Social Science & Medicine最新文献_第3页

The entangled temporalities of a forgotten disease: Making sense of the 2025 measles resurgence in the U.S. and Canada 一种被遗忘的疾病的纠缠的时间性：理解2025年麻疹在美国和加拿大的复苏。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-02-08 DOI: 10.1016/j.socscimed.2026.119089

Yanqiu Rachel Zhou

Measles outbreaks in high-income countries underscore the complex temporalities of this vaccine-preventable and all but forgotten disease. They challenge linear assumptions about the relationship between vaccine availability and disease eradication, exposing weakened public risk perception and declining vaccination uptake. Focusing on the 2025 measles outbreaks in the United States and Canada, this article explores, through a temporal lens, how the disease's return is discussed on Reddit, an online platform for public discussion. The analysis uncovers multi-scalar and entangled temporalities (e.g. historical memory, generational amnesia, political timing, and future uncertainty) that shape public understanding of measles. While vaccines remain a powerful technological intervention, their efficacy is contingent upon such social, cultural, and political factors as collective memory, institutional trust, and social solidarity. In this context, memories and historical narratives of measles and its vaccination emerge as counter-narratives to rising institutional skepticism and vaccine hesitancy. Unlike in previous eras, the intensifying politicization of vaccination in increasingly divided societies now risks normalizing diseases once effectively controlled. This temporal analysis of measles' resurgence reveals distinct yet potentially hopeful dynamics: although its future is enmeshed in contemporary challenges, its past—recalled through generational storytelling—may enable more nuanced approaches to public engagement and health communication.

高收入国家的麻疹疫情突出表明，这种疫苗可预防的、几乎被遗忘的疾病具有复杂的时代性。它们挑战了关于疫苗供应与疾病根除之间关系的线性假设，暴露出公众风险认知减弱和疫苗接种率下降。本文以2025年美国和加拿大的麻疹疫情为重点，通过时间的视角，探讨了公众讨论在线平台Reddit上如何讨论这种疾病的回归。该分析揭示了影响公众对麻疹理解的多尺度和纠缠的时间性（例如，历史记忆、代际遗忘、政治时机和未来不确定性）。虽然疫苗仍然是一种强有力的技术干预措施，但其效力取决于集体记忆、机构信任和社会团结等社会、文化和政治因素。在这种背景下，关于麻疹及其疫苗接种的记忆和历史叙述成为对不断上升的机构怀疑和疫苗犹豫的反叙述。与以往不同的是，在日益分化的社会中，疫苗接种日益政治化，现在有可能使曾经得到有效控制的疾病正常化。对麻疹卷土重来的时间分析揭示了独特而又可能充满希望的动态：尽管它的未来与当代挑战交织在一起，但它的过去——通过世代相传的故事回忆起来——可能使公众参与和卫生沟通的方法更加细致入微。

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引用次数: 0

Preventable tragedies: A longitudinal analysis of state firearm laws and K-12 school shootings in the United States (2000–2019) 可预防的悲剧：美国州枪支法和K-12学校枪击事件的纵向分析（2000-2019）。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-01-30 DOI: 10.1016/j.socscimed.2026.119049

Jack G.R. Wippell , Dana L. Haynie , David Riedman

Gun violence is a leading cause of death among children and adolescents in the United States, and school shootings represent one of its most traumatic and visible manifestations. These events can generate severe and long-lasting consequences for children, but also extend beyond direct victims to affect entire communities. Yet responses to this public health crisis remain mired in political polarization: some advocate for stricter firearm regulations to limit opportunities for violence, while others promote expanded access in the name of deterrence. Meanwhile, limited prior empirical work has formally examined firearm legislation as a structural intervention capable of reducing school shooting risk. Integrating 20 years of data on K-12 school shootings (2000–2019) with that on state firearm legislation, we conduct a state-year panel analysis to examine how restrictive firearm laws (measured both as an aggregated restrictiveness index and partitioned by policy type) relate to the incidence of school shootings. Results show that the implementation of more restrictive gun laws is significantly associated with fewer school shootings, yetmeaningful heterogeneity emerges across policy types. Notably, none of the examined laws show evidence of increasing school shootings, contrary to deterrence claims. These findings align with prior literatures linking state firearm legislation and violence, and position firearm regulation as a potential structural intervention for preventing violence against children.

