Category Archives: Technology
How does public health take care of the communities it serves during a foodborne illness or infectious disease outbreak? Through a series of sophisticated steps, most choreographed long before an emergency occurs. Every minute of every day, U.S. and global health experts monitor reports that could indicate a disease or foodborne illness outbreak, as well as review samples of food, water, soil and other resources to detect outbreaks. Some of the steps are well laid out and public; others, such as those monitored by the Department of Homeland Security—watchful for terror attacks on food and water supplies—are hidden from view, but supremely vigilant.
Other examples of outbreak preparedness activities:
- Each year the American Public Health Association updates its Control of Communicable Diseases manual, and adds updates as needed to the manual’s mobile platforms.
- Outbreak guidance for new public health officers, as well as refreshers for veterans, are provided by public health official member associations such as the National Association of County and City Health Officials and the Association of State and Territorial Health Officials.
- New public health officers are also invited to the U.S. Centers for Disease Control and Prevention (CDC) for an orientation that includes outbreak guidance.
No, health officials can’t know whether an outbreak might occur next week or next month—or never—and whether it’s going to be a new strain of flu, or tainted ground beef sold at multiple food outlets. But by having a set of continually reviewed steps for alerting the public—and keeping them up to date with real-time guidance—targeted advice for any outbreak can be quickly assessed and disseminated.
Health agencies typically share information and best practices with local and state health departments through conference calls and alerts throughout a crisis. And, with the explosion of social media, just about all health departments continually add communications channels for the people they serve. For example, health officials in Montgomery County, Texas, this week are keeping the public informed about an illness outbreak that may turn out to be a severe form of flu, through dedicated channels that include a telephone hotline and its Facebook page. Read the wealth of posts on preparedness on NewPublicHealth to see the many avenues health departments take to keep residents continually informed when an outbreak occurs.
Outbreaks can spread faster than you think. But luckily the development of new digital tools and technologies to assist with documenting, tracking and alerting the public of the spread of infectious disease is progressing even more rapidly. There are new databases, maps and communications technologies that make tracking down an outbreak and getting it under control a much quicker and more efficient process. Digital developments focusing on emergency preparedness and response can help protect more of the population from the next pandemic.
We’ve brought together a few examples of how the digital world is working to improve emergency response:
- At the University of Pittsburgh School of Public Health, a new initiative called Project Tycho is working to convert 125 years worth of data from paper documents into an open-access database. Project Tycho will save researchers around the world the time of finding reliable historical data from different sources for infectious diseases, which is critical to understanding underlying epidemic dynamics, according to Dr. Willem van Panhuis, an assistant professor of epidemiology at University of Pittsburgh School of Public Health.
- The Advanced Molecular Detection Initiative proposed in the President’s 2014 Budget could help make huge strides in controlling infectious disease. The initiative would bring together experts in laboratory science, epidemiology and bioinformatics to join forces like never before. By using genetic sequencing to examine infectious pathogens, these technologies are on the verge of revolutionizing medical professionals’ abilities to diagnose infectious diseases; investigate and control outbreaks; understand transmission patterns; develop and target vaccines; and determine antimicrobial resistance—all with increased timeliness and accuracy and decreased costs.
- Social media and crowdsourcing technologies have helped medical professionals develop tools to track the spread of disease and where outbreaks are occurring and even make the data available to the general public. HealthMap is one of the original examples of using digital technologies to track outbreaks while keeping the public informed.
- In efforts to spread the skills needed to deal with public health issues such as outbreaks, the CDC has made learning more fun through games such and applications such as CDCology and Solve the Outbreak for the iPad. CDCology is a pilot program through the CDC and supported by HHSIgnite (beta). The pilot website uses CDC staff-created, student-solved, virtual microtasks to tackle public health challenges at CDC. As they complete the short microtasks, the students gain valuable educational experience, insight and exposure to the field of public health. Solve the Outbreak puts you in the shoes of a member of the Epidemic Intelligence Service. Playing the game presents the opportunities to use clues, analyze data, solve the scenario and save lives in this virtual world, but also helps teach the public more about the process behind handling a real outbreak.
AAP Issues Recommendations on Reducing Youth Deaths from Gun Violence
Every day seven U.S. children are killed by gun violence and it remains the second-leading cause of death among youth in the country. The American Academy of Pediatrics (AAP) has issued a list of recommendations on how to keep kids safe and hopefully make an impact on these troubling statistics. “Gun violence is a public health issue that profoundly affects children and their families,” said AAP President Thomas K. McInerny, MD, FAAP. “We know what works—strong laws to enforce background checks and safe storage.” Watch a video on the APP recommendations and read more here. Read more on violence.
