Pub Date : 2025-02-01DOI: 10.1016/j.puhe.2024.12.048
Zhao Hu , Lu Tang , Yiqiang Zhan
Objective
Previous longitudinal studies have investigated the association between baseline loneliness and the risk of developing cardiovascular diseases (CVD). Nevertheless, the cumulative effect of loneliness on CVD remains uncertain. The objective of this study is to assess the relationship between the cumulative duration of loneliness and the risk of CVD in middle-aged and older adults.
Study design
Prospective cohort study.
Methods
The study utilized data from a sample of 8353 adults aged 45 years and older who participated in the China Health and Retirement Longitudinal Study (CHARLS). Loneliness was assessed biennially between 2011 and 2015, and categorized into four groups: never, one time point, two time points, and three time points. The Cox Proportional Hazards Regression Model was employed to estimate hazard ratios (HRs) and corresponding 95 % confidence intervals (CIs).
Results
Following a mean follow-up period of 4.7 years (standard deviation: 0.7 years), a total of 1314 cases of CVD were identified, including 913 cases of heart disease and 504 cases of stroke. After adjusting for potential confounding factors, individuals who experienced loneliness at one time point (HR, 1.21; 95 % CI: 1.06, 1.38), two time points (HR, 1.23; 95 % CI: 1.03, 1.45), and three time points (HR, 1.50; 95 % CI: 1.19, 1.89) had a significantly higher risk of developing CVD compared to those who never experienced loneliness.
Conclusions
Cumulative loneliness was associated with increased risk of CVD in middle-age and older adults. Additional research is warranted to delve into the underlying mechanisms, while it is advisable to contemplate social interventions aimed at addressing loneliness.
{"title":"Association between cumulative loneliness and risk of cardiovascular diseases in middle-aged and older adults: A longitudinal study","authors":"Zhao Hu , Lu Tang , Yiqiang Zhan","doi":"10.1016/j.puhe.2024.12.048","DOIUrl":"10.1016/j.puhe.2024.12.048","url":null,"abstract":"<div><h3>Objective</h3><div>Previous longitudinal studies have investigated the association between baseline loneliness and the risk of developing cardiovascular diseases (CVD). Nevertheless, the cumulative effect of loneliness on CVD remains uncertain. The objective of this study is to assess the relationship between the cumulative duration of loneliness and the risk of CVD in middle-aged and older adults.</div></div><div><h3>Study design</h3><div>Prospective cohort study.</div></div><div><h3>Methods</h3><div>The study utilized data from a sample of 8353 adults aged 45 years and older who participated in the China Health and Retirement Longitudinal Study (CHARLS). Loneliness was assessed biennially between 2011 and 2015, and categorized into four groups: never, one time point, two time points, and three time points. The Cox Proportional Hazards Regression Model was employed to estimate hazard ratios (HRs) and corresponding 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Following a mean follow-up period of 4.7 years (standard deviation: 0.7 years), a total of 1314 cases of CVD were identified, including 913 cases of heart disease and 504 cases of stroke. After adjusting for potential confounding factors, individuals who experienced loneliness at one time point (HR, 1.21; 95 % CI: 1.06, 1.38), two time points (HR, 1.23; 95 % CI: 1.03, 1.45), and three time points (HR, 1.50; 95 % CI: 1.19, 1.89) had a significantly higher risk of developing CVD compared to those who never experienced loneliness.</div></div><div><h3>Conclusions</h3><div>Cumulative loneliness was associated with increased risk of CVD in middle-age and older adults. Additional research is warranted to delve into the underlying mechanisms, while it is advisable to contemplate social interventions aimed at addressing loneliness.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"239 ","pages":"Pages 156-161"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014840","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 : 2025-02-01DOI: 10.1016/j.puhe.2024.12.037
Miri Lutski , Aliza H. Stark , Rita Dichtiar , Shay Y. Lubel , Efrat Monsnego-Ornan , Tali Sinai
Objectives
To assess adherence to the Dietary Approaches to Stop Hypertension (DASH) diet over a decade among community-dwelling older adults, with and without hypertension and to examine associated factors.
Study design
Cross-sectional study.
Methods
Data from two cross-sectional Israel National Health and Nutrition Surveys (NHNS) for older adults, from 2005 to 2006 (NHNS1) and 2014–2015 (NHNS2) were analysed. Trained personnel conducted face-to-face interviews and collected demographic, health, and lifestyle data, along with anthropometric measurements. Adherence to the DASH diet was determined from a single 24-h dietary recall using Mellen's DASH score. Logistic regression analyses were applied to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) for high DASH adherence (scores ≥4.5) versus low adherence (scores <4.5). Individual nutrient targets of the DASH diet were also assessed.
Results
The dataset was comprised of 1722 participants from NHNS1 and 916 from NHNS2. Following adjustment for potential confounders, the OR for DASH adherence among participants in NHNS2 was 1.65 (95 % CI 1.34–2.04) compared to NHNS1. NHNS2 participants reported better adherence to DASH nutrient recommendations for saturated fatty acids, total fat, protein, dietary fibre, and calcium among individuals with and without hypertension. No statistically significant differences were found for cholesterol, potassium, and sodium target intakes between surveys.
