Pub Date : 2024-07-03DOI: 10.1016/j.ypmed.2024.108060
Xiaoyi Wang , Qi Wang , Meiling Li , Yanqing Zhao , Qixiang Song , Chunying Fu , Wenting Hao , Dongshan Zhu
Background and aims
Evidence on weight transitions across life stages and cardiovascular diseases (CVDs) is limited. We aimed to explore weight transition patterns from birth to childhood to midlife and risk of incident CVDs.
Methods
A total of 193,905 participants from the UK Biobank were included. Weight at birth, childhood, and midlife were collected at baseline (2006–2010). CVD outcomes were collected at year 2022. We constructed 27 transition patterns from birth to age 10 years to midlife. Cox proportional hazard models yielded hazard ratios (HRs) and 95% confidence intervals (CI) between weight transition patterns and CVDs. Mediation analyses were performed. Rate advancement periods (RAP) were also calculated.
Results
Several weight transition patterns were clearly linked to risk of CVDs, including “Low birth weight → high weight at age 10 years → obesity at midlife” (HR 2.64, 95% CI 2.24–3.11), “Low birth weight → low weight at age 10 years → obesity at midlife” (2.27, 1.93–2.66), “High birth weight → low weight at age 10 years → obesity at midlife” (2.29, 1.96–2.67), and “High birth weight → high weight at age 10 years → obesity at midlife” (2.14, 1.89–2.42), which showed even stronger association with HF. RAPs of these patterns were 8.3–10.6 years for CVD and 10.0–13.1 for HF. 50% of the association between birth weight and CVDs was mediated by weight at midlife.
Conclusions
Our findings highlight the importance of weight management throughout the life course in reducing the risk of CVDs, especially maintaining a heathy weight at midlife.
{"title":"Life course weight transitions from birth to childhood to midlife and risk of cardiovascular diseases and its subtypes","authors":"Xiaoyi Wang , Qi Wang , Meiling Li , Yanqing Zhao , Qixiang Song , Chunying Fu , Wenting Hao , Dongshan Zhu","doi":"10.1016/j.ypmed.2024.108060","DOIUrl":"10.1016/j.ypmed.2024.108060","url":null,"abstract":"<div><h3>Background and aims</h3><p>Evidence on weight transitions across life stages and cardiovascular diseases (CVDs) is limited. We aimed to explore weight transition patterns from birth to childhood to midlife and risk of incident CVDs.</p></div><div><h3>Methods</h3><p>A total of 193,905 participants from the UK Biobank were included. Weight at birth, childhood, and midlife were collected at baseline (2006–2010). CVD outcomes were collected at year 2022. We constructed 27 transition patterns from birth to age 10 years to midlife. Cox proportional hazard models yielded hazard ratios (HRs) and 95% confidence intervals (CI) between weight transition patterns and CVDs. Mediation analyses were performed. Rate advancement periods (RAP) were also calculated.</p></div><div><h3>Results</h3><p>Several weight transition patterns were clearly linked to risk of CVDs, including “Low birth weight → high weight at age 10 years → obesity at midlife” (HR 2.64, 95% CI 2.24–3.11), “Low birth weight → low weight at age 10 years → obesity at midlife” (2.27, 1.93–2.66), “High birth weight → low weight at age 10 years → obesity at midlife” (2.29, 1.96–2.67), and “High birth weight → high weight at age 10 years → obesity at midlife” (2.14, 1.89–2.42), which showed even stronger association with HF. RAPs of these patterns were 8.3–10.6 years for CVD and 10.0–13.1 for HF. 50% of the association between birth weight and CVDs was mediated by weight at midlife.</p></div><div><h3>Conclusions</h3><p>Our findings highlight the importance of weight management throughout the life course in reducing the risk of CVDs, especially maintaining a heathy weight at midlife.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538462","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 : 2024-07-03DOI: 10.1016/j.ypmed.2024.108059
Objective
The relationship between postsecondary students' health and academic outcomes may have important implications for their collegiate experience and their future prospects. Yet a comprehensive summary of the evidence examining this potential connection does not presently exist. Seeking to fill this gap, this study reviewed the extant literature on postsecondary students' academic outcomes and health across multiple domains.
Methods
Using an established methodological framework, a scoping review was conducted to identify and summarize the attributes of all peer-reviewed research performed in the U.S. and published between 2008 and 2019 that examined the relationship between postsecondary students' health and academic outcomes.
Results
The search strategy resulted in 12,488 articles. After deduplication, initial screening, and full review of relevant articles to determine eligibility, 264 articles were included in the final review. The most frequently examined health domains were mental health and substance use. Grade point average (GPA) was the most common academic measure investigated. Most studies took place at single institutions among undergraduate students, and several studies focused on specific student sub-populations. Almost all study results indicated that healthier behavior or optimal health status was associated with better academic outcomes or did not negatively impact academic success.
Conclusions
This study serves as a first step in understanding the scope of existing research examining the connection between postsecondary students' health and academic outcomes. A substantial literature base was found; however, several gaps were identified including the need for more cohort studies, national studies, examination of graduate students, and a focus on academic outcomes beyond GPA.
