Insights into How HIAs are Characterized in the Press: Findings from a Media Analysis of Widely Circulated United States Newspapers

Background: Health impact assessments (HIAs) are burgeoning tools in the policy process, where the media plays a critical role by focusing attention on issues, informing consumers, and influencing positions. Examining how media portrays HIAs is critical to understanding HIAs in the policy context. Methods: This study considered how widely circulated, U.S. newspapers represent HIAs. After searching newspaper databases, we used a qualitative document analysis method consisting of open and axial coding to examine specific phrases of HIA depictions. Results: In coding over 1,000 unique phrases from the 62 documents generated in our search, we found an uptick in HIA-related publications since 2010. Coding these documents identified 46 distinct codes across 10 different themes. The two most prominent HIA-centered themes focused on HIA engagement and the HIA setting. While themes of policy and science, health determinants, and explanations of HIAs were also frequently featured, specific mentions of projected impacts, HIA processes, HIA values, and health outcomes were less prevalent. Conclusions: HIA media portrayals warrant further inquiry from researchers and practitioners. Focusing on how media portrays HIAs is consistent with several HIA steps. It is also important for a broader strategy to educate stakeholders about HIAs and to understand HIAs’ utility. HIA practitioners should develop and implement guidelines for media interaction and tracking that encourage practitioners to seek additional media attention and to focus such attention on health impacts and outcomes, HIA recommendations, and HIA values. Building on our work, researchers should examine HIA media portrayals beyond the context of this study

Insights into How HIAs are Characterized in the Press: Findings from a Media Analysis of Widely Circulated United States Newspapers

Background: Health impact assessments (HIAs) are burgeoning tools in the policy arena, where media plays an important role by focusing attention on issues, informing the public, and influencing positions. Examining how media portrays HIAs is critical to understanding HIAs in the policy context. Methods: This study considered how widely circulated, U.S. newspapers represent HIAs. After searching newspaper databases, we used a qualitative document analysis method consisting of open and axial coding to examine specific phrases of HIA depictions. Results: In coding over 1,000 unique phrases from the 62 documents generated in our search, we found an uptick in HIA-related publications since 2010. Coding these documents identified 46 distinct codes across 10 different themes. The two most prominent HIA-centered themes focused on HIA engagement and the HIA setting. While themes of policy and science, health determinants, and explanations of HIAs were also frequently featured, specific mentions of projected impacts, HIA processes, HIA values, and health outcomes were less prevalent. Conclusion: HIA media portrayals warrant further inquiry by researchers and practitioners. Focusing on how media portrays HIAs is consistent with several HIA steps. It is also important for a broader strategy to educate stakeholders about HIAs and to understand HIAs’ utility. HIA practitioners should develop and implement guidelines for media interaction and tracking that encourage practitioners to seek additional media attention and to focus such attention on health impacts and outcomes, HIA recommendations, and HIA values. Building on our work, researchers should examine HIA media portrayals beyond the context of this study

Assessing framing assumptions in quantitative health impact assessments: a housing intervention example.

Health impact assessment (HIA) is often used to determine ex ante the health impact of an environmental policy or an environmental intervention. Underpinning any HIA is the framing assumption, which defines the causal pathways mapping environmental exposures to health outcomes. The sensitivity of the HIA to the framing assumptions is often ignored. A novel method based on fuzzy cognitive map (FCM) is developed to quantify the framing assumptions in the assessment stage of a HIA, and is then applied to a housing intervention (tightening insulation) as a case-study. Framing assumptions of the case-study were identified through a literature search of Ovid Medline (1948-2011). The FCM approach was used to identify the key variables that have the most influence in a HIA. Changes in air-tightness, ventilation, indoor air quality and mould/humidity have been identified as having the most influence on health. The FCM approach is widely applicable and can be used to inform the formulation of the framing assumptions in any quantitative HIA of environmental interventions. We argue that it is necessary to explore and quantify framing assumptions prior to conducting a detailed quantitative HIA during the assessment stage

Institutionalizing health impact assessment in London as a public health tool for increasing synergy between policies in other areas

Objectives: To describe the background to the inclusion of health impact assessment (HIA) in the development process for the London mayoral strategies, the HIA processes developed, how these evolved, and the role of HIA in identifying synergies between and conflicting priorities of different strategies.Study design: Case series.Methods: Early HIAs had just a few weeks for the whole HIA process. A rapid appraisal approach was developed. Stages included: scoping, reviewing published evidence, a stakeholder workshop, drafting a report, review of the report by the London Health Commission, and submission of the final report to the Mayor. The process evolved as more assessments were conducted. More recently, an integrated impact assessment (IIA) method has been developed that fuses the key aspects of this HIA method with sustainability assessment, strategic environmental assessment and equalities assessment.Results: Whilst some of the early strategy drafts encompassed some elements of health, health was not a priority. Conducting HIAs was important both to ensure that the strategies reflected health concerns and to raise awareness about health and its determinants within the Greater London Authority (GLA). HIA recommendations were useful for identifying synergies and conflicts between strategies. HIA can be successfully integrated into other impact assessment processes.Conclusions: The HIAs ensured that health became more integral to the strategies and increased understanding of determinants of health and how the GLA impacts on health and health inequalities. Inclusion of HIA within IIA ensures that health and health inequalities impacts are considered robustly within statutory impact assessments. (C) 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved

