Preventive medicine最新文献_第3页

Black college women's preventive health behaviors: Applications of a Black Feminist-Womanist research paradigm 黑人女大学生的预防保健行为：黑人女权主义-妇女主义研究范式的应用。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-02 DOI: 10.1016/j.ypmed.2024.108126

Objective

The researchers applied Lindsay-Dennis' Black Feminist-Womanist research paradigm to Andersen's Behavioral Model for Health Service Use to guide initial research about Black American women's preventive health behaviors.

Methods

This article highlights this application, using interpretive phenomenological analysis for qualitative questions assessing how 40 Black college women define health and their experiences in health care. This was part of a larger convergent parallel mixed-methods approach in a 2022 cross-sectional online survey.

Results

Participants defined health as a concept involving health literacy, physical and mental health, and being free from health conditions or disease. Regarding health-related lived experiences, negative experiences were more frequently reported than positive experiences. However, many participants reported both positive and negative health care related experiences. Predisposing, enabling, and need factors were all present in qualitative responses.

Conclusions

This article highlights the fit of a Black Feminist-Womanist research paradigm to Andersen's model to better understand Black women's health experiences and illustrates ways that medical mistrust, health literacy, and past experiences with health care can influence health service use. Areas for future research on barriers and facilitators to preventive care and implications for reducing health disparities are also discussed.

目标：研究人员将 Lindsay-Dennis 的黑人女性主义-妇女主义研究范式应用于 Andersen 的健康服务使用行为模型，以指导有关美国黑人女性预防性健康行为的初步研究：本文重点介绍了这一应用，采用解释现象学分析法对 40 名黑人女大学生的定性问题进行评估，了解她们如何定义健康以及她们在医疗保健方面的经历。这是在 2022 年横断面在线调查中采用的更大范围的趋同平行混合方法的一部分：结果：参与者将健康定义为一个涉及健康知识、身体和心理健康以及远离健康状况或疾病的概念。关于与健康相关的生活经历，负面经历的报告多于正面经历。然而，许多参与者既报告了与医疗保健相关的积极经历，也报告了与医疗保健相关的消极经历。在定性回答中，倾向性因素、有利因素和需求因素都存在：本文强调了黑人女性主义-妇女主义研究范式与安徒生模型的契合，以更好地理解黑人妇女的健康经历，并说明了医疗不信任、健康素养和过去的医疗经历如何影响医疗服务的使用。此外，还讨论了有关预防性保健的障碍和促进因素的未来研究领域，以及对减少健康差异的影响。

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引用次数: 0

Relationship between participation in projects of incentives to promote walking and healthy aging among the older population: A four-year longitudinal study 老年人参与鼓励步行项目与健康老龄化之间的关系：一项为期四年的纵向研究。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-02 DOI: 10.1016/j.ypmed.2024.108125

Objective

This study aimed to evaluate the association between the Yokohama Walking Point Program, which promotes walking through feedback on step counts and incentives, and the extension of healthy life expectancy.

Methods

A total of 4298 individuals aged over 65 years who responded to the 2013 and 2016 surveys and who were not certified as needing long-term care in 2016 were included in this study. The participants were categorized into “non-participation,” “participation without uploading,” and “participation with uploading” groups based on their involvement and uploading of pedometer data. The objective variable was the occurrence of long-term care certification and deaths over the subsequent four years. A modified Poisson regression model was applied, adjusting for 15 variables before project initiation.

Results

A total of 440 participants (10.2 %) were included in the “participation with uploading” group and 206 (4.8 %) in the “participation without uploading” group. Compared with “non-participation,” the risk ratio was 0.77 (95 % confidence interval (CI): 0.59–0.99) for “participation with uploading” and 1.02 (95 % CI: 0.75–1.38) for “participation without uploading”. In the sensitivity analysis censoring death as an inapplicable outcome and considering functional decline, participation with uploading showed a risk ratio of 0.79 (95 % CI: 0.60–1.04) for the likelihood of functional decline.

