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Public Health Recommendations (public + health_recommendation)
Selected AbstractsEffects of early cat or dog ownership on sensitisation and asthma in a high-risk cohort without disease-related modification of exposurePAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2 2010Catarina Almqvist Summary Almqvist C, Garden F, Kemp AS, Li Q, Crisafulli D, Tovey ER, Xuan W, Marks GB for the CAPS investigators. Effects of early cat or dog ownership on sensitisation and asthma in a high-risk cohort without disease-related modification of exposure. Paediatric and Perinatal Epidemiology 2010; 24: 171,178. Variation in the observed association between pet ownership and allergic disease may be attributable to selection bias and confounding. The aim of this study was to suggest a method to assess disease-related modification of exposure and second to examine how cat acquisition or dog ownership in early life affects atopy and asthma at 5 years. Information on sociodemographic factors and cat and dog ownership was collected longitudinally in an initially cat-free Australian birth cohort based on children with a family history of asthma. At age 5 years, 516 children were assessed for wheezing, and 488 for sensitisation. Data showed that by age 5 years, 82 children had acquired a cat. Early manifestations of allergic disease did not foreshadow a reduced rate of subsequent acquisition of a cat. Independent risk factors for acquiring a cat were exposure to tobacco smoke at home odds ratio (OR) 1.92 [95% confidence interval (CI) 1.13, 3.26], maternal education ,12 years OR 1.95 [1.08, 3.51] and dog ownership OR 2.23 [1.23, 4.05]. Cat or dog exposure in the first 5 years was associated with a decreased risk of any allergen sensitisation, OR 0.50 [0.28, 0.88] but no association with wheeze OR 0.96 [0.57, 1.61]. This risk was not affected by age at which the cat was acquired or whether the pet was kept in- or outdoors. In conclusion, cat or dog ownership reduced the risk of subsequent atopy in this high-risk birth cohort. This cannot be explained by disease-related modification of exposure. Public health recommendations on the effect of cat and dog ownership should be based on birth cohort studies where possible selection bias has been taken into account. [source] Developing evidence-based recommendations in public health , incorporating the views of practitioners, service users and user representativesHEALTH EXPECTATIONS, Issue 1 2008Mary J Renfrew Abstract Background Guidance based on a systematic assessment of the evidence base has become a fundamental tool in the cycle of evidence-based practice and policy internationally. The process of moving from the formal evidence base derived from research studies to the formation and agreement of recommendations is however acknowledged to be problematic, especially in public health; and the involvement of practitioners, service commissioners and service users in that process is both important and methodologically challenging. Aim To test a structured process of developing evidence-based recommendations in public health while involving a broad constituency of practitioners, service commissioners and service user representatives. Methods As part of the development of national public health recommendations to promote and support breastfeeding in England, the methodological challenges of involving stakeholders were examined and addressed. There were three main stages: (i) an assessment of the formal evidence base (210 studies graded); (ii) electronic and fieldwork-based consultation with practitioners, service commissioners and service user representatives (563 participants), and an in-depth analytical consultation in three ,diagonal slice' workshops (89 participants); (iii) synthesis of the previous two stages. Results and conclusions The process resulted in widely agreed recommendations together with suggestions for implementation. It was very positively evaluated by participants and those likely to use the recommendations. Service users had a strong voice throughout and participated actively. This mix of methods allowed a transparent, accountable process for formulating recommendations based on scientific, theoretical, practical and expert evidence, with the added potential to enhance implementation. [source] Prospective Study of Alcohol Consumption in the United States: Quantity, Frequency, and Cause-Specific MortalityALCOHOLISM, Issue 3 2008Rosalind A. Breslow Background:, Alcohol average volume (quantity multiplied by frequency) has been associated with mortality in drinkers. However, average volume may mask associations due to quantity or frequency alone. Methods:, We prospectively assessed relationships between alcohol quantity and frequency, and mortality from all-causes, cardiovascular disease, cancer, and other-causes in a cohort created by linking the 1988 National Health Interview Survey (response rate 87%) to the National Death Index through 2002. Participants were 20,765 current drinkers age , 18 years. At 14-year follow-up 2,547 had died. Results:, For quantity, among men who consumed ,5 drinks (compared to 1 drink) on drinking days, adjusted relative risks (RR) of mortality were: for cardiovascular disease, 1.30 [95% confidence interval (CI) 0.96,1.75; p for linear trend (p -trend) = 0.0295], for cancer, 1.53 (95% CI 1.11,2.09; p -trend = 0.0026), and for other-causes, 1.42 (95% CI 1.08,1.87; p -trend = 0.0029); among women for other-causes, 2.88 (95% CI 1.61,5.12; p -trend = 0.0010). For frequency, among men in the highest frequency