{"title":"U.S. postsecondary students' health and academic outcomes: A comprehensive scoping review","authors":"","doi":"10.1016/j.ypmed.2024.108059","DOIUrl":"10.1016/j.ypmed.2024.108059","url":null,"abstract":"<div><h3>Objective</h3><p>The relationship between postsecondary students' health and academic outcomes may have important implications for their collegiate experience and their future prospects. Yet a comprehensive summary of the evidence examining this potential connection does not presently exist. Seeking to fill this gap, this study reviewed the extant literature on postsecondary students' academic outcomes and health across multiple domains.</p></div><div><h3>Methods</h3><p>Using an established methodological framework, a scoping review was conducted to identify and summarize the attributes of all peer-reviewed research performed in the U.S. and published between 2008 and 2019 that examined the relationship between postsecondary students' health and academic outcomes.</p></div><div><h3>Results</h3><p>The search strategy resulted in 12,488 articles. After deduplication, initial screening, and full review of relevant articles to determine eligibility, 264 articles were included in the final review. The most frequently examined health domains were mental health and substance use. Grade point average (GPA) was the most common academic measure investigated. Most studies took place at single institutions among undergraduate students, and several studies focused on specific student sub-populations. Almost all study results indicated that healthier behavior or optimal health status was associated with better academic outcomes or did not negatively impact academic success.</p></div><div><h3>Conclusions</h3><p>This study serves as a first step in understanding the scope of existing research examining the connection between postsecondary students' health and academic outcomes. A substantial literature base was found; however, several gaps were identified including the need for more cohort studies, national studies, examination of graduate students, and a focus on academic outcomes beyond GPA.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538463","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 : 2024-07-03DOI: 10.1016/j.ypmed.2024.108058
Saba Rouhani , Lingzi Luo , Himani Byregowda , Nicholas Weaver , Ju Nyeong Park
Objective
Following changes to drug criminalization policies, we re-examine the epidemiology of drug arrests among people who use drugs (PWUD) in the U.S.
Methods
Serial cross-sectional data from the National Survey on Drug Use and Health (2015–2019) were utilized. Past-year illicit drug use (excluding cannabis) and drug arrests were described by year, area of residence, drug use characteristics and participant demographics. Adjusted associations between race and drug arrest were estimated using multivariable logistic regression.
Results
Past-year illicit drug use remained consistent over time and was highest among non-Hispanic (NH) white respondents. Of those reporting past-year illicit drug use (n = 25,429), prevalence of drug arrests remained stable over time overall and in metro areas while increasing in non-metro areas. Arrests were elevated among NH Black participants and those with lower income, unemployment, housing transience, non-metro area residence, polysubstance use, history of drug injection, substance use dependence and past-year drug selling. Adjusted odds of drug arrest remained significantly higher among NH Black individuals [aOR 1.92, 95% CI 1.30, 2.84].
Conclusion
Despite recent shifts away from punitive drug policies, we detected no reduction in drug arrests nationally and increasing prevalence in non-metro areas. Despite reporting the lowest level of illicit substance use and drug selling, NH Black individuals had significantly increased odds of arrest across years. Findings highlight the need for further examination of policy implementation and policing practices in different settings, with more research focused non-metro areas, to address enduring structural racism in drug enforcement and its consequences for health.
目的:随着毒品刑事定罪政策的变化,我们重新研究了美国吸毒者(PWUD)中的毒品逮捕流行病学:随着毒品刑事定罪政策的变化,我们重新研究了美国吸毒者(PWUD)中毒品逮捕的流行病学:我们利用了《全国毒品使用与健康调查》(2015-2019 年)中的序列横截面数据。按照年份、居住地区、毒品使用特征和参与者人口统计学特征对上一年的非法药物使用(不包括大麻)和毒品被捕情况进行了描述。使用多变量逻辑回归估算了种族与吸毒被捕之间的调整关联:过去一年的非法药物使用情况在过去一段时间内保持一致,非西班牙裔(NH)白人受访者的非法药物使用率最高。在报告上一年非法药物使用情况的受访者(n = 25,429)中,吸毒被捕率在总体上和大都会地区保持稳定,而在非大都会地区则有所上升。在新罕布什尔州的黑人参与者中,以及在收入较低、失业、住房不稳定、居住在非都会区、使用多种药物、有药物注射史、药物使用依赖性和过去一年有毒品销售的参与者中,被捕率较高。调整后,新罕布什尔州黑人吸毒被捕的几率仍然明显较高[aOR 1.92, 95% CI 1.30, 2.84]:尽管近来惩罚性毒品政策有所改变,但我们发现全国范围内的毒品被捕率并没有下降,而非大都会地区的毒品被捕率却在上升。尽管报告的非法药物使用和毒品销售水平最低,但新罕布什尔州黑人在不同年份被捕的几率显著增加。研究结果突出表明,有必要进一步检查不同环境下的政策执行情况和警务实践,并将更多的研究重点放在非都会区,以解决缉毒执法中持久存在的结构性种族主义及其对健康的影响。
{"title":"Epidemiology of drug arrests in the United States: Evidence from the national survey on drug use and health, 2015–2019","authors":"Saba Rouhani , Lingzi Luo , Himani Byregowda , Nicholas Weaver , Ju Nyeong Park","doi":"10.1016/j.ypmed.2024.108058","DOIUrl":"10.1016/j.ypmed.2024.108058","url":null,"abstract":"<div><h3>Objective</h3><p>Following changes to drug criminalization policies, we re-examine the epidemiology of drug arrests among people who use drugs (PWUD) in the U.S.</p></div><div><h3>Methods</h3><p>Serial cross-sectional data from the National Survey on Drug Use and Health (2015–2019) were utilized. Past-year illicit drug use (excluding cannabis) and drug arrests were described by year, area of residence, drug use characteristics and participant demographics. Adjusted associations between race and drug arrest were estimated using multivariable logistic regression.