RESUMEN
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders with significant individual and societal negative impacts of the disorder continuing into adulthood (Danielson et al. in Journal of Clinical Child and Adolescent Psychology, in press; Landes and London in Journal of Attention Disorders 25:3-13, 2021). Genetic and environmental risk (e.g., modifiable exposures such as prenatal tobacco exposure and child maltreatment) for ADHD is likely multifactorial (Faraone et al. in Neuroscience & Biobehavioral Reviews 128:789-818, 2021). However, the evidence for potentially modifiable contextual risks is spread across studies with different methodologies and ADHD criteria limiting understanding of the relationship between early risk factors and later childhood ADHD. Using common methodology across six meta-analyses (Bitsko et al. in Prevention Science, 2022; Claussen et al. in Prevention Science 1-23, 2022; Dimitrov et al. in Prevention Science, 2023; Maher et al. in Prevention Science, 2023; Robinson, Bitsko et al. in Prevention Science, 2022; So et al. in Prevention Science, 2022) examining 59 risk factors for childhood ADHD, the papers in this special issue use a public health approach to address prior gaps in the literature. This introductory paper provides examples of comprehensive public health approaches focusing on policy, systems, and environmental changes across socio-ecological contexts to improve health and wellbeing through prevention, early intervention, and support across development using findings from these meta-analyses. Together, the findings from these studies and a commentary by an author independent from the risk studies have the potential to minimize risk conditions, prioritize prevention efforts, and improve the long-term health and wellbeing of children and adults with ADHD.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Salud Pública , Humanos , Factores de Riesgo , NiñoRESUMEN
This manuscript is being submitted as a Commentary; Abstract not applicable.
RESUMEN
Congregate work and residential locations are at increased risk for infectious disease transmission including respiratory illness outbreaks. SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is primarily spread person to person through respiratory droplets. Nationwide, the meat and poultry processing industry, an essential component of the U.S. food infrastructure, employs approximately 500,000 persons, many of whom work in proximity to other workers (1). Because of reports of initial cases of COVID-19, in some meat processing facilities, states were asked to provide aggregated data concerning the number of meat and poultry processing facilities affected by COVID-19 and the number of workers with COVID-19 in these facilities, including COVID-19-related deaths. Qualitative data gathered by CDC during on-site and remote assessments were analyzed and summarized. During April 9-27, aggregate data on COVID-19 cases among 115 meat or poultry processing facilities in 19 states were reported to CDC. Among these facilities, COVID-19 was diagnosed in 4,913 (approximately 3%) workers, and 20 COVID-19-related deaths were reported. Facility barriers to effective prevention and control of COVID-19 included difficulty distancing workers at least 6 feet (2 meters) from one another (2) and in implementing COVID-19-specific disinfection guidelines.* Among workers, socioeconomic challenges might contribute to working while feeling ill, particularly if there are management practices such as bonuses that incentivize attendance. Methods to decrease transmission within the facility include worker symptom screening programs, policies to discourage working while experiencing symptoms compatible with COVID-19, and social distancing by workers. Source control measures (e.g., the use of cloth face covers) as well as increased disinfection of high-touch surfaces are also important means of preventing SARS-CoV-2 exposure. Mitigation efforts to reduce transmission in the community should also be considered. Many of these measures might also reduce asymptomatic and presymptomatic transmission (3). Implementation of these public health strategies will help protect workers from COVID-19 in this industry and assist in preserving the critical meat and poultry production infrastructure (4).
Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Brotes de Enfermedades , Industria de Procesamiento de Alimentos , Enfermedades Profesionales/epidemiología , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Animales , COVID-19 , Infecciones por Coronavirus/prevención & control , Brotes de Enfermedades/prevención & control , Humanos , Carne , Enfermedades Profesionales/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Aves de Corral , Estados Unidos/epidemiologíaRESUMEN
In 2012, 8.2 percent (or about 52,000) of adults in Delaware reported being advised by their medical provider they have pre-diabetes. Many additional Delawareans have undiagnosed pre-diabetes. Lifestyle changes such as increasing physical activity, modest weight loss and healthier eating can prevent or delay the development of type 2 diabetes. Evidence-based programs have been developed to reduce the prevalence of the disease by providing interventions at the stage of pre-diabetes detection and are cost-effective or provide cost-savings. One such evidence-based preventive service is the Diabetes Prevention Program (DPP), developed by U.S. Department of Health and Human Services. Delaware is fortunate to be one of two states with statewide implementation of the DPP program. Increasing the identification of pre-diabetes in primary care is an important first step in preventing diabetes. Enhancing successful referrals to the DPP is also critically important to decrease the burden of diabetes. Many partners are working together in Delaware to support these improvements.
