Skip to Navigation
University of Pittsburgh
Print This Page Print this pages

December 5, 2013

Research Notes

Disease database spans 125 years

Graduate School of Public Health researchers have collected and digitized all weekly surveillance reports for reportable diseases in the United States going back more than 125 years.

The project’s goal is to aid scientists and public health officials in the eradication of deadly and devastating diseases. The free electronic version of the database also is searchable by the public at

Said lead author Willem G. van Panhuis, epidemiology faculty member: “Using this database, we estimate that more than 100 million cases of serious childhood contagious diseases have been prevented, thanks to the introduction of vaccines. But we also are able to see a resurgence of some of these diseases in the past several decades as people forget how devastating they can be and start refusing vaccines.”

Despite the availability of a pertussis vaccine since the 1920s, the largest pertussis epidemic in the U.S. since 1959 occurred last year. Measles, mumps and rubella outbreaks also have reoccurred since the early 1980s.

The digitized dataset is dubbed Project Tycho for 16th-century Danish nobleman Tycho Brahe, whose meticulous astronomical observations enabled Johannes Kepler to derive the laws of planetary motion.

Said senior author Donald S. Burke, dean and UPMC-Jonas Salk Chair of Global Health: “We hope that our Project Tycho disease database will help spur new, lifesaving research on patterns of epidemic infectious disease and the effects of vaccines. Open access to disease surveillance records should be standard practice, and we are working to establish this as the norm worldwide.”

The researchers selected eight vaccine-preventable contagious diseases for a more detailed analysis: smallpox, polio, measles, rubella, mumps, hepatitis A, diphtheria and pertussis. By overlaying the reported outbreaks with the year of vaccine licensure, the researchers are able to give a clear, visual representation of the effect that vaccines have in controlling communicable diseases.

The researchers obtained all weekly notifiable disease surveillance tables published between 1888 and 2013 — approximately 6,500 tables — in various historical reports, including the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. These tables were available only in paper format or as PDF scans in online repositories that could not be read by computers and had to be hand-entered. With an estimated 200 million keystrokes, the data — including death counts, reporting locations, time periods and diseases — were digitized. A total of 56 diseases were reported for at least some period of time during the 125-year time span, with no single disease reported continuously.

In the near future, the Project Tycho database also will be available on the web pages.

Also contributing were current and former members of the public health school: John Grefenstette, Nian Shong Chok, Anne Cross, Heather Eng, Bruce Y. Lee and Shawn Brown.

Other collaborators were Vladimir Zadorozhny of the School of Information Sciences and a faculty member from Johns Hopkins University.

The research was published in the New England Journal of Medicine and supported by the Bill and Melinda Gates Foundation and the National Institutes of Health (NIH).

Breast cancers targeted

The Breast Cancer Research Foundation (BCRF) has provided $720,000 to three researchers investigating ways to improve treatment and survival outcomes for women with breast cancer.

Nancy E. Davidson, director of the University of Pittsburgh Cancer Institute and UPMC CancerCenter; Adrian V. Lee, director of the Women’s Cancer Research Center (WCRC), a collaboration between UPCI and Magee-Womens Research Institute, and Steffi Oesterreich, director of education at WCRC, each have received $240,000 from the foundation.

Davidson’s laboratory will use the funds to continue studying the role of epigenetic changes in breast cancer development and therapy.

Said Davidson: “We know that breast cancer results from an accumulation of genetic and epigenetic changes in the cancer cell. Because epigenetic changes alter gene activity but not the genes themselves, they potentially could be reversed. We are evaluating ways to counteract these changes as a new way to treat breast cancer.”

The goal of Lee’s laboratory is to improve the prediction of breast cancer prognosis and response to treatment.

Lee said: “We’ve known for some time that there are different types of breast cancers. Now we are trying to understand how differences within the breast cancer tumor operate. One tumor can have an area of aggressive disease and an area of benign disease. We need to determine the importance of the aggressive disease. Understanding the differences within breast cancer tumors will help us refine personalized treatment approaches for breast cancer patients.”

Oesterreich has received an award from BCRF supporting her research on invasive lobular carcinomas (ILC), which represent 30,000 cases of breast cancer each year.

Said Oesterreich: “Currently, patients with this type of breast cancer receive the same type of treatment as patients with other subtypes of the disease, but some patients with ILC don’t respond as well to endocrine therapy. We hope improved understanding of the disease will lead to better, targeted treatment for patients.”