枪支暴力是美国儿童和青少年死亡的主要原因，校园枪击事件是其最具创伤性和最明显的表现之一。这些事件可能对儿童造成严重和持久的后果，但也会超出直接受害者的范围，影响到整个社区。然而，对这一公共卫生危机的应对仍然陷入政治两极分化的泥潭：一些人主张更严格的枪支管制，以限制暴力的机会，而另一些人则主张以威慑的名义扩大枪支的使用范围。与此同时，有限的先前实证工作正式审查了枪支立法作为一种能够降低校园枪击风险的结构性干预措施。将20年来K-12学校枪击事件（2000-2019年）的数据与州枪支立法的数据相结合，我们进行了一项州年度小组分析，以研究限制性枪支法律（以总限制指数和按政策类型划分）与学校枪击事件的关系。结果表明，实施更严格的枪支法律与减少校园枪击事件显著相关，但在不同的政策类型中出现了有意义的异质性。值得注意的是，与威慑的说法相反，经过审查的法律中没有一条显示出校园枪击事件增加的证据。这些发现与先前有关州枪支立法和暴力的文献一致，并将枪支监管定位为防止暴力侵害儿童的潜在结构性干预措施。

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引用次数: 0

Pedalling progress? Assessing the long-term impact of a bicycle intervention on adolescent maternal and child health in Zambia 蹬车的进展?评估自行车干预对赞比亚青少年妇幼健康的长期影响

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2025-11-05 DOI: 10.1016/j.socscimed.2025.118754

Shruti Shukla , Yulia Shenderovich , Choolwe Jacobs , Janina I. Steinert

This study evaluates the long-term impact of a gender-transformative intervention that provided bicycles to adolescent girls in rural Zambia to enhance school attendance and empowerment. Implemented in 2017 across 100 schools, the intervention aimed to reduce travel barriers and improve educational access. Using an experimental design with a final sample of 1615 adolescent girls (676 treatment, 939 control) in 92 school clusters, we estimate the causal impact of bicycle ownership on sexual, reproductive, maternal and child health indicators five years post-intervention.

Our findings indicate a statistically significant 11.5 percentage point increase in adolescent motherhood among the treatment group compared to the control group. However, the intervention did not significantly affect antenatal care visits, iron and folic acid use, institutional deliveries, birth weight, or exclusive breastfeeding (n = 382). For sexual reproductive health outcomes, girls in the treatment group were 11 percentage points more likely to report sexual debut and eight percentage points more likely to report wanting the pregnancy. Causal mediation analysis suggests increased empowerment partially mediated the observed rise in adolescent motherhood. Complier analysis indicates a higher likelihood of adolescent childbearing for girls who use the bicycle for school as intended by the programme.

These findings highlight the complexities of gender-transformative interventions in low-resource settings. While aiming to empower adolescent girls, increased mobility and decision-making power may intersect with unintended reproductive health consequences. This underscores the need for integrated program designs that complement empowerment initiatives with comprehensive sexual health education and services to mitigate adverse outcomes.

本研究评估了一项性别变革干预的长期影响，该干预为赞比亚农村的青春期女孩提供自行车，以提高入学率和赋权。该干预措施于2017年在100所学校实施，旨在减少旅行障碍并改善教育机会。采用实验设计，最终样本为92个学校群的1615名青春期女孩（676名治疗组，939名对照组），我们估计了干预五年后自行车所有权对性、生殖、孕产妇和儿童健康指标的因果影响。我们的研究结果表明，与对照组相比，治疗组的青少年母亲人数显著增加了11.5个百分点。然而，干预没有显著影响产前保健就诊、铁和叶酸的使用、机构分娩、出生体重或纯母乳喂养（n = 382）。在性健康和生殖健康方面，接受治疗的女孩报告初次性行为的可能性高出11%，报告想要怀孕的可能性高出8%。因果中介分析表明，授权的增加部分介导了观察到的青春期母亲的增加。编译分析表明，按照该方案的设想，使用自行车上学的女孩青春期生育的可能性更高。这些发现突出表明，在资源匮乏的环境中，性别变革干预措施的复杂性。虽然旨在增强少女的权能，但增加流动性和决策权可能与意外的生殖健康后果交织在一起。这强调需要综合方案设计，以全面的性健康教育和服务来补充增强权能倡议，以减轻不良后果。

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引用次数: 0

Interdisciplinary expertise to advance human-centered explainable AI 跨学科的专业知识，以推进以人为中心的可解释的人工智能。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-01-27 DOI: 10.1016/j.socscimed.2026.119036

