Long-term Health Impact Research Articles

The effect of moderate to late preterm birth on lung function over the first 5 years of life in a South African birth cohort

BackgroundPreterm birth is associated with increased mortality and morbidity, particularly due to lung disease. Low-middle income countries (LMIC) have the highest rates of preterm birth. Infants born extremely preterm rarely survive, so the largest burden is amongst moderate to late preterm (MLP) infants. The long-term health impact on MLP children in LMIC is poorly understood.AimTo assess the effect of MLP birth on lung function trajectories from birth to 5 years in the birth cohort Drakenstein Child Health Study.MethodsChildren were followed from birth with lung function measurements at 6 weeks and annually until 5 years. Exposures were longitudinally collected from the antenatal period through 5 years of age. Lung function tests included spectral and intra-breath oscillometry, tidal breathing and multiple breath washout. Mixed-effect models adjusted using a minimum set of variables were used.ResultsOf 923 children, 119 (13%) were born MLP [32-<37 weeks gestation; median gestational age (GA) 35 weeks] and 19 (2%)<32 weeks gestation. Children born MLP had altered lung function trajectories. Spectral oscillometry demonstrated a 13% reduction in compliance (0.87, 95% CI: 0.82; 0.92), 5% increase in resistance at end expiration (1.05, 95% CI: 1.01;1.09) and 1.74 Hz (95% CI: 1.10; 2.39) increase in resonance frequency over 5 years compared to term children. The proportion of children hospitalised for lower respiratory tract infections (LRTI) was higher in preterm born children (29 (23.6%) MLP; 18 (94.7%) extreme to very preterm; 109 (14%) term born children;p<0.01). LRTI and tobacco smoke exposure were associated with impaired lung function, but the impact of MLP on lung function was independent of these.ConclusionMLP born children have impaired lung function trajectories over the first 5 years of life, highlighting the importance of strengthening maternal health, perinatal care and strategies to reduce tobacco smoke exposure and early life LRTI.

Understanding community resilience during the drinking water contamination event on Oahu, Hawaii, 2021–2022: a mixed mode approach

BackgroundA petroleum leak into the Joint Base Pearl Harbor-Hickam water system on Oahu, Hawaii in November 2021 contaminated the drinking water of approximately 93,000 users, causing many to relocate for months. Perceptions of health and wellbeing were captured using the Centers for Disease Control/Agency for Toxic Substances and Disease Registry (CDC/ATSDR) Assessment of Chemical Exposures (ACE) cross-sectional survey in collaboration with the Hawaii Department of Health (HDOH).MethodsResponses from the ACE online survey of community members, businesses, schools, health care and veterinary care organizations during the contamination event, containing quantitative questions and qualitative information from an open text field, were analyzed. Separately, a qualitative key informant questionnaire was administered to community establishments. Thematic content analysis was used to analyze and identify prominent themes from the ACE open text field and the key informant responses that were triangulated by the quantitative data when the themes aligned.ResultsSix major themes of disruption, communication, trust, stress, support, and ongoing needs were identified. Burdensome logistics from obtaining alternate water, negative financial impacts from relocation or losing business, distrust of information, perceived lack of support from response entities and uncertainty of long-term health impact caused significant disruption, stress and mental health. Individuals reported needing water, shelter, and mental health care while establishments wanted financial reimbursement and a resolution.ConclusionsThe findings show that environmental disasters have significant disruptive and mental health impacts from stress. Identified themes can inform and improve emergency response and communication strategies and increase trust with community members during and after large chemical exposure events.

The impact of alcohol misuse in trauma patients: A scoping review protocol.

Alcohol use is a contributing factor in many cases of traumatic injury. There is conflicting evidence on the impact of alcohol use at the time of physical trauma on severity of injury and hospital course. Similarly, the significance of alcohol use disorder on outcomes in hospitalized trauma patients is unclear. This scoping review aims to provide a concise overview of the current literature surrounding peri-trauma alcohol use and alcohol use disorder on injury severity, in-hospital complications, patient outcomes, and long-term health impact of alcohol use in trauma. We will also explore the associated healthcare costs of this patient population. A systematic search of the following databases MEDLINE, EMBASE, and Cochrane Library will be completed to extract all studies that meet our inclusion criteria from January 2000 onwards. Case reports will be excluded. Two reviewers will screen all citations, abstracts, and full text articles. A third reviewer will act as tiebreaker at each stage of the screening process. A narrative synthesis without meta-analysis will be conducted and assessed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. This review will contribute to the literature by providing a concise overview of the current data on the impact of alcohol on outcomes following trauma. We will explore the overall themes in the literature, limitations, and future directions to focus forthcoming research in this patient population. This project is registered via the Open Science Framework. The public registration is uniquely identified with the following DOI: https://doi.org/10.17605/OSF.IO/Z84WK. There were no funders or sponsors involved in the development of this protocol.

