A research plan to define Canada’s first low-risk gambling guidelines

AbstractFrom a public health perspective, gambling shares many of the same characteristics as alcohol. Notably, excessive gambling is associated with many physical and emotional health harms, including depression, suicidal ideation, substance use and addiction and greater utilization of health care resources. Gambling also demonstrates a similar ‘dose-response’ relationship as alcohol—the more one gambles, the greater the likelihood of harm. Using the same collaborative, evidence-informed approach that produced Canada’s Low-Risk Alcohol Drinking and Lower Risk Cannabis Use Guidelines, a research team is leading the development of the first national Low-Risk Gambling Guidelines (LRGGs) that will include quantitative thresholds for safe gambling. This paper describes the research methodology and the decision-making process for the project. The guidelines will be derived through secondary analyses of several large population datasets from Canada and other countries, including both cross-sectional and longitudinal data on over 50 000 adults. A scientific committee will pool the results and put forward recommendations for LRGGs to a nationally representative, multi-agency advisory committee for endorsement. To our knowledge, this is the first systematic attempt to generate a workable set of LRGGs from population data. Once validated, the guidelines inform public health policy and prevention initiatives and will be disseminated to addiction professionals, policy makers, regulators, communication experts and the gambling industry. The availability of the LRGGs will help the general public make well-informed decisions about their gambling activities and reduce the harms associated with gambling.

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E-Cigarette Use by Smoking Status in Estonia, 2012–2018

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17020519 ◽

2020 ◽

Vol 17 (2) ◽

pp. 519

Author(s):

Rainer Reile ◽

Kersti Pärna

Keyword(s):

General Population ◽

Smoking Status ◽

Multivariate Logistic Regression Analysis ◽

Sociodemographic Factors ◽

Cigarette Use ◽

Public Health Perspective ◽

Cross Sectional ◽

The Public ◽

Period Effects ◽

Nationally Representative

Background: In the context of declining smoking rates in Estonia, this study aims to analyze the recent trends in e-cigarette use and its associations with smoking status and sociodemographic factors. Methods: Nationally representative data from biennial cross-sectional health surveys in 2012–2018 (n = 9988) were used to describe the prevalence of smoking and e-cigarette use by smoking status in Estonia. Multivariate logistic regression analysis was used to describe the sociodemographic patterns of e-cigarette use in three subgroups: the general population, smokers, and ex-smokers. Results: The prevalence of current smoking decreased from 45.4% in 2012 to 31.5% in 2018 among men and from 26.6% to 20.0% among women. At the same time, e-cigarette use in the general population had increased to 3.7% among men and to 1.2% among women. The increase in the prevalence of e-cigarette use was statistically significant among men in the general population, smokers, and ex-smokers, but non-significant among women. In addition to period effects, e-cigarette use was patterned by age, gender, and education. Conclusion: In 2002–2018, the e-cigarette use had increased but smoking had decreased in Estonia. A timely and targeted tobacco policy may alleviate the harm of e-cigarette use from the public health perspective.

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Nutritional status of adolescent girls in Bangladesh: findings of a community based survey

South East Asia Journal of Public Health ◽

10.3329/seajph.v6i1.30337 ◽

2016 ◽

Vol 6 (1) ◽

pp. 3-7 ◽

Cited By ~ 1

Author(s):

Kabir Hossen ◽

Fazlur Rahman ◽

Saidur Rahman Mashreky

Keyword(s):

