Public Health最新文献_第9页

Explanations for higher-than-expected all-cause mortality from April 2021: A scoping review 2021年4月起高于预期的全因死亡率的解释：范围审查。

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

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.10.010

F. Scott , G. McCartney , D. Walsh , S. Wild , D. Rae , J. Ramsay , G. Donaghy , M. Douglas

Objectives

Many countries have continued to experience a higher-than-expected number of deaths following the peaks in mortality observed in the first year of the Covid-19 pandemic. This review aims to identify the different explanations proposed for sustained higher-than-expected mortality beyond the first pandemic year.

Study design

Scoping review.

Methods

A systematic search of databases and grey literature sources was completed to identify English-language records proposing or investigating hypotheses for higher-than-expected mortality from April 2021 onwards in (sub)populations of high-income countries. Papers focused on survival following a diagnosis or intervention were excluded. Results were summarised narratively, and existing research prioritisation frameworks were adapted and applied to identify priorities for further research within a UK context.

Results

Seventy eligible papers were identified. Most were opinion pieces or simply presented trends; few included investigation of suggested hypotheses. Numerous explanations for higher-than-expected mortality were proposed, with hypotheses relating to direct Covid-19 mortality, sequalae of Covid-19 infection, the health service and wider impacts of the pandemic, and socioeconomic factors identified as highest-priority for further research.

Conclusions

A critical understanding of the causes of higher-than-expected mortality is essential for achieving evidence-informed policy. This review proposes priorities for further research, although these are based on author opinion only and likely to vary by setting. We did not seek to clarify the potential interactions between the hypotheses identified, however, in the UK, it is likely that the wider impacts of the Covid-19 pandemic on socioeconomic conditions have exacerbated pre-existing austerity-related trends in stalling life expectancy.

目标：在2019冠状病毒病大流行的第一年观察到死亡率高峰之后，许多国家的死亡人数继续高于预期。本综述旨在确定对大流行第一年之后持续高于预期的死亡率提出的不同解释。研究设计：范围审查。方法：完成了对数据库和灰色文献来源的系统搜索，以确定提出或调查高收入国家（亚）人群中2021年4月以后高于预期死亡率的假设的英语记录。关于诊断或干预后生存的论文被排除在外。对结果进行了叙述总结，并对现有的研究优先级框架进行了调整和应用，以确定英国背景下进一步研究的优先级。结果：筛选出70篇符合条件的论文。大多数是观点文章或简单地介绍趋势；很少包括对建议假设的调查。对高于预期的死亡率提出了许多解释，其中包括与Covid-19直接死亡、Covid-19感染的后遗症、卫生服务和大流行的更广泛影响以及社会经济因素有关的假设，这些假设被认为是进一步研究的重中之重。结论：对死亡率高于预期的原因的批判性理解对于实现循证政策至关重要。这篇综述提出了进一步研究的优先事项，尽管这些优先事项仅基于作者的意见，并且可能因环境而异。我们并没有试图澄清所确定的假设之间的潜在相互作用，然而，在英国，Covid-19大流行对社会经济状况的更广泛影响可能加剧了先前存在的与紧缩相关的趋势，导致预期寿命停滞。

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引用次数: 0

Prevalence of quitting decision and the impact of increased cigarette prices on the smoking behaviours among the male garment workers in Bangladesh 孟加拉国男性服装工人的戒烟决定患病率及卷烟价格上涨对吸烟行为的影响

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

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.11.020

Muhammad Imamuzzaman , Md Biplob Hossain , Md Shahinuzzaman , Kawsar Ahmed , Rebeka Jesmin Sarker , Aivee Akther , ABM Alauddin Chowdhury , Russell Kabir , Md Imdadul Haque

Objectives

The prevalence of tobacco use is high in Bangladesh, with a cigarette being the most consumed tobacco product. Taxing tobacco is highly effective for tobacco control, raising costs and encouraging smokers to quit or reduce cigarette consumption. Garment workers are the major group of low-wage earners in Bangladesh. This study aims to determine the perceived effects of raising cigarette prices on smoking behaviors and their influences on quitting the decision of male garment workers in Bangladesh.

