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Miao Y, Bai J, Shen Z, Li Y, Zhang W, Zhu D, Ren R, Zhang J, Guo D, Tarimo CS, Dong W, Liu R, Zhao Q, Hu J, Li M, Wei W. How urban versus rural population relates to COVID-19 booster vaccine hesitancy: A propensity score matching design study. Hum Vaccin Immunother 2024; 20:2297490. [PMID: 38214317 DOI: 10.1080/21645515.2023.2297490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/18/2023] [Indexed: 01/13/2024] Open
Abstract
During the COVID-19 pandemic, the vaccine hesitancy has significantly affected the vaccination. To evaluate the booster vaccine hesitancy and its influencing factors among urban and rural residents, as well as to estimate the net difference of booster vaccine hesitancy between urban and rural residents. We conducted a nationwide, cross-sectional Internet survey on 1-8 February 2023, and employed stratified random sampling technique to select participants (≥18 years old) from urban and rural areas. Multivariate logistic regression was used to determine the factors impacting booster vaccine hesitancy. Propensity Score Matching was used to estimate the net difference of COVID-19 booster vaccine hesitancy between urban and rural residents. The overall COVID-19 booster vaccine hesitancy rate of residents was 28.43%. The COVID-19 booster vaccine hesitancy rate among urban residents was found to be 34.70%, among rural residents was 20.25%. Chronic diseases, infection status, vaccination benefits, and trust in vaccine developers were associated with booster vaccine hesitancy among urban residents. Barriers of vaccination were associated with booster vaccine hesitancy among rural residents. PSM analysis showed that the urban residents have a higher booster vaccine hesitancy rate than rural residents, with a net difference of 6.20%. The vaccine hesitancy rate increased significantly, and the urban residents have a higher COVID-19 booster vaccine hesitancy than rural residents. It becomes crucial to enhance the dissemination of information regarding the advantages of vaccination and foster greater trust among urban residents toward the healthcare system.
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Affiliation(s)
- Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Junwen Bai
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhanlei Shen
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Li
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wanliang Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Dongfang Zhu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Institute for Hospital Management of Henan Province, Henan, China
| | - Ruizhe Ren
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Jingbao Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Dan Guo
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Department of Science and Laboratory Technology, Dar es Salaam Institute of Technology, Dar es Salaam, Tanzania
| | - Wenyong Dong
- Department of Hypertension, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Rongmei Liu
- Henan Key Laboratory for Health Management of Chronic Diseases, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Qiuping Zhao
- Henan Key Laboratory for Health Management of Chronic Diseases, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jianping Hu
- Henan Engineering technology Research Center for Health Big Data Governance, Henan Medical Communication and Project Forward Center, Zhengzhou, Henan, China
| | - Miaojun Li
- Henan Engineering technology Research Center for Health Big Data Governance, Henan Medical Communication and Project Forward Center, Zhengzhou, Henan, China
| | - Wei Wei
- Department of Medical Imaging, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Kaseje N, Ranganathan M, Magadi M, Oria K, Haines A. The effectiveness of rural community health workers in improving health outcomes during the COVID-19 pandemic: a systematic review. Glob Health Action 2024; 17:2292385. [PMID: 38180049 PMCID: PMC10773683 DOI: 10.1080/16549716.2023.2292385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/03/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Rural community health workers [CHWs] play a critical role in improving health outcomes during non-pandemic times, but evidence on their effectiveness during the COVID-19 pandemic is limited. There is a need to focus on rural CHWs and rural health systems as they have limited material and human resources rendering them more vulnerable than urban health systems to severe disruptions during pandemics. OBJECTIVES This systematic review aims to describe and appraise the current evidence on the effectiveness of rural CHWs in improving access to health services and health outcomes during the COVID-19 pandemic in low-and middle-income countries [LMICs]. METHODS We searched electronic databases for articles published from 2020 to 2023 describing rural CHW interventions during the COVID-19 pandemic in LMICs. We extracted data on study characteristics, interventions, outcome measures, and main results. We conducted a narrative synthesis of key results. RESULTS Fifteen studies from 10 countries met our inclusion criteria. Most of the studies were from Asia [10 of 15 studies]. Study designs varied and included descriptive and analytical studies. The evidence suggested that rural CHW interventions led to increased household access to health services and may be effective in improving COVID-19 and non-COVID-19 health outcomes. Overall, however, the quality of evidence was poor due to methodological limitations; 14 of 15 studies had a high risk of bias. CONCLUSION Rural CHWs may have improved access to health services and health outcomes during the COVID-19 pandemic in LMICs but more rigorous studies are needed during future pandemics to evaluate their effectiveness in improving health outcomes in different settings and to assess appropriate support required to ensure their impact at scale.
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Affiliation(s)
- Neema Kaseje
- London School of Hygiene & Tropical Medicine, London, UK
- Department of Research, Surgical Systems Research Group, Kisumu, Kenya
| | | | - Monica Magadi
- Keele School of Medicine, Keele University Staffordshire, Newcastle-under-Lyme, UK
| | - Kevin Oria
- Department of Research, Tropical Institute of Community Health, Kisumu, Kenya
| | - Andy Haines
- London School of Hygiene & Tropical Medicine, London, UK
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Simonetti V, Tomietto M, Comparcini D, Pastore F, Stefanizzi P, Tafuri S, Cicolini G. The community nurse's role on the promotion of papillomavirus vaccination among young students: A study protocol. Hum Vaccin Immunother 2024; 20:2314383. [PMID: 38356279 PMCID: PMC10877978 DOI: 10.1080/21645515.2024.2314383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/01/2024] [Indexed: 02/16/2024] Open
Abstract
Vaccination is the principal strategy for primary prevention of infection by Human Papilloma Virus (HPV), which causes different pathological conditions, up to cancer, in both males and females. However, to date, knowledge among adolescents and their parents about the HPV vaccine is still low. The aim of this quasi-experimental, multicenter study is to assess the effectiveness of a digital educational intervention, conducted by a multidisciplinary health-care team including a Community Nurse, to increase adolescents' HPV vaccination uptake, their knowledge, self-efficacy, feelings and involvement in HPV vaccine decision-making, and parents' vaccination hesitancy. The study will be carried out among a population of students (and their parents), aged between 11 and 13, at secondary schools in Italy. Validated questionnaires will be administered to both students and parents at baseline (T0) and 3 months after a digital educational intervention (T1). The findings may be useful in evaluating and deepening a methodology for designing and implementing educational interventions, embedded in the school setting, that could promote the achievement of outcomes within the broader process of youth's health promotion.
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Affiliation(s)
- Valentina Simonetti
- Department of Medicine and Surgery, Casamassima, “LUM University” Giuseppe Degennaro, Bari, Italy
| | - Marco Tomietto
- Department of Nursing, Midwifery, and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Dania Comparcini
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, Bari, Italy
| | - Francesco Pastore
- Department of Biomedicine and Prevention, TorVergata University, Rome, Italy
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, Bari, Italy
| | - Giancarlo Cicolini
- Department of Precision and Regenerative Medicine and Ionian Area - (DiMePRe-J), ”Aldo Moro” University of Bari, Bari, Italy
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Ren N, Huang H, Liu B, Wu C, Xiang J, Zhou Q, Kang S, Zhang X, Jiang Y. Interactive effects of atmospheric oxidising pollutants and heat waves on the risk of residential mortality. Glob Health Action 2024; 17:2313340. [PMID: 38381455 PMCID: PMC10883108 DOI: 10.1080/16549716.2024.2313340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/29/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND The impact of heat waves and atmospheric oxidising pollutants on residential mortality within the framework of global climate change has become increasingly important. OBJECTIVE In this research, the interactive effects of heat waves and oxidising pollutants on the risk of residential mortality in Fuzhou were examined. Methods We collected environmental, meteorological, and residential mortality data in Fuzhou from 1 January 2016, to 31 December 2021. We then applied a generalised additive model, distributed lagged nonlinear model, and bivariate three-dimensional model to investigate the effects and interactions of various atmospheric oxidising pollutants and heat waves on the risk of residential mortality. RESULTS Atmospheric oxidising pollutants increased the risk of residential mortality at lower concentrations, and O3 and Ox were positively associated with a maximum risk of 2.19% (95% CI: 0.74-3.66) and 1.29% (95% CI: 0.51-2.08). The risk of residential mortality increased with increasing temperature, with a strong and long-lasting effect and a maximum cumulative lagged effect of 1.11% (95% CI: 1.01, 1.23). Furthermore, an interaction between atmospheric oxidising pollutants and heat waves may have occurred: the larger effects in the longest cumulative lag time on residential mortality per 10 µg/m3 increase in O3, NO2 and Ox during heat waves compared to non-heat waves were [-3.81% (95% CI: -14.82, 8.63)]; [-0.45% (95% CI: -2.67, 1.81)]; [67.90% (95% CI: 11.55, 152.71)]; 16.37% (95% CI: 2.43, 32.20)]; [-3.00% (95% CI: -20.80, 18.79)]; [-0.30% (95% CI: -3.53, 3.04)]. The risk on heat wave days was significantly higher than that on non-heat wave days and higher than the separate effects of oxidising pollutants and heat waves. CONCLUSIONS Overall, we found some evidence suggesting that heat waves increase the impact of oxidising atmospheric pollutants on residential mortality to some extent.
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Affiliation(s)
- Nan Ren
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Huimin Huang
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Baoying Liu
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Chuancheng Wu
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jianjun Xiang
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Quan Zhou
- Department of Public Health, Fuzhou Center for Disease Control and Prevention, Fuzhou, China
| | - Shuling Kang
- Department of Public Health, Fuzhou Center for Disease Control and Prevention, Fuzhou, China
| | - Xiaoyang Zhang
- Department of Public Health, Fuzhou Center for Disease Control and Prevention, Fuzhou, China
| | - Yu Jiang
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
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Liu Y, Lv Z, Zhou S, Fu Z, Wang Y, Yi L, Li X, Wang Y, Hu S, Zhou Z, Chen Y. A smartwatch sphygmomanometer-based model for predicting short-term new-onset hypertension in individuals with high-normal blood pressure: a cohort study. Clin Exp Hypertens 2024; 46:2304023. [PMID: 38346228 DOI: 10.1080/10641963.2024.2304023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/03/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVES The objective was to utilize a smartwatch sphygmomanometer to predict new-onset hypertension within a short-term follow-up among individuals with high-normal blood pressure (HNBP). METHODS This study consisted of 3180 participants in the training set and 1000 participants in the validation set. Participants underwent both ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM) using a smartwatch sphygmomanometer. Multivariable Cox regressions were used to analyze cumulative events. A nomogram was constructed to predict new-onset hypertension. Discrimination and calibration were assessed using the C-index and calibration curve, respectively. RESULTS Among the 3180 individuals with HNBP in the training set, 693 (21.8%) developed new-onset hypertension within a 6-month period. The nomogram for predicting new-onset hypertension had a C-index of 0.854 (95% CI, 0.843-0.867). The calibration curve demonstrated good agreement between the nomogram's predicted probabilities and actual observations for short-term new-onset hypertension. In the validate dataset, during the 6-month follow-up, the nomogram had a good C-index of 0.917 (95% CI, 0.904-0.930) and a good calibration curve. As the score increased, the risk of new-onset hypertension significantly increased, with an HR of 8.415 (95% CI: 5.153-13.744, p = .000) for the middle-score vs. low-score groups and 86.824 (95% CI: 55.071-136.885, p = .000) for the high-score vs. low-score group. CONCLUSIONS This study provides evidence for the use of smartwatch sphygmomanometer to monitor blood pressure in individuals at high risk of developing new-onset hypertension in the near future. TRIAL REGISTRATION ChiCTR2200057354.
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Affiliation(s)
- Yuqi Liu
- Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China
- Department of Cardiology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Zhonghua Lv
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Shanshan Zhou
- Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China
- Department of Cardiology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Zihao Fu
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Yifei Wang
- Medical data center, Chinese PLA General Hospital, Beijing, China
| | - Li Yi
- Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Xiaolong Li
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Ying Wang
- Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China
- Department of Cardiology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Shunying Hu
- Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China
- Department of Cardiology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Zhirui Zhou
- Radiation Oncology Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yundai Chen
- Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China
- Department of Cardiology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
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Wilmont I, Loeffen M, Hoogeboom T. A qualitative study on the facilitators and barriers to adopting the N-of-1 trial methodology as part of clinical practice: potential versus implementation challenges. Int J Qual Stud Health Well-being 2024; 19:2318810. [PMID: 38417032 PMCID: PMC10903748 DOI: 10.1080/17482631.2024.2318810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/10/2024] [Indexed: 03/01/2024] Open
Abstract
PURPOSE To investigate opinions among healthcare stakeholders whether implementation of the N-of-1 trial approach in clinical practice is a feasible way to optimize evidence-based treatment results for unique patients. METHODS We interviewed clinicians, researchers, and a patient advocate (n = 13) with an interest in or experience with N-of-1 trials on the following topics: experience with N-of-1, measurement, validity and reliability, informally gathered data usability, and influence on physician-patient relationship. Interviews were analysed using qualitative, thematic analysis. RESULTS The N-of-1 approach has the potential to shift the current healthcare system towards embracing personalized medicine. However, its application in clinical practice carries significant challenges in terms of logistics, time investment and acceptability. New skills will be required from patients and healthcare providers, which may alter the patient-physician relationship. The rise of consumer technology enabling self-measurement may leverage the uptake of N-of-1 approaches in clinical practice. CONCLUSIONS There is a strong belief that the N-of-1 approach has the potential to play a prominent role in transitioning the current healthcare system towards embracing personalized medicine. However, there are many barriers deeply ingrained in our healthcare system that hamper the uptake of the N-of-1 approach, making it momentarily only interesting for research purposes.
