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Current Cannabis Use in the United States: Implications for Public Health Research. 美国当前的大麻使用情况:对公共卫生研究的影响》。
IF 12.7 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 DOI: 10.2105/ajph.2024.307823
Grant T Baldwin,Alana Vivolo-Kantor,Brooke Hoots,Douglas R Roehler,Jean Y Ko
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引用次数: 0
Improving Cannabis Policy Research at a Pivotal Time for Policy Development. 在政策制定的关键时刻改进大麻政策研究。
IF 12.7 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 DOI: 10.2105/ajph.2024.307799
Gillian L Schauer
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引用次数: 0
Monitoring Cannabis Adverse Events: Lessons From Edible Packaging Policies and Child Poisonings. 监测大麻不良事件:从食用包装政策和儿童中毒事件中汲取教训。
IF 12.7 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 DOI: 10.2105/ajph.2024.307789
Julia A Dilley,Robert G Hendrickson,Erik M Everson,Thomas L Jeanne
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引用次数: 0
Trends in Driving Under the Influence of Alcohol and Cannabis Among Young Adults in Washington State From Before to During the COVID-19 Pandemic. COVID-19 大流行之前至期间华盛顿州年轻人在酒精和大麻影响下驾车的趋势。
IF 12.7 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 DOI: 10.2105/ajph.2024.307767
Brittney A Hultgren,Brian H Calhoun,Charles B Fleming,Isaac C Rhew,Mary E Larimer,Jason R Kilmer,Katarina Guttmannova
Objectives. To examine trends in young adult self-reported driving under the influence of alcohol (DUI-A), cannabis (DUI-C), and simultaneous alcohol and cannabis use (DUI-AC) in a state with legalized nonmedical cannabis use from before to during the COVID-19 pandemic. Methods. We used logistic regression and annual statewide data from the Washington Young Adult Health Survey to assess DUI behaviors from 2016 to 2021. Results. Both prepandemic yearly changes in prevalence and deviations from those trends during the pandemic years were small and not statistically significant. However, prevalence estimates were alarming: 12.0% of participants reported DUI-A, 12.5% reported DUI-C, and 2.7% reported DUI-AC. Exploratory moderation analyses indicated a relative increase in DUI-A during 2020 among 4-year college students relative to young adults not attending 4-year colleges. Conclusions. Young adults in Washington State continued to engage in risky DUI behaviors during the pandemic. College students may have increased their likelihood of DUI-A during COVID-19. Public Health Implications. Young adults, for whom vehicle crashes remain a leading cause of death, showed little change in DUI behaviors during the COVID-19 pandemic. There is continued need for young adult DUI prevention efforts. (Am J Public Health. 2024;114(S8):S698-S701. https://doi.org/10.2105/AJPH.2024.307767).
目标。在 COVID-19 大流行之前至期间,在一个非医疗使用大麻合法化的州,研究年轻人自我报告的在酒精(DUI-A)、大麻(DUI-C)以及同时使用酒精和大麻(DUI-AC)影响下驾驶的趋势。方法。我们使用逻辑回归和华盛顿州青年健康调查的年度全州数据来评估 2016 年至 2021 年期间的酒驾行为。结果大流行前的流行率年度变化和大流行期间的趋势偏差都很小,没有统计学意义。然而,流行率估计值令人震惊:12.0% 的参与者报告了 DUI-A,12.5% 报告了 DUI-C,2.7% 报告了 DUI-AC。探索性调节分析表明,2020 年期间,相对于未就读四年制大学的年轻人,四年制大学生的酒驾-A 比率相对增加。结论。在大流行病期间,华盛顿州的年轻人继续从事危险的酒驾行为。在 COVID-19 期间,大学生可能会增加酒后驾车的可能性。对公共卫生的影响。车祸仍然是导致年轻人死亡的主要原因,在 COVID-19 大流行期间,年轻人的酒驾行为几乎没有变化。仍有必要继续开展预防青壮年酒驾的工作。(Am J Public Health.2024;114(S8):S698-S701. https://doi.org/10.2105/AJPH.2024.307767).
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引用次数: 0
Kids No Longer Smoke Cigarettes. Why Aren't We Celebrating? 孩子们不再吸烟。我们为什么不庆祝?
