Population health

BACKGROUND:  Breast cancer-related lymphedema (BCRL) affects many areas of daily living. Individuals with lymphedema may experience chronic and progressive swelling, recurrent skin infections, and decreased self-image and quality of life. For many years, it was considered best practice for this population to avoid exercise; however, in recent years, research has begun to challenge this belief. This systematic review and meta-analyses examined the recent literature on the effects of exercise for patients with, or at risk for, BCRL to inform best practice...

BACKGROUND: Optimal treatment strategy for the oldest patients with diffuse large B-cell lymphoma (DLBCL) remains controversial, as this group often is precluded from clinical trials, and population-based studies are limited. METHODS: All Danish DLBCL-patients ≥75 years diagnosed from 2003 to 2012 were identified, using the Danish National Lymphoma Registry (LYFO). Information regarding baseline characteristics, treatment, comorbidities and outcomes was retrieved from LYFO, the Danish National health registries and medical records...

Seaweed has a long-associated history of use as a supplemented livestock feed, providing nutrients and vitamins essential to maintaining animal health. Some species of seaweed, particularly the fucoids, are well-known accumulators of the metalloid arsenic (As). Arsenic toxicity to humans is well established even at low exposure levels and is considered a class 1 human carcinogen. As mankind's appetite for livestock produce continues to grow unabated, there is a concern that consumption of livestock produce reared on a diet supplemented with seaweed animal feed (SAF) may pose a threat to the human population due to potentially high levels of As present in seaweed...

OBJECTIVES: Preconception folic acid (PFA) taken at least 3 months before conception can decrease the incidence of neural tube defects (NTDs) by approximately 46%. NTDs contribute significantly to neonatal morbidity and mortality in migrant and refugee populations on the Thailand-Myanmar border (incidence 1.57/1000 live births). This audit aimed to assess uptake of PFA among migrant and refugee women, evaluate knowledge about PFA among local healthcare workers and implement a participatory community intervention to increase PFA uptake and decrease NTD incidence in this population...

Per- and polyfluoroalkyl substances (PFAS), man-made chemicals with variable length carbon chains containing the perfluoroalkyl moiety (Cn F2n+1 -), are used in many commercial applications. Since 1999-2000, several long-chain PFAS, including perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA), have been detected at trace levels in the blood of most participants of the National Health and Nutrition Examination Survey (NHANES)-representative samples of the U.S. general population-while short-chain PFAS have not...

The monetary value of a quality-adjusted life-year (QALY) is frequently used to assess the benefits of health interventions and inform funding decisions. However, there is little consensus on methods for the estimation of this monetary value. In this study, we use life satisfaction as an indicator of 'experienced utility', and estimate the dollar equivalent value of a QALY using a fixed effect model with instrumental variable estimators. Using a nationally-representative longitudinal survey including 28,347 individuals followed during 2002-2015 in Australia, we estimate that individual's willingness to pay for one QALY is approximately A$42,000-A$67,000, and the willingness to pay for not having a long-term condition approximately A$2000 per year...

According to climate science, ocean warming is one of the current and future greatest threats to coastal ecosystems. Projection scenarios for the end of this century show that tropical intertidal ecosystems are particularly at risk. In this study we optimized and tested a holistic method for bio-monitoring present and projected thermal pressure in such ecosystems, in order to assess organism vulnerability to ocean warming. Several species representative of different animal groups (fish, crustaceans and gastropods) were collected from the field and subjected to an experimental trial for 28 days, testing two temperatures: control (present seawater summer temperature) and elevated temperature (+3 °C, projected seawater temperature anomaly for 2100)...

The age of the population worldwide is rapidly increasing, bringing social and economic challenges. Persuasive technology can alleviate the burden on traditional healthcare services when used to support healthy behaviors, for instance in the prevention and treatment of chronic diseases. Additionally, healthy behaviors are key factors for active and healthy ageing by delaying or even reversing functional decline. In this manuscript, we present a multi-perspective analysis of technologies that can be used in the support of active and healthy ageing in the daily life...

Caregivers are critical to recipient recovery after hematopoietic cell transplant (HCT), however, little is known about their long-term health and quality of life (QoL). In this study, we surveyed 4446 caregiver/recipient pairs in the post-HCT period to describe their QoL and its determinants. In total, 849 caregiver/recipient pairs at a median of 6 years post autologous or allogeneic HCT responded. Among 849 responding caregivers at a median of 6 years post-HCT, 67% of caregivers were female and 68% indicated that they were still providing care to the recipient...

SCOPE: To assess the associations of dietary linoleic acid (LA) and α-linolenic acid (ALA) with type 2 diabetes (T2D) risk in a population-based cohort and further explore the mechanism of action in a high-fat-diet induced obese (DIO) mouse model. METHODS AND RESULTS: The occurrence of T2D among 15,100 healthy Chinese adults from China Health and Nutrition Survey (CHNS, 1997-2011) were followed up for a median of 14 years. The relations of ALA and LA intakes with T2D risk were modified by BMI, with significant associations restricted to obese/overweight subjects...

