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Association between behavioral jet lag with subjective and objective circadian rhythm among Chinese young adults 中国年轻人行为时差与主客观昼夜节律的关系
IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2025.117689
Yu-xiang Xu , Jing Li , Yu-hui Wan , Pu-yu Su , Fang-biao Tao , Ying Sun

Background

Behavioral jet lags (social and eating jet lag), the difference in sleep and eating time between weekdays and weekends, are ubiquitous in modern society. However, evidence on the effects of behavioral jet lags on circadian rhythm is limited.

Methods

Social jet lag was assessed using wrist-worn accelerometers. Eating jet lag was measured through Tencent online form with the method of ecological momentary assessment. Total jet lag was calculated as social jet lag plus eating jet lag. Participants were divided into 3 behavioral jet lag patterns: low (both social and eating jet lag < 1h), medium (social or eating jet lag ≥ 1h), and high (both social and eating jet lag ≥ 1h). Subjective and objective circadian rhythm were assessed by reduced Morningness-Eveningness Questionnaire (rMEQ)-based chronotype and the dim light melatonin onset (DLMO) time in 7 saliva samples, respectively.

Results

The mean age of the sample (n = 140) was 20.7 ± 0.8 years, and 60% were women. Compared to low behavioral jet lag group, medium and high behavioral jet lag group exhibited lower rMEQ score and later DLMO time. Each hour increase in social jet lag was associated with 2.27 point-decrease of rMEQ score, and 24 min-delay of DLMO time; each hour increase in eating jet lag was associated with 1.71 point-decrease of rMEQ score, and 28 min-delay of DLMO time; each hour increase in total jet lag was associated with 1.08 point-decrease of rMEQ score, and 17 min-delay of DLMO time (all P-values <0.05). Additionally, social jet lag explained 6.7% of the variance in the timing of DLMO, which was higher than eating jet lag (4.2%).

Conclusion

Higher behavioral jet lags were significantly associated with increased risk of circadian disruption among young adults. Maintaining consistency in daily behavioral cycles may be an effective intervention for the prevention of circadian disruption.
背景:行为时差(社交和饮食时差),即工作日和周末之间睡眠和饮食时间的差异,在现代社会中无处不在。然而,关于行为时差对昼夜节律影响的证据有限。方法:使用腕带加速度计评估社会时差。进食时差通过腾讯在线表格测量,采用生态瞬时评价法。总时差计算为社交时差加上饮食时差。参与者被分为3种行为时差模式:低(社交和饮食时差< 1小时)、中等(社交或饮食时差≥1小时)和高(社交和饮食时差≥1小时)。采用减少早晚性问卷(rMEQ)的时间型和昏暗褪黑激素(DLMO)起效时间分别评估7份唾液样本的主观和客观昼夜节律。结果:本组患者平均年龄(n = 140)为20.7±0.8岁,女性占60%。与低行为时差组相比,中、高行为时差组rMEQ得分较低,DLMO时间较晚。社交时差每增加1小时,rMEQ评分降低2.27分,DLMO时间延迟24 min;进食时差每增加1小时,rMEQ评分下降1.71分,DLMO时间延迟28 min;总时差每增加1小时,rMEQ评分降低1.08点,DLMO时间延迟17 min (p值均为p值)。结论:较高的行为时差与年轻人昼夜节律紊乱风险增加显著相关。维持日常行为周期的一致性可能是预防昼夜节律中断的有效干预措施。
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引用次数: 0
Housing hardship and health: Longitudinal evidence of the mediating role of health behaviors 住房困难与健康:健康行为中介作用的纵向证据。
IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2025.117702
Keun Young Kwon , Jinho Kim
Housing instability is widely recognized as a major environmental factor that significantly shapes both health and overall well-being. This study added to the existing literature by examining the longitudinal relationship between housing-related hardship and self-rated health. Moreover, this study explored health behaviors—specifically substance use and lifestyle behaviors—as potential mediators that link housing hardship to health. Using data from Waves I, III, IV, and V of the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study estimated regression models with lagged dependent variables (LDVs) and conducted Sobel tests to formally assess mediation. In the LDV model, housing hardship in Wave III is longitudinally associated with lower self-rated health in Wave V. This relationship remained significant (p = 0.012), though it was substantially attenuated after adjusting for a comprehensive set of confounders, including personal earnings and educational attainment. Smoking emerged as the most significant mediator, accounting for approximately 26% (p < 0.001) of the association, while unhealthy eating behaviors and marijuana use explained 13% (p < 0.001) and 8% (p = 0.008), respectively. Binge drinking and physical activity did not significantly mediate the association. Collectively, the proposed mediating variables explained 34% (p < 0.001) of the association between housing hardship and self-rated health. These findings highlight the importance of tackling both the material aspects of housing hardship and the unhealthy coping mechanisms it fosters to more effectively improve the well-being of individuals experiencing housing instability.
住房不稳定被广泛认为是影响健康和整体福祉的主要环境因素。本研究在现有文献的基础上,进一步探讨了住房相关困难与自评健康之间的纵向关系。此外,本研究还探讨了健康行为——特别是物质使用和生活方式行为——作为住房困难与健康之间联系的潜在中介。本研究使用国家青少年到成人健康纵向研究(Add Health)第一、三、四、五波的数据,估计了具有滞后因变量(ldv)的回归模型,并进行了Sobel检验来正式评估中介作用。在LDV模型中,第三波中的住房困难与第五波中较低的自评健康水平纵向相关,这种关系仍然显著(p = 0.012),尽管在调整了包括个人收入和受教育程度在内的一系列综合混杂因素后,这种关系大大减弱。吸烟成为最重要的中介因素,约占26% (p
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引用次数: 0
Patterns of socioeconomic marginalization and non-fatal overdose among people who use drugs: A gender-stratified repeated measures latent class analysis 吸毒者中社会经济边缘化和非致命过量的模式:一种性别分层重复测量潜在类分析。
IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2024.117661
Sanjana Mitra , Lindsey Richardson , Zishan Cui , Mark Gilbert , M.-J. Milloy , Kanna Hayashi , Thomas Kerr

