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1.
Sleep Health ; 2020 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-32085968

RESUMEN

OBJECTIVE: We investigated how quantity, timing, and type of childhood adversity were associated with subjectively reported and actigraphically measured sleep in adulthood. DESIGN: This is a cross-sectional design. SETTING: Data were collected from three clinical sites at the University of California, Los Angeles; the University of Wisconsin-Madison; and Georgetown, in the Washington, DC area. PARTICIPANTS: The participants were a group of 863 U.S. adults aged 25-76 years who participated in the Biomarker Project in the Midlife in the United States Refresher study. MEASUREMENT: Subjective sleep was measured by the Pittsburgh Sleep Quality Index and actigraphic sleep measures included sleep-onset latency, sleep efficiency, wake time after sleep onset, and total sleep time. Participants retrospectively reported whether they experienced 18 adverse events before age 18 years and the ages they experienced the events. RESULTS: Childhood adversity, operationalized as quantity (i.e., the total number of adverse events or experiencing 3 or more adverse events) and timing (i.e., experiencing adverse events during both childhood and adolescence) of adverse events, was related to worse subjective and actigraphic sleep (except for total sleep time) after adjusting for age, sex, and race. Models using the cumulative (i.e. dose-response) number of adverse events fit better than models using the timing and type specifications of childhood adversity in relation to subjective or actigraphic sleep measures (except for total sleep time). CONCLUSIONS: These findings highlight the importance of considering the quantity of childhood adversity in relation to self-reported and actigraphically measured sleep in adulthood.

2.
J Appl Behav Anal ; 2020 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-32107774

RESUMEN

Researchers have used multicomponent behavioral skills training packages including written and verbal instructions, modeling, rehearsal, and feedback when teaching caregivers to implement pediatric feeding treatment protocols (e.g., Anderson & McMillan, 2001; Seiverling et al., 2012). Some investigators have shown that fewer behavioral skills training components may be necessary for effective training (e.g., Mueller et al., 2003; Pangborn et al., 2013). We examined the use of in-vivo feedback following written instructions to train caregivers to implement pediatric feeding treatment protocols using a multiple baseline design across 3 caregiver dyads. Correct implementation of the feeding treatment procedures was low during baseline (written instructions only), increased with only the addition of in-vivo feedback, and remained high during follow-up sessions for all caregivers. Results are discussed in terms of clinical implications and caregiver satisfaction.

3.
Lancet ; 395(10221): 339-349, 2020 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-32007169

RESUMEN

BACKGROUND: Acute atrial fibrillation is the most common arrythmia treated in the emergency department. Our primary aim was to compare conversion to sinus rhythm between pharmacological cardioversion followed by electrical cardioversion (drug-shock), and electrical cardioversion alone (shock-only). Our secondary aim was to compare the effectiveness of two pad positions for electrical cardioversion. METHODS: We did a partial factorial trial of two protocols for patients with acute atrial fibrillation at 11 academic hospital emergency departments in Canada. We enrolled adult patients with acute atrial fibrillation. Protocol 1 was a randomised, blinded, placebo-controlled comparison of attempted pharmacological cardioversion with intravenous procainamide (15 mg/kg over 30 min) followed by electrical cardioversion if necessary (up to three shocks, each of ≥200 J), and placebo infusion followed by electrical cardioversion. For patients having electrical cardioversion, we used Protocol 2, a randomised, open-label, nested comparison of anteroposterior versus anterolateral pad positions. Patients were randomly assigned (1:1, stratified by study site) for Protocol 1 by on-site research personnel using an online electronic data capture system. Randomisation for Protocol 2 occurred 30 min after drug infusion for patients who had not converted and was stratified by site and Protocol 1 allocation. Patients and all research and emergency department staff were masked to treatment allocation for Protocol 1. The primary outcome was conversion to normal sinus rhythm for at least 30 min at any time after randomisation and up to a point immediately after three shocks. Protocol 1 was analysed by intention to treat and Protocol 2 excluded patients who did not receive electrical cardioversion. This study is registered at ClinicalTrials.gov, number NCT01891058. FINDINGS: Between July 18, 2013, and Oct 17, 2018, we enrolled 396 patients, and none were lost to follow-up. In the drug-shock group (n=204), conversion to sinus rhythm occurred in 196 (96%) patients and in the shock-only group (n=192), conversion occurred in 176 (92%) patients (absolute difference 4%; 95% CI 0-9; p=0·07). The proportion of patients discharged home was 97% (n=198) versus 95% (n=183; p=0·60). 106 (52%) patients in the drug-shock group converted after drug infusion only. No patients had serious adverse events in follow-up. The different pad positions in Protocol 2 (n=244), had similar conversions to sinus rhythm (119 [94%] of 127 in anterolateral group vs 108 [92%] of 117 in anteroposterior group; p=0·68). INTERPRETATION: Both the drug-shock and shock-only strategies were highly effective, rapid, and safe in restoring sinus rhythm for patients in the emergency department with acute atrial fibrillation, avoiding the need for return to hospital. The drug infusion worked for about half of patients and avoided the resource intensive procedural sedation required for electrical cardioversion. We also found no significant difference between the anterolateral and anteroposterior pad positions for electrical cardioversion. Immediate rhythm control for patients in the emergency department with acute atrial fibrillation leads to excellent outcomes. FUNDING: Heart and Stroke Foundation of Canada and the Canadian Institutes of Health Research.


