Intergenerational Influence of African American, Caribbean and Hispanic/Latino Adults Regarding Decision to Participate in Health-Related Research.

Introduction: Identifying effective strategies to enroll African American, Caribbean, and Hispanic/Latino adults ≥65 years of age in health research is a public health priority. This study aimed to explore intergenerational influence (IGI) among these populations living throughout Florida. Methods: African American, Caribbean, and Hispanic/Latino adults ≥65 years of age and a trusted family member/friend between 25-64 years participated in virtual listening sessions (LS). Culturally matched facilitators used a semi-structured guide to lead LS that was recorded, transcribed, and uploaded into NVivo©. The constant comparative method was used for analysis. Results: 363 African American, Caribbean, and Hispanic/Latino participated in LS. Five (5) themes relate to IGI emerged: (1) parent-child relationships; (2) family caregiving/parental illness experiences; (3) historical research maltreatment; (4) transfer of cultural knowledge; and (5) future generations. Discussion: Our findings support that IGI can be leveraged to increase the participation of African American, Caribbean, and Hispanic/Latino older adults in health research.

Serum cotinine as a predictor of lipid-related indices in Turkish immigrants with type 2 diabetes: A clinic-based cross-sectional study.

Background: Turkish immigrants form the largest ethnic minority group in the Netherlands and show a higher prevalence of (i) cardiovascular disease (CVD), (ii) cigarette smoking, and (iii) type 2 diabetes (T2D) as compared to the native Dutch. This study examines the association of CVD risk factors: serum cotinine, as an indicator of cigarette smoke, and lipid-related indices among first-generation (foreign-born) Turkish immigrants with T2D living in deprived neighbourhoods in the Netherlands. Methods: A total of 110 participants, physician-diagnosed with T2D, aged 30 years and older, were recruited by convenience sampling from the Schilderswijk neighbourhood of The Hague in a clinic-based cross-sectional design. Serum cotinine (independent variable) was measured with a solid-phase competitive chemiluminescent immunoassay. Serum lipids/lipoproteins (dependent variables) were determined by enzymatic assays and included: total cholesterol (CHOL), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and triglycerides (TG). The Castelli Risk Index-I (CRI-I), and Atherogenic Coefficient (AC) were calculated using standardised formulas and assessed as dependent variables in multiple linear regression (MLR) models. Log-transformation of HDL-c, TG, CRI-I, and AC values were performed to account for the extreme right skewness of the data. Statistical analyses included descriptive characteristics and MLR models were adjusted for all major confounders of cotinine and lipids. Results: The sample size had a mean age of 52.5 years [standard deviation (SD) = 9.21]. The geometric mean of serum cotinine level was 236.63 ng/mL [confidence interval (CI) = 175.89 ± 318.36]. The MLR models indicated that high serum cotinine levels (≥10 ng/mL) was positively associated with HDL-c (P = 0.04), CRI-I (P = 0.03), and AC (P = 0.03) in the age, gender, WC, diabetes medications, and statins-adjusted models (n = 32). Conclusion: This study indicated that lipid ratios of HDL-c, CRI-I and AC are dependent determinants of serum cotinine and higher serum cotinine levels (≥10 ng/mL) are associated with worse HDL-c, CRI-I and AC values in participants with T2D. Clinical comprehension of these biochemical indicators (lipids/lipoproteins) and symptomatic results (CVD risk) in individuals with T2D will aid in the intervention (smoking) approach for this vulnerable cohort (Turkish immigrants). Therapy that is targetted to modify this behavioural risk factor may improve cardiovascular health outcomes and prevent comorbidities in Turkish immigrants with T2D living in deprived neighbourhoods in the Netherlands. In the meantime, this report contributes to a growing body of information and provides essential guidance to researchers and clinicians.

Microalbuminuria and Hypertension among Immigrants with Type 2 Diabetes: A Community-Based Cross-Sectional Study.

