Preventive Health Research Articles

Anethum graveolens L. restores expression of free fatty acid synthesis-related genes in high fat induced-HepG2 cells

IntroductionThe ethanolic extract of Anethum graveolens (dill) and its major constituents, chlorogenic acid (CGA) and ellagic acid (EA), were investigated for hepatoprotective effects in a HepG2 cell fatty liver model. MethodsHepG2 cells were induced with a combination of oleic (1mM OA) and palmitic (1mM PA) acids and treated with either 10 µM fenofibrate, 1-10 µg/mL CGA or EA, 60-360 µg/mL A. graveolens extract, or left untreated (n=4-5 per group). After 48 hours, cell medium and cells were collected for alanine transaminase (ALT), aspartate transaminase (AST), reactive oxygen species (ROS), and fatty acid accumulation assays. The mRNA and protein expression levels of free fatty acid (FFA) synthetic pathway-related genes were determined using reverse transcription/real-time polymerase chain reaction and Western blotting analysis, respectively. ResultsHepG2 cells treated with OA and PA showed increased ALT, AST, and ROS levels, fatty acid accumulation, and modified mRNA and protein expression of PPAR, SREBP1, ACC, ACOX, FAS, SCD1, and HMGCR fatty acid synthesis-related genes. The CGA, EA, and A. graveolens extract showed hepatoprotective activities in OA and PA-induced HepG2 cells by preventing fatty acid accumulation and restoring mRNA and protein expression levels of the fatty acid synthesis-related genes to control levels, with comparable efficacy to the standard anti-lipidemic drug, fenofibrate. Furthermore, CGA, EA, and A. graveolens extract did not increase ALT and ROS levels in HepG2 cells, in contrast to fenofibrate. ConclusionA. graveolens extract, CGA, and EA are good candidates for development as preventive health supplements for fatty liver disease therapy.

Research on Application of Japanese Quince (Chaenomeles L.) and Pork Collagen in Dark Chocolate-Benefits in Prevention of Inflammation In Vitro Model.

In the present study, the effect of the addition of quince and collagen type I and III to dessert chocolate on its functional properties was determined. The study evaluated the antioxidant potential of the tested formulations using the FRAP method and the linoleic acid oxidation test and beta-carotene bleaching test. The tested samples were also evaluated for inhibitory activity against enzymes important in preventive health (inflammation and neurodegenerative disorders) namely: AChE, BChE, GR, GPx, COX, and SOD. The addition of quince and collagen to the chocolate samples resulted in higher activity compared to the control sample, as indicated by the FRAP test. The experiment highlighted the impact of including quince fruit on the antioxidant activity of the chocolate samples. Interestingly, merely increasing the quince fruit amount did not consistently enhance antioxidant potential. Specifically, chocolate samples with a lower proportion of quince fruit (2 g/100 g) exhibited greater antioxidant activity when supplemented with collagen I. Conversely, in samples with higher quince percentages (3 g and 4 g), those enriched with collagen III showed higher antioxidant activity. Similar correlations were observed in the linoleic acid oxidation test. Notably, samples containing 3 g and 4 g of quince and type III collagen demonstrated statistically similar highest antioxidant properties. Regardless of the collagen type used, there was no observed increase in activity towards the tested enzymes for samples with the lowest percentage of quince fruit. Both collagen types exhibited the highest activity in the inhibition assay against acetylcholinesterase and butyrylcholinesterase when combined with 3 g and 4 g of quince. Overall, the experimental incorporation of both fruit and collagen enhanced the chocolates' activity. Similarly to the antioxidant activity findings, chocolates with lower quince fruit quantities showed increased activity when supplemented with collagen III, while those with higher quince content (3 g and 4 g) displayed higher activity with collagen I. Bitter chocolate by itself is an attractive food product, rich in many bioactive compounds. However, enriching it with other attractive raw materials can make its properties and taste even more attractive.

