Geochemical fingerprinting of a radon anomaly: high-resolution PCA–ANOVA case study, Castleisland, SW Ireland

The Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA+) developed and offered a course on evidence-based public health (EBPH) in five sub-Saharan African (SSA) countries to enhance individual and institutional capacity. This study aims to assess, compare and learn from implementing the CEBHA+ EBPH course using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and Practical, Robust, Implementation and Sustainability Model (PRISM). This study involved CEHBA+ partner universities in five countries in SSA. We developed a framework that draws on signalling questions for RE-AIM and PRISM dimensions. Country teams reflected on, discussed and mapped unique experiences. Using this framework, we then elicited common themes across countries and distilled country-specific experiences through virtual discussions. Across countries, 130 public health practitioners, researchers and students completed the course (Reach). The course increased EBPH knowledge and skills and the capacity to teach EBPH and resulted in immediate opportunities for applying skills (Effectiveness). Hybrid offering in two countries presented challenges regarding Internet connectivity and hybrid discussions. Facilitators had previous training in teaching EBPH. While learning material was the same across countries, the content was adapted to represent local public health priorities (Implementation, Adoption). Course materials have informed other related training leading to spin-offs (Maintenance). Institutionalisation is dependent on external funding. Strengthening EBPH capacity across contexts is feasible. Curricula containing both core and contextualised elements create an authentic learning environment. Formal evaluations should be embedded within capacity-strengthening initiatives. This is the first study evaluating EBPH training in SSA using an implementation science lens, offering learning about context-relevant adaptations that assist with plans for sustainability and scale.

IntroductionEvidence-based public health offers more useful and thoughtfully developed intervention efforts worldwide. Although the practice remains most utilised in the field of clinical medicine, public health has seen an influx of research based on randomised controlled trials (RCTs) for the purpose of assessing clinical interventions in the last three decades. We propose a paradigm shifttowards an evidencebased public health system buttressed by RCTs in order to equip those who practice and make policies with the knowledge they need to make informed decisions.While RCTs have resulted in substantial gains in public health, particularly in policymaking and determining the validity of interventions, such trials have largely been applied appropriately to the unique challenges of the field.1,2 We seek to show that it is possible to apply a framework for evidence-based public health with carefully crafted trials and analyses, and that RCTs represent an effective method of applying evidencebased public health strategies on a population scale. It is our view that RCTs represent the most effective means of implementing evidence-based public health on a population level. However, only recently have evidence-based strategies even been considered in decision-making regarding complex and crucial global public health issues.3If employed on a larger scale, evidence-based public health can empower policymakers as well as public health practitioners, medical professionals, and private individuals to make informed decisions based on carefully conducted trials and analyses that represent the best of our current collective knowledge and will have resounding positive effects, such as more effective and increased access to care.4Relevance Of Evidence-Based Public HealthThe field of public health has traditionally relied on less scientific methods of information-gathering, which has affected the way recommendations have been made to policymakers. RCTs represent a driving force for evidencebased public health that can be utilised specifically for pharmaceutical and other types of clinical interventions, especially with those diseases that afflict many and are well documented. RCTs represent the most effective means of implementing evidence-based public health on a population level. By building upon existing structures for training public health professionals and by implementing RCTs, the field can reap benefits of an evidence-based public health system.An evidence-based approach to public health offers a method for making policy decisions and recommendations, as well as population-scale interventions that are grounded in the scientific method. This is a departure from the ways public health efforts have traditionally been executed. Traditionally, evidence cited in the field of public health relies on multiple caveats, which is not ideal. This is because public health studies are often observational in nature, at times fail to utilise comparison groups, and are usually not fully experimental.5 Research practices in the field of clinical medicine, which typically relies on RCTs to derive evidence, offer a model for more precise and broadly applicable data collection than what is currently utilised in the field of public health. Due to the complex nature of public health challenges, carefully crafted means of gathering and interpreting evidence for interventions are crucial.Increasing Usefulness of RCTsA sound trial design seeks to minimise bias resulting from selection of information used in the study, offers deliberate control of all variables by researchers, and strives to eliminate the possibility of chance.6 RCTs are considered the best available tool for determining validity of design because such trials are seen as meeting these three objectives. Unfortunately, the kinds of probability results generated by RCTs when applied to large-scale endeavours in the public health field are, in isolation, unable to address many of the questions that arise. …

