Preventive medicine最新文献_第10页

The association between precarious employment and stress among working aged individuals in the United States 美国老年劳动者就业不稳定与压力之间的关系。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-30 DOI: 10.1016/j.ypmed.2024.108123

Vanessa M. Oddo , Sherif Mabrouk , Sarah B. Andrea , Emily Q. Ahonen , Megan R. Winkler , Emilia F. Vignola , Anjum Hajat

Objective

Precarious employment is a plausible stressor, which may adversely affect health. We investigated the association between multidimensional precarious employment and perceived and biological stress in the U.S.

Methods

We used data from waves 4 (2008–2009) and 5 (2016–2018) of the National Longitudinal Study of Adolescent to Adult Health. Eight indicators were mapped to five dimensions of precarious employment to create a continuous score (PES, range: 0–5): material rewards, working-time arrangements, stability, workers' rights, and interpersonal relationships. Perceived stress was constructed from the four-item Cohen's perceived stress score (PSS; range: 0–16; wave 4). We measured biological stress in waves 4 and 5 via C-reactive protein (CRP). Given variability in CRP collection between waves, we treated wave 4 and 5 as cross-sectional. We employed adjusted linear regression models to estimate whether the PES was associated with the PSS in wave 4 (n = 11,510) and CRP in waves 4 (n = 10,343) and 5 (n = 3452).

Result

Individuals were aged 28 and 37 years on average in wave 4 and 5, respectively. Half were female and most identified as non-Hispanic (NH)-White (∼73 %), followed by NH-Black (∼14 %), Hispanic (∼9 %) and NH-other (∼4 %). Average PES was inversely related to education. The PSS averaged 8.1 (Interquartile Range [IQR] = 7.0,9.0). Average CRP was 4.4 mg/L (IQR = 0.8,5.0) in wave 4 and 3.6 mg/L (IQR = 0.8,4.2) in wave 5. The PES was associated with perceived stress ( $β$ =0.06; 95 % CI = 0.01,0.10) and CRP in wave 5 ( $β$ =0.34; 95 % CI = 0.07,0.62).

Conclusions

Given the deleterious effects of stress on health, policies to reduce precarious employment warrant consideration.

目的：不稳定就业是一种合理的压力源，可能会对健康产生不利影响。我们调查了美国多维度不稳定就业与感知压力和生理压力之间的关联：我们使用了全国青少年到成人健康纵向研究第 4 波（2008-2009 年）和第 5 波（2016-2018 年）的数据。八项指标被映射到不稳定就业的五个维度，从而得出连续得分（PES，范围：0-5）：物质奖励、工作时间安排、稳定性、工人权利和人际关系。感知压力由四项科恩感知压力评分（PSS；范围：0-16；第 4 波）构成。我们通过 C 反应蛋白（CRP）测量第 4 波和第 5 波的生物压力。考虑到不同波次之间 CRP 采集结果的差异，我们将第 4 波和第 5 波视为横断面。我们采用调整线性回归模型来估计 PES 是否与第 4 波的 PSS（n = 11,510 人）以及第 4 波（n = 10,343 人）和第 5 波（n = 3452 人）的 CRP 相关：第 4 次和第 5 次调查的平均年龄分别为 28 岁和 37 岁。半数为女性，大多数为非西班牙裔白人（约占 73%），其次是非西班牙裔黑人（约占 14%）、西班牙裔（约占 9%）和非西班牙裔其他族裔（约占 4%）。平均 PES 与教育程度成反比。PSS 平均为 8.1（四分位数间距 [IQR] = 7.0,9.0）。第 4 波的平均 CRP 为 4.4 毫克/升（IQR = 0.8,5.0），第 5 波为 3.6 毫克/升（IQR = 0.8,4.2）。PES与感知压力（β=0.06；95 % CI = 0.01,0.10）和第5波CRP（β=0.34；95 % CI = 0.10,0.62）相关：鉴于压力对健康的有害影响，减少不稳定就业的政策值得考虑。

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引用次数: 0

Latent transition of social participation and its effects on depression among older adults in China: A National Longitudinal Study 中国老年人社会参与的潜在转变及其对抑郁症的影响：全国纵向研究。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-28 DOI: 10.1016/j.ypmed.2024.108122

Yaqi Wang , Xueying Xu , Yuan He , Jingwen Liu , Qingyun Lv , Hairong Chang , Li Fu , Yue Zhao , Xiaonan Zhang , Xiaoying Zang

Objectives

As populations age, the issue of social participation among older adults has gained prominence. Studies indicate variability in social participation trajectories among this demographic, yet the transition patterns and their effects on depression remain unclear. This longitudinal study aims to explore the latent classes and transition patterns in social participation among older adults and to evaluate their effects on depression.

Methods

Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2014 (T1) and 2018 (T2) were analyzed, including 2293 older adults. Latent class analysis (LCA) and latent transition analysis (LTA) were employed to identify latent classes of social participation at T1 and T2, as well as the transition probabilities between these classes. Multinomial logistic regression was used to examine predictors of transitions, and depression levels at T2 were compared across transition patterns.

Results

The LCA results supported a 3-class model labeled as low, moderate, and high social participation. The probabilities of remaining stable and transitioning to other classes were similar across the three classes (ranging from 0.50 to 0.54). Age, gender, and other baseline characteristics emerged as significant predictors of transition patterns. Older adults experiencing positive transitions exhibited reduced depression compared to those in their original class over time, while those with negative transitions showed increased depression.

