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Antimicrobial Prescription Assessment Tool (AmPAT) development and validation for assessing the rationality of antimicrobial prescriptions in primary and secondary healthcare settings in India 抗菌药物处方评估工具 (AmPAT) 的开发和验证，用于评估印度初级和二级医疗机构中抗菌药物处方的合理性。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2024-11-21 DOI: 10.1016/j.puhe.2024.11.009

Adarsh Bansal , Madhu Gupta , Nusrat Shafiq , Atul Saroch , Tanvi Kiran , Jayashree Muralidharan

Objectives

Antimicrobials prescribed without indications can lead to antimicrobial resistance (AMR). This study aimed to develop a validated support and audit antimicrobial prescription assessment tool (AmPAT) to assess the rationality of prescriptions by generalist medical doctors in outpatient settings at primary and secondary healthcare facilities.

Study design

Multiphase content validity study.

Methods

AmPAT was developed in four phases. Phase 1 involved item identification and development based on literature and expert suggestions. In phase 2, the face and content validity were assessed using the Delphi technique in two rounds (16 experts in round 1 and 19 in round 2). The content validity ratio (CVR) and content validity index (CVI) were calculated. A pilot study was conducted in Phase 3 in primary and secondary-level healthcare facilities (n = 92 prescriptions) in Chandigarh, India. Five experts assessed the rationality of 30 prescriptions for inter-rater reliability. The inter-rater agreement and internal consistency were calculated using Fleiss-Kappa statistics and Cronbach's alpha, respectively. Phase 4 included a large cross-sectional study (n = 945 prescriptions) for estimating the internal consistency of AmPAT.

Results

AmPAT was developed with 19 items under three sections (patient, clinical, and treatment details). The mean CVR was 0.91 (range 0.16–1.00), and mean CVI was 0.96 (range 0.58–1.00). The kappa value was 0.91 (range 0.59–1.00) for inter-rater agreement. The Cronbach's alpha was 0.75 (95%CI 0.66–0.82) and 0.76 (0.68–0.82) in phases 3 and 4, respectively.

Conclusion

AmPAT, with good reliability, inter-rater agreement, and internal consistency, was developed to assess the rationality of antimicrobials prescribed in outpatient departments at primary and secondary-level healthcare settings.

目的：无指征处方抗菌药会导致抗菌药耐药性（AMR）。本研究旨在开发一种经过验证的支持和审计抗菌药物处方评估工具（AmPAT），以评估初级和二级医疗机构门诊环境中全科医生处方的合理性：研究设计：多阶段内容效度研究：AmPAT 分四个阶段开发。第一阶段是根据文献和专家建议确定和开发项目。在第二阶段，采用德尔菲技术分两轮对表面效度和内容效度进行评估（第一轮16名专家，第二轮19名专家）。计算了内容效度比（CVR）和内容效度指数（CVI）。第 3 阶段在印度昌迪加尔的一级和二级医疗机构进行了试点研究（n = 92 张处方）。五位专家对 30 份处方的合理性进行了评估，以获得评分者间的可靠性。评分者之间的一致性和内部一致性分别采用 Fleiss-Kappa 统计法和 Cronbach's alpha 计算。第 4 阶段包括一项大型横断面研究（n = 945 个处方），以估计 AmPAT 的内部一致性：结果：AmPAT 包含三个部分（患者、临床和治疗细节）共 19 个项目。平均 CVR 为 0.91（范围为 0.16-1.00），平均 CVI 为 0.96（范围为 0.58-1.00）。评分者之间的一致性卡帕值为 0.91（范围 0.59-1.00）。第 3 和第 4 阶段的 Cronbach's alpha 分别为 0.75（95%CI 0.66-0.82）和 0.76（0.68-0.82）：AmPAT具有良好的可靠性、评分者之间的一致性和内部一致性，可用于评估基层和二级医疗机构门诊处方抗菌药物的合理性。

