Optimising the location of antenatal classes

Objectives: To combine micro simulation and location-allocation techniques to determine antenatal class locations which minimise the distance travelled from home by potential users. Design: Micro simulation modelling and location-allocation modeling. Setting: City of Leeds, U.K. Participants: Potential users of antenatal classes. Methods: An individual-level micro simulation model was built to estimate the number of births for small areas by combining data from the UK Census 2001 and the Health Survey for England 2006. Using this model as a proxy for service demand, we then used a location-allocation model to optimize locations. Findings: Different scenarios show the advantage of combining these methods to optimize (re)locating antenatal classes and therefore reduce inequalities in accessing services for pregnant women. Key Conclusions: Use of these techniques should lead to better use of resources by allowing planners to identifyoptimal locations of antenatal classes which minimise women’s travel. Implications for practice: These results are especially important for health-care planners tasked with the difficult issue of targeting scarce resources in a cost-efficient, but also effective or accessible, manner

Design Insights to Support the Development of Effective Virtual Reality Nicotine and Vaping Dependency Therapy Scenarios for Future Telehealth

Vaping, or the use of electronic nicotine delivery systems (ENDS), has grown rapidly worldwide and is becoming an epidemic among youth in many countries. Invented as a method to help to quit smoking, ENDS are very popular, reaching increasing numbers of users and becoming a health concern. Virtual reality technology (VRT) represents an important tool for conducting addiction-associated interventions, including telemedicine. The design and quality of virtual reality scenarios (VRS) used for VR interventions are fundamental. How well VRS can replicate real-world scenarios has an impact on how realistic the VR immersion experiences are. Thus, VRS development influences therapeutic outcomes. VRT is used for interventions and treatments for smoking-related nicotine addiction but has yet to be validated for vaping-related disorders. Since vaping represents a technological step forward in nicotine consumption, the accurate contextualization of environments surrounding vapers is fundamental for developing advanced VR tools for the prevention and treatment of vaping disorders. Here, we present the results of focus group discussion with young vapers in New Zealand. The knowledge gained from this study will be used to design VRS for cue exposure and reactivity as a first step toward developing effective solutions for vaping disorders using VR interventions and telemedicine

Progress Towards Using Linked Population-Based Data For Geohealth Research: Comparisons Of Aotearoa New Zealand And The United Kingdom

Globally, geospatial concepts are becoming increasingly important in epidemiological and public health research. Individual level linked population-based data afford researchers with opportunities to undertake complex analyses unrivalled by other sources. However, there are significant challenges associated with using such data for impactful geohealth research. Issues range from extracting, linking and anonymising data, to the translation of findings into policy whilst working to often conflicting agendas of government and academia. Innovative organisational partnerships are therefore central to effective data use. To extend and develop existing collaborations between the institutions, in June 2019, authors from the Leeds Institute for Data Analytics and the Alan Turing Institute, London, visited the Geohealth Laboratory based at the University of Canterbury, New Zealand. This paper provides an overview of insight shared during a two-day workshop considering aspects of linked population-based data for impactful geohealth research. Specifically, we discuss both the collaborative partnership between New Zealand’s Ministry of Health (MoH) and the University of Canterbury’s GeoHealth Lab and novel infrastructure, and commercial partnerships enabled through the Leeds Institute for Data Analytics and the Alan Turing Institute in the UK. We consider the New Zealand Integrated Data Infrastructure as a case study approach to population-based linked health data and compare similar approaches taken by the UK towards integrated data infrastructures, including the ESRC Big Data Network centres, the UK Biobank, and longitudinal cohorts. We reflect on and compare the geohealth landscapes in New Zealand and the UK to set out recommendations and considerations for this rapidly evolving discipline

Application of geographic information systems and simulation modelling to dental public health: Where next?

Public health research in dentistry has used geographic information systems since the 1960s. Since then, the methods used in the field have matured, moving beyond simple spatial associations to the use of complex spatial statistics and, on occasions, simulation modelling. Many analyses are often descriptive in nature; however, and the use of more advanced spatial simulation methods within dental public health remains rare, despite the potential they offer the field. This review introduces a new approach to geographical analysis of oral health outcomes in neighbourhoods and small area geographies through two novel simulation methods-spatial microsimulation and agent-based modelling. Spatial microsimulation is a population synthesis technique, used to combine survey data with Census population totals to create representative individual-level population datasets, allowing for the use of individual-level data previously unavailable at small spatial scales. Agent-based models are computer simulations capable of capturing interactions and feedback mechanisms, both of which are key to understanding health outcomes. Due to these dynamic and interactive processes, the method has an advantage over traditional statistical techniques such as regression analysis, which often isolate elements from each other when testing for statistical significance. This article discusses the current state of spatial analysis within the dental public health field, before reviewing each of the methods, their applications, as well as their advantages and limitations. Directions and topics for future research are also discussed, before addressing the potential to combine the two methods in order to further utilize their advantages. Overall, this review highlights the promise these methods offer, not just for making methodological advances, but also for adding to our ability to test and better understand theoretical concepts and pathways

