Trends in Gender, Ethnicity and Less-Than-Full-Time Training among Reconstructive Plastic Surgery Registrars and Consultants between 2009 and 2020.

Objective: This study aimed to examine the trends in gender, ethnicity and less-than-full-time (LTFT) training in reconstructive plastic surgery from 2009 to 2020 in the UK by comparing them to overall surgical specialties. Methods: We analysed NHS Digital workforce data from 2009 to 2020 by examining trends in gender, ethnicity and LTFT working among reconstructive plastic surgery consultants and registrars and comparing them to overall surgical specialties. Data were analysed using linear regression models. Results: The percentage of female reconstructive plastic surgery consultants and registrars increased significantly over the period, with reconstructive plastic surgery groups having higher percentages of females than overall surgical specialties. LTFT working trends varied, with declining trends among consultants and increasing trends among registrars. Ethnicity trends were complex, varying between different ethnic categories and between consultants and registrars, but showing an increase in diversity within the workforce. Conclusion: The demographics of reconstructive plastic surgeons in the UK became more diverse from 2009 to 2020 with trends indicating that this will continue in the future. However, there were significant variations among the different groups and levels of seniority, suggesting the need for targeted interventions to promote diversity and inclusivity in surgical specialties.

Is Acne the Same Around the World?

Acne is a common skin disease associated with a range of sequelae. These include scarring and dyspigmentation, emotional and psychosocial disturbances, and occupational problems, in part because acne often manifests on the face, in addition to other body areas, and is highly visible. Worldwide, the prevalence of acne is estimated at 9.4 percent; it is most common in adolescents but also affects a relatively high proportion of adults. Early studies of acne epidemiology were conducted primarily in the United States and the United Kingdom. In more recent decades, data have been increasing for other areas of the world. There has also been more attention devoted to how acne may present and be managed in individuals with skin of color (i.e., the broad and diverse range of populations that self-identify as belonging to a non-White racial/ethnic group and share characteristics such as higher skin phototypes and propensity toward hyperpigmentation). This review seeks to highlight aspects of acne that may be unique to skin of color.

What explains differences in average wait time in the emergency department among different racial and ethnic populations: A linear decomposition approach.

Objective: Non-Hispanic Black (NHB) and Hispanic/Latino (Hispanic) patients wait longer in the emergency department (ED) to see practitioners when compared with non-Hispanic White (NHW) patients. We investigate factors contributing to longer wait times for NHB and Hispanic patients using a linear decomposition approach. Methods: This retrospective observational study included patients presenting to one tertiary hospital ED from 2019 to 2021. Median wait times among NHW, NHB, and Hispanic were calculated with multivariable linear regressions. The extent to which demographic, clinical, and hospital factors explained the differences in average wait time among the three groups were analyzed with Blinder‒Oaxaca post-linear decomposition model. Results: There were 310,253 total patients including 34.7% of NHW, 34.7% of NHB, and 30.6% of Hispanic patients. The median wait time in NHW was 9 min (interquartile range [IQR] 4‒47 min), in NHB was 13 min (IQR 4‒59 min), and in Hispanic was 19 min (IQR 5‒78 min, p < 0.001). The top two contributors of average wait time difference were mode of arrival and triage acuity level. Post-linear decomposition analysis showed that 72.96% of the NHB‒NHW and 87.77% of the Hispanic‒NHW average wait time difference were explained by variables analyzed. Conclusion: Compared to NHW patients, NHB and Hispanic patients typically experience longer ED wait times, primarily influenced by their mode of arrival and triaged acuity levels. Despite these recognized factors, there remains 12%‒27% unexplained factors at work, such as social determinants of health (including implicit bias and systemic racism) and many other unmeasured confounders, yet to be discovered.

Associations Between Flavonoid Intake and Subclinical Atherosclerosis: The MESA.

