From disease mapping to focused clustering: assesment and exploration of spatial epidemiology techniques for studying cancer in spain

Tesis doctoral inédita leida en la Universidad Autónoma de Madrid. Facultad de Medicina.Dpto de Medicina Preventiva y Salud Pública. Fecha de lectura: 17 de Diciembre de 200

Cesarean births in Spain (2010-2018)

Artículo BES V.31 N.1Introducción: en las últimas dos décadas, la tasa de cesáreas a nivel mundial y europeo ha aumentado. Cuando están indicadas, las cesáreas salvan vidas; sin embargo, realizadas de manera inoportuna tienen riesgos potenciales para la madre y el recién nacido. En España, los últimos datos muestran un gran porcentaje de partos por cesárea y, por lo tanto, es necesario encuadrar la información espacio-temporalmente y describir cómo se distribuye este fenómeno. Método: se realizó un estudio transversal de base poblacional usando los datos del Boletín Estadístico del Parto. Se incluyeron todos los partos que hubiesen tenido lugar en España entre 2010 y 2018. Se realizó un estudio descriptivo en función de distintas variables (edad materna, día de la semana y comunidad autónoma del parto…). Resultados: se incluyeron un total de 3.863.363 partos. En España, el porcentaje de cesáreas entre los años 2010 y 2018 fue del 26,9%. Se observa un ligero descenso en 2017 y 2018. Las cesáreas fueron más frecuentes en las mujeres mayores de 40 años que dieron a luz entre semana en Comunidad Valenciana, Extremadura, Cataluña y Melilla. Conclusiones: existe gran variabilidad en la tasa de cesáreas entre distintas autonomías. Existen otros factores de variabilidad como la edad materna y el día de la semana del parto. La heterogeneidad en el porcentaje de cesáreas sugiere una falta de criterios clínicos comunes. Es necesario un análisis de las causas subyacentes para estudiar el problema en profundidad y proponer soluciones.N

Bayesian joint spatio-temporal analysis of multiple diseases

In this paper we propose a Bayesian hierarchical spatio-temporal model for the joint analysis of multiple diseases which includes specific and shared spatial and temporal effects. Dependence on shared terms is controlled by disease-specific weights so that their posterior distribution can be used to identify diseases with similar spatial and temporal patterns. The model proposed here has been used to study three different causes of death (oral cavity, esophagus and stomach cancer) in Spain at the province level. Shared and specific spatial and temporal effects have been estimated and mapped in order to study similarities and differences among these causes. Furthermore, estimates using Markov chain Monte Carlo and the integrated nested Laplace approximation are compared.Peer Reviewe

Latitude and longitude as drivers of COVID-19 waves' behavior in Europe: A time-space perspective of the pandemic.

BackgroundSocial restrictions and vaccination seem to have shaped the pandemic development in Europe, but the influence of geographical position is still debated. This study aims to verify whether the pandemic spread through Europe following a particular direction, during the period between the start of the pandemic and November 2021. The existence of a spatial gradient for epidemic intensity is also hypothesized.MethodsDaily COVID-19 epidemiological data were extracted from Our World in Data COVID-19 database, which also included vaccination and non-pharmacological interventions data. Latitude and longitude of each country's centroid were used as geographic variables. Epidemic periods were delimited from epidemic surge data. Multivariable linear and Cox's regression models were performed for each epidemic period to test if geographical variables influenced surge dates. Generalized additive models (GAM) were used to test the spatial gradient hypothesis with three epidemic intensity measures.ResultsLinear models suggest a possible west-east shift in the first epidemic period and features a significant association of NPIs with epidemic surge delay. Neither latitude nor longitude had significant associations with epidemic surge timing in both second and third periods. Latitude displays strong negative associations with all epidemic intensity measures in GAM models. Vaccination was also negatively associated with intensity.ConclusionsA longitudinal spread of the pandemic in Europe seems plausible, particularly concerning the first wave. However, a recurrent trend was not observed. Southern Europe countries may have experienced increased transmissibility and incidence, despite climatic conditions apparently unfavourable to the virus

