Preventive medicine最新文献_第4页

Comparative effectiveness of high-efficacy and moderate efficacy disease-modifying agents in reducing the annualized relapse rates among multiple sclerosis patients in the United States 高效和中效改变病情药物在降低美国多发性硬化症患者年复发率方面的疗效比较。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-11-16 DOI: 10.1016/j.ypmed.2024.108180

Jieni Li , George J. Hutton , Tyler J. Varisco , Ying Lin , Ekere J. Essien , Rajender R. Aparasu

Objective

The optimal treatment strategy for the management of multiple sclerosis is widely discussed due to the increasing availability of high-efficacy disease-modifying agents (heDMAs). This study evaluated the comparative effectiveness of heDMA and moderate-efficacy disease-modifying agents (meDMAs) use in reducing annualized relapse rate (ARR) among multiple sclerosis patients.

Methods

A retrospective cohort study was conducted using the 2015–2019 United States Merative MarketScan Commercial Claims Data. Adult (18–64 years) patients with incident disease-modifying agents (DMA) use were included. Claim-based relapse algorithms were applied to measure relapse events. The inverse probability treatment weighting (IPTW) based negative binomial regression model with the offset of the follow-up period was used to compare the ARR. The moderation effect of sex on ARR was also examined.

Results

This study included 10,003 incident DMA users, with 22.9 % initiated heDMAs. The average ARR during follow-up among heDMA users was lower than meDMA users (0.25 vs. 0.28, p < 0.01). The IPTW-based regression found that sex moderated the relationship between the types of DMAs and ARR. Stratified analyses revealed that heDMAs were associated with a lower ARR in males (adjusted incidence rate ratio [aIRR] 0.74; 95 % confidence interval [CI] 0.59–0.94) compared with meDMAs. No significant differences were noted among females (aIRR 0.99; 95 % CI: 0.88–1.21).

Conclusion

The study found that sex moderated the effect of heDMAs, with male multiple sclerosis patients using heDMAs associated with a 26 % decreased risk of relapse than those with meDMAs. However, there was no difference in comparative effectiveness for females.

目的：由于高效改变病情药物（heDMAs）的供应量不断增加，治疗多发性硬化症的最佳治疗策略引起了广泛讨论。本研究评估了heDMA和中等疗效疾病修饰药物（meDMA）在降低多发性硬化症患者年复发率（ARR）方面的疗效比较：利用 2015-2019 年美国 Merative MarketScan 商业索赔数据开展了一项回顾性队列研究。研究纳入了使用改变病情药物（DMA）的成人（18-64 岁）患者。采用基于索赔的复发算法来衡量复发事件。采用基于反概率治疗加权（IPTW）的负二项回归模型，并抵消随访期来比较 ARR。研究还考察了性别对 ARR 的调节作用：本研究共纳入 10,003 名 DMA 使用者，其中 22.9% 开始使用 heDMA。在随访期间，heDMA 使用者的平均 ARR 低于 meDMA 使用者（0.25 vs. 0.28，p 结论：研究发现，性别对 ARR 有调节作用：研究发现，性别对heDMAs的影响具有调节作用，使用heDMAs的男性多发性硬化症患者的复发风险比使用meDMAs的患者降低了26%。不过，女性患者的疗效比较没有差异。

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引用次数: 0

Association of vaping with respiratory symptoms in U.S. young adults: Nicotine, cannabis, and dual vaping 美国年轻人吸烟与呼吸道症状的关系：尼古丁、大麻和双重吸食。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-11-14 DOI: 10.1016/j.ypmed.2024.108175

Ruoyan Sun , Gabriela R. Oates

Introduction

Although studies have found nicotine and cannabis vaping to be individually associated with respiratory symptoms, little is known about the harm of dual vaping. We aim to assess the association of nicotine-only, cannabis-only, and dual vaping with respiratory symptoms.

Methods

Using a national sample of 8033 U.S. young adults (ages 18–24) interviewed in 2021, we employed multivariable logistic regressions to assess the association between vaping behaviors and past 12-month respiratory outcomes.

Results

Of all participants, 75.4 % did not vape, 15.0 % vaped nicotine only, 4.7 % vaped cannabis only, and 4.9 % vaped both. Compared with no vaping, nicotine-only vaping was associated with sounding wheezy (aPR = 1.75, 95 % CI, 1.28–2.39) and dry cough at night (aPR = 1.43, 95 % CI, 1.19–1.72). Cannabis-only vaping was also associated with these two symptoms, with aPRs at 1.82 (95 % CI, 1.15–2.88) and 1.61 (95 % CI, 1.18–2.21), respectively. In addition to these two symptoms (aPR = 2.24, 95 % CI, 1.42–3.54 for sounding wheezy, and aPR = 1.50, 95 % CI, 1.01–2.22 for dry cough at night), dual vaping was associated with wheezing or whistling (aPR = 1.93, 95 % CI, 1.23–3.04) and high level of respiratory symptoms (aPR = 2.02, 95 % CI, 1.24–3.32). Compared with non-frequent vaping, cannabis-only and dual frequent vaping were associated with higher risks of wheezing or whistling.

