Preventive medicine最新文献_第5页

Systematic review of the evidence on physical activity prescriptions for youth 对青少年体育活动处方证据的系统性回顾。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-30 DOI: 10.1016/j.ypmed.2024.108145

Elizabeth L. Budd , Esmeralda Castro , Heather F. Terral , Zachary S. Farley , Nichole R. Kelly

Objective

Despite the well-documented benefits of physical activity (PA), globally, only 20 % of youth engage in sufficient PA. Reviews support the benefits of PA prescriptions on promoting adults' PA, but no comparable reviews exist on studies among youth. This systematic review 1) assesses the state of the evidence regarding PA prescriptions from healthcare practitioners on youths' PA; and 2) identifies gaps to inform future research and practice.

Methods

A search of five databases in October 2023 identified 3067 articles. After title and/or abstract reviews, 64 full articles were reviewed for inclusion criteria. Study, sample, and PA prescription characteristics and findings regarding youths' PA were extracted.

Results

Nine articles published 2001–2023 from the United States (n = 6), Spain (n = 1), Northern Ireland (n = 1), and the United States and Mexico (n = 1) were identified. Seven occurred in medical settings and two in schools. Study designs were generally strong (e.g., randomized controlled trials) and study durations were generally short (3–4 months). All but two studies measured youths' PA with self-report questionnaires. Most PA prescriptions were provided in verbal and written forms and tailored based on youths' baseline PA. Overall, healthcare practitioner-delivered PA prescriptions show minimal effects on youths' PA. Neither of the two studies that objectively measured PA found significant PA increases in objectively measured PA.

Conclusions

There is insufficient research on healthcare practitioner delivered PA prescriptions to promote youths' PA to determine effectiveness. Future research with objectively measured PA and more diverse youth samples would advance the evidence.

目的：尽管体育锻炼（PA）的益处已得到充分证实，但在全球范围内，只有 20% 的青少年进行了充分的体育锻炼。综述支持体育锻炼处方对促进成人体育锻炼的益处，但对青少年的研究却没有类似的综述。本系统性综述 1) 评估了有关医护人员为青少年开具 PA 处方的证据现状；2) 找出差距，为未来的研究和实践提供参考：方法：2023 年 10 月在五个数据库中搜索到 3067 篇文章。在对文章标题和/或摘要进行审查后，根据纳入标准对 64 篇完整文章进行了审查。提取了有关青少年体育锻炼的研究、样本、体育锻炼处方特征和结果：结果：发现了 9 篇发表于 2001-2023 年的文章，分别来自美国（6 篇）、西班牙（1 篇）、北爱尔兰（1 篇）、美国和墨西哥（1 篇）。其中 7 项发生在医疗机构，2 项发生在学校。研究设计普遍较强（如随机对照试验），研究持续时间普遍较短（3-4 个月）。除两项研究外，其他所有研究都通过自我报告问卷对青少年的 PA 进行了测量。大多数 PA 处方以口头和书面形式提供，并根据青少年的基线 PA 量身定制。总体而言，医护人员提供的 PA 处方对青少年 PA 的影响微乎其微。两项客观测量 PA 的研究均未发现客观测量的 PA 有明显增加：关于医护人员开具促进青少年 PA 的处方的研究尚不充分，无法确定其有效性。未来通过客观测量 PA 和更多样化的青少年样本进行的研究将有助于增加证据。

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引用次数: 0

Inequalities in exposure to second-hand smoke among adolescent boys and girls in 122 countries: Evidence from the Global Youth Tobacco Survey 122 个国家的少男少女接触二手烟的不平等现象：来自全球青少年烟草调查的证据。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-29 DOI: 10.1016/j.ypmed.2024.108146

Boyi Huai, Kiara C-M Chang, Filippos T. Filippidis

Background

Secondhand smoke exposure (SHS) is a major modifiable risk factor for morbidity and premature mortality. No study has assessed inequalities by sex in SHS exposure among adolescents globally. This study aims to explore the variations in SHS exposure among adolescents globally based on sex.

Methods

Most recent data from 122 countries and territories that conducted the Global Youth Tobacco Survey between 1 January 2013 and 31 December 2020, comprising 557,332 respondents aged 11–17 years, were used to assess the prevalence of SHS exposure at home, in other enclosed public places, and at school. Multivariable Poisson regression models were performed to investigate the association between sex and SHS exposure in each country.

