Public Health-related Research Research Articles

The need for standard methods for exposure classification in environmental epidemiology: Case study - pesticide emissions from cultivated agriculture

Background/Aim: The use of systematic reviews and meta-analysis and replication studies has become important in environmental epidemiology, namely when existing studies have inconsistent results. The ability to assess composition and completeness of exposure metrics is critical in this process. The aim of our study is to demonstrate the value of a standardized evaluation tool designed to ascertain whether critical determinants of exposure are incorporated in exposure metrics for epidemiology studies assessing residential exposure to fugitive pesticide emissions from cultivated agriculture (PECA). Methods: We conducted a critical review of 89 peer-reviewed articles, including 64 epidemiological studies, concerning the relevance of determinants of exposure in their PECA exposure metrics. We employed a tool designed to evaluate geospatial exposure assessment (GISEAM). We considered 21 known or suspected determinants of PECA exposure. We analyzed quality of (consistency and quantification), and compared results to a STROBE (Strengthening the Reporting of Observational studies in Epidemiology) score for each study. Results: We observed much lower overall GISEAM quality (40%; IQR 31-52%) versus STROBE scores for overall epidemiologic study design (median score 86%; IQR 77-91%), as well as a low coefficient of correlation between scores (rs = 0.2), yet near significant correlation (p = 0.077). Across majority of studies, we found significant omission or miss-quantification of key fate/transport and spatio-temporal exposure factors relevant to exposure and health risk from PECA. For example wind, a known factor in fate/transport of airborne emissions, was including in only 10% of studies. Each concluded that wind direction and/or velocity improved the accuracy of their metric. Conclusions: Our study clearly demonstrates the added value of employing a standardized tool for design and evaluation of environmental epidemiological studies related to PECA. Our findings have broad implications for optimizing environmental epidemiology risk analyses in public health related research, protective policy, and regulation.

Crime and Violence Studies in the Immigration Field: Interactions between Disciplines and Emerging Concepts

This paper uses bibliometric analysis to evaluate the literature on immigration, crime, and violence to find out how these concepts are studied across disciplines. The paper gave specific attention to the field of Criminology to demonstrate the variation of the use of these concepts in the literature and how much it differs from other disciplines. To meet these expectations, we examined how journals are categorized based on covering how immigration and crime interact in social science disciplines. Moreover, the analysis maps how research articles interact in different journals and what types of topics receive the most attention among researchers by looking at cross-citation data and keyword selection. The findings show that, overall, the number of publications used at least one of the studied items (immigration, crime, and violence) as a keyword increased tremendously in the last two decades. The most studied concept amongst all disciplines is violence, followed by gender and crime with the combination of migration, immigration, immigrants. The topic has been mostly studied from the ‘receiving country’ perspective and funding leads to an increase in publications. The findings suggest Criminology is the top field producing most of the studies in the field followed by public health-related research. These findings suggest that migration, when it is connected to crime and violence, is considered an individual- and social-level challenge requiring the attention of experts in understanding criminal and deviant behavior as well as experts from public health.

Prediction and Analysis of Tourist Management Strategy Based on the SEIR Model during the COVID-19 Period.

Tourism destinations are now facing a dilemma choice of controlling the epidemic or developing the economy. This paper takes Macao, a typical international tourist city, as an example to study the strategy of tourist source control during the COVID-19 period. According to the published epidemic data of Macao, this study has established an improved SEIR (Susceptible-Exposed-Infected-Recovered) model, formulated six control strategies against the current epidemic, and used the model above to simulate the time required for all confirmed cases to recover and discharge under different strategies. By taking into consideration the gross revenue of Macao’s gambling industry from 2017 to 2019, the impact of different strategies on the economy is predicted and three control strategies are found to be feasible. This study shows that an effective way to break through the above dilemma is to design the tourist management strategy by screening the source of passengers and controlling the upper limit of capacity of destination. These findings provide a scientific basis for tourism destinations in formulating public policies. The improved SEIR model is more consistent with the actual conversion rule of patients in the current COVID-19 epidemic, and it can be applied to further public health related research.