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引用次数: 0

Quantifying the prevalence and determinants of respiratory syncytial virus (RSV) vaccine hesitancy in US adults aged 60 or older 量化美国 60 岁及以上成年人对呼吸道合胞病毒 (RSV) 疫苗犹豫不决的普遍程度和决定因素。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2024-11-19 DOI: 10.1016/j.puhe.2024.08.004

M. Motta , T. Callaghan , M. Padmanabhan , J. Ross , L.M. Gargano , S. Bowman , D. Yokum

Objective

Federal regulators recently authorised two vaccines designed to prevent infection with respiratory syncytial virus (RSV) for adults aged 60 or older. While some efforts have been made to study vaccine uptake thus far, few have studied this group's intentions to vaccinate, as well as potential barriers to vaccination. This omission is noteworthy as adults aged 60 or older may be at an increased risk of experiencing severe complications from RSV infection.

Study design & Methods

We fielded a nationally representative survey of 1200 US adults (n = 362 aged 60+). Respondents aged 60 or older were asked a series of questions about their willingness to receive an RSV vaccine, vaccine safety, and efficacy attitudes, and their knowledge about vaccination eligibility.

Results

We find that a majority of seniors (53%) intend to refuse an RSV vaccine. As of late fall 2023, just 14% of those eligible had already received an RSV vaccine. Multivariate regression models suggest that belief in the safety and efficacy of the RSV vaccine, as well as previous flu and COVID-19 vaccine uptake, are associated with increased RSV vaccination intentions.

Conclusions

We document high levels of RSV vaccine hesitancy among adults aged 60 or older and show that negative vaccine attitudes and non-vaccination behaviors motivate RSV vaccine refusal. Our work thereby raises the possibility that efforts to communicate the safety and efficacy of RSV vaccination may have beneficial effects on RSV vaccine uptake.

目的：联邦监管机构最近批准了两种疫苗，旨在预防 60 岁或以上成年人感染呼吸道合胞病毒 (RSV)。虽然迄今为止已经对疫苗的接种情况进行了一些研究，但很少有人研究过这一群体接种疫苗的意愿以及接种疫苗的潜在障碍。这一疏忽值得注意，因为 60 岁或以上的成年人感染 RSV 后出现严重并发症的风险可能会增加：我们对 1200 名美国成年人（n = 362 名 60 岁以上的成年人）进行了一项具有全国代表性的调查。我们向 60 岁或以上的受访者提出了一系列问题，内容涉及他们接种 RSV 疫苗的意愿、对疫苗安全性和有效性的态度以及他们对疫苗接种资格的了解：我们发现，大多数老年人（53%）打算拒绝接种 RSV 疫苗。截至 2023 年晚秋，仅有 14% 的合格者已经接种了 RSV 疫苗。多变量回归模型表明，相信 RSV 疫苗的安全性和有效性以及之前接种流感疫苗和 COVID-19 疫苗与 RSV 疫苗接种意向的增加有关：我们记录了 60 岁或以上成年人对 RSV 疫苗的高度犹豫，并表明消极的疫苗态度和不接种行为是拒绝接种 RSV 疫苗的原因。因此，我们的工作提出了一种可能性，即努力宣传 RSV 疫苗接种的安全性和有效性可能会对 RSV 疫苗的接种产生有益的影响。

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引用次数: 0

Burden of Disease in Latin America: Towards a data-driven public health approach 拉丁美洲的疾病负担：采用数据驱动的公共卫生方法。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2024-11-18 DOI: 10.1016/j.puhe.2024.11.001

D.C. Malta, P.J. Garcia, M.J. Rios-Blancas, A.L.P Ribeiro

引用次数: 0

Integrated care for chronic diseases: An evolutionary step for emerging primary health care systems 慢性病综合护理：新兴初级医疗保健系统的进化步骤。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2024-11-16 DOI: 10.1016/j.puhe.2024.11.007

Muslim Abbas Syed, Mohamed Ahmed Syed, Andrew CK. Lee

Globally, people are living longer, and many will have multiple, complex chronic diseases. These chronic diseases are often a leading cause of death and disability particularly in emerging developed countries. For these emerging nations, the current trajectory of gradual health system change is likely to lag changing population needs and escalating cost pressures. Consequently, there is a need for a stepwise evolutionary change in the approach to care delivery in these countries. The integrated care (IC) concept describes a collaborative model for organizing healthcare systems, particularly for chronic disease management that pulls together health systems, social science, managerial and patient-centered perspectives. The IC approach could help drive forward efforts to improve population health outcomes, reduce duplication and inefficiency in health care systems, and could be the solution needed by emerging developed countries.