Study design

Cross-sectional study.

Methods

The Study adopted a cross-sectional method among 739 male garment workers from Gazipur and Savar, Dhaka, for six months, using a semi-structured questionnaire. Factors such as the prevalence of lifetime tobacco use and rising cigarette prices on smoking behaviors were analyzed.

Results

The study found that most participants began smoking before age 16, and increased tobacco prices influenced quitting decisions for both smoking and smokeless tobacco users, with reductions of 79% and 68%, respectively. Higher prices notably impacted smoking cessation among lower-income individuals, decreasing smoking frequency by 12-fold. Significantly changing their smoking behavior, on average, daily cigarette or biri consumption decreased from 7 to 5, with some participants switching to less expensive tobacco products.

Conclusion

Findings from the study depict that imposing a high tax on tobacco products such as cigarette or biri has a desirable impact on the smoking behavior of low earning community. The price of all tobacco products should be increased to auspicate a considerable positive change in the community.

目标：孟加拉国的烟草使用率很高，卷烟是消费量最大的烟草产品。对烟草征税对于控制烟草、提高成本和鼓励吸烟者戒烟或减少香烟消费非常有效。制衣工人是孟加拉国低收入者的主要群体。本研究旨在确定提高卷烟价格对吸烟行为的感知效应及其对孟加拉国男性服装工人戒烟决定的影响。研究设计：横断面研究。方法：采用横断面研究方法，对739名来自达卡加济布尔和萨瓦尔的男性服装工人进行了为期6个月的半结构化问卷调查。分析了终身吸烟流行率和卷烟价格上涨等因素对吸烟行为的影响。结果：研究发现，大多数参与者在16岁之前开始吸烟，烟草价格上涨影响了吸烟和无烟烟草使用者的戒烟决定，分别减少了79%和68%。高价格显著影响了低收入人群的戒烟，吸烟频率降低了12倍。他们的吸烟行为显著改变，平均每天吸烟或biri消费量从7减少到5，一些参与者转向更便宜的烟草产品。结论：研究结果表明，对香烟或biri等烟草产品征收高税收对低收入群体的吸烟行为产生了良好的影响。应提高所有烟草制品的价格，以预示社会将出现相当大的积极变化。

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引用次数: 0

Unlocking the key to HPV prevention: Exploring factors influencing HPV vaccination decisions among young people and their parents 打开 HPV 预防的钥匙：探索影响年轻人及其父母接种人乳头瘤病毒疫苗决定的因素。

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

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.12.016

Hüsna Sarıca Çevik , Ana Amariutei , Anastasiia Mazur , Gülsen Ceyhun Peker , Süleyman Görpelioğlu , Shlomo Vinker , Cosimo Bartoloni , Daniel Florov , Mehmet Ungan

Objectives

Human Papillomavirus (HPV) vaccination is a recognised preventive measure against HPV-related cancers. Despite the availability of vaccines, challenges persist, including limited awareness and gender disparities in vaccination. Addressing the challenges necessitates a comprehensive approach involving knowledge advancements, understanding societal needs and cultural beliefs, and improving vaccine communication. This study aimed to determine young people's information needs, facilitators and barriers, influential messages, and thoughts on improving vaccine communication between youth & healthcare professionals (HCPs) and parents regarding HPV vaccination.

Study design

Qualitative SWOT analysis.

Methods

This report is part of Work Package 2.1 within the EU4Health project PROTECT-EUROPE. A multi-methodological approach involved data collection through open-ended questionnaires disseminated to European youth organisations. The data underwent content and SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis.

Results

The SWOT analysis of HPV vaccination communication efforts highlighted strengths, such as using educational institutions to disseminate information and vaccination. Primary obstacles to HPV vaccination include a lack of awareness among key demographics and logistical challenges for youth accessing vaccination services. Weaknesses included barriers created by the use of technical jargon. Opportunities were seen in HCPs engaging directly with students in educational settings and open dialogue, ensuring confidentiality to the target population. Threats encompassed cultural sensitivities to HPV.

