Prevention Of Premature Death Research Articles

Gender disparities in mortality : challenges for health equity in Puerto Rico.

The aim of this study is to deepen the analysis of mortality indicators by sex in Puerto Rico. The gender perspective is used to identify the differentials and inequalities that generate disparities in mortality among women and men in that country. In 2008- 2010, life expectancy at birth for both sexes reached 78.83 years, with a gap of 7.71 years among women and men, which is higher in the group of very low mortality countries, internationally. The years of potential life lost (YPLL) by age and external causes of death and natural death are used, among other indicators, for further analysis of male mortality from a gender perspective. Young men have a very high premature mortality because many deaths are due to by external causes: homicides, suicides and accidents. In the case of women’s, premature deaths are prevalent due natural causes in all age groups. The result of the study is to promote gender mainstreaming to achieve health equity for women and men. Puerto Rico requires health plans, programs and policies that take into account gender disparities in order to achieve a longer life span-free of preventable disease, disability, injury and premature death- which currently affects more men than women.

Behavioral interventions associated with smoking cessation in the treatment of tobacco use.

Tobacco smoke is the leading cause of preventable premature death worldwide. While the majority of smokers would like to stop, the habitual and addictive nature of smoking makes cessation difficult. Clinical guidelines suggest that smoking cessation interventions should include both behavioural support and pharmacotherapy (e.g. nicotine replacement therapy). This commentary paper focuses on the important role of behavioural interventions in encouraging and supporting smoking cessation attempts. Recent developments in the field are discussed, including ‘cut-down to quit’, the behaviour change techniques taxonomy (BCTT) and very brief advice (VBA) on smoking. The paper concludes with a discussion of the important role that health professionals can and should play in the delivery of smoking cessation interventions.

The concept of temperament in psychoactive substance use among college students

Substance abuse is among the leading causes of preventable diseases and premature death but reasons and conditions leading to substance abuse are complex and multifaceted. Different models of abuse and dependence assume an underlying emotional vulnerability. Individual behavioral and emotional reactivity patterns of personality are considered in the concept of temperament but studies linking different types of temperament with substance use are rare. In this study we investigated 1380 inhabitants (59.7% females; 40.3% males) of residential student homes in Austria, using Akiskals TEMPS-M auto-questionnaire. Further, we administered the CAGE- and the HSI-questionnaire and assessed other psychoactive substance use to examine associations between traits of temperament and substance abuse using ordered logistic regression. Temperaments follow different distributions in both genders: Women have higher scores on the depressive, cyclothymic, and anxious subscales and lower scores on the hyperthymic scale than men. The cyclothymic and particularly irritable temperament serve as predictors of self-reported nicotine dependence, alcohol abuse and cannabis use. Interestingly, the depressive temperament seems to be protective against self-reported cannabis use. Substance abuse assessment is based on self-reports only and urine drug and blood tests were not performed. Also, the history of substance abuse is not documented thus temperamental factors could have been influenced by substance abuse if the time of onset was in early adolescence. The study design was cross-sectional, thus limiting causal interpretations. It might be important to consider temperamental traits as protective- and risk factors in the etiology, prevention and therapy of substance abuse in future.

Abstract LB-43: Community health advisors: a model in community outreach and health education

Abstract The Shelby County Health Department's goal is to become the healthiest and safest community in Tennessee. Our mission is to promote, protect and improve the health and environment of all Shelby County residents. We place emphasis on the following programs: environmental health, epidemiology, health education, maternal and child health, immunizations, STD, HIV and AIDs, breast and cervical cancer screening and treatment and Tuberculosis management. We are committed to closing the gaps in health status and access to care among our community's diverse populations and reducing the occurrence of preventable disease and premature death among all Shelby County residents. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-43. doi:1538-7445.AM2012-LB-43

P127 Improving smoking cessation advice through the implementation of a quality improvement intervention

BackgroundSmoking remains the main cause of preventable morbidity and premature death in England (DH data) and is estimated to cost the NHS £1.5 billion a year. Smoking counselling beginning during...

