Public Health最新文献

{"title":"Impact of COVID-19 mitigation measures on perinatal outcomes in the Netherlands","authors":"Lizbeth Burgos-Ochoa ,&nbsp;Loes CM. Bertens ,&nbsp;Nienke W. Boderie ,&nbsp;Benjamin Y. Gravesteijn ,&nbsp;Sylvia Obermann-Borst ,&nbsp;Ageeth Rosman ,&nbsp;Jeroen Struijs ,&nbsp;Jeremy Labrecque ,&nbsp;Christianne J. de Groot ,&nbsp;Jasper V. Been","doi":"10.1016/j.puhe.2024.09.002","DOIUrl":"10.1016/j.puhe.2024.09.002","url":null,"abstract":"<div><h3>Objective</h3><p>Investigate the acute impact of COVID-19 mitigation measures implemented in March 2020 on a comprehensive range of perinatal outcomes.</p></div><div><h3>Study design</h3><p>National registry-based quasi-experimental study.</p></div><div><h3>Methods</h3><p>We obtained data from the Dutch Perinatal Registry (2010–2020) which was linked to multiple population registries containing sociodemographic variables. A difference-in-discontinuity approach was used to examine the impact of COVID-19 mitigation measures on various perinatal outcomes. We investigated preterm birth incidence across onset types, alongside other perinatal outcomes including low birth weight, small-for-gestational-age, NICU admission, low-APGAR-score, perinatal mortality, neonatal death, and stillbirths.</p></div><div><h3>Results</h3><p>The analysis of the national-level dataset revealed a consistent pattern of reduced preterm births after the enactment of COVID-19 mitigation measures on March 9, 2020 (OR = 0.80, 95% CI 0.68–0.96). A drop in spontaneous preterm births post-implementation was observed (OR = 0.80, 95% CI 0.62–0.98), whereas no change was observed for iatrogenic births. Regarding stillbirths (OR = 0.95, 95% CI 0.46–1.95) our analysis did not find compelling evidence of substantial changes. For the remaining outcomes, no discernible shifts were observed.</p></div><div><h3>Conclusions</h3><p>Our findings confirm the reduction in preterm births following COVID-19 mitigation measures in the Netherlands. No discernible changes were observed for other outcomes, including stillbirths. Our results challenge previous concerns of a potential increase in stillbirths contributing to the drop in preterm births, suggesting alternative mechanisms.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"236 ","pages":"Pages 322-327"},"PeriodicalIF":3.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S003335062400386X/pdfft?md5=bbec833d93624af6388fc119c7d8fa6e&pid=1-s2.0-S003335062400386X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contributions of injury deaths to the changes in sex gaps in life expectancy and life disparity in the Nordic countries in the 21st century","authors":"A. Kiadaliri","doi":"10.1016/j.puhe.2024.08.013","DOIUrl":"10.1016/j.puhe.2024.08.013","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this study was to provide novel comparative insights on the contributions of injury deaths to the changes in sex gaps in life expectancy (SGLE) and sex gaps in life disparity (SGLD) across Nordic countries.</p></div><div><h3>Study design</h3><p>Retrospective demographic analysis of aggregated mortality data.</p></div><div><h3>Methods</h3><p>To compute life expectancy (LE)/life disparity (LD), annual data on age- and sex-specific causes of death from the World Health Organization mortality database were used to construct abridged life tables for two periods: 2000–2002 and 2016–2018 (2014–2016 for Norway). The contributions of injury deaths to the changes in the SGLE and SGLD between these two periods were decomposed by age and cause using a continuous-change model.</p></div><div><h3>Results</h3><p>Females’ LE and LD advantages due to injury deaths narrowed by 0.16–0.44 (0.06–0.35) years for LE (LD) over time. While self-inflicted injuries consistently played a predominant role in contributing to the SGLE/SGLD in all countries in both periods, in all countries but Finland, transport accidents had the greatest contributions to the narrowing SGLE/SGLD. Widening SGLE due to self-inflicted injuries in Iceland and due to falls in Sweden were unique to these countries. Accounting for &gt;20% of total contributions of injury deaths, the age group of 20–24 years had the greatest contributions to the narrowing SGLE/SGLD. Deaths due to falls in older ages and assault in younger ages generally contributed to the widening SGLE/SGLD.</p></div><div><h3>Conclusions</h3><p>Injury deaths, particularly transport accidents, contributed significantly to the narrowing SGLE and SGLD across Nordic countries, with cross-country variations in age- and cause-specific patterns. The results suggest the need for injury prevention policies targeting self-inflicted injuries in younger and falls in older males.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"236 ","pages":"Pages 315-321"},"PeriodicalIF":3.