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94-553: Researchers of the department of Epidemiology & Biostatistics at the Erasmus Medical Center led by Professor Albert Hofman, conceptualized the study in the mid-1980s as response to increase in the proportion of elderly persons in the population who are also living with chronic diseases. The study was established in 1990 in the Ommoord district of Rotterdam , The Netherlands . On March 26, 1991, Princess Juliana opened

188-561: A Linear B clay tablet found in Messenia that dates to between 1450 and 1350 BC, making Greek the world's oldest recorded living language . Among the Indo-European languages, its date of earliest written attestation is matched only by the now-extinct Anatolian languages . The Greek language is conventionally divided into the following periods: In the modern era, the Greek language entered

282-570: A basis for coinages: anthropology , photography , telephony , isomer , biomechanics , cinematography , etc. Together with Latin words , they form the foundation of international scientific and technical vocabulary ; for example, all words ending in -logy ('discourse'). There are many English words of Greek origin . Greek is an independent branch of the Indo-European language family. The ancient language most closely related to it may be ancient Macedonian , which, by most accounts,

376-437: A causal association does not exist in general. Conversely, it can be (and is in some circumstances) taken by US courts, in an individual case, to justify an inference that a causal association does exist, based upon a balance of probability . The subdiscipline of forensic epidemiology is directed at the investigation of specific causation of disease or injury in individuals or groups of individuals in instances in which causation

470-508: A faster, more convenient cursive writing style with the use of ink and quill . The Greek alphabet consists of 24 letters, each with an uppercase ( majuscule ) and lowercase ( minuscule ) form. The letter sigma has an additional lowercase form (ς) used in the final position of a word: In addition to the letters, the Greek alphabet features a number of diacritical signs : three different accent marks ( acute , grave , and circumflex ), originally denoting different shapes of pitch accent on

564-498: A health system responds to current population health issues but also how a health system can be managed to better respond to future potential population health issues. Examples of organizations that use population-based health management that leverage the work and results of epidemiological practice include Canadian Strategy for Cancer Control, Health Canada Tobacco Control Programs, Rick Hansen Foundation, Canadian Tobacco Control Research Initiative. Each of these organizations uses

658-521: A lesser extent, basic research in the biological sciences. Major areas of epidemiological study include disease causation, transmission , outbreak investigation, disease surveillance , environmental epidemiology , forensic epidemiology , occupational epidemiology , screening , biomonitoring , and comparisons of treatment effects such as in clinical trials . Epidemiologists rely on other scientific disciplines like biology to better understand disease processes, statistics to make efficient use of

752-573: A lesser extent, in the Western Mediterranean in and around colonies such as Massalia , Monoikos , and Mainake . It was also used as the official language of government and religion in the Christian Nubian kingdoms , for most of their history. Greek, in its modern form, is the official language of Greece, where it is spoken by almost the entire population. It is also the official language of Cyprus (nominally alongside Turkish ) and

846-400: A limited but productive system of compounding and a rich inflectional system. Although its morphological categories have been fairly stable over time, morphological changes are present throughout, particularly in the nominal and verbal systems. The major change in the nominal morphology since the classical stage was the disuse of the dative case (its functions being largely taken over by

940-453: A mixed syllable structure, permitting complex syllabic onsets but very restricted codas. It has only oral vowels and a fairly stable set of consonantal contrasts . The main phonological changes occurred during the Hellenistic and Roman period (see Koine Greek phonology for details): In all its stages, the morphology of Greek shows an extensive set of productive derivational affixes ,

1034-772: A population (endemic). The term "epidemiology" appears to have first been used to describe the study of epidemics in 1802 by the Spanish physician Joaquín de Villalba  [ es ] in Epidemiología Española . Epidemiologists also study the interaction of diseases in a population, a condition known as a syndemic . The term epidemiology is now widely applied to cover the description and causation of not only epidemic, infectious disease, but of disease in general, including related conditions. Some examples of topics examined through epidemiology include as high blood pressure, mental illness and obesity . Therefore, this epidemiology

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1128-520: A population-based health management framework called Life at Risk that combines epidemiological quantitative analysis with demographics, health agency operational research and economics to perform: Applied epidemiology is the practice of using epidemiological methods to protect or improve the health of a population. Applied field epidemiology can include investigating communicable and non-communicable disease outbreaks, mortality and morbidity rates, and nutritional status, among other indicators of health, with

