The double disparity facing rural local health departments: A short report

Rural residents in the U.S. face significant health challenges, including higher rates of risky health behaviors and worse health outcomes than many other groups. Rural communities are also typically served by local health departments (LHDs) that have fewer human and financial resources than their suburban and urban peers. As a result of history and need, rural LHDs are more likely than urban LHDs to provide direct health services, which may result in limited resources for population-based activities. This review examines the double disparity facing rural LHDs and their constituents: pervasively poorer health behaviors and outcomes and a historical lack of investment by local, state, and federal public health entities

Biodigital publics: personal genomes as digital media artifacts

The recent proliferation of personal genomics and direct-to-consumer (DTC) genomics has attracted much attention and publicity. Concern around these developments has mainly focused on issues of biomedical regulation and hinged on questions of how people understand genomic information as biomedical and what meaning they make of it. However, this publicity amplifies genome sequences which are also made as internet texts and, as such, they generate new reading publics. The practices around the generation, circulation and reading of genome scans do not just raise questions about biomedical regulation, they also provide the focus for an exploration of how contemporary public participation in genomics works. These issues around the public features of DTC genomic testing can be pursued through a close examination of the modes of one of the best known providers—23andMe. In fact, genome sequences circulate as digital artefacts and, hence, people are addressed by them. They are read as texts, annotated and written about in browsers, blogs and wikis. This activity also yields content for media coverage which addresses an indefinite public in line with Michael Warner’s conceptualisation of publics. Digital genomic texts promise empowerment, personalisation and community, but this promise may obscure the compliance and proscription associated with these forms. The kinds of interaction here can be compared to those analysed by Andrew Barry. Direct-to-consumer genetics companies are part of a network providing an infrastructure for genomic reading publics and this network can be mapped and examined to demonstrate the ways in which this formation both exacerbates inequalities and offers possibilities for participation in biodigital culture

Symbioses are restructured by repeated mass coral bleaching

Survival of symbiotic reef-building corals under global warming requires rapid acclimation or adaptation. The impact of accumulated heat stress was compared across 1643 symbiont communities before and after the 2016 mass bleaching in three coral species and free-living in the environment across ~900 kilometers of the Great Barrier Reef. Resilient reefs (less aerial bleaching than predicted from high satellite sea temperatures) showed low variation in symbioses. Before 2016, heat-tolerant environmental symbionts were common in ~98% of samples and moderately abundant (9 to 40% in samples). In corals, heat-tolerant symbionts were at low abundances (0 to 7.3%) but only in a minority (13 to 27%) of colonies. Following bleaching, environmental diversity doubled (including heat-tolerant symbionts) and increased in one coral species. Communities were dynamic (Acropora millepora) and conserved (Acropora hyacinthus and Acropora tenuis), including symbiont community turnover and redistribution. Symbiotic restructuring after bleaching occurs but is a taxon-specific ecological opportunity

The Double Disparity Facing Rural Local Health Departments

Residents of rural jurisdictions face significant health challenges, including some of the highest rates of risky health behaviors and worst health outcomes of any group in the country. Rural communities are served by smaller local health departments (LHDs) that are more understaffed and underfunded than their suburban and urban peers. As a result of history and current need, rural LHDs are more likely than their urban peers to be providers of direct health services, leading to relatively lower levels of population-focused activities. This review examines the double disparity faced by rural LHDs and their constituents: pervasively poorer health behaviors and outcomes and a historical lack of investment by local, state, and federal public health entities

COVID-19 impacts equine welfare : Policy implications for laminitis and obesity

Funding: This study was funded by Mars Petcare and is part of a PhD studentship funded by the Scottish Funding Council Research Excellence Grant (REG). Authors WR and MN receive salary support from the Rural and Environment Science and Analytical Services Division (RESAS). With the exception of PH (employed by the funding organization), the funding organization did not have any additional role in the conceptualization, methodology, investigation, data curation, formal analysis, decision to publish, or preparation of the manuscript. PH was involved in study design, data interpretation, and manuscript preparation. Acknowledgments We wish to extend our gratitude to the local horse owners, veterinarians, farriers and welfare centre managers who volunteered their time to take part in this research. Our thanks also to Dr Charlotte Maltin for supporting recruitment for the study and to World Horse Welfare for their continued interest in the key welfare issues addressed in the present study.Peer reviewedPublisher PD

Identifying methods for monitoring foodborne illness: review of existing public health surveillance techniques