Asunto(s)
Antiarrítmicos/uso terapéutico , Fibrilación Atrial/terapia , Cardioversión Eléctrica , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Protocolos Clínicos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto Joven
4.
Ethn Dis ; 30(1): 119-128, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31969791

RESUMEN

Background: Sparse data exist to describe national population-level trends in short sleep duration among Latinos. Because short sleep duration is associated with several health conditions that are common in Latinos, such as obesity, diabetes, and hypertension, understanding sleep trends among this population may be key to reducing their disease burden. This study aimed to document Latino subgroup differences in self-reported sleep duration by nativity and country of origin relative to Whites. Design and Setting: Pooled cross-sectional analysis of self-reported data from the National Health and Interview Survey (NHIS), 2004-2017. Participants: 303,244 respondents, aged 18 to 84 years, who self-identified as non-Latino US-born White, US-born Mexican, foreign-born Mexican, US-born Puerto Rican, island-born Puerto Rican, US-born Cuban, foreign-born Cuban, US-born Dominican, foreign-born Dominican, US-born Central/South American, foreign-born Central/South American, US-born "other" Latino, and foreign-born "other" Latino. Methods: Multinomial logistic regression models were used to predict sleep duration controlling for demographics, acculturation, socioeconomic, and health-related factors. Results: We found that all Latino subgroups (except US-born Cubans) were more likely to report poor sleep duration relative to non-Latino Whites, net of demographic, acculturation, socioeconomic, and health-related characteristics. However, the magnitude of disadvantage varies by Latino subgroup. We also found that poor sleep duration is concentrated among certain age groups for the various Latino subpopulations. Conclusions: Given that Latinos in the United States are at higher risk for obesity, diabetes, and hypertension, understanding the patterns of sleep among this population can help identify strategies to improve sleep habits in order to reduce disease burden.

5.
J Gerontol B Psychol Sci Soc Sci ; 75(2): 389-402, 2020 Jan 14.
Artículo en Inglés | MEDLINE | ID: mdl-30412237

RESUMEN

OBJECTIVES: Research on the socioeconomic gradient in mental health links disadvantaged family background with subsequent symptoms of depression, demonstrating the "downstream" effect of parental resources on children's mental health. This study takes a different approach by evaluating the "upstream" influence of adult children's educational attainment on parents' depressive symptoms. METHODS: Using longitudinal data from the U.S. Health and Retirement Study (N = 106,517 person-years), we examine whether children's college attainment influences their parents' mental health in later life and whether this association increases with parental age. We also assess whether the link between children's college completion and parents' depression differs by parents' own education. RESULTS: Parents with children who completed college have significantly lower levels of depressive symptoms than parents without college-educated children, although the gap between parents narrows with age. In addition, at baseline, parents with less than a high school education were more positively affected by their children's college completion than parents who themselves had a college education, a finding which lends support to theories of resource substitution. DISCUSSION: Offspring education is an overlooked resource that can contribute to mental health disparities among older adults in a country with unequal access to college educations.

