Preventive medicine
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Preventive medicine · Jul 2021
Development and validation of a risk prediction model for high-risk adenomas at the time of first screening colonoscopy among screening aged Canadians.
The aim of this study was to develop a risk prediction model for high risk adenomas (HRAs) detected at screening colonoscopy based on readily available participant information. The cohort consisted of 3035 participants aged 50 to 74 years with no history of cancer who underwent a primary screening colonoscopy at a centralized colon cancer screening centre between 2008 and 2016. A multivariable logistic regression model was created using CRC risk factors identified from prior research. ⋯ Our model has moderate predictive ability, with strengths in being able to rule out those with an absence of HRAs on screening colonoscopy. Maximizing screening efficiency through improved risk prediction can enhance resource allocation. Ultimately, this model has the potential to improve patient care by reducing unnecessary colonoscopies, limiting this invasive procedure to those most likely to have significant findings.
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Preventive medicine · Jul 2021
Comparative StudyCircumvention of COVID-19-related restrictions on tobacco sales by the e-cigarette industry in South Africa and comparative analyses of e-cigarette vs cigarette volume sales during 2018-2020.
As a public health measure against COVID-19, South Africa restricted the sale of "tobacco, e-cigarettes and related products" for 5 months, ending on August 17, 2020. We examined marketing activities related to novel tobacco products (e-cigarettes and heated tobacco products) during this restriction. Using web scraping, we accessed data for 2661 e-cigarette liquids marketed online by South African vendors in June 2020. ⋯ The restriction saw decreased sales of heated tobacco products; mean weekly heated tobacco product sales in the 6 weeks following the restriction (772,585 kits/week) were dramatically lower versus the 6 weeks preceding the restriction (2.26 million kits/week). Lifting the restriction saw a 131% spike in sales between the latter half of August 2020 (825,638 kits) and mid-September 2020 sales (1.90 million kits), even though total sales in September 2020 were half of what was observed in the preceding year (3.81 million units in September 2020, vs 6.33 million units, September 2019). The marketing of cannabidiol and other novel products by e-cigarette manufacturers and the tobacco industry may encourage youth use; close monitoring is required.
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Preventive medicine · Jul 2021
Understanding socioeconomic differences in incident metabolic syndrome among adults: What is the mediating role of health behaviours?
The incidence of metabolic syndrome (MetS) strongly varies by socioeconomic position (SEP), but little is known about the mediating role of health behaviours in this association. This study examines the associations between the SEP measures, education, income and occupational prestige, and incident MetS and whether the associations are mediated by health behaviours, including physical activity, smoking, alcohol intake and diet quality. ⋯ Individuals with more years of education or a higher occupational prestige had a lower risk to develop MetS. This was mainly because of non-smoking, less excessive alcohol intake and a higher diet quality. However, individuals with a higher SEP were more often physically inactive.
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Preventive medicine · Jul 2021
Smoking behavior in 18-20 year-olds after tobacco 21 policy implementation in California: A difference-in-differences analysis with other states.
In June 2016, California implemented a Tobacco 21 (T21) policy that increased the minimum sale age of tobacco products from 18 to 21. This study examined the association between California's T21 policy and smoking behavior (ever, current, daily, and nondaily) in 18-20 year-olds using data from the 2012-2019 Behavioral Risk Factor Surveillance System (n = 15,863). The annual change in odds of smoking among 18-20 year-olds post-policy (July 2016-December 2019) was compared with the pre-policy period (January 2012 - June 2016) 1) within California and 2) compared with states without a T21 policy. ⋯ Results for current smoking were similar. For daily smoking, there was an 8% annual decrease before the policy and a 26% annual decrease after the policy among 18-20 year-olds in California; D-I-D estimates were 0.80 (95% CI: 0.57, 1.14) using referent states as the comparison and 0.62 (95% CI: 0.41, 0.95) using 21-23 year-olds in California as the comparison. There was an association between California's T21 policy and a decrease in daily smoking among 18-20 year-olds, compared with 21-23 year-olds, more than three years post-implementation.
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Preventive medicine · Jul 2021
Adverse childhood experiences in a low-income black cohort: The importance of context.
Adverse Childhood Experiences (ACEs) have been definitively linked with cross-domain life course well-being. While scales measuring the ten "Conventional" ACEs (ACEs-C; intrafamilial experiences of abuse, neglect, and household dysfunction) are parsimonious, use of such scales alone may fail to capture crucial information about adversity, particularly in youth growing up in underresourced areas. Patterns and disparities in Conventional and Expanded ACEs (ACEs-E; experiences more common in impoverished and densely populated areas) were examined in the large, primarily Black Chicago Longitudinal Study cohort. ⋯ Nearly 1/5 of participants reported only ACEs-E, which are often not measured when assessing ACEs. Findings underscore enduring effects of early childhood risk factors on ACE exposure, as well as contributions of community characteristics to childhood adversity. Given strong associations between ACEs, environment, and well-being, enhancing inclusivity in our understanding of childhood adversity is a public health priority.