1222-422: A prospective study, and confounders are more easily controlled for. However, they are more costly, and there is a greater chance of losing subjects to follow-up based on the long time period over which the cohort is followed. Cohort studies also are limited by the same equation for number of cases as for cohort studies, but, if the base incidence rate in the study population is very low, the number of cases required

1316-402: A random sample from the original population at risk. This has as a consequence that the control group can contain people with the disease under study when the disease has a high attack rate in a population. A major drawback for case control studies is that, in order to be considered to be statistically significant, the minimum number of cases required at the 95% confidence interval is related to

1410-456: A state of diglossia : the coexistence of vernacular and archaizing written forms of the language. What came to be known as the Greek language question was a polarization between two competing varieties of Modern Greek: Dimotiki , the vernacular form of Modern Greek proper, and Katharevousa , meaning 'purified', a compromise between Dimotiki and Ancient Greek developed in the early 19th century that

1504-445: A unique disease process different from any other individual ("the unique disease principle"), considering uniqueness of the exposome (a totality of endogenous and exogenous / environmental exposures) and its unique influence on molecular pathologic process in each individual. Studies to examine the relationship between an exposure and molecular pathologic signature of disease (particularly cancer ) became increasingly common throughout

1598-399: Is a core component, that is unified with management science to provide efficient and effective health care and health guidance to a population. This task requires the forward-looking ability of modern risk management approaches that transform health risk factors, incidence, prevalence and mortality statistics (derived from epidemiological analysis) into management metrics that not only guide how

1692-428: Is based upon how the pattern of the disease causes change in the function of human beings. The Greek physician Hippocrates , taught by Democritus, was known as the father of medicine , sought a logic to sickness; he is the first person known to have examined the relationships between the occurrence of disease and environmental influences. Hippocrates believed sickness of the human body to be caused by an imbalance of

1786-479: Is beyond the domain of the science of epidemiology. Epidemiology has its limits at the point where an inference is made that the relationship between an agent and a disease is causal (general causation) and where the magnitude of excess risk attributed to the agent has been determined; that is, epidemiology addresses whether an agent can cause disease, not whether an agent did cause a specific plaintiff's disease. In United States law, epidemiology alone cannot prove that

1880-483: Is disputed or is unclear, for presentation in legal settings. Epidemiological practice and the results of epidemiological analysis make a significant contribution to emerging population-based health management frameworks. Population-based health management encompasses the ability to: Modern population-based health management is complex, requiring a multiple set of skills (medical, political, technological, mathematical, etc.) of which epidemiological practice and analysis

1974-527: Is famous for his investigations into the causes of the 19th-century cholera epidemics, and is also known as the father of (modern) Epidemiology. He began with noticing the significantly higher death rates in two areas supplied by Southwark Company. His identification of the Broad Street pump as the cause of the Soho epidemic is considered the classic example of epidemiology. Snow used chlorine in an attempt to clean

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2068-499: Is in the term inference . Correlation, or at least association between two variables, is a necessary but not sufficient criterion for the inference that one variable causes the other. Epidemiologists use gathered data and a broad range of biomedical and psychosocial theories in an iterative way to generate or expand theory, to test hypotheses, and to make educated, informed assertions about which relationships are causal, and about exactly how they are causal. Epidemiologists emphasize that

2162-418: Is increasing recognition that a wide range of modern data sources, many not originating from healthcare or epidemiology, can be used for epidemiological study. Such digital epidemiology can include data from internet searching, mobile phone records and retail sales of drugs. Epidemiologists employ a range of study designs from the observational to experimental and generally categorized as descriptive (involving

2256-659: Is native to Greece , Cyprus , Italy (in Calabria and Salento ), southern Albania , and other regions of the Balkans , Caucasus , the Black Sea coast, Asia Minor , and the Eastern Mediterranean . It has the longest documented history of any Indo-European language, spanning at least 3,400 years of written records. Its writing system is the Greek alphabet , which has been used for approximately 2,800 years; previously, Greek

2350-404: Is reduced by  1 ⁄ 2 . Although epidemiology is sometimes viewed as a collection of statistical tools used to elucidate the associations of exposures to health outcomes, a deeper understanding of this science is that of discovering causal relationships. " Correlation does not imply causation " is a common theme for much of the epidemiological literature. For epidemiologists, the key