Chloe R. Bennett , Heather Cole-Lewis , Stephanie Farquhar , Naama Haamel , Boris Babenko , Oran Lang , Mathias S. Fleck , Ilana Traynis , Charles Lau , Yun Liu , Ivor Horn , Courtney Lyles

The field of artificial intelligence (AI) is rapidly influencing health and healthcare, but bias and inadequate subgroup performance persists. Previous work has clearly outlined the need for more rigorous attention to data representativeness and model performance to advance population health and reduce bias. However, there is an opportunity to leverage best practices of social epidemiology, behavior science, and health services research to help develop hypotheses for associations found, particularly when using explainable AI (XAI) methods. This paper introduces a novel human-in-the-loop model that couples generative XAI with a wraparound interdisciplinary expert panel review process. This human-centered approach critically assesses AI model explanations from multiple perspectives, effectively identifying areas of bias and pinpointing directions for future research. We summarize the approach, highlighting processes and findings where the interdisciplinary expert panel produced interpretations which were historically and contextually informed. In particular, the interdisciplinary panel identified potential confounders and brought in scientific evidence from previous studies, which have clear implications to reduce bias. This promising human-centered framework not only maximizes multidisciplinary methodological rigor for AI model improvement and eventual implementation but also proactively fosters team science opportunities in future research.

人工智能（AI）领域正在迅速影响健康和医疗保健，但偏见和不充分的亚组表现仍然存在。以前的工作已经清楚地概述了需要更加严格地关注数据代表性和模型性能，以促进人口健康和减少偏见。然而，有机会利用社会流行病学、行为科学和卫生服务研究的最佳实践来帮助建立所发现的关联的假设，特别是在使用可解释的人工智能（XAI）方法时。本文介绍了一种新的人在环模型，该模型将生成式XAI与跨学科专家小组评审过程结合在一起。这种以人为本的方法从多个角度批判性地评估人工智能模型的解释，有效地识别偏见领域，并为未来的研究指明方向。我们总结了方法，突出跨学科专家小组产生的历史和背景信息解释的过程和发现。特别是，跨学科小组确定了潜在的混杂因素，并从以前的研究中引入了科学证据，这对减少偏见具有明确的意义。这个有希望的以人为中心的框架不仅最大限度地提高了人工智能模型改进和最终实施的多学科方法严谨性，而且还积极地在未来的研究中培养团队科学机会。

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引用次数: 0

Enacting assemblages of care: How young adults seek support for suicidal ideation 制定护理组合：年轻人如何寻求自杀意念的支持。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-01-31 DOI: 10.1016/j.socscimed.2026.119001

Kate LaForge

Young adults continue to suffer from high rates of suicidal ideation (SI), attempts, and deaths. How young adults enact help-seeking in their daily lives remains undertheorized. To fill this gap, this study draws from assemblage theory to explore how young adults seek help for SI. Utilizing one-on-one interviews with 39 young American adults conducted from January to July 2024, I draw from assemblage theory to offer a relational understanding of how, in the context of suicide-related help-seeking, diverse elements gather together to construct care. In the first two sections, I examine two phenomena—intimacy and spatiality—that function contingently, flowing through variably scaled assemblages, motivating courses of action, and producing particular affective experiences and relations. In the final section, I explore how these relations prime participants for a practice I call attuned disclosure, in which, given temporary arrangements of particular assemblage elements such as risk logics and technological affordances, young adults calibrate SI disclosure to achieve their desired level of care. This perspective facilitates understanding suicide-related help-seeking not as a set of behaviors but rather as a terrain on which relations between diverse entities, including services, affects, logics, and individuals, are forged and disbanded. In this perspective, help is not sought, but rather, enacted. This focus suggests that, to enhance services for young adults with SI, service providers and broader service systems may benefit from considering help-seeking practices as temporary, emergent, and highly contextual, flowing from subtle impressions and affects, and susceptible to rapid rearrangements.

