Adopting a child perspective for exposome research on mental health and cognitive development - Conceptualisation and opportunities.

Mental disorders among children and adolescents pose a significant global challenge. The exposome framework covering the totality of internal, social and physical exposures over a lifetime provides opportunities to better understand the causes of and processes related to mental health, and cognitive functioning. The paper presents a conceptual framework on exposome, mental health, and cognitive development in children and adolescents, with potential mediating pathways, providing a possibility for interventions along the life course. The paper underscores the significance of adopting a child perspective to the exposome, acknowledging children's specific vulnerability, including differential exposures, susceptibility of effects and capacity to respond; their susceptibility during development and growth, highlighting neurodevelopmental processes from conception to young adulthood that are highly sensitive to external exposures. Further, critical periods when exposures may have significant effects on a child's development and future health are addressed. The paper stresses that children's behaviour, physiology, activity pattern and place for activities make them differently vulnerable to environmental pollutants, and calls for child-specific assessment methods, currently lacking within today's health frameworks. The importance of understanding the interplay between structure and agency is emphasized, where agency is guided by social structures and practices and vice-versa. An intersectional approach that acknowledges the interplay of social and physical exposures as well as a global and rural perspective on exposome is further pointed out. To advance the exposome field, interdisciplinary efforts that involve multiple scientific disciplines are crucial. By adopting a child perspective and incorporating an exposome approach, we can gain a comprehensive understanding of how exposures impact children's mental health and cognitive development leading to better outcomes.

Protective effect of restorative possibilities on cognitive function and mental health in children and adolescents: A scoping review including the role of physical activity.

Background The exposome approach can be a powerful tool for understanding the intertwining of social, physical, and internal influences that shape mental health and cognitive development throughout childhood. To distil conceptual models for subsequent analyses, the EU-funded project Early Environmental quality and Life-course mental health effects (Equal-Life) has conducted literature reviews on potential mediators linking the exposome to these outcomes. We report on a scoping review and a conceptual model of the role of restorative possibilities and physical activity. Methods Peer-reviewed studies published since the year 2000 in English, on the association between the exposome and mental health/cognition in children/adolescents, and quantitatively investigating restoration/restorative quality as a mediating variable were considered. Database searches were last updated in December 2022. We used an unstructured expert-driven approach to fill in gaps in the reviewed literature. Results Five records of three distinct studies were identified, indicating a scarcity of empirical evidence in this newly developing research area. Not only were these studies few in numbers, but also cross-sectional, lending only tentative support to the idea that perceived restorative quality of adolescent's living environment might mediate the association between greenspace and mental health. Physical activity emerged as a mediator leading to better psychological outcomes in restorative environments. We provide a critical discussion of potential caveats when investigating the restoration mechanism in children and propose a hierarchical model including restoration, physical activity, and relational dynamics between children and their environment, including social context, as well as restorative environments other than nature. Conclusions It is justified to further explore the role of restoration and physical activity as mediators in the association between early-life exposome and mental health/cognitive development. It is important to consider the child perspective and specific methodological caveats. Given the evolving conceptual definitions/operationalizations, Equal-Life will attempt to fill in a critical gap in the literature.

Preparing Students for the Public Health Workforce: The Role of Effective High-Impact Educational Practices in Undergraduate Public Health Program Curricula.

There are several institutions of higher learning in the United States that award degrees in public health to undergraduate students. While these institutions serve as potential pipelines for the public health workforce, it is unclear if the curricula and training students receive from these institutions, really prepare them for the public health workforce or higher education. The questions sometimes asked are whether the programs offered by these institutions exist to provide students with a good understanding of public health issues so they can become good citizens for building a responsible society, or if it is to prepare students for graduate school. Regardless of what the goals are, students in undergraduate public health programs need to be exposed to curricula that adequately prepare them to enter well-defined careers in public health. Thus, institutions of higher learning offering degrees in public health to undergraduate students need to understand the market, assess, and understand the needs of public health agencies, and tailor course curricula to match those needs. Georgia State University established its undergraduate public health program in 2016. Since then, over 200 students have graduated from the program. The purpose of the study was to assess student perception of the role of high impact educational practices such as study abroad, signature experience, and undergraduate research curricula in preparing them for careers in public health.

COVID-19 and Distance Learning: Effects on Georgia State University School of Public Health Students.

