Pub Date : 2024-08-16DOI: 10.1016/j.puhe.2024.06.038
Objective
This study aimed to quantify the health and economic impacts of alcohol consumption in Brazil for 2019.
Study design
Ecological study using secondary data sources.
Methods
We calculated the disease burden using estimates from the Global Burden of Disease study, which incorporated data from health surveys and hospital records. Costs were estimated based on direct expenses recorded in the Hospital and Outpatient Information System of the Unified Health System, with data by sex, age group, cause, and Federative Units.
Results
Alcohol consumption was a necessary cause for 30,355 deaths and approximately 1.69 million disability-adjusted life years in Brazil, representing 2.2% and 2.6% of the national totals, respectively. The impact was more pronounced among men, in the Northeast region and within the 40- to 64-year-old age group. The total costs attributed to these outcomes reached approximately Int$43.1 million, with hospital admissions accounting for 94.16% of these expenses.
Conclusion
In 2019, alcohol consumption had a significant impact on both the health of Brazilians and the expenses of the health system. As a preventable risk factor, alcohol consumption necessitates effective intersectoral strategies to mitigate its burden.
{"title":"Burden of disease and costs for the Unified Health System in Brazil due to diseases whose alcohol consumption is a necessary cause: an ecological study","authors":"","doi":"10.1016/j.puhe.2024.06.038","DOIUrl":"10.1016/j.puhe.2024.06.038","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to quantify the health and economic impacts of alcohol consumption in Brazil for 2019.</p></div><div><h3>Study design</h3><p>Ecological study using secondary data sources.</p></div><div><h3>Methods</h3><p>We calculated the disease burden using estimates from the Global Burden of Disease study, which incorporated data from health surveys and hospital records. Costs were estimated based on direct expenses recorded in the Hospital and Outpatient Information System of the Unified Health System, with data by sex, age group, cause, and Federative Units.</p></div><div><h3>Results</h3><p>Alcohol consumption was a necessary cause for 30,355 deaths and approximately 1.69 million disability-adjusted life years in Brazil, representing 2.2% and 2.6% of the national totals, respectively. The impact was more pronounced among men, in the Northeast region and within the 40- to 64-year-old age group. The total costs attributed to these outcomes reached approximately Int$43.1 million, with hospital admissions accounting for 94.16% of these expenses.</p></div><div><h3>Conclusion</h3><p>In 2019, alcohol consumption had a significant impact on both the health of Brazilians and the expenses of the health system. As a preventable risk factor, alcohol consumption necessitates effective intersectoral strategies to mitigate its burden.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-16DOI: 10.1016/j.puhe.2024.07.003
Objectives
Access to health services has received increasing attention, and the International Agency for Research on Cancer (IARC) includes ‘availability’ as one of the indicators to evaluate cancer screening. Evaluating, monitoring, and decision-making on cancer screening depends on systematic quantitative evidence on access to cancer screening, but indicators are currently inconsistently, if they are reported at all. This can be improved by developing systematic indicators for evaluating and reporting access to cancer screening. This requires a thorough understanding of current indicators of access to cancer screening.
Study design
Scoping review.
Methods
We completed a scoping review of studies on access to cancer screening services from 2013 to 2022. The relevant indicators were extracted, quantified, and then matched to two widely used frameworks: a universal five-dimensional conceptual framework for access to healthcare (‘U5D’) and a cancer-specific framework/list on the availability/use of screening indicators endorsed by the IARC.
Results
A total of 331 studies on access to cancer screening services were included. Based on the U5D framework, publications from supply side reported approachability (number of publications = 16), acceptability (6), availability and accommodation (44), affordability (30), and appropriateness (11); among this process, 17 sub-indicators were identified. Correspondingly, publications from demand side reported ability to perceive (170), ability to seek (85), ability to reach (58), ability to pay (59), and ability to engage (2); 26 sub-indicators were identified. More macroscopically, the publications of the IARC-endorsed indicators reported availability of policies and guidelines for screening (13), type of screening provided (3), extent of population coverage and participation rates (76), and demographic/behavioural related considerations (167). By integrating the universal and cancer-specific frameworks, a new adapted framework was proposed.
Conclusions
This study identified and collated indicators for evaluating access to cancer screening services, and determined the gaps in the current application of various indicators. The findings are anticipated to facilitate further development of an evaluation indicator system for access to cancer screening services.