</p></div><div><h3>Results</h3><p>Past-year illicit drug use remained consistent over time and was highest among non-Hispanic (NH) white respondents. Of those reporting past-year illicit drug use (<em>n</em> = 25,429), prevalence of drug arrests remained stable over time overall and in metro areas while increasing in non-metro areas. Arrests were elevated among NH Black participants and those with lower income, unemployment, housing transience, non-metro area residence, polysubstance use, history of drug injection, substance use dependence and past-year drug selling. Adjusted odds of drug arrest remained significantly higher among NH Black individuals [aOR 1.92, 95% CI 1.30, 2.84].</p></div><div><h3>Conclusion</h3><p>Despite recent shifts away from punitive drug policies, we detected no reduction in drug arrests nationally and increasing prevalence in non-metro areas. Despite reporting the lowest level of illicit substance use and drug selling, NH Black individuals had significantly increased odds of arrest across years. Findings highlight the need for further examination of policy implementation and policing practices in different settings, with more research focused non-metro areas, to address enduring structural racism in drug enforcement and its consequences for health.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538461","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 : 2024-06-27DOI: 10.1016/j.ypmed.2024.108056
Melissa Mercincavage , Olivia A. Wackowski , Andrea C. Johnson , William J. Young , Andy S.L. Tan , Cristine D. Delnevo , Andrew A. Strasser , Andrea C. Villanti
Introduction
Widespread misperceptions about nicotine may have unintended effects on public health. We examined associations between existing messages about nicotine or tobacco and beliefs about nicotine and reduced nicotine cigarettes (RNC).
Methods
2962 U.S. 18–45-year-olds were randomized in a May 2022 web-based survey to view one of 26 text-based messages about tobacco or nicotine from three sources: ongoing research (n = 8), messages authorized by FDA for VLN cigarettes (n = 6), and FDA's “From Plant to Product to Puff” campaign (n = 12); six messages from FDA's campaign did not reference nicotine and were treated as the reference source. Analyses examined associations between messages, grouped by source and individually, with beliefs about nicotine and RNC addictiveness and harms.
Results
Relative to FDA messages that did not reference nicotine, all message sources were associated with greater odds of a correct belief about nicotine (Odds Ratios [ORs] = 1.40–1.87, p's < 0.01); VLN messages were associated with greater correct beliefs about RNC addictiveness (b = 0.23, p < .05). No campaign produced greater correct beliefs about RNC harms. At the individual level, only five messages were associated with a correct belief about nicotine (ORs = 2.12–2.56, p-values < .01), and one with correct beliefs about RNC harms (b = 1.09, p < .05), vs. the reference message.
Conclusions
Few existing messages improved understanding of the risks of nicotine separately from the risks of combustible products. Communication research is needed to promote greater public understanding of nicotine while minimizing unintended effects on nicotine and tobacco use.
{"title":"Associations of educational and marketing messages with beliefs about nicotine and reduced nicotine cigarettes","authors":"Melissa Mercincavage , Olivia A. Wackowski , Andrea C. Johnson , William J. Young , Andy S.L. Tan , Cristine D. Delnevo , Andrew A. Strasser , Andrea C. Villanti","doi":"10.1016/j.ypmed.2024.108056","DOIUrl":"10.1016/j.ypmed.2024.108056","url":null,"abstract":"<div><h3>Introduction</h3><p>Widespread misperceptions about nicotine may have unintended effects on public health. We examined associations between existing messages about nicotine or tobacco and beliefs about nicotine and reduced nicotine cigarettes (RNC).</p></div><div><h3>Methods</h3><p>2962 U.S. 18–45-year-olds were randomized in a May 2022 web-based survey to view one of 26 text-based messages about tobacco or nicotine from three sources: ongoing research (<em>n</em> = 8), messages authorized by FDA for VLN cigarettes (<em>n</em> = 6), and FDA's “From Plant to Product to Puff” campaign (<em>n</em> = 12); six messages from FDA's campaign did not reference nicotine and were treated as the reference source. Analyses examined associations between messages, grouped by source and individually, with beliefs about nicotine and RNC addictiveness and harms.</p></div><div><h3>Results</h3><p>Relative to FDA messages that did not reference nicotine, all message sources were associated with greater odds of a correct belief about nicotine (Odds Ratios [ORs] = 1.40–1.87, <em>p</em>'s < 0.01); VLN messages were associated with greater correct beliefs about RNC addictiveness (<em>b</em> = 0.23, <em>p</em> < .05). No campaign produced greater correct beliefs about RNC harms. At the individual level, only five messages were associated with a correct belief about nicotine (ORs = 2.12–2.56, <em>p</em>-values < .01), and one with correct beliefs about RNC harms (<em>b</em> = 1.09, <em>p</em> < .05), vs. the reference message.</p></div><div><h3>Conclusions</h3><p>Few existing messages improved understanding of the risks of nicotine separately from the risks of combustible products. Communication research is needed to promote greater public understanding of nicotine while minimizing unintended effects on nicotine and tobacco use.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0091743524002111/pdfft?md5=70f6a78677b57048a528a1dc33ff5981&pid=1-s2.0-S0091743524002111-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-26DOI: 10.1016/j.ypmed.2024.108057
Jessica Frankeberger , Robert W.S. Coulter , Marian Jarlenski , Elizabeth E. Krans , Christina Mair
Introduction
Pregnant persons with opioid use disorder (OUD) face a multitude of comorbid conditions that may increase the risk of adverse drug and health outcomes. This study characterizes typologies of comorbidities among pregnant persons with OUD and assesses the associations of these typologies with hospitalizations in the first year postpartum.