Particulate matter pollution in the megacities of the Pearl River Delta, China – A systematic literature review and health risk assessment

The exposure to ambient particulate matter (PM) pollution is a major threat to public health. Chinese megacities are coined by high levels of PM. Our aims were to examine the concentration levels of PM in megacities (Guangzhou, Hong Kong, and Shenzhen) of the Pearl River Delta (PRD), South China; to compare the results with international and national air quality guidelines; and to assess the health impact in terms of possible reductions in premature deaths due to PM reduction. The Medline(®) data base was used to identify published studies (systematic literature search). Based on our appraisal criteria 13 studies remained in the analysis. Additionally, publicly available data were extracted from data sources provided by municipal authorities of the cities under study. PM data reported in μg/m(3) were abstracted from single studies and municipal reports. If possible, the PM data were stratified for season of data collection (summer/winter half-year) and simple means were calculated for cities, seasons and months. Based on the abstracted data, a health impact assessment (HIA) was done in order to estimate potential preventable premature deaths due to PM pollution in the cities. Almost all PM data exceeded national and international air quality guidelines. Our HIA showed that in Guangzhou ten thousands of premature deaths could be prevented if the PM burden was reduced to these air quality limit values. We identified no suitable epidemiological study reporting PM according to our study protocol. Further epidemiological studies should be carried out to more precisely determine the spatial distribution of PM-related health risks in PRD. Environmental protection measures and public health interventions are required to reduce burden of PM-related diseases in PRD.

Medikamentöse Therapie bei Nikotinentzug

Tobacco smoking is the leading cause of preventable morbidity and premature death. Physicians are in the unique position to promote smoking cessation and to support patients in quitting smoking is a key task for every single health care provider. Counselling smoking cessation is clearly shown to be both efficient and cost-effective in terms of years of live saved. Nicotine is highly addictive and to achieve long-term abstinence pharmacotherapy is frequently inevitable. Nicotine replacement therapy is efficacious and doubles the odds of permanently abstain from smoking. Further, strong evidence supports the use of buproprion, an atypical antidepressive agent, for quit smoking. Varenicline is the first medication specifically developed for smoking cessation. Varenicline is a partial agonist and antagonist at the nicotinic receptor that reduces craving, withdrawal symptoms and the reinforcing effect of smoking. This review summarises the current clinical data on the pharmacotherapy for smoking cessation and provides practical advice for daily clinical practice.

Preclinical pharmacology, efficacy, and safety of varenicline in smoking cessation and clinical utility in high risk patients

Smoking is still the most prominent cause of preventable premature death in the United States and an increasing cause of morbidity and mortality throughout the world. Although the current treatments such as nicotine replacement therapy (NRT) and bupropion are effective, long-term abstinence rates are low. Mechanism studies suggest that the pleasurable effects of smoking are mediated predominantly by nicotine, which activates the brain reward system by activation of brain α(4)β(2) nicotinic acetylcholine receptors (nAChRs). Varenicline is a novel α(4)β(2) nAChR partial agonist and has been found to be even more effective than NRT or bupropion in attenuating smoking satisfaction and in relieving craving and withdrawal symptoms after abstinence. Thus, varenicline has been recently approved to be a first-line medication for smoking cessation in the United States and European countries. Varenicline is generally well tolerated in healthy adult smokers, with the most commonly reported adverse effects being nausea, insomnia, and headache. However, growing post-marketing data has linked varenicline to an increase in neuropsychiatric symptoms such as seizures, suicidal attempts, and depression, psychosis, as well as serious injuries potentially relating to unconsciousness, dizziness, visual disturbances, or movement disorders. Therefore, new safety warnings are issued to certain high risk populations, such as patients with mental illness and operators of commercial vehicles or heavy machinery. In particular, pilots, air traffic controllers, truck and bus drivers have been banned from taking varenicline.

