Preventive medicine最新文献_第6页

The optimization of harm reduction services in Massachusetts through the use of GIS: Location-allocation analyses, 2019–2021 通过使用地理信息系统优化马萨诸塞州的减低伤害服务：位置分配分析，2019-2021 年。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-07-30 DOI: 10.1016/j.ypmed.2024.108088

Background

Fatal opioid-related overdoses (OOD) continue to be a leading cause of preventable death across the US. Opioid Overdose Education and Naloxone Distribution programs (OENDs) play a vital role in addressing morbidity and mortality associated with opioid use, but access to such services is often inequitable. We utilized a geographic information system (GIS) and spatial analytical methods to inform prioritized placement of OEND services in Massachusetts.

Methods

We obtained addresses for OEND sites from the Massachusetts Department of Public Health and address-level fatal OOD data for January 2019 to December 2021 from the Massachusetts Registry of Vital Records and Statistics. Using location-allocation approaches in ArcGIS Pro, we created p-median models using locations of existing OEND sites and fatal OOD counts to identify areas that should be prioritized for future OEND placement. Variables included in our analysis were transportation mode, distance from public schools, race and ethnicity, and location feasibility.

Results

Three Massachusetts communities – Athol, Dorchester, and Fitchburg – were identified as priority sites for new OEND locations using location-allocation models based on capacity to maximize OOD prevention. Communities identified by the models for OEND placement had similar demographics and overdose rates (42.8 per 100,000 vs 40.1 per 100,000 population) to communities with existing OEND programs but lower naloxone kit distribution rates (2589 doses per 100,000 vs 3704 doses per 100,000). Further models demonstrated differential access based on location and transportation.

Conclusion

Our analyses identified key areas of Massachusetts with greatest need for OEND services. Further, these results demonstrate the utility of using spatial epidemiological methods to inform public health recommendations.

背景：致命的阿片类药物相关过量（OOD）仍然是全美可预防死亡的主要原因。阿片类药物过量教育和纳洛酮发放计划（OENDs）在解决与阿片类药物使用相关的发病率和死亡率方面发挥着至关重要的作用，但获得此类服务的机会往往并不公平。我们利用地理信息系统 (GIS) 和空间分析方法为马萨诸塞州的 OEND 服务的优先安排提供信息：我们从马萨诸塞州公共卫生部获得了 OEND 站点的地址，并从马萨诸塞州生命记录和统计登记处获得了 2019 年 1 月至 2021 年 12 月的地址级致命 OOD 数据。我们使用 ArcGIS Pro 中的位置分配方法，利用现有 OEND 站点的位置和致命 OOD 计数创建了 p-median 模型，以确定未来应优先放置 OEND 的区域。分析中的变量包括交通方式、与公立学校的距离、种族和民族以及选址的可行性：马萨诸塞州的三个社区--阿瑟尔（Athol）、多切斯特（Dorchester）和菲奇堡（Fitchburg）--根据最大限度预防 OOD 的能力，通过地点分配模型被确定为新的 OEND 地点的优先选址。根据模型确定的 OEND 安置点社区的人口统计和用药过量率（每 10 万人 42.8 例 vs 每 10 万人 40.1 例）与现有 OEND 计划的社区相似，但纳洛酮试剂盒的分发率较低（每 10 万人 2589 剂 vs 每 10 万人 3704 剂）。进一步的模型显示，根据地点和交通情况的不同，获得纳洛酮的机会也不同：我们的分析确定了马萨诸塞州最需要 OEND 服务的主要地区。此外，这些结果还证明了使用空间流行病学方法为公共卫生建议提供信息的实用性。

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引用次数: 0

Is use of Long-Acting Reversible Contraceptives (LARC) associated with reduced well-woman visits and STI testing? Evidence from female Medicaid clients aged 15–24 in Delaware 长效可逆避孕药 (LARC) 的使用是否与妇女健康检查和性传播感染检测的减少有关？来自特拉华州 15-24 岁女性医疗补助客户的证据。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-07-30 DOI: 10.1016/j.ypmed.2024.108089

Objective

Contraceptive method type matters to sexually transmitted infection (STI) prevention, but contraceptive counseling often emphasizes method efficacy and the benefits of “forgettable” methods, including long-acting reversible contraceptives (LARCs). We aimed to explore associations between prescription method type and annual STI testing and investigated whether these associations relate to annual well-woman visits.