Conclusions

Nicotine-only and cannabis-only vaping were associated with two respiratory symptoms while dual vaping with four. The elevated respiratory risk of dual vaping warrants future research on the underlying mechanisms of different vaping behaviors and respiratory outcomes.

导言：尽管研究发现尼古丁和大麻吸食分别与呼吸道症状有关，但对双重吸食的危害却知之甚少。我们的目的是评估只吸食尼古丁、只吸食大麻和双重吸食与呼吸道症状的关系：我们在 2021 年对 8033 名美国年轻成年人（18-24 岁）进行了全国性抽样调查，采用多变量逻辑回归评估了吸食行为与过去 12 个月呼吸系统结果之间的关联：在所有参与者中，75.4% 不吸食，15.0% 只吸食尼古丁，4.7% 只吸食大麻，4.9% 两者都吸食。与不吸食相比，只吸食尼古丁与夜间喘息（aPR = 1.75，95 % CI，1.28-2.39）和干咳（aPR = 1.43，95 % CI，1.19-1.72）有关。只吸食大麻也与这两种症状有关，aPR 分别为 1.82（95 % CI，1.15-2.88）和 1.61（95 % CI，1.18-2.21）。除了这两种症状（喘息声的 aPR = 2.24，95 % CI，1.42-3.54；夜间干咳的 aPR = 1.50，95 % CI，1.01-2.22）外，双重吸烟还与喘息或啸叫（aPR = 1.93，95 % CI，1.23-3.04）和高度呼吸道症状（aPR = 2.02，95 % CI，1.24-3.32）有关。与不经常吸食相比，只吸食大麻和双重频繁吸食与较高的喘息或吹口哨风险相关：结论：只吸食尼古丁和只吸食大麻与两种呼吸道症状有关，而双重吸食则与四种呼吸道症状有关。双重吸食者的呼吸系统风险升高，需要在未来对不同吸食行为和呼吸系统结果的内在机制进行研究。

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引用次数: 0

Clearing the air: Heightened perception of harm from secondhand cannabis smoke exposure is associated with no in-home cannabis smoking in a 21-country convenience sample 净化空气：在 21 个国家的便利抽样调查中，对二手大麻烟雾危害的高度认识与不在家中吸食大麻有关。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-11-14 DOI: 10.1016/j.ypmed.2024.108178

Osika Tripathi , Humberto Parada Jr , Sandy Liles , Yuyan Shi , Georg E. Matt , Penelope J.E. Quintana , Jason Ferris , Adam Winstock , John Bellettiere

Objective

As countries adopt more lenient cannabis use policies, perception of harm from secondhand cannabis smoke (SHCS) exposure is decreasing and most cannabis smoking is taking place at home. We quantified the relationship of reported in-home cannabis smoking with perceived harm from SHCS exposure.

Methods

The analytic sample comprised 28,154 adult respondents, from 21 countries, to the annual cross-sectional Global Drug Survey (2021) of users of licit or illicit drugs. Respondents reported perception of harm to non-smoking residents from SHCS exposure and past 30-day cannabis smoking in the home by anyone. Logistic regression estimated covariate-adjusted odds ratios and 95 % confidence intervals of in-home cannabis smoking (yes/no). The association between harm perception and in-home cannabis smoking by country of residence was also quantified.

Results

Sixty-one percent reported no in-home cannabis smoking in the last 30 days; mean perception of harm of SHCS exposure on a 10-point scale was 5.2. Those at the 75th (vs 25th) percentile of perceived harm had 70 % higher odds (OR = 1.7, 95 % CI = 1.6–1.8) of no in-home cannabis smoking. In all countries of residence, higher perception of harm was associated with reporting no in-home cannabis smoking, although not all were statistically significant. The strongest association was seen in Sweden (OR = 3.9, 95 % CI = 1.5–11.9) and New Zealand (OR = 2.3, 95 % CI = 2.0–2.7).

Conclusions

Respondents who perceived SHCS as harmful were less likely to report in-home cannabis smoking. If this association subsequently proves causal, increasing awareness of the harms associated with SHCS exposure could substantially reduce residential cannabis secondhand smoke exposure.

目的：随着各国采取更加宽松的大麻使用政策，人们对二手大麻烟雾（SHCS）暴露危害的认识正在下降，而且大多数大麻吸烟都是在家中进行的。我们量化了所报告的在家吸食大麻与二手大麻烟雾（SHCS）暴露危害感知之间的关系：分析样本包括来自 21 个国家的 28,154 名成年受访者，他们是年度横截面全球药物调查（2021 年）的合法或非法药物使用者。受访者报告了对暴露于 SHCS 对非吸烟居民造成危害的感知，以及过去 30 天内任何人在家中吸食大麻的情况。逻辑回归估算了经协变因素调整的家庭内吸食大麻（是/否）的几率比和 95 % 置信区间。此外，还按居住国量化了危害感知与在家中吸食大麻之间的关联：61%的人报告在过去 30 天内没有在家中吸食大麻；按 10 分制计算，对接触 SHCS 危害的平均感知为 5.2。危害感知处于第 75 百分位数（与第 25 百分位数相比）的人不在家中吸食大麻的几率要高出 70%（OR = 1.7，95 % CI = 1.6-1.8）。在所有居住国中，对危害感知较高的人报告未在家中吸食大麻的几率较高，但并非所有国家都具有显著的统计学意义。瑞典（OR = 3.9，95 % CI = 1.5-11.9）和新西兰（OR = 2.3，95 % CI = 2.0-2.7）的相关性最强：认为吸食大麻有害的受访者在家中吸食大麻的可能性较低。如果这种关联随后被证明是因果关系，那么提高对吸入有害健康物质相关危害的认识将大大减少住宅中的大麻二手烟暴露。

