Annual Review of Public Health最新文献

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Lessons Learned from Immigrant Health Cohorts: A Review of the Evidence and Implications for Policy and Practice in Addressing Health Inequities among Asian Americans, Native Hawaiians, and Pacific Islanders 从移民健康群组中汲取的经验教训:解决亚裔美国人、夏威夷原住民和太平洋岛民健康不平等问题的证据及对政策和实践的影响综述
IF 20.8 1区 医学
Annual Review of Public Health Pub Date : 2023-12-18 DOI: 10.1146/annurev-publhealth-060922-040413
Alice Guan, AC S. Talingdan, Sora P. Tanjasiri, Alka M. Kanaya, Scarlett L. Gomez
{"title":"Lessons Learned from Immigrant Health Cohorts: A Review of the Evidence and Implications for Policy and Practice in Addressing Health Inequities among Asian Americans, Native Hawaiians, and Pacific Islanders","authors":"Alice Guan, AC S. Talingdan, Sora P. Tanjasiri, Alka M. Kanaya, Scarlett L. Gomez","doi":"10.1146/annurev-publhealth-060922-040413","DOIUrl":"https://doi.org/10.1146/annurev-publhealth-060922-040413","url":null,"abstract":"The health of Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) is uniquely impacted by structural and social determinants of health (SSDH) shaped by immigration policies and colonization practices, patterns of settlement, and racism. These SSDH also create vast heterogeneity in disease risks across the AANHPI population, with some ethnic groups having high disease burden, often masked with aggregated data. Longitudinal cohort studies are an invaluable tool to identify risk factors of disease, and epidemiologic cohort studies among AANHPI populations have led to seminal discoveries of disease risk factors. This review summarizes the limited but growing literature, with a focus on SSDH factors, from seven longitudinal cohort studies with substantial AANHPI samples. We also discuss key information gaps and recommendations for the next generation of AANHPI cohorts, including oversampling AANHPI ethnic groups; measuring and innovating on measurements of SSDH; emphasizing the involvement of scholars from diverse disciplines; and, most critically, engaging community members to ensure relevancy for public health, policy, and clinical impact.Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":"56 1","pages":""},"PeriodicalIF":20.8,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138744405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Test and Treat for Prediabetes: A Review of the Health Effects of Prediabetes and the Role of Screening and Prevention 检测和治疗糖尿病前期:回顾糖尿病前期对健康的影响以及筛查和预防的作用
IF 20.8 1区 医学
Annual Review of Public Health Pub Date : 2023-12-18 DOI: 10.1146/annurev-publhealth-060222-023417
Rosette J. Chakkalakal, Karla I. Galaviz, Thirunavukkarasu Sathish, Megha K. Shah, K.M. Venkat Narayan
{"title":"Test and Treat for Prediabetes: A Review of the Health Effects of Prediabetes and the Role of Screening and Prevention","authors":"Rosette J. Chakkalakal, Karla I. Galaviz, Thirunavukkarasu Sathish, Megha K. Shah, K.M. Venkat Narayan","doi":"10.1146/annurev-publhealth-060222-023417","DOIUrl":"https://doi.org/10.1146/annurev-publhealth-060222-023417","url":null,"abstract":"The term prediabetes describes blood glucose levels above the normal range but below the threshold to diagnose type 2 diabetes. Several population health initiatives encourage a test and treat approach for prediabetes. In this approach, screening and identification of individuals with prediabetes should be followed by prompt referral to structured lifestyle modification programs or pharmacologic interventions that have been shown to prevent or delay the progression to type 2 diabetes in clinical trials. Here we provide a critical review of evidence for this test and treat approach by examining health outcomes associated with prediabetes and the availability and effectiveness of lifestyle modification approaches that target prediabetes. We also describe current limitations to the reach and uptake of evidence-based treatment options for prediabetes. Finally, we highlight lessons learned from identifying and labeling other preconditions to consider challenges and opportunities that may arise with increasing awareness of prediabetes as part of routine preventive care.Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":"111 1","pages":""},"PeriodicalIF":20.8,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138744060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Conceptualizing and Measuring Trust, Mistrust, and Distrust: Implications for Advancing Health Equity and Building Trustworthiness 信任、不信任和不信任的概念化与衡量:促进健康公平和建立可信度的意义
IF 20.8 1区 医学
Annual Review of Public Health Pub Date : 2023-12-15 DOI: 10.1146/annurev-publhealth-061022-044737
Jennifer Richmond, Andrew Anderson, Jennifer Cunningham-Erves, Sachiko Ozawa, Consuelo H. Wilkins
