Objectives Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads heterogeneously, disproportionately impacting poor and minority communities. The relationship between poverty and race is complex, with a diverse set of structural and systemic factors driving higher rates of poverty among minority populations. The factors that specifically contribute to the disproportionate rates of SARS-CoV-2 infection, however, are not clearly understood.
Methods We evaluated SARS-CoV-2 test results from community-based testing sites in Los Angeles, California, between June and December, 2020. We used tester zip code data to link those results with United States Census report data on average annual household income, rates of healthcare coverage, and employment status by zip code.
Results We analyzed 2 141 127 SARS-CoV-2 test results, of which 245 154 (11.4%) were positive. Multivariable modeling showed a higher likelihood of SARS-CoV-2 test positivity among Hispanic communities than among other races. We found an increased risk for SARS-CoV-2 positivity among individuals from zip codes with an average annual household income Conclusions Residence in zip codes with lower average annual household income, lower rates of employment, or lower rates of health insurance was associated with SARS-CoV-2 positivity. Further research is needed into how those factors increase the spread of SARS-CoV-2 infection among populations of lower socioeconomic status in order to develop targeted public health interventions.
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Traditional epidemiological assessments, which mainly focused on evaluating the statistical association between two major components-the exposure and outcome-have recently evolved to ascertain the in-between process, which can explain the underlying causal pathway. Mediation analysis has emerged as a compelling method to disentangle the complex nature of these pathways. The statistical method of mediation analysis has evolved from simple regression analysis to causal mediation analysis, and each amendment refined the underlying mathematical theory and required assumptions. This short guide will introduce the basic statistical framework and assumptions of both traditional and modern mediation analyses, providing examples conducted with real-world data.
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Korean summary
본 리뷰에서는 전통적으로 쓰여왔던 회귀분석 기반 매개요인분석방법과 인과적 매개요인분석방법에 대하여 간략히 소개하며, 또한 예시를 들어 설명하고 있다. 매개요인 분석 전에는 필요한 가정들이 맞는 지를 확인하는 것이 중요하다. 또한 분석결과를 올바르게 해석하는 것 또한 요구된다. 이러한 방법은 그동안의 노출-결과만을 다루는 단순 역학연구을 뛰어넘어, 인구집단연구에서 매커니즘을 밝히는 도구로서 유용하게 쓰일 것이다.
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The National Health Plan 2030 (HP2030) started to be prepared in 2017 and was completed and announced in December 2020. This study presents an overview of how it was established, the major changes in policies, its purpose, and future directions. This study analyzed the steps taken in the past 4 years to establish HP2030 and reviewed major issues at the international and governmental levels based on an evaluation of HP2020 and its content. HP2030 establishes 6 divisions and 28 topic areas, and it will continue to expand investments in health with a total budget of 2.5 trillion Korean won. It also established goals to enhance health equity for the first time, with the goal of calculating healthy life expectancy in a way that reflects the circumstances of Korea and reducing the gap in income and healthy life expectancy between regions. The establishment of HP2030 is significant in that it constitutes a sustainable long-term plan with sufficient preparation, contains policy measures that everyone participates in and makes together, and works towards improvements in universal health standards and health equity. With the announcement of HP2030, which includes goals and directions of the national health policy for the next 10 years, it will be necessary to further strengthen collaboration with relevant ministries, local governments, and agencies in various fields to concretize support for prevention-centered health management as a national task and to develop a health-friendly environment that considers health in all policy areas.
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Korean summary
본 연구는 지난 17년부터 4년간 준비한 국민건강증진종합계획2030이 발표됨에 따라 수립경과와 주요 변화정책을 분석하고, 수립의 의의를 검토하여 향후 추진방향을 제시하고자 한다. 국민건강증진종합계획2030의 수립은 충분한 준비기간을 통한 지속가능한 중장기 계획의 수립, 모든 사람에 함께 참여하고 만들어가는 정책으로서의 전환, 보편적인 건강수준 향상과 건강형평성 제고를 했다는데 그 의의가 있다 향후 10년간의 국가 건강정책의 목표와 방향을 담은 HP2030 발표를 계기로, 모든 정책 영역에서 건강을 고려하는 건강친화적 환경 구축을 위해 관련 부처와 지자체, 다양한 분야의 주체들과 협력을 강화해야 하겠다.
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Objectives This study investigated the relationship between sleep quality during pregnancy and preterm birth.
Methods This longitudinal study was conducted between August 2018 and May 2019. The participants were 150 pregnant women who had been referred to 7 healthcare centers in the city of Qazvin, Iran and met the inclusion criteria. The Petersburg Sleep Quality Index, the Epworth Sleepiness Scale, and 2 questions about daytime sleep status and a demographic questionnaire were administered at 14-18 weeks and 28-32 weeks of gestation. Data were analyzed using the Mann-Whitney test, the Fisher exact test, and univariate and multivariable logistic regression.
