scholarly journals Transitions among BMI States: A Test of Competing Hypotheses

Obesities ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 1-25
Author(s):  
Hui Liew
Keyword(s):  
Weight Loss ◽  
Empirical Work ◽  
The United States ◽  
Life Tables ◽  
Negative Consequences ◽  
Cohort Differences ◽  
Multistate Life Tables ◽  
Race Ethnicity ◽  
Black Populations ◽  
The Impact

Overweight/obesity and underweight among older adults remain major public health concerns in the United States. This study aims to assess cohort differences in transition among BMI (body mass index) statuses (underweight, normal weight, overweight, and obese) by various cohort and race/ethnicity–gender groups. The empirical work of this study was based on the 1992–2014 Health and Retirement Study (HRS). Multistate life tables (MSLT) were used to assess transitions among different BMI statuses. Results from multistate life tables suggested that the impact of cumulative advantage (disadvantage), persistent inequality, and aging-as-leveler on transition among BMI statuses was shaped along race/ethnicity–gender and cohort lines. Weight management and weight loss strategies should focus on ethnic minorities (i.e., Black and Hispanic populations) and White participants from recent cohorts. Programs aimed at minimizing the negative consequences associated with underweight and weight loss should focus on individuals from earlier cohorts and Black populations.

scholarly journals A New Look at the Living Arrangements of Older Americans Using Multistate Life Tables

2018 ◽  
Vol 74 (7) ◽  
pp. e84-e96 ◽  
Author(s):  
James M Raymo ◽  
Isabel Pike ◽  
Jersey Liang
Keyword(s):  
Life Expectancy ◽  
Educational Attainment ◽  
Living Arrangements ◽  
Living Arrangement ◽  
Later Life ◽  
The United States ◽  
Life Tables ◽  
Older Americans ◽  
Multistate Life Tables ◽  
Race Ethnicity

Abstract Objectives We extend existing research on the living arrangements of older Americans by focusing on geographic proximity to children, examining transitions in living arrangements across older ages, and describing differences by both race/ethnicity and educational attainment. Method We use data from the Health and Retirement Study (HRS) over a period of 10 years (2000–2010) to construct multistate life tables. These analyses allow us to describe the lives of older Americans between ages 65 and 90 in terms of the number of expected years of life in different living arrangements, reflecting both mortality and living arrangement transitions. Results Americans spend a substantial proportion of later life living near, but not with, adult children. There is a good deal of change in living arrangements at older ages and living arrangement-specific life expectancy differs markedly by race/ethnicity and educational attainment. However, overall life expectancy is not strongly related to living arrangements at age 65. Discussion Multistate life tables, constructed separately by sex, race/ethnicity, and educational attainment, provide a comprehensive description of sociodemographic differences in living arrangements across older ages in the United States. We discuss the potential implications of these differences for access to support and the exacerbation or mitigation of inequalities at older ages.

Didactic education in paediatric cardiology during the COVID-19 pandemic: a national fellow survey

2020 ◽  
pp. 1-4
Author(s):  
Madhusudan Ganigara ◽  
Chetan Sharma ◽  
Fernando Molina Berganza ◽  
Krittika Joshi ◽  
Andrew D. Blaufox ◽  
...  
Keyword(s):  
United States ◽  
Online Learning ◽  
United States Of America ◽  
Formal Education ◽  
Medical Training ◽  
Nationwide Survey ◽  
The United States ◽  
Negative Consequences ◽  
Paediatric Cardiology ◽  
The Impact

