中老年人群中吸烟与血压关联的前瞻性队列研究

目的 吸烟是重要的心血管事件危险因素,但部分研究却发现吸烟与高血压无关,甚至吸烟者血压水平更低。吸烟与血压的关联还需要更多纵向研究证据。本研究基于中国健康与养老追踪调查（China Health and Retirement Longitudinal Survey,CHARLS）数据探索45～80岁中老年人群中吸烟对血压的影响。方法 研究对象来源于CHARLS研究中完成2011年基线和2013、2015年随访的人群。纳入完成3次调查的研究对象,采用多水平线性回归分析吸烟对血压的影响,采用含时依变量的Cox回归分析吸烟对高血压发生风险的影响,同时调整性别、年龄、文化程度、婚姻状况、BMI和饮酒。结果 本研究共纳入6 667名无心血管疾病的研究对象,平均年龄58.8岁,男性占46.3%。多水平线性回归分析显示,在调整协变量后,相对于不吸烟者,吸烟者的SBP高1.81 mmHg（95% CI：0.55～3.07 mmHg,P<0.05）,DBP高0.85 mmHg（95% CI：0.10～1.60 mmHg,P<0.05）。Cox回归分析显示,吸烟与高血压发生风险的关联无统计学意义（HR=1.11,95% CI：0.89～1.38,P>0.05）。结论 在中老年人群中,吸烟与血压水平升高相关联。吸烟与高血压发生风险的关系有待进一步研究证实。     

Inverse association between smoking and idiopathic Parkinson's disease

An evaluation is made of the effect of smoking during the period of life between 20 and 50 years of age and idiopathic Parkinson's disease in a case-control study carried out in Navarra. An inverse association is observed: for the number of smokers (OR = 0.66, CI 90% 0.41-1.05); for the number of years smoking (OR =0.22, CI 90% 0.05-0.97); and for the quantity of cigarettes smoked (z = 2.2298, p = 0.02). Likewise, a dose-response relationship exists between the number of cigarettes consumed and the risk of Parkinson's disease (p = 0.01). The same effect is maintained on analysing the data by matching 1:1 (OR = 0.59, CI 90% 0.31-1.10). All of this contributes to giving consistency to the protective effect of smoking against idiopathic Parkinson's disease. The anti-oxidant status, measured by means of different parameters in peripheral blood, is lower in the cases than in the tests for reduced glutathione (GSH) (p = 0.001) and is an independent variable with respect to smoking.     

母乳喂养与儿童肥胖关系的Meta分析

【目的】评价母乳喂养对儿童肥胖的影响。【方法】应用Meta分析方法对1996~2008年已发表的12篇关于母乳喂养与儿童肥胖的病例对照研究文献进行分析,数据采用Revman4.3软件进行处理,根据齐性检验结果决定采用何种模型来计算OR值及其95%可信区间。【结果】肥胖组与对照组的儿童,母乳喂养率差异有显著性(P<0.000 01),采用随机效应模型,合并OR及其95%的可信区间分别为0.73(0.64~0.83)。【结论】母乳喂养对儿童肥胖的发生存在保护作用。     

Exploring children's conceptions of smoking addiction.

Tobacco addiction is a major health problem for both adults and young people--between 20 and 60% of adolescents are dependent on nicotine and more than two-thirds who attempt to quit experience withdrawal symptoms. Yet, anti-smoking efforts targeted at children emphasize primary prevention and ignore addiction education, which is generally considered relevant only to adult smoking and cessation efforts. This study reports children's concepts of smoking and addiction from interviews with 32 Western Australian boys and girls, aged 9-10 years, all non-smokers. Results suggest children's concepts of smoking addiction may influence attitudes toward smoking trials. Children who thought addiction happened immediately were committed to never smoke at all. Others who thought addiction happened after several cigarettes expressed intentions to experiment. These children believed they could avoid addiction by smoking less than the number of cigarettes that caused addiction. Children who defined addiction as 'liking' or 'enjoying the taste of cigarettes' believed they could avoid being 'hooked' as long as they managed to avoid enjoying the experience. Recent findings that children can get 'hooked' within a few days of smoking highlight the importance of addiction strategies targeted at children, particularly in relation to influencing intentions to experiment with smoking.     