PURPOSE: This study examined the association of microalbuminuria (MAU), as determined by albumin-to-creatinine ratio (ACR), with hypertension (HTN) among Turkish immigrants with type 2 diabetes (T2D) living in deprived neighborhoods of The Hague, Netherlands. METHODS: A total of 110 participants, physician-diagnosed with T2D, aged ≥ 30 years were recruited from multiple sources from The Hague, Netherlands in a cross-sectional design. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using automated office blood pressure equipment. Urine albumin was measured by immunoturbidimetric assay. Urine creatinine was determined using the Jaffe method. MAU was defined as ACR ≥ 3.5 mg/mmol for females and/or ACR ≥ 2.5 mg/mmol for males. RESULTS: MAU was present in 21% of Turkish immigrants with T2D. Adjusted logistic regression analysis indicated that the odds of having MAU were 6.6 times higher in hypertensive than those that were normotensive (p = 0.007; 95% confidence interval [CI]: 1.19, 36.4). CONCLUSION: These findings suggest that HTN and MAU may be assessed as a standard of care for T2D management for this population. Prospective studies of diabetes outcomes are recommended to further verify these findings.

Review and Implications of Intergenerational Communication and Social Support in Chronic Disease Care and Participation in Health Research of Low-Income, Minority Older Adults in the United States.

Background: Health disparities disproportionally affect Black and Hispanic older US adults. Health research is needed to understand and eliminate these disparities; however, older adults, and particularly Black and Hispanic/Latino older adults are underrepresented in health research. Adult children have influenced health behavior and health outcomes of their older parents in several demographics in the US. Analysis of these studies can lead to a model for the development of interventions aimed at improving health and healthcare participation of older Black and Hispanic US adults. Objectives: To review the role of intergenerational communication and social support in health behavior, health research, and health outcomes for older adults and to apply these findings toward a model for health interventions for Black and Hispanic US older adults. Methods: An analytical narrative review and application toward an intervention model. Results: Key topic areas were reviewed and analyzed by examining studies that applied forms of intergenerational communication and/or intergenerational social support with the goal of either improving health, disease management and/or participation in health research in populations world-wide. Next, a model for providing health interventions in older Black and Hispanic US adults was developed using strategies gleaned from the findings. Conclusion: A model for health intervention for Black and Hispanic/Latino US older adults was presented based on an analytical review and intergenerational communication and/or social support. Qualitative data are necessary to understand the enablers and barriers of intergenerational communication and social support to improve health outcomes in these populations.

Parental Perceptions of Child's Medical Care and Neighborhood and Child's Behavioral Risk Factors for Obesity in U.S. Children by Body Mass Index Classification.

Environmental factors, preventive medical care, and behaviors play a role in childhood obesity. This study used the National Survey of Children's Health, 2011-2012, for 42,828 children, ages 10-17 years. Greater percent of children in the overweight/obese category performed no moderate-to-vigorous physical activity: 11.9 (10.6, 13.3) as compared to children in the underweight/normal weight category: 9.7 (8.9 10.6). No moderate-to-vigorous physical activity was associated with no preventive medical care, inadequate or no health care, parents reporting higher percent of no parks or playgrounds, and unsafe and unsupportive neighborhoods. Odds ratios of overweight/obesity were higher for males [OR = 2.06 (1.64, 2.60)], Hispanics [OR = 1.49 (1.17, 1.90)], non-Hispanic Black females [OR = 1.59 (1.20, 2.08)], younger females [OR10-12 yrs. = 1.35 (1.03, 1.79) and OR13-15 yrs. = 1.4. (1.06, 1.89) vs. OR = 1.0016-17 yrs.], children with high television viewing [OR0-1 hr./day = 0.72 (0.61, 0.86); OR>1 to <4 hrs./day 0.84 (0.72, 0.99) = vs. OR = 1.00≥ 4 hrs./day,] and lower categories of physical activity [OR 0 days/wk. = 1.38 (1.13, 1.62); OR1-3 days/wk. = 1.14 (1.22, 1.62) vs. OR7 days/wk. = 1.00], higher poverty, smoke exposure, and parental perception of their neighborhood as unsupportive. Promoting preventive medical care and neighborhood cooperation may have potential to lower childhood obesity.