Transport policy and health inequalities: a health impact assessment of Edinburgh's transport policy

Health impact assessment (HIA) can be used to examine the relationships between inequalities and health. This HIA of Edinburgh's transport policy demonstrates how HIA can examine how different transport policies can affect different population groupings to varying degrees. In this case, Edinburgh's economy is based on tourism, financial services and Government bodies. These need a good transport infrastructure, which maintains a vibrant city centre. A transport policy that promotes walking, cycling and public transport supports this and is also good for health. The HIA suggested that greater spend on public transport and supporting sustainable modes of transport was beneficial to health, and offered scope to reduce inequalities. This message was understood by the City Council and influenced the development of the city's transport and land-use strategies. The paper discusses how HIA can influence public policy

What do we need for robust and quantitative health impact assessment?

Health impact assessment (HIA) aims to make the health consequences of decisions explicit. Decision-makers need to know that the conclusions of HIA are robust. Quantified estimates of potential health impacts may be more influential but there are a number of concerns. First, not everything that can be quantified is important. Second, not everything that is being quantified at present should be, if this cannot be done robustly. Finally, not everything that is important can be quantified; rigorous qualitative HIA will still be needed for a thorough assessment. This paper presents the first published attempt to provide practical guidance on what is required to perform robust, quantitative HIA. Initial steps include profiling the affected populations, obtaining evidence from for postulated impacts, and determining how differences in subgoups' exposures and suscepibilities affect impacts. Using epidemiological evidence for HIA is different from carrying out a new study. Key steps in quantifying impacts are mapping the causal pathway, selecting appropriate outcome measures and selecting or developing a statistical model. Evidence from different sources is needed. For many health impacts, evidence of an effect may be scarce and estimates of the size and nature of the relationship may be inadequate. Assumptions and uncertainties must therefore be explicit. Modelled data can sometimes be tested against empirical data but sensitivity analyses are crucial. When scientific problems occur, discontinuing the study is not an option, as HIA is usually intended to inform real decisions. Both qualitative and quantitative elements of HIA must be performed robustly to be of value

A role for antizyme inhibitor 2 in the biosynthesis and content of serotonin and histamine in mouse mast cells

Polyamines (putrescine, spermidine and spermine; PAs) are essential for the majority of living cells. Antizymes and antizyme inhibitors are key regulatory proteins of PA levels by affecting ornithine decarboxylase and PA uptake. In addition to PAs, mast cells (MC) synthesize and store in their granules histamine (Hia) and serotonin (5-HT), which are critical for their function. Our previous studies have indicated a metabolic interplay among PAs, Hia and 5-HT in this cell type. For instance, we showed that PAs affect Hia synthesis during early stages of IL-3-induced bone marrow cell differentiation into bone marrow derived MCs (BMMCs) and demonstrated that PAs are present in MC secretory granules and are important for granule homeostasis, including Hia storage and 5-HT levels. A few years ago, a novel antizyme inhibitor (AZIN2) was described whose expression is restricted to a few tissues and cell types including brain, testis and MCs. In MCs, it was recently proposed that AZIN2 could act as a local regulator of PA biosynthesis in association with 5-HT-containing granules and with 5-HT release following MC activation. To gain insight into the role of AZIN2 in the biosynthesis and storage of 5-HT and also Hia, we have generated BMMCs from both wild-type and transgenic mice with severe Azin2 hypomorphism, and have analyzed the content of PAs, 5-HT and Hia, and some elements of their metabolisms. Spermine and 5-HT levels were reduced in Azin2 hypomorphic BMMCs compared with wild-type controls, whereas the amount of Hia was increased. Accordingly, the level of tryptophan hydroxylase 1 (the key enzyme for 5-HT biosynthesis) was reduced and the amount of enzymatic activity of histidine decarboxylase (the enzyme responsible for Hia biosynthesis) was increased in Azin2 hypomorphic BMMCs. Taken together, our results show evidence that AZIN2 has an important role in the regulation of 5-HT and Hia biosynthesis and storage in MCsUniversidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. This work was supported by SAF2011-26518 (MINECO, Spain) and P10-CVI-6585 and Bio-267 (Junta de Andalucia, Spain). CIBERER is an iniciative of Instituto de Salud Carlos III (Spain)