Bidirectional association between mental health and physical activity in older adults: Whitehall II prospective cohort study

ObjectiveTo investigate longitudinal and bidirectional associations between mental health and physical activity from midlife into old age.MethodsAnalysis was based on data from 6909 participants (aged 45 to 69 in 1997/99) from the Whitehall II cohort in the UK. Latent growth curve analysis examined possible bidirectional associations between the SF-36 Mental Component Summary and weekly physical activity measured at three time-points over ten years.ResultsMental health and physical activity were associated at baseline (β = 0.17, 95% CI 0.13, 0.21) and associations persisted into old age. In the latent growth curve model, both mental health and physical activity increased and their rates of change ‘moved together’ over time (β = 0.24, 95% CI 0.11, 0.37). Relatively high baseline levels of either variable were associated with slightly slower increases in the other outcome (β = − 0.02, 95% CI − 0.03, − 0.01; β = − 0.07, 95% CI − 0.11, − 0.13), which are thought to reflect regression to the mean. However, those who started high on either variable remained the most advantaged at end of follow-up.ConclusionsFrom midlife to old age, greater physical activity is associated with better mental health and vice versa. These findings suggest persistent longitudinal and bidirectional associations between physical activity and mental health.     

The association between preschool classroom quality and children's social-emotional problems

This study examined the association between early childhood classroom quality and preschool children's social skills and emotional problems. Teachers completed the Early Childhood Environmental Rating Scale-Revised (ECERS-R) and the Devereux Early Childhood Assessment-Clinical Form (DECA-C). Participants included 141 preschool children from 10 kindergartens and 28 classrooms in Cairo, the capital of Egypt. The study used a mixed-methods approach to explore quantitative and qualitative data. For the qualitative data, focus groups were used to interview a group of female preschool teachers in the schools where observations were conducted. The quantitative results of the study indicated that all the ECERS-R subscales were acceptable expect for the parents and staff subscale. For the DECA-C, the Total Protective Factors (TPF) composite score (including the attachment, self-control, and initiative subscales) was above the mean, which indicates acceptable levels of social functioning. The Total Behavioural Concerns (TBC) composite score (including attention problems, aggression problems, emotional-control problems, and withdrawal/depression problems subscales) was below the mean, which refers to low levels of behavioural problems. The hierarchical multiple regression analyses showed that two subscales of the ECERS-R, namely space and furnishing, and language and reasoning predicted the TPF composite score. Also, two subscales of the ECERS-R, namely activities and interaction, significantly predicted the TBC composite score, while programme structure and parents and staff negatively predicted the TBC composite score.     

The association between demolition activity and children's blood lead levels

Urban renewal efforts are a priority for many American cities. As efforts to reconstitute urban centers increase, the demolition of old, deteriorated structures has accelerated. Recent studies have identified demolitions as a potential source of environmental lead exposure. We conducted a study examining the relationship between demolition activity and blood lead levels of children residing in neighborhoods where demolition activity occurred. A retrospective cohort study was conducted in St. Louis City, Missouri. The study period was January 1, 2002 to December 31, 2002. Data were obtained from the Missouri Childhood Lead Poisoning Prevention Program's (CLPPP) lead surveillance system and St. Louis Demolition Permit Database. Children were considered exposed to a demolition if they had a blood lead test within 45 days of any demolition on a census block. Exposure was classified as both a dichotomous (yes/no) and a categorical (none/one/multiple) variable and was analyzed separately. Linear regression models were developed to determine effects of demolitions on blood lead levels. A total of 1196 children 6-72 months of age living in 395 census blocks were included. 314 (26.3%) were exposed and 882 (73.7%) were unexposed to a demolition. In an adjusted model, exposure to multiple demolitions was found to have significant effects on children blood lead levels (coefficient=0.281; 95% CI=0.069, 0.493; P-value=0.010). Age of the child, race, and age of housing where children's resided were also significant predictors. This study suggests that multiple demolitions within a census block may significantly increase children's blood lead levels. The findings may be useful to municipal planners in older cities where demolitions are being used as an urban renewal tool.     