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Affiliation(s)
- Ilona Wilmont
- Data & Knowledge Engineering, HAN University of Applied Sciences, Arnhem, the Netherlands
- Institute for Computing and Information Sciences, Data Science, Radboud University Nijmegen, Nijmegen, the Netherlands
| | | | - Thomas Hoogeboom
- IQ healthcare, Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
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Wang W, Feng Y, Zhao H, Wang X, Cai R, Cai W, Zhang X. Mdpg: a novel multi-disease diagnosis prediction method based on patient knowledge graphs. Health Inf Sci Syst 2024; 12:15. [PMID: 38440103 PMCID: PMC10908733 DOI: 10.1007/s13755-024-00278-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/23/2024] [Indexed: 03/06/2024] Open
Abstract
Diagnosis prediction, a key factor in enhancing healthcare efficiency, remains a focal point in clinical decision support research. However, the time-series, sparse and multi-noise characteristics of electronic health record (EHR) data make it a great challenge. Existing methods commonly address these issues using RNNs and incorporating medical prior knowledge from medical knowledge bases, but they neglect the local spatial characteristics and spatial-temporal correlation of the data. Consequently, we propose MDPG, a diagnosis prediction model based on patient knowledge graphs. Initially, we represent the electronic visit records of patients as a patient-centered temporal knowledge graph, capturing the local spatial structure and temporal characteristics of the visit information. Subsequently, we design the spatial graph convolution block, temporal self-attention block, and spatial-temporal synchronous graph convolution block to capture the spatial, temporal, and spatial-temporal correlations embedded in them, respectively. Ultimately, we accomplish the prediction of patients' future states through multi-label classification. We conduct comprehensive experiments on two real-world datasets independently and evaluate the results using visit-level precision@k and code-level accuracy@k metrics. The experimental results demonstrate that MDPG outperforms all baseline models, yielding the best performance.
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Affiliation(s)
- Weiguang Wang
- School of Computer Science and Engineering, Northeastern University, Shenyang, 110819 Liaoning China
- Neusoft Research of Intelligent Healthcare Technology, Co. Ltd, Shenyang, 110167 Liaoning China
| | - Yingying Feng
- School of Computer Science and Engineering, Northeastern University, Shenyang, 110819 Liaoning China
| | - Haiyan Zhao
- School of Computer Science, Peking University, Beijing, 100871 China
- Key Laboratory of High Confidence Software Technologies (PKU), Ministry of Education, Beijing, 100871 China
| | - Xin Wang
- College of Intelligence and Computing, Tianjin University, Tianjin, 300354 China
| | - Ruikai Cai
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, 110004 Liaoning China
| | - Wei Cai
- Neusoft Research of Intelligent Healthcare Technology, Co. Ltd, Shenyang, 110167 Liaoning China
| | - Xia Zhang
- School of Computer Science and Engineering, Northeastern University, Shenyang, 110819 Liaoning China
- Neusoft Research of Intelligent Healthcare Technology, Co. Ltd, Shenyang, 110167 Liaoning China
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Spurr S, Burles M, Hyslop S, Bally J, Bullin C, Froehlich Chow A, Tootoosis H, Oosman S. Preventing type 2 diabetes among Indigenous youth: A systematic review of community-based interventions. Int J Circumpolar Health 2024; 83:2320449. [PMID: 38412067 PMCID: PMC10901188 DOI: 10.1080/22423982.2024.2320449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/14/2024] [Indexed: 02/29/2024] Open
Abstract
A systematic review was conducted to assess evidence on effectiveness of community-based interventions promoting wellbeing and prevention of type 2 diabetes (T2D) among Indigenous youth. A convergent, segregated, mixed methods approach was used, with six databases and four grey literature sites searched from inception to May 2022. Articles selected for inclusion were about community-based interventions related to T2D prevention with Indigenous youth that evaluated effectiveness or youth experience published in English. Reference lists were also searched for relevant sources. Seven quantitative research articles met the inclusion and quality assessment criteria. No qualitative articles were identified. The results were synthesised through narrative analysis, while meta-analysis was not possible due to heterogenous study designs. Common foci across interventions included promoting physical wellness, improving physical activity and healthy eating patterns, enhancing knowledge, and psychosocial wellness. Interventions deemed effective addressed multiple areas, were school-based, and operated for at least a year. Findings support multi-strategy, community-based interventions implemented over longer periods of time. However, gaps in research and reporting included the extent to which interventions are culturally informed and based on community-driven priorities. Future research should include Indigenous, mixed and qualitative methods and Indigenous-driven measures of success to better understand effectiveness in alignment with Indigenous worldviews.
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Affiliation(s)
- Shelley Spurr
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Meridith Burles
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Shannon Hyslop
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jill Bally
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Carol Bullin
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Amanda Froehlich Chow
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Helen Tootoosis
- Indigenous Liaison Advisor for Saskatchewan, Statistics Canada, Saskatchewan, Canada
| | - Sarah Oosman
- School of Rehabilitation Sciences, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Guo T, Tian S, Xin H, Du J, Cao X, Feng B, He Y, He Y, Wang D, Zhang B, Liu Z, Yan J, Shen L, Di Y, Chen Y, Jin Q, Pan S, Kioumourtzoglou MA, Gao L, Gao X. Impact of fine particulate matter on latent tuberculosis infection and active tuberculosis in older adults: a population-based multicentre cohort study. Emerg Microbes Infect 2024; 13:2302852. [PMID: 38240283 PMCID: PMC10826784 DOI: 10.1080/22221751.2024.2302852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/03/2024] [Indexed: 01/30/2024]
Abstract
Evidence showed that air pollution was associated with an increased risk of tuberculosis (TB). This study aimed to study the impact of long-term exposure to ambient particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) on the acquisition of LTBI and on the risk of subsequent active disease development among rural older adults from a multicentre cohort, which have not yet been investigated to date. A total of 4790 older adults were included in a population-based, multicentre, prospective cohort study (LATENTTB-NSTM) from 2013 to 2018. The level of long-term exposure to PM2.5 for each participant was assessed by aggregating satellite-based estimates. Logistic regression and time-varying Cox proportional hazards models with province-level random intercepts were employed to assess associations of long-term exposures to PM2.5 with the risk of LTBI and subsequent development of active TB, respectively. Out of 4790 participants, 3284 were LTBI-free at baseline, among whom 2806 completed the one-year follow-up and 127 developed newly identified LTBI. No significant associations were identified between PM2.5 and the risk of LTBI. And among 1506 participants with LTBI at baseline, 30 active TB cases were recorded during the 5-year follow-up. Particularly, an increment of 5 μg/m3 in 2-year moving averaged PM2.5 was associated with a 50.6% increased risk of active TB (HR = 1.506, 95% CI: 1.161-1.955). Long-term air pollution might be a neglected risk factor for active TB development from LTBI, especially for those living in developing or less-developed areas where the air quality is poor.
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Affiliation(s)
- Tonglei Guo
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Sifan Tian
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, People’s Republic of China
| | - Henan Xin
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Jiang Du
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Xuefang Cao
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Boxuan Feng
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yijun He
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yongpeng He
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Dakuan Wang
- Center for Diseases Control and Prevention of Zhongmu, Zhengzhou, People’s Republic of China
| | - Bin Zhang
- Center for Diseases Control and Prevention of Zhongmu, Zhengzhou, People’s Republic of China
| | - Zisen Liu
- Center for Diseases Control and Prevention of Zhongmu, Zhengzhou, People’s Republic of China
| | - Jiaoxia Yan
- Center for Diseases Control and Prevention of Zhongmu, Zhengzhou, People’s Republic of China
| | - Lingyu Shen
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yuanzhi Di
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yanxiao Chen
- College of Public Health, Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Qi Jin
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Shouguo Pan
- Center for Diseases Control and Prevention of Zhongmu, Zhengzhou, People’s Republic of China
| | | | - Lei Gao
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Xu Gao
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, People’s Republic of China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, People's Republic of China
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Masood Y, Alvarez Nishio A, Starling B, Dawson S, Salsberg J, Blackburn S, van Vliet E, Pittens CA. Series: Public engagement with research. Part 2: GPs and primary care researchers working inclusively with minoritised communities in health research to help address inequalities. Eur J Gen Pract 2024; 30:2322996. [PMID: 38477291 PMCID: PMC10939099 DOI: 10.1080/13814788.2024.2322996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Public engagement in health research is vital for addressing health disparities and promoting inclusivity among minoritised communities who often face barriers to accessing healthcare. Minoritised communities are groups, which have been made minorities by a dominant culture, race, ethnic group and/or social class and may experience health inequalities as a result. By incorporating diverse perspectives and lived experiences of minoritised communities, this approach aims to achieve contextually relevant research outcomes that reduce health inequalities and improve overall well-being. However, underrepresentation and lack of inclusivity challenges persist, necessitating the establishment of inclusive partnerships and grassroots participatory methodologies. To foster inclusive public engagement, it is important to overcome structural and cultural barriers, address socioeconomic challenges, and build trust with minoritised communities. This can be achieved by promoting a cultural shift that values inclusivity, providing comprehensive training to researchers, and collecting rigorous data on engagement demographics for transparency and accountability. Involving minoritised communities in decision-making through participatory research approaches enhances trust and yields successful outcomes. Additionally, allocating sufficient resources, collaborating in co-production, and prioritising the diverse needs and perspectives of stakeholders contribute to fostering inclusive public engagement in research. Overall, inclusive engagement practices particularly in primary care research have the potential to reduce health inequalities and cater to the unique requirements of minoritised communities, thereby creating more impactful outcomes and promoting equitable healthcare access.
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Affiliation(s)
- Yumna Masood
- Centre for Evidence Based Medicine | Nuffield Department of Primary Care Health Sciences |, University of Oxford Radcliffe Primary Care Building, University of Oxford, Oxford, UK
| | | | - Bella Starling
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Shoba Dawson
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Jon Salsberg
- University of Limerick, Family Medicine Limerick, Limerick, Ireland
| | - Steven Blackburn
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Esther van Vliet
- Academic Collaborative Centers, Knowledge Transfer Office, Tilburg University, Tilburg, The Netherlands
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Westerskov Dalgas B, Elmose-Østerlund K, Bredahl TVG. Exploring basic psychological needs within and across domains of physical activity. Int J Qual Stud Health Well-being 2024; 19:2308994. [PMID: 38327214 PMCID: PMC10854434 DOI: 10.1080/17482631.2024.2308994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/19/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE This study explored variations in adults' experience of satisfaction, unfulfilment and frustration of basic psychological needs within and across four domains of physical activity: Transport, household, occupation, and recreation. METHODS We utilized a qualitative approach, conducting semi-structured interviews with a diverse group of 42 Danish adults. The participants ranged in age from 16 to 79 years (mean age 49 years, SD 21 years), gender (45% men, 55% women), and physical activity levels (38% low, 33% average, 29% high). Data were analysed using a thematic analysis, applying Self-Determination Theory as the guiding framework. RESULTS In the Transport domain, while most activities were seen as utilitarian necessities, autonomy satisfaction emerged for some through control over their means of transport. In Household domain, tasks were generally viewed as obligatory; however, activities with personal significance led to autonomy satisfaction and skill development. Occupation-wise, physical activity satisfaction varied, with the nature of the job impacting feelings of autonomy and competence. For Recreation domain, personal choice dictated autonomy satisfaction, with competence and relatedness varying according to goal achievement and social interactions. CONCLUSION The variations in the findings across domains indicate the effectiveness of applying strategies tailored to specific domains for enhancing need satisfaction.
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Affiliation(s)
- Birgitte Westerskov Dalgas
- CONTACT Birgitte Westerskov Dalgas Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, Odense5230, Denmark
| | - Karsten Elmose-Østerlund
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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12
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Lindly OJ, Wahl TA, Stotts NM, Shui AM. Adaptation of a health literacy screener for computerized, self-administered use by U.S. adults. PEC Innov 2024; 4:100262. [PMID: 38375351 PMCID: PMC10875223 DOI: 10.1016/j.pecinn.2024.100262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/19/2023] [Accepted: 02/05/2024] [Indexed: 02/21/2024]
Abstract
Objective Health literacy is a critical health determinant, for which few computerized, self-administered assessments exist. This study adapted and tested the reliability of the Newest Vital Sign© (NVS) as a computerized, self-administered health literacy screener. Methods Phase one involved 33 participants to create response options for a computerized, self-administered NVS (C-NVS). Phase two was a randomized crossover trial to test the consistency of C-NVS and original, interviewer-administered NVS (I-NVS) scores in 89 participants. Results Linear mixed-effects regression model results showed a significant carryover effect (p < .001). Crossover trial data from time 1 showed that participants who initially received the C-NVS had significantly higher average scores (M = 5.7, SD = 0.6) than participants who received the I-NVS (M = 4.5, SD = 1.5; t(87) = 5.25, p < .001). Exploratory analysis results showed that when the washout period was longer than 33 days (75th percentile) the carryover effect was not statistically significant (p = .077). Conclusion and innovation Findings suggest learning can occur when health literacy screeners are administered more than once in less than a month's time and computerized, self-administered health literacy screeners may produce ceiling effects. A universal precautions approach to health literacy therefore remains germane.
