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Public Health, Public Safety, Research, Technology

Mining Twitter to identify cases of foodborne illness

During this year’s Big Data in Biomedicine conference at Stanford, Taha Kass-Hout, MD, chief health informatics officer for the U.S. Food and Drug Administration, talked about the potential of social media to monitor food safety saying, “You are what you eat, and in this world, you are what you tweet.” Taking this concept into a real-world setting, officials at the Chicago Department of Public Health developed an algorithm to mine Chicago-based tweets for sentiments of food illnesses and, as a result, were able to investigate incidents of food poisoning that would have otherwise gone unnoticed. According to a recent article in Popular Science:

… in a recent project, the city of Chicago sought food poisoning cases by setting an algorithm to mine Chicago-area tweets for complaints. The Chicago Department of Public Health’s Twitter bot, plus a new online complaint form, helped the department identify 133 restaurants for inspections over a 10-month period. Twenty-one of those restaurants failed inspection and 33 passed with “critical or serious” violations. Not a bad haul.

Chicago is now working with the health departments of Boston and New York to see if its system could work in those cities, according to a report city researchers published with the U.S. Centers for Disease Control and Prevention. Plus, Twitter isn’t the only social media platform cities are looking to mine for public health violations. In May, New York City’s department of health reported on using an algorithm to spot Yelp reviews that point to food poisoning cases. New York’s Yelp project led the city to discover three restaurants that had multiple violations. All the Yelp cases the city inspected had otherwise gone unreported, New York officials wrote in their own CDC report.

The Chicago bot was pretty simple, as Twitter-reading computer programs go. It searched for tweets geo-located to Chicago and its surrounding suburbs that mentioned “food poisoning.” Human staff then read the tweets to determine if they were relevant. (Sounds fun.) Staff marked tweets as relevant or not relevant, to give the algorithm data to better learn what tweets to pull in the future. Then staff members responded to relevant tweets themselves.

Previously: Videos of Big Data in Biomedicine keynotes and panel discussions now available online, Discussing access and transparency of big data in government and Improving methods for tracking flu trends using Twitter

From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.

Global Health, Infectious Disease, Public Health, Public Safety, Stanford News

Biosecurity experts discuss Ebola and related public health concerns and policy implications

Biosecurity experts discuss Ebola and related public health concerns and policy implications

ebola_081214

More than 1,800 people in the West African nations of Liberia, Sierra Leone and Guinea have contracted the Ebola virus since March and the death toll has surpassed 1,000, according to the latest figures from the World Health Organization. As the number of cases and death continue to climb many are concerned about what can be done to curtail the outbreak and the likelihood of it spreading to the United States.

In a Q&A recently published by the Center for International Security and Cooperation and The Freeman Spogli Institute for International Studies, Stanford biosecurity experts David Relman, MD, and Megan Palmer jointly answer these questions and others related to the public health concerns and policy implications of the outbreak. On the topic of broader lessons about the dynamics and ecology of emerging infectious diseases that can help prevent or respond to outbreaks now and in the future, they respond:

These latest outbreaks remind us that potential pathogens are circulating, replicating and evolving in the environment all the time, and human action can have an immense impact on the emergence and spread of infectious disease.

We are starting to see common factors that may be contributing to the frequency and severity of outbreaks. Increasing human intrusion into zoonotic disease reservoir habitats and natural ecosystems, increasing imbalance and instability at the human-animal-vector interface, and more human population displacement all are likely to increase the chance of outbreaks like Ebola.

The epicenter of this latest outbreak was Guéckédou, a village near the Guinean Forest Region. The forest there has been routinely exploited, logged, and neglected over the years, leading to an abysmal ecological status quo. This, in combination with the influx of refugees from conflicts in Guinea, Liberia, Sierra Leone, and Cote d’Ivoire, has compounded the ecological issues in the area, potentially facilitating the spread of Ebola. There seems to be a strong relationship between ecological health and the spread of disease, and this latest outbreak is no exception.