Prospective association between dieting and smoking initiation among adolescents

PURPOSE: To examine the relation between dieting and smoking initiation among adolescents. DESIGN: Prospective data from a nationally representative study were used. SETTING: Two waves (1994 to 1996) of the National Longitudinal Study of Adolescent Health. SUBJECTS: The sample included 7795 non-Latino Caucasian and non-Latino African-American adolescents. MEASURES: Dieting status was the independent variable and trying smoking and initiation of regular smoking were the dependent variables. Covariates included age, ethnicity, overweight status, false self-perception about being overweight, and availability of cigarettes at home. ANALYSIS: Logistic regression and latent transition analyses were used. RESULTS: Females had a higher prevalence of dieting (55%) when compared with males (25%). Dieting initiation was a significant predictor for initiation of regular smoking among females (OR = 1.94, p = .010), but not among males. Inactive dieting was a significant predictor among males (OR = 1.74, p = .031), but not among females. Compared to nondieters, initiating and consistent female dieters reported a higher probability of transitioning to having tried regular smoking, although results from logistic regression suggested that the association between consistent dieting and initiation of regular smoking was not significant. CONCLUSIONS: There is a positive relation between initiating dieting and initiating regular smoking among females, but among males it is the inactive dieters who show a positive relationship. Results illustrate the importance of examining the association between dieting and the initiation of regular smoking.     

Correspondence between children's indoor and outdoor play in Japanese preschool daily life

This study examined the correspondence between children's indoor and outdoor play in a preschool environment to investigate whether the children maintained a tendency to engage in a particular type of play irrespective of the environment, or whether they changed the type of play according to the environment. Play behaviours of 18 three-year-old and 20 five-year-old children were observed in both settings in an urban preschool in Japan. Various characteristics of play were examined based on cognitive play categories, social play categories, and types of objects used. The results indicate that children do not maintain fixed play behaviour without taking into consideration the play settings: their play differed greatly in accordance with the play setting. Not every child showed the same differences in play corresponding to differences in the setting. However, for each age group there was a qualitative difference based on the setting. For the three-year-olds, the ‘subject of interest’ changed between settings, whereas for the five-year-olds, the ‘participation in society’ changed related to the setting (indoor or outdoor). The ‘relation with the environment’ was greater for both age groups in the outdoor setting. There were no significant sex differences.     

The association between two windchill indices and daily mortality variation in The Netherlands.

OBJECTIVES. The purpose of this study was to compare temperature and two windchill indices with respect to the strength of their association with daily variation in mortality in the Netherlands during 1979 to 1987. The two windchill indices were those developed by Siple and Passel and by Steadman. METHODS. Daily numbers of cause-specific deaths were related to the meteorological variables by means of Poisson regression with control for influenza incidence. Lag times were taken into account. RESULTS. Daily variation in mortality, especially mortality from heart disease, was more strongly related to the Steadman windchill index than to temperature or the Siple and Passel index (34.9%, 31.2%, and 31.5%, respectively, of mortality variation explained). The strongest relation was found with daytime values of the Steadman index. CONCLUSIONS. In areas where spells of cold are frequently accompanied by strong wind, the use of the Steadman index probably adds much to the identification of weather conditions involving an increased risk of death. The results of this study provide no justification for the wide-spread use (e.g., in the United States) of the Siple and Passel index.     

A prospective study of the relation between smoking and fertility

A prospective study of fertility was conducted from 1977 to 1982. Analysis of the relation between cigarette smoking and occurrence of a pregnancy was performed on 1887 couples. The actuarial pregnancy rate was 82.9% at the end of a year. Cigarette smoking by both members of the couple was found to be related to decreased fertility when this factor was considered alone. But after including all the confounding covariates in a Cox semi-proportional hazards model for survival data, no relationship remained between cigarette smoking and fertility. Odds ratios were respectively 0.86 (95% confidence interval: 0.63, 1.19) and 0.99 (0.85, 1.14) for women smoking and men smoking. This could suggest that the relationship found by other authors might be at least partly explained by a relation between cigarette smoking and other factors related to fertility.     

拒烟自我效能在吸烟危害认知对戒烟成功影响的中介效应分析

目的 分析拒烟自我效能在吸烟危害认知对戒烟成功影响的中介效应。方法 采用以社区人群为基础的病例对照研究设计,以642例男性自发性戒烟成功者为病例组,700例男性自发性戒烟失败者为对照组。吸烟危害认知水平由12个评分项目的总分评估,拒烟自我效能由拒烟自我效能问卷评估。总效应被分解为直接效应和间接效应,通过基于KHB法的logistic回归分析探讨各效应。结果 调整潜在混杂因素(包括年龄、开始吸烟年龄、职业、教育水平、婚姻状况)后,拒烟自我效能的中介效应仅占吸烟危害认知对戒烟成功影响总效应的6.03%,吸烟危害认知对戒烟成功影响的直接效应占总效应的93.97%;在3种拒烟自我效能情境(包括积极、消极、习惯情境)下的中介效应占吸烟危害认知对戒烟成功总效应的比例分别为6.80%、3.08%和2.32%。结论 拒烟自我效能在吸烟危害认知对戒烟成功的影响具有部分中介效应。提高吸烟者的危害认知水平可直接促使其戒烟成功,并可通过增大拒烟自我效能促使其成功戒烟。     

The association between workplace smoking bans and self-perceived,work-related stress among smoking workers

Background  

There is substantial empirical evidence on the benefits of smoking bans; however, the unintended consequences of this anti-smoking measure have received little attention. This paper examines whether workplace smoking bans (WSB's) are associated with higher self-perceived, work-related stress among smoking workers.     

