Preventive medicine
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Preventive medicine · Jul 2021
Tobacco and cannabis poly-substance and poly-product use trajectories across adolescence and young adulthood.
Tobacco and cannabis poly-substance and poly-product use is common in adolescents and young adults (AYAs), but few studies have examined developmental trajectories of poly-use. This study characterized the prevalence, patterns, and racial/ethnic and sex differences of developmental trajectories of use and poly-use of 8 different widely-marketed tobacco and cannabis products across adolescence and young adulthood. 3322 AYAs from Los Angeles, California completed 5 surveys from fall of 11th grade (2015) to 1-2 years post-high school (2018-2019). Self-reported past 30-day use of three tobacco (nicotine vaping, cigarette, hookah) and five cannabis (combustible, blunt, edible, vaping, dabbing) products were analyzed using parallel growth mixture modeling to identify tobacco and cannabis use and poly-use trajectories; racial/ethnic and sex differences were evaluated as correlates of trajectory membership. ⋯ Non-Users) trajectory (aOR = 1.30[1.02-1.66]). Tobacco and cannabis poly-substance use patterns, including use of various products, appear to be a common developmental trajectory during some point in adolescence and young adulthood. The interplay of tobacco and cannabis poly-substance/poly-product use merit attention in prevention and regulatory policies to protect AYA health.
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Preventive medicine · Jul 2021
Temporal physical activity patterns are associated with obesity in U.S. adults.
Few attempts have been made to incorporate multiple aspects of physical activity (PA) to classify patterns linked with health. Temporal PA patterns integrating time and activity counts were created to determine their association with health status. Accelerometry data from the National Health and Nutrition Examination Survey 2003-2006 was used to pattern PA counts and time of activity from 1999 adults with one weekday of activity. ⋯ Cluster 1 was also associated with higher BMI (β = 1.5 ± 0.5 kg/m2, 95% CI: 0.1, 2.8) and WC (β = 3.6 ± 1.3 cm, 95% CI: 0.1, 7.0) compared to Cluster 4 with activity counts reaching 9.6e4 cph between 8:00-11:00. A Temporal PA pattern with the lowest PA counts had significantly higher mean BMI and WC compared to temporal PA patterns of higher activity counts performed early (8:00-11:00) or late (16:00-21:00) throughout the day. Temporal PA patterns appear to meaningfully link to health status.
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Preventive medicine · Jul 2021
Gains in insurance coverage following the affordable care act and change in preventive services use among non-elderly US immigrants.
Immigrants have lower and disproportionate use of preventive care. We use longitudinal panel data to examine how the 2014 full implementation of the ACA mandates affected change in preventive services (PS) use among immigrants that gained insurance. We used data on Foreign-Born (FB) and US-Born (USB) adults, ages 26-64 years, from the 2013/16 Medical Expenditures Panel Survey longitudinal files to examine within-person change in yearly utilization of age/sex specific United States Preventive Services Task Force (USPSTF) recommended services. ⋯ Newly-insured FB PS use remained lower than use among continuously-insured USB adults, but some of the differences were explained by adjustment to enabling and health needs factors. Briefly, health insurance gains among immigrants translated into substantial improvements in use of recommended PS. Still, notable disparities persist among the newly-insured FB, and more so among the 1 in 5 that remain continuously uninsured.
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Preventive medicine · Jul 2021
Low-dose aspirin for primary prevention of cardiovascular disease: Trends in use patterns among African American adults in Minnesota, 2015-2019.
Cardiovascular disease (CVD) disproportionately affects African Americans. Aspirin has long been recommended to reduce cardiovascular events. However, national guideline changes in 2016 limited the aspirin recommended population and several clinical trials questioning the utility of primary prevention aspirin were published in 2018. ⋯ However, fewer participants believed aspirin was helpful in 2019 compared to 2015-75% versus 84% (p < 0.001). Aspirin discussions with a health care practitioner were highly associated with aspirin use (adjusted RR 2.97, 95% CI 2.49-3.54) and aspirin use was 2.56 times higher (adjusted RR 95% CI 2.17-3.03) in respondents who agreed that people close to them thought they should take aspirin compared with those who disagreed or did not know. Despite major changes in national guidelines, overall primary prevention aspirin use did not significantly change in these African American samples from 2015 to 2019.
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Preventive medicine · Jul 2021
Self-reported sickness absence and presenteeism as predictors of future disability pension: Cohort study with 11-year register follow-up.
Many healthcare workers in eldercare are pushed out of the labor market before the official retirement age due to poor health. Identification of early warnings signs is important to avoid complete loss of work ability. The aim of this study was to investigate to what degree sickness absence and presenteeism increase future risk for disability pension among eldercare workers. ⋯ Eldercare workers aged >45 years were at a higher risk for disability pension in all included categories. Sickness absence and presenteeism increased the risk of disability pension among female eldercare workers. These results suggest that organizations would benefit from identifying early warning signs among workers in the prevention of involuntary early retirement.