Abstract The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on medical educational curricula. We aimed to examine the impact of these unprecedented changes on the formal education of paediatric cardiology fellows through a nationwide survey. A REDCap™-based voluntary anonymous survey was sent to all current paediatric cardiology fellows in the United States of America in May, 2020. Of 143 respondents, 121 were categorical fellows, representing over one-fourth of all categorical paediatric cardiology fellows in the United States of America. Nearly all (140/143, 97.9%) respondents utilised online learning during the pandemic, with 134 (93.7%) reporting an increase in use compared to pre-pandemic. The percentage of respondents reporting curriculum supplementation with outside lectures increased from 11.9 to 88.8% during the pandemic. Respondents considered online learning to be “equally or more effective” than in-person lectures in convenience (133/142, 93.7%), improving fellow attendance (132/142, 93.0%), improving non-fellow attendance (126/143, 88.1%), and meeting individual learning needs (101/143, 70.6%). The pandemic positively affected the lecture curriculum of 83 respondents (58.0%), with 35 (24.5%) reporting no change and 25 (17.5%) reporting a negative effect. A positive effect was most noted by those whose programmes utilised supplemental outside lectures (62.2 versus 25.0%, p = 0.004) and those whose lecture frequency did not decrease (65.1 versus 5.9%, p < 0.001). Restrictions imposed by the COVID-19 pandemic have greatly increased utilisation of online learning platforms by medical training programmes. This survey reveals that an online lecture curriculum, despite inherent obstacles, offers advantages that may mitigate some negative consequences of the pandemic on fellowship education.

The Impact of Race/Ethnicity on the Outcomes of Burn Patients: A Systematic Review of the Literature

2021 ◽  
Author(s):  
Jasmine Peters ◽  
Mariel S Bello ◽  
Leigh Spera ◽  
T Justin Gillenwater ◽  
Haig A Yenikomshian
Keyword(s):  
Systematic Review ◽  
Native American ◽  
The United States ◽  
Current Status ◽  
Surgical Trauma ◽  
Insurance Status ◽  
Inclusion Criteria ◽  
Burn Care ◽  
Race Ethnicity ◽  
The Impact

Abstract Racial and ethnic disparities are endemic to the United States and are only beginning to attract the attention of researchers. With an increasingly diverse population, focused and tailored medicine to provide more equitable care is needed. For surgical trauma populations, this topic is a small but expanding field and still rarely mentioned in burn medicine. Disparities in prevention, treatment, and recovery outcomes between different racial and ethnic minorities who are burned are rarely discussed. The purpose of this study is to determine the current status of identified disparities of care in the burn population literature and areas of future research. A systematic review was conducted of literature utilizing PubMed for articles published between 2000-2020. Searches were used to identify articles that crossed the burn term (burn patient OR burn recovery OR burn survivor OR burn care) and a race/ethnicity and insurance status-related term (race/ethnicity OR African-American OR Black OR Asian OR Hispanic OR Latino OR Native American OR Indigenous OR Mixed race OR 2 or more races OR socioeconomic status OR insurance status). Inclusion criteria were English studies in the US that discussed disparities in burn injury outcomes or risk factors associated with race/ethnicity. 1,169 papers were populated, 55 were reviewed, and 36 articles met inclusion criteria. Most studies showed minorities had poorer inpatient and outpatient outcomes. While this is a concerning trend, there is a paucity of literature in this field and more research is needed to create culturally-tailored medical care and address the needs of disadvantaged burn survivors.

scholarly journals COVID-19 In United States: Statistical Analysis and Inferences From the Empirical Data

2021 ◽  
Author(s):  
Nivedita Rethnakar
Keyword(s):  
United States ◽  
Statistical Analysis ◽  
Statistical Inference ◽  
Empirical Data ◽  
Respiratory Diseases ◽  
Temporal Dynamics ◽  
The United States ◽  
Mortality Statistics ◽  
Race Ethnicity ◽  
The Impact

Abstract This paper investigates the mortality statistics of the COVID-19 pandemic from the United States perspective. Using empirical data analysis and statistical inference tools, we bring out several exciting and important aspects of the pandemic, otherwise hidden. Specific patterns seen in demo- graphics such as race/ethnicity and age are discussed both qualitatively and quantitatively. We also study the role played by factors such as population density. Connections between COVID-19 and other respiratory diseases are also covered in detail. The temporal dynamics of the COVID-19 outbreak and the impact of vaccines in controlling the pandemic are also looked at with suf- ficient rigor. It is hoped that statistical inference such as the ones gathered in this paper would be helpful for better scientific understanding, policy prepa- ration and thus adequately preparing, should a similar situation arise in the future.