Results

A total of 195,299 (35.0 %) adolescents reported exposure to SHS at home, 256,938 (46.1 %) in other enclosed public places, 258,528 (46.4 %) at school, and 399,644 (71.7 %) in any place. There were important inequalities in the prevalence of SHS exposure between countries. More girls than boys reported exposure to SHS at home in 54 countries (vs. one country with prevalence higher in boys than girls) and in other enclosed public places in 50 countries (vs. six countries). In contrast, the prevalence of SHS exposure at school was significantly higher in boys than girls in 25 countries while the opposite was observed in 14 countries.

Conclusions

These findings emphasize the disparities in SHS exposure between adolescent boys and girls and, hence, highlight the urgent need to strengthen smoke-free policies and adopt targeted policies to address them.

背景：二手烟暴露（SHS）是导致发病和过早死亡的主要可改变风险因素。目前还没有研究对全球青少年接触二手烟的性别不平等现象进行评估。本研究旨在探讨全球青少年因性别不同而在接触 SHS 方面存在的差异：本研究使用了在 2013 年 1 月 1 日至 2020 年 12 月 31 日期间开展全球青少年烟草调查的 122 个国家和地区的最新数据（包括 557,332 名年龄在 11-17 岁的受访者），以评估在家中、其他封闭的公共场所和学校接触 SHS 的普遍程度。研究人员采用多变量泊松回归模型来调查每个国家的性别与接触 SHS 的相关性：据报告，共有 195,299 名青少年（35.0%）在家中、256,938 名青少年（46.1%）在其他封闭的公共场所、258,528 名青少年（46.4%）在学校、399,644 名青少年（71.7%）在任何地方接触过可吸入有害气体。在接触可吸入有害烟雾的普遍程度方面，各国之间存在严重的不平等。在 54 个国家中，报告在家中接触过可吸入二手烟的女孩多于男孩（而在一个国家中，男孩的接触率高于女孩）；在 50 个国家中，报告在其他封闭的公共场所接触过可吸入二手烟的女孩多于男孩（而在 6 个国家中，女孩的接触率高于男孩）。与此相反，在 25 个国家/地区，男孩在学校接触可吸入有害气体的比例明显高于女孩，而在 14 个国家/地区则相反：这些发现强调了男女青少年在接触 SHS 方面的差异，因此强调了加强无烟政策和采取有针对性的政策来解决这些问题的迫切性。

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引用次数: 0

A systematic review and meta-analysis evaluating the effectiveness of minimally supervised home and community exercise interventions in improving physical activity, body adiposity and quality of life in adults living with HIV 一项系统性综述和荟萃分析，评估了在最小监督下的家庭和社区锻炼干预措施在改善成年艾滋病病毒感染者的体育锻炼、身体脂肪含量和生活质量方面的有效性。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-29 DOI: 10.1016/j.ypmed.2024.108144

Jeannine Anyingu A. Aminde , Nicola W. Burton , Caroline Thng , Kelly Clanchy

People living with HIV (PLWH) are physically inactive and risk cardiometabolic dysfunction. Home and community exercise (HCE) is pragmatic, cost-effective and improves health in varied chronic conditions. This review aimed to synthesize evidence on the effectiveness of minimally supervised HCE for physical activity (PA), adiposity, quality of life (QoL), and other physical and psychological health indices for PLWH.

Methods

Databases were searched for studies published January 2000 to April 2023. Risk of bias in experimental and quasi-experimental studies was assessed with the Cochrane Risk-of-Bias for Randomized Trials and Risk-of-Bias in Non-Randomized Studies of Interventions tools, respectively. A random-effects meta-analysis was conducted.

Results

From 9648 records, 13 studies (14 HCE groups) with 857 PLWH (average ages 29-56 years) were included; 12 comparator and one single group trial. Aerobic and strength HCE significantly improved PA relative to control by 0.377 units (95 %CI = 0.097, 0.657; p = 0.008) and 1097steps/day (95 %CI = 39.27, 2156.62; p = 0.042). There was a reduction from baseline in percent body fat of 3.36 % (95 %CI = -6.10, 0.42; p = 0.025), but no change in BMI (−0.21 kg/m2; 95 %CI = -0.67, 0.24; p = 0.351) relative to control. HCE improved QoL relative to control in the physical domain by 13points (95 %CI = 6.15, 19.86; p < 0.001), but not in other domains like general health (6.6points; 95 %CI = -1.19, 14.36; p < 0.097). HCE completed at moderate intensity or higher was associated with improvement in outcomes more so than lower intensity HCE. Walking-only interventions were at least as beneficial as other activities. No adverse events were recorded.