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Affiliation(s)
| | - Taylor A. Wahl
- Department of Health Sciences, Northern Arizona University, USA
| | - Noa M. Stotts
- Department of Biological Sciences, Northern Arizona University, USA
| | - Amy M. Shui
- Massachusetts General Hospital Biostatistics Center, USA
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13
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Alan A, Ennabe M, Sulaiman A, Weinand M. Discontinuation of affirmative action: Consequences for black educational equity, neurosurgical residency, and medical diversity, with consideration of potential adversity as a new path forward. World Neurosurg X 2024; 23:100339. [PMID: 38497060 PMCID: PMC10943114 DOI: 10.1016/j.wnsx.2024.100339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/21/2024] [Indexed: 03/19/2024] Open
Affiliation(s)
- Albert Alan
- Department of Neurosurgery, University of Arizona, Tucson, AZ, USA
- University of Arizona College of Medicine, Tucson, AZ, USA
- Global Neurosurgical Alliance, Tucson, AZ, USA
| | - Michelle Ennabe
- Global Neurosurgical Alliance, Tucson, AZ, USA
- University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Abdulmuizz Sulaiman
- Global Neurosurgical Alliance, Tucson, AZ, USA
- College of Health Sciences, University of Ilorin, Kwara State, Nigeria
| | - Martin Weinand
- Department of Neurosurgery, University of Arizona, Tucson, AZ, USA
- University of Arizona College of Medicine, Tucson, AZ, USA
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Matthews KR, Lakshmanan R, Kalakuntla N, Tallapragada N. Personal rights over public Health: Anti-vaccine rhetoric in the Texas Legislature. Vaccine X 2024; 18:100468. [PMID: 38450107 PMCID: PMC10915400 DOI: 10.1016/j.jvacx.2024.100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 01/29/2024] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
During the COVID-19 pandemic, there was an observed increase in anti-vaccine sentiment linked with requirements for the vaccines. But how did these ideas impact the politics of vaccines? In this paper, the authors analyze witness statements from the 2021 Texas Legislative Session during vaccine-related hearings. Specifically, the research focused on five hearings for bills that related to vaccine requirements or vaccine transparency laws filed during the 2021Texas Legislative Session and witnesses who opposed these measures. From the 128 witnesses cataloged and analyzed, we found 84 witnesses opposed to vaccines. Medical freedom and the right to opt-out of a medical procedure as well as concerns about vaccine safety and effectiveness were most frequently used by witnesses to justify their stance against vaccine requirements or vaccines. While some witnesses were opposed to all vaccines, most focused their objections on the COVID-19 vaccine specifically.
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Affiliation(s)
- Kirstin R.W. Matthews
- Baker Institute for Public Policy, Rice University, 6100 Main Street, MS-40, Houston, TX 77478, USA
| | - Rekha Lakshmanan
- Baker Institute for Public Policy, Rice University, 6100 Main Street, MS-40, Houston, TX 77478, USA
- The Immunization Partnership, PO Box 346, Houston, TX 77001, USA
| | - Neha Kalakuntla
- Baker Institute for Public Policy, Rice University, 6100 Main Street, MS-40, Houston, TX 77478, USA
| | - Neha Tallapragada
- Baker Institute for Public Policy, Rice University, 6100 Main Street, MS-40, Houston, TX 77478, USA
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15
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Graham C. Accumulating burden: Exposure to interpersonal discrimination based on multiple attributes and allostatic load. SSM Popul Health 2024; 26:101639. [PMID: 38516525 PMCID: PMC10955412 DOI: 10.1016/j.ssmph.2024.101639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/10/2024] [Accepted: 02/18/2024] [Indexed: 03/23/2024] Open
Abstract
Exposure to interpersonal discrimination is an acute type of social stressor. Extant evidence suggests a positive association exists between experiencing interpersonal discrimination and physiological dysregulation measured by allostatic load. However, research to date has overlooked the role of exposure to interpersonal discrimination based on multiple attributes. This is an important oversight because individuals who confront discrimination often accredit the experiences to more than one attribute, which may be associated with increased stress and adverse physiological functioning. Using data from the Wave V biomarker subsample of the National Longitudinal Study of Adolescent to Adult Health (Add Health), I investigate the relationship between reports of interpersonal discrimination based on multiple attributes and allostatic load among adults ages 33-44. I also consider the roles of frequency of exposure to discrimination and perceived stress in this relationship through moderation and mediation analyses. Results reveal a positive association between the number of forms of discrimination that individuals report and allostatic load. However, frequency of exposure to discrimination does not moderate this association. Moreover, frequency of discrimination did not mediate the association between the number of forms of discrimination and perceived stress only marginally mediated it. This study offers novel and important insight into the role of exposure to more than one form of discrimination and allostatic load. Given that heightened allostatic load is a precursor to the development of chronic conditions and a strong risk factor for mortality, efforts to reduce discrimination among Americans adults will work to improve physical health.
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Verma M, Sangeeta K, Verma BK, Dubey DK, Mondal M, Mazumder MN, Khan HT, Verma V. The association between anti-smoking legislation and prevalence of acute respiratory illnesses in Indian children. Public Health Pract (Oxf) 2024; 7:100481. [PMID: 38419738 PMCID: PMC10901132 DOI: 10.1016/j.puhip.2024.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/22/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
Objective Exposure to tobacco smoke causes numerous health problems in children, and create burden on the population in terms of economy, morbidity and mortality. In order to protect the child from exposure to tobacco smoke in the outdoor environment, sufficient legislative enactments are available in Indian legislation. The objective of the present study is to investigate the fact that in absence of any specific laws stating about protection of children from exposure to tobacco smoke in indoor environment, whether outdoor related legislations are sufficient to protect children from exposureand to explore the scope for enforcement of both state and central laws in improving health of children in India. Study design The study considered cross-sectional survey data of Demographic and Health Survey Data on India, National Family and Health Survey fourth round (NFHS-4) for the year 2015-16 on Indian children (below age of four). Methods Both bivariate and multivariate logistic regression models were used to assess the impact of anti-smoking laws on the prevalence of acute respiratory infection (ARI) based on the place of residence, indoor tobacco smoke exposure and age of the child. Results The results have shown an inclination of ARI among children in association with states having single law, rural area resident, exposure to indoor tobacco smoke and age of the child, both as independent or in combination are quite conspicuous, and are found to be underestimated. The logistic regression also revealed the influence of these factors both as independent and even in interaction with other. Conclusions Legislative intervention through both at central (or national)and state levels through anti-smoking laws will decrease the indoor tobacco smoke exposure as a result ARI prevalence will also decrease among children in India.
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Affiliation(s)
- Mamta Verma
- Department of Law, Kazi Nazrul University, West Bengal, 713340, India
| | - K. Sangeeta
- HRC HOSPITAL, Hyderabad, 500016, Telangana, India
| | | | - Dharmendra Kumar Dubey
- Department of Biostatistics, School of Allied Health Sciences (SAHS), Sharda Hospital, Sharda University, Uttar Pradesh, 201310, India
| | - Mukul Mondal
- Department of Law, Kazi Nazrul University, West Bengal, 713340, India
| | - Mousumi Nath Mazumder
- Indian Council of Social Science Research (ICSSR), JNU Institutional Area, Aruna Asaf Ali Marg, New Delhi, 110067, India
| | - Hafiz T.A. Khan
- Health Promotion and Public Health, College of Nursing, Midwifery and Healthcare, University of West London, Paragon House, Boston Manor Road, Brentford, TW8 9GB, United Kingdom
| | - Vivek Verma
- Department of Statistics, Assam University, Silchar, Assam, 788011, India
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Painter H, Parry E, McCann L, Dehn Lunn A, Ford J. Social needs screening in primary care: A tool in the fight for health equity? Public Health Pract (Oxf) 2024; 7:100466. [PMID: 38323126 PMCID: PMC10844637 DOI: 10.1016/j.puhip.2024.100466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 02/08/2024] Open
Abstract
Progress on addressing health inequalities is slow and in many places around the world the gap between the privileged and the disadvantaged is widening. This is driven largely by an unfair and unequal distribution of the social determinants of health. While upstream policy and agenda commitment is needed to improve social determinants of health at a population level, healthcare also has a role. Currently social information is sporadically collected and used in healthcare. Improving our understanding of social problems is crucial in targeting services and to reduce the overreliance on area-level measures of deprivation. This has the potential to improve patient care as well as more accurately capture socio-economic disadvantage. Here we argue that there is a role for primary care in screening for social needs to help address inequalities. Social needs screening, more commonly used in North America than Europe, aims to systematically collect social information in health and care settings. Healthcare professionals ask patients about social issues including employment, finances, housing, education and social isolation and this information is used to prompt referral to community services to address any need identified. Social needs screening has potential to address negative impacts of social determinants of health at an individual and population level. Providing a reliable measure of social need, screening gives healthcare professionals an opportunity to tailor and improve quality of care for patients and offer individualised support. It has been shown to improve individual social and health outcomes and positively impact healthcare utilisation. At a population level, social needs screening can improve the data on social determinants of health and therefore support policy makers and service delivery leaders to target resources and services more effectively to the communities most in need. Implementing social needs screening must take account of local healthcare service capacity and available community resources but where sustainable, effective programmes can be introduced, the potential benefits are manifold. While primary care alone cannot solve the root causes of health inequalities, we argue it could be a powerful actor in the fight for health equity.
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Affiliation(s)
- H. Painter
- Wolfson Institute for Population Health, Queen Mary University of London, UK
| | - E. Parry
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK
| | - L. McCann
- Wolfson Institute for Population Health, Queen Mary University of London, UK
| | - A. Dehn Lunn
- Wolfson Institute for Population Health, Queen Mary University of London, UK
| | - J. Ford
- Wolfson Institute for Population Health, Queen Mary University of London, UK
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Dhakal B, McLeod GF, Insch A, Boden J. Modified inverse propensity weighting method to alleviate estimation errors in the model with multiple endogenous variables. MethodsX 2024; 12:102513. [PMID: 38192361 PMCID: PMC10772818 DOI: 10.1016/j.mex.2023.102513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/03/2023] [Indexed: 01/10/2024] Open
Abstract
Multiple mental health disorders affect on decisions of people. The disorders are also outcomes of other factors. Health studies commonly follow an inverse propensity weight (IPW) method to address estimation errors associated with the presence of one confounder or covariate number exceeding the recommended sample size. However, approaches of IPW appropriate to alleviate the estimation error associated with multiple confounders distributed unequally in the study samples were not explained in our search literature. This study used longitudinal cohort data from Christchurch Health and Development Study and demonstrated IPW approach to address two confounders with similar natures in terms of etiological process. In our sample, some individuals had no mental health disorder at all, while others had either one of depression or anxiety or both. The methodological step to evaluate a new IPW approach include * Estimated IPWs from all possible combinations of the major depression and anxiety disorder: (a) IPW based on anxiety factor only assuming both mental health problems resulted from the same etiological processes; (b) IPW based on major depression factor only assuming both mental health problems resulted from the same etiological processes; (c) IPW assuming three (independent) categories of etiological processes: neither; either; both of major depression or anxiety disorder, (d) IPW assuming four (independent) categories of etiological processes: neither; major depression only; any anxiety disorder only; both. (e) No IPW or control model (no confounding problem.•Estimated outcome model with one each IPW at a time and one without IPw (control model).•Compared fit statistics of all estimated models.•The IPW derived assuming four categories of etiological processes produced the robust based fit statistics criteria. The study showed significant effects of both mental health problems on investment but the anxiety revealed a stronger effect than that of major depression.
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Affiliation(s)
- Bhubaneswor Dhakal
- Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch 8140, New Zealand
| | - Geraldine. F.H. McLeod
- Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch 8140, New Zealand
| | - Andrea Insch
- Department of Marketing, University of Otago, Dunedin, New Zealand
| | - Joseph.M. Boden
- Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch 8140, New Zealand
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Devillanova C, Franco C, Spada A. Downgraded dreams: Labor market outcomes and mental health in undocumented migration. SSM Popul Health 2024; 26:101652. [PMID: 38516529 PMCID: PMC10950686 DOI: 10.1016/j.ssmph.2024.101652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/02/2024] [Accepted: 03/05/2024] [Indexed: 03/23/2024] Open
Abstract
Undocumented immigrant workers are particularly exposed to mental health risk factors, including occupational downgrading - i.e. the loss in occupational status upon arrival. This study breaks new ground by examining the relationship between occupational downgrading and mental health among this hard-to-reach population, offering the first-ever investigation of its kind. Leveraging a unique dataset collected by a primary care outpatient clinic in Milan, Italy, which combines medical evaluations with detailed occupational information, we construct a direct measure of occupational downgrading, which adds to the literature. We employ logistic regression models to estimate odds ratios (ORs) for mental and behavioral disorders. The study also offers fresh evidence on the socioeconomic and health status of a sizable sample of undocumented migrants. The study sample consists of 1738 individuals that had their first medical examination in 2017-18. Prevalence of mental health conditions is 5.58%. Data also highlight poor labor market integration: one third of individuals in the sample is employed, mostly in elementary occupations; 66.63% of immigrant workers experienced occupational downgrading. Regression results show that undocumented immigrants who undergo occupational downgrading are at considerably higher risk of mental disorders. ORs range from 1.729 (95% CI 1.071-2.793), when the model only includes individual characteristics determined prior to migration, to 2.659 (CI 1.342-5.271), when it accounts for all the available controls. From a policy perspective, our study underscores the need to consider the broader impact of policies, including restrictive entry and integration policies, on migrant health. Additionally, ensuring access to primary care for all immigrants is crucial for early detection and treatment of mental health conditions.
