Department of Public Health Sciences

For more than 50 years, the Department of Public Health Sciences has provided graduate education and engaged in research aimed at improving health and health care for citizens. The focus of research and graduate programs is on health policy and management, health technology assessment, epidemiology and biostatistics, environmental health and global health. Collectively, faculty members represent many disciplines in the natural, biomedical, clinical, social, economic and behavioral sciences.
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  1. Adult Obesity Management: Knowledge, Attitudes, and Practices of Alberta Family Physicians [Download]

    Title: Adult Obesity Management: Knowledge, Attitudes, and Practices of Alberta Family Physicians
    Creator: Hilary Short
    Description: Obesity is a national and global issue. Primary care is an important area in the prevention and treatment of obesity. There are numerous potential barriers physicians face in delivering effective practices in obesity management. Identifying major barriers will aid health care systems, medical practices, and primary care physicians in the improvement of counseling obese patients to lose weight and maintain their weight loss for the long term. The purpose of the study was to explore the relationship of physician attitudes, knowledge, and practice environment on their practice behaviours in delivering obesity management to adults in primary care. Physicians were assessed using a survey instrument, developed on the basis of four previously validated surveys. A database from the College of Physicians and Surgeons of Alberta was used to identify Alberta family physicians to invite to participate and gather data from. 129 physicians participated in the study through completion of the survey. The results of the study did not indicate that physicians’ attitudes towards obese patients explain for their behaviour in delivering obesity management in primary practice. Physician knowledge, responsibility, and practice environment modestly explain physician behaviours with respect to how they manage adults with obesity. Further efforts in identifying the determinants of physician behaviours in obesity management are needed.
    Subjects: adult obesity, primary care, obesity management
  2. Isomer profiles of perfluorochemicals in matched maternal, cord and house dust samples: manufacturing sources and transplacental transfer. [Download]

    Title: Isomer profiles of perfluorochemicals in matched maternal, cord and house dust samples: manufacturing sources and transplacental transfer.
    Creator: Beesoon. S.
    Description: Background: Perfluorochemicals (PFCs) are detectable in the general population and in the human environment, including house dust. Sources are not well characterized, but isomer patterns should enable differentiation of historical and contemporary manufacturing sources. Isomer-specific maternal–fetal transfer of PFCs has not been examined despite known developmental toxicity of perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) in rodents. Objectives: We elucidated relative contributions of electrochemical (phased out in 2001) and telomer (contemporary) PFCs in dust and measured how transplacental transfer efficiency (TTE; based on a comparison of maternal and cord sera concentrations) is affected by perfluorinated chain length and isomer branching pattern. Methods: We analyzed matching samples of house dust (n = 18), maternal sera (n = 20), and umbilical cord sera (n = 20) by isomer-specific high-performance liquid chromatography tandem mass spectrometry. Results: PFOA isomer signatures revealed that telomer sources accounted for 0–95% of total PFOA in house dust (median, 31%). This may partly explain why serum PFOA concentrations are not declining in some countries despite the phase-out of electrochemical PFOA. TTE data indicate that total branched isomers crossed the placenta more efficiently than did linear isomers for both PFOS (p < 0.01) and PFOA (p = 0.02) and that placental transfer of branched isomers of PFOS increased as the branching point moved closer to the sulfonate (SO3–) end of the molecule. Conclusions: Results suggest that humans are exposed to telomer PFOA, but larger studies that also account for dietary sources should be conducted. The exposure profile of PFOS and PFOA isomers can differ between the mother and fetus—an important consideration for perinatal epidemiology studies of PFCs.
    Subjects: PFOA, PFOS, isomers, perfluorochemicals, transplacental transfer
    Date Created: 2011
  3. Science Communication in Transition: Genomics Hype, Public Engagement, Education and Commercialization Pressures [Download]