Conclusions
A positive trend towards healthier dietary patterns was identified among both the hypertensive and non-hypertensive older adults over a 10-year period. This underscores the importance of ongoing monitoring to appropriately address changing population needs and promote healthy dietary practices.
目的：评估十年来社区居住的老年人（有和没有高血压）对饮食方法停止高血压（DASH）饮食的依从性，并检查相关因素。研究设计：横断面研究。方法：分析2005 - 2006年（NHNS1）和2014-2015年（NHNS2）两次以色列老年人全国健康与营养调查（NHNS）的数据。训练有素的人员进行了面对面访谈，并收集了人口、健康和生活方式数据以及人体测量数据。DASH饮食的依从性是通过使用melellen的DASH评分进行单次24小时饮食回忆来确定的。应用Logistic回归分析来估计高DASH依从性（评分≥4.5）与低依从性（评分）的比值比（ORs）和95%置信区间（ci）。结果：数据集由来自NHNS1的1722名参与者和来自NHNS2的916名参与者组成。调整潜在混杂因素后，与NHNS1相比，NHNS2参与者DASH依从性的OR为1.65 （95% CI 1.34-2.04）。NHNS2参与者报告说，在高血压患者和非高血压患者中，对DASH营养建议的饱和脂肪酸、总脂肪、蛋白质、膳食纤维和钙的依从性更好。在调查中，胆固醇、钾和钠的目标摄入量没有统计学上的显著差异。结论：在10年的时间里，高血压和非高血压老年人都有向健康饮食模式发展的积极趋势。这强调了持续监测的重要性，以适当解决不断变化的人口需求和促进健康的饮食习惯。
{"title":"Increased adherence to the DASH dietary pattern in community dwelling older adults: Findings from two National Health and Nutrition Surveys","authors":"Miri Lutski , Aliza H. Stark , Rita Dichtiar , Shay Y. Lubel , Efrat Monsnego-Ornan , Tali Sinai","doi":"10.1016/j.puhe.2024.12.037","DOIUrl":"10.1016/j.puhe.2024.12.037","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess adherence to the Dietary Approaches to Stop Hypertension (DASH) diet over a decade among community-dwelling older adults, with and without hypertension and to examine associated factors.</div></div><div><h3>Study design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>Data from two cross-sectional Israel National Health and Nutrition Surveys (NHNS) for older adults, from 2005 to 2006 (NHNS1) and 2014–2015 (NHNS2) were analysed. Trained personnel conducted face-to-face interviews and collected demographic, health, and lifestyle data, along with anthropometric measurements. Adherence to the DASH diet was determined from a single 24-h dietary recall using Mellen's DASH score. Logistic regression analyses were applied to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) for high DASH adherence (scores ≥4.5) versus low adherence (scores <4.5). Individual nutrient targets of the DASH diet were also assessed.</div></div><div><h3>Results</h3><div>The dataset was comprised of 1722 participants from NHNS1 and 916 from NHNS2. Following adjustment for potential confounders, the OR for DASH adherence among participants in NHNS2 was 1.65 (95 % CI 1.34–2.04) compared to NHNS1. NHNS2 participants reported better adherence to DASH nutrient recommendations for saturated fatty acids, total fat, protein, dietary fibre, and calcium among individuals with and without hypertension. No statistically significant differences were found for cholesterol, potassium, and sodium target intakes between surveys.</div></div><div><h3>Conclusions</h3><div>A positive trend towards healthier dietary patterns was identified among both the hypertensive and non-hypertensive older adults over a 10-year period. This underscores the importance of ongoing monitoring to appropriately address changing population needs and promote healthy dietary practices.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"239 ","pages":"Pages 112-120"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014873","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 : 2025-02-01DOI: 10.1016/j.puhe.2024.12.031
Camila Lorenz , Thiago Salomão de Azevedo , Francisco Chiaravalloti-Neto
Objectives
The Western equine encephalitis virus (WEEV) is a globally relevant vector-borne pathogen that causes encephalitis. The role of environmental variables in the epidemiology of WEEV has become greater in the context of climate change. In December 2023, a significant resurgence of WEEV began in South America, with major ongoing outbreaks in Argentina and Uruguay. In this study, we employed a machine learning algorithm to model the distribution of WEEV in South America, considering both present and future scenarios.
Study Design
Ecological retrospective study.
Methods
We conducted a modelling study to identify areas with the highest prevalence of WEEV in South America, based on confirmed human and equine cases during the 2023/2024 outbreak and climatic variables. Our analysis utilised Maxent software, a machine learning algorithm for species distribution modelling.