{"title":"Evaluation indicators for access to cancer screening services: a scoping review","authors":"","doi":"10.1016/j.puhe.2024.07.003","DOIUrl":"10.1016/j.puhe.2024.07.003","url":null,"abstract":"<div><h3>Objectives</h3><p>Access to health services has received increasing attention, and the International Agency for Research on Cancer (IARC) includes ‘availability’ as one of the indicators to evaluate cancer screening. Evaluating, monitoring, and decision-making on cancer screening depends on systematic quantitative evidence on access to cancer screening, but indicators are currently inconsistently, if they are reported at all. This can be improved by developing systematic indicators for evaluating and reporting access to cancer screening. This requires a thorough understanding of current indicators of access to cancer screening.</p></div><div><h3>Study design</h3><p>Scoping review.</p></div><div><h3>Methods</h3><p>We completed a scoping review of studies on access to cancer screening services from 2013 to 2022. The relevant indicators were extracted, quantified, and then matched to two widely used frameworks: a universal five-dimensional conceptual framework for access to healthcare (‘U5D’) and a cancer-specific framework/list on the availability/use of screening indicators endorsed by the IARC.</p></div><div><h3>Results</h3><p>A total of 331 studies on access to cancer screening services were included. Based on the U5D framework, publications from supply side reported approachability (number of publications = 16), acceptability (6), availability and accommodation (44), affordability (30), and appropriateness (11); among this process, 17 sub-indicators were identified. Correspondingly, publications from demand side reported ability to perceive (170), ability to seek (85), ability to reach (58), ability to pay (59), and ability to engage (2); 26 sub-indicators were identified. More macroscopically, the publications of the IARC-endorsed indicators reported availability of policies and guidelines for screening (13), type of screening provided (3), extent of population coverage and participation rates (76), and demographic/behavioural related considerations (167). By integrating the universal and cancer-specific frameworks, a new adapted framework was proposed.</p></div><div><h3>Conclusions</h3><p>This study identified and collated indicators for evaluating access to cancer screening services, and determined the gaps in the current application of various indicators. The findings are anticipated to facilitate further development of an evaluation indicator system for access to cancer screening services.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-15DOI: 10.1016/j.puhe.2024.07.005
Objectives
The public health burden of gambling remains difficult to estimate, given the lack of relevant, available data. Death by suicide, represents a substantial and quantifiable public health cost. The current study reviews data from the National Violent Death Reporting System to detect cases where gambling was identified as a meaningful contextual factor to a death by suicide.
Study design
This study is an exploratory content analysis.
Methods
We analysed narrative data from cases of death by suicide, collected from 2003 to 2020 recorded in the Restricted Access Data of the National Violent Death Reporting System. Gambling-related cases identified in our analysis were compared against all other cases on demographic characteristics, case characteristics, US state, and incident year. Chi-square tests of independence and the Wilcoxon ranked sum tests were used in bivariate comparisons.
Results
Overall, 1306 of 296 317 cases were classified as gambling-related. This represented 0.44% of total cases. Gambling-related classification was over-represented among those identified as Asian (7.0% vs 2.2%) and under-represented among those identified as Black or African American (4.0% vs 6.4%) compared with all other deaths by suicide. Gambling-related cases were also over-represented in cases where alcohol use was suspected (28.0% vs 21.2%), where there were significant financial problems (50.3% vs 8.6%), where there were intimate partner problems (31.5% vs 25.6%), and under-represented in cases where there was a previous mental health diagnosis (35.1% vs 38.8%). The rate of gambling-related cases in Nevada was approximately nine times greater than the rate in the overall sample (4.0% vs 0.44%).
Conclusions
Administrative data can be used to study the impacts of gambling on public health in the absence of quality representative survey data. However, these sources are still likely to underestimate the public health burden of gambling with current structures and procedures. Requiring intentional collection of gambling-related information in cases of suicide would be a significant step towards better quantifying the public health burden of gambling in the United States.