BACKGROUND: Flavonoids may play a role in mitigating atherosclerotic cardiovascular diseases, with evidence suggesting effects may differ between vascular beds. Studies examining associations with subclinical markers of atherosclerosis between subpopulations with different underlying risks of atherosclerosis are lacking. METHODS: Among 5599 participants from the MESA (Multi-Ethnic Study of Atherosclerosis), associations between dietary flavonoid intakes (estimated from a food frequency questionnaire) and subclinical measures of atherosclerosis (ankle-brachial index, carotid plaques and intima-media thickness, and coronary artery calcification) were examined using repeated measures models. Exposures and outcomes were measured at exam 1 (2000-2002) and exam 5 (2010-2011). Stratified analyses and interaction terms were used to explore effect modification by time, sex, race/ethnicity, and smoking status. RESULTS: In the analytic population, at baseline, ≈46% were males with a median age of 62 (interquartile range, 53-70) years and total flavonoid intakes of 182 (interquartile range, 98-308) mg/d. After multivariable adjustments, participants with the highest (quartile 4) versus lowest (quartile 1) total flavonoid intakes had 26% lower odds of having an ankle-brachial index <1 (odds ratio, 0.74 [95% CI, 0.60-0.92]) and 18% lower odds of having a carotid plaque (odds ratio, 0.82 [95% CI, 0.69-0.99]), averaged over exams 1 and 5. Moderate (quartile 3) to high (quartile 4) intakes of flavonols, flavanol monomers, and anthocyanins were associated with 19% to 34% lower odds of having an ankle-brachial index <1 and 18% to 20% lower odds of having carotid plaque. Participants with the highest intakes of anthocyanins (quartile 4) at baseline had a marginally slower rate of carotid plaque progression than those with moderate intakes (quartiles 2 and 3). There were no significant associations with intima-media thickness or coronary artery calcification. Observed associations did not differ by sex, race/ethnicity, or smoking status. CONCLUSIONS: In this multi-ethnic population, higher dietary flavonoid intakes were associated with lower odds of peripheral and carotid artery atherosclerosis. Increasing intakes of healthy, flavonoid-rich foods may protect against atherosclerosis in the peripheral and carotid arteries.

Adding ethnicity to cardiovascular risk prediction: External validation and model updating of SCORE2 using data from the HELIUS population cohort.

BACKGROUND: Current prediction models for mainland Europe do not include ethnicity, despite ethnic disparities in cardiovascular disease (CVD) risk. SCORE2 performance was evaluated across the largest ethnic groups in the Netherlands and ethnic backgrounds were added to the model. METHODS: 11,614 participants, aged between 40 and 70 years without CVD, from the population-based multi-ethnic HELIUS study were included. Fine and Gray models were used to calculate sub-distribution hazard ratios (SHR) for South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin groups, representing their CVD risk relative to the Dutch group, on top of individual SCORE2 risk predictions. Model performance was evaluated by discrimination, calibration and net reclassification index (NRI). RESULTS: Overall, 274 fatal and non-fatal CVD events, and 146 non-cardiovascular deaths were observed during a median of 7.8 years follow-up (IQR 6.8-8.8). SHRs for CVD events were 1.86 (95 % CI 1.31-2.65) for the South-Asian Surinamese, 1.09 (95 % CI 0.76-1.56) for the African-Surinamese, 1.48 (95 % CI 0.94-2.31) for the Ghanaian, 1.63 (95 % CI 1.09-2.44) for the Turkish, and 0.67 (95 % CI 0.39-1.18) for the Moroccan origin groups. Adding ethnicity to SCORE2 yielded comparable calibration and discrimination [0.764 (95 % CI 0.735-0.792) vs. 0.769 (95 % CI 0.740-0.797)]. The NRI for adding ethnicity to SCORE2 was 0.24 (95 % CI 0.18-0.31) for events and - 0.12 (95 % CI -0.13-0.12) for non-events. CONCLUSIONS: Adding ethnicity to the SCORE2 risk prediction model in a middle-aged, multi-ethnic Dutch population did not improve overall discrimination but improved risk classification, potentially helping to address CVD disparities through timely treatment.

Patient participation in clinical trials conducted by principal investigators who speak one or more language(s) beyond english: Exploring ethnicity as proxy for language.