在全球范围内，人们的寿命越来越长，许多人会患有多种复杂的慢性疾病。这些慢性病往往是导致死亡和残疾的主要原因，尤其是在新兴发达国家。对于这些新兴国家来说，目前逐步改变医疗系统的轨迹很可能会落后于不断变化的人口需求和不断升级的成本压力。因此，这些国家需要逐步改变提供医疗服务的方式。综合护理（IC）概念描述了一种组织医疗保健系统的合作模式，特别是在慢性病管理方面，它将医疗保健系统、社会科学、管理和以患者为中心的观点结合在一起。综合护理方法有助于推动改善人口健康成果的工作，减少医疗保健系统中的重复和低效，并可能成为新兴发达国家所需的解决方案。

引用次数: 0

Association of regular health check-ups with a reduction in mortality in 625,279 elderly participants with hypertension: A population-based cohort study 在 625 279 名患有高血压的老年参与者中，定期健康检查与降低死亡率的关系：一项基于人群的队列研究。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2024-11-14 DOI: 10.1016/j.puhe.2024.10.024

Zhengxin Li , Junru Wu , Qing Wen , Sangya Fu , Xuejing Sun , Tian He , Wen Zhang , Yao Lu , Hong Yuan , Jingjing Cai

Objectives

Health check-ups constitute an essential part of China's primary health care policy and a key measure for health screening and risk assessment for elderly people with hypertension and chronic diseases. The role of health check-ups in reducing the incidence of cardiovascular and all-cause mortality remains controversial. This study aimed to investigate the relationship between health check-ups and cardiovascular and all-cause mortality in elderly individuals with hypertension.

Study design

Retrospective cohort study.

Methods

This study included 625,279 elderly participants with hypertension. Associations of regular and irregular health check-ups with cardiovascular disease related (CVD-related) mortality, all-cause mortality and non-CVD-related mortality were tested via the inverse probability of treatment weighting (IPTW) matching and Cox proportional hazard models. Adjusted hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated for mortality.

Results

A total of 625,279 participants completed health assessments. During a median follow-up of 5.43 years, 45,927 CVD-related deaths and 25,519 non-CVD-related deaths were recorded. After IPTW, regular health check-ups were significantly associated with reduced CVD-related mortality and all-cause mortality (HR: 0.442, 95 % CI: 0.434–0.450; and HR: 0.441, 95 % CI: 0.435–0.448, respectively). An even stronger association between regular health check-ups and reduced CVD-related mortality was observed in participants with diabetes (HR: 0.40, 95 % CI: 0.39–0.42, P for interaction <0.001), dyslipidaemia (HR: 0.43, 95 % CI: 0.42–0.44, P for interaction <0.001) and a high risk or very high risk of hypertension (HR: 0.41, 95 % CI: 0.40–0.42, P for interaction <0.001).

Conclusions

Regular health check-ups may be associated with reductions in CVD mortality and all-cause mortality in the elderly population with hypertension, especially in individuals with diabetes, dyslipidaemia and a high risk or very high risk of hypertension.