While forensic analyses are ongoing, unregulated food and animal trade in general is also a key factor in the spread of infectious diseases across large geographic regions. Some studies suggest that trade of primates, including great apes, and other animals such as bats, may be responsible for transit of this Ebola strain from Central to Western Africa.

Overall, Relman and Palmer remind the public, “It’s important that we not lose sight of more chronic, but less headline-grabbing diseases that will be pervasive, insidious long-standing challenges for Africa and elsewhere.”

Previously: Stanford global health chief launches campaign to help contain Ebola outbreak in Liberia and Health workers use crowdsourced maps to respond to Ebola outbreak in Guinea
Photo by European Commission DG ECHO

From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.

Addiction, In the News, Public Health, Public Safety

Can the “24/7 sobriety” model reduce drunken disorderly conduct and violence in London?

beer_london_pubIn an article published yesterday in the Telegraph, Stanford addiction expert Keith Humphreys, PhD, discusses how public officials in London are turning to the United States’ “24/7 sobriety” model in an effort to reduce repeat offenders convicted of alcohol-related crimes. The program, which combines mandatory sobriety and daily breathalyser tests, was created under Humphreys’ guidance. He writes:

Research by the RAND Corporation – a US-based non-profit global policy think tank – found that 24/7 sobriety dropped repeat drink driving arrests by 12 per cent. The same study also yielded a pleasant surprise: domestic violence arrests dropped by 9 per cent, despite not being a focus of the programme. Removing alcohol from the lives of criminals can apparently have radiating benefits beyond those directly related to their most recent offence.

In light of its positive results, judges across the U.S. have been adopting the 24/7 sobriety approach. This week, under the leadership of Mayor Johnson and his team, a pilot of the programme will be launched in South London. Leaping the pond will come with some challenges, particularly around delivering sanctions swiftly within the constraints of British law, but local tailoring of innovations is always an essential part of making them spread.

In any event, with over one million alcohol-related assaults occurring nationally each year and many London boroughs being regularly marred by violence and disorder on weekend evenings, the time for new approaches to binge drinking criminal offenders has clearly arrived. The judges and probation officers who are undertaking this pilot should be applauded for refusing to accept the status quo.

Previously: Text messages after ER visit could reduce young adults’ binge drinking by more than 50 percent, Study shows legal drinking age of 21 saves lives and reduces health risks for young adults, Alcoholism: Not just a man’s problem and Stopping criminal men from drinking reduces domestic violence
Photo by Paul Downey

Cancer, Dermatology, In the News, Public Safety, Research, Stanford News

A closer look at new research showing disproportionate rates of melanoma in Marin County

Last week, Cancer Prevention Institute of California/Stanford Cancer Institute researcher Christine Clarke, PhD, shared results of a new report (.pdf) showing that a county in California has higher numbers of melanoma skin cancer than the rest of the state. On this morning’s Forum Clarke joined two other guests, including Stanford dermatologist Susan Swetter, MD, director of the Pigmented Lesion and Melanoma Program at the Stanford Cancer Institute, to discuss the research and to offer skin safety and screening tips for the summer.

It’s worth a listen – especially if you live in the county just north of San Francisco.

Previously: Melanoma rates exceed rates of lung cancer in some areasWorking to protect athletes from sun dangers, As summer heats up take steps to protect your skin, Stanford study: Young men more likely to succumb to melanoma, New research shows aspirin may cut melanoma risk and Working to prevent melanoma

CDC, Nutrition, Pediatrics, Public Safety, Research, Stanford News

“Happy Meal ban”: Where are we now?

"Happy Meal ban": Where are we now?

MuppetBabiesA newly released Centers for Disease Control report of a study conducted at Stanford has examined the effects of San Francisco’s 2010 “Happy Meal ban.” The ban prohibited the free distribution of toys with unhealthy meals; the fast-food restaurants McDonald’s and Burger King instead sold the toys for 10 cents. Though neither restaurant complied with the ordinance’s specific calls for changes in nutritional content, improvements have been made.