Background: To explore the association between ethnicity, as a proxy for language, and participation in clinical trials (CT) conducted by Principal Investigators (PI) who speak one or more language in addition to English. Methods: This retrospective, descriptive study utilized CT participant demographic data extracted from the largest Midwestern non-profit healthcare system between January 1, 2019 and 12/31/2021. The CT participant sample (N = 4308) was divided for comparison: CT Participants of Hispanic or Latino Origin (N = 254; 5.90 %) and CT Participants of Non-Hispanic or Latino Origin (N = 4054; 94.10 %). Logistic regressions were performed to generate the crude and adjusted odds of patients of Hispanic or Latino origin participating in CTs conducted by PIs who speak another language in addition to English. Results: Crude analysis revealed that patients of Hispanic or Latino ethnicity had 2.04 (1.58, 2.64) times greater odds of participating in CTs conducted by PIs who speak another language than English (<0.0001), which increased to 2.67 (1.97, 3.62) times greater odds after adjusting for sex, race, age and insurance (p < 0.0001). Conclusions: Overall findings indicate that patients of Hispanic or Latino ethnicity, who are more likely to speak Spanish, have greater odds of participating in CTs conducted by PIs who speak another language beyond English. This may imply that cultural sensitivity at the top of a CT study team, as likely to be demonstrated by PIs who speak another language beyond English, may be an important contributor to reducing ethnicity- and language-based barriers to diversity in CTs and a relationship worth exploring further.

Population-specific differences in the human microbiome: Factors defining the diversity.

Differences in microbial communities at different body habitats define the microbiome composition of the human body. The gut, oral, skin vaginal fluid and tissue microbiome, are pivotal for human development and immune response and cross talk between these microbiomes is evident. Population studies reveal that various factors, such as host genetics, diet, lifestyle, aging, and geographical location are strongly associated with population-specific microbiome differences. The present review discusses the factors that shape microbiome diversity in humans, and microbiome differences in African, Asian and Caucasian populations. Gut microbiome studies show that microbial species Bacteroides is commonly found in individuals living in Western countries (Caucasian populations), while Prevotella is prevalent in non-Western countries (African and Asian populations). This association is mainly due to the high carbohydrate, high fat diet in western countries in contrast to high fibre, low fat diets in African/ Asian regions. Majority of the microbiome studies focus on the bacteriome component; however, interesting findings reveal that increased bacteriophage richness, which makes up the virome component, correlates with decreased bacterial diversity, and causes microbiome dysbiosis. An increase of Caudovirales (bacteriophages) is associated with a decrease in enteric bacteria in inflammatory bowel diseases. Future microbiome studies should evaluate the interrelation between bacteriome and virome to fully understand their significance in the pathogenesis and progression of human diseases. With ethnic health disparities becoming increasingly apparent, studies need to emphasize on the association of population-specific microbiome differences and human diseases, to develop microbiome-based therapeutics. Additionally, targeted phage therapy is emerging as an attractive alternative to antibiotics for bacterial infections. With rapid rise in microbiome research, focus should be on standardizing protocols, advanced bioinformatics tools, and reducing sequencing platform related biases. Ultimately, integration of multi-omics data (genomics, transcriptomics, proteomics and metabolomics) will lead to precision models for personalized microbiome therapeutics advancement.

Risk factors and clinical features of pre-eclampsia in Iranian and Afghan mothers: A comparative study.

OBJECTIVE: To assess variations in the presentation and clinical implications of pre-eclampsia between Iranian and Afghan mothers at a maternity center in Tehran. METHODS: We conducted a cross-sectional study of Iranian and Afghan mothers diagnosed with pre-eclampsia. Data were collected from March 2021 to February 2023 at a maternity center in Tehran, Iran. Demographic information, clinical characteristics, and laboratory findings were extracted from medical records. Statistical analyses were employed to compare differences between Iranian and Afghan mothers, including Mann-Whitney U, Pearson χ2 tests, and logistic regression models. RESULTS: We included 822 pregnant women with pre-eclampsia, predominantly Iranian (75.5%) and Afghan (24.5%). Regarding the multivariate logistic regression model, Iranian mothers were older, with a higher proportion over 35 years. Although Afghan mothers showed higher gravidity counts and greater gestational ages at delivery, they had lower rates of hypothyroidism. Iranian women were more often categorized as obese than Afghan women, and the difference was statistically significant. Serum levels of alkaline phosphatase were significantly greater in Afghan women. CONCLUSION: Pre-eclampsia poses significant maternal health risks, especially among Afghan refugees in Iran. Variances in age, gravidity, and hypothyroidism prevalence highlight the need for tailored healthcare strategies. Addressing cultural barriers and implementing targeted interventions can improve maternal and fetal outcomes in these populations.