Methods
A cohort of pregnant persons with OUD at delivery in 2018 were identified in a Pennsylvania statewide hospital dataset (n = 2055). Latent class analysis assessed 12 comorbid conditions including substance use disorders (SUDs), mental health conditions, and infections. Multivariable logistic regressions examined the association between comorbidity classes and hospitalizations (all-cause, OUD-specific, SUD-related, mental health-related) during early (0–42 days) and late (43–365 days) postpartum.
Results
A three-class model best fit the data. Classes included low comorbidities (56.9% of sample; low prevalence of co-occurring conditions), moderate polysubstance/depression (18.4%; some SUDs, all with depression), and high polysubstance/bipolar disorder (24.7%; highest probabilities of SUDs and bipolar disorder). Overall, 14% had at least one postpartum hospitalization. From 0 to 42 days postpartum, the moderate polysubstance/depression and high polysubstance/bipolar disorder classes had higher odds of all-cause and mental health-related hospitalization, compared to the low comorbidities class. From 43 to 365 days postpartum, the high polysubstance/bipolar disorder class had higher odds of all-cause hospitalizations, while both the high polysubstance/depression and moderate polysubstance/bipolar disorder classes had higher odds of SUD-related and mental health-related hospitalizations compared to the low comorbidities class.
Conclusions
Findings highlight the need for long-term, multidisciplinary healthcare delivery interventions to address comorbidities and prevent adverse postpartum outcomes.
{"title":"Co-occurring conditions during pregnancy and hospitalizations in the first year postpartum among persons with opioid use disorder","authors":"Jessica Frankeberger , Robert W.S. Coulter , Marian Jarlenski , Elizabeth E. Krans , Christina Mair","doi":"10.1016/j.ypmed.2024.108057","DOIUrl":"10.1016/j.ypmed.2024.108057","url":null,"abstract":"<div><h3>Introduction</h3><p>Pregnant persons with opioid use disorder (OUD) face a multitude of comorbid conditions that may increase the risk of adverse drug and health outcomes. This study characterizes typologies of comorbidities among pregnant persons with OUD and assesses the associations of these typologies with hospitalizations in the first year postpartum.</p></div><div><h3>Methods</h3><p>A cohort of pregnant persons with OUD at delivery in 2018 were identified in a Pennsylvania statewide hospital dataset (<em>n</em> = 2055). Latent class analysis assessed 12 comorbid conditions including substance use disorders (SUDs), mental health conditions, and infections. Multivariable logistic regressions examined the association between comorbidity classes and hospitalizations (all-cause, OUD-specific, SUD-related, mental health-related) during early (0–42 days) and late (43–365 days) postpartum.</p></div><div><h3>Results</h3><p>A three-class model best fit the data. Classes included <em>low comorbidities</em> (56.9% of sample; low prevalence of co-occurring conditions), <em>moderate polysubstance/depression</em> (18.4%; some SUDs, all with depression), and <em>high polysubstance/bipolar disorder</em> (24.7%; highest probabilities of SUDs and bipolar disorder). Overall, 14% had at least one postpartum hospitalization. From 0 to 42 days postpartum, the moderate polysubstance/depression and high polysubstance/bipolar disorder classes had higher odds of all-cause and mental health-related hospitalization, compared to the low comorbidities class. From 43 to 365 days postpartum, the high polysubstance/bipolar disorder class had higher odds of all-cause hospitalizations, while both the high polysubstance/depression and moderate polysubstance/bipolar disorder classes had higher odds of SUD-related and mental health-related hospitalizations compared to the low comorbidities class.</p></div><div><h3>Conclusions</h3><p>Findings highlight the need for long-term, multidisciplinary healthcare delivery interventions to address comorbidities and prevent adverse postpartum outcomes.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470328","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 : 2024-06-24DOI: 10.1016/j.ypmed.2024.108055
Wei Wang , Wei Yao , Wanyun Tang , Yuhao Li , Qiaomei Lv , Wenbo Ding
Background
Rheumatoid arthritis (RA) stands as a persistent systemic inflammatory autoimmune condition. Despite this understanding, the precise impact of the systemic inflammation response index (SIRI) on the prognosis of RA patients remains elusive. This study aims to elucidate the correlation between the inflammatory biomarker SIRI and both all-cause mortality and cardiovascular mortality among RA patients.