Methods

We constructed a panel of 20,949 young women (<25) enrolled in Delaware's Medicaid program from 2012 through 2019. Conditional logit regressions measured associations between contraceptive method type and annual testing for gonorrhea, chlamydia, or syphilis. We stratified contraceptive methods into LARC, short-acting reversible methods (SARC; pills, patch, ring, and injectable), or no prescription method. We estimated three models examining STI testing in year of method initiation, in years afterwards, and attendance to a well-woman visit as a potential mediator of these associations.

Results

STI testing rates did not differ between LARC versus SARC users in the year of method initiation. In the two years after method initiation, LARC versus SARC users were less likely to be tested (OR = 0.73 to OR = 0.87) and less likely to have a well-woman visit (OR = 0.65 to OR = 0.79). In models controlling for attendance to well-woman visits, the decreased likelihood of STI testing in years after initiating LARC versus SARC is largely eliminated, indicating that well-woman visits mediate the relationship between method type and STI testing.

Conclusions

LARC use relates to reduced STI testing in years after method initiation due to reduced attendance to well-women visits. These findings can inform clinical practice and STI prevention.

目的：避孕方法类型对预防性传播感染（STI）很重要，但避孕咨询通常强调避孕方法的功效和 "易遗忘 "方法的益处，包括长效可逆避孕药（LARCs）。我们旨在探索处方方法类型与年度 STI 检测之间的关联，并调查这些关联是否与年度妇女健康检查有关：方法：我们建立了一个由 20949 名年轻女性组成的小组（结果：不同处方药的性传播感染检测率没有差异）：在开始使用避孕方法的当年，LARC 和 SARC 使用者的性传播感染检测率没有差异。在开始使用避孕方法后的两年中，LARC 使用者与 SARC 使用者接受检测的可能性较低（OR = 0.73 至 OR = 0.87），接受妇女健康检查的可能性也较低（OR = 0.65 至 OR = 0.79）。在控制妇女健康检查出席率的模型中，开始使用 LARC 与使用 SARC 后几年内性传播感染检测可能性降低的情况基本消除，这表明妇女健康检查介导了方法类型与性传播感染检测之间的关系：结论：LARC 的使用与开始使用 LARC 后数年内性传播感染检测的减少有关，因为参加妇科检查的人数减少了。这些发现可为临床实践和性传播感染预防提供参考。

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引用次数: 0

Contribution of greenness, air pollution, and residential food environment to excess gestational weight gain: A cross-sectional study in Wuhan, China 绿化、空气污染和居住地饮食环境对妊娠体重超常增长的影响：中国武汉的一项横断面研究。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-07-24 DOI: 10.1016/j.ypmed.2024.108086

Objectives

Our goal was to explore how greenness, air pollution, and residential food environment were linked to excessive gestational weight gain (EGWG), and to estimate their combined effects on this condition.

Method

This cross-sectional analysis included 51,507 pregnant women from the Wuhan Maternal and Child Health Management Information System between 2016 and 2019. Generalized linear mixed regression models were employed to explore the relationships between greenness, air pollution, residential food environmental exposure, and EGWG; and the combined effects were further estimated by cluster analysis and principal components analysis.

Result

We only found a significant association between convenience store density within the 250 m buffer zone (OR = 1.03 and 95% CI: 1.01,1.05) and EGWG. In terms of air pollution, sulfur dioxide(SO₂), particulate matter with a diameter of 10 μm or less(PM₁₀), and particulate matter with a diameter of 2.5 μm or less(PM_2.5) were substantially correlated with a higher prevalence of EGWG and higher GWG, with (OR = 1.16 and 95% CI: 1.12,1.21; OR = 1.12 and 95% CI: 1.08,1.16; OR = 1.17 and 95% CI: 1.14,1.21, respectively) per interquartile range(IQR) increase. Cluster analysis revealed the presence of three clusters representing urban exposures. In contrast to urban environment clusters characterized by favourable conditions, those exhibiting elevated air pollution levels, high-density residential food environment and low levels of greenness were found to have increased odds of EGWG (OR = 1.10, 95% CI: 1.03, 1.19).

