Pub Date : 2025-11-25DOI: 10.1016/j.ypmed.2025.108474
Juyeon Lee , Ye-Jee Kim , Bo Ram Yang
Objective
This study investigated the association between weekend catch-up sleep (WCS) and systemic inflammation, as indicated by serum white blood cell (WBC) counts.
Methods
A cross-sectional study of 22,143 participants from the Korea National Health and Nutrition Examination Survey (2016–2018, and 2021) categorized into no-WCS (<1 h), moderate WCS (1 to <3 h), and extended WCS (≥3 h). WBC counts were divided into quartiles, and polytomous logistic regression was used to assess associations between WCS and WBC counts. Stratified analyses considered age, sex, body mass index (BMI), sleep duration, and bedtime inconsistency.
Results
Extended WCS was modestly associated with higher WBC counts, particularly in adults aged 20–39 years (odds ratio [OR] = 1.42, 95 % confidence interval [CI]: 1.08, 1.87), 40–64 years (OR = 1.54, 95 % CI: 1.19, 1.99), males (OR = 1.56, 95 %e CI: 1.21, 2.01), individuals with BMI < 25 kg/m2 (OR = 1.45, 95 % CI: 1.21, 1.76), and those with irregular bedtimes (OR = 1.78, 95 % CI: 1.34, 2.37). Moderate WCS was inversely associated with higher BMI (OR = 0.79, 95 % CI: 0.64, 0.97). Significant interactions were observed by age, sex, BMI, and bedtime inconsistency.
Conclusions
Extended WCS was associated with elevated systemic inflammation in specific subgroups. Maintaining regular and moderate sleep patterns may help mitigate low-grade inflammation.
{"title":"Association between weekend catch-up sleep and white blood cell count among Korean adults: A population-based cross-sectional study","authors":"Juyeon Lee , Ye-Jee Kim , Bo Ram Yang","doi":"10.1016/j.ypmed.2025.108474","DOIUrl":"10.1016/j.ypmed.2025.108474","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigated the association between weekend catch-up sleep (WCS) and systemic inflammation, as indicated by serum white blood cell (WBC) counts.</div></div><div><h3>Methods</h3><div>A cross-sectional study of 22,143 participants from the Korea National Health and Nutrition Examination Survey (2016–2018, and 2021) categorized into no-WCS (<1 h), moderate WCS (1 to <3 h), and extended WCS (≥3 h). WBC counts were divided into quartiles, and polytomous logistic regression was used to assess associations between WCS and WBC counts. Stratified analyses considered age, sex, body mass index (BMI), sleep duration, and bedtime inconsistency.</div></div><div><h3>Results</h3><div>Extended WCS was modestly associated with higher WBC counts, particularly in adults aged 20–39 years (odds ratio [OR] = 1.42, 95 % confidence interval [CI]: 1.08, 1.87), 40–64 years (OR = 1.54, 95 % CI: 1.19, 1.99), males (OR = 1.56, 95 %e CI: 1.21, 2.01), individuals with BMI < 25 kg/m<sup>2</sup> (OR = 1.45, 95 % CI: 1.21, 1.76), and those with irregular bedtimes (OR = 1.78, 95 % CI: 1.34, 2.37). Moderate WCS was inversely associated with higher BMI (OR = 0.79, 95 % CI: 0.64, 0.97). Significant interactions were observed by age, sex, BMI, and bedtime inconsistency.</div></div><div><h3>Conclusions</h3><div>Extended WCS was associated with elevated systemic inflammation in specific subgroups. Maintaining regular and moderate sleep patterns may help mitigate low-grade inflammation.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108474"},"PeriodicalIF":3.2,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620083","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}
Pub Date : 2025-11-22DOI: 10.1016/j.ypmed.2025.108470
Mary A. Gerend , Lucille J. Wilkinson , Chandler Pendleton , Angelina R. Sutin , Janet E. Shepherd
Objective
Little research has investigated whether people's experiences with weight-related discrimination serve as a barrier to cancer screening. This study examined the association between weight discrimination and receipt of up to date (UTD) cervical and breast cancer screening in a demographically diverse sample of US women with representation across the body mass index (BMI) spectrum.
Methods
In 2021, women aged 25–64 years completed an online survey. Multivariable logistic regression assessed the association between perceived weight discrimination (as measured by the Stigmatizing Situations Survey-Brief) and self-reported cervical (N = 909) and breast cancer screening (N = 442), in Black and White women, adjusting for BMI and demographic characteristics.
