Preventive Medicine Reports最新文献_第3页

Early onset of e-cigarette use and subsequent use frequency among US high school students 美国高中生电子烟的早期使用和随后的使用频率

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2024-12-01 DOI: 10.1016/j.pmedr.2024.102935

Ruoyan Sun , Nengjun Yi

Objective

The aim of this study was to examine whether the age of e-cigarette use onset predicts subsequent use of e-cigarettes.

Methods

We used the National Youth Tobacco Survey (NYTS) from 2022. Our sample consisted of 4537 US high school students who had ever used e-cigarettes. Age of first e-cigarette use was assessed by a categorical variable (

\leq

12 years, 13 years, 14 years, 15 years, 16 years, and

\geq

17 years). We also constructed a binary variable of early onset use (

<

14 years vs

\geq

14 years). E-cigarette use outcomes in the past 30 days included any use and frequent use (used on

\geq

20 days). Weighted multivariable logistic regressions were conducted for each outcome to assess the associations between early onset of e-cigarette use and subsequent use frequency, adjusting for a list of covariates.

Results

Among 4537 high school students who had ever used e-cigarettes, 49.5 % (95 % CI, 46.1 %–52.9 %) reported any use in the past 30 days and 22.8 % (95 % CI, 20.0 %–25.7 %) reported frequent e-cigarette use. Early-onset users, compared with those who tried e-cigarettes at age 14 or older, showed significantly higher risks of any use (aRR = 1.21, 95 % CI, 1.11–1.33) and frequent use (aRR = 1.88, 95 % CI, 1.60–2.20) in the past 30 days. We found younger age at first use to be associated with higher risk of current and frequent use.

Conclusions

Our findings highlight the importance for age-sensitive efforts, prioritizing younger adolescents, to prevent and delay e-cigarette use initiation.

目的本研究的目的是研究电子烟开始使用的年龄是否能预测随后的电子烟使用。方法采用2022年全国青少年烟草调查（NYTS）。我们的样本包括4537名曾经吸过电子烟的美国高中生。通过分类变量（≤12岁、13岁、14岁、15岁、16岁和≥17岁）评估首次使用电子烟的年龄。我们还构建了早发用药的二元变量（14年vs≥14年）。过去30天内的电子烟使用结果包括任何使用和频繁使用（≥20天）。对每个结果进行加权多变量逻辑回归，以评估早期开始使用电子烟与随后使用频率之间的关系，并对一系列协变量进行调整。结果在4537名曾经吸过电子烟的高中生中，49.5% （95% CI, 46.1% - 52.9%）报告在过去30天内吸过电子烟，22.8% （95% CI, 20.0% - 25.7%）报告经常吸电子烟。与14岁或以上尝试电子烟的人相比，早发用户在过去30天内任何使用（aRR = 1.21, 95% CI, 1.11-1.33）和频繁使用（aRR = 1.88, 95% CI, 1.60-2.20）的风险明显更高。我们发现，首次使用的年龄越小，当前和频繁使用的风险越高。结论：我们的研究结果强调了对年龄敏感的努力的重要性，优先考虑年轻青少年，以预防和延迟电子烟的使用。

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引用次数: 0

Caregiver worry about COVID-19 as a predictor of social mitigation behaviours and SARS-CoV-2 infection in a 12-city U.S. surveillance study of households with children 在美国12个城市对有孩子的家庭进行的一项监测研究中，看护者担心COVID-19是社会缓解行为和SARS-CoV-2感染的预测因素

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2024-11-27 DOI: 10.1016/j.pmedr.2024.102936

Steven M. Brunwasser , Tebeb Gebretsadik , Anisha Satish , Jennifer C. Cole , William D. Dupont , Christine Joseph , Casper G. Bendixsen , Agustin Calatroni , Samuel J. Arbes Jr , Patricia C. Fulkerson , Joshua Sanders , Leonard B. Bacharier , Carlos A. Camargo, Jr , Christine Cole Johnson , Glenn T. Furuta , Rebecca S. Gruchalla , Ruchi S. Gupta , Gurjit K. Khurana Hershey , Daniel J. Jackson , Meyer Kattan , Tina V. Hartert

Objective

Understanding compliance with COVID-19 mitigation recommendations is critical for informing efforts to contain future infectious disease outbreaks. This study tested the hypothesis that higher levels of worry about COVID-19 illness among household caregivers would predict lower (a) levels of overall and discretionary social exposure activities and (b) rates of household SARS-CoV-2 infections.