Asunto(s)
Diabetes Mellitus Tipo 2/prevención & control , Epidemias/prevención & control , Medicina Basada en la Evidencia , Estado Prediabético/diagnóstico , Atención Primaria de Salud , Derivación y Consulta , Adulto , Delaware/epidemiología , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiología , Humanos , Estado Prediabético/epidemiología , Estado Prediabético/prevención & control , Servicios Preventivos de Salud/organización & administraciónRESUMEN
The novel H1N1 influenza in 2009 and 2010 demonstrated the important relationship between medicine and public health. Delaware physicians may benefit from knowing how the state Division of Public Health (DPH) responded. One way to describe that response is to compare H1N1 influenza activities to the Ten Essential Public Health Services, adopted as standard practice by most public health agencies.
Asunto(s)
Brotes de Enfermedades/prevención & control , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/prevención & control , Administración en Salud Pública , Salud Pública , Delaware , Educación en Salud , Promoción de la Salud/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Gripe Humana/epidemiología , Administración en Salud Pública/legislación & jurisprudenciaRESUMEN
Many primary care physicians are not providing care that is consistent with recommendations to prevent, to identify, and to manage childhood obesity. This report presents modifications made to the electronic medical record system of a large pediatric health care system, using a quality improvement approach, to support these recommendations and office system changes. Although it is possible to make practice changes secondary to electronic medical record system enhancements, challenges to development and implementation exist.
Asunto(s)
Electrónica Médica , Registros Médicos , Obesidad/epidemiología , Obesidad/prevención & control , Atención Primaria de Salud/métodos , Índice de Masa Corporal , Niño , Femenino , Humanos , Tamizaje Masivo , Obesidad/terapiaRESUMEN
This paper describes an innovative approach that integrates community-based health promotion and disease prevention into a well-established pediatric medical care system. System components include a population-level focus in multiple service sectors, community coalitions, knowledge dissemination, and social marketing. The combination of these components is intended to bring about widespread changes in health/social policy and professional practice, which, in turn, should improve health behavior and outcomes. Early lessons are discussed.
Asunto(s)
Servicios de Salud del Niño/organización & administración , Protección a la Infancia , Atención a la Salud/organización & administración , Promoción de la Salud , Necesidades y Demandas de Servicios de Salud , Prevención Primaria , Niño , Preescolar , Femenino , Educación en Salud , Humanos , Masculino , Innovación Organizacional , Mercadeo Social , Estados UnidosRESUMEN
Since the American Heart Association last presented nutrition guidelines for children, significant changes have occurred in the prevalence of cardiovascular risk factors and nutrition behaviors in children. Overweight has increased, whereas saturated fat and cholesterol intake have decreased, at least as percentage of total caloric intake. Better understanding of children's cardiovascular risk status and current diet is available from national survey data. New research on the efficacy of diet intervention in children has been published. Also, increasing attention has been paid to the importance of nutrition early in life, including the fetal milieu. This scientific statement summarizes current available information on cardiovascular nutrition in children and makes recommendations for both primordial and primary prevention of cardiovascular disease beginning at a young age.
Asunto(s)
Fenómenos Fisiológicos Nutricionales de los Adolescentes , Fenómenos Fisiológicos Nutricionales Infantiles , Necesidades Nutricionales , Adolescente , Enfermedades Cardiovasculares/prevención & control , Niño , Preescolar , Humanos , Lactante , Recién NacidoRESUMEN
Since the American Heart Association last presented nutrition guidelines for children, significant changes have occurred in the prevalence of cardiovascular risk factors and nutrition behaviors in children. Overweight has increased, whereas saturated fat and cholesterol intake have decreased, at least as percentage of total caloric intake. Better understanding of children's cardiovascular risk status and current diet is available from national survey data. New research on the efficacy of diet intervention in children has been published. Also, increasing attention has been paid to the importance of nutrition early in life, including the fetal milieu. This scientific statement summarizes current available information on cardiovascular nutrition in children and makes recommendations for both primordial and primary prevention of cardiovascular disease beginning at a young age.