目标由于缺乏相关的可用数据，赌博对公共健康造成的负担仍然难以估计。自杀死亡是一项可量化的重大公共卫生成本。本研究回顾了全国暴力死亡报告系统（National Violent Death Reporting System）中的数据，以发现赌博被认定为自杀死亡的重要背景因素的案例。研究设计本研究是一项探索性内容分析。方法我们分析了全国暴力死亡报告系统限制访问数据（Restricted Access Data of the National Violent Death Reporting System）中记录的2003年至2020年自杀死亡案例的叙述性数据。我们将分析中发现的赌博相关病例与所有其他病例在人口统计学特征、病例特征、美国各州和事件发生年份方面进行了比较。结果总体而言，296 317 例病例中有 1306 例被归类为与赌博有关，占病例总数的 0.44%。这占病例总数的 0.44%。与所有其他自杀死亡病例相比，与赌博有关的病例在被确认为亚裔的病例中所占比例过高（7.0% vs 2.2%），而在被确认为黑人或非裔美国人的病例中所占比例过低（4.0% vs 6.4%）。在怀疑酗酒（28.0% 对 21.2%）、有重大经济问题（50.3% 对 8.6%）、有亲密伴侣问题（31.5% 对 25.6%）的病例中，与赌博有关的病例所占比例也过高（35.1% 对 38.8%）。内华达州与赌博有关的病例比例约为总体样本的 9 倍（4.0% 对 0.44%）。结论：在缺乏有质量代表性的调查数据的情况下，可以利用行政数据来研究赌博对公众健康的影响。然而，在目前的结构和程序下，这些数据仍有可能低估赌博对公众健康造成的负担。要求有意收集自杀案例中与赌博相关的信息，将是朝着更好地量化美国赌博对公共健康造成的负担迈出的重要一步。
{"title":"Gambling as a precipitating factor in deaths by suicide in the National Violent Death Reporting System","authors":"","doi":"10.1016/j.puhe.2024.07.005","DOIUrl":"10.1016/j.puhe.2024.07.005","url":null,"abstract":"<div><h3>Objectives</h3><p>The public health burden of gambling remains difficult to estimate, given the lack of relevant, available data. Death by suicide, represents a substantial and quantifiable public health cost. The current study reviews data from the National Violent Death Reporting System to detect cases where gambling was identified as a meaningful contextual factor to a death by suicide.</p></div><div><h3>Study design</h3><p>This study is an exploratory content analysis.</p></div><div><h3>Methods</h3><p>We analysed narrative data from cases of death by suicide, collected from 2003 to 2020 recorded in the Restricted Access Data of the National Violent Death Reporting System. Gambling-related cases identified in our analysis were compared against all other cases on demographic characteristics, case characteristics, US state, and incident year. Chi-square tests of independence and the Wilcoxon ranked sum tests were used in bivariate comparisons.</p></div><div><h3>Results</h3><p>Overall, 1306 of 296 317 cases were classified as gambling-related. This represented 0.44% of total cases. Gambling-related classification was over-represented among those identified as Asian (7.0% vs 2.2%) and under-represented among those identified as Black or African American (4.0% vs 6.4%) compared with all other deaths by suicide. Gambling-related cases were also over-represented in cases where alcohol use was suspected (28.0% vs 21.2%), where there were significant financial problems (50.3% vs 8.6%), where there were intimate partner problems (31.5% vs 25.6%), and under-represented in cases where there was a previous mental health diagnosis (35.1% vs 38.8%). The rate of gambling-related cases in Nevada was approximately nine times greater than the rate in the overall sample (4.0% vs 0.44%).</p></div><div><h3>Conclusions</h3><p>Administrative data can be used to study the impacts of gambling on public health in the absence of quality representative survey data. However, these sources are still likely to underestimate the public health burden of gambling with current structures and procedures. Requiring intentional collection of gambling-related information in cases of suicide would be a significant step towards better quantifying the public health burden of gambling in the United States.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S003335062400283X/pdfft?md5=6c7b92f35da71183f488f26184c09a80&pid=1-s2.0-S003335062400283X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141991063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-14DOI: 10.1016/j.puhe.2024.06.019
Objectives
Child maltreatment (CM) is a major risk factor across the lifespan. While research on CM and its consequences has risen strongly during the last decades, research is mainly focused on the prevalence of types of CM incidents. As valid prevalence rates on timing and chronicity of CM are lacking to date, we aimed to assess the timing of experienced CM by describing the age of onset, duration, and prevalence at each year of age for each CM subtype in a population-based sample.
Study design
Cross-sectional, observational study in a representative sample.
Methods
Using different sampling steps including a random route procedure, a probability sample of the German population above the age of 16, encompassing 2514 persons (50.6% female, mean age: 50.08 years) was generated. Participants were asked about sociodemographic information in a face-to-face interview, CM was assessed using the ICAST-R questionnaire.
Results
The earliest mean age of onset was seen in neglect with 8.07 (±3.07) years for boys and 7.90 (±2.96) years for girls, while the mean age of onset for sexual abuse was in adolescence with 13.65 (±3.86) years for boys and 13.91(±3.17) years for girls. The overall duration of CM was lowest for sexual abuse with 2.12 (±2.01) years for boys and 2.35 (±1.73) years for girls, the highest duration was seen for emotional abuse with 4.00 (±3.54) years for boys and 4.21 (±3.77) years for girls.
Conclusions
Our novel results provide important epidemiological information for prevention efforts.