Conclusion

This study emphasizes that exposure to elevated air pollution, high-density residential neighbourhood food environments, and low levels of greenness is a neighbourhood obesogenic environment for pregnant women.

目标：我们的目标是探索绿化、空气污染和居住地饮食环境如何与妊娠体重增加过快（EGWG）相关联：我们的目标是探索绿化、空气污染和居住地饮食环境与妊娠体重增长过快（EGWG）之间的关系，并估算它们对这种情况的综合影响：这项横断面分析纳入了武汉市妇幼保健管理信息系统中2016年至2019年间的51507名孕妇。采用广义线性混合回归模型探讨了绿化、空气污染、居住地食物环境暴露与EGWG之间的关系，并通过聚类分析和主成分分析进一步估计了其综合效应：结果：我们仅发现 250 米缓冲区内的便利店密度（OR = 1.03，95% CI：1.01,1.05）与 EGWG 之间存在明显联系。在空气污染方面，二氧化硫（SO2）、直径在 10 μm 或以下的颗粒物（PM10）和直径在 2.5 μm 或以下的颗粒物（PM2.5）与较高的 EGWG 患病率和较高的 GWG 患病率密切相关，每四分位数间距（IQR）增加（OR = 1.16 和 95% CI：1.12,1.21；OR = 1.12 和 95% CI：1.08,1.16；OR = 1.17 和 95% CI：1.14,1.21）。聚类分析显示存在三个代表城市暴露的聚类。与具有良好条件的城市环境群组相比，空气污染水平升高、高密度居住食品环境和低绿化水平的群组发生 EGWG 的几率更高（OR = 1.10，95% CI：1.03, 1.19）：本研究强调，暴露于高浓度空气污染、高密度居住区食品环境和低绿化水平的环境是导致孕妇肥胖的邻里环境。

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引用次数: 0

Association between a diagnosis of diabetes mellitus and smoking abstinence: An analysis of the National Health Interview Survey (2006-2018) 糖尿病诊断与戒烟之间的关系：全国健康访谈调查分析。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-07-23 DOI: 10.1016/j.ypmed.2024.108085

Objective

Both diabetes and smoking significantly increase the risk of cardiovascular disease (CVD). Understanding whether a diagnosis of diabetes can be leveraged to promote smoking cessation is a gap in the literature.

Methods

We used data from the US National Health Interview Survey, 2006 to 2018, to investigate the relationship between self-report of diagnosis of diabetes and subsequent smoking abstinence among 142,884 respondents who reported regular smoking at baseline. Effect sizes were presented as hazard ratios (HRs) derived from multivariable Cox regression models adjusted for potential confounders using diabetes as a time-dependent covariate. Subgroup-specific estimates were obtained using interaction terms between diabetes and variables of interest.

Results

A self-reported diagnosis of diabetes was associated with smoking abstinence (HR: 1.21; 95% CI: 1.16 to 1.27). The strength of the association varied based on race (P for interaction: 0.004), where it was strongest in African Americans (HR: 1.44; 95% CI: 1.29 to 1.60); income (P for interaction <0.001), where it was strongest in those with a yearly income less than $35,000 (HR: 1.45; 95% CI: 1.36 to 1.53); and educational attainment (P for interaction <0.001), where it was strongest in those who did not attend college (HR: 1.48; 95% CI: 1.40 to 1.57).

Conclusion

Among adults who smoke, a diagnosis of diabetes is significantly associated with subsequent smoking abstinence. The association is strongest in socially disadvantaged demographics, including African Americans, low-income individuals, and those who did not attend college.