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引用次数: 0

Human papillomavirus-associated cancers, precancers, and genital warts in Denmark, 2000–2022 – Current burden of disease and population impact of multi-cohort HPV vaccination 2000-2022 年丹麦与人类乳头瘤病毒相关的癌症、癌前病变和生殖器疣 - 当前疾病负担和多队列人类乳头瘤病毒疫苗接种对人口的影响。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-11-10 DOI: 10.1016/j.ypmed.2024.108165

Emma L. Kaderly Rasmussen , Sofie Lindquist , Louise Baandrup , Tatiana Hansen , Christian Munk , Kirsten Frederiksen , Susanne K. Kjær

Objectives

We present incidence trends of cancer and precancer at human papillomavirus(HPV)-associated sites, and genital warts, including the current burden of HPV-associated disease in Denmark, a country with multi-cohort HPV vaccination.

Method

Cases were identified from high-quality nationwide registries (2000−2022). The age-specific incidence rate, age-standardized incidence rate (ASR) and estimated annual percentage change (EAPC) were calculated according to sex and calendar year. The current burden (2020−2022) of HPV-associated disease was estimated as the average annual number of each lesion multiplied by the disease-specific HPV-attributable fraction.

Results

ASRs of cervical precancer and genital warts declined markedly in the post-HPV vaccination period – for genital warts corresponding to an EAPC of −13.7 % (−15.0;−12.4)(women) and −8.8 % (−9.4;−8.2)(men), respectively. ASRs of HPV-associated cancer sites increased continuously in men (EAPC: 2.8 % (2.2;3.5)), and the same was observed for non-cervical HPV-associated cancer sites in women (EAPC: 2.5 % (2.0;3.0)). Cervical cancer, however, decreased in the post-HPV vaccination period (EAPC: −2.7 % (−3.8;−1.5)). Age-specific incidence rates of HPV-associated cancer sites decreased slightly in younger women and were stable in younger men, while incidence rates in older men approached or even surpassed that of older women. Data on the current burden showed that cervical precancer and genital warts are still the major contributors to HPV-associated disease, and oropharyngeal cancer now accounts for more annual cases on a population level than cervical cancer.

Conclusion

Danish data show decreased incidence of cervical lesions and genital warts in the post-vaccine era. Despite population impact of HPV vaccination, HPV-associated disease remains a public health issue and increasingly among men.

目的：我们介绍了人乳头瘤病毒（HPV）相关部位癌症和癌前病变以及生殖器疣的发病趋势，包括丹麦（一个接种多组HPV疫苗的国家）目前HPV相关疾病的负担：方法：从高质量的全国性登记（2000-2022 年）中确定病例。根据性别和日历年计算特定年龄发病率、年龄标准化发病率（ASR）和估计年百分比变化（EAPC）。目前（2020-2022 年）HPV 相关疾病的负担是以每种病变的年平均数量乘以疾病特异性 HPV 可归因部分估算得出的：宫颈癌前病变和生殖器疣的ASR在接种HPV疫苗后明显下降--生殖器疣的EAPC分别为-13.7% (-15.0;-12.4)（女性）和-8.8% (-9.4;-8.2)（男性）。男性 HPV 相关癌症部位的 ASR 持续上升（EAPC：2.8 % (2.2;3.5)），女性非宫颈 HPV 相关癌症部位的 ASR 也是如此（EAPC：2.5 % (2.0;3.0)）。不过，宫颈癌的发病率在接种 HPV 疫苗后有所下降（欧洲和中亚地区：-2.7 % (-3.8;-1.5)）。HPV相关癌症部位的特定年龄发病率在年轻女性中略有下降，在年轻男性中保持稳定，而老年男性的发病率接近甚至超过了老年女性。有关目前负担的数据显示，宫颈癌前病变和生殖器疣仍然是导致 HPV 相关疾病的主要因素，而口咽癌目前在人群中的年发病率超过了宫颈癌：丹麦的数据显示，在疫苗接种后的时代，宫颈病变和生殖器疣的发病率有所下降。尽管接种人乳头瘤病毒疫苗对人口产生了影响，但人乳头瘤病毒相关疾病仍然是一个公共卫生问题，而且越来越多地发生在男性身上。