Public Health In Conflict And War: A Response To An Ever Evolving Landscape

Abstract Background The bases for this proposal are the current and ongoing conflict and war situations around the world, causing turmoil for nations and hardship and public health crises for people. We can no longer ignore the critical and time-sensitive need to address issues of Public Health (PH) in conflict and war in our education and training programmes. Objectives To consider appropriate themes and topics in Conflict and War that should be included in PH education and training programmes; and to consider how and where they are best represented. Member schools of the Association of Schools of PH in the European Region (ASPHER) were asked to provide details of their curricula relating PH in Conflict and War. Submissions on this topic were received from over 10 schools. Information was collated into logical themes, to which elements of the curriculum were mapped. In a modified Delphi process, respondents were asked for their level of agreement for inclusion in a curriculum and at what level content should be delivered. Results Findings from the survey allowed identification of seven main themes from topics provided: Contextual Factors; Preventive Strategies; Emergency Preparedness; Impact and Response; Conflict Resolution and Solidarity, Rehabilitation and Recovery. Respondents had high levels of agreement that content should be included in curricula and be delivered at every level in PH education and training. Conclusions PH education and training have been deficient in not including PH in Conflict and War as a subject area in programmes. The knowledge and expertise developed of necessity in some places can be shared across the ASPHER network and beyond to increase awareness of the PH considerations of conflict and war. Key messages • Public health in war and conflict zones is critical due to unique challenges and urgent needs of affected populations. • An Integrated curriculum is vital for addressing conflict’s long-term health impact and preparing skilled workforce for health, resilience, action and laying the path to peace.

Gaza’s hidden crisis: adults, children, and generations of psychological torment to come

ABSTRACT For more than a year, the world has been exposed to the ongoing conflict in Gaza, and the destruction, medical devastation, and the death toll of this crisis. What has been largely missing from the picture, has been an attention to the long-term mental health impact of the ongoing trauma among the Palestinian civilians and the Israeli hostages in Gaza. This article anticipates the enduring generational impact of war trauma on mental health of the civilians in Gaza, drawing from the author’s clinical and research experiences of Iraqi, Syrian, Afghan, African, and Ukrainian war-exposed civilians, refugees, and survivors of torture. Across most different studies, war exposure leads to PTSD in nearly 30–50% of adult civilians, and similar rates of depression and anxiety. Civilians in Gaza, facing daily horrors and a profound sense of helplessness, are likely experiencing even greater psychological distress. Children, significantly affected during critical developmental stages, are at risk of long-term mental and physical health issues. The psychological, cultural, and epigenetic aspects of the intergenerational transmission of trauma can lead to psychological torment across generations. Addressing the mental health needs of these populations is crucial to mitigating the profound and lasting impact of war.

A Nationwide Physical Activity Intervention for 654,500 Adults in Singapore: Cost-Utility Analysis.