Methods
Utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2020, a retrospective analysis was conducted. Survival data were depicted through Kaplan-Meier survival curves, while the relationship between SIRI and all-cause or cardiovascular mortality in RA patients was scrutinized via multivariable Cox proportional hazards regression analysis and restricted cubic spline plots. Furthermore, subgroup analysis and mediation analysis were also performed.
Results
This study encompassed 2656 RA patients with a comprehensive 20-year follow-up, during which 935 all-cause deaths and 273 deaths attributed to cardiovascular disease were recorded. We observed a nonlinear positive correlation between SIRI with both all-cause and cardiovascular mortality in RA patients. Notably, at a SIRI level of 1.12, the hazard ratio reached 1, indicating a shift from low to high mortality risk. Furthermore, mediation analysis revealed that 12.6% of the association between RA and mortality risk was mediated through SIRI. Subgroup analysis indicated a more pronounced association between SIRI and mortality in female patients or those with a high BMI.
Conclusion
This study underscores a non-linear positive correlation between the biomarker SIRI and both all-cause mortality and cardiovascular mortality in RA patients.
背景:类风湿性关节炎(RA)是一种持续性全身炎症性自身免疫疾病。尽管如此,全身炎症反应指数(SIRI)对类风湿性关节炎患者预后的确切影响仍然难以捉摸。本研究旨在阐明炎症生物标志物 SIRI 与 RA 患者全因死亡率和心血管死亡率之间的相关性:方法:利用美国国家健康与营养调查(NHANES)1999 年至 2020 年的数据进行回顾性分析。生存数据通过 Kaplan-Meier 生存曲线进行描述,SIRI 与 RA 患者全因或心血管死亡率之间的关系则通过多变量 Cox 比例危险回归分析和限制性立方样条图进行研究。此外,还进行了亚组分析和中介分析:本研究共对2656名RA患者进行了长达20年的全面随访,期间共记录了935例全因死亡和273例心血管疾病死亡。我们观察到,SIRI 与 RA 患者的全因死亡率和心血管死亡率之间存在非线性正相关。值得注意的是,当 SIRI 达到 1.12 时,危险比达到 1,表明死亡风险从低向高转移。此外,中介分析显示,12.6%的RA与死亡风险之间的关联是通过SIRI中介的。亚组分析表明,女性患者或体重指数高的患者的SIRI与死亡率之间的关系更为明显:本研究强调了生物标志物SIRI与RA患者全因死亡率和心血管死亡率之间的非线性正相关。
{"title":"Systemic inflammation response index is associated with increased all-cause and cardiovascular mortality in US adults with rheumatoid arthritis","authors":"Wei Wang , Wei Yao , Wanyun Tang , Yuhao Li , Qiaomei Lv , Wenbo Ding","doi":"10.1016/j.ypmed.2024.108055","DOIUrl":"10.1016/j.ypmed.2024.108055","url":null,"abstract":"<div><h3>Background</h3><p>Rheumatoid arthritis (RA) stands as a persistent systemic inflammatory autoimmune condition. Despite this understanding, the precise impact of the systemic inflammation response index (SIRI) on the prognosis of RA patients remains elusive. This study aims to elucidate the correlation between the inflammatory biomarker SIRI and both all-cause mortality and cardiovascular mortality among RA patients.</p></div><div><h3>Methods</h3><p>Utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2020, a retrospective analysis was conducted. Survival data were depicted through Kaplan-Meier survival curves, while the relationship between SIRI and all-cause or cardiovascular mortality in RA patients was scrutinized via multivariable Cox proportional hazards regression analysis and restricted cubic spline plots. Furthermore, subgroup analysis and mediation analysis were also performed.</p></div><div><h3>Results</h3><p>This study encompassed 2656 RA patients with a comprehensive 20-year follow-up, during which 935 all-cause deaths and 273 deaths attributed to cardiovascular disease were recorded. We observed a nonlinear positive correlation between SIRI with both all-cause and cardiovascular mortality in RA patients. Notably, at a SIRI level of 1.12, the hazard ratio reached 1, indicating a shift from low to high mortality risk. Furthermore, mediation analysis revealed that 12.6% of the association between RA and mortality risk was mediated through SIRI. Subgroup analysis indicated a more pronounced association between SIRI and mortality in female patients or those with a high BMI.</p></div><div><h3>Conclusion</h3><p>This study underscores a non-linear positive correlation between the biomarker SIRI and both all-cause mortality and cardiovascular mortality in RA patients.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458856","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 : 2024-06-22DOI: 10.1016/j.ypmed.2024.108054
Stephen T. Higgins , Tyler Erath , Fang-Fang Chen
Objective
This study is part of a programmatic investigation of rural disparities in cigarette smoking examining disparities in smoking prevalence and for the first-time quit ratios among adult women of reproductive age (18–44 years), a highly vulnerable population due to risk for multigenerational adverse effects.