Nutritional Status ◽

Adolescent Girls ◽

Large Population ◽

Population Data ◽

Health Care Facilities ◽

Cross Sectional Survey ◽

Community Based ◽

Cross Sectional ◽

Household Level ◽

Under Nutrition

Poverty, large population, socio- economic inequalities and inadequate access to proper health care facilities are the key causes of under nutrition in Bangladesh. Adolescents are the most vulnerable group for under nutrition and having great consequence as they will be parent in future. Studies on nutritional status of adolescent girls are fewer in number and have great effect for intervention. The objective of this study was to assess the nutritional status and predisposing factors of under nutrition among the adolescent girls in Bangladesh. A community-based cross-sectional survey was carried out from July to December 2013. Adolescent girls were the study population. Data was collected by face to face interview at household level. According to BMI category (kg/m2) the prevalence of under-weight (BMI<18.5) was found 65.9% and as per Gomez Classification (Weight for age), the prevalence of malnutrition was 48.2% (mild), 23.5% (moderate) and 2.8% (severe) categories and finally, as per Water Low Classification wasting found 16.6% (mild), 3.5%(moderate) and 0.2% severe categories. On the other hand, stunting found 39.6 % (mild), 9.2% (moderate) and 2.3% (severe) categories. Prevalence of under nutrition was found much higher (82.3%) among younger age group (?12 years). Higher prevalence of under-nutrition also found among the functionally illiterate adolescent girls, it was 75.8% and 51.3% among illiterate and literate group respectively. In both of the cases difference was statistically significant (p<0.001). The prevalence of illness found higher among under-weight adolescent girls in last two weeks compare to healthy adolescent girls both in rural and urban settings. This difference also found statistically significant (p<0.001). Under nourishment found higher among younger and low literate girls. Prevalence of other symptoms is also found higher among them.South East Asia Journal of Public Health Vol.6(1) 2016: 3-7

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E-cigarette advertising exposure among South African adults in 2017: findings from a nationally representative cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2020-048462 ◽

2021 ◽

Vol 11 (8) ◽

pp. e048462

Author(s):

Israel Terungwa Agaku ◽

Catherine O Egbe ◽

Olalekan A Ayo-Yusuf

Keyword(s):

Public Health ◽

South Africa ◽

Cigarette Smoking ◽

South African ◽

Cross Sectional ◽

Tobacco Products ◽

Cigarette Advertising ◽

Nationally Representative ◽

Advertising Exposure ◽

Electronic Delivery

ObjectivesIn South Africa, the Control of Tobacco and Electronic Delivery Systems Bill seeks to regulate e-cigarettes as tobacco products, including their advertising, promotion and sponsorship. Population data on e-cigarette advertising in South Africa are needed to inform public health programs, practice and policy. We examined self-reported e-cigarette advertising exposure during 2017.DesignCross-sectional.SettingHousehold-based survey.Participants3063 individuals who participated in the 2017 South African Social Attitudes survey, a nationally representative, in-person survey of the non-institutionalised civilian adult population aged ≥16 yearsExposure‘In the past 12 months, have you seen advertisements or promotions for e-cigarettes (including e-shisha, e-pipe) on any of the following media: newspapers/magazines, billboards, in the malls or any other source?’Main outcomesBeliefs and attitudes regarding e-cigarettes.FindingsParticipants’ mean age was 37.7 years. Overall, 20.1% reported exposure to e-cigarette advertisements. By age, exposure was most prevalent among those aged 16–19 years (24.6%). Top sources of exposure among those exposed were stores, 40.7%; malls, 30.9%; and television, 32.5%. Of those aware of e-cigarettes, 61.2% believed ‘e-cigarette advertisements and promotion may make adolescents think of smoking traditional cigarettes’; 62.7% believed that ‘e-cigarette advertisements and promotions may make ex-smokers think of starting smoking cigarettes again’; and 59.5% supported the statement that ‘e-cigarette smoking should be banned indoors just as traditional cigarette smoking’. Notably, teens aged 16–19 reported the lowest prevalence (49.0%) of those believing that ‘e-cigarette advertisements and promotion may make adolescents think of smoking traditional cigarettes’, whereas this percentage was highest among those aged 55–64 years (73.2%).ConclusionComprehensive regulatory efforts are needed to address e-cigarette advertising, marketing and sponsorship in order to protect public health. The urgent enactment of the new tobacco control legislation, The Control of Tobacco Products and Electronic Delivery Systems Bill, can help reduce youth exposure to e-cigarette advertising in South Africa.

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Covid-19 Estimating the burden of symptomatic disease in the community and the impact of public health measures on physical, mental and social wellbeing: a study protocol

HRB Open Research ◽

10.12688/hrbopenres.13103.1 ◽

2020 ◽

Vol 3 ◽

pp. 49

Author(s):

M. Isabela Troya ◽

Ali Khashan ◽

Patricia Kearney ◽

Ella Arensman ◽

Philipp Hoevel ◽

...