BackgroundDespite the growing body of literature examining social media in health contexts, including public health communication, promotion, and surveillance, limited insight has been provided into how the utility of social media may vary depending on the particular public health objectives governing an intervention. For example, the extent to which social media platforms contribute to enhancing public health awareness and prevention during epidemic disease transmission is currently unknown. Doubtlessly, coronavirus disease (COVID-19) represents a great challenge at the global level, aggressively affecting large cities and public gatherings and thereby having substantial impacts on many health care systems worldwide as a result of its rapid spread. Each country has its capacity and reacts according to its perception of threat, economy, health care policy, and the health care system structure. Furthermore, we noted a lack of research focusing on the role of social media campaigns in public health awareness and public protection against the COVID-19 pandemic in Jordan as a developing country.ObjectiveThe purpose of this study was to examine the influence of social media platforms on public health protection against the COVID-19 pandemic via public health awareness and public health behavioral changes as mediating factors in Jordan.MethodsA quantitative approach and several social media platforms were used to collect data via web questionnaires in Jordan, and a total of 2555 social media users were sampled. This study used structural equation modeling to analyze and verify the study variables.ResultsThe main findings revealed that the use of social media platforms had a significant positive influence on public health protection against COVID-19 as a pandemic. Public health awareness and public health behavioral changes significantly acted as partial mediators in this relationship. Therefore, a better understanding of the effects of the use of social media interventions on public health protection against COVID-19 while taking public health awareness and behavioral changes into account as mediators should be helpful when developing any health promotion strategy plan.ConclusionsOur findings suggest that the use of social media platforms can positively influence awareness of public health behavioral changes and public protection against COVID-19. Public health authorities may use social media platforms as an effective tool to increase public health awareness through dissemination of brief messages to targeted populations. However, more research is needed to validate how social media channels can be used to improve health knowledge and adoption of healthy behaviors in a cross-cultural context.

Long-Term Evaluation of a Course on Evidence-Based Public Health in the U.S. and Europe

The most difficult step of evidence-based medicine (EBM) and evidence-based public health (EBPH) is to link the evidence with current clinical knowledge and experience, especially with the continued focus on using evidence in decision-making. Standards of care and clinical practice guidelines are now established and reported using nationally and globally recognized protocols to ensure standard nomenclature and clinical crosswalks. This chapter examines relevant background issues, including concepts underlying EBM, EBPH, and definitions of evidence; describes key analytic tools to enhance the adoption of evidence-based decision-making; and finishes with challenges and opportunities for implementation in public health practice.

The paper discusses using sorption preconcentration of elements from mineral waters by graphene oxide. The procedure aims to extract heavy metals such as Cd, Cr, Cu, Pb, Zn and other analytes from solution. Inductively coupled plasma – mass spectrometry (ICP-MS) and inductively coupled plasma – optical emission spectrometry (ICP-OES) were used to determine the analyte content. Graphene oxide was obtained by microwave exfoliation of graphite oxide. The sorption of analytes on the graphene oxide at different pH values and coexisting ion effect were studied in detail. Preliminary preconcentration of analytes provides good extraction recoveries using the optimal conditions. The limits of detection (LODs) of 27 analytes for the developed procedure ranged 0.1 to 200 ng L−1 for ICP-MS and from 5 to 1000 ng L−1 for ICP-OES. Sorption concentration provides recoveries of analytes from 80 to 110%. Graphene oxide was successfully employed for the sorption preconcentration of analytes from mineral and tap water.