Conclusion

Minimally supervised HCE can improve PA, body fat, physical QoL and other health indices in PLWH.

艾滋病病毒感染者（PLWH）缺乏运动，有可能出现心脏代谢功能障碍。家庭和社区锻炼（HCE）既实用又具有成本效益，还能改善各种慢性病患者的健康状况。本综述旨在归纳有关最低限度监督下的家庭和社区锻炼对艾滋病毒感染者的身体活动（PA）、脂肪、生活质量（QoL）以及其他身体和心理健康指数的有效性的证据：方法：在数据库中搜索 2000 年 1 月至 2023 年 4 月发表的研究。分别使用 Cochrane Risk-of-Bias for Randomized Trials 和 Risk-of-Bias in Non-Randomized Studies of Interventions 工具评估了实验研究和准实验研究的偏倚风险。然后进行了随机效应荟萃分析：从 9648 份记录中，共纳入了 13 项研究（14 组 HCE）和 857 名 PLWH（平均年龄 29-56 岁）；其中包括 12 项比较试验和 1 项单组试验。与对照组相比，有氧和力量型 HCE 显著改善了 PA，分别提高了 0.377 个单位（95 %CI = 0.097, 0.657; p = 0.008）和 1097 步/天（95 %CI = 39.27, 2156.62; p = 0.042）。与对照组相比，体脂百分比比基线值降低了 3.36% (95 %CI = -6.10, 0.42; p = 0.025)，但体重指数没有变化 (-0.21 kg/m2; 95 %CI = -0.67, 0.24; p = 0.351)。相对于对照组，HCE 在身体素质方面的 QoL 提高了 13 分（95 %CI = 6.15，19.86；p 结论：在最少监督下进行的 HCE 可以改善 PLWH 的 PA、体脂、身体 QoL 和其他健康指数。

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引用次数: 0

“I've been really happy since I got that letter!”: Longitudinal patient perspectives on lung cancer screening communication "自从收到那封信，我真的很开心！"：患者对肺癌筛查沟通的纵向看法。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-21 DOI: 10.1016/j.ypmed.2024.108142

Sara E. Golden , Liana Schweiger , Sarah Ono , Anne C. Melzer , Santanu Datta , James Davis , Christopher Slatore

Objective

Experts recommend structured shared decision making when discussing lung cancer screening (LCS) and reporting low-dose computed tomography (LDCT) results. We examined patients' reactions to pre- and post-LDCT results communication processes at three medical centers in the US with established LCS programs.

Methods

Multicenter, qualitative, longitudinal study of patients considering and receiving LCS using data from semi-structured interviews guided by a patient-centered communication model using conventional content analysis. We conducted 61 interviews among 32 patients (sixteen of whom had a nodule on their LDCT) at one month and 12 months after an initial LCS decision making interaction.

Results

Participants were mostly satisfied with LCS communication processes pre- and post-LDCT even though guideline concordant shared decision making was rare. Most participants reported no more than mild distress even if the LDCT detected a pulmonary nodule, felt relief after getting the results, and reported the perceived benefits of LCS outweighed their distress. Nearly all participants were satisfied with recommended follow-up plans. They reported that they trusted their clinicians and health care system to provide appropriate care and recommendations. They did not appear to regret their decision since almost all participants planned to get their next LDCT. However, they were at risk of non-adherence to follow-up recommendations since they often relied on the health care system to ensure they received timely follow-up.

Conclusions

Despite receiving guideline discordant decision-making communication, patients seem very satisfied, rarely experience severe distress, and have low decisional regret after LCS decision making and receiving the results of their LDCT.

