Formula for success: Multilevel modelling of Formula One Driver and Constructor performance, 1950-2014

This paper uses random-coefficient models and (a) finds rankings of who are the best formula 1 (F1) drivers of all time, conditional on team performance; (b) quantifies how much teams and drivers matter; and (c) quantifies how team and driver effects vary over time and under different racing conditions. The points scored by drivers in a race (standardised across seasons and Normalised) is used as the response variable in a cross-classified multilevel model that partitions variance into team, team-year and driver levels. These effects are then allowed to vary by year, track type and weather conditions using complex variance functions. Juan Manuel Fangio is found to be the greatest driver of all time. Team effects are shown to be more important than driver effects (and increasingly so over time), although their importance may be reduced in wet weather and on street tracks. A sensitivity analysis was undertaken with various forms of the dependent variable; this did not lead to substantively different conclusions. We argue that the approach can be applied more widely across the social sciences, to examine individual and team performance under changing conditions

Spatial clustering of mental disorders and associated characteristics of the neighbourhood context in Malmö, Sweden, in 2001

Study objective: Previous research provides preliminary evidence of spatial variations of mental disorders and associations between neighbourhood social context and mental health. This study expands past literature by (1) using spatial techniques, rather than multilevel models, to compare the spatial distributions of two groups of mental disorders (that is, disorders due to psychoactive substance use, and neurotic, stress related, and somatoform disorders); and (2) investigating the independent impact of contextual deprivation and neighbourhood social disorganisation on mental health, while assessing both the magnitude and the spatial scale of these effects. Design: Using different spatial techniques, the study investigated mental disorders due to psychoactive substance use, and neurotic disorders. Participants: All 89 285 persons aged 40–69 years residing in Malmö, Sweden, in 2001, geolocated to their place of residence. Main results: The spatial scan statistic identified a large cluster of increased prevalence in a similar location for the two mental disorders in the northern part of Malmö. However, hierarchical geostatistical models showed that the two groups of disorders exhibited a different spatial distribution, in terms of both magnitude and spatial scale. Mental disorders due to substance consumption showed larger neighbourhood variations, and varied in space on a larger scale, than neurotic disorders. After adjustment for individual factors, the risk of substance related disorders increased with neighbourhood deprivation and neighbourhood social disorganisation. The risk of neurotic disorders only increased with contextual deprivation. Measuring contextual factors across continuous space, it was found that these associations operated on a local scale. Conclusions: Taking space into account in the analyses permitted deeper insight into the contextual determinants of mental disorders

Completion Dissection or Observation for Sentinel-Node Metastasis in Melanoma.

Sentinel-lymph-node biopsy is associated with increased melanoma-specific survival (i.e., survival until death from melanoma) among patients with node-positive intermediate-thickness melanomas (1.2 to 3.5 mm). The value of completion lymph-node dissection for patients with sentinel-node metastases is not clear. In an international trial, we randomly assigned patients with sentinel-node metastases detected by means of standard pathological assessment or a multimarker molecular assay to immediate completion lymph-node dissection (dissection group) or nodal observation with ultrasonography (observation group). The primary end point was melanoma-specific survival. Secondary end points included disease-free survival and the cumulative rate of nonsentinel-node metastasis. Immediate completion lymph-node dissection was not associated with increased melanoma-specific survival among 1934 patients with data that could be evaluated in an intention-to-treat analysis or among 1755 patients in the per-protocol analysis. In the per-protocol analysis, the mean (±SE) 3-year rate of melanoma-specific survival was similar in the dissection group and the observation group (86±1.3% and 86±1.2%, respectively; P=0.42 by the log-rank test) at a median follow-up of 43 months. The rate of disease-free survival was slightly higher in the dissection group than in the observation group (68±1.7% and 63±1.7%, respectively; P=0.05 by the log-rank test) at 3 years, based on an increased rate of disease control in the regional nodes at 3 years (92±1.0% vs. 77±1.5%; P<0.001 by the log-rank test); these results must be interpreted with caution. Nonsentinel-node metastases, identified in 11.5% of the patients in the dissection group, were a strong, independent prognostic factor for recurrence (hazard ratio, 1.78; P=0.005). Lymphedema was observed in 24.1% of the patients in the dissection group and in 6.3% of those in the observation group. Immediate completion lymph-node dissection increased the rate of regional disease control and provided prognostic information but did not increase melanoma-specific survival among patients with melanoma and sentinel-node metastases. (Funded by the National Cancer Institute and others; MSLT-II ClinicalTrials.gov number, NCT00297895 .)

