BMC Public Health最新文献

Background: Although obesity is on the rise in Afghanistan, to date no studies have investigated associations with diet and dietary patterns. Therefore, the present study aimed to assess the different dietary patterns consumed among Afghan adults living in Kandahar province and evaluate the correlations between those predominant dietary patterns and anthropometric measures.

Methods: A cross-sectional study was conducted in Kandahar, Afghanistan, where data on sociodemographic characteristics, anthropometric measurements and diet were collected. A total of 711 men and women aged between 20 and 75 years were included in the final analysis. Dietary data were collected in 2018-2019 using a food frequency questionnaire and dietary patterns were identified by principal component analysis. Dietary pattern scores were then categorised into tertiles, where tertile 1 represented a lower adherence and tertile 3 the highest adherence to the pattern. Bonferroni adjusted P value of 0.004 was considered statistically significant.

Results: Three dietary patterns were derived: a Western (WDP, rich in sweet beverages and refined grains), a Fruits and vegetables (FVDP), and a Traditional (TDP, rich in potatoes, fats and oil, and whole grains) dietary pattern. In this population, men had significantly higher adherence to WDP and TDP than women. Participants with higher socioeconomic status had significantly higher adherence to WDP and TDP and lower adherence to the FVDP. In linear regression models adjusted for potential confounders, BMI and waist and hip circumferences were positively correlated with WDP and FVDP and inversely correlated with the TDP, in particular among men and people with high SES, although none of these associations reached the Bonferroni-corrected threshold for statistical significance.

Conclusions: Three distinct dietary patterns were identified among Afghan adults from Kandahar. Weak positive associations were found between the Western dietary pattern and general and central obesity. Associations of fruits and vegetables and traditional dietary patterns with obesity deserve further evaluation in a larger sample and with more detailed dietary intake assessment methods that also consider preparation methods and food processing.

Background: Chemsex, characterized by the intentional use of specific drugs to enhance sexual experiences during group sessions, represents a challenge for the health of some sexually active communities, such as men who have sex with men (MSM). MSM may experience mental health issues associated with chemsex participation. This survey aims to investigate the characteristics, prevalence, and correlates of sexualized drug use (SDU) and chemsex with a focus on the emotional vulnerability associated with chemsex and SDU engagement among MSM at high risk of sexually transmitted infections (STI).

Methods: A self-administered anonymous questionnaire to investigate demographical data, attitudes toward substance dependence, sexual behaviors and vulnerability for common mental disorders (CMD), was offered to consecutive MSM attending the STI/HIV Unit of San Gallicano Dermatological Institute of Rome, Italy, from 1 to 30 November 2023. The Mann-Whitney and Fisher's test were used to assess differences in terms of sexual behavior, SDU, STI risk and vulnerability for CMD between MSM who don't engage in SDU, who engage only in SDU (no chemsex) and chemsex.

Results: One hundred and twenty-two MSM agreed to participate. Overall, 47.3% (57/119) were people living with HIV (PLWH) on antiretroviral therapy (ART); fifty (40.9%, 95% CI: 32.7-49.9) participants reported SDU, 24 (19.7%, 95% CI: 13.6-27.6) of which reported chemsex. Participants reporting SDU or chemsex were in unstable relationships (p = < 0.01), engaged in group sex (p = < 0.01) and had more than 10 sexual partners in the previous year (p = < 0.01) compared to those who denied SDU. Chemsex participants were more likely to use condoms inconsistently (p = 0.02), have a history of STIs (p = 0.02), and have had over 10 sexual partners in the past year (p = 0.04) than those who only engaged in SDU. Chemsex participants used specific and exclusive drugs when compared to other MSM engaged in SDU. Overall, 35 (28.7%; 95% CI: 21.4-37.2) and 52 (42.6%; 95% CI: 34.2-51.5) participants showed symptoms of depression and anxiety, respectively. Chemsex involvement showed a strong association with symptoms of depression compared with no-SDU andno- chemsex (COR = 3.8; 95% CI: 1.22-11.6; p < 0.01), particularly among PLWH (p = 0.04).

Conclusions: Depression may be associated with chemsex behavior, particularly in MSM with HIV. SDU, in particular chemsex, are proxies in practitioners for increased STIs risk and severe psychological distress, both as determinants and outcomes. Healthcare professionals in STI centers need more awareness of SDU and ongoing evaluation with a larger population.

