Preventive medicine
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Preventive medicine · Jul 2020
Positive emotions and favorable cardiovascular health: A 20-year longitudinal study.
No studies have examined whether positive emotions lead to favorable cardiovascular health (CVH) early in the lifespan, before cardiovascular disease is diagnosed. Moreover, the direction of the association has not been thoroughly investigated. Among younger adults, we investigated whether baseline positive emotions were associated with better CVH over 20 years. ⋯ Positive emotions in early to middle adulthood were associated with better CVH across several decades. Baseline CVH was also associated with greater positive emotions during follow-up. Future research may be able to disentangle these relationships by assessing positive emotions and CVH earlier in life.
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Preventive medicine · Jul 2020
The differential impact of nicotine replacement therapy sampling on cessation outcomes across established tobacco disparities groups.
Cigarette smoking is increasingly concentrated among marginalized populations with limited access to evidence-based cessation treatment. This includes racial/ethnic minorities, lower income individuals, those with lower educational attainment, and residents of rural areas. To reach Healthy People 2020 objectives, successful cessation interventions must narrow these disparities. ⋯ Results suggest that NRT sampling may be more effective among some of the most disadvantaged groups of smokers, including smokers with lower income and education, as well those who live in more rural areas. The effects of NRT sampling did not differ by race. In sum, NRT sampling is a low-cost, low-burden intervention that could be disseminated broadly to reach large numbers of smokers and potentially narrow cessation disparities.
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Preventive medicine · Jul 2020
Randomized Controlled TrialImpact of sugar taxes and front-of-package nutrition labels on purchases of protein, calcium and fibre.
Taxes and front-of-package (FOP) labels can be effective interventions for reducing consumption of sugar, saturated fat, and sodium; however, few studies have examined their impact on intake of 'positive' nutrients. The current study explored the impact of sugar taxes and FOP labels on the protein, calcium and fibre density of snack food purchases. A total of 3584 Canadians aged 13 years and older participated in an experimental marketplace using a 3 × 8 between-within group experiment. ⋯ The results indicate that participants purchased snack foods with higher fibre density when either sugar tax was applied (+0.1 g/100 kcal) compared to no tax, and when they were assigned to see the multiple traffic light (+0.4 g/100 kcal) or health star rating (+0.3 g/100 kcal) FOP labels, compared to no FOP label. There were no significant differences in the protein or calcium density of snack foods purchased across the tax or FOP labelling conditions. Overall, the findings suggest that as consumers respond to tax or labelling policies by moving away from sugars, sodium, and saturated fat, there may be no downside-or even an increase-in 'positive' nutrient density.
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Preventive medicine · Jul 2020
Opioid prescriptions in emergency departments: Findings from the 2016 National Hospital Ambulatory Medical Care Survey.
In the past decade, there has been a rising trend in the emergency department (ED) visits in the US and these visits carry a significant burden of prescription opioids. This study utilized the latest available data from the 2016 National Hospital Ambulatory Medical Care Survey (NHAMCS) and examined the factors associated with opioid prescriptions in the ED. The outcome variable was receipt of opioid prescription, and the primary variable of interest was the type of visit (dental/non-dental). ⋯ Opioid prescriptions among 45-64 years old were 7.1 times (95% CI = 5.5-9.1] more likely compared to those among under 18 age-group. Opioid prescriptions in ED differed significantly by the type of visit and pain level. Given the higher likelihood of opioid prescriptions among dental visits, it is imperative to develop better prescription guidelines for dental visits in ED.
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Preventive medicine · Jul 2020
Identifying patterns and predictors of lifestyle modification in electronic health record documentation using statistical and machine learning methods.
Just under half of the 85.7 million US adults with hypertension have uncontrolled blood pressure using a hypertension threshold of systolic pressure ≥ 140 or diastolic pressure ≥ 90. Uncontrolled hypertension increases risks of death, stroke, heart failure, and myocardial infarction. Guidelines on hypertension management include lifestyle modification such as diet and exercise. ⋯ Logistic regression was the best machine learning method for classifying lifestyle modification documentation at ≤3 months with an AUROC of 0.685. Analyzing narrative and coded data from electronic health records can improve understanding of timing of lifestyle modification and patient, clinic and provider characteristics that are correlated with or predictive of documentation of lifestyle modification for hypertension. This information can inform improvement efforts in hypertension care processes, treatment implementation, and ultimately hypertension control.