"Dem sey mi mad": a scoping review of the attitudes and beliefs of English-speaking Afro-Caribbeans about psychosis.

Introduction: The mental health disparities suffered by the English-speaking Afro-Caribbean diaspora living with psychosis in North America and the United Kingdom have been well described for decades, but the root causes of these disparities remain poorly understood. Part of the problem may be that the attitudes and beliefs of Caribbean communities regarding psychosis have never been systematically assessed. Such an inquiry could lay the foundation for changes to how psychiatric services for psychosis are implemented with migrant Caribbean communities. The ideal would be a re-design of services, or cultural adaptation of care, based on input from community members, patients, and their families, with the hope that disparities of care would be reduced or eliminated as clinicians co-create interventions that are more appropriate and acceptable to Caribbean people. To lay the groundwork of such an important endeavor, we investigated the shared attitudes, beliefs, experiences, practices, and traditions of English-speaking Afro-Caribbean people in relation to psychosis and psychiatric care. Methods: We conducted a scoping review by searching Medline, PsychINFO and Scopus, reviewing 764 articles, and selecting 220 for thematic content analysis. Results: We highlighted the heterogeneity in the Caribbean diaspora living in North America and the UK. Five principal themes emerged: (1) The enduring effects of colonialism on the psychiatric care of Afro-Caribbean migrants; (2) The effects of adaptation to migration on the experience of psychosis; (3) Pervasive cultural mistrust of psychiatry and mental health institutions; (4) A collective approach to life; and (5) The role of religion and spirituality in the understanding of psychosis. Conclusion: Historical, sociocultural, and geopolitical themes characterize the English Afro-Caribbean experience of psychosis and inform culturally adapted clinical interventions for patients with psychosis and their families. Careful attention to these adaptations will reduce clinical bias and misdiagnosis, optimize adherence to treatment, engage patients and families in recovery, and ultimately, reduce treatment disparities while empowering Afro-Caribbean people and their communities. By bringing forward the themes in this chapter, individual clinicians will be given tools to change how they work with Caribbean people with psychosis in addition to laying the foundation for higher order changes in the mental health professions and society as a whole.

Idiopathic intracranial hypertension in Asians: a retrospective dual-center study.

BACKGROUND: There have been limited data on idiopathic intracranial hypertension (IIH) in Asians and there remain uncertainties whether a cerebrospinal fluid (CSF) pressure of 250 mm CSF is an optimum diagnostic cutoff. The aims of the present study included (1) characterization of IIH patients in Taiwan, (2) comparisons among different diagnostic criteria for IIH, and (3) comparisons between patients with CSF pressures of > 250 and 200-250 mm CSF. METHODS: This retrospective study involved IIH patients based on the modified Dandy criteria from two tertiary medical centers in Taiwan. Clinical manifestations were retrieved from electronic medical records, and findings on ophthalmologic examination and magnetic resonance images (MRIs) were reviewed. RESULTS: A total of 102 patients (71 F/31 M, mean age 33.4 ± 12.2 years, mean CSF pressure 282.5 ± 74.5 mm CSF) were identified, including 46 (45.1%) with obesity (body-mass index ≥ 27.5), and 57 (62.6%) with papilledema. Overall, 80 (78.4%), 55 (53.9%), 51 (50.0%), and 58 (56.9%) patients met the Second and Third Edition of International Classification of Headache Disorders, Friedman, and Korsbæk criteria, respectively. Patients in the 200-250 mm CSF group (n = 40) were less likely to have papilledema (48.5% vs. 70.7%, p = 0.035), transient visual obscuration (12.5% vs. 33.9%, p = 0.005), and horizontal diplopia (10.0% vs. 30.6%, p = 0.006), and had fewer signs on MRIs (2.2 ± 1.3 vs. 2.8 ± 1.0, p = 0.021) when compared with those with CSF pressures > 250 mm CSF (n = 62). However, the percentages of patients with headache (95.0% vs. 87.1%, p = 0.109) at baseline, chronic migraine at six months (31.6% vs. 25.0%, p = 0.578), and visual field defect (86.7% vs. 90.3%, p = 0.709) were similar. CONCLUSIONS: It was found that obesity and papilledema were less common in Asian IIH patients when compared with Caucasian patients. Although patients with CSF pressures of 200-250 mm CSF had a less severe phenotype, the risks of having headache or visual loss were comparable to those in the > 250 mm CSF group. It is possible that a diagnostic cutoff of > 200 mm CSF could be more suitable for Asians, although further studies are still needed.