目的：糖尿病和吸烟都会大大增加心血管疾病（CVD）的风险。了解是否可以利用糖尿病诊断来促进戒烟是文献中的一个空白：我们利用 2006 年至 2018 年美国全国健康访谈调查的数据，调查了 142884 名基线时报告经常吸烟的受访者自我报告糖尿病诊断与随后戒烟之间的关系。影响大小以危险比（HRs）表示，该危险比来自多变量 Cox 回归模型，该模型使用糖尿病作为时间依赖性协变量，并对潜在混杂因素进行了调整。利用糖尿病与相关变量之间的交互项得出了特定亚组的估计值：自我报告的糖尿病诊断与戒烟相关（HR：1.21；95% CI：1.16 至 1.27）。这种关联的强度因种族而异（交互作用 P：0.004），其中非裔美国人的关联强度最大（HR：1.44；95% CI：1.29 至 1.60）；收入（交互作用 P：0.005）和吸烟（交互作用 P：0.006）也与之相关：在成年吸烟者中，糖尿病诊断与随后的戒烟有显著相关性。在社会弱势群体中，包括非裔美国人、低收入者和未上过大学的人，这种关联性最强。

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引用次数: 0

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-07-23 DOI: 10.1016/j.ypmed.2024.108079

Background

Inborn Errors of Immunity (IEI) significantly affect patients' health-related quality of life (HRQOL), presenting greater challenges than those faced by the healthy population and other chronic disease sufferers. Current research lacks comprehensive integration of this critical issue.

Objective

This study explores HRQOL in IEI patients, identifies impacting factors, and advocates for increased research focus on their quality of life.

Methods

Following systematic review and meta-analysis guidelines, a search of Scopus and PubMed until November 15, 2023, yielded 1633 publications. We evaluated the literature, assessed study quality, and compared the HRQOL of IEI patients to that of healthy individuals and other chronic disease patients.

Results

Of 90 articles and 10,971 IEI patients analyzed, study quality varied (nine good, 63 moderate, and 18 poor). The Short Form-36 (SF-36) and Pediatric Quality of Life Inventory generic core scales (PedsQL) were the primary generic instruments used among adults and children, respectively, with 12 studies each using the disease-specific instruments. Meta-analysis showed IEI patients have significantly lower scores in general health, physical and mental health, and social and emotional roles compared to healthy populations. We noted significant differences between self and proxy reports, indicating caregiver anxiety and perception disparities.

Conclusion

Despite limitations like small sample sizes and reliance on generic instruments, this research underscores the substantially lower HRQOL among IEI patients, emphasizing the need for a patient-centered, multidisciplinary approach to improve their life quality and calling for more focused attention on IEI patients and their caregivers' HRQOL.

背景：先天性免疫错误 (IEI) 严重影响患者的健康相关生活质量 (HRQOL)，与健康人群和其他慢性病患者相比，IEI 带来了更大的挑战。目前的研究缺乏对这一关键问题的全面整合：本研究探讨了 IEI 患者的 HRQOL，确定了影响因素，并倡导加强对其生活质量的研究：根据系统综述和荟萃分析指南，我们对 Scopus 和 PubMed 进行了检索，截至 2023 年 11 月 15 日，共检索到 1633 篇文献。我们对文献进行了评估，对研究质量进行了评估，并将 IEI 患者的 HRQOL 与健康人和其他慢性病患者的 HRQOL 进行了比较：在分析的 90 篇文章和 10971 名 IEI 患者中，研究质量参差不齐（9 篇良好，63 篇中等，18 篇较差）。简表-36 (SF-36) 和儿科生活质量量表通用核心量表 (PedsQL) 分别是成人和儿童使用的主要通用量表，另有 12 项研究使用了疾病特异性量表。元分析表明，与健康人群相比，IEI 患者在一般健康、身心健康以及社会和情感角色方面的得分明显较低。我们注意到自我报告和代理报告之间存在明显差异，这表明护理人员存在焦虑和认知差异：尽管存在样本量小和依赖通用工具等局限性，但这项研究强调了 IEI 患者的 HRQOL 明显较低，强调需要以患者为中心的多学科方法来改善他们的生活质量，并呼吁更多关注 IEI 患者及其照顾者的 HRQOL。

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引用次数: 0

Cross-sectional associations of gender identity and sexual orientation, with co-occurrence and clustering of health-related behaviours among British adolescents: Millennium cohort study 英国青少年中性别认同和性取向与健康相关行为的共同发生和聚类的横截面关联：千年队列研究。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-07-22 DOI: 10.1016/j.ypmed.2024.108084

Purpose

We examined whether gender identity and sexual orientation were associated with seven health-related behaviours, and with co-occurrence and clustering of these behaviours among British adolescents.

