47 research outputs found

    Problematic Use of Mobile Phones in Australia…Is It Getting Worse?

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    Rapid technological innovations over the past few years have led to dramatic changes in today's mobile phone technology. While such changes can improve the quality of life of its users, problematic mobile phone use can result in its users experiencing a range of negative outcomes such as anxiety or, in some cases, engagement in unsafe behaviors with serious health and safety implications such as mobile phone distracted driving. The aims of the present study are two-fold. First, this study investigated the current problem mobile phone use in Australia and its potential implications for road safety. Second, based on the changing nature and pervasiveness of mobile phones in Australian society, this study compared data from 2005 with data collected in 2018 to identify trends in problem mobile phone use in Australia. As predicted, the results demonstrated that problem mobile phone use in Australia increased from the first data collected in 2005. In addition, meaningful differences were found between gender and age groups in this study, with females and users in the 18–25 year-old age group showing higher mean Mobile Phone Problem Use Scale (MPPUS) scores. Additionally, problematic mobile phone use was linked with mobile phone use while driving. Specifically, participants who reported high levels of problem mobile phone use, also reported handheld and hands-free mobile phone use while driving

    Alcohol-impaired Walking in 16 Countries:A Theory-Based Investigation

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    Alcohol is a global risk factor for road trauma. Although drink driving has received most of the scholarly attention, there is growing evidence of the risks of alcohol-impaired walking. Alcohol-impaired pedestrians are over-represented in fatal crashes compared to non-impaired pedestrians. Additionally, empirical evidence shows that alcohol intoxication impairs road-crossing judgements. Besides some limited early research, much is unknown about the global prevalence and determinants of alcohol-impaired walking. Understanding alcohol-impaired walking will support health promotion initiatives and injury prevention. The present investigation has three aims: (1) compare the prevalence of alcohol-impaired walking across countries; (2) identify international groups of pedestrians based on psychosocial factors (i.e., Theory of Planned Behaviour (TPB) and perceptions of risk); and (3) investigate how segments of pedestrians form their intention for alcohol-impaired walking using the extended TPB (i.e. subjective norm, attitudes, perceived control, and perceived risk). A cross-sectional design was applied. The target behaviour question was “have you been a pedestrian when your thinking or physical ability (balance/strength) is affected by alcohol?” to ensure comparability across countries. Cluster analysis based on the extended TPB was used to identify groups of countries. Finally, regressions were used to predict pedestrians’ intentions per group. A total of 6,166 respondents (Age M(SD) = 29.4 (14.2); Males = 39.2%) completed the questionnaire, ranging from 12.6% from Russia to 2.2% from Finland. The proportion of participants who reported never engaging in alcohol-impaired walking in the last three months ranged from 30.1% (Spain) to 83.1% (Turkey). Four groups of countries were identified: group-1 (Czech Republic, Spain, and Australia), group-2 (Russia and Finland), group-3 (Japan), and group-4 (final ten countries including Colombia, China, and Romania). Pedestrian intentions to engage in alcohol- impaired walking are predicted by perceptions of risk and TPB-psychosocial factors in group-1 and group-4. Favourable TPB-beliefs and low perceived risk increased alcohol-impaired walking intentions. Conversely, subjective norms were not significant in group-2 and only perceived risk predicted intention in group-3. The willingness of pedestrians to walk when alcohol-impaired differs significantly across the countries in this study. Perceived risk was the only common predictor among the 16 countries.</p

    Hereditary Hemochromatosis (HFE) genotypes in heart failure: Relation to etiology and prognosis

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    <p>Abstract</p> <p>Background</p> <p>It is believed that hereditary hemochromatosis (HH) might play a role in cardiac disease (heart failure (HF) and ischemia). Mutations within several genes are HH-associated, the most common being the <it>HFE </it>gene. In a large cohort of HF patients, we sought to determine the etiological role and the prognostic significance of <it>HFE </it>genotypes.</p> <p>Methods</p> <p>We studied 667 HF patients (72.7% men) with depressed systolic function, enrolled in a multicentre trial with a follow-up period of up to 5 years. All were genotyped for the known <it>HFE </it>variants C282Y, H63D and S65C.</p> <p>Results</p> <p>The genotype and allele frequencies in the HF group were similar to the frequencies determined in the general Danish population. In multivariable analysis mortality was not predicted by C282Y-carrier status (HR 1.2, 95% CI: 0.8-1.7); H63D-carrier status (HR 1.0, 95% CI: 0.7-1.3); nor S65C-carrier status (HR 1.2, 95% CI: 0.7-2.0). We identified 27 (4.1%) homozygous or compound heterozygous carriers of <it>HFE </it>variants. None of these carriers had a clinical presentation suggesting hemochromatosis, but hemoglobin and ferritin levels were higher than in the rest of the cohort. Furthermore, a trend towards reduced mortality was seen in this group in univariate analyses (HR 0.4, 95% CI: 0.2-0.9, p = 0.03), but not in multivariate (HR 0.5, 95% CI: 0.2-1.2).</p> <p>Conclusion</p> <p><it>HFE </it>genotypes do not seem to be a significant contributor to the etiology of heart failure in Denmark. <it>HFE </it>variants do not affect mortality in HF.</p

    Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

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    BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

    Substance use among sexual minority young people: The influence of community attitudes and identities

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    This thesis provides an examination of the disproportionate use of licit and illicit substances among sexual minority young people. It shows a clear picture that substance use is not equally distributed among all groups within this population, and that a range of underlying factors are responsible for existing disparities between this population and the general population. These include marginalisation and mental health as well as characteristics of the LGBT community such as peer pressure, high concentration of licensed venues, and socio-political values. Both connectedness to and participation in the LGBT community were significantly associated with substance use involvement

    The effect of distance to health facility on neonatal mortality in Ethiopia

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    Abstract Introduction In Ethiopia, more than half of newborn babies do not have access to Emergency Obstetric and Neonatal Care (EmONC) services. Understanding the effect of distance to health facilities on service use and neonatal survival is crucial to recommend policymakers and improving resource distribution. We aimed to investigate the effect of distance to health services on maternal service use and neonatal mortality. Methods We implemented a data integration method based on geographic coordinates. We calculated straight-line (Euclidean) distances from the Ethiopian 2016 demographic and health survey (EDHS) clusters to the closest health facility. We computed the distance in ESRI ArcGIS Version 10.3 using the geographic coordinates of DHS clusters and health facilities. Generalised Structural Equation Modelling (GSEM) was used to estimate the effect of distance on neonatal mortality. Results Poor geographic accessibility to health facilities affects maternal service usage and increases the risk of newborn mortality. For every ten kilometres (km) increase in distance to a health facility, the odds of neonatal mortality increased by 1.33% (95% CI: 1.06% to 1.67%). Distance also negatively affected antenatal care, facility delivery and postnatal counselling service use. Conclusions A lack of geographical access to health facilities decreases the likelihood of newborns surviving their first month of life and affects health services use during pregnancy and immediately after birth. The study also showed that antenatal care use was positively associated with facility delivery service use and that both positively influenced postnatal care use, demonstrating the interconnectedness of the components of continuum of care for maternal and neonatal care services. Policymakers can leverage the findings from this study to improve accessibility barriers to health services

    An interactive method for engaging the public health workforce with evidence

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    Introduction Systematic review authors are increasingly directing their attention to not only ensuring the robust processes and methods of their syntheses, but also to facilitating the use of their reviews by public health decision-makers and practitioners. This latter activity is known by several terms including knowledge translation, for which one definition is a ‘dynamic and iterative process that includes synthesis, exchange and ethically sound application of knowledge’.1 Unfortunately—and despite good intentions—the successful translation of knowledge has at times been inhibited by the failure of reviews to meet the needs of decision-makers, and the limitations of the traditional avenues by which reviews are disseminated.2 Encouraging the utilization of reviews by the public health workforce is a complex challenge. An unsupportive culture within the workforce, a lack of experience in assessing evidence, the use of traditional academic language in communication and the lack of actionable messages can all act as barriers to successful knowledge translation.3 Improving communication through developing strategies that include summaries, podcasts, webinars and translational tools which target key decision-makers such as HealthEvidence.org should be considered by authors as promising actions to support the uptake of reviews into practice.4,5 Earlier work has also suggested that to better meet the research evidence needs of public health professionals, authors should aim to produce syntheses that are actionable, relevant and timely.2 Further, review authors must interact more with those who will, or could use their reviews; particularly when determining the scope and questions to which a review will be directed.2 Unfortunately, individual engagement, ideal for examining complex issues and addressing particular concerns, is often difficult, particularly when attempting to reach large groups where for efficiency purposes, the strategy tends to be didactic, ‘lecturing’ and therefore less likely to change attitudes or encourage higher order thinking.6

    Intersectionality and risk-taking behaviours in minority and socially disadvantaged groups: Findings from the Global Drug Survey (GDS)

