Socially disadvantaged individuals with HIV experience unacceptably high rates of AIDS and death. The authors developed an adversity index to quantify the impact of demographic and psychosocial factors on HIV care. Th...Socially disadvantaged individuals with HIV experience unacceptably high rates of AIDS and death. The authors developed an adversity index to quantify the impact of demographic and psychosocial factors on HIV care. This retrospective cohort study included 431 participants with HIV on combined antiretroviral therapy between 2000 and 2005. Poor outcome was defined as progression to AIDS, death, virologic failure, or CD4 < 200 cells/μl at six months. The index utilized eight demographic and psychosocial variables independently associated with poor outcome. Exposure to higher numbers of variables in the adversity index significantly increased the rates of poor outcome from 14% (exposure to no variables) to 100% (exposure to seven variables). The odds of poor outcome decreased but remained significant after adjusting for adherence-defining variables, indicating a possible mediating effect of poor adherence. Durably effective therapeutic strategies must include addressing adverse demographic and psychosocial factors affecting people living with HIV.展开更多
BACKGROUND While Crohn’s disease has been studied extensively in high-income countries,its epidemiology and care in low and lower-middle income countries(LLMICs)is not well established due to a lack of disease regist...BACKGROUND While Crohn’s disease has been studied extensively in high-income countries,its epidemiology and care in low and lower-middle income countries(LLMICs)is not well established due to a lack of disease registries and diagnostic capacity.AIM To describe the published burden,diagnostic/treatment capacity,service utilization,challenges/barriers to individuals with Crohn’s in LLMICs and their providers.METHODS We conducted a scoping review utilizing a full search strategy was developed and conducted in PubMed,Embase and World Health Organization Global Index Medicus.Two independent reviewers screened the titles and abstracts of all of the publications found in this search,reviewed selected publications,and extracted relevant data,which underwent descriptive review and was analyzed in Excel.RESULTS The database search yielded 4486 publications,216 of which were determined to be relevant to the research questions.Of all 79 LLMICs,only 21(26.6%)have publications describing individuals with Crohn’s.Overall,the highest number of studies came from India,followed by Tunisia,and Egypt.The mean number of Crohn’s patients reported per study is 57.84 and the median is 22,with a wide range from one to 980.CONCLUSION This scoping review has shown that,although there is a severe lack of populationbased data about Crohn’s in LLMICs,there is a signal of Crohn’s in these settings around the world.展开更多
Background:Previous studies have reported associations of specific maternal and paternal lifestyle factors with offspring’s cognitive development during early childhood.This study aimed to investigate the prospective...Background:Previous studies have reported associations of specific maternal and paternal lifestyle factors with offspring’s cognitive development during early childhood.This study aimed to investigate the prospective associations between overall parental lifestyle and offspring’s cognitive performance during adolescence and young adulthood in China.Methods:We included 2531 adolescents aged 10-15 years at baseline in 2010 from the China Family Panel Studies.A healthy parental lifestyle score(ranged 0-5)was constructed based on the following five modifiable lifestyle factors:Smoking,drinking,exercise,sleep,and diet.Generalized estimating equation models were used to examine the association between baseline parental healthy lifestyle scores and offspring’s fluid and crystallized intelligence in subsequent years(2012,2014,2016,and 2018).Results:Offspring in the top tertile of parental healthy lifestyle scores performed better in overall fluid intelligence(multivariable-adjusted β=0.53,95%confidence interval[CI]:0.29-0.77)and overall crystallized intelligence(multivariable-adjusted β=0.35,95%CI:0.16-0.54)than those in the bottom tertile of parental healthy lifestyle scores.The results were similar after further adjustment for the offspring’s healthy lifestyle scores and persisted across the subgroups of parental socioeconomic status.Additionally,maternal and paternal healthy lifestyle scores were independently associated with better offspring’s cognitive performance,with significant contribution observed for paternal never-smoking,weekly exercise,and diversified diet.When both parents and offspring adhered to a healthier lifestyle,we observed the highest level of the offspring’s overall crystallized intelligence.Conclusions:Our study indicates that parental adherence to a healthier lifestyle is associated with significantly better offspring’s cognitive performance during adolescence and early adulthood,regardless of socioeconomic status.These findings highlight the potential cognitive benefits of promoting healthy lifestyles among parents of adolescents.展开更多
文摘Socially disadvantaged individuals with HIV experience unacceptably high rates of AIDS and death. The authors developed an adversity index to quantify the impact of demographic and psychosocial factors on HIV care. This retrospective cohort study included 431 participants with HIV on combined antiretroviral therapy between 2000 and 2005. Poor outcome was defined as progression to AIDS, death, virologic failure, or CD4 < 200 cells/μl at six months. The index utilized eight demographic and psychosocial variables independently associated with poor outcome. Exposure to higher numbers of variables in the adversity index significantly increased the rates of poor outcome from 14% (exposure to no variables) to 100% (exposure to seven variables). The odds of poor outcome decreased but remained significant after adjusting for adherence-defining variables, indicating a possible mediating effect of poor adherence. Durably effective therapeutic strategies must include addressing adverse demographic and psychosocial factors affecting people living with HIV.