Background: Tobacco use deepens poverty. Egypt, a lower-middle income country, is one of the few countries worldwide where tobacco use is rising. However, no published study examined the adverse impacts of tobacco on the Egyptian household welfare, specifically after the first Egyptian Pound (EGP) devaluation by 80% in 2016. To address this gap and inform tobacco taxation policymaking, we aimed to provide evidence characterizing national household tobacco expenditure in Egypt.

Methods: We conducted a secondary analysis of the 2017/2018 Household Income, Expenditure and Consumption Survey, focusing on the most used tobacco products in Egypt: cigarette and waterpipe tobacco. We identified the proportion and background characteristics of cigarette and waterpipe tobacco smoker households. We calculated household tobacco expenditure share as a proportion of total household expenditure. We compared mean household expenditure shares of 12 expenditure groups among smoker and nonsmoker households and examined the differences by income quintiles. We determined the factors associated with household tobacco expenditure. Descriptive, bivariable, and multivariable analyses were performed.

Results: Cigarette and waterpipe tobacco smokers were present in 41.1% and 7.0% of 12,845 households, respectively. Annual household expenditure on cigarettes (10.7%) was triple that of waterpipe tobacco (3.4%) (p < 0.001). Smoker households spent less than nonsmoker households on virtually all expenditure groups (p < 0.001). The poorest income quintile spent 11.1% of its total expenditure on tobacco (1.26 times higher than the richest, p = 0.006). More waterpipe tobacco than cigarette smoker households lived below the poverty line (40.6% versus 24.4%, p < 0.001). Cigarette smoker households spent less on food and housing but more on tobacco than waterpipe tobacco smoker households. The poorest cigarette and waterpipe tobacco smoker households spent 7.0-9.7 times as much on tobacco as on education. Common independent factors associated with higher household expenditure on cigarettes and waterpipe tobacco were urban residence (p = 0.011 and p = 0.015, respectively), and lower income (p < 0.001).

Conclusion: In 2017/2018, one-tenth of Egyptian smoker household's expenditure was allocated to tobacco, disproportionately concentrated among the poorest. Our results preliminarily indicate that tobacco expenditure is associated with potential compromises of varying extent in almost all other expenditures in smoker households. This baseline profiling of household tobacco expenditure can potentially inform an evidence-based tobacco taxation policy, supporting the reduction of tobacco-associated socioeconomic inequalities.

Background: Homelessness is a growing concern in the United States, especially among people who use drugs (PWUD). The degree of material hardship among this population may be linked to worse health outcomes. PWUD experiencing homelessness in urban areas are increasingly subjected to policies and social treatment, such as forced displacement, which may worsen material hardship. It is critical to describe hardship among PWUD and examine if it is linked to health outcomes.

Methods: Data were collected as part of a prospective cohort study of PWUD in Los Angeles, California and Denver, Colorado (n = 476). Analysis sample size was smaller (N = 395) after selecting for people experiencing homelessness and for whom data were complete. Five indicators assessing hardship (difficulty finding food, clothing, restrooms, places to wash/shower, and shelter) in the past three months were obtained from participants at baseline and were used in latent class analysis (LCA). We chose a base latent class model after examination of global fit statistics. We then built three auxiliary models using the three-step Bolck-Croon-Hagenaars (BCH) method to test the relationship of latent class membership to several hypothesized social and health variables in this same three month time period.

Results: Fit statistics, minimum classification probabilities, and ease of interpretation indicated a three-class solution for level of material difficulty. We termed these classes "High Difficulty" (n = 82), "Mixed Difficulty" (n = 215), and "Low Difficulty" (n = 98). Average classification probabilities indicated good class separability. "High Difficulty" participants had high probabilities of usually having difficulty accessing all five resources. "Mixed Difficulty" participants indicated a range of difficulty accessing all resources, with restrooms and bathing facilities being the most difficult. "Low Difficulty" participants were defined by high probabilities of never having access difficulty. In auxiliary analyses, there were significant (p < 0.05) differences in experiences of displacement, opioid withdrawal symptoms, nonfatal overdose, and violent victimization between classes.

Conclusions: This LCA indicates that among PWUD experiencing homelessness there exist distinct differences in resource access and material hardship, and that these differences are linked with political, social, substance use, and other health outcomes. We add to the literature on the relationship between poverty and health among PWUD. Policies which increase difficulty accessing necessary material resources may negatively impact health in this population.