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    Objectives Intersectionality is a theoretical concept and tool for critical thought about how disadvantage is experienced within different minority groups, and in particular when people fall into multiple groups and experience increased social oppression as a result. While this school of thought is used frequently in sociological and political arenas, it has not been widely applied in epidemiological context to understand how health behaviours and outcomes are affected when people identify in more than one minority, or socially disadvantaged category. This study aimed to use the theoretical framework of intersectionality to guide and interpret the analysis of the data from a large scale survey looking at substance and alcohol use across different genders, sexualities, and ethnicities. Specifically we aimed to understand whether intersectionality acted as a risk or protective factor when examining alcohol and drug use. Methods The paper analysed data from 92,183 participants within the Global Drug Survey from January 2015. 92.5% of participants are from High Income OECD-member country as defined by the World Bank. Data was analysed to look for differences in ethnic identity, genders, and sexual orientation Results Ethnicity single group odds ratios are higher for five substances and lower for four substances. Intersecting identity shows generally lower odds ratios of lifetime and past year use than single group odds ratios. Intersecting identity (ethnicity and sexual minority) appears to have a protective factor against substance use and health impact of alcohol. Ethnic minorities show generally higher odds ratios (single group comparison) for all substances both lifetime and past year use. Ethnic minority females show higher odds ratios than ethnic majority females for lifetime and past year substance use. Sexual minority single odds ratios are generally higher than those for female (except lifetime alcohol use). Potential protective factors of an intersecting identity of ethnic minority and sexual minority appear to be lower for females than for males. The potential short-term protective factor of sexual minority females decreases drastically for ethnic minority females. Conclusion This study shows the impact of intersecting identities on health risk behaviours as significant and in need of further research to bring a better understanding of behavioural patterns within the most vulnerable groups within society in order to intervene effectively in future

    Effects of participation in and connectedness to the LGBT community on substance use involvement of sexual minority young people

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    Introduction Research shows disproportionate levels of substance use among sexual minority young people. A range of reasons for these disparities have been suggested, including connectedness to and participation in the LGBT community. Little is known about how these constructs are related to substance use involvement in sexual minority (sub)groups or how these relationships are affected by other factors. Methods 1266 young sexual minority Australians completed a cross-sectional online survey. Multiple regressions were conducted to assess associations between connectedness to and participation in the LGBT community on substance use involvement, before and after controlling for other factors such as substance use motives, psychological distress, wellbeing, resilience, minority stress, and age. Results/conclusion Most participants identified as homosexual (57%, n = 726) and male (54%, n = 683). In the overall sample, participation in and connectedness the LGBT community were significantly associated with increased substance use involvement before (F(2,1263) = 35.930, p ≤ 0.001, R2 = 0.052) and after controlling for other variables (F(8,1095) = 33.538, p ≤ 0.001, R2 = 0.191), with meaningfully higher effect sizes for participation than for connectedness. After controlling for other variables, connectedness only remained significant for homosexuals. Effect sizes for participation were higher for females than males, and bisexuals than homosexuals. However, participation in the LGBT Community was not associated with substance use in participants identifying with a non-binary gender identity. In conclusion, substance use involvement was associated with participation in the LGBT community, but connectedness to the LGBT community only had a weak association with substance use involvement in the homosexual subgroup

    Effects of participation in and connectedness to the LGBT community on substance use involvement of sexual minority young people

    No full text
    Introduction Research shows disproportionate levels of substance use among sexual minority young people. A range of reasons for these disparities have been suggested, including connectedness to and participation in the LGBT community. Little is known about how these constructs are related to substance use involvement in sexual minority (sub)groups or how these relationships are affected by other factors. Methods 1266 young sexual minority Australians completed a cross-sectional online survey. Multiple regressions were conducted to assess associations between connectedness to and participation in the LGBT community on substance use involvement, before and after controlling for other factors such as substance use motives, psychological distress, wellbeing, resilience, minority stress, and age. Results/conclusion Most participants identified as homosexual (57%, n = 726) and male (54%, n = 683). In the overall sample, participation in and connectedness the LGBT community were significantly associated with increased substance use involvement before (F(2,1263) = 35.930, p ≤ 0.001, R2 = 0.052) and after controlling for other variables (F(8,1095) = 33.538, p ≤ 0.001, R2 = 0.191), with meaningfully higher effect sizes for participation than for connectedness. After controlling for other variables, connectedness only remained significant for homosexuals. Effect sizes for participation were higher for females than males, and bisexuals than homosexuals. However, participation in the LGBT Community was not associated with substance use in participants identifying with a non-binary gender identity. In conclusion, substance use involvement was associated with participation in the LGBT community, but connectedness to the LGBT community only had a weak association with substance use involvement in the homosexual subgroup
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