Preventive medicine最新文献_第7页

Assessing the association between cigarette smoking and blood C-reactive protein levels using restructured cohort data 利用重组队列数据评估吸烟与血液 C 反应蛋白水平之间的关系

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-10-15 DOI: 10.1016/j.ypmed.2024.108151

Dong-Hee Koh , Sangjun Choi , Ju-Hyun Park , Sang-Gil Lee , Hwan-Cheol Kim , Inah Kim , Soon-Sil Han , Dong-Uk Park

Introduction

Cigarette smoke exposure is known to induce inflammation, leading to elevated levels of inflammatory markers such as white blood cell (WBC) count and C-reactive protein (CRP). Despite extensive research on this relationship, longitudinal studies are limited. We aimed to explore the association between cigarette smoke exposure and WBC count and CRP levels by restructuring community cohort data.

Methods

Data from a community cohort of the Korean population, followed biennially from 2001 to 2018, were utilized. Smoking status was determined through self-administered questionnaires. WBC and CRP levels were measured in a central laboratory with stringent quality control. Cohort data were restructured into pairs representing before and after measurements. We analyzed smoking effects on WBC and CRP using pairwise before-after tests based on changes in smoking status. Furthermore, parallel group analyses comparing changes in smoking status to no change were conducted.

Results

Analysis included 4336 pairs for WBC and 3068 pairs for CRP from 10,030 participants. Pairwise analysis showed a significant decrease in WBC transitioning from current smoker to non-smoker and an increase from non-smoker to current smoker. Parallel group analysis demonstrated a significant decrease in WBC transitioning from current smoker to non-smoker compared to remaining current smoker, and an increase from non-smoker to current smoker compared to remaining non-smoker. CRP did not exhibit significant associations in either analysis.

Conclusions

In a community cohort, cigarette smoking was associated with elevated WBC count. However, CRP levels did not consistently reflect inflammation associated with cigarette smoking.

导言：众所周知，吸烟会诱发炎症，导致白细胞（WBC）计数和 C 反应蛋白（CRP）等炎症标志物水平升高。尽管对这种关系进行了广泛的研究，但纵向研究却很有限。我们旨在通过重组社区队列数据，探讨香烟烟雾暴露与白细胞计数和 CRP 水平之间的关系。通过自填问卷确定吸烟状况。白细胞和 CRP 水平在中央实验室进行测量，并有严格的质量控制。队列数据被重组为代表测量前后的数据对。我们根据吸烟状态的变化，使用成对的前后检验来分析吸烟对白细胞和 CRP 的影响。此外，我们还进行了平行组分析，将吸烟状态的变化与无变化进行比较。结果分析包括来自 10,030 名参与者的 4336 对 WBC 和 3068 对 CRP。配对分析表明，从当前吸烟者到非吸烟者，白细胞显著下降，而从非吸烟者到当前吸烟者，白细胞显著上升。平行组分析表明，与目前仍吸烟者相比，从目前吸烟者转变为非吸烟者的白细胞显著减少，而与目前仍不吸烟者相比，从不吸烟者转变为目前吸烟者的白细胞显著增加。结论在社区队列中，吸烟与白细胞计数升高有关。结论在社区队列中，吸烟与白细胞计数升高有关，但 CRP 水平并不能一致反映与吸烟有关的炎症。

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引用次数: 0

Organized cervical cancer screening: A randomized controlled trial assessing the effect of sending invitation letters 有组织的宫颈癌筛查：评估发送邀请函效果的随机对照试验。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-10-15 DOI: 10.1016/j.ypmed.2024.108150

Delphine Teigné , Anne-Sophie Banaszuk , Charlotte Grimault , Aline Lebon , France Nanin , Aurélie Gaultier , Cédric Rat

Objective

To evaluate the effect of implementing two modalities of organized Cervical Cancer Screening (CCS) program on screening uptake after a six-month delay.

Methods

A three-armed cluster randomized control trial was conducted in France between January 8 and July 2, 2021, involving148 510 women aged 40 to 65 and 1070 general practitioners.

In the Optimized screening group, an invitation letter was posted to non-adherent women, and general practitioners were sent a list of their non-adherent patients.

In the Organized screening group, an invitation letter was posted to non-adherent women.

In the Usual care group, no invitation was sent.

The endpoint was cervical cancer screening uptake after a six months period a) among all eligible women (primary endpoint); and b) among initially non-adherent women (post-hoc analysis).

Statistical analysis was based on a logistic mixed model that compared between-group percentages of adherent women. A hierarchical comparison successively tested differences between the three arms (alpha 5 % risk).