Conclusions

This research prompts a deep understanding of social participation dynamics in older adults and their effects on depression. Identifying social participation classes and transition patterns could inform interventions to enhance social participation and reduce depression among older adults.

目的：随着人口老龄化，老年人的社会参与问题日益突出。研究表明，这一人群的社会参与轨迹存在差异，但过渡模式及其对抑郁症的影响仍不清楚。本纵向研究旨在探索老年人社会参与的潜在类别和过渡模式，并评估其对抑郁症的影响：分析了中国健康长寿纵向调查（CLHLS）2014年（T1）和2018年（T2）的数据，包括2293名老年人。采用潜类分析（LCA）和潜转移分析（LTA）来识别T1和T2的社会参与潜类，以及这些类别之间的过渡概率。多项式逻辑回归被用来研究过渡的预测因素，并比较了不同过渡模式在 T2 阶段的抑郁水平：结果：LCA 结果支持低、中、高社会参与度的三类模型。在这三个等级中，保持稳定和过渡到其他等级的概率相似（从 0.50 到 0.54 不等）。年龄、性别和其他基线特征是过渡模式的重要预测因素。随着时间的推移，经历了积极转变的老年人与原来阶层的老年人相比，抑郁程度有所降低，而经历了消极转变的老年人抑郁程度则有所上升：这项研究促使我们深入了解老年人的社会参与动态及其对抑郁症的影响。确定社会参与等级和过渡模式可以为干预措施提供依据，从而提高老年人的社会参与度并减少抑郁。

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引用次数: 0

Food insecurity trends and disparities according to immigration status in the US households, 2011–2021 2011-2021 年美国家庭中不同移民身份的粮食不安全趋势和差距

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-28 DOI: 10.1016/j.ypmed.2024.108121

Junxiu Liu , Zhiyang Zhou , Xi Cheng , Donglan Zhang , Lihua Li , Xiaotao Zhang , Nita Vangeepuram

Background

Food insecurity related to immigration status remains largely underexplored. This study examined trends and disparities in household food insecurity by immigration status in the United States (US).

Methods

We analyzed data from 427,942 households from the US Current Population Survey Food Security Supplement from 2011 to 2021. Immigration status categories included recent immigrants (< 5 years), long-term immigrants (≥ 5 years), naturalized citizens, and US-born citizens. Food insecurity was assessed using validated questions on consistent access to enough food for an active and healthy life.

Results

From 2011 to 2021, food insecurity prevalence declined from 14.9 % (95 % CI, 14.5 %–15.3 %) to 10.2 % (95 % CI, 9.8 %–10.6 %). Among recent immigrants, prevalence decreased from 25.2 % (95 % CI, 23.1–27.4) in 2011 to 15.0 % (95 % CI, 12.8 %–17.2 %) in 2019, then increased to 17.7 % (95 % CI, 14.7 %–20.2 %) in 2020 and 17.4 % (95 % CI, 14.7 %–20.2 %) in 2021. Long-term immigrants' prevalence dropped from 20.4 % (95 % CI, 16.9 %–24.0 %) in 2011 to 10.2 % (95 % CI, 7.2 %–13.1 %) in 2018, then increased to 17.7 % (95 % CI, 13.7 %–21.7 %) in 2021. Naturalized citizens' prevalence decreased from 14.4 % (95 % CI, 12.9 %–15.9 %) to 9.5 % (95 % CI, 8.2 %–10.9 %). US-born citizens' prevalence decreased from 14.2 % (95 % CI, 13.8 %–14.6 %) to 9.7 % (95 % CI, 9.3 %–10.2 %). Compared to the US-born citizens, the adjusted prevalence ratio was 1.63 (95 % CI,1.57–1.69) for recent immigrants, 1.22 (95 % CI, 1.13–1.31) for long-term immigrants, and 0.94 (95 % CI, 0.90–0.98) for naturalized citizens. Significant disparities exist in subgroups.

Conclusions

The findings provide insights for stakeholders to address food insecurity among vulnerable immigrant groups in the US.

背景与移民身份有关的粮食不安全问题在很大程度上仍未得到充分探讨。本研究探讨了美国按移民身份划分的家庭粮食不安全的趋势和差异。方法我们分析了 2011 年至 2021 年美国当前人口调查食品安全补充调查中 427,942 个家庭的数据。移民身份类别包括新移民（< 5 年）、长期移民（≥ 5 年）、入籍公民和美国出生公民。结果从 2011 年到 2021 年，粮食不安全的发生率从 14.9%（95% CI，14.5%-15.3%）下降到 10.2%（95% CI，9.8%-10.6%）。在新移民中，流行率从 2011 年的 25.2%（95 % CI，23.1-27.4%）下降到 2019 年的 15.0%（95 % CI，12.8%-17.2%），然后又上升到 2020 年的 17.7%（95 % CI，14.7%-20.2%）和 2021 年的 17.4%（95 % CI，14.7%-20.2%）。长期移民的患病率从 2011 年的 20.4%（95 % CI，16.9%-24.0%）下降到 2018 年的 10.2%（95 % CI，7.2%-13.1%），然后在 2021 年上升到 17.7%（95 % CI，13.7%-21.7%）。入籍公民的患病率从 14.4 %（95 % CI，12.9 %-15.9 %）下降到 9.5 %（95 % CI，8.2 %-10.9 %）。美国出生公民的患病率从 14.2%（95% CI，13.8%-14.6%）下降到 9.7%（95% CI，9.3%-10.2%）。与美国出生的公民相比，新移民的调整患病率比率为 1.63（95 % CI，1.57-1.69），长期移民为 1.22（95 % CI，1.13-1.31），入籍公民为 0.94（95 % CI，0.90-0.98）。结论研究结果为利益相关者解决美国弱势移民群体的粮食不安全问题提供了启示。

