Important Public Health Concern (important + public_health_concern)

Distribution by Scientific Domains

Selected Abstracts

Effects of Gain Versus Loss Frame Antidrug Ads on Adolescents

Hyunyi Cho
Improving the effectiveness of antidrug ads is an important public health concern. Central to achieving this aim is identifying the message strategies that address the differential characteristics of adolescent audiences. This study examined the effects of gain versus loss frame antidrug ads on adolescents with different social and behavioral characteristics. A posttest-only experiment was conducted to examine if these audience factors moderate the effects of message framing. Loss-frame messages, rather than gain-frame messages, were more persuasive for adolescents who report that their friends use drugs. Neither gain nor loss framing had a persuasive advantage for adolescents who report that their friends do not use drugs, although this outcome may be the result of a ceiling effect. Implications of the results for future theory and research are discussed. [source]

Hazardous Drinking: Prevalence and Associations in the Finnish General Population

ALCOHOLISM, Issue 9 2008
Jukka T. Halme
Background:, Hazardous drinking, defined as consuming alcohol on a risky level and not meeting the diagnostic criteria of alcohol use disorders (AUDs), has been suggested for a new complementary nondependence diagnosis. This study aimed to investigate the prevalence and associations of hazardous drinking in comparison to AUDs, moderate drinking, and abstinence. Methods:, A national representative sample of Finns was examined in the Health 2000 Survey. For 4477 subjects aged 30 to 64 years (76%, 2341 females), both the quantity frequency data about alcohol consumption and Composite International Diagnostic Interview (CIDI) data concerning AUD diagnoses were available. The nationally recommended limits for hazardous dinking were used (males: 24 drinks, females: 16 drinks/wk). Logistic regression models were used to analyze associations. Results:, The prevalence of hazardous drinking was 5.8%. Hazardous drinking was more prevalent among males than females (8.5% vs. 3.1%). It was most prevalent among the subjects aged 40 to 49 years (7.3%), divorced or separated (8.3%), unemployed (8.2%) and subjects living in the southern (Helsinki) region (7.5%). AUDs versus hazardous drinking were more likely to be in males versus females and in the unemployed versus employed. Subjects aged 40 and over had higher odds for hazardous drinking versus AUDs. The odds for hazardous versus moderate drinking were higher for males versus females (adjusted odds ratio = 3.24), for subjects aged over 40 years, unemployed versus employed and cohabiting, divorced/separated or unmarried subjects versus married subjects. Conclusion:, The high prevalence of hazardous drinking makes it an important public health concern. Hazardous drinkers have different sociodemographic characteristics as compared to people in other alcohol use categories. [source]

Validation of diagnostic codes for outpatient-originating sudden cardiac death and ventricular arrhythmia in Medicaid and Medicare claims data,

Sean Hennessy PharmD
Abstract Purpose Sudden cardiac death (SD) and ventricular arrhythmias (VAs) caused by medications have arisen as an important public health concern in recent years. The validity of diagnostic codes in identifying SD/VA events originating in the ambulatory setting is not well known. This study examined the positive predictive value (PPV) of hospitalization and emergency department encounter diagnoses in identifying SD/VA events originating in the outpatient setting. Methods We selected random samples of hospitalizations and emergency department claims with principal or first-listed discharge diagnosis codes indicative of SD/VA in individuals contributing at least 6 months of baseline time within 1999,2002 Medicaid and Medicare data from five large states. We then obtained and reviewed medical records corresponding to these events to serve as the reference standard. Results We identified 5239 inpatient and 29,135 emergency department events, randomly selected 100 of each, and obtained 119 medical records, 116 of which were for the requested courses of care. The PPVs for an outpatient-originating SD/VA precipitating hospitalization or emergency department treatment were 85.3% (95% confidence interval [CI],=,77.6,91.2) overall, 79.7% (95%CI,=,68.3,88.4) for hospitalization claims, and 93.6% (95%CI,=,82.5,98.7) for emergency department claims. Conclusions First-listed SD/VA diagnostic codes identified in inpatient or emergency department encounters had very good agreement with clinical diagnoses and functioned well to identify outpatient-originating events. Researchers using such codes can be confident of the PPV when conducting studies of SD/VA originating in the outpatient setting. Copyright 2009 John Wiley & Sons, Ltd. [source]

Medication use and risk of falls

C. Ineke Neutel PhD, FACE
Abstract Purpose Injuries due to falls are an important public health concern, particularly for the elderly, and effective prevention is an ongoing endeavour. The present study has two related objectives: (1) to describe associations between drug use and falls in an institutionalized population, and (2) to identify a high risk subgroup within the larger population. Methods The initial analysis was based on a population of 227 residents who were followed over a 1-year period. Logistic regression techniques were used to estimate odds ratios (ORs) of the association of falls and drug use. The study of potential ,high-risk' groups employed a case,crossover design to estimate the risk of falling associated with starting a new drug course. Results Relatively weak ORs for risk of falling were observed for various drug classes; the highest OR was for benzodiazepines (BZD) at OR=1.8, (unadjusted). Residents taking multiple drugs were at particular risk for falling, e.g. an OR of 6.1, for those using 10+ drugs. The case,crossover analysis indicated that residents starting a new BZD/antipsychotic were at very high risk (OR,=,11.4,) for experiencing a fall. Conclusions Residents who took many different types of medications, as well as residents starting a new BZD/antipsychotics were at greatly increased risk of falling. These are high risk groups where increased monitoring or adjustments to drug regimens could lead to prevention of falls. Copyright 2002 John Wiley & Sons, Ltd. [source]

The Life-Years Saved by a Deceased Organ Donor

Mark A. Schnitzler
Understanding the additional life-years given to patients by deceased organ donors is necessary as substantial investments are being proposed to increase organ donation. Data were drawn from the Scientific Registry of Transplant Recipients. All patients placed on the wait-list as eligible to receive or receiving a deceased donor solid organ transplant between 1995 and 2002 were studied. The benefit of transplant was determined by the difference in the expected survival experiences of transplant recipients and candidates expecting transplant soon. An average organ donor provides 30.8 additional life-years distributed over an average 2.9 different solid organ transplant recipients, whereas utilization of all solid organs from a single donor provides 55.8 additional life-years spread over six organ transplant recipients. The relative contribution of the different organs to the overall life-year benefit is higher for liver, heart and kidney, and lowest for lung and pancreas. The life-year losses from unprocured and unused organs are comparable to suicide, congenital anomalies, homicide or perinatal conditions and half that of HIV. Approximately 250 000 additional life-years could be saved annually if consent for potential deceased donors could be increased to 100%. Therefore, increasing organ donation should be considered among our most important public health concerns. [source]