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
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
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
Randomized Controlled TrialChildhood COVID-19 vaccine acceptance and preference from caregivers and healthcare workers in China: A survey experiment.
With approval of more COVID-19 vaccines for children, vaccine attributes may influence parental acceptance and choices. We aimed to assess effects of vaccine attributes and information on herd immunity on childhood COVID-19 vaccine acceptance. A survey experiment was conducted with caregivers of children aged 6 months to 11 years old and health care workers (HCWs) in China from September 14 to November 18, 2021. ⋯ To achieve herd immunity target (> 80% vaccination coverage), vaccine efficacy should reach over 70% and risk of adverse reactions lower than 1 in 10,000. Knowledge on herd immunity target increased the odds of vaccine acceptance (1.82 [1.34-2.46] for caregivers; 2.42 [1.58-3.72] for HCWs). Childhood COVID-19 vaccine acceptance was high in China, independent of child's age, and depended on vaccine attributes.
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Preventive medicine · Aug 2022
Childhood socioeconomic status, healthy lifestyle, and colon cancer risk in a cohort of U.S. women.
Colon cancer is the third most common cancer in the US. While the socioeconomic status -health gradient has been established, findings linking adult socioeconomic status to colon cancer incidence specifically are mixed. Considering childhood socioeconomic status (CSES) and relevant risk factors, including related lifestyle behaviors, may provide more insight. ⋯ Compared to women whose parents were white collar workers, women whose parents were farmers had lower colon cancer risk (HR = 0.84; 95%CI: 0.72, 0.98), but no differences were evident for women whose parents were blue collar workers in models adjusting for age and familial history of colon cancer. Using the same comparison group, risk of adopting an unhealthy lifestyle over follow-up was not significantly different in women with farmer parents (HR = 0.96, 95% CI: 0.91, 1.02), while children of blue collar workers had slightly greater risk (HR = 1.07; 95%CI: 1.03, 1.12) in age-adjusted models. These findings suggest the impact of CSES on colon cancer risk is modest and varies across outcomes and occupational status.