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1.
Environ Monit Assess ; 192(8): 552, 2020 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-32737629

RESUMEN

The high-altitude regions of Himalaya are among the best indicators of climate change yet noticeable for the lack of climate monitoring stations. However, they support ethnic communities whose livelihood activities are climate driven. Consequently, these communities are keen observers of the same and documenting their perception on changing climate is now an important area of global research. Therefore, the present study was conducted with the prime objective of documenting the climate change perception of Bhangalis-a resident community of western Himalaya, and analyzing variation in their perceptions in relation to age and gender. For this, respondent surveys (household, n = 430; individual interviews, n = 240) were carried out and the collected data were subjected to statistical analyses. The study also validated the perception of Bhangalis using the available weather data (1974-2017) through the Mann-Kendall test. The results reveal that Bhangalis perceived 11 indicators of changing climate, of which decrease in snowfall was the most prominent (reported by ~ 97% of the respondents). The perceptions varied between the two genders with males having significantly higher proportion of responses for all the 11 indicators. Similarly, differences in perception among the age groups were also observed, elderly people reported higher proportion of climate change indicators as compared to respondents of lower age. Notably, patterns of temperature and rainfall perceptions by the Bhangalis agreed with the trends of meteorological data. This highlights the importance of the study in documenting knowledge of ethnic communities especially from areas that lack monitoring stations. It argues for involving them in climate change programs.


Asunto(s)
Cambio Climático , Meteorología , Anciano , Documentación , Monitoreo del Ambiente , Femenino , Humanos , Masculino , Temperatura
2.
Arch Gerontol Geriatr ; 91: 104112, 2020 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-32738518

RESUMEN

BACKGROUND: We examined how the relationship between education and latelife cognitive impairment (defined as a Mini Mental State Examination score below 24) is influenced by age, sex, ethnicity, and Apolipoprotein E epsilon 4 (APOE*4). METHODS: Participants were 30,785 dementia-free individuals aged 55-103 years, from 18 longitudinal cohort studies, with an average follow-up ranging between 2 and 10 years. Pooled hazard ratios were obtained from multilevel parametric survival analyses predicting cognitive impairment (CI) from education and its interactions with baseline age, sex, APOE*4 and ethnicity. In separate models, education was treated as continuous (years) and categorical, with participants assigned to one of four education completion levels: Incomplete Elementary; Elementary; Middle; and High School. RESULTS: Compared to Elementary, Middle (HR = 0.645, P = 0.004) and High School (HR = 0.472, P < 0.001) education were related to reduced CI risk. The decreased risk of CI associated with Middle education weakened with older baseline age (HR = 1.029, P = 0.056) and was stronger in women than men (HR = 1.309, P = 0.001). The association between High School and lowered CI risk, however, was not moderated by sex or baseline age, but was stronger in Asians than Whites (HR = 1.047, P = 0.044), and significant among Asian (HR = 0.34, P < 0.001) and Black (HR = 0.382, P = 0.016), but not White, APOE*4 carriers. CONCLUSION: High School completion may reduce risk of CI associated with advancing age and APOE*4. The observed ethnoregional differences in this effect are potentially due to variations in social, economic, and political outcomes associated with educational attainment, in combination with neurobiological and genetic differences, and warrant further study.

