Preventive medicine
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Preventive medicine · Dec 2021
HCV testing: Order and completion rates among baby boomers obtaining care from seven health systems in Florida, 2015-2017.
Many U. S. residents infected with hepatitis C virus (HCV) are baby boomers (born 1945-1965), who remain undiagnosed. Past CDC and USPSTF guidelines recommended one-time HCV testing for all baby boomers, with newer guidelines recommending universal screening for all adults. ⋯ Tests ordered (11.42, 10.94-11.92) and completed (2.25, 1.94-2.60) were more likely among those with hepatitis history. Test orders were more likely for HIV-positive patients (3.68, 3.45-3.93), but completion was less likely (0.67, 0.57-0.78). Interventions are needed to increase testing rates so that HCV infections are treated early, mitigating HCV-related morbidity and mortality, especially related to liver cancer.
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Preventive medicine · Dec 2021
Randomized Controlled TrialInfluence of package colour, branding and health warnings on appeal and perceived harm of cannabis products among respondents in Canada and the US.
'Plain packaging' and health warnings can reduce appeal and increase risk perceptions of tobacco products. This study tested the effect of health warnings and restricted brand imagery on perceptions of cannabis products. Participants in Canada and the US (n = 45,378) were randomized to view packages of three cannabis brands in 2019. ⋯ Message recall was significantly higher for Canadian versus US health warnings, and for the US warning versus no warning (p < 0.001). Message recall was greater among those who saw plain versus fully branded packages for two of the three warning messages (p < 0.01). Prominent health warnings and restrictions on brand imagery may be warranted in jurisdictions considering non-medical cannabis legalization.
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Preventive medicine · Dec 2021
Psychosocial factors at work from the job strain model and preventable mortality in France: The STRESSJEM prospective study.
The study aimed to explore the prospective associations between psychosocial factors at work from the job strain model and preventable mortality, including smoking- and alcohol-related mortality as well as external causes of death. The study was based on prospective data and relied on a sample of 1,511,456 individuals for which data on job history, mortality and causes of death were linked over the 1976-2002 period. Exposures were the factors from the job strain model imputed through a job-exposure matrix. ⋯ The fractions of preventable mortality attributable to current exposure to job strain and isostrain were significant among men only (5.1% and 3.3%). Psychosocial factors at work from the job strain model may play a role on preventable mortality. Intensifying research and prevention towards the psychosocial work environment may be helpful to reduce risky health-related behaviours and related mortality.
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Human Papillomavirus (HPV) infection is a necessary risk factor for cervical cancer. If HPV is no longer spread, no new cervical cancer precursors will occur. The timepoint for control of the HPV infection will therefore be a rate-limiting step for cervical cancer elimination. ⋯ Above age 35, we found an R0 of 0.4. Thus, when younger birth cohorts no longer transmit HPV to women >35 years of age, we predict that the HPV infection will no longer be sustained among the older women. Given adequate resources, campaigns to eliminate HPV that are designed based on the R0 measurements followed by screening to detect and treat pre-existing cervical cancer precursors could achieve accelerated cervical cancer elimination.
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Preventive medicine · Dec 2021
Randomized Controlled TrialAdherence with protocol medication use and mortality from unrelated causes in a prevention trial.
Several studies have shown that non-adherence to medication use is associated with lower use of preventive services and increased mortality. We aimed to study the relationship between initial adherence to medication use and mortality in the Prostate Cancer Prevention Trial (PCPT). The PCPT randomized men age 55 and over to a finasteride or placebo arm. ⋯ Hazard ratios (HRs) at 5 years were 1.62 (95% CI: 1.37-1.91), 1.55 (95% CI: 1.30-1.83) and 1.49 (95% CI: 1.25-1.76) for Models I-III. HRs at ten years were lower but still statistically significant. Non-adherence to taking protocol medications was associated with increased mortality from unrelated conditions.