2444-758: Is still used internationally for the writing of Ancient Greek . In Greek, the question mark is written as the English semicolon, while the functions of the colon and semicolon are performed by a raised point (•), known as the ano teleia ( άνω τελεία ). In Greek the comma also functions as a silent letter in a handful of Greek words, principally distinguishing ό,τι ( ó,ti , 'whatever') from ότι ( óti , 'that'). Ancient Greek texts often used scriptio continua ('continuous writing'), which means that ancient authors and scribes would write word after word with no spaces or punctuation between words to differentiate or mark boundaries. Boustrophedon , or bi-directional text,

2538-611: Is to modern spoken English ". Greek is spoken today by at least 13 million people, principally in Greece and Cyprus along with a sizable Greek-speaking minority in Albania near the Greek-Albanian border. A significant percentage of Albania's population has knowledge of the Greek language due in part to the Albanian wave of immigration to Greece in the 1980s and '90s and the Greek community in

2632-521: Is typically determined using DNA from peripheral blood leukocytes. Since the 2000s, genome-wide association studies (GWAS) have been commonly performed to identify genetic risk factors for many diseases and health conditions. While most molecular epidemiology studies are still using conventional disease diagnosis and classification systems, it is increasingly recognized that disease progression represents inherently heterogeneous processes differing from person to person. Conceptually, each individual has

2726-439: Is used to describe the intersection of Host , Agent , and Environment in analyzing an outbreak. Case-series may refer to the qualitative study of the experience of a single patient, or small group of patients with a similar diagnosis, or to a statistical factor with the potential to produce illness with periods when they are unexposed. The former type of study is purely descriptive and cannot be used to make inferences about

2820-544: The British Overseas Territory of Akrotiri and Dhekelia (alongside English ). Because of the membership of Greece and Cyprus in the European Union, Greek is one of the organization's 24 official languages . Greek is recognized as a minority language in Albania, and used co-officially in some of its municipalities, in the districts of Gjirokastër and Sarandë . It is also an official minority language in

2914-637: The European canon . Greek is also the language in which many of the foundational texts in science and philosophy were originally composed. The New Testament of the Christian Bible was also originally written in Greek. Together with the Latin texts and traditions of the Roman world , the Greek texts and Greek societies of antiquity constitute the objects of study of the discipline of Classics . During antiquity , Greek

Rotterdam Study - Misplaced Pages Continue

3008-980: The ICD-10 system. The results of the Rotterdam Study have been published in more than 1700 research articles and reports. A list of publications from the Rotterdam Study. Epidemiology Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population . It is a cornerstone of public health , and shapes policy decisions and evidence-based practice by identifying risk factors for disease and targets for preventive healthcare . Epidemiologists help with study design, collection, and statistical analysis of data, amend interpretation and dissemination of results (including peer review and occasional systematic review ). Epidemiology has helped develop methodology used in clinical research , public health studies, and, to

3102-510: The Indo-Iranian languages (see Graeco-Aryan ), but little definitive evidence has been found. In addition, Albanian has also been considered somewhat related to Greek and Armenian, and it has been proposed that they all form a higher-order subgroup along with other extinct languages of the ancient Balkans; this higher-order subgroup is usually termed Palaeo-Balkan , and Greek has a central position in it. Linear B , attested as early as

3196-633: The United Kingdom , and throughout the European Union , especially in Germany . Historically, significant Greek-speaking communities and regions were found throughout the Eastern Mediterranean , in what are today Southern Italy , Turkey , Cyprus , Syria , Lebanon , Israel , Palestine , Egypt , and Libya ; in the area of the Black Sea , in what are today Turkey, Bulgaria , Romania , Ukraine , Russia , Georgia , Armenia , and Azerbaijan ; and, to

3290-468: The genitive ). The verbal system has lost the infinitive , the synthetically -formed future, and perfect tenses and the optative mood . Many have been replaced by periphrastic ( analytical ) forms. Pronouns show distinctions in person (1st, 2nd, and 3rd), number (singular, dual , and plural in the ancient language; singular and plural alone in later stages), and gender (masculine, feminine, and neuter), and decline for case (from six cases in

3384-417: The syntax of Greek have remained constant: verbs agree with their subject only, the use of the surviving cases is largely intact (nominative for subjects and predicates, accusative for objects of most verbs and many prepositions, genitive for possessors), articles precede nouns, adpositions are largely prepositional, relative clauses follow the noun they modify and relative pronouns are clause-initial. However,