Effects of physical efforts on injury in elite soccer

In this study, the influence of physical efforts on occurrence of match injury in a professional soccer club was investigated. Computerised motion-analysis was used to measure the physical efforts of players during 10 injury situations. Total distance and those covered at different movement intensities were measured across the 5-min period preceding injury. If the final run preceding injury involved a high-intensity action (HIA), the distance, duration and speed of the effort and the recovery time between this and the penultimate HIA were measured. To determine the influence of these physical efforts, the results were compared to a normative profile for players computed from data across 5 games for the same variables; habitual distances covered over a 5-min period and characteristics of and recovery time between HIA. Compared to the normative profile, no differences were reported in physical characteristics during the period leading up to injury or for HIA although the latter were substantially higher in intensity (duration and distance). A lower than normal recovery time between HIA prior to injury was observed (35.6±16.8 s vs. 98.8±17.5 s, p=0.003). Within the limitations of the small sample, these findings may aid in further understanding injury and physical performance in elite soccer

A role for antizyme inhibitor 2 in the biosynthesis and content of histamine and serotonin in mouse mast cells

Polyamines (putrescine, spermidine and spermine; PAs) are required for the survival of the majority of living cells. Antizymes and antizyme inhibitors are key regulatory proteins of PA levels by affecting ornithine decarboxylase, the rate-limiting biosynthetic enzyme, and PA uptake. In addition to PA, mast cells (MC) synthesize and store in their granules the biogenically active amines histamine (Hia) and serotonin (5-HT), which are of critical importance for their function. Previously, we have performed several studies in this cell type regarding the interplay between the metabolisms of PAs and Hia and 5-HT. Our results showed that PAs affect Hia synthesis during early stages of IL-3-induced bone marrow cell differentiation into bone marrow derived MCs (BMMCs) and demonstrated that PAs are present in MC secretory granules and are important for granule homeostasis, including Hia storage and 5-HT levels. A few years ago, a novel antizyme inhibitor (AZIN2) was described. In contrast to AZIN1, AZIN2 expression is restricted to a few tissues and cell types including brain, testis and MCs. In MCs, it was recently described that AZIN2 could act as a local regulator of PA biosynthesis in association with the 5-HT granule content and release. At present, our aim is to gain further insight into the role of AZIN2 in the biosynthesis, storage and release of both Hia and 5-HT. In this study, we have generated BMMCs from both wild-type and transgenic mice with severe Azin2 hypomorphism, and have analyzed the content of PAs, Hia and 5-HT, and some elements of their metabolisms. Both PAs and 5-HT levels were reduced in Azin2 hypomorphic BMMCs compared with wild-type controls, whereas the amount of Hia was increased. Accordingly, the level of tryptophan hydroxylase 1 (the key enzyme for 5-HT biosynthesis) was reduced and the amount of enzymatic activity of histidine decarboxylase (the enzyme responsible for histamine biosynthesis) was increased in Azin2 hypomorphic BMMCs. Taken together, our results show evidence that AZIN2 has an important role in the regulation of Hia and 5-HT biosynthesis and storage in MCs. Department of Molecular Biology and Biochemistry, and CIBER de Enfermedades Raras (CIBER-ER), Faculty of Sciences, University of Málaga, Málaga 29071, Spain. Corresponding author: I. Fajardo ([email protected]) This work was supported by SAF2011-26518 (MINECO, Spain) and P10-CVI-6585 and Bio-267 (Junta de Andalucia, Spain). CIBERER is an iniciative of Instituto de Salud Carlos III (Spain).Universidad de Málaga. Campus de Excelencia Internacional Andalucía-Tech. SAF2011-26518 (MINECO, Spain) and P10-CVI-6585 and Bio-267 (Junta de Andalucia, Spain. CIBERER is an iniciative of Instituto de Salud Carlos III (Spain)

Current Global Health Impact Assessment Practice

Health impact assessment (HIA) practice has expanded across the world, since it was established more than two decades ago. This paper presents a snapshot of current global HIA practice based on the findings of an online questionnaire survey. HIA practitioners from all world regions were invited to participate. A total of 122 HIA practitioners from 29 countries completed the survey, following a broad international outreach effort. The large variety in the types of HIAs conducted, and the application of HIA in various fields reported by respondents, demonstrates that HIA practice has evolved over the past two decades. Although differences in the use of HIA were reported across world regions, an overall increasing trend in global HIA practice can be observed. In order to sustain this upward trend, efforts are needed to address the main barriers in the utilisation of HIA. The establishment of new national and international HIA teaching and training offerings seems to be an obvious strategy to pursue along with the strengthening of policies and legal frameworks that specify the circumstances, under which HIA is required, and to what extent