年轻人自杀意念（SI）、企图自杀和死亡的比例仍然很高。年轻人在日常生活中如何寻求帮助仍未得到充分的理论解释。为了填补这一空白，本研究从组合理论中探索年轻人如何寻求SI帮助。我从2024年1月到7月对39名年轻的美国成年人进行了一对一的访谈，利用组合理论来提供一种关系理解，在与自杀相关的寻求帮助的背景下，不同的元素如何聚集在一起来构建关怀。在前两节中，我考察了两种现象——亲密感和空间性——它们偶然地发挥作用，流经不同规模的集合，激发行动过程，并产生特定的情感体验和关系。在最后一节中，我探讨了这些关系如何成为我称之为“协调披露”的实践的主要参与者，在这种实践中，给定特定组合元素（如风险逻辑和技术支持）的临时安排，年轻人校准SI披露以达到他们所需的护理水平。这种观点有助于理解与自杀相关的寻求帮助，而不是将其视为一系列行为，而是将其视为不同实体（包括服务、影响、逻辑和个人）之间的关系形成和解除的一个领域。从这个角度来看，帮助不是寻求，而是付诸实施。这一重点表明，为了加强对患有SI的年轻人的服务，服务提供者和更广泛的服务系统可能会受益于将寻求帮助的做法视为临时的、紧急的、高度情境化的、来自微妙的印象和影响的、易受快速重新安排影响的行为。

{"title":"Enacting assemblages of care: How young adults seek support for suicidal ideation","authors":"Kate LaForge","doi":"10.1016/j.socscimed.2026.119001","DOIUrl":"10.1016/j.socscimed.2026.119001","url":null,"abstract":"<div><div>Young adults continue to suffer from high rates of suicidal ideation (SI), attempts, and deaths. How young adults enact help-seeking in their daily lives remains undertheorized. To fill this gap, this study draws from assemblage theory to explore how young adults seek help for SI. Utilizing one-on-one interviews with 39 young American adults conducted from January to July 2024, I draw from assemblage theory to offer a relational understanding of how, in the context of suicide-related help-seeking, diverse elements gather together to construct care. In the first two sections, I examine two phenomena—intimacy and spatiality—that function contingently, flowing through variably scaled assemblages, motivating courses of action, and producing particular affective experiences and relations. In the final section, I explore how these relations prime participants for a practice I call <em>attuned disclosure,</em> in which, given temporary arrangements of particular assemblage elements such as risk logics and technological affordances, young adults calibrate SI disclosure to achieve their desired level of care. This perspective facilitates understanding suicide-related help-seeking not as a set of behaviors but rather as a terrain on which relations between diverse entities, including services, affects, logics, and individuals, are forged and disbanded. In this perspective, help is not sought, but rather, enacted. This focus suggests that, to enhance services for young adults with SI, service providers and broader service systems may benefit from considering help-seeking practices as temporary, emergent, and highly contextual, flowing from subtle impressions and affects, and susceptible to rapid rearrangements.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"394 ","pages":"Article 119001"},"PeriodicalIF":5.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anticipating unintended consequences of public health nutrition policy: Implications for disordered eating and weight stigma 预期公共卫生营养政策的意外后果：对饮食失调和体重耻辱的影响

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-02-10 DOI: 10.1016/j.socscimed.2026.119091

Amanda Raffoul , Sharon I. Kirkpatrick

The prevention of weight gain continues to be a predominant focus of public health nutrition policy, often with approaches that aim to improve individual eating practices. However, policies emphasizing weight-related behaviour change may have unintended consequences, including increased weight stigma and disordered eating risk. This paper proposes a framework, guided by complex systems science, to inform nutrition policies that can improve eating practices with minimal unintended consequences for weight stigma and disordered eating. Eating- and weight-related practices are interconnected and complex, and interventions that aim to shift weight without considering complexity can increase stigma. Systems science, rooted in complexity and chaos theories, is valuable to inform a framework that considers the interactions among the drivers that underlie eating- and weight-related practices and outcomes. Such a framework can highlight how weight-centric approaches can result in policy resistance (e.g., messaging related to maintaining a healthy weight may encourage unhealthy dieting that leads to poor health outcomes), with unintended consequences for population health. Drawing upon two public health interventions, educational nutrition campaigns and nutrition labelling, we demonstrate how this framework can be applied to anticipate unintended consequences for weight stigma and disordered eating. Once potential unintended consequences have been identified, interventions can be modified and accompanying mitigation strategies can be implemented. This framework empowers public health nutrition researchers and practitioners to recognize the interconnectedness and complexity of eating- and weight-related practices and to identify approaches to promote nutritional health and overall wellbeing that do not increase disordered eating, weight stigma, and their consequences.