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Affiliation(s)
- Carlo Devillanova
- Department of Social and Political Sciences and Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Italy
| | - Cristina Franco
- European Commission, Directorate-General for Neighbourhood Policy and Enlargement Negotiations, Belgium
| | - Anna Spada
- On Behalf of Naga, Organizzazione di Volontariato per l’Assistenza Socio-Sanitaria e per i Diritti di Cittadini Stranieri, Rom e Sinti, Italy
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Larkins A, Vannamahaxay S, Puttana V, Chittavong M, Southammavong F, Mayxay M, Boyd D, Bruce M, Ash A. Scaling up One Health: A network analysis in Lao PDR. One Health 2024; 18:100661. [PMID: 38179311 PMCID: PMC10761780 DOI: 10.1016/j.onehlt.2023.100661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/06/2023] [Indexed: 01/06/2024] Open
Abstract
Background One Health focuses on sustainable health for humans, animals, and ecosystems. The approach has been well demonstrated, yet most efforts have not been scaled up. Understanding the organisations involved in scaling up processes is critical to translating research into practice. The Lao People's Democratic Republic has successfully implemented One Health projects for multiple decades; however, the organisational network has not been described and scaling up efforts have been limited. Methods Data from organisations involved in One Health projects over the past five years were collected by key-informant interview or workshop. The network was investigated using a mixture of quantitative network analysis and qualitative thematic analysis. Results The organisational network was quantitatively described as sparse and centralised. Organisations were required to harness pre-existing relationships to maximise scarce resources and make co-ordination and alignment of priorities more efficient. A lack of international organisations in the top 10% of resource sharing metrics suggests a potential disconnect between donors. This was reflected in the challenges faced by national organisations and a feeling of being stretched thin over numerous externally funded projects with donor-driven priorities. Conclusions It appears that high-level political support for country ownership of development and aid priorities remains unrealised. Developing network capacity and capability may assist scaling up efforts and build resilience in the network and its core organisations. This may allow for the inclusion of more development, education, environment, and water, sanitation, and hygiene organisations that were perceived to be lacking. Future One Health programmes should focus on practical activities that do not overload staff capacity. There is much for One Health to learn about the art of scaling up and organisations are encouraged to include implementation science in their research to inform future scaling up efforts.
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Affiliation(s)
- Andrew Larkins
- School of Medical, Molecular and Forensic Sciences, Murdoch University, Perth, Australia
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Australia
| | - Soulasack Vannamahaxay
- Faculty of Agriculture, National University of Laos, Vientiane, Lao Democratic People’s Republic
| | - Vannaphone Puttana
- Faculty of Agriculture, National University of Laos, Vientiane, Lao Democratic People’s Republic
- Lao One Health University Network, Vientiane, Lao Democratic People’s Republic
| | - Malavanh Chittavong
- Faculty of Agriculture, National University of Laos, Vientiane, Lao Democratic People’s Republic
- Lao One Health University Network, Vientiane, Lao Democratic People’s Republic
| | - Fongsamouth Southammavong
- Faculty of Agriculture, National University of Laos, Vientiane, Lao Democratic People’s Republic
- Lao One Health University Network, Vientiane, Lao Democratic People’s Republic
| | - Mayfong Mayxay
- Institute of Research and Education Development, University of Health Sciences, Ministry of Health, Vientiane, Lao Democratic People’s Republic
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Lao Democratic People’s Republic
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Lao One Health University Network, Vientiane, Lao Democratic People’s Republic
| | - Davina Boyd
- Centre for Sustainable Farming Systems, Food Futures Institute, Murdoch University, Perth, Australia
| | - Mieghan Bruce
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Australia
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Amanda Ash
- School of Medical, Molecular and Forensic Sciences, Murdoch University, Perth, Australia
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Australia
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Argüello TM. Spatializing HIV: Putting Queer (men) in its place via social marketing. Dialogues Health 2024; 4:100169. [PMID: 38516214 PMCID: PMC10954028 DOI: 10.1016/j.dialog.2024.100169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 03/23/2024]
Abstract
The current study is concerned with how HIV is spatialized, or emplaced in everyday life, and therefore how prevention, Queer identity, and the virus itself are given meaning. Employing a transdisciplinary methodology based in Critical Discourse Studies and critical human geography, this study provides a geosemiotic analysis of an HIV prevention social marketing effort called the Little Prick campaign. Findings showed that space was constructed through multiple competing dynamics across professionals and citizens, as well as amidst contested notions of risk and branding in the epidemic. The analysis illuminates the discursive relationship amongst Queer, HIV, and prevention. Equally, this study counters the biased notion that "prevention fatigue" in high-risk populations hampers professional labor by, instead, exposing a semiotic fatigue in the HIV epidemic and prevention efforts.
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Affiliation(s)
- Tyler M. Argüello
- Director and Professor, School of Social Work, California State University, Sacramento, 6000 J Street, 4010 Mariposa, MS 6090, Sacramento, CA 95819, USA
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22
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Aljabali AAA, Obeid MA, El-Tanani M, Mishra V, Mishra Y, Tambuwala MM. Precision epidemiology at the nexus of mathematics and nanotechnology: Unraveling the dance of viral dynamics. Gene 2024; 905:148174. [PMID: 38242374 DOI: 10.1016/j.gene.2024.148174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 01/21/2024]
Abstract
The intersection of mathematical modeling, nanotechnology, and epidemiology marks a paradigm shift in our battle against infectious diseases, aligning with the focus of the journal on the regulation, expression, function, and evolution of genes in diverse biological contexts. This exploration navigates the intricate dance of viral transmission dynamics, highlighting mathematical models as dual tools of insight and precision instruments, a theme relevant to the diverse sections of Gene. In the context of virology, ethical considerations loom large, necessitating robust frameworks to protect individual rights, an aspect essential in infectious disease research. Global collaboration emerges as a critical pillar in our response to emerging infectious diseases, fortified by the predictive prowess of mathematical models enriched by nanotechnology. The synergy of interdisciplinary collaboration, training the next generation to bridge mathematical rigor, biology, and epidemiology, promises accelerated discoveries and robust models that account for real-world complexities, fostering innovation and exploration in the field. In this intricate review, mathematical modeling in viral transmission dynamics and epidemiology serves as a guiding beacon, illuminating the path toward precision interventions, global preparedness, and the collective endeavor to safeguard human health, resonating with the aim of advancing knowledge in gene regulation and expression.
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Affiliation(s)
- Alaa A A Aljabali
- Faculty of Pharmacy, Department of Pharmaceutics & Pharmaceutical Technology, Yarmouk University, Irbid 21163, Jordan.
| | - Mohammad A Obeid
- Faculty of Pharmacy, Department of Pharmaceutics & Pharmaceutical Technology, Yarmouk University, Irbid 21163, Jordan
| | - Mohamed El-Tanani
- College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates.
| | - Vijay Mishra
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Yachana Mishra
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Murtaza M Tambuwala
- Lincoln Medical School, University of Lincoln, Brayford Pool Campus, Lincoln LN6 7TS, United Kingdom.
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23
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Van den Bergh BRH, Antonelli MC, Stein DJ. Current perspectives on perinatal mental health and neurobehavioral development: focus on regulation, coregulation and self-regulation. Curr Opin Psychiatry 2024; 37:237-250. [PMID: 38415742 DOI: 10.1097/yco.0000000000000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW Perinatal mental health research provides an important perspective on neurobehavioral development. Here, we aim to review the association of maternal perinatal health with offspring neurodevelopment, providing an update on (self-)regulation problems, hypothesized mechanistic pathways, progress and challenges, and implications for mental health. RECENT FINDINGS (1) Meta-analyses confirm that maternal perinatal mental distress is associated with (self-)regulation problems which constitute cognitive, behavioral, and affective social-emotional problems, while exposure to positive parental mental health has a positive impact. However, effect sizes are small. (2) Hypothesized mechanistic pathways underlying this association are complex. Interactive and compensatory mechanisms across developmental time are neglected topics. (3) Progress has been made in multiexposure studies. However, challenges remain and these are shared by clinical, translational and public health sciences. (4) From a mental healthcare perspective, a multidisciplinary and system level approach employing developmentally-sensitive measures and timely treatment of (self-)regulation and coregulation problems in a dyadic caregiver-child and family level approach seems needed. The existing evidence-base is sparse. SUMMARY During the perinatal period, addressing vulnerable contexts and building resilient systems may promote neurobehavioral development. A pluralistic approach to research, taking a multidisciplinary approach to theoretical models and empirical investigation needs to be fostered.
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Affiliation(s)
| | - Marta C Antonelli
- Laboratorio de Programación Perinatal del Neurodesarrollo, Instituto de Biología Celular y Neurociencias "Prof.E. De Robertis", Facultad de Medicina. Universidad de Buenos Aires, Buenos Aires, Argentina
- Frauenklinik und Poliklinik, Klinikum rechts der Isar, Munich, Germany
| | - Dan J Stein
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
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24
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Stone RA, Brown A, Douglas F, Green MA, Hunter E, Lonnie M, Johnstone AM, Hardman CA. The impact of the cost of living crisis and food insecurity on food purchasing behaviours and food preparation practices in people living with obesity. Appetite 2024; 196:107255. [PMID: 38367913 DOI: 10.1016/j.appet.2024.107255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/12/2024] [Accepted: 02/06/2024] [Indexed: 02/19/2024]
Abstract
Lower income households are at greater risk of food insecurity and poor diet quality than higher income households. In high-income countries, food insecurity is associated with high levels of obesity, and in the UK specifically, the cost of living crisis (i.e., where the cost of everyday essentials has increased quicker than wages) is likely to have exacerbated existing dietary inequalities. There is currently a lack of understanding of the impact of the current UK cost of living crisis on food purchasing and food preparation practices of people living with obesity (PLWO) and food insecurity, however this knowledge is critical in order to develop effective prevention and treatment approaches to reducing dietary inequalities. Using an online survey (N = 583) of adults residing in England or Scotland with a body mass index (BMI) of ≥30 kg/m2, participants self-reported on food insecurity, diet quality, perceived impact of the cost of living crisis, and their responses to this in terms of food purchasing behaviours and food preparation practices. Regression analyses found that participants adversely impacted by the cost of living crisis reported experiencing food insecurity. Additionally, food insecurity was associated with use of specific purchasing behaviours (i.e., use of budgeting, use of supermarket offers) and food preparation practices (i.e., use of energy-saving appliances, use of resourcefulness). Exploratory analyses indicated that participants adversely impacted by the cost of living crisis and who used budgeting had low diet quality, whereas use of meal planning was associated with high diet quality. These findings highlight the fragility of food budgets and the coping strategies used by PLWO and food insecurity during the cost of living crisis. Policy measures and interventions are urgently needed that address the underlying economic factors contributing to food insecurity, to improve access to and affordability of healthier foods for all.
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Affiliation(s)
- Rebecca A Stone
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, L69 7ZA, UK.
| | - Adrian Brown
- Department of Medicine, Centre for Obesity Research, University College London, London, WC1E 6JF, UK.
| | - Flora Douglas
- School of Nursing, Midwifery & Paramedic Practice, Robert Gordon University, Aberdeen, AB10 7QE, UK.
| | - Mark A Green
- Department of Geography & Planning, University of Liverpool, Liverpool, L69 7ZT, UK.
| | - Emma Hunter
- School of Nursing, Midwifery & Paramedic Practice, Robert Gordon University, Aberdeen, AB10 7QE, UK.
| | - Marta Lonnie
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Alexandra M Johnstone
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Charlotte A Hardman
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, L69 7ZA, UK.
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da Costa MP, Severo M, Araújo J, Vilela S. Longitudinal tracking of diet quality from childhood to adolescence: The Interplay of individual and sociodemographic factors. Appetite 2024; 196:107279. [PMID: 38401601 DOI: 10.1016/j.appet.2024.107279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 02/06/2024] [Accepted: 02/16/2024] [Indexed: 02/26/2024]
Abstract
This study aimed to examine diet tracking from childhood to adolescence, using 4 time-points, and the influence of socioeconomic and individual characteristics in this transition. The sample included 6893 children from the Portuguese birth cohort Generation XXI with complete information on Food Frequency Questionnaire in at least one of the considered follow-ups. A Healthy Eating Index (HEI), previously developed to assess adherence to WHO's dietary recommendations, was applied at all ages (4, 7, 10 and 13y). The intraclass correlation coefficient (ICC) was used to analyse the tracking of diet quality. Linear mixed-effect models were performed to estimate the association of the child's socioeconomic and individual characteristics with the HEI score and respective trajectories over time. The overall diet quality decreased from childhood (22.2 ± 3.6 at 4y) to adolescence (18.2 ± 3.9 at 13y), with moderate tracking (ICC = 0.53), showing that children who start a healthy diet earlier might have a better diet quality as time goes by. Children of older mothers (β = 0.079, 95%CI = 0.061-0.097) and with higher education (β = 0.203, 95%CI = 0.178-0.229) and a higher household monthly income (β = 0.024,95%CI = 0.007-0.041) had a higher diet quality over time. Besides family characteristics, the child's sedentary activities (β = -0.009, 95%CI = -0.014--0.003) negatively influence diet quality throughout life. In contrast, being a girl (β = -0.094, 95%CI = -0.132--0.056) and having higher sleep duration (β = 0.039, 95%CI = 0.015-0.064) are associated with a higher diet quality over time. The presence of dietary tracking from childhood to adolescence implies that promoting healthy eating habits during the first years of life is crucial for a healthier diet quality during late childhood and early adolescence, focusing on maternal and individual child characteristics.