目的：健康体检是中国初级卫生保健政策的重要组成部分，也是对患有高血压和慢性病的老年人进行健康筛查和风险评估的关键措施。健康体检在降低心血管疾病和全因死亡率方面的作用仍存在争议。本研究旨在调查健康体检与患有高血压的老年人心血管疾病和全因死亡率之间的关系：研究设计：回顾性队列研究：这项研究纳入了625279名患有高血压的老年人。通过逆概率治疗加权（IPTW）匹配和 Cox 比例危险模型，检验了定期和不定期健康检查与心血管疾病相关（CVD 相关）死亡率、全因死亡率和非 CVD 相关死亡率的关系。对死亡率的调整后危险比（HRs）和 95 % 置信区间（CIs）进行了估计：共有 625 279 名参与者完成了健康评估。在 5.43 年的中位随访期间，共记录了 45,927 例心血管疾病相关死亡和 25,519 例非心血管疾病相关死亡。在 IPTW 之后，定期健康检查与心血管疾病相关死亡率和全因死亡率的降低显著相关（HR：0.442，95 % CI：0.434-0.450；HR：0.441，95 % CI：0.435-0.448）。在糖尿病患者中，定期健康检查与降低心血管疾病相关死亡率之间的关系更为密切（HR：0.40，95 % CI：0.39-0.42，P 为交互作用结论）：在患有高血压的老年人群中，尤其是在患有糖尿病、血脂异常和高血压高风险或极高风险的人群中，定期体检可能与心血管疾病死亡率和全因死亡率的降低有关。

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引用次数: 0

The effect of parents' lifestyle on Schoolchildren's consumption of ultra-processed food 父母的生活方式对学童食用超加工食品的影响。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2024-11-13 DOI: 10.1016/j.puhe.2024.11.005

G.A.L. Oliveira , V.S.S. Gonçalves , E.Y. Nakano , N. Toral

Objectives

To assess the association between schoolchildren's consumption of ultra-processed foods (UPFs) and various lifestyle factors of their parents in Brazil.

Study design

Cross-sectional population-based study with parent-child dyads aged 6–11.

Methods

The sample was distributed proportionally across Brazilian macro-regions and type of school. Recruitment utilized the snowball technique, and participants filled in an online questionnaire. Initially, parents provided data on education, eating practices, food consumption markers, screen time, and physical activity. Subsequently, their children reported their UPF consumption using the Illustrated Questionnaire on Food Consumption for Brazilian Schoolchildren. The UPF consumption among children was assessed using the NOVA score. Poisson's regression log-linear analysis was performed (p < 0.05) with adjustments for macro-regions, type of school (as a proxy for socioeconomic status), gender, and age of the child.

Results

This study included a total of 2021 child-parent dyads. On average, children consumed 3.5 UPFs on the previous day. We found a significant association between high consumption of UPFs by the child and parents with less healthy eating practices (p < 0.05), excessive screen time (p < 0.05), and high UPF consumption (p < 0.05).

Conclusions

These findings demonstrate a relationship between Brazilian schoolchildren's consumption of UPFs and various lifestyle factors of their parents, particularly regarding eating practices, food consumption markers, screen time, and physical activity. This underscores the importance of the home food environment in shaping children's health during this critical developmental stage of life, emphasizing the need to incorporate support for family lifestyle factors into public health policies.

研究目的评估巴西学龄儿童食用超标加工食品（UPF）与父母各种生活方式因素之间的关联：研究设计：以人口为基础的横断面研究，研究对象为 6-11 岁的亲子二人组：样本按比例分布于巴西各大区和学校类型。采用 "滚雪球 "技术进行招募，参与者填写在线问卷。首先，家长提供了有关教育、饮食习惯、食物消费标记、屏幕时间和体育活动的数据。随后，他们的子女使用《巴西学童食品消费图解问卷》报告了自己的 UPF 消费情况。儿童的 UPF 消费情况通过 NOVA 分数进行评估。进行了泊松回归对数线性分析（P 结果：这项研究共包括 2021 个儿童-家长二元组。平均而言，儿童在前一天摄入了 3.5 个 UPF。我们发现，儿童摄入较多的 UPFs 与父母的饮食习惯不太健康之间存在明显的关联（p 结论：这些研究结果表明，巴西的学校和家庭之间存在一定的关系：这些研究结果表明，巴西学龄儿童的 UPFs 消费量与其父母的各种生活方式因素（尤其是饮食习惯、食物消费指标、屏幕时间和体育活动）之间存在关系。这凸显了家庭饮食环境对儿童在这一人生关键发育阶段的健康塑造的重要性，强调了将支持家庭生活方式因素纳入公共卫生政策的必要性。