Pendidikan dan Pelatihan tentang Pengaruh Gizi Seimbang Terhadap Kesehatan Umum dan Rongga Mulut Tim Penggerak PKK Cideng Jakarta Pusat

Nutrition has an important role during the growth and development of children in general, especially in the oral cavity. Children who are malnourished can cause abnormalities in the hard tissue of the teeth and periodontal. Abnormalities in the oral cavity can disrupt masticatory function, which can affect food intake. Parental knowledge is important in choosing food for the family, because it can affect the nutritional status of children and their families. This Community Service (PkM) were attended by 36 participants from the PKK mobilization team, Cideng, Central Jakarta. The materials provided are the effect of balanced nutrition on general health, the effect of nutrition on the tooth supporting tissue, the impact and prevention of poor dental health and good oral health care in power points, videos and posters. The results of the PkM training were evaluated by a pre-post test using a google form. The evaluation results showed an increase in participants' knowledge scores from an average pre-test score of 45.78 to an average post-test score of 82.19. It is hoped that this PkM activity can increase the knowledge of the PKK mobilization team, so that in the future they can provide education to the public regarding the influence of balanced nutrition on general health and the oral cavity as well as how to maintain oral health.

Impact of a Distress Brief Intervention on Suicidal Ideation, Suicide Attempts and Self-harm in the immediate, short and longer term: a mixed method evaluation study protocol

Background The Distress Brief Intervention (DBI) is a new approach aimed at reducing distress and is embedded in Scotland’s suicide prevention and mental health strategies. People in distress can be referred to DBI by front-line healthcare and emergency service staff. DBI promises to make contact within 24 hours and offers people in distress 14 days of compassionate, community-based, and person-centred support. The development of NHS 24, a new specialist National Health Service Mental Health Hub (MHH) embedded in Scotland’s urgent care service created a new national route to access DBI. Protocol This study is a mixed-method evaluation of the impact of DBI on suicidal ideation, suicide attempts and self-harm in the immediate, short and longer term among people presenting in distress. Evaluation participants include adults who access DBI, DBI staff, individuals who have used NHS 24 MHH, and GPs. A combination of analysis of quantitative survey and linked administrative data, including a comparator group analysis, qualitative interview and focus group data will support understanding of whether and how DBI can reduce suicidal ideation, suicidal behaviour and self-harm among those presenting to front-line services in distress. A survey of General Practitioners and a review of existing literature will be used to model typical care pathways for individuals in distress and at risk of self-harm. Modelled resource use and costs will be explored. All data collected will be triangulated through a summative evidence synthesis to develop evidence-based insights and conclusions to inform policy and practice development. Discussion Understanding whether, how and why DBI has helped prevent future suicidal thoughts and behaviour in those with a history of suicidal risk will provide important insights into how the intervention can be further developed and optimised as a suicide prevention intervention.

Excess prevalence of preexisting chronic conditions in older adults with incident epilepsy.

Prior studies have examined chronic conditions in older adults with prevalent epilepsy, but rarely among those with incident epilepsy. Identifying the chronic conditions with which older adults present at epilepsy incidence assists with the evaluation of disease burden in this patient population and informs coordinated care development. The aim of this study was to identify preexisting chronic conditions with excess prevalence in older adults with incident epilepsy compared to those without. Using a random sample of 4 999 999 fee-for-service Medicare beneficiaries aged >65 years, we conducted a retrospective cohort study of epilepsy incidence in 2019. Non-Hispanic Black and Hispanic beneficiaries were oversampled. We identified preexisting chronic conditions from the 2016-2018 Medicare Beneficiary Summary Files and compared chronic condition prevalence between Medicare beneficiaries with and without incident epilepsy in 2019. We characterized variations in preexisting excess chronic condition prevalence by age, sex, and race/ethnicity, adjusting for the racial/ethnic oversampling. We observed excess prevalence of most preexisting chronic conditions in beneficiaries with incident epilepsy (n = 20 545, weighted n = 19 631). For stroke, for example, the adjusted prevalence rate ratio (APRR) was 4.82 (99% CI:4.60, 5.04), meaning that, compared to those without epilepsy, beneficiaries with incident epilepsy in 2019 had 4.82 times the stroke prevalence. Similarly, beneficiaries with incident epilepsy had a higher prevalence rate for preexisting neurological conditions (APRR = 3.17, 99% CI = 3.08-3.27), substance use disorders (APRR = 3.00, 99% CI = 2.81-3.19), and psychiatric disorders (APRR = 1.98, 99% CI = 1.94-2.01). For most documented chronic conditions, excess prevalence among beneficiaries with incident epilepsy in 2019 was larger for younger age groups compared to older age groups, and for Hispanic beneficiaries compared to both non-Hispanic White and non-Hispanic Black beneficiaries. Compared to epilepsy-free Medicare beneficiaries, those with incident epilepsy in 2019 had a higher prevalence of most preexisting chronic conditions. Our findings highlight the importance of health promotion and prevention, multidisciplinary care, and elucidating shared pathophysiology to identify opportunities for prevention.