预防体重增加仍然是公共卫生营养政策的主要重点，其方法往往旨在改善个人饮食习惯。然而，强调体重相关行为改变的政策可能会产生意想不到的后果，包括增加体重耻辱和饮食失调风险。本文提出了一个框架，在复杂系统科学的指导下，为营养政策提供信息，可以改善饮食习惯，最大限度地减少体重耻辱和饮食失调的意外后果。饮食和体重相关的做法是相互关联和复杂的，旨在改变体重而不考虑复杂性的干预措施可能会增加耻辱。植根于复杂性和混沌理论的系统科学，对于建立一个考虑饮食和体重相关实践和结果背后驱动因素之间相互作用的框架是有价值的。这样一个框架可以突出表明，以体重为中心的做法如何可能导致政策阻力（例如，与保持健康体重有关的信息传递可能鼓励导致不良健康结果的不健康饮食），从而对人口健康产生意想不到的后果。利用两项公共卫生干预措施，即营养教育运动和营养标签，我们展示了如何将这一框架应用于预测体重耻辱和饮食失调的意外后果。一旦发现潜在的意外后果，就可以修改干预措施，并实施相应的缓解战略。该框架使公共卫生营养研究人员和从业人员能够认识到饮食和体重相关实践的相互联系和复杂性，并确定促进营养健康和整体福祉的方法，而不会增加饮食失调、体重耻辱及其后果。

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引用次数: 0

Social determinants of brain structure and cognition 大脑结构和认知的社会决定因素。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1016/j.socscimed.2026.119045

Mahsa Mayeli , David Matuskey , for the Alzheimer's Disease Neuroimaging Initiative

Background

Socioeconomic disadvantage is recognized as a risk factor for cognitive decline, yet its associated neural pathways remain unclear. We investigated whether neighborhood disadvantage, measured by the Area Deprivation Index (ADI), was associated with cognitive performance in older adults and patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD), and whether structural brain differences explained this relationship.

Methods

Participants included 822 older adults (478 cognitively unimpaired [CU], 271 with MCI, and 73 with AD). Associations between ADI, cognition, and brain structure were examined using regression models adjusting for age and sex. Mediation analyses tested whether total brain volume accounted for ADI–cognition relationships.

Results

Higher ADI was associated with poorer cognitive performance across all domains in CU individuals (National ADI: memory β = −0.008, p < 0.001; executive function β = −0.005, p < 0.001; language β = −0.005, p < 0.001; visuospatial β = −0.004, p < 0.001) and across multiple domains in MCI (memory β = −0.007, p = 0.002; executive β = −0.007, p < 0.001). ADI was also associated with smaller total cerebral, gray, and white matter volumes in CU (State ADI and gray matter β = −2.37, FDR-p = 0.006) and greater white matter hyperintensity burden (β = 0.152, FDR-p = 0.009). Associations were weaker in MCI and absent in AD. Mediation analyses showed that total brain volume significantly mediated the effect of ADI on language performance (ACME p = 0.024; proportion mediated = 19.7 %, p = 0.036).

Conclusions

Neighborhood disadvantage is linked to widespread cognitive vulnerability and structural brain differences. However, brain volume explains only a small portion of these associations, suggesting that environmental and contextual factors shape cognitive performance through pathways that extend beyond structural neurodegeneration.

背景：社会经济劣势被认为是认知能力下降的危险因素，但其相关的神经通路尚不清楚。我们调查了以区域剥夺指数（ADI）衡量的邻里劣势是否与老年人、轻度认知障碍（MCI）和阿尔茨海默病（AD）患者的认知表现有关，以及大脑结构差异是否解释了这种关系。方法：参与者包括822名老年人（478名认知未受损[CU]， 271名轻度认知障碍患者，73名AD患者）。使用年龄和性别调整后的回归模型检验了ADI、认知和大脑结构之间的关系。中介分析测试了脑容量总量是否与ad -认知关系有关。结果：高ADI与CU个体各领域较差的认知表现相关（National ADI: memory β = -0.008,p ）。结论：邻里不利与广泛的认知脆弱性和大脑结构差异有关。然而，脑容量只能解释这些关联的一小部分，这表明环境和背景因素通过超出结构神经变性的途径塑造认知表现。

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引用次数: 0

Shift work and risk of chronic kidney disease: A systematic review and meta-analysis 轮班工作和慢性肾脏疾病的风险：一项系统回顾和荟萃分析。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-02-02 DOI: 10.1016/j.socscimed.2026.119055

Jiyoun Jung , Cheol Whee Park , Dong-Wook Lee , Seong-Sik Cho , Seilin Uhm , Jongin Lee , Mo-Yeol Kang

Objectives

This systematic review and meta-analysis is aimed to critically evaluate and quantify the association between shift work and chronic kidney disease (CKD).