Methods

Data were drawn from a surveillance study of households with children (N = 1913) recruited from 12 U.S. cities during the initial year of the pandemic and followed for 28 weeks (data collection: 1-May-2020 through 22-Feb-2021). Caregivers rated how much they worried about family members getting COVID-19 and subsequently reported household levels of outside-the-home social activities that could increase risk for SARS-CoV-2 transmission at 14 follow-ups. Caregivers collected household nasal swabs on a fortnightly basis and peripheral blood samples at study conclusion to monitor for SARS-CoV-2 infections by polymerase chain reaction and serology. Primary analyses used generalized linear and generalized mixed-effects modelling.

Results

Caregivers with high enrollment levels of worry about COVID-19 illness were more likely to reduce direct social contact outside the household, particularly during the U.S.'s most deadly pandemic wave. Households of caregivers with lower COVID-19 worry had higher odds of (a) reporting discretionary outside-the-home social interaction and (b) SARS-CoV-2 infection.

Conclusions

This was, to our knowledge, the first study showing that caregiver COVID-19 illness worry was predictive of both COVID-19 mitigation compliance and laboratory-determined household infection. Findings should inform studies weighing the adaptive value of worrying about infectious disease outbreaks against established detrimental health effects.

目的了解COVID-19缓解建议的遵守情况对于为控制未来传染病暴发提供信息至关重要。这项研究验证了这样一个假设，即家庭照顾者对COVID-19疾病的担忧程度越高，就意味着(a)整体和可自由支配的社会接触活动水平越低，(b)家庭SARS-CoV-2感染率越低。方法数据来自一项监测研究，该研究在大流行的头一年从美国12个城市招募有孩子的家庭（N = 1913），并进行了28周的随访（数据收集：2020年5月1日至2021年2月22日）。护理人员评估了他们对家庭成员感染COVID-19的担忧程度，随后在14次随访中报告了可能增加SARS-CoV-2传播风险的家庭外社交活动水平。护理人员每两周采集一次家庭鼻拭子，并在研究结束时采集外周血样本，通过聚合酶链反应和血清学监测SARS-CoV-2感染。初步分析采用广义线性和广义混合效应模型。结果对COVID-19疾病担忧程度高的护理人员更有可能减少家庭以外的直接社会接触，特别是在美国美国最致命的流行病浪潮。对COVID-19担忧程度较低的护理人员家庭(a)报告可自由支配的家庭外社交活动和(b)感染SARS-CoV-2的几率更高。据我们所知，这是第一项研究表明，护理人员对COVID-19疾病的担忧既可以预测COVID-19缓解依从性，也可以预测实验室确定的家庭感染。研究结果应该为权衡担心传染病爆发对确定的有害健康影响的适应价值的研究提供信息。

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引用次数: 0

Associations of sociodemographic and smoking characteristics with intention to quit among Chinese adults aged 20–69 years who smoke: Findings from nationwide China Health Literacy Survey during 2018–19 中国20-69岁吸烟成年人的社会人口学和吸烟特征与戒烟意向的关系：2018 - 2019年中国健康素养调查结果

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2024-11-26 DOI: 10.1016/j.pmedr.2024.102933

Zhen-xiao Huang , Ying-hua Li , Ying Xie , Yi Liu , Zheng Su , Xin Xia , Dan Xiao , Chen Wang

Objective

To identify factors influencing the intention to quit (ItQ) among Chinese who smoke, focusing on 10th Revision of the International Classification of Diseases (ICD-10) Nicotine dependence. Additionally, to estimate the number of individuals with ItQ, supporting optimal allocation of cessation resources.

Methods

This study used data from the 2018 China Health Literacy Survey, a nationally representative cross-sectional study with 20,288 participants who smoke currently aged 20–69 years. The ItQ proportions were estimated overall and by subgroup. Logistic regression was employed to estimate ORs and 95 % CIs for ItQ. The number of people who smoke with ItQ was estimated based on the census data.