Conclusions

These insights underscore the importance of developing communication strategies that are effective and sensitive to cultural contexts and of creating accessible and adaptable vaccination programs. The findings suggest that targeted education and active engagement strategies can mitigate these issues. Moreover, prioritising open communication between HCPs and young individuals is critical for increasing vaccination uptake.

目的：人乳头瘤病毒（HPV）疫苗接种是公认的预防HPV相关癌症的措施。尽管有疫苗，但挑战依然存在，包括疫苗接种方面的认识有限和性别差异。应对这些挑战需要采取综合办法，涉及知识进步、了解社会需求和文化信仰以及改善疫苗宣传。本研究旨在确定年轻人的信息需求、促进因素和障碍、有影响力的信息，以及改善青少年和卫生保健专业人员（HCPs）与父母之间关于HPV疫苗接种的疫苗沟通的想法。研究设计：定性SWOT分析。方法：本报告是EU4Health项目PROTECT-EUROPE工作包2.1的一部分。一种多方法方法包括通过向欧洲青年组织散发的开放式问卷收集数据。数据进行了内容和SWOT（优势，劣势，机会，威胁）分析。结果：HPV疫苗接种传播工作的SWOT分析突出了优势，如利用教育机构传播信息和接种疫苗。HPV疫苗接种的主要障碍包括关键人口统计数据缺乏认识，以及青年获得疫苗接种服务面临后勤挑战。缺点包括使用技术术语造成的障碍。医护人员有机会在教育环境中直接与学生接触，并进行公开对话，确保对目标人群保密。威胁包括对HPV的文化敏感性。结论：这些见解强调了制定有效且对文化背景敏感的传播策略以及创建可获取且适应性强的疫苗接种规划的重要性。研究结果表明，有针对性的教育和积极参与策略可以缓解这些问题。此外，优先考虑医务人员与年轻人之间的公开交流对于提高疫苗接种率至关重要。

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引用次数: 0

Knowledge is not all you need for comfort in use of AI in healthcare 在医疗保健中使用人工智能时，知识并不是你所需要的全部。

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

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.11.019

Anson Kwok Choi Li , Ijaz A. Rauf , Karim Keshavjee

Objectives

The adoption of artificial intelligence (AI) in healthcare is rapidly expanding, transforming areas such as diagnostics, drug discovery, and patient monitoring. Despite these advances, public perceptions of AI in healthcare, particularly in Canada, remain underexplored. This study investigates the relationship between Canadians' knowledge, comfort, and trust in AI, focusing on key sociodemographic factors like age, gender, education, and income.

Study design

Cross-sectional study.

Methods

Using data from the 2021 Canadian Digital Health Survey of 12,052 respondents, we employed ordinal logistic and multivariate polynomial regression analyses to uncover trends and disparities.

Results

Findings reveal that women and older adults consistently report lower levels of knowledge and comfort with AI, with middle-aged women expressing the most significant discomfort. Comfort levels are closely tied to concerns over data privacy, especially regarding the use of identifiable personal health data. Healthcare professionals exhibited heightened discomfort with AI, indicating potential issues with trust in AI's reliability and ethical governance.

Conclusions

Our results underscore that increasing knowledge alone does not necessarily lead to greater comfort with AI in healthcare. Addressing public concerns through robust data governance, transparency, and inclusive AI design is essential to fostering trust and successful integration of AI in healthcare systems.

