Public Health Research Priority Research Articles

12-Year Trends of Orofacial Clefts in the United States: Highlighting Racial/Ethnic Differences in Prevalence of Cleft Lip and Cleft Palate.

Discrepancies in prevalence among infants with orofacial clefts are public health research priorities. Our objective was to calculate updated estimated prevalence of orofacial clefts in the United States, with sub-analyses by racial/ethnic group. The National Birth Defect Prevention Network database was used to evaluate trends in cases with orofacial cleft in the United States from 2006 to 2018. Cases with cleft lip with and without cleft palate (CL ± P) and cleft palate (CP) alone were sub-stratified by racial/ethnic category. Estimated prevalence was calculated using the total live births reported in each maternal racial/ethnic group. The odds ratio (OR) was calculated to measure the strength of association between racial/ethnic group and risk of orofacial clefts. Estimated prevalence rates show that maternally-reported Native American/Alaskan Native individuals were 43.8% (p < 0.0001) and 36.0% (p < 0.0001) more likely to have CL ± P and CP alone, respectively, compared to maternally-reported non-Hispanic White individuals. Estimated prevalence of CL ± P in maternally-reported non-Hispanic Black individuals (OR = 0.64) and maternally-reported Asians/Pacific Islander individuals were significantly lower than in maternally-reported non-Hispanic White individuals (OR = 0.63, p < 0.0001). Estimated prevalence of CP alone was significantly lower in maternally-reported non-Hispanic Black individuals (OR = 0.64, p < 0.0001), maternally-reported Asians/Pacific Islander individuals (OR = 0.69, p < 0.0001), and maternally-reported Hispanic individuals (OR = 0.81, p < 0.0001). Across the total population, there was no significant change in estimated orofacial cleft prevalence. However, there were significant disproportions in estimated orofacial cleft prevalence across racial/ethnic groups, which may guide further discussion among craniofacial health care providers and centers and their patients regarding differences in cleft risk factors.

Public health priorities for gastroschisis: Summary of a meeting sponsored by the Centers for Disease Control and Prevention and the March of Dimes.

Gastroschisis has increased worldwide over several decades; however, there are significant gaps in understanding risk factors for development of the defect, particularly those that might be modifiable. Despite advances in survival, little is known about longer-term outcomes for affected individuals. On April 27- and 28, 2023, the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention (CDC) and March of Dimes sponsored a meeting entitled "Public Health Priorities for Gastroschisis". The meeting goals were to review current knowledge on gastroschisis, discuss research gaps, and identify future priorities for public health surveillance, research, and action related to gastroschisis. Meeting participants encompassed a broad range of expertise and experience, including public health, clinical care of individuals with gastroschisis, affected individuals and families, and representatives from professional organizations and federal agencies. Several goals were identified for future public health surveillance and research, including focused theory-driven research on risk factors and increased study of longer-term effects of gastroschisis through improved surveillance. Certain public health actions were identified, that which could improve the care of affected individuals, including increased education of providers and enhanced resources for patients and families. These efforts may lead to an improved understanding of pathogenesis, risk factors, and outcomes and to improved care throughout the lifespan.

POPULATION ATTRIBUTABLE FRACTION OF POOR ORAL HEALTH FOR THE INCIDENCE OF DEMENTIA: A POPULATION-BASED COHORT STUDY

Abstract Emerging evidence indicates a positive association between suboptimal oral health and increased risks of dementia. Despite the preventable and treatable nature of many oral health problems, oral health has not been considered in the risk factors for dementia that shape public health policy and research priorities. We aimed to quantify and compare the fractions of incident dementia attributable to poor oral health and other modifiable risk factors. The research included a nationally-representative sample of 15,474 cognitively intact adults aged≥50 from the Health and Retirement Study, with the outcome of incident dementia between 2006 to 2016. We estimated the multivariate-adjusted hazard ratio (HR) and population attributable fraction (PAF) of edentulism and nine risk additional dementia factors. Additional analyses were conducted on 1,239 individuals who completed the “Dental Health Module” in 2008, examining oral health problems as an exposure. Edentulism was associated with a higher risk of dementia for both men (HR,1.38; 95%CI, 1.15-1.66) and women (HR, 1.32; 95%CI, 1.16-1.51). The PAF of edentulism for dementia was 4.64%, which exceeded that of hearing impairment (3.58%) and hypertension (2.90%). Oral health problems were also a significant factor for men (HR, 2.01; 95%CI, 1.49-3.39) and women (HR, 1.15; 95% CI, 1.02-1.30), with a PAF of 11.84% among men, the second-largest following less education (22.60%). The substantial estimated proportion of dementia attributed to poor oral health in the aging population, particularly in men, warrants more attention. Dental care should be an integral component of a comprehensive approach to promoting cognitive health.