Results

In China, 41.34 % of individuals who smoke had ItQ, higher in females (44.89 %) than males (41.34 %). Provincial proportions ranged from 23.53 % to 63.56 %. ItQ was significantly associated with smoking characteristics, including occasional smoking (OR = 2.08, 95 % CI = 1.88–2.20), fewer pack-years (OR = 0.70, 95 % CI = 0.68–0.73), older smoking initiation age (OR = 1.22, 95 % CI = 1.18–1.27), and ICD-10 Nicotine dependence (OR = 1.12, 95 % CI = 1.06–1.19), as well as age, sex, socioeconomic factors, and health status. Withdrawal symptoms were positively associated with ItQ in individuals who smoke without ICD-10 Nicotine dependence but negatively in those with ICD-10 Nicotine dependence. An estimated 100.3 million adults aged 20–69 in China have ItQ, with 52.14 million suffering from ICD-10 Nicotine dependence.

Conclusions

The intention to quit smoking among Chinese who smoke is low and varies by ICD-10 Nicotine dependence and region, underscoring the need for targeted smoking cessation interventions across diverse smoking populations.

目的以第十版《国际疾病分类》（ICD-10）尼古丁依赖为研究对象，探讨影响我国吸烟者戒烟意向的因素。此外，估计ItQ个体的数量，支持戒烟资源的最佳分配。本研究使用了2018年中国健康素养调查的数据，这是一项具有全国代表性的横断面研究，共有20288名吸烟的参与者，目前年龄在20-69岁之间。对ItQ比例进行总体和亚组估计。采用Logistic回归估计ItQ的or和95% ci。吸烟的人数是根据人口普查数据估计的。结果中国吸烟人群中有41.34%患有ItQ，女性（44.89%）高于男性（41.34%）。省级比例从23.53%到63.56%不等。ItQ与吸烟特征显著相关，包括偶尔吸烟（OR = 2.08, 95% CI = 1.88-2.20）、较少的包年（OR = 0.70, 95% CI = 0.68-0.73）、较大的开始吸烟年龄（OR = 1.22, 95% CI = 1.18-1.27）、ICD-10尼古丁依赖（OR = 1.12, 95% CI = 1.06-1.19），以及年龄、性别、社会经济因素和健康状况。无ICD-10尼古丁依赖者的戒断症状与ItQ呈正相关，而有ICD-10尼古丁依赖者的戒断症状与ItQ呈负相关。据估计，中国有1.003亿20-69岁的成年人患有ItQ，其中5214万人患有ICD-10尼古丁依赖症。结论中国吸烟者的戒烟意愿较低，且因ICD-10尼古丁依赖和地区而异，强调需要针对不同吸烟人群进行有针对性的戒烟干预。

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引用次数: 0

Impact of the COVID-19 pandemic on adherence to diagnostic colonoscopy after a positive non-invasive screening test for colorectal cancer in two Indiana healthcare systems 在印第安纳州的两个医疗保健系统中，COVID-19大流行对结直肠癌非侵入性筛查试验阳性患者坚持诊断结肠镜检查的影响

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2024-11-26 DOI: 10.1016/j.pmedr.2024.102937

Benjamin Richter , Sarah M. Roth , Lilian Golzarri-Arroyo , Vinod Kumar , Rick Tuason , Thomas F. Imperiale

Objective

To describe trends in the use of non-invasive tests (NIST) and the interval between a positive NIST and diagnostic colonoscopy.

Methods

Using a retrospective time-trend design, we examined medical records of patients within two large Indiana integrated healthcare systems who had a positive NIST between January 2019 and June 2021 and quantified the proportion of patients who had not completed colonoscopy within 60, 90, and 180 days to determine the interval between NIST result and diagnostic colonoscopy in days.

Results

Of 1379 patients with positive NISTs, 930 (68 %) underwent diagnostic colonoscopy during the 30-month study timeframe. Median time to colonoscopy completion was significantly longer in 2020 compared to 2019 (50 vs. 37 days, p < 0.01) and 2021 (46 days, p = 0.06). The proportion of patients completing colonoscopy within 90 days of a positive FIT in 2019, 2020, and 2021 were 79 %, 83 %, and 72 %, respectively (p = 0.63), and were 86 %, 78 %, and 84 %, respectively, after positive FIT/DNA (p = 0.07). Median time to diagnostic colonoscopy completion was significantly longer in 2020, likely due to the COVID-19 pandemic.