scholarly journals Warlords, the United States, and the state of anarchy in Afghanistan

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Ahmad Shah Azami
Keyword(s):  
United States ◽  
The United States ◽  
State Building ◽  
The State ◽  
Negative Consequences ◽  
Human Rights Abuses ◽  
Illegal Mining ◽  
The Us ◽  
The Government ◽  
The Impact

As part of its “War on Terror”, the United States (US) provided immense sums of money and advanced equipment to Afghan warlords in order to defeat and dismantle the Taliban and al-Qaeda in Afghanistan. Nearly two decades after the 2001 US-led intervention in Afghanistan that toppled the Taliban regime, the US continues supporting the warlords in various ways. As the intervention was also aimed at establishing a functioning state and reconstruction of the war-torn country, the US needed the support of local warlords to achieve its goals. However, over time, warlords and warlordism became a major challenge to the postTaliban state-building project and in many ways undermined the overall security and the state monopoly on violence. These warlords, who had been mostly expelled and defeated by the Taliban regime, returned under the aegis of the B52 bombers, recaptured parts of the country and reestablished their fiefdoms with US support and resources. They not only resist giving up the power and prestige they have accumulated over the past few years, but also hamper the effort to improve governance and enact necessary reforms in the country. In addition, many of them run their private militias and have been accused of serious human rights abuses as well as drug trafficking, arms smuggling, illegal mining and extortion in the areas under their control or influence. In many ways, they challenge the government authority and have become a major hurdle to the country’s emerging from lawlessness and anarchy. This paper explores the emergence and reemergence of warlords in Afghanistan as well as the evolution of chaos and anarchy in the country, especially after the US-led intervention of late 2001. It also analyzes the impact of the post-9/11 US support to Afghan warlords and its negative consequences for the overall stability and the US-led state-building process in Afghanistan.

Supporting Children Who Experience Domestic Violence: Evaluating the Child Witness to Domestic Violence Program

2021 ◽  
pp. 088626052110358
Author(s):  
Erin C. Schubert
Keyword(s):  
Domestic Violence ◽  
Intervention Group ◽  
Well Being ◽  
The United States ◽  
Control Group ◽  
Child Witness ◽  
Negative Consequences ◽  
Emotional Symptoms ◽  
Child Gender ◽  
The Impact

Impacting 1 in 4 children in the United States, childhood exposure to domestic violence predicts myriad negative sequelae. Intervening post exposure is critical to help children and their protective parent heal and avoid long-term negative consequences. Children aged 2-17 and their mothers who were victims of domestic violence participated in a 12-week group program delivered by domestic violence agency staff that provides psychoeducation on the impact of trauma and domestic violence and aims to improve parent and child well-being. The impact of the Child Witness to Domestic Violence (CWDV) program was tested in an intervention group ( n = 69 children, 33 mothers) who participated in CWDV and control group ( n = 80 children, 39 mothers) consisting of children whose mothers received adult-focused domestic violence services but were not enrolled in CWDV or other child-focused services. Multiple regression analyses controlling for child gender, child age, mother’s age, and the outcome of interest at time 1 found that participation in CWDV program significantly predicted better child functioning as indicated by less hyperactivity ( B = –.85, p = .06), fewer negative emotional symptoms ( B = –1.14, p = .01), and fewer total behavioral difficulties ( B = –2.48, p = .02) as well as higher maternal hope ( B = .57, p = .03). These data provide promising evidence of the impact of a brief, replicable group intervention that promotes healing and well-being among children and parents exposed to domestic violence. Limitations include a quasi-experimental design and reliance on maternal report.