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033350624003585/pdfft?md5=68443d206baefed2a49bc3b47d73ee9c&pid=1-s2.0-S0033350624003585-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality in extreme heat events: an analysis of Los Angeles County Medical Examiner data","authors":"L. Baker ,&nbsp;R. Sturm","doi":"10.1016/j.puhe.2024.08.008","DOIUrl":"10.1016/j.puhe.2024.08.008","url":null,"abstract":"<div><h3>Objectives</h3><p>Climate change is intensifying heat events, and local governments are working to absorb and mitigate the associated costs. To develop effective responses, local data on the relationship between climate and health are crucial. This study investigates the impact of heat events on unexpected mortality, focusing on deaths investigated by the Medical Examiner in Los Angeles County.</p></div><div><h3>Study design</h3><p>A retrospective observational study.</p></div><div><h3>Methods</h3><p>We estimate the associations between the National Weather Service's HeatRisk index and deaths investigated by the Medical Examiner in Los Angeles County using negative binomial count models with controls for time trends and seasonality. In subgroup analyses, we explore how these effects vary for those who are homeless or living in care facilities.</p></div><div><h3>Results</h3><p>Compared to days with no HeatRisk, days with moderate, major, or extreme HeatRisk were associated with death increases of 6.7% [CI: 1.9–11.7%], 15.3% [CI: 2.9–29.1%], and 65.5% [CI: 34.9–102.1%], respectively. Effects were more pronounced for individuals who were homeless or in care facilities. Major or extreme heat days were associated with a 59.3% [CI: 19.8–109.4%] increase in deaths among homeless individuals and a 91.4% [CI: 19.0–198.6%] increase in deaths among those in care facilities.</p></div><div><h3>Conclusions</h3><p>Heat events have a significant impact on mortality investigated by the Medical Examiner, especially among vulnerable groups. Local governments may consider using the warning tools provided by the National Weather Service to focus their resources on the most intense heat events, especially to target those living in care facilities or who are homeless.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"236 ","pages":"Pages 290-296"},"PeriodicalIF":3.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033350624003548/pdfft?md5=5af1e3bdcf00d243da61e188fb389c1a&pid=1-s2.0-S0033350624003548-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Us versus Them”: is the voice of the community heard when planning communication screening programmes for preschoolers?","authors":"V.Z. Peter ,&nbsp;P. Rea ,&nbsp;M. Pillay ,&nbsp;Y. Saman","doi":"10.1016/j.puhe.2024.08.003","DOIUrl":"10.1016/j.puhe.2024.08.003","url":null,"abstract":"<div><h3>Objectives</h3><p>Community consultation is necessary to ensure the uptake and use of community-based screening intervention to detect early childhood disabilities, as its absence can result in poor service acceptance and usage. To document stakeholders' perspectives regarding planning a community-based communication disorder (an impairment in the ability to receive, send, process and comprehend concepts or verbal, non-verbal and graphic symbol systems) screening programmes for pre-schoolers.</p></div><div><h3>Study design</h3><p>This qualitative research design used purposive and random sampling to recruit 46 participants from eThekwini Municipality, South Africa. These stakeholders consisted of caregivers/parents of children who underwent screening for communication disorders, People who are Deaf, their parents, early childhood development practitioners, health professionals and government officials involved with children with disabilities. All participants were adults aged between 19 and 79 years, with an average age of 39.7 years.</p></div><div><h3>Methods</h3><p>Data was collected through focus group discussions and individual interviews, which were thematically analysed.</p></div><div><h3>Results</h3><p>The four emergent themes were screening approaches, methods, location and personnel. Service users expected greater access to screening and reliable tests to identify problems by trained personnel at sites within the community. Service providers preferred a targeted approach to screening with parental input. Task shifting and sharing were seen as a solution to address staff shortages and provide services at health facilities, as resource constraints made it challenging to provide outreach services.</p></div><div><h3>Conclusion</h3><p>Stakeholder engagement revealed diverging views between service users and providers, with implications for programme provision and uptake. There is a need for ongoing, inclusive discussion to ensure consensus during the planning stage, in order to render services that address issues of equity and accessibility for people with disabilities in marginalised communities.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"236 ","pages":"Pages 297-306"},"PeriodicalIF":3.