Cross-sectional analysis of unhealthy foods, race/ethnicity, sex and cardiometabolic risk factors in U.S. adults.

AIM: The purpose of the present study was to determine the association of unhealthy dietary food items with cardiometabolic risk factors with and without sociodemographic factors. METHODS: This cross-sectional study used data available to the public from the National Health and Nutrition Survey (NHANES) 2009-2010 where unhealthy food consumption was based on responses to the Dietary Screener Questionnaire (unique to this NHANES cycle), and cardiometabolic risk factors were based on laboratory results, anthropometric measures, interview and examination questions for 2045 adults aged 20-69 and belonging to four racial/ethnic groups: 473 Mexican Americans (MA); 267 Other Hispanics (OH); 389, non-Hispanic Blacks (NHB) and 916 non-Hispanic Whites (NHW) (characterised by NHANES). RESULTS: A higher percent of MA, followed by OH and NHB, consumed soft drinks as compared to NHW. Consumption of fried potatoes was over 75% across groups and was associated with higher odds dyslipidaemia (high non-HDL cholesterol) in the reduced model: OR = 1.38 (1.10, 1.73), P = 0.009 and full model: OR = 1.50 (1.15, 1.96), P = 0.005. All unhealthy foods measured were consumed more often by males as compared to females. CONCLUSIONS: Dyslipidaemia was associated with fried potato consumption and marginally with processed meats. Dietary interventions, tailored to specific populations, are needed to determine if substituting healthy foods in place of unhealthy ones will improve cardiometabolic outcomes.

The quantum theory of time, the block universe, and human experience.

Advances in our understanding of the physical universe have dramatically affected how we view ourselves. Right at the core of all modern thinking about the universe is the assumption that dynamics is an elemental feature that exists without question. However, ongoing research into the quantum nature of time is challenging this view: my recently introduced quantum theory of time suggests that dynamics may be a phenomenological consequence of a fundamental violation of time reversal symmetry. I show here that there is consistency between the new theory and the block universe view. I also discuss the new theory in relation to the human experience of existing in the present moment, able to reflect on the past and contemplate a future that is yet to happen.This article is part of a discussion meeting issue 'Foundations of quantum mechanics and their impact on contemporary society'.

Do mothers affect daughter's behaviors? Diet, physical activity, and sedentary behaviors in Kuwaiti mother-daughter dyads.

The objective of the study was to evaluate 169 Kuwaiti mother-daughter dyads and their associations with health behaviors for eating healthy, engaging in physical activity, daughters perceived body weight, time spent with computer/video, and time viewing television. Female students aged 10-14 years were selected from private and public schools in the State of Kuwait. Results demonstrated that daughters exhibited similar behaviors to their mothers in their perceived eating behavior, physical activity, computer/video game use, and TV screen time. Future research is essential to determine the role of mothers in effective health behavior intervention strategies for female Kuwaiti adolescents.

Osteoporosis, Activities of Daily Living Skills, Quality of Life, and Dietary Adequacy of Congregate Meal Participants.

Osteoporosis, a chronic disease that results in low bone mass with an increased risk of fragility fractures, is prevalent in older adults. Diet can prevent or lessen the severity of osteoporosis. The purpose of this cross-sectional study was to assess differences in diet, quality of life, self-rated health, and physical function between congregate meal participants with and without osteoporosis. Data were from telephone survey, 10th Annual National Survey of Older American Act Participants, a representative sample of congregate meal attendees across the United States. (N = 888). Osteoporosis was present in 20% of this population. Participants with, as compared to without, osteoporosis reported that their physical health limited moderate activities (31.5% vs. 18.9%, p = 0.026), stair climbing (32.2% vs. 22.8%, p = 0.032), and shopping (27.4 vs. 15.3, p = 0.018). More than half of the participants consumed less than the recommended servings of dairy, meat, grains, and fruits/vegetables regardless of osteoporosis status. Participants with osteoporosis had lower self-rated health and more physical limitations than people without osteoporosis. Although congregate meals are a way to improve nutritional intake, additional methods to improve nutrition (including education) may be of benefit, since undernutrition is a concern in this population.