目标：人工智能（AI）在医疗保健领域的应用正在迅速扩大，正在改变诊断、药物发现和患者监测等领域。尽管取得了这些进步，但公众对人工智能在医疗保健领域的看法，尤其是在加拿大，仍未得到充分探讨。这项研究调查了加拿大人对人工智能的了解、舒适和信任之间的关系，重点关注年龄、性别、教育和收入等关键社会人口因素。研究设计：横断面研究。方法：使用来自2021年加拿大数字健康调查的12,052名受访者的数据，我们采用有序逻辑和多元多项式回归分析来揭示趋势和差异。结果：研究结果显示，女性和老年人对人工智能的了解程度和舒适度一直较低，中年女性表现出最明显的不适。舒适度与对数据隐私的关切密切相关，特别是在使用可识别的个人健康数据方面。医疗保健专业人员对人工智能表现出高度的不安，表明对人工智能可靠性和道德治理的信任存在潜在问题。结论：我们的研究结果强调，仅仅增加知识并不一定会使人工智能在医疗保健中更加舒适。通过强有力的数据治理、透明度和包容性的人工智能设计来解决公众关注的问题，对于促进信任和人工智能在医疗系统中的成功整合至关重要。

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引用次数: 0

The feasibility of utilizing district health information system and short message services on decreasing child immunization dropout and increasing vaccination timeliness in Duhok Governorate 利用地区卫生信息系统和短信服务减少杜胡克省儿童免疫失学率和提高疫苗接种及时性的可行性。

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

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.12.013

Haliz Taha Abdulbaqi , Govand Salih Kadir

Objectives

To develop a customized individual-based electronic immunization registry using the DHIS-2 platform and investigate its effectiveness combined with short message service reminders to decrease the child immunization dropout rate and improve vaccination timeliness in the Duhok Governorate.

Study design

This was a quasi-experimental study.

Methods

The study included a preliminary pilot assessment examining deficiencies and requirements of the current paper-based immunization system, which informed the development of a tailored electronic immunization registry. This registry was implemented in a quasi-experimental study at four randomly selected vaccination units at primary healthcare centers with high dropout rates in Duhok Governorate, targeting 390 children under one year who were vaccinated or eligible to be vaccinated with the PENTA-1 vaccine and followed up for five months to receive successive doses of the PENTA-2 and PENTA-3 vaccines. The children were distributed into two groups: 195 children in the intervention group, whose children's information was entered into the electronic immunization registry and whose parents received vaccination appointment reminders, and 195 children in the control group, whose children received the regular vaccination service, information entered into the paper-based immunization registry, and did not receive vaccination appointment reminders.

Results

The results showed a statistically significant decrease in the PENTA-1 to PENTA-3 dropout rate among children enrolled in the intervention group (5.7 % compared to 29.7 % in the control group, p-value< 0.001).

Conclusion

This study offers compelling evidence that implementing the DHIS-2 platform tracker EIR with SMS reminders is an effective tool for significantly enhancing the child immunization program's outcomes. It also guides the implementation of an individual-based electronic immunization registry using the DHIS-2 tracker module by the national health team. Therefore, we recommend adopting its application to encompass a broader spectrum of vaccines and health facilities nationwide.

目标：利用DHIS-2平台开发定制的基于个人的电子免疫登记，并调查其与短信服务提醒相结合的有效性，以降低杜胡克省的儿童免疫辍学率并提高疫苗接种的及时性。研究设计：这是一项准实验研究。方法：该研究包括一项初步的试点评估，审查了当前基于纸张的免疫系统的缺陷和要求，为定制电子免疫登记的开发提供了信息。这一登记是在杜胡克省高辍学率的初级保健中心的四个随机选择的疫苗接种单位进行的一项准实验研究中实施的，目标是390名一岁以下的儿童，他们接种了PENTA-1疫苗或有资格接种PENTA-1疫苗，并随访了五个月，连续接种了PENTA-2和PENTA-3疫苗。将儿童分为两组：干预组195名儿童，其儿童信息输入电子免疫登记系统，其父母收到疫苗接种预约提醒；对照组195名儿童，其儿童接受常规疫苗接种服务，信息输入纸质免疫登记系统，未收到疫苗接种预约提醒。结果：结果显示，干预组儿童PENTA-1至PENTA-3的辍学率显著降低（5.7%，对照组29.7%，p值< 0.001）。结论：本研究提供了令人信服的证据，证明实施带有短信提醒的DHIS-2平台跟踪器EIR是显著提高儿童免疫规划结果的有效工具。它还指导国家卫生队使用DHIS-2跟踪模块实施基于个人的电子免疫登记。因此，我们建议将其适用范围扩大到全国范围的疫苗和卫生设施。

