American journal of preventive medicine
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Transgender and gender diverse people often face discrimination and may experience disproportionate emotional distress that leads to suicide attempts. Therefore, it is essential to estimate the frequency and potential determinants of suicide attempts among transgender and gender diverse individuals. ⋯ Among transgender and gender diverse individuals, younger people, people with previous suicidal ideation or attempts, and people with multiple mental health diagnoses are at a higher risk for suicide attempts. Future research should examine the impact of gender-affirming healthcare use on the risk of suicide attempts and identify targets for suicide prevention interventions among transgender and gender diverse people in clinical settings.
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Unaddressed social risks among hospitalized patients with chronic conditions contribute to costly complications and preventable hospitalizations. This study examines whether the Centers for Medicaid and Medicare Services State Innovation Models initiative, through payment and delivery system reforms, accelerates the diagnosis of social risk factors among hospitalized adults with diabetes. ⋯ The State Innovation Models initiative slightly but significantly improved the diagnosis of social risks among hospitalized adults with diabetes. State-led delivery system and payment reform may help support movement of hospitals toward better recognition and management of social determinants of health.
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In biomarker-driven clinical trials, translational strategies typically involve moving findings from animal experiments to human trials. Typically, the translation is static, using a fixed model derived from animal experiments for the duration of the trial. Bayesian designs, capable of incorporating information external to the experiment, provide a dynamic translational strategy. This article demonstrates an example of such a dynamic Bayesian strategy in a clinical trial. ⋯ A Bayesian design was effective in adaptively revising the dosing algorithm, resulting in a lower pill burden.
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The nutritional quality of restaurant foods in Canada is not monitored by government and limited research has evaluated the nutrient content of these foods. Given the increasing proportion of foods consumed outside the home, this study aims to assess levels of nutrients of public health concern in Canadian fast-food and sit-down restaurant menu items. ⋯ Levels of nutrients of concern in Canadian menu items are excessive among most food categories. As the frequency of eating out in restaurants rises, government policies to promote reformulation and increase transparency of the nutritional content of these items are required to reduce their negative impact on public health.
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Physical inactivity, high screen time, and short sleep are targets of public health initiatives for children. However, few data exist on how many U.S. children meet guidelines for these behaviors-data vital to inform which needs greater targeting. This study describes national prevalence estimates of U.S. children who meet physical activity, screen time, and sleep guidelines alone or in combination across each childhood year. ⋯ Few U.S. children meet all the 3 movement guidelines, with prevalence rates of children meeting guidelines declining with age. Although many meet sleep guidelines, few meet physical activity or screen time guidelines. Initiatives targeting physical activity and screen time, especially for adolescents, should be pursued.