Mental health programs to improve problem-solving skills and reduce stress through social gameplay can improve psychiatric outcomes, but little is known about whether adult patients are interested in using them. Primary care patients (n = 467) completed a cross-sectional survey to assess interest in using 2 types of group programs for mental health. A significantly greater percentage (23.7%) of patients expressed interest in a gameplay-based program than in interpersonal therapy (17.6%) (P < .001). Lonely patients and younger patients were more likely to report interest in gameplay...

BACKGROUND: the aim of the current study was to evaluate and compare the quality of life (QOL) and psychological status of adult patients who underwent heart transplant (HTx) at pediatric or adult ages. METHODS: The population consisted of two groups: patients who received HTx after 18 years-old, pediatrics who received HTx between the age of 1 and 18 years. At the time of the study all patients were over 18 years old. QOL data were collected from patients using 36-item Short Form Health Survey (SF-36) and psychological-distress by the Symptom checklist 90-revised questionnaire (SCL-90-R)...

Introduction Vulnerable pregnant women (e.g. women with low socio-economic status or recent immigrants) are less likely to receive adequate prenatal care or to attend perinatal education classes. CenteringPregnancy (CP) is a model of group prenatal care which combines assessment, education and support. This study aimed to assess patient experience among vulnerable women in group prenatal care compared to individual care. Methods Women participating in CP at a community-based health centre in urban Alberta were eligible to participate...

Prison inmates suffer from a heavy burden of physical and mental health problems and have considerable need for healthcare and coverage after prison release. The Affordable Care Act may have increased Medicaid access for some of those who need coverage in Medicaid expansion states, but inmates in non-expansion states still have high need for Medicaid coverage and face unique barriers to enrollment. We sought to explore barriers and facilitators to Medicaid enrollment among prison inmates in a non-expansion state...

AIMS/HYPOTHESIS: Case reports have linked influenza infections to the development of type 1 diabetes. We investigated whether pandemic and seasonal influenza infections were associated with subsequent increased risk of type 1 diabetes. METHODS: In this population-based registry study, we linked individual-level data from national health registries for the entire Norwegian population under the age of 30 years for the years 2006-2014 (2.5 million individuals). Data were obtained from the National Registry (population data), the Norwegian Patient Registry (data on inpatient and outpatient specialist care), the Primary Care Database, the Norwegian Prescription Database and the Norwegian Surveillance System for Communicable Diseases...

Breast milk is the optimal nutrition for babies in their first six months of life and provides health benefits for both children and mothers. As part of the Robert Koch Institute's health monitoring, the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) regularly collects population-based data on the health situation of children and adolescents living in Germany, including information on breastfeeding. This article describes breastfeeding behaviour based on the results of KiGGS Wave 2 (2014-2017)...

In the Australian subtropics, flying-foxes (family Pteropididae) play a fundamental ecological role as forest pollinators. Flying-foxes are also reservoirs of the fatal zoonosis, Hendra virus. Understanding flying fox foraging ecology, particularly in agricultural areas during winter, is critical to determine their role in transmitting Hendra virus to horses and humans. We developed a spatiotemporal model of flying-fox foraging intensity based on foraging patterns of 37 grey-headed flying-foxes (Pteropus poliocephalus) using GPS tracking devices and boosted regression trees...

OBJECTIVE: Understanding the real-world impacts of lifestyle modification (LSM) for diabetes prevention is imperative to inform resource allocation. The purpose of this study was to synthetize global evidence on the impact of LSM strategies on diabetes incidence and risk factors in one parsimonious model. RESEARCH DESIGN AND METHODS: PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched for studies published between January 1990 and April 2015. Effectiveness/translation studies of any design testing LSM strategies, targeting high-risk populations (with prediabetes or diabetes risk factors), and reporting diabetes incidence, weight, or glucose outcomes were included...

BACKGROUND: Despite increasing usage of endovascular treatments for intracranial aneurysms, few research studies have been conducted on the incidence of unruptured aneurysm (UA) and subarachnoid hemorrhage (SAH), and could not show a decrease in the incidence of SAH. Moreover, research on socioeconomic disparities with respect to the diagnosis and treatment of UA and SAH is lacking. METHOD: Trends in the incidences of newly detected UA and SAH and trends in the treatment modalities used were assessed from 2005 to 2015 using the nationwide database of the Korean National Health Insurance Service in South Korea...

INTRODUCTION: Exercise prehabilitation may improve outcomes after surgery. Frailty is a key predictor of adverse postoperative outcomes in older people; the multidimensional nature of frailty makes this a population who may derive substantial benefit from exercise prehabilitation. The objective of this trial is to test the efficacy of exercise prehabilitation to improve postoperative functional outcomes for people living with frailty having cancer surgery with curative intent. METHODS AND ANALYSIS: We will conduct a single-centre, parallel-arm randomised controlled trial of home-based exercise prehabilitation versus standard care among consenting patients >60 years having elective cancer surgery (intra-abdominal and intrathoracic) and who are frail (Clinical Frailty Scale >4<u>)</u>...