Background

While marked gender-based differences in drug-related risk and harm between men women who use drugs have been characterized to some extent, the complex relationship between gendered socioeconomic conditions, overdose risk, and drug use patterns and behaviours remains underexplored.

Methods

We conducted gender-stratified repeated measures latent class analyses (RMLCA) with data from two ongoing cohorts of people who use drugs in Vancouver, Canada to identify discrete subgroups based on socioeconomic exposures. Multivariable generalized estimating equations models weighted by the respective posterior membership probabilities were applied to estimate the associations between socioeconomic class membership and non-fatal overdose. Sub-analyses investigated whether these relationships were explained by drug use-related variables.

Results

Between June 2014 and March 2020, 1723 participants provided 12120 observations. At study baseline, 1074 (62.3%) were men and 649 (37.7%) were women. In RMLCA, five distinct profiles of socioeconomic exposures emerged for men, and four emerged for women. Classes were presented in ascending order of socioeconomic disadvantage (i.e., ranging from Class 1 [least disadvantage] to Class 4/Class 5 [most disadvantage]) and were primarily distinguished by variations in income, material and housing in/security, participation in illegal/informal income generation, and criminal justice involvement. In analyses adjusting for demographic characteristics, for both men and women, progressive increases in exposure to multiple dimensions of disadvantage were positively and independently associated with non-fatal overdose when compared to the least socioeconomically disadvantaged subgroup. Subsequent analyses revealed that systematic differences in drug use patterns and behaviours across categories of socioeconomic disadvantage largely accounted for these relationships.