Study: African-American Men from Single-Parent Homes More Likely to Suffer from Hypertension
African-American men who grew up in two-parent homes are less likely to suffer from hypertension as adults than are their peers who grew up in single-parent homes, according to a new study in the journal Hypertension. The researchers analyzed data on 515 men enrolled in the Howard University Family Study. Possible explanations for the disparity include the fact that children who live only with their mothers are three times as likely to live in poverty, and socioeconomic status has been linked to higher blood pressure. “Family structure is among a slew of environmental influences that, along with our genes, help determine our health as adults,” said Dan Kastner, MD, PhD, scientific director, National Human Genome Research Institute (NHGRI). “This study makes important observations about home life that may affect susceptibility to complex diseases later on in life.” The National Institutes of Health’s NHGRI and National Institute on Minority Health and Health Disparities conducted the study. Read more on health disparities.
Excessive Cellphone Use Tied to Higher Anxiety, Lower Productivity in College Kids
Excessive cellphone use is linked to higher levels of anxiety, less satisfaction with life and lower grades in college-age adults, according to a new study in the journal Computers in Human Behavior. Researchers examined data on approximately 500 men and women enrolled at Kent State University in 82 different fields of study. The average student spent 279 using their cellphone each day, sending an average of 77 text messages, and researchers believe that a perceived obligation to stay connected on social media may be behind the increased anxiety and decreased productivity. "At least for some students, the sense of obligation that comes from being constantly connected may be part of the problem,” said Andrew Lepp, lead study author and an associate professor at Kent State University. "Some may not know how to be alone to process the day's events, to recover from certain stressors." Read more on technology.
Recommended Reading: ‘Retweet This’—Researchers See Rise in Use of Twitter to Share Scientific Journal Articles
The top two tweeted peer-reviewed science articles between 2010 and 2012 were about the effect of radiation on humans, according to a study published in the Journal of the Association for Information Science and Technology. Researchers reviewed 1.4 million articles to determine the most tweeted studies. Runners up in the top 15 of the most tweeted articles included studies on acne in teenagers and the link between physical activity and mortality rates. Nature, a highly regarded journal, received the most tweets: 13,430 Twitter mentions of 1,083 papers.
However, the researchers found that a retweet rate doesn’t necessarily correlate with a high rate of citations for an article in other studies, which is a standard measurement of significance for a scientific study. The most tweeted study—on genetic changes during radiation exposure—was tweeted 963 times but was cited in journals only nine times.
"The most popular scientific articles on Twitter stress health implications or have a humorous or surprising component. This suggests that articles having the broadest scientific impact do not have the widest distribution," said Stefanie Haustein, of the University of Montreal School of Library and Information Science, and a co-author of the study.
Still, the researchers say the increase in tweets that include a link or description of scientific studies is important even if the rates don’t correlate with journal citations. For one thing, the number of scientific researchers on Twitter is still low and “the fact that more and more articles are tweeted [at all] is good news because it helps scientific communication [and] regardless of whether non-scientists are sending this information, it proves that science is an aspect of general culture,” said Vincent Larivière, PHD, a co-author of the study and professor at the University of Montreal, who holds the Canada Research Chair on the Transformation of Academic Communication.
Read the full study.
As smartphone technology becomes ever more ubiquitous and the dangers of tobacco become ever more apparent, it's not surprising that there are 414 quit-smoking apps available between iPhones and Androids, with Androids alone seeing about 700,000 downloads of these apps each month.
There's no question that these apps are in demand in the United States, where an estimated 11 million smokers own a smartphone and more than half of smokers in 2010 tried to quit.
The question is: Are they effective?
According to a new study in the American Journal of Preventive Medicine, the answer is too often "no," with many of the most popular apps failing to employ and advocate known and successful anti-tobacco strategies.
"Quit-smoking apps are an increasingly available tool for smokers," said lead author Lorien Abroms, ScD, an associate professor of Prevention and Community Health at the George Washington University School of Public Health and Health Services (SPHHS), according to Health Canal. "Yet our study suggests these apps have a long way to go to comply with practices that we know can help people stub out that last cigarette."
The study looked at the 50 top anti-smoking apps for both iPhones and Androids, analyzing their tactics on a number of fronts, including how well they aligned with guidelines from the U.S. Public Health Service on treating tobacco use. The review found serious issues with the apps' advice, especially concerning clinical practices. It found that:
- Most lacked basic advice on how to quit smoking and did not help people establish a "quit plan"
- None recommend calling a quit-line, which can more than double the chances of successfully quitting tobacco
- Fewer than one in 20 of the apps recommended medications, even though studies show how nicotine replacement therapy can help curb cravings
Taken together these, last two findings are especially troubling, as their pairing has been found to more than triple the chances of a person successfully breaking their nicotine addiction. One of the biggest takeaways from the study, according to Abroms, is that while quit-smoking apps can be important components of a larger plan to quit smoking, there might also be a simpler way to use those fancy smartphones.