Studies on transport phenomena in electrothermal vaporization sample introduction applied to inductively coupled plasma for optical emission and mass spectrometry

Since 2002, a course entitled 'Evidence-Based Public Health (EBPH): A Course in Noncommunicable Disease (NCD) Prevention' has been taught annually in Europe as a collaboration between the Prevention Research Center in St Louis and other international organizations. The core purpose of this training is to strengthen the capacity of public health professionals, in order to apply and adapt evidence-based programmes in NCD prevention. The purpose of the present study is to assess the effectiveness of this EBPH course, in order to inform and improve future EBPH trainings. A total of 208 individuals participated in the European EBPH course between 2007 and 2016. Of these, 86 (41%) completed an online survey. Outcomes measured include frequency of use of EBPH skills/materials/resources, benefits of using EBPH and barriers to using EBPH. Analysis was performed to see if time since taking the course affected EBPH effectiveness. Participants were then stratified by frequency of EBPH use (low v. high) and asked to participate in in-depth telephone interviews to further examine the long-term impact of the course (n = 11 (6 low use, 5 high use)). The most commonly reported benefits among participants included: acquiring knowledge about a new subject (95%), seeing applications for this knowledge in their own work (84%), and becoming a better leader to promote evidence-based decision-making (82%). Additionally, not having enough funding for continued training in EBPH (44%), co-workers not having EBPH training (33%) and not having enough time to implement EBPH approaches (30%) were the most commonly reported barriers to using EBPH. Interviews indicated that work-place and leadership support were important in facilitating the use of EBPH. Although the EBPH course effectively benefits participants, barriers remain towards widely implementing evidence-based approaches. Reaching and communicating with those in leadership roles may facilitate the growth of EBPH across countries.

The manufacture and production of industrial chemicals continues to increase, with hundreds of thousands of chemicals and chemical mixtures used worldwide, leading to widespread population exposures and resultant health impacts. Low-wealth communities and communities of color often bear disproportionate burdens of exposure and impact; all compounded by regulatory delays to the detriment of public health. Multiple authoritative bodies and scientific consensus groups have called for actions to prevent harmful exposures via improved policy approaches. We worked across multiple disciplines to develop consensus recommendations for health-protective, scientific approaches to reduce harmful chemical exposures, which can be applied to current US policies governing industrial chemicals and environmental pollutants. This consensus identifies five principles and scientific recommendations for improving how agencies like the US Environmental Protection Agency (EPA) approach and conduct hazard and risk assessment and risk management analyses: (1) the financial burden of data generation for any given chemical on (or to be introduced to) the market should be on the chemical producers that benefit from their production and use; (2) lack of data does not equate to lack of hazard, exposure, or risk; (3) populations at greater risk, including those that are more susceptible or more highly exposed, must be better identified and protected to account for their real-world risks; (4) hazard and risk assessments should not assume existence of a “safe” or “no-risk” level of chemical exposure in the diverse general population; and (5) hazard and risk assessments must evaluate and account for financial conflicts of interest in the body of evidence. While many of these recommendations focus specifically on the EPA, they are general principles for environmental health that could be adopted by any agency or entity engaged in exposure, hazard, and risk assessment. We also detail recommendations for four priority areas in companion papers (exposure assessment methods, human variability assessment, methods for quantifying non-cancer health outcomes, and a framework for defining chemical classes). These recommendations constitute key steps for improved evidence-based environmental health decision-making and public health protection.

Compared to evidence-based public health, evidence-based medicine is a more familiar phrase. Evidence-based medicine has become increasingly popular in the past decade, due in large part to the emergence of computerized database search technology and advanced statistical tools which allow researchers to quickly identify and summarize vast amounts of scientific information.Today, the concept of evidence-based public health is gaining momentum and has grown in popularity. However, the term “evidence-based” lacks clarification and is subject to a variety of interpretations. The evidence that supports evidence-based medicine or public health may include individual experience, anecdotal information, the content of a single scientific article, or the results of a sophisticated systematic review of scientific literature. The imprecise language used to describe evidence leads to confusion over what types of evidence are most appropriate in answering different types of questions.

