Several studies have shown that a poor vitamin D status may increase the risk of developing metabolic syndrome, which leaves the question whether improving one's vitamin D status may reduce the risk ...for the syndrome. Here we investigate the effect of temporal changes in serum 25-hydroxyvitamin D (25(OH)D) concentrations on metabolic syndrome among Canadians enrolled in a preventive health program that promotes vitamin D supplementation. We accessed and analyzed data of 6682 volunteer participants with repeated observations on serum 25(OH)D concentrations and metabolic syndrome. We applied logistic regression to quantify the independent contribution of baseline serum 25(OH)D and temporal increases in serum 25(OH)D to the development of metabolic syndrome. In the first year in the program, participants, on average, increased their serum 25(OH)D concentrations by 37 nmol/L. We observed a statistical significant inverse relationship of increases in serum 25(OH)D with risk for metabolic syndrome. Relative to those without improvements, those who improved their serum 25(OH)D concentrations with less 25 nmol/L, 25 to 50 nmol/L, 50 to 75 nmol/L, and more 75 nmol/L had respectively 0.76, 0.64, 0.59, 0.56 times the risk for metabolic syndrome at follow up. These estimates were independent of the effect of baseline serum 25(OH)D concentrations on metabolic syndrome. Improvement of vitamin D status may help reduce the public health burden of metabolic syndrome, and potential subsequent health conditions including type 2 diabetes and cardiovascular disease.
Abstract
School-based health promotion is drastically disrupted by school closures during public health emergencies or natural disasters. Climate change will likely accelerate the frequency of these ...events and hence school closures. We identified innovative health promotion practices delivered during COVID-19 school closures and sought consensus among education experts on their future utility. Fifteen health promotion practices delivered in 87 schools across Alberta, Canada during COVID-19 school closures in Spring 2020, were grouped into: ‘awareness of healthy lifestyle behaviours and mental wellness’, ‘virtual events’, ‘tangible supports’ and ‘school-student-family connectedness’. Two expert panels (23 school-level practitioners and 20 decision-makers at the school board and provincial levels) rated practices on feasibility, acceptability, reach, effectiveness, cost-effectiveness and other criteria in three rounds of online Delphi surveys. Consensus was reached if 70% or more participants (strongly) agreed with a statement, (strongly) disagreed or neither. Participants agreed all practices require planning, preparation and training before implementation and additional staff time and most require external support or partnerships. Participants rated ‘awareness of healthy lifestyle behaviours and mental wellness’ and ‘virtual events’ as easy and quick to implement, effective and cost-effective, sustainable, easy to integrate into curriculum, well received by students and teachers, benefit school culture and require no additional funding/resources. ‘Tangible supports’ (equipment, food) and ‘school-student-family connectedness’ were rated as most likely to reach vulnerable students and families. Health promotion practices presented herein can inform emergency preparedness plans and are critical to ensuring health remains a priority during public health emergencies and natural disasters.
Overdose deaths can be prevented by distributing take home naloxone (THN) kits. The emergency department (ED) is an opportune setting for overdose prevention, as people who use opioids frequently ...present for emergency care, and those who have overdosed are at high risk for future overdose death. We evaluated the implementation of an ED-based THN program by measuring the extent to which THN was offered to patients presenting with opioid overdose. We analyzed whether some patients were less likely to be offered THN than others, to identify areas for program improvement.
We retrospectively reviewed medical records from all ED visits between April 2016 and May 2017 with a primary diagnosis of opioid overdose at a large, urban tertiary hospital located in Alberta, Canada. A wide array of patient data was collected, including demographics, opioid intoxicants, prescription history, overdose severity, and whether a naloxone kit was offered and accepted. Multivariable analyses were used to identify patient characteristics and situational variables associated with being offered THN.
Among the 342 ED visits for opioid overdose, THN was offered in 49% (n = 168) of cases. Patients were more likely to be offered THN if they had been found unconscious (Adjusted Odds Ratio 3.70; 95% Confidence Interval 1.63, 8.37), or if they had smoked or injected an illegal opioid (AOR 6.05 2.15,17.0 and AOR 3.78 1.32,10.9, respectively). In contrast, patients were less likely to be offered THN if they had a current prescription for opioids (AOR 0.41 0.19, 0.88), if they were admitted to the hospital (AOR 0.46 0.22,0.97, or if they unexpectedly left the ED without treatment or before completing treatment (AOR 0.16 0.22, 0.97).
In this real-world evaluation of an ED-based THN program, we observed that only half of patients with opioid overdose were offered THN. ED staff readily identify patients who use illegal opioids or experience a severe overdose as potentially benefitting from THN, but may miss others at high risk for future overdose. We recommend that hospital EDs provide additional guidance to staff to ensure that all eligible patients at risk of overdose have access to THN.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Depression and anxiety among adolescents are major public health concerns. Findings indicate that income inequality was associated with increased risk for depression and anxiety among adolescents; ...however, this has not been tested longitudinally. We aim to quantify the longitudinal association between income inequality and depression and anxiety among Canadian adolescents.
We used longitudinal data on 21,141 students from three waves (2016/17–2018/19) of the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behavior (COMPASS) school-based study. Multilevel modeling was used to assess the association between census division (CD)-level income inequality and depressive and anxiety symptoms and odds for depression and anxiety over time.