Residential mobility: Towards progress in mobility health research

Research into health disparities has long recognized the importance of residential mobility as a crucial factor in determining health outcomes. However, a lack of connectivity between the health and mobility literatures has led to a stagnation of theory and application on the health side, which lacks the detail and temporal perspectives now seen as critical to understanding residential mobility decisions. Through a critical re-think of mobility processes with respect to health outcomes and an exploitation of longitudinal analytical techniques, we argue that health geographers have the potential to better understand and identify the relationship that residential mobility has with health

Assessment of personal exposure to air pollutants in Scotland – an integrated approach using personal monitoring data

High levels of air pollution are associated with adverse effects on public health. Pollutant concentrations are typically subject to a high spatial and temporal variability. To investigate and quantify potential relations between pollutant concentrations and health effects, e.g. cases of respiratory diseases, sophisticated geospatial tools and methods are required. Air pollutants are ubiquitous and a certain level of exposure is inevitable. For risk assessments and public health advice, however, it is necessary to quantify human exposure to specific pollutants of concern. This is a challenging task as individual daily mobility patterns substantially influence exposure to air pollutants over time and in space. But it is not only people’s activities making the quantification difficult, also air chemistry, microclimatic and meteorological influences are changing over space and time, resulting in high spatial and temporal variation of ambient pollutant concentrations. Within a research project funded by the Scottish Government (EDPHiS, Environmental Determinants of Public Health in Scotland), the application of GIS methods and tools for integrating data from personal monitoring trials with supporting Scotland-wide datasets such as air pollution concentrations, land use and population data for personal exposure assessment will be examined. The work described here is conducted in the frame of a joint PhD studentship between the Centre for Ecology & Hydrology and the University of Exeter. It focuses on the development of methods for personal exposure monitoring as well as the integration of measured data with supporting secondary data for improving human exposure assessment. For this purpose, an experimental design with a small, wearable personal monitoring device to derive personal time-activity patterns and exposure profiles is currently devised. Resulting personal exposure profiles will be integrated and assessed using geographic Information Systems (GIS) methods for a complementary human exposure assessment approach. The work presented here will focus on the aspect of monitoring personal activity and resulting exposure. Its challenges and methods for quantification will be elaborated

Examining the effect of geographic region of residence on childhood malnutrition in Uganda

Objectives: In our study, we examine how geographic region of residence may predict childhood malnutrition, expressed as stunting, wasting and underweight, among children under the age of 5 years in Uganda. Methods: Using data from the 2016 Uganda Demographic and Health Survey, we performed an incremental multivariate multilevel mixed-effect modelling to examine the effect of a child, parental and household factors on the association between region of residence and each indicator of childhood malnutrition. Results: Approximately 28%, 3% and 9% of children under age 5 suffered from stunting, wasting and underweight, respectively. The bivariate result shows that the proportion of children suffering from stunting and underweight was relatively lower in the Kampala region compared with the other regions. With the exception of the Northern region (6.44%), wasting was higher (4.12%) among children in the Kampala region. Children in the other regions were more likely to experience stunting and underweight. When controlling for child, parent and household factors, children in the other regions were less likely to suffer from underweight and stunting, compared with those in Kampala region. Children in the other regions, except the Northern region, were less likely to be wasted compared with those in Kampala region. Conclusion: Our finding suggests that child, parental and household characteristics have effects on the association between region of residence and childhood malnutrition. Addressing individual and household socioeconomic disparities may be vital in tackling regional differences in childhood malnutrition