Results
Among White women, more frequent exposure to weight discrimination was associated with significantly lower odds of UTD cervical cancer screening, AOR = 0.78; 95 % CI = 0.62, 0.97, and breast cancer screening, AOR = 0.53, 95 % CI = 0.36, 0.78; for each unit increase on the weight discrimination scale, the odds of screening decreased by approximately 25–50 %. In contrast, weight discrimination was not significantly associated with either type of screening among Black women.
Conclusions
Previous experiences with weight discrimination may deter some women from seeking routine cancer screening. Strategies for mitigating the harmful consequences of weight-related discrimination in health care settings are needed.
目的：很少有研究调查人们的体重相关歧视经历是否会成为癌症筛查的障碍。本研究调查了体重歧视与接受最新（UTD）宫颈癌和乳腺癌筛查之间的关系，研究对象是人口统计学上不同的美国女性，她们的身体质量指数（BMI）各不相同。方法：2021年，年龄在25-64岁 的女性完成在线调查。多变量逻辑回归评估了黑人和白人女性感知体重歧视（通过污名化情况调查简报测量）与自我报告的宫颈癌（N = 909）和乳腺癌筛查（N = 442）之间的关联，调整了BMI和人口统计学特征。结果：在白人女性中，更频繁地暴露于体重歧视与UTD宫颈癌筛查的几率显著降低相关，AOR = 0.78；95 % CI = 0.62,0.97，乳腺癌筛查，AOR = 0.53,95 % CI = 0.36,0.78；体重歧视量表上每增加一个单位，筛查的几率就下降大约25-50 %。相比之下，在黑人女性中，体重歧视与两种筛查方式都没有显著关联。结论：以往体重歧视的经历可能会阻止一些女性寻求常规的癌症筛查。需要制定战略，减轻保健环境中与体重有关的歧视的有害后果。
{"title":"Weight discrimination and up-to-date breast and cervical cancer screening in US women","authors":"Mary A. Gerend , Lucille J. Wilkinson , Chandler Pendleton , Angelina R. Sutin , Janet E. Shepherd","doi":"10.1016/j.ypmed.2025.108470","DOIUrl":"10.1016/j.ypmed.2025.108470","url":null,"abstract":"<div><h3>Objective</h3><div>Little research has investigated whether people's experiences with weight-related discrimination serve as a barrier to cancer screening. This study examined the association between weight discrimination and receipt of up to date (UTD) cervical and breast cancer screening in a demographically diverse sample of US women with representation across the body mass index (BMI) spectrum.</div></div><div><h3>Methods</h3><div>In 2021, women aged 25–64 years completed an online survey. Multivariable logistic regression assessed the association between perceived weight discrimination (as measured by the Stigmatizing Situations Survey-Brief) and self-reported cervical (<em>N</em> = 909) and breast cancer screening (<em>N</em> = 442), in Black and White women, adjusting for BMI and demographic characteristics.</div></div><div><h3>Results</h3><div>Among White women, more frequent exposure to weight discrimination was associated with significantly lower odds of UTD cervical cancer screening, AOR = 0.78; 95 % CI = 0.62, 0.97, and breast cancer screening, AOR = 0.53, 95 % CI = 0.36, 0.78; for each unit increase on the weight discrimination scale, the odds of screening decreased by approximately 25–50 %. In contrast, weight discrimination was not significantly associated with either type of screening among Black women.</div></div><div><h3>Conclusions</h3><div>Previous experiences with weight discrimination may deter some women from seeking routine cancer screening. Strategies for mitigating the harmful consequences of weight-related discrimination in health care settings are needed.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108470"},"PeriodicalIF":3.2,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145595913","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}
Pub Date : 2025-11-22DOI: 10.1016/j.ypmed.2025.108472
Xuexin Yu , Katrina L. Kezios , Peiyi Lu , Samuel L. Swift , Adina Zeki Al Hazzouri
Objective
Losing Supplemental Nutrition Assistance Program (SNAP) benefits is common and can be stressful. We evaluated cumulative SNAP participation in relation to subsequent memory aging among older adults.
Methods
Data were from 2633 adults aged 65+ in US Health and Retirement Study 1996–2018. Cumulative SNAP participation over the eight-year period was measured as the percentage of the time individuals participated in SNAP when they were eligible and operationalized as never (n = 2257), intermittent (<2/3, n = 219), and sustained (≥2/3, n = 157). Memory function was assessed by composite memory z-scores incorporating direct and proxy assessments. We fit mixed-effects linear regression models to investigate the association of interest.
