Preventive medicine
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Preventive medicine · Feb 2021
ReviewUniversal school-based mental health programmes in low- and middle-income countries: A systematic review and narrative synthesis.
Depression and anxiety pose a significant burden during adolescence, which may have consequences for adulthood and future generations. The mental health needs of children and adolescents in low- and middle-income countries are not adequately addressed due to a lack of availability and access to services, and limited intervention research in these contexts. Universal school-based interventions provide a unique and potentially scalable opportunity to prevent and address mental health concerns amongst children and adolescents in low- and middle-income countries. ⋯ Of the 12,478 articles identified, 12 studies met our inclusion criteria and were included in this review. The included studies report on a variety of interventions differing in approach, format and content. Given the small number of studies and concerns with study quality, we are unable to conclude that universal school-based interventions may reduce symptoms of anxiety and depression in children in low- and middle-income countries.
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Preventive medicine · Feb 2021
ReviewCognitions and behaviours of general practitioners in France regarding HPV vaccination: A theory-based systematic review.
Human papillomavirus (HPV) vaccination is safe and efficacious to prevent persistent HPV infection, precancerous anogenital lesions and cervical cancer. However, in countries where vaccination programmes are implemented outside of schools, such as France, reaching high HPV vaccination coverage of the target population is challenging. Many studies have been performed in France to assess cognitions of general practitioners (GPs) regarding HPV vaccination. ⋯ GPs' injunctive norms, i.e. trust in institutional information, were shown to be associated positively with GPs' willingness to recommend HPV vaccination. Parents' fears, girls' age, and potential connection with sexuality do not seem to affect GPs' recommendations. These results will inform the development of a professional educational intervention targeting GPs in France.
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Preventive medicine · Feb 2021
The prospective association between illicit drug use and nonprescription opioid use among vulnerable adolescents.
In recent years, more than half of all drug overdose deaths in United States involved an opioid. To address this epidemic, antecedents to opioid misuse must be identified and empirically validated. The objective of the current investigation was to examine whether illicit drug use was prospectively associated with nonprescription opioid use among adolescents from a vulnerable population with a greater prevalence of substance abuse. ⋯ Multilevel, covariate-adjusted logistic regression models indicated that the odds of experimentation with nonprescription opioids was greater among adolescents who had used illicit drugs or illicit drugs excluding marijuana. Nonmedical marijuana use alone was a statistically significant predictor in unadjusted but not covariate-adjusted models. While prior studies have examined the progression from nicotine, alcohol, and marijuana use to nonprescription opioid use, the present findings emphasize the importance of illicit drug use as a detectable and empirically supported risk factor for future opioid misuse.
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Preventive medicine · Feb 2021
The bidirectional association between sleep and physical activity: A 6.9 years longitudinal analysis of 38,601 UK Biobank participants.
Although physical activity and sleep may influence each other, little is known about the bidirectional association of these two behaviors. The present analyses included 38,601 UK Biobank participants (51% female, 55.7 ± 7.6 years old, 6.9 ± 2.2 years of follow-up). Physical activity was categorized by the weekly metabolic equivalent of task minutes (highly active: ≥ 1200; active: 600 to <1200; inactive: < 600), and sleep patterns were determined using a composite score of healthy sleep characteristics: morning chronotype, adequate sleep duration (7-8 h/d), never or rare insomnia, never or rare snoring, and infrequent daytime sleepiness. ⋯ Compared to individuals highly active at both time points, being physically inactive at baseline and reducing physical activity over time were both associated with higher odds for poor sleep at follow-up. In conclusion, sleep improvements over time benefitted physical activity at follow-up, while reduced physical activity had a detrimental effect on sleep patterns at follow-up. Our results provide scope for interventions to concurrently target physical activity and sleep.
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Preventive medicine · Feb 2021
Review Meta AnalysisObjectively measured physical activity and all cause mortality: A systematic review and meta-analysis.
Current physical activity recommendations have been based on evidence from systematic reviews of questionnaire-based data. Questionnaire-based physical activity data are subject to both random and non-random error. If the estimated association between physical activity and health outcomes was different when a more accurate, objective measure was used, this would have important health policy implications for physical activity. ⋯ Individuals in the highest category of light, moderate-to-vigorous, and total physical activity had 40% (95%CI 20% to 55%), 56% (95%CI 41% to 67%), and 67% (95%CI 57% to 75%), respectively, lower risk for mortality compared to individuals in the lowest category of light, moderate-to-vigorous, and total physical activity. The summary hazard ratio for objectively measured physical activity and all cause mortality is lower than previously estimated from questionnaire based studies. Current recommendations for physical activity that are based on subjective measurement may underestimate the true reduction in mortality risk associated with physical activity.