Across CDs, the mean Gini coefficient was 0.37 (range: 0.30, 0.46). Attending schools in CDs with higher levels of income inequality was associated with higher depressive scores (ß = 0.08; 95% confidence interval CI = 0.02, 0.14) and an increased odds for depression (odds ratio = 1.55, 95% CI = 1.06, 2.28) over time. Income inequality was not significantly associated with anxiety symptoms or experiencing anxiety over time. Additional analyses showed that income inequality was associated with higher depressive scores among females (ß = 0.10; 95% CI = 0.01, 0.18) and males (ß = 0.08, 95% CI = 0.01, 0.15) and for anxiety scores among females (ß = 0.13, 95% CI = 0.04, 0.22), but not among males (ß = −0.01, 95% CI = −0.09, 0.06).
Findings from this study indicated that income inequality is associated with depression over time among adolescents. This study highlights key points of intervention for the prevention of mental illness in adolescents.
To examine whether eating while watching television poses a risk for poor nutrition and excess body weight over and above that of time spent watching television.
We analysed data of grade 5 students ...participating in a comprehensive population-based survey in the Canadian province of Nova Scotia. This survey included the Harvard's Youth Food Frequency Questionnaire, students' height and weight measurements, and a parent survey. We applied multivariable linear and logistic random effects models to quantify the associations of watching television and eating while watching television with diet quality and body weight.
The province of Nova Scotia, Canada.
Grade 5 students (n 4966).
Eating supper while watching television negatively affected the consumption of fruits and vegetables and overall diet quality. More frequent supper while watching television was associated with more soft drink consumption, a higher percentage energy intake from sugar out of total energy from carbohydrate, a higher percentage energy intake from fat, and a higher percentage energy intake from snack food. These associations appeared independent of time children spent watching television. Both watching television and eating while watching television were positively and independently associated with overweight.
Our observations suggest that both sedentary behaviours from time spent watching television as well as poor nutrition as a result of eating while watching television contribute to overweight in children. They justify current health promotion targeting time spent watching television and call for promotion of family meals as a means to avoid eating in front of the television.
Objectives:
Children’s mental health and wellbeing declined during the first COVID-19 lockdown (Spring 2020), particularly among those from disadvantaged settings. We compared mental health and ...wellbeing of school-aged children observed pre-pandemic in 2018 and after the first lockdown was lifted and schools reopened in Fall 2020.
Methods:
In 2018, we surveyed 476 grade 4–6 students (9–12 years old) from 11 schools in socioeconomically disadvantaged communities in Northern Canada that participate in a school-based health promotion program targeting healthy lifestyle behaviours and mental wellbeing. In November-December 2020, we surveyed 467 grade 4–6 students in the same schools. The 12 questions in the mental health and wellbeing domain were grouped based on correlation and examined using multivariable logistic regression.
Results:
There were no notable changes pre-pandemic vs. post-lockdown in responses to each of the 12 questions or any of the sub-groupings.
Conclusion:
Supporting schools to implement health promotion programs may help mitigate the impact of the pandemic on children’s mental health and wellbeing. The findings align with recent calls for schools to remain open as long as possible during the pandemic response.
Both lower serum 25-hydroxyvitamin D 25(OH)D and elevated homocysteine concentrations are potential risk factors for cardiovascular disease (CVD). A recent analysis of the National Health and ...Nutrition Examination Survey reported an inverse association of serum 25(OH)D with homocysteine, however, the longitudinal relationship has yet to be investigated. We hypothesized and examined whether a temporal increase in 25(OH)D concentrations is paralleled by a reduction in the risk for elevated homocysteine. We analyzed data of 4475 participants with repeated assessments of serum 25(OH)D and homocysteine concentrations who enrolled in a preventive health program that encourages vitamin D supplementation and monitors serum 25(OH)D and homocysteine concentrations. We defined elevated homocysteine as concentrations greater than 13 micromoles per liter. Logistic regression was applied to assess the association of temporal changes in serum 25(OH)D with the risk of elevated homocysteine. We observed an inverse gradient whereby greater increases in 25(OH)D concentrations were associated with a lower prevalence of elevated homocysteine. Relative to those without temporal increases in 25(OH)D, participants who showed improvements in their serum 25(OH)D concentrations of "<25", "25-50", "50-75", and "≥75" nanomoles per liter at follow up were 0.92 (95% confidence interval: 0.62-1.37), 0.52 (0.33-0.80), 0.34 (0.20-0.58), and 0.32 (0.19-0.54) times as likely to have elevated homocysteine, respectively. These observations suggest that temporal improvements in vitamin D status reduce serum homocysteine concentrations, and therefore may potentially contribute to the primary prevention of CVD.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Context: Neck circumference (NC) has been suggested as an alternative measure to screen for excess body weight.
Objective: The aim of this study was to demonstrate the accuracy of neck circumference ...(NC) as a measure for assessing overweight and obesity in both sexes in different age groups.
Methods: Detailed individual search strategies were developed for each of the following bibliographic databases: Cochrane, LILACS, PubMed/MEDLINE, Science Direct, Scopus and Web of Science. The QUADAS-2 checklist was used to assess the methodology of the studies included.
Results: Thirty-eight assessments were performed in 11 articles according to age, sex and weight status. Using sensitivity and specificity, 27 assessments (71.0%) considered NC an accurate measure to diagnose overweight and obesity. The best sensitivity and specificity were found for the age >19 years (82.0%, 82.0%), female (80.0%, 73.0%), and obese (80.0%, 85.0%) categories.
Conclusion: NC is an accurate tool for assessing overweight and obesity in males and females of different age groups and could be used to screen for excess body weight in routine medical practice or epidemiological studies. It is also believed that more studies will permit the creation of a reference dataset of NC cut-off values for world populations.
Celotno besedilo
Dostopno za:
DOBA, FSPLJ, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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