Increasing physical inactivity is a primary risk factor for diabetes and hypertension, contributing to rising health care expenditure and productivity losses. As Singapore's aging population grows, there is an increased disease burden on Singapore's health systems. Large-scale physical activity interventions could potentially reduce the disease burden but face challenges with the uncertainty of long-term health impact and high implementation costs, hindering their adoption. We examined the cost-effectiveness of the Singapore National Steps Challenge (NSC), an annual nationwide mobile health (mHealth) intervention to increase physical activity, from both the health care provider perspective, which only considers the direct costs, and the societal perspective, which considers both the direct and indirect costs. We used a Markov model to assess the long-term impact of increased physical activity from the NSC on adults aged 17 years and older. A Monte Carlo simulation with 1000 samples was conducted to compare two situations: the NSC conducted yearly for 10 years against a no-intervention situation with no NSC. The model projected inpatient and outpatient costs and mortality arising from diabetes and hypertension, as well as their complications. Health outcomes were expressed in terms of the quality-adjusted life-years (QALYs) gained. All future costs and QALYs were discounted at 3% per annum. Sensitivity analyses were done to test the robustness of our model results. We estimated that conducting the NSC yearly for 10 years with a mean cohort size of 654,500 participants was projected to prevent 6200 diabetes cases (95% credible interval 3700 to 9100), 10,500 hypertension cases (95% credible interval 6550 to 15,200), and 4930 deaths (95% credible interval 3260 to 6930). This led to a reduction in health care costs of SGD (Singapore dollar) 448 million (95% credible interval SGD 132 million to SGD 1.09 billion; SGD 1=US $0.73 for the year 2019). There would be 78,800 (95% credible interval 55,700 to 102,000) QALYs gained. Using a willingness-to-pay threshold of SGD 10,000 per QALY gained, the NSC would be cost-saving. When indirect costs were included, the NSC was estimated to reduce societal costs by SGD 1.41 billion (95% credible interval SGD 353 million to SGD 3.80 billion). The model was most sensitive to changes in the inpatient cost of treatment for diabetes complications, time horizon, and program compliance. In this modeling study, increasing physical activity by conducting a yearly nationwide physical activity intervention was cost-saving, preventing diabetes and hypertension and reducing mortality from these diseases. Our results provide important information for decision-making in countries that may consider introducing similar large-scale physical activity programs.

National health and economic impact of a lifestyle program to prevent type 2 diabetes mellitus in Germany: a simulation study

IntroductionTo examine the long-term health and economic impact of a lifestyle diabetes prevention program in people with high risk of developing type 2 diabetes in Germany.Research design and methodsWe assessed...

Modelling the long-term health impact of COVID-19 using Graphical Chain Models

BackgroundLong-term sequelae of SARS-CoV-2 infection, namely long COVID syndrome, affect about 10% of severe COVID-19 survivors. This condition includes several physical symptoms and objective measures of organ dysfunction resulting from a complex interaction between individual predisposing factors and the acute manifestation of disease. We aimed at describing the complexity of the relationship between long COVID symptoms and their predictors in a population of survivors of hospitalization for severe COVID-19-related pneumonia using a Graphical Chain Model (GCM).Methods96 patients with severe COVID-19 hospitalized in a non-intensive ward at the “Santa Maria” University Hospital, Terni, Italy, were followed up at 3–6 months. Data regarding present and previous clinical status, drug treatment, findings recorded during the in-hospital phase, presence of symptoms and signs of organ damage at follow-up were collected. Static and dynamic cardiac and respiratory parameters were evaluated by resting pulmonary function test, echocardiography, high-resolution chest tomography (HRCT) and cardiopulmonary exercise testing (CPET).ResultsTwelve clinically most relevant factors were identified and partitioned into four ordered blocks in the GCM: block 1 - gender, smoking, age and body mass index (BMI); block 2 - admission to the intensive care unit (ICU) and length of follow-up in days; block 3 - peak oxygen consumption (VO2), forced expiratory volume at first second (FEV1), D-dimer levels, depression score and presence of fatigue; block 4 - HRCT pathological findings. Higher BMI and smoking had a significant impact on the probability of a patient’s admission to ICU. VO2 showed dependency on length of follow-up. FEV1 was related to the self-assessed indicator of fatigue, and, in turn, fatigue was significantly associated with the depression score. Notably, neither fatigue nor depression depended on variables in block 2, including length of follow-up.ConclusionsThe biological plausibility of the relationships between variables demonstrated by the GCM validates the efficacy of this approach as a valuable statistical tool for elucidating structural features, such as conditional dependencies and associations. This promising method holds potential for exploring the long-term health repercussions of COVID-19 by identifying predictive factors and establishing suitable therapeutic strategies.