Methods

We searched PubMed, Embase, and Web of Science through May 2025 for observational studies examining shift work—including night or rotating shifts—and CKD outcomes among adults. Eligible outcomes included reduced estimated glomerular filtration rate (eGFR), proteinuria, or albuminuria. Study quality was assessed using the Newcastle–Ottawa Scale, and meta-analyses were performed where feasible.

Results

Twelve studies were included in this systematic review. Most studies defined CKD as eGFR below 60 mL/min/1.73 m² or presence of albuminuria, although outcome definitions varied. Meta-analysis of 6 studies found that shift workers had significantly higher odds of CKD (pooled odds ratio: 1.43; 95% CI: 1.06–1.92) compared to non-shift workers. Risk of bias was moderate to low across studies. Heterogeneity was modest, and no significant publication bias was detected.

Conclusions

Shift work is associated with a modestly increased risk of CKD. Circadian disruption and related metabolic disturbances may underlie this relationship. Given the widespread prevalence of shift work and the global burden of CKD, these findings support the need for targeted occupational health surveillance and preventive strategies for shift-working populations.

目的：本系统综述和荟萃分析旨在批判性地评估和量化轮班工作与慢性肾脏疾病（CKD）之间的关系。方法：我们检索了PubMed， Embase和Web of Science到2025年5月的观察性研究，研究轮班工作（包括夜班或轮班）和成人CKD结局。符合条件的结果包括肾小球滤过率（eGFR）、蛋白尿或蛋白尿降低。使用纽卡斯尔-渥太华量表评估研究质量，并在可行的情况下进行荟萃分析。结果：本系统综述纳入了12项研究。大多数研究将CKD定义为eGFR低于60 mL/min/1.73 m2或存在蛋白尿，尽管结果定义各不相同。6项研究的荟萃分析发现，与非轮班工人相比，轮班工人患慢性肾病的几率明显更高（合并优势比：1.43;95% CI: 1.06-1.92）。所有研究的偏倚风险为中到低。异质性不大，未发现显著的发表偏倚。结论：轮班工作与CKD风险适度增加有关。昼夜节律紊乱和相关的代谢紊乱可能是这种关系的基础。鉴于轮班工作的普遍存在和CKD的全球负担，这些发现支持了对轮班工作人群进行有针对性的职业健康监测和预防策略的必要性。

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引用次数: 0

Perceived ideological polarization, trust in science and healthcare, and COVID-19 vaccination intention: A four-wave cross-lagged mediation panel analysis 意识形态极化感知、对科学和医疗保健的信任与COVID-19疫苗接种意图：四波交叉滞后中介面板分析

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI: 10.1016/j.socscimed.2026.119057

Andrej Kirbiš, Stefani Branilović

Ideological polarization is often theorized to erode trust in science and healthcare, thereby reducing compliance with health guidelines and vaccine uptake. In this study, we examined the longitudinal relationships between perceived ideological polarization, trust in science and healthcare, and COVID-19 vaccination intention, using a four-wave panel design. We analysed four waves of panel data from a sample of 488 Slovenians, representative by gender, age, and education. Pearson correlations and a random intercept cross-lagged panel model (RI-CLPM) were used to assess both within- and between-person associations, and to test whether trust in science and healthcare mediated the relationship between perceived ideological polarization and vaccination intention over time. Baseline correlations showed a positive association between perceived ideological polarization, trust, and vaccination intention, though these associations weakened and became non-significant in later waves. RI-CLPM results revealed no evidence of causal, within-person effects of perceived ideological polarization on later trust or vaccination intention, and no longitudinal mediation pathways. However, between-person effects indicated that individuals with consistently higher trust in science and healthcare reported higher vaccination intentions across time. These findings challenge the assumption that ideological polarization undermines trust and vaccination intention, suggesting that cross-sectional associations observed in prior research may reflect stable between-person differences rather than dynamic causal processes. By distinguishing cross-sectional from longitudinal evidence, this study underscores institutional trust as the key predictor of vaccination intention and calls for comparative research across political and cultural contexts.

