Preventive medicine最新文献

Introduction: Recent studies suggest that ambient air pollution may contribute to osteoporosis; however, research focusing on populations with greater susceptibility is lacking. This study seeks to explore the association between air pollution and osteoporosis focusing on cancer survivors.

Materials and methods: We analyzed data from 8977 individuals (2245 cancer survivors, 6732 cancer-free population) obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) during 2007-2009 and 2015-2021. Air pollution exposures to PM₁₀, PM_2.5, SO₂, NO₂, and CO were estimated using air quality models and satellite data. Moving average concentrations over 1-3 years prior to the survey were calculated. Logistic regression models adjusting for demographic and lifestyle factors were used to assess the association between air pollution and osteoporosis status. Analyses were stratified by cancer survivorship status and sex.

Results: Among cancer survivors, particularly female cancer survivors, higher long-term exposure to air pollutants was associated with greater odds of osteoporosis. Cancer survivors exposed to higher PM₁₀ over 1-, 2-, and 3-year periods had greater odds of osteoporosis (all p < 0.05). In female cancer survivors, 1-year exposure to PM_2.5 was associated with 25 % higher odds of osteoporosis (OR = 1.25, 95 % CI = 1.02-1.54), and NO₂ exposure showed a similar association (OR = 1.42; 95 % CI = 1.06-1.90). These associations were not observed in the individuals without cancer history.

Conclusion: The association between air pollution and osteoporosis was observed in cancer survivors, especially among female cancer survivors. Our findings emphasize the need for targeted interventions for at-risk populations such as cancer survivors.

Introduction: While preventive healthcare guidelines recommend that pregnant women or those planning pregnancy engage in preventive care and maintain healthy lifestyles, it is unknown whether women engage in these activities before conception. We examined the association between maternal status and participation in preventive health checks and healthy lifestyle practices.

Methods: We included 4447 women from 1989 to 95 cohort of Australian Longitudinal Study on Women's Health, categorised into three groups: pregnant women, women in preconception period, and women who were neither pregnant nor trying to become pregnant between surveys one to six. Generalised estimating equation was used for analyses.

Results: At the sixth survey when women were aged 24-29, 7 % and 32 % of women in the preconception period did not have their blood pressure and weight checked, respectively. Concerning healthy lifestyles during preconception period, 37 % of women did not meet the minimum physical activity guidelines; 64 % and 85 % of women, respectively, did not meet the recommended serves of fruits and vegetables; 92 % consumed any level of alcohol; and 31 % tried other illicit drugs. Women in the preconception period were more likely to have their weight checked (OR 1.83; CI 1.39, 2.41) and to abstain from using illicit drugs (OR 1.12; CI 1.01, 1.26) than other women who were not trying to become pregnant.

Conclusions: There were no differences in most behaviours between women in preconception period and in other women who were not pregnant. More awareness of preconception health is required to encourage women to engage in preventive activities.

Objective: This study aimed to assess the relationship between the independent effects of dietary quality (DQ) (Healthy Eating Index [HEI]-2015) and physical activity (PA) and their joint effects and the risk of obstructive sleep apnea (OSA).

Methods: This cross-sectional study collected information on participants with complete DQ, PA, and OSA diagnostic data from the 2015 to 2020 National Health and Nutrition Examination Survey (NHANES). We used multivariate logistic regression modeling to explore the relationship between the independent and joint effects of DQ and PA and OSA. In addition, sensitivity analyses were conducted to further validate the robustness of the results.

Results: A total of 8050 participants were included in this study, 3930 males and 4120 females. After adjusting for confounders, qualified DQ and high-level PA were significantly associated with a lower risk of OSA, with an odd ratio (OR) of 0.860 (95 % CI: 0.759-0.974) and 0.849 (95 % CI: 0.751-0.961), respectively. In the combined analysis, qualified DQ and high-level PA significantly reduced the risk of OSA (OR: 0.705, 95 % CI: 0.591-0.842). The sensitivity analysis results were consistent with the original results, further validating our findings.

Conclusions: The results of this study demonstrated that the combination of qualified DQ and high-level PA was significantly associated with a reduced risk of OSA. This finding emphasized the importance of a healthy lifestyle in the prevention of OSA.

Aims: Cardiovascular disease (CVD) is the leading cause of death in the United States (U.S.). This study aimed to explore prospective associations between long working hours with CVD mortality using a large, national study in the U.S.

Methods: Data from the Midlife in the U.S. (MIDUS) Study were used, including 4051 currently employed participants without prior experience of myocardial infarction or stroke at baseline in 1995-1996. Working hours were categorized into: <35 h/week, 35-40 h/week (reference), 41-48 h/week, 49-54 h/week, and ≥ 55 h/week. Mortality data were extracted from the National Death Index (NDI) through Spring 2021. Cox proportional hazards regression was applied to analyze the prospective associations between working hours at baseline and CVD mortality, adjusting for sociodemographic and lifestyle factors. Stratified analyses by socioeconomic status (i.e., education and financial situation) were also conducted.