Healthy Men 2020

Every 10 years, the U.S. Department of Health and Human Services uses scientific information and best lessons learned from the past decade, along with evidencebased findings and information generated from research, current trends, and innovations, to formulate national objectives. These national objectives are written into a Healthy People document. The Healthy People document provides science-based 10-year national objectives focused on promoting health and preventing disease. Healthy People 2020 will use a risk factors and determinants of health approach to inform and guide improvements in health and build on past iterations of Healthy People objectives. The vision for our nation in 2020 is a society in which all people live long, healthy lives. This vision is expected to be accomplished through four goals: attaining high quality, longer lives free of preventable disease, disability, injury, and premature death; achieving health equity, eliminating disparities, and improving the health of all groups; creating social and physical environments that promote good health for all; and promoting quality of life, healthy development, and healthy behaviors across all life stages. The Healthy People 2020 objectives are organized within the following topical areas: access to health services; adolescent health; arthritis, osteoporosis, and chronic back conditions; blood disorders and blood safety; cancer; chronic kidney disease; diabetes; disability and secondary conditions; early and middle childhood; education and community-based programs; environmental health; family planning; food safety; genomics; global health; health communication and health information technology; health care–associated infections; hearing and other sensory or communication disorders; heart disease and stroke; human immunodeficiency virus infection; immunization and infectious diseases; injury and violence prevention; maternal, infant, and child health; medical product safety; mental health and mental disorders; nutrition and weight status; occupational safety and health; older adults; oral health; physical activity and fitness; public health infrastructure; quality of life and well-being; respiratory diseases; sexually transmitted infections; social determinants of health; substance abuse; tobacco use; and vision. A detailed outline of each specific measurable objective can be reviewed at www.healthypeople.gov. The Healthy People 2020 specifically outlines the following objectives specifically targeting males:

Smoking cessation: an economic analysis and review of varenicline.

Despite efforts to decrease tobacco use, smoking continues to be a leading cause of preventable morbidity and premature death. The associated economic burden is substantial, both in the form of direct costs (healthcare expenditures) and indirect costs (lost productivity), regardless of whether the burden is assessed from the standpoint of an employer, a health plan, or society as a whole. Cessation programs are considered among the most cost-effective in healthcare, and are often used as a benchmark for other medical interventions. This analysis specifically considers the cost-effectiveness of varenicline, a novel α(4)β(2) partial agonist used for smoking cessation, in comparison to other approved therapies. Clinical trial data have demonstrated that varenicline has the ability to decrease cravings and withdrawal symptoms, and lessen positive reinforcement associated with smoking. Varenicline's novel mechanism has translated into superior efficacy in comparison to other available therapies. For this reason, despite an initial cost that typically exceeds that of other medications, varenicline is a cost-effective option for smoking cessation.