Conclusions

The use of pedometers and health point programs based on walking activity is associated with enhancing the health of older individuals participating in the program, representing a population-centric strategy targeting all citizens.

研究目的本研究旨在评估 "横滨步行点计划 "与延长健康预期寿命之间的关系：本研究共纳入了 4298 名 65 岁以上的老人，他们都对 2013 年和 2016 年的调查做出了回应，并且在 2016 年没有被证明需要长期护理。根据参与和上传计步器数据的情况，将参与者分为 "未参与 "组、"参与但未上传 "组和 "参与但上传 "组。客观变量是在随后四年中发生的长期护理认证和死亡事件。在项目启动前，对 15 个变量进行了调整，采用了修正的泊松回归模型：共有 440 名参与者（10.2%）被纳入 "参与并上传 "组，206 名参与者（4.8%）被纳入 "未参与并上传 "组。与 "未参与 "相比，"参与上传 "的风险比为 0.77（95% 置信区间（CI）：0.59-0.99），"参与未上传 "的风险比为 1.02（95% 置信区间（CI）：0.75-1.38）。在敏感性分析中，将死亡作为不适用的结果进行了删减，并考虑了功能衰退的因素，结果显示，参与并上传计步器对功能衰退可能性的风险比为 0.79（95 % CI：0.60-1.04）：使用计步器和以步行活动为基础的健康积分计划有助于提高参与计划的老年人的健康水平，是一项针对所有公民的以人口为中心的战略。

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引用次数: 0

Firearm violence and associated factors among young adults presenting to emergency departments in three cities: Baseline results from Project SPARK 三个城市急诊科就诊的年轻成年人中的枪支暴力及相关因素：SPARK 项目的基线结果。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-02 DOI: 10.1016/j.ypmed.2024.108124

Objective

Recent shifts in U.S. violence dynamics call for updated violence epidemiology among general emergency department (ED) samples of young adults. Using baseline data from a multi-site longitudinal study of firearm violence prediction, we describe violence rates and associated factors.

Methods

Staff approached age 18–24 entrants to Level-1 trauma centers in three cities (Flint, Seattle, Philadelphia; 7/2021–5/2023). Consenting participants completed a survey including validated measures of violence experience, firearm-related behaviors, substance use, mental health symptoms, peer/parental/familial behaviors, community violence, and attitudes/norms. We described the sample and examined factors associated with firearm assault (victimization/aggression, including threats).

Results

Across sites, 1506 participants enrolled (41.7. % Black; 33.6 % White; 61.4. % female). Half of participants self-reported past-six-month violent victimization and/or aggression; non-partner violence, and violent victimization were most common. Over half of participants self-reported high-risk substance use, and over half screened positive for post-traumatic stress disorder, depression, and/or anxiety. About 14.4 % self-reported past-six-month firearm assault, and 5.9 % self-reported firearm violence (excluding threats). Adjusted analysis showed community violence exposure was most strongly associated with firearm assault; each one-point-increase corresponded to a 13.7 % (95 %CI: 10.4 %–16.9 %) absolute increase in firearm assault prevalence. Drug misuse, mental health symptoms, firearm carrying, retaliatory attitudes, prosocial attitudes, and family conflict were also associated with firearm assault.

Conclusions

Violence, including firearm assault, is common among young adults entering urban EDs, and is associated with several psychosocial factors. High rates of substance use and mental health symptoms underscore this as a high-need population. Leveraging this information could help tailor interventions and optimize resource allocation.

