Top hot reads March 2009

Ten top hot reads provided monthly by our australian colleague Dr Mavis Duncanson

1. Core Competencies for Injury and Violence Prevention American Journal of Public Health 2009 Vol 99: 600-606.

A stellar cast of injury prevention practitioners has developed a set of core competencies for public health practitioners in injury and violence prevention programs. This appears to be a valuable contribution to efforts to reduce the burden of injury and violence, and the authors note that it can provide benchmarks against which to assess progress in professional capacity for injury and violence prevention.

2. Rotavirus Vaccines – Early Success, Remaining Questions New England Journal of Medicine 2009 Volume 360:1063-1065.

A free full text article reporting on rotavirus vaccine uptake in the USA. The early success refers to changes in rotavirus surveillance. The big question of course whether rotavirus vaccines will work equally well in the developing world, where they offer the greatest potential lifesaving benefits. And IF they are effective, HOW to ensure that they reach children in the poorest countries, where the vast majority of deaths from rotavirus occur. 

3. Socioeconomic Inequality in Exposure to Bullying During Adolescence: A Comparative, Cross-Sectional, Multilevel Study in 35 Countries American Journal of Public Health, 10.2105/AJPH.2008.139303

Using data for the 2001-2002 school year from an international survey of 162305 students, the authors found socioeconomic inequality in exposure to bullying among adolescents, leaving children of greater socioeconomic disadvantage at higher risk of victimisation. The students were aged 11, 13, and 15 years and came from nationally representative samples of 5998 schools in 35 countries in Europe and North America. International differences in prevalence of exposure to bullying were not associated with the economic level of the country (as measured by gross national income) or the school, but not surprisingly wide disparities in affluence at a school and large economic inequality (as measured by the Gini coefficient) at the national level were associated with an increased prevalence of exposure to bullying.

4. Are adolescents with chronic conditions particularly at risk of bullying? Arch Dis Child 2009. doi:10.1136/adc.2008.146571. 

Another article on the theme of bullying, and another cross-sectional survey, this time comparing adolescents with and without chronic conditions and the prevalence and intensity of bullying; as well as characteristics of the victims of bullying. These were older students – aged 16-20 years. The prevalence of bullying in the total sample was 13.85% and adolescents with chronic conditions were more likely to be victims of bullying and to be victims of two or three forms of bullying. Victims of bullying with chronic conditions were more likely than non-victims to be depressed, to have more physical symptoms, to have a poorer relationship with their parents, to have a poorer school climate, and to have been victims of sexual abuse or other forms of violence. Although these characteristics apply to victims in general, in most cases they are less pronounced among victims without chronic conditions.
 

5. Proximity of Fast-Food Restaurants to Schools and Adolescent Obesity American Journal of Public Health 2009, 99: 505-510.

A cross-sectional study examined the relationship between fast-food restaurants near schools and obesity among middle and high school students in California and found that students with fast-food restaurants within one half mile of their schools, compared with youths whose schools were not near fast-food restaurants

• consumed fewer servings of fruits and vegetables
• consumed more servings of soda
• were more likely to be overweight or obese

Student- and school-level characteristics were controlled for.  The result was unique to eating at fast-food restaurants (compared with other nearby establishments) and was not observed for smoking.  They conclude that policy interventions limiting the proximity of fast-food restaurants to schools could help reduce adolescent obesity.

6. Adolescents’ use of purpose built shade in secondary schools: cluster randomised controlled trial BMJ 2009;338:b95. A cluster randomised trial from Victoria of purpose built shade sails in secondary schools found that students used rather than avoided the newly shaded areas in their lunch times. A good example of positive environmental intervention reducing UV exposure in Australian adolescents.

7. Yet again thanks to Graham Vimpani for finding Health Inequities in British Columbia a discussion paper which in Graham’s words “is good and covers turf that should have been covered in the NHHRC paper but wasn’t…” This comprehensive publication

• Explains the concept of health inequity and the social determinants of health (very well – in my opinion)
• Examines the extent of health inequities in British Columbia
• Outlines some of the social and economic costs of health inequities, as well the benefits of addressing health inequities
• Provides a number of health inequity policy considerations
• Presents policy options for consideration towards addressing health inequities

If time is short – then even a skim through the 8-page Executive Summary provides a succinct summary of the issues and the policy issues.

8. Neonatal vitamin A supplementation for prevention of mortality and morbidity in infancy: systematic review of randomised controlled trials BMJ 2009; 338: b919.

A timely review of six trials from developing countries found no convincing evidence of a reduced risk of mortality and possibly morbidity, nor of increased early adverse effects after neonatal supplementation with vitamin A. There is thus no justification for initiating such supplementation as a public health intervention in developing countries for reducing infant mortality and morbidity.

9. Target to reduce child mortality is under threat from lack of progress on diarrhoea BMJ 2009;338:b972

Continuing the international health theme, the WHO warns that if childhood diarrhoea is not tackled urgently, the world will fail to achieve the United Nations’ fourth millennium development goal of reducing the number of child deaths by two thirds by 2015. The key research area is ensuring that the children who most need treatment get it. The paper identifies and prioritises 154 research questions.