Results: Long working hours (≥55 h/week) were significantly associated with increased CVD mortality (adjusted HR 1.50; 95 % CI 1.03-2.17) compared to the reference group. Subgroup analyses showed that individuals with low education level or poor financial situation had a higher risk of CVD mortality when working long hours.

Conclusion: Long working hours are a significant risk factor for CVD mortality in this national sample of U.S. workers, and participants with low socioeconomic status are more vulnerable to the effects of long working hours on CVD deaths. These findings highlight the need for considering working hour interventions in public health strategies to improve cardiovascular health outcomes in the workforce.

Introduction: Activity limitations among transgender and non-binary individuals remain largely unexplored using population-based samples. This study examines the risk of activity limitations across different gender identities in Canada.

Method: Using data from the 2021 Canadian long-form Census, logistic regressions estimated the adjusted odds of reporting activity limitations (seeing, hearing, mobility/dexterity, mental, cognitive, and other) across gender identities.

Results: Non-binary individuals assigned female at birth (AFAB) had the highest predicted probability of reporting any activity limitations (76.13 %), followed by non-binary individuals assigned male at birth (AMAB) at 61.56 %, transgender men (44.71 %), and transgender women (34.41 %). Cisgender men (19.31 %) and cisgender women (21.98 %) had the lowest probabilities. Mental limitations showed the largest disparity, with 39.4 % of non-binary AFAB individuals affected, compared to 4.9 % of cisgender men. These findings highlight significant disparities in activity limitations across gender identities.

Conclusion: Non-binary and transgender individuals are most at risk for activity limitations. These findings underscore the need for targeted policies to address challenges faced by gender-diverse populations. Future research should investigate the mechanisms behind these disparities. Healthcare policies must prioritize culturally competent, transgender-inclusive care to reduce disparities in activity limitations.

Background: Dementia represents a major public health challenge. Despite numerous initiatives promoting screening for early cognitive impairment to help prevent or delay its onset, participation remains limited. Moreover, there is limited evidence regarding screening intentions and predictors among populations at high risk of dementia. This study used the theory of planned behavior to identify modifiable factors associated with screening participation.

Methods: This cross-sectional survey was conducted from November 16, 2021, to April 2, 2022, and involved 439 individuals at high risk of dementia selected using convenience sampling from two major regional communities in Guangzhou, China. A validated custom questionnaire based on the theory of planned behavior was used for data collection, and logistic regression and structural equation modeling were applied to identify related predictors.

Results: Overall, 62 % of the participants expressed willingness to undergo dementia screening. Behavioral intention was primarily associated with Perceived behavioral control (PBC, path coefficient = 0.36), Subjective norm (path coefficient = 0.16), and Attitude (path coefficient = 0.13). Additionally, PBC was associated with a positive attitude toward dementia screening (path coefficient = 0.39).

Conclusions: PBC, subjective norm, and attitudes are associated with dementia screening willingness among high-risk groups. Healthcare professionals and policymakers should focus on enhancing favorable attitudes toward screening, increasing familial encouragement, and reducing perceived barriers to developing effective prevention or intervention strategies.

Introduction: Changes in up-to-date cervical cancer screening (CCS) over time by sexual orientation and race/ethnicity were estimated to identify trends in screening disparities.

Methods: This 2024 retrospective, cross-sectional analysis of National Health Interview Survey data (years 2013, 2015, 2019 and 2021) included 40,818 cisgender women aged 21-65 without hysterectomy. Joinpoint analysis was performed to calculate the annual percent change (APC) of up-to-date CCS from 2013 to 2021. Logistic regression (years 2019 and 2021) was used to describe the relationship between up-to-date screening and sexual orientation, race/ethnicity, and the interaction thereof.

Results: The adjusted odds of up-to-date CCS were 22 % lower for lesbian, gay, and/or bisexual (LGB) compared to heterosexual women (OR = 0.78, p = 0.01). Up-to-date CCS fell significantly from 80.50 % in 2013 to 75.00 % in 2021 for heterosexual respondents (APC = -0.97 %, p < 0.01), but was stable across years for LGB respondents. Up-to-date CCS decreased for Hispanic (APC = -1.52, p < 01) and non-Hispanic White only heterosexual women (APC = -0.63, p = 0.02). It also decreased for non-Hispanic Black/African American only LGB women (APC = -2.67, p < 0.01) falling from 85.22 % in 2013 to 67.91 % in 2021. By multiplicative interaction, LGB Hispanic women were more up-to-date than their heterosexual counterparts (p = 0.05).