IF 9.6 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 DOI: 10.2105/AJPH.2024.307841
Kenneth E Warner
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引用次数: 0
Notes From the Field: Why They Are Important. 现场笔记:为什么它们很重要?
IF 9.6 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 DOI: 10.2105/AJPH.2024.307852
Alfredo Morabia
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引用次数: 0
Health Care Delivery Site- and Patient-Level Factors Associated With COVID-19 Primary Vaccine Series Completion in a National Network of Community Health Centers. 全国社区卫生中心网络中与完成 COVID-19 初次接种系列疫苗相关的医疗保健提供场所和患者层面因素。
IF 9.6 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 DOI: 10.2105/AJPH.2024.307773
Rachel Gold, Anna Steeves-Reece, Aileen Ochoa, Jee Oakley, Rose Gunn, Shuling Liu, Brigit A Hatch, Sean T O'Leary, Christine I Spina, Treasure Allen, Erika K Cottrell

Objectives. To assess multilevel factors associated with variation in COVID-19 vaccination rates in a US network of community health centers. Methods. Using multilevel logistic regression with electronic health record data from ADVANCE (Accelerating Data Value Across a National Community Health Center Network; January 1, 2022-December 31, 2022), we assessed associations between health care delivery site-level (n = 1219) and patient-level (n = 1 864 007) characteristics and COVID-19 primary vaccine series uptake. Results. A total of 1 337 440 patients completed the COVID-19 primary vaccine series. Health care delivery site characteristics were significantly associated with lower series completion rates, including being located in non-Medicaid expansion states and isolated or rural communities and serving fewer patients. Patient characteristics associated with significantly lower likelihood of completing the vaccine series included being Black/African American or American Indian/Alaska Native (vs White), younger age, lower income, being uninsured or publicly insured (vs using private insurance), and having fewer visits. Conclusions. Both health care delivery site- and patient-level factors were significantly associated with lower COVID-19 vaccine uptake. Community health centers have been a critical resource for vaccination during the pandemic. (Am J Public Health. 2024;114(11):1242-1251. https://doi.org/10.2105/AJPH.2024.307773).

目的评估与美国社区卫生中心网络中 COVID-19 疫苗接种率变化相关的多层次因素。方法。利用 ADVANCE(Accelerating Data Value Across a National Community Health Center Network,2022 年 1 月 1 日至 2022 年 12 月 31 日)的电子健康记录数据进行多层次逻辑回归,我们评估了医疗保健服务机构(n = 1219)和患者(n = 1 864 007)的特征与 COVID-19 疫苗接种率之间的关系。结果共有 1 337 440 名患者完成了 COVID-19 初次接种。医疗保健服务机构的特征与较低的疫苗接种完成率明显相关,包括位于非医疗补助扩展州、偏远或农村社区以及服务的患者较少。与完成系列疫苗接种的可能性明显较低有关的患者特征包括:黑人/非洲裔美国人或美洲印第安人/阿拉斯加原住民(与白人相比)、年龄较小、收入较低、无保险或公共保险(与使用私人保险相比)以及就诊次数较少。结论。医疗机构和患者层面的因素都与 COVID-19 疫苗接种率较低密切相关。社区卫生中心是大流行期间疫苗接种的重要资源。(Am J Public Health.2024;114(11):1242-1251. https://doi.org/10.2105/AJPH.2024.307773).
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引用次数: 0
Four Models of Wastewater-Based Monitoring for SARS-CoV-2 Complementing Individual Screening in Jail Settings. 四种基于废水的 SARS-CoV-2 监测模式对监狱中的个人筛查进行补充。
IF 9.6 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 DOI: 10.2105/AJPH.2024.307785
Shanika S Kennedy, Lindsay B Saber, Victoria M Brown, Rachel A Boehm, Amadin A Olotu, Jeffery Osei, Jacob A Pluznik, Lindsey R Riback, Ebrima Sidibeh, Beth Jordan, Eleni O'Donovan, Anilkumar Mangla, Christine Nzokou, Tracey L Elam, Jane Gubser, Peter J Koutoujian, Kashif A Siddiqi, Steven Wilensky, Victoria L Phillips, Alysse G Wurcel, Chad J Zawitz, Matthew J Akiyama, Anne C Spaulding

Objectives. To describe 4 unique models of operationalizing wastewater-based surveillance (WBS) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in jails of graduated sizes and different architectural designs. Methods. We summarize how jails of Cook County, Illinois (average daily population [ADP] 6000); Fulton County, Georgia (ADP 3000); Middlesex County, Massachusetts (ADP 875); and Washington, DC (ADP 1600) initiated WBS between 2020 and 2023. Results. Positive signals for SARS-CoV-2 via WBS can herald a new onset of infections in previously uninfected jail housing units. Challenges implementing WBS included political will and realized value, funding, understanding the building architecture, and the need for details in the findings. Conclusions. WBS has been effective for detecting outbreaks of SARS-CoV-2 in different sized jails, those with both dorm- and cell-based architectural design. Public Health Implications. Given its effectiveness in monitoring SARS-CoV-2, WBS provides a model for population-based surveillance in carceral facilities for future infectious disease outbreaks. (Am J Public Health. 2024;114(11):1232-1241. https://doi.org/10.2105/AJPH.2024.307785).