    Title: Science Communication in Transition: Genomics Hype, Public Engagement, Education and Commercialization Pressures
    Creator: Bubela, Tania
    Description: This essay reports on the final session of a 2-day workshop entitled ‘Genetic Diversity and Science Communication’, hosted by the CIHR Institute of Genetics in Toronto, April 2006. The first speaker, Timothy Caulfield, introduced the intersecting communities that promulgate a ‘cycle of hype’ of the timelines and expected outcomes of the Human Genome Project (HGP): scientists, the media and the public. Other actors also contribute to the overall hype, the social science and humanities communities, industry and politicians. There currently appears to be an abatement of the overblown rhetoric of the HGP. As pointed out by the second speaker, Sharon Kardia, there is broad recognition that most phenotypic traits, including disease susceptibility are multi-factorial. That said, George Davey-Smith reminded us that some direct genotype–phenotype associations may be useful for public health issues. The Mendelian randomization approach hopes to revitalize the discipline of epidemiology by strengthening causal influences about environmentally modifiable risk factors. A more realistic informational environment paves the way for greater public engagement in science policy. Two such initiatives were presented by Kardia and Jason Robert, and Peter Finegold emphasized that science education and professional development for science teachers are important components of later public engagement in science issues. However, pressures on public research institutions to commercialize and seek industry funding may have negative impacts in both encouraging scientists to inappropriately hype research and on diminishing public trust in the scientific enterprise. The latter may have a significant effect on public engagement processes, such as those proposed by Robert and Kardia.
    Subjects: public trust, science education, science communication, genomics, commercialization, media, public engagement, public opinion
    Date Created: 2014/11/14
  4. Is Belief Larger than Fact: Expectations, Optimism and Reality for Translational Stem Cell Research [Download]

    Title: Is Belief Larger than Fact: Expectations, Optimism and Reality for Translational Stem Cell Research
    Creator: Bubela, Tania
    Description: Background Stem cell (SC) therapies hold remarkable promise for many diseases, but there is a significant gulf between public expectations and the reality of progress toward clinical application. Public expectations are fueled by stakeholder arguments for research and public funding, coupled with intense media coverage in an ethically charged arena. We examine media representations in light of the expanding global landscape of SC clinical trials, asking what patients may realistically expect by way of timelines for the therapeutic and curative potential of regenerative medicine? Methods We built 2 international datasets: (1) 3,404 clinical trials (CT) containing 'stem cell*' from and the World Health Organization's International Clinical Trials Registry Search Portal; and (2) 13,249 newspaper articles on SC therapies using We compared word frequencies between the CT descriptions and full-text newspaper articles for the number containing terms for SC type and diseases/conditions. We also developed inclusion and exclusion criteria to identify novel SC CTs, mainly regenerative medicine applications. Results Newspaper articles focused on human embryonic SCs and neurological conditions with significant coverage as well of cardiovascular disease and diabetes. In contrast, CTs used primarily hematopoietic SCs, with an increase in CTs using mesenchymal SCs since 2007. The latter dominated our novel classification for CTs, most of which are in phases I and II. From the perspective of the public, expecting therapies for neurological conditions, there is limited activity in what may be considered novel applications of SC therapies. Conclusions Given the research, regulatory, and commercialization hurdles to the clinical translation of SC research, it seems likely that patients and political supporters will become disappointed and disillusioned. In this environment, proponents need to make a concerted effort to temper claims. Even though the field is highly promising, it lacks significant private investment and is largely reliant on public support, requiring a more honest acknowledgement of the expected therapeutic benefits and the timelines to achieving them.
    Subjects: commercialization, public expectations, newspaper coverage, stem cell therapy, clinical trials, ethics
    Date Created: 2014/10/24
  5. Trends in Evidence-Based Medicine for Herbal Remedies and Media Coverage [Download]