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033350624003470/pdfft?md5=ea9c9b6f2f63e27d84eef93bfdfd2605&pid=1-s2.0-S0033350624003470-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leprosy in Brazil: an analysis of the Global Burden of Disease estimates between 1990 and 2019","authors":"V.E.M. de Araújo ,&nbsp;G.A. Veloso ,&nbsp;L.R.F.S. Kerr ,&nbsp;J.M. Pescarini ,&nbsp;L.S. de M. Cardoso ,&nbsp;M. Naghavi ,&nbsp;D.C. Malta ,&nbsp;the Unit on the Social and Environmental Determinants of Health Inequalities (SEDHI)","doi":"10.1016/j.puhe.2024.07.035","DOIUrl":"10.1016/j.puhe.2024.07.035","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the occurrence of leprosy in Brazil and its states between 1990 and 2019, according to Global Burden of Disease (GBD) estimates, and its correlation with development status.</p></div><div><h3>Study design</h3><p>A descriptive and analytical ecological epidemiological study.</p></div><div><h3>Methods</h3><p>Rates of incidence, prevalence, and years lived with disability (YLD) due to leprosy, standardized by age, per 100,000 inhabitants, were analyzed. The trend analysis consisted of the joinpoint regression model and the average annual percentage change. The correlation between the incidence rate and the sociodemographic index (SDI) was investigated (Spearman test) at a 5% significance level. Incidence, prevalence and YLD rates were presented by country's states, sex, and age.</p></div><div><h3>Results</h3><p>There was an average percentage decrease of −1.1% per year (<em>P</em> &lt; 0.001) in the incidence rate in the country and, between 1990 and 2019, a decline from 4.8 to 3.5 per 100,000 inhabitants; prevalence from 26.1 to 22.2, and YLD from 1.1 to 1.0. The incidence rate was higher among men and the elderly. Maranhão (7.0 in 1990; 4.2 in 2019), Alagoas (6.6 in 1990; 4.1 in 2019), Acre (6.1 in 1990; 4.0 in 2019), Mato Grosso (5.2 in 1990 and 3.7 in 2019), and Mato Grosso do Sul (4.8 in 1990 and 3.7 in 2019) presented the highest incidence rates. A negative correlation was observed between SDI levels and leprosy incidence rates in 1990 (R = −0.71; <em>P</em> &lt; 0.0001) and 2019 (R = −0.81; <em>P</em> &lt; 0.0001).</p></div><div><h3>Conclusions</h3><p>Despite the decrease in the rates of leprosy incidence, prevalence, and YLDs over the analyzed period, Brazil has a long way towards achieving its eradication. The greater burden of the disease in males stands out. The estimated risk of the disease was higher in the states with the lowest SDI levels. Therefore, interventions must consider the heterogeneity of the disease burden geographically and between sociodemographic groups.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"236 ","pages":"Pages 307-314"},"PeriodicalIF":3.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033350624003536/pdfft?md5=0431faed07e0a0df623f4d9971bbddd4&pid=1-s2.0-S0033350624003536-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explaining the role of socioeconomic, healthcare access and infrastructural shifts in nutritional transition among women in Bangladesh between 2004 and 2018","authors":"M.M. Khudri ,&nbsp;P.B. Chowdhury ,&nbsp;S. Hossain ,&nbsp;K.Z. Ahsan","doi":"10.1016/j.puhe.2024.08.010","DOIUrl":"10.1016/j.puhe.2024.08.010","url":null,"abstract":"<div><h3>Objectives</h3><p>Shifts in socioeconomic factors, healthcare access, lifestyle and infrastructure facilities have resulted in increased body mass index (BMI) of populations in developing countries. These shifts result in a large increase in overweight and obese individuals, with a corresponding decline in the number of those who are underweight. Although this nutritional transition among women in Bangladesh is evident, studies elucidating such change are scarce. This study aimed to explain how socioeconomic, healthcare access and infrastructural shifts contributed to the nutritional transition among women of childbearing age in Bangladesh between 2004 and 2018.</p></div><div><h3>Study design</h3><p>Repeated cross-sectional study of respondents who participated in the latest five rounds of Bangladesh Demographic Health Surveys (BDHS) from 2004 to 2017–18.</p></div><div><h3>Methods</h3><p>Applying counterfactual decomposition techniques to data from the latest five rounds of BDHS, this study examined how variations in observed nutrition-related determinants, and returns to them across rounds, contributed to the nutritional transition among women of childbearing age.</p></div><div><h3>Results</h3><p>Shifts in nutritional outcomes were primarily attributed to gains in partner's education, improved access to healthcare, a decline in breastfeeding practice and the number of births. Wealth accumulation, contraception and improved sanitation facilities appeared as secondary contributing factors. Additionally, this study identified that the BMI gap widened between the lower and the upper quantile of the distribution over the study period.