The Role of Health Education by Community Nurses in Reducing Smoking Habits in Adolescents

This study explores the role of health education by community nurses in reducing smoking habits among adolescents through qualitative interview methods. The background of this problem is rooted in the long-term health impact of smoking habits, which are often influenced by factors such as peer influence and advertising, as well as a lack of knowledge about the dangers of smoking. The purpose of this study is to understand how health education can affect changes in adolescents' smoking knowledge, attitudes, and behaviors, as well as to assess the role of social support from the family. The method used was in-depth interviews with 20 adolescents who had participated in a health education program guided by a community nurse. The interview data was analyzed using thematic analysis techniques to identify key patterns and themes. The results showed that health education significantly increased adolescents' knowledge about the dangers of smoking and improved their attitudes towards the habit. Teens also reported gaining practical skills to resist the offer of smoking, and family support played an important role in their success in quitting smoking. The implications of this study emphasize the importance of integrating health education with family support to increase program effectiveness. Health education programs by community nurses must be continued and expanded, involving other elements of society, and adapted to the needs of adolescents and technological developments. Support from various parties, including government policies and health agencies, is critical to strengthening these programs and creating an environment that supports the overall health of adolescents Keywords : Health Education, Community Nurses, Smoking, Adolescents

Couples in breast cancer survivorship: Daily associations in relationship satisfaction, stress, and health

Romantic relationships are a key health determinant underlying both morbidity and mortality. Dr. Janice Kiecolt-Glaser’s prolific research revealed cardiovascular, metabolic, endocrine, and immune pathways connecting marriage to health and longevity. In addition to her empirical work, she developed conceptual models on marriage, the gut microbiome, stress reactivity, and spousal health concordance; these models guide and inspire mechanistic research, serve as essential readings for graduate students and mentees, and provide inspiration for researchers across career stages. This paper highlights Dr. Kiecolt-Glaser’s influential work, includes personal reflections and professional growth as past mentees, and provides Dr. Kiecolt-Glaser-inspired evidence linking relationships to health among couples in breast cancer survivorship. Using baseline questionnaires and daily dairies, breast cancer survivors (stage I-IIIB) and their cohabiting partners (60 individuals, 30 couples) rated their relationship satisfaction, stress, and physical health symptoms every day for 7 days. Results suggest that breast cancer survivors and their partners who felt more satisfied with their relationships also felt less stressed, both typically and on a daily basis. Survivors’ and partners’ lower stress was also associated with fewer physical health problems on average and in daily life. These findings demonstrate the daily stress and health advantages of satisfying relationships for both breast cancer survivors and their partners. We discuss the study’s implications and several avenues for Dr. Kiecolt-Glaser-inspired research addressing a relationship’s long-term health impact among couples in survivorship.

The Untapped Biomarker Potential of MicroRNAs for Health Risk-Benefit Analysis of Vaping vs. Smoking.

Despite the popularity of electronic cigarettes (e-cigs) among adolescent never-smokers and adult smokers seeking a less pernicious substitute for tobacco cigarettes, the long-term health impact of vaping is largely unknown. Like cigarette smoke, e-cig vapor contains harmful and potentially harmful compounds, although in fewer numbers and at substantially lower concentrations. Many of the same constituents of e-cig vapor and cigarette smoke induce epigenetic changes that can lead to the dysregulation of disease-related genes. MicroRNAs (MiRNAs) are key regulators of gene expression in health and disease states. Extensive research has shown that miRNAs play a prominent role in the regulation of genes involved in the pathogenesis of smoking-related diseases. However, the use of miRNAs for investigating the disease-causing potential of vaping has not been fully explored. This review article provides an overview of e-cigs as a highly consequential electronic nicotine delivery system, describes trends in e-cig use among adolescents and adults, and discusses the ongoing debate on the public health impact of vaping. Highlighting the significance of miRNAs in cell biology and disease, it summarizes the published and ongoing research on miRNAs in relation to gene regulation and disease pathogenesis in e-cig users and in vitro experimental settings. It identifies gaps in knowledge and priorities for future research while underscoring the need for empirical evidence that can inform the regulation of tobacco products to protect youth and promote public health.

Assessing the Long-Term Health Impact and Evolving Needs of the Zaatari Refugee Camp Population

Assessing the Long-Term Health Impact and Evolving Needs of the Zaatari Refugee Camp Population

Parental Mental Health, Gender, and Lifestyle Effects on Post-Pandemic Child and Adolescent Psychosocial Problems: A Cross-Sectional Survey in Northern Italy.