目的：专家建议在讨论肺癌筛查（LCS）和报告低剂量计算机断层扫描（LDCT）结果时进行结构化的共同决策。我们在美国三家已建立 LCS 项目的医疗中心研究了患者对 LDCT 结果沟通前后过程的反应：对考虑和接受 LCS 的患者进行多中心、定性、纵向研究，采用传统内容分析法，在以患者为中心的沟通模式指导下进行半结构式访谈。我们对 32 名患者（其中 16 名患者的 LDCT 上有结节）进行了 61 次访谈，访谈时间分别为首次 LCS 决策互动后 1 个月和 12 个月：结果：尽管与指南一致的共同决策很少见，但参与者大多对 LCS 在 LDCT 前后的沟通过程表示满意。大多数参与者表示，即使 LDCT 检测出肺部结节，他们也只是感到轻微的痛苦，在得到结果后感到轻松，并表示 LCS 带来的益处超过了他们的痛苦。几乎所有参与者都对推荐的随访计划感到满意。他们表示相信临床医生和医疗系统会提供适当的治疗和建议。他们似乎并不后悔自己的决定，因为几乎所有参与者都计划接受下一次 LDCT。但是，他们有可能不遵守随访建议，因为他们通常依赖医疗系统来确保他们得到及时的随访：结论：尽管收到了与指南不一致的决策沟通，但患者似乎非常满意，很少有严重的痛苦，而且在LCS决策和收到LDCT结果后，对决策后悔的程度很低。

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引用次数: 0

Newborn pulse oximetry screening coverage in a nationwide complex survey sample: An assessment of a congenital heart disease early detection program at the regional level in Brazil 全国性复杂调查样本中的新生儿脉搏血氧仪筛查覆盖率：对巴西地区一级先天性心脏病早期检测计划的评估。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-18 DOI: 10.1016/j.ypmed.2024.108141

Arn Migowski , Gustavo Tavares Lameiro da Costa , Helena Cramer Veiga Rey

Objectives

To estimate the coverage of newborn pulse oximetry screening (POS) in Brazil, as well as identifies associated factors and the proportion of positive screening results.

Methods

Coverage was estimated based on the most recent National Health Survey (2019). Adjusted marginal prevalence ratios were estimated via poisson regression model with robust variance.

Results

The POS coverage was 66.3 % (95 %CI: 65.5–67.1; N = 3,140,023) and was higher in children born in privately funded hospitals (PFHs) than in the Unified Health System (SUS): 78.1 % (76.7–79.5) versus 61.1 % (60.2–62.1). In the North region, the POS coverage in PFHs (64.9 %, 59.7–70.1) was lower than that in the South (82.5 %, 79.4–85.6) and the Southeast (81.5 %, 79.3–83.6); it was even lower in SUS in the North (44.0 %; 42.4–45.6). After a federal ordinance providing financial resources to postscreening diagnostic, the screening coverage in SUS increased from 57.6 % (56.2–59.1) to 64.6 % (63.3–65.9). The proportion of positive screening tests was 9.2 % (8.9–9.5) in SUS and 7.8 % (7.3–8.3) in PFHs, of which 40.8 % (40.5–41.1) underwent complementary exams in SUS and 57.2 % (56.7–57.7) in PFHs. In the multivariate model, the main independent predictors of POS were the coverage of other newborn screening tests.

Conclusions

Inequalities were found between major regions and healthcare systems. Government financial incentives have reduced this inequality, although the percentage of postscreening complementary exams remains insufficient and unequal. The main independent predictors of screening prevalence were those related to the organization of health services.

目的估算巴西新生儿脉搏氧饱和度筛查（POS）的覆盖率，并确定相关因素和筛查结果呈阳性的比例：方法：根据最新的国家健康调查（2019 年）估算覆盖率。通过带有稳健方差的泊松回归模型估算调整后的边际患病率：POS覆盖率为66.3%（95%CI：65.5-67.1；N=3,140,023），在私人资助医院（PFHs）出生的儿童中，POS覆盖率高于统一卫生系统（SUS）：78.1%（76.7-79.5%）对 61.1%（60.2-62.1%）。在北部地区，PFHs 的 POS 覆盖率（64.9%，59.7-70.1%）低于南部地区（82.5%，79.4-85.6%）和东南部地区（81.5%，79.3-83.6%）；在北部地区的统一卫生系统中，POS 覆盖率甚至更低（44.0%；42.4-45.6%）。在一项为筛查后诊断提供财政资源的联邦法令颁布后，统一卫生系统的筛查覆盖率从 57.6%（56.2-59.1%）上升到 64.6%（63.3-65.9%）。筛查结果呈阳性的比例在统一卫生系统为 9.2%（8.9-9.5），在私人家庭医疗机构为 7.8%（7.3-8.3），其中在统一卫生系统接受辅助检查的比例为 40.8%（40.5-41.1），在私人家庭医疗机构为 57.2%（56.7-57.7）。在多变量模型中，POS 的主要独立预测因素是其他新生儿筛查项目的覆盖率：结论：主要地区和医疗系统之间存在不平等。政府的财政激励措施减少了这种不平等，但筛查后补充检查的比例仍然不足且不平等。筛查普及率的主要独立预测因素与医疗服务组织有关。