{"title":"Timing and chronicity of child maltreatment in Germany: results from a representative sample","authors":"","doi":"10.1016/j.puhe.2024.06.019","DOIUrl":"10.1016/j.puhe.2024.06.019","url":null,"abstract":"<div><h3>Objectives</h3><p>Child maltreatment (CM) is a major risk factor across the lifespan. While research on CM and its consequences has risen strongly during the last decades, research is mainly focused on the prevalence of types of CM incidents. As valid prevalence rates on timing and chronicity of CM are lacking to date, we aimed to assess the timing of experienced CM by describing the age of onset, duration, and prevalence at each year of age for each CM subtype in a population-based sample.</p></div><div><h3>Study design</h3><p>Cross-sectional, observational study in a representative sample.</p></div><div><h3>Methods</h3><p>Using different sampling steps including a random route procedure, a probability sample of the German population above the age of 16, encompassing 2514 persons (50.6% female, mean age: 50.08 years) was generated. Participants were asked about sociodemographic information in a face-to-face interview, CM was assessed using the ICAST-R questionnaire.</p></div><div><h3>Results</h3><p>The earliest mean age of onset was seen in neglect with 8.07 (±3.07) years for boys and 7.90 (±2.96) years for girls, while the mean age of onset for sexual abuse was in adolescence with 13.65 (±3.86) years for boys and 13.91(±3.17) years for girls. The overall duration of CM was lowest for sexual abuse with 2.12 (±2.01) years for boys and 2.35 (±1.73) years for girls, the highest duration was seen for emotional abuse with 4.00 (±3.54) years for boys and 4.21 (±3.77) years for girls.</p></div><div><h3>Conclusions</h3><p>Our novel results provide important epidemiological information for prevention efforts.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-13DOI: 10.1016/j.puhe.2024.06.023
Objectives
To assess factors associated with the risk of severe disease in children aged 5 years or younger with laboratory-confirmed respiratory syncytial virus (RSV) infection.
Study design
We conducted a nationwide retrospective cohort study in Mexico.
Methods
Eligible participants included children aged 5 years or younger with laboratory-confirmed RSV infection January 1, 2023, and May 15, 2024. We collected relevant clinical and epidemiological data. Risk ratios (RR) and 95% confidence intervals (CI) were employed to identify factors associated with the risk of severe disease, characterized by clinical and radiographic evidence of bronchiolitis or pneumonia requiring hospital admission.
Results
Data from 2022 children were analyzed and the overall risk of severe disease was 21.0% (n = 424/2022). In multiple generalized linear regression analysis, a personal history of immunosuppression (due to any cause) showed a protective effect (RR = 0.14, 95% CI 0.05–0.42, = 0.001) against severe RSV disease, while an increased risk was documented for each additional day elapsed between the date of symptom onset and the date of seeking healthcare RR = 1.06, 95% CI 1.02–1.10, = 0.004).
Conclusion
These findings provide insights into risk stratification and suggest specific directions for future research. This information informs the development of targeted intervention strategies to mitigate the impact of RSV infections in this vulnerable population.
{"title":"Risk factors for severe disease in pediatric respiratory syncytial virus infections","authors":"","doi":"10.1016/j.puhe.2024.06.023","DOIUrl":"10.1016/j.puhe.2024.06.023","url":null,"abstract":"<div><h3>Objectives</h3><p>To assess factors associated with the risk of severe disease in children aged 5 years or younger with laboratory-confirmed respiratory syncytial virus (RSV) infection.</p></div><div><h3>Study design</h3><p>We conducted a nationwide retrospective cohort study in Mexico.</p></div><div><h3>Methods</h3><p>Eligible participants included children aged 5 years or younger with laboratory-confirmed RSV infection January 1, 2023, and May 15, 2024. We collected relevant clinical and epidemiological data. Risk ratios (RR) and 95% confidence intervals (CI) were employed to identify factors associated with the risk of severe disease, characterized by clinical and radiographic evidence of bronchiolitis or pneumonia requiring hospital admission.</p></div><div><h3>Results</h3><p>Data from 2022 children were analyzed and the overall risk of severe disease was 21.0% (<em>n</em> = 424/2022). In multiple generalized linear regression analysis, a personal history of immunosuppression (due to any cause) showed a protective effect (RR = 0.14, 95% CI 0.05–0.42, <span><math><mrow><mi>P</mi></mrow></math></span> = 0.001) against severe RSV disease, while an increased risk was documented for each additional day elapsed between the date of symptom onset and the date of seeking healthcare RR = 1.06, 95% CI 1.02–1.10, <span><math><mrow><mi>P</mi></mrow></math></span> = 0.004).</p></div><div><h3>Conclusion</h3><p>These findings provide insights into risk stratification and suggest specific directions for future research. This information informs the development of targeted intervention strategies to mitigate the impact of RSV infections in this vulnerable population.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141978754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-13DOI: 10.1016/j.puhe.2024.06.004
Objectives
Both obesity and non-alcoholic fatty liver disease (NAFLD) increase the risk of metabolic abnormalities. However, the metabolic status of children suffering from NAFLD and exhibiting various subtypes of obesity is currently unclear. We aimed to explore the association between NAFLD and metabolic abnormalities in children with different weight statuses.