目的。描述在不同规模和不同建筑设计的监狱中实施基于废水的严重急性呼吸系统综合征冠状病毒 2 (SARS-CoV-2) 监控 (WBS) 的 4 种独特模式。方法。我们总结了伊利诺伊州库克县(日均人口 [ADP] 6000)、佐治亚州富尔顿县(日均人口 3000)、马萨诸塞州米德尔塞克斯县(日均人口 875)和华盛顿特区(日均人口 1600)的监狱在 2020 年至 2023 年期间如何启动 WBS。结果通过 WBS 检测出 SARS-CoV-2 的阳性信号可能预示着以前未感染过 SARS-CoV-2 的监狱单位会出现新的感染病例。实施 WBS 所面临的挑战包括政治意愿和实现价值、资金、对建筑结构的理解以及对研究结果细节的需求。结论。WBS 可以有效检测不同规模监狱中的 SARS-CoV-2 爆发情况,这些监狱既有宿舍式建筑设计,也有牢房式建筑设计。对公共卫生的影响。鉴于 WBS 在监测 SARS-CoV-2 方面的有效性,它为未来在囚禁设施中开展基于人群的传染病疫情监测提供了一种模式。(Am J Public Health.2024;114(11):1232-1241. https://doi.org/10.2105/AJPH.2024.307785).
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引用次数: 0
Role of Doulas in Improving Maternal Health and Health Equity Among Medicaid Enrollees, 2014‒2023. 2014-2023 年,Doulas 在改善医疗补助(Medicaid)参保者的孕产妇健康和健康平等方面的作用。
IF 9.6 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 DOI: 10.2105/AJPH.2024.307805
April M Falconi, Leah Ramirez, Rebecca Cobb, Carrie Levin, Michelle Nguyen, Tiffany Inglis

Objectives. To assess the relationship between doula utilization and health outcomes of females enrolled in Medicaid-affiliated plans in the United States. Methods. In this retrospective, observational cohort study, we used Medicaid claims data from a national health insurer to compare health outcomes between females who used and who did not use a doula (2014-2023). We conducted propensity score matching using a 1:1 case‒control match, without replacement, and fit logistic regressions to analyze the relative risks for maternal health outcomes. Results. The study population included 722 matched pairs with and without a doula. Results indicate females with doulas had a 47% lower risk of cesarean delivery and a 29% lower risk of preterm birth, and were 46% more likely to attend a postpartum checkup (all differences P < .05). Conclusions. Doula care is associated with improved health outcomes among Medicaid enrollees. Public Health Implications. Doulas have garnered increasing interest from policymakers as a strategy to address increasing trends in maternal morbidity and persistent health disparities. This study provides evidence from Medicaid enrollees across the United States that doula care can improve maternal health. (Am J Public Health. 2024;114(11):1275-1285. https://doi.org/10.2105/AJPH.2024.307805).