Results
Compared to those who were eligible but never participated in SNAP, individuals with intermittent (0.017 SD units; 95 % CI: −0.002 to 0.036) and sustained SNAP participation (0.020 SD units; 95 % CI: 0.001 to 0.040) experienced a slower rate of memory decline, although the estimate for the intermittent SNAP group crossed the null. The observed effect size was equivalent to delaying memory decline by 1.87 and 2.24 years per decade for SNAP intermittent and sustained participants.
Conclusion
Cumulative SNAP participation may help to preserve memory health among low-income older adults in the United States.
{"title":"Cumulative supplemental nutrition assistance program participation and memory aging among US older adults, 1996–2018","authors":"Xuexin Yu , Katrina L. Kezios , Peiyi Lu , Samuel L. Swift , Adina Zeki Al Hazzouri","doi":"10.1016/j.ypmed.2025.108472","DOIUrl":"10.1016/j.ypmed.2025.108472","url":null,"abstract":"<div><h3>Objective</h3><div>Losing Supplemental Nutrition Assistance Program (SNAP) benefits is common and can be stressful. We evaluated cumulative SNAP participation in relation to subsequent memory aging among older adults.</div></div><div><h3>Methods</h3><div>Data were from 2633 adults aged 65+ in US Health and Retirement Study 1996–2018. Cumulative SNAP participation over the eight-year period was measured as the percentage of the time individuals participated in SNAP when they were eligible and operationalized as never (<em>n</em> = 2257), intermittent (<2/3, <em>n</em> = 219), and sustained (≥2/3, <em>n</em> = 157). Memory function was assessed by composite memory z-scores incorporating direct and proxy assessments. We fit mixed-effects linear regression models to investigate the association of interest.</div></div><div><h3>Results</h3><div>Compared to those who were eligible but never participated in SNAP, individuals with intermittent (0.017 SD units; 95 % CI: −0.002 to 0.036) and sustained SNAP participation (0.020 SD units; 95 % CI: 0.001 to 0.040) experienced a slower rate of memory decline, although the estimate for the intermittent SNAP group crossed the null. The observed effect size was equivalent to delaying memory decline by 1.87 and 2.24 years per decade for SNAP intermittent and sustained participants.</div></div><div><h3>Conclusion</h3><div>Cumulative SNAP participation may help to preserve memory health among low-income older adults in the United States.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108472"},"PeriodicalIF":3.2,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597274","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}
Pub Date : 2025-11-19DOI: 10.1016/j.ypmed.2025.108469
Fantu Mamo Aragaw , Angela Dawson , Peter Lekkas , Sarah Yeo , Yan Cheng , Temesgen Muchie Ewunie , Andrew Hayen
Objective
Cancer screening is a crucial strategy for reducing cancer morbidity and mortality. Refugees encounter disproportionate challenges in preventive healthcare, yet their cancer screening uptake remain poorly characterized. We aimed to synthesize breast, cervical, and colorectal cancer screening uptake among refugees in high and middle-income countries.
Method
A systematic search was conducted using OVID (Medline, Embase), CINAHL, Web of Science, and Scopus from inception to July 2024 to identify studies reporting breast, cervical, and colorectal cancer screening uptake among refugees. Articles were screened in Covidence, and methodological quality was assessed using the Joanna Briggs Institute checklist. Data were synthesized with a descriptive and narrative approach.
Result
Of 2044 articles retrieved, 23 studies included in the review. Refugees exhibited lower cervical, breast, and colorectal cancer screening uptake than non-refugees with variation across cancer types. Reported rates of ever having Pap test and mammogram among refugee women ranged from 13.9 % to 59 %, and 5.3 % to 63 %, respectively. Commonly cited determinants of cancer screening uptake included education, length of stay, cultural/religious beliefs, and family/provider recommendations.
Conclusion
Refugees had lower cancer screening uptake than host populations. Targeted, culturally informed multilevel interventions addressing their unique barriers are needed to improve refugees access to cancer screening.