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引用次数: 0

Predicting oral and esophageal cancers by one model in a Chinese prospective cohort study 在一项中国前瞻性队列研究中，用一个模型预测口腔癌和食管癌。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-28 DOI: 10.1016/j.ypmed.2024.108119

Ping Chen , Wenting Zhao , Sicong Wang , Zilong Bian , Shu Li , Wenyuan Li , Huakang Tu , Chi Pang Wen , Xifeng Wu

Objective

Oral and esophageal cancers are both upper gastrointestinal cancers that share a number of risk factors. However, most previous risk prediction models only focused on one of these two types of cancer. There is no single model that could predict both cancers simultaneously. Our objective was to develop a model specifically tailored for oral and esophageal cancers.

Methods

From 1996 to 2007, a total of 431,460 subjects aged 20 and older without a history of cancer at baseline were included and were monitored for an average duration of 7.3 years in Taiwan, China. A total of 704 cases of oral and esophageal cancers were detected. We utilized both univariate and multivariate COX regression for screening predictors and constructing the model. We evaluated the goodness of fit of the model based on discriminatory accuracy, Harrell's C-index, and calibration.

Results

Finally, we developed a Cox regression model using the twelve most significant variables: age, gender, alcohol consumption, betel chewing, smoking status, history of oral ulceration, educational level, marital status, oropharynx status, family history of nasopharyngeal carcinoma, volume ratio of blood cell, and gamma-glutamyl transferase. The AUC (area under the curve) for the complete model was 0.82. Additionally, the C-index was 0.807 (with a 95 % confidence interval ranging from 0.789 to 0.824) and internal calibration results demonstrated that the model performed well.

Conclusions

This study identified the twelve most significant common risk factors for oral and esophageal cancers and developed a single prediction model that performs well for both types of cancer.

目的：口腔癌和食管癌都是上消化道癌症，它们都有一些共同的风险因素。然而，以往的风险预测模型大多只关注这两种癌症中的一种。目前还没有一个模型可以同时预测这两种癌症。我们的目标是开发一个专门针对口腔癌和食管癌的模型：方法：从 1996 年到 2007 年，中国台湾地区共纳入了 431,460 名 20 岁及以上、基线无癌症病史的受试者，并对其进行了平均 7.3 年的监测。共发现 704 例口腔癌和食道癌病例。我们利用单变量和多变量 COX 回归筛选预测因子并构建模型。我们根据判别准确性、哈雷尔 C 指数和校准来评估模型的拟合度：最后，我们利用以下 12 个最重要的变量建立了 Cox 回归模型：年龄、性别、饮酒量、咀嚼槟榔、吸烟状况、口腔溃疡史、教育程度、婚姻状况、口咽状况、鼻咽癌家族史、血细胞体积比和γ-谷氨酰转移酶。完整模型的 AUC（曲线下面积）为 0.82。此外，C 指数为 0.807（95 % 置信区间为 0.789 至 0.824），内部校准结果表明该模型性能良好：这项研究确定了口腔癌和食管癌的 12 个最重要的常见风险因素，并开发了一个单一的预测模型，该模型对这两种癌症都有很好的预测效果。

{"title":"Predicting oral and esophageal cancers by one model in a Chinese prospective cohort study","authors":"Ping Chen , Wenting Zhao , Sicong Wang , Zilong Bian , Shu Li , Wenyuan Li , Huakang Tu , Chi Pang Wen , Xifeng Wu","doi":"10.1016/j.ypmed.2024.108119","DOIUrl":"10.1016/j.ypmed.2024.108119","url":null,"abstract":"<div><h3>Objective</h3><p>Oral and esophageal cancers are both upper gastrointestinal cancers that share a number of risk factors. However, most previous risk prediction models only focused on one of these two types of cancer. There is no single model that could predict both cancers simultaneously. Our objective was to develop a model specifically tailored for oral and esophageal cancers.</p></div><div><h3>Methods</h3><p>From 1996 to 2007, a total of 431,460 subjects aged 20 and older without a history of cancer at baseline were included and were monitored for an average duration of 7.3 years in Taiwan, China. A total of 704 cases of oral and esophageal cancers were detected. We utilized both univariate and multivariate COX regression for screening predictors and constructing the model. We evaluated the goodness of fit of the model based on discriminatory accuracy, Harrell's C-index, and calibration.</p></div><div><h3>Results</h3><p>Finally, we developed a Cox regression model using the twelve most significant variables: age, gender, alcohol consumption, betel chewing, smoking status, history of oral ulceration, educational level, marital status, oropharynx status, family history of nasopharyngeal carcinoma, volume ratio of blood cell, and gamma-glutamyl transferase. The AUC (area under the curve) for the complete model was 0.82. Additionally, the C-index was 0.807 (with a 95 % confidence interval ranging from 0.789 to 0.824) and internal calibration results demonstrated that the model performed well.</p></div><div><h3>Conclusions</h3><p>This study identified the twelve most significant common risk factors for oral and esophageal cancers and developed a single prediction model that performs well for both types of cancer.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"189 ","pages":"Article 108119"},"PeriodicalIF":4.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0091743524002743/pdfft?md5=8ea8a75f48d16b787ca9f868de906263&pid=1-s2.0-S0091743524002743-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of accelerometer-derived “weekend warrior” moderate to vigorous physical activity, chronic kidney disease and acute kidney injury 加速度计得出的 "周末战士 "中度至剧烈运动与慢性肾病和急性肾损伤的关系。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-24 DOI: 10.1016/j.ypmed.2024.108120

