Journal of community health
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Smokeless tobacco (ST) use among US high school males living in rural areas exceeds national levels. Subgroups at heightened risk of ST use have been identified, but less is known regarding ST decision-making within high-risk groups. The study objective was to describe rural adolescent males' perceived ST acceptability, health risks, and social implications and how those perceptions differ between ST users and never-users. ⋯ Other differences included perceived parental permissiveness and the expected social benefits of ST use, such as peer acceptance and conveying maturity. Within this population of rural male adolescents, ST users emphasized the social benefits of ST use, while acknowledging but discounting health risks. Differences and similarities in tobacco perceptions among adolescents living in similar environments may inform effective health communication.
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Despite the substantial increase in the number of adolescent smartphone users, few studies have investigated the behavioural effects of smartphone use on adolescent students as it relates to musculoskeletal discomfort. The purpose of this study was to explore the association between smartphone use and musculoskeletal discomfort in students at a Taiwanese junior college. We hypothesised that the duration of smartphone use would be associated with increased instances of musculoskeletal discomfort in these students. ⋯ The logistic regression analysis showed that the students who talked on the phone >3 h/day had a higher risk of upper back discomfort than did those who talked on the phone <1 h/day [odds ratio (OR) = 4.23, p < 0.05]. This study revealed that the relationship between smartphone use and musculoskeletal discomfort is related to the duration of smartphone ancillary function use. Moreover, hours spent talking on the phone was a predictor of upper back discomfort.
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E-cigarette use among youth in the United States (U. S.) continues to increase. In the rural Northeast Tennessee, where prevalence of tobacco use is higher than national and state averages, there is no literature on e-cigarette use to inform policies and programs. ⋯ Adjusting for covariates, current e-cigarette use was positively associated with cigarette smoking [Odds Ratio (OR) 27.32, 95% confidence interval (CI) 14.4-51.7] and smokeless tobacco use [OR 7.92, 95% CI 3.8-16.5]. E-cigarette use was more common among the high school students than cigarette and smokeless tobacco use, and a significant proportion of users either smoked cigarettes, used smokeless tobacco, or both. Thus, there is a critical need for preventive policies and programs to address dual and poly-use of these products.
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We describe changes in emergency department (ED) visits and the proportion of patients with hospitalizations through the ED classified as Ambulatory Care Sensitive Hospitalization (ACSH) for the uninsured before (2011-2013) and after (2014-2015) Affordable Care Act (ACA) health insurance expansion in Illinois. Hospital administrative data from 201 non-federal Illinois hospitals for patients age 18-64 were used to analyze ED visits and hospitalizations through the ED. ACSH was defined using Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators (PQIs). ⋯ ED visits for the uninsured declined dramatically after ACA implementation in Illinois but over 12% of ED visits are for the remaining uninsured. The proportion of visits resulting in ACSH remained stable. Providing universal insurance with care coordination focused on improved access to home and ambulatory care could be highly cost effective.