Methods
We included 6086 participants aged 6–18 years from the China Child and Adolescent NAFLD Study (CCANS), all of whom had undergone ultrasonography or magnetic resonance imaging-proton density fat fraction (MRI-PDFF) to identify NAFLD and metabolic abnormalities, including hyperglycemia, high triglycerides (TG), low high-density lipoprotein cholesterol (HDL-C), high low-density lipoprotein cholesterol, high total cholesterol, and hyperuricemia.
Results
Among the participants, there were 2408 children with obesity and NAFLD, 174 with NAFLD, 2396 with obesity, and 1108 without obesity and NAFLD. The odds ratios (ORs) of suffering from individual metabolic abnormalities were significantly greater in children with obesity and NAFLD than in children without obesity and NAFLD, with ORs ranging from 6.23 (95% CI: 4.56, 8.53) to 1.77 (95% CI: 1.06, 2.94). The ORs of metabolic abnormalities, except for low HDL-C, were greater in children with NAFLD alone than in children without obesity or NAFLD, with ORs ranging from 4.36 (95% CI: 2.77, 6.84) to 2.08 (95% CI: 1.14, 3.78). Notably, obesity and NAFLD had a multiplicative effect on overall metabolic abnormalities, high TG levels, and low HDL-C levels.
Conclusions
Children with obesity and NAFLD could be at a significantly increased risk of metabolic abnormalities. Even for children without obesity, NAFLD appears to be associated with an increased risk of experiencing a worsened metabolic status.
{"title":"Association between non-alcoholic fatty liver disease and metabolic abnormalities in children with different weight statuses","authors":"","doi":"10.1016/j.puhe.2024.06.004","DOIUrl":"10.1016/j.puhe.2024.06.004","url":null,"abstract":"<div><h3>Objectives</h3><p>Both obesity and non-alcoholic fatty liver disease (NAFLD) increase the risk of metabolic abnormalities. However, the metabolic status of children suffering from NAFLD and exhibiting various subtypes of obesity is currently unclear. We aimed to explore the association between NAFLD and metabolic abnormalities in children with different weight statuses.</p></div><div><h3>Methods</h3><p>We included 6086 participants aged 6–18 years from the China Child and Adolescent NAFLD Study (CCANS), all of whom had undergone ultrasonography or magnetic resonance imaging-proton density fat fraction (MRI-PDFF) to identify NAFLD and metabolic abnormalities, including hyperglycemia, high triglycerides (TG), low high-density lipoprotein cholesterol (HDL-C), high low-density lipoprotein cholesterol, high total cholesterol, and hyperuricemia.</p></div><div><h3>Results</h3><p>Among the participants, there were 2408 children with obesity and NAFLD, 174 with NAFLD, 2396 with obesity, and 1108 without obesity and NAFLD. The odds ratios (ORs) of suffering from individual metabolic abnormalities were significantly greater in children with obesity and NAFLD than in children without obesity and NAFLD, with ORs ranging from 6.23 (95% CI: 4.56, 8.53) to 1.77 (95% CI: 1.06, 2.94). The ORs of metabolic abnormalities, except for low HDL-C, were greater in children with NAFLD alone than in children without obesity or NAFLD, with ORs ranging from 4.36 (95% CI: 2.77, 6.84) to 2.08 (95% CI: 1.14, 3.78). Notably, obesity and NAFLD had a multiplicative effect on overall metabolic abnormalities, high TG levels, and low HDL-C levels.</p></div><div><h3>Conclusions</h3><p>Children with obesity and NAFLD could be at a significantly increased risk of metabolic abnormalities. Even for children without obesity, NAFLD appears to be associated with an increased risk of experiencing a worsened metabolic status.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141978753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-13DOI: 10.1016/j.puhe.2024.06.032
Objective
The objective of this study was to investigate the effects of self-management education integrated with text-message support (SME-TMS) on glycaemic control in individuals with type 2 diabetes.
Study design
a randomized, controlled trial.
Methods
Patients from two communities were randomized into the intervention group (n = 53) or the control group (n = 52). The six-month intervention included the culturally tailored diabetes education and text-messaging support for behaviour changes. The control group received treatment as usual. The primary outcome was reductions in HbA1c and fasting blood glucose at six-month non-intervention follow-up. Secondary outcomes were reductions in body weight, body mass index (BMI), blood pressure, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, physical activity, and health beliefs.