Methods

Millennium Cohort Study (age 17 wave) provided data on the exposures, gender identity (male, female, genderqueer) and sexual orientation (heterosexual, bisexual, gay or lesbian, or other), and seven self-reported health-related behaviours (binge drinking, drug use, no consumption of breakfast, no consumption of fruits or vegetables, physical inactivity, poor sleep, and smoking or vaping). Poisson regressions examined associations between the exposures and single behaviours (reporting prevalence ratios (PRs)); and multinomial logistic regressions were used for behavioural cumulative co-occurrence score (reporting PRs). Cluster patterns were identified using Ward's agglomerative hierarchical cluster analysis while associations with cluster membership were performed using logistic regressions (reporting odds ratios (ORs)).

Results

Our sample included 6022 adolescents (55.4% female, 1.5% genderqueer, 11.6% non-heterosexual). Adolescents who identified as genderqueer had the highest prevalence of not eating breakfast (PR: 60.5% [95%CI 48.4–71.4]) and poor sleep (68.7% [95%CI 55.6–79.3]). Those who identified as bisexual had a higher PR of co-occurring behaviours (2.46 [95%CI 1.39–4.27]). Among the three clusters identified (1: Multiple risk behaviours; 2: Physical inactivity and binge drinking; 3: Poor diet and physical inactivity), adolescents who identified as genderqueer or other sexual orientation showed the highest prevalence in cluster 3.

Conclusion

Gender and sexual minority British adolescents showed a higher prevalence of risky health-related behaviours, and higher risk of co-occurring behaviours. Physical inactivity and poor diet behaviours commonly clustered together for these groups.

目的：我们研究了在英国青少年中，性别认同和性取向是否与七种与健康有关的行为相关，以及这些行为的共同发生和聚类情况：千禧年队列研究（17 岁波）提供了有关暴露、性别认同（男性、女性、变性者）和性取向（异性恋、双性恋、男同性恋或女同性恋或其他）以及七种自我报告的健康相关行为（酗酒、吸毒、不吃早餐、不吃水果或蔬菜、缺乏运动、睡眠不足以及吸烟或吸食毒品）的数据。泊松回归检验了暴露与单一行为（报告流行率 (PRs)）之间的关联；多项式逻辑回归用于行为累积共同发生得分（报告流行率 (PRs)）。使用沃德聚类分层聚类分析确定聚类模式，使用逻辑回归（报告几率比（ORs））分析与聚类成员资格的关联：我们的样本包括 6022 名青少年（55.4% 为女性，1.5% 为异性，11.6% 为非异性恋）。被认定为性别同异的青少年不吃早餐（PR：60.5% [95%CI 48.4-71.4]）和睡眠质量差（68.7% [95%CI 55.6-79.3]）的发生率最高。那些被认定为双性恋的人有更高的并发行为 PR（2.46 [95%CI 1.39-4.27]）。在已确定的三个群组（1：多种危险行为；2：缺乏运动和酗酒；3：不良饮食习惯和缺乏运动）中，在群组 3 中，被确定为性别少数或其他性取向的青少年发病率最高：结论：在性别和性取向上属于少数群体的英国青少年的健康相关危险行为发生率较高，同时出现并发行为的风险也较高。在这些群体中，缺乏运动和不良饮食行为通常集中在一起。

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引用次数: 0

The cross-sectional association between dietary total, animal, and plant-based protein intake and the prevalence and severity of depressive symptoms in Dutch adults with type 2 diabetes: The Hoorn Diabetes Care System cohort 荷兰成年 2 型糖尿病患者膳食总蛋白、动物蛋白和植物蛋白摄入量与抑郁症状发生率和严重程度之间的横断面关联：霍恩糖尿病护理系统队列。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-07-22 DOI: 10.1016/j.ypmed.2024.108065

Objective

This study aimed to investigate cross-sectional associations of total, animal, and plant-based protein intake and depressive symptoms in Dutch adults with type 2 diabetes (T2D).

