Metabolic Changes After a 24-Week Soccer-Based Adaptation of the Diabetes Prevention Program in Hispanic Males: A One-Arm Pilot Clinical Trial

Aims: One third of the U.S. adult population is estimated to have obesity-associated prediabetes. Hispanics have a 50% higher type 2 diabetes death rate compared to non-Hispanic whites, yet low participation in lifestyle change programs, making this subgroup an important target for prevention. Our objective was to determine the feasibility and the effects of an intervention implementing the Center for Disease Control and Prevention National Diabetes Prevention Program (NDPP) plus recreational soccer (RS) in Hispanic men.Methods: Overweight and obese Hispanic men, aged 30–57 years with prediabetes at screening were recruited (n = 41). Trained soccer coaches led 30-min facilitated discussion of the NDPP modules after each RS session, with two sessions per week for 12 weeks and once per week for the following 12 weeks. The 1-h RS sessions followed the Football Fitness curriculum. Assessments included body mass index, waist circumference, bioelectrical impedance analysis (InBody 270), blood pressure, glycated hemoglobin (HbA1c), and validated physical fitness tests. Multilevel mixed models assessed the outcomes as a function of time and cohort and incorporated an unstructured covariance structure to examine the changes from baseline to 24 weeks. All analyses were conducted as intent-to-treat using SAS v 9.4.Results: Hispanic males (n = 41; mean age 41.7 [0.1] years) were obese at baseline (mean BMI 32.7, standard error of mean [0.7], mean weight 93.9 [2.2] kg). Attendance rate was 65% overall at 12 weeks but differed between cohorts. Five mild injuries occurred over the trial. After 24 weeks of the NDPP+RS intervention, there were significant decreases in systolic and diastolic blood pressure (%change −4.7[SE 2.4]; 95% CI [−11.5, −1.7] and −6.1 [1.7] mmHg; [−9.6, −2.6], respectively), HbA1c (−0.2 [0.1]; [−0.3, −0.1]), Despite significant reductions in weight (−3.8 [0.7]; [−5.2, −2.5]), waist circumference (−6.6 [0.7] cm; [−8.0, −5.1]), body fat % (−1.9 [0.5]; [−2.8, −1.0]), lean body mass was preserved (−0.9 [0.3]; [−1.6, −0.2]).Conclusion: A 24-week soccer-based adaptation of the Diabetes Prevention Program is safe and feasible among middle-aged Latino men.

Excess mortality from COVID and non-COVID causes in minority populations

The 2020 US mortality totaled 2.8 million after early March, which is 17.3% higher than age-population–weighted mortality over the same time interval in 2017 to 2019, for a total excess death count of 413,592. We use data on weekly death counts by cause, as well as life tables, to quantify excess mortality and life years lost from both COVID-19 and non–COVID-19 causes by race/ethnicity, age, and gender/sex. Excess mortality from non–COVID-19 causes is substantial and much more heavily concentrated among males and minorities, especially Black, non-Hispanic males, than COVID-19 deaths. Thirty-four percent of the excess life years lost for males is from non–COVID-19 causes. While minorities represent 36% of COVID-19 deaths, they represent 70% of non–COVID-19 related excess deaths and 58% of non–COVID-19 excess life years lost. Black, non-Hispanic males represent only 6.9% of the population, but they are responsible for 8.9% of COVID-19 deaths and 28% of 2020 excess deaths from non–COVID-19 causes. For this group, nearly half of the excess life years lost in 2020 are due to non–COVID-19 causes.

The Intersection Between Sex and Race in Understanding Substance Co-Use Patterns in Adolescents From the Fragile Families Study

The current study examined the prevalence of alcohol, cigarette, and cannabis co-use among a longitudinal cohort of youth predominately born to single-parent families. Data were drawn from wave six of the Fragile Families and Child Wellbeing Study ( N = 2976; M age = 15.6; 49% female; 53% non-Hispanic Black, 27% Hispanic, 20% White). Adolescents’ reports of their past 30-day use of alcohol, cigarettes, and cannabis were used to construct eight mutually exclusive use groups. Multinomial logistic regressions adjusting for sociodemographic factors revealed that Black adolescents were at lower relative risk of using Alcohol Only compared to White adolescents. Black males were at greater relative risk of using Cannabis Only than both White males and Black females. Finally, Hispanic males were at a marginally increased relative risk of co-using Alcohol and Cannabis compared to White males. Prevention efforts targeting Black and Hispanic males’ use of cannabis (both alone and in combination with alcohol) may be beneficial.