目的：癌症筛查是降低癌症发病率和死亡率的重要策略。难民在预防保健方面遇到了不成比例的挑战，但他们的癌症筛查情况仍然很差。我们的目的是综合高收入和中等收入国家难民的乳腺癌、宫颈癌和结直肠癌筛查情况。方法：系统检索OVID (Medline, Embase)， CINAHL， Web of Science和Scopus从成立到2024年7月，以确定报告难民中乳腺癌，宫颈癌和结直肠癌筛查的研究。在《covid - ence》中筛选文章，并使用乔安娜布里格斯研究所的检查表评估方法质量。数据以描述性和叙述性的方法合成。结果：在检索到的2044篇文章中，有23篇研究被纳入综述。与非难民相比，难民的宫颈癌、乳腺癌和结直肠癌筛查率较低，癌症类型存在差异。据报道，难民妇女曾经接受巴氏试验和乳房x光检查的比率分别为13.9 %至59 %和5.3 %至63 %。通常被引用的癌症筛查的决定因素包括教育程度、住院时间、文化/宗教信仰和家庭/提供者建议。结论：难民接受癌症筛查的比例低于东道国人口。有针对性的、了解文化的多层次干预措施需要解决其独特的障碍，以改善难民获得癌症筛查的机会。
{"title":"Cancer screening uptake among refugees in high and middle-income countries: a systematic review","authors":"Fantu Mamo Aragaw , Angela Dawson , Peter Lekkas , Sarah Yeo , Yan Cheng , Temesgen Muchie Ewunie , Andrew Hayen","doi":"10.1016/j.ypmed.2025.108469","DOIUrl":"10.1016/j.ypmed.2025.108469","url":null,"abstract":"<div><h3>Objective</h3><div>Cancer screening is a crucial strategy for reducing cancer morbidity and mortality. Refugees encounter disproportionate challenges in preventive healthcare, yet their cancer screening uptake remain poorly characterized. We aimed to synthesize breast, cervical, and colorectal cancer screening uptake among refugees in high and middle-income countries.</div></div><div><h3>Method</h3><div>A systematic search was conducted using OVID (Medline, Embase), CINAHL, Web of Science, and Scopus from inception to July 2024 to identify studies reporting breast, cervical, and colorectal cancer screening uptake among refugees. Articles were screened in Covidence, and methodological quality was assessed using the Joanna Briggs Institute checklist. Data were synthesized with a descriptive and narrative approach.</div></div><div><h3>Result</h3><div>Of 2044 articles retrieved, 23 studies included in the review. Refugees exhibited lower cervical, breast, and colorectal cancer screening uptake than non-refugees with variation across cancer types. Reported rates of ever having Pap test and mammogram among refugee women ranged from 13.9 % to 59 %, and 5.3 % to 63 %, respectively. Commonly cited determinants of cancer screening uptake included education, length of stay, cultural/religious beliefs, and family/provider recommendations.</div></div><div><h3>Conclusion</h3><div>Refugees had lower cancer screening uptake than host populations. Targeted, culturally informed multilevel interventions addressing their unique barriers are needed to improve refugees access to cancer screening.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108469"},"PeriodicalIF":3.2,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574145","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}
Using South Korea's National Health Insurance Service data (2010−2022), this cohort study compared the risk of depression and anxiety in adolescents with visual disabilities to matched controls, examining the effects of disability severity and duration.
Methods
The study included a cohort of adolescents aged 6–17, consisting of 1444 individuals with visual disabilities and 1444 matched controls. The risks for developing depression and anxiety were assessed using multivariable Cox regression analysis, allowing for the adjustment of covariates.
Results
The incidence of depression was 16.62 % in adolescents with visual disabilities versus 12.12 % in matched controls, while anxiety incidence was 20.64 % versus 16.20 %. After adjustment, adolescents with visual disabilities had a higher risk of depression (adjusted Hazard Ratio [aHR]: 1.35, 95 % CI: 1.11, 1.65) and anxiety (aHR: 1.29, 95 % CI: 1.08, 1.53). Severe visual disability was associated with both conditions. A shorter disability duration (0–3 years) heightened depression risk, whereas a longer duration (≥6 years) was linked to increased anxiety risk.
Conclusions
Visual disability severity and duration are significant determinants of mental health in adolescents. These results highlight a critical need for proactive screening and tailored psychological support to address the specific challenges faced by this vulnerable population.