Rethinking ‘carriage’ of take-home naloxone

Take-home naloxone (THN) provision to people who use drugs, their family/friends, and non-medical personnel is considered a public health strategy to improve community-based naloxone access and reduce the time to antidote treatment for opioid overdose in order to prevent fatal outcome.THN programs typically report up to three performance indicators: the volume of THN kits distributed, the rate of requests for re-supply of THN kits (e.g., following naloxone use for overdose reversal), and – increasingly – THN “carriage”.In this Research Methods piece, we discuss the current shortcomings in the latter measurement of THN carriage from a mixed-methods perspective and describe possible implications for public health related research and improved data analyses. We present an argument for the need to improve research methods in the case of THN “carriage” and propose a multidimensional measurement structure that takes into account: 1) the location of the THN kit relative to its owner, 2) the owner's immediate access to the kit in an emergency, 3) the type of THN device, and 4) the purpose of THN ownership (i.e., for use in self or known/unknown other/s).

US EPA Research Approaches to Better Understand Human Impacts from Wildfire Smoke Exposure

In recent years, wildland fire and the smoke from these fires has affected populations both near and far from the fire locations. The U.S. Environmental Protection Agency’s (EPA) Office of Research and Development (ORD) developed a Wildland Fire Research Framework 2019-2022 to outline a research agenda related to the public health impacts of wildland fire, in support of the Agency’s mission to protect public health and the environment. The framework supports a breadth of research and outreach designed to help federal, state, local, and tribal organizations prepare and respond to impacts from wildland fire. This work is designed to fill gaps in scientific information related to air quality, water quantity and quality, public health, toxicology, emissions measurement and modeling, and social science. Further, this information is used to prevent and reduce the impact of wildland fire and smoke, and support translation of research and tools into action that reduces the public health burden of these events. This presentation highlights the following projects designed around wildland fire smoke and health: 1) clinical and epidemiological studies aimed to increase the understanding of the magnitude of risk, identify susceptible populations, and reduce health impacts during smoke episodes; 2) Smoke Sense: A crowdsourcing, citizen science research project with an objective to increase issue awareness and engagement in health protective behaviors related to smoke; and, 3) Smoke Ready Communities, a community capacity framework that fosters preparedness and response to wildfire smoke episodes and addresses the need for a model to help communities improve their response. The purpose of this presentation is to provide an overview of EPA’s current public health related research efforts aligned to meet objectives of the framework.Disclaimer: The views expressed in this report are those of the authors and do not reflect the views or policies of the U.S. Environmental Protection Agency.

“Less is more”

Purpose This work studies automated user classification on Twitter in the public health domain, a task that is essential to many public health-related research works on social media but has not been addressed. The purpose of this paper is to obtain empirical knowledge on how to optimise the classifier performance on this task. Design/methodology/approach A sample of 3,100 Twitter users who tweeted about different health conditions were manually coded into six most common stakeholders. The authors propose new, simple features extracted from the short Twitter profiles of these users, and compare a large set of classification models (including state-of-the-art) that use more complex features and with different algorithms on this data set. Findings The authors show that user classification in the public health domain is a very challenging task, as the best result the authors can obtain on this data set is only 59 per cent in terms of F1 score. Compared to state-of-the-art, the methods can obtain significantly better (10 percentage points in F1 on a “best-against-best” basis) results when using only a small set of 40 features extracted from the short Twitter user profile texts. Originality/value The work is the first to study the different types of users that engage in health-related communication on social media, applicable to a broad range of health conditions rather than specific ones studied in the previous work. The methods are implemented as open source tools, and together with data, are the first of this kind. The authors believe these will encourage future research to further improve this important task.

Asking Sensitive Questions Using the Randomized Response Approach in Public Health Research: An Empirical Study on the Factors of Illegal Waste Disposal.