The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, an analysis was conducted to understand how these elements continue to affect young populations in the post-pandemic era. In April 2023, a comprehensive online survey was administered to families in South Tyrol, Italy, with children aged 7-19 years, to ensure age and gender representation. The survey included parent ratings and adolescent (11-19 years) self-reports using standardized instruments to measure the symptoms of mental health problems (Strengths and Difficulties Questionnaire, SDQ), anxiety (Screen for Child Anxiety Related Emotional Disorders, SCARED), and depression (Patient Health Questionnaire-2, PHQ-2). Statistical analyses included descriptive statistics, chi-square tests, and unadjusted odds ratios (ORs). Of the 4525 valid responses, 1831 were self-reported by adolescents. Notable gender differences in mental health outcomes were identified, along with significant demographic predictors, such as age, single parenthood, parental mental health problems, and immigrant background. Negative effects were associated with reduced family climate and increased screen time, whereas physical activity showed beneficial effects. Proxy reports overestimated adolescents' mental health problems, whereas self-reports tended to underestimate them. Persistent mental health problems and gender disparities highlight the need for a public health approach. This should include accessible support services, resilience building, targeted support for vulnerable families and gender-specific interventions.

The effectiveness and health impact of fad diets on obese patients: a literature review

Introduction and purpose Obesity is a serious health problem nowadays and it is becoming more and more common. There are plenty of causes of obesity including bad eating habits, genetic factors, and psychological factors. A lot of obese people look for a way to lose weight. Fad diets are popular dietary strategies which are promoted as a quick way to lose weight. This article highlights some popular dietary strategies including low-carbohydrate diet, low-fat diet, Paleolithic Diet and Detox Diet. The aim of this paper is to analyse their effectiveness in the process of successful weight loss and their health impact. State of knowledge According to WHO in 2022 1 in 8 people in the world were obese. Fad diets are promoted as methods to improve health and as a quick way to lose weight. However, available research suggests a rather unfavorable impact on human health in the context of long-term adherence to these diets. Limited data suggests the beneficial long-term health impact of such diets. Moreover, dieting and weight cycling caused by the repetitive process of weight loss after dieting and weight regain afterwards may also play a role in the development of obesity. Conclusion Fad diets are not recommended as a long-term way of nutrition. The main limitation of these dietary strategies is their short-term effectiveness rather than long-term. Adherence to these diets is hard for patients. Because of their strict rules and food exclusions, the risk of weight regain is high. Moreover, they do not show many positive long-term health consequences and they are not superior to conventional healthy diets. What’s more, strict obedience to fad diets for extended periods of time may be detrimental to the dieter's health.

EFEKTIVITAS MUSIK MOZART DAN EDUKASI AUDIOVISUAL PADA IBU POSTPARTUM BLUES

Introduction: Postpartum blues is a situation of mood swings that occur in women after childbirth. Postpartum blues can have a long-term mental health impact on the mother. The short-term impact on the mother is the inability to carry out her role as a mother and maternal self-care. The results of EPDS screening in postpartum patients at RSUD. Bekasi patients were detected to have postpartum depression. This condition occurs because of the focus on postpartum physiological conditions. One of the treatments that can be given to postpartum mothers is to provide Mozart music relaxation therapy and audiovisual education to respondents. Methods: The research design used is one group pre-post test design method with pre experiment research design. The population in this study were 80 postpartum mothers with inclusion of Postpartum Blues. Results: analysis of research data shows that there is an average difference (mean) between the pre-test and post-test scores of Mozart music therapy intervention and audiovisual education to overcome postpartum blues, with an average pre-test of 14.44 and an average post-test of 11.13. Conclusion: Mozart music therapy and audiovisual education reduce the EPDS score of postpartum mothers. There is a significant difference between postpartum blues mothers before and after being given the intervention of Mozart Music therapy and Audiovisual Education for postpartum blues. Mozart music therapy and audiovisual education can be applied in the management of postpartum blues.

Are expectations of labour and birth fulfilled? A qualitative investigation of first-time parents.