3478-476: The " one cause – one effect " understanding is a simplistic mis-belief. Most outcomes, whether disease or death, are caused by a chain or web consisting of many component causes. Causes can be distinguished as necessary, sufficient or probabilistic conditions. If a necessary condition can be identified and controlled (e.g., antibodies to a disease agent, energy in an injury), the harmful outcome can be avoided (Robertson, 2015). One tool regularly used to conceptualize

3572-459: The "who, what, where and when of health-related state occurrence". However, analytical observations deal more with the 'how' of a health-related event. Experimental epidemiology contains three case types: randomized controlled trials (often used for a new medicine or drug testing), field trials (conducted on those at a high risk of contracting a disease), and community trials (research on social originating diseases). The term 'epidemiologic triad'

3666-515: The 2000s. However, the use of molecular pathology in epidemiology posed unique challenges, including lack of research guidelines and standardized statistical methodologies, and paucity of interdisciplinary experts and training programs. Furthermore, the concept of disease heterogeneity appears to conflict with the long-standing premise in epidemiology that individuals with the same disease name have similar etiologies and disease processes. To resolve these issues and advance population health science in

3760-504: The 2010s. By 2012, it was recognized that many pathogens' evolution is rapid enough to be highly relevant to epidemiology, and that therefore much could be gained from an interdisciplinary approach to infectious disease integrating epidemiology and molecular evolution to "inform control strategies, or even patient treatment." Modern epidemiological studies can use advanced statistics and machine learning to create predictive models as well as to define treatment effects. There

3854-566: The 20th century on), especially from French and English, are typically not inflected; other modern borrowings are derived from Albanian , South Slavic ( Macedonian / Bulgarian ) and Eastern Romance languages ( Aromanian and Megleno-Romanian ). Greek words have been widely borrowed into other languages, including English. Example words include: mathematics , physics , astronomy , democracy , philosophy , athletics , theatre, rhetoric , baptism , evangelist , etc. Moreover, Greek words and word elements continue to be productive as

Rotterdam Study - Misplaced Pages Continue

3948-519: The ERGO research center at Briandplaats, Rotterdam. The Rotterdam Study consists of three cohorts. The initial cohort (RS-I) started out in 1990 with 7,983 men and women aged 55 years and over. Follow-up visits were held in 1993–1995, in 1997–1999, 2002–2004, 2009–2011, and 2014-2015. In 2000 a second cohort was established (RS-II). Another 3,011 inhabitants of Ommoord aged 55 years and over agreed to participate. The participants of this second cohort visited

4042-538: The Greek alphabet since approximately the 9th century BC. It was created by modifying the Phoenician alphabet , with the innovation of adopting certain letters to represent the vowels. The variant of the alphabet in use today is essentially the late Ionic variant, introduced for writing classical Attic in 403 BC. In classical Greek, as in classical Latin, only upper-case letters existed. The lower-case Greek letters were developed much later by medieval scribes to permit

4136-540: The Greek language was the Cypriot syllabary (also a descendant of Linear A via the intermediate Cypro-Minoan syllabary ), which is closely related to Linear B but uses somewhat different syllabic conventions to represent phoneme sequences. The Cypriot syllabary is attested in Cyprus from the 11th century BC until its gradual abandonment in the late Classical period, in favor of the standard Greek alphabet. Greek has been written in

4230-554: The OR, a RR greater than 1 shows association, where the conclusion can be read "those with the exposure were more likely to develop the disease." Prospective studies have many benefits over case control studies. The RR is a more powerful effect measure than the OR, as the OR is just an estimation of the RR, since true incidence cannot be calculated in a case control study where subjects are selected based on disease status. Temporality can be established in

4324-404: The acute during the late 20th century, and it has only been retained in typography . After the writing reform of 1982, most diacritics are no longer used. Since then, Greek has been written mostly in the simplified monotonic orthography (or monotonic system), which employs only the acute accent and the diaeresis. The traditional system, now called the polytonic orthography (or polytonic system),

4418-474: The arrival of Proto-Greeks, some documented in Mycenaean texts ; they include a large number of Greek toponyms . The form and meaning of many words have changed. Loanwords (words of foreign origin) have entered the language, mainly from Latin, Venetian , and Turkish . During the older periods of Greek, loanwords into Greek acquired Greek inflections, thus leaving only a foreign root word. Modern borrowings (from