Vulnerability to heatwaves: a scoping review of prevention programs. Results from the ENBEL project

Abstract Background This study, conducted as part of the European ENBEL project (Horizon 2020), aims at synthesising the scientific evidence on heat health preventive measures targeting vulnerable populations, considering other environmental co-exposures, such as air pollution, wildfires and droughts. Methods A scoping review was performed on Medline and Embase (Ovid) through search terms on clinical and social vulnerabilities, health outcomes (morbidity, mortality, hospitalisation), heatwaves, droughts, air pollution, wildfires, and preventive measures. Records in English published between 2000 and 2023 were included and screened according to PRISMA guidelines. Results 8608 records were retrieved, 5895 of which screened after duplicate removal. 51 were included in the qualitative synthesis. The interventions, mainly targeting workers (from agriculture, healthcare, waste management, firefighting and military sectors) and school athletes, were the most evaluated preventive measures. The role of hydration, rest in the shade, cooling cloths and food, and acclimatisation procedures were highlighted for both groups. On the other hand, local prevention plans, mainly from high-income Countries, focused on the elderly, adults in poor health conditions, homeless and institutionalised people. The implemented measures concentrate on cooling interventions, provision of health care and social services, education and information campaigns. Regarding co-exposures, a study on prevention for firefighters and one on the implementation of Clean Air Centres in California for people vulnerable to heat and smoke were retrieved. A search of the grey literature will be performed to avoid publication bias. Conclusions There is still limited evidence on the effectiveness of preventive measures aimed at protecting vulnerable subgroups from heat-related health effects. The present findings can help orient the public health agenda and research priorities on climate changes adaptation measures. Key messages • Heatwaves are more frequent due to climate change, putting vulnerable population at risk. Developing plans and programs aimed at reducing negative health outcomes related to heat should be a priority. • Hydration, rest, and acclimatization procedures reduce heat-related illnesses in workers and athletes. Local prevention plans for the elderly show the role of education and information.

Public Health Research Priorities for Fungal Diseases: A Multidisciplinary Approach to Save Lives.

Fungal infections can cause severe disease and death and impose a substantial economic burden on healthcare systems. Public health research requires a multidisciplinary approach and is essential to help save lives and prevent disability from fungal diseases. In this manuscript, we outline the main public health research priorities for fungal diseases, including the measurement of the fungal disease burden and distribution and the need for improved diagnostics, therapeutics, and vaccines. Characterizing the public health, economic, health system, and individual burden caused by fungal diseases can provide critical insights to promote better prevention and treatment. The development and validation of fungal diagnostic tests that are rapid, accurate, and cost-effective can improve testing practices. Understanding best practices for antifungal prophylaxis can optimize prevention in at-risk populations, while research on antifungal resistance can improve patient outcomes. Investment in vaccines may eliminate certain fungal diseases or lower incidence and mortality. Public health research priorities and approaches may vary by fungal pathogen.

Our health, our research. Identifying public health research priorities among children and youth in a multiethnic population: protocol for a community-based participatory health research priority survey

IntroductionEmphasis on public involvement (PI) in health research has increased in the last 20 years. However, there is limited literature on PI in planning and conducting population-based health research. This...

Do not let the ideal be the enemy of good enough regulation.

