Kassandra R. Snook

Change in Percentages of Adults With Overweight or Obesity Trying to Lose Weight, 1988-2014

Socially acceptable body weight is increasing.1 If more individuals who are overweight or obese are satisfied with their weight, fewer might be motivated to lose unhealthy weight. This study assessed the trend in the percentage of adults who were overweight or obese and trying to lose weight during 3 periods from 1988 through 2014. We used data from the National Health and Nutrition Examination Survey (NHANES), an ongoing, stratified, multistage probability sample of the US noninstitutionalized population designed to represent the health and nutritional status of the general population. A strength of NHANES is that the sampling approaches, interviews, and physical examination methods are standardized across surveys and have been published extensively elsewhere.2 NHANES protocol was approved by the National Center for Health Statistics institutional review board, and written informed consent was obtained.2 The current analysis was categorized as exempt by the Georgia Southern University institutional review board.

Ebola virus disease and social media: A systematic review

OBJECTIVES We systematically reviewed existing research pertinent to Ebola virus disease and social media, especially to identify the research questions and the methods used to collect and analyze social media. METHODS We searched 6 databases for research articles pertinent to Ebola virus disease and social media. We extracted the data using a standardized form. We evaluated the quality of the included articles. RESULTS Twelve articles were included in the main analysis: 7 from Twitter with 1 also including Weibo, 1 from Facebook, 3 from YouTube, and 1 from Instagram and Flickr. All the studies were cross-sectional. Eleven of the 12 articles studied ≥ 1of these 3 elements of social media and their relationships: themes or topics of social media contents, meta-data of social media posts (such as frequency of original posts and reposts, and impressions) and characteristics of the social media accounts that made these posts (such as whether they are individuals or institutions). One article studied how news videos influenced Twitter traffic. Twitter content analysis methods included text mining (n = 3) and manual coding (n = 1). Two studies involved mathematical modeling. All 3 YouTube studies and the Instagram/Flickr study used manual coding of videos and images, respectively. CONCLUSIONS Published Ebola virus disease-related social media research focused on Twitter and YouTube. The utility of social media research to public health practitioners is warranted.

Public health implications of social media use during natural disasters, environmental disasters, and other environmental concerns

Social media allows users to share information and communicate interpersonally during natural disasters, environmental disasters, and other environmental concerns. We conducted a scoping review of the literature using the Arksey and O’Malley framework to examine how social media is used during these environmental concerns, determine what the implications are for public health officials, and identify research gaps. Thirty-four articles were retrieved for the review. From these articles, four main questions were answered: How can social media be used to disseminate information to others? How is social media used for data prediction and early warnings? How is social media used for environmental awareness and health promotion? Lastly, how can social media be used as an indicator of public participation in social media during environmental concerns? We found evidence supporting social media as a useful surveillance tool during natural disasters, environmental disasters, and other environmental concerns. Public health officials can use social media to gain insight into public opinions and perceptions. Social media allows public health workers and emergency responders to act more quickly and efficiently during crises. Further research is needed to improve the use of social media during natural disasters, environmental disasters, and other environmental concerns.

Gender-based differences in water, sanitation and hygiene-related diarrheal disease and helminthic infections: a systematic review and meta-analysis

BACKGROUND Qualitative evidence suggests that inadequate water, sanitation and hygiene (WASH) may affect diarrheal and helminthic infection in women disproportionately. We systematically searched PubMed in June 2014 (updated 2016) and the WHO website, for relevant articles. METHODS Articles dealing with the public health relevance of helminthic and diarrheal diseases, and highlighting the role of gender in WASH were included. Where possible, we carried out a meta-analysis. RESULTS In studies of individuals 5 years or older, cholera showed lower prevalence in males (OR 0.56; 95% CI 0.34-0.94), while Schistosoma mansoni (1.38; 95% CI 1.14-1.67), Schistosoma japonicum (1.52; 95% CI 1.13-2.05), hookworm (1.43; 95% CI 1.07-1.89) and all forms of infectious diarrhea (1.21; 95% CI 1.06-1.38) showed a higher prevalence in males. When studies included all participants, S. mansoni and S. japonicum showed higher prevalence with males (OR 1.40; 95% CI 1.27-1.55 and 1.84; 95% CI 1.27-2.67, respectively). Prevalence of Trichiuris and hookworm infection showed effect modification with continent. CONCLUSIONS Evidence of gender differences in infection may reflect differences in gender norms, suggesting that policy changes at the regional level may help ameliorate gender related disparities in helminthic and diarrheal disease prevalence.

Authors' Response: Health Benefits/Hazards Associated with Companion Animal-Exposure Might be Endpoint-and-Animal Specific.

We thank Dr. Richard Gillum for his interest in our study [1] and critical viewpoints [2]. It’s true that both Dr. Gillum’s and ours used the data collected from roughly the same cohort, i.e. the participants of the National Health and Nutritional Examination Survey, 1988–1994. The two studies, however, are fundamentally different as Dr. Gillum summarized in his letter. It might be inappropriate to assess the consistency of the conclusions from studies with different study populations using different endpoints. As Dr. Gillum correctly pointed out that study population in ours were the ‘‘persons under 50 (vs. 40) at baseline and those with chronic medical conditions were excluded (vs. included); the sample was followed 6 years longer; endpoints were restricted to deaths from cardiovascular disease including stroke (vs. all causes)’’ [2]. It is in particular relevant that Dr. Gillum’s study used all cause deaths [3] and ours instead examined deaths from cardiovascular events [1]. Companion animals include various species, from mammals to reptiles. The impact of living with companion animals might be not ‘‘all-or-nothing’’ or ‘‘black-andwhite’’, not only in terms of the types of animals but also the endpoints selected. The health benefits may be overshadowed by health drawbacks for selected animals with selected health endpoints. The heterogeneity of exposures (types of animal) and outcomes (causes of death, in this case) may explain a substantial part of the inconsistency of the literature, certainly, including the discrepancy between Dr. Gillum’s and ours. A beneficial association between pet ownership and cardiovascular disease was observed from numerous studies, including ours. Potential health hazards from keeping a pet were also reported from others, with a majority using cancer, in particular, leukemia and lung cancer [4], as the endpoint. With that said, we believe it is not surprising to find no or a weak relationship between having a pet and all—cause mortality in Dr. Gillum’s study [3] since the hazardous and beneficial effects on different health outcomes may be counter acting each other. We agree with Dr. Gillum that ‘‘we need to wait for better studies before making any firm conclusions about pets and survival among their owners’’ [2], and we are short of an overall assessment of the associations of companion animals with human health, in particular, among general population. For these reasons, we believe that our study [1], in nature, was exploratory, as such, we tried to minimize the type II error and did not adjust for multiple comparisons, which in turn may end with an increased type I error as Dr. Gillum was concerned. We had no intention to ‘‘emphasize findings that likely were due to chance (i.e. not statistically significant) and a single finding (women living with cats and stroke) [2]’’. As a matter of fact, in addition to the ‘‘single finding (women living with cats and stroke)’’, all the estimates for women were below the null value regardless of the cardiovascular endpoints (last & Jian Zhang jianzhang@georgiasouthern.edu