Bayesian joint spatio-temporal analysis of multiple diseases

In this paper we propose a Bayesian hierarchical spatio-temporal model for the joint analysis of multiple diseases which includes specific and shared spatial and temporal effects. Dependence on shared terms is controlled by disease-specific weights so that their posterior distribution can be used to identify diseases with similar spatial and temporal patterns. The model proposed here has been used to study three different causes of death (oral cavity, esophagus and stomach cancer) in Spain at the province level. Shared and specific spatial and temporal effects have been estimated and mapped in order to study similarities and differences among these causes. Furthermore, estimates using Markov chain Monte Carlo and the integrated nested Laplace approximation are compared.Peer Reviewe

Bayesian joint spatio-temporal analysis of multiple diseases

In this paper we propose a Bayesian hierarchical spatio-temporal model for the joint analysis of multiple diseases which includes specific and shared spatial and temporal effects. Dependence on shared terms is controlled by disease-specific weights so that their posterior distribution can be used to identify diseases with similar spatial and temporal patterns. The model proposed here has been used to study three different causes of death (oral cavity, esophagus and stomach cancer) in Spain at the province level. Shared and specific spatial and temporal effects have been estimated and mapped in order to study similarities and differences among these causes. Furthermore, estimates using Markov chain Monte Carlo and the integrated nested Laplace approximation are compared

Exposure to residential traffic and trajectories of unhealthy ageing in older adults

XLI Reunión anual de la Sociedad Española de Epidemiología (SEE) y XVIII Congresso da Associação Portuguesa de Epidemiología (APE). Porto (Portugal), del 5 al 8 de septiembre de 2023.Background/Objectives: Exposure to traffic has been associated with biomarkers of increased biological aging, incidence of chronic morbidities and increased cause-specific and all-cause mortality. However, no previous study has evaluated whether traffic pollution is associated with trajectories of unhealthy ageing. The present study aims to fill some of the gaps in existing research by evaluating the association between residential traffic and unhealthy ageing, as assessed through the accumulation of overall and domain-specific health deficits over a 10-year follow-up of a nationally representative cohort of community-dwelling older adults in Spain. Methods: Population-based prospective study with individuals aged ≥ 60 years who contributed 8,291 biannual visits. Unhealthy ageing was estimated with a deficit accumulation index (DAI, range 0 to 100%), calculated with the number and severity of health deficits including 22 objectively-measured impairments in physical and cognitive functioning. Differences in DAI at each follow-up across categories of residential traffic density (RTD) at 500 and 1,000 meters, as well as of quintiles of nearest distance to a petrol station, were estimated using marginal structural models with inverse probability of censoring weights. Models were adjusted for sociodemographic and time-varying lifestyle factors, social deprivation index at the census tract and residential exposure to natural spaces. Results: The average increase in DAI (95% confidence interval) for participants in quintiles 2 to 5 vs. 1 (Q2-Q5 vs. Q1) of RTD at 500 meters was of 0.08 (-0.43, 0.59), 0.25 (-0.28, 0.78), 0.43 (-0.09, 0.95) and 0.80 (0.30, 1.30), respectively. Similar findings were observed across quintiles of RTD at 1000 meters. Distance to the nearest petrol station showed a linear inverse dose-response with prospective changes in DAI: results in quintiles Q2-Q5 vs. Q1 were -0.57 (-1.14, -0.01), -0.66 (-1.21, -0.11), -0.43 (-0.99, 0.13), and -0.91 (-1.44, -0.39), respectively. Conclusions/Recommendations: Exposure to traffic is associated with accelerated trajectories of unhealthy ageing. Diminishing traffic pollution should become a priority intervention for adding healthy years to life in the old age.Funding: CIBERESP: Proyecto ESP21PI04.N