Results
The intervention led to substantially increase days of weekly physical activity (42% vs. 0%, P < 0.001) and health beliefs (coefficient = 7.0, 95% confidence interval [CI]: 4.4 to 9.6, P < 0.001). However, no greater reduction was found in HbA1c at six months after the intervention, compared with the control group (0.13%, 95% CI: −0.20 to 0.46, P = 0.443). The reductions of blood pressure, TC, and LDL-C were greater in the control group than in the intervention group (all P < 0.050). Within the intervention group, participants had significant reduction in BMI, whereas the control group had greater reductions in TC and LDL-C (all P < 0.050).
Conclusions
The SME-TMS intervention led to a greater increase in the weekly physical activity and health belief score in the older patients at 6-month follow-up than with the usual care. Further research is needed to ascertain how these benefits could be translated into favorable medium-and long-term glycaemic control.
Trail registration number
This study was registered on Chinese Clinical Trials Registry (ChiCTR2300075112).
{"title":"Effects of a diabetes education program integrated with text-message support for lifestyle change among older individuals with type 2 diabetes in communities: a randomised controlled trial","authors":"","doi":"10.1016/j.puhe.2024.06.032","DOIUrl":"10.1016/j.puhe.2024.06.032","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this study was to investigate the effects of self-management education integrated with text-message support (SME-TMS) on glycaemic control in individuals with type 2 diabetes.</p></div><div><h3>Study design</h3><p>a randomized, controlled trial.</p></div><div><h3>Methods</h3><p>Patients from two communities were randomized into the intervention group (<em>n</em> = 53) or the control group (<em>n</em> = 52). The six-month intervention included the culturally tailored diabetes education and text-messaging support for behaviour changes. The control group received treatment as usual. The primary outcome was reductions in HbA<sub>1c</sub> and fasting blood glucose at six-month non-intervention follow-up. Secondary outcomes were reductions in body weight, body mass index (BMI), blood pressure, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, physical activity, and health beliefs.</p></div><div><h3>Results</h3><p>The intervention led to substantially increase days of weekly physical activity (42% vs. 0%, <em>P</em> < 0.001) and health beliefs (coefficient = 7.0, 95% confidence interval [CI]: 4.4 to 9.6, <em>P</em> < 0.001). However, no greater reduction was found in HbA<sub>1c</sub> at six months after the intervention, compared with the control group (0.13%, 95% CI: −0.20 to 0.46, <em>P</em> = 0.443). The reductions of blood pressure, TC, and LDL-C were greater in the control group than in the intervention group (all <em>P</em> < 0.050). Within the intervention group, participants had significant reduction in BMI, whereas the control group had greater reductions in TC and LDL-C (all <em>P</em> < 0.050).</p></div><div><h3>Conclusions</h3><p>The SME-TMS intervention led to a greater increase in the weekly physical activity and health belief score in the older patients at 6-month follow-up than with the usual care. Further research is needed to ascertain how these benefits could be translated into favorable medium-and long-term glycaemic control.</p></div><div><h3>Trail registration number</h3><p>This study was registered on Chinese Clinical Trials Registry (ChiCTR2300075112).</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-12DOI: 10.1016/j.puhe.2024.06.033
Objective
To determine the parameters for providing primary care in cardiovascular health, with an ethnic and gender focus through telemedicine.
Study Design
Systematic Literature Review.
Methods
A systematic review was conducted using databases including PUBMED, Cochrane Library, CINAHL, EMBASE VHL, and other relevant sources. We included articles published in the last 15 years on parameters of telemedicine care with a differential approach focusing on ethnicity and gender. Screening, full-text reading, and information extraction were performed in duplicate and independently, though methodological quality assessment was not conducted.
Results
Twenty-eight studies were included, with 46.43% originating from Australia and 50.00% employing a qualitative approach. Thirty-five point seventy-one percent provided operational recommendations, and 32.14% related to the ethnic approach. Seven operational categories were identified: holistic approach to health, flexible approach to health, accessible health services, continuous improvement in service quality, culturally appropriate and qualified workforce, self-determination and empowerment, and community participation. Additionally, five categories were identified pertaining to the ethnic approach: public policy in favor of ancestral knowledge in primary health care, training of community agents and health personnel from an intercultural perspective, complementarity between traditional and western health practices, and the recognition of telehealth's value in intercultural approaches.