    Title: Trends in Evidence-Based Medicine for Herbal Remedies and Media Coverage
    Creator: Bubela, Tania
    Description: Complementary and Alternative Medicines [CAM] are interventions that are not widely taught in medical schools and are not part of the usual arsenal of treatments and medications recommended and prescribed by physicians and available in hospitals. CAM is big business ($30 billion in the US) with aggressive marketing. Their use in Europe and North America is increasing significantly. For example, a 1998 phone survey of 1539 adults found that 42.1% in the United States had used at least one CAM within a twelve month period and that use had increased since 1990; the most used treatments were herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing and homeopathy. In 2003, 20% of all Canadians visited a CAM practitioner, up from 15% in 1994/5.4 Users of CAM are more likely to have higher education levels and report lower health status. Common health problems treated with CAM are anxiety, back problems, chronic pain, and urinary tract problems. Use of CAM is dependent, not on dissatisfaction with conventional medicine as it is most commonly used in association with conventional medicine, but on philosophical orientations towards health and life, such as feminism, spirituality, and personal growth. Other studies suggest that CAM use allows patients and consumers greater control over their health and a level of self-empowerment. For these reasons, it has become increasingly important to understand the nature and impact of popular representations of CAM in this context. The combination of educated and self-empowered users of CAM suggests a high degree of reliance on information sources outside of mainstream medical practitioners. Not surprisingly, coverage in sources including newspapers, television, magazines, other media, and the internet has increased to meet the demand for information. A vast quantity of information of varying quality exists in the media and on the internet. There are concerns, however, that the media and internet provide too rosy a picture of CAM and downplay adverse reactions to CAM, which can be dangerous and potentially fatal. Such coverage augments the common misperception that CAM is natural and therefore, less harmful than conventional medical treatments. Indeed, Barnes et al. (1998) found that users of CAM were less likely to report adverse effects than users of over-the-counter medicines. These factors suggest that significant improvements need to be made to knowledge translation mechanisms for the public, healthcare professionals, and policy makers. The response of the medical and scientific community has been an increasing interest in CAM issues. There has been an increase in the number and proportion of clinical trials of CAM, which suggests a trend toward an evidence-based approach. The cumulative number of clinical trial articles indexed on MEDLINE, however, remains small (0.4%), and more high-quality original research is needed. Further, the proportion of those articles on CAM indexed as clinical trial-type studies is 2.1%, but rising. The lack of clinical trials may be due to a number of factors. There may be little incentive for commercial manufacturers of CAM products to run expensive clinical trials. However, the recent move to evidence-based health claims for CAM labeling and advertising in Canada may drive an increase in CAM clinical trials in that country. Some authors have suggested that there may be a publishing bias from mainstream medical journals during peer review or editorial process, in either rejecting CAM studies outright or favouring CAM studies with negative results. However, others suggest that most CAM studies may simply be of insufficient quality to be published in high impact factor medical journals. At least 50% of CAM articles were published in journals with no impact factor. Here we present preliminary data from a study that explores how knowledge is translated in the socio-economic-political context of CAM. This will have significant policy implications as Canada’s new natural health product (NHP) regulations were introduced on January 1, 2004 by the Natural Health Products Directorate (NHPD), Health Canada. The NHPD’s mandate is to “ensure that all Canadians have ready access to natural health products that are safe, effective and of high quality, while respecting freedom of choice and philosophical and cultural diversity.” Specifically, we are interested in whether clinical trials and media coverage of herbal remedies, one of the predominant forms of CAM, are of sufficient quality to provide the public with information required for rational, informed and low-risk decision making.
    Subjects: --
    Date Created: 201/11/12
  6. Wicked Issues for Canada at the Intersection of Intellectual Property and Public Health: Mechanisms for Policy Coherence [Download]

    Title: Wicked Issues for Canada at the Intersection of Intellectual Property and Public Health: Mechanisms for Policy Coherence
    Creator: Bubela, Tania
    Description: This article focuses on the intersection of health and one of the main drivers of the global economy, intellectual property (―IP‖). It is widely recognized that IP is an inter-sectoral issue with linkages to many other important public policy areas, such as health, agriculture, the environment, and education. In inter-sectoral issues such as IP, there is discussion on the need for governments around the world to achieve policy coherence not only across their various departments, but also between their domestic and international positions in important fora. To appreciate better the complexity of achieving policy coherence, this article first gives a multi-disciplinary view of policy coherence and then provides the Canadian context for the debate. Next, it describes three examples at the border of public health and intellectual property in Canada and internationally: (1) health innovation and access to medicines in developing countries; (2) traditional knowledge (medicinal); and (3) pandemic influenza preparedness. Finally, the article discuses international experiences with a variety of mechanisms for achieving policy coherence in IP and health, including the practice of advisory groups, multi-stakeholder dialogue, inter-departmental coordination mechanisms, broad delegations for international meetings, and white papers. From this review, a few observa-tions can be made. First, effective coordination requires two main factors: leadership and a permanent institution that can build trust. While inter-ministerial coordination is a widely used process for policy coherence, it is not always successful. Indeed, the lack of leadership in inter-ministerial coordination has strongly constrained policy coherence.
    Subjects: --
    Date Created: 2014/10/29
  7. Media Representations of Genetic Discoveries: Hype in the Headlines? [Download]