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Affiliation(s)
- Marta Pinto da Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto, Rua de Jorge Viterbo Ferreira, nº288, 4050-321, Porto, Portugal
| | - Joana Araújo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Sofia Vilela
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal.
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26
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Gordon REF, Kosty D, Khurana A. The mediating role of child delay of gratification in the link between early and prolonged poverty exposure and adolescent allostatic load. Psychoneuroendocrinology 2024; 163:106990. [PMID: 38412742 PMCID: PMC10954378 DOI: 10.1016/j.psyneuen.2024.106990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/01/2024] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
Early and prolonged exposure to poverty disrupts biological processes associated with the body's stress response system, leading to long-term negative health outcomes, including obesity, autoimmune disorders, and cardiovascular disease. Allostatic load (AL), a composite measure of chronic stress on the body, is a robust predictor of subsequent health outcomes. However, developmental research examining the associations of early poverty exposure with AL in adolescence, as well as the underlying mechanisms of influence is limited. Early poverty exposure also impedes healthy development of child self-regulation, which may increase risk for high AL in adolescence, but this mechanistic pathway has not yet been tested. We used data from the national Study of Early Child Care and Youth Development (SECCYD) to examine the longitudinal associations between prolonged poverty exposure in early childhood (0-3 years) and AL in adolescence (age 15). We also tested the mediating role of child delay of gratification, a behavioral measure of self-regulation (at age 54 months), in the potential association between early poverty exposure and adolescent AL. Accounting for model covariates (i.e., child biological sex and race-ethnicity) and individual differences in child delay of gratification, early and prolonged poverty exposure was significantly associated with higher AL at age 15. The indirect effect through child delay of gratification was not significant, but the individual pathways of the indirect effect were significant, and the overall direct association of early poverty exposure with adolescent AL was significant. Our findings show that prolonged exposure to poverty in early childhood (0-3 years) can have significant negative associations with both child delay of gratification (at 54 months) and AL (at age 15). Given that the detrimental impacts of poverty exposure can be detected at an early age, targeted prevention efforts (e.g., anti-poverty programs such as cash assistance programs) may be able to offset some of the risks of early poverty exposure on self-regulation and AL.
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Affiliation(s)
- Rebecca E F Gordon
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA.
| | - Derek Kosty
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Atika Khurana
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
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27
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Joshi A, Viswanathan SH, Jaiswal AK, Sadeghi K, Bartels L, Jain RM, Pathikonda G, Vanos JK, Middel A, Rykaczewski K. Characterization of human extreme heat exposure using an outdoor thermal manikin. Sci Total Environ 2024; 923:171525. [PMID: 38458460 DOI: 10.1016/j.scitotenv.2024.171525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/08/2024] [Accepted: 03/04/2024] [Indexed: 03/10/2024]
Abstract
Extreme heat is a current and growing global health concern. Current heat exposure models include meteorological and human factors that dictate heat stress, comfort, and risk of illness. However, radiation models simplify the human body to a cylinder, while convection ones provide conflicting predictions. To address these issues, we introduce a new method to characterize human exposure to extreme heat with unprecedented detail. We measure heat loads on 35 body surface zones using an outdoor thermal manikin ("ANDI") alongside an ultrasonic anemometer array and integral radiation measurements (IRM). We show that regardless of body orientation, IRM and ANDI agree even under high solar conditions. Further, body parts can be treated as cylinders, even in highly turbulent flow. This geometry-rooted insight yields a whole-body convection correlation that resolves prior conflicts and is valid for diverse indoor and outdoor wind flows. Results will inform decision-making around heat protection, adaptation, and mitigation.
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Affiliation(s)
- Ankit Joshi
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA; Julie Ann Wrigley Global Futures Laboratory, Arizona State University, Tempe, AZ, USA
| | - Shri H Viswanathan
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA
| | - Ankush K Jaiswal
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA; Julie Ann Wrigley Global Futures Laboratory, Arizona State University, Tempe, AZ, USA
| | - Kambiz Sadeghi
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA; Julie Ann Wrigley Global Futures Laboratory, Arizona State University, Tempe, AZ, USA
| | - Lyle Bartels
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA
| | - Rajan M Jain
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA
| | - Gokul Pathikonda
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA
| | - Jennifer K Vanos
- Julie Ann Wrigley Global Futures Laboratory, Arizona State University, Tempe, AZ, USA; School of Sustainability, Arizona State University, Tempe, AZ, USA
| | - Ariane Middel
- Julie Ann Wrigley Global Futures Laboratory, Arizona State University, Tempe, AZ, USA; School of Arts, Media and Engineering, Arizona State University, Tempe, AZ, USA; School of Computing and Augmented Intelligence, Arizona State University, Tempe, AZ, USA
| | - Konrad Rykaczewski
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA; Julie Ann Wrigley Global Futures Laboratory, Arizona State University, Tempe, AZ, USA.
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28
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Hall MG, Lee CJY, Jernigan DH, Ruggles P, Cox M, Whitesell C, Grummon AH. The impact of "pinkwashed" alcohol advertisements on attitudes and beliefs: A randomized experiment with US adults. Addict Behav 2024; 152:107960. [PMID: 38309239 PMCID: PMC10923020 DOI: 10.1016/j.addbeh.2024.107960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/15/2023] [Accepted: 01/18/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVE To examine the impact of alcohol advertisements related to breast cancer awareness or charities (i.e., pinkwashed ads) on attitudes and beliefs. METHODS In 2023, an online experiment randomized 602 US adults to view three pinkwashed ads for beer, wine, and liquor, or three standard ads for the same products. RESULTS Breast cancer risk perceptions (average differential effect [ADE] = 0.03; p = 0.58)) and intentions to purchase the advertised product (ADE = -0.01, p = 0.95) did not differ by ad type. When informed about the link between alcohol and breast cancer, participants who viewed pinkwashed ads reported the ads were more misleading (ADE = 0.51, p < 0.001) and had stronger support for requiring alcohol breast cancer warnings (ADE = 0.23, p < 0.001). The pinkwashed ads for beer (but not for wine or liquor) led to greater: perceived product healthfulness (ADE = 0.16, p = 0.03), perceived social responsibility of the company (ADE = 0.18, p = 0.02), and favorable brand attitudes (ADE = 0.14, p = 0.03). CONCLUSIONS Informing the public about pinkwashing increases perceptions of misleadingness and support for alcohol policies. POLICY IMPLICATIONS Exposing the industry practice of pinkwashing could be a promising theme for campaigns to reduce alcohol consumption and increase support for alcohol policies.
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Affiliation(s)
- Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Cristina J Y Lee
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, United States.
| | - David H Jernigan
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States.
| | - Phoebe Ruggles
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Melissa Cox
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Callie Whitesell
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Anna H Grummon
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, United States; Department of Health Policy, Stanford University School of Medicine, Stanford, CA, United States.
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29
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Domnich A, Ferrari A, Ogliastro M, Orsi A, Icardi G. Web search volume as a near-real-time complementary surveillance tool of tick-borne encephalitis (TBE) in Italy. Ticks Tick Borne Dis 2024; 15:102332. [PMID: 38484539 DOI: 10.1016/j.ttbdis.2024.102332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/04/2024] [Accepted: 03/08/2024] [Indexed: 03/24/2024]
Abstract
The Internet is an important gateway for accessing health-related information, and data generated through web queries have been increasingly used as a complementary source for monitoring and forecasting of infectious diseases and they may partially address the issue of underreporting. In this study, we assessed whether tick-borne encephalitis (TBE)-related Internet search volume may be useful as a complementary tool for TBE surveillance in Italy. Monthly Google Trends (GT) data for TBE-related information were extracted for the period between January 2017 and September 2022, corresponding to the available time series of TBE notifications in Italy. Time series modeling was performed by applying seasonal autoregressive integrated moving average (SARIMA) models with or without GT data. The search terms relative to tick bites reflected best the observed temporal distribution of TBE cases, showing a correlation coefficient of 0.81 (95 % CI: 0.71-0.88). Particularly, both the reported number of TBE cases and GT searches occurred mainly during the summer. The peak of disease notifications coincided with that of Google searches in 4 of 6 years. Once calibrated, SARIMA models with or without GT data were applied to a validation set. Retrospective forecast made by the model with GT data was associated with a lower prediction error and accurately predicted the peak timing. By contrast, the traditional SARIMA model underestimated the actual number of TBE notifications by 65 %. Timeliness, easy availability, low cost and transparency make monitoring of the TBE-related Internet search queries a promising addition to the traditional methods of TBE surveillance in Italy.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Allegra Ferrari
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
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30
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Kubala AG, Roma PG, Jameson JT, Sessoms PH, Chinoy ED, Rosado LR, Viboch TB, Schrom BJ, Rizeq HN, Gordy PS, Hirsch LDA, Biggs LAT, Russell DW, Markwald RR. Advancing a U.S. navy shipboard infrastructure for sleep monitoring with wearable technology. Appl Ergon 2024; 117:104225. [PMID: 38219375 DOI: 10.1016/j.apergo.2024.104225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/20/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
Development of fatigue management solutions is critical to U.S. Navy populations. This study explored the operational feasibility and acceptability of commercial wearable devices (Oura Ring and ReadiBand) in a warship environment with 845 Sailors across five ship cohorts during at-sea operations ranging from 10 to 31 days. Participants were required to wear both devices and check-in daily with research staff. Both devices functioned as designed in the environment and reliably collected sleep-wake data. Over 10,000 person-days at-sea, overall prevalence of Oura and ReadiBand use was 69% and 71%, respectively. Individual use rates were 71 ± 38% of days underway for Oura and 59 ± 34% for ReadiBand. Analysis of individual factors showed increasing device use and less device interference with age, and more men than women found the devices comfortable. This study provides initial support that commercial wearables can contribute to infrastructures for operational fatigue management in naval environments.
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Affiliation(s)
- Andrew G Kubala
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Peter G Roma
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Jason T Jameson
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Pinata H Sessoms
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA
| | - Evan D Chinoy
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA
| | - Luis R Rosado
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Trevor B Viboch
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Brandon J Schrom
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Hedaya N Rizeq
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Prayag S Gordy
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | | | - Lcdr Adam T Biggs
- Psychological Health and Resilience Department, Military Population Health Directorate, Naval Health Research Center, San Diego, CA, USA
| | - Dale W Russell
- Commander Naval Surface Force, U.S. Pacific Fleet, San Diego, CA, USA; Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Rachel R Markwald
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA.
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Bigby C, Humphreys L. The strength of Frontline Practice Leadership in Australian supported accommodation services: Challenges confronting service providers. J Appl Res Intellect Disabil 2024; 37:e13227. [PMID: 38520280 DOI: 10.1111/jar.13227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/27/2024] [Accepted: 03/02/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND The strength of practice leadership predicts the quality of Active Support but it can be compromised by other demands on frontline managers. The study aimed to identify and understand differences in practice leadership over time and between organisations. METHOD Data collected in 2022 in 96 services from 11 organisations using the Observed Measure of Practice Leadership were compared to similar data from 2013 and 2018. Qualitative fieldnotes were analysed thematically. FINDINGS Practice leadership scores increased significantly between 2013 and 2018 but declined significantly between 2018 and 2022. Scores were significantly higher in organisations that had implemented Active Support since 2013 compared to later adopters. Higher scoring organisations had structures that supported frontline managers with practice leadership and that countered increasing administrative demands. CONCLUSIONS Establishment of support structures for practice leadership by organisations warrants further investigation together with the relative importance of each task of practice leadership.
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Affiliation(s)
- Christine Bigby
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Lincoln Humphreys
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
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Yamaguchi Y, Takeda K, Yoshida S, Maruo K. Optimal biological dose selection in dose-finding trials with model-assisted designs based on efficacy and toxicity: a simulation study. J Biopharm Stat 2024; 34:379-393. [PMID: 37114985 DOI: 10.1080/10543406.2023.2202259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 04/06/2023] [Indexed: 04/29/2023]
Abstract
With the emergence of molecular targeted agents and immunotherapies in anti-cancer treatment, a concept of optimal biological dose (OBD), accounting for efficacy and toxicity in the framework of dose-finding, has been widely introduced into phase I oncology clinical trials. Various model-assisted designs with dose-escalation rules based jointly on toxicity and efficacy are now available to establish the OBD, where the OBD is generally selected at the end of the trial using all toxicity and efficacy data obtained from the entire cohort. Several measures to select the OBD and multiple methods to estimate the efficacy probability have been developed for the OBD selection, leading to many options in practice; however, their comparative performance is still uncertain, and practitioners need to take special care of which approaches would be the best for their applications. Therefore, we conducted a comprehensive simulation study to demonstrate the operating characteristics of the OBD selection approaches. The simulation study revealed key features of utility functions measuring the toxicity-efficacy trade-off and suggested that the measure used to select the OBD could vary depending on the choice of the dose-escalation procedure. Modelling the efficacy probability might lead to limited gains in OBD selection.