Overdose prevention activities led by local public health departments, 2019–2023

BackgroundDrug overdose deaths in the United States increased to historic levels in recent years, with provisional estimates indicating more than 111,000 deaths in the 12 months ending July 2023. In 2019, the Centers for Disease Control and Prevention’s Division of Overdose Prevention in collaboration with the National Association of City and County Health Officials, funded local health departments (LHDs) to work on overdose prevention activities. This paper aims to: 1) describe the overdose prevention activities that LHDs implemented during the four eighteen-month funding cycles; 2) identify programmatic successes and areas of opportunity for LHDs to consider when implementing future overdose prevention activities; and to 3) inform policy considerations and future overdose prevention programming at the local level.MethodsWe used programmatic data to identify overdose prevention activities implemented by 45 LHDs. Activities were double-coded according to the social-ecological model and the U.S. Department of Health and Human Services Overdose Prevention Strategies and Guiding Principles. We analyzed final codes to identify distribution and overlap of the Strategies and Guiding Principles across the social ecological model co-occurrences.ResultsApproximately 55.9% (n=123) of the 220 overdose prevention activities that were coded took place at the community level, 32.3% (n=71) at the individual level, 8.6% (n=19) at the relationship level, and 3.2% (n=7) at the policy level. Most of the activities were coded as coordination, collaboration, and integration (n=52, 23.6%), harm reduction (n=51, 23.1%), data and evidence (n=47, 21.4%) or reducing stigma (n=24, 10.9%). Few activities were related to primary prevention (n=14, 6.4%), equity (n=14, 6.4%), recovery support (n=11, 5.0%), and evidence-based treatment (n=7, 3.2%).ConclusionsLocalities have primarily implemented activities focused on the community and individual levels, with most of these centered around coordination, collaboration, and integration; harm reduction; or data and evidence. This study identified gaps in overdose prevention for LHDs related to treatment and health equity and that more interventions should be implemented at the relationship and policy levels. Continuing these efforts is important as LHDs explore opportunities to enhance and expand their work in various strategy areas across the social ecology. Findings from this study may be used to inform localities as they design and implement future overdose prevention activities.

Perspective on Emerging Micronutrient Deficiencies in Latin America and the Caribbean.

The moral imperative of public health systems is to maximize the health and welfare of the population to the extent possible. Constraints often include a lack of resources, political will, popular acceptance, or an acceptable safety margin. Major agencies have established iron, iodine, and vitamin A as the principal elements for micronutrients, with folate and zinc on the second plane. As the armamentarium of interventions to favor micronutrient nutrition, for example, preventive health measures, dietary improvement, forms of fortification, and nutrient supplements, is offered in public health policy. The utility of their merger with other nutrients, emergent nutrients, has been considered. The Latin America and Caribbean Region has unique characteristics. The scientific and epidemiology considerations for action in the Region's health concern on 4 emergent nutrient deficiencies of public health-vitamins D and E, essential fatty acids, and choline-are reviewed.