Results
Our results indicate that environmental variables, particularly thermal seasonality and annual rainfall, can directly influence the occurrence of WEEV, leading to increased virus incidence. Consequently, high-risk areas may shift in the future. Countries, such as Paraguay, Venezuela, Colombia, and various regions in Brazil, particularly the Northeast, Midwest, and the Pantanal biomes, will be significantly impacted, drastically altering the current distribution of WEEV.
Conclusions
The ongoing WEEV outbreak in South America is concerning because it coincides with migratory bird stopovers. These birds are natural hosts that can spread the virus to unaffected areas. Our results will help to identify priority areas for developing preventive measures and establishing epidemiological surveillance.
{"title":"Effects of climate change on the occurrence and distribution of Western equine encephalitis virus in South America","authors":"Camila Lorenz , Thiago Salomão de Azevedo , Francisco Chiaravalloti-Neto","doi":"10.1016/j.puhe.2024.12.031","DOIUrl":"10.1016/j.puhe.2024.12.031","url":null,"abstract":"<div><h3>Objectives</h3><div>The Western equine encephalitis virus (WEEV) is a globally relevant vector-borne pathogen that causes encephalitis. The role of environmental variables in the epidemiology of WEEV has become greater in the context of climate change. In December 2023, a significant resurgence of WEEV began in South America, with major ongoing outbreaks in Argentina and Uruguay. In this study, we employed a machine learning algorithm to model the distribution of WEEV in South America, considering both present and future scenarios.</div></div><div><h3>Study Design</h3><div>Ecological retrospective study.</div></div><div><h3>Methods</h3><div>We conducted a modelling study to identify areas with the highest prevalence of WEEV in South America, based on confirmed human and equine cases during the 2023/2024 outbreak and climatic variables. Our analysis utilised Maxent software, a machine learning algorithm for species distribution modelling.</div></div><div><h3>Results</h3><div>Our results indicate that environmental variables, particularly thermal seasonality and annual rainfall, can directly influence the occurrence of WEEV, leading to increased virus incidence. Consequently, high-risk areas may shift in the future. Countries, such as Paraguay, Venezuela, Colombia, and various regions in Brazil, particularly the Northeast, Midwest, and the Pantanal biomes, will be significantly impacted, drastically altering the current distribution of WEEV.</div></div><div><h3>Conclusions</h3><div>The ongoing WEEV outbreak in South America is concerning because it coincides with migratory bird stopovers. These birds are natural hosts that can spread the virus to unaffected areas. Our results will help to identify priority areas for developing preventive measures and establishing epidemiological surveillance.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"239 ","pages":"Pages 1-8"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899855","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 : 2025-02-01DOI: 10.1016/j.puhe.2024.12.032
Han T. Vo , Thang V. Dao , Tinh X. Do , Binh N. Do , Tan T. Nguyen , Khue M. Pham , Vinh H. Vu , Linh V. Pham , Lien T.H. Nguyen , Lan T.H. Le , Hoang C. Nguyen , Tuan V. Tran , Trung H. Nguyen , Anh T. Nguyen , Hoan V. Nguyen , Phuoc B. Nguyen , Thu T.M. Pham , Tien D. Dao , Thuy T. Le , Thao T.P. Nguyen , Tuyen V. Duong
Objectives
We investigated the effect modification of health literacy (HL) in ameliorating the negative impact of underlying health conditions (UHC) on long COVID among non-hospitalized and hospitalized survivors.
Study design
An online cross-sectional study was conducted in Vietnam from December 2021 to October 2022.
Methods
A sample of 4507 participants recruited from 18 hospitals and health centers were those aged 18 or older, had contracted COVID-19 for at least 28 days, and were not in the acute phase of reinfection. Participants reported their long COVID symptoms, UHC, health literacy, socio-demographics, clinical parameters, the COVID-19 impact battery disability scale, and health-related behaviors. The logistic regression models were used to examine the associations and interactions.
Results
Underlying health conditions were associated with a higher likelihood of long COVID in non-hospitalized participants (adjusted odds ratio, aOR = 2.10 [1.61, 2.61]; p < 0.001), and hospitalized ones (aOR = 2.26 [1.87, 2.73]; p < 0.001). In non-hospitalized participants, higher HL scores were significantly linked to a reduced likelihood of experiencing long COVID (aOR = 0.96 [0.95, 0.97]; p < 0.001). Furthermore, HL moderated the adverse effect of underlying health conditions (UHC) on long COVID in this group (aOR = 0.97 [0.94–0.99]; p = 0.042). In hospitalized participants, although higher HL scores were also associated with a lower risk of long COVID (aOR = 0.99 [0.98–0.99]; p = 0.036), HL did not significantly mitigate the negative impact of UHC on long COVID (aOR = 1.01 [0.99–1.03]; p = 0.332).
Conclusions
In non-hospitalized individuals, high health literacy ameliorated the negative impact of UHC on long COVID. Such effects of health literacy were not observed in hospitalized COVID-19 survivors.