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引用次数: 0

Couple depression concordance and adverse health outcomes among middle-aged and older adults: A longitudinal study in China 中国中老年人夫妻抑郁一致性与不良健康结局：一项纵向研究

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

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.10.017

Yi Li , Zhenqiu Liu , Hong Fan , Haili Wang , Xin Zhang , Chengnan Guo , Tiejun Zhang

Objectives

Little is known about the interactive patterns of depressive symptoms and the consequent joint health burden in couples. This study aimed to evaluate the impacts of couple depression concordance on activities of daily living (ADL) disability, instrumental ADL (IADL) disability, hospitalization, and all-cause mortality among middle-aged and older couples.

Study design

This study used a longitudinal research design.

Methods

Data were obtained from the China Health and Retirement Longitudinal Study. At baseline, 3985 couples aged 45 years and older were included, being categorized into four groups: nondepressed husband-nondepressed wife (NN), depressed husband-nondepressed wife (DHNW), nondepressed husband-depressed wife (NHDW), and depressed husband-depressed wife (DD). Modified Poisson regression models were used to estimate relative risks (RRs) in terms of short-term (2011–2013) and long-term (2011–2018) follow-up.

Results

Compared with participants in the NN group, those in the other three groups were at increased risk of ADL and IADL disability (P < 0.001), with the highest risk in the DD group. Any partner with depressive symptoms in a couple was associated with increased risks of ADL and IADL disability for both members. Depressed middle-aged couples were at a higher long-term risk of ADL disability than the elderly (P _interaction = 0.031). Additionally, participants in the DD group had a significantly increased risk of hospitalization.

Conclusions

Depressive symptoms and subsequent health decline are interdependent in couples. Couples where both individuals have depressive symptoms are particularly vulnerable. More consideration should be given to couple-based management and treatment strategies in addressing depression and its detrimental consequences.

目的：对夫妻抑郁症状的相互作用模式和随之而来的关节健康负担知之甚少。本研究旨在探讨夫妻抑郁一致性对中老年夫妻日常生活活动（ADL）、工具性ADL （IADL）残疾、住院治疗和全因死亡率的影响。研究设计：本研究采用纵向研究设计。方法：数据来源于中国健康与退休纵向研究。在基线时，包括3985对年龄在45岁及以上的夫妇，分为四组：非抑郁的丈夫-非抑郁的妻子（NN）、抑郁的丈夫-非抑郁的妻子（DHNW）、非抑郁的丈夫-抑郁的妻子（NHDW）和抑郁的丈夫-抑郁的妻子（DD）。采用修正泊松回归模型估计短期（2011-2013年）和长期（2011-2018年）随访的相对风险（rr）。结果：与NN组相比，其他三组患者ADL和IADL残疾的风险均增加（P交互作用= 0.031）。此外，DD组的参与者住院的风险显著增加。结论：夫妻抑郁症状和随后的健康下降是相互依赖的。双方都有抑郁症状的夫妻尤其容易受到伤害。应更多地考虑以夫妻为基础的管理和治疗策略，以解决抑郁症及其有害后果。

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引用次数: 0

Impact of COVID-19 pandemic on vaccine hesitancy and sentiment changes: A survey of healthcare workers in 12 countries COVID-19 大流行对疫苗犹豫不决和情绪变化的影响：对 12 个国家医护人员的调查。

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

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.11.016

Andrea Parisi , Luca Regazzi , Emma Sophie Spanaus , Angelica Valz Gris , Chiara Cadeddu , Michael Moore , Walter Ricciardi , Marta Lomazzi

Objectives

Healthcare workers (HCWs) are a trusted source of vaccine-related information for patients and communities, but they can show hesitancy or reluctance towards vaccinations. The objective of our study was to investigate HCWs’ sentiment and hesitancy towards vaccination, focusing on COVID-19 and influenza vaccination.