Mental Health Promotion in Children and Adolescents

Mental illnesses among children and adolescents are on the rise and are becoming one of the prime causes of disability across the globe. Untreated or unaddressed mental health issues can extend to adulthood. They can have severe long-term physical, social and economic adverse effects, including low employment rate, lesser wages if employed, interpersonal difficulties and more legal and criminal contacts. However, the focus on preventative and promotive mental health measures has gotten rather less emphasis than the sickness side, including treatment and research on mental illnesses. Resilience and positive well-being are protective against developing mental illnesses and improving courses for those who have developed such issues. Resilience can be enhanced by adopting a healthy lifestyle, music, and other art forms as a recreational activity, limiting screen use and having good social support. Various school-based programs are being developed and tested, targeting positive mental well-being and resilience in children and adolescents. A few of them discussed in this review are life skill education, PAX good behavior games, source of strength, Zippy’s Friends, You Can Do It!, and mindfulness-based stress reduction (MBSR). The responsive advocacy for life and learning in youth (RALLY). Despite these, more investments should be directed towards the prevention of illness and promotion of mental well-being than mere treatment and rehabilitation a ARTICLE INFO fter an illness.

Two years outcome of an individualized oral health preventive program for preschool children with neurodevelopmental disorders.

Limited data exist on the effectiveness of oral health preventive programs in children with Neurodevelopmental Disorders (NDD). The aim of this study was to evaluate the effectiveness of an individualized preventive oral health program for preschool children with NDD at a rehabilitation center, over a two years period. In this study, 102 preschool children with NDD were assessed for caries (dmft), oral hygiene status (Green & Vermillion Index) and presence of developmental dental defects. An individualized preventive program was applied based on caries risk and children were followed for two years. Effectiveness of the program was assessed for caries and dental plaque change and explanatory individual factors were used in multivariate models. After two years prospective, dmft increased significantly from 1.1 (SD=2.7) to 2.04 (SD=3.6), while GVPI was reduced significantly from 1.8 (SD=0.9) to 1.4 (SD=0.9). Children in the moderate and high-risk groups missed significantly more follow-ups compared to the low caries risk group (p<.001) while older maternal age (OR=1.38, 95%CI=1.057-1.808) and consumption of more than three sugary snacks/day (OR=0.005, 95%CI=0-0.0794) were significantly correlated with dental caries. The individualized preventive program for preschool children with NDD was effective in improving oral hygiene but not dental caries status.

Experiences of Deployed Physicians in Support of Operation Allies Refuge/Operation Allies Welcome: Lessons to Inform Improvements in Training.

Stability operations, including humanitarian assistance and disaster relief missions, are key functions of U.S. Military medicine and the Military Medical Humanitarian Assistance Course (MMHAC) is a 2-day course widely used to prepare military medical personnel for such missions. It focuses on caring for those most vulnerable in the wake of disasters, particularly children. The large-scale humanitarian deployment of military medical providers in support of Operation Allies Welcome/Operation Allies Refuge (OAW/OAR) presents an opportunity to evaluate the preparedness of these providers to care for the needs of the Afghan travelers, so we explored the experiences of military medical providers deployed in support of OAW/OAR to inform improvements in the MMHAC. We conducted a qualitative study of military medical providers who were deployed in support of OAW/OAR using a series of three virtual focus groups. Focus group questions were structured around the main topics covered in the MMHAC (patient care, ethical considerations, logistical concerns, and preventive and public health) and explicitly asked about adaptive leadership challenges faced and strategies used to overcome them. We analyzed transcripts using inductive thematic analysis within a constructivist paradigm, with adaptive leadership as a sensitizing concept. The study was approved by the Institutional Review Board of Uniformed Services University. We constructed 4 themes from participant responses, each addressing challenges that medical providers faced during their mission: (1) Medical providers navigated tension between medical and public health priorities and military mission priorities; (2) Chronic and complex care needs posed unique challenges for medical personnel; (3) Challenges in patient care were compounded by logistical and system-based barriers; and (4) Cultural barriers led to ethical dilemmas that physicians felt inadequately prepared to handle, most notably with respect to gender-related concerns. Within each theme, participants described which aspects of MMHAC training were most helpful and which areas were inadequate. Physicians found the OAR/OAW mission meaningful but also identified challenges related to medical care provision, public health, logistics, and ethical dilemmas that hindered their ability to carry out their medical mission. Lessons learned from OAW/OAR highlight several areas in which the MMHAC training could be augmented and improved to further mitigate these challenges.