Keyword(s):

Public Health ◽

Network Model ◽

Cross Sectional ◽

Telephone Surveys ◽

Symptomatic Disease ◽

Health Measures ◽

Social Wellbeing ◽

Nationally Representative ◽

June July ◽

The Impact

Introduction: Covid-19 was declared a pandemic in March 2020. Since then, governments have implemented unprecedented public health measures to contain the virus. This study will provide evidence to inform responses to the pandemic by: i) estimating population prevalence and trends of self-reported symptoms of Covid-19 and the proportions of symptomatic individuals and household contacts testing positive for Covid-19; ii) describing acceptance and compliance with physical-distancing measures, explore effects of public health measures on physical, mental and social wellbeing; iii) developing a mathematical network model to inform decisions on the optimal levels of physical distancing measures. Methods: Two cross-sectional nationally-representative telephone surveys will be conducted in Ireland using random digit-dialling, with response rates estimates based on proportion of non-operational and non-answering numbers. The first survey with four waves in May and June will address adherence to social distancing measures and whether the respondent or other household members are or have been unwell during the preceding two weeks with one or more symptoms of Covid-19. The second survey with three waves in June, July and September will address knowledge, attitudes, and compliance towards physical-distancing measures and physical, mental and social wellbeing. The mathematical network model will be developed for all-Ireland (on various levels of spatial granularity including the scale of counties and electoral divisions) based on outputs from both cross-sectional surveys and relevant publicly available data to inform decisions on optimal levels and duration of physical distancing measures. Discussion: This study will contribute to our understanding of the impact and sustainability of public health measures of the Covid-19 pandemic. Findings will have long-lasting benefits, informing decision-making on the best levels, and duration of physical-distancing measures, balancing a range of factors including capacity of the health service with the effects on individuals’ wellbeing and economic disruption. Findings will be shared with key policy-makers.

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Prevalence of Parental Alcohol Problems among a General Population Sample of 28,047 Norwegian Adults: Evidence for a Socioeconomic Gradient

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105412 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5412

Author(s):

Siri H. Haugland ◽

Tobias H. Elgán

Keyword(s):

Public Health ◽

Socioeconomic Status ◽

General Population ◽

Low Socioeconomic Status ◽

Population Sample ◽

Alcohol Problems ◽

Public Health Perspective ◽

Cross Sectional ◽

Welfare Benefits ◽

Parental Alcohol

The aim of the study presented here was to estimate the prevalence of parental alcohol problems during childhood in a general population of Norwegian adults, and to investigate associations between parental alcohol problems during childhood and lower socioeconomic status in adulthood. This cross-sectional study recruited 28,047 adults (≥18 years) to an online health survey (Norwegian Counties Public Health Surveys). We evaluated demographic and socioeconomic measures and responses to a shortened version of the Children of Alcoholics Screening Test (CAST-6) scale to assess whether respondents perceived parental alcohol consumption during childhood as problematic. Respondents reported parental alcohol problems at a rate of 15.6%, but the experience was more prevalent among adults with a low education (20.0%), compared to those with intermediate (16.4%) or high educations (13.8%, χ2(2) = 87.486, p < 0.001), and it was more common among respondents with low economic capabilities (21.1%) compared to those with middle/high capabilities (14.2%, χ2(1) = 162.089, p < 0.001). Parental alcohol problems were most prevalent among respondents that received welfare benefits (24.5%). Multivariable logistic regression analyses revealed associations between parental alcohol problems and low socioeconomic status in adulthood; odds ratios (95% confidence intervals) ranged from 1.33 (1.25–1.42) to 1.89 (1.72–2.06). From a public health perspective, children who grow up with parental alcohol problems should be reached through both universal and selective interventions.