On March 11, 2020, the World Health organization declared COVID-19 a global pandemic. Following the speed with which COVID-19 spread to all parts of the world, and to contain the spread of the disease, most governments around the world, including the US, authorized unprecedented social containment measures to stem the tide. These measures among others required social distancing and the temporary physical closure of educational institutions. The Georgia State University School of Public Health, like all other institutions of higher learning, had to create distance-learning opportunities to enable students to complete the 2019-2020 academic year. The unplanned, rapid, and uncertain duration of the approach presented challenges at all academic levels. Not much information on best practices was available to guide such abrupt transitions to college education. The purpose of the study was to collect data on how the transition to distance learning impacted undergraduate and graduate students taking courses in public health at GSU. The goal was to identify student academic challenges and the unforeseen benefits of distance learning, and to use that information to inform practices that can be implemented during crises that impact university education.

Integrative Learning in US Undergraduate Public Health Education: A Review of Student Perceptions of Effective High-Impact Educational Practices at Georgia State University.

In 2003, the United States (US) Institute of Medicine of the National Academies recommended that all undergraduate students have access to an education in public health to assist with diversifying the public health workforce and ensuring an educated citizenry on public health issues. In line with this recommendation, and that of the Consensus Conference on Undergraduate Public Health Education, Georgia State University established a Bachelor of Science in Public Health (BSPH) program in 2016, with the mission of advancing health through leadership, scholarship, research, and service, to better the human condition and to promote the common good, especially for urban communities in the US and for global populations. Using integrative approaches that encourage student empowerment, self-development, integrative thinking, and reflective learning, the Georgia State University BSPH program currently offers a range of generalist introductory public health courses to over 400 students. This review seeks to examine student perceptions of integrative practices utilized by Georgia State University faculty in the BSPH program and to investigate the extent to which student perceive these integrative educational practices as preparing them to use insights gained in the classroom and from the field, to question, modify, connect, and integrate material learned in the academic setting, to real-life public health challenges. It also seeks to identify which of the integrative educational practices have the highest impact of helping students integrate the knowledge and skills gained to public health issues.

Improving the soundscape quality of urban areas exposed to aircraft noise by adding moving water and vegetation.

Research shows that the sight of trees and the sound of moving water improve the soundscape quality of outdoor spaces exposed to road traffic noise. Effects are attributed to non-energetic masking, visual attentional distortion, and congruence between sight and hearing. However, there is no literature on such effects for aircraft noise. Aircraft noise varies from other traffic sources, i.e., in terms temporal variability, duration, and spectral composition, complicating the application of findings without further research. In a virtual reality experiment reported in this article, participants were asked to rate scenarios with different sound levels of flyovers, urban typologies, vegetation, and/ or water features. The results showed a significant improvement of the soundscape quality when (1) vegetation and (2) moving water were present, and especially when (3) vegetation and moving water were presented simultaneously, especially for residential areas in terms of the relative change. Moving water also reduced the saliency of aircraft flyovers significantly, changing the constellation of fore- and background sounds. Moving water raised the perceived audibility of the most dominant sound source too, which could be attributed to non-energetic masking effects. The findings of this study indicate that soundscape strategies can complement noise abatement in areas prone to aircraft noise.

Type of activity and order of experimental conditions affect noise annoyance by identifiable and unidentifiable transportation noise.

Previous studies have shown that identifiability of sound sources influence noise annoyance levels. The aim of the present experiment was to additionally study the effects of actively performing a task versus a less active pastime on noise annoyance. This was done by asking participants to perform a task (task condition) or read a magazine of their choice (no-task condition), while listening to identifiable and unidentifiable samples of transportation noise at varying sound exposure levels (55-85 ASEL). Annoyance was higher for identifiable samples (recordings) than for unidentifiable transformed samples (with equal spectral energy and envelope). Although there was no main effect of activity type on noise annoyance, for the transformed samples, an interaction was found between activity type and sound exposure levels: annoyance started lower in the no-task condition, but rose more steeply with ascending exposure levels than was the case during task performance (large effect). When assessing order effects, it was found that annoyance was higher when the task condition came first, especially for lower sound exposure levels (large effects). It is therefore concluded that the type of activity and the condition order do influence noise annoyance but in interaction with exposure levels, the type of noise and habituation.

Effect of marijuana use on cardiovascular and cerebrovascular mortality: A study using the National Health and Nutrition Examination Survey linked mortality file.