3.
Ethn Dis ; 30(3): 469-478, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32742152

RESUMEN

Background: We assessed cross-sectional differences in sleep quality and risk factors among Asian, Black, Latino, and White participants in the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study. Methods: KHANDLE enrolled community-dwelling adults aged ≥65 years living in northern California. Participants completed a modified Pittsburgh Sleep Quality Index to measure six sleep components and a global sleep score (scored 0-24). Covariates included age, sex, central adiposity, education, income, alcohol consumption, ever smoking, physical activity, and depression. Ordinal logistic regression was used to model sleep component scores across race/ethnic groups. Linear regression was used to assess racial/ethnic differences in global sleep score and the association between risk factors and global sleep score. Results: 1,664 participants with a mean age of 76 (SD=7) and mean global sleep score of 6 (SD=4) were analyzed. Using Latinos as reference (highest average sleep score), Blacks had an average .96 (.37, 1.54) unit higher global sleep score (worse sleep) while Asians [ß: .04 (-.56, .63)] and Whites [ß: .28 (-.29, .84)] did not significantly differ. Compared with Latinos, Blacks and Asians had greater odds of a worse score on the sleep duration component; Blacks and Whites had greater odds of a worse score on the sleep disturbances component; and, Whites had greater odds of a worse score on the medication component. Risk factors for poor sleep did not differ by race/ethnicity except alcohol consumption (interaction P=.04), which was associated with poor sleep in Blacks only. Conclusions: In this cohort, racial/ethnic differences in sleep quality were common.

4.
Bone Joint J ; 102-B(8): 1016-1024, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32731825

RESUMEN

AIMS: Although bone cement is the primary mode of fixation in total knee arthroplasty (TKA), cementless fixation is gaining interest as it has the potential of achieving lasting biological fixation. By 3D printing an implant, highly porous structures can be manufactured, promoting osseointegration into the implant to prevent aseptic loosening. This study compares the migration of cementless, 3D-printed TKA to cemented TKA of a similar design up to two years of follow-up using radiostereometric analysis (RSA) known for its ability to predict aseptic loosening. METHODS: A total of 72 patients were randomized to either cementless 3D-printed or a cemented cruciate retaining TKA. RSA and clinical scores were evaluated at baseline and postoperatively at three, 12, and 24 months. A mixed model was used to analyze the repeated measurements. RESULTS: The mean maximum total point motion (MTPM) at three, 12, and 24 months was 0.33 mm (95% confidence interval (CI) 0.25 to 0.42), 0.42 mm (95% CI 0.33 to 0.51), and 0.47 mm (95% CI 0.38 to 0.57) respectively in the cemented group, versus 0.52 mm (95% CI 0.43 to 0.63), 0.62 mm (95% CI 0.52 to 0.73), and 0.64 mm (95% CI 0.53 to 0.75) in the cementless group (p = 0.003). However, using three months as baseline, no difference in mean migration between groups was found (p = 0.497). Three implants in the cemented group showed a > 0.2 mm increase in MTPM between one and two years of follow-up. In the cementless group, one implant was revised due to pain and progressive migration, and one patient had a liner-exchange due to a deep infection. CONCLUSION: The cementless TKA migrated more than the cemented TKA in the first two-year period. This difference was mainly due to a higher initial migration of the cementless TKA in the first three postoperative months after which stabilization was observed in all but one malaligned and early revised TKA. Whether the biological fixation of the cementless implants will result in an increased long-term survivorship requires a longer follow-up. Cite this article: Bone Joint J 2020;102-B(8):1016-1024.

5.
Soc Sci Med ; : 113218, 2020 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-32732096

RESUMEN

Integrating intersectionality theory and employing a quantitative design, the current study explores how migration-related health inequalities in Europe interact with migrant generation, occupational status and gender. Multilevel logistic regression analyses are conducted using pooled data from six waves of the European Social Survey (2004-2014), from 27 countries for two subjective health measures (general self-reported health and hampering conditions). The results reveal multiple relationships of health inequality that operate simultaneously and the complexity through which the combination of social privilege and disadvantage can have a particularly negative impact on individual health. The 'healthy migrant effect' seems to apply particularly for first-generation immigrants working as manual employees, and within occupational categories, in certain cases non-migrant women are more susceptible to poor health than migrant men. This evidence highlights how the health impact of migration is subject to additional dimensions of social positioning as well as the importance of an intersectional perspective for the monitoring of health inequalities in Europe.

