Preventive medicine
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Preventive medicine · Aug 2022
Tests for confounding with cigarette smoking in the association of E-cigarette use with respiratory disorder: 2020 National-Sample Data.
Associations of e-cigarette use with respiratory disorder have been demonstrated but it has been unclear whether these are confounded by current or previous cigarette smoking. We address this question through studying different time frames for e-cigarette use and respiratory disorders in 2020 BRFSS data (N = 214,945). E-cigarette use and combustible cigarette smoking were classified into four categories: Participant never used either (Nonuse); used e-cigarettes/cigarettes but not in the past 30 days (Former Use), used in past 30 days on some days (Nondaily Use), or used past 30 days on all days (Daily Use). ⋯ Stratified analyses showed significant associations of e-cigarette use with respiratory disorder among nonsmokers as well as among smokers. We conclude that independent associations for former e-cigarette use (controlling for current/former smoking) and significant associations of e-cigarette use with respiratory disorder among nonsmokers indicate these associations are not confounded with cigarette smoking and suggest reverse causation is implausible. Findings for former use are discussed with reference to possible mechanisms including sensitization effects.
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Preventive medicine · Aug 2022
Improving the wellbeing of LGBTQ+ employees: Do workplace diversity training and ally networks make a difference?
Despite growing recognition that lesbian, gay, bisexual, trans, queer, and other minority (LGBTQ+) employees have lower levels of workplace wellbeing than cis-gender heterosexual employees, few studies have examined how different workplace interventions may mitigate these disparities. This study provides first-time evidence of associations between LGBTQ+ employee wellbeing and two types of initiatives that have received substantial public attention and employer uptake: workplace gender and sexuality diversity training and ally (or employee) networks. To accomplish this, the analyses leverage Australian data from a unique, national employer-employee survey of workplace inclusion (2020 Australian Workplace Equality Index Employee Survey; n = 31,277). ⋯ These findings have significant implications for health policy and practice. Specifically, they indicate that diversity training and ally networks may improve wellbeing amongst LGBTQ+ employees. This suggests that employer investments in diversity training and ally networks are effective interventions to enhance workplace culture, employee productivity and intergroup relations.
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Preventive medicine · Aug 2022
ReviewA systematic review of effective strategies for chronic disease management in humanitarian settings; opportunities and challenges.
Large number of people with non-communicable diseases (NCDs) face barriers to adequate healthcare in humanitarian settings. We conducted a systematic literature review in MEDLINE/PubMed, Web of Science, EMBASE/DARE, Cochrane, and grey literature from 1990 to 2021 to evaluate effective strategies in addressing NCDs (diabetes, cardiovascular diseases, COPD, cancer) in humanitarian settings. From 2793 articles, 2652 were eliminated through title/abstract screening; 141 articles were reviewed in full; 93 were eliminated for not meeting full criteria. ⋯ Cancer care is significantly understudied. Simplified care models adapted to contexts and program evaluations of implemented strategies could address gaps in applied research. Inherent challenges in humanitarian settings pose unavoidable perils to evidence generation which requires a shift in research mindset to match aspirations with practicality, research collaborations at the inception of projects, reworking of desired conventional level of research evidence considering resource-intense constraints (HR, time, cost), and adapted research tools, methods, and procedures.
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Preventive medicine · Aug 2022
Observational StudyCharacteristics of statewide prescription drug monitoring programs and potentially inappropriate opioid prescribing to patients with non-cancer chronic pain: A machine learning application.
Unnecessary/unsafe opioid prescribing has become a major public health concern in the U. S. Statewide prescription drug monitoring programs (PDMPs) with varying characteristics have been implemented to improve safe prescribing practice. ⋯ The results show that among 1,886,146 NCCP opioid-related claims, 22.8% had an opioid dosage ≥50 MME/day and 8.9% ≥90 MME/day, 70.3% had days supply ≥7 days, and 10.3% were when benzodiazepine was filled ≤7 days ago. GBM had superior model performance. We identified the most salient PDMP characteristics that predict opioid-related PIPs (e.g., broader access to patient prescription history, monitoring Schedule IV controlled substances), which could be informative to the states considering the redesign of PDMPs.
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Preventive medicine · Aug 2022
Relationship between communicative and critical health literacy, health information sources, and participation in health checkups among middle-aged Japanese community residents.
We assessed the relationship between health literacy and participation in health checkups among middle-aged Japanese community residents. Additionally, we explored the health information sources related to participation in health checkups among those with low, medium, and high health literacy. This mail survey using a self-administered questionnaire was conducted in 2020 and included 33,902 community residents with National Health Insurance (NHI), aged 40-64 years from five cities in Osaka Prefecture, Japan. ⋯ After adjusting for confounding factors, the multivariable-adjusted odds ratios for non-participation in health checkups were 1.20 (95% CI 1.01-1.43, p = 0.039) in the medium health literacy group and 1.47 (95% CI 1.20-1.80, p < 0.001) in the low health literacy group compared with the high health literacy group. Additionally, some health information sources were associated with participation in health checkups in the medium and high health literacy groups, whereas none of the health information sources were associated with participation in health checkups in the low health literacy group. We believe that it is important to develop materials and interventions aimed at low health literacy populations to promote participation in health checkups.