Study design

A global cross-sectional study spanning four continents.

Methods

Utilizing a web-based survey, we gathered responses from 7793 HCWs across twelve countries. We used Latent Class Analysis models to build response profiles for respondents. We employed multilevel multivariable logistic regression models to assess the impact of individual determinants and country contextual effects on change in vaccine sentiment (ChVS) and COVID-19 vaccine hesitancy (CoVH).

Results

HCWs exhibited high agreement on the safety, effectiveness, and usefulness of vaccines. However, 21% reported strong or moderate CoVH. Country contextual effects significantly influenced ChVS and CoVH, with variations observed across nations, accounting for 6% of global variance in both ChVS and CoVH. Individual factors such as educational level, fear of contracting COVID-19, knowledge of COVID 19 vaccines, CoVH, influenza vaccination behaviour and general confidence in vaccines significantly influenced ChVS. CoVH was related to profession, influenza vaccination behaviour, fear of COVID-19 and main information sources.

Conclusions

Individual factors played a major role in determining change in vaccine sentiment and COVID-19 vaccine hesitancy, but they can be modulated by other contextual elements at the country level. There is a need for tailored, nation-specific strategies to address vaccine hesitancy and enhance vaccine confidence among HCWs.

目的：卫生保健工作者（HCWs）是患者和社区疫苗相关信息的可靠来源，但他们可能对疫苗接种表现出犹豫或不情愿。本研究的目的是调查卫生保健工作者对疫苗接种的情绪和犹豫，重点是COVID-19和流感疫苗接种。研究设计：一项横跨四大洲的全球横断面研究。方法：利用基于网络的调查，我们收集了来自12个国家的7793名卫生保健工作者的回复。我们使用潜在类分析模型来建立受访者的反应概况。我们采用多水平多变量logistic回归模型来评估个体决定因素和国家背景对疫苗情绪（ChVS）和COVID-19疫苗犹豫（CoVH）变化的影响。结果：卫生保健工作者对疫苗的安全性、有效性和有用性表现出高度一致。然而，21%的患者报告了重度或中度CoVH。国家背景效应显著影响ChVS和CoVH，在各国之间观察到差异，占ChVS和CoVH全球差异的6%。受教育程度、对感染COVID-19的恐惧、对COVID-19疫苗的了解、COVID-19疫苗、流感疫苗接种行为和对疫苗的总体信心等个人因素显著影响ChVS。CoVH与职业、流感疫苗接种行为、对COVID-19的恐惧以及主要信息来源有关。结论：个体因素在决定疫苗情绪和COVID-19疫苗犹豫变化方面发挥了主要作用，但它们可以被国家层面的其他背景因素调节。有必要制定针对具体国家的量身定制战略，以解决疫苗犹豫问题，并增强卫生保健工作者对疫苗的信心。

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引用次数: 0

Global, regional, and national burden of early-onset colorectal cancer and projection to 2050: An analysis based on the Global Burden of Disease Study 2021 早发性结直肠癌的全球、区域和国家负担及2050年预测：基于2021年全球疾病负担研究的分析

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

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.12.011

Xinyi Li , Xueyan Xiao , Zenghong Wu , Anni Li , Weijun Wang , Rong Lin

Objectives

Early-onset colorectal cancer (EO-CRC) is becoming increasingly concerning due to its impact on individuals under 50 years old. We explored the burden of EO-CRC to provide information for planning effective management and prevention strategies.

Study design

We conducted secondary analyses to assess the burden of EO-CRC using data from GBD 2021.

Methods

The incidence, prevalence, deaths, disability-adjusted life years (DALYs) and their rates across 204 countries and territories were obtained from GBD 2021 database. The estimated annual percentage change (EAPC) calculation was used to assess temporal trends in these metrics. Additionally, we reported the proportion of DALYs attributable to risk factors and projected future disease burden till 2050.