Letter

Back to table of contents Previous article Next article LetterFull AccessLetterMeghan Caughey M.A., M.F.A.Meghan Caughey M.A., M.F.A.Search for more papers by this authorPublished Online:13 Jan 2015https://doi.org/10.1176/ps.2008.59.10.1218AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail The Wellness ModelTo the Editor: I was pleased to see that the August issue focused on improving medical care for persons with mental illness, of which I am one. The problem of medical care must be solved at all levels, not simply with a "top down" approach. The medical model first sought to "fix" us via the actions of clinicians upon us. The best that we could hope for was to have our illness controlled, in remission, or "maintained." We could strive to be "higher functioning," but this was an elusive goal. Clinicians sometimes helped us, but we learned that the power for changing our lives lay outside of us.It was an improvement when we claimed for ourselves the recovery model. According to this model, recovery is possible for every person and we are all capable of leading a meaningful and unique life. A life is created by each person out of her or his own potential and expresses that individual's constellation of abilities, strengths, supports, and choices. We learned that the power of recovery lies within each of us. Although we may use supports, we have the power to determine our own course.Now we have the wellness model, which takes the recovery model one step further. According to the wellness model:•It is our human birthright to recover and be well.•It is our right to express and enjoy our recovery without suffering preventable diseases and premature death.•We must have hope, believing in the truth that we can enjoy long, meaningful lives.•We have the ability to make choices that support our greater health, safety, and well-being.•We are inherently whole at the deepest of level of our being, and the path to wellness is the journey of discovering and expressing this wholeness.•Our deep wholeness can guide us in making choices about what we need to be well. This intuitive sense is powerful when combined with all of the available resources and information to help us make informed choices.•Keys to wellness are kindness, gentleness, and a nonjudgmental stance toward self and others. We cannot push ourselves or other people into wellness. We can offer hope and, as Patricia Deegan, Ph.D., a former patient and a mental health activist, said, "We can, with understanding, create conditions that potentially excite motivation."•Keys to success include working to express one's potential while accepting one's self and communicating positive expectations and acceptance of self and peers.According to the wellness model, clients of the public mental health system do not have to die 25 years before their time. Mutual support and personal efforts to develop wellness lifestyle changes can create a "culture of wellness" within the mental health community. Every time we encourage and support one another to make a choice for health or choose this for ourselves, we are helping to create a paradigm shift.Most of us know of persons who died too early. We need to turn this trend around. This transformation is for our very survival.Ms. Caughey is the peer wellness coordinator at Benton County Health Services, Corvallis, Oregon. FiguresReferencesCited byDetailsCited ByNone Volume 59Issue 10 October, 2008Pages 1218-1218PSYCHIATRIC SERVICES October 2008 Volume 59 Number 10 Metrics PDF download History Published online 13 January 2015 Published in print 1 October 2008

Prevention of hypertrophic cardiomyopathy-related deaths: theory and practice

In 1958, the British forensic pathologist, Donald Teare, reported a family in which eight young people had died suddenly from asymmetrical hypertrophy of the left ventricle. Five decades on, the...

Military tobacco use: A synthesis of the literature on prevalence, factors related to use, and cessation interventions

Tobacco use remains the number one cause of preventable morbidity and premature death in the United States. As a result, military leaders are recognizing that tobacco can adversely affect military fitness levels, deployment readiness, and safety and can increase health care costs. Yet military members continue to use tobacco. Tobacco may be viewed as part of the military culture since military members have used tobacco for many decades for pleasure, comfort, and currency and as a morale booster. Most recently, the military has seen an increase in tobacco use among young military members. A number of research studies have examined the prevalence of tobacco and factors related to use in the military, and several have evaluated cessation and prevention interventions. This article provides a brief historical perspective of military tobacco use in the 20th century and a critical review of the literature published between 1991 and 2006 describing prevalence of tobacco use, factors influencing use, and cessation interventions in the military. Recommendations for future research and for interventions are provided.

Caring for Homeless People: Can Doctors Make a Difference?

Homeless men, women, and children make up a growing population that is vulnerable to preventable disease, progressive morbidity, and premature death.1,2 Homeless people with multiple and interacting social and medical problems are in need of social medical care. Regarding the provision of care, doctors are trained to help people with their medical problems, to look for a medical diagnosis, and advise on medical care. In the case of homelessness, doctors need to advise on medical care in very difficult social circumstances. In the medical literature, there is little evidence on good practice in caring for homeless people.3 How do doctors perform in these circumstances? Can we make a difference? For more than …

Public health milestone

The ‘smoking epidemic’ of the 20th century will likely be viewed with incredulity by historians of the future. How could our society, first in ignorance, but later with full knowledge have promoted and tolerated a habit that is the single greatest cause of preventable illness and premature death in the UK, killing more than 114 000 people in this country every year and costing the NHS about £1.5 billion a year (Peto et al, 2006)?