Conclusions

Addressing multiple forms of mutually reinforcing health inequities may offer additional opportunity to mitigate non-fatal overdose in men and women who use drugs.
背景:虽然在某种程度上已经确定了男性和女性吸毒者在药物相关风险和伤害方面的显著性别差异,但性别社会经济条件、过量风险和药物使用模式和行为之间的复杂关系仍未得到充分探讨。方法:我们对加拿大温哥华两个正在进行的药物使用人群的数据进行了性别分层重复测量潜在类分析(RMLCA),以确定基于社会经济暴露的离散亚组。应用由各自的后验隶属度概率加权的多变量广义估计方程模型来估计社会经济阶层隶属度与非致命性过量用药之间的关系。亚分析调查了这些关系是否可以用药物使用相关变量来解释。结果:2014年6月至2020年3月期间,1723名参与者提供了12120项观察结果。在研究基线时,男性为1074例(62.3%),女性为649例(37.7%)。在RMLCA中,男性出现了五种不同的社会经济暴露概况,女性出现了四种。阶级按社会经济劣势的升序呈现(即从1级[最低劣势]到4级/ 5级[最劣势]),并主要通过收入、物质和住房/安全、参与非法/非正式创收和刑事司法参与等方面的差异来区分。在调整人口统计学特征的分析中,对于男性和女性来说,与社会经济上最不利的亚组相比,暴露于多种不利因素的逐渐增加与非致命性药物过量呈正相关且独立相关。随后的分析显示,不同社会经济劣势类别的药物使用模式和行为的系统性差异在很大程度上解释了这些关系。结论:解决多种形式的相互加强的卫生不公平现象,可能会为减少男性和女性药物使用者的非致命性过量提供更多机会。
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引用次数: 0
Grandparental childcare and subjective well-being: The role of activities and reasons for care
IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2025.117711
Karen Glaser , Giorgio Di Gessa
Despite extensive research on the impact of grandchild care on grandparents' well-being, no studies have examined the frequency of activities that grandparents engage in with their grandchildren or the reasons for care using nationally representative data. We address this gap using waves 8 (2016/2017) and 9 (2018/19) of the English Longitudinal Study of Ageing, a nationally representative study of English older adults. We employ hybrid regression models to distinguish between within- and between-individual effects on grandparents’ subjective wellbeing, as captured by quality of life and depressive symptoms. Our findings show that the mostly positive relationships between frequency of grandparental activities and reasons for care and well-being are largely due to between-grandparent differences rather than within-grandparent changes over time. Within-grandparent analyses show a mostly non-significant impact of increased grandparental activities on well-being, except for a detrimental effect when grandchildren stay overnight or are cared for when sick. The influence of reasons for care are more nuanced. Changes in reasons, such as giving parents a break or allowing them to go out in the evening, are significantly associated with a worsening of elevated depressive symptoms. Conversely, changes such as helping grandchildren develop as people or feeling engaged with young people improve the quality of life for the same grandparents over time. When grandparental care is provided because it is difficult to refuse we find a negative association with well-being between grandparents. Overall, our findings highlight the importance of more detailed information on grandparent-grandchild interactions and reasons for care to better understand well-being outcomes.
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引用次数: 0
Are we ready for the next pandemic? Public preferences and trade-offs between vaccine characteristics and societal restrictions across 21 countries
IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2025.117687
Marcello Antonini , Mesfin G. Genie , Katie Attwell , Arthur E. Attema , Jeremy K. Ward , Alessia Melegaro , Aleksandra Torbica , Brian Kelly , Chiara Berardi , Ana Rita Sequeira , Neil McGregor , Adrian Kellner , Shuli Brammli-Greenberg , Madeleine Hinwood , Liubovė Murauskienė , Daiga Behmane , Zsolt J. Balogh , Terje P. Hagen , Francesco Paolucci