Conclusions

Studies of outcomes in those who declined or delayed colonoscopy in 2020 are needed to estimate the potential subsequent colorectal cancer disease burden.

目的描述无创检查（NIST）的使用趋势以及NIST阳性与诊断性结肠镜检查之间的间隔。方法采用回顾性时间趋势设计，研究了2019年1月至2021年6月印第安纳州两个大型综合医疗保健系统中NIST阳性患者的医疗记录，并量化了60、90和180天内未完成结肠镜检查的患者比例，以确定NIST结果与诊断性结肠镜检查之间的间隔天数。结果在1379例nist阳性患者中，930例（68%）在30个月的研究期间接受了诊断性结肠镜检查。与2019年相比，2020年结肠镜检查完成的中位时间明显更长(50天对37天，p <；0.01)和2021（46天，p = 0.06）。2019年、2020年和2021年FIT阳性后90天内完成结肠镜检查的患者比例分别为79%、83%和72% (p = 0.63)， FIT/DNA阳性后分别为86%、78%和84% （p = 0.07）。2020年完成诊断性结肠镜检查的中位时间明显更长，可能是由于COVID-19大流行。结论需要对2020年拒绝或延迟结肠镜检查的患者的结局进行研究，以估计潜在的后续结直肠癌疾病负担。

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引用次数: 0

Substituting time spent in physical activity and sedentary time and its association with cardiovascular disease among northwest Chinese adults 中国西北地区成年人体力活动和久坐时间的替代及其与心血管疾病的关系

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.pmedr.2024.102934

Yutong Wang , Peiying Yang , Huimeng Liu , Suixia Cao , Jingchun Liu , Yating Huo , Kun Xu , Binyan Zhang , Mengchun Wang , Qian Huang , Chunlai Yang , Lingxia Zeng , Shaonong Dang , Baibing Mi

Objectives

To examine the association between physical activity (PA) and leisure-time sedentary time and cardiovascular disease (CVD).

Methods

This cross-sectional study used baseline data from the Regional Ethnic Cohort Study in Northwest China from June 2018 to May 2019. PA and leisure-time sedentary time were self-reported. Logistic regression models analyzed the association of PA and leisure-time sedentary time with CVD prevalence individually and jointly. Restricted cubic spline analyses assessed dose-response relationships. Isotemporal substitution models were used to investigate substituting leisure-time sedentary time, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with CVD prevalence.

Results

The prevalence of CVD was 31.8 %. Compared to the lowest quartile, participants in the highest quartile of total PA had a 32 % lower CVD prevalence (odds ratio [OR]: 0.68, 95 % confidence interval [CI]: 0.62–0.74; P for trend <0.001). The fully adjusted OR for the highest quartile of leisure-time sedentary time compared to the lowest quartile was 1.09 (1.01–1.18; P for trend =0.04). An L-shaped dose-response relationship was observed between PA and CVD prevalence. An active lifestyle and reduced daily leisure-time sedentary time were associated with a 26 % (0.74 [0.63–0.86]) lower CVD prevalence. Additionally, substituting 30 min/day of leisure-time sedentary time with equivalent MVPA was associated with a 2 % (0.98 [0.97–0.99]) reduction in CVD prevalence. Substituting sedentary time with LPA was associated with a lower CVD prevalence in females.

Conclusions

An active lifestyle was associated with a lower prevalence of CVD in regional populations, suggesting a feasible strategy for CVD prevention and regional health promotion.

目的探讨体力活动（PA）和休闲时间久坐与心血管疾病（CVD）的关系。方法本横断面研究使用2018年6月至2019年5月中国西北地区区域民族队列研究的基线数据。PA和休闲时间久坐时间是自我报告的。Logistic回归模型分析了PA和休闲时间久坐时间与CVD患病率单独和共同的关系。限制三次样条分析评估了剂量-反应关系。使用等时间替代模型来研究休闲时间久坐时间、轻度身体活动（LPA）和中度至剧烈身体活动（MVPA）与心血管疾病患病率的替代关系。结果CVD患病率为31.8%。与最低四分位数相比，总PA最高四分位数的参与者心血管疾病患病率降低32%(优势比[OR]: 0.68, 95%可信区间[CI]: 0.62-0.74；P代表趋势<；0.001)。休闲时间久坐时间的最高四分位数与最低四分位数的完全调整OR为1.09 (1.01-1.18；P代表趋势=0.04)。PA与CVD患病率呈l型剂量-反应关系。积极的生活方式和每天减少的休闲时间久坐与心血管疾病患病率降低26%（0.74[0.63-0.86]）相关。此外，用相等的MVPA代替30分钟/天的休闲久坐时间，心血管疾病患病率降低2%（0.98[0.97-0.99]）。用LPA代替久坐时间与女性较低的心血管疾病患病率相关。结论积极的生活方式可降低区域人群心血管疾病的患病率，为心血管疾病的预防和区域健康促进提供了可行的策略。

