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T E Aldrich

Publications and source records attributed to T E Aldrich.

At least 19 recordsLinked to original sources
PubMed2000

Environmental epidemiology forward.

Environmental epidemiology is the specialized aspect of public health science that studies human health risk from environmental hazards. It is rises largely upon a foundation of public health surveillance, and relies heavily upon analyses of data for small areas and sparse population groups. To a degree, environmental epidemiology is assigned the role of discerning very subtle human health impacts, or discerning early evidence of a tragic sequence. In that context, environmental epidemiology has a substantial public education and risk communication role. Environmental epidemiology will be greatly advanced as effective biological markers of exposure and precursor health effects are developed. At this point in time, statistical methods are in place to monitor population-level disease rates in high-risk populations for early risk identification and sentinel event recognition. Advances in geographic methods have provided a boon to the discipline by advantaging spatial studies. These advances in the discipline still need further refinement and pilot experiences. The inclusion of environmental epidemiological considerations with instances of proposed industrial expansion, hazardous waste management, and contamination remediation is heartily recommended.

Environmental Medicine↗
PubMed2000

Help-seeking for intimate partner violence and forced sex in South Carolina.

PURPOSE: In this population-based, random-digit-dial, cross-sectional survey, we assessed the lifetime victimization of intimate partner violence (IPV) and forced or coerced sex among 556 women and men in South Carolina, and the help-seeking behaviors of victims. RESULTS: Among women, 25.3% experienced IPV (sexual, physical, or emotional violence) compared with 13.2% of men. Although women were significantly more likely to report physical or sexual IPV (17.8%) than were men (4.9%), men (8.3%) were as likely as women (7.4%) to report perceived emotional abuse without physical or sexual IPV. One half of men and women with annual incomes <$15, 000 reported IPV. Among women experiencing physical or sexual IPV, 53% sought community-based or professional services for IPV; women with higher education levels and those experiencing more severe violence were most likely to seek services. CONCLUSIONS: These data show that IPV is common and that most victims do not receive services to address this violence.

Adolescent↗
PubMed2000

The relative merits of contemporary measurements and historical calculated fields in the Swedish childhood cancer study.

We present arguments that suggest that historical average calculated fields, which are widely used to estimate biologically relevant exposure to electromagnetic fields, may be less accurate than contemporary spot measurements, which are made at a time following the biologically relevant period of exposure. We use data from the seminal Feychting and Ahlbom study of the health effects of electromagnetic field exposure in a Swedish population to illustrate our argument. We also show how the two types of measurements can produce divergent estimates of risk, and show how in the Feychting and Ahlbom study, the less accurate measurement, the historical average calculated fields, may have resulted in a spurious increase in the estimates of risk. Finally, we consider the implications of our arguments for other studies that rely on wire codes and historical calculations of personal exposure.

Bias↗
PubMed1999

Prostate cancer: demographic and behavioral correlates of stage at diagnosis among blacks and whites in North Carolina.

OBJECTIVES: Although stage at diagnosis is one of the most important predictors of survival from prostate cancer, demographic factors, screening practices, and knowledge and beliefs associated with stage at diagnosis have not been well documented, particularly by race. METHODS: We conducted telephone interviews with 117 black and 114 white men diagnosed with prostate cancer to identify the demographic factors, healthcare-seeking behaviors, and prostate cancer-related knowledge, attitudes, and practices associated with stage. The sample was stratified by stage at diagnosis and was composed of men 50 to 74 years old who resided in a contiguous 63-county region in North Carolina and who were diagnosed at 1 of 16 participating hospitals. RESULTS: Among blacks, stage was inversely correlated with income (P = 0.04) and health insurance status (P < or = 0.001); among whites, stage was not associated with income or health insurance status, but approached significance with marital status (P = 0.06). Awareness of prostate cancer before diagnosis tended to decline with advancing stage among black men (P = 0.07), but was high for all stages (greater than 93%) among whites. Report of a prostate-specific antigen screen was inversely correlated with stage among black men (P = 0.01); a trend was observed among whites but was not significant (P = 0.20). Knowledge of prostate cancer risk factors was not significantly associated with stage for blacks or whites. Less than one third of men in each race and stage group knew that black men are at increased risk of prostate cancer. CONCLUSIONS: Demographic and other factors vary with stage and should be considered when designing and targeting interventions to reduce late diagnosis of prostate cancer.

Black or African American↗
PubMed1999

The modifiable factors contributing to leading causes of death in South Carolina.