Results

The global number of new EO-CRC cases increased from 107,310 in 1990 to 211,890 in 2021. Both age-standardized incidence rate (ASIR) and prevalence rate (ASPR) of EO-CRC showed overall increases over the study period (ASIR: EAPC = 0.96 (0.9–1.02), ASPR: EAPC = 1.5 (1.44–1.55)). However, a decline in ASIR and ASPR was observed in 2020 and 2021. Males consistently showed higher EO-CRC indicators compared to females. Furthermore, projections indicated that deaths and DALYs cases are likely to fluctuate but generally increase by 2050, reaching 85,602 and 4,283,093, respectively.

Conclusions

The global impact of EO-CRC has increased significantly from 1990 to 2021, revealing notable variations across SDI regions, countries, age groups, and sexes. Besides, deaths and DALYs are predicted to rise by 2050. These results highlight the importance of implementing measures to address the growing burden of EO-CRC globally.

目的：早发性结直肠癌（EO-CRC）因其对50岁以下人群的影响而越来越受到关注。我们探讨了EO-CRC的负担，为规划有效的管理和预防策略提供信息。研究设计：我们使用GBD 2021的数据进行了二次分析，以评估EO-CRC的负担。方法：从GBD 2021数据库中获取204个国家和地区的发病率、患病率、死亡率、残疾调整生命年（DALYs）及其比率。估计年百分比变化（EAPC）计算用于评估这些指标的时间趋势。此外，我们报告了可归因于风险因素的伤残调整生命年的比例，并预测了到2050年的未来疾病负担。结果：全球EO-CRC新发病例数从1990年的107310例增加到2021年的211890例。EO-CRC的年龄标准化发病率（ASIR）和患病率（ASPR）在研究期间均呈总体上升趋势(ASIR: EAPC = 0.96 （0.9-1.02), ASPR: EAPC = 1.5(1.44-1.55)）。然而，在2020年和2021年观察到ASIR和ASPR的下降。与女性相比，男性始终表现出更高的EO-CRC指标。此外，预测表明，到2050年，死亡人数和残疾调整生命年病例可能会波动，但总体上会增加，分别达到85 602人和4 283 093人。结论：从1990年到2021年，全球EO-CRC的影响显著增加，显示出SDI地区、国家、年龄组和性别之间的显著差异。此外，预计到2050年，死亡人数和伤残调整寿命将会上升。这些结果突出了在全球范围内采取措施解决日益严重的eoc - crc负担的重要性。

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引用次数: 0

Do self-management supportive interventions reduce healthcare utilization for people with musculoskeletal pain conditions? – A systematic review 自我管理支持干预是否会降低肌肉骨骼疼痛患者的医疗保健利用率？-系统评价。

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

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.10.021

S. Grøn , M. Johansson , D. Schiphof , B. Koes , A. Kongsted

Objective

The aim of this systematic review was to investigate the effect of self-management supportive interventions on healthcare utilization in adult cares seekers with musculoskeletal pain conditions.

Study design

Systematic review.

Methods

We included studies comparing the effect of a self-management supportive intervention against a control intervention and included measures of healthcare utilization. Studies were searched in MEDLINE, Embase, PsycINFO, CINAHL, Pedro, and the Cochrane Library. Results were extracted for the follow-up point closest to 12 months. Risk of bias was assessed using the Cochrane Risk of Bias tool 2, and quality of evidence by The Grading of Recommendations Assessment, Development and Evaluation. Results were synthesized on study level as mean differences or odds ratios with 95 % CI.

Results

We included 28 studies. Eighteen studies reported on the use of primary care at follow-up, and ten, four, and 13 on specialty care, diagnostics imaging, and oral pain medication, respectively. Overall, there was very low-quality evidence for no effect of self-management interventions on healthcare utilization in all groups. All studies were classified as either having a “high risk of bias” or “some concerns”.

Conclusion

Due to substantial heterogeneity in the types and measurement of healthcare utilization outcomes, it was not feasible to conduct a meta-analysis to estimate an overall effect size. A standardized way of reporting and measuring these outcomes could aid future research in this area. The current evidence suggests that self-management supportive interventions do not affect healthcare utilization in people with musculoskeletal pain conditions, but future high-quality studies may substantially change this conclusion.