{"title":"Visual disabilities and depression/anxiety among adolescents: A nationwide cohort study","authors":"Zhaoyan Piao , Hee Kyoung Choi , Boyoung Jeon , Euna Han","doi":"10.1016/j.ypmed.2025.108468","DOIUrl":"10.1016/j.ypmed.2025.108468","url":null,"abstract":"<div><h3>Objectives</h3><div>Using South Korea's National Health Insurance Service data (2010−2022), this cohort study compared the risk of depression and anxiety in adolescents with visual disabilities to matched controls, examining the effects of disability severity and duration.</div></div><div><h3>Methods</h3><div>The study included a cohort of adolescents aged 6–17, consisting of 1444 individuals with visual disabilities and 1444 matched controls. The risks for developing depression and anxiety were assessed using multivariable Cox regression analysis, allowing for the adjustment of covariates.</div></div><div><h3>Results</h3><div>The incidence of depression was 16.62 % in adolescents with visual disabilities versus 12.12 % in matched controls, while anxiety incidence was 20.64 % versus 16.20 %. After adjustment, adolescents with visual disabilities had a higher risk of depression (adjusted Hazard Ratio [aHR]: 1.35, 95 % CI: 1.11, 1.65) and anxiety (aHR: 1.29, 95 % CI: 1.08, 1.53). Severe visual disability was associated with both conditions. A shorter disability duration (0–3 years) heightened depression risk, whereas a longer duration (≥6 years) was linked to increased anxiety risk.</div></div><div><h3>Conclusions</h3><div>Visual disability severity and duration are significant determinants of mental health in adolescents. These results highlight a critical need for proactive screening and tailored psychological support to address the specific challenges faced by this vulnerable population.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108468"},"PeriodicalIF":3.2,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565045","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}
Pub Date : 2025-11-14DOI: 10.1016/j.ypmed.2025.108467
Hoyol Jhang , Whanhee Lee , Jong Tae Lee , Yoonhee Kim , Chul-Hyun Cho , Soojung Kim , Seung-Ah Choe
Objective
Little is known about whether issuing particulate matter ≤2.5 μm (PM2.5) alerts influences emergency department presentations for mental health or mortality. We evaluated the impact of PM2.5 alerts on mental disorder-related emergency visit and mortality.
Methods
We conducted a time-stratified case-crossover analysis comparing PM2.5 alert versus non-alert days between 1 January 2015 and 31 December 2021 using multiple South Korean databases. Alert days were 1:1 matched to non-alert days on the basis of daily mean municipal-level of PM2.5. We applied conditional Poisson regression models, stratified by region, to estimate relative risks of mental disorder, related emergency department visits and mortality for PM2.5 alert.
Results
A 20 μg/m3 increase in PM2.5 was associated with elevated risks of mental disorder-related emergency department visits and mortality. On PM2.5 alert days, the risk of mental disorder-related emergency visits was lower compared with matched non-alert days (RR = 0.94, 95 % confidence intervals [CI]: 0.92, 0.97). This association was observed for both organic and non-organic mental disorders. All-cause, cardiovascular, and respiratory mortality showed small, non-significant increases on alert days.
Conclusions
Issuance of PM2.5 alerts in South Korea was associated with a modest reduction in emergency visits for mental disorders but did not correspond with lower mortality.
{"title":"Mental health emergencies and mortality following public fine particulate matter alerts: A Nationwide case-crossover study in South Korea","authors":"Hoyol Jhang , Whanhee Lee , Jong Tae Lee , Yoonhee Kim , Chul-Hyun Cho , Soojung Kim , Seung-Ah Choe","doi":"10.1016/j.ypmed.2025.108467","DOIUrl":"10.1016/j.ypmed.2025.108467","url":null,"abstract":"<div><h3>Objective</h3><div>Little is known about whether issuing particulate matter ≤2.5 μm (PM<sub>2.5</sub>) alerts influences emergency department presentations for mental health or mortality. We evaluated the impact of PM<sub>2.5</sub> alerts on mental disorder-related emergency visit and mortality.</div></div><div><h3>Methods</h3><div>We conducted a time-stratified case-crossover analysis comparing PM<sub>2.5</sub> alert versus non-alert days between 1 January 2015 and 31 December 2021 using multiple South Korean databases. Alert days were 1:1 matched to non-alert days on the basis of daily mean municipal-level of PM<sub>2.5</sub>. We applied conditional Poisson regression models, stratified by region, to estimate relative risks of mental disorder, related emergency department visits and mortality for PM<sub>2.5</sub> alert.</div></div><div><h3>Results</h3><div>A 20 μg/m<sup>3</sup> increase in PM<sub>2.5</sub> was associated with elevated risks of mental disorder-related emergency department visits and mortality. On PM<sub>2.5</sub> alert days, the risk of mental disorder-related emergency visits was lower compared with matched non-alert days (RR = 0.94, 95 % confidence intervals [CI]: 0.92, 0.97). This association was observed for both organic and non-organic mental disorders. All-cause, cardiovascular, and respiratory mortality showed small, non-significant increases on alert days.</div></div><div><h3>Conclusions</h3><div>Issuance of PM<sub>2.5</sub> alerts in South Korea was associated with a modest reduction in emergency visits for mental disorders but did not correspond with lower mortality.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108467"},"PeriodicalIF":3.2,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534710","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}
Pub Date : 2025-11-11DOI: 10.1016/j.ypmed.2025.108440
Irene Vidal , Katharina Beelen , Annelies Smets , Monika Rut , Evelin Piirsalu , Julia Diez , Manuel Franco
Objective
We describe the development of the Whole School Food Approach framework and its implementation in 12 European countries participating in the European-funded project, SchoolFood4Change.