To describe if first-time parents' expectations of labour and birth, explored during the third trimester of pregnancy, were fulfilled or not when investigated 1 year following birth. Qualitative Husserlian phenomenological approach. The sample comprises 10 parents (five couples), who participated in an online semi-structured audio-recorded individual interview conducted 1 year after birth, between September 2020 and October 2020. Parents' expectations of labour and birth, described throughout a focus group discussion on pregnancy, were compared with their experience explored 1 year after birth. A thematic analysis was adopted and member checking was used to validate participants' thoughts. Participants gave birth in a II level maternity unit and one-to-one midwifery care was provided. Although during the focus group conducted in pregnancy, women reported being aware of the unpredictable nature of childbirth, they expressed sadness and failure after experiencing some unexpected interventions. The midwife was a reassuring guide, as expected; however, sometimes, the communication was not effective, and women perceived lack of support. Some women partly blame themselves for not being prepared to manage labour pain, which hurt more than expected. Feeling of uncertainty about events were experienced in relation to seeking care at an early stage of labour, which confirmed the fears expressed during pregnancy. During the antenatal focus group discussion, fathers doubted they could be helpful for the labouring women. This negative emotion was confirmed after birth. However, they understood the importance to be present and to support their partner. One year after birth, participants had consistent memories of their birth experience. Professionals might identify fundamental components of quality maternity care that are meaningful for parents, with the potential to generate a long-term positive health impact on them. Respectful maternity care should be ensured through a family-centred approach, with the aim to promote satisfaction. The study highlights the importance of taking parents' expectations into account when providing antenatal care to tailor individualized support that addresses their distinct needs and preferences. Healthcare professionals might consider initiating a post-natal discussion with parents to assess whether their needs and perspectives have been addressed. This perspective may present valuable insights to achieve long-term positive outcomes, provide high-quality maternity care, address issues and make improvements. The study showed that 1 year after birth, parents can accurately recall their birth. They might also give significant insights into fundamental components of care that they value as crucial to shape a positive birthing experience. Professionals should use this information to build solutions, promoting long-term well-being for parents. Respectful interactions and trusting relationships emerged as key elements in parents' experience. A midwifery care focused on parents' needs may contribute to the achievement of positive birth memories. This study used the Standards for Reporting Qualitative Research checklist. No patient or public contribution.

Adolescents' Tsunami Exposure and Mental Health Consequences: Protective Role of Cultural Coping Strategies.

There is a knowledge gap regarding the link between disaster exposure and adolescent mental health problems in developing countries. This study examines the case of Sri Lanka to investigate (a) the immediate and long-term mental health impact of the 2004 tsunami disaster on adolescents and (b) the potential moderating effects of unique cultural and family practices that prevail in Sri Lanka. This study used a random sample of 160 adolescents (ages 12-19) and their mothers who were exposed to the tsunami disaster while living in a southern Sri Lankan village and provided prospective data immediately after the disaster (2005) and three years later (2008). A cross-culturally validated instrument assessed adolescent-mother dyads' tsunami exposure, stressful loss, family cultural rituals and familism, and adolescent mental health. Structural equation modeling analysis showed that exposure and perceptions of tsunami-induced stressful experiences were associated with early and later mental health problems in adolescents. In addition, this study found that unique cultural practices and familism moderated the link between adolescent tsunami exposure, stressful experiences, and levels of PTSD and depressive symptoms. The findings of this study could be utilized to develop prevention and intervention programs that are contextually and culturally valid and empirically supported, which would be more effective for trauma-exposed adolescents in developing countries.

Abstract 3117: Cannabis Use Disorder And The Risk Of Atherosclerotic Cardiovascular Diseases