As reported by SFGate.com:

…over the study’s two-year period, McDonald’s in particular made big changes to its Happy Meals, said [Jennifer Otten, MD,] of the University of Washington School of Public Health — first in California, then nationally.

The fast food giant cut the amount of French fries it serves in Happy Meals in half, replacing them with apples; stopped serving caramel sauce with apples; and began offering nonfat chocolate milk to customers. Otten said those substitutions were “pretty dramatic,” — they reduced the calories in a Happy Meal by 110, and cut the sodium and fat content of the meal as well.

Otten and her colleagues, including senior author Abby King, PhD, concluded in the study, “Although the changes…  did not appear to be directly in response to the ordinance, the transition to a more healthful beverage and default side dish was consistent with the intent of the ordinance. Study results… suggest that public policies may contribute to positive restaurant changes.”

Previously: How fast-food restaurants respond to limits on free toys with kids’ meals, Toying with Happy Meals, How food advertising and parents’ influence affect children’s nutritional choices and Living near fast food restaurants influences California teens’ eating habits
Photo by Ursala Urdbeer

Global Health, In the News, Pediatrics, Public Safety, Sexual Health, Women's Health

Stanford research shows rape prevention program helps Kenyan girls “find the power to say no”

Stanford research shows rape prevention program helps Kenyan girls "find the power to say no"

The San Francisco Chronicle has a great story today about a collaborative project that is reducing rape and sexual assault of impoverished girls in Kenya.

The story highlights the combined efforts of activists Jake Sinclair, MD, and his wife, Lee Paiva Sinclair, who founded nonprofit No Means No Worldwide to provide empowerment training to Kenayn girls, and the Stanford team that has been analyzing the results of their efforts. As we’ve described before, this work is a great example of the academic chops of Stanford experts’ being combined with on-the-ground activism to make a difference for an urgent real-world problem.

As the article explains:

The girls and hundreds of others like them have participated in a rape-prevention workshop created by Jake Sinclair and Lee Paiva, a San Francisco doctor and his artist wife who have been working in Kenya for 14 years.

Their program is working, and that’s not just according to the dozen or so testimonials online, the couple said. Two studies out of Stanford – one published in April this year, one the year before – have found that girls who have gone through the couples’ classes experience fewer sexual assaults after the workshops.

More telling, perhaps: More than half of the girls report using some tool they learned from the classes to protect themselves, from kicking a man in the groin to yelling at someone to stop.

“It’s great to see the girls just find their voice, to find the power to say ‘no,’ ” Sinclair said. “It’s so enlightening. You can see it in their eyes, that something’s changed.”

Stanford research scholar Clea Sarnquist, DrPH, who has played an important role in the project, adds:

“A lot of these girls are using voice and verbal skills first,” Sarnquist said. “That’s one of the key things, is teaching the girls that they have the right to protect themselves – that they have domain over their own bodies, and they have the right to speak up for their own self interest.”

The whole story is definitely worth a read.

Previously: Empowerment training prevents rape of Kenyan girls and Self-defense training reduces rapes in Kenya

Global Health, Health Policy, Public Safety, Women's Health

Lobbying Congress on bill to stop violence against women

Lobbying Congress on bill to stop violence against women

capitol - smallWhen I walked into the U.S. Capitol building this week, it was with the weight of history – my own and my country’s. Years ago, I had walked these hallowed halls as a writer for a Congressional publication and had lived in a house just blocks away. But this time I was there for a very different purpose: I was going to try my hand at lobbying, plying Congress for a cause that had become dear to my heart.