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Assessing and protecting the mental health of the nation: A study protocol

HRB Open Research ◽

10.12688/hrbopenres.13207.1 ◽

2021 ◽

Vol 4 ◽

pp. 5

Author(s):

Philip Hyland ◽

Frédérique Vallières

Keyword(s):

Public Health ◽

Mental Health ◽

General Population ◽

Mental Health Disorders ◽

Self Report ◽

First Year ◽

Cross Sectional ◽

Health Disorders ◽

Nationally Representative ◽

Quota Sampling

Background: Coronavirus disease 2019 (COVID-19) and the public health measures enacted to control its spread may affect the mental health of the general population of Ireland. Funded under the Health Research Board’s COVID-19 Pandemic Rapid Response Funding Call, this protocol outlines the aims of a project to assess and protect the mental health of the population of Ireland during this pandemic. We will determine (i) the prevalence of common mental health disorders at various times during the first year of the pandemic, (ii) changes in the prevalence of mental health disorders during the first year of the pandemic, (iii) if there are distinct groups of people experiencing different mental health responses to the pandemic, and (iv) the factors associated with different mental health reactions. Methods: This quantitative study uses cross-sectional and longitudinal designs. Data have been collected from a nationally representative sample of Irish adults at four assessments: Wave 1 (N = 1,041) occurred during the first week of lockdown in March 2020, Wave 2 in May, Wave 3 in August, and Wave 4 in December. Wave 5 is planned for March 2021. Participants from Wave 1 have been recontacted at each wave to produce a longitudinal dataset. New participants were recruited using quota sampling to ensure the availability of nationally representative samples at each wave. Self-report measures of demographic, economic, psychological, and mental health variables were completed. Conclusion: This design will allow us to determine whether there has been a change in mental health disorders in the general population during the first year of the pandemic, and if so, what variables are associated with changes in mental health. Results will be used to inform the government’s ongoing response to this crisis, to better protect the mental health of the nation during this and any future public health emergency.

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Fear and Attitude towards SARS-CoV-2 (COVID-19) Infection in Spanish Population during the Period of Confinement

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19020834 ◽

2022 ◽

Vol 19 (2) ◽

pp. 834

Author(s):

Ana María Recio-Vivas ◽

Isabel Font-Jiménez ◽

José Miguel Mansilla-Domínguez ◽

Angel Belzunegui-Eraso ◽

David Díaz-Pérez ◽

...

Keyword(s):

Public Health ◽

Risk Perception ◽

Online Survey ◽

Health Sector ◽

Population Data ◽

Relevant Information ◽

Sociodemographic Factors ◽

Spanish Population ◽

Cross Sectional ◽

Preventive Behaviour

In January 2020, the WHO classified SARS-CoV-2 infection as a public health emergency and it was declared a pandemic on 11 March 2020. The media warned about the danger of infection, fuelling the population’s fear of the new situation and increasing the perception of risk. This fear can cause behaviour that will determine the course of the pandemic and, therefore, the purpose of this study was to analyse the fear of infection from COVID-19 among the Spanish population during the state of emergency. A cross-sectional, descriptive observational study was conducted with 16,372 participants. Data on sociodemographic factors, health factors, risk perception and fear were collected through an online survey. Level of fear is associated with older age, a lower level of education, having a person infected with SARS-CoV-2 in the immediate surroundings and living with and belonging to the most socioeconomically vulnerable group of people. Risk perception is associated with increased preventive behaviour. This paper provides relevant information for the public health sector since it contributes first-hand knowledge of population data that is highly useful in terms of prevention. Understanding the experiences of people in this pandemic helps to create more effective future intervention strategies in terms of planning and management for crisis situations.

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Socioeconomic Inequalities in Metabolic Syndrome by Age and Gender in a Spanish Working Population

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph181910333 ◽

2021 ◽

Vol 18 (19) ◽

pp. 10333

Author(s):

Manuela Abbate ◽

Jordi Pericas ◽

Aina M. Yañez ◽

Angel A. López-González ◽

Joan De Pedro-Gómez ◽

...

