neighborhood disorder and depressive symptoms was mediated by perception of neighborhood crime and safety problems which, in turn, was mediated by reported CE.</p><p><strong>Discussion: </strong>The pathway between neighborhood disorder and depressive symptoms may be reduced by intervening on reducing neighborhood crime and safety problems and/or improving CE in Jamaican neighborhoods.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"5 ","pages":"1467838"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis on the association between PM_2.5 exposure and increased influenza risk.","authors":"Ava Orr, Rebekah L Kendall, Zeina Jaffar, Jon Graham, Christopher T Migliaccio, Jonathon Knudson, Curtis Noonan, Erin L Landguth","doi":"10.3389/fepid.2025.1475141","DOIUrl":"https://doi.org/10.3389/fepid.2025.1475141","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review and meta-analysis investigate the relationship between PM_2.5 exposure and increased influenza risk (e.g., increased hospital admissions, confirmed influenza cases), synthesizing previous findings related to pollutant effects and exposure durations.</p><p><strong>Methods: </strong>We searched PubMed, Web of Science, and Scopus for relevant studies up to 1 January 2010, following Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines for selection and analysis.</p><p><strong>Results: </strong>Our review included 16 studies and found that a 10 μg/m³ increase in daily PM_2.5 levels was associated with an increase of 1.5% rise in influenza risk (95% CI: 0.08%, 2.2%), with significant variations across different temperatures and lag times post-exposure. The analysis revealed heightened risks, with the most significant increases observed under extreme temperature conditions. Specifically, colder conditions were associated with a 14.2% increase in risk (RR = 14.2%, 95% CI: 3.5%, 24.9%), while warmer conditions showed the highest increase, with a 29.4% rise in risk (RR = 29.4%, 95% CI: 7.8%, 50.9%). Additionally, adults aged 18-64 were notably affected (RR = 4%, 95% CI: 2.9%, 5.1%).</p><p><strong>Discussion: </strong>These results highlight PM_2.5's potential to impair immune responses, increasing flu susceptibility. Despite clear evidence of PM_2.5's impact on flu risk, gaps remain concerning exposure timing and climate effects. Future research should broaden to diverse regions and populations to deepen understanding and inform public health strategies.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"5 ","pages":"1475141"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence and behavioral risk factors contributing to non-communicable diseases in Bushbuckridge, Mpumalanga province, South Africa.","authors":"Thabo D Pilusa, Cairo B Ntimana, Eric Maimela","doi":"10.3389/fepid.2025.1560971","DOIUrl":"https://doi.org/10.3389/fepid.2025.1560971","url":null,"abstract":"<p><strong>Background: </strong>Intervention strategies such as health campaigns, pre-screening, health education, and health talks exist. Still, they are only active if there are outbreaks of the specific infectious disease not mainly NCDs. Therefore, there is a need to develop intervention strategies to improve the prevention and control of behavioral risk factors for NCDs by determining social, economic, and health system factors. Hence, the study aimed to determine the prevalence and determinants of behavioral risk factors contributing to NCDs in Bushbuckridge, South Africa.</p><p><strong>Methods: </strong>This cross-sectional descriptive study involved 2,400 respondents selected from healthcare facilities. The participants were selected using simple random sampling. Data was analyzed using SPSS version 29. A comparison of proportions was performed using the chi-square test. The association between sociodemographic and lifestyle factors with predictors of behavioral risk factors for NCD was analyzed using binary regression analysis, and the statistical significance was set at a <i>p</i>-value of <0.05.</p><p><strong>Results: </strong>The mean age of the study was 46.27 ± 13.38. The prevalence of Smoking was 51.3% (1,211). The prevalence of alcohol consumption within the past year was 19.3% (463), while inadequate fruit and vegetable intake was 76.2%. Physical inactivity was 97.2%. Additionally, hypertension and diabetes were 51% and 50.1% respectively. Participants (≥35 years) were likely to have low fruit and vegetable intake (aOR = 1.3; 95% CI: 0.99-1.62). Widows were 30% less likely to smoke (aOR = 0.72; 95% CI: 0.57-0.92), yet they were 1.4 times more likely to consume alcohol (aOR = 1.4; 95% CI: 0.99-1.84). Unemployed participants were found to have a higher likelihood of consuming alcohol (aOR = 1.3; 95% CI: 1.02-1.54).