Research on the effectiveness and efficiency of different methods of regulating cannabis potency should be a high priority for public health research that will inform the design of cannabis regulations that minimize public health harms. Our article [1] was intended to alert the addictions field to the critical issue of increased cannabis potency as a public health concern, counter the cannabis industry argument that such regulation is unnecessary and canvas some regulatory options. We thank our commentators for their thoughtful responses, which reveal that regulating tetrahydrocannabinol (THC) potency is more complex than it seems at first sight. Freeman & Lorenzetti highlight consumers’ need for simpler advice on labels, much as standard drinks of alcohol [2]. They have led consensus projects to define standard doses of THC that could be used in this way. They also make the useful point that regulators need to consider setting minimum unit prices for cannabis, much as those that have been implemented to reduce heavy alcohol consumption in some countries. Pardal & Wadsworth highlight the fact that the US model of cannabis legalization—a commercialized for-profit market, with minimal regulation of potency and promotion—is not the only model on offer [3]. Uruguay has limited sales to herbal cannabis and capped the THC content of cannabis sold in pharmacies. The Canadian province of Quebec has banned sales of cannabis extracts, limited the sale of edibles and imposed a cap on the THC content of herbal cannabis. The effectiveness of these policies is well worth investigation. The major empirical question is whether the policies will succeed in the longer term, when neighbouring jurisdictions allow the sale of banned products that can be easily transported across borders. Caulkins points out the economic drivers of increasing cannabis potency in the United States; namely, cannabis producers’ need to make maximum use of whole cannabis plants to compete in a market in which cannabis prices are declining [4]. He argues that bans on the sale of high-potency cannabis products would be simpler and easier to implement than attempting to regulate the potency of the many different cannabis products in US legal cannabis markets. He cites evidence that bans need not generate large-scale illicit markets. We agree that banning high-potency products could be the most effective measure to protect public health in countries contemplating cannabis legalization. We doubt its feasibility, however, in mature US markets that already sell high-potency products and in which cannabis retailers will strenuously oppose the policy. Governments regulating these markets may also prefer the revenue from taxing cannabis products on the basis of their THC content. The regulation of cannabis potency is nowhere near as straightforward as regulating alcohol, but we should not allow the cannabis industry to use this as a reason for failing to regulate cannabis potency. In cannabis regulation, as in any area of public health, we should not allow the ideal to be the enemy of the good enough. Research on the effectiveness and efficiency of different methods of regulating cannabis potency should be a high priority for public health research that will inform the design of cannabis regulations which minimize public health harms. Open access publishing facilitated by The University of Queensland, as part of the Wiley - The University of Queensland agreement via the Council of Australian University Librarians. None.

Monkeypox public health research priorities for Africa: A DEENIP paradigm for strengthening global health security

While clinically less severe than smallpox, monkeypox is a viral zoonosis with symptoms that are comparable to those of smallpox. The 2022 multi-country monkeypox outbreak which is an international public health emergency has raised challenging issues for research. For instance, even though monkeypox can be prevented, detected, and treated with the use of vaccines, medicines, and diagnostics, further studies are required to help establish the appropriate use of these medical products. There are further concerns regarding the length of illness and the reasons why some people get sicker than others. Priorities for monkeypox public health research in Africa are to raise awareness of studies that could be conducted whose conclusions, when they are made, will significantly improve global health security. We present 6 key Monkeypox Public Health research priorities for Africa from a DEENIP paradigm for strengthening global health security. The DEENIP priorities as an organizing framework are D= D: Diagnostic tools and surveillance, E =Epidemiological, clinical and immunological traits, E= Equitable, effective, and safety distribution of vaccines including therapeutics, N= New and innovative methods for assessing medical countermeasures, I=Improve equity and reduce stigma during public health emergency, P = Public health communication strategies.

Public health research priorities for WHO on COVID-19 in the South-East Asia Region: results of a prioritization survey