{"title":"Association between underlying health conditions and long COVID among non-hospitalized and hospitalized individuals as modified by health literacy: A multi-center study","authors":"Han T. Vo , Thang V. Dao , Tinh X. Do , Binh N. Do , Tan T. Nguyen , Khue M. Pham , Vinh H. Vu , Linh V. Pham , Lien T.H. Nguyen , Lan T.H. Le , Hoang C. Nguyen , Tuan V. Tran , Trung H. Nguyen , Anh T. Nguyen , Hoan V. Nguyen , Phuoc B. Nguyen , Thu T.M. Pham , Tien D. Dao , Thuy T. Le , Thao T.P. Nguyen , Tuyen V. Duong","doi":"10.1016/j.puhe.2024.12.032","DOIUrl":"10.1016/j.puhe.2024.12.032","url":null,"abstract":"<div><h3>Objectives</h3><div>We investigated the effect modification of health literacy (HL) in ameliorating the negative impact of underlying health conditions (UHC) on long COVID among non-hospitalized and hospitalized survivors.</div></div><div><h3>Study design</h3><div>An online cross-sectional study was conducted in Vietnam from December 2021 to October 2022.</div></div><div><h3>Methods</h3><div>A sample of 4507 participants recruited from 18 hospitals and health centers were those aged 18 or older, had contracted COVID-19 for at least 28 days, and were not in the acute phase of reinfection. Participants reported their long COVID symptoms, UHC, health literacy, socio-demographics, clinical parameters, the COVID-19 impact battery disability scale, and health-related behaviors. The logistic regression models were used to examine the associations and interactions.</div></div><div><h3>Results</h3><div>Underlying health conditions were associated with a higher likelihood of long COVID in non-hospitalized participants (adjusted odds ratio, aOR = 2.10 [1.61, 2.61]; p < 0.001), and hospitalized ones (aOR = 2.26 [1.87, 2.73]; p < 0.001). In non-hospitalized participants, higher HL scores were significantly linked to a reduced likelihood of experiencing long COVID (aOR = 0.96 [0.95, 0.97]; p < 0.001). Furthermore, HL moderated the adverse effect of underlying health conditions (UHC) on long COVID in this group (aOR = 0.97 [0.94–0.99]; p = 0.042). In hospitalized participants, although higher HL scores were also associated with a lower risk of long COVID (aOR = 0.99 [0.98–0.99]; p = 0.036), HL did not significantly mitigate the negative impact of UHC on long COVID (aOR = 1.01 [0.99–1.03]; p = 0.332).</div></div><div><h3>Conclusions</h3><div>In non-hospitalized individuals, high health literacy ameliorated the negative impact of UHC on long COVID. Such effects of health literacy were not observed in hospitalized COVID-19 survivors.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"239 ","pages":"Pages 87-93"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972906","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 : 2025-02-01DOI: 10.1016/j.puhe.2024.12.014
Paloma Martínez-Castañeiras , Cristina Ortiz , Nerea Fernandez de Larrea-Baz , Virginia Lope , Gary Sánchez-Gordón , Emma Ruiz-Moreno , Isabel Alonso , Esther Garcia-Esquinas , Beatriz Pérez-Gómez , Roberto Pastor-Barriuso , Iñaki Galán , Adela Castelló
Objectives
The aim of this study was to explore the association of fruit, vegetable, and pulses consumption with all-cause, cardiovascular, and cancer mortality.
Study design
This prospective study included 66,933 individuals from three Spanish health surveys linked to the national death registry up to December 2022.
Methods
Adjusted Poisson regression models were used to analyze the data, categorizing fruit, vegetable and pulses intake according to Spanish dietary recommendations and using splines to examine non-linear relationships.
Results
No clear association was found between pulses intake and mortality. Consuming fruits and vegetables ≥2 times/day reduced all-cause mortality risk by 20 % (95%CI = 10%–29 %) and 17 % (95%CI = 7%–26 %) respectively, compared with <3 times/week. Combined intake of fruits and vegetables from 1 to 1.99 to ≥5 times/day showed reductions in all-cause and CVD mortality ranging from 16 % (95%CI = 5%–26 %) to 30 % (95%CI = 20%–39 %), and from 25 % (95%CI = 5%–41 %) to 35 % (95%CI = 14%–50 %), respectively, compared with <1 time/day. No additional benefits against all-cause and CVD mortality for intakes of fruits over 2–3 times/day, but gradual reductions in mortality risk for vegetable intake of 2–5 times/day were observed. Combined intake showed protection up to intakes of 10 times/day, notably for CVD mortality. Associations were similar but weaker for cancer mortality.
Conclusions
This study suggests that significant benefits of fruits and, specially, vegetables intake might go beyond the recommended five servings a day. Confirmation of these results could lead to specific dietary recommendations to prevent chronic diseases.