Conclusions: In 2021 there were approximately 19.72 million women aged 21-65 who were not up-to-date with CCS. 1.76 million LGB women were not up-to-date for CCS, and a greater proportion of these women identified as non-Hispanic Black/African American. CCS must be improved for all cisgender women, and specific attention should be given to those who identify as LGB and/or Black/African American.

Objective: The purpose of this cross-sectional analysis is to compare the degree to which adolescents and adults with and without impairments in the US engage in illicit drug use.

Methods: This cross-sectional study utilized data from the 2022 National Survey of Drug Use and Health. Impairment status (mobility, cognitive, hearing, vision, self-care, and communication impairments), illicit drug use (cocaine, crack, heroin, hallucinogens, LSD, ecstasy and molly, inhalants, and methamphetamine), and demographic variables were measured using self-report. Weighted prevalence estimates for illicit drug use across each category were provided. Group differences in drug prevalence between individuals with and without impairments were examined, then logistic regressions estimated crude and adjusted odds of drug use among impairment groups by age. Prevalence of use and age of first time use for illicit drugs were explored across impairment type.

Results: The sample comprised of 35,921 individuals, with an estimate of 12.9 % experiencing at least one impairment. Among emerging adults, hallucinogens were the highest reported used drug in the past year, with a significantly higher percentage of those with impairments (12.8 %, 95 % CI: 1.5, 9.6), compared to adults without impairments (7.1 %, 95 % CI: 6.3, 8.0), reporting recent use. Individuals with impairments (mean = 16.2 years) were significantly younger when they first tried an illicit drug compared to peers (mean = 18.1 years).

Conclusions: Overall, individuals with impairments were more than twice as likely to engage in illicit drug use compared to counterparts. People with impairments were younger, on average, when they first tried any illicit drugs.

Objective: This study aimed to evaluate the effectiveness of school environmental factors in promoting adolescents' physical activity.

Methods: A systematic search of five databases (PubMed, Embase, Web of Science, EBSCO, and Cochrane Library) was conducted from the earliest available records up to September 2023. Meta-analyses were performed for each school environmental factor, provided that at least two studies reported on the association between that factor and adolescents' physical activity. The factors examined included seven school social environmental factors and six school physical environmental factors.

Results: 18 studies comprising 340,749 participants were included in the meta-analysis. A significant positive correlation was observed between the school environment and adolescents' physical activity. Specifically, the school social environment was positively associated with adolescents' physical activity. In particular, school-offered daily physical education, school-organized extracurricular physical activities, encouragement of using sports equipment or facilities, and outdoor obstacle course were all significantly positively correlated with adolescents' physical activity. While the overall school physical environment did not show a significant relationship with adolescents' physical activity, the number of school physical activity facilities demonstrated a significant positive correlation with adolescents' physical activity.

Conclusions: This meta-analysis demonstrates the role of school environment in promoting adolescents' physical activity. School social environmental factors, including school-offered daily physical education, school-organized extracurricular physical activities, encouragement to use sports resources, and outdoor obstacle courses, are particularly effective in enhancing adolescents' physical activity. Among school physical environmental factors, the number of physical activity facilities was found to be a key factor in promoting adolescents' physical activity.

Introduction: Adverse childhood experiences (ACEs) are preventable, potentially traumatic events that occur in childhood. Alcohol use during pregnancy can result in miscarriage, stillbirth, preterm birth, and a range of lifelong behavioral, intellectual, and physical disabilities in the child. Limited research has examined the relationship between ACEs and alcohol use in pregnancy; available studies might not reflect current trends in this relationship.

Methods: Using 2019-2023 Behavioral Risk Factor Surveillance System data from 41 U.S. jurisdictions, the prevalence of self-reported current alcohol use among pregnant persons aged 18-49 years (N = 2371) was estimated by ACEs and selected characteristics. We calculated unadjusted and adjusted prevalence ratios (aPR) for the relationship between ACEs and alcohol use during pregnancy.

Results: The prevalence of current alcohol use was 16.2 % (95 % CI = 11.5-20.9) among pregnant persons who reported experiencing four or more ACEs, and 8.6 % (95 % CI = 5.7-11.5) among those who reported no ACEs. When adjusting for sociodemographic characteristics, pregnant persons who reported four or more ACEs were more likely to report current alcohol use compared to those who reported no ACEs (aPR = 1.8, 95 % CI = 1.1-2.9). Individually, pregnant persons who experienced emotional abuse (aPR = 1.9, 95 % CI = 1.3-2.7) and witnessed intimate partner violence (aPR = 1.6, 95 % CI = 1.1-2.4) were more likely to use alcohol during pregnancy compared to pregnant persons who did not report experiencing these ACEs.

Conclusions: Higher ACE exposure was associated with alcohol use during pregnancy. Steps can be taken to mitigate their potential harms. Clinical and community-level interventions can address ACEs, which might reduce alcohol use during pregnancy.