Class III Obesity as a Risk Factor for Persistent Asthma.

BACKGROUND: The burden of asthma remains steady with no decline observed in the past few decades. Obesity prevalence has been steadily increasing with a rate of 41.9% in the United States between 2017-2020. Obesity is an inflammatory chronic condition that may partially contribute to the burden and severity of asthma. This study aimed to examine whether the association between obesity and asthma varies with the categories of obesity (class I, II, and III) and persistent asthma (mild, moderate, and severe asthma). We hypothesized that subjects with elevated body mass index (BMI) are more likely to be diagnosed with persistent asthma than subjects without obesity with asthma. METHODS: As a retrospective and cross-sectional study, this study used a total of 1,977 records of subjects with asthma (age ≥ 19 y) hospitalized in Nevada between 2016-2021. BMI and persistent asthma were evaluated as the main exposure and outcome of interest. Logistic regression was used to estimate the magnitude of the association between obesity and persistent asthma. RESULTS: Among the selected subject records, subjects with obesity were more likely to be diagnosed with persistent asthma compared to subjects without obesity (odds ratio 1.50 [CI 1.10-2.05]). Subgroup analyses revealed that subjects with class III obesity (BMI ≥ 40) were more likely than subjects without obesity to be diagnosed with mild persistent asthma (odds ratio 2.21 [CI 1.18-4.16]) and severe persistent asthma (odds ratio 1.74 [CI 1.12-2.70]). CONCLUSIONS: Obesity was identified as a risk factor for persistent asthma, particularly class III obesity. This in turn increases the potential for greater health care utilization and economic burden. Public health and clinical interventions are necessary among those with comorbid asthma and obesity.

Non-response to ACE items is associated with demographic variables and health indicators in the 2021 Behavioral Risk Factor Surveillance System.

Background: Adverse childhood experiences (ACE) encompass traumatic events occurring before age 18, with lasting impacts on health. While ACE disclosure is important for understanding these effects, some individuals decline to respond to ACE-related survey items due to sensitivity, privacy concerns, or psychological distress. This study explores the relationship between non-response to ACE items and health outcomes, shedding light on the implications for those who choose not to disclose. Methods: We performed a secondary analysis of the 2021 Behavioral Risk Factor Surveillance System (BRFSS)-a national telephone survey querying health behaviors and conditions. Sociodemographic factors, ACE exposure, and non-response to ACE items were analyzed. Results: Individuals who decline to respond to ACE items exhibit similar patterns of health behaviors and conditions as those reporting ACE exposure. Non-response is linked to both healthier behaviors (lifetime HIV testing) and riskier behaviors (higher odds of smoking and e-cigarette use). Moreover, non-responders have higher odds of being underweight or obese, experiencing concentration difficulties, reporting poor self-rated health, and reporting multiple health diagnoses including depression, diabetes, high blood pressure, heart attack, and stroke. Conclusions: The study underscores the need to address health disparities associated with ACE, regardless of disclosure status. Healthcare interventions should target respondents and non-respondents of ACE screeners, tailoring strategies to promote healthier coping mechanisms and mitigate maladaptive behaviors. These results emphasize the importance of trauma-informed care, early intervention, and targeted public health initiatives for individuals affected by ACE, irrespective of their disclosure choices.

Heterogeneity of Asthma Care Among Hispanic Subgroups: Lower Utilization of Hospital-based Care among Spanish-speaking Hispanics.