The self-reported oral health status and dental attendance of smokers and non-smokers in England

Smoking has been identified as the second greatest risk factor for global death and disability and has impacts on the oral cavity from aesthetic changes to fatal diseases such as oral cancer. The paper presents a secondary analysis of the National Adult Dental Health Survey (2009). The analysis used descriptive statistics, bivariate analyses and logistic regression models to report the self-reported oral health status and dental attendance of smokers and non-smokers in England. Of the 9,657 participants, 21% reported they were currently smoking. When compared with smokers; non-smokers were more likely to report ‘good oral health’ (75% versus 57% respectively, p<0.05). Smokers were twice as likely to attend the dentist symptomatically (OR = 2.27, CI = 2.02–2.55) compared with non-smoker regardless the deprivation status. Smokers were more likely to attend symptomatically in the most deprived quintiles (OR = 1.99, CI = 1.57–2.52) and perceive they had poorer oral health (OR = 1.77, CI = 1.42–2.20). The present research is consistent with earlier sub-national research and should be considered when planning early diagnosis and management strategies for smoking-related conditions, considering the potential impact dental teams might have on smoking rates

Experiences of the Built Environment, Falls and Fear of Falling Outdoors among Older Adults: An Exploratory Study and Future Directions

Falls can have serious impacts on the health, wellbeing and daily mobilities of older adults. Falls are a leading cause of injury and death amongst older adults and outdoor falls comprise a substantial proportion of pedestrian injuries. As well as physical injuries, the psychological impacts of experiencing a fall can result in older adults getting out of the house less often, resulting in lower levels of physical activity and social connection. Despite the known consequences of falls, relatively little research considers the impact of the urban built environment on falls among older adults. This research aimed to explore the experiences of older adults in the urban environment, falling and the fear of falling outdoors. We conducted an online survey with adults aged 50+ using a participatory mapping survey tool and a convenience sample. The study area was Greater Christchurch, New Zealand. Results suggest that both perceived accessibility and neighbourhood conditions are independently associated with fear of falling, after controlling for frequency of falling, gender and activities of daily living. Our findings demonstrate the need for much better understandings of the relationships between the urban environment, outdoor mobility, fear of falling and falling among older adults and we propose suggestions for future research

Location Analysis of Smoking Cessation Services in Austria. GI_Forum|GI_Forum 2015 – Geospatial Minds for Society|

Lung cancer is still at the top of the list of commonly preventable diseases, for both men and women, and smoking is the major trigger that causes lung cancer. The Austrian Health Ministry implements different actions to decrease lung cancer in the future. For instance, it offers smoking cessation services; but are these services always located in the right places to efficiently reach the target groups? This paper highlights the advantages of location analysis methods to spatially estimate the need at local level (i.e. where are clusters of smokers distributed at a small spatial level), and correspondingly position (more accurately) the offer of such services. With the help of our solution framework called simSALUD, we estimate the smoking prevalence by using Spatial Microsimulation Modelling in this project. Then, location-allocation modelling can be applied to find the places with the highest demand for smoking cessation services. The results of our project might be highly relevant for future health policy planning to decrease smoking prevalence, and therefore lung cancer

"I virtually quit": A Review of Virtual Reality Technology Applications in Cigarette Craving and Smoking Interventions.

Background: Over the last 2 decades, virtual reality technologies (VRTs) have been proposed as a way to enhance and improve smoking cessation therapy. Objective: This systematic review aims to evaluate and summarize the current knowledge on the application of VRT in various smoking cessation therapies, as well as to explore potential directions for future research and intervention development. Methods: A literature review of smoking interventions using VRT was conducted. Results: Not all intervention studies included an alternative therapy or a placebo condition against which the effectiveness of the intervention could be benchmarked, or a follow-up measure to ensure that the effects were lasting. Virtual reality (VR) cue exposure therapy was the most extensively studied intervention, but its effect on long-term smoking behavior was inconsistent. Behavioral therapies such as a VR approach-avoidance task or gamified interventions were less common but reported positive results. Notably, only 1 study combined Electronic Nicotine Delivery Devices with VRT. Conclusions: The inclusion of a behavioral component, as is done in the VR approach-avoidance task and gamified interventions, may be an interesting avenue for future research on smoking interventions. As Electronic Nicotine Delivery Devices are still the subject of much controversy, their potential to support smoking cessation remains unclear. For future research, behavioral or multicomponent interventions are promising avenues of exploration. Future studies should improve their validity by comparing their intervention group with at least 1 alternative or placebo control group, as well as incorporating follow-up measures