Methods
The framework was developed in 2022 by a multidisciplinary team following an evidence-based approach. Data on implementation criteria were collected through mixed-methods in schools between 2022 and 2025 in 17 cities. Surveys with national project coordinators assessed achievement of bronze-level criteria for each framework component. Implementation scores were calculated based on the number of bronze criteria achieved. Semi-structured interviews with city representatives explored perceptions, challenges, and enablers of implementation.
Results
The framework comprised four interrelated components and three scalable levels of progress: bronze, silver, and gold. To date, 549 schools have implemented it. Online surveys from participating cities and schools (n = 109) showed diverse levels of implementation across schools, with 21 achieving bronze-level. Semi-structured interviews (n = 16) identified cross-departmental collaboration, staff capacity, and time availability as main barriers. Political and institutional support was reported as the main facilitator for promoting school food policies.
Conclusions
Findings showed a diverse implementation of the framework in participating European countries. Despite challenges, the Whole School Food Approach was perceived as a valuable tool for developing healthy and sustainable school food systems.
{"title":"The Whole School Food Approach: A European framework and implementation to promote healthy and sustainable school food systems","authors":"Irene Vidal , Katharina Beelen , Annelies Smets , Monika Rut , Evelin Piirsalu , Julia Diez , Manuel Franco","doi":"10.1016/j.ypmed.2025.108440","DOIUrl":"10.1016/j.ypmed.2025.108440","url":null,"abstract":"<div><h3>Objective</h3><div>We describe the development of the Whole School Food Approach framework and its implementation in 12 European countries participating in the European-funded project, SchoolFood4Change.</div></div><div><h3>Methods</h3><div>The framework was developed in 2022 by a multidisciplinary team following an evidence-based approach. Data on implementation criteria were collected through mixed-methods in schools between 2022 and 2025 in 17 cities. Surveys with national project coordinators assessed achievement of bronze-level criteria for each framework component. Implementation scores were calculated based on the number of bronze criteria achieved. Semi-structured interviews with city representatives explored perceptions, challenges, and enablers of implementation.</div></div><div><h3>Results</h3><div>The framework comprised four interrelated components and three scalable levels of progress: bronze, silver, and gold. To date, 549 schools have implemented it. Online surveys from participating cities and schools (<em>n</em> = 109) showed diverse levels of implementation across schools, with 21 achieving bronze-level. Semi-structured interviews (<em>n</em> = 16) identified cross-departmental collaboration, staff capacity, and time availability as main barriers. Political and institutional support was reported as the main facilitator for promoting school food policies.</div></div><div><h3>Conclusions</h3><div>Findings showed a diverse implementation of the framework in participating European countries. Despite challenges, the Whole School Food Approach was perceived as a valuable tool for developing healthy and sustainable school food systems.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108440"},"PeriodicalIF":3.2,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513768","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}
Pub Date : 2025-11-10DOI: 10.1016/j.ypmed.2025.108441
Kaisa Taavela , Tiina Koivisto , Tiina Eriksson , Dan Apter , Matti Lehtinen , Karolina Louvanto
Objective
Concerns have been raised that human papillomavirus (HPV)-vaccination programs may alter risk perceptions and increase risk-taking sexual behavior among adolescents. This study aimed to assess induced abortion rates (as a potential indicator of such behavior) between vaccinated and unvaccinated individuals.
Methods
This longitudinal, cluster-randomized cohort study included 6200 HPV-vaccinated women born in 1992–1993 who participated in a 2007 launched HPV-vaccination trial in Finland, and 19,473 unvaccinated women born in 1990–1991 from the same communities. Registry data from a 12-year follow-up period (between 2007 and 2020, depending on the group) up to the age of 28 years was obtained from The Finnish Register on Induced Abortions.
Results
Incidence rate of induced abortions per 10,000 person-years was significantly lower among HPV-vaccinated (145.6(95 %CI 137.1,154.5)) compared to unvaccinated individuals (161.4(95 %CI 156.4,166.7)). HPV-vaccinated individuals induced abortions in earlier gestational weeks (p = 0.049). Up to four-years post sexual health education given at HPV vaccination visits, induced abortion rates were significantly lower among individuals aged 15–19 (33.7(95 %CI 29.8,38.2)) than age-aligned unvaccinated controls (42.4(95 %CI 38.9,44.1)).