Health Indicators of US Older Adults Who Received or Did Not Receive Meals Funded by the Older Americans Act.

BACKGROUND: The Older Americans Act (OAA) requires that nutrition programs provide meals and related nutrition services that promote health and help manage chronic diseases. The purpose of this study was to compare health status, food security, functional limitations, and chronic diseases of older adults who received or did not receive OAA meals using data from a representative sample of US adults. METHODS: Data were from the National Health and Nutrition Surveys 2011-2014 for 2,392 older adults ≥ 65 years of age, including 187 Mexican Americans, 212 other Hispanics, 521 non-Hispanic Blacks, 219 non-Hispanic Asians, and 1253 non-Hispanic Whites. RESULTS: Those receiving OAA meals had higher percent of food insecurity and functional disabilities. Adjusting for potential confounders, adults who received OAA meals had higher odds of emphysema (OR = 2.02; 1.05, 3.89) and lower odds of good-to-excellent health (OR = 0.52; 0.36, 0.77). Women and minorities had poorer health status compared to non-Hispanic Whites. CONCLUSION: A higher proportion of older adults who received nutritional services reported poorer health as compared to older adults who do not participate in these services. Future studies should assess nutritional adequacy for older adults who participate in nutritional programs comparing sex and race/ethnicity.

Corrigendum to "Perceived Body Image, Eating Behavior, and Sedentary Activities and Body Mass Index Categories in Kuwaiti Female Adolescents".

[This corrects the article DOI: 10.1155/2016/1092819.].

Sex and Race/Ethnic Disparities in Food Security and Chronic Diseases in U.S. Older Adults.

Objective: The purpose of this study was to determine the relationships among sex, race/ethnicity, and food security with the likelihood of cancer, diabetes, cardiovascular disease, and lung disease for older adults. Method: Complex sample analysis by logistic regression models for chronic diseases were conducted from National Health and Nutrition Examination Surveys, 2011 to 2012 and 2013 to 2014, for N = 3,871 adults aged ≥55 years. Results: Being female with low food security was associated with lung disease and diabetes. Poverty, rather than low food security, was associated with cardiovascular diseases. Minority status was independently associated with low food security and diabetes. Discussion: Food insecurity, sex, and race/ethnicity were associated with chronic diseases in a representative sample of U.S. older adults.

Discrete Fluctuations in Memory Erasure without Energy Cost.

According to Landauer's principle, erasing one bit of information incurs a minimum energy cost. Recently, Vaccaro and Barnett (VB) explored information erasure within the context of generalized Gibbs ensembles and demonstrated that for energy-degenerate spin reservoirs the cost of erasure can be solely in terms of a minimum amount of spin angular momentum and no energy. As opposed to the Landauer case, the cost of erasure in this case is associated with an intrinsically discrete degree of freedom. Here we study the discrete fluctuations in this cost and the probability of violation of the VB bound. We also obtain a Jarzynski-like equality for the VB erasure protocol. We find that the fluctuations below the VB bound are exponentially suppressed at a far greater rate and more tightly than for an equivalent Jarzynski expression for VB erasure. We expose a trade-off between the size of the fluctuations and the cost of erasure. We find that the discrete nature of the fluctuations is pronounced in the regime where reservoir spins are maximally polarized. We also state the first laws of thermodynamics corresponding to the conservation of spin angular momentum for this particular erasure protocol. Our work will be important for novel heat engines based on information erasure schemes that do not incur an energy cost.

Health-Related Characteristics of Older Adults Who Attend Congregate Meal Sites in the United States.