4512-407: The assessment of data covering time, place, and person), analytic (aiming to further examine known associations or hypothesized relationships), and experimental (a term often equated with clinical or community trials of treatments and other interventions). In observational studies, nature is allowed to "take its course", as epidemiologists observe from the sidelines. Conversely, in experimental studies,

4606-414: The case control study. However, the point estimate generated is the relative risk (RR), which is the probability of disease for a person in the exposed group, P e  =  A  / ( A  +  B ) over the probability of disease for a person in the unexposed group, P u  =  C  / ( C  +  D ), i.e. RR  =  P e  /  P u . As with

4700-429: The causation of the disease. Case-control studies are usually faster and more cost-effective than cohort studies but are sensitive to bias (such as recall bias and selection bias ). The main challenge is to identify the appropriate control group; the distribution of exposure among the control group should be representative of the distribution in the population that gave rise to the cases. This can be achieved by drawing

4794-427: The cause-and-effect hypothesis and none can be required sine qua non ." Epidemiological studies can only go to prove that an agent could have caused, but not that it did cause, an effect in any particular case: Epidemiology is concerned with the incidence of disease in populations and does not address the question of the cause of an individual's disease. This question, sometimes referred to as specific causation,

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4888-765: The country. Prior to the Greco-Turkish War and the resulting population exchange in 1923 a very large population of Greek-speakers also existed in Turkey , though very few remain today. A small Greek-speaking community is also found in Bulgaria near the Greek-Bulgarian border. Greek is also spoken worldwide by the sizable Greek diaspora which has notable communities in the United States , Australia , Canada , South Africa , Chile , Brazil , Argentina , Russia , Ukraine ,

4982-445: The data and draw appropriate conclusions, social sciences to better understand proximate and distal causes, and engineering for exposure assessment . Epidemiology , literally meaning "the study of what is upon the people", is derived from Greek epi  'upon, among' demos  'people, district' and logos  'study, word, discourse', suggesting that it applies only to human populations. However,

5076-441: The dative led to a rise of prepositional indirect objects (and the use of the genitive to directly mark these as well). Ancient Greek tended to be verb-final, but neutral word order in the modern language is VSO or SVO. Modern Greek inherits most of its vocabulary from Ancient Greek, which in turn is an Indo-European language, but also includes a number of borrowings from the languages of the populations that inhabited Greece before

5170-497: The disease to the cases in the series. A prospective study would involve following the case series over time to evaluate the disease's natural history. The latter type, more formally described as self-controlled case-series studies, divide individual patient follow-up time into exposed and unexposed periods and use fixed-effects Poisson regression processes to compare the incidence rate of a given outcome between exposed and unexposed periods. This technique has been extensively used in

5264-528: The earliest forms attested to four in the modern language). Nouns, articles, and adjectives show all the distinctions except for a person. Both attributive and predicative adjectives agree with the noun. The inflectional categories of the Greek verb have likewise remained largely the same over the course of the language's history but with significant changes in the number of distinctions within each category and their morphological expression. Greek verbs have synthetic inflectional forms for: Many aspects of

5358-612: The epidemiologist is the one in control of all of the factors entering a certain case study. Epidemiological studies are aimed, where possible, at revealing unbiased relationships between exposures such as alcohol or smoking, biological agents , stress , or chemicals to mortality or morbidity . The identification of causal relationships between these exposures and outcomes is an important aspect of epidemiology. Modern epidemiologists use informatics and infodemiology as tools. Observational studies have two components, descriptive and analytical. Descriptive observations pertain to

5452-771: The era of molecular precision medicine , "molecular pathology" and "epidemiology" was integrated to create a new interdisciplinary field of " molecular pathological epidemiology " (MPE), defined as "epidemiology of molecular pathology and heterogeneity of disease". In MPE, investigators analyze the relationships between (A) environmental, dietary, lifestyle and genetic factors; (B) alterations in cellular or extracellular molecules; and (C) evolution and progression of disease. A better understanding of heterogeneity of disease pathogenesis will further contribute to elucidate etiologies of disease. The MPE approach can be applied to not only neoplastic diseases but also non-neoplastic diseases. The concept and paradigm of MPE have become widespread in

5546-412: The extent that one can speak of a new language emerging. Greek speakers today still tend to regard literary works of ancient Greek as part of their own rather than a foreign language. It is also often stated that the historical changes have been relatively slight compared with some other languages. According to one estimation, " Homeric Greek is probably closer to Demotic than 12-century Middle English

