IMIM - Institut Hospital del Mar d'Investigacions Mèdiques

Epidemiologia i salut pública

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Objectius assolits, 2015

Scientific objectives

During 2015, researchers of the program have:

• Published 253 papers in scientific journals ranging from Nature, PLOS Medicine JAMA, Circulation JAMA Psychiatry, to journals internationally recognized in the fields of molecular, clinical, and environmental epidemiology: such a broad integration of basic, clinical and epidemiologic knowledge is one of our signs of identity worldwide.

Investigators of the Cardiovascular Epidemiology & Genetics group and others have:

• Analyzed the burden of coronary heart disease and cardiovascular risk factors and their trends at the population level.

• Evaluated the relationship between lifestyles (diet, physical activity), environmental exposures (air pollution, noise) and cardiovascular risk factors and subclinical markers of atherosclerosis.

• Analyzed differences in the management and the prognosis of myocardial infarction (MI) patients across Europe and have developed a valid standardized and adjusted benchmarking monitoring tool.

Developed and validated new cardiovascular risk functions and analyzed the predictive added value of new biomarkers.

• Contributed to the knowledge of the genetic and epigenetic architecture of several cardiovascular traits such as myocardial infarction, venous thromboembolism, atrial fibrillation, stroke and hypertension.

Investigators of the Cardiovascular Risk & Nutrition group and others have:

• Functional virgin olive oil with thyme improves HDL-subclass distribution and composition, in hypercholesterolemic patients.

• The consumption of olive oil polyphenols decreased plasma LDL concentrations and LDL atherogenicity in healthy young men.

• Weight loss and other lifestyle recommendations during the first postoperative year after bariatric surgery must be encouraged to avoid hypertension relapse.

• The condition of hypogonadism in men with type-1 diabetes can be detected with a formula based on clinical parameters.

• The consumption of soft drinks was associated with increased waist circumference and abdominal obesity, in adults.

Investigators of the Clinical and Molecular Epidemiology of Cancer group and others have:

• Showed that there is no association between vitamin D-related genes and pancreatic cancer risk, hence suggesting that other pathways may explain the association between vitamin D and such risk.

• Contributed to explain the increasing incidence of diabetes by environmental chemical agents, as well as the corresponding direct economic costs in the European Union.

• Explained how and why the current ‘deconstruction of paradoxes’ is one sign of the current methodological ‘revolution’ in medicine

• Described that significant subgroups of the general population accumulate mixtures of Persistent Toxic Pollutants at high body concentrations.

Investigators of the Drug Abuse Epidemiology group and others have:

• Described trends of heavy and binge drinking and cannabis use in relation to the economic crisis by gender.

• Estimated cocaine use prevalence trends for the city of Barcelona.

• Established the health-related quality of life impact of psychiatric comorbidity among street-recruited illegal substance users.

Investigators of the Epidemiology and Evaluation group and others have:

• Established the impact of digital mammography in ductal carcinoma in situ detection.

• Described risk of breast cancer according types of previous benign breast disease and radiological characteristics of different breast cancer phenotypes.

• Provided results of the first round of the Barcelona colorectal cancer screening program.

• Completed a cohort of 3,000 Spanish women with incident breast cancer to study health care variability and survival.

• Estimated the average cost weights of APR-DRG for the Spanish NHS based on RECH (Spanish Hospital Cost Network) dataset.

Investigators of the Health Services Research group and others have:

• Identified urinary incontinence as the side effect with the highest impact on preferences of patients with localized prostate cancer.

• Shown that current studies on determinants of non-adherence to inhaled corticosteroids have numerous limitations.

• Completed recruitment of 2,347 Spanish university students to estimate the incidence and predict risks of mental disorders, addictions and suicide.

• Estimated the benefit of assisted diagnosis for detecting anxiety disorders in primary care.

• Described the association of mental disorders with subsequent chronic physical conditions in 17 countries worldwide.

Investigators of the Occupational & Environment Epidemiology group and others have:

• Shown that night work has a more general effect on sex steroid hormones rather than only on melatonin.

• Initiated a large study on workers rotating evaluating hormonal levels, genetic variants and gene-expression within the same individual at different shifts.

• Started a new collaboration with immunologists in ISGlobal and pathologists in Mozambique for researching on endemic Burkitt’s lymphoma (eBL) in Africa evaluating the effect of malaria, EBV and environmental factors.

Investigators of the Respiratory Health, Air Pollution &Childhood Development group and others have:

• Described altered brain connectivity in school children exposed to high levels of traffic pollution.

• Completed the field work of the Human Early-Life Exposome study (HELIX project) with more than 1,200 mother-child pairs evaluated.

• Initiated a population based randomized controlled trial to determine the effectiveness of a dietary intervention (four walnuts per day, ~1.5g of n-3 PUFA) in enhancing brain development in teenagers.

Investigators of the Social Epidemiology & Occupational Health group and others have:

• Completed a Basic Working and Employment Questionnaire, providing nationally representative, comparable data on work and health status of workers in the formal and informal economy in six Latin America and Caribbean countries

• Shown that unstable labour market trajectories are associated with early retirement due to permanent disability and mortality, based on analyses of the Spanish Continuous Working Life Sample

• Developed the Occupational Disease Unit at the Parc Salut Mar.

Technological and Translational Objectives

3 patents related to the prediction of cardiovascular and thromboembolic diseases risk have been transferred to a biotechnology company.

• The CASSANDRA model, an open access web application, is used to assess the impact of preventive interventions at the population level (www.redheracles.net/cassandra/es/).

• A standardized benchmarking tool was developed by EPISAP researchers to monitor hospitals coronary artery disease outcomes (http://www.eurhobop.eu/).

BiblioPRO, the online library of reference for Patient Reported Outcomes (PRO) in Spanish, has reached 3,500 monthly visits and 2,897 new users in 2015 (www.bibliopro.org).

• A platform to study working conditions and workers health risks was developed from databases of the Social Security workforce based on the “Continuous Work History Sample”.

EPISAP researchers have continued participating in national and international expert committees, such as: WHO, European Research Council, Expert Boards, European Medicines Agency (EMA), European Monitoring Center for Drugs and Drug Addiction (EMCDDA), Generalitat de Catalunya, and the Spanish Ministry of Health, among others.

• The Spanish Chapter of EuroDRG book has been updated with the lead of EPISAP researchers (www.euro.who.int/__data/assets/pdf_file/0004/162265/e96538.pdf)

• A basic questionnaire for the future Working Condition Survey in Latin America.

• A mathematical model developed by EPISAP researchers is being used by the Director Plan of Oncology to predict future need of colonoscopies in Catalonia.

Educational Objectives

In 2015 investigators of EPISAP have:

• Mentored 11 doctoral theses which were successfully defended

• Led a number of formal educational education activities:

  • Postgraduate programs: Master’s in Public Health (120 ECTS) with 2 specialties: research and professional; Master’s Degree in Occupational Health and Safety, in collaboration with the Universitat Politècnica de Barcelona (UPC) and Universitat de Barcelona (UB); and the Postgraduate Diploma in Public Health (30 ECTS).
  • Graduate courses: The Health System; Epidemiology; Community Health; Health Management; Preventive Medicine and Public Health (Medicine), among many others.
  • Other programs: EPISAP researchers have continued actively participating in the Medical Specialties Residency Program, as part of the educational units for the medical specialties of Preventive Medicine & Public Health, and Occupational Medicine. Collaboration with other programs include: European Educational Program in Epidemiology (EEPE), Master in Nursing Sciences, Master in Cardiology Nursing, Bachelor’s degree in Biology, Biotechnology and Biochemistry, among many others.

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