A survey study is a research method commonly used to quantify population characteristics in biostatistics and public health research, two fields that often involve sensitive questions. However, if answering sensitive questions could cause social undesirability, respondents may not provide honest responses to questions that are asked directly. To mitigate the response distortion arising from dishonest answers to sensitive questions, the randomized response technique (RRT) is a useful and effective statistical method. However, research has seldom addressed how to apply the RRT in public health research using an online survey with multiple sensitive questions. Thus, we help fill this research gap by employing an innovative unrelated question design method. To illustrate how the RRT can be implemented in a multivariate analysis setting, we conducted a survey study to examine the factors affecting the intention of illegal waste disposal. This study demonstrates an application of the RRT to investigate the factors affecting people’s intention of illegal waste disposal. The potential factors of the intention were adopted from the theory of planned behavior and the general deterrence theory, and a self-administered online questionnaire was employed to collect data. Using the RRT, a covariance matrix was extracted for examining the hypothesized model via structural equation modeling. The survey results show that people’s attitude toward the behavior and their perceived behavioral control significantly positively affect their intention. This paper is useful for showing researchers and policymakers how to conduct surveys in environmental or public health related research that involves multiple sensitive questions.

Considerations for community engagement when conducting clinical trials during infectious disease emergencies in West Africa.

Community engagement in research, including public health related research, is acknowledged as an ethical imperative. While medical care and public health action take priority over research during infectious disease outbreaks, research is still required in order to learn from epidemic responses. The World Health Organisation developed a guide for community engagement during infectious disease epidemics called the Good Participatory Practice for Trials of Emerging (and Re-emerging) Pathogens that are Likely to Cause Severe Outbreaks in the Near Future and for which Few or No Medical Counter-Measures Exist (GPP-EP). This paper identified priorities for community engagement for research conducted during infectious disease outbreaks drawing on discussions held with a purposive sample of bioethicists, social scientists, researchers, policy makers and laypersons who work with ethics committees in West Africa. These perspectives were considered in the light of the GPP-EP, which adds further depth and dimension to discussions on community engagement frameworks. It concludes that there is no presumptive justification for the exclusion of communities in the design, implementation and monitoring of clinical trials conducted during an infectious disease outbreak. Engagement that facilitates collaboration rather than partnership between researchers and the community during epidemics is acceptable.

A fishnet-constrained land use mix index derived from remotely sensed data

ABSTRACTResearch works related to public health, transportation and urban planning have called for indices of land use mix (LUM) to support their spatial models. We propose a fishnet-based LUM calculation algorithm that works with the National Land Cover Database (NLCD) land cover data, a high-level product of Landsat satellite images. Comparing to the traditional LUM calculation, the fishnet structure can work at various spatial scales if aggregating to the administrative boundaries. Test results from regression models showed that our method was able to solve the scale problem identified as modifiable area unit problem that caused an unexpected positive correlation of obesity rate with LUM at the county scale. This is due to the fact that the existing methods do not limit the distance of LUM. The fishnet method provides a feasible way to calculate LUM indices across multiple scales. The NLCD data are the state-of-the art land use and land cover data for the contiguous United States. Our research provides a working example of the application of NLCD data or similar remote sensing products in public health-related research.

Transparency and the Duty of Full Disclosure in Public and Environmental Health

For this paper, we will consider the necessity of full disclosure and the duty to inform the public of the results of public health related and environmental health studies. The focus of the paper is that the results of the research, which is related to public and environmental health can lead to risks for public health that can endanger human health, so no matter how small the statistical representativeness is, full transparency must be achieved. We chose to review and make an analysis on the public health issues related to the duty to inform the public of research results in a study of dry cleaning workers; the 10b.case as exposed by Steven S. Coughlin in his book “Case Studies in Public Health Ethics”, 2009. In supporting the theme of this paper, the necessity for full transparency of data, which could be of public health and environmental health interest – we will bring a series of pros and cons to full disclosure, followed by a construction of counter arguments and will offer possible solutions to the issue of full disclosure towards the public in the case of data or results of public health related research.

MULTIPLE IMPUTATION FOR MISSINGNESS DUE TO NONLINKAGE AND PROGRAM CHARACTERISTICS: A CASE STUDY OF THE NATIONAL HEALTH INTERVIEW SURVEY LINKED TO MEDICARE CLAIMS.