quartile (compared to the lowest), RR were: for cardiovascular disease, 0.79 (95% CI 0.63,0.99; p -trend = 0.0330), for cancer, 1.23 (95% CI 0.95,1.59; p -trend = 0.0461), and for other-causes, 1.30 (95% CI 1.01,1.67; p -trend = 0.0070); among women, for cancer, 1.65 (95% CI 1.12,2.45, p -trend = 0.0031). Average volume obscured effects of quantity alone and frequency alone, particularly for cardiovascular disease in men where quantity and frequency trended in opposite directions. Conclusions:, Alcohol quantity and frequency were independently associated with cause-specific mortality. Accumulating evidence of their differential effects may, in the future, be useful for clinical and public health recommendations. [source] Sunlight robbery: A critique of public health policy on vitamin D in the UKMOLECULAR NUTRITION & FOOD RESEARCH (FORMERLY NAHRUNG/FOOD), Issue 8 2010Oliver GillieArticle first published online: 28 JUN 2010 Abstract The British Isles have a very cloudy climate and as a result receive fewer hours of clear sunlight than most other industrial regions. The majority of people in these islands have low blood levels of vitamin D [25(OH)D] all year round. Few food products are fortified with vitamin D in the UK and the government does not recommend any vitamin D supplement for most adults in the UK. Diseases associated with vitamin D insufficiency such as cancer, heart disease, diabetes (types 1 and 2) and multiple sclerosis are more frequent in the UK, and particularly in Scotland, than in many other European countries and some, such as multiple sclerosis and diabetes (types 1 and 2), are increasing in incidence. Present knowledge suggests that the risk of some chronic diseases could be reduced if vitamin D intake or sun exposure of the population were increased. Yet policy and public health recommendations of the UK government and its agencies (e.g. the Health Protection Agency, the Food Standards Agency) and of Cancer Research UK have failed to take full account of established and putative benefits of vitamin D and/or sunshine. The epidemic of chronic disease in the UK, which is associated with and caused at least in part by vitamin D insufficiency, has not been adequately recognized by these agencies, and too often measures taken by them have been misguided, inappropriate or ineffective. [source] Physical activity trends in Queensland (2002 to 2008): are women becoming more active than men?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2010Corneel Vandelanotte Abstract Objective: Regular monitoring of population levels of physical activity is an effective way to assess change over time towards meeting public health recommendations. The objective of this study was to determine physical activity trends in Central Queensland over the period 2002 to 2008. Methods: Data was obtained from the Central Queensland Social Survey (CQSS) conducted annually from 2002 to 2008. A total sample of 8,936 adults aged 18 and over participated in seven cross-sectional surveys. Physical activity was measured using the Active Australia Questionnaire. Binary logistic regression was used to examine trends in sufficient physical activity. Results: Averaged over all survey years 46.5% of study participants met national physical activity guidelines. A small significant upward trend was found for meeting physical activity recommendations across all years (OR=1.03; 95%CI=1.01,1.05), indicating that the odds of meeting the guidelines increased by an average of 3% per year from 2002 to 2008. Slightly more men than women met the activity guidelines (ns); however a significant positive trend in achieving sufficient activity levels was present in women only (4%). Conclusions and Implications: Although an increasing trend for sufficient physical activity was observed, overall physical activity levels in Central Queensland remain suboptimal and more efforts to increase physical activity are needed. The gender differences in physical activity trends indicate that men and women might need to be targeted differently in health promotion messages. The continuous monitoring of population levels of physical activity in Australia, which allow both state specific and international comparisons, is needed. [source] A healthy diet consistent with Australian health recommendations is too expensive for welfare-dependent familiesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2009Christine Kettings Abstract Objective: Examine the cost of healthy food habits for welfare-dependent families in Australia. Method: A seven-day meal plan was developed, based on Australian public health recommendations, for two typical welfare-dependent families: a couple-family (two adults, two children) and a one-parent family (one adult, two children). The cost of the meal plan was calculated using market brand and generic brand grocery items, and total cost compared to income. Results: In Australia, the cost of healthy food habits uses about 40% of the disposable income of welfare-dependent families. Families earning an average income would spend only 20% of their disposable income to buy the same healthy food. Substituting generic brands for market brands reduced the weekly food cost by about 13%. This is one of few economic models to include generic brands. Conclusion: Compared with average-income Australian families, healthy food habits are a fiscal challenge to welfare-dependent families. Implications: These results provide a benchmark for economic and social policy analysis, and the influence disposable income has on prioritising healthy food habits. [source] | ||||||||||