I came to Washington, D.C. with nearly 150 volunteers and staff from the American Jewish World Service, an international development organization that promotes human rights and works to end poverty in the developing world. This year, one of the group’s legislative priorities is passage of the International Violence Against Women Act, now pending in Congress. In February, I had traveled to Uganda as a Global Justice Fellow with AJWS, learning first-hand why this bill is so crucial to the lives of women around the world. I met a gay woman whose life had become hell because of her gender identity; she’d been beaten, raped and robbed and was suffering the emotional trauma of being ostracized by family and community. I also met sex workers, many of them single mothers just trying to make a living, who had been subjected to unprovoked beatings and police brutality. And I met a transgender woman whose home had been burned to the ground and who had been terrorized by her community simply because of who she was. In fact, I would learn that one in three women around the world are beaten, abused or raped at some point in their lifetime – an appalling figure.

The bill would help combat this trend by using the full force of U.S. diplomacy, as well as existing U.S. foreign aid funding, to support legal, social, educational, economic and health initiatives to prevent violence, support victims and change attitudes about women and girls in society. When women become victims of violence, everyone suffers; gender-based violence can reduce a nation’s GDP by as much as 3 percent because women are so key to collective productivity.

“If you want to get a barometer on how a country will fare – its stability – just look at the way it treats its women,” Sen. Ben Cardin (D-Maryland) told our group as we prepared to head out to visit Members of Congress. “Women invest in children and family. Men invest in war.”

With the recent kidnapping of more than 250 Nigerian school girls, the need for the legislation has become all the more pressing. “This is the moment to strike,” Sen. Barbara Boxer (D-Calif.) said during a meeting with 20 members of our group. We met with Boxer in the sumptuous President’s Room in the U.S. Capitol, adorned with gilt, frescoes and historical portraits and the spot where Abraham Lincoln and Martin Luther King once stood. Boxer had just come from a vote on several new judges and was gracious enough to stop by to spend 20 minutes listening to our pitch and discussing strategy.

A strong women’s rights activist, she has been an ardent supporter of the bill from the start. With 300 nonprofit groups now clamoring for its passage, she said she felt it was time to introduce it into the Senate, which she did a week ago. It’s now critical, she said, to enlist additional Republican co-sponsors of the legislation, particularly among members of the Senate Foreign Relations Committee, to give it greater weight and bipartisan appeal. In the House, the bill already has 63 Democratic and 11 Republican co-sponsors, with more being sought.

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Global Health, Pediatrics, Public Safety, Research, Stanford News, Women's Health

Empowerment training prevents rape of Kenyan girls

Empowerment training prevents rape of Kenyan girls

Adolescent girls in the slums of Nairobi, Kenya, are frequent targets of sexual harassment and assault: Nearly one in five of them is raped each year. When these crimes are perpetrated against Nairobi’s teen girls, they’re often expected to react with shame and silence.

But a small non-governmental organization, No Means No Worldwide, has a strategy to change that. The co-founders, Jake Sinclair, MD, and Lee Paiva, an American husband-and-wife team, developed a curriculum of empowerment training to teach girls that it’s OK to say “no” to unwanted sexual advances. The training also gives girls specific verbal and physical skills to defend themselves, as well as information about where to go for help after a rape or other sexual assault.

The results are impressive. Stanford researchers who work with Sinclair and Paiva report today in Pediatrics that the empowerment training cut annual rates of rape by more than a third. Among the group of 1,978 girls trained during the study, more than half used their new knowledge to fend off attempted rape, and 65 percent stopped instances of harassment, halting hundreds of incidents.

From our press release about the research:

“Clearly, girls should never be placed in these situations in the first place,” said Clea Sarnquist, DrPH, the study’s lead author and a senior research scholar in pediatrics at Stanford. Changing males’ attitudes and behavior about assault is an important area for the team’s current and future work, she said. “But with such a high prevalence of rape, these girls need something to protect them now. By giving them the tools to speak up and the knowledge that ‘I have domain over my own body,’ we’re giving them the opportunity to protect themselves.”

