Spatiotemporal patterns of small for gestational age and low birth weight births and associations with land use and socioeconomic status

In addition to small for gestational age (SGA) and low birth weight at term (LBWT), critically ill cases of SGA/LBWT are significant events from outcomes and economic perspectives that require further understanding of risk factors. We aimed to assess the spatiotemporal distribution of locations where there were consistently higher numbers of critically ill SGA/LBWT (hot spots) in comparison with all SGA/LBWT and all births. We focused on Edmonton (2008-2010) and Calgary (2006-2010), Alberta, and used a geographical information system to apply emerging hot spot analysis, as a new approach for understanding SGA, LBWT, and the critically ill counterparts (ciSGA or ciLBWT). We also compared the resulting aggregated categorical patterns with proportions of land use and socioeconomic status (SES) using Spearman correlation and logistic regression. There was an overall increasing trend in all space-time clusters. Whole period emerging hot spot patterns among births and SGA generally coincided, but SGA with ciSGA and LBWT with ciLBWT did not. Regression coefficients were highest for low SES with SGA and LBWT, but not with ciSGA and ciLBWT. Open areas and industrial land use were most associated with ciLBWT but not with ciSGA, SGA, or LBWT. Differences in the space-time hot spot patterns and the associations with ciSGA and ciLBWT indicate further need to research the interplay of maternal and environmental influences. We demonstrated the novel application of emerging hot spot analysis for small newborns and spatially related them to the surrounding environment

Key Components of Collaborative Research in the Context of Environmental Health: A Scoping Review

In a collaborative research process, the participation of interdisciplinary researchers and multi-sectoral stakeholders supports the co-creation, translation, and exchange of new knowledge. Following a scoping review methodology, we explored the collaborative research processes in the specific context of environment and human health research. Initially, our literature search strategy identified 1,328 publications. After several phases of reviewing and applying screening criteria to titles, abstracts, and full text, 45 publications were selected for final review. Data were charted by different topics and then collated, summarized, and analyzed thematically. From the different experiences and research approaches analyzed, we identified comprehensive details of the key components, facilitators, challenges, and best practices that impact the collaborative research process. Specifically, we identified the following seven emerging themes: (a) allocating time and resources, (b) addressing disciplinary and sectoral issues, (c) building relationships, (d) ensuring representation, (e) embedding participation in the research, (f) supporting ongoing collaboration, and (g) developing knowledge translation and exchange

Building a children's health and environment research agenda in Alberta, Canada: A multi-stakeholder engagement process

As new environmental exposures are continuously identified, environmental influences on health are of growing concern. Knowledge regarding the impacts of environmental exposures is constantly evolving and is often incomplete. In this paper, we describe a multi-phased, multi-stakeholder engagement initiative involving diverse stakeholders with an interest in building a children's environmental health research agenda which would link with and support local practices and policies. The intent of this initiative was to identify priority research issues, themes and questions by implementing a tested Research Planning Model that encompassed the engagement of diverse stakeholders. Here, we describe the model application, which was specifically focused on children's health and the environment. A key component of the model was the ongoing stakeholder engagement process. This included two stakeholder forums, during which participants identified three main research themes (social determinants of health, environmental exposures and knowledge translation) and a short list of research questions. Other key components of the model included the development of a Global Sounding Board of key stakeholders, an Advisory Board and a Scientific Panel with mandates to review and prioritise the research questions. In our case, the Advisory Board and Scientific Panel prioritised questions that focused on environmental exposures related to children's respiratory outcomes. The stakeholder engagement described here is an evolving process with frequent changes of context, sustained by the commitment and dedication of the Children's Environment and Health Research planning team and the Advisory Board. In this article, we share the engagement process, outcomes, successes, challenges and lessons learned from this ongoing experience. Keywordsstakeholder engagement, children's health, environmental health, health researc

Stated benefits from urban afforestation in an arid city: a contingent valuation in Mexicali, Baja California, Mexico

The pervasiveness of particulate matter in arid cities has yet to be discussed and tackled. Given that urban trees have been documented to provide air-filtering and dry deposition services, this study documents the stated benefits from an urban afforestation scenario in Mexicali –an arid city located northwest Mexico at the US-Mexico border. Our doublebounded dichotomous contingent valuation protocol yields an estimated average annual willingness to pay (WTP) of USD 88 per household. Variations in the WTP are associated with perception of air quality and presence of respiratory symptoms in the respondent’s household. The smallest WTP (USD 75) is reported by respondents perceiving poor air quality in their neighborhood and with no household members affected by respiratory symptoms. In contrast, respondents perceiving good air quality and with at least one household member facing respiratory symptoms reported a WTP of USD 99. The average stated benefits represent around 0.8% of the annual household income

Stated benefits from air quality improvement through urban afforestation in an arid city – A contingent valuation in Mexicali, Baja California, Mexico