Methods
Data came from 18 years (2002–2019) of the U.S. National Survey on Drug Use and Health (NSDUH) among women (n = 280,626) categorized by rural-urban residence, pregnancy status, using weighted logistic regression models testing time trends and controlling for well-established sociodemographic predictors of smoking (race/ethnicity, education, income). Concerns regarding changes in survey methods used before 2002 and after 2019 precluded inclusion of earlier and more recent survey years in the present study.
Results
Overall smoking prevalence across years was greater in rural than urban residents (adjusted odds ratio [AOR] = 1.11; 95%CI, 1.07–1.15; P < .001) including those not-pregnant (AOR = 1.10; 1.07–1.14; P < .001) and pregnant (AOR = 1.29; 1.09–1.52; P < .001). Overall quit ratios across years were lower in rural than urban residents (AOR = 0.93; 0.87–0.99; P < .001) including those not-pregnant (AOR = 0.93; 0.88–1.00, P = .035) and pregnant (AOR = 0.78; 0.62–0.99; P = .039). Interactions of rural versus urban residence with study years for prevalence and quit ratios overall and by pregnancy status are detailed in the main text.
Conclusions
These results support a longstanding and robust rural disparity in smoking prevalence among women of reproductive age including those currently pregnant and provides novel evidence that differences in smoking cessation contribute to this disparity further underscoring a need for greater access to evidence-based tobacco control and regulatory interventions in rural regions.
{"title":"Examining U.S. disparities in smoking among rural versus urban women of reproductive age: 2002–2019","authors":"Stephen T. Higgins , Tyler Erath , Fang-Fang Chen","doi":"10.1016/j.ypmed.2024.108054","DOIUrl":"10.1016/j.ypmed.2024.108054","url":null,"abstract":"<div><h3>Objective</h3><p>This study is part of a programmatic investigation of rural disparities in cigarette smoking examining disparities in smoking prevalence and for the first-time quit ratios among adult women of reproductive age (18–44 years), a highly vulnerable population due to risk for multigenerational adverse effects.</p></div><div><h3>Methods</h3><p>Data came from 18 years (2002–2019) of the U.S. National Survey on Drug Use and Health (NSDUH) among women (<em>n</em> = 280,626) categorized by rural-urban residence, pregnancy status, using weighted logistic regression models testing time trends and controlling for well-established sociodemographic predictors of smoking (race/ethnicity, education, income). Concerns regarding changes in survey methods used before 2002 and after 2019 precluded inclusion of earlier and more recent survey years in the present study.</p></div><div><h3>Results</h3><p>Overall smoking prevalence across years was greater in rural than urban residents (adjusted odds ratio [AOR] = 1.11; 95%CI, 1.07–1.15; <em>P</em> < .001) including those not-pregnant (AOR = 1.10; 1.07–1.14; <em>P</em> < .001) and pregnant (AOR = 1.29; 1.09–1.52; P < .001). Overall quit ratios across years were lower in rural than urban residents (AOR = 0.93; 0.87–0.99; <em>P</em> < .001) including those not-pregnant (AOR = 0.93; 0.88–1.00, <em>P</em> = .035) and pregnant (AOR = 0.78; 0.62–0.99; <em>P</em> = .039). Interactions of rural versus urban residence with study years for prevalence and quit ratios overall and by pregnancy status are detailed in the main text.</p></div><div><h3>Conclusions</h3><p>These results support a longstanding and robust rural disparity in smoking prevalence among women of reproductive age including those currently pregnant and provides novel evidence that differences in smoking cessation contribute to this disparity further underscoring a need for greater access to evidence-based tobacco control and regulatory interventions in rural regions.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446865","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 : 2024-06-22DOI: 10.1016/j.ypmed.2024.108053
Stephanie A. Prince , Aviroop Biswas , Marisol T. Betancourt , Stephanie Toigo , Karen C. Roberts , Rachel C. Colley , Shawn Brule , Jean-Philippe Chaput , Justin J. Lang
Objective
To assess the association between work location and movement behaviours (physical activity [PA], screen time, sleep) and adherence to the Canadian 24-Hour Movement Guidelines (24-H Guidelines) among Canadian workers during the COVID-19 pandemic.
Methods
Using cross-sectional data from the 2021 Canadian Community Health Survey (n = 10,913 working adults 18–75 years), primary work location was categorized as: worked outside the home at a fixed location (fixed workplace), worked at home (telework), and worked outside the home at no fixed location (non-fixed workplace). Recreational, transportation and occupational/household PA, as well as leisure screen time and sleep duration were self-reported. Logistic regression assessed associations between work location and adherence to movement behaviour recommendations, adjusting for covariates.
