Preventive medicine
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Preventive medicine · Oct 2020
ReviewImpact of school-based educational interventions in middle adolescent populations (15201317 yrs) on human papillomavirus (HPV) vaccination uptake and perceptions/knowledge of HPV and its associated cancers: A systematic review.
The American Academy of Paediatrics (AAP) divides adolescence into early (12-14 years), middle (15-17 years), and late (18-21 years) stages. School-based HPV educational interventions are largely directed at parents of early adolescents at the time of vaccination. As the average age of first sexual intercourse in high income countries is 15-17 years old, a second educational intervention for middle adolescents could have a strong impact on HPV prevention, providing an opportunity for self-consenting to HPV vaccination in many countries. ⋯ Stakeholder engagement was absent in most intervention designs and many were not grounded in evidenced theory. Content was largely focused on female cervical cancer, rarely discussing oropharyngeal cancer, the most pre-dominant HPV-associated cancer in men. An optimal mixed gender intervention remains to be established for middle adolescents.
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Preventive medicine · Oct 2020
Pre-injury health status and excess mortality in persons with traumatic brain injury: A decade-long historical cohort study.
An increasing number of patients are able to survive traumatic brain injuries (TBIs) with advanced resuscitation. However, the role of their pre-injury health status in mortality in the following years is not known. Here, we followed 77,088 consecutive patients (59% male) who survived the TBI event in Ontario, Canada for more than a decade, and examined the relationships between their pre-injury health status and mortality rates in excess to the expected mortality calculated using sex- and age-specific life tables. ⋯ Additional analyses in the validation dataset confirmed that these findings were unlikely a result of TBI misclassification or unmeasured confounding. Thus, detection and subsequent management of pre-injury health status should be an integral component of any strategy to reduce excess mortality in TBI patients. The complexity of pre-injury comorbidity calls for integration of multidisciplinary health services to meet TBI patients' needs and prevent adverse outcomes.
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Preventive medicine · Oct 2020
The Healthy Aging Index analyzed over 15 years in the general population: The Doetinchem Cohort Study.
The Healthy Aging Index (HAI), an index of physiological aging, has been demonstrated to predicts mortality, morbidity and disability. We studied the longitudinal development of the HAI to identify aging trajectories and evaluated the role of baseline sociodemographic characteristics and lifestyle factors of the trajectories. Four measurements with intervals of 5 years were included from the Doetinchem Cohort Study. ⋯ This study emphasizes that 'physiological aging' is not only an issue of older ages. Between 30 and 70 years of age, 'early' aging men and women had approximately five healthy years less compared to 'gradual' aging men. Lifestyle factors (e.g. nutrition and physical activity) seem to play an important role in optimal aging.
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Preventive medicine · Oct 2020
Home smoking and vaping policies among US adults: results from the Population Assessment of Tobacco and Health (PATH) study, wave 3.
We examined the prevalence of home smoking and vaping restrictions among US adults, and compared home policy differences for smoking and vaping among vapers, smokers, and dual users. Secondary data from the Population Assessment of Tobacco and Health (PATH) Study Wave 3 (2015-2016) with 28,148 adults were analyzed using weighted multivariable logistic regression models that account for complex sampling design to compare differences in home policies among non-users, vapers only, smokers only, and dual users. Compared to never-users, current vapers who were ex-smokers and dual users were more likely to allow home vaping (aOR = 11.06, 95% CI: 8.04-15.21; aOR = 6.44, 95% CI: 5.01-8.28) and smoking (aOR = 1.62, 95% CI: 1.19-2.22; aOR = 3.58, 95% CI: 2.88-4.45). ⋯ Vapers reported much lower rates of vape-free home policies relative to both their smoke-free home policies and to vape-free home policies among smokers. Vapers may be using e-cigarettes in hopes of harm reduction, but interpreting "harm reduction" as safe, thus exposing non-users in their homes to second- and thirdhand aerosols. This underscores the need to healthcare providers to extend intervention with vapers to include implementing vape-free home policies.
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Preventive medicine · Oct 2020
ReviewUniversal masking during COVID-19 pandemic: Can textile engineering help public health? Narrative review of the evidence.
The Coronavirus Disease-2019 (COVID-19) pandemic caused by the virus SARS-CoV-2 is spreading very quickly around the world. In less than 7 months since it became known to the international community, the virus has infected 18 million in more than 180 countries and killing more than 700,000 people. Person-to-person transmission through infected respiratory droplets from patients with symptoms and asymptomatic carriers is the main mode of spread in the community. ⋯ To avoid personal protective equipment (PPE) shortage crisis for medical staff and other frontline workers, health authorities are recommending the use cloth masks. Although in theory, cloth masks can be helpful to limit the spread of the COVID-19, serious consideration should be given to the choice of textile, the number of layers of cloth used, pre-treatment of the material with water repellent material and other compounds that can enhance the filtration efficiency of the masks without compromising their breathability. This review uses concepts of textile engineering and the theoretical principles of filtration to make suggestions and recommendations to improve the quality and safety of cloth masks for the general public.