6.
J Diabetes Complications ; : 107682, 2020 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-32732136

RESUMEN

BACKGROUND: Obesity is a global epidemic and prevalence of obesity is higher in African Americans (AAs) compared to Caucasians. The endocannabinoid system (EC) and polymorphism in the endocannabinoid receptor type 1 (CNR1) gene 3813A/G and 4895A/G and in the fatty acid amide hydrolase (FAAH) are associated with obesity. The objective was to explore racial and sex differences in these polymorphisms and the biochemical abnormalities seen in obesity. METHODS: A cross-sectional study of 667 subjects (53.67% female; 49.18% AA; 69.72% were obese (body mass index [BMI] ≥30)) were screened for CNR1 3813, 4895 and FAAH 385 polymorphisms using a real-time polymerase chain reaction (PCR) system. RESULTS: Subjects with FAAH 385 polymorphisms were more likely to be obese (75.14% vs. 67.81, P = 0.046). There were no significant sex differences for CNR1 3813 and CNR1 4895; or between obese and control group. AAs had higher prevalence of CNR1 3813 (OR, 2.80, 95% CI, 1.95-4.04) and FAAH 385 (OR, 2.48, 95% CI, 1.82-3.38). Association between African American race and the three genotypes persisted after adjustment of all the variables (P < 0.001). CONCLUSION: FAAH 385 polymorphism is more likely seen in obese and in older subjects. AAs had higher prevalence of CNR1 3813 and FAAH 385 polymorphisms; and lower prevalence of CNR1 4895 polymorphism. These findings may explain some of the racial differences, but not the sex differences in the clinical expression of obesity.

7.
Artículo en Inglés | MEDLINE | ID: mdl-32732248

RESUMEN

BACKGROUND: Incidence rates of epithelial ovarian cancer (EOC) vary across racial/ethnic groups, yet little is known about the impact of hormone-related EOC risk factors in non-Whites. METHODS: Among 91,625 female Multiethnic Cohort Study participants, 155 incident EOC cases were diagnosed in Whites, 93 in African Americans, 57 in Native Hawaiians, 161 in Japanese Americans, and 141 in Latinas. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between race/ethnicity and EOC risk and between hormone-related factors and EOC risk across racial/ethnic groups. RESULTS: Compared to Whites, African Americans and Japanese Americans had a lower multivariable adjusted EOC risk; Native Hawaiians had a suggestive higher risk. Parity and oral contraceptive (OC) use were inversely associated with EOC risk (Pint race/ethnicity >=0.43); associations were strongest among Japanese Americans (e.g. >=4 vs 0 children, HR 0.45 [CI 0.26-0.79]). Age at natural menopause and postmenopausal hormone (PMH) use were not associated with EOC risk in the overall population, but were positively associated with risk in Latinas (e.g. >=5 years vs never PMH use, HR 2.13 [CI 1.30-3.49]). CONCLUSIONS: We observed strong associations with EOC risk for parity and OC use in Japanese Americans and PMH use and age at natural menopause in Latinas. However, differences in EOC risk among racial/ethnic groups were not fully explained by established hormone-related risk factors. IMPACT: Our study indicates there are racial/ethnic differences in EOC risk and risk factors, and could help improve prevention strategies for non-White women.

8.
J Phys Act Health ; : 1-8, 2020 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-32732453

RESUMEN

BACKGROUND: The effects of aerobic physical activity (PA) and muscular strengthening activity (MSA) on all-cause mortality risk need further exploration among ethnically diverse populations. PURPOSE: To examine potential effect modification of race-ethnicity on meeting the PA guidelines and on all-cause mortality. METHODS: The study sample (N = 14,384) included adults (20-79 y of age) from the 1999-2006 National Health and Nutrition Examination Survey. PA was categorized into 6 categories based on the 2018 PA guidelines: category 1 (inactive), category 2 (insufficient PA and no MSA), category 3 (active and no MSA), category 4 (no PA and sufficient MSA), category 5 (insufficient PA and sufficient MSA), and category 6 (meeting both recommendations). Race-ethnic groups examined included non-Hispanic white, non-Hispanic black, and Mexican American. Cox-proportional hazard models were used. RESULTS: Significant risk reductions were found for categories 2, 3, and 6 for non-Hispanic white and non-Hispanic black. Among Mexican American, significant risk reductions were found in category 6. CONCLUSION: In support of the 2018 PA guidelines, meeting both the aerobic PA and MSA guidelines significantly reduced risk for all-cause mortality independent of race-ethnicity. The effects of aerobic PA alone seem to be isolated to non-Hispanic white and non-Hispanic black.