Results

Among all 148,510 eligible women, screening uptake was 63.6 % (31,731/49910) in the Optimized screening group vs 61.8 % (30,210/48847) in the Usual care group (OR [IC95 %] = 1.05[0.93; 1.18]).

Among the 64,370 initially non-adherent women, screening uptake was 17.9 % (3955/22134) in the Optimized screening group vs 11.6 % (5321/20995) in the Usual care group (OR [IC95 %] = 1.70[1.56;1.86]). There was no significant difference between Optimized and Organized screening groups (17.2 % vs 17.9 %; OR [IC95 %] = 1.02[0.94; 1.11]).

Conclusions

The implementation of an organized screening based on an invitation letter resulted in a modest increase in participation among non-adherent women six months later.

目的评估宫颈癌筛查（CCS）计划的两种组织模式在延迟六个月后对筛查率的影响：2021年1月8日至7月2日期间，法国开展了一项三臂群组随机对照试验，共有148 510名40至65岁的女性和1070名全科医生参与。在优化筛查组中，向未坚持筛查的妇女张贴了邀请函，并向全科医生发送了一份未坚持筛查的患者名单。在有组织筛查组中，向未坚持筛查的妇女张贴了邀请函。常规护理组未发出邀请函。终点是在 6 个月后，a）所有符合条件的妇女接受宫颈癌筛查的情况（主要终点）；b）最初未接受筛查的妇女接受筛查的情况（事后分析）。统计分析采用逻辑混合模型，比较组间坚持筛查妇女的百分比。分层比较连续检验了三个组之间的差异（α 5 % 风险）：在所有符合条件的 148510 名妇女中，优化筛查组的筛查率为 63.6%（31731/49910），而常规护理组为 61.8%（30210/48847）（OR [IC95 %] = 1.05[0.93; 1.18]）。在 64,370 名最初未坚持筛查的妇女中，优化筛查组的筛查率为 17.9%（3955/22134），而常规护理组为 11.6%（5321/20995）（OR [IC95 %] = 1.70[1.56;1.86]）。优化筛查组和有组织筛查组之间没有明显差异（17.2% vs 17.9%；OR [IC95 %] = 1.02[0.94; 1.11]）：结论：以邀请函为基础的有组织筛查在 6 个月后使未坚持筛查的妇女的参与率略有提高。

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引用次数: 0

Secular trends of physical fitness in Austrian children attending sports schools: An analysis of repeated cross-sections from 2006 to 2023 奥地利体育学校学生体能的长期趋势：对 2006 年至 2023 年重复横截面的分析。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-10-09 DOI: 10.1016/j.ypmed.2024.108149

Alexandra Unger , Walter Reichel , Katrin Röttig , Jan Wilke

Background

Physical fitness (PF) offers numerous physical and mental health benefits, especially during childhood. Previous studies investigating trends in children's PF over the years reported contradictory findings.

Objective

To identify and analyse secular trends in PF among Austrian schoolchildren from 2006 to 2023.

Method

A repeated cross-sections design was used to examine the PF of children enrolling in sports schools between 2006 and 2023. During this period, a standardized eight-item motor performance testing battery was administered yearly to capture markers of strength, speed, endurance, agility and reaction time in Austrian schools.

Results

A total of n = 3827 children (996 girls) with a mean age of 9.9 ± 1.0 years were included. Linear mixed models indicated significant declines in sprint performance (5, 10, 20 m), tapping, jump (long jump and drop jump), throwing (medicine ball), and agility (snake run). No changes were observed in cardiorespiratory fitness (8 min run) or reaction time.

Conclusion

There has been a steady decline in PF among Austrian children attending sports schools. This finding underscores the need for enhanced PF monitoring and training in schools to improve public health outcomes.

背景：体能（PF）对身心健康有诸多益处，尤其是在儿童时期。以往对儿童体适能趋势的调查报告结果相互矛盾：确定并分析 2006 年至 2023 年奥地利学龄儿童体适能的长期趋势：方法：采用重复横截面设计，研究 2006 年至 2023 年体育学校入学儿童的 PF。在此期间，每年在奥地利学校进行一次标准化的八项运动表现测试，以获取力量、速度、耐力、敏捷性和反应时间等指标：结果：共有 n = 3827 名儿童（996 名女孩）参加了测试，他们的平均年龄为 9.9 ± 1.0 岁。线性混合模型显示，儿童的短跑成绩（5 米、10 米、20 米）、拍击、跳跃（跳远和跳高）、投掷（药丸）和敏捷性（蛇形跑）明显下降。心肺功能（8 分钟跑步）和反应时间均无变化：结论：在体育学校就读的奥地利儿童的肺活量持续下降。结论：在奥地利体育学校就读的儿童的体能持续下降，这一发现强调了在学校加强体能监测和训练以改善公共卫生成果的必要性。

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引用次数: 0

Food insecurity and substance use among young adults in the United States 美国青少年的粮食不安全和药物使用情况。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-10-05 DOI: 10.1016/j.ypmed.2024.108148

Sarah A. Pitman , Keryn E. Pasch , Natalie S. Poulos , Cayley E. Velazquez

Purpose

The purpose of this study was to examine the association between food insecurity and substance use among young adults aged 18–25 in the U.S.