Ziliang Ye, Mengyi Liu, Sisi Yang, Yanjun Zhang, Yuanyuan Zhang, Panpan He, Chun Zhou, Xiaoqin Gan, Hao Xiang, Yu Huang, Fan Fan Hou, Xianhui Qin

Objective

To examine the relationship between an accelerometer-derived “weekend warrior” pattern, characterized by achieving the most moderate to vigorous physical activity (MVPA) over 1–2 days, as opposed to more evenly distributed patterns, with risk of chronic kidney disease (CKD) and acute kidney injury (AKI).

Methods

77,977 participants without prior kidney diseases and with usable accelerometer data (collected between 2013 and 2015) were included from the UK Biobank. Three physical activity patterns were compared: active weekend warrior pattern (achieving ≥150 min MVPA per week and accumulating ≥50 % of total MVPA in 1–2 days), active regular pattern (achieving ≥150 min MVPA but not meeting active weekend warrior criteria per week), and inactive pattern (<150 min MVPA per week). The study outcomes included incident CKD and AKI, ascertained through self-report data and data linkage with primary care, hospital admissions, and death registry records.

Results

During a median follow-up of 6.8 years, 1324 participants developed CKD and 1515 developed AKI. In multivariable-adjusted models, when compared with inactive participants, individuals with active weekend warrior pattern (CKD: hazard ratio [HR], 0.79, 95 % confidence interval [CI], 0.69–0.89; AKI: HR, 0.70, 95 %CI, 0.62–0.79) and those with active regular pattern (CKD: HR, 0.81, 95 %CI, 0.69–0.95; AKI: HR, 0.79, 95 %CI, 0.68–0.91) exhibited a similar and significantly lower risk of incident CKD and AKI. Similar findings were observed at the median threshold of ≥230.4 min of MVPA per week.

Conclusion

Concentrated MVPA within 1 to 2 days is as effective as distributed ones in decreasing the risk of renal outcomes.

目的方法：从英国生物库中纳入 77,977 名无肾脏疾病且有可用加速度计数据（收集于 2013 年至 2015 年）的参与者。比较了三种体育锻炼模式：积极的周末战士模式（每周达到≥150 分钟的 MVPA，并在 1-2 天内累计达到总 MVPA 的≥50%）、积极的常规模式（每周达到≥150 分钟的 MVPA，但未达到积极的周末战士标准）和不积极的模式：在中位随访 6.8 年期间，1324 名参与者患上了慢性肾脏病，1515 名参与者患上了急性肾脏病。在经多变量调整的模型中，与不活动的参与者相比，周末活跃型参与者（CKD：危险比 [HR]，0.79，95 % 置信区间 [CI]，0.69-0.89；AKI：HR，0.70，95 %CI，0.62-0.79）和那些活跃的常规模式（CKD：HR，0.81，95 %CI，0.69-0.95；AKI：HR，0.79，95 %CI，0.68-0.91）表现出相似且显著较低的发生 CKD 和 AKI 的风险。在每周 MVPA ≥230.4 分钟的中位阈值上也观察到了类似的结果：结论：在降低肾脏疾病风险方面，1 到 2 天内集中的 MVPA 与分散的 MVPA 同样有效。

{"title":"Association of accelerometer-derived “weekend warrior” moderate to vigorous physical activity, chronic kidney disease and acute kidney injury","authors":"Ziliang Ye, Mengyi Liu, Sisi Yang, Yanjun Zhang, Yuanyuan Zhang, Panpan He, Chun Zhou, Xiaoqin Gan, Hao Xiang, Yu Huang, Fan Fan Hou, Xianhui Qin","doi":"10.1016/j.ypmed.2024.108120","DOIUrl":"10.1016/j.ypmed.2024.108120","url":null,"abstract":"<div><h3>Objective</h3><p>To examine the relationship between an accelerometer-derived “weekend warrior” pattern, characterized by achieving the most moderate to vigorous physical activity (MVPA) over 1–2 days, as opposed to more evenly distributed patterns, with risk of chronic kidney disease (CKD) and acute kidney injury (AKI).</p></div><div><h3>Methods</h3><p>77,977 participants without prior kidney diseases and with usable accelerometer data (collected between 2013 and 2015) were included from the UK Biobank. Three physical activity patterns were compared: active weekend warrior pattern (achieving ≥150 min MVPA per week and accumulating ≥50 % of total MVPA in 1–2 days), active regular pattern (achieving ≥150 min MVPA but not meeting active weekend warrior criteria per week), and inactive pattern (<150 min MVPA per week). The study outcomes included incident CKD and AKI, ascertained through self-report data and data linkage with primary care, hospital admissions, and death registry records.</p></div><div><h3>Results</h3><p>During a median follow-up of 6.8 years, 1324 participants developed CKD and 1515 developed AKI. In multivariable-adjusted models, when compared with inactive participants, individuals with active weekend warrior pattern (CKD: hazard ratio [HR], 0.79, 95 % confidence interval [CI], 0.69–0.89; AKI: HR, 0.70, 95 %CI, 0.62–0.79) and those with active regular pattern (CKD: HR, 0.81, 95 %CI, 0.69–0.95; AKI: HR, 0.79, 95 %CI, 0.68–0.91) exhibited a similar and significantly lower risk of incident CKD and AKI. Similar findings were observed at the median threshold of ≥230.4 min of MVPA per week.</p></div><div><h3>Conclusion</h3><p>Concentrated MVPA within 1 to 2 days is as effective as distributed ones in decreasing the risk of renal outcomes.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"187 ","pages":"Article 108120"},"PeriodicalIF":4.3,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk-stratified screening and colorectal cancer incidence and mortality: A retrospective study from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial 风险分层筛查与结直肠癌发病率和死亡率：前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验的回顾性研究。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-22 DOI: 10.1016/j.ypmed.2024.108117