BackgroundEffectively addressing the coronavirus disease 2019 (COVID-19) pandemic caused by the new pathogen requires continuous generation of evidence to inform decision-making. Despite an unprecedented amount of research occurring globally, the need to identify gaps in knowledge and prioritize a research agenda that is linked to public health action is indisputable. The WHO South-East Asia Region (SEAR) is likely to have region-specific research needs.MethodsWe aimed to identify a priority research agenda for guiding the regional and national response to the COVID-19 pandemic in SEAR countries. An online, anonymous research prioritization exercise using recent WHO guidance was conducted among the technical staff of WHO’s country and regional offices engaged with the national COVID-19 response during October 2020. They were each asked to contribute up to five priority research ideas across seven thematic areas. These research ideas were reviewed, consolidated and scored by a core group on six parameters: regional specificity, relevance to the COVID-19 response, feasibility within regional research capacity, time to availability for decision-making, likely impact on practice, and promoting equity and gender responsiveness. The total scores for individual suggestions were organized in descending order, and ideas in the upper tertile were considered to be of high priority.ResultsA total of 203 priority research ideas were received from 48 respondents, who were primarily research and emergency response focal points in country and regional offices. These were consolidated into 78 research ideas and scored. The final priority research agenda of 27 items covered all thematic areas—health system (n=10), public health interventions (n=6), disease epidemiology (n=5), socioeconomic and equity (n=3), basic sciences (n=1), clinical sciences (n=1) and pandemic preparedness (n=1).ConclusionsThis exercise, a part of WHO’s mandate to “shape the research agenda”, can help build a research roadmap ensuring efficient use of limited resources. This prioritized research agenda can act as a catalyst for Member States to accelerate research that could impact the COVID-19 response in SEAR.

Defining research priorities for youth public mental health: reflections on a coproduction approach to transdisciplinary working

BackgroundWith most mental health problems established during childhood/adolescence, young people must be a key focus of public mental health approaches. Despite the range of factors known to influence mental health, evidence for effective interventions is lacking for this age group. This study aimed to define priorities for future public health intervention-focused research to support youth mental health by engaging with transdisciplinary stakeholder groups.MethodsOur coproduction approach involved priority-setting workshops with young people, researchers, practitioners and policy-makers. Each workshop focused on three thematic areas: social connections and relationships; schools and other education settings; and key groups at greater risk of mental ill-health, specifically LGBTQ+ and care-experienced young people. Workshop outputs were synthesized to define research priorities.ResultsThis paper presents the research priorities that were defined through the priority-setting workshops, and our reflections on the coproduction approach to guide future similar activities undertaken by others. Ten priorities for youth public mental health research were defined, covering the following areas: building supportive relationships; whole system approaches; social media; support at times of transition; improving links between different services; development and training for those who support young people; staff mental health; engaging with families; awareness of and access to services; and out-of-school and community settings.ConclusionsThese research priorities can inform future intervention development to support youth public mental health. Our transdisciplinary approach means the identified research priorities are likely to be relevant to young people’s experiences and needs, and to fit with the needs of those working in practice and policy to support young people.

Are you more impulsive with age? Examining age, marital status, and gender on cognitive ageing

Understanding non-pathological cognitive aging processes remains a public health goal and research priority. Age-associated cognitive aging is a normal human process, however, individual differences may aid in the mitigation of cognitive aging. Assessing the role of certain protective factors (i.e., age, marital status, and gender) that influence age-related cognitive aging is imperative to slow down the progression of unwarranted cognitive aging. Participants aged over 18 (N = 123; 97 females and 26 males) recruited from Sydney, New South Wales, and Gold Coast, Queensland, completed an online neuropsychological test battery with computer-administered tasks, assessing impulsivity and working memory, which were entered as dependent variables. A 3(Age Group: 18–27 years; 28–61 years; 62+ years) x2(Marital Status: married; single) x2(Gender: male; female) Multivariate Analysis of Covariance (MANCOVA) design was used to examine the relationship between age, marital status, and gender (entered as independent variables) on cognitive aging. Participants’ total scores from psychometrically sound measures assessing depressive symptomology, personal wellbeing, resilience, and social network engagement, were entered as covariates. No significant effects were found from the independent variables included in the MANCOVA. A significant covariate effect for resilience and depressive symptomology on impulsivity was found. A multiple regression analysis was performed on the significant covariates, and revealed increased resilience and depressive symptomology to significantly predict greater impulsivity.

Burden of sleep disturbance in non-Hispanic Black pregnant women.