Methods

A cross-sectional online survey was completed by a diverse sample of 1024 young adults (50.2 % female; 62 % non-white; m age = 21.7[SD = 2.26]) between January–April 2022. Logistic regression analyses were used to examine the association between food insecurity and current cigarette use, Electronic Nicotine Delivery System (ENDS) use, cannabis use, alcohol use, and binge drinking controlling for socio-demographic and economic factors, mental health, and experiences of discrimination.

Results

Nearly 70 % of participants reported being food insecure over the past year. Substance use was also common: 45.9 % of participants reported current cigarette use, 50.9 % ENDS use, 57 % cannabis use, 65.9 % alcohol use, and 50.4 % engaged in binge drinking in the past two weeks. Being food insecure was associated with greater odds of cigarette use (OR = 2.49, 95 % CI = [1.77, 3.50]), ENDS use (OR = 2.18, 95 % CI = [1.58, 3.01]), cannabis use (OR = 1.73, 95 % CI = [1.26, 2.37]), alcohol use (OR = 1.60, 95 % CI = [1.16, 2.19]) and binge drinking (OR = 1.98, 95 % CI = [1.44, 2.72]), controlling for all other factors.

Conclusion

Food insecurity may serve as an important indicator of substance use among young adults. Practitioners should consider screening for food insecurity, providing information about food access, and developing interventions to address food insecurity among the young adults with whom they work. Future research should examine these associations prospectively to better understand how food insecurity may contribute to the initiation and/or escalation of substance use.

目的：本研究的目的是探讨美国 18-25 岁青壮年中食物不安全与药物使用之间的关系：2022 年 1 月至 4 月间，1024 名年轻成年人（50.2% 为女性；62% 为非白人；平均年龄 = 21.7[SD = 2.26]）完成了一项横断面在线调查。在控制社会人口和经济因素、心理健康和歧视经历的情况下，使用逻辑回归分析来研究食物无保障与当前吸烟、使用电子尼古丁输送系统（ENDS）、吸食大麻、饮酒和酗酒之间的关系：近 70% 的参与者表示在过去一年中粮食无保障。使用药物的情况也很普遍：45.9%的参与者表示目前使用香烟，50.9%使用ENDS，57%使用大麻，65.9%饮酒，50.4%在过去两周内酗酒。食物无保障与吸烟（OR = 2.49，95 % CI = [1.77，3.50]）、使用 ENDS（OR = 2.18，95 % CI = [1.58，3.01]）、吸食大麻（OR = 1.73，95 % CI = [1.26，2.37]）、饮酒（OR = 1.60，95 % CI = [1.16，2.19]）和暴饮暴食（OR = 1.98，95 % CI = [1.44，2.72]）：结论：食物不安全可能是青少年使用药物的一个重要指标。从业人员应考虑筛查食物不安全状况，提供有关食物获取的信息，并制定干预措施，以解决他们所服务的青壮年中存在的食物不安全问题。未来的研究应该对这些关联进行前瞻性研究，以更好地了解食物不安全如何导致药物使用的开始和/或升级。

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引用次数: 0

An atlas on risk factors for gastrointestinal cancers: A systematic review of Mendelian randomization studies 胃肠道癌症风险因素图集：孟德尔随机研究的系统回顾。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-10-03 DOI: 10.1016/j.ypmed.2024.108147

Yi-Xuan Huang , Jun-Hua Wu , Yu-Qiang Zhao , Wan-Nian Sui , Tian Tian , Wen-Xiu Han , Jing Ni

Objective

Gastrointestinal cancers are one of the most frequent cancer types and seriously threaten human life and health. Recent studies attribute the occurrence of gastrointestinal cancers to both genetic and environmental factors, yet the intrinsic etiology remains unclear. Mendelian randomization is a powerful well-established statistical method that is based on genome-wide association study (GWAS) to evaluate the causal relationship between exposures and outcomes. In the present study, we aimed to conduct a systematic review of Mendelian randomization studies investigating any causal risk factors for gastrointestinal cancers.