"They should simply pick up their smartphone and call a quit-line now to get proven help on how to beat a tobacco addiction."
And the lack of adequate advice and guidance isn't limited to quit-smoking apps. A study by the IMS Institute for Healthcare Informatics found that while apps remain popular, they also remain limited.
"It clearly demonstrated that, to date, most efforts in app development have been in the overall wellness category with diet and exercise apps accounting for the majority available. An assessment finds that healthcare apps available today have both limited and simple functionality--the majority do little more than provide information.
Read the full story at Health Canal.
>>Bonus content: Read the previous NewPublicHealth post, "Public Health: There's An App For That"
>>Bonus link: Mobile Health and FDA Guidance
>>Bonus links: Here's a quick look at a few of the newest apps designed to improve public health in a variety of ways:
- My Health Apps offers a vast array of apps, sorted by categories such as "Mental Health," "Me and My Doctor" and "Staying Healthy"
- Hula, which helps people find STD testing, get the results on their phone and even share verified results
- My Fitness Pal, which combines guidance and community to help people lose weight
- Planned Parenthood offers a series of teen-focused apps on important issues such as birth control, condoms and even substance abuse
University of Maryland Study Shows Need for Improved Communication by Dental Professionals
New research from the University of Maryland School of Public Health found that a majority of dentists and dental hygienists are not regularly using recommended communication techniques with their patients that can contribute to improved oral health literacy and prevention of oral disease. The researchers, who published their findings in the Journal of Dental Hygiene, surveyed 540 Maryland dental hygienists to determine the frequency of the use of 18 recommended communication techniques to effectively communicate science-based information to patients. Only one basic technique—use of simple language—was used by more than 90 percent of dental offices, according to survey responders. The survey also found that dental professionals who had taken a communication course in a non-dental educational setting were more likely to regularly use varying types of communication techniques. Read more on health literacy.
Study: Online Medical Searches Not a Good Idea for People Who Struggle With Uncertainty, Anxiety
People who struggle with uncertainty and anxiety might want to stay away from online health information searches, according to a new study in the journal Cyberpsychology, Behavior and Social Networking. The study, which included 512 healthy men and women with a mean age of about 33, analyzed how online searchers affected their anxiety, as well as their reactions to statements such as "I always want to know what the future has in store for me" and "I spend most of my time worrying about my health." "If I'm someone who doesn't like uncertainty, I may become more anxious, search further, monitor my body more, go to the doctor more frequently—and the more you search, the more you consider the possibilities," said Thomas Fergus, an assistant professor of psychology and neuroscience at Baylor University. "If I see a site about traumatic brain injuries and have difficulties tolerating uncertainty, I might be more likely to worry that's the cause of the bump on my head." These persistent worries can increase the likelihood of worrying about potential medical bills, disability and job loss, which in turn can lead to even more online searches, doctors visits, unnecessary medical tests and stress. Read more about technology.
Study: TV Drug Ads Are Often Misleading
A study on the veracity of television drug ads by researchers at Dartmouth and the University of Wisconsin-Madison found that six out of 10 claims could potentially mislead a viewer. The study was published in the Journal of General Internal Medicine. The researchers found misleading claims among television ads for both prescription and nonprescription drugs, and that some of the ads omitted or exaggerated information. The researchers studied the 6:30 to 7 p.m. portion of nightly news broadcast, which often contains drug ads, and reviewed 168 different drug advertisements that aired between 2008 and 2010. Trained researchers classified the ads as truthful, potentially misleading or false. The researchers found only one in ten claims were false, while six in ten were misleading and included errors such as leaving out important information, exaggerating information, providing opinions or making meaningless associations with lifestyles. Read more on prescription drugs.
Even Healthy Weight Adults with High Body Fat at Increased Risk of Heart Disease
Even older adults with healthy body weights can be at increased risk of cardiovascular diseases if they have high percentages of body fat, according to a new study The American Journal of Cardiology. "Just because someone has a normal BMI does not necessarily mean they are metabolically normal," said lead researcher Dr. John Batsis, a geriatrician at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire. The study found that women with excess body fat (above 35 percent) were 57 percent more likely to die from heart-related causes within 11 years than were women with healthy body fat levels. Javier Salvador, MD, an endocrinologist at the University Clinic of Navarra in Pamplona, Spain, who was not involved in the study, said the findings demonstrate the limits of body mass index (BMI), which measures weight in relation to height. Read more on heart health.
