Preventive medicine
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Preventive medicine · Jan 2023
Evaluation of co-testing with cytology and human papillomavirus testing in cervical screening.
Cervical screening is increasingly switching to human papillomavirus (HPV) testing. In many settings, the switch has involved one or several co-tests (testing using both cytology and HPV) in the screening guidelines, to ensure safety. When Sweden switched to HPV testing in 2015 the guidelines included a co-test at age 41. ⋯ Among these, 325 women had a CIN2+ in histopathology, 290 were double positive, 13 women were cyt+/HPV-, and 11 women each were HPV+/cyt- and HPV-/Cyt-. In summary, the additional yield of CIN2+ with co-testing was 2 cases per 10,643 women as compared with 195/10,643 CIN2+ cases detected with HPV screening alone. However, for cervical samples taken outside the screening program (e.g. taken on a clinical indication) there was an increased yield (314 CIN2+ cases detected with co-testing as compared to 301 cases with HPV screening).
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Preventive medicine · Jan 2023
A qualitative framing analysis of how firearm manufacturers and related bodies communicate to the public on gun-related harms and solutions.
There is a growing understanding that the producers and sellers of harmful products directly and indirectly affect population health and policy, including through seeking to influence public understanding about the nature of harms and their solutions. However, the firearm industry and related organisations have not to date been the subject of this type of enquiry. This study sought to address this evidential gap through examining the ways in which the firearm industry and industry-associated organisations frame firearms, firearm-related harms and possible solutions to gun violence. ⋯ The firearm industry and firearm industry-funded organisations use framings about the safety and role of guns, evidence on associated harms and solutions that align with the industry's business interests, consistent with evidence on other harmful product manufacturers. This study identified framing strategies employed by the firearm industry and related organisations. These included attempts to undermine evidence, linking regulation to a dystopian future, minimising some of the most common harms, placing the responsibility for harms on individuals, and attempting to foster a heightened sense of risk to personal safety.
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Preventive medicine · Jan 2023
Modeling cigarette smoking disparities between people with and without serious psychological distress in the US, 1997-2100.
Cigarette smoking rates are significantly higher among people with serious psychological distress (SPD) compared to the general population. US simulation models that project future smoking disparities by SPD status could inform policy interventions, but have not been developed. We calibrated two compartmental models to the National Health Interview Survey 1997-2018 for populations with and without SPD, calculating smoking prevalence, mortality, and life-years lost by SPD status under different scenarios from 2023 to 2100. ⋯ Preventing smoking initiation could avert up to 18% of these deaths, while improving smoking cessation could avert up to 82%. Smoking-related disparities for people with SPD will persist unless a shift in tobacco control substantially improves cessation and prevents initiation in this subpopulation. Smoking disparities by SPD may widen in relative but narrow in absolute terms, so both perspectives should be evaluated.
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Preventive medicine · Jan 2023
Sense of control as a mediator of the association between social capital and health inequality in China.
Social capital was shown to be associated with health. However, less is known about the pathways of the association and whether the mediating effect of the pathways varies across different income groups. Using adults (≥18 years) data from the 2010 Chinese General Social Survey (N = 3265), we examined the mediating effect of sense of control between social capital and health and whether income groups moderated the mediating effect in China. ⋯ Moderated mediation analysis further showed that sense of control mediated the association between frequency of socializing and health in all income groups, with the mediating effect decreasing when income increased (β (95% CI) from Q1 to Q5: 0.026 (0.015, 0.040); 0.022 (0.012, 0.036); 0.018 (0.009, 0.030); 0.013 (0.005, 0.024); 0.008 (0.000, 0.018)). Moderated mediation analysis also showed the same patterns for the mediating effect of sense of control on the association between trust and health and reciprocity and health. Our study suggested that employing social capital to promote sense of control could not only be beneficial for people's health but also be helpful to narrow the health gap on the income gradient.
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Nationally, between 2011 and 2019, suicide was the second leading cause of injury death, and about half of all suicides were firearm related. An overlooked factor connecting firearms and suicide is lead exposure. Lead bullets and primers are used throughout the US and pose danger to adults and children. ⋯ Lead was a predictor of all suicide types. Our study appears to be the first to show the established firearm suicide relationships holds within municipalities in a single state. We provide evidence concerning the link between lead exposure and suicide, particularly from firearms, and provide a glimpse into the relationship between firearm prevalence and elevated blood lead levels.