Methods

We systematically searched Mendelian randomization studies that addressed the associations of genetically predicted exposures with five main gastrointestinal cancers from September 2014 to March 2024, as well as testing the research quality and validity.

Results

Our findings suggested robust and consistent causal effects of body mass index (BMI), basal metabolic rate, fatty acids, total cholesterol, total bilirubin, insulin like growth factor-1, eosinophil counts, interleukin 2, alcohol consumption, coffee consumption, apolipoprotein B on colorectal cancer risks, BMI, waist circumference, low-density lipoprotein (LDL), total testosterone, smoking on gastric cancer risks, BMI, fasting insulin, LDL, waist circumference, visceral adipose tissue (VAT), immune cells, type 2 diabetes mellitus (T2DM) on pancreatic cancer risks, waist circumference, smoking, T2DM on esophageal adenocarcinoma risks, and VAT, ferritin, transferrin, alcohol consumption, hepatitis B virus infection, rheumatoid arthritis on liver cancer risks, respectively.

Conclusion

Larger, well-designed Mendelian randomization studies are practical in determining the causal status of risk factors for diseases.

目的：胃肠癌是最常见的癌症类型之一，严重威胁着人类的生命和健康。最新研究认为，胃肠道癌症的发生与遗传和环境因素有关，但其内在病因仍不清楚。孟德尔随机化是一种强大而成熟的统计方法，它基于全基因组关联研究（GWAS）来评估暴露与结果之间的因果关系。本研究旨在对调查胃肠道癌症因果风险因素的孟德尔随机研究进行系统回顾：方法：我们系统地检索了 2014 年 9 月至 2024 年 3 月期间涉及基因预测暴露与五种主要胃肠道癌症相关性的孟德尔随机研究，并对研究质量和有效性进行了检测：我们的研究结果表明，体重指数（BMI）、基础代谢率、脂肪酸、总胆固醇、总胆红素、胰岛素样生长因子-1、嗜酸性粒细胞计数、白细胞介素 2、饮酒量、咖啡饮用量、载脂蛋白 B 对结直肠癌风险，BMI、腰围、低密度脂蛋白（LDL）、总睾酮，以及吸烟对胃癌风险，BMI、腰围、低密度脂蛋白（LDL）、总睾酮，都具有稳健且一致的因果效应、吸烟对胃癌风险的影响，体重指数、空腹胰岛素、低密度脂蛋白、腰围、内脏脂肪组织（VAT）、免疫细胞、2 型糖尿病（T2DM）对胰腺癌风险的影响，腰围、吸烟、T2DM 对食管腺癌风险的影响，以及 VAT、铁蛋白、转铁蛋白、饮酒、乙型肝炎病毒感染、类风湿性关节炎对肝癌风险的影响。结论规模更大、设计合理的孟德尔随机研究对于确定疾病风险因素的因果关系非常实用。

{"title":"An atlas on risk factors for gastrointestinal cancers: A systematic review of Mendelian randomization studies","authors":"Yi-Xuan Huang , Jun-Hua Wu , Yu-Qiang Zhao , Wan-Nian Sui , Tian Tian , Wen-Xiu Han , Jing Ni","doi":"10.1016/j.ypmed.2024.108147","DOIUrl":"10.1016/j.ypmed.2024.108147","url":null,"abstract":"<div><h3>Objective</h3><div>Gastrointestinal cancers are one of the most frequent cancer types and seriously threaten human life and health. Recent studies attribute the occurrence of gastrointestinal cancers to both genetic and environmental factors, yet the intrinsic etiology remains unclear. Mendelian randomization is a powerful well-established statistical method that is based on genome-wide association study (GWAS) to evaluate the causal relationship between exposures and outcomes. In the present study, we aimed to conduct a systematic review of Mendelian randomization studies investigating any causal risk factors for gastrointestinal cancers.</div></div><div><h3>Methods</h3><div>We systematically searched Mendelian randomization studies that addressed the associations of genetically predicted exposures with five main gastrointestinal cancers from September 2014 to March 2024, as well as testing the research quality and validity.</div></div><div><h3>Results</h3><div>Our findings suggested robust and consistent causal effects of body mass index (BMI), basal metabolic rate, fatty acids, total cholesterol, total bilirubin, insulin like growth factor-1, eosinophil counts, interleukin 2, alcohol consumption, coffee consumption, apolipoprotein B on colorectal cancer risks, BMI, waist circumference, low-density lipoprotein (LDL), total testosterone, smoking on gastric cancer risks, BMI, fasting insulin, LDL, waist circumference, visceral adipose tissue (VAT), immune cells, type 2 diabetes mellitus (T2DM) on pancreatic cancer risks, waist circumference, smoking, T2DM on esophageal adenocarcinoma risks, and VAT, ferritin, transferrin, alcohol consumption, hepatitis B virus infection, rheumatoid arthritis on liver cancer risks, respectively.</div></div><div><h3>Conclusion</h3><div>Larger, well-designed Mendelian randomization studies are practical in determining the causal status of risk factors for diseases.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"189 ","pages":"Article 108147"},"PeriodicalIF":4.3,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Moral values and vaccination behavior in Russia during the COVID-19 pandemic COVID-19 大流行期间俄罗斯的道德价值观和疫苗接种行为。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-10-02 DOI: 10.1016/j.ypmed.2024.108143