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引用次数: 0

Gender-dependent effect of physical activity on the risk of incident multimorbidity during the COVID-19 pandemic: Findings from the PAMPA cohort, Brazil 在 COVID-19 大流行期间，体育锻炼对突发多病风险的影响与性别有关：巴西 PAMPA 队列的研究结果。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2024-11-13 DOI: 10.1016/j.puhe.2024.11.006

Natan Feter , Felipe Mendes Delpino , Felipe Fossati Reichert , Eduardo L. Caputo , Airton J. Rombaldi , Caroline Huckembeck , Jayne Santos Leite , Carine Nascimento da Silva , Júlia Cassuriaga , Ricardo Alt , Marcelo Cozzensa da Silva

Objectives

We aimed to investigate the association between physical activity (PA) and the risk of incident multimorbidity in adults from southern Brazil during the COVID-19 pandemic.

Study design

Prospective Study.

Methods

We analyzed data from the Prospective Study about Physical and Mental Health (PAMPA) cohort, a longitudinal study of adults living in southern Brazil. The baseline assessment occurred in June/July 2020, and further data collection occurred 6 and 12 months later. Participants with no multimorbidity (2 or more simultaneous chronic conditions) at baseline were included in the present analysis. PA weekly volume, status, type, and place were also assessed at baseline.

Results

Over one year, 30.8 % of participants developed multimorbidity. Men participants, classified as physically active before or during the pandemic, had reduced risk of multimorbidity. Practicing PA at home reduced the risk in both genders, while PA at and out of home only reduced the risk in women participants. Endurance and combined activities reduced the risk among women, while strength activities reduced the risk in both genders.

Conclusions

PA reduced the risk of incident multimorbidity among adults in southern Brazil, with different parameters moderating this effect between genders.

研究目的研究设计：前瞻性研究：研究设计：前瞻性研究：我们分析了身心健康前瞻性研究（PAMPA）队列中的数据，这是一项针对巴西南部成年人的纵向研究。基线评估于 2020 年 6 月/7 月进行，6 个月和 12 个月后进一步收集数据。基线时未患有多病（同时患有两种或两种以上慢性病）的参与者被纳入本次分析。基线时还评估了每周的运动量、状态、类型和地点：结果：一年中，30.8%的参与者患上了多病。在大流行之前或期间被归类为体育锻炼的男性参与者患多种疾病的风险较低。在家中进行体育锻炼可降低男女参与者的患病风险，而在家中和户外进行体育锻炼只能降低女性参与者的患病风险。耐力活动和综合活动降低了女性的风险，而力量活动则降低了男女的风险：结论：体育锻炼降低了巴西南部成年人发生多病症的风险，不同的参数对性别间的影响有调节作用。

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引用次数: 0

Envisioning the sustainable and climate resilient hospital of the future 展望未来可持续发展和气候适应性强的医院。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2024-11-12 DOI: 10.1016/j.puhe.2024.10.028

Federica Pascale , Nebil Achour

Objectives

This study aims to create a vision of the future hospital to help healthcare leaders understand how changes in society and the healthcare system, compounded by climate change, could affect future hospital estate.

Study design

The study is part of a larger project based on participatory backcasting aimed at providing integrated strategies for transitioning to a zero-carbon future and adapting to existing climate change through improved asset management.

Methods

The data presented in this paper were collected during a full-day workshop to construct the vision of the future hospital in 2050. A multidisciplinary team of 19 participants participated in the discussions. A six-phase thematic analysis was applied to the data to develop the narrative vision and graphic recording.

Results

The healthcare system is undergoing transformative changes due to evolving healthcare delivery, patient expectations, emerging technologies, climate change, and sustainability. However, current hospital strategies often fail to consider the interrelationship between the hospital estate and its socio-environmental context. Policymakers, healthcare system leaders, and hospital leaders need a clear vision of the hospital of the future to implement transformational strategies.

Conclusions

Healthcare transformations require shifting from traditional centralised hospitals to a more flexible, distributed model. Healthcare leaders need to proactively assess how hospitals respond to current and future hazards and consider the impacts within the context of integrated and dispersed healthcare delivery. To address this, a systematic approach to modelling hazards and evaluating design or upgrading options is essential to mitigate the transfer of climate-related risks within healthcare systems.