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引用次数: 0

Social isolation and loneliness and their association with all-cause mortality. A population-based longitudinal study in Norway: The Tromsø Study 1994–2023 社会隔离和孤独感及其与全因死亡率的关系。挪威一项基于人口的纵向研究：特罗姆瑟研究 1994-2023

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2024-11-20 DOI: 10.1016/j.pmedr.2024.102930

Ola Løvsletten, Tormod Brenn

Objectives

Loneliness and social isolation are associated with increased mortality, but few studies have assessed this association over long time in young adults.

Methods

The study sample comprised 9061 women and 8735 men aged 25 to 69 years who participated in the Tromsø4 survey (1994–95, baseline) of the Tromsø Study, Norway. A subset of the study sample also attended the Tromsø5 (2001), Tromsø6 (2007–08), and Tromsø7 (2015–16) surveys. Participants were followed up for all-cause mortality until November 2023; with 1630 women and 2099 men deceased. Information on social isolation (least isolated, modestly isolated, and most isolated) and loneliness (yes, no) were taken from self-administered questionnaires. Sex-specific, time-varying Cox models were employed, updating exposures and covariates from Tromsø5.

Results

Most-isolated versus least-isolated women and men had hazard ratios of 1.37 (95 % confidence interval 1.18–1.59) and 1.41 (1.25–1.60), respectively, after adjustment for covariates. These hazard ratios were higher in younger adults (HR = 1.55 in women and HR = 1.76 in men aged <50 years at baseline), though the age-isolation interaction was not statistically significant in women (P = 0.26), but in men (P = 0.01). For loneliness, the adjusted hazard ratios were 1.51 (1.23–1.87) and 1.46 (1.16–1.84). Over time, 51 % and 47 % of participants remained most isolated at Tromsø5 and Tromsø7, respectively; 25 % of those initially lonely remained so at Tromsø5, while only 2.6 % of those initially non-lonely became lonely at Tromsø5.

Conclusion

Both social isolation and loneliness are strongly associated with all-cause mortality, particularly among younger adults, underscoring their importance as public health concerns.

研究样本包括参加挪威特罗姆瑟研究的特罗姆瑟4调查（1994-95年，基线）的9061名女性和8735名男性，他们的年龄在25至69岁之间。研究样本的一部分还参加了特罗姆瑟5（2001年）、特罗姆瑟6（2007-08年）和特罗姆瑟7（2015-16年）调查。对参与者的全因死亡率进行了跟踪调查，直至 2023 年 11 月；其中有 1630 名女性和 2099 名男性死亡。有关社会隔离（最不隔离、适度隔离和最隔离）和孤独感（是、否）的信息来自自填问卷。结果在调整协变量后，最孤立与最不孤立的男女危险比分别为 1.37（95 % 置信区间为 1.18-1.59）和 1.41（1.25-1.60）。这些危险比在较年轻的成年人中更高（基线年龄为 50 岁的女性和男性的危险比分别为 1.55 和 1.76），尽管年龄与孤独的交互作用在女性（P = 0.26）和男性（P = 0.01）中没有统计学意义。孤独感的调整危险比分别为 1.51（1.23-1.87）和 1.46（1.16-1.84）。随着时间的推移，在特罗姆瑟5和特罗姆瑟7，分别有51%和47%的参与者仍处于最孤立的状态；在特罗姆瑟5，最初孤独的人中有25%仍处于孤独状态，而在特罗姆瑟5，最初不孤独的人中只有2.6%变得孤独。

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引用次数: 0

Anger and associated risk and protective factors among rural American adolescents: Implications for violence prevention 美国农村青少年的愤怒及相关风险和保护因素：对预防暴力的影响

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2024-11-19 DOI: 10.1016/j.pmedr.2024.102932

Rosalina Mills , Christa L. Lilly , Robin A. Pollini , Keith J. Zullig , Traci Jarrett , Alfgeir L. Kristjansson

Background

Adolescent violence in the United States is a prevalent public health problem and is understudied in rural settings. Anger is a significant risk factor for adolescent violence. To better craft adolescent violence interventions, it is important to examine anger and identify its most significant associated factors.