意识形态的两极分化经常被理论化，以削弱对科学和医疗保健的信任，从而减少对健康指南的遵守和疫苗的吸收。在这项研究中，我们使用四波面板设计，研究了感知到的意识形态两极分化、对科学和医疗保健的信任以及COVID-19疫苗接种意图之间的纵向关系。我们分析了来自488名斯洛文尼亚人样本的四波面板数据，这些数据按性别、年龄和教育程度具有代表性。使用Pearson相关性和随机截距交叉滞后面板模型（RI-CLPM）来评估人与人之间和人与人之间的关联，并测试对科学和医疗保健的信任是否会随着时间的推移介导感知的意识形态极化和接种意愿之间的关系。基线相关性显示，感知到的意识形态极化、信任和疫苗接种意图之间存在正相关，尽管这些关联在后来的浪潮中减弱并变得不显著。RI-CLPM结果显示，没有证据表明意识形态两极分化对后来的信任或疫苗接种意图有因果关系，也没有纵向中介途径。然而，人与人之间的影响表明，对科学和医疗保健的信任度一贯较高的个体报告了更高的疫苗接种意愿。这些发现挑战了意识形态两极分化破坏信任和疫苗接种意图的假设，表明在先前的研究中观察到的横断面关联可能反映了稳定的人与人之间的差异，而不是动态的因果过程。通过区分横截面证据和纵向证据，本研究强调了机构信任是疫苗接种意图的关键预测因素，并呼吁进行跨政治和文化背景的比较研究。

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引用次数: 0

Adolescence in social context: Longitudinal associations of 15 social factors with health and well-being 社会背景下的青少年：15个社会因素与健康和幸福的纵向关联。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-01-22 DOI: 10.1016/j.socscimed.2026.118993

Renae Wilkinson , Eric S. Kim , Ying Chen , Julianne Holt-Lunstad , Tyler J. VanderWeele

Concern is growing that social disconnection poses serious risks to health and well-being, especially for adolescents. Yet without clear evidence on which relational factors (e.g., parent-child, sibling, romantic, and friend relationships; connectedness to families, schools, and neighborhoods) matter most, designing effective, developmentally attuned interventions remains difficult. To address this question, we used data from a large, nationally representative sample of U.S. adolescents (Add Health) and an outcome-wide approach to prospectively test whether one-year changes (between Wave I: 1994–1995 and Wave II: 1996) in 15 social factors, spanning structural, functional, and quality domains, were associated with 34 indicators of health and well-being 11.37 years later (in Wave IV: 2008, N = 11,040) or 20.64 years later (in Wave V: 2016–2018, N = 9003), adjusting for an extensive set of covariates. The outcome-wide framework fits a series of regression models for the relationship between one predictor and a set of outcomes (one outcome analyzed at a time), adjusting for the same set of covariates in each regression model. Six factors (school connectedness, loneliness, emotional support, neighborhood cohesion, religious service attendance, and family cohesion) showed associations with at least one-quarter of outcomes. Associations were most consistent in psychological well-being, mental health, and civic/prosocial domains. Strengthening school connectedness and emotional support, and reducing loneliness, appear especially promising for fostering long-term health.

人们越来越担心，与社会脱节对健康和福祉构成严重威胁，特别是对青少年而言。然而，没有明确的证据表明哪些关系因素（例如，亲子、兄弟姐妹、浪漫和朋友关系；与家庭、学校和社区的联系）最重要，设计有效的、与发展相适应的干预措施仍然很困难。为了解决这个问题，我们使用了来自美国青少年的大型全国代表性样本的数据（添加健康）和结果范围的方法来前瞻性地测试15个社会因素的一年变化（第一波：1994-1995年和第二波：1996年），跨越结构，功能和质量领域，是否与11.37年后（第四波：2008年，N = 11040）或20.64年后（第五波：2008年）的34个健康和福祉指标相关。2016-2018, N = 9003)，调整了广泛的协变量集。结果范围框架适用于一个预测器和一组结果（一次分析一个结果）之间关系的一系列回归模型，并对每个回归模型中的同一组协变量进行调整。六个因素（学校联系、孤独感、情感支持、邻里凝聚力、宗教服务出席率和家庭凝聚力）与至少四分之一的结果相关。关联在心理健康、心理健康和公民/亲社会领域最为一致。加强学校联系和情感支持，减少孤独感，似乎对促进长期健康尤其有希望。

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