Conclusions
There is a need to adjust operational aspects related to the implementation of indigenous public policy, and to increase the number of qualified community human resources to provide holistic, comprehensive, and culturally appropriate care. Regarding gender, there is a necessity to implement public policy based on health determinants that will dismantle barriers to accessing gender-specific services and comprehensively assess cardiovascular risk.
{"title":"Parameters for delivering ethnically and gender-sensitive primary care in cardiovascular health through telehealth. Systematic review","authors":"","doi":"10.1016/j.puhe.2024.06.033","DOIUrl":"10.1016/j.puhe.2024.06.033","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the parameters for providing primary care in cardiovascular health, with an ethnic and gender focus through telemedicine.</p></div><div><h3>Study Design</h3><p>Systematic Literature Review.</p></div><div><h3>Methods</h3><p>A systematic review was conducted using databases including PUBMED, Cochrane Library, CINAHL, EMBASE VHL, and other relevant sources. We included articles published in the last 15 years on parameters of telemedicine care with a differential approach focusing on ethnicity and gender. Screening, full-text reading, and information extraction were performed in duplicate and independently, though methodological quality assessment was not conducted.</p></div><div><h3>Results</h3><p>Twenty-eight studies were included, with 46.43% originating from Australia and 50.00% employing a qualitative approach. Thirty-five point seventy-one percent provided operational recommendations, and 32.14% related to the ethnic approach. Seven operational categories were identified: holistic approach to health, flexible approach to health, accessible health services, continuous improvement in service quality, culturally appropriate and qualified workforce, self-determination and empowerment, and community participation. Additionally, five categories were identified pertaining to the ethnic approach: public policy in favor of ancestral knowledge in primary health care, training of community agents and health personnel from an intercultural perspective, complementarity between traditional and western health practices, and the recognition of telehealth's value in intercultural approaches.</p></div><div><h3>Conclusions</h3><p>There is a need to adjust operational aspects related to the implementation of indigenous public policy, and to increase the number of qualified community human resources to provide holistic, comprehensive, and culturally appropriate care. Regarding gender, there is a necessity to implement public policy based on health determinants that will dismantle barriers to accessing gender-specific services and comprehensively assess cardiovascular risk.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141953936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02DOI: 10.1016/j.puhe.2024.07.002
Objectives
Food security plays a critical role in achieving Sustainable Development Goal 2 (SDG-2) and public health outcomes; however, its effectiveness under the impact of international sanctions remains unclear. This study examined the impact of international sanctions on achieving SDG-2 and food security.
Study design
This cross-country empirical analysis was based on a combined database that included data from the Global Sanctions Data Base (GSDB), Food and Agriculture Organization Statistics (FAOSTAT) and United Nations (UN) Comtrade.
Methods
First, an instrumental variable (IV) strategy was used to deal with the endogeneity of other events in target countries’ sanctions. Second, a two-stage least square (2SLS) regression was conducted using high-dimensional fixed effects. Third, based on the Structural Gravity Model, a Poisson pseudo maximum likelihood (PPML) regression on bilateral agricultural trade was performed.
Results
Findings from this study showed that international sanctions had a negative impact on the achievement of SDG-2 and food security, which was associated with poor public health outcomes. This was mainly evidenced by an increase in the prevalence of undernourishment and a high population of children with moderate or severe stunting. Sanctions were also shown to distort the agricultural value-added share and decrease domestic agricultural production. In addition, sanctions impeded bilateral import supply, which resulted in a lower import value and quantity, and a higher import price.
Conclusions
Food security and agricultural sustainability associated with hunger, nutrition and health from 1950 to 2019 were significantly associated with international sanctions. Under the uncertain shock of international sanctions, progress towards SDG-2 deteriorated, mainly for Targets 2.1, 2.2 and 2.a, and the impact was non uniform across all targets. From a sociopolitical perspective, the empirical findings of this study provide vital lessons for policymakers and public health communities to increase humanitarian outreach.