5640-564: The field and advanced methods to study cancer, a disease with patterns and mode of occurrences that could not be suitably studied with the methods developed for epidemics of infectious diseases. Geography pathology eventually combined with infectious disease epidemiology to make the field that is epidemiology today. Another breakthrough was the 1954 publication of the results of a British Doctors Study , led by Richard Doll and Austin Bradford Hill , which lent very strong statistical support to

5734-405: The four humors (black bile, yellow bile, blood, and phlegm). The cure to the sickness was to remove or add the humor in question to balance the body. This belief led to the application of bloodletting and dieting in medicine. He coined the terms endemic (for diseases usually found in some places but not in others) and epidemic (for diseases that are seen at some times but not others). In

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5828-458: The general population of patients with that disease. These types of studies, in which an astute clinician identifies an unusual feature of a disease or a patient's history, may lead to a formulation of a new hypothesis. Using the data from the series, analytic studies could be done to investigate possible causal factors. These can include case-control studies or prospective studies. A case-control study would involve matching comparable controls without

5922-449: The language show both conservative and innovative tendencies across the entire attestation of the language from the ancient to the modern period. The division into conventional periods is, as with all such periodizations, relatively arbitrary, especially because, in all periods, Ancient Greek has enjoyed high prestige, and the literate borrowed heavily from it. Across its history, the syllabic structure of Greek has varied little: Greek shows

6016-463: The late 15th century BC, was the first script used to write Greek. It is basically a syllabary , which was finally deciphered by Michael Ventris and John Chadwick in the 1950s (its precursor, Linear A , has not been deciphered and most likely encodes a non-Greek language). The language of the Linear B texts, Mycenaean Greek , is the earliest known form of Greek. Another similar system used to write

6110-575: The link between tobacco smoking and lung cancer . In the late 20th century, with the advancement of biomedical sciences, a number of molecular markers in blood, other biospecimens and environment were identified as predictors of development or risk of a certain disease. Epidemiology research to examine the relationship between these biomarkers analyzed at the molecular level and disease was broadly named " molecular epidemiology ". Specifically, " genetic epidemiology " has been used for epidemiology of germline genetic variation and disease. Genetic variation

6204-403: The main etiological work that brought forward the concept. His concepts were still being considered in analysing SARS outbreak by WHO in 2004 in the context of traditional Chinese medicine. Another pioneer, Thomas Sydenham (1624–1689), was the first to distinguish the fevers of Londoners in the later 1600s. His theories on cures of fevers met with much resistance from traditional physicians at

6298-448: The many other countries of the Greek diaspora . Greek roots have been widely used for centuries and continue to be widely used to coin new words in other languages; Greek and Latin are the predominant sources of international scientific vocabulary . Greek has been spoken in the Balkan peninsula since around the 3rd millennium BC, or possibly earlier. The earliest written evidence is

6392-448: The middle of the 16th century, a doctor from Verona named Girolamo Fracastoro was the first to propose a theory that the very small, unseeable, particles that cause disease were alive. They were considered to be able to spread by air, multiply by themselves and to be destroyable by fire. In this way he refuted Galen 's miasma theory (poison gas in sick people). In 1543 he wrote a book De contagione et contagiosis morbis , in which he

6486-465: The morphological changes also have their counterparts in the syntax, and there are also significant differences between the syntax of the ancient and that of the modern form of the language . Ancient Greek made great use of participial constructions and of constructions involving the infinitive, and the modern variety lacks the infinitive entirely (employing a raft of new periphrastic constructions instead) and uses participles more restrictively. The loss of

6580-506: The multicausality associated with disease is the causal pie model . In 1965, Austin Bradford Hill proposed a series of considerations to help assess evidence of causation, which have come to be commonly known as the " Bradford Hill criteria ". In contrast to the explicit intentions of their author, Hill's considerations are now sometimes taught as a checklist to be implemented for assessing causality. Hill himself said "None of my nine viewpoints can bring indisputable evidence for or against

6674-417: The odds of exposure in the cases (A/C) to the odds of exposure in the controls (B/D), i.e. OR = (AD/BC). If the OR is significantly greater than 1, then the conclusion is "those with the disease are more likely to have been exposed", whereas if it is close to 1 then the exposure and disease are not likely associated. If the OR is far less than one, then this suggests that the exposure is a protective factor in