{"title":"Intake of fruit, vegetables and pulses, and all-cause, cardiovascular and cancer mortality: Results from a population-based prospective study","authors":"Paloma Martínez-Castañeiras , Cristina Ortiz , Nerea Fernandez de Larrea-Baz , Virginia Lope , Gary Sánchez-Gordón , Emma Ruiz-Moreno , Isabel Alonso , Esther Garcia-Esquinas , Beatriz Pérez-Gómez , Roberto Pastor-Barriuso , Iñaki Galán , Adela Castelló","doi":"10.1016/j.puhe.2024.12.014","DOIUrl":"10.1016/j.puhe.2024.12.014","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to explore the association of fruit, vegetable, and pulses consumption with all-cause, cardiovascular, and cancer mortality.</div></div><div><h3>Study design</h3><div>This prospective study included 66,933 individuals from three Spanish health surveys linked to the national death registry up to December 2022.</div></div><div><h3>Methods</h3><div>Adjusted Poisson regression models were used to analyze the data, categorizing fruit, vegetable and pulses intake according to Spanish dietary recommendations and using splines to examine non-linear relationships.</div></div><div><h3>Results</h3><div>No clear association was found between pulses intake and mortality. Consuming fruits and vegetables ≥2 times/day reduced all-cause mortality risk by 20 % (95%CI = 10%–29 %) and 17 % (95%CI = 7%–26 %) respectively, compared with <3 times/week. Combined intake of fruits and vegetables from 1 to 1.99 to ≥5 times/day showed reductions in all-cause and CVD mortality ranging from 16 % (95%CI = 5%–26 %) to 30 % (95%CI = 20%–39 %), and from 25 % (95%CI = 5%–41 %) to 35 % (95%CI = 14%–50 %), respectively, compared with <1 time/day. No additional benefits against all-cause and CVD mortality for intakes of fruits over 2–3 times/day, but gradual reductions in mortality risk for vegetable intake of 2–5 times/day were observed. Combined intake showed protection up to intakes of 10 times/day, notably for CVD mortality. Associations were similar but weaker for cancer mortality.</div></div><div><h3>Conclusions</h3><div>This study suggests that significant benefits of fruits and, specially, vegetables intake might go beyond the recommended five servings a day. Confirmation of these results could lead to specific dietary recommendations to prevent chronic diseases.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"239 ","pages":"Pages 169-178"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042667","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 : 2025-02-01DOI: 10.1016/j.puhe.2024.12.010
Brian Sheridan , Abyan Irzaldy , Eveline A.M. Heijnsdijk , Nadya Dimitrova , Carlo Senore , Partha Basu , Harry J. de Koning
Objectives
A key element in ensuring appropriate balance of harms and benefits in cancer screening is to develop a priority set of performance and outcome indicators to be used in screening data evaluation systems. These indicators need to be equity-focused, aligned to new screening approaches and broad-based to cover possible opportunistic screening, but at the same time as limited as possible.
Study design
Indicators for breast, colorectal and cervical cancer screening programs were chosen through a consensus building Delphi methodology involving a panel of cancer screening experts.
Methods
The list of indicators was developed using a multistage process. First, a systematic search was performed along with an extensive grey literature search to identify all potential existing indicators. Next, these indicators were refined by two expert groups, definitions and calculations were agreed upon, redundant indicators removed. A final list of 38 indicators was put forward into a Delphi study. 33 cancer screening experts were invited to take part. The Delphi study consisted of two rounds of an online survey and an online facilitated discussion between the cancer screening experts.
Results
23 indicators were chosen covering 10 predefined indicator categories with detection rate, examination coverage and interval cancer rate deemed most important. Outcome indicators such as crude incidence rate and time from screen to result notification, while ultimately reaching consensus were deemed of less importance.
Conclusion
23 priority indicators cover the entire screening pathway including harms, barriers and inequalities. These indicators have been piloted by the CanScreen-ECIS project.
{"title":"Prioritizing performance and outcome indicators for quality assessment of cancer screening programs in the EU","authors":"Brian Sheridan , Abyan Irzaldy , Eveline A.M. Heijnsdijk , Nadya Dimitrova , Carlo Senore , Partha Basu , Harry J. de Koning","doi":"10.1016/j.puhe.2024.12.010","DOIUrl":"10.1016/j.puhe.2024.12.010","url":null,"abstract":"<div><h3>Objectives</h3><div>A key element in ensuring appropriate balance of harms and benefits in cancer screening is to develop a priority set of performance and outcome indicators to be used in screening data evaluation systems. These indicators need to be equity-focused, aligned to new screening approaches and broad-based to cover possible opportunistic screening, but at the same time as limited as possible.</div></div><div><h3>Study design</h3><div>Indicators for breast, colorectal and cervical cancer screening programs were chosen through a consensus building Delphi methodology involving a panel of cancer screening experts.</div></div><div><h3>Methods</h3><div>The list of indicators was developed using a multistage process. First, a systematic search was performed along with an extensive grey literature search to identify all potential existing indicators. Next, these indicators were refined by two expert groups, definitions and calculations were agreed upon, redundant indicators removed. A final list of 38 indicators was put forward into a Delphi study. 33 cancer screening experts were invited to take part. The Delphi study consisted of two rounds of an online survey and an online facilitated discussion between the cancer screening experts.</div></div><div><h3>Results</h3><div>23 indicators were chosen covering 10 predefined indicator categories with detection rate, examination coverage and interval cancer rate deemed most important. Outcome indicators such as crude incidence rate and time from screen to result notification, while ultimately reaching consensus were deemed of less importance.</div></div><div><h3>Conclusion</h3><div>23 priority indicators cover the entire screening pathway including harms, barriers and inequalities. These indicators have been piloted by the CanScreen-ECIS project.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"239 ","pages":"Pages 185-192"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054049","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 : 2025-02-01DOI: 10.1016/j.puhe.2025.01.001
H.W. Jung , H.J. Park
Objectives
This study investigated how socio-economic and environmental factors contribute to suicidal ideation in South Korea.