Non-Hispanic Black pregnant women disproportionately experience poor perinatal outcomes compared to other racial/ethnic groups. Sleep disruption has emerged as a risk factor for adverse pregnancy outcomes, but there are limited data in minority pregnant women. We examined the prevalence of habitual snoring and its timing of onset with several key sleep-wake disturbances and their associations with perinatal outcomes in a cohort of non-Hispanic Black pregnant women. Non-Hispanic Black pregnant women in their third trimester were recruited from a large academic medical center and screened for habitual snoring and its timing relative to pregnancy, along with sleep quality, symptoms of insomnia, excessive daytime sleepiness, and daytime function. Clinical diagnoses of hypertensive disorders of pregnancy were obtained along with delivery outcomes. In 235 women, the vast majority (80%) reported 3 or more sleep-wake disturbances, and almost half had at least 5 disturbances. Sixteen percent reported prepregnancy snoring and 20% reported pregnancy-onset snoring. Women with pregnancy-onset snoring had significantly increased odds of poor sleep quality (adjusted odds ratio [aOR] = 8.2), trouble staying asleep (aOR = 3.6), waking up too early (aOR = 2.7), excessive daytime sleepiness (aOR = 2.3), and poor daytime function (aOR = 8.7) but no relationship with perinatal outcomes. In contrast, prepregnancy snoring was related to chronic hypertension, preterm delivery, and fetal growth restriction (aOR = 2.6, aOR = 2.8, and aOR = 5.1, respectively). Sleep-wake disturbances confer a significant burden to pregnant non-Hispanic Black women, an infrequently studied yet disproportionately affected population. Contributions of maternal sleep to racial disparities in perinatal health should be a priority for public health research. White KM, Dunietz GL, Pitts DS, Kalmbach DA, Lucchini M, O'Brien LM. Burden of sleep disturbance in non-Hispanic Black pregnant women. J Clin Sleep Med. 2022;18(5):1319-1325.

Field Epidemiology and Public Health Research Priorities in the Eastern Mediterranean Region: Delphi Technique.

Research is essential for evidence-based decision making. This study aimed to identify research priorities in the areas of field epidemiology and public health in the Eastern Mediterranean Region (EMR) from the perspectives of public health professionals. A Delphi technique, using online survey, was employed to reach 168 public health professionals who have experience in the EMR countries. The study took place between November 2019 and January 2020. Consensus on the research priorities was reached after two-round online questionnaires. A list of top 10 field epidemiology and public health research priorities in the EMR was developed. Of those priorities, four fell under health in emergency, war and armed conflict, two under communicable diseases, two under immunization, one under digital health, and one under sexual, reproductive, and adolescent health. Availability, adequacy, and quality of health services in crisis settings were scored as a top priority (mean = 4.4, rank 1), followed by use of technology to improve the collection, documentation, and analysis of health data (mean = 4.28, rank 2), and capacity of countries in the region to respond to emergencies (mean = 4.25, rank 3). This study was conducted prior to COVID-19 pandemic and, thus, it did not capture COVID-19 research as a priority area. Nevertheless, identified priorities under communicable diseases including outbreak investigation of infectious diseases, epidemics and challenges related to communicable diseases in the EMR were still notable. In conclusion, the field epidemiology and public health research priorities identified in this study through a systematic inclusive process could be useful to make informed decisions and gear the research efforts to improve the health of people in the EMR.

Allied health professions public health research priorities: A modified e-delphi study in the United Kingdom

ObjectivesThis study identifies the United Kingdom (UK) Allied Health Professions (AHP) public health research priorities through a modified e-Delphi study conducted with an expert panel. Study designA modified e-Delphi study was utilised in this study. MethodsThis study used a modified e-Delphi approach to reach a consensus on research priorities. Expert panel members were invited to participate and complete three rounds of the e-Delphi. Ethical approval was obtained through the Public Health England Research and Evidence Governance Group. ResultsA total of 38 participants completed three rounds of the e-Delphi study between September and November 2020. Consensus was reached on nine AHP public health research priorities. ConclusionSeveral areas of AHP public health research were identified as priority, however, a number of priorities refer to the impact of AHP public health activities as opposed to empirical research. The identified priorities will be used to progress the AHP public health research agenda through a UK wide AHP public health strategy implementation group and through support and engagement from the AHP professional bodies and arm's length bodies.