Doctor-parent interaction could improve teens’ health

Improved communication between pediatric providers and the parents and guardians of adolescents could lead to better health outcomes, a School of Medicine study reports in Patient Education and Counseling.

Between June and November 2009, the research team of lead author Aletha Akers, faculty member in obstetrics and gynecology, administered an anonymous, self-reported questionnaire to 358 parents accompanying their adolescent children on visits to general outpatient pediatric clinics at Children’s Hospital to assess the main health issues concerning their adolescents.

The questionnaire relied on the parent’s or guardian’s ability to recall their conversations with their adolescent’s health care provider on a range of preventive health topics including nutrition, mental health, physical activity, sexual activity and substance abuse. According to Akers, most parents could recall discussing at least one adolescent preventive health topic with their adolescent’s care provider. They were much more likely to recall discussing general prevention topics like physical activity and nutrition than they were to recall discussing more sensitive topics like sexual activity, substance abuse and mental health issues.

Said Akers: “Adolescence is a relatively healthy period of life, and most adolescent morbidity comes from participating in high-risk behaviors. Most preventive health conversations between parents and providers take place during early childhood, but such communication is arguably even more important during the adolescent years, when adolescents’ health choices could directly influence health outcomes.

“Ideally, these results are the first step toward improving communication between pediatric care providers and parents and guardians,” Akers added. “By building on tools we already have in place, we can improve conversations about high-risk health behaviors, including incorporating screening and counseling practices into acute care visits or visits for school physicals, since many adolescents miss their annual well-child check-ups. The use of electronic medical records can remind care providers of essential health topics that need to be discussed with adolescents and their guardians.”

This study was funded by NIH and the Robert Wood Johnson Foundation.

Pittsburgh is “civically healthy”

Pittsburgh residents are significantly more civically healthy than average Americans and other Pennsylvanians, according to the Pittsburgh Civic Health Index, a new report compiled by Pitt and Carnegie Mellon University (CMU) collaborators for the National Conference on Citizenship. Civic health, a measurement of community participation in activities such as voting and interacting with and trusting neighbors, has been shown to be a major contributing factor in a community’s ability to be resilient during economic downturns.

Report co-authors included David Miller, director of Pitt’s Center for Metropolitan Studies and faculty member in public and international affairs in the Graduate School of Public and International Affairs (GSPIA).

The Pittsburgh Civic Health Index features a demographic profile of Pittsburgh and presents charts and data on measures of civic engagement such as volunteering, voting, relationships with neighbors, and residents’ reports on their overall quality of life. The researchers drew data from previous surveys and from the Current Population Survey, sponsored jointly by the U.S. Census Bureau and the U.S. Bureau of Labor Statistics.

The index shows that the Pittsburgh region exceeds both the Pennsylvania and national averages in levels of political involvement, with Pittsburgh residents more likely to attend public meetings and voice concerns. Pittsburghers also are significantly more likely to have contacted a public official: 36.8 percent more likely than average Americans and 37.4 percent more likely than other Pennsylvanians. Pittsburgh residents also interact with their neighbors more and are 37.3 percent more likely to trust their neighbors than other Americans.

The report outlines recommendations for the city to strengthen its health in three areas: overall civic health; each neighborhood’s capacity to engage in public discourse, and the connections between municipalities within the region:

• Make Pittsburgh a center of deliberative democracy. Create opportunities for issue-oriented, small-group discussions that will be leveraged by stakeholder involvement and outcomes that can guide policy. For example, include citizen deliberation as part of the regulatory requirements for public comment or engage in new initiatives, such as participatory budget planning.

• Shift Pittsburgh’s approach to city planning and neighborhood development from top-down to bottom-up by creating an environment in which residents can produce and share their ideas and participate more dynamically.

• Facilitate communication and activity among municipalities. The Pittsburgh region’s complicated local government system appeals to residents and seems to give them access to civic engagement, so instead of replacing it with a less fragmented system, the report recommends improving integrations with the city and region. An example of this would be expanding the scope, funding and capacity of Councils of Governments — associations of local governments representing the region that are uniquely positioned to translate urban issues to the suburbs and vice versa.

Said Miller: “Pittsburgh and the surrounding region have already taken steps that work toward the goals of these recommendations. One initiative that is cultivating a greater sense of the urban core that expands beyond city borders is the Congress of Neighboring Communities. CONNECT has successfully brought the City of Pittsburgh and the 36 municipalities that surround the city together to collaborate on common issues that cross borders, establishing a cohesive voice for the urban core of our region. Through CONNECT, these communities have developed a greater understanding of the issues that unite them, have built trust and are able to tackle regional challenges collectively.”