</p><p><strong>Conclusion: </strong>The prevalence of behavioral risk factors for NCDs was found to be high among rural populations residing in Bushbuckridge, underscoring the need for sustained and comprehensive interventions. In rural areas like Bushbuckridge, the combination of poverty, unemployment, limited healthcare access, and evolving social dynamics creates a challenging environment that fosters unhealthy behaviors and increases the risk of NCDs. To effectively reduce the burden of these diseases in such communities, public health strategies must focus on socio-economic and cultural determinants, rather than just demographic factors.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"5 ","pages":"1560971"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study on nosocomial and community-acquired bacterial urinary tract infections: prevalence, antimicrobial susceptibility pattern, and associated risk factors among symptomatic patients attending Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia.","authors":"Sisay Fekadu, Fitsum Weldegebreal, Tadesse Shumie, Getachew Kabew Mekonnen","doi":"10.3389/fepid.2025.1517476","DOIUrl":"https://doi.org/10.3389/fepid.2025.1517476","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) remain one of the most common diseases worldwide that occur both in the community and in healthcare settings. Thus, this study aimed to compare the burden of nosocomial and community-acquired bacterial UTIs among patients attending Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia.</p><p><strong>Method: </strong>A hospital-based cross-sectional study was conducted using a convenient sampling technique from January 2024 to April 2024. Descriptive statistics were employed, and bivariate and multivariable logistic regression analyses were used to identify associated factors at <i>p</i> < 0.05 with a 95% confidence interval (CI) considered statistically significant.</p><p><strong>Results: </strong>The rate of hospital-acquired UTIs was 42% (95% CI: 35-50), while the rate of community-acquired UTIs was 28% (95% CI: 22-36). The predominant bacterial isolates were <i>Escherichia coli</i> (37%), <i>Staphylococcus aureus</i> (7.8%), and <i>Klebsiella pneumoniae</i> (7.8%). The overall multidrug resistance rate was 91 (77.8%). Lack of formal education [adjusted odds ratio (AOR), 0.02; 95% CI: 0.001-0.6], surgery during admission (AOR, 0.02; 95% CI: 0.002-0.3), delay in voiding urine (AOR, 0.01; 95% CI: 0.005-0.1), previous UTIs (AOR, 0.04; 95% CI: 0.004-0.4), and previous admission (AOR, 0.07; 95% CI: 0.01-0.5) were the main factors significantly associated with bacterial UTIs.</p><p><strong>Conclusions: </strong>A significantly higher prevalence of hospital-acquired bacterial UTIs was observed compared to community-acquired bacterial UTIs. The commonest isolates were <i>E.coli</i>, <i>S. aureus</i>, and <i>K. pneumoniae</i>. The drug resistance rate was very high. Modifiable individual-level factors were the major significant factors of UTIs. Thus, health workers and other stakeholders should tackle UTIs by increasing community awareness, promoting personal hygiene, and improving healthcare service quality.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"5 ","pages":"1517476"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholera outbreak and associated risk factors in Dollo Ado district, Ethiopia: un-matched case-control study, 2023.","authors":"Fitsum Hagos, Habtamu Molla Ayele, Eyob Hailu Kebede, Abdulnasir Abagero, Awgichew Kifle","doi":"10.3389/fepid.2025.1480230","DOIUrl":"https://doi.org/10.3389/fepid.2025.1480230","url":null,"abstract":"<p><strong>Background: </strong>Cholera is a highly contagious bacterial disease that causes severe watery diarrhea. It spreads mainly through contaminated food or water containing <i>Vibrio cholerae</i> O139 and remains a major global public health threat. We investigated an outbreak to identify its cause, source, and risk factors and to develop control measures.