研究目的本研究旨在创建未来医院的愿景，帮助医疗保健领导者了解社会和医疗保健系统的变化以及气候变化对未来医院资产的影响：研究设计：本研究是基于参与式反向预测的大型项目的一部分，旨在通过改进资产管理，为过渡到零碳未来和适应现有气候变化提供综合战略：本文所提供的数据是在为构建 2050 年未来医院愿景而举办的全天研讨会上收集的。一个由 19 名参与者组成的多学科团队参与了讨论。对数据进行了六阶段主题分析，以形成叙述性愿景和图形记录：由于医疗服务的不断发展、患者的期望、新兴技术、气候变化和可持续发展，医疗保健系统正在经历转型变革。然而，当前的医院战略往往没有考虑到医院资产与其社会环境之间的相互关系。政策制定者、医疗系统领导者和医院领导者需要对未来医院有一个清晰的愿景，以实施转型战略：医疗转型需要从传统的集中式医院转变为更加灵活的分布式模式。医疗保健领导者需要积极评估医院如何应对当前和未来的危险，并在整合和分散医疗保健服务的背景下考虑其影响。为此，必须采用系统的方法来模拟灾害并评估设计或升级方案，以减轻医疗保健系统中与气候相关的风险转移。

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引用次数: 0

Sugar-sweetened beverage consumption in Thailand: Determinants and variation across socioeconomic status 泰国的含糖饮料消费：不同社会经济地位的决定因素和差异。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2024-11-12 DOI: 10.1016/j.puhe.2024.10.037

Kittiphong Thiboonboon, Richard De Abreu Lourenco, Jody Church, Stephen Goodall

Objectives

Reducing consumption of sugar-sweetened beverages (SSBs) is a primary public health goal in Thailand, but information on the characteristics of SSB consumers remains limited. This study aims to gain knowledge about the characteristics of SSB consumers in Thailand.

Study design

Secondary analysis of survey data.

Methods

The study used data from the Health Behaviour of Population Survey conducted by Thailand's National Statistics Office between February and May 2021. SSB consumption was sourced from a survey question about the consumption of prepackaged sugar-sweetened non-alcoholic beverages. The influence of demographic, socioeconomic, behavioural, habitual, and health factors on mean daily intake and daily consumption was assessed using a two-part model and logistic regression analysis, respectively. Decomposition analysis was conducted to understand how the impact of these factors affecting SSB consumption varied across socioeconomic groups.

Results

Frequent SSB consumers exhibited various unhealthy behaviours, including smoking, unhealthy food consumption, low physical activity, and making food selections driven by appetitive motivations. Although higher socioeconomic status was associated with greater consumption of SSBs, it stabilised at elevated income levels. Increased SSB consumption in higher socioeconomic groups was linked to mixed eating habits, being overweight, and occasional drinking, while in lower socioeconomic groups, it was associated with unhealthy behaviours like smoking, regular alcohol drinking, appetitive food choices, and low physical activity.

Conclusions

SSB consumption in Thailand is multifactorial, varying by socioeconomic status. These insights are crucial for policy formation aimed at reducing SSB consumption in the country. Policymakers should explore interventions that address overall unhealthy behaviours alongside those targeting overconsumption of SSBs.