Afro-Latina/os

2019 ◽  
Author(s):  
Carlos Ulises Decena
Keyword(s):  
United States ◽  
20Th Century ◽  
African Ancestry ◽  
Racial Diversity ◽  
The United States ◽  
Racial Identification ◽  
Latin Americans ◽  
Race Ethnicity ◽  
Black Populations ◽  
Politics Of Race

The term Afro Latina/os references people in Latin America and in the Latino United States who claim African ancestry. Although the use of the prefix Afrocan be traced back to the work of intellectuals in Cuba, Mexico, and Brazil at the beginning of the 20th century, usages were connected with anti-racist and African Diaspora struggles, organizing, and advocacy in the second half of the 20th century. More recently, the appellation Afro Latina/o has become mobilized in US Latina/o communities as a critique of the processes through which racial diversity and black populations in these communities have been rendered invisible. Because it conjures various meanings and foci, several authors engaged in the study of afrolatinidades suggest that hemispheric, transnational, and comparative approaches are necessary to appreciate the nuances of use, categorization, and experience as Afro Latina/os navigate complex histories and politics of race, ethnicity, and belonging in the United States and the Americas. The author argues that the term appellation does not resolve the complexities of racial subordination, racism, and self-making among Latin Americans and US Latina/os. He further suggests that sites of unintelligibility, confusion, and perplexity are valuable in thinking of “Afro-Latina/o” as a term that points to a cluster of urgent intellectual and political problems stemming from the irreducibility of individual experience to any term or concept. The increase in claims of Afro-Latina/o as a marker of identity must be calibrated by a consideration of how institutional sites and think tanks collaborate in the making and sedimentation of existing and emerging grids of legibility. At the same time, claiming Afro-Latina/o needs to be understood as a project related to yet distinct from one’s racial identification and relationship with blackness, and the experience of US Latina/os and other ethnic/racial minorities suggests that the work continues to be not only to understand how individuals and groups categorize themselves and others, but also to better grasp what it is that terms such as Afro-Latino/a do.

scholarly journals COVID-19: US federal accountability for entry, spread, and inequities—lessons for the future

2020 ◽  
Vol 35 (11) ◽  
pp. 995-1006 ◽  
Author(s):  
William P. Hanage ◽  
Christian Testa ◽  
Jarvis T. Chen ◽  
Letitia Davis ◽  
Elise Pechter ◽  
...  
Keyword(s):  
Occupational Safety ◽  
The United States ◽  
Health Administration ◽  
Worldwide Population ◽  
Safety And Health ◽  
The Us ◽  
Working Age ◽  
Community Transmission ◽  
Race Ethnicity ◽  
The Impact

AbstractThe United States (US) has been among those nations most severely affected by the first—and subsequent—phases of the pandemic of COVID-19, the disease caused by SARS-CoV-2. With only 4% of the worldwide population, the US has seen about 22% of COVID-19 deaths. Despite formidable advantages in resources and expertise, presently the per capita mortality rate is over 585/million, respectively 2.4 and 5 times higher compared to Canada and Germany. As we enter Fall 2020, the US is enduring ongoing outbreaks across large regions of the country. Moreover, within the US, an early and persistent feature of the pandemic has been the disproportionate impact on populations already made vulnerable by racism and dangerous jobs, inadequate wages, and unaffordable housing, and this is true for both the headline public health threat and the additional disastrous economic impacts. In this article we assess the impact of missteps by the Federal Government in three specific areas: the introduction of the virus to the US and the establishment of community transmission; the lack of national COVID-19 workplace standards and enforcement, and lack of personal protective equipment (PPE) for workplaces as represented by complaints to the Occupational Safety and Health Administration (OSHA) which we find are correlated with deaths 16 days later (ρ = 0.83); and the total excess deaths in 2020 to date already total more than 230,000, while COVID-19 mortality rates exhibit severe—and rising—inequities in race/ethnicity, including among working age adults.