目的：美国暴力动态的最新变化要求对普通急诊科（ED）青壮年样本中的暴力流行病学进行更新。我们利用枪支暴力预测多站点纵向研究的基线数据，描述了暴力发生率及相关因素：工作人员与三个城市（弗林特、西雅图、费城；2021 年 7 月至 2023 年 5 月）的一级创伤中心的 18-24 岁入院者进行了接触。征得同意的参与者完成了一项调查，其中包括暴力经历、枪支相关行为、药物使用、精神健康症状、同伴/父母/家庭行为、社区暴力以及态度/规范等方面的有效测量。我们对样本进行了描述，并研究了与枪支攻击（受害/攻击，包括威胁）相关的因素：在各个地点，共有 1506 名参与者（40.9% 为黑人；34.3% 为白人；60.1% 为女性）。半数参与者自我报告了过去六个月的暴力伤害和/或侵犯行为；非伴侣暴力和暴力伤害最为常见。半数以上的参与者自述曾使用高风险药物，半数以上的参与者在创伤后应激障碍、抑郁和/或焦虑症筛查中呈阳性。约有 14.4% 的人自述在过去六个月中遭受过枪支攻击，5.9% 的人自述遭受过枪支暴力（不包括威胁）。调整后的分析表明，社区暴力风险与持枪攻击行为的关系最为密切；每增加一个点，持枪攻击行为的发生率就会绝对增加 13.7%（95%CI：10.4%-16.9%）。药物滥用、精神健康症状、携带枪支、报复态度、亲社会态度和家庭冲突也与持枪伤人有关：暴力（包括持枪伤人）在进入城市急诊室的年轻成年人中很常见，并与多种社会心理因素有关。高比率的药物使用和精神健康症状突出表明这是一个高需求人群。利用这些信息有助于调整干预措施和优化资源分配。

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引用次数: 0

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

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

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

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

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。

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引用次数: 0

Reprint of: Smoking and pulmonary health in women: A narrative review and behavioral health perspective. 重印本：女性吸烟与肺部健康：叙述性综述和行为健康视角。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-27 DOI: 10.1016/j.ypmed.2024.108113

Katherine E Menson, Sulamunn R M Coleman

Objective: Cigarette smoking prevalence has declined slower among women than men, and smoking-related pulmonary disease (PD) has risen among women. Given these trends, there is a critical need to understand and mitigate PD risk among women who smoke. The purpose of this narrative review and commentary is to highlight important evidence from the literature on smoking and PD among women.

Methods: This review focuses broadly on examining cigarette smoking and PD among women within six topic areas: (1) demographic characteristics and prevalence of smoking, (2) smoking behavior, (3) lung cancer, (4) obstructive PD, (5) diagnostic and treatment disparities, and (6) gaps in the literature and potential directions for future research and treatment.

Results: Growing evidence indicates that compared to men, women are at increased risk for developing smoking-related PD and poorer PD outcomes. Gender disparities in smoking-related PD may be largely accounted for by genetic differences and sex hormones contributing to PD pathogenesis and presentation, smoking behavior, nicotine dependence, and pathogen/carcinogen clearance. Moreover, gender disparities in smoking-related PD may be exacerbated by important social determinants (e.g., women with less formal education and those from minoritized groups may be at especially high risk for poor PD outcomes due to higher rates of smoking).

Conclusion: Rising rates of smoking-related PD among women risk widening diagnostic and treatment disparities. Ongoing research is needed to explore potentially complex relationships between sex, gender, and smoking-related PD processes and outcomes, and to improve smoking-cessation and PD treatment for women.

目的：女性吸烟率的下降速度慢于男性，而与吸烟相关的肺部疾病（PD）在女性中有所上升。鉴于这些趋势，我们亟需了解并降低吸烟女性患肺部疾病的风险。这篇叙述性综述和评论旨在强调女性吸烟和肺部疾病文献中的重要证据：方法：本综述主要从以下六个方面对女性吸烟与帕金森病进行研究：（1）人口特征和吸烟率；（2）吸烟行为；（3）肺癌；（4）阻塞性帕金森病；（5）诊断和治疗差异；（6）文献中的空白以及未来研究和治疗的潜在方向：越来越多的证据表明，与男性相比，女性罹患与吸烟相关的帕金森病的风险更高，且帕金森病的治疗效果更差。与吸烟相关的帕金森病的性别差异可能在很大程度上是由遗传差异和性激素造成的，而遗传差异和性激素又与帕金森病的发病机制和表现、吸烟行为、尼古丁依赖以及病原体/致癌物质清除有关。此外，与吸烟相关的帕金森病的性别差异可能会因重要的社会决定因素而加剧（例如，正规教育程度较低的女性和来自少数群体的女性可能因吸烟率较高而特别容易出现帕金森病的不良后果）：结论：女性中与吸烟相关的帕金森病发病率不断上升，有可能扩大诊断和治疗方面的差异。需要持续开展研究，探索性、性别和吸烟相关的帕金森病过程和结果之间潜在的复杂关系，并改善女性的戒烟和帕金森病治疗。