Overexpression of human adiponectin in transgenic mice results in suppression of fat accumulation and prevention of premature death by high-calorie diet

Adiponectin, a physiologically active polypeptide secreted by adipocytes, shows insulin-sensitizing, anti-inflammatory, and antiatherogenic properties in rodents and humans. To assess the effects of chronic hyperadiponectinemia on metabolic phenotypes, we established three lines of transgenic mice expressing human adiponectin in the liver. When maintained on a high-fat/high-sucrose diet, mice of two lines that had persistent hyperadiponectinemia exhibited significantly decreased weight gain associated with less fat accumulation and smaller adipocytes in both visceral and subcutaneous adipose tissues. Macrophage infiltration in adipose tissue was markedly suppressed in the transgenic mice. Expression levels of adiponectin receptors were not altered in skeletal muscle or liver. Circulating levels of endogenous adiponectin were elevated, whereas fasting glucose, insulin, and leptin levels were reduced compared with control mice. In the hyperadiponectinemic mice daily food intake was not altered, but oxygen consumption was significantly greater, suggesting increased energy expenditure. Moreover, high-calorie diet-induced premature death was almost completely prevented in the hyperadiponectinemic mice in association with attenuated oxidative DNA damage. The transgenic mice also showed longer life span on a conventional low-fat chow. In conclusion, transgenic expression of human adiponectin blocked the excessive fat accumulation and reduced the morbidity and mortality in mice fed a high-calorie diet. These observations may provide new insights into the prevention and therapy of metabolic syndrome in humans.

Thiazolidinediones for Initial Treatment of Type 2 Diabetes?

The twin epidemics of obesity and type 2 diabetes mellitus have spawned a public health crisis. In the United States, an estimated 1.5 million new cases of diabetes occur every year,1 and the projected microvascular and cardiovascular complications2 — already the greatest cause of blindness, kidney failure, and amputations in the Western world, and a substantial contributing factor in heart disease — are likely to become the major cause of preventable disease and premature death in this millennium. The gravity of this epidemic is reflected by evidence-based efforts to stem it.3,4 Moreover, in the United States, approval of five . . .

The anesthesia preoperative assessment: an opportunity for smoking cessation intervention

Smoking is the single most cause of preventable disease and premature death in the United States. We discuss potential hazards that the anesthesiologist should be aware of when caring for patients who abuse tobacco. A review of recent preoperative smoking cessation initiatives is also provided in addition to recommendations on how anesthesiologists may use the preoperative visit as an opportunity to play a more active role in reducing the burden of tobacco-related disease.

Consequences of youth tobacco use: a review of prospective behavioural studies

Cigarette smoking represents a significant health problem and tobacco has been identified as causing more preventable diseases and premature deaths than any other drug. Although health consequences from smoking have been documented, there has been a surprising lack of research into behavioural consequences. To review what is known of the long-term relationship between patterns of tobacco use prior to age 18 years and behavioural consequences in adulthood. A literature search of electronic abstraction services from 1980 to September 2005 was conducted. To be included in the review, studies had to have large, representative samples, be longitudinal studies with baseline age under 18 years and follow-up age 18 years or older and clarify effects due to attrition, leaving 16 articles that met the inclusion criteria. Two reviewers evaluated each paper. Adolescent tobacco use predicts a range of early adult social and health problems. Surprisingly few studies met the inclusion criteria. The limited evidence available suggests that adolescent tobacco smoking increases the likelihood of early adult tobacco use and the initiation of alcohol use or the development of alcohol-related problems. The link between adolescent tobacco use and subsequent cannabis use was not resolved convincingly from the studies summarized. The effects of tobacco use on later illicit drug use tended to fall away when adjusting for underlying risk factors. Existing studies of the effects of tobacco use on later mental health have many limitations. Nevertheless, a finding that youth tobacco use may predict subsequent mental health problems deserves further investigation. The possible effects of tobacco use on academic/social problems and sleep problems also warrant further investigation. This review highlights links between youth tobacco use and subsequent behavioural and mental health problems. It provides health care professionals with evidence of the possible harmful effects of youth tobacco smoking on later social, emotional, and behavioural well-being.

The nurse’s role in promoting smoking cessation

In this article the authors discuss strategies to help patients stop smoking--the greatest cause of preventable illness and premature death in the UK. They outline the various products and local support services available for patients.