Background: Association of cigarette use with risk of prostate cancer remains unclear. We performed this study to examine whether cigarette use is associated with increased risk of prostate cancer.

Methods: This cross-sectional study used data from the 1999 to 2020 National Health and Nutrition Examination Survey (NHANES), a population-based nationally representative survey designed to assess the health and nutritional status of US adults and children. Males were eligible if they were aged ≥ 20 years at the time of participation. Cigarette use (ever use, categorized into former use and current use) was defined as having smoked at least 100 cigarettes in life. Smoking duration, cigarettes smoked per day, and smoking pack-years were calculated in former smokers and current smokers. The primary outcome was self-reported diagnosis of prostate cancer by participants. Logistic regression was used to calculate the adjusted odd ratios (aOR) and 95% CI for the associations of cigarette use with risk of prostate cancer, adjusting for demographic characteristics. Subgroup analyses by age group were conducted. Data were analyzed from June 4 to November 30, 2023.

Results: Of the 107 622 participants in 1999-2020 NHANES, 28 170 were included in the analysis. The mean (SD) age of the 28 170 participants was 46.4 (16.4) years, 68.0% were non-Hispanic White. Compared with never smokers, ever (aOR, 2.41 [95% CI, 1.15-5.06]) and former smokers (aOR, 3.56 [95% CI, 1.62-7.85]) had a higher risk of prostate cancer. This higher risk in former (aOR, 3.82 [95% CI, 1.69-8.64]) and ever smokers (aOR, 2.82 [95% CI, 1.27-6.25]) was also found in participants aged 20-59 years. Dose-response analysis showed a positive association between smoking duration (aOR, 1.07 [95% CI, 1.03-1.11]), cigarettes smoked per day (aOR, 1.03 [95% CI, 1.00-1.07]), smoking pack-years (aOR, 1.02 [95% CI, 1.01-1.03]) and risk of prostate cancer in current smokers.

Conclusions: This study suggests that cigarette use was associated with an increased risk of prostate cancer in US males, especially among those aged 20-59 years. Further research utilizing prospective study design and modeling family history is needed to confirm the findings.

Objective: This study aims to investigate the relationships between living and neighborhood environmental factors and anxiety symptoms among older adults residing in urban and rural areas of Anhui Province, China.

Methods: Data were collected from 5876 participants in a cross-sectional study carried out in four cities located in Anhui, China. Anxiety symptoms were evaluated via the Generalized Anxiety Disorder scale (GAD-7), and participants with scores of 5 and above were defined as having anxiety symptoms. The presence of dust and noise in the context of daily life was used to evaluate the living environment of the participants. The neighborhood environment was assessed by the availability of barrier-free facilities, proximity to facilities (supermarkets, restaurants, hospitals, and parks), and green and blue space near participants' dwellings. Multilevel linear and logistic regression analyses were used to estimate the associations between these environmental factors and anxiety symptoms.

Results: The participants who lived in dusty environments had elevated GAD-7 scores and higher odds of anxiety (dust: β = 0.754, 95% CI: 0.337, 1.171; OR = 1.451, 95% CI: 1.164, 1.809). Having barrier-free facilities and the existence of a neighboring park decreased the GAD-7 scores and the likelihood of having anxiety symptoms (barrier-free facilities: β=-0.503, 95% CI: -0.992, -0.085; OR = 0.768, 95% CI: 0.656, 0.899; park: β=-0.478, 95% CI: -0.830, -0.125; OR = 0.599, 95% CI: 0.440, 0.816). However, participants residing in close proximity to the hospital presented an increased likelihood of experiencing anxiety symptoms (OR = 1.377, 95% CI: 1.162, 1.631).

Conclusions: Participants who lived in dusty and noisy environments were more likely to suffer from anxiety, whereas those who lived near barrier-free facilities and parks were at lower risk. The findings emphasize the need for targeted interventions to create age-friendly communities, suggesting an integrated approach that combines environmental health strategies with mental health strategies for older adults.