In 1996, there were 34,035 deaths in South Carolina. Almost 70 percent of these deaths were due to chronic diseases. There are known ways to prevent chronic diseases from developing or at least delay their developmental process, thereby lengthening years of life. The purpose of this paper is to report modifiable risk factors for mortality related to leading causes of death. The top ten causes of death in South Carolina were obtained from the South Carolina Department of Health and Environmental Control. Estimates of the number of deaths due to certain modifiable risk factors were made using results of a study published by McGinnis and Foege. The percentage of deaths due to each cause was adapted to South Carolina death certificate data from the national estimates. Results indicate that small modifications in individual lifestyles could prevent or delay nearly 50 percent of deaths in South Carolina annually. Tobacco use, diet and physical activity, and misuse of alcohol contribute to the largest number of deaths. Other modifiable behaviors contributing to the 50 percent mortality are microbial agents, toxic agents, firearms, sexual behavior, motor vehicle accidents, and illicit use of drugs. The implication in these findings is that these risk factors for mortality are mainly modifiable. There are many causes of death that may be delayed due to these modifiable risk factors. By looking at preventable causes of death, rather than focusing on traditional causes of death, it becomes clear that prevention strategies are critically important.

Cause of Death↗
PubMed1998

Treatment options, selection, and satisfaction among African American and white men with prostate carcinoma in North Carolina.

BACKGROUND: In the U.S., prostate carcinoma mortality is greatest among African Americans. In North Carolina, the state with the fourth largest population of African Americans, the prostate carcinoma mortality rate is 2.5 times greater among African Americans than among whites and is the highest reported rate for any state in the nation. To explore potential reasons for the racial differential in mortality, a study was undertaken to determine whether differences related to treatment existed between African American and white men who were diagnosed with prostate carcinoma during the period 1994-1995. METHODS: Cases were selected from 16 institutions within a region comprising 63 contiguous counties where the overall population was >20% African American. A stratified design was employed to accrue subjects into groups of even size according to race and disease stage (n = 231). A telephone survey was conducted, which assessed treatment options discussed by patients with their physicians, treatment(s) received, factors influencing treatment, satisfaction with treatments discussed and options given, and sociodemographic information. RESULTS: All measures related to treatment were consistently associated with stage at diagnosis (P < 0.001) rather than other variables measured (i.e., race, age, income, comorbidity, education, and residential status). Furthermore, most subjects reported that their physicians presented several treatment options (65%), that they were satisfied with the options presented (90%), and that the physician was the most important factor influencing their treatment decision (57%). CONCLUSIONS: These data suggest that African American and white men in North Carolina receive comparable treatment for prostate carcinoma. Therefore, efforts to reduce the racial disparity in mortality should be directed toward lessening the high incidence of later stage disease at diagnosis and exploring potential biologic differences that may increase the risk of more aggressive disease among African Americans.

Aged↗
PubMed1995

The Carolina Breast Cancer Study: integrating population-based epidemiology and molecular biology.

The integration of epidemiology and molecular biology provides a new strategy to identify additional risk factors for breast cancer and to better understand the role played by traditionally recognized risk factors. The Carolina Breast Cancer Study (CBCS) is a population-based, case-control study designed to identify causes of breast cancer among Caucasian and African-American women who are residents of a 24-county area of central and eastern North Carolina. Information on established and potential breast cancer risk factors is obtained by personal interviews. Blood samples are collected from all consenting participants. Medical record documentation and paraffin-embedded tumor specimens are obtained for all breast cancer patients. DNA from tumor tissue is tested for a variety of molecular alterations characteristic of breast cancer. Germline DNA from blood lymphocytes is evaluated for presence of alleles increasing susceptibility to breast cancer. Statistical analyses evaluate gene-environment interaction by exploring the associations between environmental/behavioral factors and breast cancer in relation to specific molecular alterations (germline and tumor). Results will help identify high-risk women, clarify causal pathways, and hopefully contribute to the prevention of breast cancer.

Adult↗
PubMed1995

Rapid reporting of cancer incidence in a population-based study of breast cancer: one constructive use of a central cancer registry.

To support a study of genetic risk factors for breast cancer, the North Carolina Central Cancer Registry has implemented a rapid reporting procedure for hospitals in the study area. This system permits the identification of newly diagnosed breast cancer cases within a very short time period (less than one month). The procedures are straightforward, cost-effective, and greatly benefit the objectives of tissue collection and interviews with the cases. This article describes the rapid reporting procedures and their potential impact for population-based research. For the objective of making generalizable risk statements, the necessity of population-based research is stressed; participation with central cancer registries is endorsed for this and other molecular epidemiologic applications.

Breast Neoplasms↗
PubMed1995

Cancer risk among women sterilized with transcervical quinacrine hydrochloride pellets, 1977 to 1991.