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引用次数: 0

Interventions to promote colorectal cancer screening among people with a family history of colorectal cancer: A scoping review 在有大肠癌家族史的人群中推广大肠癌筛查的干预措施：范围综述。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-12 DOI: 10.1016/j.ypmed.2024.108137

Tun Firzara Abdul Malik , Hooi Chin Beh , Christine Shamala Selvaraj , Christian David Mallen , Chirk Jenn Ng , Yew Kong Lee

Background

The global incidence of colorectal cancer (CRC) is rising, with people having a family history of CRC (PFH-CRC) facing double the risk compared to the average-risk population. Despite this, CRC screening uptake among PFH-CRC remains low. There is a lack of systematic mapping of interventions promoting CRC screening in this high-risk population.

Objective

We conducted a scoping review to identify the types of interventions targeting PFH-CRC, their effectiveness in increasing CRC screening uptake, and the elements associated with the outcomes.

Methods

The Joanna Briggs Institute methodology for scoping review was followed. The search for eligible articles was conducted from the inception of each database until 17 July 2024 in PubMed, EMBASE, CINAHL, Cochrane, PsycINFO and Web of Science with no restrictions on language.

Results

Thirty studies from 1995 to 2023 across 13 countries were included; mostly from high-income countries. There was considerable variability in study design, intervention characteristics, and screening outcomes. Eleven studies used theoretical frameworks in intervention development. Fourteen studies reported statistically significant increases in screening uptake among PFH-CRC, most using complex, multiple-component interventions. Tailored print materials and patient navigation more consistently demonstrated increased screening uptake, while counselling yielded mixed results.

Conclusion

Interventions for promoting CRC screening uptake in PFH-CRC commonly incorporate print material, patient navigation and counselling, often combined into complex interventions. Future research should include more implementation studies to translate these interventions into real-world settings. Additionally, there are gaps in research from low- and middle-income countries, highlighting the need for further research in these resource-limited settings.

背景：全球结直肠癌（CRC）发病率呈上升趋势，有 CRC 家族史的人（PFH-CRC）面临的风险是平均风险人群的两倍。尽管如此，有家族史的人接受 CRC 筛查的比例仍然很低。在这一高风险人群中，缺乏促进 CRC 筛查的干预措施的系统性规划：我们进行了一项范围综述，以确定针对 PFH-CRC 的干预措施类型、其在提高 CRC 筛查接受率方面的有效性以及与结果相关的要素：方法：采用乔安娜-布里格斯研究所（Joanna Briggs Institute）的方法进行范围界定研究。在PubMed、EMBASE、CINAHL、Cochrane、PsycINFO和Web of Science等数据库中搜索符合条件的文章，搜索时间从每个数据库的开始时间起至2024年7月17日，语言不限：共纳入了 13 个国家从 1995 年到 2023 年的 30 项研究，其中大部分来自高收入国家。研究设计、干预特点和筛查结果存在很大差异。有 11 项研究在制定干预措施时使用了理论框架。有 14 项研究报告称，PFH-CRC 的筛查率在统计学上有了显著提高，其中大多数研究采用了复杂的多成分干预措施。量身定制的印刷材料和患者导航更一致地表明筛查接受率有所提高，而咨询的结果则好坏参半：结论：促进PFH-CRC接受CRC筛查的干预措施通常包括印刷材料、患者指导和咨询，通常结合成复杂的干预措施。未来的研究应包括更多的实施研究，以便将这些干预措施应用到实际环境中。此外，中低收入国家的研究还存在空白，这凸显了在这些资源有限的环境中开展进一步研究的必要性。

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引用次数: 0

Association between physical activity and the N-terminal pro-brain natriuretic peptide in a middle-aged Japanese population: The interaction with alcohol consumption, 2005–2006 日本中年人群中体育锻炼与 N 端前脑钠肽之间的关系：与饮酒量的相互作用，2005-2006 年

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-11 DOI: 10.1016/j.ypmed.2024.108138

Yuichiro Nishida , Megumi Hara , Naoto Taguchi , Kazuyo Nakamura , Hinako Nanri , Takeshi Imaizumi , Tatsuhiko Sakamoto , Chisato Shimanoe , Mikako Horita , Takuma Furukawa , Chiharu Iwasaka , Koichi Shinchi , Yasuki Higaki , Keitaro Tanaka

Objective

Higher N-terminal pro-brain natriuretic peptide (NT-proBNP) levels are a strong risk factor for cardiovascular disease. The current study aimed to clarify the cross-sectional association of physical activity (PA) with NT-proBNP and to identify the interaction of PA with alcohol consumption or cigarette smoking in middle-aged individuals.