In vaccination decisions, individuals must weigh the benefits against the risks of remaining unvaccinated and potentially facing social restrictions. Previous studies have focused on individual preferences for vaccine characteristics and societal restrictions separately. This study aims to quantify public preferences and the potential trade-offs between vaccine characteristics and societal restrictions, including lockdowns and vaccine mandates, in the context of a future pandemic. We conducted a discrete choice experiment (DCE) involving 47,114 respondents from 21 countries between July 2022 and June 2023 through an online panel. Participants were presented with choices between two hypothetical vaccination programs and an option to opt-out. A latent class logit model was used to estimate trade-offs among attributes. Despite some level of preference heterogeneity across countries and respondents’ profiles, we consistently identified three classes of respondents: vaccine refusers, vaccine-hesitant, and pro-vaccine individuals. Vaccine attributes were generally deemed more important than societal restriction attributes. We detected strong preferences for the highest levels of vaccine effectiveness and for domestically produced vaccines across most countries. Being fully vaccinated against COVID-19 was the strongest predictor of pro-vaccine class preferences. Women and younger people were more likely to be vaccine refusers compared to men and older individuals. In some countries, vaccine hesitancy and refusal were linked to lower socioeconomic status, whereas in others, individuals with higher education and higher income were more likely to exhibit hesitancy. Our findings emphasize the need for tailored vaccination programs that consider local contexts and demographics. Building trust in national regulatory authorities and international organizations through targeted communication, along with investing in domestic production facilities, can improve vaccine uptake and enhance public health responses in the future.
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引用次数: 0
Gender differences in later life: Labor supply responses to spousal disability 晚年生活中的性别差异:劳动力供给对配偶残疾的反应。
IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2024.117638
Liping Fu , Ruizhen Wang , Chaoying He
This study uses panel data from the 2011, 2013, 2015, 2018, and 2020 China Health and Retirement Longitudinal Study to examine the labor supply effects of spousal disability in later life. Employing a staggered difference-in-differences strategy, we provide causal evidence of gender-specific impacts, with a significant and enduring negative effect on female employment lasting over eight years, in contrast to minimal changes for males. The negative effect on female employment is particularly pronounced among low-educated individuals, those with agricultural hukou, and those influenced by stronger Confucian cultural norms. Mechanism analysis attributes the gender disparity to the caregiving effect and the health effect, with females experiencing increased caregiving responsibilities and health deterioration. We do not find enough evidence to support the added worker effect and the joint leisure effect. Furthermore, following the death of a disabled spouse, both genders exhibit an increased withdrawal from the labor market, with females increasingly assuming grandchild care responsibilities. These findings reveal the persistent gender differences in later life and suggest that policy interventions should prioritize the equitable allocation of social welfare resources to mitigate caregiving burdens faced by older women.