OBJECTIVE: To determine whether a cluster of eight cancers among 572 women who had received transcervical quinacrine hydrochloride was a random occurrence or evidence of an increased risk of cancer. DESIGN: Retrospective cohort study using interviews and reviews of medical records. Cancer cases were evaluated using cohort analyses and space-time cluster methods. SETTING: Santiago and Valdivia, Chile. SUBJECTS: Fourteen hundred ninety-two women who received transcervical quinacrine pellets for sterilization between 1977 and 1989. MAIN OUTCOME MEASURE: Age- and site-specific incidence of invasive cancers. RESULTS: Eight hundred two women were interviewed. From 1 to 14 years of data were available on 600 of the noninterviewed women from clinic records. During 7,852 women-years of follow-up, 17 invasive cancers were identified, compared with 11.8 expected, based on age-specific rates from the Cali, Colombia cancer registry. Five cases of cervical cancer were observed, compared with 3.96 expected. Only one other uterine cancer was observed, a leiomyosarcoma, compared with 0.2 or 0.3 other uterine cancers expected. CONCLUSIONS: The occurrence of an unusual cluster was confirmed, but no evidence was found of excess cancer risk associated with quinacrine pellet sterilization. However there was a single provocative observation (the leiomyosarcoma), and surveillance of the cohort is continuing.

Adult↗
PubMed1993

Working with community organizations to evaluate potential disease clusters.

Increasingly, private citizens are organizing themselves to resist the intrusion of hazardous substances in their residential environments, or to promote the removal of the same. This movement is the source of the acronym (NIMBY-Not In My Back Yard). In North Carolina, the Cancer Surveillance Section has several experiences working with such community organizations. We have developed a commentary of our experience and observations on some of the characteristics that are more conductive to successful endeavors to resolve perception of increased health risk. Advantages and disadvantages of joint (health agency/concerned citizens group) studies or surveys are described. A case study of a successful joint survey to ascertain possible increased cancer incidence is described.

Cluster Analysis↗
PubMed1992

Clustering in sparse data and an analysis of rhabdomyosarcoma incidence.

Time series of epidemiologic events often contain periods of atypically low or high frequency. Correspondingly, for quite rate diseases there occur instances of long vacuous durations interrupted noticeably by periods of some disease activity. A recent community-based observation of the incidence of rhabdomyosarcoma (RMS), and an investigation of it, yielded sparse data of this general description. We introduce a combinatorial test for patchy time series and apply it to the RMS data. We comment on the prevalent practice of post hoc data analysis of alleged clusters, and on scale effects.

Adolescent↗
PubMed1991

Impact of a humanmade disaster on the utilization pattern of a psychiatric emergency service.

In May 1980, Liberty City Miami, a black area, suffered a humanmade disaster: a riot. The effects of the riot on the utilization pattern of the only psychiatric emergency service (PES) for the Liberty City catchment area were studied in two ways: autocorrelation and cross-correlation analyses were used to determine whether PES presentations demonstrated a 7-day cycle and whether this cycle was disturbed by the riot; and analyses of variance (ANOVAs) were used to compare numerically the riot week to the preceding week, the riot week to the following 12 weeks, and the 12 pre-riot weeks to the 12 post-riot weeks. Black PES presentations did not demonstrate a statistically discernable cycle, and none of the ANOVAs were statistically significant. It was concluded that the riot did not have a significant psychiatric morbidity effect as measured by PES presentation data. These results are discussed in reference to previous disaster studies.

Analysis of Variance↗
PubMed1990

The establishment of a population-based Cancer Registry for North Carolina.

In 1984 the North Carolina Medical Society's House of Delegates adopted Report S, which called for the North Carolina Legislature to fund a statewide cancer incident reporting system. The Cancer Committee continues to be advisory to the Division of Adult Health. A subcommittee of the Cancer Committee advises the Central Cancer Registry.

Forecasting↗
PubMed1989

Statistical approach to combining the results of similar experiments, with application to the hematologic effects of extremely-low-frequency electric field exposures.

A large proportion of scientific effort in investigating the possible biological effects of exposure to extremely-low-frequency (ELF) fields consists of laboratory studies on experimental animals. Most experiments in which hematologic properties are measured show no statistically significant effect due to exposure. However, some studies show significant effects which, in general, are not clearly reproducible. A difficult question must then be addressed: Are these relatively few indications of ELF effects statistical artifacts due to the increased risk of a type I error in multiple studies, or is there a real biological effect that is undetected in most studies due to the relatively small sample sizes commonly used? A statistical approach for examining the accumulated results of multiple experiments which results in a single test for treatment effect is presented. The technique requires very mild assumptions, and is valid for experiments that vary widely in specific characteristics such as exposure level, duration, and laboratory. The method is applied to the results of a collection of hematologic and serum chemistry experiments, and the combined results indicate the existence of experimental effects on some end points.

Animals↗