{"title":"Human papillomavirus-associated cancers, precancers, and genital warts in Denmark, 2000–2022 – Current burden of disease and population impact of multi-cohort HPV vaccination","authors":"Emma L. Kaderly Rasmussen , Sofie Lindquist , Louise Baandrup , Tatiana Hansen , Christian Munk , Kirsten Frederiksen , Susanne K. Kjær","doi":"10.1016/j.ypmed.2024.108165","DOIUrl":"10.1016/j.ypmed.2024.108165","url":null,"abstract":"<div><h3>Objectives</h3><div>We present incidence trends of cancer and precancer at human papillomavirus(HPV)-associated sites, and genital warts, including the current burden of HPV-associated disease in Denmark, a country with multi-cohort HPV vaccination.</div></div><div><h3>Method</h3><div>Cases were identified from high-quality nationwide registries (2000−2022). The age-specific incidence rate, age-standardized incidence rate (ASR) and estimated annual percentage change (EAPC) were calculated according to sex and calendar year. The current burden (2020−2022) of HPV-associated disease was estimated as the average annual number of each lesion multiplied by the disease-specific HPV-attributable fraction.</div></div><div><h3>Results</h3><div>ASRs of cervical precancer and genital warts declined markedly in the post-HPV vaccination period – for genital warts corresponding to an EAPC of −13.7 % (−15.0;−12.4)(women) and −8.8 % (−9.4;−8.2)(men), respectively. ASRs of HPV-associated cancer sites increased continuously in men (EAPC: 2.8 % (2.2;3.5)), and the same was observed for non-cervical HPV-associated cancer sites in women (EAPC: 2.5 % (2.0;3.0)). Cervical cancer, however, decreased in the post-HPV vaccination period (EAPC: −2.7 % (−3.8;−1.5)). Age-specific incidence rates of HPV-associated cancer sites decreased slightly in younger women and were stable in younger men, while incidence rates in older men approached or even surpassed that of older women. Data on the current burden showed that cervical precancer and genital warts are still the major contributors to HPV-associated disease, and oropharyngeal cancer now accounts for more annual cases on a population level than cervical cancer.</div></div><div><h3>Conclusion</h3><div>Danish data show decreased incidence of cervical lesions and genital warts in the post-vaccine era. Despite population impact of HPV vaccination, HPV-associated disease remains a public health issue and increasingly among men.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"189 ","pages":"Article 108165"},"PeriodicalIF":4.3,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626107","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

The impact of a lifestyle behaviour change program on healthcare costs: Quasi-experimental real-world evidence from an open-access mobile health app in the Netherlands 改变生活方式计划对医疗成本的影响：来自荷兰一款开放式移动医疗应用程序的准实验性真实证据。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-11-10 DOI: 10.1016/j.ypmed.2024.108174

Elena Agachi , Jochen O. Mierau , Koert van Ittersum , Tammo H.A. Bijmolt

Objective

Recognizing the substantial role of modifiable risk factors such as physical inactivity, unhealthy diets, and substance use in driving global healthcare expenses, this study aims to assess the impact of a lifestyle behaviour change mobile health (mHealth) app on healthcare costs within a real-world setting.

Methods

Employing a difference-in-difference approach, this research compared healthcare costs between users of an mHealth app (treatment group) and a propensity score-matched control group of non-users. The study included data from 15,506 participants in the Netherlands, covering healthcare cost records collected from 2015 to 2019.

Results

The implementation of the mHealth app was linked to a steady reduction in healthcare costs, achieving a 4.9 % decrease (

β = - 0.05, 95 % CI : - 0.10 to 0.00

) during the first year following the program's implementation, and a further 5.3 % decrease (

β = - 0.05, 95 % CI : - 0.10 to - 0.00

) in the second year. This healthcare costs reduction is associated with lower expenses for general practitioner services as well as diminished specialist visits. Additionally, increased app use led to further cost reductions, with frequency of use proving more important than intensity.

Conclusions

This study demonstrates that a behaviour change mHealth app is linked to significant reductions in healthcare costs, with more frequent and intense use leading to greater savings. Given their relatively low cost and ability to reach diverse population groups, such apps not only enhance individual health outcomes but can also serve as effective policy tools for large-scale health promotion, supporting broader societal health improvements.

研究目的本研究旨在评估改变生活方式行为的移动医疗（mHealth）应用对现实世界中医疗费用的影响：本研究采用差分法，比较了移动医疗应用程序用户（治疗组）与倾向得分匹配的非用户对照组的医疗费用。研究纳入了荷兰15506名参与者的数据，涵盖2015年至2019年收集的医疗成本记录：移动医疗应用程序的实施与医疗费用的稳步下降有关，在计划实施后的第一年，医疗费用下降了4.9%（β=-0.05，95%CI：-0.10至0.00），第二年进一步下降了5.3%（β=-0.05，95%CI：-0.10至0.00）。医疗成本的降低与全科医生服务费用的降低以及专科医生就诊次数的减少有关。此外，增加应用程序的使用还能进一步降低成本，使用频率比使用强度更重要：这项研究表明，改变行为的移动医疗应用程序可显著降低医疗成本，使用频率和强度越高，节省的费用就越多。鉴于其相对低廉的成本和覆盖不同人群的能力，此类应用程序不仅能提高个人健康水平，还能作为有效的政策工具，促进大规模的健康推广，支持更广泛的社会健康改善。

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引用次数: 0

Disparities in trends of smoke-free home associated with socioeconomic disadvantages in the United States from 2001 to 2019 2001 年至 2019 年美国与社会经济劣势相关的无烟家庭趋势差异。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-11-09 DOI: 10.1016/j.ypmed.2024.108173

Boram Lee , Douglas E. Levy

Objective

To examine disparities in trends of smoke-free home (SFH) rule prevalence in the United States from 2001 to 2019 by individuals' number of socioeconomic disadvantages.