Background Reports associate marijuana use with cardiovascular emergencies. Studies relating marijuana use to cardiovascular mortality are scarce. Recent advance towards marijuana use legalization emphasizes the importance of understanding relationships between marijuana use and cardiovascular deaths; the primary ranked mortality. Recreational marijuana is primarily smoked; we hypothesize that like cigarette smoking, marijuana use will be associated with increased cardiovascular mortalities. Design The design of this study was based on a mortality follow-up. Method We linked participants aged 20 years and above, who responded to questions on marijuana use during the 2005 US National Health and Nutrition Examination Survey to data from the 2011 public-use linked mortality file of the National Center for Health Statistics, Centers for Disease Control and Prevention. Only participants eligible for mortality follow-up were included. We conducted Cox proportional hazards regression analyses to estimate hazard ratios for hypertension, heart disease, and cerebrovascular mortality due to marijuana use. We controlled for cigarette smoking and other relevant variables. Results Of the 1213 eligible participants 72.5% were presumed to be alive. The total follow-up time was 19,569 person-years. Adjusted hazard ratios for death from hypertension among marijuana users compared to non-marijuana users was 3.42 (95% confidence interval: 1.20-9.79) and for each year of marijuana use was 1.04 (95% confidence interval: 1.00-1.07). Conclusion From our results, marijuana use may increase the risk for hypertension mortality. Increased duration of marijuana use is associated with increased risk of death from hypertension. Recreational marijuana use potentially has cardiovascular adverse effects which needs further investigation.

Annoyance by transportation noise: The effects of source identity and tonal components.

Aircraft noise is consistently rated as more annoying than noise from other sources with similar intensity. In three experiments, it was investigated whether this penalty is due to the source identity of the noise. In the first experiment, four samples were played to participants engaged in a working memory task: road traffic noise, an Airbus 320 flyover, and unidentifiable, transformed versions of these samples containing the same spectral content and envelope. Original, identifiable samples were rated as more annoying than the transformed samples. A second experiment tested whether these results were due to the absence of tonal components in the transformed samples. This was partly the case: an additional sample, created from the A320 flyover by filtering out major tonal components, was rated as less annoying than the original A320 sample, but as more annoying than the transformed sample. In a third experiment, participants either received full disclosure of the generation of the samples or no information to identify the transformed samples. The transformed sample was rated as most annoying when the A320 identity was disclosed, but as least annoying when it was not. Therefore, it was concluded that annoyance is influenced by both identifiability and the presence of tonal components.

Socio-demographic Differences in Toxic Release Inventory Siting and Emissions in Metro Atlanta.

Prior research has found that low socioeconomic status (SES) populations and minorities in some areas reside in communities with disproportionate exposure to hazardous chemicals. The objectives of this study were to evaluate the relevance of socio-demographic characteristics on the presence of Toxic Release Inventory (TRI) facilities, air releases, and prevalence and resolution of air quality complaints in the 20-county Atlanta Metropolitan Statistical Area (MSA). We found that there were 4.7% more minority residents in census tracts where TRI facilities were located. The odds ratio (OR) for the presence of a TRI facility was 0.89 (p < 0.01) for each 1% increase of females with a college degree and 2.4 (p < 0.01) for households with an income of $22,000-$55,000. The estimated reduction in the amount of chemicals emitted per release associated with population of females with a college degree was 18.53 pounds (p < 0.01). Complaints took longer to resolve in census tracts with higher Hispanic populations (OR = 1.031, 95% CI: 1.010-1.054). Overall, results indicate that SES and race/ethnicity are related to TRI facility siting, releases, and complaints in the Atlanta area. These findings have not been documented previously and suggest that lower SES and non-White communities may be disproportionately exposed.

A Pilot Study to Examine the Disparities in Water Quality between Predominantly Haitian Neighborhoods and Dominican Neighborhoods in Two Cities in the Dominican Republic.

Worldwide, diarrheal disease is a leading cause of death affecting over 1.7 million individuals annually. Much of this can be attributed to lack of clean water, sanitation and hygiene. Nearly all of these deaths occur in countries with developing economies. This public health problem is apparent in the island of Hispaniola; the island that is shared by Haiti and the Dominican Republic. Significant gaps in income between the countries have resulted in Haitians migrating into the Dominican Republic. While there has been increased migration into the Dominican Republic, many of the neighborhoods remain segregated. A cross-sectional analysis was conducted at 49 sites in the Dominican Republic. Samples were classified as being from a Haitian neighborhood or Dominican neighborhood and analyzed for microbial contamination. Overall, Haitian neighborhoods were found to have statistically significantly higher levels of contamination of both coliform and E. coli. The odds of having E. coli contaminated water in Haitian neighborhoods are 4.25 times as high as Dominican neighborhoods. The odds of having coliform contaminated water in Haitian neighborhoods are 4.78 times as high as Dominican neighborhoods. This study provides evidence of the disparity in access to clean drinking water for Haitian immigrants and highlights the need for further investigation.