Yu Zhang , Chao Sheng , Zeyu Fan , Ya Liu , Xiaomin Liu , Hongyuan Duan , Hongji Dai , Zhangyan Lyu , Lei Yang , Fangfang Song , Fengju Song , Yubei Huang , Kexin Chen

Objective

To determine whether risk stratification can optimize the benefits of flexible sigmoidoscopy (FSG) screening.

Methods

The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial was conducted from 1993 to 2001 in the United States. A colorectal cancer (CRC) risk stratification tool was developed in the control arm (n = 64,207) from the PLCO cohort and validated in the UK Biobank (n = 270,726). PLCO participants (n = 130,021) were classified into low-, medium-, and high-risk groups. Cumulative incidence and mortality were estimated using the Kaplan-Meier method. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between screening and CRC incidence and mortality.

Results

The CRC risk stratification tool was based on age, gender, body mass index, smoking status, family history of CRC, diabetes, regular use of aspirin, and CRC screening history. Compared with the control arm, FSG screening was significantly associated with a reduction in mortality in both the medium-risk (HR = 0.76, 95% CI = 0.63–0.92) and high-risk groups (0.58, 0.46–0.73), but not in the low-risk group (0.85, 0.61–1.19). FSG screening also reduced distal CRC incidence and mortality in the medium-risk and high-risk groups. Furthermore, it was associated with a reduction in incidence (0.74, 0.59–0.92) and mortality (0.59, 0.40–0.87) of proximal colon cancer in the high-risk group.

Conclusions

FSG screening yielded more benefits for the high-risk group than for the low-risk and medium-risk groups, supporting the development of a risk-stratified CRC screening strategy.

目的：确定风险分层是否能优化柔性乙状结肠镜（FSG）筛查的益处：确定风险分层是否能优化柔性乙状结肠镜（FSG）筛查的益处：前列腺癌、肺癌、结直肠癌和卵巢癌（PLCO）筛查试验于 1993 年至 2001 年在美国进行。在 PLCO 队列的对照组（n = 64,207 人）中开发了结直肠癌（CRC）风险分层工具，并在英国生物库（n = 270,726 人）中进行了验证。PLCO 参与者（n = 130,021）被分为低、中、高风险组。采用 Kaplan-Meier 法估算累积发病率和死亡率。采用 Cox 比例危险模型估算筛查与 CRC 发病率和死亡率之间关系的危险比 (HR) 和 95% 置信区间 (CI)：CRC风险分层工具基于年龄、性别、体重指数、吸烟状况、CRC家族史、糖尿病、定期服用阿司匹林和CRC筛查史。与对照组相比，FSG筛查显著降低了中风险组（HR = 0.76，95% CI = 0.63-0.92）和高风险组（0.58，0.46-0.73）的死亡率，但没有降低低风险组（0.85，0.61-1.19）的死亡率。FSG筛查还降低了中危组和高危组的远端CRC发病率和死亡率。此外，FSG筛查还降低了高风险组近端结肠癌的发病率（0.74，0.59-0.92）和死亡率（0.59，0.40-0.87）：FSG筛查对高危人群的益处大于对低危和中危人群的益处，支持制定风险分层的CRC筛查策略。

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引用次数: 0

Combined effects of sleep timing and nighttime sleep duration on non-alcoholic fatty liver disease 睡眠时间和夜间睡眠时间对非酒精性脂肪肝的综合影响。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-18 DOI: 10.1016/j.ypmed.2024.108116

Xiaolong Xing , Mengwei Ding , Chunjun Li , Mianzhi Zhang , Ximing Xu , Li Zhang , Fenghua Guo , Shuo Chen , Yujie Niu , Feng Liu , Rong Zhang , Qiang Li , Shitao Ma , Minying Zhang

Background

While short sleep duration is linked to higher risk of non-alcoholic fatty liver disease (NAFLD), the combined effects of sleep timing and sleep duration on NAFLD are less explored.