6768-498: The odds ratio by the equation: where N is the ratio of cases to controls. As the odds ratio approaches 1, the number of cases required for statistical significance grows towards infinity; rendering case-control studies all but useless for low odds ratios. For instance, for an odds ratio of 1.5 and cases = controls, the table shown above would look like this: For an odds ratio of 1.1: Cohort studies select subjects based on their exposure status. The study subjects should be at risk of

6862-414: The outcome under investigation at the beginning of the cohort study; this usually means that they should be disease free when the cohort study starts. The cohort is followed through time to assess their later outcome status. An example of a cohort study would be the investigation of a cohort of smokers and non-smokers over time to estimate the incidence of lung cancer. The same 2×2 table is constructed as with

6956-400: The prevailing Miasma Theory of the time, a model of disease in which poor air quality was blamed for illness. This was used to rationalize high rates of infection in impoverished areas instead of addressing the underlying issues of poor nutrition and sanitation, and was proven false by his work. Other pioneers include Danish physician Peter Anton Schleisner , who in 1849 related his work on

7050-627: The prevention of the epidemic of neonatal tetanus on the Vestmanna Islands in Iceland . Another important pioneer was Hungarian physician Ignaz Semmelweis , who in 1847 brought down infant mortality at a Vienna hospital by instituting a disinfection procedure. His findings were published in 1850, but his work was ill-received by his colleagues, who discontinued the procedure. Disinfection did not become widely practiced until British surgeon Joseph Lister 'discovered' antiseptics in 1865 in light of

7144-434: The purpose of communicating the results to those who can implement appropriate policies or disease control measures. Greek language Greek ( Modern Greek : Ελληνικά , romanized :  Elliniká , [eliniˈka] ; Ancient Greek : Ἑλληνική , romanized :  Hellēnikḗ ) is an Indo-European language, constituting an independent Hellenic branch within the Indo-European language family. It

7238-622: The regions of Apulia and Calabria in Italy. In the framework of the European Charter for Regional or Minority Languages , Greek is protected and promoted officially as a regional and minority language in Armenia, Hungary , Romania, and Ukraine. It is recognized as a minority language and protected in Turkey by the 1923 Treaty of Lausanne . The phonology , morphology , syntax , and vocabulary of

7332-527: The research center for a follow-up examinations in 2004-2005, 2011–2012, and 2015-2016. The third cohort of the Rotterdam Study (RS-III) started in 2006, this time with inhabitants aged 45 years and over. Inclusion ended in December 2008 and 3,932 participants have been included in this third cohort. The first follow-up examinations were held in 2012-2014. A typical examination at the Rotterdam Study includes an extensive standardized home interview and two visits to

7426-405: The research center for clinical examinations. Risk factors are measured at the research center, which is located in the middle of the district of Ommoord. Clinical outcomes are continuously monitored throughout the study period for all participants of the three cohorts. Data on morbidity and mortality are collected at general practitioners‘ practises and hospitals. Events are classified according to

7520-402: The same population that gave rise to the cases. The case-control study looks back through time at potential exposures that both groups (cases and controls) may have encountered. A 2×2 table is constructed, displaying exposed cases (A), exposed controls (B), unexposed cases (C) and unexposed controls (D). The statistic generated to measure association is the odds ratio (OR), which is the ratio of

7614-437: The stressed vowel; the so-called breathing marks ( rough and smooth breathing ), originally used to signal presence or absence of word-initial /h/; and the diaeresis , used to mark the full syllabic value of a vowel that would otherwise be read as part of a diphthong. These marks were introduced during the course of the Hellenistic period. Actual usage of the grave in handwriting saw a rapid decline in favor of uniform usage of

7708-456: The study of adverse reactions to vaccination and has been shown in some circumstances to provide statistical power comparable to that available in cohort studies. Case-control studies select subjects based on their disease status. It is a retrospective study. A group of individuals that are disease positive (the "case" group) is compared with a group of disease negative individuals (the "control" group). The control group should ideally come from

7802-439: The term is widely used in studies of zoological populations (veterinary epidemiology), although the term " epizoology " is available, and it has also been applied to studies of plant populations (botanical or plant disease epidemiology ). The distinction between "epidemic" and "endemic" was first drawn by Hippocrates , to distinguish between diseases that are "visited upon" a population (epidemic) from those that "reside within"