Rural-Urban Mortality Disparities: Variations Across Causes of Death and Race/Ethnicity, 2013–2017

2020 ◽  
Vol 110 (9) ◽  
pp. 1325-1327 ◽  
Author(s):  
Janice C. Probst ◽  
Whitney E. Zahnd ◽  
Peiyin Hung ◽  
Jan M. Eberth ◽  
Elizabeth L. Crouch ◽  
...  
Keyword(s):  
Respiratory Disease ◽  
Alaska Native ◽  
Causes Of Death ◽  
The United States ◽  
Death Rates ◽  
All Cause Mortality ◽  
Race Ethnicity ◽  
Black Populations ◽  
Lower Respiratory Disease ◽  
Hispanic White

Objectives. To examine rural-urban disparities in overall mortality and leading causes of death across Hispanic (any race) and non-Hispanic White, Black, American Indian/Alaska Native (AI/AN), and Asian/Pacific Islander populations. Methods. We performed a retrospective analysis of age-adjusted death rates for all-cause mortality and 5 leading causes of death (cardiovascular, cancer, unintentional injuries, chronic lower respiratory disease, and stroke) by rural versus urban county of residence in the United States and race/ethnicity for the period 2013 to 2017. Results. Rural populations, across all racial/ethnic groups, had higher all-cause mortality rates than did their urban counterparts. Comparisons within causes of death documented rural disparities for all conditions except cancer and stroke among Hispanic individuals; Hispanic rural residents had death rates similar to or lower than urban residents. Rural Black populations experienced the highest mortality for cardiovascular disease, cancer, and stroke. Unintentional injury and chronic lower respiratory disease mortality were highest in rural AI/AN and rural non-Hispanic White populations, respectively. Conclusions. Investigating rural-urban disparities without also considering race/ethnicity leaves minority health disparities unexamined and thus unaddressed. Further research is needed to clarify local factors associated with these disparities and to test appropriate interventions.

scholarly journals Dietary and herbal supplements for weight loss: assessing the quality of patient information online

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Jeremy Y. Ng ◽  
Saad Ahmed ◽  
Catherine Jiayi Zhang
Keyword(s):  
Weight Loss ◽  
Health Information ◽  
Healthcare Providers ◽  
The United States ◽  
Consumer Health Information ◽  
Consumer Health ◽  
High Quality ◽  
The Mean ◽  
The Impact

Abstract Background Given the high prevalence of dietary and herbal supplement (DHS) use in tandem with the growing ease of internet access, patients commonly search online for consumer health information about these products. One common reason for DHSs use includes weight loss. Healthcare providers need to be aware of the quality of online information about DHSs for weight loss so they can adequately counsel their patients and provide them with guidance surrounding the identification of high-quality information resources. This study aimed to assess the quality of online DHSs consumer health information for weight loss that a “typical” patient might access online. Methods Six search terms were used to generate the first 20 websites on the Google search engine in four countries: Australia, Canada, the United Kingdom, and the United States (n = 480 websites). After applying exclusion criteria, eligible websites were quality assessed using the DISCERN instrument. This tool is comprised of 16 questions, each evaluated on a 5-point scale. The averages and standard deviations for each DISCERN instrument item, in addition to overall summed scores between 15 and 75 were calculated. Results Across 87 eligible websites, the mean summed score was 44.80 (SD = 11.53), while the mean overall DISCERN score of each website was 2.72 (SD = 0.99). In general, websites detailed and achieved their specified aims and described treatment benefits. However, most websites failed to describe the impact of treatment on overall quality of life and the impact of a no treatment option. The highest-scoring websites were largely government or health portal websites, while the lowest-scoring websites were largely commercial in nature. Conclusion High variability in DISCERN instrument scores was found across all websites assessed. Healthcare providers should be aware of the fact that their patients may be accessing misinformation online surrounding the use of DHSs for weight loss. Therefore, it is important for healthcare providers to ensure that they are providing their patients with guidance on how to identify high-quality resources online, in order that safe, effective, and evidence-based decisions are made surrounding the use of DHSs for weight loss.

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