目标：减少含糖饮料（SSB）的消费是泰国公共卫生的首要目标，但有关含糖饮料消费者特征的信息仍然有限。本研究旨在了解泰国 SSB 消费者的特征：研究设计：对调查数据进行二次分析：研究使用的数据来自泰国国家统计局在 2021 年 2 月至 5 月期间进行的人口健康行为调查。SSB 消费量来源于一个关于预包装含糖非酒精饮料消费量的调查问题。通过两部分模型和逻辑回归分析，分别评估了人口、社会经济、行为、习惯和健康因素对平均日摄入量和日消费量的影响。为了解这些因素对不同社会经济群体消费固体饮料的影响有何不同，还进行了分解分析：结果：经常食用固体饮料的人表现出各种不健康行为，包括吸烟、食用不健康食品、体力活动少以及在食欲驱使下选择食物。虽然较高的社会经济地位与较高的固态饮料消费量有关，但在收入水平较高时，消费量趋于稳定。在社会经济地位较高的群体中，固态饮料消费量的增加与混合饮食习惯、超重和偶尔饮酒有关，而在社会经济地位较低的群体中，固态饮料消费量的增加则与吸烟、经常饮酒、偏食和体力活动少等不健康行为有关：结论：在泰国，固体饮料的消费受多种因素影响，因社会经济地位而异。这些见解对于制定旨在减少该国 SSB 消费量的政策至关重要。政策制定者应探索针对整体不健康行为的干预措施，同时也要针对超量消费固态饮料的行为进行干预。

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引用次数: 0

The epidemiological profile and morbidity-mortality patterns of the natural hazards-related disasters in the Americas from 2000 to 2021 2000 年至 2021 年美洲与自然灾害有关的流行病学概况和发病率-死亡率模式。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2024-11-11 DOI: 10.1016/j.puhe.2024.11.004

Andrea Fernández García, Rick Kye Gan, José Antonio Cernuda Martínez, Pedro Arcos González

Objective

To analyze the epidemiological profile of natural hazard-related disasters in the Americas between 2000 and 2021.

Study design

Cross-sectional study.

Methods

Mean and standard deviation were used to calculate the mean rates of affected individuals, injuries, and mortality per year and per million inhabitants. The ANOVA test was applied between the calculated mean rates by type of disasters. Exponential smoothing was used to forecast the number of disasters up to the year 2026.

Results

A total of 2045 natural hazard-related disasters were recorded. Of these, 81 (3.96 %) were biological, 199 (9.73 %) were climatological, 140 (6.85 %) were geophysical, 843 (41.22 %) were hydrological, and 782 (38.24 %) were meteorological. A statistically significant difference was observed between the mean injury rates per million inhabitants of natural hazard-related disasters (F = 3.40; p = 0.010). The mortality rate per million inhabitants (F = 0.43; p = 0.786) and the mean affected rate per million inhabitants (F = 0.68; p = 0.609) were not found to be statistically significant regarding the type of disaster. The results demonstrated no statistically significant decline in the mean rate of affected individuals per million inhabitants (tau = −0.086, p = 0.336), the mean mortality rate per million inhabitants (tau = −0.221, p = 0.159), and the mean rate of injuries per million inhabitants (tau = 0.169, p = 0.284).

Conclusions

Hydrological disasters had the highest mean mortality rate, biological disasters had the highest mean injury rate, and geophysical disasters had the highest mean rate of affected individuals.

目的：分析 2000 年至 2021 年期间美洲与自然灾害有关的流行病学概况：研究设计：横断面研究：研究设计：横断面研究：采用平均值和标准差计算每年和每百万居民的受灾人数、受伤人数和死亡率的平均值。根据灾害类型对计算出的平均率进行方差分析。采用指数平滑法预测到 2026 年的灾害数量：结果：共记录了 2045 起与自然灾害相关的灾难。其中，生物灾害 81 起（3.96%），气候灾害 199 起（9.73%），地球物理灾害 140 起（6.85%），水文灾害 843 起（41.22%），气象灾害 782 起（38.24%）。在与自然灾害相关的灾害中，每百万居民平均受伤率之间存在明显的统计学差异（F = 3.40; p = 0.010）。每百万居民的死亡率 (F = 0.43; p = 0.786) 和每百万居民的平均受灾率 (F = 0.68; p = 0.609) 与灾害类型没有统计学意义。结果表明，每百万居民的平均受灾率（tau = -0.086，p = 0.336）、每百万居民的平均死亡率（tau = -0.221，p = 0.159）和每百万居民的平均受伤率（tau = 0.169，p = 0.284）在统计学上没有显著下降：结论：水文灾害的平均死亡率最高，生物灾害的平均受伤率最高，地球物理灾害的平均受灾人口率最高。

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