Cities in drylands are expected to experience increasing challenges when it comes to air pollution. Currently, concentrations of particulate matter in these cities frequently reach dangerous levels. Urban afforestation represents an alternative to increase human health in arid cities via air-filtering and dry deposition. By simulating a non-existing market through a contingent valuation protocol, this study estimates the willingness to contribute monetarily to an urban afforestation scenario in Mexicali -an arid city located at the US-Mexico border. We estimate an average annual willingness to pay (WTP) of (2019) USD 88 per household. Variations in WTP are associated with the respondent's perception of air quality and the presence of respiratory symptoms in the respondent's household. The smallest WTP (USD 75) is reported by those perceiving poor air quality in their neighborhood and with no household members affected by respiratory symptoms. Respondents perceiving good air quality and with at least one household member facing respiratory symptoms report a WTP of USD 99. The highest WTP represents around 0.8 % of the annual household income. This WTP, when extrapolated to and aggregated over the total number of households in Mexicali, justifies the implementation of an urban afforestation program supplying 30 thousand tree seedlings annually

The index lift in data mining has a close relationship with the association measure relative risk in epidemiological studies.

BACKGROUND: Data mining tools have been increasingly used in health research, with the promise of accelerating discoveries. Lift is a standard association metric in the data mining community. However, health researchers struggle with the interpretation of lift. As a result, dissemination of data mining results can be met with hesitation. The relative risk and odds ratio are standard association measures in the health domain, due to their straightforward interpretation and comparability across populations. We aimed to investigate the lift-relative risk and the lift-odds ratio relationships, and provide tools to convert lift to the relative risk and odds ratio. METHODS: We derived equations linking lift-relative risk and lift-odds ratio. We discussed how lift, relative risk, and odds ratio behave numerically with varying association strengths and exposure prevalence levels. The lift-relative risk relationship was further illustrated using a high-dimensional dataset which examines the association of exposure to airborne pollutants and adverse birth outcomes. We conducted spatial association rule mining using the Kingfisher algorithm, which identified association rules using its built-in lift metric. We directly estimated relative risks and odds ratios from 2 by 2 tables for each identified rule. These values were compared to the corresponding lift values, and relative risks and odds ratios were computed using the derived equations. RESULTS: As the exposure-outcome association strengthens, the odds ratio and relative risk move away from 1 faster numerically than lift, i.e. |log (odds ratio)| ≥ |log (relative risk)| ≥ |log (lift)|. In addition, lift is bounded by the smaller of the inverse probability of outcome or exposure, i.e. lift≤ min (1/P(O), 1/P(E)). Unlike the relative risk and odds ratio, lift depends on the exposure prevalence for fixed outcomes. For example, when an exposure A and a less prevalent exposure B have the same relative risk for an outcome, exposure A has a lower lift than B. CONCLUSIONS: Lift, relative risk, and odds ratio are positively correlated and share the same null value. However, lift depends on the exposure prevalence, and thus is not straightforward to interpret or to use to compare association strength. Tools are provided to obtain the relative risk and odds ratio from lift

Early Childhood Respiratory Morbidity and Health Services Utilization in Children Born Preterm or Small and Large for Gestational Age

Introduction Alterations in duration of gestation and fetal growth such as preterm birth (PTB) or small and large for gestational age (SGA, LGA) have long-term consequences on respiratory health. The risk of health services use for respiratory conditions in infants born PTB, SGA or LGA in Canada needs to be evaluated. Objectives and Approach We evaluated the association between PTB, SGA and LGA and health services utilization for respiratory diseases in early childhood. We linked three administrative health databases to identify all singleton live births in Alberta between 2005-2010. We obtained data on the number of hospital admissions and emergency department (ED) visits in the first five years of life for acute upper respiratory infections, acute lower respiratory infections, wheezing disorders, bronchopulmonary dysplasia, and influenza and pneumonia. Odds ratios (OR) of health services use for PTB, SGA, LGA were calculated adjusting for important covariates (e.g., maternal age, sex, socioeconomic status, total antepartum risk score). Results The cohort contained 206,994 infants of whom 9.1% were PTB, 8.5% were SGA and 9.4% were LGA. Babies born prematurely (PTB) were more likely to have a respiratory disease in the first five years of life than babies experienced fetal growth alterations (SGA or LGA). PTB increased significantly the odds of acute lower respiratory infections by 30 to 90%, of wheezing disorders by 40 to 70%, of influenza and pneumonia by 30 to 60%, and of acute upper respiratory infections by 10 to 50%. By contrast, SGA increased the odds of bronchopulmonary dysplasia by 3 to 300%, and LGA increased the odds of acute upper respiratory infections by 11 to 18% and of acute lower respiratory infections by 8 to 11%. Conclusion/Implications Prematurity and alterations in fetal growth are associated with increased hospital and ED admissions in early childhood. The patterns differ for PTB, SGA, and LGA. Linkage of administrative health data provides useful epidemiological evidence to inform the burden of early childhood respiratory diseases resulting from adverse birth outcomes