6.
J Clin Sleep Med ; 15(12): 1769-1776, 2019 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-31855162

RESUMEN

STUDY OBJECTIVES: Previous research has reported mixed results in terms of sex differences in sleep quality. We conducted an analysis of measurement invariance of the Pittsburgh Sleep Quality Index (PSQI) between men and women to provide a necessary foundation for examining sleep differences. METHODS: The sample included 861 adults (mean age = 52.73 years, 47.85% male) from the 2012-2016 wave of the Midlife in the United States (MIDUS) Refresher Biomarker survey. We randomly divided the sample into two half samples for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. We conducted EFA with a weighted least squares mean and variance adjusted (WLSMV) estimator and Geomin rotation to explore the underlying structure of the PSQI. We then employed multiple-group CFA with the WLSMV estimator and theta parameterization to examine measurement invariance between males and females. RESULTS: EFA suggested a two-factor structure of the PSQI, and the two-factor CFA model fit the data well. The finding that the two-factor PSQI model was invariant between males and females on configuration, factor loadings, thresholds for all but one measure, and residual variances for all but one measure provided evidence that the two-factor PSQI model was partially invariant between men and women. Females had higher means on latent factors, suggesting worse self-reports of sleep among women. CONCLUSIONS: Overall, the measure of the PSQI assesses the same factors in a comparable way among men and women. Women reported worse sleep than men.

7.
Artículo en Inglés | MEDLINE | ID: mdl-31711225

RESUMEN

OBJECTIVES: To examine changes in Healthy Life Expectancy (HLE) against the backdrop of rising mortality among less educated white Americans during the first decade of the 21st century. METHOD: This study documented changes in HLE by education among U.S. non-Hispanic whites, using data from the U.S. Multiple Cause of Death public-use files, the Integrated Public Use Microdata Sample (IPUMS) of the 2000 Census and the 2010 American Community Survey, and the Health and Retirement Study (HRS). Changes in HLE were decomposed into contributions from: (1) change in age-specific mortality rates; and (2) change in disability prevalence, measured via Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). RESULTS: Between 2000 and 2010, HLE significantly decreased for white men and women with less than 12 years of schooling. By contrast, HLE increased among college-educated white men and women. Declines or stagnation in HLE among less educated whites reflected increases in disability prevalence over the study period, whereas improvements among the college educated reflected decreases in both age-specific mortality rates and disability prevalence at older ages. DISCUSSION: Differences in HLE between education groups increased among non-Hispanic whites from 2000 to 2010. In fact, education-based differences in HLE were larger than differences in total life expectancy. Thus, the lives of less educated whites were not only shorter, on average, compared with their college-educated counterparts, but they were also more burdened with disability.

8.
J Clin Sleep Med ; 2019 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-31662183

RESUMEN

STUDY OBJECTIVES: Previous research has reported mixed results in terms of sex differences in sleep quality. We conducted an analysis of measurement invariance of the Pittsburgh Sleep Quality Index (PSQI) between men and women to provide a necessary foundation for examining sleep differences. METHODS: The sample included 861 adults (mean age = 52.73 years, 47.85% male) from the 2012-2016 wave of the Midlife in the United States (MIDUS) Refresher Biomarker survey. We randomly divided the sample into two half samples for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. We conducted EFA with a weighted least squares mean and variance adjusted (WLSMV) estimator and Geomin rotation to explore the underlying structure of the PSQI. We then employed multiple-group CFA with the WLSMV estimator and theta parameterization to examine measurement invariance between males and females. RESULTS: EFA suggested a two-factor structure of the PSQI, and the two-factor CFA model fit the data well. The finding that the two-factor PSQI model was invariant between males and females on configuration, factor loadings, thresholds for all but one measure, and residual variances for all but one measure provided evidence that the two-factor PSQI model was partially invariant between men and women. Females had higher means on latent factors, suggesting worse self-reports of sleep among women. CONCLUSIONS: Overall, the measure of the PSQI assesses the same factors in a comparable way among men and women. Women reported worse sleep than men.