Methods

We included 1137 individuals with T2D (aged 68.6 ± 9.0) from the Hoorn Diabetes Care System cohort. Energy-adjusted protein intake was assessed using a validated Food Frequency Questionnaire. The nine-item Patient Health Questionnaire (PHQ-9) was used to assess the prevalence of depressive symptoms (PHQ-9 ≥ 10 and/or anti-depressant use) and the severity of depressive symptoms (continuous PHQ-9 score). Associations between total, animal, and plant-based protein (quartiles) with depressive symptoms were assessed using multiple logistic and linear regression.

Results

Highest intake of total, animal, and plant-based protein was not associated with the prevalence of depressive symptoms, compared to lowest intake (e.g., total protein, ORQ4vsQ1:0.75, 95%CI 0.42;1.32). For the severity of depressive symptoms, highest total protein intake was significantly associated with lower PHQ-9 scores (ORQ4vsQ1:0.87, 95%CI 0.75;1.00), compared to lowest intake. Animal protein was not associated with the severity of depressive symptoms (β ∼ 1), while the association for plant-based protein was marginally non-significant (βQ4vsQ1:0.88, 95%CI 0.76;1.02).

Conclusion

In individuals with T2D, higher total protein intake was associated with reduced severity of depressive symptoms, but not with the prevalence of depressive symptoms. Further prospective research with a larger sample size is needed to confirm these associations.

研究目的本研究旨在调查荷兰成年 2 型糖尿病（T2D）患者总蛋白质、动物蛋白质和植物蛋白质摄入量与抑郁症状之间的横断面关联：我们纳入了霍恩糖尿病护理系统队列中的 1137 名 2 型糖尿病患者（年龄为 68.6 ± 9.0）。我们使用经过验证的食物频率问卷评估了能量调整后的蛋白质摄入量。九项患者健康问卷（PHQ-9）用于评估抑郁症状的发生率（PHQ-9≥10和/或使用抗抑郁药）和抑郁症状的严重程度（PHQ-9连续得分）。采用多元逻辑回归和线性回归评估了总蛋白、动物蛋白和植物蛋白（四分位数）与抑郁症状之间的关系：结果：与最低摄入量相比，总蛋白、动物蛋白和植物蛋白的最高摄入量与抑郁症状的发生率无关（如总蛋白，ORQ4vsQ1:0.75, 95%CI 0.42;1.32）。就抑郁症状的严重程度而言，与最低摄入量相比，总蛋白质的最高摄入量与较低的 PHQ-9 评分显著相关（ORQ4vsQ1:0.87, 95%CI 0.75;1.00）。动物蛋白与抑郁症状的严重程度无关（β ~ 1），而植物蛋白与抑郁症状的相关性略微不显著（βQ4vsQ1:0.88, 95%CI 0.76;1.02）：在患有 T2D 的人群中，总蛋白质摄入量的增加与抑郁症状严重程度的降低有关，但与抑郁症状的发生率无关。要证实这些关联，还需要进一步开展样本量更大的前瞻性研究。

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引用次数: 0

Birth defects among offspring of California firefighters, 2007–2019 2007-2019 年加利福尼亚消防员后代中的出生缺陷。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-07-20 DOI: 10.1016/j.ypmed.2024.108080

Purpose

Limited research examines birth defects from maternal or paternal firefighting exposure. This study aims to assess if maternal or paternal occupational exposure to firefighting during periconception is associated with offspring birth defects.

Methods

Data from California birth certificates (2007–2019) were linked to maternal / offspring hospitalization records. Occupation during the periconceptional period was categorized from vital statistics as the following: paternal non-firefighting (n = 4,135,849), paternal firefighting (n = 22,732), maternal non-firefighting (n = 3,332,255) and maternal firefighting (n = 502). Birth defects were identified using ICD codes, grouped by anatomical regions. Adjusted odds ratios were estimated, and sensitivity analyses explored police officer reference groups and detailed birth defect categories.