Short Root Anomaly in a Hispanic Population: Risk for Orthodontic Root Resorption

While the presentation of Short Root Anomaly (SRA) in Hispanic patients has been described previously, it is not known if this population is predisposed to increased orthodontic root resorption. This study evaluates the response of pre-existing short roots in Hispanic SRA patients to orthodontic treatment. Selected maxillary and mandibular teeth of 40 Hispanic SRA patients (19 male, 21 female) and 40 age and gender matched Caucasian patients (19 male, 21 female) with normal root length were evaluated for root resorption following comprehensive orthodontic treatment. The age range of the subjects was between 10 and 19 years. Relative root length was calculated before and after orthodontic treatment from digital panoramic radiographs. Overall, statistically significant root resorption occurred in the control group, but orthodontic root resorption was not significant in the Hispanic group (p > 0.05). When genders were separated, Hispanic females did experience a mild degree of root resorption in the upper incisors while resorption in Hispanic males was not significant. Caucasian females experienced greater root resorption than Caucasian males. Hispanic SRA patients may be safely treated with comprehensive orthodontics and could be at no more risk of root resorption than Caucasian patients with normal initial root length.

Work Patterns and Financing College: A Descriptive Regional Report regarding Students at Hispanic-Serving Institutions in New Mexico and Texas

College students at 14 Hispanic-Serving Institutions (HSIs) in New Mexico and Texas were surveyed about their experiences in and perceptions of higher education. Three primary foci were students’ employment status, work commitments, and means of financing college. Most of the informants reported working while in college and, similar to previously reported national averages, 69.4% of the informants were actively employed. Twice as many of the actively employed informants worked off campus as on campus and over three-quarters of employed students reported working part-time. There were no significance differences in these areas by gender, ethnicity, or even when broken out as Latinas, Latinos, non-Hispanic females and non-Hispanic males but students of non-traditional age reported a work commitment at significantly higher levels. For hours of work per week, there were also no significant differences by gender, ethnicity, and for the four possible subsets (Latinas, Latinos, etc.) but being a non-traditional aged student and being married/cohabiting were associated with working more hours at statistically significant levels. Students at the HSIs in New Mexico also reported more hours of work at statistically significant levels. Differences by gender, ethnicity, age, relational status, and state were found for means of funding college.

Hispanic Male Recruitment into Obesity-Related Research: Evaluating Content Messaging Strategies, Experimental Findings, and Practical Implications

Hispanic men have the highest prevalence of overweight and obesity among men in the U.S. Current research is lacking to inform best practices to engage Hispanic men in obesity-related research. The purpose of this work was to evaluate messaging strategies to engage Hispanic men in obesity-related research. Outreach took place in an outdoor marketplace in Southern Arizona, US. Messaging strategies (fear appeal/arousal, positive masculinity, and spousal convergence) identified in formative research were utilized. Two six-foot standing banners displayed content messages and infographics in both English and Spanish. Trained bilingual and bicultural staff collected health information survey cards that elicited self-reported demographic information and health concerns. Four aspects of recruitment were evaluated: volume, efficiency, community representation, and primary health concerns. A comparative analysis was conducted in the fall of 2016 to determine the effectiveness of each messaging strategy. 387 survey cards were collected, 221 were from Hispanic men. Obesity, diabetes, and cancer were identified as the most pertinent health concerns. Fear appeal yielded 209 completed surveys, followed by 110 for positive masculinity, and 68 for spousal convergence. Fear appeal/arousal and positive masculinity content messaging were effective approaches to engage Hispanic males in research, preventive and treatment efforts. Findings warrant replication as there is potential for confounding seasonal effects.