Methods

Data were drawn from the 2001–2019 Tobacco Use Supplements to the U.S. Current Population Survey, a nationally representative cross-sectional survey. The sample comprised respondents (aged≥18 years) who answered items about SFH rules and socioeconomic disadvantage, defined as past-month unemployment, income below the federal poverty line, and/or education less than a high school diploma (N = 867,552). Multivariable logistic regressions estimated associations between adoption of an SFH rule and the number of socioeconomic disadvantages, including interaction terms between time and disadvantages, to assess changes in disparities over time.

Results

SFH prevalence increased substantially from 64.6 % in 2001–2002 to 89.0 % in 2018–2019. Differences in SFH prevalence by socioeconomic disadvantage narrowed somewhat over the 19 years among non-smokers but widened among smokers. Among non-smokers, SFH prevalence increased by 17.2 ppt (76.5 % to 93.7 %) for those without disadvantages, while it increased by 24.3 ppt (61.8 % to 86.1 %) among those with three disadvantages. In contrast, among smokers, increases in SFH prevalence over time were smaller among those with one (22.8 % to 51.5 %), two (19.5 % to 45.1 %), and three disadvantages (17.3 % to 37.1 %), compared with those without disadvantages (27.7 % to 61.4 %). The widened disparities were found even among smokers living with children.

Conclusion

Despite a large increase in the SFH prevalence, disparities remain. Our findings underscore the need for continued efforts to promote SFH, particularly among socioeconomically disadvantaged smokers.

目的研究2001年至2019年美国无烟家庭（SFH）规则普及率趋势的差异，按个人的社会经济劣势数量进行分类：数据来自 2001-2019 年美国当前人口调查烟草使用补充资料，这是一项具有全国代表性的横断面调查。样本包括回答有关 SFH 规则和社会经济劣势（定义为上月失业、收入低于联邦贫困线和/或教育程度低于高中文凭）项目的受访者（年龄≥18 岁）（N = 867,552 人）。多变量逻辑回归估算了采用自费住房规则与社会经济劣势数量之间的关联，包括时间与劣势之间的交互项，以评估差异随时间的变化：SFH的流行率从2001-2002年的64.6%大幅上升至2018-2019年的89.0%。19年间，非吸烟者中因社会经济劣势而导致的SFH患病率差异有所缩小，但吸烟者中的差异却有所扩大。在非吸烟者中，无劣势人群的SFH患病率增加了17.2个百分点（从76.5%上升到93.7%），而有三种劣势人群的SFH患病率增加了24.3个百分点（从61.8%上升到86.1%）。相比之下，在吸烟者中，有一项不利条件（22.8%至51.5%）、两项不利条件（19.5%至45.1%）和三项不利条件（17.3%至37.1%）的吸烟者的 SFH 患病率随时间推移的增长幅度要小于没有不利条件的吸烟者（27.7%至61.4%）。即使在与子女同住的吸烟者中，差距也有所扩大：尽管 SFH 患病率大幅上升，但差距依然存在。我们的研究结果表明，有必要继续努力推广自律吸烟，尤其是在社会经济条件较差的吸烟者中。

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引用次数: 0

Evaluating the effectiveness of mailout smoking cessation support: A systematic review and meta-analysis 评估邮寄戒烟支持的有效性：系统回顾和荟萃分析。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-11-05 DOI: 10.1016/j.ypmed.2024.108162

Amanual Getnet Mersha , Jamie Bryant , Kade Booth , Michelle Kennedy

Objective

One of the main barriers to smoking cessation support is accessibility. Mailout supports can potentially mitigate access barriers, but their effectiveness has not been explored. The aim of this review is to evaluate the effectiveness of mailout smoking cessation support.

Methods

A systematic review was conducted using studies retrieved from six databases, from inception to May 2024. The methodological qualities were assessed using the Joanna Briggs Institute Critical Appraisal tools. Meta-analysis was performed using random-effects model to estimate pooled effects. Heterogeneity was evaluated using the Higgins' I² test. Publication bias was assessed through a funnel plot and Egger's regression test.

Results

A total of 1918 citations were screened, resulting in the inclusion of 12 RCTs. Mailout support significantly improved the odds of smoking cessation at six to twelve months (OR = 1.43, 95 % CI: 1.29, 1.59). Interventions that included nicotine replacement therapies (NRT) were associated with higher odds of smoking cessation (OR = 1.61, 95 % CI: 1.38, 1.87) compared to behavioural interventions alone (OR = 1.28, 95 % CI: 1.11, 1.48). Interventions lasting longer than 12 weeks resulted in higher odds of smoking cessation (OR = 1.57, 95 % CI 1.29, 1.59) compared to interventions lasting 8 to 12 weeks (OR = 1.52, 95 % CI 1.29, 1.80) and less than 8 weeks (OR = 1.40, 95 % CI 1.10, 1.77).

Conclusion

Mailout smoking cessation support improves quitting, especially when interventions include NRT and delivered for longer than 12 weeks. While further research is needed to refine implementation strategies, mailout smoking cessation supports are effective and have potential to reduce access barriers.