9.
Artículo en Inglés | MEDLINE | ID: mdl-30889842

RESUMEN

Although increasing attention has been given to student academic achievement, usually measured by grade point average (GPA), and fitness in children and adolescents, much fewer studies have been conducted in higher education settings, especially in China. This study investigated the longitudinal associations of aerobic fitness (AF), body mass index (BMI), and GPA in Chinese pre-service teachers at a university. A longitudinal research design was employed to track changes in AF, BMI, and GPA, for a total of 1980 students for four years. Multi-level growth models were used to examine the interactive changes of the above three variables. It was found that GPA and BMI increased each year, while AF declined dramatically at the fourth year. The three-way interaction among GPA, gender, and BMI was significant, suggesting females who were overweight/obese had lower GPA. The data from the current study suggested that AF did not impact students' GPA. Class standing (i.e., the fourth year) and gender (i.e., females) need to be taken into consideration when designing interventions to improve student overall fitness and academic performance in Chinese pre-service teacher populations.


Asunto(s)
Rendimiento Académico , Índice de Masa Corporal , Ejercicio , Aptitud Física , Maestros , Adolescente , China , Personal Docente , Femenino , Humanos , Estudios Longitudinales , Masculino , Sobrepeso , Adulto Joven
10.
Soc Sci Res ; 79: 101-114, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30857656

RESUMEN

U.S. military veterans are a large and racially heterogeneous population. There are reasons to expect that racial disparities in mortality among veterans are smaller than those for non-veterans. For example, blacks are favorably selected into the military, receive relatively equitable treatment within the military, and after service accrue higher socioeconomic status and receive health and other benefits after service. Using the 1997-2009 National Health Interview Survey (N = 99,063) with Linked Mortality Files through the end of 2011 (13,691 deaths), we fit Cox proportional hazard models to estimate whether racial disparities in the risk of death are smaller for veterans than for non-veterans. We find that black/white disparities in mortality are smaller for veterans than for non-veterans, and that this is explained by the elevated socioeconomic resources of black veterans relative to black non-veterans. Leveraging birth cohort differences in military periods, we document that the smaller disparities are concentrated among All-Volunteer era veterans.

11.
J Aging Health ; 31(10): 1748-1769, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30141717

RESUMEN

Objectives: Measures of disability depend on health and social roles in a given environment. Yet, social roles can change over time as they have by gender. We document how engagement in Instrumental Activities of Daily Living (IADLs) is shifting by gender and birth cohort among older adults, and the challenges these shifts can create for population-level estimates of disability. Method: We used the Health and Retirement Study (N = 25,047) and multinomial logistic regression models with an interaction term between gender and birth cohort to predict limitation and nonperformance relative to no difficulty conducting IADLs. Results: Nonperformance of IADLs have significantly decreased among younger cohorts. Women in younger cohorts were more likely to use a map, whereas men in younger cohorts were more likely to prepare meals and shop. Discussion: Failing to account for gender and cohort changes in IADL, performance may lead to systematic bias in estimates of population-level disability.

12.
J Gerontol B Psychol Sci Soc Sci ; 74(4): 715-723, 2019 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-28158847

RESUMEN

OBJECTIVES: The ability of older adults to live independently is often assessed with a battery of questions known as Instrumental Activities of Daily Living (IADLs). Many of these questions query the difficulty conducting household activities that have been predominantly conducted by women (e.g., the ability to prepare a meal), especially for cohorts now in old age. Although previous research has documented gender differences in IADL limitations, it has not been documented whether IADLs equivalently measure the same latent construct for men and women. METHODS: We apply psychometric tests of measurement invariance to data from the 1998 Health and Retirement Study. We then estimate corrected models that account for violations of measurement invariance across genders. RESULTS: We find that IADLs do not equivalently measure same latent construct for men and women. We find that men are more likely not to do the IADL activities for reasons unrelated to health limitations, which may reflect gendered expectations regarding household activities. Accounting for this we still find that women report greater health-related IADL limitations than men. DISCUSSION: Researchers should be cautious making gender comparisons for IADLs without attending to the gender-specific measurement properties of many of the items of which the IADL is comprised.