文摘BACKGROUND While Crohn’s disease has been studied extensively in high-income countries,its epidemiology and care in low and lower-middle income countries(LLMICs)is not well established due to a lack of disease registries and diagnostic capacity.AIM To describe the published burden,diagnostic/treatment capacity,service utilization,challenges/barriers to individuals with Crohn’s in LLMICs and their providers.METHODS We conducted a scoping review utilizing a full search strategy was developed and conducted in PubMed,Embase and World Health Organization Global Index Medicus.Two independent reviewers screened the titles and abstracts of all of the publications found in this search,reviewed selected publications,and extracted relevant data,which underwent descriptive review and was analyzed in Excel.RESULTS The database search yielded 4486 publications,216 of which were determined to be relevant to the research questions.Of all 79 LLMICs,only 21(26.6%)have publications describing individuals with Crohn’s.Overall,the highest number of studies came from India,followed by Tunisia,and Egypt.The mean number of Crohn’s patients reported per study is 57.84 and the median is 22,with a wide range from one to 980.CONCLUSION This scoping review has shown that,although there is a severe lack of populationbased data about Crohn’s in LLMICs,there is a signal of Crohn’s in these settings around the world.
基金supported by grants from the Zhejiang University Education Foundation Global Partnership Fund(to CZY)the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province(No.2020E10004).
文摘Background:Previous studies have reported associations of specific maternal and paternal lifestyle factors with offspring’s cognitive development during early childhood.This study aimed to investigate the prospective associations between overall parental lifestyle and offspring’s cognitive performance during adolescence and young adulthood in China.Methods:We included 2531 adolescents aged 10-15 years at baseline in 2010 from the China Family Panel Studies.A healthy parental lifestyle score(ranged 0-5)was constructed based on the following five modifiable lifestyle factors:Smoking,drinking,exercise,sleep,and diet.Generalized estimating equation models were used to examine the association between baseline parental healthy lifestyle scores and offspring’s fluid and crystallized intelligence in subsequent years(2012,2014,2016,and 2018).Results:Offspring in the top tertile of parental healthy lifestyle scores performed better in overall fluid intelligence(multivariable-adjusted β=0.53,95%confidence interval[CI]:0.29-0.77)and overall crystallized intelligence(multivariable-adjusted β=0.35,95%CI:0.16-0.54)than those in the bottom tertile of parental healthy lifestyle scores.The results were similar after further adjustment for the offspring’s healthy lifestyle scores and persisted across the subgroups of parental socioeconomic status.Additionally,maternal and paternal healthy lifestyle scores were independently associated with better offspring’s cognitive performance,with significant contribution observed for paternal never-smoking,weekly exercise,and diversified diet.When both parents and offspring adhered to a healthier lifestyle,we observed the highest level of the offspring’s overall crystallized intelligence.Conclusions:Our study indicates that parental adherence to a healthier lifestyle is associated with significantly better offspring’s cognitive performance during adolescence and early adulthood,regardless of socioeconomic status.These findings highlight the potential cognitive benefits of promoting healthy lifestyles among parents of adolescents.