Introduction: With the legalization of cannabis, concerns have emerged regarding the long-term health impact of excessive use. The current literature has struggled to address questions about the adverse effects of cannabis, particularly in the context of atherosclerotic cardiovascular disease (ASCVD). Using genetic approaches to causal inference, we explored the relationship between cannabis use disorder (CUD) and ASCVD. Methods: Genetic instruments were constructed from a multi-population GWAS comprising 64,314 individuals with and 990,051 without CUD. Outcome data for coronary artery disease (CAD), ischemic stroke, peripheral artery disease (PAD), and abdominal aortic aneurysms (AAA) were derived from multi-population GWAS. Univariable Mendelian randomization (MR) was performed using the inverse-variance weighted (IVW) method to test the association of CUD with each outcome. Multivariable MR (MVMR) was performed to assess if the impact of cardiometabolic risk factors accounted for the association of CUD with ASCVD using summary statistics from publicly available GWAS of cardiometabolic risk factors. Results: CUD was associated with increased risk of CAD (OR 1.27; 95% CI 1.17-1.38; P=<0.01), ischemic stroke (OR 1.10; 95%CI 1.03-1.19; P=<0.01), PAD (OR 1.31; 95% CI 1.17-1.46; P=<0.01), and AAA (OR 1.37; 95% CI 1.21-1.55; P=<0.01). CUD also had a significant impact on cardiometabolic risk factors including triglycerides, waist-to-hip ratio, BMI, type 2 diabetes, obesity, and heart failure. The effect of CUD on ASCVD, other than stroke, remained largely independent of traditional risk factors except for lipids and tobacco smoking. Controlling for lifetime smoking index attenuated all associations between CUD and ASCVD except CAD, which remained significant (OR 1.21; 95% CI 1.11-1.31). Conclusion: Excessive cannabis use has the potential to increase ASCVD risk, independent of cardiometabolic risk factors, although this risk may in part be attributable to shared susceptibility to lipids and tobacco use. Awareness of the long-term risks of excessive cannabis use should be considered when formulating medical advice and public policy.

Assessment of health consequences of fossil fuel energy use in Osun state, Nigeria: burden and implications

The use of fossil fuel energy persists in all the continents of the world, especially in Africa. This study examined fossil fuel energy usage and its health implications in residents of Osun State, Nigeria. This was a cross-sectional study done across Osun State Nigeria. The study took place between January and June 2020. 1044 participants were recruited by multi-stage random sampling. Structured questionnaires were used to obtain necessary information from the study participants. The study data shows there were 534 females (51.1%). 601 (57.6%) relied solely on fossil fuel energy compared to 443 (42.4%) who use non-traditional energy sources. The proportion of people whose annual income is less than 56.6 USD (fifty thousand Naira based on the current official exchange rate as of Jan 2024) is far higher among those who use fossil fuel energy (88.0%) compared to those who use modern energy (59.1%). Electricity consumption accessibility was also more likely among those who used modern energy (91.9%) compared to 52.4% of those who use fossil fuel energy for daily energy needs. Reports of ill-health were significantly commoner among those who used fossil fuel than modern energy in the population including asthma illness (15.3% vs. 11.3%), cough (21.1% vs. 16.7%), catarrh (19.3% vs. 10.8%) and difficulty in breathing (9.3% vs. 6.3%) respectively. This study showed that fossil fuel energy use is very prevalent among residents of Osun State, Nigeria. And may be linked with many indices of poverty. It is associated with significant health impacts including respiratory diseases and poor quality of life. There is a need to encourage and implement policies toward effective and efficient energy use among residents in Osun State to reduce the associated long-term health impact.

Long-term effects of chronic exposure to electronic cigarette aerosol on the cardiovascular and pulmonary system in mice: A comparative study to cigarette smoke

Electronic cigarettes (e-cigarettes) have rapidly gained popularity as alternatives to traditional combustible cigarettes. However, their long-term health impact remains uncertain. This study aimed to investigate the effects of chronic exposure to e-cigarette aerosol (ECA) in mice compared to conventional cigarette smoke (CS) exposure. The mice were exposed to air (control), low, medium, or high doses of ECA, or a reference CS dose orally and nasally for eight months. Various cardiovascular and pulmonary assessments have been conducted to determine the biological and prosthetic effects. Histopathological analysis was used to determine structural changes in the heart and lungs. Biological markers associated with fibrosis, inflammation, and oxidative stress were investigated. Cardiac proteomic analysis was applied to reveal the shared and unique protein expression changes in ECA and CS groups, which related to processes such as immune activation, lipid metabolism, and intracellular transport. Overall, chronic exposure to ECA led to adverse cardiovascular and pulmonary effects in mice, although they were less pronounced than those of CS exposure. This study provides evidence that e-cigarettes may be less harmful than combustible cigarettes for the long-term health of the cardiovascular and respiratory systems in mice. However, further human studies are needed to clarify the long-term health risks associated with e-cigarette use.