目的：戒烟支持的主要障碍之一是可及性。邮寄戒烟支持有可能减轻获得戒烟支持的障碍，但其有效性尚未得到探讨。本综述旨在评估邮寄戒烟支持的有效性：方法：采用从六个数据库中检索到的研究进行了系统综述，研究时间从开始到 2024 年 5 月。采用乔安娜-布里格斯研究所的批判性评估工具对研究方法的质量进行了评估。使用随机效应模型进行元分析，以估计集合效应。异质性采用希金斯I2检验进行评估。通过漏斗图和Egger回归检验评估发表偏倚：结果：共筛选了 1918 篇引文，纳入了 12 项研究性试验。邮寄支持能明显提高戒烟六至十二个月的几率（OR = 1.43，95 % CI：1.29, 1.59）。与单纯的行为干预（OR = 1.28，95 % CI：1.11, 1.48）相比，包含尼古丁替代疗法（NRT）的干预与更高的戒烟几率相关（OR = 1.61，95 % CI：1.38, 1.87）。与持续 8 至 12 周（OR = 1.52，95 % CI 1.29，1.80）和不足 8 周（OR = 1.40，95 % CI 1.10，1.77）的干预相比，持续 12 周以上的干预戒烟几率更高（OR = 1.57，95 % CI 1.29，1.59）：结论：邮寄戒烟支持可提高戒烟率，尤其是当干预措施包括非依赖性戒烟剂（NRT）且持续时间超过12周时。虽然还需要进一步的研究来完善实施策略，但邮寄戒烟支持是有效的，并有可能减少获得戒烟支持的障碍。

{"title":"Evaluating the effectiveness of mailout smoking cessation support: A systematic review and meta-analysis","authors":"Amanual Getnet Mersha , Jamie Bryant , Kade Booth , Michelle Kennedy","doi":"10.1016/j.ypmed.2024.108162","DOIUrl":"10.1016/j.ypmed.2024.108162","url":null,"abstract":"<div><h3>Objective</h3><div>One of the main barriers to smoking cessation support is accessibility. Mailout supports can potentially mitigate access barriers, but their effectiveness has not been explored. The aim of this review is to evaluate the effectiveness of mailout smoking cessation support.</div></div><div><h3>Methods</h3><div>A systematic review was conducted using studies retrieved from six databases, from inception to May 2024. The methodological qualities were assessed using the Joanna Briggs Institute Critical Appraisal tools. Meta-analysis was performed using random-effects model to estimate pooled effects. Heterogeneity was evaluated using the Higgins' I<sup>2</sup> test. Publication bias was assessed through a funnel plot and Egger's regression test.</div></div><div><h3>Results</h3><div>A total of 1918 citations were screened, resulting in the inclusion of 12 RCTs. Mailout support significantly improved the odds of smoking cessation at six to twelve months (OR = 1.43, 95 % CI: 1.29, 1.59). Interventions that included nicotine replacement therapies (NRT) were associated with higher odds of smoking cessation (OR = 1.61, 95 % CI: 1.38, 1.87) compared to behavioural interventions alone (OR = 1.28, 95 % CI: 1.11, 1.48). Interventions lasting longer than 12 weeks resulted in higher odds of smoking cessation (OR = 1.57, 95 % CI 1.29, 1.59) compared to interventions lasting 8 to 12 weeks (OR = 1.52, 95 % CI 1.29, 1.80) and less than 8 weeks (OR = 1.40, 95 % CI 1.10, 1.77).</div></div><div><h3>Conclusion</h3><div>Mailout smoking cessation support improves quitting, especially when interventions include NRT and delivered for longer than 12 weeks. While further research is needed to refine implementation strategies, mailout smoking cessation supports are effective and have potential to reduce access barriers.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"189 ","pages":"Article 108162"},"PeriodicalIF":4.3,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604293","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

A framework to conceptualize social prescribing services from a prevention perspective 从预防角度构思社会处方服务的框架。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-11-04 DOI: 10.1016/j.ypmed.2024.108164

Adrienne Alayli , Kerryn Husk , Vashti Berry , Freia De Bock

Objective

Social prescribing models are expanding worldwide to serve multiple goals, such as attending to social conditions that affect people's health, supporting patients with mental health issues or other long-term conditions, facilitating community building and reducing demands on the health care system. Implicitly, many social prescribing services seek to promote health, prevent morbidity or deterioration of disease. Given that the scientific literature currently does not systematically describe these services as preventive service models, we propose a framework to explicitly conceptualize social prescribing from a prevention perspective.

Methods

Based on concepts from prevention science (e.g., classifications of prevention approaches), and a comparison of social prescribing models in different countries, we compiled a framework allowing to conceptualize, plan and evaluate social prescribing from a prevention perspective. Examples of social prescribing models were identified using systematic reviews and focused key-word-searches.

Results

Our framework outlines a systematic process for explicitly designing social prescribing models for prevention purposes. It consists of the following steps: defining target populations (e.g., young people with mild mental health issues), formulating intended outcomes (e.g., improved social participation), determining a prevention approach (e.g., universal or indicated prevention), deciding on the implementation setting (e.g., primary or specialized care) and selecting services for prescription (e.g., physical activity outdoors).

