Journal of public health (Oxford, England)最新文献

Background: Data on the birth prevalence of congenital anomalies in low- and middle-income countries report wide variations in prevalence estimates. We conducted a scoping review to identify the sources of bias in studies reporting birth prevalence of congenital anomalies in World Health Organization South-East Asia region (SEAR) countries.

Methods: PubMed and Google Scholar databases were screened for relevant literature. Data on study characteristics and sources of bias was extracted. A narrative synthesis of the data is reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A checklist for reporting studies on birth prevalence of congenital anomalies (CD-Checklist) was developed.

Results: The literature search retrieved 47 articles. Birth prevalence varied from 0.21% to 9.68%. Sampling bias was evident as studies were single hospital studies, lacked relevant description of sample, did not justify sample size or describe the process of sampling. Information bias was identified as studies did not mention classification system used, and failed to clearly distinguish between number of malformations and babies with malformations. Observer and reporting bias were noted.

Conclusions: Several sources of bias introduce variations in birth prevalence reports of congenital anomalies in SEAR countries. A checklist (CD-Checklist) has been suggested which can guide investigators to minimize the risk of bias in studies.

Background: Housing instability is a known barrier to healthcare utilization potentially affecting the prevention, diagnosis and treatment of chronic diseases among diverse groups of adults. We examined the intersection of recent housing instability with prevalent cardiovascular disease, diabetes, cancer and psychiatric diagnoses among aging adults.

Methods: Cross-sectional data on 147 465 participants of the 'All of Us' Research Program (6 May 2018-1 July 2022), ≥50 years of age at enrollment, were analyzed. Self-reported housing instability over the past 6 months was examined in relation to diagnosed conditions at age ≥50 years based on electronic health records. Multivariable logistic regression models sequentially adjusting for demographic and socioeconomic characteristics were constructed to estimate odds ratios (OR) with their 95% confidence intervals (CI).

Results: After adjusting for confounders, past 6 months housing instability was associated with lower odds of diagnosed cardiovascular disease (OR = 0.89, 95% CI: 0.87, 0.93) and cancer (OR = 0.82, 95% CI: 0.78, 0.86), higher odds of diagnosed psychiatric (OR = 1.35, 95% CI: 1.30, 1.40) conditions, but was unrelated to diagnosed diabetes (OR = 0.98, 95% CI: 0.94, 1.01).

Conclusions: Recent housing instability among aging adults is positively associated with psychiatric diagnoses, but negatively associated with cardiovascular and cancer diagnoses, with implications for chronic disease prevention.

Background: In 2018, Scotland pioneered national legislation which set a Minimum Unit Price (MUP) of 50 pence (∼US$0.64, €0.59) per unit of UK alcohol sold (8 g/10 ml). To inform policy development, we examine the policy effect using the Alcohol Use Disorders Identification Test (AUDIT-C), employing longitudinal data for over 17 200 individuals.

Methods: The effect of MUP on AUDIT-C scores is inferred by employing difference-in-difference regression. Pre- and post-intervention alcohol behaviours of individuals from Scotland are compared to a matched 'control' from England. Drinking at hazardous and harmful levels could be identified, as well as the frequency of alcohol consumption, number of drinks and heavy episodic drinking. Estimates adjust for demographic, socioeconomic and health characteristics. Potential inequalities by gender, age and household income are examined.

Results: MUP led to an estimated 5.3% reduction in the number of drinks consumed on drinking occasions, though a statistically significant effect on overall reported AUDIT-C scores or drinking at hazardous levels was not detected, with few differential effects for subgroups.

Conclusions: Differences in the findings of this research compared to other studies may be explained by differences in population coverage collected in the survey data, compared to more comprehensive, population-wide administrative data, as well as sample attrition.

Background: During the first year of the covid-19 pandemic the adoption of non-pharmacological interventions (NPI), resulted in a significant fall in the incidence of respiratory tract infections. However, after the relaxation of these restrictions some of these infections have returned. This study evaluates the incidence and severity of community acquired pneumonias (CAPs) in children before and after the onset of pandemic.

Methods: Characteristics of CAPs admitted to Archbishop Makarios Hospital, between March 2016 and February 2023 were reviewed. Comparison was made between the first, second and third pandemic year, and the four pre-pandemic years.

Results: The mean annual number of admissions in the pre-pandemic years was 32 and dropped to 11 during the first pandemic year. However, admissions increased again in the second year of the pandemic to 41 (increase by 28%), and this increase was sustained into the third year. The proportion of complicated pneumonias, approximately doubled, from 20% in the pre-pandemic years to 35% and 33% in the second and third pandemic year, respectively.

Conclusions: During the first year the use of NPIs appeared to have decreased the incidence of pneumonias. However, during the second and third pandemic years, an increase in the numbers and severity of pneumonias was noted.

Background: Although there is evidence that sitting time (ST) and insufficient physical activity (PA) are associated with premature mortality, the burden of cardiovascular disease (CVD) and all-cause mortality (ACM) attributable to the combined effects of ST and PA in counterfactual scenarios is limited.

Methods: Potential impact fractions (PIFs) were used to calculate premature deaths (PDs) and disability-adjusted life years (DALYs). Cause-eliminated life tables were utilized to estimate health-adjusted life expectancy (HALE) gains. Monte Carlo simulations were performed for uncertainty analysis.

Results: The theoretical minimum risk exposure level (ST < 4 $mathrm{h} cdot{mathrm{d}}^{-1}$, PA > 65 $mathrm{min} cdot{mathrm{d}}^{-1}$) could prevent 16.7% of CVD deaths and 12.3% of all-cause deaths annually. This would save 669 to 2,630 DALYs per 100,000 and increase healthy life years by 0.57 to 2.94. Increasing PA to > 65 $mathrm{min} cdot{mathrm{d}}^{-1}$ while maintaining ST could yield gains in HALE from 0.49 (CVD) to 2.60 (ACM) years. Reducing ST to < 4 $mathrm{h}cdot{mathrm{d}}^{-1}$ while keeping PA constant could lead to gains in HALE from 0.07 (CVD) to 0.34 (ACM) years. A 50% reduction in suboptimal ST (≥ 4 $mathrm{h}cdot{mathrm{d}}^{-1}$) doubled HALE gains, ranging from 0.11 to 0.63 years.

Conclusions: Public health decision-makers should prioritize vulnerable populations, including older adults and individuals with inadequate PA levels.