Individual and contextual predictors of overweight or obesity among women in Uganda: a spatio-temporal perspective

Being overweight and obesity are emerging public health issues in sub-Saharan Africa. Currently, there is limited knowledge on the temporal trend of the effect of socioeconomic factors and air quality on being overweight or obesity. Using data from the Ugandan Demographic and Health Survey and NASA’s Socioeconomic Data and Applications Center (SEDAC), we examined the spatio-temporal effect of individual and contextual factors on overweight and obesity among women in Uganda using cross-sectional data on 15,655 women in Uganda. We employed multilevel mixed-effect analysis and Bayesian hierarchical spatial models to examine the effect of individual socioeconomic status, contextual socioeconomic factors and air quality on women’s risk of being overweight or obese as well as investigate spatial heterogeneity in the association. The prevalence of overweight/obesity for the study periods were 17.23% (2000/2001), 15.36% (2006), 19.36% (2011) and 21.93% (2016). The result from the multilevel analysis shows change in the directions of the association between individual factors (educational status and household wealth) and overweight or obese over the years. Women with secondary education were 1.514 times (p = 0.002) more likely to be overweight or obese in the 2000/2001 group but 0.655 times (p = 0.007) less likely to be overweight or obese in the 2016 group. It also reveals temporal consistency in the effect of the air pollutant PM2.5 on overweight or obese. The spatial models reveal spatial heterogeneity in the association between district-level factors and the proportion of overweight or obese women. The findings suggest improving women’s socioeconomic status and air quality could reduce the rising obesity epidemic in Ugandan women

GIS-based emergency and evacuation planning for volcanic hazards in New Zealand

Geographic Information Systems (GIS) provide a range of techniques which allow ready access to data, and the opportunity to overlay graphical location-based information for ease of interpretation. They can be used to solve complex planning and management problems. All phases of emergency management (reduction, readiness, response and recovery) can benefit from GIS, including applications related to transportation systems, a critical element in managing effective lifelines in an emergency. This is particularly true immediately before and during a volcanic eruption

Integrating health and environmental impact analysis

Scientific investigations have progressively refined our understanding of the influence of the environment on human health, and the many adverse impacts that human activities exert on the environment, from the local to the planetary level. Nonetheless, throughout the modern public health era, health has been pursued as though our lives and lifestyles are disconnected from ecosystems and their component organisms. The inadequacy of the societal and public health response to obesity, health inequities, and especially global environmental and climate change now calls for an ecological approach which addresses human activity in all its social, economic and cultural complexity. The new approach must be integral to, and interactive, with the natural environment. We see the continuing failure to truly integrate human health and environmental impact analysis as deeply damaging, and we propose a new conceptual model, the ecosystems-enriched Drivers, Pressures, State, Exposure, Effects, Actions or ‘eDPSEEA’ model, to address this shortcoming. The model recognizes convergence between the concept of ecosystems services which provides a human health and well-being slant to the value of ecosystems while equally emphasizing the health of the environment, and the growing calls for ‘ecological public health’ as a response to global environmental concerns now suffusing the discourse in public health. More revolution than evolution, ecological public health will demand new perspectives regarding the interconnections among society, the economy, the environment and our health and well-being. Success must be built on collaborations between the disparate scientific communities of the environmental sciences and public health as well as interactions with social scientists, economists and the legal profession. It will require outreach to political and other stakeholders including a currently largely disengaged general public. The need for an effective and robust science-policy interface has never been more pressing. Conceptual models can facilitate this by providing theoretical frameworks and supporting stakeholder engagement process simplifications for inherently complex situations involving environment and human health and well-being. They can be tools to think with, to engage, to communicate and to help navigate in a sea of complexity. We believe models such as eDPSEEA can help frame many of the issues which have become the challenges of the new public health era and can provide the essential platforms necessary for progress