Assessing the mental health of slum dwellers: an ordinal logistic approach

BackgroundStress, depression and anxiety are prevalent mental health concerns that are getting worse every day in the context of rapidly expanding megacities, where a rising number of people live in slums. The purpose of this study is to evaluate the state of mental health and related variables underlying mental health issues among the impoverished population.MethodologyA total of 384 slum residents from the Khulna division responded to our questionnaire, which included the DASS-21 and other pertinent questions. Using ordinal logistic regression, the significant factors were extracted.ResultsThe Cronbach’s reliability coefficient for the DASS-21 scale lies between 0.79 and 0.89 which indicates the high reliability of the DASS-21 scales. According to the findings, roughly 72.7%, 84.1%, and 69% of participants slum dwellers experienced anxiety, depression, and anxiety problems respectively. The result of ordinal logistic regression shows, slum dwellers of female gender (B = 0.669*, 95% CI 0.141, 1.197), married (B = 1.506*, 95% CI 0.119, 2.893), having only one earning member in the family (B = 1.224*, 95% CI 0.526, 1.922), day laborers (B = 2.294*, 95% CI 1.115, 3.473), not being able to educate children due to financial problem (B = 0.558*, 95% CI 0.183, 0.932) were more likely to report high levels of anxiety, depression, and stress.ConclusionThe study finds that a significant portion of people who live in slums struggle with mental health issues. It also points to the need for further support, intervention, and study on Khulna's slum inhabitants who are experiencing mental health issues. The authors anticipate that the results will spur policymakers and government representatives to enhance financing for slum dwellers and employ psychological intervention strategies, both of which will aid in achieving the Sustainable Development Goal.

Influence of Political Ideology on Colorectal Cancer Screening Among Adults in the United States.

Political ideologies have emerged as one of the risk factors driving healthcare decisions, including colorectal cancer screening in US adults. Previous links between conservative viewpoints and lower awareness of preventive health services have been established. We aimed to evaluate how differences in political ideology affect CRC screening practices using a nationally representative sample of US adults. Using data from the 2020 Health Information National Trends Survey (HINTS), we compared compliance with CRC screening guidelines between conservative, moderate, and liberal political groups. Survey-weighted multivariable logistic regression models were employed to ascertain the relationship between political ideology and CRC screening. Of the 3368 respondents, 71.0% (95% CI: 67.8, 74.0) were screened for CRC. A total of 1026 (30.5%) were liberal, 1148 (34.1%) were moderate, and 1194 (35.4%) were conservative. Out of the conservatives (78.8%) were non-Hispanic Whites compared to moderates (61.4%) and liberals (64.0%). There was no significant difference in age, level of education, or income group by political ideology. In adjusted models, there was no significant difference in CRC screening by political ideology. Contrary to previous ties, we found no significant differences in compliance with CRC screening guidelines among these groups, concluding that CRC screening remains a significant health concern for all individuals, irrespective of political ideologies.

“I Had No Idea about This:” A Mixed-Methods Exploration of Sexual Health and HIV Prevention Needs among Black Youth in a Southern City

HIV disparities continue to persist among Black youth in the South. We conducted quantitative surveys (N = 83) and follow-up qualitative interviews (n = 13) to assess sexual health needs including but not limited to Pre-Exposure Prophylaxis (PrEP) awareness. Participants all identified as Black; most survey respondents identified as being assigned female sex at birth and heterosexual. Both qualitatively and quantitatively, knowledge about HIV and PrEP and engagement in sexual health preventive behaviors was low. Participants described a need for more comprehensive sexual health education at younger ages and more routinized HIV testing. The latter was recommended even for people with a low perceived risk of HIV. Future studies should explore how to tailor communication to youth of color specifically and understand nuances of experiences they may have based on their sexual orientation and gender identity to promote engagement in sexual health preventive care, including but not limited to HIV prevention and PrEP uptake. The findings suggest that comprehensive sexual care that provides education on HIV, STI, and pregnancy prevention is critical for youth experiencing inequities in a Southern city context.