A serological survey of COVID-19 among predominantly aboriginal residents of a tourist island in southern Thailand.

BACKGROUND: The current survey describes the seroprevalence, history of coronavirus disease 2019 (COVID-19), and vaccination status among predominantly aboriginal residents on a tourist island in southern Thailand. This information can be translated into COVID-19 vaccination and control plans for this population. METHODS: We implemented questionnaire interviews and collected blood samples from 249 residents of Lipe Island, Satun Province, in January 2022. We measured the anti-nucleocapsid protein and anti-spike (anti-S) receptor-binding protein levels of immunoglobulin (Ig) M and IgG. The differences in antibody levels among participants with different histories of vaccination and infection were analyzed using one-way analysis of variance with multiple comparisons. RESULTS: During the 2-year pandemic period, no island residents with COVID-19 required hospitalization despite the high prevalence of hypertension (33.3%) and diabetes mellitus (21.7%). Approximately 18.8% of the participants reported a history of COVID-19 diagnosis. In total, 95.1% of the participants had a history of complete vaccination, of which 93.5% were seropositive. The anti-S IgG geometric means (geometric standard deviation) were 3945.8 (2.0), 829.8 (9.7) AU/mL, 789.9 (5.3) AU/mL, and 22.7 (7.1) AU/mL, respectively, in participants with a history of both COVID-19 diagnosis and complete vaccination (group 1), incomplete vaccination and subsequent COVID-19 diagnosis (group 2), complete vaccination but no previous infection (group 3), or neither previous COVID-19 and complete vaccination (group 4). Significant pairwise differences in anti-S IgG levels were found between certain groups (1 vs 3, 1 vs 4, 2 vs 4, and 3 vs 4). CONCLUSIONS: The high coverage of vaccination, high levels of population antibody titers, variable antibody levels among completely vaccinated non-infected residents, and high prevalence of non-communicable diseases (NCDs) suggested that the local health systems could control the pandemic. However, continuing surveillance, booster vaccinations, and NCD prevention programs were still required.

Income and campus application disparities among European and non-European heritage Hispanic undergraduate applicants.

Leveraging every undergraduate application submitted by self-identified Hispanic applicants to the University of California system in the 2016 and 2017 application cycles, we show that a significant number of applicants claim Hispanic identity by virtue of European heritage. We subsequently demonstrate that Hispanic-identifying students of European descent are significantly more affluent and more likely to apply to selective University of California campuses than their non-European Hispanic peers. We comment on the practical implications of these disparities, as well as their relevance for studies of inequality in the social sciences and education.

Physical Activity, Cardiorespiratory Fitness, and the Obesity Paradox with Consideration for Racial and/or Ethnic Differences: A Broad Review and Call to Action.

Despite decades of extensive research and clinical insights on the increased risk of all-cause and disease-specific morbidity and mortality due to obesity, the obesity paradox still presents a unique perspective, i.e., having a higher body mass index (BMI) offers a protective effect on adverse health outcomes, particularly in people with known cardiovascular disease (CVD). This protective effect may be due to modifiable factors that influence body weight status and health, including physical activity (PA) and cardiorespiratory fitness (CRF), as well as non-modifiable factors, such as race and/or ethnicity. This article briefly reviews the current knowledge surrounding the obesity paradox, its relationship with PA and CRF, and compelling considerations for race and/or ethnicity concerning the obesity paradox. As such, this review provides recommendations and a call to action for future precision medicine to consider modifiable and non-modifiable factors when preventing and/or treating obesity.

Pharmacotherapeutic options for the treatment of hypertension in pregnancy.