Background: Traditional methods of monitoring foodborne illness are associated with problems of untimeliness and underreporting. In recent years, alternative data sources such as social media data have been used to monitor the incidence of disease in the population (infodemiology and infoveillance). These data sources prove timelier than traditional general practitioner data, they can help to fill the gaps in the reporting process, and they often include additional metadata that is useful for supplementary research. Objective: The aim of the study was to identify and formally analyze research papers using consumer-generated data, such as social media data or restaurant reviews, to quantify a disease or public health ailment. Studies of this nature are scarce within the food safety domain, therefore identification and understanding of transferrable methods in other health-related fields are of particular interest. Methods: Structured scoping methods were used to identify and analyze primary research papers using consumer-generated data for disease or public health surveillance. The title, abstract, and keyword fields of 5 databases were searched using predetermined search terms. A total of 5239 papers matched the search criteria, of which 145 were taken to full-text review—62 papers were deemed relevant and were subjected to data characterization and thematic analysis. Results: The majority of studies (40/62, 65%) focused on the surveillance of influenza-like illness. Only 10 studies (16%) used consumer-generated data to monitor outbreaks of foodborne illness. Twitter data (58/62, 94%) and Yelp reviews (3/62, 5%) were the most commonly used data sources. Studies reporting high correlations against baseline statistics used advanced statistical and computational approaches to calculate the incidence of disease. These include classification and regression approaches, clustering approaches, and lexicon-based approaches. Although they are computationally intensive due to the requirement of training data, studies using classification approaches reported the best performance. Conclusions: By analyzing studies in digital epidemiology, computer science, and public health, this paper has identified and analyzed methods of disease monitoring that can be transferred to foodborne disease surveillance. These methods fall into 4 main categories: basic approach, classification and regression, clustering approaches, and lexicon-based approaches. Although studies using a basic approach to calculate disease incidence generally report good performance against baseline measures, they are sensitive to chatter generated by media reports. More computationally advanced approaches are required to filter spurious messages and protect predictive systems against false alarms. Research using consumer-generated data for monitoring influenza-like illness is expansive; however, research regarding the use of restaurant reviews and social media data in the context of food safety is limited. Considering the advantages reported in this review, methods using consumer-generated data for foodborne disease surveillance warrant further investment

Evaluating the Implementation of a Twitter-Based Foodborne Illness Reporting Tool in the City of St. Louis Department of Health

Foodborne illness is a serious and preventable public health problem affecting 1 in 6 Americans with cost estimates over $50 billion annually. Local health departments license and inspect restaurants to ensure food safety and respond to reports of suspected foodborne illness. The City of St. Louis Department of Health adopted the HealthMap Foodborne Dashboard (Dashboard), a tool that monitors Twitter for tweets about food poisoning in a geographic area and allows the health department to respond. We evaluated the implementation by interviewing employees of the City of St. Louis Department of Health involved in food safety. We interviewed epidemiologists, environmental health specialists, health services specialists, food inspectors, and public information officers. Participants viewed engaging innovation participants and executing the innovation as challenges while they felt the Dashboard had relative advantage over existing reporting methods and was not complex once in place. This study is the first to examine practitioner perceptions of the implementation of a new technology in a local health department. Similar implementation projects should focus more on process by developing clear and comprehensive plans to educate and involve stakeholders prior to implementation

The impact of a team-based intervention on the lifestyle risk factor management practices of community nurses: outcomes of the community nursing SNAP trial

BackgroundLifestyle risk factors like smoking, nutrition, alcohol consumption, and physical inactivity (SNAP) are the main behavioural risk factors for chronic disease. Primary health care is an appropriate setting to address these risk factors in individuals. Generalist community health nurses (GCHNs) are uniquely placed to provide lifestyle interventions as they see clients in their homes over a period of time. The aim of the paper is to examine the impact of a service-level intervention on the risk factor management practices of GCHNs.MethodsThe trial used a quasi-experimental design involving four generalist community nursing services in NSW, Australia. The services were randomly allocated to either an intervention group or control group. Nurses in the intervention group were provided with training and support in the provision of brief lifestyle assessments and interventions. The control group provided usual care. A sample of 129 GCHNs completed surveys at baseline, 6 and 12 months to examine changes in their practices and levels of confidence related to the management of SNAP risk factors. Six semi-structured interviews and four focus groups were conducted among the intervention group to explore the feasibility of incorporating the intervention into everyday practice.ResultsNurses in the intervention group became more confident in assessment and intervention over the three time points compared to their control group peers. Nurses in the intervention group reported assessing physical activity, weight and nutrition more frequently, as well as providing more brief interventions for physical activity, weight management and smoking cessation. There was little change in referral rates except for an improvement in weight management related referrals. Nurses’ perception of the importance of ‘client and system-related’ barriers to risk factor management diminished over time.ConclusionsThis study shows that the intervention was associated with positive changes in self-reported lifestyle risk factor management practices of GCHNs. Barriers to referral remained. The service model needs to be adapted to sustain these changes and enhance referral

Ethical choices behind quantifications of fair contributions under the Paris Agreement

The Parties to the UNFCCC and Paris Agreement agreed to act on the basis of equity to protect the climate system. Equitable effort sharing is an irreducibly normative matter, yet some influential studies have sought to create quantitative indicators of equitable effort that claim to be value-neutral (despite evident biases). Many of these studies fail to clarify the ethical principles underlying their indicators, some mislabel approaches that favour wealthy nations as ‘equity approaches’ and some combine contradictory indicators into composites we call derivative benchmarks. This Perspective reviews influential climate effort-sharing assessments and presents guidelines for developing and adjudicating policy-relevant (but not ethically neutral) equity research