Aims

This study examined (1) self-reported anger changes over time for rural American adolescents; and (2) structural, community, interpersonal, and individual level factors that may contribute to anger.

Methods

We analyzed self-reported survey data from West Virginian middle schoolers (N = 2861) with anger as the outcome. Data was collected twice yearly from October 2020 through April 2023. Independent variables included perceptions of inequality, individual socioeconomic status (SES), neighborhood characteristics, family structure, support from adults at home and school, and harsh parenting.

Analysis

Generalized estimating equation Poisson regression models for main effects and gender interaction were used. Parameter estimates were exponentiated and interpreted as Rate Ratios (RR). Self-reported gender was an effect modifier.

Results

Significant main effects included perceived inequality (RR = 0.98, 95 % CI = 0.97–0.99), SES (RR = 0.99, 95 % CI = 0.98–0.99), supportive adults at school (RR = 0.99, 95 % CI = 0.98–0.99), primary caregiver support (RR = 0.99, 95 % CI = 0.98–0.99), and harsh parenting (RR = 1.10, 95 % CI = 1.05–1.05). Significant gender interaction terms included perceived harsh parenting (RR = 0.98, 95 % CI = 0.97–0.99) and supportive adults at school (RR = 1.01, 95 % CI = 1.00–1.02) for ‘other’ genders (i.e., participants identifying as neither boy nor girl) compared to boys.

Conclusions

Findings underline the importance of examining rural adolescent anger development and associated risk factors for designing prevention approaches to curb downstream violent behavior.

背景美国的青少年暴力是一个普遍存在的公共健康问题，但对农村地区的青少年暴力问题研究不足。愤怒是青少年暴力的一个重要风险因素。为了更好地制定青少年暴力干预措施，研究愤怒并确定其最重要的相关因素非常重要。本研究探讨了（1）美国农村青少年自我报告的愤怒随时间的变化；以及（2）可能导致愤怒的结构、社区、人际和个人层面的因素。从 2020 年 10 月到 2023 年 4 月，我们每年收集两次数据。自变量包括对不平等的看法、个人社会经济地位（SES）、邻里特征、家庭结构、来自家庭和学校成人的支持以及严厉的养育方式。参数估计值经过指数化处理，并解释为比率（RR）。99）、学校成人的支持（RR = 0.99，95 % CI = 0.98-0.99）、主要照顾者的支持（RR = 0.99，95 % CI = 0.98-0.99）和严厉的养育（RR = 1.10，95 % CI = 1.05-1.05）。与男孩相比，"其他 "性别（即既非男孩也非女孩的参与者）的显著性别交互项包括感知到的严厉养育（RR = 0.98，95 % CI = 0.97-0.99）和学校成人的支持（RR = 1.01，95 % CI = 1.00-1.02）。

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引用次数: 0

Feasibility of interventions to increase HPV vaccination acceptability and coverage in school-based programs: Findings from a pilot study in Quebec, Canada 提高校本计划中 HPV 疫苗接种可接受性和覆盖率的干预措施的可行性：加拿大魁北克试点研究结果

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2024-11-19 DOI: 10.1016/j.pmedr.2024.102931

Maude Dionne , Chantal Sauvageau , Doriane Etienne , Holly O. Witteman , Ève Dubé

Introduction

Human papillomavirus (HPV) vaccines have been offered in Quebec schools to 4th-grade (9–10 years old) girls since 2008 and boys since 2016. HPV vaccine coverage does not reach the 90 % target in many regions. This project evaluated the feasibility and the acceptability of interventions to improve HPV vaccine acceptability and coverage in school-based programs.