Record linkage is a valuable and efficient tool for connecting information from different data sources. The National Center for Health Statistics (NCHS) has linked its population-based health surveys with administrative data, including Medicare enrollment and claims records. However, the linked NCHS-Medicare files are subject to missing data; first, not all survey participants agree to record linkage, and second, Medicare claims data are only consistently available for beneficiaries enrolled in the Fee-for-Service (FFS) program, not in Medicare Advantage (MA) plans. In this research, we examine the usefulness of multiple imputation for handling missing data in linked National Health Interview Survey (NHIS)-Medicare files. The motivating example is a study of mammography status from 1999 to 2004 among women aged 65 years and older enrolled in the FFS program. In our example, mammography screening status and FFS/MA plan type are missing for NHIS survey participants who were not linkage eligible. Mammography status is also missing for linked participants in an MA plan. We explore three imputation approaches: (i) imputing screening status first, (ii) imputing FFS/MA plan type first, (iii) and imputing the two longitudinal processes simultaneously. We conduct simulation studies to evaluate these methods and compare them using the linked NHIS-Medicare files. The imputation procedures described in our paper would also be applicable to other public health-related research using linked data files with missing data issues arising from program characteristics (e.g., intermittent enrollment or data collection) reflected in administrative data and linkage eligibility by survey participants.

Bacterial meningitis: a density-equalizing mapping analysis of the global research architecture.

Bacterial meningitis is caused by a variety of pathogens and displays an important public health threat all over the world. Despite the necessity to develop customized public health-related research projects, a thorough study of global meningitis research is not present, so far. Therefore, the aim of this study was a combined density-equalizing and scientometric study. To evaluate the scientific efforts of bibliometric methods, density-equalizing algorithms and large-scale data analysis of the Web of Science were applied in the period between 1900 and 2007. From this, 7998 publications on bacterial meningitis have been found. With a number of 2698, most publications have been written by U.S. authors, followed by the UK (912), Germany (749) and France (620). This dominance can also be shown in the international cooperation. The specific citation analyses reveal that the nation with the highest average citation rate (citations per publications) was Norway (26.36), followed by Finland (24.16) and the U.S. (24.06). This study illustrates the architecture of global research on bacterial meningitis and points to the need for customized research programs with a focus on local public health issues in countries with a low development index, but high incidences, to target this global public health problem.

Rurality as a Root or Fundamental Social Determinant of Health

lace matters; it contextualizes health. When examining the influence of ommunity, neighborhood, and social space, researchers from multiple isciplines found that geography matters when assessing health status, ealth service use, health service deficits, adequacy of health care, and ealth-related behaviors. Where people live, work, and play protects and romotes their health and/or contributes to the health risks they experince. Koh et al advocate that all individuals should have an equal pportunity to maximize their health. However, some might experience a ealth disparity because of where they live. Such disparities, though, are ot fixed. Once identified, changes to improve health outcomes and educe disparities are possible. A health disparity or health inequity refers to differences in health or ealth outcomes related to factors such as gender, race, ethnicity, ocioeconomic status, or sexual orientation. As government reports such s Healthy People 2020 advocate for the fundamental human justice of ddressing avoidable health-related inequities, it is important to recognize he extensive body of public health-related research associating place or eographic locale as a significant factor in identifying populations ulnerable to health disparities. Although there is long-standing awareess of the health inequities for people living in the inner city, there is an merging body of research acknowledging the importance of rurality in ocial epidemiology, as well as the vulnerability of this specific opulation.

Training physician investigators in medicine and public health research.

We have described and evaluated the impact of a unique fellowship program designed to train postdoctoral, physician fellows in research at the interface of medicine and public health. We developed a rigorous curriculum in public health content and research methods and fostered linkages with research mentors and local public health agencies. Didactic training provided the foundation for fellows' mentored research initiatives, which addressed real-world challenges in advancing the health status of vulnerable urban populations. Two multidisciplinary cohorts (6 per cohort) completed this 2-year degree-granting program and engaged in diverse public health research initiatives on topics such as improving pediatric care outcomes through health literacy interventions, reducing hospital readmission rates among urban poor with multiple comorbidities, increasing cancer screening uptake, and broadening the reach of addiction screening and intervention. The majority of fellows (10/12) published their fellowship work and currently have a career focused in public health-related research or practice (9/12). A fellowship training program can prepare physician investigators for research careers that bridge the divide between medicine and public health.