INTRODUCTION: Hypertensive disorders of pregnancy affect approximately one in 10 pregnancies and are associated with increased risk of adverse fetal, neonatal and maternal outcomes. There is strong evidence that effective treatment of hypertension (blood pressure ≥ 140/90 mmHg), and enhanced monitoring throughout pregnancy reduces these risks. AREAS COVERED: This article provides a contemporaneous review of treatment of hypertension in pregnancy with antihypertensive agents. We completed a systematic search and review of all meta-analyses and systematic reviews of studies comparing antihypertensives for treatment of pregnancy hypertension in the last five years. We provide a clinically focused summary of when to treat hypertension in pregnancy and which antihypertensive agents can be offered. Special scenarios reviewed include treatment-resistant hypertension and pre-pregnancy antihypertensive optimization. EXPERT OPINION: Several antihypertensives are considered safe and are known to be effective for treatment of hypertension in pregnancy. Given the current uncertainty as to which antihypertensive(s) are superior for treatment of hypertension in pregnancy, women should be counselled and offered a range of antihypertensive options in keeping with evidence on clinical effectiveness, local context and availability of antihypertensive(s), potential side effect profile, and women's preference. Further research is required to help guide clinical decision making, and move toward personalized treatment.

Trends and Outcomes of US Hypertriglyceridemia-Induced Acute Pancreatitis Hospitalizations in Hispanic Americans: Epidemiology from 2016 to 2020.

OBJECTIVE: Hypertriglyceridemia-induced acute pancreatitis (HTG-AP) hospitalizations are increasing in the USA; however, the impact of race and ethnicity on key outcomes in Hispanic and non-Hispanic white HTG-AP hospitalizations has not been studied. METHODS: We queried the National Inpatient Sample (NIS) between 2016 and 2020 identifying all patients with discharge diagnosis AP. HTG-AP hospitalizations were identified for Hispanic and non-Hispanic white patients. Primary outcomes included yearly rate of HTG-AP and in-hospital mortality from HTG-AP. Secondary outcomes were length of stay (LOS) and inflation-adjusted hospital costs. RESULTS: HTG-AP hospitalizations accounted for 5.9% of all AP hospitalizations; 17,440 and 48,235 hospitalizations included a Hispanic and non-Hispanic white patient, respectively. The yearly rate of HTG-AP hospitalizations per 100,000 adult population was statistically higher for Hispanics compared to non-Hispanic whites. The HTG-AP hospitalization rate increased for both Hispanics and non-Hispanic whites (both ptrend < 0.001); however, the trends were not statistically different. The number of observed in-hospital deaths for Hispanics was too low to report, precluding subsequent analysis. Hispanics were younger, more likely to be female, more commonly Medicaid recipients, and from zip codes with lower income quartiles. Despite clinically similar rates of plasmapheresis use and LOS, adjusted hospital costs were 18.9% higher for Hispanics compared to non-Hispanic whites (95% CI, 15.4 to 22.6% higher, p < 0.001). CONCLUSIONS: HTG-AP incidence is increasing in the USA in Hispanic and non-Hispanic whites. Despite clinically similar outcomes, HTG-AP hospitalizations in Hispanic patients were associated with $26,805,280 in excess costs compared to non-Hispanic white hospitalizations.

Neighborhood Racial and Ethnic Predominance, Child Opportunity, and Violence-Related Mortality among Children and Adolescents in Chicago.

Our objective was to determine whether Child Opportunity Index (COI), a measure of neighborhood socioeconomic and built environment specific to children, mediated the relationship of census tract Black or Hispanic predominance with increased rates of census tract violence-related mortality. The hypothesis was that COI would partially mediate the relationship. This cross-sectional study combined data from the American Community Survey 5-year estimates, the COI 2.0, and the Illinois Violent Death Reporting System 2015-2019 for the City of Chicago. Individuals ages 0-19 years were included. The primary exposure was census tract Black, Hispanic, White, and other race predominance (> 50% of population). The primary outcome was census tract violence-related mortality. A mediation analysis was performed to evaluate the role of COI as a potential mediator. Multivariable logistic regression modeling census tract violence-related mortality demonstrated a direct effect of census tract Black predominance (adjusted odds ratio [aOR] 2.59, 95% confidence interval [CI] 1.30-5.14) on violence-related mortality compared to White predominance. There was no association of census tract Hispanic predominance with violence-related mortality compared to White predominance (aOR 1.57, 95% CI 0.88-2.84). Approximately 64.9% (95% CI 60.2-80.0%) of the effect of census tract Black predominance and 67.9% (95% CI 61.2-200%) of the effect of census tract Hispanic predominance on violence-related mortality was indirect via COI. COI partially mediated the effect of census tract Black and Hispanic predominance on census tract violence-related mortality. Interventions that target neighborhood social and economic factors should be considered to reduce violence-related mortality among children and adolescents.