Conclusion

The framework advances the field by guiding the conceptualization, development and evaluation of social prescribing services. It contributes to widening possible settings for social prescribing and considers potential adverse consequences. Thereby the framework opens up new avenues for social prescribing as preventive service model.

目的：社会处方模式正在全球范围内扩展，以实现多种目标，例如关注影响人们健康的社会状况、为有精神健康问题或其他长期疾病的患者提供支持、促进社区建设以及减少对医疗保健系统的需求。隐含的意思是，许多社会处方服务旨在促进健康、预防发病或疾病恶化。鉴于目前的科学文献并没有系统地将这些服务作为预防性服务模式，我们提出了一个框架，从预防的角度来明确社会处方的概念：方法：基于预防科学的概念（如预防方法的分类）以及对不同国家社会处方模式的比较，我们编制了一个框架，以便从预防的角度对社会处方进行概念化、规划和评估。通过系统回顾和重点关键词搜索，我们确定了社会处方模式的范例：结果：我们的框架概述了明确设计社会处方模式用于预防目的的系统过程。它包括以下步骤：确定目标人群（如有轻微精神健康问题的年轻人）、制定预期结果（如改善社会参与）、确定预防方法（如普遍预防或指定预防）、决定实施环境（如初级或专门护理）以及选择处方服务（如户外体育活动）：结论：该框架通过指导社会处方服务的概念化、开发和评估，推动了该领域的发展。它有助于拓宽社会处方的可能范围，并考虑到潜在的不良后果。因此，该框架为作为预防性服务模式的社会处方开辟了新的途径。

{"title":"A framework to conceptualize social prescribing services from a prevention perspective","authors":"Adrienne Alayli , Kerryn Husk , Vashti Berry , Freia De Bock","doi":"10.1016/j.ypmed.2024.108164","DOIUrl":"10.1016/j.ypmed.2024.108164","url":null,"abstract":"<div><h3>Objective</h3><div>Social prescribing models are expanding worldwide to serve multiple goals, such as attending to social conditions that affect people's health, supporting patients with mental health issues or other long-term conditions, facilitating community building and reducing demands on the health care system. Implicitly, many social prescribing services seek to promote health, prevent morbidity or deterioration of disease. Given that the scientific literature currently does not systematically describe these services as preventive service models, we propose a framework to explicitly conceptualize social prescribing from a prevention perspective.</div></div><div><h3>Methods</h3><div>Based on concepts from prevention science (e.g., classifications of prevention approaches), and a comparison of social prescribing models in different countries, we compiled a framework allowing to conceptualize, plan and evaluate social prescribing from a prevention perspective. Examples of social prescribing models were identified using systematic reviews and focused key-word-searches.</div></div><div><h3>Results</h3><div>Our framework outlines a systematic process for explicitly designing social prescribing models for prevention purposes. It consists of the following steps: defining target populations (e.g., young people with mild mental health issues), formulating intended outcomes (e.g., improved social participation), determining a prevention approach (e.g., universal or indicated prevention), deciding on the implementation setting (e.g., primary or specialized care) and selecting services for prescription (e.g., physical activity outdoors).</div></div><div><h3>Conclusion</h3><div>The framework advances the field by guiding the conceptualization, development and evaluation of social prescribing services. It contributes to widening possible settings for social prescribing and considers potential adverse consequences. Thereby the framework opens up new avenues for social prescribing as preventive service model.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"189 ","pages":"Article 108164"},"PeriodicalIF":4.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591145","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

Examining childhood and adulthood stressors as risk factors for gestational diabetes mellitus in working pregnant individuals: A prospective cohort study 将童年和成年期的压力因素作为工作孕妇妊娠糖尿病的风险因素进行研究：前瞻性队列研究。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-11-04 DOI: 10.1016/j.ypmed.2024.108163

Lizette Mendez , Jian Li , Cheng-Tzu Hsieh , Lu Zhang , Jessica Britt , Amy Crockett , Liwei Chen

Aims

This study aimed to examine the individual and joint associations of adverse childhood experiences (ACEs) and maternal work and non-work related stressors with the risk of gestational diabetes mellitus (GDM).

Methods

Working pregnant individuals (n = 1163) from a United States (U.S.) prospective cohort conducted in South Carolina between 2016 and 2021 were included in the study. ACEs were assessed at study enrollment before 20 gestational weeks (GW), while maternal stressors were assessed in late pregnancy and GDM diagnosis occurred between 24 and 30 GW. Multivariable logistic regressions were performed to assess associations of ACEs and maternal stressors with GDM.

Results

Childhood abuse, an ACE subdomain, was associated with an elevated but statistically insignificant risk of GDM (adjusted OR = 1.47; 95 % CI: 0.85–2.53). Only maternal work stressors were associated with an increased risk of GDM (adjusted OR = 2.11; 95 % CI: 1.17–3.79) and the association became much stronger among those with childhood abuse experiences (adjusted OR = 3.80; 95 % CI:1.68–8.60).

Conclusion

Among U.S. working pregnant individuals, having work stressors during pregnancy was associated with an elevated risk of developing GDM, particularly among those who had childhood experience of abuse.