Dmitry Kislitsyn , Peter Meylakhs , Dmitry Schapov , Dmitry Kurakin , Ekaterina Aleksandrova

Objective

Effective persuasive communication necessitates message matching; the conveyed message should resonate with the recipient's characteristics, including individual moral values. While studies examining the relationship between moral values and vaccination behavior have been conducted in a limited number of countries, this study seeks to provide evidence on this relationship beyond Western democracies.

Methods

A cross-sectional online survey was conducted from November 4 to December 17, 2021, in Russia. Participants reported their COVID-19 vaccination behavior and completed the Moral Foundations Questionnaire, designed to measure the endorsement of moral values (n = 415). Regression analysis was employed to assess the association between each moral foundation and COVID-19 vaccination behavior.

Results

Our findings indicate that the moral foundations of Care, Loyalty, Fairness, and Sanctity significantly influence vaccination behavior. Individuals who strongly endorse Fairness (AME = −0.019; 95 % CI = −0.033, −0.005) and Sanctity (AME = −0.016; 95 % CI = −0.031, −0.002) were less likely to be vaccinated. Conversely, individuals endorsing Care (AME = −0.018; 95 % CI = −0.031, −0.005) and Loyalty (AME = −0.015; 95 % CI = −0.028, −0.001) were less likely to report refusal of vaccination. These results remain robust after adjusting for sociodemographic variables related to vaccination barriers.

Conclusion

Our findings carry public health implications; an understanding of the moral psychology underlying vaccination behavior can facilitate more targeted and effective health communication. Employing skillfully crafted moral appeals may mitigate negative attitudes toward vaccination and enhance vaccination rates.

目标有效的说服性传播必须与信息相匹配；传达的信息应与接受者的特点（包括个人道德价值观）产生共鸣。尽管对道德价值观与疫苗接种行为之间关系的研究只在少数国家进行，但本研究试图为西方民主国家以外的国家提供有关这种关系的证据：方法：2021 年 11 月 4 日至 12 月 17 日在俄罗斯进行了一项横断面在线调查。参与者报告了他们的 COVID-19 疫苗接种行为，并填写了道德基础问卷，该问卷旨在测量道德价值观的认可度（n = 415）。我们采用回归分析法评估了每种道德基础与 COVID-19 疫苗接种行为之间的关联：结果：我们的研究结果表明，"关爱"、"忠诚"、"公平 "和 "神圣 "等道德基础对疫苗接种行为有显著影响。强烈支持公平（AME = -0.019；95 % CI = -0.033，-0.005）和神圣（AME = -0.016；95 % CI = -0.031，-0.002）的人接种疫苗的可能性较低。相反，支持 "关怀"（AME = -0.018; 95 % CI = -0.031, -0.005）和 "忠诚"（AME = -0.015; 95 % CI = -0.028, -0.001）的人则不太可能拒绝接种疫苗。在对与疫苗接种障碍有关的社会人口变量进行调整后，这些结果仍然是稳健的：我们的研究结果具有公共卫生方面的意义；了解疫苗接种行为背后的道德心理可以促进更有针对性、更有效的健康传播。巧妙地运用道德诉求可以减轻人们对疫苗接种的负面态度，提高疫苗接种率。

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引用次数: 0

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。

{"title":"“I've been really happy since I got that letter!”: Longitudinal patient perspectives on lung cancer screening communication","authors":"Sara E. Golden , Liana Schweiger , Sarah Ono , Anne C. Melzer , Santanu Datta , James Davis , Christopher Slatore","doi":"10.1016/j.ypmed.2024.108142","DOIUrl":"10.1016/j.ypmed.2024.108142","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"189 ","pages":"Article 108142"},"PeriodicalIF":4.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0