Study design
This was a cross-sectional study.
Methods
Using a Bayesian multilevel analysis, the study highlights the impact of housing insecurity, financial burden, and subjective health perceptions on mental health. Data from the 2018 Korea Health Panel and regional statistics were used to analyze variables at the individual, household, and regional levels.
Results
The results suggest that poor subjective health perception, depression, and a precarious financial situation increase suicidal ideation. Regions with high housing vacancies exhibit lower suicide ideation rates, implying that reduced housing competition may alleviate mental stress.
Conclusions
Targeted mental health interventions and improved housing policies are required to help vulnerable populations.
{"title":"The effects of socio-economic and environmental factors on Korean suicidal ideation: A Bayesian multilevel analysis","authors":"H.W. Jung , H.J. Park","doi":"10.1016/j.puhe.2025.01.001","DOIUrl":"10.1016/j.puhe.2025.01.001","url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigated how socio-economic and environmental factors contribute to suicidal ideation in South Korea.</div></div><div><h3>Study design</h3><div>This was a cross-sectional study.</div></div><div><h3>Methods</h3><div>Using a Bayesian multilevel analysis, the study highlights the impact of housing insecurity, financial burden, and subjective health perceptions on mental health. Data from the 2018 Korea Health Panel and regional statistics were used to analyze variables at the individual, household, and regional levels.</div></div><div><h3>Results</h3><div>The results suggest that poor subjective health perception, depression, and a precarious financial situation increase suicidal ideation. Regions with high housing vacancies exhibit lower suicide ideation rates, implying that reduced housing competition may alleviate mental stress.</div></div><div><h3>Conclusions</h3><div>Targeted mental health interventions and improved housing policies are required to help vulnerable populations.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"239 ","pages":"Pages 193-200"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061238","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 : 2025-02-01DOI: 10.1016/j.puhe.2024.12.034
Sunday Azagba, Todd Ebling, Galappaththige S.R. de Silva
Objectives
This study investigated the associations between diverse sexual and gender identities and adolescent use of e-cigarettes, tobacco products, and cannabis vaping.
Study design
Cross-sectional study.
Methods
Data were collected from a nationally representative sample of high school students in 2023. Multivariable logistic regression analyses were employed to examine the relationships between sexual orientation, gender identity, and transgender status with e-cigarette, tobacco, and cannabis vaping.
Results
Bisexual, pansexual, or queer students had the highest prevalence of e-cigarette use at 16.12 %, followed by gay or lesbian students at 14.46 %. Asexual students were more likely to vape cannabis (aOR = 2.22, 95 % CI = 1.08–4.56) compared to heterosexual students. Nonbinary, genderfluid, or genderqueer students had higher odds of e-cigarette use (aOR = 2.10, 95 % CI = 1.16–3.80) compared to boys. Bisexual, pansexual, or queer students were also more likely to use e-cigarettes (aOR = 2.47, 95 % CI = 1.59–3.83) and vape cannabis (aOR = 1.87, 95 % CI = 1.17–2.98) compared to heterosexual students. Transgender or questioning students had higher odds of e-cigarette use (aOR = 2.35, 95 % CI = 1.11–5.00) and other tobacco product use (aOR = 3.51, 95 % CI = 1.38–8.96) compared to non-transgender students.
Conclusions
Findings reveal significant disparities in substance use behaviors among sexual and gender minority (SGM) youth compared to their heterosexual and cisgender peers. These results highlight the need for tailored prevention and intervention strategies to address the unique needs of SGM youth.