7896-702: The time. He was not able to find the initial cause of the smallpox fever he researched and treated. John Graunt , a haberdasher and amateur statistician, published Natural and Political Observations ... upon the Bills of Mortality in 1662. In it, he analysed the mortality rolls in London before the Great Plague , presented one of the first life tables , and reported time trends for many diseases, new and old. He provided statistical evidence for many theories on disease, and also refuted some widespread ideas on them. John Snow

7990-413: The water and removed the handle; this ended the outbreak. This has been perceived as a major event in the history of public health and regarded as the founding event of the science of epidemiology, having helped shape public health policies around the world. However, Snow's research and preventive measures to avoid further outbreaks were not fully accepted or put into practice until after his death due to

8084-628: The work of Louis Pasteur . In the early 20th century, mathematical methods were introduced into epidemiology by Ronald Ross , Janet Lane-Claypon , Anderson Gray McKendrick , and others. In a parallel development during the 1920s, German-Swiss pathologist Max Askanazy and others founded the International Society for Geographical Pathology to systematically investigate the geographical pathology of cancer and other non-infectious diseases across populations in different regions. After World War II, Richard Doll and other non-pathologists joined

8178-568: Was a distinct dialect of Greek itself. Aside from the Macedonian question, current consensus regards Phrygian as the closest relative of Greek, since they share a number of phonological, morphological and lexical isoglosses , with some being exclusive between them. Scholars have proposed a Graeco-Phrygian subgroup out of which Greek and Phrygian originated. Among living languages, some Indo-Europeanists suggest that Greek may be most closely related to Armenian (see Graeco-Armenian ) or

8272-546: Was also used in Ancient Greek. Greek has occasionally been written in the Latin script , especially in areas under Venetian rule or by Greek Catholics . The term Frankolevantinika / Φραγκολεβαντίνικα applies when the Latin script is used to write Greek in the cultural ambit of Catholicism (because Frankos / Φράγκος is an older Greek term for West-European dating to when most of (Roman Catholic Christian) West Europe

8366-541: Was by far the most widely spoken lingua franca in the Mediterranean world . It eventually became the official language of the Byzantine Empire and developed into Medieval Greek . In its modern form , Greek is the official language of Greece and Cyprus and one of the 24 official languages of the European Union . It is spoken by at least 13.5 million people today in Greece, Cyprus, Italy, Albania, Turkey , and

8460-480: Was recorded in writing systems such as Linear B and the Cypriot syllabary . The alphabet arose from the Phoenician script and was in turn the basis of the Latin , Cyrillic , Coptic , Gothic , and many other writing systems. The Greek language holds a very important place in the history of the Western world. Beginning with the epics of Homer , ancient Greek literature includes many works of lasting importance in

8554-664: Was the first to promote personal and environmental hygiene to prevent disease. The development of a sufficiently powerful microscope by Antonie van Leeuwenhoek in 1675 provided visual evidence of living particles consistent with a germ theory of disease . During the Ming dynasty , Wu Youke (1582–1652) developed the idea that some diseases were caused by transmissible agents, which he called Li Qi (戾气 or pestilential factors) when he observed various epidemics rage around him between 1641 and 1644. His book Wen Yi Lun (瘟疫论, Treatise on Pestilence/Treatise of Epidemic Diseases) can be regarded as

8648-566: Was under the control of the Frankish Empire ). Frankochiotika / Φραγκοχιώτικα (meaning 'Catholic Chiot') alludes to the significant presence of Catholic missionaries based on the island of Chios . Additionally, the term Greeklish is often used when the Greek language is written in a Latin script in online communications. The Latin script is nowadays used by the Greek-speaking communities of Southern Italy . The Yevanic dialect

8742-637: Was used for literary and official purposes in the newly formed Greek state. In 1976, Dimotiki was declared the official language of Greece, after having incorporated features of Katharevousa and thus giving birth to Standard Modern Greek , used today for all official purposes and in education . The historical unity and continuing identity between the various stages of the Greek language are often emphasized. Although Greek has undergone morphological and phonological changes comparable to those seen in other languages, never since classical antiquity has its cultural, literary, and orthographic tradition been interrupted to

8836-653: Was written by Romaniote and Constantinopolitan Karaite Jews using the Hebrew Alphabet . In a tradition, that in modern time, has come to be known as Greek Aljamiado , some Greek Muslims from Crete wrote their Cretan Greek in the Arabic alphabet . The same happened among Epirote Muslims in Ioannina . This also happened among Arabic-speaking Byzantine rite Christians in the Levant ( Lebanon , Palestine, and Syria ). This usage

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