Methods

The study included 4613 individuals (1824 men and 2789 women) (November 2005–November 2006). Total PA, steps, light-intensity PA (LPA), and moderate-to-vigorous-intensity PA (MVPA) were assessed using accelerometer. Serum NT-proBNP levels were measured. Cross-sectional associations of total PA and steps with NT-proBNP were analyzed using multiple regression with adjustment for potential confounders. The isotemporal substitution model was used to assess activity intensity-specific association. The interaction between PA and alcohol consumption or smoking was also examined.

Results

Total PA was independently and inversely associated with NT-proBNP in the entire sample (P = 0.04). The inverse association of substituting LPA with MVPA for NT-proBNP was clearer in men than in women (P_interaction = 0.04). Inverse associations of total PA or steps with NT-proBNP were clearer in heavy drinkers than in moderate drinkers and non-drinkers in the entire sample (P_interaction < 0.05). In men, the inverse association of substituting LPA with MVPA for NT-proBNP was also clearer in heavy drinkers (P_interaction = 0.02). No interactions of PA with smoking were detected.

Conclusions

Higher total PA was associated with better NT-proBNP in middle-aged individuals. Additionally, the effect of substituting LPA with MVPA on NT-proBNP was greater in men than in women. Furthermore, the association between PA and NT-proBNP may be modified by alcohol consumption.

目的较高的 N 端前脑钠肽 (NT-proBNP) 水平是心血管疾病的一个重要风险因素。本研究旨在阐明体力活动（PA）与 NT-proBNP 的横断面关联，并确定中年人体力活动与饮酒或吸烟的相互作用。使用加速度计评估了总运动量、步数、轻度运动量（LPA）和中强度运动量（MVPA）。此外，还测量了血清 NT-proBNP 水平。使用多元回归分析了总 PA 和步数与 NT-proBNP 的横截面关系，并对潜在的混杂因素进行了调整。等时替代模型用于评估活动强度与NT-proBNP的相关性。结果在整个样本中，总 PA 与 NT-proBNP 呈独立的反比关系（P = 0.04）。用 MVPA 代替 LPA 与 NT-proBNP 的反向关系在男性中比在女性中更明显（P=0.04）。在整个样本中，重度饮酒者的总PA或步数与NT-proBNP的反向关系比中度饮酒者和不饮酒者更明显（Pinteraction < 0.05）。在男性中，用 MVPA 替代 LPA 与 NT-proBNP 的反向关系在大量饮酒者中也更为明显（Pinteraction = 0.02）。结论总 PA 越高，中年人的 NT-proBNP 越好。此外，男性用 MVPA 替代 LPA 对 NT-proBNP 的影响大于女性。此外，PA 与 NT-proBNP 之间的关系可能会因饮酒而改变。

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引用次数: 0

Perceptions of neighborhood disorder and gun carrying during adolescence: The indirect effect of exposure to violence 青少年时期对邻里关系混乱和持枪的看法：暴力事件的间接影响

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-07 DOI: 10.1016/j.ypmed.2024.108129

Joshua Rosenbaum, Anika Proctor, Samuel Agboola, Mason Myers, D'Andre Walker

Objective

As society strives to curb gun violence among adolescents, understanding the risk factors associated with gun carrying is of critical importance. The current study seeks to examine the relationship between perceived neighborhood disorder and adolescents' susceptibility to carrying a gun to school. More specifically, the aim of the current study was threefold: (1) to examine the direct relationship between perceived neighborhood disorder and exposure to violence, (2) to investigate the association between perceived neighborhood disorder and gun carrying, and (3) to test the mediating effect of exposure to violence on the relationship between perceived neighborhood disorder and gun carrying.