BACKGROUND: Studies found heterogeneity of asthma prevalence among Hispanic subgroups using survey data but addressed under-diagnosis issues due to limited access to health care and diagnosis bias. OBJECTIVES: To examine heterogeneity by language in health care utilization for asthma among Hispanic subgroups. RESEARCH DESIGN: A retrospective, longitudinal cohort study of Medi-Cal claims data (2018-2019) using logistic regression to estimate the odds ratio of health care utilization for asthma. SUBJECTS: In all, 12,056 (ages 5-64) Hispanics living in Los Angeles were identified as having persistent asthma. MEASURES: Primary language is the predictor variable and outcome measures include ED visits, hospitalizations, and outpatient visits. RESULTS: The odds of ED visits among Spanish-speaking Hispanics were lower than English-speaking Hispanics in the subsequent 6 (95% CI=0.65-0.93) and 12 (95% CI=0.66-0.87) months. Spanish-speaking Hispanics were less likely than their English-speaking counterparts to utilize hospitalization in the 6 months (95% CI=0.48-0.98), while they were more likely to utilize outpatient care (95% CI=1.04-1.24). For Hispanics of Mexican origin, the odds of ED visits among Spanish-speaking Hispanics were also lower in the 6 and 12 months (95% CI=0.63-0.93, 95% CI=0.62-0.83), but their odds of outpatient visits were higher for outpatient visits in the 6 months (95% CI=1.04-1.26). CONCLUSIONS: Spanish-speaking Hispanics with persistent asthma were less likely than English-speaking Hispanics to utilize ED visits and hospitalizations but were more likely to utilize outpatient visits. The findings suggest the reduced burden of asthma among the Spanish-speaking Hispanic subgroup and contribute to explaining the protection effect, specifically among Spanish-speaking Hispanics living in highly segregated communities.

A higher Asthma Medication Ratio (AMR) predicts a decrease in ED visits among African American and Hispanic children.

INTRODUCTION: Higher rates of ED visits and hospitalizations for asthma among African American and Hispanic children may indicate suboptimal management of asthma, leading to a greater financial burden of healthcare. It is not well known if an association of race/ethnicity with controller medication and hospital-based care utilization exists. OBJECTIVE: This study examines whether the Asthma Medication Ratio (AMR) predicts healthcare utilization for asthma by race/ethnicity. METHODS: 4,584 Medi-Cal children (Ages 5-11) with persistent asthma in Los Angeles were identified and their AMRs (2018) were calculated based on the HEDIS criteria. Healthcare utilization data were used, including hospitalizations, ED visits, and pharmacy claims to examine whether a higher AMR predicts decreases in healthcare utilization by race/ethnicity in the subsequent 3,6, and 12 months (2019). RESULTS: The average AMR was lowest among African American children (0.401). In the subsequent 12 months, they were highest in ED visits (0.249) and hospitalizations (0.121), but lowest in outpatient visits (0.793). The results of logistic regression showed that a higher value of AMR (>0.5) contributed to decreases in ED visits in the subsequent 12 months only among African Americans (OR = 0.551, 95% CI 0.364-0.832) and Hispanics (OR = 0.613, 95% CI 0.489-0.770). No association between AMR and hospitalizations was found. CONCLUSIONS: Our findings indicate that increased use of controller medication contributes to a decrease in ED visits among African American and Hispanic children with persistent asthma. Increased use of controller medications and caregiver's efforts for medication adherence may contribute to a reduction in asthma disparities.

The Influence of Transcranial Direct Current Stimulation on Shooting Performance in Elite Deaflympic Athletes: A Case Series.

Transcranial direct current stimulation (tDCS) has been shown to improve motor learning in numerous studies. However, only a few of these studies have been conducted on elite-level performers or in complex motor tasks that have been practiced extensively. The purpose was to determine the influence of tDCS applied to the dorsolateral prefrontal cortex (DLPFC) on motor learning over multiple days on 10-m air rifle shooting performance in elite Deaflympic athletes. Two male and two female elite Deaflympic athletes (World, European, and National medalists) participated in this case series. The study utilized a randomized, double-blind, SHAM-controlled, cross-over design. Anodal tDCS or SHAM stimulation was applied to the left DLPFC for 25 min with a current strength of 2 mA concurrent with three days of standard shooting practice sessions. Shooting performance was quantified as the points and the endpoint error. Separate 2 Condition (DLPFC-tDCS, SHAM) × 3 Day (1,2,3) within-subjects ANOVAs revealed no significant main effects or interactions for either points or endpoint error. These results indicate that DLPFC-tDCS applied over multiple days does not improve shooting performance in elite athletes. Different stimulation parameters or very long-term (weeks/months) application of tDCS may be needed to improve motor learning in elite athletes.