{"title":"Conceptualizing and Measuring Trust, Mistrust, and Distrust: Implications for Advancing Health Equity and Building Trustworthiness","authors":"Jennifer Richmond, Andrew Anderson, Jennifer Cunningham-Erves, Sachiko Ozawa, Consuelo H. Wilkins","doi":"10.1146/annurev-publhealth-061022-044737","DOIUrl":"https://doi.org/10.1146/annurev-publhealth-061022-044737","url":null,"abstract":"Trust is vital to public confidence in health and science, yet there is no consensus on the most useful way to conceptualize, define, measure, or intervene on trust and its related constructs (e.g., mistrust, distrust, and trustworthiness). In this review, we synthesize literature from this wide-ranging field that has conceptual roots in racism, marginalization, and other forms of oppression. We summarize key definitions and conceptual frameworks and offer guidance to scholars aiming to measure these constructs. We also review how trust-related constructs are associated with health outcomes, describe interventions in this field, and provide recommendations for building trust and institutional trustworthiness and advancing health equity. We ultimately call for future efforts to focus on improving the trustworthiness of public health professionals, scientists, health care providers, and systems instead of aiming to increase trust in these entities as they currently exist and behave.Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":"47 1","pages":""},"PeriodicalIF":20.8,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138687313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bridges and Mechanisms: Integrating Systems Science Thinking into Implementation Research 桥梁与机制:将系统科学思维融入实施研究
IF 20.8 1区 医学
Annual Review of Public Health Pub Date : 2023-12-15 DOI: 10.1146/annurev-publhealth-060922-040205
Douglas A. Luke, Byron J. Powell, Alejandra Paniagua-Avila
{"title":"Bridges and Mechanisms: Integrating Systems Science Thinking into Implementation Research","authors":"Douglas A. Luke, Byron J. Powell, Alejandra Paniagua-Avila","doi":"10.1146/annurev-publhealth-060922-040205","DOIUrl":"https://doi.org/10.1146/annurev-publhealth-060922-040205","url":null,"abstract":"We present a detailed argument for how to integrate, or bridge, systems science thinking and methods with implementation science. We start by showing how fundamental systems science principles of structure, dynamics, information, and utility are relevant for implementation science. Then we examine the need for implementation science to develop and apply richer theories of complex systems. This can be accomplished by emphasizing a causal mechanisms approach. Identifying causal mechanisms focuses on the “cogs and gears” of public health, clinical, and organizational interventions. A mechanisms approach focuses on how a specific strategy will produce the implementation outcome. We show how connecting systems science to implementation science opens new opportunities for examining and addressing social determinants of health and conducting equitable and ethical implementation research. Finally, we present case studies illustrating successful applications of systems science within implementation science in community health policy, tobacco control, health care access, and breast cancer screening.Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":"23 1","pages":""},"PeriodicalIF":20.8,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138687011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Economics of Treatment for Depression 抑郁症治疗的经济学
IF 20.8 1区 医学
Annual Review of Public Health Pub Date : 2023-12-15 DOI: 10.1146/annurev-publhealth-061022-040533
Chad Stecher, Sara Cloonan, Marisa Elena Domino
{"title":"The Economics of Treatment for Depression","authors":"Chad Stecher, Sara Cloonan, Marisa Elena Domino","doi":"10.1146/annurev-publhealth-061022-040533","DOIUrl":"https://doi.org/10.1146/annurev-publhealth-061022-040533","url":null,"abstract":"The global prevalence of depression has risen over the past three decades across all socioeconomic groups and geographic regions, with a particularly rapid increase in prevalence among adolescents (aged 12–17 years) in the United States. Depression imposes large health, economic, and societal costs, including reduced life span and quality of life, medical costs, and reduced educational attainment and workplace productivity. A wide range of treatment modalities for depression are available, but socioeconomic disparities in treatment access are driven by treatment costs, lack of culturally tailored options, stigma, and provider shortages, among other barriers. This review highlights the need for comparative research to better understand treatments’ relative efficacy, cost-effectiveness, scalability, and potential heterogeneity in efficacy across socioeconomic groups and country and cultural contexts. To address the growing burden of depression, mental health policy could consider reducing restrictions on the supply of providers, implementing digital interventions, reducing stigma, and promoting healthy lifestyles.Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":"264 1","pages":""},"PeriodicalIF":20.8,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138687008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