The purpose of this study was to determine health-related characteristics of a representative sample of older adults who attend congregate meal sites in the United States, and compare races/ethnicities and sexes. Participants were adults, aged 60 years and older, (N = 901) of the 2015 Tenth Annual National Survey of Older American Act Participants (NSOAAP). Difficulties with mobility and Activities of Daily Living were common among older adults who attended congregate meals. Health-related characteristics differed by race/ethnicity and sex. Higher percentages of men reported eating more than half their calories from the site: 61.0% (53, 68), compared to women: 41.2% (33,50); while twice the number of women reported exercising at the site: 42.7% (36, 50), compared to 21.8% (16, 29) for men. Hispanics reported poor/fair health, food insecurity, diabetes, and poverty more often than White non-Hispanics. The odds of reporting that meals helped maintain independence were higher for persons with food insecurity: OR = 2.67 (1.05, 6.80) and those who reported eating half or more of their calories from the site: OR = 5.78 (2.36, 14.30). Strategies that consider preferences by sex and race/ethnicity are required at congregate meal sites to encourage mobility and healthy eating.

Sex and Race/Ethnicity Differences in Following Dietary and Exercise Recommendations for U.S. Representative Sample of Adults With Type 2 Diabetes.

This study examined sex by race/ethnicity differences in medical advice received for diet and exercise with corresponding health behaviors of a U.S. representative sample of adults with type 2 diabetes ( N = 1,269). Data from the National Health and Nutrition Examination Surveys for 2011-2014 for 185 Mexican Americans, 123 Other Hispanics, 392 non-Hispanic Blacks, 140 non-Hispanic Asians, and 429 non-Hispanic Whites were analyzed using logistic regression analyses. Reporting being given dietary and exercise advice was positively associated with reporting following the behavior. There were differences in sex and sex by race/ethnicity for reporting receiving medical advice and performing the advised health behavior. These results suggest the importance of physicians having patient-centered communication skills and cultural competency when discussing diabetes management.

Cardiovascular Endurance, Body Mass Index, Physical Activity, Screen Time, and Carotenoid Intake of Children: NHANES National Youth Fitness Survey.

Background. Approximately 17% of children aged 6-11 years were classified as obese in the United States. Obesity adversely affects physical functioning and leads to reduced quality of life. Heart function for overweight and obese children has not been reported. Methods. Data for this study were from NHANES National Youth Fitness Survey (NNYFS) conducted in conjunction with the National Health and Nutrition Examination Survey (NHANES) in 2012. This study used data from children aged 6-12 (N = 732) that had the cardiorespiratory endurance measure, body mass index for age and sex, and dietary data (N = 682). Cardiovascular endurance was estimated by heart rate reserve. Results. Compared to the highest percentile of heart rate reserve, those in the first percentile had 3.52 (2.36, 5.24) odds and those in the second percentile had 3.61 (1.84, 7.06) odds of being in the overweight/obese as compared to the under/normal weight category. Considering the highest percentile, boys had a heart rate reserve of 35%, whereas girls had a heart rate reserve of 13% (less than half that of boys). Conclusion. Having an overweight or obese classification for children in this study demonstrated a compromise in cardiovascular endurance. Parental awareness should be raised as to the detrimental consequence of overweight and heart health.

Quantum asymmetry between time and space.

An asymmetry exists between time and space in the sense that physical systems inevitably evolve over time, whereas there is no corresponding ubiquitous translation over space. The asymmetry, which is presumed to be elemental, is represented by equations of motion and conservation laws that operate differently over time and space. If, however, the asymmetry was found to be due to deeper causes, this conventional view of time evolution would need reworking. Here we show, using a sum-over-paths formalism, that a violation of time reversal (T) symmetry might be such a cause. If T symmetry is obeyed, then the formalism treats time and space symmetrically such that states of matter are localized both in space and in time. In this case, equations of motion and conservation laws are undefined or inapplicable. However, if T symmetry is violated, then the same sum over paths formalism yields states that are localized in space and distributed without bound over time, creating an asymmetry between time and space. Moreover, the states satisfy an equation of motion (the Schrödinger equation) and conservation laws apply. This suggests that the time-space asymmetry is not elemental as currently presumed, and that T violation may have a deep connection with time evolution.

