International Journal of Public Health最新文献

Objectives: The association between ultra-processed foods (UPF) consumption and cognitive performance needs to be better characterized in adolescents, especially in low-income settings, where the cost of human capital is high. This study investigated the association between cognitive performance and UPF in adolescents from the countryside of the Brazilian Northeast.

Methods: Adolescents (15-18 years old) from three public high schools were included. Food intake was assessed using three 24-hour dietary recalls. The classification of foods as UPF was determined according to the Nova classification. Cognitive performance was evaluated using the Non-Verbal General Intelligence Test.

Results: 116 adolescents were included, of which 50 (43.1%) showed low cognitive performance. The average energy intake was 1973.5 kcal, with 24.2% coming from UPF. Participants with low cognitive performance consumed 26.5% (95% CI: [22.2; 30.7]%) of daily energy intake from UPF compared to 22.5% ([18.8; 26.2]%) of those with medium-high cognitive performance (P = 0.17), without differences in energy and macronutrient intake.

Conclusion: Despite similar UPF consumption compared to the Brazilian average, no association was found between UPF consumption and cognitive performance in this low-income adolescent sample.

Objectives: We assessed the relationship between heat and emergency hospital admissions (EHAs) in Switzerland using clinically relevant metrics.

Methods: Applying distributed lag non-linear models, we investigated temperature-admission associations between May and September 1998-2019 for various disease groups, by age class and gender. We estimated the relative risk (RR) for moderate (29°C) and extreme (34°C) daily maximum temperatures relative to disease-specific optimum temperature, and calculated attributable fractions (AFs) for hot days and the following week. We also calculated the total number of heat-related EHAs.

Results: We attributed 31,387 (95% confidence interval: 21,567-40,408) EHAs to above-optimal temperatures, 1.1% (0.7%-1.4%) of the total. Extreme temperatures increased the EHA risk for mental, infectious and neurological diseases. We observed particularly high AFs due to extreme heat for dehydration (85.9%, 95% CI: 82.4%-88.8%) and acute kidney injury (AKI, 56.1%, 95% CI: 45.3%-64.7%). While EHA risk generally increased with age, we also found high RRs for infectious diseases in children (0-15 years) and AKI in young adults (15-64 years).

Conclusion: Hot weather increases the EHA risk in Switzerland. Therefore a comprehensive clinical and public health response is needed.

Objectives: To assess the association of disability with suicide mortality, separately for women and men by age group.

Methods: Information was obtained from a representative national sample of 161,809 community-dwelling adults (≥18 years). Participants contributed to follow-up time from baseline interview (2008) until suicide, death by other causes, or 2017. We calculated, by sex, standardized suicide mortality differences (SSMD), comparing persons with and without disabilities standardized to sociodemographic distribution of disability population.

Results: 29 women died by suicide during 800,754 person-years follow-up and 97 men during 735,709 person-years. Among women with disabilities, SSMD (95% Confidence interval) per 100,000 person-years at 5 years was 54.4 deaths (-17.2 to 126.1) [100.0 (-27.4 to 227.4) in women <65 years and -4.8 (-27.3 to 17.7) in women ≥65 years (P homogeneity = 0.11)]. Among men, SSMD increased by 122.2 deaths (4.1 to 240.3) [37.2 (-40.2 to 114.6) in men <65 years and 74.7 (-51.8 to 200.5) in men ≥65 years (P homogeneity = 0.62)].

Conclusion: Suicide risk was higher in women and men with disability. In women higher risk was only notable for those <65. Men presented similar effects in both age groups. Nevertheless, due to imprecision of estimates, results should be viewed cautiously.

Objectives: Precision Medicine (PM) uses advanced Machine Learning (ML) techniques and big data to develop personalized treatments, but healthcare still relies on traditional statistical procedures not targeted on individuals. This study investigates the impact of ML on epidemiology.

Methods: A quantitative analysis of the articles in PubMed for the years 2000-2019 was conducted to investigate the use of statistical methods and ML in epidemiology. Using structural topic modelling, two groups of topics were identified and analysed over time: topics closer to the clinical side of epidemiology and topics closer to the population side.

Results: The curve of the prevalence of topics associated with population epidemiology basically corresponds to the curve of the relative statistical methods, while the more dynamic curve of clinical epidemiology broadly reproduces the trend of algorithmic methods.

Conclusion: The findings suggest that a renewed separation between clinical epidemiology and population epidemiology is emerging, with clinical epidemiology taking more advantage of recent developments in algorithmic techniques and moving closer to bioinformatics, whereas population epidemiology seems to be slower in this innovation.

Objectives: Childhood overweight/obesity is a serious public health problem in the world today specially low-and-middle income countries like Ethiopia. This study aimed to assess the prevalence of overweight/obesity and associated factors among preschool children.