Exploratory analysis of the associations between neonicotinoids and measures of adiposity among US adults: NHANES 2015-2016.

BACKGROUND: Toxicology studies suggest that neonicotinoids may be associated with adiposity development via thyroid hormone disruption and increased oxidative stress. Prior epidemiological studies report mixed results for the association between neonicotinoids and adiposity measures. OBJECTIVE: To examine the association between detectable concentrations of parent neonicotinoids (imidacloprid, acetamiprid, clothianidin) and neonicotinoid metabolites (5-hydroxy-imidacloprid, N-desmethyl-acetamiprid) with adiposity measures among US adults, and whether sex modifies the associations for neonicotinoid metabolites with adiposity. METHODS: National Health and Nutrition Examination Survey (NHANES) 2015-2016 data was utilized to estimate covariate-adjusted associations between detectable neonicotinoids and fat mass index (FMI), lean mass index (LMI), waist circumference, body fat percentage, and body mass index (BMI) using multiple linear regression. We estimated incidence rate ratios (IRRs) for overweight or obese status with detectable neonicotinoid concentrations using Poisson's modified regression. Sampling strategies were accounted for in the regression models. RESULTS: Detectable levels of acetamiprid were associated with a decrease in FMI (ß = -3.17 kg/m2, 95% CI [-4.79, -1.54]), LMI (ß = -3.17 kg/m2, 95% CI [-5.17, -1.17]), body fat percentage (ß = -4.41, 95% CI [-8.20, -0.62]), waist circumference (ß = -9.80 cm, 95% CI [-19.08, -0.51]), and BMI (ß = -3.88kg/m2, 95% CI [-7.25, -0.51]) among adults. In contrast, detectable levels of 5-hydroxy-imidacloprid were associated with greater rates of being overweight/obese (IRR = 1.11, 95% CI [1.04, 1.18)) and increased LMI (ß = 0.67 kg/m2, 95% CI [0.04, 1.29]). Sex modified the association between N-desmethyl-acetamiprid and LMI (pint = 0.075) with a positive association among males (ß = 1.14 kg/m2, 95% CI [0.38, 1.90]), and an insignificant inverse association in females. Sex also modified the association for N-desmethyl-acetamiprid with FMI (pint = 0.095) and body fat percentage (pint = 0.072), with suggestive evidence showing positive associations for males and inverse associations for females. CONCLUSION: Detectable concentrations of acetamiprid were inversely associated with adiposity, while there were mixed findings for 5-hydroxy-imidacloprid. Findings suggest sex differences, though results are not clear with regard to the directionality of the association by sex.

Can the Multi-Theory Model (MTM) of Health Behavior Change Explain the Intent for People to Practice Meditation?

Meditation is gaining popularity as adjuvant therapy for many chronic ailments, mental well-being, and spiritual growth. Behavioral theories have been underutilized in understanding meditation behavior. This study aimed to test if a fourth-generation multi-theory model (MTM) could explain the intent for starting and maintaining meditation behavior in a sample of US adults. A face and content valid 48-item instrument based on MTM was administered in a cross-sectional design through an online survey (n = 330). Internal consistency (Cronbach's alpha > 0.70) and construct validation using structural equation modeling of the subscales were all acceptable. Hierarchical multiple regression revealed that, after controlling for demographic covariates, the MTM constructs of participatory dialogue (ß = 0.153; P = .002) and behavioral confidence (ß = 0.479; P < .001) were statistically significant in predicting intent for starting meditation behavior and accounted for 32.9% of the variance. Furthermore, after controlling for demographic covariates, the MTM constructs of emotional transformation (ß = 0.390; P < .001) and changes in the social environment (ß = 0.395; P < .001) were statistically significant and accounted for 52.9% of the variance in the intent for maintaining meditation behavior. Based on this study, it can be concluded that MTM offers a pragmatic framework to design, implement, and evaluate evidence-based (theory-based) meditation behavior change interventions.

Opioid-related hospitalizations and intravenous drug users: Socio-demographic, spatial, and comorbid associations among hospital inpatients and community-based harm reduction organization participants.