Methods

Data from waves I and II (1994–1996) of the National Longitudinal Study of Adolescent to Adult Health was analyzed (N = 11,887). Due to the binary nature of the mediating and dependent variables (i.e., exposure to violence and gun carrying) a series of logistic regression models were estimated.

Results

Our analyses revealed that perceived neighborhood disorder is positive and significantly associated with, both, exposure to violence and gun carrying. The relationship between perceived neighborhood disorder and gun carrying was fully mediated by exposure to violence.

Conclusions

While neighborhood disorder is a risk factor for gun carrying among youth, exposure to violence explains the relationship between perceived neighborhood disorder and carrying a gun to school. To reduce the prevalence of gun carrying and gun violence among the adolescent population, mental health resources should be provided to those who reside in communities with high levels of disorder and violence.

目标随着社会努力遏制青少年中的枪支暴力，了解与携带枪支相关的风险因素至关重要。本研究旨在探讨邻里关系混乱与青少年携带枪支上学的易感性之间的关系。更具体地说，本研究的目的有三：（1）研究感知到的邻里关系混乱与接触暴力之间的直接关系；（2）调查感知到的邻里关系混乱与携带枪支之间的关联；（3）检验接触暴力对感知到的邻里关系混乱与携带枪支之间关系的中介效应。方法分析了《全国青少年到成人健康纵向研究》第一和第二阶段（1994-1996 年）的数据（N = 11,887 人）。由于中介变量和因变量（即遭受暴力和携带枪支）的二元性质，我们对一系列逻辑回归模型进行了估计。结果我们的分析表明，邻里关系混乱与遭受暴力和携带枪支有显著的正相关。结论虽然邻里关系混乱是青少年携带枪支的一个风险因素，但暴力事件可以解释邻里关系混乱与携带枪支上学之间的关系。为了减少青少年携带枪支和枪支暴力的发生率，应该为那些居住在混乱和暴力程度较高的社区的青少年提供心理健康资源。

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引用次数: 0

Life-period associations of body mass index with adult carotid intima-media thickness: The Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study 体重指数与成人颈动脉内膜中层厚度的生命周期关联：博格卢萨心脏研究和芬兰年轻人心血管风险研究。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-06 DOI: 10.1016/j.ypmed.2024.108128

Jack T. Evans , Marie-Jeanne Buscot , Brooklyn J. Fraser , Markus Juonala , Yajun Guo , Camilo Fernandez , Mika Kähönen , Matthew A. Sabin , Matthew K. Armstrong , Jorma S.A. Viikari , Lydia A. Bazzano , Olli T. Raitakari , Costan G. Magnussen

Objective

Child and adult body mass index (BMI) associates with adult carotid artery intima-media thickness (cIMT). However, the relative contribution of BMI at different life-periods on adult cIMT has not been quantified. This study aimed to determine the life-course model that best explains the relative contribution of BMI at different life-periods (childhood, adolescence, and young-adulthood) on cIMT in adulthood.

Methods

BMI was calculated from direct measurements of height and weight at up to seven time-points from childhood to adulthood (1973–2007) among 2485 participants of the Cardiovascular Risk in Young Finns Study (YFS) and 1271 participants in the Bogalusa Heart Study (BHS). BMI measures at three ages representative of childhood (9-years), adolescence (18 years) and young-adulthood (30 years) life-periods were used. B-mode ultrasound was used to measure common cIMT in adulthood (>30 years). Associations were evaluated using the Bayesian relative life-course exposure model.

Results

In both cohorts, cumulative exposure to higher levels of BMI across the life-course was associated with greater cIMT. Of the examined life-periods, BMI in young-adulthood provided the greatest relative contribution towards the development of adult cIMT for YFS (49.9 %, 95 % CrI = 34–68 %) and white BHS participants (48.6 %, 95 % CrI = 9–86 %), whereas BMI in childhood had the greatest relative contribution for black BHS participants (54.0 %, 95 % CrI = 8–89 %).

Conclusion

Although our data suggest sensitive periods in the life-course where prevention and intervention aimed at reducing BMI might provide most benefit in limiting the effects of BMI on cIMT, maintaining lower BMI across the life-course appears to be optimal.