MALAMA: Cultivating Food Sovereignty through Backyard Aquaponics with Native Hawaiian Families.

Native Hawaiians were a healthy and robust population who developed a sophisticated food system that was dismantled by colonization. Currently, Native Hawaiians face pervasive health disparities due to the limited access to healthy foods and lifestyles. This study pilot tested a family-based community-driven intervention called MALAMA, which teaches families to build and use a backyard aquaponics system to grow their own food. A total of 21 participants from 10 families completed a three-month curriculum that included a series of hands-on workshops. Participant attendance was recorded and participants completed a behavioral health questionnaire as well as provided clinical indicators at three time points. They also attended a focus group at the end of the curriculum. There was a high level of engagement and no participant attrition. Fruit consumption among all participants significantly increased and there were favorable trends in blood pressure and fish and vegetable consumption. No significant differences were found in the other clinical indicators. Participants found MALAMA to be highly culturally acceptable and identified multiple benefits. Community-driven solutions, such as MALAMA, may be a promising approach to addressing pervasive health disparities and promoting health equity in minority and Indigenous communities.

Association of the weight-adjusted waist index with hypertension in the context of predictive, preventive, and personalized medicine.

Objective: Hypertension (HTN) is a prevalent global health concern. From the standpoint of preventive and personalized medicine (PPPM/3PM), early detection of HTN offers a crucial opportunity for targeted prevention and personalized treatment. This study aimed to evaluate the association between the weight-adjusted waist index (WWI) and HTN risk. Methods: A case-control study using data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 was conducted. Logistic regression models assessed the association between WWI and HTN. Subgroup analyses explored differences in age, sex, ethnicity, and diabetes status. Restricted cubic spline (RCS) analyses examined potential nonlinear relationships. Results: A total of 32,116 participants, with an average age of 49.28 ± 17.56 years, were included in the study. A significant positive association between WWI and the risk of HTN was identified (odds ratio [OR], 2.49; 95% CI, 2.39-2.59; P < 0.001). When WWI was categorized into quartiles (Q1-Q4), the highest quartile (Q4) exhibited a stronger association compared to Q1 (OR, 2.94; 95% CI, 2.65-3.27; P < 0.001). Subgroup analyses indicated that WWI was a risk factor for HTN across different populations, although variations in the magnitude of effect were observed. Furthermore, the findings from the RCS elucidated a nonlinear positive correlation between WWI and HTN. Conclusion: WWI is independently associated with HTN risk, highlighting its potential as a risk assessment tool in clinical practice. Incorporating WWI into early detection strategies enhances targeted prevention and personalized management of HTN. Supplementary Information: The online version contains supplementary material available at 10.1007/s13167-024-00375-3.

Race and ethnic differences in step- versus biological parent support to adult children.

Objective: This brief report examines differences in step- versus biological family support between White, Black, and Hispanic families in the United States. Background: The increasing share of stepfamilies reflects a potential shift in family relationships. Although research finds that stepfamilies are generally less likely to engage in instrumental support than biological families, recent work suggests that the relationship between family structure and family behaviors may vary across racial/ethnic groups. Method: Using data from the 2015-2017 Add Health Parent Study, this report examines racial/ethnic differences in step- versus biological family support between parents and adult children. Specifically, parents' likelihood of and hours of providing instrumental support to adult children are assessed. Results: Findings from this report indicate for Black and White families, stepfamilies are less likely to provide instrumental support to their adult children than biological families. Among Hispanic families, however, stepfamilies are not more or less likely to provide support than biological families. When hours of instrumental support are examined, White stepfamilies provide fewer hours of support than biological families, whereas no difference is found for Black or Hispanic families. Conclusion: Findings from this study contribute to broader work that calls for more nuanced understanding of the differential effects of family structure across social groups. Future research should consider applying within-race/ethnicity analyses when examining the association between family structure and intergenerational support.