Development Of Public Health Recommendations Research Articles

Contextual influences on the role of evidence in e-cigarette recommendations: a multi-method analysis of international and national jurisdictions.

E-cigarette policy has varied across jurisdictions, contrasting with the previous coordinated approach of international tobacco control communities. A multi-method case study approach was used to understand the role of evidence and external and internal contextual factors in the development of public health recommendations across four purposively selected jurisdictions (WHO, UK, Australia and USA). Informed by Dobrow et al.'s (2004) conceptual framework for context-based evidencebased decision-making, four data sources were drawn upon: 1) 15 public health bodies' e-cigarette recommendation documents, 2) seven development documents produced by the public health bodies, 3) sources of evidence cited in the public health bodies' recommendation documents and 4) 15 qualitative interviews with experts. Thematic analysis and citation analysis were conducted to aid triangulation of evidence. We found a complex interplay between internal and external factors which influence the role and use of evidence in the development of e-cigarette recommendations. For example, recommendation documents' remit (internal factor) was influenced by various external factors such as epidemiology and policy history, with decisions made over time having reshaped the external context. Considering the findings with respect to evidence utilisation, we propose a modified version of Dobrow et al.'s (2004) framework, highlighting the important interplay between internal and external contextual factors. This research suggest internal and external contextual factors mutually interact and influence how evidence is incorporated into recommendations. This dynamic interplay of contextual factors may help explain the why different policy approaches are pursued concerning public health topics, particularly e-cigarettes.

The Association between Body Mass Index and Muscular Fitness in Chinese College Freshmen.

(1) Background: The present study aimed to investigate the association between body mass index (BMI) and muscular fitness in Chinese college freshmen. (2) Methods: A total of 6425 college freshmen in mainland China were recruited. BMI was classified as underweight (<18.5 kg/m2), normal weight (18.5~23.9 kg/m2), overweight (24~27.9 kg/m2), and obese (≥28 kg/m2), according to the Working Group on Obesity in China. Health-related physical fitness components including cardiorespiratory fitness, lower body explosive power, upper body muscular endurance, abdominal muscular endurance, flexibility, and vital capacity were assessed. Physical fitness index and muscular fitness index were calculated, respectively, as the sum score of the standardized values (z-score) of the corresponding components. Three regression models were used to evaluate the potential associations: a linear regression model, a polynomial regression model, and a restricted cubic spline regression model. Adjust R square was used to compare among models. (3) Results: Significant differences were observed among different BMI categories in nearly all physical fitness components as well as physical fitness z-score and muscular fitness z-score (p < 0.001), regardless of gender. Significant linear associations were found between BMI and physical fitness z-score as well as muscular fitness z-score among total, male, and female groups (p < 0.05). However, the restricted cubic spline regression model showed a better fitting effect (adjust R2 was 7.9%, 11.2%, and 4.8% in total, male, and female for physical fitness and 7.7%, 15.7%, and 4.0%, for muscular fitness, respectively), compared with the linear and polynomial regression models, presented by a higher adjusted R2. Restricted cubic splines analysis showed that BMI value and physical fitness z-score showed a non-linear relationship with an approximate inverted U curve in all groups, while an approximate reversed J-shaped association was observed between BMI and muscular fitness z-score in all groups. (4) Conclusions: The present study showed a nonlinear negative relationship between BMI and physical fitness with underweight and overweight/obese college freshmen having poorer physical fitness and muscular fitness than their normal BMI peers, which may provide useful evidence to the development of public health recommendations and encourage the health management of young adults. Future studies should further explore the relationship between BMI and muscular fitness with multi-centered large sample size studies.

Going with the grain: Fiber, cognition, and the microbiota-gut-brain-axis.