目的：本研究旨在探讨不良童年经历（ACE）、孕产妇工作和非工作相关压力因素与妊娠糖尿病（GDM）风险之间的个体和联合关联：本研究纳入了 2016 年至 2021 年期间在南卡罗来纳州进行的一项美国前瞻性队列研究中的工作孕妇（n = 1163）。在 20 孕周（GW）前的研究注册时对 ACE 进行了评估，在孕晚期对母体压力因素进行了评估，GDM 诊断发生在 24 至 30 孕周之间。研究人员进行了多变量逻辑回归，以评估ACE和母体压力因素与GDM的关联：结果：作为 ACE 子域的童年虐待与 GDM 风险升高有关，但在统计学上并不显著（调整 OR = 1.47；95 % CI：0.85-2.53）。只有孕产妇的工作压力与 GDM 风险的增加有关（调整 OR = 2.11；95 % CI：1.17-3.79），而在有童年受虐经历的孕产妇中，这种关联变得更为强烈（调整 OR = 3.80；95 % CI：1.68-8.60）：结论：在美国工作的孕妇中，怀孕期间的工作压力与罹患 GDM 的风险升高有关，尤其是在那些童年曾遭受虐待的孕妇中。

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引用次数: 0

Cancer mortality among solid organ transplant recipients: A systematic review and meta-analysis 实体器官移植受者的癌症死亡率：系统回顾和荟萃分析。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-11-02 DOI: 10.1016/j.ypmed.2024.108161

Zhipeng Wang , Lihong Deng , Wen Hou , Shiyu Liu , Yacong Zhang , Chao Sheng , Yu Zhang , Jun Li , Zhongyang Shen

Objectives

To evaluate the cancer mortality risk among solid organ transplant recipients through a systematic review and meta-analysis.

Methods

Systematic searches were conducted in PubMed (starting from 1965), ISI Web of Science (starting from 1900), MEDLINE (starting from 1976), and Scopus (starting from 1968) from the inception of each database until July 15, 2024. Studies published in English reporting at least one type of cancer mortality risk among recipients of any type of solid organ transplantation were included. The main outcomes were the standardized mortality ratio (SMR) for cancer mortality in transplant recipients compared to the general population, and the hazard ratio (HR) for cancer mortality in transplant recipients versus cancer patients without prior transplantation.

Results

Solid organ transplant recipients had a 2.06-fold increased cancer mortality risk (SMR, 2.06 [95 % CI, 1.56–2.71]) than the general population. Risks were higher in kidney (SMR 1.92 [95 % CI: 1.30–2.84]), liver (SMR 3.07 [95 % CI: 1.80–5.24]), and lung/heart (SMR 4.87 [95 % CI: 3.33–7.12]) transplant recipients. Cancer patients with prior transplantation had a 1.47-fold increased cancer mortality risk (HR 1.47 [95 % CI: 1.29–1.68]) than those without. East Asia female transplant recipients exhibited higher mortality risks from breast, ovarian, cervix and uterus cancers than those from other regions (SMR 3.13 [95 % CI: 1.93–5.07] vs. 1.16 [95 % CI: 0.88–1.53], P < 0.01).

Conclusions

Solid organ transplant recipients face significantly higher cancer mortality risks than the general population, highlighting the need for targeted cancer screening and interventions, especially for female solid organ transplant recipients from East Asia.

目的：通过系统回顾和荟萃分析评估实体器官移植受者的癌症死亡风险：通过系统综述和荟萃分析评估实体器官移植受者的癌症死亡风险：在PubMed（始于1965年）、ISI Web of Science（始于1900年）、MEDLINE（始于1976年）和Scopus（始于1968年）数据库中进行系统检索，检索时间从各数据库建立之初至2024年7月15日。纳入的研究以英文发表，报告了任何类型实体器官移植受者中至少一种癌症的死亡风险。主要结果是移植受者与普通人群癌症死亡率的标准化死亡率（SMR），以及移植受者与未接受过移植的癌症患者癌症死亡率的危险比（HR）：与普通人群相比，实体器官移植受者的癌症死亡风险增加了 2.06 倍（SMR，2.06 [95 % CI，1.56-2.71]）。肾脏（SMR：1.92 [95 % CI：1.30-2.84]）、肝脏（SMR：3.07 [95 % CI：1.80-5.24]）和肺/心脏（SMR：4.87 [95 % CI：3.33-7.12]）移植受者的风险更高。曾接受移植手术的癌症患者的癌症死亡风险（HR 1.47 [95 % CI：1.29-1.68]）比未接受移植手术的患者高出 1.47 倍。东亚女性移植受者患乳腺癌、卵巢癌、宫颈癌和子宫癌的死亡风险高于其他地区（SMR 3.13 [95 % CI: 1.93-5.07] vs. 1.16 [95 % CI: 0.88-1.53], P 结论：东亚女性移植受者患乳腺癌、卵巢癌、宫颈癌和子宫癌的死亡风险高于其他地区：实体器官移植受者面临的癌症死亡风险明显高于普通人群，这凸显了进行有针对性的癌症筛查和干预的必要性，尤其是对东亚女性实体器官移植受者而言。

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引用次数: 0