10.
Alcohol Alcohol ; 2020 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-32734284

RESUMEN

AIM: the objective was to test the hypothesis that a higher proportion of students with non-Western origin in high school classes is associated with lower and less frequent alcohol consumption among ethnic Danish students. METHOD: data on country of origin was obtained from the Danish Civil Registration System, while information on drinking habits were derived from the Danish National Youth Study 2014. Multilevel zero-inflated binominal regression was used to assess the association between class proportion of students with non-Western origin and odds of non-drinking and mean weekly alcohol consumption, while multilevel logistic regression was used to assess the association with frequent binge drinking. RESULTS: a higher proportion of students with non-Western origin in class was associated with higher odds of non-drinking among ethnic Danish student in the same class. For example, ethnic Danish boys in classes with more than 15% of the students of non-Western origin had 77% higher odds of being non-drinkers, compared to ethnic Danish boys in classes where 0-5% had non-Western origin (OR: 1.77, 95% CI; 1.42-2.20). Among ethnic Danish students that did consume alcohol, class proportion of students with non-Western origin was not associated with weekly alcohol consumption, while a higher proportion of students with non-Western origin in class was associated with lower odds of frequent binge drinking. CONCLUSION: the downward drinking trend among adolescents in Western countries may be partly explained by the higher proportion of youth with non-Western origin, influencing the prevalence of drinking and frequency of binge drinking among adolescents in the ethnic majority population.

11.
Clin Exp Ophthalmol ; 2020 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-32734654

RESUMEN

IMPORTANCE: Evidence-based guidelines are essential for glaucoma screening to work effectively. BACKGROUND: To derive a vertical cup-to-disc ratio (VCDR) cut-off for glaucoma screening in a multi-ethnic Asian population. DESIGN: The Singapore Epidemiology of Eye Diseases (SEED) study is a population-based study conducted from 2004 to 2011 in a single tertiary care research institute. PARTICIPANTS: SEED comprised of 10 033 Chinese, Malay and Indian adults aged ≥40 (response rate 75.6%). After excluding participants with a history of glaucoma medication or surgery, 9673 participants were included for analysis. METHODS: A systematic eye examination, which included applanation tonometry, visual field testing, gonioscopy, and dilated fundus examination was conducted. MAIN OUTCOME MEASURE: Diagnosis of glaucoma. RESULTS: The distribution of VCDR and VCDR asymmetry were relatively homogenous in this multi-ethnic Asian population, with a 97.fifth percentile value of 0.67 and 0.17 respectively. In the absence of more definite signs of glaucoma, VCDR ≥0.60 and VCDR asymmetry ≥0.20 provided the best balance between sensitivity (95.1%) and specificity (90.9%) in detecting glaucoma. For larger optic disc (≥2.0 mm), VCDR ≥0.65 with VCDR asymmetry ≥0.20 provided the best balance between sensitivity (84.8%) and specificity (93.2%). CONCLUSION AND RELEVANCE: Overall, VCDR ≥0.60 with VCDR ≥0.20 asymmetry provides a good balance between sensitivity and specificity in detecting glaucoma. For larger optic disc, VCDR ≥0.65 should be considered instead to mitigate against false-referrals due to larger physiological disc cupping. Our findings may act as a reference to populations with similar VCDR distribution.