Pneumococcal Pneumonia Vaccination Among Older African American and Hispanic Men With Chronic Conditions

The CDC estimates that 70% of adults ages 65 years and older received the pneumococcal pneumonia vaccination (PPV). However, documented PPV rates are substantially lower for men, especially non-white men. This study examined common and unique factors associated with PPV among racial/ethnic minority men age 65 and older with one or more chronic conditions. Data were analyzed from a national sample of 470 African American (n=267) and Hispanic (n=203) males using an internet-delivered questionnaire. Two binary logistic regression models were fitted to compare factors associated with PPV. On average, participants were age 70.1(±4.5) years and reported 3.9(±2.6) chronic conditions. PPV rates were 56.8% and 43.2% among African American and Hispanic males, respectively. Across models, men who received vaccines for influenza (P<0.001) and shingles (P<0.01) were more likely to receive the PPV; whereas, those who reported more disease self-care barriers were less likely to receive the PPV (P<0.05). Among African American males, those who were widowed (OR=3.80, P=0.022) and had an annual eye examination (OR=3.10, P=0.001) were more likely to receive the PPV; whereas, divorced/separated men were less likely to receive the PPV (OR=0.33, P=0.003). Among Hispanic males, those who took more medications daily (OR=1.36, P=0.005), reported higher disease self-management efficacy (OR=1.15, P=0.011), and had a colon cancer test in the past 12 months (OR=3.55, P=0.007) were more likely to receive the PPV. Findings suggest the need for culturally tailored education and self-management interventions to increase PPV and preventive healthcare service utilization among older racial/ethnic minority men.

Law enforcement worker suicide: an updated national assessment

PurposeThe purpose of this paper is to update the assessment of national data on law enforcement worker suicide based on the National Occupational Mortality Surveillance database (NOMS, Centers for Disease Control and Prevention).Design/methodology/approachDeath certificate data for 4,441,814 decedents, age 18–90 who died in one of the 26 reporting states were the source of NOMS data. Utilizing proportionate mortality ratios (PMRs), the ratio of suicides in law enforcement occupations in those who are 18–90 years old with a designated usual occupation was calculated.FindingsFindings indicate a significantly higher proportion of deaths from suicide for law enforcement officers (PMR = 154, 95% CI = 147–162), compared to all the US decedents in the study population who were employed during their lifetime. Law enforcement personnel are 54% more likely to die of suicide than all decedents with a usual occupation. PMRs were highest for African-Americans, Hispanic males and for females. PMRs were similar for detectives, corrections officers and all law enforcement jobs, when not stratified by race, ethnicity and sex.Research limitations/implicationsBias may arise because a PMR can be affected by disproportionate increased or decreased mortality from causes of death other than suicide.Practical implicationsA better understanding of the scope of law enforcement suicide can inform policy focused on the planning and initiation of prevention programs.Originality/valueThe use of a national database to study law enforcement worker suicide adds to other information available on law enforcement worker suicide in specific geographic areas. The discussion on prevention in this paper presents ideas for policy.

Safe tracheostomy in COVID-19 patients: a case series

The coronavirus (COVID-19) pandemic has led to a critical need in treating severe respiratory disease while providing adequate protection to healthcare workers. Critically ill COVID-19 patients have required prolonged intubation and mechanical ventilation, not limited to those with multiple comorbidities or the elderly. At the height of the pandemic in New York City; our institution intubated 192 COVID-19 patients. Many institutions have avoided performing tracheostomy in this population due to high risk of virus aerosolization. This study is a retrospective, IRB approved, single center case series of 14 consecutive tracheostomies in COVID-19 patients at a community hospital in Flushing, New York City. Data from 1 March to 31 May 2020 was collected from electronic medical records. All COVID-19 positive patients undergoing tracheostomy were included; patients undergoing tracheostomy that were not COVID-19 positive were excluded. Fourteen patients underwent tracheostomy during the study period. Average age was 62 and 64.3% were male (n=9). Hispanic males represented 50% of patients undergoing tracheostomy and 71.4% were from home. Average days from initial intubation to tracheostomy was 20.6, ranging from 12 to 43 days. With the exception of two patients, all underwent a single intubation. No involved operating room staff became ill during or after these procedures. Tracheostomy may be safely performed in COVID-19 patients while minimizing risk to staff; however, patient outcomes may not be significantly altered. Further research is needed to determine the optimal timing and overall benefit of tracheostomy in this population.