Preventive medicine
-
Preventive medicine · Dec 2021
Cannabis use assessment and documentation in healthcare: Priorities for closing the gap.
Several factors, including the lack of a systematic cannabis use assessment within healthcare systems, have led to significant under-documentation of cannabis use and its correlates in medical records, the unpreparedness of clinicians, and poor quality of cannabis-related electronic health record data, limiting its utilization in research. Multiple steps are required to overcome the existing knowledge gaps and accommodate the health needs implied by the increasing cannabis use prevalence. ⋯ Employing electronic health record data in cannabis-related research is crucial to accelerate research in light of the existing knowledge gaps on a wide array of health outcomes. Thus, improving and modernizing cannabis use assessment and documentation in healthcare is an integral step on which research conduct and evidence generation primarily rely.
-
Preventive medicine · Dec 2021
Dietary quality modifies the association between multimorbidity and change in mobility limitations among older Americans.
To identify potentially modifiable risk-factors in the age-related disablement process, we examined the association between change in mobility limitations and multimorbidity and how dietary quality moderates this association. Information from 3320 adults aged 65 and older in 2012 was drawn from the Health and Retirement Study and the Health Care and Nutrition Study. Mobility limitations reported in 2012 and change in mobility limitations from 2012 to 2014 were regressed on multimorbidity measured as number of chronic conditions in 2012, dietary quality measured in 2013 using the Alternative Healthy Eating Index-2010 (AHEI-2010), and their interaction term using Poisson regression. ⋯ For those with AHEI-2010 scores ≥48.4, dietary quality appeared to moderate the association between multimorbidity and change in mobility limitations. These results suggest that improving dietary quality may be an effective means of reducing the progression of mobility limitations among older adults and that dietary quality may modify the effect of multimorbidity on progressive disablement. Our work adds to research supporting dietary quality as a potentially intervenable factor in the reduction of disablement in aging populations.
-
Preventive medicine · Dec 2021
Bullying and suicide risk among sexual minority youth in the United States.
Bullying is associated with increased suicide risk and maladaptive development for sexual minority youth (SMY). The purpose of this study is to determine whether multiple forms of bullying mediate the relationship between biological sex and suicide risk among SMY and to determine whether sexual identity moderates these relationships (i.e., moderated mediation). Data from the 2015-2019 National Youth Risk Behavior Surveillance Survey was analyzed using multiple group structural equation modeling with the 5967 youth that self-identified as Lesbian/Gay, Bisexual, or Not sure of their sexual identity. ⋯ These finding align with the minority stress theory which posits the victimization experiences are linked to negative mental health outcomes among minority youth. Although sexual identity did not moderate these relationships, this study reveals new mechanistic pathways influencing sex-based suicide risk disparities among SMY. Findings can inform future research and the development of suicide prevention interventions that address the unique needs of SMY occurring at the intersection of sex and sexual identity.
-
Societies are looking for ways to mitigate risk while stimulating economic recovery from COVID-19. Facial coverings (masks) reduce the risk of disease spread but there is limited understanding of public beliefs regarding mask usage in the U. S. where mask wearing is divisive and politicized. ⋯ Agreement with the statements healthcare is a human right and I always wear my seat belt when driving were positively correlated with the belief masks had a role. Only 47% of respondents agreed that "Wearing a mask will help prevent future lock-downs in my community related to COVID-19." Public perception of the importance of mask usage revealed public transportation, grocery/food stores, and schools, as the relatively most important public places for mask usage among those seven places studied. Results suggest that public health advisories about riskiness of various situations or locations and public perception of importance of risk mitigation by location may not be well aligned.
-
Over the past 10 years cholesterol levels have been falling while the number of Americans dying of heart disease has been steadily climbing. This apparent paradox compels us to question whether lowering cholesterol is the best way to prevent coronary heart disease. ⋯ Despite the widespread utilization of cholesterol-lowering statins in Europe, observational studies indicate that there has been no accompanying decline in coronary heart disease deaths. This new evidence should give us pause as we try to understand why the campaign to prevent heart disease by lowering cholesterol has not achieved its goals.