Preventive medicine
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Preventive medicine · Jan 2019
Prevalence of children walking to school and related barriers-United States, 2017.
Children and adolescents can engage in an active lifestyle by walking to school; however, several barriers may limit this behavior. This study estimates the prevalence of walking to school and related barriers as reported by U. S. parents. ⋯ Prevalence of walking to school is low in the U. S., and living too far away and traffic-related danger are common barriers reported by parents. Implementing Safe Routes to School programs and other initiatives that utilize strategies to overcome locally-relevant barriers could help increase the prevalence of children walking to school.
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Preventive medicine · Jan 2019
Multicenter StudyDoes outpatient cardiac rehabilitation help patients with acute myocardial infarction quit smoking?
Outpatient cardiac rehabilitation (OCR) reinforces patients' efforts to quit smoking, but the association between participation in OCR and long-term smoking status after acute myocardial infarction (AMI) is unknown. We studied hospitalized smokers with confirmed AMI from two multicenter prospective registries (PREMIER, from January 1, 2003, to June 28, 2004, and TRIUMPH, from April 11, 2005, to December 31, 2008) to describe the association of OCR participation with smoking cessation. Eligible patients smoked at least 1 cigarette per day on average in the 30 days prior to enrollment and completed 12-month follow-up (N = 1307). ⋯ At 12-month follow-up, 30-day PPA was 57% in OCR participants, compared to 41% in matched OCR non-participants. Participation in OCR was a significant predictor of 30-day PPA at 12 months (adjusted RR 1.38, 95% CI 1.20-1.57). In conclusion, smokers who participated in OCR were significantly more likely to abstain from smoking 12 months after AMI hospitalization.
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Preventive medicine · Jan 2019
Reduction in purchases of energy-dense nutrient-poor foods in Mexico associated with the introduction of a tax in 2014.
In 2014, an 8% tax on energy-dense nutrient-poor foods was implemented in Mexico with the aim of reducing its consumption. This paper estimated changes in household purchases of taxed food. We used the latest five waves of the nationally representative Mexican Income and Expenditure Survey (2008, 2010, 2012, 2014 and 2016). ⋯ The largest relative reductions were in urban areas (-6.9%), among households with children (-7.0%), households where the head had an intermediate educational level (-9.9%) and the southern region (-14.8%). We did not find a significant reduction in rural areas. While there is a large heterogeneity, the fiscal instrument has been effective in reducing taxed food purchases and has generated substantial revenue that could be used to finance policies for the prevention and treatment of obesity.
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Preventive medicine · Jan 2019
Characteristics of the environment and physical activity in midlife: Findings from UK Biobank.
Characteristics of the environment influence health and may promote physical activity. We explored the associations between neighborhood environmental characteristics grouped within five facets (spaces for physical activity, walkability, disturbance, natural environment, and the sociodemographic environment) and objective ('recorded') and self-reported ('reported') physical activity in adults from UK Biobank. Recorded activity was assessed using wrist-worn accelerometers (2013-2015, n = 65,967) and time spent in moderate-to-vigorous physical activity (MVPA), walking, and walking for pleasure was self-reported (2006-2010, n = 337,822). ⋯ We found participants living in areas with higher concentrations of air pollution recorded and reported lower levels of physical activity and those in rural areas and more walkable areas had higher levels of both recorded and reported activity. Some associations varied according to the specificity of the outcome, for example, those living in the most deprived areas were less likely to record higher levels of MVPA (upper tertile: RRR: 0.80 95% CI: 0.74, 0.86) but were more likely to report higher levels of walking (upper tertile: RRR: 1.09, 95% CI: 1.06, 1.13). Environmental characteristics have the potential to contribute to different physical activities but interventions which focus on a single environmental attribute or physical activity outcome may not have the greatest benefits.
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Preventive medicine · Jan 2019
Review Meta AnalysisWorthy of further consideration: An updated meta-analysis to address the feasibility, acceptability, safety and efficacy of thermal ablation in the treatment of cervical cancer precursor lesions.
Treatment of preinvasive lesions is critical to the success of secondary prevention of cervical cancer. In many settings, however, excision or ablation of preinvasive lesions can prove challenging. Thermal ablation (TA) is a form of treatment for cervical precancer that may present fewer logistical challenges in resource limited settings. ⋯ The overall response rate for TA treatment of biopsy proven CIN2+ was 93.8%. Consistent with the wide variety of settings and patient populations, there was significant heterogeneity between studies. TA appears to be an effective treatment for CIN2+ across a variety of settings, including in LMICs.