Methods

The evaluation was conducted in 32 Quebec schools in 2019–2020. We tested a strategy of three interventions implemented in sequence (face-to-face information session, email reminder with an online decision support tool, and telephone reminder using motivational interviewing (MI) techniques). Parents and school staff completed online surveys. School nurses participated in individual interviews. Key stakeholders participated in a workshop to identify enabling conditions and barriers to implementing interventions across Quebec.

Results

The strategy was generally well-received by school staff, nurses, and parents. Many parents found the 3 interventions helpful to support their vaccination decision. Most parents (92 %) suggested that the face-to-face information session and the decision support tool (82 %) be offered to all parents. Nevertheless, delivering classroom presentations was perceived by nurses as logistically challenging. Parents were generally satisfied with the telephone reminder, but only a limited number of nurses applied motivational interviewing techniques, as half (51 %) of unreturned consent forms were due to forgetfulness.

Conclusion

Our strategy was accepted and deemed feasible by a majority of parents, school staff, and nurses. Collaboration between health authorities and schools is essential for implementing interventions to enhance vaccine acceptance in school-based programs.

导言自 2008 年起，魁北克省学校开始为四年级（9-10 岁）女生接种人类乳头瘤病毒 (HPV) 疫苗，自 2016 年起开始为男生接种。在许多地区，HPV 疫苗覆盖率未达到 90% 的目标。本项目评估了干预措施的可行性和可接受性，以提高校本项目中 HPV 疫苗的可接受性和覆盖率。我们测试了依次实施的三种干预策略（面对面信息交流会、带有在线决策支持工具的电子邮件提醒以及使用动机访谈（MI）技术的电话提醒）。家长和学校教职员工完成了在线调查。学校护士参加了个别访谈。主要利益相关者参加了一个研讨会，以确定在魁北克各地实施干预措施的有利条件和障碍。许多家长认为这 3 项干预措施有助于支持他们的疫苗接种决定。大多数家长（92%）建议向所有家长提供面对面的信息交流会和决策支持工具（82%）。然而，护士们认为在课堂上进行讲解在后勤方面具有挑战性。家长们普遍对电话提醒表示满意，但只有少数护士采用了动机访谈技术，因为半数（51%）未交回的同意书是由于遗忘造成的。卫生部门和学校之间的合作对于实施干预措施以提高校本项目中疫苗的接受度至关重要。

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引用次数: 0

Survival benefit of metformin use according to cancer diagnosis in diabetic patients with metabolic syndrome 根据代谢综合征糖尿病患者的癌症诊断结果使用二甲双胍对其生存的益处

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2024-11-15 DOI: 10.1016/j.pmedr.2024.102928

Ji Soo Park , Soo Jin Moon , Hyung Seok Park , Sang-Hoon Cho

Background

Metabolic syndrome (MetSyn) is a disease cluster causing cardiovascular disease, cancer, and high mortality. Metformin is the most common antidiabetic agent inhibiting the tumorigenesis and insulin resistance of MetSyn. We describe the association between metformin intake and survival of patients with type 2 diabetes mellitus (T2DM) and MetSyn, according to the presence of cancer.

Methods

We analyzed the clinical characteristics and all-cause mortality of patients with T2DM and MetSyn using a 5-year dataset between January 1, 2009 and December 31, 2013 derived from the Korean National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS). Cox proportional hazards regression models were used to investigate metformin effects adjusted for other potential confounding variables.

Results

Among a total of 43,043 patients with both MetSyn and T2DM, 24,725 patients (57.4 %) received metformin regularly. Female sex, high income, regular exercise, and metformin use were good prognostic factors, whereas hypertension, current smoking, cancer, and diabetes medication (except metformin) were poor prognostic factors. After adjustment for possible confounding variables, metformin showed a significant effect on patient survival (hazard ratio [HR], 0.68; 95 % confidence interval [CI], 0.63–0.75; p < 0.001). The effect of metformin was pronounced on the group of patients with liver, lung, colorectal, or prostate cancers (HR, 0.57; CI, 0.46–0.70).

Conclusions

Metformin intake may be related to favorable survival among patients with T2DM and MetSyn. The efficacy might be more remarkable in those with liver, lung, colorectal, and prostate cancers. The potential benefit of metformin in patients with these risk factors should be further investigated.