The video above, one of a series of testimonials that No Means No Worldwide has collected from Nairobi girls, shows the power of that sense of domain over one’s body. In the video, a schoolgirl named Catherine tells how she stopped a male student from harassing her. When the video begins, it’s impossible not to notice how young and vulnerable she seems. But then she recounts how, when this boy followed her and demanded sex, she remembered her self-defense classes.

“I stood and maintained eye contact,” she says in the video. “I warned him that day and told him he should never in his life dare follow me.”

As she says the words, her demeanor transforms: She draws herself up straight, looks directly in the camera, and raises her index finger in a gesture of commanding attention.

Maryanne Wangui, a young Kenyan woman who recorded many of the testimonials, said something to me that resonates with Catherine’s account and sticks in my mind: “If you give girls the right skills, they know what to do. It doesn’t matter the age of the girl or the size of the girl; they’re all powerful inside.”

Previously: Self-defense training reduces rapes in Kenya
Video courtesy of No Means No Worldwide

Behavioral Science, Mental Health, Public Safety, Stanford News

Stanford’s Keith Humphreys on Golden Gate Bridge suicide prevention: Get the nets

GGBridgeOver on the Huffington Post, Keith Humphreys, PhD, professor of psychiatry and behavioral science at Stanford, writes about a tragic phenomenon in the Bay Area: the popularity of suicide by jumping from the Golden Gate Bridge. He makes a case to put public money toward installing nets and other suicide-prevention services there and in other suicide “hotspots.”

From the post:

Professor Richard Seiden [PhD] painstakingly tracked down death records for the 515 individuals who had been prevented by police from jumping off the bridge from 1937 to 1971. Remarkably, only 6 percent had committed suicide. Even if every individual who died in what was believed to be an accident were assumed to have intentionally caused their own deaths, the proportion of suicides rose only to 10 percent. In other words, 90 percent or more of people stopped from committing suicide at the Golden Gate Bridge lived out the full natural extent of their lives.

Previously: Full-length video available for Stanford’s Health Policy Forum on serious mental illnessLucile Packard Children’s Hospital partners with high schools on student mental health programs and ECT for depression – not so shocking
Photo by image_monger

Parenting, Public Safety, Research, Sports

Is repetitive heading in soccer a health hazard?

Is repetitive heading in soccer a health hazard?

soccer_headerIn the 20 years that I played soccer as a child and young adult, I used my head countless times to challenge and control the ball as it sailed through the air. During practices, coaches gave instructions on which part of the head to use in making contact and redirecting the ball so that the impact was less painful. They also trained me and my teammates on the body mechanics of receiving the ball to maintain possession. But there was never a discussion on the potential health affects of repetitively heading the ball.

So I was interested to read about a paper (subscription required) recently published in Brain Injury wherein researchers raise concerns about long-term consequences of repetitive heading. In the study, Canadian researchers analyzed nearly 50 papers that examining the incidence of concussion in soccer. Among their findings:

  • Overall, concussions accounted for 5.8 per cent to 8.6 per cent of total injuries sustained during games.
  • In particular, girls’ soccer accounted for 8.2 per cent of sports-related concussions, the second highest sport after football.
  • Research papers that looked at the mechanism of injury found 41.1 per cent of concussions resulted from contact by an elbow, arm or hand to the head.
  • Another study showed 62.7 per cent of varsity soccer players had suffered symptoms of a concussion during their playing careers, yet only 19.2 per cent realized it.
  • Studies on the long-term effects of heading found greater memory, planning and perceptual deficits in forwards and defenders, players who execute more headers.
  • One study found professional players reporting the highest prevalence of heading during their careers did poorest in tests of verbal and visual memory as well as attention.

Considering that an estimated 265 million(.pdf) people worldwide play soccer, researchers say these findings show more research on the long-term consequences of repetitive heading is greatly needed.

Previously: Kids and concussions: What to keep in mind, Measuring vs. reporting concussions in cheerleading, Can a single concussion cause lasting brain damage? and A conversation with Daniel Garza about football and concussions
Photo by Gordon Marino

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