Machine Learning for Drug Overdose Surveillance

ABSTRACT

We describe two recently proposed machine learning approaches for discovering emerging trends in fatal accidental drug overdoses. The Gaussian Process Subset Scan (Herlands, McFowland, Wilson, & Neill, 2017 Neill, D. B. (2017). Multidimensional tensor scan for drug overdose surveillance. Journal of Public Health Informatics, 9(1), e20. doi:10.5210/ojphi.v9i1.7598[Crossref] , [Google Scholar]) enables early detection of emerging patterns in spatio-temporal data, accounting for both the complex, correlated nature of the data and the fact that detecting subtle patterns requires integration of information across multiple spatial areas and multiple time steps. We apply this approach to 17 years of county-aggregated data for monthly opioid overdose deaths in the New York City metropolitan area, showing clear advantages in the utility of discovered patterns as compared to typical anomaly detection approaches. To detect and characterize emerging overdose patterns that differentially affect a subpopulation of the data, including geographic, demographic, and behavioral patterns (e.g., which combinations of drugs are involved), we apply the Multidimensional Tensor Scan (Neill, 2017 Neill, D. B. (2017). Multidimensional tensor scan for drug overdose surveillance. Journal of Public Health Informatics, 9(1), e20. doi:10.5210/ojphi.v9i1.7598[Crossref] , [Google Scholar]) to 8 years of case-level overdose data from Allegheny County, Pennsylvania. We discover previously unidentified overdose patterns which reveal unusual demographic clusters, show impacts of drug legislation, and demonstrate potential for early detection and targeted intervention. These approaches to early detection of overdose patterns can inform prevention and response efforts, as well as understanding the effects of policy changes.     

Tracking of sport and exercise types from midlife to old age: a 20-year cohort study of British men

Background

Previous physical activity (PA) tracking studies have examined the stability of overall PA and/or PA types, but few have investigated how specific types of sport/exercise track over the life course. The aim of this study was to determine how specific sports/exercises in midlife track and predict future sport/exercise and PA in men transitioning to old age.

Methods

Seven thousand seven hundred thirty-five men (aged 40–59?years) recruited in 1978–80 were followed up after 12, 16 and 20?years. At each wave men self-reported participation in sport/exercise. Frequent sport/exercise participants (>?1/month) reported the types of sport/exercise they engaged in. Men also reported total PA, health status, lifestyle behaviours and socio-demographic characteristics. Stability of each sport/exercise was assessed using kappa statistics and intraclass correlation coefficients. Logistic regression estimated the odds of participating in sport/exercise and being active at 20-year follow up according to specific types of sport/exercise in midlife.

Results

Three thousand three hundred eighty-four men with complete data at all waves were included in analyses. Tracking of specific sports/exercises ranged from fair to substantial, with golf being the most common and most stable. Bowls was the most frequently adopted. Odds of participating in sport/exercise and being active in old age varied according to sport/exercise types in midlife. Golf and bowls in midlife were the strongest predictors of sport/exercise participation in old age. Golf, cricket and running/jogging in midlife were among the strongest predictors of being active in old age. Compared to participating in just one sport/exercise in midlife, sampling multiple sports/exercises was more strongly associated with sport/exercise participation and being active in old age.

Conclusion

The stability of sport/exercise participation from midlife to old age varies by type. Specific sports/exercises in midlife may be more likely to predict future PA than others. However, participating in a range of sports/exercises may be optimal for preserving PA into old age.

     

A Cost–Benefit Analysis of a Family Systems Intervention for Managing Pediatric Chronic Illness

Despite recent increases of psychosocial programs for pediatric chronic illness, few studies have explored their economic benefits. This study investigated the costs–benefits of a family systems‐based, psychosocial intervention for pediatric chronic illness (MEND: Mastering Each New Direction). A quasi‐prospective study compared the 12‐month pre–post direct and indirect costs of 20 families. The total cost for program was estimated to $5,320. Families incurred $15,249 less in direct and $15,627 less in indirect costs after MEND. On average, medical expenses reduced by 86% in direct and indirect costs, for a cost–benefit ratio of 0.17. Therefore, for every dollar spent on the program, families and their third payers saved approximately $5.74. Implications for healthcare policy and reimbursements are discussed.     

Occupational Engagement and Academic Major Satisfaction: Vocational Identity's Mediating Role

This study examined vocational identity as a mediator of the relationship between occupational engagement (i.e., participation in a breadth of activities and interactions) and academic major satisfaction. Furthermore, the authors evaluated whether satisfaction with academic major related to academic success (i.e., grade point average). The mediational model was tested in a sample of undergraduate students (N = 215). Results indicated that occupational engagement significantly predicted academic major satisfaction and that vocational identity fully mediated that relationship. These findings support occupational engagement as an important contributor to adaptive career decision making and encourage research on occupational engagement as an intervention point for career counselors.     