Dental health of cleft patients attending the 18-month-old clinic at a specialised centre

Orofacial clefts are the most common craniofacial anomaly and children with a cleft are at increased risk of dental caries and anomalies, the most common being hypodontia. This evaluation aimed to establish whether implemented changes after the first cycle led to improved oral health prevention in children attending the 18-month-year-old cleft dental appointment. A total of 44 records were analysed retrospectively over a 9-month period for the second cycle. The initial findings were presented locally and nationally to cleft teams, and an article discussing the dental health of 18-month-old cleft patients was published in the British Dental Journal. Despite the Covid-19 pandemic limiting dental care access, registration with a local dentist increased by 8% in the second cycle. There was a 24% increase in the number of patients having twice-daily toothbrushing performed and an 11% increase in the number of cleft patients who have stopped bottle-feeding by 18 months. The implemented changes following the initial cycle looking at dental health had a positive impact on the percentage of patients who brush twice daily, stopped bottle-feeding and registered with a local dentist.

Prediabetes and diabetes were attributed to the prevalence and severity of sarcopenia in middle-aged and elderly adults

BackgroundSarcopenia and diabetes are both prevalent health problems worldwide. However, little is known about the relationship between prediabetes and the prevalence and severity of sarcopenia. Therefore, the current study aimed to explore the association between glucose status and the components of sarcopenia, including low muscle mass (LMM), low muscle strength (LMS) and low gait speed (LGS) in US adults.MethodsData from the 1999 to 2002 National Health and Nutrition Examination Survey (NHANES) were analyzed. A total of 4002 participants aged ≥ 50 years with available information on glucose status (NGR: 1939 cases; prediabetes: 1172 cases; diabetes: 891 cases) and sarcopenia were included in this study. Sarcopenia was defined according to the Foundation for National Institute of Health criteria. Muscle mass, muscle strength and gait speed were used to evaluate sarcopenia and its severity. Weighed multivariable logistic regression were used to explore the association between glucose status and the components of sarcopenia. The hypothetical population attributable fraction (PAF) for the glucose status was also calculated.ResultsThe mean age of the cohort was 63.01 ± 9.89 years, with 49.4% being male. Multiple logistic regression analysis suggested that diabetes was an independent risk factor for sarcopenia (OR = 5.470, 95% CI 1.551–19.296) and showed a marginal association with severe sarcopenia (OR = 10.693, 95% CI 0.955–119.73) compared to NGR in men, but not in women. Additionally, prediabetes was independently associated with severe sarcopenia (OR = 3.647, 95% CI 1.532–8.697), LMS (OR = 1.472, 95% CI 1.018–2.127) and LGS (OR = 1.673, 95% CI 1.054–2.655) in the entire cohort. When stratifying by gender, we further observed that prediabetes was significantly associated with LMS in men (OR = 1.897, 95% CI 1.019–3.543) and related to LMM (OR = 3.174, 95% CI 1.287–7.829) and LGS (OR = 2.075, 95% CI 1.155–3.727) in women. HbA1c was positively associated with the prevalence of sarcopenia in men (OR = 1.993, 95% CI 1.511–2.629). PAF showed that diabetes accounted for 16.3% of observed sarcopenia cases. Maintaining NGR in the entire population could have prevented 38.5% of sarcopenia cases and 50.9% of severe sarcopenia cases.ConclusionsPrediabetes and diabetes were independently associated with the prevalence and severity of sarcopenia in US population. Slowing down the progression of hyperglycemia could have prevented a significant proportion of sarcopenia cases.

