Preventive medicine
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Preventive medicine · Apr 2019
Comparative StudyPrescription opioid misuse among middle-aged and older adults in the United States, 2015-2016.
Adults ≥50 years of age have high rates of prescription opioid use. The purpose of this study is to estimate the prevalence and correlates of prescription opioid misuse among middle-aged and older adults in the United States who use prescription opioids. Data from adults age ≥ 50 from the two most recent cohorts (2015 and 2016) of the National Survey of Drug Use and Health were examined (N = 17,608). ⋯ Past-year misuse was lower among adults with 2 or more chronic diseases. Past-year prescription misuse of sedatives (AOR 4.08 [95% CI 2.05-8.12]), stimulants (AOR 3.88 [95% CI 2.00-7.53]), and tranquilizers (AOR 10.02 [95% CI 6.48-15.50]) were all associated with past-year opioid misuse. Characteristics of opioid misusers determined in this study-particularly misuse of other substances-may help determine middle-aged and older adults at risk for prescription opioid misuse.
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Preventive medicine · Apr 2019
Associations between aerobic and muscle-strengthening exercise with depressive symptom severity among 17,839 U.S. adults.
For the prevention and management of chronic diseases, global physical activity guidelines state that an adult should engage in regular moderate-to-vigorous aerobic physical activity (MVPA; e.g. walking, cycling, running) and muscle-strengthening exercise (MSE; e.g. strength/resistance training). However, the associations between combined MVPA-MSE with chronic health conditions are rarely examined in large population studies. In particular, little is known associations between combined MVPA-MSE with depressive disorders, one of the leading causes of disability worldwide. ⋯ When compared with those meeting neither guideline, for mild, moderate and moderately severe/severe depressive symptoms, the PRs were lowest among meeting both guidelines (range: 0.26-0.54), followed by MVPA only (range: 0.36-0.62) and MSE only (range: 0.49-0.84). Among a large sample of U. S. adults, compared to other guideline adherence categories, meeting both MVPA-MSE guidelines was associated with a lowest likelihood of reporting depressive symptoms.
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Preventive medicine · Apr 2019
Randomized Controlled Trial Multicenter StudyImproving child weight management uptake through enhanced National Child Measurement Programme parental feedback letters: A randomised controlled trial.
This single-blind, pragmatic, cluster randomised controlled trial aims to investigate uptake of children's weight management services in response to enhanced National Child Measurement Programme (NCMP) letters providing weight status feedback to parents in three English counties in 2015. Parents of 2642 overweight or very overweight (obese) children aged 10-11 years received an intervention or control letter informing them of their child's weight status. Intervention letters included (i) a visual tool to help weight status recognition, (ii) a social norms statement, and for very overweight children, (iii) a prepopulated booking form for weight management services. ⋯ A similar picture emerged for contact with services (4.80% Intervention vs. 2.41% Control; OR = 2.10, p = .003; AOR = 2.46, p < .001) and attendance at services, although group differences in the latter measure were not significant after corrections for multiple comparisons (1.89% Intervention vs. 1.02% Control; AOR = 2.11, p = .047). No effects were found on self-report variables. Theoretically informed weight status feedback letters appear to be an effective strategy to improve enrolment in paediatric weight management services.
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Preventive medicine · Apr 2019
ReviewMeasles outbreaks in Italy: A paradigm of the re-emergence of vaccine-preventable diseases in developed countries.
Over the last decade, outbreaks of vaccine-preventable diseases have been reported in developed countries around the world. In particular, measles outbreaks have been ongoing in the European Union since 2017, with the majority of cases concentrated in Romania and Italy. Measles has been identified as a powerful indicator of the status of vaccination programs in a region, as outbreaks have been reported to quickly emerge as a result of underlying problems in the immunisation routine. ⋯ Data from government agencies including the Italian National Institute of Statistics (ISTAT) and the Italian National Institute of Health (ISS) are analysed to describe incidence and mortality trends from 1887 to the present day, including regional variations and the impact of measles vaccination coverage. The topic of compulsory vaccination is currently the object of heated debate in the Italian social and political panorama; this paper discusses the current state of the vaccination controversy in the Italian political discourse and its potential impact on immunisation policies and measles vaccine coverage amongst the population. A burgeoning body of evidence indicates that every effort should be made to bolster the existing legislation on mandatory vaccination through widespread health education campaigns aimed at improving scientific literacy amongst the Italian population with regards to the topic of immunisation.
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Preventive medicine · Apr 2019
Comparative StudyIs susceptibility to E-cigarettes among youth associated with tobacco and other substance use behaviors one year later? Results from the PATH study.
E-cigarettes are the most commonly used tobacco product among youth. In addition to harm potential, e-cigarette use is associated with initiating cigarette smoking. Limited research exists whether susceptibility to e-cigarette use is a risk factor for future tobacco and other substance use initiation. ⋯ Additionally, cigarette susceptibility, but not e-cigarette susceptibility, was associated with cigarette initiation (aOR: 3.36, 95% CI: 1.95-5.82) and past 30-day use (aOR: 2.83, 95% CI: 1.34-5.97). Prevention policies, as well as future research, could target youth susceptible to e-cigarettes to reduce the current trends on the use of these alternative tobacco products. Such efforts may also reduce the use of cigarettes and other substances.