Bibliometric analysis of public health research in Africa: The overall trend and regional comparisons

Many diseases in Africa can be prevented with appropriate public health interventions. This study aimed to assess the bibliometric characteristics of public health related research articles published by researchers in African institutions from 1991 to 2005. Data used in this study were obtained from the online version of the ISI Web of Science: Science Citation Index Expanded (SCI-Expanded). Articles published between 1991 and 2005 that had the phrase ‘public health’ in the title, author keywords or abstract, and had at least one author whose contact address was in an African country, were selected for analysis. The annual number of public health related articles published by African researchers significantly increased from 28 articles in 1991 to 135 articles in 2005, a 382% increase. International collaboration also increased: from 45% of articles having international collaborators during 1991–1995, to 52% during1996–2000, and to 67% during 2001–2005. Collaborations were mostly with European and North American countries. Keywords, subject categories and collaboration patterns of articles varied across regions, reflecting differences in needs and collaboration networks. Public health related research output, as well as international collaborations, have been increasing in Africa. Regional variation observed in this study may assist policymakers to facilitate the advancement of public health research in different regions of Africa, and could be useful for international organisations in identifying needs and to allocate research funding. Future bibliometric analyses of articles published by African researchers, can consider conducting regional comparisons using standardised methods, as well as describing the overall patterns, in order to provide a more comprehensive view of their bibliometric characteristics.

Comparing Probability and Non-Probability Sampling Methods in Ecstasy Research: Implications for the Internet as a Research Tool

The usage of Ecstasy and related drug (ERD) has increasingly been the focus of epidemiological and other public health-related research. One of the more promising methods is the use of the Internet as a recruitment and survey tool. However, there remain methodological concerns and questions about representativeness. Three samples of ERD users in Melbourne, Australia surveyed in 2004 are compared in terms of a number of key demographic and drug use variables. The Internet, face-to-face, and probability sampling methods appear to access similar but not identical groups of ERD users. Implications and limitations of the study are noted and future research is recommended.

Differential Item Functioning of a Family Affluence Scale: Validation Study on Data from HBSC 2001/02

Methodology for making cross-national comparisons is an area of increasing interest in social and public health related research. When studying socio-economic differences in health outcomes cross-nationally, there are several methodological issues of concern, especially when data is derived from self-reported questionnaires. Health Behaviour in School-aged Children (Currie et al. 1998) is a WHO cross-national study using school samples. HBSC provides comparable data, and thereby a unique opportunity to study associations between social indicators and health outcomes within an international perspective. In 2001/02 data was collected from a total of 162,323 children in 32 countries (Austria, Belgium, Canada, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Greenland, Hungary, Ireland, Israel, Italy, Latvia, Lithuania, Macedonia, Malta, Netherlands, Norway, Poland, Portugal, Russia, Slovenia, Spain, Sweden, Switzerland, Ukraine, United Kingdom, USA.). Studies of social inequalities requires that a comparable measure of socio-economic position (SEP) is in use. HBSC has developed a proxy for social position measuring material wealth, the Family Affluence Scale (FAS). This paper studies FAS and whether it is comparable across population subgroups defined by country, age and gender. Initial analysis revealed that an item measuring perceived family wealth was a valid FAS item. Including this item in the FAS score will improve the reliability of FAS. Graphical log-linear Rasch models (GLLRM) showed that FAS contain differential item functioning (DIF) with respect to country, age, and gender as well as local dependency (LD) between items. During the analysis, test equating techniques where used to adjust for the test bias generated by DIF. We recommend that the equated scores are used whenever FAS is included as a variable. This study suggests that HBSC-FAS should contain five items (additional item: perceived family wealth) when analysing data from HBSC 2001/02, and furthermore that each country should adjust for the DIF or make use of the converted FAS scores provided. If using FAS as a proxy for social position at an international level, it is not advised to compare the absolute levels of FAS, but weigh the scale by ridit transformation.