Results
Compared to a fixed workplace, those teleworking reported more recreational PA (21.1 vs 17.0 min/day, p < 0.0001) and sleep (7.2 vs 7.1 h/night, p = 0.026) and were more likely to meet sleep duration recommendations (adjusted odds ratio [aOR] = 1.28, 95% CI: 1.08–1.51) and the 24-H Guidelines (aOR = 1.25, 95% CI: 1.04–1.51). Compared to fixed workplaces, those at non-fixed workplaces reported more occupational PA (62.7 vs 32.8 min/day, p < 0.0001) and less leisure screen time (2.5 vs 2.7 h/day, p = 0.021), and were more likely to meet the PA recommendation (aOR = 1.46, 95% CI: 1.15–1.85) and the 24-H Guidelines (aOR = 1.38, 95% CI: 1.09–1.75).
Conclusions
Results suggest that adherence to the 24-H Guidelines varies by work location, and work location should be considered when developing strategies to promote healthy movement behaviours. Future studies could explore hybrid work arrangements, and longitudinal study designs.
{"title":"Telework and 24-hour movement behaviours among adults living in Canada during the COVID-19 pandemic","authors":"Stephanie A. Prince , Aviroop Biswas , Marisol T. Betancourt , Stephanie Toigo , Karen C. Roberts , Rachel C. Colley , Shawn Brule , Jean-Philippe Chaput , Justin J. Lang","doi":"10.1016/j.ypmed.2024.108053","DOIUrl":"10.1016/j.ypmed.2024.108053","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the association between work location and movement behaviours (physical activity [PA], screen time, sleep) and adherence to the Canadian 24-Hour Movement Guidelines (24-H Guidelines) among Canadian workers during the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>Using cross-sectional data from the 2021 Canadian Community Health Survey (<em>n</em> = 10,913 working adults 18–75 years), primary work location was categorized as: worked outside the home at a fixed location (fixed workplace), worked at home (telework), and worked outside the home at no fixed location (non-fixed workplace). Recreational, transportation and occupational/household PA, as well as leisure screen time and sleep duration were self-reported. Logistic regression assessed associations between work location and adherence to movement behaviour recommendations, adjusting for covariates.</p></div><div><h3>Results</h3><p>Compared to a fixed workplace, those teleworking reported more recreational PA (21.1 vs 17.0 min/day, <em>p</em> < 0.0001) and sleep (7.2 vs 7.1 h/night, <em>p</em> = 0.026) and were more likely to meet sleep duration recommendations (adjusted odds ratio [aOR] = 1.28, 95% CI: 1.08–1.51) and the 24-H Guidelines (aOR = 1.25, 95% CI: 1.04–1.51). Compared to fixed workplaces, those at non-fixed workplaces reported more occupational PA (62.7 vs 32.8 min/day, <em>p</em> < 0.0001) and less leisure screen time (2.5 vs 2.7 h/day, <em>p</em> = 0.021), and were more likely to meet the PA recommendation (aOR = 1.46, 95% CI: 1.15–1.85) and the 24-H Guidelines (aOR = 1.38, 95% CI: 1.09–1.75).</p></div><div><h3>Conclusions</h3><p>Results suggest that adherence to the 24-H Guidelines varies by work location, and work location should be considered when developing strategies to promote healthy movement behaviours. Future studies could explore hybrid work arrangements, and longitudinal study designs.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446866","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 : 2024-06-20DOI: 10.1016/j.ypmed.2024.108044
Aesha K. Patel , Emily Stiehl , Natalie Siegel , Jeffrey Panzer , Chloe Edmiston , Emily Deis , Betsy Q. Cliff
Objective
The objective of this paper is to assess implementation facilitators and challenges for advanced team-based care (aTBC) in a federally qualified health center (FQHC). In aTBC, care team coordinators room patients, perform vitals and agenda setting during patient intake, and remain present alongside providers during patient visits.
Methods
The authors conducted a qualitative post-hoc analysis of the aTBC implementation using data from several sources. They used content analysis to code items as facilitators or challenges and thematic analysis to group those into larger themes. Finally, they applied a priori codes from the revised consolidated framework for implementation research (CFIR) to organize the facilitators and barriers into subdomains.
Results
The existing evidence-base around aTBC, the FQHC's ability to pilot and adapt it, and strong implementation leads were key facilitating factors. Challenges included an external shock (i.e., the COVID-19 pandemic), aTBC complexity, and uncertainty about whether success required implementation of the full model versus easier-to-integrate smaller components.
Conclusions
FQHCs that wish to implement aTBC models need strong champions and internal structures for piloting, adapting, and disseminating interventions. FQHC leaders must think strategically about how to build support and demonstrate success to improve an FQHC's chances of expanding and sustaining aTBC.
