Preventive medicine
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Preventive medicine · Oct 2020
The link between LGBTQ-supportive communities, progressive political climate, and suicidality among sexual minority adolescents in Canada.
Despite supportive structural changes to reduce stigma towards lesbian, gay, and bisexual, transgender, queer, and questioning (LGBTQ) Canadian residents, sexual minority youth still face disparities compared to heterosexual peers. We aimed to characterize LGBTQ-supportive environments and political climates, and examine their links to suicidal behavior among sexual minority adolescents in western Canada. Data were from the 2013 British Columbia Adolescent Health Survey, a cluster-stratified random cross-sectional survey of public school students in BC, Canada; We sampled 2678 self-identified LGB and mostly heterosexual students (69% girls) from 274 schools, representing an estimated provincial population of 24,624 sexual minority students in weighted models. ⋯ Further, progressive political climates predicted marginally significant lower suicidal ideation (aOR = 0.89, 95% CI [0.78, 1.02]) and significantly lower self-harm behaviors (aOR = 0.87, 95% CI [0.77, 0.99]). For sexual minority adolescent boys, no community-level variables were associated with suicidal behavior in adjusted models. Thus, LGBTQ-supportive communities and progressive political climates appear to be protective against suicidal behavior among sexual minority adolescent girls, but not sexual minority adolescent boys.
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Preventive medicine · Oct 2020
Randomized Controlled TrialEffects of a lifestyle intervention on cardiovascular risk among high-risk individuals for diabetes in a low- and middle-income setting: Secondary analysis of the Kerala Diabetes Prevention Program.
We aimed to examine whether a lifestyle intervention was effective in reducing cardiovascular disease (CVD) risk in individuals at high-risk of developing diabetes in a low- and middle-income setting. The Kerala Diabetes Prevention Program was evaluated by a cluster-randomized controlled trial (2013-2016) of 1007 individuals (aged 30-60 years) at high-risk for diabetes (Indian Diabetes Risk Score ≥ 60 and without diabetes) in Kerala state, India. Sixty polling areas in Kerala were randomized to intervention or control groups by an independent statistician using a computer-generated randomization sequence. ⋯ The favorable change in CVD risk with the intervention condition was mainly due to the reduction in tobacco use (change index: -0.25, 95% CI: -0.42 to -0.09). Our findings suggest that a community-based peer-support lifestyle intervention could reduce CVD risk in individuals at high-risk of developing diabetes in India. TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Registry ACTRN12611000262909.
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Preventive medicine · Oct 2020
Evaluation of rates of laboratory-confirmed influenza hospitalization in rural and urban census tracts over eight influenza seasons.
The burden of influenza in rural areas is largely unstudied. Rural populations may be vulnerable yet isolated from circulating virus. ⋯ Race, ethnicity, poverty, health insurance coverage, and distance from a hospital accounted for rate differences. Our interpretation is: 1) influenza regularly circulates in urban areas and inconsistently spreads to rural areas, 2) demographic and socioeconomic factors drive morbidity in exposed populations, and 3) public health interventions targeting high-risk urban census tracts may be beneficial.
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Accumulating evidence shows that a higher sense of purpose in life is associated with lower risk of chronic conditions and premature mortality. Health behaviors might partially explain these findings, however, the prospective association between sense of purpose and health behaviors is understudied. We tested whether a higher sense of purpose at baseline was associated with lower likelihood of developing unhealthy behaviors over time. ⋯ Further there was a marginal reduction in smoking relapse (HR = 0.65, 95% CI: 0.41-1.03) and no association with heavy alcohol use (HR = 1.02, 95% CI: 0.81-1.29). Findings for physical inactivity, sleep problems, and unhealthy BMI remained evident after further adjusting for baseline health status and depression. Our results, suggest that a sense of purpose in life might emerge (with further research) as a valuable target to consider for interventions aimed at helping older adults maintain some health behaviors.
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Preventive medicine · Oct 2020
The impact of the Great Recession on California domestic violence events, and related hospitalizations and emergency service visits.
Explore the impact of the Great Recession on domestic violence (DV) related hospitalizations and emergency department (ED) visits in California. ⋯ Recessions are frequent in modern economies and are repeated cyclically. Our study provides critical information on the effects of the 2007 financial crisis on DV-related healthcare service utilization in California. Given the current financial crisis associated with COVID-19, which expert predict could extend for years, the results from this study shine a spotlight on the importance of DV-related screening, prevention and response.