Keyword(s):

Public Health ◽

Metabolic Syndrome ◽

Economic Status ◽

Early Adulthood ◽

Cross Sectional Study ◽

Public Health Perspective ◽

Cross Sectional ◽

Age And Gender ◽

And Gender ◽

Late Stages

Lower socio-economic status (SES) is significantly associated with metabolic syndrome (MS) prevalence, possibly affecting women more than men, although evidence in Spain is still limited. The present cross-sectional study analyzed the association between MS and SES by age and gender among 42,146 working adults living in the Balearic Islands (Spain). Prevalence was higher in men (9.4% by ATP-III; 12.3% by IDF) than women (3.8% by ATP-III; 5.7% by IDF) and in the lower social class (7.9% by ATP-III; 10.7% by IDF) than the higher (4.1% by ATP-III; 5.9% by IDF). The SES gradient in MS prevalence was larger in women (PR 95% CI: 3.38, 2.50–4.58 by ATP-III; 3.06, 2.43–3.86 by IDF) than in men (1.23, 1.06–1.41 by ATP-III; 1.15, 1.03–1.30 by IDF) and was already evident from early adulthood, reaching the highest ratio at the late stages of middle adulthood (4.34, 1.11–16.98). Among men, it was significant during the late stages of early adulthood only (1.80, 1.19–2.73). Lower SES influenced MS prevalence in both genders, however, women seemed more affected than men. From a public health perspective, SES could be strongly associated with the burden of MS; in an effort to reduce its prevalence, public health policies should focus on gender differences in socio-economic inequality and consider women with low socio-economic resources as a priority.

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Covid-19 Estimating the burden of symptomatic disease in the community and the impact of public health measures on physical, mental and social wellbeing: a study protocol

HRB Open Research ◽

10.12688/hrbopenres.13103.2 ◽

2020 ◽

Vol 3 ◽

pp. 49

Author(s):

M. Isabela Troya ◽

Ali Khashan ◽

Patricia Kearney ◽

Ella Arensman ◽

Philipp Hoevel ◽

...

Keyword(s):

Public Health ◽

Network Model ◽

Cross Sectional ◽

Telephone Surveys ◽

Symptomatic Disease ◽

Health Measures ◽

Social Wellbeing ◽

Nationally Representative ◽

June July ◽

The Impact

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Evaluation of community pharmacists’ readiness to implement the Falsified Medicines Directive (Directive 2011/62/EC): an English cross-sectional survey with geospatial analysis

BMJ Open ◽

10.1136/bmjopen-2019-033405 ◽

2020 ◽

Vol 10 (1) ◽

pp. e033405 ◽

Cited By ~ 1

Author(s):

Ravina Barrett

Keyword(s):

Public Health ◽

Community Pharmacists ◽

Health Campaigns ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Public ◽

Falsified Medicines ◽

Ethical Approval ◽

Nationally Representative ◽

Public Health Campaigns

ObjectivesTo evaluate the readiness to implement the Falsified Medicines Directive (FMD) by community pharmacies in England. Eight secondary objectives were assessed.SettingCommunity/retail pharmacies.ParticipantsWe invited pharmacists from 501 pharmacies to complete a survey. Non-contractors, non-pharmacists or pharmacists practising abroad were excluded. We randomly selected addresses, ensuring that they were nationally representative.InterventionsWe mailed the survey in October 2018 with a single follow-up in January 2019. Respondents were invited to provide self-reported answers. A prepaid self-addressed envelope was provided. We received favourable ethical approval.Results102 responses (20.44% response rate) were received. Readiness to implement was poor: 4 (3.9%) said very much, while 40 (39.2%) said not at all and 29 (28.4%) said not really. Increased workload and reduced profitability were anticipated, accompanied with improved patient safety. Prevalence of ‘substandard and falsified (SF) medical products’ was estimated at 1%–5%, with erectile dysfunction at greatest risk of falsification. Different packaging would raise suspicions. Five (4.9%) had identified SFs (p<0.001 one-sample binomial test). Of these, three (2.9%) informed the medicines agency. None had been involved in any public health campaigns. Confidence and self-efficacy was low. Strategies to reduce SFs reaching the public are described. Pharmacist’s role in combating SFs was elucidated. SFs were identified in deprived areas 4 (9%) more often than in affluent areas 1 (2%).ConclusionsMany pharmacies are not ready to implement FMD, potentially not capturing anticipated benefits of the directive, with greatest risk of harm in deprived area. We further validated a confidence scale. Limited public health campaigns may result in a lack of awareness among pharmacy professionals and patients. Limited awareness of technologies to identify falsified medicines exist, though further training is welcome. A worrying trend of under-reporting maybe prevalent. A larger sample study using this survey would be valuable.

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