Methods

In this cross-sectional study of 39,471 participants from Beijing-Tianjin-Hebei region of China, self-reported sleep information and ultrasonography-diagnosed NAFLD were obtained from Jan 2018 to Jan 2020. Sleep timing was categorized based on sleep midpoint: early-type (before 2:00 AM), intermediate-type (2:00–2:30 AM), and late-type (after 2:30 AM). We used multivariable logistic regression to explore the relationship between sleep timing, duration, and NAFLD. We analyzed sleep midpoint and duration categorically and continuously, and conducted stratification analyses by age, sex, body mass index, hypertension, diabetes, and dyslipidemia.

Results

Intermediate-type (OR: 1.15, 95% confidence interval: 1.05–1.26) and late-type sleep timing (OR: 1.08, 1.00–1.16) were associated with higher NAFLD risk compared to early-type. Additionally, longer sleep duration was linked to lower risk (OR: 0.92, 0.90–0.95 per hour increase). Notably, intermediate to late-type sleepers with normal sleep duration (7 to <8 h) exhibited a 20% higher NAFLD risk compared to early-type sleepers with the same duration (OR: 1.20, 1.04–1.39). The increased NAFLD risk associated with intermediate to late sleep timing was particularly evident in men, hypertension, and prediabetes or diabetes participants.

Conclusions

Intermediate to late sleep timing, even with normal sleep duration, is associated with increased NAFLD risk. These findings underscore the importance of considering both sleep timing and sleep duration for NAFLD prevention, especially in men and individuals with cardiometabolic conditions.

背景：虽然睡眠时间短与非酒精性脂肪肝（NAFLD）的高风险有关，但睡眠时间和睡眠持续时间对非酒精性脂肪肝的综合影响还较少被探讨：在这项针对中国京津冀地区 39471 名参与者的横断面研究中，获得了自 2018 年 1 月至 2020 年 1 月期间自我报告的睡眠信息和超声诊断的非酒精性脂肪肝。根据睡眠中点将睡眠时间分为：早期型（凌晨2:00之前）、中期型（凌晨2:00-2:30）和晚期型（凌晨2:30之后）。我们使用多变量逻辑回归来探讨睡眠时间、持续时间与非酒精性脂肪肝之间的关系。我们对睡眠中点和持续时间进行了分类和连续分析，并按年龄、性别、体重指数、高血压、糖尿病和血脂异常进行了分层分析：与早睡型相比，中睡型（OR：1.15，95% 置信区间：1.05-1.26）和晚睡型（OR：1.08，1.00-1.16）与较高的非酒精性脂肪肝风险相关。此外，睡眠时间越长，风险越低（OR：0.92，每增加一小时为 0.90-0.95）。值得注意的是，睡眠时间正常的中晚期睡眠者（7 到结论：中晚期睡眠者的非酒精性脂肪肝风险较高：即使睡眠时间正常，中晚期睡眠时间也会增加非酒精性脂肪肝的风险。这些发现强调了同时考虑睡眠时间和睡眠持续时间对预防非酒精性脂肪肝的重要性，尤其是对男性和患有心脏代谢疾病的人。

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引用次数: 0

Conceptualizing vaccine champions from an implementation science perspective: Findings from a national survey of primary care health professionals 从实施科学的角度理解疫苗拥护者：全国初级保健专业人员调查的结果。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-17 DOI: 10.1016/j.ypmed.2024.108104

Kathryn L. Kennedy , Melissa B. Gilkey , Tara L. Queen , Jennifer A. Heisler-MacKinnon , Bennett Hanson , Wei Yi Kong , Micaela K. Brewington , Brigid K. Grabert

Objective

Clinical champions are healthcare professionals who help their colleagues improve the delivery of evidence-based care. Because little is known about champions working in the context of adolescent vaccination, we sought to identify vaccine champion roles among primary care health professionals (PCHPs).

Methods

In 2022, we surveyed 2527 US PCHPs who serve adolescents. The survey assessed the extent to which respondents identified as vaccine champions and the activities they performed. Guided by the Consolidated Framework for Implementation Research, we used these data to categorize PCHPs as: champions who led projects to increase vaccination rates (“implementation leaders”); facilitating champions who more generally shared vaccination data, information, and encouragement (“facilitators”); or non-champions. We used multinomial logistic regression to identify correlates of being a leader or facilitator as opposed to a non-champion.

Results

About one-fifth (21%) of PCHPs were implementation leaders, one-quarter (25%) were facilitators, and the remainder (54%) were non-champions. Leaders were more common among PCHPs with medium or high versus low practice experience (31% and 36% versus 20%, both p < .01) and adolescent patient volume (29% and 39% versus 17%, both p < .01). Being a facilitator was also associated with higher practice experience and patient volume. Leaders and facilitators reported a similar number of barriers to their work (mean = 1.8 and 1.9, respectively), with time and competing quality metrics being most common.

Conclusions

Our findings suggest that both implementation leaders and facilitators are common vaccine champions in adolescent primary care. These champions are more often found among PCHPs with higher experience and patient volume.