KANSURVIVE: Testing a telementoring model for improving cancer survivorship care in rural practice.

e13791 Background: Cancer survivors require long-term, coordinated care to address the physical, emotional, and psychosocial effects of cancer and its treatment. KanSurvive, a single arm feasibility trial, evaluated the effectiveness of the KanSurvive ECHO intervention combined with practice facilitation (PF) to promote better adoption of evidence-based practice (EBP) survivorship care guidelines for breast, colorectal, lung, and prostate cancer among rural survivors. Methods: Fifteen primary care clinics in Kansas (80% in RUCA codes 4-10), including 62 healthcare professionals, were invited to participate in four, 1-hour Project ECHO telementoring program held in 2021. Real-time videoconferencing sessions covered EBP survivorship guidelines for breast, colorectal, lung, and prostate cancer. Clinics used brief plan-do-study-act cycles with PF supporting implementation of the quality improvement process. Utilizing the National Quality Forum framework, a performance indicator booklet with established measures in preventive health and cancer survivorship was developed as a data collection and quality improvement resource. Performance indicators included EBP screening actions related to cancer surveillance, lifestyle factors, distress, evidence of a review of family history of cancer, and the patient’s cancer diagnosis documented in the EHR. Results: Three clinics (7 = healthcare professionals) withdrew from the project citing competing demands and a provider leaving the practice. The COVID-19 pandemic delayed project initiation and prevented clinic visits. Recruitment and study procedures were implemented remotely. Clinic staff identified 138 cancer survivors (M = 13, IQR [6-16] per practice) seen in the year pre-intervention, and 129 survivors in the year prior to post-intervention. Pre-intervention, overall tumor surveillance was 91%, but lung cancer surveillance was lower than other tumor types at 70%. Other than surveillance, measures of baseline performance were similar across tumor types: screening for distress 84%, assessment of BMI 97%, screening for tobacco use 83% and documentation of family history 70%. Post-intervention performance indicators were similar except for documentation of family history which increased to 89% (p &lt; 0.01). Conclusions: Standardized survivorship metrics can facilitate quality assessment as part of an ECHO-based cancer survivorship program. Although there are modest opportunities for improvement, PCPs in this study caring for rural patients perform reasonably well across a variety of cancer survivorship performance metrics comparable to national primary care quality measures. Documented assessment of family history of cancer lags other metrics and improved after participation in the KanSurvive telementoring program.

Early adulthood BMI and cardiovascular disease: a prospective cohort study from the China Kadoorie Biobank.

The associations of early adulthood BMI with cardiovascular diseases have yet to be completely delineated. There is little reliable evidence about these associations among east Asian populations, that differ in fat distribution, disease patterns, and lifestyle factors from other populations. We aimed to study the associations between early adulthood BMI and cardiovascular diseases in a Chinese population, and the effect of midlife lifestyle factors on outcomes. In this prospective analysis, we used data from the China Kadoorie Biobank, a large and long-term cohort from five urban areas and five rural areas, using participants aged 35-70 years. The primary outcome was the incidence of cardiovascular diseases as a group, ischaemic heart disease, haemorrhagic stroke, and ischaemic stroke, which were obtained mainly through linkage to disease registries and the national database for health insurance claims. Early adulthood BMI was assessed through self-report at baseline survey. We used Cox proportional hazards regression models to examine the prospective associations. We also undertook multiplicative and additive interaction analyses to investigate the potential modification effect of midlife healthy lifestyle factors (a combined score covering smoking, drinking, physical activity, and diet). Participants were recruited for baseline survey between June, 2004, and July, 2008. During a median follow-up of 12·0 years (IQR 11·3-13·1), we documented 57 203 (15·9%) of incident cardiovascular diseases in 360 855 participants. After adjustment for potential confounders, monotonic dose-response associations were observed between higher early adulthood BMI and increased risks of incident cardiovascular diseases. Compared with an early adulthood BMI of 20·5-22·4 kg/m2 (the reference group), the hazard ratios for a BMI of less than 18·5 kg/m2 was 0·97 (95% CI 0·94-1·00), 18·5-20·4 kg/m2 was 0·97 (0·95-0·99), 22·5-23·9 kg/m2 was 1·04 (1·02-1·07), 24·0-25·9 kg/m2 was 1·12 (1·09-1·15), 26·0-27·9 kg/m2 was 1·19 (1·14-1·24), 28·0-29·9 kg/m2 was 1·34 (1·25-1·44), and ≥30·0 kg/m2 was 1·58 (1·42-1·75). Except for haemorrhagic stroke, lower early adulthood BMI (<20·5 kg/m2) was associated with decreased incident cardiovascular disease risks. No significant interaction was found between midlife healthy lifestyle factors and early adulthood BMI on cardiovascular disease risks. Increased risks of cardiovascular disease incidence were found among participants with high early adulthood adiposity, including ischaemic heart disease, haemorrhagic stroke, and ischaemic stroke. Our findings suggest early adulthood as an important time to focus on weight management and obesity prevention for cardiovascular health later in life. National Natural Science Foundation of China, National Key Research and Development Program of China, Chinese Ministry of Science and Technology, Kadoorie Charitable Foundation, and the Wellcome Trust.