OBJECTIVE: To provide an updated analysis of opioid-related injuries in Nevada and provide a first-time analysis of the intravenous drug user (IDU) population within Clark County. DESIGN: Cross-sectional study. SETTING: Center for Health Information Analysis (CHIA) database and IDU data from Trac-B Exchange (Trac-B). PARTICIPANTS: Patients hospitalized for opioid-related causes (n = 9,064) and participants from Trac-B. MAIN OUTCOME MEASURE(S): Variables assessed included age, gender, and race/ethnicity. Zip codes were retrieved to find differences in geographical usage patterns of hospital or sterile injection equipment (SEP) sites. Contingency tables were utilized to determine the frequency of comorbidities. Additionally, GIS was used to investigate potential spatial patterns of interest. RESULTS: Totally 5,268 out of the 9,064 opioid-related cases reported in Nevada were Clark County residents. The highest frequency for comorbidities associated with opioid-related hospitalizations (ORHs) included: infections, chronic bodily pain, and malnutrition. There was a higher proportion of 18-35-year-olds who used SEPs as compared to hospitals and a higher proportion of individuals aged 36 years or older who used hospitals as compared to using SEPs. Of the nearly 100 zip codes in Clark County, six showed a disproportionally high frequency of ORHs, and three comprised the majority of injection drug use. CONCLUSIONS: There is an opioid epidemic in Nevada that has contributed to addiction, heroin usage, injection drug use, and transmission of bloodborne diseases. Understanding the ORHs and intravenous drug use trends can help guide the development of program interventions.

Obesity in Early Childhood: Examining the Relationship among Demographic, Behavioral, Nutritional, and Socioeconomic Factors.

Background: The present study sought to explore the combined relationship of physical activity, screen time, consumption of sugar-sweetened beverages, infant feeding practices, and demographic factors with obesity in early childhood. Methods: The current study included cross-sectional Kindergarten Health Survey data collected annually from 2012 to 2016. The sample included 7814 kindergarten students, with a mean age of 5.02 [standard deviation = 0.33]. A Multinomial Logistic Regression using body mass index as the dependent variable and select demographic traits, dietary practices, sedentary behaviors, and physical activity indicators as independent variables was used to assess relationship of aforementioned factors to obesity. Results: Children were more likely to be obese if they were non-Caucasian, male, lived in rural areas, lived at or below the poverty level, had public insurance, or lived in single-parent households. Children who received less than 30 minutes of physical activity 3 or fewer days per week, had more than 2 hours of daily screen time, consumed any amount of soda, and consumed anything other than breast milk at 6 months of age also had a higher probability of being obese. Conclusions: The findings from this study suggest that investments in prevention strategies are needed to address the behavioral patterns and socioeconomic disparities before kindergarten. Efforts that increase access to nutritious food, physical activity, and overall family wellness and education, such as high-quality early childhood education, could be feasible prevention approaches.

Risk factors associated with cardiovascular disease among adult Nevadans.

OBJECTIVE: Cardiovascular disease (CVD) remains the number one cause of death in the US and Nevada is ranked 11th highest for CVD mortality. The study sought to examine the association between self-reported risk factors and CVD presence among adult Nevadans, between years 2011 and 2017. METHODS: This is a cross-sectional, population-based study that utilized the 2011 and 2017 Nevada Behavioral Risk Factor Surveillance System data. Data were analyzed between 2019 and 2020. RESULTS: A total of 5,493 and 3,764 subjects in 2011 and 2017, respectively were included. BMI (overweight/obesity) remained the most prevalent CVD risk factor. The second most common CVD risk factor was high cholesterol, followed by hypertension. Compared to females, males were 1.64 times more likely to have reported CVD in 2011, which increased to 1.92 in 2017. Compared to non-smokers, everyday smokers were 1.96 times more likely in 2011 and 3.62 times more likely in 2017. Individuals with high cholesterol status were 2.67 times more likely to have reported CVD compared to those with normal levels in 2011. In 2011, individuals with hypertension were 3.74 times more likely to have reported CVD compared to those who did not have hypertension. This relationship increased its magnitude of risk to 6.18 times more likely in 2017. In 2011, individuals with diabetes were 2.90 times more likely to have reported CVD compared to those without the condition. CONCLUSIONS: Public health and healthcare providers need to target preventable cardiovascular risk factors and develop recommendations and strategies locally, nationally, and globally.