{"title":"E-cigarette, tobacco, and cannabis vaping among diverse sexual and gender identities in U.S. high school students","authors":"Sunday Azagba, Todd Ebling, Galappaththige S.R. de Silva","doi":"10.1016/j.puhe.2024.12.034","DOIUrl":"10.1016/j.puhe.2024.12.034","url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigated the associations between diverse sexual and gender identities and adolescent use of e-cigarettes, tobacco products, and cannabis vaping.</div></div><div><h3>Study design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>Data were collected from a nationally representative sample of high school students in 2023. Multivariable logistic regression analyses were employed to examine the relationships between sexual orientation, gender identity, and transgender status with e-cigarette, tobacco, and cannabis vaping.</div></div><div><h3>Results</h3><div>Bisexual, pansexual, or queer students had the highest prevalence of e-cigarette use at 16.12 %, followed by gay or lesbian students at 14.46 %. Asexual students were more likely to vape cannabis (aOR = 2.22, 95 % CI = 1.08–4.56) compared to heterosexual students. Nonbinary, genderfluid, or genderqueer students had higher odds of e-cigarette use (aOR = 2.10, 95 % CI = 1.16–3.80) compared to boys. Bisexual, pansexual, or queer students were also more likely to use e-cigarettes (aOR = 2.47, 95 % CI = 1.59–3.83) and vape cannabis (aOR = 1.87, 95 % CI = 1.17–2.98) compared to heterosexual students. Transgender or questioning students had higher odds of e-cigarette use (aOR = 2.35, 95 % CI = 1.11–5.00) and other tobacco product use (aOR = 3.51, 95 % CI = 1.38–8.96) compared to non-transgender students.</div></div><div><h3>Conclusions</h3><div>Findings reveal significant disparities in substance use behaviors among sexual and gender minority (SGM) youth compared to their heterosexual and cisgender peers. These results highlight the need for tailored prevention and intervention strategies to address the unique needs of SGM youth.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"239 ","pages":"Pages 55-61"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139844","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 : 2025-02-01DOI: 10.1016/j.puhe.2024.12.030
Yan Luo , Yahai Wang , Jing Guo
Objectives
This study aimed to determin the sex differences in associations between daily stair climbing with cardiovascular disease (CVD) risk, and the role of genetic predisposition.
Study design
This study is a prospective cohort study from the UK Biobank.
Methods
A total of 389,973 adults (mean age of 55.7 years, 45.2 % men) from the UK Biobank were analyzed. The frequency of daily stair climbing was self-reported via questionnaires, and the polygenetic risk score (PRS) of CVD was measured to assess genetic predisposition. Cox proportional hazards regression was used to predict CVD risk.
Results
During a median follow-up of 13.7 years, 57,704 cases were recorded. Compared with the no stair climbing group, both sexes achieved a peak CVD benefit at 11–15 times/day of stair climbing (hazard ratio (HR) 95 % confidence intervals (CI) 0.92 [0.88–0.98] for male, HR 95 % CI 0.86 [0.82–0.90] for female). In the joint analyses, 11–15 times/day of stair climbing was significantly associated with a 12 % lower CVD risk even in the high PRS group of women. For males, 11–15 times/day of stair climbing was significantly associated with CVD risk only in intermediate and high PRS groups, but not in the low PRS group. Results were consistent in subgroup analyses stratified by age.
Conclusions
Our study demonstrated the negative associations of daily stair climbing with CVD risk were more pronounced in females than in males, and these associations were independent of disease susceptibility to CVD only in females. These findings highlight stair climbing as a low-cost intervention strategy for preventing CVD, especially in females.
目的：本研究旨在确定每日爬楼梯与心血管疾病（CVD）风险之间的性别差异，以及遗传易感性的作用。研究设计：本研究是来自英国生物银行的前瞻性队列研究。方法：对来自英国生物银行的389,973名成年人（平均年龄55.7岁，45.2%男性）进行分析。通过问卷自报每日爬楼梯的频率，测量心血管疾病多遗传风险评分（PRS）以评估遗传易感性。采用Cox比例风险回归预测心血管疾病风险。结果：在中位随访13.7年期间，记录了57,704例病例。与不爬楼梯组相比，男女均在11-15次/天爬楼梯时达到心血管疾病获益的峰值（男性风险比（HR） 95%可信区间（CI） 0.92[0.88-0.98]，女性HR 95% CI 0.86[0.82-0.90]）。在联合分析中，每天爬11-15次楼梯与心血管疾病风险降低12%显著相关，即使在高PRS组的女性中也是如此。对于男性来说，11-15次/天的爬楼梯与心血管疾病风险显著相关，只有在中等和高PRS组中，而在低PRS组中则没有。按年龄分层的亚组分析结果一致。结论：我们的研究表明，每天爬楼梯与CVD风险的负相关在女性中比在男性中更为明显，并且这些关联仅在女性中与CVD的疾病易感性无关。这些发现强调爬楼梯是预防心血管疾病的低成本干预策略，尤其是对女性。
{"title":"Sex differences in associations of daily stair climbing, genetic predisposition, and risk of cardiovascular disease among 389,973 UK adults","authors":"Yan Luo , Yahai Wang , Jing Guo","doi":"10.1016/j.puhe.2024.12.030","DOIUrl":"10.1016/j.puhe.2024.12.030","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to determin the sex differences in associations between daily stair climbing with cardiovascular disease (CVD) risk, and the role of genetic predisposition.</div></div><div><h3>Study design</h3><div>This study is a prospective cohort study from the UK Biobank.</div></div><div><h3>Methods</h3><div>A total of 389,973 adults (mean age of 55.7 years, 45.2 % men) from the UK Biobank were analyzed. The frequency of daily stair climbing was self-reported via questionnaires, and the polygenetic risk score (PRS) of CVD was measured to assess genetic predisposition. Cox proportional hazards regression was used to predict CVD risk.