目的评估美国医疗补助计划(Medicaid)附属计划中女性使用朵拉与健康结果之间的关系。方法。在这项回顾性观察队列研究中,我们利用一家全国性医疗保险公司提供的医疗补助理赔数据,比较了使用和未使用朵拉的女性(2014-2023 年)的健康状况。我们使用 1:1 的病例对照匹配进行倾向得分匹配,不进行替换,并通过逻辑回归分析孕产妇健康结果的相对风险。结果研究对象包括 722 对有朵拉和没有朵拉的配对。结果显示,有朵拉的女性剖宫产风险降低了 47%,早产风险降低了 29%,参加产后检查的可能性增加了 46%(所有差异均为 P 结论:朵拉护理与产妇健康状况的改善相关。杜拉护理与医疗补助计划参保者健康状况的改善有关。对公共卫生的影响。作为应对孕产妇发病率上升趋势和持续存在的健康差异的一种策略,杜拉拉越来越受到政策制定者的关注。这项研究从美国各地的医疗补助参保者中提供了证据,证明朵拉护理可改善孕产妇健康。(Am J Public Health.2024;114(11):1275-1285. https://doi.org/10.2105/AJPH.2024.307805).
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引用次数: 0
Trends in Medical Encounters Involving Cannabis-Related Disorders Among US Medicare Beneficiaries, 2017-2022. 2017-2022 年美国医疗保险受益人中涉及大麻相关疾病的就诊趋势。
IF 12.7 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 DOI: 10.2105/ajph.2024.307729
Silvia Perez-Vilar,Sara Kazemian,Christina Greene,Pablo Freyria Duenas,Rose Radin,Arnstein Lindaas,Sandia Akhtar,Michael Wernecke,Yoganand Chillarige,Jeffrey A Kelman,David J Graham
Objectives. To characterize cannabis-related disorder medical encounter trends in the US Medicare population during 2017 to 2022. Methods. We conducted a descriptive study, which included 56 624 432 beneficiaries aged 65 years or older and 10 247 953 aged 18 to 64 years with disability. All were continuously enrolled in Medicare (Fee-for-Service or Advantage) for 183 or more days before the first day of the calendar year. We identified cannabis-related disorder encounters using International Classification of Diseases, 10th Revision, Clinical Modification diagnosis codes and computed annual encounter rates per 10 000 beneficiaries. We used the Mann-Kendall test to analyze trends over time. Results. Annual cannabis-related disorder encounter trends among beneficiaries aged 65 years or older ranged from 15.9 (95% confidence interval [CI] = 15.8, 16.0) to 39.3 (95% CI = 39.1, 39.5) per 10 000. Rates among beneficiaries aged 18 to 64 years with disability ranged from 274.8 (95% CI = 273.6, 276.0) to 373.7 (95% CI = 372.3, 375.2) per 10 000. Rates increased over time across both groups, with average annual increases of 4.3 (95% CI = 3.3, 5.3; P = .01) and 17.1 (95% CI = 11.0, 23.2; P = .02) per 10 000, respectively. Conclusions. Further work is needed to explore the impact of coexisting medical conditions on outcomes that result from cannabis-related disorders. (Am J Public Health. 2024;114(S8):S694-S697. https://doi.org/10.2105/AJPH.2024.307729).
目标。描述 2017 年至 2022 年期间美国医疗保险人群中大麻相关疾病的就医趋势。方法。我们进行了一项描述性研究,其中包括 56 624 432 名 65 岁或以上的受益人和 10 247 953 名 18 至 64 岁的残疾人士。所有受益人在日历年第一天之前均已连续参加医疗保险(付费服务或优势服务)183 天或 183 天以上。我们使用《国际疾病分类》第 10 版临床修正诊断代码确定了大麻相关疾病的就诊情况,并计算了每 10,000 名受益人的年度就诊率。我们使用 Mann-Kendall 检验来分析随时间变化的趋势。结果。在 65 岁或以上的受益人中,大麻相关疾病的年发病率趋势为每 10,000 人中有 15.9 人(95% 置信区间 [CI] = 15.8, 16.0)至 39.3 人(95% 置信区间 = 39.1, 39.5)。18至64岁残疾受益人的发病率为每1万人274.8(95% CI = 273.6,276.0)至373.7(95% CI = 372.3,375.2)。随着时间的推移,这两个群体的发病率都有所上升,平均每年每 10,000 人中的发病率分别上升 4.3 (95% CI = 3.3, 5.3; P = .01) 和 17.1 (95% CI = 11.0, 23.2; P = .02)。结论。需要进一步开展工作,探讨并存的医疗条件对大麻相关疾病导致的结果的影响。(Am J Public Health.2024;114(S8):S694-S697. https://doi.org/10.2105/AJPH.2024.307729).
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American journal of public health
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