Preventive medicine
-
Preventive medicine · Dec 2020
School characteristics and children's mental health: A linked survey-administrative data study.
Mental health difficulties are childhood-onset with lifelong health, social and economic consequences. Children spend a large amount of time in schools, making schools an important context for mental health prevention and support. We examine how school composition and school climate, controlling for individual child-level characteristics, are associated with children's mental health difficulties (emotional and behavioural difficulties). ⋯ More positive school climate was associated with lower emotional (coef = -0.09 [95%CI:-0.11,-0.08]) and behavioural (coef = -0.13 [95% CI,-0.15:-0.11]) symptoms and lower odds of mental health difficulties (OR = 0.78, 95%CI:0.74,0.81). Some associations between school factors and mental health were moderated by child sex and SES. School composition factors were weakly associated with children's mental health, whereas school climate explained a larger amount of between-school variation and appears a good target for universal prevention of mental health difficulties in children.
-
Preventive medicine · Dec 2020
The multivariate physical activity signature associated with metabolic health in children and youth: An International Children's Accelerometry Database (ICAD) analysis.
There is solid evidence for an association between physical activity and metabolic health outcomes in children and youth, but for methodological reasons most studies describe the intensity spectrum using only a few summary measures. We aimed to determine the multivariate physical activity intensity signature associated with metabolic health in a large and diverse sample of children and youth, by investigating the association pattern for the entire physical intensity spectrum. We used pooled data from 11 studies and 11,853 participants aged 5.8-18.4 years included in the International Children's Accelerometry Database. ⋯ Associations with the composite metabolic health score were weak for sedentary time and light physical activity, but gradually strengthened with increasing time spent in moderate and vigorous intensities (up to 4000-5000 counts per minute). Association patterns were fairly consistent across sex and age groups, but varied across different metabolic health outcomes. This novel analytic approach suggests that vigorous intensity, rather than less intense activities or sedentary behavior, are related to metabolic health in children and youth.
-
Preventive medicine · Dec 2020
A model exploring the relationship between nutrition knowledge, behavior, diabetes self-management and outcomes from the dining with diabetes program.
To examine the relationship between changes in participant's knowledge, beliefs, dietary behavior, diabetes self-management and program outcomes in West Virginia Dinning with Diabetes (DWD) program. We used a longitudinal pre-test and post-test study design and data from 2745 individuals with diabetes who participated from 2007 to 2012. The DWD was offered in community-based settings across the state as an educational program (five classes over a 3-month period). ⋯ Diabetes self-management mediated the relationship between knowledge, dietary behavior and program outcomes. The indexes of fit for the tested model indicated a good fit [TLI =0.99, CFI = 0.95, and Root Mean Square Error of Approximation (RMSEA) =0.05]. Results indicate DWD group sessions can be effective in supporting individuals with diabetes to change knowledge, dietary behaviors, adherence to self-management and follow-up provider visits for diabetes care.
-
Preventive medicine · Nov 2020
Cluster analysis of urinary tobacco biomarkers among U.S. adults: Population Assessment of Tobacco and Health (PATH) biomarker study (2013-2014).
Tobacco use delivers nicotine, tobacco-specific nitrosamines (TSNAs), volatile organic compounds (VOCs), and polycyclic aromatic hydrocarbons (PAHs), which are metabolized and excreted in urine offering useful biomarkers of exposure. Previous studies compared individual toxicants across tobacco users. Based on a group of biomarkers, cluster analysis was used to define tobacco toxicant exposure profiles. ⋯ Clusters heavily populated by dual and poly tobacco users were the same as those heavily populated by cigarette smokers. Ten exposure profiles (clusters) were determined and linked to tobacco use behavior. Findings could inform future research and policy initiatives.
-
In this paper we have attempted to identify missed opportunities to change the trajectory of smoking and smoking caused diseases in America over the past 100 years. Many of the missed opportunities identified are due to the actions of cigarette manufacturers who misled the public about the dangers of cigarette smoking, the addictiveness of nicotine, and the feasibility of providing lower risk alternative nicotine delivery products to addicted smokers. An important lesson learned from the past is that treating all tobacco/nicotine products as equivalently harmful is counterproductive to public health as it only serves to protect the most lethal nicotine product - cigarettes. ⋯ However, this requires embracing risk-proportionate regulation, taxation policies, and providing consumers with accurate public messaging on product relative risks. A regulatory framework based on sound science that encourages and rewards new or existing manufacturers to invest in consumer acceptable lower risk products to replace cigarettes needs to be encouraged. The past is indeed not the future in smoking control, but it may be difficult to escape the past unless a realignment of market forces and policies can be achieved.