‘Image Discrepancies’ of Job Roles Can Hurt Job Satisfaction, Performance and Pay
The lack of client understanding of the actual job roles of nurse practitioners and other professionals can negatively impact job satisfaction, performance and pay, according to a recent study in the Academy of Management Journal. "If people don't understand what you do, they tend to devalue what you do," study co-author Michael Pratt, a professor of management and organization at Boston College. "They don't understand why you're making all this money—'Why should I pay you all this money?' is a common question these professionals keep hearing." The study looked at “image discrepancies” in four professions—nurse practitioners, architects, litigation attorneys and certified public accountants—finding a noticeable and negative lack of understanding by clients for each. For example, many patients don’t realize that nurse practitioners can examine patients and prescribe medicine, and instead insist on seeing a doctor. "I assumed professionals would actually get over it, that there would be frustration, it would be an interpersonal problem, and that would be the extent of it," Pratt said. "I didn't think it would have such a big impact on how they did their job, how it affected their pay and how they performed. I was surprised at the depth of how this affected job performance. It's not simply annoying -- it has real impact.” Read more on mental health.
CDC Emphasizing Electronic Laboratory Reporting to Improve Public Health’s Response to Disease Outbreaks
The U.S. Centers for Disease Control and Prevention’s (CDC) emphasis on the widespread adoption of electronic laboratory reporting (ELR) has helped improve public health’s response to dangerous infections, according to data from CDC’s Morbidity and Mortality Weekly Report (MMWR). ELRs enable labs to report disease outbreak information quickly and in a usable format. The number of labs that utilize ELRs has more than doubled since 2005, and CDC has helped fund their increased use since 2010 in 57 state, local and territorial health departments. Current estimates are that about 62 percent of lab reports were received electronically. “Electronic laboratory reporting can give health officials better, more timely and complete information on emerging infections and outbreaks than they have ever received before,” said Robert Pinner, MD, associate director for surveillance, programs and informatics in CDC’s National Center for Emerging and Zoonotic Diseases. “Implementing these systems is a complex task that requires substantial investment, but ELR will provide health departments the tools they need to quickly identify and respond to disease threats and monitor disease trends now and in the future.” Read more on technology.
After years of deliberation, the U.S. Food and Drug Administration (FDA) has issued final guidance on the regulation of smartphone medical devices. In a nutshell, generally speaking any device used in diagnosis or treatment can’t be marketed until it’s approved by the FDA; other apps—such as calorie counters, or pedometers built into a phone—don’t need the FDA’s nod. The FDA’s criteria is how much risk an app poses for a consumer. The agency says it “intends to focus its regulatory oversight on a subset of mobile medical apps that present a greater risk to patients if they do not work as intended.”
Specifically, the FDA will focus its oversight on mobile medical apps that:
- Are intended to be used as an accessory to a regulated medical device—for example, an application that allows a health care professional to make a specific diagnosis by viewing a medical image from a picture archiving and communication system (PACS) on a smartphone or a mobile tablet.
- Transform a mobile platform into a regulated medical device—for example, an application that turns a smartphone into an electrocardiography (ECG) machine to detect abnormal heart rhythms or determine whether a patient is experiencing a heart attack.
“We have worked hard to strike the right balance, reviewing only the mobile apps that has the potential to harm consumers if they do not function properly,” said Jeffrey Shuren, M.D., J.D., director of the FDA’s Center for Devices and Radiological Health. “Our mobile medical app policy provides app developers with the clarity needed to support the continued development of these important products.”
While the final guidelines were only just released, FDA has cleared 100 mobile medical apps for marketing in the last few years, and 40 of those were just in the last two years.
Synim Rivers, an FDA spokesman, answered questions for NewPublicHealth about the final guidance on mobile medical apps.
Public health institutions across the country are joining the 10.5 million users on the virtual pinboard website, Pinterest, to share important health information and images. Topics such as women’s health, healthy living, emergency preparedness and public health history are a few of the boards on the CDCgov page. Harvard School of Public Health focuses more on healthy eating, recommended readings and inspirational quotes. Users are able to categorize topics and pictures anyway they want, allowing every institute’s page to be unique.
Users of the online scrapbook view content, “re-pin” photos to their pages, add comments to images and “like” user’s content. Pages encourage users to leave comments on the images that they like most or would like to see more of. Pinterest is the third-fastest growing social network, with 80 percent of users being women and 50 percent mothers, according to TechCrunch. The site is another way for public health professionals to stay at the center of the public health conversation and interact with their key audience on the most recent public health issues. The dissemination of information continues to grow as more people participate in the sorting, collecting and sharing of public health information.
Take a look at some of the other public health institutions that are joining Pinterest: American Public Health Association (APHA), Ohio State's College of Public Health and Association of Public Health Laboratories (APHL).