132b - Risk prevention and training approaches for safety and health in graphene production processes

132b - Risk prevention and training approaches for safety and health in graphene production processes

Gender differences in COVID-19 preventative measures and vaccination rates in the United States: A longitudinal survey analysis

BackgroundPandemics present challenges for individuals as they face uncertainties, risks, and decisions which influence their attitudes towards public health interventions. This study investigates gender differences in attitudes towards COVID-19 preventive measures and vaccination intentions in the United States, focusing on the link between risk perception and attitudes towards public health guidelines. MethodsWe utilised data from the Understanding America Study, a nationally representative longitudinal survey of U.S. adults from March 2020 to March 2022 to assess how gender differences in health risk perception were associated with attitudes, behaviours, and vaccination intentions, while also evaluating how these gender effects changed over time. We used multilevel logistic regression models to adjust for age, level of education, employment status and income. ResultsWomen had a higher risk perception of COVID-19 and exhibited greater compliance with preventive measures compared to men. Women also showed higher agreement with COVID-19 restraining public policy measures. However, this contrasted with attitudes towards the COVID-19 vaccine, where men displayed more positive views and a higher intention to receive the vaccine. This gender effect was persistent over time. ConclusionsThis seemingly paradoxical outcome suggests that while women’s heightened risk perception relative to men’s leads to greater adherence to non-pharmaceutical COVID-19 preventative public health interventions, it may also result in more negative views towards the novel COVID-19 vaccine. Understanding the complex interactions between risk perception, behaviour, and gender can inform policymakers and health authorities to tailor interventions that address the diverse needs of the population.

Фізична культура та спорт як фактор формування здорового способу життя населення

The purpose of this work. To conduct research and analysis of indicators of physical development and physical fitness of two groups of higher education students, as well as the functional state of their cardiovascular, muscular, and respiratory systems, in order to substantiate the importance and necessity of systematic physical education and sports. Materials and methods of research. In accordance with the purpose of the study, the following methods were used: theoretical (analysis and generalization of scientific literature), empirical (survey), testing to determine the physical fitness of students, physiometric and instrumental methods of studying the functional state of students' body systems. Results. Research and analysis of indicators of physical development, physical fitness, and functional state of body systems (cardiovascular, muscular, and respiratory) of higher education students at Cherkasy State Technological University were conducted. The analysis of the research results showed the importance of the role and place of physical culture and sports in preventive medicine and public health. Conclusions. The analyzed indicators of physical development, physical fitness of the studied groups of students, and the functional state of their cardiovascular, muscular, and respiratory systems showed how much physical education and sports allow young people to improve their physical fitness, maintain their health at an appropriate level to overcome life's difficulties, realize their abilities, and be useful to society. The results of our research to some extent coincide with the results of the research of many authors among different age categories of the population.