12.
Am J Hosp Palliat Care ; : 1049909120946729, 2020 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-32734763

RESUMEN

BACKGROUND: Compared to Whites, racial/ethnic minorities are less likely to enroll in hospice and if they enroll, more likely to experience poor quality care. Building cultural competence (CC) among hospice staff is a strategy that may reduce disparities. OBJECTIVE: To describe the state of CC training across hospices. DESIGN: National survey of hospices' practices to promote CC. RESULTS: A total of 197 hospices participated; most were not-for-profit (80%) with an average daily census less than 100 (47%); 73% offered staff cultural competence training (CCT). There were no differences in characteristics of hospices who offered CCT and those that did not. Of hospices offering CCT, 61% held it annually. Most trainings were 1 hour (60%); content was delivered via web (58%) and/or lecture (58%). While over 90% of staff (i.e., nurses, social workers, chaplains) completed CCT, a smaller proportion of medical directors (64%), senior leaders (71%) and board members (26%) did so. Most common topics were: cross-cultural communication, death/illness beliefs, spirituality's role, and healthcare disparities. The majority focused on African-Americans (83%), Hispanics (76%), and Asians (62%)-the most common U.S. minority groups. Almost 30% reported no effectiveness assessment of CCT, while 51% reported a quiz at the end of training. Most hospices offered some CCT. CONCLUSIONS: CCT has been shown to improve healthcare providers' knowledge and skills in caring for diverse patients and it is associated with increased patient satisfaction. Future research should evaluate effectiveness of CCT in improving the ability of hospices to deliver high quality end-of-life care to diverse groups of older adults.

13.
PLoS One ; 15(7): e0235190, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32735593

RESUMEN

To examine changes in U.S. medical school basic science faculty over the last 20 years (1998-2018), we undertook an observational study utilizing data from the American Association of Medical Colleges Faculty Roster. Rank (Instructor, Assistant Professor, Associate Professor, and Professor), sex (Female), and race/ethnicity (Asian, Black or African American, Hispanic, Latino, Spanish Origin, or Multiple Race-Hispanic, and White) were analyzed; this reflected a population of 14,047 (1998) to 18,601 (2018) faculty. Summary percent of faculty in various gender, race/ethnicity origin categories were analyzed across years of the study using regression models. We found that females (24.47% to 35.32%) were underrepresented at all timepoints and a minority of faculty identified as Black or African American (1.57% to 1.99%), Hispanic, Latino, Spanish Origin, or Multiple Race-Hispanic (3.03% to 4.44%), or Asian (10.90% to 20.41%). The largest population at all time points was White Male Professors (30.53% to 20.85%), followed by White Male Associate Professors (15.67% to 9.34%), and White Male Assistant Professors (13.22% to 9.75%). Small statistically significant increases were observed among female faculty and faculty at multiple ranks who identified as Black or African American or Hispanic, Latino, Spanish Origin, or Multiple Race-Hispanic. We then completed secondary analyses looking at the interaction of race/ethnicity and Gender. We found: (1) a significant increase (p<0.0001) in both genders who identify as Asian although males had a higher rate of increase (6 point difference, p<0.0001); (2) a significant increase for Black or African American females (P<0.01) not found among males; (3) significant increases (p<0.0001) among both genders of faculty who identify as Hispanic, Latino, Spanish Origin, or Multiple Race-Hispanic although females had an approximately 1% higher rate of increase; and (4) among faculty who identify as White, males had a significant decrease (p<0.0001) while females demonstrated an increase (p<0.0001).

14.
Artículo en Inglés | MEDLINE | ID: mdl-32735741

RESUMEN

Throughout the COVID-19 pandemic, limited racial and ethnic data have been published about the prevalence and severity of the disease in pregnant women. Ethical approval was obtained from the Brigham and Women's Hospital Institutional Review Board. The present study reviewed the cases of women at an academic hospital-based obstetrics practice diagnosed with COVID-19 during pregnancy or within eight weeks postpartum and abstracted data from electronic medical records including demographics, pregnancy, neonatal, and COVID-19 outcomes.