目的：临床拥护者是帮助同事改善循证医疗服务的医疗保健专业人员。由于对青少年疫苗接种工作中的带头人知之甚少，我们试图确定初级保健医疗专业人员（PCHPs）中的疫苗带头人角色：2022 年，我们对 2527 名为青少年提供服务的美国初级保健专业人员进行了调查。调查评估了受访者认定自己为疫苗卫士的程度以及他们所开展的活动。在 "实施研究综合框架 "的指导下，我们利用这些数据将公立医疗机构分为：领导提高疫苗接种率项目的拥护者（"实施领导者"）；更广泛地分享疫苗接种数据、信息和鼓励的促进拥护者（"促进者"）；或非拥护者。我们使用多项式逻辑回归来确定领导者或促进者与非倡导者之间的相关性：约五分之一（21%）的初级保健中心是实施领导者，四分之一（25%）是促进者，其余（54%）为非领导者。在具有中度或高度实践经验的初级保健中心中，领导者的比例要高于低实践经验的初级保健中心（31% 和 36% 对 20%，均为 p 结论：我们的研究结果表明，在青少年初级保健中，实施领导者和促进者都是常见的疫苗倡导者。在经验丰富、患者数量较多的初级保健医生中，这些倡导者更为常见。

{"title":"Conceptualizing vaccine champions from an implementation science perspective: Findings from a national survey of primary care health professionals","authors":"Kathryn L. Kennedy , Melissa B. Gilkey , Tara L. Queen , Jennifer A. Heisler-MacKinnon , Bennett Hanson , Wei Yi Kong , Micaela K. Brewington , Brigid K. Grabert","doi":"10.1016/j.ypmed.2024.108104","DOIUrl":"10.1016/j.ypmed.2024.108104","url":null,"abstract":"<div><h3>Objective</h3><p>Clinical champions are healthcare professionals who help their colleagues improve the delivery of evidence-based care. Because little is known about champions working in the context of adolescent vaccination, we sought to identify vaccine champion roles among primary care health professionals (PCHPs).</p></div><div><h3>Methods</h3><p>In 2022, we surveyed 2527 US PCHPs who serve adolescents. The survey assessed the extent to which respondents identified as vaccine champions and the activities they performed. Guided by the Consolidated Framework for Implementation Research, we used these data to categorize PCHPs as: champions who led projects to increase vaccination rates (“implementation leaders”); facilitating champions who more generally shared vaccination data, information, and encouragement (“facilitators”); or non-champions. We used multinomial logistic regression to identify correlates of being a leader or facilitator as opposed to a non-champion.</p></div><div><h3>Results</h3><p>About one-fifth (21%) of PCHPs were implementation leaders, one-quarter (25%) were facilitators, and the remainder (54%) were non-champions. Leaders were more common among PCHPs with medium or high versus low practice experience (31% and 36% versus 20%, both <em>p</em> < .01) and adolescent patient volume (29% and 39% versus 17%, both <em>p</em> < .01). Being a facilitator was also associated with higher practice experience and patient volume. Leaders and facilitators reported a similar number of barriers to their work (mean = 1.8 and 1.9, respectively), with time and competing quality metrics being most common.</p></div><div><h3>Conclusions</h3><p>Our findings suggest that both implementation leaders and facilitators are common vaccine champions in adolescent primary care. These champions are more often found among PCHPs with higher experience and patient volume.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"187 ","pages":"Article 108104"},"PeriodicalIF":4.3,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unraveling the role of BMI and blood markers in the relationship between plant-based diets and osteoporosis: A prospective cohort study 揭示体重指数和血液指标在植物性饮食与骨质疏松症之间关系中的作用：一项前瞻性队列研究。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-14 DOI: 10.1016/j.ypmed.2024.108103

Yi Zheng , Jiacheng Wang , Yucan Li , Yawen Wang , Chen Suo , Yanfeng Jiang , Li Jin , Kelin Xu , Xingdong Chen

Background

The potential adverse effects of plant-based diets on bone health have raised significant concern, while the prospective evidence is limited. This study aimed to evaluate the association between plant-based diet indexes and incident osteoporosis while exploring the underlying mechanisms involved in this relationship.

Methods

The analysis included 202,063 UK Biobank participants conducted between 2006 and 2022. Plant-based diet indexes (hPDI and uPDI) were calculated using the 24-h dietary questionnaire. Cox proportional risk regression and mediation analysis were used to explore the associations of plant-based diet indexes with osteoporosis, estimating the contribution of BMI and blood markers.

Results

We found the highest quintile for hPDI (HR = 1.16; 95% CI: 1.05 to 1.28) and uPDI (HR = 1.15; 95% CI: 1.05 to 1.26) were associated with an increased risk of osteoporosis. BMI was identified as an important mediator in the association between hPDI and osteoporosis, with mediation proportions of 46.17%. For blood markers, the mediating (suppressing) effects of C-reactive protein, alkaline phosphatase, and insulin-like growth factor-1 on the association between uPDI (hPDI) and osteoporosis were significant, ranging from 5.63%–16.87% (4.57%–6.22%).

Conclusion

Adherence to a plant-based diet is associated with a higher risk of osteoporosis, with BMI and blood markers potentially contributing to this relationship. Notably, even a healthy plant-based diet necessitates attention to weight management to mitigate its impact on bone loss. These findings emphasize the importance of personalized dietary recommendations and lifestyle interventions to decrease the risk of osteoporosis.