Results

Offspring of paternal firefighters had lower odds of circulatory defects (aOR = 0.9, 95% CI 0.8, 1.0), oral clefts (aOR = 0.6, 95% CI 0.4, 0.8) and respiratory defects (0.7, 95% CI 0.6, 0.9) compared to paternal non-firefighters. Associations between maternal firefighting and offspring birth defects were imprecise. Substituting police officers as the reference group attenuated findings.

Conclusions

Offspring of paternal firefighters may have similar or slightly lower birth defect odds compared to offspring of non-firefighters. Limited data was available for assessing maternal firefighting outcomes. Future studies should prioritize studies using occupational exposure matrices to limit misclassification of exposure.

目的：有关母亲或父亲接触消防所导致的出生缺陷的研究有限。本研究旨在评估母亲或父亲在围孕期接触消防职业是否与后代出生缺陷有关：方法：将加利福尼亚州出生证明（2007-2019 年）中的数据与母亲/后代的住院记录联系起来。围孕期的职业根据生命统计分类如下：父亲非消防 (n = 4,135,849), 父亲消防 (n = 22,732), 母亲非消防 (n = 3,332,255) 和母亲消防 (n = 502)。出生缺陷使用 ICD 编码进行鉴定，并按解剖区域分组。估算了调整后的几率比，并对警官参照组和详细的出生缺陷类别进行了敏感性分析：结果：与非父方消防员相比，父方消防员的后代出现循环系统缺陷（aOR = 0.9，95% CI 0.8，1.0）、口腔裂隙（aOR = 0.6，95% CI 0.4，0.8）和呼吸系统缺陷（0.7，95% CI 0.6，0.9）的几率较低。母亲从事消防工作与后代出生缺陷之间的关系并不精确。用警察作为参照组会削弱研究结果：与非消防员的后代相比，父亲是消防员的后代出生缺陷几率可能相似或略低。评估母亲消防工作结果的数据有限。未来的研究应优先考虑使用职业暴露矩阵的研究，以限制暴露的错误分类。

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引用次数: 0

Tweeting environmental pollution: Analyzing twitter language to uncover its correlation with county-level obesity rates in the United States 推特环境污染：分析 twitter 语言，揭示其与美国县级肥胖率的相关性。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-07-20 DOI: 10.1016/j.ypmed.2024.108081

Background

Environmental pollution has been linked to obesogenic tendencies. Using environmental-related posts from Twitter (now known as X) from U.S. counties, we aim to uncover the association between Twitter linguistic data and U.S. county-level obesity rates.

Methods

Analyzing nearly 300 thousand tweets from January 2020 to December 2020 across 207 U.S. counties, using an innovative Differential Language Analysis technique and drawing county-level obesity data from the 2020 Food Environment Atlas to identify distinct linguistic features in Twitter relating to environmental-related posts correlated with socioeconomic status (SES) index indicators, obesity rates, and obesity rates controlled for SES index indicators. We also employed predictive modeling to estimate Twitter language's predictive capacity for obesity rates.

Results

Results revealed a negative correlation between environmental-related tweets and obesity rates, both before and after adjusting for SES. Contrarily, non-environmental-related tweets showed a positive association with higher county-level obesity rates, indicating that individuals living in counties with lower obesity rates tend to tweet environmental-related language more frequently than those living in counties with higher obesity rates. The findings suggest that linguistic patterns and expressions employed in discussing environmental-related themes on Twitter can offer unique insights into the prevailing cross-sectional patterns of obesity rates.

Conclusions

Although Twitter users are a subset of the general population, incorporating environmental-related tweets and county-level obesity rates and using a novel language analysis technique make this study unique. Our results indicated that Twitter users engaging in more active dialog about environmental concerns might exhibit healthier lifestyle practices, contributing to reduced obesity rates.