15.
J Neurosurg Pediatr ; : 1-7, 2020 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-32736354

RESUMEN

OBJECTIVE: Social disparities in healthcare outcomes are almost ubiquitous, and trauma care is no exception. Because social factors cannot cause a trauma outcome directly, there must exist mediating causal factors related to the nature and severity of the injury, the robustness of the victim, access to care, or processes of care. Identification of these causal factors is the first step in the movement toward health equity. METHODS: A noninferiority analysis was undertaken to compare mortality rates between Black children and White children after traumatic brain injury (TBI). Data were derived from the Trauma Quality Improvement Program (TQIP) registries for the years 2014 through 2017. Inclusion criteria were age younger than 19 years and head Abbreviated Injury Scale scores of 4, 5, or 6. A noninferiority margin of 10% was preselected. A logistic regression propensity score model was developed to distinguish Black and White children based on all available covariates associated with race at p < 0.10. Stabilized inverse probability weighting and a one-tailed 95% CI were used to test the noninferiority hypothesis. RESULTS: There were 7273 observations of White children and 2320 observations of Black children. The raw mortality rates were 15.6% and 22.8% for White and Black children, respectively. The final propensity score model included 31 covariates. It had good fit (Hosmer-Lemeshow χ2 = 7.1604, df = 8; p = 0.5194) and good discrimination (c-statistic = 0.752). The adjusted mortality rates were 17.82% and 17.79% for White and Black children, respectively. The relative risk was 0.9986, with a confidence interval upper limit of 1.0865. The relative risk corresponding to the noninferiority margin was 1.1. The hypothesis of noninferiority was supported. CONCLUSIONS: Data captured in the TQIP registries are sufficient to explain the observed racial disparities in mortality after TBI in childhood. Speculations about genetic or epigenetic factors are not supported by this analysis. Discriminatory care may still be a factor in TBI mortality disparities, but it is not occult. If it exists, evidence for it can be sought among the data included in the TQIP registries.

16.
Hum Immunol ; 2020 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-32736900

RESUMEN

BACKGROUND: Angiotensin II type 1 receptor antibody (AT1R-Ab) is a non-HLA antibody that has been reported to cause antibody-mediated rejection and graft loss in kidney transplantation. The prevalence of positive AT1R-Ab varies between 8% and 18% in different regions. Thus, this study aims to determine the prevalence of AT1R-Ab among the Malaysian population. METHODOLOGY: All sera for AT1R-Ab were collected at the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. The sera were centrifuged and kept refrigerated at -80 °C before being transported to the South Australian Transplantation and Immunogenetics Laboratory (SATIS). Enzyme-linked immunosorbent assay kit (One Lambda) was used for the detection of AT1R-Ab, and it was performed according to the manufacturer's instructions. The level of >17.1 U/mL was considered to be AT1R-Ab positive; 10.0-17.1 U/mL at risk, and <10.0 U/mL negative. RESULTS: A total of 115 samples were collected from 99 patients pre and post-kidney transplant recipients. From the pre-transplant sera (n = 68) 17.7% were positive, 35.3% were at risk and 47.0% were negative. The positive AT1R-Ab cohort were relatively younger, with a mean age of 34.7 ± 8.3 years old and statistically significant, with a p-value of 0.028. Among the sera that were tested positive, 19.0% were from the Chinese ethnicity, 6.7% from Malay and 16.7% from Indian. There was no difference in the rejection episodes, persistent or de novo HLA-DSA, and graft function between the group (AT1R-Ab negative vs AT1R-Ab at risk and positive) and the results were consistent in a model adjusted for all potential confounders. CONCLUSION: The prevalence of positive (>17.1 U/mL) pre-transplant AT1R-Ab was 17.7% and 35.3% were at risk (10.0-17.1 U/mL) in our pre-transplant cohort.