This chapter presents the origins and assumptions of evidence-based medicine as rooted in the philosophy of science called positivism. The basic principles of the positivist approach to science, empiricism, exclusivity, universality, and autonomy are explained and identified in reproductive and perinatal health outcomes related studies from the systematic reviews of the Cochrane Library, the premier database on evidence-based medicine. A series of articles published in the Evidence-based Public Health Policy and Practice section of the Journal of Epidemiology and Community Health are used to contrast the difference between evidence-based medicine and evidence-based public health. The series of seven articles related to issues of reproductive and perinatal health outcomes demonstrates that evidence-based public health departs from positivism by their incorporation of a diversity of methodological research strategies, by their interest in local and community focus, and by embracing research with clear political implications. As evidence-based public health overcomes the limitations of positivism, researchers should be aware of the limitations of some evidence-based approaches.

The joint structure of normal and pathological personality: Further evidence for a dimensional model

Evidence-based medicine (EBM) emphasizes the integration of the “best” evidence in clinical decision making and has become a dominant framework for practice over the past few decades. In that time, EBM thinking has been adopted by other health professions and fields, including public health. That has given rise to evidence-based public health (EBPH). However, application of the principles of EBM, which were established in light of the clinical encounter, in public health may not always be appropriate. In this chapter, we will provide a brief review of EBM and the major criticisms of the movement. This will include an overview of the GRADE framework for developing evidence-based recommendations, a process that has been adopted by several key organizations responsible for providing technical knowledge about responding to health issues, such as the World Health Organization (WHO). We will then discuss the role of EBM thinking in public health. That discussion will include an examination of issues that arise when adopting or adhering to standards of evidence developed for clinical practice by public health decision makers. These issues will be illustrated using a case study of face covering in public as an intervention to mitigate spread of Covid-19.

BackgroundPublic health agencies are responsible for implementing effective, evidence-based public health programs and policies to reduce the burden of chronic diseases. Evidence-based public health can be facilitated by modifiable administrative evidence-based practices (A-EBPs) (e.g., workforce development, organizational climate), yet little is known about how practitioners view A-EBPs. Thus, the purpose of this qualitative study was to understand state health department practitioners’ perceptions about how A-EBPs are implemented and what facilitators and barriers exist to using A-EBPs.MethodsChronic disease prevention and health promotion program staff who were members of the National Association of Chronic Disease Directors were recruited to participate in telephone interviews using a snowball sampling technique. Interviews were transcribed verbatim, and transcripts were analyzed using a common codebook and the a priori method in NVivo.ResultsTwenty seven interviews were conducted with practitioners in four states (5–8 interviews per state). All practitioners felt that their work unit culture is positive and that leadership encouraged and expected staff to use evidence-based processes. Participants discussed the provision of trainings and technical assistance as key to workforce development and how leaders communicate their expectations. Access to evidence, partnerships, and funding restrictions were the most commonly discussed barriers to the use of A-EBPs and EBDM.ConclusionsResults of this study highlight practitioners’ perspectives on promoting evidence-based public health in their departments. Findings can inform the development and refinement of resources to improve A-EBP use and organizational and leadership capacity of state health departments.

Sustainable chicken meat production has grown rapidly worldwide in the context of development. The study aimed to analyze macro (Ca, K, Mg, Na, P, S), micro (Cu, Mn, Rb, Sr, Zn), trace (Ba, Co, Cr, Ga, Li, Se, V), and toxic trace (As, Cd, Pb) elements in chicken breast meat from conventional and sustainable farms of South Korea. The elemental analyses were conducted by inductively coupled plasma – optical emission spectrometry (ICP-OES) and inductively coupled plasma – mass spectrometry (ICP-MS). The contents of Zn, Sr, Ba, Se, Li, and Ga were higher in sustainable samples compared to in conventional farms. The trace and toxic element contents were lower compared to recommended standard values. Chemometric tests, including principal component analysis (PCA) and linear discriminant analyses (LDA), together explained the highest variability index (100.0%). The outcomes of this study help in profiling the elemental composition of chicken breast meat from South Korean conventional and sustainable farms.