Preventive medicine
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Preventive medicine · Apr 2022
Prevalence and factors associated with self-reported exposure to secondhand cannabis smoke in the United States and Canada in 2019.
Little is known about exposure to secondhand cannabis smoke (SHCS) among residents of detached single-family homes and multiunit housing (MUH). Using data from the 2019 International Cannabis Policy Study, the prevalence of (a) self-reported exposure to SHCS at home (n = 33,024) and (b) self-reported SHCS incursions into MUH (defined as SHCS from another unit/the outdoors, n = 15,634) was estimated in (1) Canada; (2) US states where non-medical cannabis use was legal, and (3) US states where it remained illegal. Factors associated with exposures and incursions were assessed using weighted logistic regression. ⋯ One quarter (25.7%) of Canadian MUH residents, 26.6% from US legal states, and 20.1% from US illegal states reported at least monthly incursions. Sociodemographic factors associated with incursions suggested MUH residents reporting incursions lived in qualitatively different MUH than those not reporting incursions. Irrespective of the legality of non-medical cannabis use, smoke-free policies in MUH should protect residents from involuntary exposure to all types of secondhand smoke.
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Preventive medicine · Apr 2022
Suicidal behavior in Mexican adolescents: A test of a latent class model using two independent probability samples.
Suicidal behavior is a serious health issue that affects the adolescent population and that may be prevented through evidence-based approaches. There are many risk factors involved in suicidal behavior, but there are few studies encompassing the complex relationships between them. This study tested the similarity between two latent class models from two different epidemiological samples of middle-school students and evaluated if the multinomial regression model replicated the associations between the classes and the psychosocial variables. ⋯ The model with data from Querétaro was consistent with the previous LC model from Campeche. The four latent classes were nearly identical for both populations and can be defined as follows: 1) "No Problems," included 73% of the adolescents; 2) "Drug Use Only," comprised 7% of the adolescents; 3) "Suicidal Behavior, No Depression," captured 8% of the adolescents (25% reported binge drinking in the past month, 50% self-inflicted injuries, and 43% low-lethality suicide attempt); 4) "Depression and Suicidal Behavior," comprised 12% of the sample (66% met criteria for Major Depressive Episode, 28% reported binge drinking in the past month, and 11% had a high-lethality suicide attempt). The congruence between the models and the consistency with identified factors highlight the need for appropriate and effective prevention strategies to minimize risk factors and reinforce protective factors in the adolescent population.
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Preventive medicine · Apr 2022
Optimizing screening with faecal immunochemical test for both sexes - Cost-effectiveness analysis from Finland.
A faecal immunochemical test (FIT) screening pilot was introduced in Finland in 2019 with sex-specific screening strategies. This study aims to model cost-effectiveness of sex-specific strategies for the whole population, and to assess whether the current strategies are optimal. We developed separate MISCAN-Colon models, including different FIT performances, for the Finnish men and women using the first-year data of the FIT screening pilot. ⋯ Among strategies with the same target age and interval for both sexes, expected benefits from optimal screening were lower but still reasonable. Our results support a wider age range of screening in men, and a lower cut-off for a positive test in women when restrictions on colonoscopy capacity and costs are in place. National FIT screening program should start at younger age.
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Preventive medicine · Apr 2022
Expanding adverse child experiences to inequality and racial discrimination.
There is a well-established correlation between health and adverse childhood experiences (ACEs). Arguments have been made to expand ACE scales to include indicators of racism and structural inequalities. In this paper, we use nationally representative data to examine the relationships between latent groups of an expanded adversity scale and a broad range of child health outcomes. ⋯ Compared to low all group, high all had particularly higher odds of any special (OR = 2.29) or complex (OR = 2.53) healthcare need, frequent severe headaches (OR = 2.07), and depression (OR = 3.4) or anxiety (OR = 2.11). Our analysis noted separation of experiences based on additional items related to structural inequalities: food insecurity, poverty, and unkempt housing. However, augmenting existing ACE scales with these indicators may be unnecessary as children most at-risk for poor health were a very small group (1 in 28) that experienced multiple forms of violence and parental problems.
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Preventive medicine · Apr 2022
Trends in risk factors and management strategies used by people with type 2 diabetes in New South Wales, Australia.
Adopting healthy lifestyle behaviours is an important component of Type 2 diabetes (T2D) self-management, which can lower risks of further health complications. Monitoring lifestyle risk factors including overweight or obesity, healthy diet and physical activity behaviours, alcohol consumption, smoking and psychological distress remain important. This study examined prevalence trends in these factors and adoption of three diabetes lifestyle self-management strategies in adults (aged 40+) with T2D in New South Wales (NSW), Australia. ⋯ There were also declines in those reporting they manage their diabetes through following a special diet [73.6% to 55.9%] and exercising most days [33.5% to 22.2%]. This study highlights potential gaps in T2D secondary prevention and suggests more targeted diabetes education services are needed to address lifestyle risks. Increased understanding of why fewer people with T2D adopt these lifestyle management strategies is needed to inform policy and practice.