17.
Eur J Nutr ; 2020 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-32737612

RESUMEN

PURPOSE: To examine the prospective association between serum Mg level and the incidence of cognitive impairment. METHODS: A random sub-cohort (n = 2063) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort was included in this study. Baseline serum Mg concentration was measured using inductively coupled plasma mass spectrometry. According to the current reference interval of serum magnesium (0.75-0.95 mmol/L), we classified participants below the interval as Level 1 and used it as the referent. The rest of the study population were equally divided into three groups, named Level 2 to 4. Incident cognitive impairment was identified using the Six-Item Screener. Multivariable-adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using logistic regression models. RESULTS: After adjustment for potential confounders, an inverse threshold association between serum Mg level and incident cognitive impairment was observed. Compared to those with hypomagnesemia (Level 1: < 0.75 mmol/L), the relative odds of incident cognitive impairment was reduced by 41% in the second level [OR (95% CI) = 0.59 (0.37, 0.94)]; higher serum Mg level did not provide further benefits [Level 3 and 4 versus Level 1: OR (95% CI) = 0.54 (0.34, 0.88) and 0.59 (0.36, 0.96), P for linear trend = 0.08]. CONCLUSIONS: Findings from this prospective study suggest that sufficient Mg status within the normal range may be beneficial to cognitive health in the US general population.

18.
Ann Epidemiol ; 2020 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-32738401

RESUMEN

PURPOSE: Race differences in health are pervasive in the United States. American-style football players are a racially diverse group with social status and other benefits that may reduce health disparities. Whether race disparities in health exist among former professional football players, and whether they differ by era of play, is unknown. METHODS: We examined the association of self-reported race with health outcomes (e.g., physical and cognitive function, pain, depression and anxiety), among 3,747 participants in the Football Players Health Study, comprised of former National Football League (NFL) players who played since 1960. We conducted analyses stratified by age. RESULTS: Black players had increased risk of all five adverse health outcomes versus white players (risk ratio (RR) range=1.36 to 1.89). Native Hawaiians and men of other races had greater risk of all health outcomes except impaired physical functioning, compared with white players (RR range=1.25 to 1.64). No clear patterns were observed by era of play. In general, race disparities were not accounted for by health-related exposures during playing years. Adjustment for current BMI somewhat attenuated associations. CONCLUSIONS: Social and economic advantages of playing professional football did not appear to equalized race disparities in health.

19.
Sci Rep ; 10(1): 12917, 2020 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-32737355

RESUMEN

Despite persistent efforts in understanding the motives and patterns of human migration behaviors, little is known about the microscopic mechanism that drives migration and its association with migrant types. To fill the gap, we develop a population game model in which migrants are allowed to be heterogeneous and decide interactively on their destination, the resulting migration network emerges naturally as an Nash equilibrium and depends continuously on migrant features. We apply the model to Chinese labor migration data at the current and expected stages, aiming to quantify migration behavior and decision mode for different migrant groups and at different stages. We find the type-specific migration network differs significantly for migrants with different age, income and education level, and also differs from the aggregated network at both stages. However, a deep analysis on model performance suggests a different picture, stability exists for the decision mechanism behind the "as-if" unstable migration behavior, which also explains the relative invariance of low migration efficiency in different settings. Finally, by a classification of cities from the estimated game, we find the richness of education resources is the most critical determinant of city attractiveness for migrants, which gives hint to city managers in migration policy design.

20.
AIDS Behav ; 2020 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-32737817

RESUMEN

We conducted a web-based survey to understand the impact of social distancing measures on Brazilian MSM and transgender/non-binary lives. A total of 3486 respondents were included in this analysis and the great majority were cismen (98%). The median age was 32 years (IQR: 27-40), 44% non-white, 36% low schooling and 38% low income. Most of participants reported HIV negative/unknown status (77%). Participants on-PrEP reported more condomless anal sex than those off-PrEP. Conversely, 24% off-PrEP were at substantial HIV-risk. PrEP/ART continuation were reported by the majority, despite reports of impediments to medication refill. Transgender/non-binary reported more mental health problems and challenges to access health care. Social and racial disparities were associated with unattainability of maintaining social distancing. Tailored social and economic support policies during COVID-19 pandemic should be made available to these populations. Challenges for PrEP/ART access will demand the implementation of innovative solutions to avoid the expansion of the HIV epidemic.

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