本研究使用2011年、2013年、2015年、2018年和2020年中国健康与退休纵向研究的面板数据来检验配偶晚年残疾对劳动力供给的影响。采用交错差异策略,我们提供了性别特定影响的因果证据,与男性的微小变化相比,女性就业受到持续八年以上的显著而持久的负面影响。对女性就业的负面影响在受教育程度低的个体、农业户口和受儒家文化规范影响的个体中尤为明显。机制分析将性别差异归因于照顾效应和健康效应,女性的照顾责任增加,健康状况恶化。我们没有找到足够的证据来支持额外的工人效应和共同闲暇效应。此外,在残疾配偶死亡后,男女都越来越多地退出劳动力市场,女性越来越多地承担起照顾孙子的责任。这些发现揭示了老年妇女在晚年生活中持续存在的性别差异,并建议政策干预应优先考虑社会福利资源的公平分配,以减轻老年妇女面临的照顾负担。
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引用次数: 0
Life course social mobility and cognitive function among middle-aged and older adults in India: Exploring heterogeneity by gender 印度中老年人的生命历程、社会流动性和认知功能:按性别探索异质性。
IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2024.117640
Soohyeon Ko , Hannah Oh , S.V. Subramanian , Rockli Kim
This study investigates the link between life course social mobility and cognitive function among middle-aged and older adults in India, specifically emphasizing whether upward and downward mobility exerts symmetric associations and potential gender heterogeneity within these associations. Leveraging data from the Longitudinal Aging Study in India 2017–2018, encompassing 64,710 individuals aged 45 years or above, we classified social mobility as ‘consistently high,’ ‘upward mobility,’ ‘downward mobility,’ and ‘consistently low,’ based on socioeconomic position during childhood and late adulthood. Multivariable regression and gender-interaction analyses were employed to assess associations. Overall, 35.69% maintained a consistently high socioeconomic position, whereas 22.87% remained consistently low; 20.05% experienced upward mobility, and 21.39% faced downward mobility. Compared to consistently high socioeconomic position, consistently low socioeconomic position was associated with lower cognitive function (b = −1.47; 95% CI = −1.59, −1.34), followed by downward mobility (b = −0.84; 95% CI = −0.95, −0.72) and upward mobility (b = −0.72; 95% CI = −0.84, −0.61). Notably, the interaction model revealed significant differences by gender, especially between opposite social mobility groups. Among men, upward and downward mobility displayed asymmetric associations, with upward mobility being associated with a higher cognitive function than downward mobility (b = 0.31; 95% CI = 0.13, 0.50), whereas such differences were not observed for women (b = −0.01; 95% CI = −0.20, 0.17). These findings highlight the critical influence of life course social mobility on cognitive health, with implications for interventions tailored to the unique trajectories of social mobility by gender in India.
本研究调查了印度中老年人群一生中社会流动与认知功能之间的联系,特别强调了向上和向下流动是否会产生对称关联,以及这些关联中潜在的性别异质性。利用2017-2018年印度纵向老龄化研究的数据,我们根据儿童和成年后期的社会经济地位,将社会流动性分为“持续高”、“向上流动”、“向下流动”和“持续低”。采用多变量回归和性别相互作用分析来评估相关性。总体而言,35.69%的人保持较高的社会经济地位,22.87%的人保持较低的社会经济地位;20.05%的人向上流动,21.39%的人向下流动。与持续较高的社会经济地位相比,持续较低的社会经济地位与较低的认知功能相关(b = -1.47;95% CI = -1.59, -1.34),其次是向下流动(b = -0.84;95% CI = -0.95, -0.72)和上进心(b = -0.72;95% ci = -0.84, -0.61)。值得注意的是,互动模型揭示了性别之间的显著差异,特别是在相反的社会流动群体之间。在男性中,向上和向下流动表现出不对称的关联,向上流动比向下流动具有更高的认知功能(b = 0.31;95% CI = 0.13, 0.50),而在女性中没有观察到这种差异(b = -0.01;95% ci = -0.20, 0.17)。这些发现强调了生命历程中社会流动对认知健康的关键影响,对针对印度按性别划分的独特社会流动轨迹进行干预具有启示意义。
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引用次数: 0
The experiences in close relationship and internet addiction among college Students: A moderated mediation model of anxiety and information cocoon 大学生的亲密关系经历与网络成瘾:焦虑与信息茧的中介模型。
IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2024.117641
Yuan Luo , Yuqian Deng , Yibo Wu , Jiaxin Liu , Haiye Ran , Jie Yuan , Liping Zhao