Background: School bullying is a common phenomenon that has negative consequences for student development in many areas and is a significant public health problem. Research conducted, particularly in the socioecological model, provides knowledge about the relationships between both individual characteristics and broader social context factors and bullying. The results of the research conducted in recent years indicate that bullying may be influenced by the leadership provided by school principals. The aim of the present research was to search for relationships between leadership styles reported by school principals and the victimization and perpetration of bullying reported by students.

Methods: Data analyzed were collected from 3,863 students in grades 7-9 from 22 schools combined with data from self-reported leadership styles of principals. Data on victimization and perpetration of bullying, student characteristics and the school climate reported by students, and data on the leadership styles of school principals were collected. Logistic regression was used in the analyses.

Results: The charismatic leadership style of principals is associated with increased reported victimization and perpetration of bullying by students. Two leadership styles play a protective role. A team-oriented leadership style is associated with decreased victimization, and a humane-oriented style is associated with decreased reported bullying perpetration by students.

Conclusions: The results add nuance to the findings of previous research indicating that the leadership style of school principals may act as a risk or protective factor against peer bullying.

Background: To explore unhealthy diet and lifestyle factors associated with female androgenetic alopecia (FAGA) in a community-based study.

Methods: A total of 3,008 participants were recruited from the Jidong community (Tangshan, Hebei, China). FAGA was assessed by the Savin scale. Data collection was conducted through structured questionnaires. Univariate and multivariate logistic regression analyses were employed to identify potential factors. Multivariable models were built by selecting covariates with P < 0.05 in univariable analyses and removing collinear variables identified by a variance inflation factor > 5. The predictive performance was evaluated using the receiver operating characteristic curve.

Results: The prevalence of FAGA in this study was 6.85% (206/3008). Sleep snoring (adjusted odds ratio [AOR] = 1.398, 95% confidence interval [CI] 1.032-1.894, P = 0.031), frequent consumption of bacon and preserved meat (AOR = 2.205, 95% CI 1.181-4.118, P = 0.013), frequently drinking unboiled water (AOR = 1.984, 95% CI 1.156-3.406, P = 0.013), age (AOR = 1.063, 95% CI 1.050-1.076, P < 0.001) and suboptimal health status score (AOR = 1.033, 95% CI 1.020-1.047, P < 0.001) were identified as independent factors associated with FAGA.

Conclusions: In conclusion, our data suggest that females who snore during sleep, frequently consume bacon and preserved meats, and regularly drink unboiled water are more susceptible to androgenetic alopecia. Additionally, our analysis revealed that age and suboptimal health status score are significantly correlated with FAGA.

Background: The joint association of dietary diversity (DD) and physical activity (PA) on anxiety, depressive symptoms, and their comorbidity have not been extensively explored. Hence, this study focused on examining this association.

Methods: Data in this cross-sectional study was derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Based on self-reported dietary diversity score (DDS) questions were used to assess DD, ranging from 0 to 8. DDS < 5 was defined as insufficient DD and DDS ≥ 5 was defined as sufficient DD. PA was based on a self-reported binary question. Anxiety was assessed using the Generalized Anxiety Disorder Scale-7 (GAD-7), and depressive symptoms were evaluated by the Center for Epidemiologic Studies Depression Scale-10 (CESD-10). The independent and joint associations of DD and PA on anxiety, depressive symptoms, and their comorbidity were examined by multivariable-adjusted binary logistic regression models.

Results: In this cross-sectional study, sufficient DD was independently associated with a decreased risk of anxiety (adjusted OR = 0.57, 95% CI = 0.50-0.65), depressive symptoms (adjusted OR = 0.69, 95% CI = 0.63-0.77), and their comorbidity (adjusted OR = 0.58, 95% CI = 0.49-0.68). Similarly, exposure to current exercise was also a significant protective factor for mental health. Importantly, co-exposure to sufficient DD and current exercise may amplify the protective effects on mental health (adjusted OR = 0.47, 95% CI = 0.38-0.57 for anxiety; adjusted OR = 0.36, 95% CI = 0.31-0.42 for depressive symptoms; adjusted OR = 0.37, 95% CI = 0.29-0.48 for their comorbidity). The robustness of these associations was demonstrated in four sensitivity analyses.

Conclusions: Our study found that sufficient DD and current exercise were associated with a decreased risk of mental health disorders. Importantly, the combination of both appeared to enhance this protective effect. Our findings promote the joint assessment of DD and PA to provide new insights into health-related behaviors for prevention strategies for mental health disorders in older adults.