13.
Sleep ; 42(2)2019 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-30452725

RESUMEN

Study Objectives: To document trends in self-reported sleep duration for the noninstitutionalized U.S. civilian population from 2004 to 2017 and examine how sleep trends vary by race/ethnicity. Methods: We use data from the National Health Interview Survey (NHIS) for U.S. noninstitutionalized adults aged 18-84 from 2004 to 2017 (N = 398 382). NHIS respondents were asked how much they slept in a 24-hour period on average, which we categorized as ≤6 hr (short sleep), 7-8 hr (adequate sleep), and ≥9 hr (long sleep). We used multinomial logistic regression models to examine trends in self-reported sleep duration and assess race/ethnic differences in these trends. Our models statistically adjusted for demographic, socioeconomic, familial, behavioral, and health covariates. Results: The prevalence of short sleep duration was relatively stable from 2004 to 2012. However, results from multinomial logistic regression models indicated that there was an increasing trend toward short sleep beginning in 2013 (b: 0.09, 95% CI: 0.05-0.14) that continued through 2017 (b: 0.18, 95% CI: 0.13-0.23). This trend was significantly more pronounced among Hispanics and non-Hispanic blacks, which resulted in widening racial/ethnic differences in reports of short sleep. Conclusions: Recent increases in reports of short sleep are concerning as short sleep has been linked with a number of adverse health outcomes in the population. Moreover, growing race/ethnic disparities in short sleep may have consequences for racial and ethnic health disparities.


Asunto(s)
Grupos Étnicos/estadística & datos numéricos , Estado de Salud , Privación de Sueño/fisiopatología , Sueño/fisiología , Adolescente , Adulto , Afroamericanos/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Salud , Hispanoamericanos/estadística & datos numéricos , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Autoinforme , Factores de Tiempo , Estados Unidos , Adulto Joven
14.
Biodemography Soc Biol ; 64(1): 63-81, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29741416

RESUMEN

To understand the education-mortality association among U.S. adults, recent studies have documented its national functional form. However, the functional form of education-mortality relationship may vary across geographic contexts. The four U.S. Census regions differ considerably in their social and economic policies, employment opportunities, income levels, and other factors that may affect how education lowers the risk of mortality. Thus, we documented regional differences in the functional form of the education-mortality association and examined the role of employment and income in accounting for regional differences. We used data on non-Hispanic white adults (2,981,672, person years) aged 45-84 in the 2000-2009 National Health Interview Survey, with Linked Mortality File through 2011 (37,598 deaths) and estimated discrete-time hazard models. The functional form of education and adult mortality was best characterized by credentialism in the Midwest, Northeast, and for Western men. For Western women, the association was linear, consistent with the human capital model. In the South, we observed a combination of mechanisms, with mortality risk declining with each year of schooling and a step change with high school graduation, followed by steeper decline thereafter. Our work adds to the increasing body of research that stresses the importance of contexts in shaping the education-mortality relationship.


Asunto(s)
Escolaridad , Mapeo Geográfico , Mortalidad/tendencias , Anciano , Anciano de 80 o más Años , Teorema de Bayes , Femenino , Humanos , Renta/estadística & datos numéricos , Entrevistas como Asunto/métodos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Estados Unidos
15.
Ann Emerg Med ; 72(4): 333-341, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-29729811