Shifting research priorities in maternal and child health in the COVID-19 pandemic era in India: A renewed focus on systems strengthening.

The remarkable progress seen in maternal and child health (MCH) in India over the past two decades has been impacted by the COVID-19 pandemic. We aimed to undertake a rapid assessment to identify key priorities for public health research in MCH in India within the context and aftermath of the COVID-19 pandemic. A web-based survey was developed to identify top research priorities in MCH. It consisted of 26 questions on six broad domains: vaccine preventable diseases, outbreak preparedness, primary healthcare integration, maternal health, neonatal health, and infectious diseases. Key stakeholders were invited to participate between September and November 2020. Participants assigned importance on a 5-point Likert scale, and assigned overall ranks to each sub-domain research priority. Descriptive statistics were used to examine Likert scale responses, and a ranking analysis was done to obtain an "average ranking score" and identify the top research priority under each domain. Amongst the 84 respondents from across 15 Indian states, 37% were public-health researchers, 25% healthcare providers, 20% academic faculty and 13% were policy makers. Most respondents considered conducting systems strengthening research as extremely important. The highest ranked research priorities were strengthening the public sector workforce (vaccine preventable diseases), enhancing public-health surveillance networks (outbreak preparedness), nutrition support through community workers (primary care integration), encouraging at least 4-8 antenatal visits (maternal health), neonatal resuscitation to reduce birth asphyxia (neonatal health) and screening and treatment of tuberculosis (infectious diseases). Common themes identified through open-ended questions primarily included systems strengthening priorities across domains. The overall focus for research priorities in MCH in India during the COVID-19 pandemic is on strengthening existing services and service delivery, rather than novel research. Our results highlight pivotal steps within the roadmap for advancing and sustaining maternal and child health gains during the ongoing COVID-19 pandemic and beyond.

COVID-19 Infection among People with HIV/AIDS in Africa: Knowledge Gaps, Public Health Preparedness and Research Priorities.

The emergence of novel virus SARS-CoV-2 that causes COVID-19 has complicated Africa’s public health challenges, especially with the pre-existing epidemics such as HIV/AIDS. We highlight the known evidence related to COVID-19 infections among people with HIV (PWH) with specific reference to Africa. The knowledge gaps, level of public health preparedness and the potential research priorities are also outlined. Although the epidemiology and clinical course of COVID-19 in HIV patients are evolving, existing evidence indicate that the disease outcomes are comparable to that of the general population. However, PWH with low CD4 cell counts may have worse outcomes than individuals with restored immunity, whereas old age and co-morbidities such as obesity, hypertension and diabetes can further increase their overall risk. While there may be slight disruption of HIV service delivery in selected African countries, the resilience and resourcefulness of others have helped to sustain HIV service delivery and enhanced the level of public health preparedness and fight against the pandemic. The paucity of data and research studies on HIV-COVID-19 coinfection in Africa, call for concerted efforts to address these limitations.

Uses of Reminiscence in Dementia Care

Improving the quality of life for older adults diagnosed with dementia is a public health research priority. Reminiscence is one non-pharmacological technique used to address the behavioral and psychosocial problems associated with dementia. The uses of reminiscence in dementia care have not yet been integrated, synthesized, critically analyzed, or delineated in the literature. Whittemore and Knafl’s five-step method provided the framework for this integrative review. A comprehensive search of PubMed, CINAHL Plus, SCOPUS, and PsycINFO was undertaken. Articles published in English, focused on participants with a diagnosis of mild to moderate dementia, and with evidence of using reminiscence in dementia care were included. Twenty-six studies published between 2009 and 2019 that met the inclusion criteria were analyzed. Four themes emerged from the integrated findings: (a) recovery from the darkness of depressive symptoms; (b) enhancement of cognitive functions and filling the memory gap; (c) living a fulfilling life in late adulthood, and (d) fulfilling reminiscence functions. The critical appraisal process revealed mixed effectiveness of the use reminiscence on health outcomes in dementia care due to diverse types of reminiscence, different outcomes measures, different data collection toolkits, and a lack of a standardized reminiscence protocol among research studies. Results from this review provide a better understanding of the potential benefits of using reminiscence in dementia care. However, improving the methodological rigor of future studies is necessary to attain conclusive evidence of the effectiveness of using reminiscence in dementia care. Implications of these findings for gerontological education, practice, and research will be presented.