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Affiliation(s)
- Yusuke Yamaguchi
- Astellas Pharma Global Development, Inc, Northbrook, Illinois, USA
| | - Kentaro Takeda
- Astellas Pharma Global Development, Inc, Northbrook, Illinois, USA
| | | | - Kazushi Maruo
- Department of Biostatistics, University of Tsukuba, Tsukuba, Japan
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Romanova A, Rubinelli S, Diviani N. Improving health and scientific literacy in disadvantaged groups: A scoping review of interventions. Patient Educ Couns 2024; 122:108168. [PMID: 38301598 DOI: 10.1016/j.pec.2024.108168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/05/2023] [Accepted: 01/21/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVE To explore approaches for developing and implementing interventions aimed at improving health literacy and health-related scientific literacy in disadvantaged groups. METHODS A scoping review of literature published in 2012-2022 was conducted, followed by quality appraisal of eligible studies. RESULTS Interventions were conducted mainly in community settings, where the most popular venues were adult education facilities. The primary target groups were those with limited income or education, ethnic minorities, or immigrants. Programs were often held in-person using interactive and culturally appropriate methods. They were predominantly focused on functional and interactive health literacy dimensions rather than on critical and scientific ones. Evaluations measured knowledge, health literacy, behavioral and psychological outcomes using various quantitative and qualitative instruments. CONCLUSIONS The findings offer a comprehensive overview of the ways to design and evaluate health and scientific literacy interventions tailored to disadvantaged groups. PRACTICE IMPLICATIONS Future interventions should prioritize participatory designs, culturally appropriate materials, and shift focus to critical and scientific health literacy, as well as to program scalability in less controlled conditions.
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Affiliation(s)
- Anna Romanova
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Luzern, Switzerland; Swiss Paraplegic Research, Person-Centered Healthcare & Health Communication Group, Guido A, Zäch-Strasse 4, 6207 Nottwil, Switzerland
| | - Sara Rubinelli
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Luzern, Switzerland; Swiss Paraplegic Research, Person-Centered Healthcare & Health Communication Group, Guido A, Zäch-Strasse 4, 6207 Nottwil, Switzerland
| | - Nicola Diviani
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Luzern, Switzerland; Swiss Paraplegic Research, Person-Centered Healthcare & Health Communication Group, Guido A, Zäch-Strasse 4, 6207 Nottwil, Switzerland.
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Zhang D. Spousal health, marital satisfaction, and older Chinese adults' sleep: The moderating role of psychological resilience. Arch Gerontol Geriatr 2024; 120:105329. [PMID: 38237378 DOI: 10.1016/j.archger.2024.105329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 03/10/2024]
Abstract
PURPOSES This study aims to examine the moderating role of psychological resilience in the association between two common marital relationship stressors (poor spousal health and low marital satisfaction) and sleep (sleep quality and sleep duration) among older adults in China. METHODS This study used four waves of data from the Chinese Longitudinal Healthy Longevity Survey (2008-2018) (N = 8769), and mixed-effects logistic models were used. RESULTS Poor spousal health and low marital satisfaction were independently associated with increased odds of poor sleep quality and short sleep duration, and decreased odds of long sleep duration. Greater psychological resilience was associated with increased odds of good sleep quality and decreased odds of short sleep duration, but had no significant effect on long sleep duration. In addition, psychological resilience moderated the odds of poor spousal health and low marital satisfaction on the risk of short sleep duration among older Chinese adults. CONCLUSION The findings provide novel evidence for the increased importance of marital stress and psychological resilience on sleep health in later life. Policy interventions are needed to support vulnerable older adults who experience poor spousal health and/or low marital satisfaction.
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Affiliation(s)
- Dan Zhang
- School of Public Administration, Hohai University, West Focheng Rd No.8, Nanjing, 211100, PR China.
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Chen WJ, Radix AE. Primary Care and Health Care of Transgender and Gender-Diverse Older Adults. Clin Geriatr Med 2024; 40:273-283. [PMID: 38521598 DOI: 10.1016/j.cger.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
Clinicians working with older transgender and gender-diverse (TGD) individuals need to acquire the necessary knowledge and skills to provide care that is high quality and culturally appropriate. This includes supporting patients in their exploration of gender and attainment of gender-affirming medical interventions. Clinicians should strive to create environments that are inclusive and safe, and that will facilitate health care access and build constructive provider-patient relationships. Clinicians should be aware of best practices, including that age-appropriate health screenings should be anatomy based, and ensure that TGD older adults on gender-affirming hormone therapy (GAHT) receive ongoing laboratory monitoring and physical assessments, including serum hormone levels and biomarkers. Older TGD adults underutilize advance care planning, and need individualized assessments that consider their unique family structures, social support, and financial situation. End-of-life care services should ensure that TGD individuals are treated with dignity and respect.
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Affiliation(s)
- Wendy J Chen
- Department of Medicine, Loyola University Medicine Center, Chicago, IL, USA; Internal Medicine, ACP AGS WPATH USPATH.
| | - Asa E Radix
- Department of Medicine, Callen-Lorde Community Health Center, 356 West 18th Street, New York, NY 10011, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA
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Shingde R, Guha C, van Zwieten A, Kim S, Walker A, Francis A, Didsbury M, Teixeira-Pinto A, Prestidge C, Lancsar E, Mackie F, Kwon J, Howard K, Howell M, Jaure A, Hayes A, Raghunandan R, Petrou S, Lah S, McTaggart S, Craig JC, Mallitt KA, Wong G. Longitudinal associations between socioeconomic position and overall health of children with chronic kidney disease and their carers. Pediatr Nephrol 2024; 39:1533-1542. [PMID: 38049703 DOI: 10.1007/s00467-023-06236-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Disadvantaged socioeconomic position (SEP) is an important predictor of poor health in children with chronic kidney disease (CKD). The time course over which SEP influences the health of children with CKD and their carers is unknown. METHODS This prospective longitudinal study included 377 children, aged 6-18 years with CKD (stages I-V, dialysis, and transplant), and their primary carers. Mixed effects ordinal regression was performed to assess the association between SEP and carer-rated child health and carer self-rated health over a 4-year follow-up. RESULTS Adjusted for CKD stage, higher family household income (adjusted odds ratio (OR) (95% CI) 3.3, 1.8-6.0), employed status of primary carers (1.7, 0.9-3.0), higher carer-perceived financial status (2.6, 1.4-4.8), and carer home ownership (2.2, 1.2-4.0) were associated with better carer-rated child health. Household income also had a differential effect on the carer's self-rated health over time (p = 0.005). The predicted probabilities for carers' overall health being 'very good' among lower income groups at 0, 2, and 4 years were 0.43 (0.28-0.60), 0.34 (0.20-0.51), and 0.25 (0.12-0.44), respectively, and 0.81 (0.69-0.88), 0.84 (0.74-0.91), and 0.88 (0.76-0.94) for carers within the higher income group. CONCLUSIONS Carers and their children with CKD in higher SEP report better overall child and carer health compared with those in lower SEP. Carers of children with CKD in low-income households had poorer self-rated health compared with carers in higher-income households at baseline, and this worsened over time. These cumulative effects may contribute to health inequities between higher and lower SEP groups over time. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Rashmi Shingde
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia.
| | - Chandana Guha
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Anita van Zwieten
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Siah Kim
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | | | - Anna Francis
- School of Medicine, University of Queensland, Brisbane, Australia
- Child and Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Australia
| | - Madeleine Didsbury
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | | | - Emily Lancsar
- Department of Health Services Research and Policy, Australian National University, Canberra, Australia
| | - Fiona Mackie
- Sydney Children's Hospital, Randwick, Australia
- School of Women's and Child Health, University of New South Wales, Kensington, Australia
| | - Joseph Kwon
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England
| | - Kirsten Howard
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Menzies Centre for Health Policy & Economics, School of Public Health, University of Sydney, Sydney, Australia
| | - Martin Howell
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Menzies Centre for Health Policy & Economics, School of Public Health, University of Sydney, Sydney, Australia
| | - Allison Jaure
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Alison Hayes
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Rakhee Raghunandan
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Menzies Centre for Health Policy & Economics, School of Public Health, University of Sydney, Sydney, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England
| | - Suncica Lah
- School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Steven McTaggart
- School of Medicine, University of Queensland, Brisbane, Australia
- Child and Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Kylie-Ann Mallitt
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Germaine Wong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
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Wang W, Zhuang Z, Song Z, Zhao Y, Huang T. Sleep patterns, genetic predisposition, and risk of chronic liver disease: A prospective study of 408,560 UK Biobank participants. J Affect Disord 2024; 352:229-236. [PMID: 38199417 DOI: 10.1016/j.jad.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/27/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Little is known about the role that combined sleep behaviors play in the association with chronic liver disease (CLD) risk. METHODS We included 408,560 participants initially free of CLD from the UK Biobank. A healthy sleep pattern was defined by early chronotype, sleep duration of 7-8 h/day, no insomnia, no snoring, and no excessive daytime sleepiness. Cox regression models were used to examine the association of healthy sleep pattern with incident CLD and their interaction with PNPLA3 genetic risk. RESULTS During a median 12.5 years of follow-up, we documented 10,915 incident all-cause CLD cases, including 388 viral hepatitis, 4782 non-alcoholic fatty liver disease (NAFLD), 1356 cirrhosis, 973 alcoholic liver disease, and 725 liver cancer cases. Compared to participants with a healthy sleep score of 0-1, the hazard ratio (HR) (95 % confidence interval [CI]) for those with a sleep score of 5 was 0.54 (0.49, 0.60) for CLD, 0.52 (0.30, 0.90) for viral hepatitis, 0.47 (0.41, 0.55) for NAFLD, 0.57 (0.43, 0.75) for cirrhosis, 0.32 (0.23, 0.44) for alcoholic liver disease, and 0.53 (0.37, 0.77) for liver cancer. Healthy sleep pattern and PNPLA3 genetic risk exerted significant additive effects on CLD risk (relative excess risk due to the interaction: 0.05; attributable proportion due to the interaction: 13 %). LIMITATIONS Measurement error was unavoidable for self-reported data on sleep behaviors. CONCLUSIONS Our analyses provide evidence that healthy sleep pattern was inversely associated with the development of CLD, and participants with higher genetic risk were more likely to develop CLD when exposed to the unhealthy sleep pattern.
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Affiliation(s)
- Wenxiu Wang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zhenhuang Zhuang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zimin Song
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yimin Zhao
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China.
| | - Tao Huang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China; Center for Intelligent Public Health, Academy for Artificial Intelligence, Peking University, Beijing, China.
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Thorsted AB, Thygesen LC, Jezek AH, Pedersen MM, Jorgensen MG, Vinding K, Kannegaard PN, Pedersen SGH. The De Morton Mobility Index (DEMMI) in hospitalized geriatric patients is associated with risk of readmission, mortality, and discharge to a post-acute care facility: A nationwide register-based cohort study. Arch Gerontol Geriatr 2024; 120:105325. [PMID: 38237375 DOI: 10.1016/j.archger.2024.105325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/15/2023] [Accepted: 01/01/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To examine the association between the de Morton Mobility Index (DEMMI) score on admission in geriatric patients and readmission and mortality within 30, 180, and 365 days after discharge, and discharge to a post-acute care facility. METHODS A nationwide register-based cohort study including 23,941 geriatric in-patients aged ≥65 years admitted to a geriatric ward between 2014 and 2017 and included in the Danish National Database for Geriatrics. The DEMMI score was categorized into four subcategories: very low mobility (DEMMI=0-24), low mobility (DEMMI=27-39), moderately reduced mobility (DEMMI=41-57), and independent mobility (DEMMI=62-100). Patients were followed 30, 180 and 365 days after discharge for readmission and mortality. Their risk of being discharged to a post-acute care facility was examined. Adjusted hazard ratios (HRs) and odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated. RESULTS HRs for readmission within 30-days were 1.36 (1.24-1.48) for very low mobility, 1.30 (1.20-1.42) for low mobility and 1.17 (1.08-1.28) for moderately reduced compared with independent mobility. Similar results were seen for readmission within 180- and 365-days. For mortality, HR for 30-day mortality ranged from1.93 and 5.66, 180-day mortality between 1.62 and 3.19, and 365-day mortality between 1.54 and 2.81 compared with patients with independent mobility. OR for discharge to a post-acute care facility was 8.76 (7.29-10.53) for lowest compared with the highest DEMMI mobility subcategory. CONCLUSION In geriatric in-patients, lower DEMMI scores on hospital admission are associated with increased rates of discharge to a post-acute care facility, and for readmission, and mortality within one year.
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Affiliation(s)
- Anne B Thorsted
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen, Denmark
| | - Lau C Thygesen
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen, Denmark
| | - Andrea H Jezek
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen, Denmark
| | - Mette M Pedersen
- Department of Clinical Research and Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Copenhagen University Hospital at Amager and Hvidovre, Kettegaard alle 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Martin G Jorgensen
- Department of Geriatric Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Kirsten Vinding
- Diagnostic Center, Department of Medicine, Odense University Hospital, Baagøes Alle 31, 5700 Svendborg, Denmark
| | - Pia N Kannegaard
- Department of Geriatric and Palliative Medicine, Bispebjerg-Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Solvejg G H Pedersen
- Department of Medicine 2, Geriatric section, Holbaek University Hospital, Smedelundsgade 60, 4300 Holbaek, Denmark.
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Pérez S, Layrón JE, Barrigón ML, Baca-García E, Marco JH. Perceived burdensomeness, thwarted belongingness, and hopelessness as predictors of future suicidal ideation in Spanish university students. Death Stud 2024; 48:454-464. [PMID: 37449532 DOI: 10.1080/07481187.2023.2235569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
The Interpersonal Theory of Suicide (IPTS) has received support for its role in understanding suicidal thoughts and behaviors. However, few longitudinal studies have focused on testing this theory in university students. The present study aimed to confirm the theoretical model of the IPTS in a sample of 225 Spanish university students, using path analysis in a longitudinal study. We assessed thwarted belongingness and perceived burdensomeness at T1 and hopelessness and suicidal ideation at T2, 12-14 weeks later. Moreover, we assessed suicidal ideation weekly for 14 weeks. Path analyses confirmed the Interpersonal Theory of Suicide model, with thwarted belongingness and perceived burdensomeness as direct and indirect predictors of suicidal ideation through hopelessness. Providers of guidance and clinical services in university settings should be trained to identify perceived burdensomeness, social belongingness, hopelessness, and suicidal ideation when screening for suicide prevention.