The Pittsburgh Civic Health Index was funded by the Pittsburgh Foundation.

Teen solitary drinking predicts alcohol use

Most teenagers who drink alcohol do so with their friends in social settings, but a new study led by Kasey Creswell, who completed the research while a Pitt psychology doctoral student but now is a faculty member at CMU, reveals that a significant number of adolescents consume alcohol while they are alone.

The researchers found that, compared to their peers who drink only in social settings, teens who drink alone have more alcohol problems, are heavier drinkers and are more likely to drink in response to negative emotions. Solitary teenage drinkers also are more likely to develop alcohol use disorders in early adulthood.

Said Creswell: “We’re learning that kids who drink alone tend to do so because they’re feeling lonely, are in a bad mood or had an argument with a friend. They seem to be using alcohol to self-medicate as a way to cope with negative emotions and, importantly, this pattern of drinking places them at high risk to escalate their alcohol use and develop alcohol problems in adulthood.”

For the study, the researchers first surveyed 709 adolescents ages 12-18 at the Pittsburgh Adolescent Alcohol Research Center (PAARC), asking them to report on their alcohol use in the past year. Adolescents represented youth from clinical treatment programs and the community. When the participants turned 25, they again were asked about their alcohol use and assessed for alcohol use disorders.

The results showed that 38.8 percent of teens in the sample reported drinking alone. This behavior was linked to unpleasant emotions, and solitary drinkers were one-and-a-half times more likely to develop alcohol dependence at age 25.

Said co-author Tammy Chung, faculty member in psychiatry and epidemiology in the School of Medicine: “Because adolescent solitary drinking is an early warning sign for alcohol use disorder in young adulthood, and solitary drinking tends to occur in response to negative emotions, youth who report solitary drinking might benefit from interventions that teach more adaptive strategies for coping with negative emotions.”

Funded by the National Institute on Alcohol Abuse and Alcoholism and National Institute on Mental Health, the study will be published in Clinical Psychological Science.

Homeless but working: How to encourage savings?

New research by GSPIA faculty member Sera Linardi offers a possible insight into helping the homeless improve their future prospects.

The research examines the saving behavior of the working homeless, surmising that better understanding this population may provide clues to the problem of chronic homelessness and also provide insights into how the very poor reintegrate into the economic mainstream.

Linardi and an Arizona State University colleague worked with residents at an Arizona homeless shelter who were best complying with community rules and honoring responsibilities. The shelter provided food, toiletries and transportation expenses on the conditions that residents would find jobs and save a portion of their income each month. Shelter residents who participated in the study had jobs and were close to obtaining permanent housing.

Linardi and her colleague categorized 123 residents into baseline and competition groups. The baseline group engaged in their ordinary saving behaviors, depositing a portion of their income in savings accounts or giving it to the shelter’s case manager for safekeeping.

In the competition group, however, residents were offered a $100 prize for the individual who saved the largest percentage of his or her pay during a one-month period.

The results were impressive, with the average rate of savings increasing from $127 to $207 during the month of the competition — a 33 percent increase, from 53 percent to 86 percent of earnings saved by participants, whose average monthly income was $240.

Repeating the competition for a second month, Linardi and her co-author no longer found any difference in saving between the competition group and the baseline group. They speculate that this is because those residents who responded to competition in the first month were able to leave the shelter soon afterward. Linardi also speculated that the experiment “may have worked too well, spurring a burst of unsustainable effort” and leaving residents in the competition group unable to save at the same high rate for a second month.

Added Linardi, who also is a Department of Economics faculty member in the Dietrich School of Arts and Sciences: “If it was the case that people who wanted to leave the shelter sooner used the competition as a way to spark a last burst of effort, and that increased their total savings in the end, then it’s useful. If, on the other hand, it exhausts them, then that’s not good.

“Previously, in other environments, the homeless might have felt that they could not get ahead of others in terms of their finances,” she added. “But competing among clients of a homeless shelter levels the playing field.”

The authors concluded that focusing on savings might be premature, and lead to only short-term results, if such initiatives are not paired with efforts to improve the job skills and income of the homeless over the long run.

The paper appeared in the Journal of Economic Behavior and Organization.


The University Times Research Notes column reports on funding awarded to Pitt researchers as well as findings arising from University research.

We welcome submissions from all areas of the University. Submit information via email to:, by fax to 412/624-4579 or by campus mail to 308 Bellefield Hall.

For detailed submission guidelines, visit “Deadlines” page.

Leave a Reply