The association between smoking and sexual behavior among teens in US contraceptive clinics.

A study of teenage women in 32 contraceptive clinics in the United States shows a strong negative relationship between age of first intercourse and the level of cigarette smoking; the association is strong enough to reverse the usual correlation of smoking and age during the teenage years. Preventive, timely contraceptive behavior is also negatively associated to smoking. These findings suggest that interventions could well be designed and located in settings which take this association into account.     

Cigarette smoking and diabetes mellitus: evidence of a positive association from a large prospective cohort study.

OBJECTIVE: Only a few prospective studies have examined the relationship between the frequency of cigarette smoking and the incidence of diabetes mellitus. The purpose of this study was to determine whether greater frequency of cigarette smoking accelerated the development of diabetes mellitus, and whether quitting reversed the effect. METHODS: Data were collected in the Cancer Prevention Study I, a prospective cohort study conducted from 1959 through 1972 by the American Cancer Society where volunteers recruited more than one million acquaintances in 25 US states. From these over one million original participants, 275,190 men and 434,637 women aged > or = 30 years were selected for the primary analysis using predetermined criteria. RESULTS: As smoking increased, the rate of diabetes increased for both men and women. Among those who smoked > or = 2 packs per day at baseline, men had a 45% higher diabetes rate than men who had never smoked; the comparable increase for women was 74%. Quitting smoking reduced the rate of diabetes to that of non-smokers after 5 years in women and after 10 years in men. CONCLUSIONS: A dose-response relationship seems likely between smoking and incidence of diabetes. Smokers who quit may derive substantial benefit from doing so. Confirmation of these observations is needed through additional epidemiological and biological research.     

Exposure to cigarette smoking and children's growth

An analysis of data from 5903 children from a study of primary schools in England and Scotland in 1982 showed that the number of cigarettes smoked by the parents at home was significantly associated with the attained height of their children. This relation was statistically significant after allowing for parents' height, child's birthweight, mother's smoking during pregnancy, overcrowding and number of older siblings. Number of cigarettes smoked at home was more strongly related to height than number of cigarettes smoked by the mother during pregnancy. The results suggest that passive smoking may have an effect on the height of a child independent of genetic factors, the social environment and mother's smoking in pregnancy. Whether this is a direct effect of parents' smoking on the child's growth remains unclear.     

孕前父亲烟草暴露与6岁儿童智力水平的前瞻性队列研究

目的 评估孕前父亲烟草暴露对6岁儿童智力的影响,为指导优生优育服务提供循证依据。方法 本研究纳入2012年建立的上海闵行出生队列的530对母子,在孕妇建大卡时通过结构式问卷获得了孕前3个月父亲烟草暴露情况,在儿童6岁时利用第四版《儿童韦氏智力测试量表》中文版简版考察儿童智力水平。采用多因素线性回归模型分析孕前父亲烟草暴露对6岁儿童智力水平的影响。结果 调整协变量后,孕前父亲烟草暴露使儿童总智商下降2.83分(95%CI:-5.51～-0.16),其中孕前父亲吸烟的效应值(OR=3.15,95%CI:-6.32～0.03)略高于孕前父亲二手烟暴露(OR=2.62,95%CI:-5.54～0.30)。孕前父亲吸烟对儿童总智商和知觉推理的影响呈剂量反应关系(趋势检验P<0.05),父亲每天吸烟5支以上的儿童,总智商下降6.57分(95%CI:-10.88～-2.26),知觉推理下降5.83分(95%CI:-10.61～-1.05)。此外,儿童性别和胎龄与孕前父亲烟草暴露在对儿童智商的影响中表现出显著的交互作用(P<0.05),即父亲烟草暴露对女童、胎龄<39周的儿童的智力影响更强。结论 本研究发现孕前3个月父亲的烟草暴露与6岁儿童智力水平的下降有关,提示孕前健康指导应加强对备孕期间丈夫控烟的宣传,倡导夫妻双方共同承担起优生优育的责任。