Background and aims

Internet addiction is one of the most serious behavioral addiction problems affecting the physical and mental health of college students. A model is constructed to reveal the mediating role of anxiety and the moderating role of information cocoons in the relationship between the experiences in close relationship and internet addiction among college students in this article.

Methods

A cross-sectional survey investigated 2946 college students in China who had experienced close romantic relationships. A questionnaire was used to measure the general information, the experiences in close relationship, internet addiction, anxiety, information cocoons among participants.

Results

The poorer experiences in close relationship were directly associated with a higher risk of internet addiction among college students. Anxiety mediated the relationship between the experiences in close relationship and internet addiction. Additionally, the information cocoon was also found to moderate an indirect effect: a higher level of information cocoons diminished the impact of the experiences in close relationship on anxiety, while information cocoons intensified the association between anxiety and internet addiction.

Conclusions

A positive close relationship can alleviate anxiety and thereby help prevent internet addiction. Meanwhile, various interventions should be implemented to avoid falling into the information cocoons to promote mental health and reduce internet addiction among college students.
背景与目的:网络成瘾是影响大学生身心健康的最严重的行为成瘾问题之一。本文构建了一个模型来揭示焦虑在大学生亲密关系体验与网络成瘾关系中的中介作用和信息茧的调节作用。方法:采用横断面调查法对2946名有过亲密恋爱经历的大学生进行调查。采用问卷调查的方法对被试的一般信息、亲密关系经历、网络成瘾、焦虑、信息茧等进行了测量。结果:大学生的亲密关系体验越差,其网络成瘾风险越高。焦虑在亲密关系体验与网络成瘾之间起中介作用。此外,研究还发现,信息茧还会调节一种间接效应:高水平的信息茧会降低亲密关系经历对焦虑的影响,而信息茧则会加剧焦虑与网络成瘾之间的联系。结论:积极的亲密关系可以缓解焦虑,从而有助于预防网络成瘾。同时,应采取多种干预措施,避免陷入信息茧中,促进大学生心理健康,减少网络成瘾。
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引用次数: 0
Corrigendum to 'Does the UK-public's aversion to inequalities in health differ by group-labelling and health-gain type? A choice-experiment' [Soc. Sci. Med. Volume 269, January 2021, 113573]. 英国公众对健康不平等的厌恶程度因群体标签和健康收益类型而异?选择实验"[《社会科学-医学》第 269 卷,2021 年 1 月,113573]。
IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2024.117248
Simon McNamara, Aki Tsuchiya, John Holmes
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引用次数: 0
“We use it a lot for everything”: Antibioticalization and everyday life in a refugee camp in Lebanon “我们在所有事情上都使用它”:黎巴嫩难民营的抗生素和日常生活。
IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2024.117652
Amanda Hylland Spjeldnæs , Livia Wick , Heidi E. Fjeld , Anne Kveim Lie
Increasing rates of antimicrobial resistance has accelerated global efforts to reduce antibiotic use. While antibiotic resistance poses a significant threat, especially in low-income settings, there is a scarcity of research on how people in such environments, including refugee camps, access and use antibiotics. This article explores factors that contribute to the shaping of antibiotic use in Shatila refugee camp in Lebanon. It is based on six months of fieldwork from October 2021 to April 2022 in Shatila, consisting of participant observation, semi-structured interviews and group workshops with 32 camp residents and health workers. Following the onset of the Syrian war in 2011, the number of informal pharmacies and Syrian medicines boomed in Shatila. Aiming to describe and analyze how camp residents access and use antibiotics, we address two main themes: 1) the omnipresence of antibiotics in a context of scarcity, and 2) antibiotics as a panacea – a quick-fix for everyday ailments. Antibiotic consumption patterns in Shatila are formed by a scarcity of quality healthcare services on the one hand, and an omnipresence of antibiotics on the other. We demonstrate that in this loosely regulated context, where pharmaceuticals are bought over-the-counter; there is extensive antibiotic consumption. Camp residents often self-medicate with antibiotics for a wide range of purposes, extending beyond the treatment of infections. The high consumption of antibiotics will increase the level of antimicrobial resistance and pose a risk to the camp residents by disturbing local microbiomes and the amount of resistant genes (the resistome) in the environment, thus leading to new potential health risks. Building on theories of pharmaceuticalization and social suffering, we propose the concept of “antibioticalization.” This distinct form of pharmaceuticalization is characterized by the pervasive and generalized use of antibiotics, especially in contexts of healthcare and resource scarcity.
不断增加的抗菌素耐药性加速了全球减少抗生素使用的努力。虽然抗生素耐药性构成重大威胁,特别是在低收入环境中,但缺乏关于包括难民营在内的这种环境中的人们如何获得和使用抗生素的研究。本文探讨了影响黎巴嫩沙提拉难民营抗生素使用的因素。该报告基于2021年10月至2022年4月在夏提拉进行的为期6个月的实地考察,包括参与观察、半结构化访谈和与32名营地居民和卫生工作者的小组讲习班。2011年叙利亚战争爆发后,沙提拉的非正规药店和叙利亚药品数量激增。为了描述和分析营地居民如何获取和使用抗生素,我们讨论了两个主要主题:1)在稀缺的背景下抗生素无处不在,2)抗生素作为万灵药-一种快速解决日常疾病的方法。沙提拉的抗生素消费模式一方面是由于缺乏高质量的卫生保健服务,另一方面是由于抗生素无处不在。我们证明,在这种监管松散的情况下,药品是非处方购买的;大量使用抗生素。难民营的居民经常出于多种目的自行使用抗生素,而不仅仅是治疗感染。抗生素的大量消耗将增加抗菌素耐药性水平,并通过扰乱当地微生物组和环境中耐药基因(抗性组)的数量,对营地居民构成风险,从而导致新的潜在健康风险。在药物化和社会苦难理论的基础上,我们提出了“抗生素化”的概念。这种独特的药物化形式的特点是抗生素的普遍和广泛使用,特别是在卫生保健和资源稀缺的情况下。
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引用次数: 0
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