{"title":"The impact of international sanctions on food security and Sustainable Development Goal 2 (SDG-2)","authors":"","doi":"10.1016/j.puhe.2024.07.002","DOIUrl":"10.1016/j.puhe.2024.07.002","url":null,"abstract":"<div><h3>Objectives</h3><p>Food security plays a critical role in achieving Sustainable Development Goal 2 (SDG-2) and public health outcomes; however, its effectiveness under the impact of international sanctions remains unclear. This study examined the impact of international sanctions on achieving SDG-2 and food security.</p></div><div><h3>Study design</h3><p>This cross-country empirical analysis was based on a combined database that included data from the Global Sanctions Data Base (GSDB), Food and Agriculture Organization Statistics (FAOSTAT) and United Nations (UN) Comtrade.</p></div><div><h3>Methods</h3><p>First, an instrumental variable (IV) strategy was used to deal with the endogeneity of other events in target countries’ sanctions. Second, a two-stage least square (2SLS) regression was conducted using high-dimensional fixed effects. Third, based on the Structural Gravity Model, a Poisson pseudo maximum likelihood (PPML) regression on bilateral agricultural trade was performed.</p></div><div><h3>Results</h3><p>Findings from this study showed that international sanctions had a negative impact on the achievement of SDG-2 and food security, which was associated with poor public health outcomes. This was mainly evidenced by an increase in the prevalence of undernourishment and a high population of children with moderate or severe stunting. Sanctions were also shown to distort the agricultural value-added share and decrease domestic agricultural production. In addition, sanctions impeded bilateral import supply, which resulted in a lower import value and quantity, and a higher import price.</p></div><div><h3>Conclusions</h3><p>Food security and agricultural sustainability associated with hunger, nutrition and health from 1950 to 2019 were significantly associated with international sanctions. Under the uncertain shock of international sanctions, progress towards SDG-2 deteriorated, mainly for Targets 2.1, 2.2 and 2.a, and the impact was non uniform across all targets. From a sociopolitical perspective, the empirical findings of this study provide vital lessons for policymakers and public health communities to increase humanitarian outreach.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02DOI: 10.1016/j.puhe.2024.06.005
Objectives
This study aims to evaluate the age- and sex-specific associations of comorbidities with stroke and MI and further calculate the population-attributable fractions (PAFs) of five comorbid diseases for stroke and myocardial infarction (MI) by age and sex.
Study design
This is a prospective cohort study.
Methods
This study leveraged data from a sub-cohort of the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project. Participants aged 35–75 years without a prevalent stroke and MI were enrolled from January 2016 to December 2020, with follow-up through December 2021. Five common comorbidities were collected at baseline, and the study outcome was hospitalization for stroke and MI identified from the Inpatients Registry.
Results
Of 100,873 participants, the mean age was 54.2 (±10.2) years, 34.2% were ≥60 years old, and 60.8% were women. After a median follow-up of 3.52 years, 4156 participants had stroke/MI. The strengths of the associations between hypertension, diabetes, and obesity with stroke/MI were higher in younger individuals than in seniors, and obesity had a more hazardous impact on stroke/MI in men than in women. The five comorbidities collectively explained a higher population attributable fraction (PAF) for stroke/MI in the young group (51.5[46.9, 55.7] %) than in the senior group (41.3[37.0, 45.4] %), in men (45.6[40.9, 49.9] %) than in women (41.1[36.1, 45.7] %).
Conclusions
Most of the common comorbidities were significantly associated with stroke and MI. Several age and sex differences in the impacts of comorbidities on stroke/MI were observed, highlighting the importance of age- and sex-specific preventive strategies to reduce premature stroke and MI.
{"title":"Age and sex differences in the impact of common comorbidities on stroke and myocardial infarction: results from the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project","authors":"","doi":"10.1016/j.puhe.2024.06.005","DOIUrl":"10.1016/j.puhe.2024.06.005","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aims to evaluate the age- and sex-specific associations of comorbidities with stroke and MI and further calculate the population-attributable fractions (PAFs) of five comorbid diseases for stroke and myocardial infarction (MI) by age and sex.</p></div><div><h3>Study design</h3><p>This is a prospective cohort study.</p></div><div><h3>Methods</h3><p>This study leveraged data from a sub-cohort of the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project. Participants aged 35–75 years without a prevalent stroke and MI were enrolled from January 2016 to December 2020, with follow-up through December 2021. Five common comorbidities were collected at baseline, and the study outcome was hospitalization for stroke and MI identified from the Inpatients Registry.</p></div><div><h3>Results</h3><p>Of 100,873 participants, the mean age was 54.2 (±10.2) years, 34.2% were ≥60 years old, and 60.8% were women. After a median follow-up of 3.52 years, 4156 participants had stroke/MI. The strengths of the associations between hypertension, diabetes, and obesity with stroke/MI were higher in younger individuals than in seniors, and obesity had a more hazardous impact on stroke/MI in men than in women. The five comorbidities collectively explained a higher population attributable fraction (PAF) for stroke/MI in the young group (51.5[46.9, 55.7] %) than in the senior group (41.3[37.0, 45.4] %), in men (45.6[40.9, 49.9] %) than in women (41.1[36.1, 45.7] %).</p></div><div><h3>Conclusions</h3><p>Most of the common comorbidities were significantly associated with stroke and MI. Several age and sex differences in the impacts of comorbidities on stroke/MI were observed, highlighting the importance of age- and sex-specific preventive strategies to reduce premature stroke and MI.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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