Results In the present study, poor sleep quality affected 84.7% of the participants at 14-18 weeks and 93.3% at 28-32 weeks of gestation. The final model for preterm birth prediction incorporated age and the Petersburg Sleep Quality Index score in the second and third trimesters. Preterm birth increased by 14% with each unit increase in age. With each unit increase in the Petersburg Sleep Quality Index score in the second and third trimesters, preterm birth increased by 42% and 28%, respectively, but the p-values of these factors were not significant.
Conclusions Although a significant percentage of pregnant women had poor sleep quality, no significant relationship was found between sleep quality during pregnancy and preterm birth.
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Objectives Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes.
Methods This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study.
Results Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members’ advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55).
Conclusions Knowledge of the adverse effects of diabetes, physicians’ and healthcare providers’ advice about the benefits of early disease detection, and family members’ advice were independent predictors of screening adherence.
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Association between a family history of diabetes and carotid artery atherosclerosis in Korean adults Sun Young Shim, Ga Bin Lee, Jee-Seon Shim, Sun Jae Jung, Hyeon Chang Kim Epidemiology and Health.2021; 43: e2021049. CrossRef
Objectives Physical inactivity is the fourth leading global risk factor for mortality, followed by obesity. The combination of these risk factors is associated with non-communicable diseases, impaired physical function, and declining mental function. The World Health Organization recommends physical activity to reduce the mortality rate. Thus, this study examined the effects on anthropometric measurements of a 12-week walking program for elderly people in Samarahan, Sarawak, Malaysia with a 7000-step goal and weekly group walking activities.
Methods A quasi-experimental study was conducted involving 109 elderly people with a body mass index (BMI) ≥25.0 kg/m2. BMI, body composition, and average daily steps were measured at baseline, 6 weeks, and 12 weeks. Data were analyzed using SPSS version 26.0, and repeated-measures analysis of variance with the paired t-test for post-hoc analysis was conducted.
Results In total, 48 participants in the intervention group and 61 participants in the control group completed the study. A significant interaction was found between time and group. The post-hoc analysis showed a significant difference between pre-intervention and post-intervention (within the intervention group). The post-intervention analysis revealed an increase in the mean number of daily steps by 3571.59, with decreases in body weight (-2.20 kg), BMI (-0.94 kg/m2), body fat percentage (-3.52%), visceral fat percentage (-1.29%) and waist circumference (-2.91 cm). Skeletal muscle percentage also showed a significant increase (1.67%).
Conclusions A 12-week walking program combining a 7000-step goals with weekly group walking activities had a significant effect on the anthropometric measurements of previously inactive and overweight/obese elderly people.
Summary
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Objectives In spite of the importance of green space for reducing obesity-related problems, there has been little exploration of whether access to green space (e.g., parks and recreational facilities) influences the obesity rate of adults in the United States. The purpose of the study was to investigate the relationships among accessibility of green space, obesity rates, and socioeconomic and demographic variables among adults living in the State of Indiana, United States.
Methods We conducted a secondary data analysis to investigate the relationships among accessibility to green space, obesity rates, and socio-demographic variables with employing Geographic Information System in order to measure the accessibility of green space.
Results This study found that accessibility of green space served as a strong predictor of reduced obesity rates among adults (β=-2.478; p<0.10). In addition, adults with higher education levels, as well as better access to green space, were found to have even lower obesity rates (β=-0.188; p<0.05). Other control variables such as unemployment rates, food security, and physical inactivity are additional factors that influence obesity rates among adults.
Conclusions Accessibility of green space may play an important role in facilitating physical activity participation and reducing obesity rates.
Summary
Korean summary
본 연구는 미국 인디애나 주의 녹지공간의 접근성 (공원 및 레크레이션 시설), 성인 비만 및 다양한 변수 (교육열, 실업률 및 임금) 사이의 관계를 분석하기위해 지리정보시스템 (GIS) 와 다중회귀 방법을 함께 사용하였습니다. 이 연구는 녹지공간의 접근성이 성인 비만율을 감소시키는 역활을 한다고 밝혀내었습니다. 녹지공간 접근성이 높은 카운티는 접근성이 낮은 카운티에 비해 성인들의 비만 가능성이 낮다는것을 시사하였습니다. 게다가, 녹지공간에 더 잘 접근할 뿐만 아니라 더 높은 교육 수준을 가진 카운티는 더 낮은 비만율을 가지고 있다는것으로 밝혀졌습니다.
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The identification of human remains can be performed visually through families and next-of-kin, but it is not advisable to rely only on visual recognition; instead, it is preferable to conduct a forensic comparison of antemortem and postmortem data for primary identifiers (fingerprints, DNA, and dental data). A dental autopsy is particularly valuable in the identification process of skeletonized, carbonized, saponified, and fragmented human remains. The principal challenge in the identification process is the search and collection of antemortem data. To this end, all dental information held on a missing person can represent a precious source of individualizing information that families should share with the police or investigating agencies after reporting a disappearance.
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