Healthy dietary intake has been acknowledged for decades as one of the main contributors to health. More recently, the field of nutritional psychiatry has progressed our understanding regarding the importance of nutrition in supporting mental health and cognitive function. Thereby, individual nutrients, including omega-3 fatty acids and polyphenols, have been recognized to be key drivers in this relationship. With the progress in appreciating the influence of dietary fiber on health, increasingly research is focusing on deciphering its role in brain processes. However, while the importance of dietary fiber in gastrointestinal and metabolic health is well established, leading to the development of associated health claims, the evidence is not conclusive enough to support similar claims regarding cognitive function. Albeit the increasing knowledge of the impact of dietary fiber on mental health, only a few human studies have begun to shed light onto the underexplored connection between dietary fiber and cognition. Moreover, the microbiota-gut-brain axis has emerged as a key conduit for the effects of nutrition on the brain, especially fibers, that are acted on by specific bacteria to produce a variety of health-promoting metabolites. These metabolites (including short chain fatty acids) as well as the vagus nerve, the immune system, gut hormones, or the kynurenine pathway have been proposed as underlying mechanisms of the microbiota-brain crosstalk. In this minireview, we summarize the evidence available from human studies on the association between dietary fiber intake and cognitive function. We provide an overview of potential underlying mechanisms and discuss remaining questions that need to be answered in future studies. While this field is moving at a fast pace and holds promise for future important discoveries, especially data from human cohorts are required to further our understanding and drive the development of public health recommendations regarding dietary fiber in brain health.

Physical activity and sedentary behavior in Belgium (BNFCS2014): design, methods and expected outcomes.

BackgroundThere is strong evidence to indicate that regular moderate intensity physical activity is associated with health benefits. Furthermore, sedentary behavior has been related with an increased risk for all-cause mortality. The accurate measurement of physical activity and sedentary behavior is therefore vital to evaluate their health impact and provide evidence for the development of public health recommendations. This paper describes the methodology used for assessing physical activity and sedentary behavior in the Belgian population in the context of the Belgian National Food Consumption Survey 2014 (BNFCS2014).ResultsData about physical activity and sedentary behavior were collected as part of the cross-sectional BNFCS2014 between February 2014 and May 2015. A nationally-representative sample of children (3–9 years) and adolescents (10–17 years) were asked to wear an accelerometer (Actigraph® GT3X) during their waking hours for 7 consecutive days. Data were recorded in 15-second epochs and respondents with at least 2 valid week days (i.e., 10 h of wear-time) and 1 valid week-end day (i.e., 8 h of wear-time) were retained for the analyses. The Evenson cut points were used to assess the time spent in each physical activity intensity level: sedentary, low, moderate and vigorous. Complementary, diaries were provided to register the activities performed when the accelerometer was removed; these activities were added to the measures provided by the accelerometers. In addition, age-specific self-reported questionnaires (ToyBox and FPAQ) were completed to provide contextual information about the type of activities performed. Due to financial constraints, physical activity in adults (18–64 years) was assessed and described through the self-reported International Physical Activity Questionnaire (IPAQ long version) only.ConclusionData were collected in the context of the BNFCS2014 to provide a comprehensive picture of the physical activity and sedentary behavior in the Belgian population, with a special focus on children (3–9 years) and adolescents (10–17 years). Levels of physical activity and sedentary behavior can be compared to international guidelines and analyzed according to several background variables, such as age, gender, Body Mass Index, education level and region. Such results are aimed to underpin future policies in the field of physical activity.

Turning big data into personalised diabetes care

Turning big data into personalised diabetes care

Some methodological issues in the development of public health recommendations from field trials of new malaria vector control interventions