目的：儿童和成人的体重指数（BMI）与成人颈动脉内膜中层厚度（cIMT）有关。然而，不同生命周期的体重指数对成人 cIMT 的相对影响尚未量化。本研究旨在确定最能解释不同生命时期（童年、青春期和青年期）BMI 对成年期 cIMT 的相对影响的生命过程模型：芬兰青年心血管风险研究》（YFS）的 2485 名参与者和《博加卢萨心脏研究》（BHS）的 1271 名参与者在从童年到成年（1973-2007 年）多达七个时间点的身高和体重直接测量值计算出了体重指数。研究采用了儿童期（9 岁）、青少年期（18 岁）和青年期（30 岁）三个年龄段的 BMI 测量值。B 型超声波用于测量成年期（30 岁以上）的常见 cIMT。采用贝叶斯相对生命期暴露模型对相关性进行了评估：结果：在两个队列中，一生中累积暴露于较高水平的体重指数与较大的 cIMT 相关。在所研究的生命周期中，青年时期的 BMI 对 YFS（49.9%，95% CrI = 34-68%）和白人 BHS 参与者（48.6%，95% CrI = 9-86%）的成人 cIMT 发展的相对贡献最大，而童年时期的 BMI 对黑人 BHS 参与者的相对贡献最大（54.0%，95% CrI = 8-89%）：尽管我们的数据表明，在生命过程的敏感期，旨在降低体重指数的预防和干预措施可能会在限制体重指数对 cIMT 的影响方面带来最大益处，但在整个生命过程中保持较低的体重指数似乎是最佳选择。

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引用次数: 0

Association between life satisfaction, self-esteem, and health checkup participation: A population-based longitudinal study in South Korea 生活满意度、自尊与参加健康检查之间的关系：韩国一项基于人口的纵向研究。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-05 DOI: 10.1016/j.ypmed.2024.108127

Seong-Uk Baek , Jin-Ha Yoon

Objective

Previous studies have shown that background sociodemographic factors are associated with health checkup participation. However, little is known about the psychological determinants of health checkup participation in longitudinal studies. This study explored the psychological determinants of health checkup participation based on a longitudinal study in South Korea.

Methods

Data were retrieved from a nationwide, longitudinal panel study in South Korea, which included community-dwelling general adults, conducted from 2005 to 2022. Established scales for assessing life satisfaction and self-esteem were employed, and life satisfaction and self-esteem levels were categorized into four groups based on quartile values (lowest, low, high, and highest). Respondents reported whether they had undergone a health checkup in the past year. Fixed effects logistic regressions were fitted to determine within-individual associations between life satisfaction, self-esteem, and health checkup participation (n = 15,771; 171,943 observations). Odds ratios (OR) and 95 % confidence interval (CI) were determined.

Results

Compared with the lowest life satisfaction, the highest life satisfaction is associated with increased odds of health checkup participation (OR: 1.17, 95 % CI: 1.13–1.23). Compared to the lowest self-esteem level, the highest self-esteem level was positively associated with health checkup participation (OR, 1.14; 95 % CI: 1.10–1.18). The odds of participating in health checkups were also positively associated with age, income, and educational level.

Conclusion

Although the effect sizes were modest, high life satisfaction and self-esteem were associated with an increased likelihood of participating in health checkups.

目的以往的研究表明，背景社会人口因素与参加健康体检有关。然而，在纵向研究中，人们对参加健康体检的心理决定因素知之甚少。本研究以韩国的一项纵向研究为基础，探讨了参加健康体检的心理决定因素：研究数据来自于 2005 年至 2022 年在韩国开展的一项全国性纵向小组研究，研究对象包括居住在社区的普通成年人。研究采用了既定的生活满意度和自尊心评估量表，并根据四分位值（最低、低、高和最高）将生活满意度和自尊心水平分为四组。受访者报告了他们在过去一年中是否接受过健康检查。固定效应逻辑回归用于确定生活满意度、自尊和健康体检参与度之间的个体内部联系（n = 15,771; 171,943 个观察值）。结果表明：生活满意度最低的人，参加健康检查的比例较高，而生活满意度最高的人，参加健康检查的比例较低：结果：与最低生活满意度相比，最高生活满意度与参加健康体检的几率增加相关（OR：1.17，95 % CI：1.13-1.23）。与最低自尊水平相比，最高自尊水平与参加健康体检呈正相关（OR：1.14；95 % CI：1.10-1.18）。参加健康体检的几率与年龄、收入和教育水平也呈正相关：尽管影响大小不大，但生活满意度高和自尊心强与参加健康体检的可能性增加有关。

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引用次数: 0