研究目的本系统综述旨在研究自我管理支持性干预对患有肌肉骨骼疼痛的成年求医者使用医疗服务的影响：研究设计：系统综述：我们纳入了比较自我管理支持性干预与对照干预效果的研究，并纳入了医疗保健利用率的测量指标。研究在 MEDLINE、Embase、PsycINFO、CINAHL、Pedro 和 Cochrane 图书馆中进行了检索。研究结果以最接近 12 个月的随访点为提取对象。采用 Cochrane 偏倚风险工具 2 评估偏倚风险，并采用建议评估、制定和评价分级法评估证据质量。研究结果以平均差异或几率比加 95 % CI 的形式进行综合：我们纳入了 28 项研究。结果：我们纳入了 28 项研究，其中 18 项研究报告了随访时初级护理的使用情况，10 项、4 项和 13 项分别报告了专科护理、影像诊断和口服止痛药的使用情况。总体而言，有极低质量的证据表明，自我管理干预对所有组别的医疗保健使用率均无影响。所有研究均被归类为 "偏倚风险较高 "或 "存在一些问题"：由于医疗保健利用率结果的类型和测量方法存在很大的异质性，因此无法进行荟萃分析来估算总体效应大小。对这些结果进行标准化的报告和测量，有助于今后在这一领域的研究。目前的证据表明，自我管理支持性干预措施不会影响肌肉骨骼疼痛患者的医疗保健利用率，但未来的高质量研究可能会大大改变这一结论。

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引用次数: 0

Global burden of neonatal preterm birth: A systematic analysis for the global burden of disease study 2019 新生儿早产的全球负担：2019年全球疾病负担研究的系统分析。

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

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.10.029

Qing Hu , Hua Liao , Haiyan Yu

Objectives

Addressing the research gap on neonatal preterm birth's global impact, this study aims to present a detailed analysis of its incidence and mortality rates from 1990 to 2019, capturing the disease burden's evolution during this timeframe.

Methods

We analyzed Global Burden of Disease Study 2019 data across 204 countries to assess age-standardized incidence, prevalence, mortality, and DALYs for neonatal preterm birth from 1990 to 2019, along with EPAC and risk factors.

Results

From 1990 to 2019, EPAC for neonatal death at 0–6 days was −1.75 %, and DALYs was −1.75 %. For deaths under 5 years, EPAC was −2.23 %, and DALYs was −2.19 %. Key risk factors for neonatal preterm birth DALYs included low birth weight, gestational age, ambient air pollution, and household pollution from solid fuels.

Conclusions

Preterm birth notably increases neonatal risks at 0–6 days and under 5 years. Our study shows diseased disease burdens in these periods. Preventive strategies, such as reducing household and ambient air pollution, are crucial for preterm birth reduction. Tailored regional interventions are essential.

研究目的为了填补关于新生儿早产对全球影响的研究空白，本研究旨在详细分析 1990 年至 2019 年期间新生儿早产的发病率和死亡率，捕捉这一期间疾病负担的演变过程：我们分析了 204 个国家的 2019 年全球疾病负担研究数据，以评估 1990 年至 2019 年新生儿早产的年龄标准化发病率、流行率、死亡率和残疾调整寿命年数，以及 EPAC 和风险因素：1990年至2019年，0-6天新生儿死亡的EPAC为-1.75%，DALY为-1.75%。5岁以下死亡的EPAC为-2.23%，残疾调整寿命年数为-2.19%。新生儿早产残疾调整寿命年数的主要风险因素包括低出生体重、胎龄、环境空气污染和固体燃料造成的家庭污染：早产显著增加了 0-6 天和 5 岁以下新生儿的风险。我们的研究表明，这些时期的疾病负担较重。减少家庭和环境空气污染等预防策略对于减少早产至关重要。有针对性的区域干预措施至关重要。

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引用次数: 0