In this paper, I consider some technical aspects of the process by which public health recommendations are inferred from the results of epidemiological field trials and other research on new vector control products and technologies. I argue that the conventional Cochrane Collaboration methods for summarising clinical trials may need to be modified and extended in order to be valid when applied to vector control. With medical interventions, for which the Cochrane methods were originally designed, the primary mode of action of the intervention works through biological processes within an individual, and the individual person is a natural experimental unit. This makes it easier to assume that a series of trials from different locations are more or less replicates of each other: they are asking more or less the same question, and in the absence of bias and sampling error they should produce more or less the same answer. In the case of vector control, on the other hand, the intervention has its most direct effects on mosquitoes, and the causal chain that leads to health benefits mostly occurs outside people, in the external environment. For this reason, in order to summarise a series of vector control trials, it is necessary to standardise not only the human populations, the interventions and the observed outcomes, but also the local vector populations and the broader ecological characteristics of the settings where the trials were carried out. Only with this additional matching is it valid to assume that vector control trials carried out in different settings are asking the broadly same question about the same intervention. The same applies to the process of generalising from a set of field trials in specific settings to broader public health recommendations. We know from first principles that a vector control intervention that is effective in one setting may not be so in another. Moreover, the field trials of a new intervention can include only a small subset of the likely range of settings where the intervention might eventually be used. Thus we need systematic methods for asking not just “whether” an intervention will be effective, but also “where and when” it will be effective. In the past, malariologists have used “eco-epidemiological stratification” to deal with this problem: this approach now needs to be made more systematic and integrated. Particular attention therefore needs to be given to the “epidemiological mode of action” of entomological interventions. This is the causal chain by which effects on mosquitoes lead to reduced infective biting for at least some people (e.g. “personal protection” and “the mass effect” caused by ITNs). This useful new concept, which has emerged from current discussions within the vector control product development community, appears to play a central role in the interpretation of evidence from vector control field trials for public health purposes.

Decision-Making for Recommendations and Communication Based on Totality of Food-Related Research, an ILSI North America-sponsored Workshop at the Omni Shoreham Hotel, Washington, DC, December 15, 2008

INTRODUCTION The extended abstracts in this report are based on presentations from the Workshop on Decision-Making for Dietary Recommendations and Communication Based on Totality of Food-Related Research, which was organized and sponsored by the Technical Committees on Food and Chemical Safety, Lipids, and Carbohydrates of the North American Branch of the International Life Sciences Institute (ILSI North America) and partially supported by the American Meat Institute Foundation. The workshop was held at the Omni Shoreham Hotel in Washington, DC, on December 15, 2008. The aims of this workshop were to educate the nutrition and food safety communities about current practices in the field of epidemiology regarding the interpretation of weak associations and to stimulate a dialogue around improving the transparency and approaches to the use of epidemiological data in combination with other types of data for the development of public health recommendations. The workshop provided an overview of epidemiological methods, provided case-study examples of applications, and reviewed appropriate interpretation and application of epidemiological data and decision making for recommendations.

Differential effects of whole soy extract and soy isoflavones on apoptosis in prostate cancer cells

Previous studies have suggested that soy isoflavones exert anticarcinogenic effects against prostate cancer. We propose that soy extracts, containing a mixture of soy isoflavones and other bioactive components, would be a more potent chemo-preventive agent than individual soy isoflavones. We compared the apoptotic effects of whole soy extracts and individual soy isoflavones, genistein and daidzein, on prostate cancer cells. The soy extract contained 50% w/w of total isoflavones with approximately 1:5.5:3.5 ratios of genistin, daidzin and glycitin, respectively. Benign prostate hyperplasia (BPH-1), LnCap and PC3 cells were treated with varying concentrations of soy extract, genistein or daidzein and analyzed for cell cycle alterations and induction of apoptosis. At equal concentrations (25 micromol/L), soy extract induced a significantly higher percentage of cells undergoing apoptosis than genistein or daidzein (P < 0.001). No significant changes in cell cycle arrest or apoptosis were observed in non-cancerous BPH-1 cells treated with soy extract, suggesting that the effects of soy extract may be tumor cell specific. On the contrary, both genistein and daidzein induced apoptosis in BPH-1 cells, suggesting that individual isoflavones may have cytotoxicity in non-cancerous cells. Soy extracts also increased Bax expression in PC3 cells, but no significant changes in nuclear factor kappaB (NF kappaB) activation were detected, suggesting that the induction of apoptosis was independent of the NF kappaB pathway. Food products that bear a combination of active compounds may be more efficacious and safer as chemo-preventive agents than individual compounds. This 'whole-food'-based approach is significant for the development of public health recommendations for prostate cancer prevention.