背景：植物性饮食对骨骼健康的潜在不利影响引起了人们的极大关注，但前瞻性证据却很有限。本研究旨在评估植物性膳食指数与骨质疏松症发病率之间的关系，同时探索这种关系的内在机制：分析对象包括 2006 年至 2022 年间的 202,063 名英国生物库参与者。采用 24 小时膳食调查问卷计算植物性膳食指数（hPDI 和 uPDI）。我们使用 Cox 比例风险回归和中介分析来探讨植物性膳食指数与骨质疏松症的关系，并估计了体重指数和血液指标的贡献：我们发现，hPDI（HR = 1.16；95% CI：1.05 至 1.28）和 uPDI（HR = 1.15；95% CI：1.05 至 1.26）的最高五分位数与骨质疏松症风险增加有关。在 hPDI 与骨质疏松症的关系中，BMI 被认为是一个重要的中介因素，其中介比例为 46.17%。在血液标志物方面，C反应蛋白、碱性磷酸酶和胰岛素样生长因子-1对uPDI（hPDI）与骨质疏松症之间关系的中介（抑制）作用显著，介于5.63%-16.87%（4.57%-6.22%）之间：结论：坚持以植物为基础的饮食与较高的骨质疏松症风险有关，体重指数和血液指标可能是造成这种关系的原因。值得注意的是，即使是健康的植物性饮食也需要注意体重管理，以减轻其对骨质流失的影响。这些发现强调了个性化饮食建议和生活方式干预对降低骨质疏松症风险的重要性。

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引用次数: 0

Age, sex, and pre-arrest comorbidities shape the risk trajectory of sudden cardiac death— Patterns highlighted by population data in Taiwan 年龄、性别和猝死前的合并症决定了心脏性猝死的风险轨迹--台湾的人口数据凸显了这一模式。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-14 DOI: 10.1016/j.ypmed.2024.108102

Chih-Wei Sung , Hua-Chih Chang , Cheng-Yi Fan , Chi-Hsin Chen , Edward Pei-Chuan Huang , Likwang Chen

Objectives

Few reports have indicated the secular trend in the sudden cardiac death (SCD) incidence and pre-arrest comorbidities. This study aimed to comprehensively analyze the trend of SCD incidence and its association with pre-arrest comorbidities.

Methods

This population-based cohort study analyzed Taiwan's National Health Insurance (NHI) research database and identified SCD incidents by inspecting data from all emergency department visits from 2011 to 2018. The inclusion criteria were ICD-9:427.5 or 427.41, or ICD-10:I46.9, I46.8, or I46.2. Pre-existing comorbidities were confirmed based on medication use. Multivariable logistic regression was adopted with covariates age, sex, and pre-existing comorbidities.

Results

This study reviewed a total of 184,164,969 person-year records, and identified 92,138 SCD incidents. From 2011 to 2018, the SCD incidence rate increased from 36.3 to 55.4 per 100,000 enrollees in Taiwan. The top five pre-arrest comorbidities were stable, while the prevalence of chronic kidney disease rose significantly. Compared to those aged 20–29, enrollees aged >65 years had significantly higher odds of SCD (aOR:27.30, 95% CI:26.05–28.61). Higher odds of SCD were noted in the enrollees who had a seizure (aOR:2.24, 95% CI:2.12–2.38), parkinsonism (aOR:1.81, 95% CI:1.73–1.89), psychological disorders (aOR:1.59, 95% CI:1.56–1.62), diabetes mellitus (aOR:1.44, 95% CI:1.41–1.46), heart diseases (aOR:1.41, 95% CI:1.38–1.44).

Conclusions

The incidence of SCD steadily increased in Taiwan from 2011 to 2018. Hypertension, diabetes mellitus, heart disease, psychological disorders, and arthritis were major pre-arrest comorbidities. Age is the most important risk factor for SCD. Further large-scaled population-based study that investigated in diverse ethnicities from countries in addition to Asians would be warranted.

目的：很少有报告指出心脏性猝死（SCD）发病率与猝死前合并症的长期趋势。本研究旨在全面分析 SCD 发病率的趋势及其与猝死前合并症的关系：这项基于人群的队列研究分析了台湾的国民健康保险（NHI）研究数据库，并通过检查2011年至2018年期间所有急诊科就诊数据确定了SCD事件。纳入标准为ICD-9:427.5或427.41，或ICD-10:I46.9、I46.8或I46.2。根据用药情况确认是否存在既往合并症。采用多变量逻辑回归法，辅以年龄、性别和既往合并症：本研究共查阅了 184 164 969 人年记录，发现了 92 138 例 SCD 事件。从2011年到2018年，台湾每10万名参保者的SCD发病率从36.3上升到55.4。发病前的五大合并症保持稳定，而慢性肾病的发病率则显著上升。与 20-29 岁的参保者相比，年龄大于 65 岁的参保者发生 SCD 的几率明显更高（aOR:27.30, 95% CI:26.05-28.61）。患有癫痫发作（aOR:2.24，95% CI:2.12-2.38）、帕金森病（aOR:1.81，95% CI:1.73-1.89）、心理障碍（aOR:1.59，95% CI:1.56-1.62）、糖尿病（aOR:1.44，95% CI:1.41-1.46）和心脏病（aOR:1.41，95% CI:1.38-1.44）的参保者发生 SCD 的几率更高：从2011年到2018年，SCD的发病率在台湾稳步上升。高血压、糖尿病、心脏病、心理障碍和关节炎是发病前的主要合并症。年龄是 SCD 最重要的风险因素。除了亚洲人之外，还需要对不同国家的不同种族进行进一步的大规模人群研究。

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引用次数: 0