Vitamin Information Center

Case Cohort Study
Definition
In a case-cohort study, cases are defined as those participants
of the cohort who developed the disease of interest,
but controls are identified before the cases develop.
This means that controls are randomly chosen from all
cohort participants regardless of whether they have the
disease of interest or not, and that baseline data can be
collected early in the study.
Case-cohort studies are very similar to nested casecontrol
studies. The main difference between a nested
case-control study and a case-cohort study is the way in
which controls are chosen. Generally, the main advantage
of case-cohort design over nested case-control
design is that the same control group can be used
for comparison with different case groups in a casecohort
study. The main disadvantages of the case-cohort
design is that it requires a more complicated statistical
analysis and it can be less efficient than a nested casecontrol
study under some circumstances (e. g., in studies
with long follow-up).

Carlowitz, Hans Carl von
Definition
Hans Carl von Carlowitz was born on 24th December
in 1645 in Oberrabenstein, near of Chemnitz (Saxony/
Germany), and died on 3rd of March 1714 in
Freiberg (Saxony/Germany). He was a mine captain
and responsible for cameralistic accountancy.Carlowitz
created the term sustained yield forestry and mentioned
it in his publication about the economic cultivation
of silvicultures (Sylvicultura oeconomica or
‘die haußwirtschaftliche Nachricht und Naturmäßige
Anweisung zur wilden Baum-Zucht’) in 1713. Carlowitz
is considered to be the creator of sustained yield
forestry.

Caries Decline
Definition
The term “caries decline” describes the decrease of dental
caries prevalence in children and adolescents during
the last two decades of the 20th century. Causes of
this improvement of oral health are not quite clear and
multi-causal. It is assumed that it probably can be traced
back to, for example, fluoridation becoming widespread
in public (toothpaste, water, salt) and improved dental
hygiene among the public. This development was
observed mainly in the Western world.

Caregiver Burden
Definition
Caregiver burden refers to the stress experienced by
family, professional and other providers when assisting
others, especially individuals with disabling medical or
psychiatric problems.

Cardiovascular Diseases
Definition
Cardiovascular disease is the general term for several
chronic diseases concerning the heart and circulatory
system. The major cardiovascular diseases (CVD)
are coronary (or ischemic) heart disease (heart attack),
cerebrovascular disease (stroke), hypertension (high
blood pressure), heart failure and rheumatic heart disease.
According to the WHO, CVD made up almost 17
million (19%) of total global deaths of which around
80% occurred in low and middle-income countries. It is
expected that CVD will be the leading cause of death
in developing countries by 2010. Several risk factors
exist for CVD which can be categorized in unmodifiable
factors (e. g. male, gender and heredity) and modifiable
factors (e. g. cigarette smoking, high blood pressure,
high blood cholesterol levels, physical inactivity,
diabetes and obesity). It is estimated that more than
50% of the deaths and disabilities from heart disease
and stroke could be avoided with effective prevention
efforts targeted at reducing the modifiable risk factors.

Cardiac Surgery
Definition
Cardiac surgery is surgery on the heart, in most cases
applied to correct congenital heart disease or the complications
of ischemic heart disease or valve problems,
which can be caused by different causes e. g. endocarditis.

Capitation
Definition
In capitation-based payment systems, payment is made
for individual patients. Physicians receive a specified
sum of money for the care of individual patients for
a specified period of time. Payment is independent of
the extent of services individual patients require. Ideally,
payments to physicians are risk-adjusted ( risk
adjustment) for differences in morbidity of patients in
order to reduce incentives for  dumping. Physician
income is determined by (risk-adjusted) capitation multiplied
by the number of individual patients enrolled
with the physician. There may be limits as to the maximum
number of patients enrolled with one physician
or decreasing capitation payments above a threshold of
patients.

Canonical Correlation Analysis
Definition
A canonical correlation analysis is a multivariate statistical
technique that investigates the relationships
between two (or more) sets of variables. In most applications,
however, the two sets are not treated symmetrically;
rather, one set is the predictor set, which is
the set of independent variables, and the other set is
the response set, which is the set of dependent variables.
For example, one may want to study the relationship
of various risk factors to the development of
a group of symptoms; compute the (simultaneous) relationship
between three measures of scholastic ability
with five measures of success in school; or investigate
the relationship between two predictors of social mobility
based on interviews, with actual subsequent social
mobility measured by four different indicators. The
underlying principle is to develop two linear combinations
(i. e., canonical variables) of variables in each set
(both dependent and independent if such a distinction is
made) that best explain the variation in the variables of
the other set, i. e. such that the correlation between the
composite variates is maximized.

Cancer Palliative Care
Synonyms
Palliative therapy in oncology; Symptomatic cancer
palliation; Chemotherapy-effects and palliative care
Definition
Palliative care aims to improve the symptoms of
patients with advanced incurable cancer who may
undergo surgery, radiation therapy and/or chemotherapy,
and symptomatic treatments and may suffer the
unwanted effects of these therapies. The goal of cancer
palliative care is to improve the quality of the
remaining life. Palliative management usually is founded
on a multimodality approach based on the advice of
experts from various disciplines and careful coordination.

Cancer
Synonyms
Malignant tumors; Neoplasms
Definition
Cancer is the general term for more than 100 different
distinct diseases that can affect every part of the
body. Cancer is defined by a rapid abnormal cell growth
beyond usual boundaries that can affect adjoining parts
of the body including other organs. This process is
referred to as metastasis which is the major cause of
death from cancer. Cancer is caused by changes in the
genes responsible for cell growth and repair, driven by
interaction between genetic host factors and external
agents. These external agents can be categorized into
physical carcinogens, chemical carcinogens and biological
carcinogens. Prevention strategies play a vital role
in reducing the burden of cancer as up to one third of all
cases could be avoided by: changing tobacco and alcohol
use, adjusting dietary and physical activity patterns
or reducing exposure to sunlight, etc. Early detection
and treatment of cancer is another key element in reducing
the burden of cancer as it significantly improves the
prognosis. When cancer is treated, the main objectives
are curing, prolonging life and improving the quality
of life of the patients affected. The common treatment
methods are surgery, radiotherapy and chemotherapy