Ability of Prenylflavanones Present in Hops to Induce Apoptosis in a Human Burkitt Lymphoma Cell Line

The identification of effective cancer preventive compounds from hops has become an important issue in public health-related research. We compared the antiproliferative and apoptosis-inducing effects of side chain variants of prenylflavanones, e. g., 8-prenylnaringenin (7) and 8-geranylnaringenin (10), which have been identified in hops (Humulus lupulus), and their synthetic variations 8-furanmethylnaringenin (8) and 8-cinnamylnaringenin (9). These were accessible by a Mitsunobu reaction and Claisen rearrangement. Flavanones 9 and 10 showed cytotoxic and apoptotic activities. Apoptosis was induced in a mitochondrial dependent manner. 8-Cinnamylnaringenin (9) displayed noticeably improved apoptotic effects when compared to 8-prenylnaringenin. The potential of 8-prenylnaringenin (7) is shown in an ex vivo experiment on a multi-drug resistant leukaemia blast.

Mechanism-based in vitro screening of potential cancer chemopreventive agents

Identification and use of effective cancer chemopreventive agents have become an important issue in public health-related research. For identification of potential cancer chemopreventive constituents we have set up a battery of cell- and enzyme-based in vitro marker systems relevant for prevention of carcinogenesis in vivo. These systems include modulation of drug metabolism (inhibition of Cyp1A activity, induction of NAD(P)H:quinone reductase (QR) activity in Hepa1c1c7 murine hepatoma cell culture), determination of radical scavenging (DPPH scavenging) and antioxidant effects (scavenging of superoxide anion-, hydroxyl- and peroxyl-radicals), anti-inflammatory mechanisms (inhibition of lipopolysaccharide (LPS)-mediated nitric oxide (NO) generation by inducible NO synthase (iNOS) in Raw 264.7 murine macrophages, cyclooxygenase-1 (Cox-1) inhibition), and anti-tumor promoting activities (inhibition of phorbol ester-induced ornithine decarboxylase (ODC) activity in 308 murine keratinocytes). We have tested a series of known chemopreventive substances belonging to several structural classes as reference compounds for the identification of novel chemopreventive agents or mechanisms. These include organosulfur compounds (phenethylisothiocyanate (PEITC), diallylsulfide, diallyldisulfide), terpenes (limonene, perillyl alcohol, oleanolic acid, 18-β-glycyrrhetinic acid), short-chain fatty acids (sodium butyrate), indoles (indole-3-carbinol), isoflavonoids (quercetin, silymarin, genistein), catechins ((−)-epigallocatechin gallate (EGCG)), simple phenols (ellagic acid, resveratrol, piceatannol, curcumin), pharmaceutical agents (piroxicam, acetylsalicylic acid, tamoxifen), and vitamins/derivatives (ascorbic acid, Trolox). We confirmed known chemopreventive mechanisms of these compounds. Additionally, we could demonstrate the usefulness of our approach by identification of hitherto unknown mechanisms of selected agents. As an example, we detected anti-inflammatory properties of PEITC, based on NF-κB-mediated inhibition of NO production. Further, PEITC inhibited phorbol ester-induced superoxide anion radical production in granulocytes, and ODC induction in the 308 cell line. These mechanisms might contribute to the chemopreventive potential of PEITC.

Cancer prevention clinical trials.

Prevention of cancer through interventions based on sound scientific research remains an important strategy of oncology research at the National Cancer Institute (NCI). Reducing the burden of cancer in the United States is focused on clinical investigations in medical settings and public health intervention research on cancer risk factors regarding lifestyle and diet. Chemoprevention research at the NCI has progressed systematically to identify potential agents that reduce cancer risk and to develop public health strategies that take advantage of basic research results. In addition, advances in our understanding of molecular targets and pathways and our use of new and emerging technologies have become important tools for oncology research. Priority areas for chemoprevention research, identified from experimental and clinical research, are investigated in clinical trials to determine their ability to reduce cancer risk in selected populations or in the general population. Priority areas discussed in this review are the relationship of the arachidonic acid pathway to carcinogenesis, lung cancer prevention in former smokers, breast cancer prevention, and prostate cancer prevention. In addition, two lifestyle factors that have potential to influence cancer risk-obesity and functionally enhanced foods-are discussed in the context of their link between clinical and public health-related research.