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Affiliation(s)
- Sandra Pérez
- Department of Personality, Assessment and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - Jose Enrique Layrón
- School of Doctorate, Universidad Católica de Valencia "San Vicente Mártir", Valencia, Spain
- Faculty of Psychology, International University of Valencia, Valencia, Spain
| | - Maria Luisa Barrigón
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Gregorio Marañón, Madrid, Spain
| | - Enrique Baca-García
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
- Department of Psychiatry, Centre Hospitalier Universitaire De Nîmes, Nîmes, France
- Universidad Autónoma de Madrid, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain
- Universidad Católica del Maule, Talca, Chile
- CIBERSAM (Centro de Investigación Biomédica en Red Salud Mental), Carlos III Institute of Health, Madrid, Spain
| | - Jose H Marco
- Department of Personality, Assessment and Psychological Treatments, Universidad de Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutricion (CIBEROBN), Madrid, Spain
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Abufarsakh B, Okoli CTC, Darville AK, Williams LB, Garcia AR, Martin C. Tobacco use behavior among adults exposed to cumulative adverse childhood experiences: A systematic review and meta analysis. Addict Behav 2024; 152:107948. [PMID: 38277993 DOI: 10.1016/j.addbeh.2023.107948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Tobacco use remains one of the most used substances among adults globally and substantially impacts individuals and society. Adverse childhood experiences (ACEs) contribute to tobacco use. However, the association between cumulative ACEs and tobacco use behaviors (TUB) has not been established in the literature. In this review, we aimed to estimate the prevalence of ACEs among adult tobacco users and evaluated the relationship between cumulative ACEs and TUB. METHODS We identified original articles published before October 2022 by searching PubMed, CINAHL, and Psych INFO databases. Inclusion criteria were: English language, adults and used instruments assessing for cumulative ACEs defined as four or more ACEs. RESULTS Forty-two studies, totaling 674,087 participants; predominantly cohort and cross-sectional in study design (n = 33). Exposure to 4 ≥ ACEs was significantly associated with increasing the odds of current tobacco use (n = 35), ever or former tobacco use (n = 13), tobacco use initiation, (n = 3) nicotine dependence (n = 1), and ever using electronic cigarettes (n = 1). In the meta-analysis, as compared to those without ACEs, those with 4 ≥ ACEs were twice as likely to have ever used tobacco (OR = 2.16, 95 %CI:1.73-2.70) and approximately four times more likely to have used tobacco currently (OR = 3.73, 95 %CI:2.69-5.18). CONCLUSION The cumulative ACEs exposure can increase the risk for TUB. However, the evidence is limited primarily to cigarette use. Ongoing research into the effects of cumulative ACEs on TUB is needed to integrate trauma-informed intervention in treating tobacco use and guide public health initiatives aimed to reduce the prevalence of ACEs and TUB among adults.
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Affiliation(s)
| | | | - Audrey K Darville
- University of Kentucky College of Nursing, Lexington, KY 40536, USA.
| | | | - Antonio R Garcia
- University of Kentucky College of Social Work, Lexington, KY 40508, USA.
| | - Catherine Martin
- University of Kentucky Health Care Good Samaritan Hospital, Lexington, KY 40508, USA.
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Liu Y, You S, Ding L, Yuan F, Sun Y. Hepatotoxic effects of chronic exposure to environmentally relevant concentrations of Di-(2-ethylhexyl) phthalate (DEHP) on crucian carp: Insights from multi-omics analyses. Sci Total Environ 2024; 923:171447. [PMID: 38447714 DOI: 10.1016/j.scitotenv.2024.171447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/08/2024]
Abstract
Di-(2-ethylhexyl) phthalate (DEHP) is an extensively used phthalate esters (PAEs) that raise growing ecotoxicological concerns due to detrimental effects on living organisms and ecosystems. This study performed hepatotoxic investigations on crucian carp under chronic low-dosage (CLD) exposure to DEHP at environmentally relevant concentrations (20-500 μg/L). The results demonstrated that the CLD exposure induced irreversible damage to the liver tissue. Multi-omics (transcriptomics and metabolomics) analyses revealed the predominant toxicological mechanisms underlying DEHP-induced hepatotoxicity by inhibiting energy production pathways and the up-regulation of the purine metabolism. Disruption of metabolic pathways led to excessive reactive oxygen species (ROS) production and subsequent oxidative stress. The adverse metabolic effects were exacerbated by an interplay between oxidative stress and endoplasmic reticulum stress. This study not only provides new mechanistic insights into the ecotoxicological effects of DEHP under chronic low-dosage exposure, but also suggests a potential strategy for further ecological risk assessment of PAEs.
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Affiliation(s)
- Yingjie Liu
- Heilongjiang River Fisheries Research Institute of Chinese Academy of Fishery Sciences, Laboratory of Quality & Safety Risk Assessment for Aquatic Products (Harbin), Ministry of Agriculture and Rural Areas, Harbin 150070, China
| | - Shijie You
- State Key Laboratory of Urban Water Resource and Environment, School of Environment, Harbin Institute of Technology, Harbin 150090, China
| | - Lu Ding
- Heilongjiang River Fisheries Research Institute of Chinese Academy of Fishery Sciences, Laboratory of Quality & Safety Risk Assessment for Aquatic Products (Harbin), Ministry of Agriculture and Rural Areas, Harbin 150070, China
| | - Fangying Yuan
- Heilongjiang River Fisheries Research Institute of Chinese Academy of Fishery Sciences, Laboratory of Quality & Safety Risk Assessment for Aquatic Products (Harbin), Ministry of Agriculture and Rural Areas, Harbin 150070, China
| | - Yanchun Sun
- Heilongjiang River Fisheries Research Institute of Chinese Academy of Fishery Sciences, Laboratory of Quality & Safety Risk Assessment for Aquatic Products (Harbin), Ministry of Agriculture and Rural Areas, Harbin 150070, China.
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Chowdhury S, Hänninen R, Sofiev M, Aunan K. Fires as a source of annual ambient PM 2.5 exposure and chronic health impacts in Europe. Sci Total Environ 2024; 922:171314. [PMID: 38423313 DOI: 10.1016/j.scitotenv.2024.171314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/29/2024] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Abstract
Chronic exposure to ambient PM2.5 is the largest environmental health risk in Europe. We used a chemical transport model and recent exposure response functions to simulate ambient PM2.5, contribution from fires and related health impacts over Europe from 1990 to 2019. Our estimation indicates that the excess death burden from exposure to ambient PM2.5 declined across Europe at a rate of 10,000 deaths per year, from 0.57 million (95 % confidence intervals: 0.44-0.75 million) in 1990 to 0.28 million (0.19-0.42 million) in the specified period. Among these excess deaths, approximately 99 % were among adults, while only around 1 % occurred among children. Our findings reveal a steady increase in fire mortality fractions (excess deaths from fires per 1000 deaths from ambient PM2.5) from 2 in 1990 to 13 in 2019. Notably, countries in Eastern Europe exhibited significantly higher fire mortality fractions and experienced more pronounced increases compared to those in Western and Central Europe. We performed sensitivity analyses by considering fire PM2.5 to be more toxic as compared to other sources, as indicated by recent studies. By considering fire PM2.5 to be more toxic than other PM2.5 sources results in an increased relative contribution of fires to excess deaths, reaching 2.5-13 % in 2019. Our results indicate the requirement of larger mitigation and adaptation efforts and more sustainable forest management policies to avert the rising health burden from fires.
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Affiliation(s)
| | | | | | - Kristin Aunan
- CICERO Center for International Climate Research, Oslo, Norway
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Stolicyn A, Harris MA, de Nooij L, Shen X, Macfarlane JA, Campbell A, McNeil CJ, Sandu AL, Murray AD, Waiter GD, Lawrie SM, Steele JD, McIntosh AM, Romaniuk L, Whalley HC. Disrupted limbic-prefrontal effective connectivity in response to fearful faces in lifetime depression. J Affect Disord 2024; 351:983-993. [PMID: 38220104 DOI: 10.1016/j.jad.2024.01.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/07/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Multiple brain imaging studies of negative emotional bias in major depressive disorder (MDD) have used images of fearful facial expressions and focused on the amygdala and the prefrontal cortex. The results have, however, been inconsistent, potentially due to small sample sizes (typically N<50). It remains unclear if any alterations are a characteristic of current depression or of past experience of depression, and whether there are MDD-related changes in effective connectivity between the two brain regions. METHODS Activations and effective connectivity between the amygdala and dorsolateral prefrontal cortex (DLPFC) in response to fearful face stimuli were studied in a large population-based sample from Generation Scotland. Participants either had no history of MDD (N=664 in activation analyses, N=474 in connectivity analyses) or had a diagnosis of MDD during their lifetime (LMDD, N=290 in activation analyses, N=214 in connectivity analyses). The within-scanner task involved implicit facial emotion processing of neutral and fearful faces. RESULTS Compared to controls, LMDD was associated with increased activations in left amygdala (PFWE=0.031,kE=4) and left DLPFC (PFWE=0.002,kE=33), increased mean bilateral amygdala activation (β=0.0715,P=0.0314), and increased inhibition from left amygdala to left DLPFC, all in response to fearful faces contrasted to baseline. Results did not appear to be attributable to depressive illness severity or antidepressant medication status at scan time. LIMITATIONS Most studied participants had past rather than current depression, average severity of ongoing depression symptoms was low, and a substantial proportion of participants were receiving medication. The study was not longitudinal and the participants were only assessed a single time. CONCLUSIONS LMDD is associated with hyperactivity of the amygdala and DLPFC, and with stronger amygdala to DLPFC inhibitory connectivity, all in response to fearful faces, unrelated to depression severity at scan time. These results help reduce inconsistency in past literature and suggest disruption of 'bottom-up' limbic-prefrontal effective connectivity in depression.
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Affiliation(s)
- Aleks Stolicyn
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom.
| | - Mathew A Harris
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom
| | - Laura de Nooij
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom; Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen 6525 EN, Netherlands
| | - Xueyi Shen
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom
| | - Jennifer A Macfarlane
- Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee DD1 9SY, United Kingdom; Department of Medical Physics, NHS Tayside, Dundee DD2 1UB, United Kingdom; SINAPSE Consortium(2), United Kingdom
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, United Kingdom
| | - Christopher J McNeil
- SINAPSE Consortium(2), United Kingdom; Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZN, United Kingdom
| | - Anca-Larisa Sandu
- SINAPSE Consortium(2), United Kingdom; Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZN, United Kingdom
| | - Alison D Murray
- SINAPSE Consortium(2), United Kingdom; Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZN, United Kingdom
| | - Gordon D Waiter
- SINAPSE Consortium(2), United Kingdom; Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZN, United Kingdom
| | - Stephen M Lawrie
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom
| | - J Douglas Steele
- Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee DD1 9SY, United Kingdom; SINAPSE Consortium(2), United Kingdom
| | - Andrew M McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom; SINAPSE Consortium(2), United Kingdom; Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, United Kingdom
| | - Liana Romaniuk
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom; SINAPSE Consortium(2), United Kingdom
| | - Heather C Whalley
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom; SINAPSE Consortium(2), United Kingdom; Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, United Kingdom
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Dang X, Yang R, Jing Q, Niu Y, Li H, Zhang J, Liu Y. Association between high or low-quality carbohydrate with depressive symptoms and socioeconomic-dietary factors model based on XGboost algorithm: From NHANES 2007-2018. J Affect Disord 2024; 351:507-517. [PMID: 38307135 DOI: 10.1016/j.jad.2024.01.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Depressive symptoms are a serious public mental health problem, and dietary intake is often considered to be associated with depressive symptoms. However, the relationship between the quality of dietary carbohydrates and depressive symptoms remains unclear. Therefore, this study aimed to investigate the relationship between high and low-quality carbohydrates and depressive symptoms and to attempt to construct an integrated model using machine learning to predict depressive symptoms. METHODS A total of 4982 samples from the National Health and Nutrition Examination Survey (NHANES) were included in this study. Carbohydrate intake was assessed by a 24-h dietary review, and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ9). Variance inflation factor (VIF) and Relief-F algorithms were used for variable feature selection. RESULTS The results of multivariate linear regression showed a negative association between high-quality carbohydrates and depressive symptoms (β: -0.147, 95 % CI: -0.239, -0.056, p = 0.002) and a positive association between low-quality carbohydrates and depressive symptoms (β: 0.018, 95 % CI: 0.007, 0.280, p = 0.001). Subsequently, we used the XGboost model to produce a comprehensive depressive symptom evaluation model and developed a corresponding online tool (http://8.130.128.194:5000/) to evaluate depressive symptoms clinically. LIMITATIONS The cross-sectional study could not yield any conclusions regarding causality, and the model has not been validated with external data. CONCLUSIONS Carbohydrate quality is associated with depressive symptoms, and machine learning models that combine diet with socioeconomic factors can be a tool for predicting depression severity.