背景：环境污染与肥胖倾向有关。我们利用美国各县推特（现在称为 X）上与环境相关的帖子，旨在揭示推特语言数据与美国县级肥胖率之间的关联：分析 2020 年 1 月至 2020 年 12 月期间美国 207 个县的近 30 万条推文，使用创新的差异语言分析技术，并从 2020 年食品环境地图集中提取县级肥胖数据，以确定推特中与环境相关帖子相关的独特语言特征，这些语言特征与社会经济地位（SES）指数指标、肥胖率以及控制 SES 指数指标的肥胖率相关。我们还采用了预测模型来估计推特语言对肥胖率的预测能力：结果显示，在调整社会经济地位指数之前和之后，环境相关推文与肥胖率之间均呈负相关。相反，与环境无关的推文与较高的县级肥胖率呈正相关，这表明生活在肥胖率较低的县的人往往比生活在肥胖率较高的县的人更频繁地在推特上发布与环境有关的语言。研究结果表明，在推特上讨论与环境相关的主题时所使用的语言模式和表达方式可以为了解肥胖率的普遍横截面模式提供独特的见解：尽管推特用户是普通人群的一个子集，但将与环境相关的推文和县级肥胖率纳入其中，并使用新颖的语言分析技术，使本研究独具特色。我们的研究结果表明，参与有关环境问题的更积极对话的推特用户可能会表现出更健康的生活方式，从而有助于降低肥胖率。

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引用次数: 0

Clustering of behavioral economic biases in decision-making and risk for cigarette smoking and other substance use in women and men 决策中的行为经济学偏差与女性和男性吸烟及其他药物使用风险的聚类。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-07-19 DOI: 10.1016/j.ypmed.2024.108072

Background

Low loss aversion (LA) and high delay discounting (DD) are behavioral-economic decision-making biases that independently predict cigarette smoking and other risky substance use. Here we examine (1) whether low-LA and high-DD co-occur, (2) does co-occurrence increase the odds of current smoking and other substance use compared to only low-LA, high-DD, or neither; and (3) potential gender differences in these associations.

Method

Data are from five studies with U.S. adults who currently smoked or never-smoked cigarettes recruited using online convenience sampling matching on gender and education. Participants completed identical sociodemographic, substance use (cigarette, other drugs, alcohol), and LA (hypothetical 50–50 gambles) and DD (monetary-choice questionnaire) measures. LA and DD scores were dichotomized as low and high using Receiver-Operating-Characteristic Curve logistic regression.

Results

LA and DD each independently predicted substance use and with few exceptions were not influenced by gender. Low-LA compared to high-LA predicted two-fold greater odds of co-occurring high-DD (AOR = 2.120, 95%CI:1.749–2.571, p < .0001). Similarly, high-DD compared to low DD predicted two-fold greater odds of low-LA (AOR = 2.118, 95%CI:1.747–2.568, p < .0001). Among those with co-occurring low-LA and high-DD, odds of substance use were 5–10 times greater than those exhibiting neither, and 2–3 times greater than those exhibiting only low-LA or high-DD.

Conclusions

Low-LA and high-DD cluster in women and men such that exhibiting one of these decision-making biases doubles the odds of exhibiting the other. These results demonstrate reliable clustering of low-LA and high-DD and a striking increase in risk for substance use relative to having only one or neither decision-making bias.

背景：低损失厌恶（LA）和高延迟贴现（DD）是行为经济决策偏差，可独立预测吸烟和其他危险物质的使用。在此，我们研究了（1）低LA和高DD是否同时存在；（2）与仅低LA、高DD或两者均不存在相比，同时存在是否会增加当前吸烟和使用其他药物的几率；以及（3）这些关联中潜在的性别差异：数据来自五项研究，研究对象为美国成年人，他们目前吸烟或从未吸烟，研究采用在线便利抽样的方式，根据性别和教育程度进行匹配。参与者完成了相同的社会人口学、药物使用（香烟、其他药物、酒精）、LA（假设五五分成赌博）和 DD（货币选择问卷）测量。使用接收器-操作-特征曲线逻辑回归法将LA和DD得分分为低分和高分：结果：LA 和 DD 均可独立预测药物使用情况，除少数例外情况外，不受性别影响。低 LA 与高 LA 相比，并发高 DD 的几率要高出两倍（AOR = 2.120，95%CI:1.749-2.571, p 结论：低 LA 和高 DD 聚类在一起：低LA和高DD在女性和男性中聚集，表现出其中一种决策偏差会使表现出另一种决策偏差的几率增加一倍。这些结果表明，低LA和高DD具有可靠的聚集性，相对于只有一种或两种决策偏差，使用药物的风险显著增加。

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引用次数: 0