GIS-Based Assessments of Neighborhood Food Environments and Chronic Conditions: An Overview of Methodologies 基于地理信息系统的邻里食品环境和慢性疾病评估:方法概述
IF 20.8 1区 医学
Annual Review of Public Health Pub Date : 2023-12-07 DOI: 10.1146/annurev-publhealth-101322-031206
Kurubaran Ganasegeran, Mohd Rizal Abdul Manaf, Nazarudin Safian, Lance A. Waller, Khairul Nizam Abdul Maulud, Feisul Idzwan Mustapha
{"title":"GIS-Based Assessments of Neighborhood Food Environments and Chronic Conditions: An Overview of Methodologies","authors":"Kurubaran Ganasegeran, Mohd Rizal Abdul Manaf, Nazarudin Safian, Lance A. Waller, Khairul Nizam Abdul Maulud, Feisul Idzwan Mustapha","doi":"10.1146/annurev-publhealth-101322-031206","DOIUrl":"https://doi.org/10.1146/annurev-publhealth-101322-031206","url":null,"abstract":"The industrial revolution and urbanization fundamentally restructured populations’ living circumstances, often with poor impacts on health. As an example, unhealthy food establishments may concentrate in some neighborhoods and, mediated by social and commercial drivers, increase local health risks. To understand the connections between neighborhood food environments and public health, researchers often use geographic information systems (GIS) and spatial statistics to analyze place-based evidence, but such tools require careful application and interpretation. In this article, we summarize the factors shaping neighborhood health in relation to local food environments and outline the use of GIS methodologies to assess associations between the two. We provide an overview of available data sources, analytical approaches, and their strengths and weaknesses. We postulate next steps in GIS integration with forecasting, prediction, and simulation measures to frame implications for local health policies.Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":"165 1","pages":""},"PeriodicalIF":20.8,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138555726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Value and Impacts of Academic Public Health Departments. 学术公共卫生部门的价值与影响。
IF 21.4 1区 医学
Annual Review of Public Health Pub Date : 2023-04-03 Epub Date: 2022-10-20 DOI: 10.1146/annurev-publhealth-071421-031614
Paul C Erwin, Julie H Grubaugh, Stephanie Mazzucca-Ragan, Ross C Brownson
{"title":"The Value and Impacts of Academic Public Health Departments.","authors":"Paul C Erwin, Julie H Grubaugh, Stephanie Mazzucca-Ragan, Ross C Brownson","doi":"10.1146/annurev-publhealth-071421-031614","DOIUrl":"10.1146/annurev-publhealth-071421-031614","url":null,"abstract":"<p><p>The academic health department (AHD) is a partnership between an academic institution and a governmental health agency. These partnerships are meant to provide mutual benefits that include opportunities for student field placements and internships, practice-informed curriculum, and practice-based research. The term academic health department dates back only to 2000, although there are several examples of academic-practice partnerships prior to that date. In addition to AHDs that have been established over the past two decades, other forms of academic-practice engagement provide similar mutual benefits, such as prevention research centers and public health training centers. Current research on AHDs explores how these partnerships matter regarding the outputs, outcomes, and impacts of the units that comprise them. This review also considers the most recent perspectives on how AHDs have responded to the COVID-19 pandemic and how they might advance public health's efforts to address structural racism and promote health equity.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":"44 ","pages":"343-362"},"PeriodicalIF":21.4,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9308268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhancing Capacity for Food and Nutrient Intake Assessment in Population Sciences Research. 提高人口科学研究中的食物和营养摄入评估能力。
IF 21.4 1区 医学
Annual Review of Public Health Pub Date : 2023-04-03 Epub Date: 2022-12-16 DOI: 10.1146/annurev-publhealth-071521-121621
Marian L Neuhouser, Ross L Prentice, Lesley F Tinker, Johanna W Lampe