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Affiliation(s)
- Xiangji Dang
- Department of Pharmaceutical, Lanzhou University Second Hospital, Cui Ying Men No.80, Lanzhou 730030, Gansu Province, PR China
| | - Ruifeng Yang
- School of Second Clinical Medical, Lanzhou University, Donggang West Road No. 199, Lanzhou 730020, PR China
| | - Qi Jing
- School of Second Clinical Medical, Lanzhou University, Donggang West Road No. 199, Lanzhou 730020, PR China
| | - Yingdi Niu
- Science and Technology Museum, Gansu, Yin'an Road No.568, Lanzhou 730070, PR China
| | - Hongjie Li
- School of Second Clinical Medical, Lanzhou University, Donggang West Road No. 199, Lanzhou 730020, PR China
| | - Jingxuan Zhang
- School of Second Clinical Medical, Lanzhou University, Donggang West Road No. 199, Lanzhou 730020, PR China
| | - Yan Liu
- School of Pharmacy, Lanzhou University, Donggang West Road No. 199, Gansu 730020, P.R. China.
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Jenkins JA, Draugelis-Dale RO, Hoffpauir NM, Baudoin BA, Matkin C, Driver L, Hodges S, Brown BL. Flow cytometric assessments of metabolic activity in bacterial assemblages provide insight into ecosystem condition along the Buffalo National River, Arkansas. Sci Total Environ 2024; 921:170462. [PMID: 38311076 DOI: 10.1016/j.scitotenv.2024.170462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/06/2024]
Abstract
The Buffalo National River (BNR), on karst terrain in Arkansas, is considered an extraordinary water resource. Water collected in Spring 2017 along BNR was metagenomically analyzed using 16S rDNA, and for 17 months (5/2017-11/2018), bacterial responses were measured in relation to nutrients sampled along a stretch of BNR near a concentrated animal feed operation (CAFO) on Big Creek. Because cell count and esterase activity can increase proportionally with organic enrichment, they were hypothesized to be elevated near the CAFO. Counts (colony forming units; CFUs) were different among sites for 73 % of the months; Big Creek generated highest CFUs 27 % of the time, with the closest downstream site at 13.3 %. Esterase activity was different among sites 94 % of the time, with Big Creek exhibiting lowest activity 71 % of the time. Over the months, activity was similar across sites at ~70 % active, except at Big Creek (56 %). The α-diversity of BNR microbial consortia near a wastewater treatment plant (WWTP) and the CAFO was related to distance from the WWTP and CAFO. The inverse relationship between high CFUs and low esterase activity at Big Creek (r = -0.71) actuated in vitro exposures of bacteria to organic wastewater contaminants (OWC) previously identified in the watershed. Exponential-phase Escherichia coli (stock strain), Streptococcus suis (avirulent, from swine), and S. dysgalactiae (virulent, from silver carp, Hypophthalmichthys molitrix) were incubated with atrazine, pharmaceuticals (17 α-ethynylestradiol and trenbolone), and antimicrobials (tylosin and butylparaben). Bacteria were differentially responsive. Activity varied with exposure time and OWC type, but not concentration; atrazine decreased it most. Taken together - the metagenomic taxonomic similarities along BNR, slightly higher bacterial growth and lower bacterial esterase at the CAFO, and the lab exposures of bacterial strains showing that OWC altered metabolism - the results indicated that bioactive OWC entering the watershed can strongly influence microbial processes in the aquatic ecosystem.
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Affiliation(s)
- Jill A Jenkins
- U.S. Geological Survey, Wetland and Aquatic Research Center, 700 Cajundome Blvd., Lafayette, LA 70506, USA.
| | - Rassa O Draugelis-Dale
- U.S. Geological Survey, Wetland and Aquatic Research Center, 700 Cajundome Blvd., Lafayette, LA 70506, USA
| | - Nina M Hoffpauir
- U.S. Geological Survey, Wetland and Aquatic Research Center, 700 Cajundome Blvd., Lafayette, LA 70506, USA
| | - Brooke A Baudoin
- U.S. Geological Survey, Wetland and Aquatic Research Center, 700 Cajundome Blvd., Lafayette, LA 70506, USA
| | - Caroline Matkin
- U.S. Geological Survey, Wetland and Aquatic Research Center, 700 Cajundome Blvd., Lafayette, LA 70506, USA.
| | - Lucas Driver
- U.S. Geological Survey, Lower Mississippi-Gulf Water Science Center, 401 Hardin Rd., Little Rock, AR 72211, USA.
| | - Shawn Hodges
- Buffalo National River, National Park Service, 402 N. Walnut St., Harrison, AR 72601, USA.
| | - Bonnie L Brown
- Department of Biological Sciences, University of New Hampshire, 105 Main St., Durham, NH 03824, USA.
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Tchonkouang RD, Onyeaka H, Nkoutchou H. Assessing the vulnerability of food supply chains to climate change-induced disruptions. Sci Total Environ 2024; 920:171047. [PMID: 38373458 DOI: 10.1016/j.scitotenv.2024.171047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/19/2024] [Accepted: 02/15/2024] [Indexed: 02/21/2024]
Abstract
Climate change is one of the most significant challenges worldwide. There is strong evidence from research that climate change will impact several food chain-related elements such as agricultural output, incomes, prices, food access, food quality, and food safety. This scoping review seeks to outline the state of knowledge of the food supply chain's vulnerability to climate change and to identify existing literature that may guide future research, policy, and decision-making aimed at enhancing the resilience of the food supply chain. A total of 1526 publications were identified using the SCOPUS database, of which 67 were selected for the present study. The vulnerability assessment methods as well as the adaptation and resilience measures that have been employed to alleviate the impact of climate change in the food supply chain were discussed. The results revealed a growing number of publications providing evidence of the weakening of the food supply chain due to climate change and extreme weather events. Our assessment demonstrated the need to broaden research into the entire food supply chain and various forms of climatic variability because most studies have concentrated on the relationships between climatic fluctuations (especially extreme rainfall, temperatures, and drought) and production. A lack of knowledge about the effects of climate change on the food supply chain and the underlying socio-economic consequences could result in underperformance or failure of the food supply chain.
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Affiliation(s)
- Rose Daphnee Tchonkouang
- MED-Mediterranean Institute for Agriculture, Environment and Development & Change-Global Change and Sustainability Institute, Faculty of Sciences and Technology, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Helen Onyeaka
- School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom.
| | - Hugue Nkoutchou
- Public Policy in Africa Initiative (PPiAI), Douala, Cameroon
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Wang S, Zhang T, Li Z, Hong J. Exploring pollutant joint effects in disease through interpretable machine learning. J Hazard Mater 2024; 467:133707. [PMID: 38335621 DOI: 10.1016/j.jhazmat.2024.133707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/16/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
Identifying the impact of pollutants on diseases is crucial. However, assessing the health risks posed by the interplay of multiple pollutants is challenging. This study introduces the concept of Pollutants Outcome Disease, integrating multidisciplinary knowledge and employing explainable artificial intelligence (AI) to explore the joint effects of industrial pollutants on diseases. Using lung cancer as a representative case study, an extreme gradient boosting predictive model that integrates meteorological, socio-economic, pollutants, and lung cancer statistical data is developed. The joint effects of industrial pollutants on lung cancer are identified and analyzed by employing the SHAP (Shapley Additive exPlanations) interpretable machine learning technique. Results reveal substantial spatial heterogeneity in emissions from CPG and ILC, highlighting pronounced nonlinear relationships among variables. The model yielded strong predictions (an R of 0.954, an RMSE of 4283, and an R2 of 0.911) and emphasized the impact of pollutant emission amounts on lung cancer responses. Diverse joint effects patterns were observed, varying in terms of patterns, regions (frequency), and the extent of antagonistic and synergistic effects among pollutants. The study provides a new perspective for exploring the joint effects of pollutants on diseases and demonstrates the potential of AI technology to assist scientific discovery.
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Affiliation(s)
- Shuo Wang
- Shandong Key Laboratory of Environmental Processes and Health, School of Environmental Science and Engineering, Shandong University, Qingdao 266237, China
| | - Tianzhuo Zhang
- Shandong Key Laboratory of Environmental Processes and Health, School of Environmental Science and Engineering, Shandong University, Qingdao 266237, China
| | - Ziheng Li
- Shandong Key Laboratory of Environmental Processes and Health, School of Environmental Science and Engineering, Shandong University, Qingdao 266237, China
| | - Jinglan Hong
- Shandong Key Laboratory of Environmental Processes and Health, School of Environmental Science and Engineering, Shandong University, Qingdao 266237, China; Shandong University Climate Change and Health Center, Public Health School, Shandong University, Jinan 250012, China.
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Lee CS, Sirin SR, Choi E, Sin EJ. Meta-Analysis of Acculturation and Suicide-Related Outcomes: A Test of the Immigrant Paradox. J Racial Ethn Health Disparities 2024; 11:913-927. [PMID: 36943654 DOI: 10.1007/s40615-023-01572-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE This meta-analysis aimed to systematically test the relation between acculturation and suicide-related outcomes among immigrants, with attention to key methodological (i.e., measure of suicide-related outcome, measure of acculturation) and demographic (i.e., race, gender, age, geographic region, publication year) moderators. METHOD We conducted a meta-analysis of 72 independent samples from 50 studies (38 peer-reviewed articles, 12 dissertations) representing more than 1.4 million immigrants. Participants' age ranged from 11.20 to 74.70 years (M = 29.96, SD = 15.07). Random effects models were used for both main and moderation analyses. RESULTS We found significant positive associations between acculturation and suicidal ideation, but not suicide attempts and deaths. We also found a significant and positive effect of acculturation on suicide-related outcomes when acculturation was measured by psychological scales, but not by generation status, length of residence in the host country, and proficiency in the host country's language. More acculturated Latinx immigrants were at higher risk for suicide-related outcomes, whereas a reverse pattern was found among Asian immigrants. Meta-regressions revealed that the moderating effects of participants' age and publication year were also significant. CONCLUSION Our results show partial support for the immigrant paradox but suggest that the relation between acculturation and suicide-related outcomes is complex and multifaceted. We discuss the implications of our findings and recommendations for research and prevention.
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Affiliation(s)
- Christina Seowoo Lee
- Department of Applied Psychology, New York University, 246 Greene St, New York, NY, 10004, USA.
| | - Selcuk R Sirin
- Department of Applied Psychology, New York University, 246 Greene St, New York, NY, 10004, USA
| | - Elysia Choi
- Department of Applied Psychology, New York University, 246 Greene St, New York, NY, 10004, USA
| | - Esther J Sin
- Department of Applied Psychology, New York University, 246 Greene St, New York, NY, 10004, USA
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Caemmerer JM, Hennessy B, Niileksela CR. Third variables in longitudinal research: Application of longitudinal mediation and moderation in school psychology. J Sch Psychol 2024; 103:101283. [PMID: 38432732 DOI: 10.1016/j.jsp.2024.101283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 07/12/2023] [Accepted: 01/04/2024] [Indexed: 03/05/2024]
Abstract
Third variable models, such as mediation and moderation, can identify contextual factors that help explain the relation between two variables. Although used less frequently in school psychology research, longitudinal mediation, longitudinal moderation, and the integration of these two approaches can be used to describe the developmental changes in children's psychological and behavioral processes throughout the school years and beyond. This article provides conceptual descriptions of longitudinal mediation, longitudinal moderation, longitudinal moderated mediation, and longitudinal mediated moderation and demonstrates the use of these methods with a large sample of elementary students. Extensions of these methods and applied examples from the literature are also discussed. The Mplus syntax from our illustrated examples are provided for those interested in reproducing the analyses.
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Affiliation(s)
- Jacqueline M Caemmerer
- University of Connecticut, Neag School of Education, 249 Glenbrook Road, Storrs, CT 06269, USA.
| | - Briana Hennessy
- University of Connecticut, Neag School of Education, 249 Glenbrook Road, Storrs, CT 06269, USA.
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50
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Kranjac AW, Kranjac D, Kain ZN, Ehwerhemuepha L, Jenkins BN. Obesity Heterogeneity by Neighborhood Context in a Largely Latinx Sample. J Racial Ethn Health Disparities 2024; 11:980-991. [PMID: 36997832 PMCID: PMC10933170 DOI: 10.1007/s40615-023-01578-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/27/2023] [Accepted: 03/19/2023] [Indexed: 04/01/2023]
Abstract
Neighborhood socioeconomic context where Latinx children live may influence body weight status. Los Angeles County and Orange County of Southern California both are on the list of the top ten counties with the largest Latinx population in the USA. This heterogeneity allowed us to estimate differential impacts of neighborhood environment on children's body mass index z-scores by race/ethnicity using novel methods and a rich data source. We geocoded pediatric electronic medical record data from a predominantly Latinx sample and characterized neighborhoods into unique residential contexts using latent profile modeling techniques. We estimated multilevel linear regression models that adjust for comorbid conditions and found that a child's place of residence independently associates with higher body mass index z-scores. Interactions further reveal that Latinx children living in Middle-Class neighborhoods have higher BMI z-scores than Asian and Other Race children residing in the most disadvantaged communities. Our findings underscore the complex relationship between community racial/ethnic composition and neighborhood socioeconomic context on body weight status during childhood.
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Affiliation(s)
- Ashley W Kranjac
- Department of Sociology, Chapman University, Orange, CA, USA
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA
| | - Dinko Kranjac
- Department of Psychology, Institute for Mental Health and Psychological Well-Being, University of La Verne, La Verne, CA, USA
| | - Zeev N Kain
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA
- Yale Child Study Center, Yale University, New Haven, CT, USA
| | | | - Brooke N Jenkins
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA.
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA.
- Department of Psychology, Chapman University, One University Drive, Orange, CA, 92866, USA.
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