    Title: Media Representations of Genetic Discoveries: Hype in the Headlines?
    Creator: Caulfield, Timothy
    Description: Many commentators have expressed concern regarding the sensationalistic reporting of biomedical stories by the popular press. It has been suggested that inaccurate or exaggerated reporting can have an adverse impact on public understanding, creating unwarranted hope or fears, and the development of informed policies. Readers get their first or only impressions from headlines. Unfortunately, there are reasons to believe that headlines may be particularly inaccurate or “hyped.” Science and medical stories have to compete with other news stories and, as such, headlines must be constructed to catch the attention of both the potential reader and editors who make publishing decisions. As a result, even when a media report is circumspect, headlines may be sensationalized. “Headline sensationalism” has been associated with a variety of specific social concerns. For example, in the context of genetic discoveries, repeated exposure of the lay public to such headlines may lead to heightened genetic determinism. That is, the public will come to develop an inaccurate belief that there is a tight causal linkage between a gene and a given human trait or disease. It has also been noted that headlines can influence how the reader interprets the information presented within the body of the full article. Sensationalized headlines that bear little resemblance to the article may generate antipathy or disappointment among some readers, creating a degree of bad will with a portion of the potential audience that should give editors pause. They may also alienate sources, including those in the scientific community. While there is a growing body of research on the accuracy and nature of newspaper stories, there is little available data on the accuracy of headlines in the context of genetic research. This study builds on the results of a previous paper examining the accuracy of newspaper stories. We examine the degree and nature of the “hype” present in newspaper headlines associated with stories on genetic discoveries.
    Subjects: --
    Date Created: 2014/11/14
  8. Knowledge Management and the Contextualisation of Intellectual Property Rights in Innovation Systems [Download]

    Title: Knowledge Management and the Contextualisation of Intellectual Property Rights in Innovation Systems
    Creator: Castle, David
    Description: Intellectual property rights play a central role in biotechnology innovation. Patents, in particular, preoccupy research funding agencies, venture capitalists and governments, despite the fact that the value of patents is disputed and their impact continues to foster controversy. Perhaps more crucially to a fuller understanding of innovation, focus on instruments of intellectual property protection over-illuminates one stage of the flow of knowledge in innovation, leaving up- and down-stream phases in relative obscurity. Knowledge is an intangible asset, and is produced, tracked, managed, and accounted for in innovation systems. Yet what remains unclear, and this is problematic, are the respective roles of knowledge and intellectual property management, their relation, and the potential of a broadened perspective on knowledge flows in innovation. Participants at a Canada-U.K. workshop in Edinburgh examined the relationship between intellectual property rights and knowledge management by framing innovation in terms of knowledge management while attempting to bracket off the effects of patenting – the “Un-IP” approach. Eight critical issues arising at the heart of knowledge management and intellectual property rights were articulated, and general consensus emerged that, conceptually speaking, intellectual property rights needed to be subsumed under knowledge management as a particular class of intangible asset. At the same time, however, practical issues associated with patents continued to dominate the discussion, causing deviation away from the primary theme of the workshop, and highlighting the need to more fully explore eight emerging themes and contextualise the role of intellectual property rights.
    Subjects: --
    Date Created: 2014/10/29
  9. Stem Cell Research in the News: More than a Moral Status Debate? [Download]

    Title: Stem Cell Research in the News: More than a Moral Status Debate?
    Creator: Rachul, Christen
    Description: The interest and controversy generated by stem cell research over the past decade has raised hopes for scientific breakthroughs and debates regarding the limits of ethical research. In particular, the debate surrounding the moral status of the embryo has received considerable attention in scientific and political arenas. However, coverage in the public arena of the elite press is less clear. We explore and reflect on the coverage of this debate in the public realm of the elite press in the United States, the United Kingdom, and Canada, by examining newspaper articles from each jurisdiction collected over a period of two decades.
    Subjects: --
    Date Created: 2014/10/29
  10. Media portrayal of conflicts of interest in biomedical research [Download]

    Title: Media portrayal of conflicts of interest in biomedical research
    Creator: Koper, Megan
    Description: Due to the growing industry support of biomedical research, studies are increasingly scrutinized because of conflicts of interest of investigators and concerns about inaccurate reporting of study results by the popular media. The Association of American Medical Colleges has defined conflict of interest in science as “situations in which financial or other personal considerations may compromise, or have the appearance of compromising, an investigator’s professional judgment in conducting or reporting research.” For the purpose of our study, conflict of interest referred to both “research conflicts”, the primary example of which is industry funding of research, and “researcher conflicts” which occur when the researchers themselves have financial ties to industry, and in some cases could potentially benefit from a particular study outcome. Researchers who are employed by or invest in the manufacturer of a study compound or its competitors would fall into this category. This issue is important in a media context as the general public gets much of its information about science and technology from the popular media. For this reason, media reporting has the capacity to shape public perceptions of safety and efficacy of a particular treatment, thereby influencing patterns of use. Our study compared newspaper coverage of biomedical research to the reporting of the same studies in the medical literature. To do this, we first examined 109 clinical trials of both herbal remedies (n=58) and conventional pharmaceuticals (n=51), as reported in the medical literature. We then compared them to 598 newspaper articles that reported the results of these trials. We primarily assessed the disclosure of funding information and competing interests, as well as claims of efficacy, and reporting of risk and overall tone.
    Subjects: --
    Date Created: 2014/11/12