{"title":"Enhancing Capacity for Food and Nutrient Intake Assessment in Population Sciences Research.","authors":"Marian L Neuhouser, Ross L Prentice, Lesley F Tinker, Johanna W Lampe","doi":"10.1146/annurev-publhealth-071521-121621","DOIUrl":"10.1146/annurev-publhealth-071521-121621","url":null,"abstract":"<p><p>Nutrition influences health throughout the life course. Good nutrition increases the probability of good pregnancy outcomes, proper childhood development, and healthy aging, and it lowers the probability of developing common diet-related chronic diseases, including obesity, cardiovascular disease, cancer, and type 2 diabetes. Despite the importance of diet and health, studying these exposures is among the most challenging in population sciences research. US and global food supplies are complex; eating patterns have shifted such that half of meals are eaten away from home, and there are thousands of food ingredients with myriad combinations. These complexities make dietary assessment and links to health challenging both for population sciences research and for public health policy and practice. Furthermore, most studies evaluating nutrition and health usually rely on self-report instruments prone to random and systematic measurement error. Scientific advances involve developing nutritional biomarkers and then applying these biomarkers as stand-alone nutritional exposures or for calibrating self-reports using specialized statistics.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":"44 ","pages":"37-54"},"PeriodicalIF":21.4,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9707258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Literature Review of the Effects of Air Pollution on COVID-19 Health Outcomes Worldwide: Statistical Challenges and Data Visualization. 全球空气污染对 COVID-19 健康结果影响的文献综述:统计挑战与数据可视化。
IF 15.8 1区 医学
Annual Review of Public Health Pub Date : 2023-04-03 Epub Date: 2022-12-21 DOI: 10.1146/annurev-publhealth-071521-120424
A Bhaskar, J Chandra, H Hashemi, K Butler, L Bennett, Jacqueline Cellini, Danielle Braun, Francesca Dominici
{"title":"A Literature Review of the Effects of Air Pollution on COVID-19 Health Outcomes Worldwide: Statistical Challenges and Data Visualization.","authors":"A Bhaskar, J Chandra, H Hashemi, K Butler, L Bennett, Jacqueline Cellini, Danielle Braun, Francesca Dominici","doi":"10.1146/annurev-publhealth-071521-120424","DOIUrl":"10.1146/annurev-publhealth-071521-120424","url":null,"abstract":"<p><p>Several peer-reviewed papers and reviews have examined the relationship between exposure to air pollution and COVID-19 spread and severity. However, many of the existing reviews on this topic do not extensively present the statistical challenges associated with this field, do not provide comprehensive guidelines for future researchers, and review only the results of a relatively small number of papers. We reviewed 139 papers, 127 of which reported a statistically significant positive association between air pollution and adverse COVID-19 health outcomes. Here, we summarize the evidence, describe the statistical challenges, and make recommendations for future research. To summarize the 139 papers with data from geographical locations around the world, we also present anopen-source data visualization tool that summarizes these studies and allows the research community to contribute evidence as new research papers are published.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":"44 ","pages":"1-20"},"PeriodicalIF":15.8,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9255246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Impacts of Paid Family and Medical Leave on Worker Health, Family Well-Being, and Employer Outcomes. 带薪探亲假和病假对工人健康、家庭福利和雇主成果的影响。
IF 20.8 1区 医学
Annual Review of Public Health Pub Date : 2023-04-03 DOI: 10.1146/annurev-publhealth-071521-025257
Ann Bartel, Maya Rossin-Slater, Christopher Ruhm, Meredith Slopen, Jane Waldfogel
{"title":"The Impacts of Paid Family and Medical Leave on Worker Health, Family Well-Being, and Employer Outcomes.","authors":"Ann Bartel,&nbsp;Maya Rossin-Slater,&nbsp;Christopher Ruhm,&nbsp;Meredith Slopen,&nbsp;Jane Waldfogel","doi":"10.1146/annurev-publhealth-071521-025257","DOIUrl":"https://doi.org/10.1146/annurev-publhealth-071521-025257","url":null,"abstract":"<p><p>This article reviews the evidence on the impacts of paid family and medical leave (PFML) policies on workers' health, family well-being, and employer outcomes. While an extensive body of research demonstrates the mostly beneficial effects of PFML taken by new parents on infant, child, and parental health, less is known about its impact on employees who need leave to care for older children, adult family members, or elderly relatives. The evidence on employers is similarly limited but indicates that PFML does not impose major burdens on them. Taken together, the evidence suggests that PFML policies are likely to have important short- and long-term benefits for population health, without generating large costs for employers. At thesame time, further research is needed to understand the effects of different policy parameters (e.g., wage replacement rate and leave duration) and of other types of leave beyond parental leave.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":"44 ","pages":"429-443"},"PeriodicalIF":20.8,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9308272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
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