{"title":"Implementing an advanced team-based care model in a federally qualified health center (FQHC): Assessing implementation facilitators and challenges","authors":"Aesha K. Patel , Emily Stiehl , Natalie Siegel , Jeffrey Panzer , Chloe Edmiston , Emily Deis , Betsy Q. Cliff","doi":"10.1016/j.ypmed.2024.108044","DOIUrl":"10.1016/j.ypmed.2024.108044","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this paper is to assess implementation facilitators and challenges for advanced team-based care (aTBC) in a federally qualified health center (FQHC). In aTBC, care team coordinators room patients, perform vitals and agenda setting during patient intake, and remain present alongside providers during patient visits.</p></div><div><h3>Methods</h3><p>The authors conducted a qualitative post-hoc analysis of the aTBC implementation using data from several sources. They used content analysis to code items as facilitators or challenges and thematic analysis to group those into larger themes. Finally, they applied a priori codes from the revised consolidated framework for implementation research (CFIR) to organize the facilitators and barriers into subdomains.</p></div><div><h3>Results</h3><p>The existing evidence-base around aTBC, the FQHC's ability to pilot and adapt it, and strong implementation leads were key facilitating factors. Challenges included an external shock (i.e., the COVID-19 pandemic), aTBC complexity, and uncertainty about whether success required implementation of the full model versus easier-to-integrate smaller components.</p></div><div><h3>Conclusions</h3><p>FQHCs that wish to implement aTBC models need strong champions and internal structures for piloting, adapting, and disseminating interventions. FQHC leaders must think strategically about how to build support and demonstrate success to improve an FQHC's chances of expanding and sustaining aTBC.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0091743524001993/pdfft?md5=45a16b93bba5d4bc0a8131cd8bb0f90a&pid=1-s2.0-S0091743524001993-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-20DOI: 10.1016/j.ypmed.2024.108023
Andrea R. Titus , Kelly Terlizzi , Sarah Conderino , Lan N. Ðoàn , Byoungjun Kim , Lorna E. Thorpe
Objective
There are persistent disparities in pediatric asthma morbidity in the U.S. We linked claims data with information on neighborhood-level risk factors to explore drivers of asthma disparities among Medicaid-enrolled children in New York City subsidized housing.
Methods
We constructed a cohort of Medicaid-enrolled children living in public or other subsidized housing, based on residential address, in NYC between 2016 and 2019 (n = 108,969). We examined claims-derived asthma prevalence across age and racial and ethnic groups, integrating census tract-level information and using the Bayesian Improved Surname Geocoding (BISG) algorithm to address high rates of missing data in self-reported race and ethnicity. We used inverse probability weighting (IPW) to explore the extent to which disparities persisted when exposure to asthma risk factors – related to the built environment, neighborhood poverty, and air quality – were balanced across groups. This analysis was conducted in 2022–2023.
Results
Claims-derived asthma prevalence was highest among children <7 years at baseline and among non-Hispanic Black and Hispanic children. For example, among children aged 3–6 years at baseline, claims-derived prevalence was 17.3% and 18.1% among non-Hispanic Black and Hispanic children, respectively, compared to 9.3% and 9.0% among non-Hispanic White and non-Hispanic Asian American/Pacific Islander children. Using IPW to balance exposure to asthma risk factors across racial and ethnic groups attenuated, but did not eliminate, disparities in asthma prevalence.
Conclusions
We found high asthma burden among children living in subsidized housing. Modifiable place-based characteristics may be important contributors to pediatric asthma disparities.
{"title":"Patterns and drivers of disparities in pediatric asthma outcomes among Medicaid-enrolled children living in subsidized housing in NYC","authors":"Andrea R. Titus , Kelly Terlizzi , Sarah Conderino , Lan N. Ðoàn , Byoungjun Kim , Lorna E. Thorpe","doi":"10.1016/j.ypmed.2024.108023","DOIUrl":"10.1016/j.ypmed.2024.108023","url":null,"abstract":"<div><h3>Objective</h3><p>There are persistent disparities in pediatric asthma morbidity in the U.S. We linked claims data with information on neighborhood-level risk factors to explore drivers of asthma disparities among Medicaid-enrolled children in New York City subsidized housing.</p></div><div><h3>Methods</h3><p>We constructed a cohort of Medicaid-enrolled children living in public or other subsidized housing, based on residential address, in NYC between 2016 and 2019 (<em>n</em> = 108,969). We examined claims-derived asthma prevalence across age and racial and ethnic groups, integrating census tract-level information and using the Bayesian Improved Surname Geocoding (BISG) algorithm to address high rates of missing data in self-reported race and ethnicity. We used inverse probability weighting (IPW) to explore the extent to which disparities persisted when exposure to asthma risk factors – related to the built environment, neighborhood poverty, and air quality – were balanced across groups. This analysis was conducted in 2022–2023.</p></div><div><h3>Results</h3><p>Claims-derived asthma prevalence was highest among children <7 years at baseline and among non-Hispanic Black and Hispanic children. For example, among children aged 3–6 years at baseline, claims-derived prevalence was 17.3% and 18.1% among non-Hispanic Black and Hispanic children, respectively, compared to 9.3% and 9.0% among non-Hispanic White and non-Hispanic Asian American/Pacific Islander children. Using IPW to balance exposure to asthma risk factors across racial and ethnic groups attenuated, but did not eliminate, disparities in asthma prevalence.</p></div><div><h3>Conclusions</h3><p>We found high asthma burden among children living in subsidized housing. Modifiable place-based characteristics may be important contributors to pediatric asthma disparities.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440797","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}