Factors and cost associated with atopic dermatitis in Nevada.

Objectives: Atopic dermatitis, or eczema, is an inflammatory illness that impacts individuals of all ages. The cost of treating AD and the impact on the quality of life have not been well documented in the state of Nevada. This study seeks to fill this gap by identifying factors that impact the cost of AD in the state utilizing clinical and patient demographics. Methods: ANOVA with Bonferroni adjustment was performed using a large hospital utilization database to examine the cost of AD in the state of Nevada across all hospital settings. Results: Several significant factors were associated with the overall cost of AD in Nevada, including hospital setting type (outpatient vs. inpatient), physician type, region, AD diagnosis level, and age (p < 0.05). Stratified analysis was performed by setting type. In the inpatient setting, region, diagnosis level, and records with age listed between 0 and 5 years remained significant (p < 0.05). In the outpatient setting, physician type, region, and African American race remained significant (p < 0.05). Conclusions: Data from this study indicate that the AD cost burden is dependent on both demographic and clinical factors in the state of Nevada. These differences suggest that patients with AD may encounter higher costs depending on age, race, and clinical factors.

Eosinophilic esophagitis: comorbidities and atopic disease in Nevada.

Eosinophilic esophagitis (EoE) is a rare, immune-mediated illness. We aimed to examine the comorbidities and sensitization patterns associated with an EoE diagnosis in Nevada. The study goal was two-fold: to determine the most common EoE comorbidities and sequela in the state of Nevada using healthcare utilization records across all settings and to determine the most common food and aeroallergens in histologically positive EoE pediatric patients using clinical sensitization data. Esophageal obstruction/stricture was the most frequently reported diagnosis in adults with EoE (29.5%). Among pediatrics, the highest ranking comorbidities included asthma (13.4%); diseases of the stomach, duodenum, and intestine (7.26%); allergies (7.01%); and gastroesophageal reflux disease (GERD) (3.69%). Additionally, the top sensitizations reported in histologically positive EoE patients were largely pollen related (82.9%). Atopic disease and specifically food allergens are commonly reported as comorbid conditions with EoE in the literature. However, our clinical pediatric data set from this study revealed that aeroallergen sensitizations far exceeded that of food allergens (82.9% aero-positive vs. 17.1% dood positive). The high presence of esophageal stricture/obstruction in adults could be indicative of late diagnosis; in addition, the aeroallergen sensitization in children could suggest different clinical management techniques necessary may be needed for this disease. Education among healthcare providers regarding the presence of aeroallergen sensitization in this population may result in earlier diagnoses and help reduce morbidity and the cost from this disease.

A description of eosinophilic esophagitis in the Southwestern state of Nevada.

OBJECTIVES: Eosinophilic esophagitis (EoE) is a rare immune-mediated esophageal disorder that has been documented worldwide. Prior to this study, eosinophilic esophagitis had not been described in the Southwestern state of Nevada. Records containing positive eosinophilic esophagitis diagnosis codes were extracted from a large hospital utilization database and yielded over 2,000 records over 5 years (2013-2017). METHODS: Descriptive statistics were used to identify the overall population demography. Logistic regression was used to determine the factors associated with an eosinophilic esophagitis event in Nevada. RESULTS: Males were 2.93 times more likely (95% CI: 2.53, 3.41; p < 0.001) to have had an eosinophilic esophagitis event when compared to females. Older age was also significant; for each additional year in age the odds of having an eosinophilic esophagitis visit increased by 30% (95% CI: 1.28, 1.31; p < 0.001). Finally, individuals living in the Northern region had 1.95 higher odds of an eosinophilic esophagitis event than their Southern counterparts (OR = 1.95, 95% CI: 1.68, 2.26; p < 0.001). CONCLUSIONS: The climate in Nevada makes this study novel, as the climate is unlike other studies reporting EoE disease prevalence. Previous atopic studies in Nevada report that warmer, drier weather leads to increased atopic illness and perennial pollen, which ultimately may be contributing to the higher than expected number of EoE records identified. Given the well-documented relationship between EoE and atopy, Nevada may be a susceptible region for this condition and an ideal location for future studies.

