American journal of preventive medicine
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Despite the proven effectiveness of immunization in preventing morbidity and mortality, adult vaccines remain underutilized. The objective of this study was to describe clinicians' and pharmacists' self-reported implementation of the Standards for Adult Immunization Practice ("the Standards"; i.e., routine assessment, recommendation, and administration/referral for needed vaccines, and documentation of administered vaccines, including in immunization information systems). ⋯ This report highlights gaps in access to vaccines recommended for adults across the spectrum of provider specialties. Greater implementation of the Standards by all providers could improve adult vaccination rates in the U.S. by reducing missed opportunities to recommend vaccinations and either vaccinate or refer patients to vaccine providers.
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Falls often cause severe injuries and are one of the most costly health conditions among older adults. Yet, many falls are preventable. The number of preventable medically treated falls and associated costs averted were estimated by applying evidence-based fall interventions in clinical settings. ⋯ This report is the first to estimate the number of medically treated falls that could be prevented and the direct medical costs that could be adverted. Preventing falls can benefit older adults substantially by improving their health, independence, and quality of life.
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Review Meta Analysis
Chronic Noise Exposure and Adiposity: A Systematic Review and Meta-analysis.
Noise is a key environmental stressor affecting millions of people worldwide on a daily basis. Chronic exposure to noise may elevate the risk of adiposity through sleep deprivation and heightened stress level. ⋯ Noise tends to be positively associated with waist circumference but not BMI in adults, but current evidence remains limited. Future studies should assess the impact of noise on adiposity in alternative settings and across population subgroups and geographic areas, examine different sources of noise, and elucidate the biomedical and psychosocial pathways linking noise to adiposity.
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The goal of this study was to describe differences in time use and energy expenditure associated with exercise, prolonged TV viewing, and work days in a longitudinal study of older adults. ⋯ Exercise days had more physical activity energy expenditure, but because of reductions in other activities, only about half of the energy expended during exercise was added to total daily physical activity energy expenditure. Prolonged TV viewing days had less physical activity energy expenditure and less moderate-vigorous activity. These findings provide new insights into possible compensation associated with exercise, and suggest a strong link between TV viewing and physical inactivity.
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There are major problems with failure to replicate research findings. Contributing to this problem is a failure to report on factors related to external validity. Frequently, researchers have little knowledge whether findings apply more generally, especially to low-resource settings and underserved populations. The CONSORT flow diagram has improved reporting on variables related to internal validity, but it has very limited detail on issues related to external validity. A recent CONSORT update and other publications have called for more transparent reporting on external validity and context, and information regarding the sustainability of interventions. All of these elements influence the generalizability of findings from outcomes research. ⋯ Improving transparent reporting on external validity by using the proposed expanded CONSORT figure would help to address both the scientific replication crisis and health equity concerns. This figure provides a method to efficiently address the representativeness, generalizability, and sustainability of outcomes research.