Preventive medicine
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Preventive medicine · Dec 2021
Imaging-guided evaluation of subclinical atherosclerosis to enhance cardiovascular risk prediction in asymptomatic low-to-intermediate risk individuals: A systematic review.
Carotid intima-media thickness (cIMT), plaque quantification and coronary artery calcium (CAC) scoring have been suggested to improve risk prediction of cardiovascular disease (CVD), particularly for asymptomatic individuals classified as low-to-intermediate risk. We aimed to compare the predictive value of cIMT, carotid plaque identification, and CAC scoring for identifying sub-clinical atherosclerosis and assessing future risk of CVD in asymptomatic, low-to-intermediate risk individuals. We conducted a comprehensive search of Ovid (Embase and Medline), Cochrane Central Register of Controlled Trials (CENTRAL) and Medline complete (EBSCO health). ⋯ The c-statistic enhanced predictive value by a minimum increase of 0.7. Finally, the NRI ranked higher with CAC (≥11.2%), followed by carotid plaque (≥2%) and cIMT (3%). CAC scoring was superior compared to carotid plaque and cIMT measurements in asymptomatic individuals classified as being at low-to-intermediate risk.
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Preventive medicine · Dec 2021
Prevalence and predictors of cost-related medication nonadherence in individuals with cardiovascular disease: Results from the Behavioral Risk Factor Surveillance System (BRFSS) survey.
Medication nonadherence is highly prevalent among patients with chronic cardiovascular disease. Poor adherence has been associated with increased morbidity and mortality. Medication cost is a major driver for medication nonadherence. ⋯ We conclude that the prevalence of CRMNA is 10% among U. S. adults overall and is higher among those with common chronic diseases. Risk factors associated with CRMNA should be addressed in order to improve adherence rates and health outcomes among high-risk individuals.
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Preventive medicine · Dec 2021
Impact of achievement and change in achievement of lifestyle recommendations in middle-age on risk of the most common potentially preventable cancers.
This study aimed to assess the association between achievement, and within-person change in achievement, of lifestyle recommendations in middle-age and incidence of the most common potentially preventable cancers. We used data from 44,572 participants from the Swedish Västerbotten Intervention Programme who had attended at least two health checks 9-11 years apart. We assessed the association between the mean number of healthy lifestyle recommendations achieved (lifestyle score), and change in lifestyle score between the health checks, and risk of one or more of the eight most common potentially preventable cancers using Cox regression. ⋯ These findings support the inclusion of lifestyle recommendations in cancer prevention guidelines. They further suggest that interventions to change health behaviours in middle-age may reduce risk of the most common preventable cancers in men, but this association was not observed in women. Strategies to encourage healthy lifestyles earlier in the life course may be more effective.
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Preventive medicine · Dec 2021
Driving under the influence of cannabis risk perceptions and behaviour: A population-based study in Ontario, Canada.
Driving under the influence of cannabis (DUIC) is detrimental to road safety. Risk perception is a strong determinant of DUIC behaviour, yet little is known about the factors influencing DUIC risk perception in the general population. The objective of this study was to identify factors associated with risk perceptions of motor vehicle collision and legal consequences due to DUIC and examine whether these perceptions were associated with DUIC behaviour. ⋯ Cannabis legalization provides a timely opportunity for DUIC prevention strategies. This study suggests that policymakers should target male cannabis users and highlight the safety risks of DUIC. Further research is needed to assess the effectiveness of prevention measures and the impact of cannabis legalization on DUIC perceptions and behaviour.
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Preventive medicine · Dec 2021
Identifying malleable factors that could arrest progression to type 2 diabetes: A cluster analysis of Australian adults.
Lifestyle-based disease prevention and self-management strategies play an important role in the mitigation of health, social, and economic burdens associated with type 2 diabetes mellitus (T2DM) and other chronic diseases. However, there are significant implementation and translational challenges associated with the design and delivery of effective interventions. In this study, data-driven techniques for the identification of optimal target audiences and intervention targets for T2DM prevention interventions were applied. ⋯ Within each cluster, psychosocial variables explained approximately 25% of the variance in T2DM status, with future orientation identified as a significant modifiable predictor of T2DM. For the male cluster, health literacy was also significant (p ≤0.01). Findings indicate that men and women should be targeted separately in T2DM prevention or management programs and that future interventional research targeting future orientation is warranted.