Preventive medicine
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Preventive medicine · Aug 2022
Health locus of control and all-cause, cardiovascular, cancer and other cause mortality: A population-based prospective cohort study in southern Sweden.
The aim was to investigate associations between health locus of control (HLC) and all-cause, cardiovascular (CVD), cancer and other cause mortality. A public health postal questionnaire was distributed in the autumn of 2008 to a stratified random sample of the 18-80 year old adult population in Scania in southernmost Sweden. The participation rate was 54.1%, and 25,517 participants were included in the present study. ⋯ In the models with women and men combined, external HLC had significantly higher all-cause, CVD, cancer and other cause mortality even after adjustments for sociodemographic factors and chronic disease at baseline, but after the introduction of health-related behaviors, external HLC only displayed higher cancer mortality compared to internal HLC. External HLC displayed higher all-cause, cancer and other cause mortality for men in the final model adjusted for health-related behaviors, but not for women. Other pathways than health-related behaviors may exist for the association between external HLC and cancer mortality, particularly among men.
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Preventive medicine · Aug 2022
Hepatitis C virus (HCV) seroprevalence, RNA detection, and genotype distribution across Florida, 2015-2018.
Chronic hepatitis C virus (HCV) infection is a leading cause of hepatocellular carcinoma (HCC) in the U. S. Due to high rates of HCV among baby boomers (born 1945-1965), it was recommended they receive universal screening. ⋯ A similar age/race pattern was observed for active HCV infection. There was a higher prevalence of genotype 1A and 3 and lower prevalence of 1B in younger adults. Patterns of HCV seroprevalence and active HCV infection identified in our study support the recent shift from age and risk-based screening guidelines to universal adult screening.
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Preventive medicine · Aug 2022
A first look at breast cancer screening in over 1000 community health centers in the United States.
Community Health Centers (CHCs) primarily serve low-income and vulnerable patients. Breast cancer screening recently became a quality-of-care metric in the annual Uniform Data System (UDS) report, and this study examines the first year of breast cancer screening data among 1375 CHCs in the United States. Clinics with available screening data (n = 1070) were categorized based on US region, state expansion of Medicaid to low-income adults under the Affordable Care Act, ranked terciles of race/ethnic composition (non-Hispanic Black, non-Hispanic Asian, and Hispanic/Latino patients), and proportion uninsured. ⋯ In conclusion, our findings show that only half of women eligible who received care within CHCs were screened for breast cancer. Disparities in breast cancer screening rates are seen for clinics with high proportions of Black and uninsured patients, along with clinics outside the northeast and clinics in non-Medicaid expansion states. Targeted solutions centered around reducing cost, improving quality, and reducing structural disparities are needed to address low rates of breast cancer screening in low-income women who visited CHCs and already experience healthcare inequities.
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Preventive medicine · Aug 2022
Use of heated tobacco products, moderate alcohol drinking, and anti-SARS-CoV-2 IgG antibody titers after BNT162b2 vaccination among Japanese healthcare workers.
The effect of heated tobacco products (HTPs) use and moderate alcohol drinking on immunogenicity to coronavirus disease (COVID-19) vaccines remain elusive. This study aimed to examine the association of tobacco product use and alcohol consumption with anti-SARS-CoV-2 spike IgG antibody titers after the BNT162b2 vaccine. Participants were 3433 healthcare workers receiving two vaccine doses in the 4 national centers for advanced medical and research in Japan. ⋯ Compared with non-drinkers of alcohol (GMT = 123), alcohol drinkers consuming <1 go/day (GMT = 113; RoM = 0.93 [95%CI: 0.88-0.98]), 1-1.9 go/day (GMT = 104; RoM = 0.85 [95%CI: 0.78-0.93]), and ≥ 2 go/day (GMT = 103; RoM = 0.84 [95%CI: 0.74-0.96]) had significantly lower antibody titers (P for trend<0.01). Spline analysis showed a large reduction of antibody until around 1 go/day of alcohol consumption, and then they gradually decreased. Results suggest that in addition to conventional cigarette smoking and heavy alcohol drinking, HTPs use and moderate alcohol drinking may be predictors of lower immunological response to COVID-19 vaccine.
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Preventive medicine · Aug 2022
Emergency health services use and medically-treated suicidal behaviors following depression screening among adolescents: A longitudinal cohort study.
The primary goal of depression screening is to reduce adverse psychiatric outcomes, which may have downstream implications for reducing avoidable health services use. The objective of this study was to examine the association of depression screening with emergency health services use and medically-treated suicidal behaviors among adolescents in the U. S. ⋯ Associations were similar in magnitude among male and female adolescents. The results of this study suggest that depression screening, as it is currently practiced in the U. S., may not deter avoidable health services use among adolescents.