Cost of chronic inflammatory disease: The impact of eosinophilic esophagitis in Nevada.

OBJECTIVES: The cost of treating the rare eosinophilic esophagitis (EoE) disease and its impact on patients' quality of life have not been well documented in the literature. This study seeks to fill this gap by comparing the cost of EoE with other well-known inflammatory diseases, including Crohn's disease (CD) and celiac disease (CeD). METHODS: A Mann-Whitney U test and multiple logistic regression were used to examine the cost of EoE in the state of Nevada across all hospital settings and its impact on quality of life compared with CD and CeD. RESULTS: Several factors were associated with the overall cost of EoE in Nevada, including patients' age, sex and region (P < 0.001). EoE was significantly more expensive to treat in the pediatric group ($4001 EoE; $985 CD; $856 CeD), among men ($2532 EoE; $1500 CD; $1724 CeD), among those residing in the southern region of Nevada ($4501 EoE; $2538 CD; $1888 CeD), and among patients seeking medical care from outpatient clinics ($3298 EoE; $741 CD; $1686 CeD) (P < 0.001). Age, sex, region and hospital setting were all associated with having a positive EoE record compared with CeD or CD (P < 0.001). CONCLUSIONS: Data from this study indicate that the EoE burden is significantly higher in cost for certain demographics and regions compared with CD and CeD in the state of Nevada, specifically among pediatric and male patients. These differences suggest that clinicians may encounter similar issues when treating EoE.

Factors Associated with Rapid Readmission Among Nevada State Psychiatric Hospital Patients.

Rapid readmission (RR) of psychiatric patients within 30 days of discharge places a costly burden on state psychiatric facilities and may indicate suboptimal service provisions. Information regarding variables associated with RR of psychiatric patients is limited, particularly in Nevada. This study attempts to identify factors associated with RR at a Nevada state psychiatric hospital. Participants included 7177 patients admitted between May 2012 and April 2014. Using logistic regression, all admissions were reviewed and rapid readmits compared to counterparts who were not readmitted within 30 days. Nevada suffers from budget cuts in mental health care spending because of recent economic crisis and severe lack of bed space. This study demonstrates that it may be possible to reduce rates of costly RR by focusing on those with a history of RR and modifiable factors including social and financial support, as well as reliable and stable housing.

Association between alcohol screening and brief intervention during routine check-ups and alcohol consumption among adults living in California.

BACKGROUND: Alcohol consumption accounts for 1 in 10 deaths among U.S. adults and cost upwards of $200 billion each year due to productivity loss. Alcohol Screening and Brief Intervention and Referral to Treatment (aSBIRT) was developed as a treatment approach for use in primary care to identify and reduce substance abuse. Although aSBIRT has proven to be successful, implementation rates remain low. METHODS: Using population level representative data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS) conducted in California, this study utilizes logistic regression to analyze the association between self-reported drinking levels and screening and brief intervention practices during routine check-ups. RESULTS: The results demonstrated that the more an individual drank, the lower the odds of receiving aSBIRT during a routine check-up. Men had reduced odds of receiving intervention compared to women (odds ratio [OR], 2.21; confidence interval [CI], 1.68-2.90, p < 0.01) and diabetics had reduced odds of receiving intervention compared to non-diabetics (OR, 0.66; CI, 0.45-0.97, p = 0.3). Finally, those with lower income had reduced odds of intervention compared to those with higher income (OR, 1.84; CI, 1.33-2.56, p < 0.01). Among those who were at risk for alcohol abuse (83%) the intervention was only administered to 39%, and men had reduced odds of receiving intervention. CONCLUSION: Physicians perform alcohol screenings, but do not follow up the screening with intervention. Attention should be focused on delivering intervention to those identified as at risk for alcohol abuse through standard screening tools, specifically to men, diabetics, and lower income groups. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Timely reminder interventions to improve annual Papanicolaou (Pap) smear rates among HIV-infected women in an outpatient center of southern Nevada: a short report.