</p></div><div><h3>Conclusions</h3><p>Addressing the rise in BMI and the prevalence of overnutrition is imperative for the future health of the population in Bangladesh. Considering the study findings and existing national nutrition policies and programmes, it is evident that targeted policy interventions, programmatic approaches and multisectoral collaborations are essential.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"236 ","pages":"Pages 268-273"},"PeriodicalIF":3.9,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between adherence to 24-Hour Movement Guidelines with continuous metabolic syndrome score among Chinese children and adolescents","authors":"Fangqu Liu ,&nbsp;Bingxuan Kong ,&nbsp;Zhuangyu Zhang ,&nbsp;Li Chen ,&nbsp;Yan Li ,&nbsp;Jingfan Xiong ,&nbsp;Ping Yao ,&nbsp;Yanyan Li ,&nbsp;Yuhan Tang","doi":"10.1016/j.puhe.2024.08.005","DOIUrl":"10.1016/j.puhe.2024.08.005","url":null,"abstract":"<div><h3>Objectives</h3><p>The objective of this study was to evaluate the associations between adherence to 24-Hour Movement Guidelines (24-HMG) with continuous metabolic syndrome score (cMetS) among Chinese children.</p></div><div><h3>Study design</h3><p>Cross-sectional study.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional study among 4604 children aged 6–17 years from Shenzhen, China. The 24-HMG was constructed using the self-report information on moderate-to-vigorous physical activity (MVPA), screen time (ST), and sleep duration. The cMetS was calculated based on waist circumference, homoeostatic model assessment for insulin resistance, mean arterial blood pressure, high-density lipoprotein cholesterol, and triglyceride. Multivariate linear regression models were used to assess the associations between adherence to recommendations of 24-HMG and cMetS.</p></div><div><h3>Results</h3><p>Among the participants, 563 (12.23%) students adhered to 3 recommendations of the 24-HMG. We found that adhering to more recommendations was negatively associated with cMetS (<em>P</em> for trend: &lt;0.001). For specific combinations, meeting the ST + MVPA recommendations was negatively associated with cMetS (coefficients [β]: −0.686; 95% confidence interval [CI]: −1.148, −0.223). Individuals who adhered to all recommendations had a lower cMetS (β: −0.693; 95% CI: −1.147, −0.238) than those who met none of the recommendations.</p></div><div><h3>Conclusions</h3><p>Our study showed that adherence to more recommendations of the 24-HMG was associated with lower levels of cMetS in Chinese children and adolescents.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"236 ","pages":"Pages 274-280"},"PeriodicalIF":3.9,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors associated with undiagnosed hypertension among adults aged 15–49 years in India: insights from the National Family Health Survey (NFHS-5)","authors":"P. Sahadevan ,&nbsp;A. Sasidharan ,&nbsp;B. Bhavani Shankara ,&nbsp;A. Pal ,&nbsp;D. Kumari ,&nbsp;M. Murhekar ,&nbsp;P. Kaur ,&nbsp;V.K. Kamal","doi":"10.1016/j.puhe.2024.07.032","DOIUrl":"10.1016/j.puhe.2024.07.032","url":null,"abstract":"<div><h3>Objectives</h3><p>To estimate the prevalence and identify the factors associated with undiagnosed hypertension in India.</p></div><div><h3>Study design</h3><p>A secondary data analysis using the National Family Health Survey (NFHS-5) covering the period 2019–2021.</p></div><div><h3>Methods</h3><p>Information on hypertension among individuals aged 15–49 years was extracted from the survey dataset. We estimated the prevalence of undiagnosed hypertension using physical measurements along with self-reported data from the survey. A log-binomial model with survey-adjusted Poisson regression was used to estimate the prevalence ratio between undiagnosed and diagnosed hypertension. Multinomial logistic regression analysis examined the factors associated with diagnosed hypertension (vs healthy) and undiagnosed hypertension (vs healthy). All the analyses were survey-weight adjusted and stratified by gender.</p></div><div><h3>Results</h3><p>The survey-adjusted prevalence of undiagnosed hypertension was 8.75% (8.62%–8.87%) and was higher among males [13.56% (13.03%–14.12%)] than in females [8.14% (8.03%–8.25%)]. The proportion of individuals with undiagnosed hypertension among total hypertension was 44.99% (44.44%–45.55%) and was higher in males [65.94% (64.25%–67.60%)] than in females [42.18% (41.66%–42.71%)].</p></div><div><h3>Conclusions</h3><p>Our findings revealed that age, higher body mass index, no access to health care, and having no comorbidities were risk factors for undiagnosed hypertension. One in twelve people had undiagnosed hypertension, and of those with hypertension, one in two were undiagnosed, with males being disproportionately affected. Targeted public health interventions are crucial to improve hypertension screening, particularly among middle-aged and obese individuals without comorbidities.