Conclusions
HPV-vaccinated had lower induced abortion rates than unvaccinated individuals. When further developing HPV-vaccination programs, simultaneous sexual health education should be considered to comprehensively improve the reproductive health of adolescents.
{"title":"Induced abortion rates among women vaccinated against human papillomavirus: Registry-based follow-up of a community-randomized trial","authors":"Kaisa Taavela , Tiina Koivisto , Tiina Eriksson , Dan Apter , Matti Lehtinen , Karolina Louvanto","doi":"10.1016/j.ypmed.2025.108441","DOIUrl":"10.1016/j.ypmed.2025.108441","url":null,"abstract":"<div><h3>Objective</h3><div>Concerns have been raised that human papillomavirus (HPV)-vaccination programs may alter risk perceptions and increase risk-taking sexual behavior among adolescents. This study aimed to assess induced abortion rates (as a potential indicator of such behavior) between vaccinated and unvaccinated individuals.</div></div><div><h3>Methods</h3><div>This longitudinal, cluster-randomized cohort study included 6200 HPV-vaccinated women born in 1992–1993 who participated in a 2007 launched HPV-vaccination trial in Finland, and 19,473 unvaccinated women born in 1990–1991 from the same communities. Registry data from a 12-year follow-up period (between 2007 and 2020, depending on the group) up to the age of 28 years was obtained from The Finnish Register on Induced Abortions.</div></div><div><h3>Results</h3><div>Incidence rate of induced abortions per 10,000 person-years was significantly lower among HPV-vaccinated (145.6(95 %CI 137.1,154.5)) compared to unvaccinated individuals (161.4(95 %CI 156.4,166.7)). HPV-vaccinated individuals induced abortions in earlier gestational weeks (<em>p</em> = 0.049). Up to four-years post sexual health education given at HPV vaccination visits, induced abortion rates were significantly lower among individuals aged 15–19 (33.7(95 %CI 29.8,38.2)) than age-aligned unvaccinated controls (42.4(95 %CI 38.9,44.1)).</div></div><div><h3>Conclusions</h3><div>HPV-vaccinated had lower induced abortion rates than unvaccinated individuals. When further developing HPV-vaccination programs, simultaneous sexual health education should be considered to comprehensively improve the reproductive health of adolescents.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108441"},"PeriodicalIF":3.2,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506297","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}
Pub Date : 2025-11-08DOI: 10.1016/j.ypmed.2025.108438
Ana S. Neumann , Iakovos Toumazis , Jennifer A. O'Brien , Diane Beneventi , Sai Keerthi Annam , Anita Joy-Thomas , Robert J. Volk
Objective
Tobacco use negatively impacts oral and general health and influences dental treatment outcomes. To advance prevention, we surveyed dental patients at an academic institution to characterize their history of tobacco use and eligibility for lung cancer screening (LCS).
Methods
Anonymous surveys were administered to adult dental patients at the UTHealth Houston School of Dentistry between April 2022 and October 2022. Surveys collected information on smoking history, pack-year history, health literacy, personal and family history of lung cancer, and previous LCS. Demographic variables included age, gender, race/ethnicity, and education level.
Results
Among 432 patients (mean age: 46.4, range 18–88 years, 57.0 % female), 22.7 % were patients who currently smoked cigarettes, and 13.2 % were patients who formerly smoked. Smoking rates were highest among males (36.2 %) and patients younger than 50 (26.0 %). Among patients who currently smoked, 44.1 % met eligibility for LCS based on age and a 20+ pack-year smoking history; 43.2 % of patients who formerly smoked were eligible for LCS.
Conclusions
A substantial proportion of patients are eligible for LCS; tailored cessation counseling and electronic-referral pathways could impact screening and cessation support for millions of high-risk adults who visit a dentist each year, closing a critical gap in cancer prevention.