Health services research in France: bridging the gap between academia and policymaking.

-We aimed to identify the knowledge producers, the knowledge that they produce and the main areas of interest for health services research (HSR) in France, which is one of the priorities for public health research planning. -A two-phase approach comprising a bibliometric analysis and semi-structured interviews with 20 researchers and 13 staff members of public health bodies was used. -In France today, interdisciplinary research teams are being organized in the main cities despite a lack of critical mass. The interviews showed that the term 'health services research' is vague with fuzzy boundaries between research, scientific expertise and evaluation. A keyword cluster analysis showed that French HSR is more hospital-centric compared to those countries that publish most frequently. The analysis also revealed a lack of research on methodological aspects. -We analyzed the structure of HSR in France and the specificity of the French publications in this field, compared with other countries. The results indicate the obstacles faced by researchers and decision-makers and offer insight into how these barriers may be removed.

Associations of Lifestyle Factors With Cognition in Community-Dwelling Adults Aged 50 and Older: A Longitudinal Cohort Study.

In the absence of an effective treatment to alter the progressive course of cognitive decline and dementia, identification of modifiable risk factors that could promote healthy cognitive aging has become a public health research priority. This study seeks to comprehensively determine the contemporaneous associations of a broad spectrum of time-varying modifiable lifestyle factors with age-related cognitive decline in a large population-based cohort of older adults. A total of 5,711 subjects aged 50 and older from the WHO Study on global AGEing and adult health (SAGE) in Shanghai were studied. Repeated measures of lifestyle factors and cognitive performance were conducted in 2009–2010 and 2014–2015. Linear random slope models were used to evaluate the contemporaneous associations between time-varying lifestyle factors and cognitive performance. Person-mean centering method was used to disaggregate the between- and within-person effects in the time-varying lifestyle factors in the random slope models. We found that higher vegetable and fruit consumption, as well as higher level of physical activity were positively associated with all cognitive domains. Body mass index (BMI) was negatively associated with all cognitive domains, whereas waist-to-hip ratio (WHR) was negatively associated with verbal fluency score only. Sedentary time was negatively associated with digit span score but positively associated with verbal fluency score. The between-person effects seem to be more dominant than within-person effects. Overall, our findings suggest better management of multiple lifestyle factors may protect against cognitive decline in later life. Higher vegetable and fruit consumption and physical activity are protective, whereas obesity is detrimental to cognitive decline in older adults. This study underpins the development of multi-domain lifestyle recommendations to promote healthy cognitive aging.

The Impact of Climate Change on Vaccine-Preventable Diseases: Insights From Current Research and New Directions.

Purpose of ReviewVaccine-preventable diseases remain a major public health concern globally. Climate is a key driver of the dynamics of many infectious diseases, including those that are vaccine preventable. Understanding the impact of climate change on vaccine-preventable diseases is, thus, an important public health research priority. Here, we summarize the recent literature and highlight promising directions for future research.Recent FindingsVaccine-preventable enteric diseases, such as cholera, exhibit sensitivity to precipitation and flooding events. The predicted increase in extreme weather events as a result of climate change could exacerbate outbreaks of these pathogens. For airborne pathogens, temperature and specific humidity have been shown to be the most important environmental drivers, although the impact of climate change on disease burden and dynamics remains unclear. Finally, the transmission dynamics of vector-borne diseases are dependent on both temperature and precipitation, and climate change is expected to alter the burden and geographic range of these diseases. However, understanding the interacting effects of multiple factors, including socioeconomic and ecological factors, on the vector-borne disease ecosystem will be a crucial step towards forecasting disease burden under climate change.SummaryRecent work has demonstrated associations between climate and transmission of vaccine-preventable diseases. Translating these findings into forecasts under various climate change scenarios will require mechanistic frameworks that account for both intrinsic and extrinsic drivers of transmission, and the non-linear effects on disease burden. Future research should also pay greater attention to uncertainty in both the climate modeling processes as well as disease outcomes in the context of vaccine-preventable diseases.