Associations Between Food Insufficiency and Health Conditions Among New York City Adults, 2017-2018.

Food insecurity, a critical social determinant of health, has been measured nationwide in the United States for years. This analysis focuses on food insufficiency, a more severe form of food insecurity, in New York City (NYC) and its association with self-reported physical and mental health conditions. Data from the 2017-2018 NYC Community Health Survey were used to estimate the prevalence of food insufficiency citywide, by neighborhood, and across selected socioeconomic characteristics. Multivariable logistic regression was used to explore the associations between food insufficiency and hypertension, diabetes obesity, and depression, adjusting for selected sociodemographic characteristics. Approximately 9.4% (95% CI:8.8-10.0%]) of adult New Yorkers aged 18 + reported food insufficiency, with neighborhood variation from 1.7% (95% CI:0.5-6.2%) to 19.4% (95% CI:14.2-25.8%). Food insufficiency was more prevalent among Latinos/as (16.9%, 95% CI:15.5-18.3%, p < 0.001), Black (10.1%, 95% CI:8.8-11.5%, p < 0.001) and Asian/Pacific Islanders (6.6%, 95% CI:5.4-8.1%, p = 0.002) compared to White New Yorkers (4.2%, 95% CI:3.5-5.1%). Prevalence of food insufficiency was higher among NYC adults with less than a high school education, (19.6%, 95% CI:17.7-21.6%), compared to college graduates (3.8%, 95% CI:3.2-4.4%, p < 0.001). In the adjusted logistic regression model, food insufficiency was associated with diabetes (OR = 1.36; 95% CI:1.12-1.65), hypertension (OR = 1.58; 95% CI:1.32-1.89]) and depression (OR = 2.98; 95% CI:2.45-3.59), but not with obesity (OR = 0.99; 95% CI:0.84-1.21). Our findings highlight food insufficiency at an important intersection of inequity and disease burden which is critical to informing public health interventions in the context of a large, densely populated metropolis like NYC.

Concepts, Characterizations, and Cautions: A Public Health Guide and Glossary for Planning Food Environment Measurement.

Background: There is no singular approach to measuring the food environment suitable for all studies. Understanding terminology, methodology, and common issues is crucial to choosing the best approach. Objective: This review is designed to support a shared understanding so diverse multi-institutional teams engaged in food environment measurement can justify their measurement choices and have informed discussions about reasons for measurement strategies to vary across projects. Methods: This guide defines key terms and provides annotated resources identified as a useful starting point for exploring the food environment literature. The writing team was an academic-practice collaboration, reflecting on the experience of a multi-institutional team focused on retail environments across the US relevant to cardiovascular disease. Results: Terms and annotated resources are divided into three sections: food environment constructs, classification and measures, and errors and strategies to reduce error. Two examples of methods and challenges encountered while measuring the food environment in the context of a US health department are provided. Researchers and practice professionals are directed to the Food Environment Electronic Database Directory (https://www.foodenvironmentdirectory.com/) for comparing available data resources for food environment measurement, focused on the US; this resource incorporates updates informed by user input and literature reviews. Discussion: Measuring the food environment is complex and risks oversimplification. This guide serves as a starting point but only partially captures some aspects of neighborhood food environment measurement. Conclusions: No single food environment measure or data source meets all research and practice objectives. This shared starting point can facilitate theoretically grounded food environment measurement.

Estudio comparativo de la eficacia y seguridad entre la belomicina, tetraciclina o ambas en el tratamiento d elos derrames pleurales malignos metastáticos mediante pleurodesis / Comparative study of the efficiency and safety between the belomicina, tetracycline or both in the treatment d elos pleural malignant spillages metastáticos by means of pleurodesis

Obrjetivo: Comparar la eficacia y la seguridad de los agentes esclerosantes empleados en nuestro medio en le manejo de los derrames pleurales malignos metastásicos: tetraciclina, bleomicina o su combinación. Material y métodos: Se llevó a cabo un estudio prospectivo, asignación secuencial, comparativo. Se incluyeron a todos los pacientes que requirieron colocación de tubo de drenaje para posterior pleurodesis como manejo del derrame pleural maligno metatásicos durante el periódo de julio a diciembre del 2006. Los agentes a comparar fueron la tetraciclina sola, la bleomicina sola o el uso combinado de ambas. En todos los casos el seguimiento prospectivo se hizo con al realizacion de una radiografía de tórax cada 30 días por un periódo de 180 días para cada paciente (Agosto 2006 - Junio 2007). Se analizaron los datos comparando la sobrevida, los efectos adversos relacionados al agente esclerosante y la realización de una pleurodesis óptima definida como la ausencia total de recidiva del derrame pleural o el derrame pleural que no requiere toracocentesis o una nueva colocación de tubo de drenaje. Resultados: 27 pacientes de un total de 38 cumplian con los criterios de inclusión y no de exclusión. Obteniéndose que la sobrevida total a seis meses fue de 37 por ciento. No hubo diferencias estadísticamente significativas en cuanto al agente estudiado y la sobrevida. No se encontraron diferencias estadísticamente significativas de efectos adversos en los diferentes grupos. Al excluir a los fallecidos para cada grupo, la tetraciclina tuvo mejor efecto esclerosante siendo esta diferencia estadísticamente significativa. Conclusiones: El derrame pleural maligno matastásico es un signo ominoso de la enfermedad. En este tipo de pacientesla tetraciclina demostró tener un mejor perfil como agente esclerosantem un número de efectos adversos comparables al otro agente o a la combinación y no demostró diferencias en cuanto a la sobrevida.

Objective: To compare the effectiveness and security of sclerosing agents used in tha management of metastatic malignant pleural effusion: tetracycline, bleomycin or the combination of both. Patient and methods: A prospective, sequential, comparative study was performed. All patients who required drainage tube placement followed by pleurodesis as management of metastatic malignant pleural effusion during the period from july to december 2006 were included. The agents to compare were tetracycline, bleomycin or the combined used of both. In all cases the prospective surveillance was made with a chest X - ray every 30 days in a 180 days period for each patient (august 2006 to june 2007). Data were analyzed comparing survival rate, adverse events related with the sclerosing agent and optimal pleurodesis defined as the complete absence of recurrent pleural effusion or pleural effusion that not requires thoracocentesis or a new drainage tube placement. Results: From a total of 38 patients, 27 filled the inclusion but not the exclusion criteria of the study. The survival rate at six months was of 37 per cent. There were no statistically significant differences between the studied agent and teh survival rate. No adverse events. After excluding those who had died in each group, tetracycline had the best sclerosing effect being this difference statistically significant. Conclusions: Metestatic malignant pleural effusion is an ominous sign of the disease. In this kind of patients, tetracycline had a better profile as sclerosing agent, the number of adverse events in comparison with the other agent or their combination showed no differences in the survival rate.