{"title":"Tobacco use and eligibility for lung cancer screening among dental patients at an academic institution in Houston, Texas","authors":"Ana S. Neumann , Iakovos Toumazis , Jennifer A. O'Brien , Diane Beneventi , Sai Keerthi Annam , Anita Joy-Thomas , Robert J. Volk","doi":"10.1016/j.ypmed.2025.108438","DOIUrl":"10.1016/j.ypmed.2025.108438","url":null,"abstract":"<div><h3>Objective</h3><div>Tobacco use negatively impacts oral and general health and influences dental treatment outcomes. To advance prevention, we surveyed dental patients at an academic institution to characterize their history of tobacco use and eligibility for lung cancer screening (LCS).</div></div><div><h3>Methods</h3><div>Anonymous surveys were administered to adult dental patients at the UTHealth Houston School of Dentistry between April 2022 and October 2022. Surveys collected information on smoking history, pack-year history, health literacy, personal and family history of lung cancer, and previous LCS. Demographic variables included age, gender, race/ethnicity, and education level.</div></div><div><h3>Results</h3><div>Among 432 patients (mean age: 46.4, range 18–88 years, 57.0 % female), 22.7 % were patients who currently smoked cigarettes, and 13.2 % were patients who formerly smoked. Smoking rates were highest among males (36.2 %) and patients younger than 50 (26.0 %). Among patients who currently smoked, 44.1 % met eligibility for LCS based on age and a 20+ pack-year smoking history; 43.2 % of patients who formerly smoked were eligible for LCS.</div></div><div><h3>Conclusions</h3><div>A substantial proportion of patients are eligible for LCS; tailored cessation counseling and electronic-referral pathways could impact screening and cessation support for millions of high-risk adults who visit a dentist each year, closing a critical gap in cancer prevention.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108438"},"PeriodicalIF":3.2,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145489984","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}
Pub Date : 2025-11-05DOI: 10.1016/j.ypmed.2025.108439
Wanqing Dong , Jie Bai , Benrui Wu , Kaixin Zhou , Hongwei Jiang
Objective
To investigate the independent and combined associations of type 2 diabetes (T2D) and APOE genotype on dementia risk.
Methods
We analyzed 104,911 participants aged ≥50 years from the Kunshan Aging Research with E-Health cohort (2018–2024). Incident dementia was identified using electronic medical records. Cox proportional hazards models and additive interaction analyses assessed associations and interactions.
Results
Over a median follow-up of 6.19 years, 8115 participants developed dementia. T2D was associated with higher risks of all-cause dementia (HR:2.06), Alzheimer's disease (HR:2.16), and vascular dementia (HR:1.62). APOE ε4 carriers had higher Alzheimer's risk (HR:1.35), while ε2 carriers had lower risk (HR:0.87). The combination of T2D and ε4 was associated with the highest Alzheimer's risk (HR:2.87) with a significant positive additive interaction. In men, T2D interacted with ε2 on a multiplicative scale, whereas in women, a positive additive interaction was observed between T2D and ε2 for Alzheimer's disease.
Conclusions
T2D was associated with higher dementia risk. APOE ε4 was associated with higher and ε2 with lower Alzheimer's risk. A positive additive T2D–ε4 interaction and sex-specific ε2 associations underscore integrating diabetes management with genetic profiling to optimize dementia risk reduction strategies.
{"title":"Incidence and synergistic Association of Type 2 diabetes and apolipoprotein E epsilon 4 with dementia risk in the Kunshan aging research with E-health cohort study","authors":"Wanqing Dong , Jie Bai , Benrui Wu , Kaixin Zhou , Hongwei Jiang","doi":"10.1016/j.ypmed.2025.108439","DOIUrl":"10.1016/j.ypmed.2025.108439","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the independent and combined associations of type 2 diabetes (T2D) and APOE genotype on dementia risk.</div></div><div><h3>Methods</h3><div>We analyzed 104,911 participants aged ≥50 years from the Kunshan Aging Research with <em>E</em>-Health cohort (2018–2024). Incident dementia was identified using electronic medical records. Cox proportional hazards models and additive interaction analyses assessed associations and interactions.</div></div><div><h3>Results</h3><div>Over a median follow-up of 6.19 years, 8115 participants developed dementia. T2D was associated with higher risks of all-cause dementia (HR:2.06), Alzheimer's disease (HR:2.16), and vascular dementia (HR:1.62). APOE ε4 carriers had higher Alzheimer's risk (HR:1.35), while ε2 carriers had lower risk (HR:0.87). The combination of T2D and ε4 was associated with the highest Alzheimer's risk (HR:2.87) with a significant positive additive interaction. In men, T2D interacted with ε2 on a multiplicative scale, whereas in women, a positive additive interaction was observed between T2D and ε2 for Alzheimer's disease.</div></div><div><h3>Conclusions</h3><div>T2D was associated with higher dementia risk. APOE ε4 was associated with higher and ε2 with lower Alzheimer's risk. A positive additive T2D–ε4 interaction and sex-specific ε2 associations underscore integrating diabetes management with genetic profiling to optimize dementia risk reduction strategies.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108439"},"PeriodicalIF":3.2,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471802","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}
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