背景代谢综合征（MetSyn）是一种导致心血管疾病、癌症和高死亡率的疾病群。二甲双胍是最常见的抗糖尿病药物，可抑制代谢综合征的肿瘤发生和胰岛素抵抗。我们利用韩国国民健康保险服务-国民健康筛查队列（NHIS-HEALS）中 2009 年 1 月 1 日至 2013 年 12 月 31 日的 5 年数据集，分析了 T2DM 和 MetSyn 患者的临床特征和全因死亡率。结果在43043名同时患有MetSyn和T2DM的患者中，有24725名患者（57.4%）定期服用二甲双胍。女性、高收入、经常锻炼和服用二甲双胍是预后良好的因素，而高血压、目前吸烟、癌症和糖尿病药物（二甲双胍除外）则是预后不良的因素。在对可能的混杂变量进行调整后，二甲双胍对患者的存活率有显著影响（危险比[HR]，0.68；95%置信区间[CI]，0.63-0.75；p <0.001）。二甲双胍对肝癌、肺癌、结直肠癌或前列腺癌患者的影响更为明显（HR，0.57；CI，0.46-0.70）。结论二甲双胍的摄入可能与T2DM和MetSyn患者的生存率有关，对肝癌、肺癌、结直肠癌和前列腺癌患者的疗效可能更为显著。应进一步研究二甲双胍对具有这些风险因素的患者的潜在益处。

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引用次数: 0

High prevalence and seasonal patterns of vitamin D deficiency in children and adolescents in Central China: a three-year single-center study 华中地区儿童和青少年维生素 D 缺乏症的高流行率和季节性模式：一项为期三年的单中心研究

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2024-11-13 DOI: 10.1016/j.pmedr.2024.102929

Lei Xi , Xiaomei Wang , Jingjing Rao, Ye Zeng, Yun Xiang, Changzhen Li

Objective

This study aimed to determine the prevalence and associated factors of vitamin D deficiency and insufficiency in children and adolescents in Central China.

Methods

In total, 8,248 children and adolescents aged 0–18 years at a children’s hospital from January 2019 to February 2022, were recruited. Their serum vitamin D levels were measured, and monthly meteorological and air pollution data were collected.

Results

The overall mean serum vitamin D level was 37.7 ± 17.7 ng/mL, and the prevalence of vitamin D deficiency and insufficiency was 17.7 % and 23.4 %, respectively. Children aged 13–18 years had the highest vitamin D deficiency rate (64.1 %) and the lowest sufficiency rate (4.8 %). The incidence of vitamin D deficiency in girls, especially those aged 6–13 years and 13–18 years, was higher compared to boys. The highest prevalence of vitamin D deficiency was observed in winter (23.2 %), whereas the lowest was found in autumn (12.0 %). Vitamin D insufficiency was most prevalent in summer (27.0 %), significantly higher than in other seasons. Girls were more prone than boys to vitamin D deficiency in spring and summer. Stepwise multiple linear regression analysis showed a positive correlation between vitamin D levels, nitrogen dioxide concentrations, and sunshine hours and a negative correlation with particulate matter 2.5 (PM2.5).

Conclusion

Our study found high vitamin D deficiency among children in central China, especially girls aged 13–18. Strategies should include promoting sunlight, reducing air pollution, and considering supplementation, particularly in spring and summer.

方法从2019年1月至2022年2月，在一家儿童医院共招募了8248名0-18岁的儿童和青少年，测量他们的血清维生素D水平，并收集每月的气象和空气污染数据。结果血清维生素D总平均水平为（37.7±17.7）纳克/毫升，维生素D缺乏率为17.7%，维生素D不足率为23.4%。13-18 岁儿童的维生素 D 缺乏率最高（64.1%），充足率最低（4.8%）。与男孩相比，女孩，尤其是 6-13 岁和 13-18 岁女孩的维生素 D 缺乏率更高。维生素 D 缺乏症发病率最高的是冬季（23.2%），最低的是秋季（12.0%）。维生素 D 不足在夏季最为普遍（27.0%），明显高于其他季节。在春季和夏季，女孩比男孩更容易缺乏维生素 D。逐步多元线性回归分析表明，维生素 D 水平、二氧化氮浓度和日照时间呈正相关，而与颗粒物 2.5（PM2.5）呈负相关。应采取的策略包括促进日照、减少空气污染，并考虑补充维生素 D，尤其是在春季和夏季。

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引用次数: 0