Perceived Body Image, Eating Behavior, and Sedentary Activities and Body Mass Index Categories in Kuwaiti Female Adolescents.

Background. The State of Kuwait has a growing obesity epidemic in both genders and all age groups; however, obesity rates in the young seem to be rising. Methods. We conducted a cross-sectional survey in 169 Kuwaiti female adolescents attending both private and public schools spanning the six governorates in the State of Kuwait in order to explore female adolescents' self-image, body dissatisfaction, type of school (private versus public), TV viewing, and computer games and their relationship to body mass index. Results. Approximately half the students classified as obese perceived their body image to lie in the normal range. Females in the obese category were the most dissatisfied with their body image, followed by those in the overweight category. Eating behavior, level of physical activity, school type, television viewing, computer/video usage, and desired BMI were not significantly associated with level of obesity. Conclusion. This study was one of the few studies to assess adolescent females' body image dissatisfaction in relation to obesity in the State of Kuwait. The results suggest that including body image dissatisfaction awareness into obesity prevention programs would be of value.

Diabetes Self-Management Behaviors, Medical Care, Glycemic Control, and Self-Rated Health in U.S. Men by Race/Ethnicity.

Men, particularly minorities, have higher rates of diabetes as compared with their counterparts. Ongoing diabetes self-management education and support by specialists are essential components to prevent the risk of complications such as kidney disease, cardiovascular diseases, and neurological impairments. Diabetes self-management behaviors, in particular, as diet and physical activity, have been associated with glycemic control in the literature. Recommended medical care for diabetes may differ by race/ethnicity. This study examined data from the National Health and Nutrition Examination Surveys, 2007 to 2010 for men with diabetes (N = 646) from four racial/ethnic groups: Mexican Americans, other Hispanics, non-Hispanic Blacks, and non-Hispanic Whites. Men with adequate dietary fiber intake had higher odds of glycemic control (odds ratio = 4.31, confidence interval [1.82, 10.20]), independent of race/ethnicity. There were racial/ethnic differences in reporting seeing a diabetes specialist. Non-Hispanic Blacks had the highest odds of reporting ever seeing a diabetes specialist (84.9%) followed by White non-Hispanics (74.7%), whereas Hispanics reported the lowest proportions (55.2% Mexican Americans and 62.1% other Hispanics). Men seeing a diabetes specialist had the lowest odds of glycemic control (odds ratio = 0.54, confidence interval [0.30, 0.96]). The results of this study suggest that diabetes education counseling may be selectively given to patients who are not in glycemic control. These findings indicate the need for examining referral systems and quality of diabetes care. Future studies should assess the effectiveness of patient-centered medical care provided by a diabetes specialist with consideration of sociodemographics, in particular, race/ethnicity and gender.

Lifestyle behaviors and self-rated health: the living for health program.

BACKGROUND: Lack of adherence to dietary and physical activity guidelines has been linked to an increase in chronic diseases in the United States (US). The aim of this study was to assess the association of lifestyle behaviors with self-rated health (SRH). METHODS: This cross-sectional study used self-reported data from Living for Health Program (N = 1,701) which was conducted from 2008 to 2012 in 190 health fair events in South Florida, US. RESULTS: Significantly higher percent of females as compared to males were classified as obese (35.4% versus 27.0%), reported poor/fair SRH (23.4% versus 15.0%), and were less physically active (33.9% versus 25.4%). Adjusted logistic regression models indicated that both females and males were more likely to report poor/fair SRH if they consumed ≤2 servings of fruits and vegetables per day (OR = 2.14, 95% CI 1.30-3.54; OR = 2.86, 95% CI 1.12-7.35, resp.) and consumed mostly high fat foods (OR = 1.58, 95% CI 1.03-2.43; OR = 3.37, 95% CI 1.67-2.43, resp.). The association of SRH with less physical activity was only significant in females (OR = 1.66, 95% CI 1.17-2.35). CONCLUSION: Gender differences in health behaviors should be considered in designing and monitoring lifestyle interventions to prevent cardiovascular diseases.