100 key research questions for the post‐2015 development agenda

The Sustainable Development Goals (SDGs) herald a new phase for international development. This article presents the results of a consultative exercise to collaboratively identify 100 research questions of critical importance for the post‐2015 international development agenda. The final shortlist is grouped into nine thematic areas and was selected by 21 representatives of international and non‐governmental organisations and consultancies, and 14 academics with diverse disciplinary expertise from an initial pool of 704 questions submitted by 110 organisations based in 34 countries. The shortlist includes questions addressing long‐standing problems, new challenges and broader issues related to development policies, practices and institutions. Collectively, these questions are relevant for future development‐related research priorities of governmental and non‐governmental organisations worldwide and could act as focal points for transdisciplinary research collaborations.     

Mangrove forests store high densities of carbon across the tropical urban landscape of Singapore

Tropical forested ecosystems provide multiple ecosystem services to rural and urban landscapes, with carbon storage gaining particular attention. Deforestation due to rural-urban transitions may lead to a reduction in carbon storage ability. Coastal mangrove forests are particularly at risk from deforestation due to their location in the rapidly urbanizing coastal zone, and the city state of Singapore is an extreme example, losing as much as 90 % of its original mangrove cover due to land reclamation and reservoir construction. Knowledge of mangrove ecosystem services may allow better conservation, restoration and incorporation of remaining mangrove patches into the urban landscape. Focusing on the regulating ecosystem service of carbon storage, mangrove carbon stocks have been estimated for Singapore using a combination of field and remote sensing techniques. Biomass carbon showed substantial spatial variation, with old, contiguous mangrove patches containing a higher density of biomass carbon than fragmented, river-fringing or restored mangroves. In total, national biomass carbon equated to 116,117.1 megagrams of carbon (Mg C), and a coarse estimate of the total carbon stock (including soil carbon) suggests that Singapore’s mangroves may store 450,571.7 Mg C. While lower than other regional estimates focused on natural, oceanic mangroves, this is a significant carbon stock for a disturbed, urban mangrove system, and may be equivalent to the average annual carbon emissions of 621,000 residents. This analysis, alongside a review of other urban forest studies, highlights the importance of forested ecosystems such as mangroves in providing a carbon storage ecosystem service to urban areas.     

中国经济转型期城镇少数民族教育收益率的实证研究

文章分别使用了OLS方法和分位回归技术,考察了1995—2007年间中国城镇少数民族教育收益率的总体水平及其长期变化趋势,并将之与汉族进行了比较,发现在经济转型期,中国城镇居民教育收益率总体上呈逐年上升趋势,少数民族与汉族之间的教育收益率没有显著差异。政策的力量与市场的力量有机结合、相互叠加,是转型时期中国城镇少数民族的地位并没有发生逆转的重要原因。与汉族相同,少数民族的教育收益率随着收入分位点提高而逐渐减小,即收入水平越高,教育收益率越低。     

Determining Differences in Expert Judgment: Implications for Knowledge Acquisition and Validation*

In knowledge acquisition, it is often desirable to aggregate the judgments of multiple experts into a single system. In some cases this takes the form of averaging the judgments of those experts. In these situations it is desirable to determine if the experts have different views of the world before their individual judgments are aggregated. In validation, multiple experts often are employed to compare the performance of expert systems and other human actors. Often those judgments are then averaged to establish performance quality of the expert system. An important part of the comparison process should be determining if the experts have a similar view of the world. If the experts do not have similar views, their evaluations of performance may differ, resulting in a meaningless average performance measure. Alternatively, if all the validating experts do have similar views of the world then the validation process may result in paradigm myopia.     

The Positive Effects of Easy Goals on Decision Quality and Risk Propensity in an MCPLP Task

In this study the potential performance benefits of easy goals were examined within the multiple cue probability learning paradigm (MCPLP). Specifically, the effects of varying levels of goal difficulty on performance and risk propensity (used to define a form of commitment) were investigated. With few exceptions, previous studies demonstrated support for difficult goals. In this study, contrary to the majority of past evidence, as goals became easier decision quality significantly improved. Moreover, risk propensity increased with easier goals and, as suggested by a post-hoc analysis, had more direct impact on decision makers’ behaviors than goal levels. Goal-related behavior in complex MCPLP tasks appears to significantly differ from the majority of goal evidence in other types of research due to the tendency for subjects to view complex task properties in the same context as goal levels.