RESUMEN

STUDY OBJECTIVE: The Canadian C-Spine Rule has been widely applied by emergency physicians to safely reduce use of cervical spine imaging. Our objective is to evaluate the clinical effect and safety of real-time Canadian C-Spine Rule implementation by emergency department (ED) triage nurses to remove cervical spine immobilization. METHODS: We conducted this multicenter, 2-phase, prospective cohort program at 9 hospital EDs and included alert trauma patients presenting with neck pain or with cervical spine immobilization. During phase 1, ED nurses were trained and then had to demonstrate competence before being certified. During phase 2, certified nurses were empowered by a medical directive to "clear" the cervical spine of patients, allowing them to remove cervical spine immobilization and to triage to a less acute area. The primary outcomes were clinical effect (cervical spine clearance by nurses) and safety (missed clinically important cervical spine injuries). RESULTS: In phase 1, 312 nurses evaluated 3,098 patients. In phase 2, 180 certified nurses enrolled 1,408 patients (mean age 43.1 years, women 52.3%, collision 56.5%, and cervical spine injury 1.1%). In phase 2 and for the 806 immobilized ambulance patients, the primary outcome of immobilization removal by nurses was 41.1% compared with 0% before the program. The primary safety outcome of cervical spine injuries missed by nurses was 0. Time to discharge was reduced by 26.0% (3.4 versus 4.6 hours) for patients who had immobilization removed. In only 1.3% of cases did nurses indicate their discomfort with applying the Canadian C-Spine Rule. CONCLUSION: We clearly demonstrated that ED triage nurses can successfully implement the Canadian C-Spine Rule, leading to more rapid and comfortable management of patients without any threat to patient safety. Widespread adoption of this approach should improve care and comfort for trauma patients, and could decrease length of stay in our very crowded EDs.


Asunto(s)
Servicio de Urgencia en Hospital/normas , Traumatismos Vertebrales/diagnóstico , Triaje , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Canadá , Protocolos Clínicos , Estudios de Cohortes , Técnicas de Apoyo para la Decisión , Femenino , Implementación de Plan de Salud , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Traumatismos Vertebrales/diagnóstico por imagen , Traumatismos Vertebrales/enfermería , Adulto Joven
16.
Sleep Health ; 4(2): 127-134, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29555124

RESUMEN

OBJECTIVES: To determine whether historical neighborhood poverty measures are associated with mothers' reports of their children's sleep duration and to compare results from historical neighborhood poverty measures to contemporaneous measures of neighborhood poverty. DESIGN: The Geographic Research on Wellbeing (GROW) study is a follow-up survey of mothers who gave birth between 2003 and 2007. GROW mothers assessed their own and their children's health and health behaviors 5-10 years later (2012-2013). SETTING: Urban Californian counties. PARTICIPANTS: GROW respondents. MEASUREMENTS: We categorized children's sleep as adequate or inadequate using clinical age-specific guidelines and based on mothers' reports of their child's sleep duration. We conducted a latent class analysis to identify historical poverty classes for all California census tracts using data from 1970 to 2005-2009, and we categorized current neighborhood poverty based on data from 2005 to 2009 only. We then assigned children to different neighborhood exposure classes based on their neighborhood of residence at birth and follow-up. RESULTS: Logistic models indicated that net of controls for demographics, child behavior and health characteristics, mother characteristics, and household socioeconomic status, children who grew up in historically low (OR: 0.64, 95% confidence interval=0.45-0.92) or historically moderate poverty classes (OR: 0.68, 95% confidence interval=0.48-0.98) had lower odds of inadequate sleep duration compared with children who grew up in historically high poverty. We show that the historical specification of neighborhood poverty remained significant despite controls, whereas contemporaneous measures of neighborhood poverty did not. CONCLUSIONS: Our findings indicate strong associations between historical neighborhood poverty and child sleep duration.