</div></div><div><h3>Results</h3><div>During a median follow-up of 13.7 years, 57,704 cases were recorded. Compared with the no stair climbing group, both sexes achieved a peak CVD benefit at 11–15 times/day of stair climbing (hazard ratio (HR) 95 % confidence intervals (CI) 0.92 [0.88–0.98] for male, HR 95 % CI 0.86 [0.82–0.90] for female). In the joint analyses, 11–15 times/day of stair climbing was significantly associated with a 12 % lower CVD risk even in the high PRS group of women. For males, 11–15 times/day of stair climbing was significantly associated with CVD risk only in intermediate and high PRS groups, but not in the low PRS group. Results were consistent in subgroup analyses stratified by age.</div></div><div><h3>Conclusions</h3><div>Our study demonstrated the negative associations of daily stair climbing with CVD risk were more pronounced in females than in males, and these associations were independent of disease susceptibility to CVD only in females. These findings highlight stair climbing as a low-cost intervention strategy for preventing CVD, especially in females.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"239 ","pages":"Pages 9-14"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899856","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 : 2025-02-01DOI: 10.1016/j.puhe.2024.12.038
Jannie Dressler , Morten Rasmussen , Lars N. Jørgensen , Liza Sopina
Objectives
This Danish nationwide retrospective register-based cohort study investigated healthcare costs for patients with screen-detected colorectal cancer (SD-CRC) compared to non-screen-detected CRC (NSD-CRC).
Study design
Nationwide cohort study.
Methods
Quarterly healthcare costs including costs of hospital care, out-of-hospital medication, and primary sector contacts were compared between the two groups from two years before diagnosis of CRC until two years after. A quasi-experimental difference-in-differences analysis was performed to estimate the differences per patient in total quarterly healthcare costs between the groups.
Results
A total of 13,852 patients were included, 4703 with SD-CRC, 7420 with NSD-CRC, and 1,729 with interval- or post-colonoscopy CRC (I-PC-CRC). The total quarterly healthcare costs per patient were significantly higher in the NSD-CRC group than in SD-CRC. This was consistent across the total period and in 6-month analyses, accruing additional €16,600 of costs for patients with NSD-CRC over two years after diagnosis. Total healthcare costs were significantly higher for patients with NSD-CRC as compared to patients with SD-CRC across all Union for International Cancer Control (UICC) stages, except for UICC stage I. Correspondingly, total costs associated with I-PC-CRC were significantly higher than for SD-CRC.
Conclusions
Apart from improving post-treatment outcomes, higher participation rates in the CRC screening programmes present an opportunity for reducing healthcare costs related to patients diagnosed with CRC.
{"title":"Reduced healthcare costs for patients with screen-detected colorectal cancer: A Danish nationwide cohort study","authors":"Jannie Dressler , Morten Rasmussen , Lars N. Jørgensen , Liza Sopina","doi":"10.1016/j.puhe.2024.12.038","DOIUrl":"10.1016/j.puhe.2024.12.038","url":null,"abstract":"<div><h3>Objectives</h3><div>This Danish nationwide retrospective register-based cohort study investigated healthcare costs for patients with screen-detected colorectal cancer (SD-CRC) compared to non-screen-detected CRC (NSD-CRC).</div></div><div><h3>Study design</h3><div>Nationwide cohort study.</div></div><div><h3>Methods</h3><div>Quarterly healthcare costs including costs of hospital care, out-of-hospital medication, and primary sector contacts were compared between the two groups from two years before diagnosis of CRC until two years after. A quasi-experimental difference-in-differences analysis was performed to estimate the differences per patient in total quarterly healthcare costs between the groups.</div></div><div><h3>Results</h3><div>A total of 13,852 patients were included, 4703 with SD-CRC, 7420 with NSD-CRC, and 1,729 with interval- or post-colonoscopy CRC (I-PC-CRC). The total quarterly healthcare costs per patient were significantly higher in the NSD-CRC group than in SD-CRC. This was consistent across the total period and in 6-month analyses, accruing additional €16,600 of costs for patients with NSD-CRC over two years after diagnosis. Total healthcare costs were significantly higher for patients with NSD-CRC as compared to patients with SD-CRC across all Union for International Cancer Control (UICC) stages, except for UICC stage I. Correspondingly, total costs associated with I-PC-CRC were significantly higher than for SD-CRC.</div></div><div><h3>Conclusions</h3><div>Apart from improving post-treatment outcomes, higher participation rates in the CRC screening programmes present an opportunity for reducing healthcare costs related to patients diagnosed with CRC.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"239 ","pages":"Pages 62-69"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957842","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}
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