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"236 ","pages":"Pages 250-260"},"PeriodicalIF":3.9,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A longitudinal study of learning difficulties in adolescence and biomarkers of cardiometabolic risk in adulthood: A gendered pathways approach","authors":"Minsung Sohn ,&nbsp;Gum-Ryeong Park ,&nbsp;Jinho Kim","doi":"10.1016/j.puhe.2024.09.008","DOIUrl":"10.1016/j.puhe.2024.09.008","url":null,"abstract":"<div><h3>Objectives</h3><p>Little is known about the relationship between learning difficulties (LD) in adolescence and physical health in adulthood. This study investigates the gender-specific pathways through which LD is longitudinally associated with cardiometabolic risk in adulthood.</p></div><div><h3>Study design</h3><p>We used data from the National Longitudinal Study of Adolescent to Adult Health (<em>N</em> = 11,342). To assess cardiometabolic risk, 11 biomarkers related to cardiovascular functioning, glucose metabolism, lipid metabolism, and inflammation were utilized.</p></div><div><h3>Methods</h3><p>We first estimated the association between LD in adolescence and cardiometabolic risk in adulthood. Then, we examined whether this association is mediated by educational attainment and body mass index (BMI). Finally, we employed a moderated mediation model to determine whether gender moderates these mediation patterns.</p></div><div><h3>Results</h3><p>LD in adolescence was positively associated with cardiometabolic risk in adulthood (<em>b</em> = 0.165, <em>p</em> &lt; 0.001). LD also predicted lower educational attainment (<em>b</em> = −0.724, <em>p</em> &lt; 0.001) and higher BMI (<em>b</em> = 0.589, <em>p</em> &lt; 0.05). Educational attainment and BMI explained 18 and 25 percent of the positive association between LD and cardiometabolic risk, respectively. A moderated mediation model revealed that indirect effects of LD on cardiometabolic risk via educational attainment and BMI were more pronounced among women than men.</p></div><div><h3>Conclusion</h3><p>LD in adolescence is a significant predictor of cardiometabolic risk in adulthood. Interventions focusing on the academic and health behaviors of girls with LD may be effective in improving their adult physical health.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"236 ","pages":"Pages 281-289"},"PeriodicalIF":3.9,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting the risk of nursing home placement of elderly persons using a population-based stratification score","authors":"Giovanni Corrao ,&nbsp;Matteo Franchi ,&nbsp;Gloria Porcu ,&nbsp;Alina Tratsevich ,&nbsp;Andrea Stella Bonaugurio ,&nbsp;Giulio Zucca ,&nbsp;Danilo Cereda ,&nbsp;Olivia Leoni ,&nbsp;Guido Bertolaso","doi":"10.1016/j.puhe.2024.08.030","DOIUrl":"10.1016/j.puhe.2024.08.030","url":null,"abstract":"<div><h3>Objective</h3><p>To develop and validate a novel score predictive of nursing home placement in elderly.</p></div><div><h3>Study design</h3><p>Population-based case-control study based on healthcare utilization databases of Lombardy, a region of Northern Italy.</p></div><div><h3>Methods</h3><p>The 2.4 million citizens aged ≥65 years who on January 1, 2018 lived outside nursing home formed the target population. Cases were citizens who experienced nursing home admission (the outcome of interest) until December 31, 2019. Cases were matched 1:1 by gender, age, and municipality of residence to one control. Conditional logistic regression was fitted to select candidate predictors (the exposure to 69 clinical conditions and 11 social and healthcare services) independently associated with the outcome. The model was built from the 26,156 cases, and as many controls (training set), and applied to a validation set (15,807 case-control couples). Predictive performance was assessed by discrimination and calibration.</p></div><div><h3>Results</h3><p>Twenty-one factors were identified as predictive of nursing home admission and were included in the “Elderly Nursing Home Placement” (ENHP) score. Mental health disorders and chronic neurological illnesses contributed most to prediction of nursing home admission. ENHP performance showed an area under the receiver operating characteristic curve of 0.77 and a remarkable calibration of observed and predicted outcome risk.</p></div><div><h3>Conclusions</h3><p>A simple score derived from data used for public health management may reliably predict the risk of nursing home placement in elderly. Its use by healthcare decision makers allows to accurately identify high-risk individuals who need home services, thereby avoiding admission to nursing homes.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"236 ","pages":"Pages 224-229"},"PeriodicalIF":3.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033350624003834/pdfft?md5=a7b20ddb73a2d9d1b2ae62ac8d21da28&pid=1-s2.0-S0033350624003834-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142173127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}