Current guidelines recommend annual Papanicolaou (Pap) smears for human immunodeficiency virus (HIV)-infected women for cervical cancer screening. Rates for such screening in Nevada are below the national rate. Our cohort includes 485 eligible HIV-infected adult women from an outpatient center in Southern Nevada of which only 12 women had obtained a Pap smear in the past year. An intervention was conducted from June 2015 to September 2015, in which reminders to schedule a Pap smear were sent to the remaining cohort of 473 women via sequential text messaging, followed by phone call attempts. Of all subjects, 94% contacted by text messages and 41% contacted by phone calls were successfully reached. There was an increase in the rate of completed Pap smears from 2.5% (12/485) at baseline to 11.8% (56/473) after interventions (p < 0.0001) in a period of three months. Out of the 68 Pap smear results, 20 (29.4%) were abnormal. Our intervention, utilizing methods of communication such as text messaging and phone calls, markedly increased the rate of completed Pap smear screening in our population.

Sleep duration associated with cardiovascular conditions among adult Nevadans.

BACKGROUND: Associations between sleep duration and cardiovascular conditions have been inconsistent. Both short and long sleep duration are associated with increased risk for diabetes, hypertension, obesity, high cholesterol, depression, and overall metabolic dysfunction; all of which are cardiovascular disease risk factors. This study aimed to determine if deficient or excessive sleep duration is associated with cardiovascular conditions. METHODS: Data were obtained from the 2013 Behavioral Risk Factor Surveillance System for the state of Nevada. A total of 5101 participants completed the survey and answered questions as to whether they had ever had a cardiovascular condition ie, myocardial infarction, coronary heart disease or angina, and stroke. Multiple logistic regression was implemented during analyses and yielded four models including demographics, co-morbidity, behavior, and final significant variables. RESULTS: Six significant predictor variables were identified in the final model. Sleep duration was statistically significant (p < 0.0001). Individuals having deficient sleep, eg, 1-4 h a night, were 2.4 times more likely to have a cardiovascular condition versus those sleeping 7-9 h per night (OR = 2.412, CI = 1.139, 5.107). As for individuals who sleep excessively, eg, 10-18 h a night, they were nearly 7.2 times more likely to have a cardiovascular condition, compared to individuals who receive a normal night's sleep (OR = 7.170, CI = 3.284, 15.654). CONCLUSIONS: Both deficient and excessive sleep duration were significantly associated with a cardiovascular condition, even after adjustment for covariates. The findings from this study can be used as additional evidence to encourage further research on improving sleep by developing future treatment therapies, and recommendations, that may help lower the risk of cardiovascular disease conditions.

Oral health in transition: The Hadza foragers of Tanzania.

Conventional wisdom holds that a decline in oral health accompanies the transition from hunting and gathering to agriculture, given increased consumption of carbohydrates. This widely touted example of the mismatch between our biology and modern lifestyle has been intuited largely from the bioarchaeological record of the Neolithic Revolution in the New World. Recent studies of other populations have, however, challenged the universality of this assertion. Here, we present the first comprehensive study of oral health among a living population in transition from the bush to village life, the Hadza hunter-gatherers of Tanzania, to test the hypothesis that the shift from foraging to farming, or agricultural intensification, inevitably leads to increased periodontal disease, caries, and orthodontic disorders. Our results showed that women living in villages consuming a mostly agricultural diet exhibited more caries and periodontal disease than those living in the bush consuming a mostly wild-food diet. Furthermore, men living in the bush consuming mostly a wild-food diet had more than those living in the village consuming a mostly agricultural diet. These findings are explained by the high incidence of maize consumption in village settings, along with previously recognized variation in rate of caries between men and women. The unexpected discovery of high caries incidences for men in the bush is likely explained by heavy reliance on honey, and perhaps differential access to tobacco and marijuana. These data support the notions that mechanisms of cariogenesis are multifactorial and that the relationships between oral health and the shift from a predominantly wild-food diet to one dominated by cultigens are nuanced.