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引用次数: 0

Reprint of: Examining U.S. disparities in smoking among rural versus urban women of reproductive age: 2002-2019. 重印本：研究美国农村与城市育龄妇女吸烟的差异：2002-2019 年。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-26 DOI: 10.1016/j.ypmed.2024.108115

Stephen T Higgins, Tyler Erath, Fang-Fang Chen

Objective: This study is part of a programmatic investigation of rural disparities in cigarette smoking examining disparities in smoking prevalence and for the first-time quit ratios among adult women of reproductive age (18-44 years), a highly vulnerable population due to risk for multigenerational adverse effects.

Methods: Data came from 18 years (2002-2019) of the U.S. National Survey on Drug Use and Health (NSDUH) among women (n = 280,626) categorized by rural-urban residence, pregnancy status, using weighted logistic regression models testing time trends and controlling for well-established sociodemographic predictors of smoking (race/ethnicity, education, income). Concerns regarding changes in survey methods used before 2002 and after 2019 precluded inclusion of earlier and more recent survey years in the present study.

Results: Overall smoking prevalence across years was greater in rural than urban residents (adjusted odds ratio [AOR] = 1.11; 95%CI, 1.07-1.15; P < .001) including those not-pregnant (AOR = 1.10; 1.07-1.14; P < .001) and pregnant (AOR = 1.29; 1.09-1.52; P < .001). Overall quit ratios across years were lower in rural than urban residents (AOR = 0.93; 0.87-0.99; P < .001) including those not-pregnant (AOR = 0.93; 0.88-1.00, P = .035) and pregnant (AOR = 0.78; 0.62-0.99; P = .039). Interactions of rural versus urban residence with study years for prevalence and quit ratios overall and by pregnancy status are detailed in the main text.

Conclusions: These results support a longstanding and robust rural disparity in smoking prevalence among women of reproductive age including those currently pregnant and provides novel evidence that differences in smoking cessation contribute to this disparity further underscoring a need for greater access to evidence-based tobacco control and regulatory interventions in rural regions.

研究目的本研究是对农村地区吸烟差异进行的一项计划性调查的一部分，调查对象为育龄成年女性（18-44 岁）中吸烟率和首次戒烟率的差异：数据来自美国全国药物使用和健康调查（NSDUH）18 年（2002-2019 年）的数据，按城乡居住地和怀孕状况对妇女（n = 280,626 人）进行分类，使用加权逻辑回归模型检验时间趋势，并控制已确立的吸烟社会人口预测因素（种族/民族、教育、收入）。考虑到 2002 年之前和 2019 年之后调查方法的变化，本研究未将较早和较近的调查年份纳入其中：结果：农村居民在不同年份的总体吸烟率高于城市居民（调整后的几率比 [AOR] = 1.11；95%CI，1.07-1.15；P 结论：这些结果支持了农村居民吸烟率的长期稳健增长：这些结果表明，农村育龄妇女（包括怀孕妇女）的吸烟率长期存在巨大差异，并提供了新的证据表明，戒烟方面的差异导致了这种差异，这进一步强调了农村地区需要更多的循证烟草控制和监管干预措施。

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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

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":"","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":null,"pages":null},"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