Asunto(s)
Áreas de Pobreza , Características de la Residencia/estadística & datos numéricos , Sueño , California , Niño , Preescolar , Femenino , Humanos , Masculino , Factores de Tiempo
17.
Health Place ; 46: 49-57, 2017 07.
Artículo en Inglés | MEDLINE | ID: mdl-28499148

RESUMEN

Neighborhoods (and people) are not static, and are instead shaped by dynamic long-term processes of change (and mobility). Using the Geographic Research on Wellbeing survey, a population-based sample of 2339 Californian mothers, we characterize then investigate how long-term latent neighborhood poverty trajectories predict the likelihood of obesity, taking into account short-term individual residential mobility. We find that, net of individual and neighborhood-level controls, living in or moving to tracts that experienced long-term low poverty was associated with lower odds of being obese relative to living in tracts characterized by long-term high poverty.


Asunto(s)
Madres/estadística & datos numéricos , Obesidad/epidemiología , Pobreza/estadística & datos numéricos , Adulto , California , Femenino , Humanos , Obesidad/etnología , Dinámica Poblacional/tendencias , Características de la Residencia/estadística & datos numéricos
18.
Soc Sci Med ; 181: 93-101, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-28384483

RESUMEN

The well-being of older adults is frequently tied to support from their adult children. Here, we assess whether the education of adult offspring is associated with changes to older parents' short- and long-term health in Mexico, a rapidly aging context with historically limited institutional support for the elderly. Educational expansion over the past half century, however, provides older adults with greater resources to rely on via the education of their children. Using longitudinal data from the Mexican Health and Aging Study (2001-2012), we find that offspring education is not associated with short-term changes in parents' physical functioning, but is associated with increased parental longevity, net of children's financial status and transfers. In addition, we find that mothers' longevity is more sensitive to offspring education than fathers. Our findings add to a growing body of literature that urges policy-makers to consider the multi-generational advantages of expanding educational opportunities in Mexico.


Asunto(s)
Niños Adultos/educación , Escolaridad , Estado de Salud , Padres , Adulto , Niños Adultos/estadística & datos numéricos , Anciano , Femenino , Humanos , Esperanza de Vida/tendencias , Masculino , México , Persona de Mediana Edad , Factores Socioeconómicos
19.
Res Aging ; 38(3): 322-45, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26966254

RESUMEN

This article asks how adult children's education influences older parents' physical health in Mexico, a context where older adults often lack access to institutional resources and rely on kin, primarily children, as a main source of support. Using logistic and negative binomial regression models and data from the first wave of the Mexican Health and Aging Study (N = 9,661), we find that parents whose children all completed high school are less likely to report any functional limitations as well as fewer limitations compared to parents with no children who completed high school. This association remains significant even after accounting for parent and offspring-level characteristics, including parents' income that accounts for children's financial transfers to parents. Future research should aim to understand the mechanisms that explain the association between adult children's education and changes to parents' health over time.


Asunto(s)
Niños Adultos/etnología , Envejecimiento/etnología , Escolaridad , Estado de Salud , Relaciones Padres-Hijo/etnología , Anciano , Femenino , Humanos , Relaciones Intergeneracionales , Masculino , México/etnología , Persona de Mediana Edad , Factores Socioeconómicos
20.
J Aging Health ; 27(8): 1311-38, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25903978

RESUMEN

OBJECTIVE: Adverse events in childhood can indelibly influence adult health. While evidence for this association has mounted, a fundamental set of questions about how to operationalize adverse events has been understudied. METHOD: We used data from the National Survey of Midlife Development in the United States to examine how quantity, timing, and types of adverse events in childhood are associated with adult cardiometabolic health. RESULTS: The best-fitting specification of quantity of events was a linear measure reflecting a dose-response relationship. Timing of event mattered less than repeated exposure to events. Regarding the type of event, academic interruptions and sexual/physical abuse were most important. Adverse childhood events elevated the risk of diabetes and obesity similarly for men and women but had a greater impact on women's risk of heart disease. DISCUSSION: Findings demonstrate the insights that can be gleaned about the early-life origins of adult health by examining operationalization of childhood exposures.


Asunto(s)
Adultos Sobrevivientes de Eventos Adversos Infantiles/estadística & datos numéricos , Diabetes Mellitus/epidemiología , Cardiopatías/epidemiología , Obesidad/epidemiología , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Riesgo , Factores de Tiempo , Estados Unidos/epidemiología
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