</p><p><strong>Method: </strong>A suspected case was classified as the occurrence of acute watery diarrhea in a Dollo Ado District resident aged 2 or older between February 2, 2023 and March 15, 2023. A confirmed case was a suspected case with <i>Vibrio cholerae</i> detected in the patient's stool sample. An investigation of the outbreak was conducted; cases were described and the environment, where contamination may take place assessed and an unmatched case-control study conducted in Suftu Kebele, which served as the epi center of the outbreak. Logistic regression was used to identify risk factors for cholera infection.</p><p><strong>Results: </strong>A total of 92 cases were identified, including 66 males and 26 females, with four deaths (4.3% fatality rate). Males had a higher attack rate (2.4 per 1,000 people) than females (1.6 per 1,000 people). Suftu village was the hardest-hit area (attack rate: 41 per 1,000 people). The outbreak began after a person suspected of having cholera returned from mandera, kenya, on February 2, 2023. Five days later, cases emerged in suftu village. Many residents practiced open defecation and used the dawa river for bathing, washing clothes, and drinking. Using untreated river water significantly increased the risk of infection (AOR = 20, 95% CI: 5.2-73).</p><p><strong>Conclusion: </strong>The outbreak likely started at a funeral of a suspected cholera case, spreading through contaminated river water. It was contained within a week by restricting river water use and preventing further contamination.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"5 ","pages":"1480230"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between brominated flame retardants, including polybrominated diphenyl ethers, and immune responses among women in the California Teachers Study.","authors":"Emily L Cauble, Peggy Reynolds, Marta Epeldegui, Priyanthi S Dassanayake, Larry Magpantay, Daniel Blyakher, Pratima Regmi, Julie Von Behren, Otoniel Martinez-Maza, Debbie Goldberg, Emma S Spielfogel, James V Lacey, Sophia S Wang","doi":"10.3389/fepid.2025.1452934","DOIUrl":"10.3389/fepid.2025.1452934","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the associations between brominated flame retardants (BFRs), including polybrominated diphenyl ethers (PBDEs), exposure and circulating immune markers in a subset of women from the California Teachers Study cohort.</p><p><strong>Methods: </strong>In this cross-sectional study, serum from 813 female participants in the California Teachers Study collected in 2013-2016 were evaluated for 11 BFR congeners and 16 immune markers. Three BFR congeners [BDE153 [2,2',4,4',5,5'-Hexabromodiphenyl ether], BDE47 [2,2',4,4'-Tetrabromodiphenyl ether], PBB153 [2,2',4,4',5,5'-Hexabromobiphenyl]] had median levels that were above the level of detection and were further evaluated for associations with circulating immune markers. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by a logistic regression model where BFR congeners (in quartiles) were associated with immune markers (dichotomized as above and below the respective median), adjusted for age and total lipids. Sensitivity analyses were also conducted evaluating BFR congeners as a continuous exposure (per pg/ml).</p><p><strong>Results: </strong>All participants had at least one of the 11 measured BFR congeners detected in their serum. Increasing levels of BDE47 were associated with elevated levels of BAFF (B-cell activating factor; OR_{Quartile 4} = 1.67, 95% CI = 1.11-2.51), soluble CD27 (sCD27, cluster of differentiation 27; OR_{Quartile 4} = 1.69, 95% CI = 1.12-2.55) and IL6 (interleukin 6; OR_{Quartile 4} = 1.74, 95% CI = 1.13-2.66). Increasing levels of PBB153 were associated with elevated levels of CXCL13 (chemokine ligand 13; OR_{Quartile 4} = 1.55, 95% CI = 1.02-2.35) but inversely associated with sCD27 (OR_{Quartile 4} = 0.57, 95% CI = 0.38-0.87). Results from continuous models of BFR were largely consistent. No associations were observed between BDE153 and any of the immune markers assessed.</p><p><strong>Conclusions: </strong>Two BFR congeners were statistically associated with altered levels of circulating immune markers involved in B cell activation pathways; replication and further evaluation of these novel associations are warranted. If confirmed, our results add to the current literature regarding possible immune mechanisms by which BFR exposures contribute to immune-related health endpoints and conditions where B cell activation is prominent, including autoimmune conditions.