Methods: A community-based cross-sectional study was conducted among preschool children aged 3-5 years in Arba Minch city from April to June 2022. A multistage sampling method was used to select 577 study participants. Data were collected using a structured and pretested questionnaire. A binary logistic regression model was used for analysis. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to assess the strength of the association.

Results: The combined prevalence of overweight/obesity was 23.9% (95% CI: 20.5, 27.6). Age of 36-47 months, family size < five, watching TV/video for ≥2 h, and consuming sweet foods, were factors associated with being overweight/obese among preschool children.

Conclusion: Overweight/obesity was predicted by consuming sweet foods, long time TV/video watching, and large family size in the study area. Special attention should be given to child feeding practices and reducing sedentary lifestyles.

Objectives: To examine how unmet healthcare needs and the exposure to the pandemic impacted self-reported health (SRH) among individuals aged 50 and above.

Methods: We use data from two waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) Corona Survey collected in 2020 and 2021 in 27 European countries and Israel (N = 42,854). Three dimensions of barriers to healthcare access were investigated: healthcare forgone, postponed, and denied. Mixed-effects logistic regression analysis was employed to explore SRH deterioration during the pandemic.

Results: Findings indicate that unmet healthcare needs decreased throughout the pandemic but significantly contributed to the worsening of SRH among older adults. Mild or severe exposure to the pandemic heightened the likelihood of reporting deteriorated SRH. Additionally, the pandemic disproportionately affected females, the oldest-old, and those living alone or facing economic vulnerability.

Conclusion: To mitigate the adverse effects on the health status of older adults, policymakers are strongly advised to prioritize addressing the healthcare needs of those who have been disproportionately affected by the pandemic.

Objectives: For the development of the 2021 global air quality guidelines, the World Health Organization (WHO) commissioned a series of systematic reviews and meta-analyses to assess the association between exposure to air pollution and all-cause and cause-specific mortality. One of these reviews, which we aim to update, focused on the effects of long-term exposure to PM_2.5 and PM₁₀ on all-cause and cause-specific mortality.

Methods: The protocol for this study was registered in PROSPERO (CRD42023425327). We searched the PubMed and Embase databases for studies published between September 2018 and May 2023. Study-specific effects were pooled using random-effects models.

Results: We included 106 studies in the meta-analysis, 46 studies from the previous review and 60 from this update. All exposure-outcome pairs analysed showed positive and significant associations, except for PM₁₀ and cerebrovascular mortality. The certainty of the evidence was rated as high for the majority of exposure-outcome pairs.

Conclusion: We included a large number of new cohorts, and provided new concentration-response functions that will inform WHO advice on the use of this information for air pollution health risk assessments.

Objectives: We aim to investigate the associations between lifestyle, ambient air pollution with crucial outcomes in the progression of adult asthma, including asthma new-onset and asthma hospitalisation.

Methods: 176,800 participants were included to assess the prospective association between baseline risk exposures and the subsequent asthma onset, 17,387 participants were used to evaluate asthma hospitalisation. Cox regression models were employed to examine the associations.

Results: In terms of lifestyle factors, the HRs (95% CIs) of the least healthy lifestyle categories for asthma incidence and hospitalization were 1.099 (1.017-1.187) and 1.064 (1.008-1.123), respectively. For pollutants, PM_2.5, especially the traffic-related PM_2.5 component, was consistently recognized as a significant risk factor for asthma onset (HR = 1.064, 95% CI: 1.034-1.094) and hospitalisation (HR = 1.031, 95% CI: 1.010-1.052) under various model adjustments. Low socioeconomic status also played a major role in the progression of adult asthma.

Conclusion: Our study provides crucial insights into factors influencing the progression of adult asthma. Monitoring and reducing exposure to air pollution, particularly PM_2.5, promoting healthier lifestyle, and addressing socioeconomic inequity are important in preventing and managing asthma.

Objectives: This study aims to determine clusters of access to healthcare among adults with rare diseases in Switzerland, identify associated individual characteristics of access, and impact on health-related quality of life (HRQoL).

Methods: Swiss adults (N = 341) diagnosed with a rare disease completed an online survey including the Perception of Access to Healthcare Questionnaire (PAHQ) and Short Form Health Survey (SF-12). We employed partition around medoids algorithm to identify patient clusters based on the PAHQ. Various sociodemographic/disease-related factors and HRQoL were assessed.

Results: We identified two patient clusters: higher (n = 227) and lower access (n = 114). Significantly associated with lower access were an unstable disease course (p < 0.05), increased number of misdiagnoses (p < 0.05), and diseases affecting the nervous system (p < 0.01). Membership in the lower access cluster was significantly associated with worse HRQoL (p < 0.05).

Conclusion: Findings highlight the need for comprehensive assessment of healthcare access in adults with rare diseases and identifies potential targets for tailored interventions.