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"5 ","pages":"1452934"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demystifying impact evaluation: an impact evaluation framework.","authors":"Janet Michel, Kimon Schneider","doi":"10.3389/fepid.2025.1460997","DOIUrl":"10.3389/fepid.2025.1460997","url":null,"abstract":"<p><p>As the global financial, economic, social, environmental, political, technological and health crises deepen and become more complex, funders are increasingly eliciting for programs/research that demonstrate impact. A lot of evaluations often lack the methodological robustness to inform further action by failing to demonstrate the context mechanism and outcome pathways. The landscape is changing. The value of programs/interventions and research is increasingly coming under scrutiny. Impact evaluation is the process of determining to what extent observed changes in the outcome are attributable to the intervention. Figures alone cannot explain why things are that way, and stories alone cannot demonstrate who or how many people benefited and to what extent. Additional methodological tools, such as participatory methods, theories of change, and human centred designs citizen science and the engagement of all key stakeholders, including those previously known as beneficiaries is fundamental. This facilitates a better understanding of the problems while unraveling potential solutions, bearing in mind that any health system intervention can have positive, negative, intended, unintended, direct and indirect consequences. Transdisciplinary, multi and inter-disciplinary approaches and mixed methods therefore become indispensable. To that end we propose an impact evaluation framework with seven central tenets namely; Theory of change (TOC) or program theory, Stakeholder engagement including beneficiaries, Use of mixed method indicators, Baseline of outcome of interest, Midline assessment of outcome of interest, Endline assessment of outcome of interest and Validation/Co-creation.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"5 ","pages":"1460997"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in defining thresholds for health effects: some considerations for asbestos and silica.","authors":"Julie E Goodman, Lorenz R Rhomberg, Samuel M Cohen, Kenneth A Mundt, Bruce Case, Igor Burstyn, Michael J Becich, Graham Gibbs","doi":"10.3389/fepid.2025.1557023","DOIUrl":"10.3389/fepid.2025.1557023","url":null,"abstract":"<p><p>This paper summarizes several presentations in the Thresholds in Epidemiology and Risk Assessment session at the Monticello III conference. These presentations described evidence regarding thresholds for particles, including asbestos and silica, and cancer (e.g., mesothelioma) and noncancer (e.g., silicosis) endpoints. In the case of exposure to various types of particles and malignancy, it is clear that even though a linear non-threshold model has often been assumed, experimental and theoretical support for thresholds exist (e.g., through particle clearance, repair mechanisms, and various other aspects of the carcinogenic process). For mesothelioma and exposure to elongate mineral particles (EMPs), there remains controversy concerning the epidemiological demonstration of thresholds. However, using data from the Québec mining cohort studies, it was shown that a \"practical\" threshold exists for chrysotile exposure and mesothelioma. It was also noted that, in such evaluations, measurement error in diagnosis and exposure assessment needs to be incorporated into risk analyses. Researchers were also encouraged to use biobanks that collect specimens and data on mesothelioma to more precisely define cases of mesothelioma and possible variants for cases of all ages, and trends that may help define background rates and distinguish those mesotheliomas related to EMP exposures from those that are not, as well as other factors that support or define thresholds. New statistical approaches have been developed for identifying and quantifying exposure thresholds, an example of which is described for respirable crystalline silica (RCS) exposure and silicosis risk. Finally, the application of Artificial Intelligence (AI) to considering the multiple factors influencing risk and thresholds may prove useful.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"5 ","pages":"1557023"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}