Socioeconomic Disparities in Colon Cancer Survival: Revisiting Neighborhood Poverty Using Residential Histories.

BACKGROUND: Residential histories linked to cancer registry data provide new opportunities to examine cancer outcomes by neighborhood socioeconomic status (SES). We examined differences in regional stage colon cancer survival estimates comparing models using a single neighborhood SES at diagnosis to models using neighborhood SES from residential histories. METHODS: We linked regional stage colon cancers from the New Jersey State Cancer Registry diagnosed from 2006 to 2011 to LexisNexis administrative data to obtain residential histories. We defined neighborhood SES as census tract poverty based on location at diagnosis and across the follow-up period through 31 December 2016 based on residential histories (average, time-weighted average, time-varying). Using Cox proportional hazards regression, we estimated associations between colon cancer and census tract poverty measurements (continuous and categorical), adjusted for age, sex, race/ethnicity, regional substage, and mover status. RESULTS: Sixty-five percent of the sample was nonmovers (one census tract); 35% (movers) changed tract at least once. Cases from tracts with >20% poverty changed residential tracts more often (42%) than cases from tracts with <5% poverty (32%). Hazard ratios (HRs) were generally similar in strength and direction across census tract poverty measurements. In time-varying models, cases in the highest poverty category (>20%) had a 30% higher risk of regional stage colon cancer death than cases in the lowest category (<5%) (95% confidence interval [CI] = 1.04, 1.63). CONCLUSION: Residential changes after regional stage colon cancer diagnosis may be associated with a higher risk of colon cancer death among cases in high-poverty areas. This has important implications for postdiagnostic access to care for treatment and follow-up surveillance. See video abstract: http://links.lww.com/EDE/B705.

A bidirectional model of postural sway using force plate data.

This work was designed to expand on our previous anterior-posterior postural control model to include medial-lateral sway of unperturbed posture during quiet standing. The bidirectional model simulates two decoupled inverted pendulums, each restricted to sway in either the anterior-posterior (AP) direction (ankle strategy) or medial-lateral (ML) direction (hip strategy), and each controlled by a Proportional-Integral-Derivative (PID) controller. Postural data was collected from 31 healthy participants under different sensory test conditions: eyes closed, eyes open, and eyes open with real-time visual feedback. Simulation iterations of the bidirectional model were run for each sensory test condition to adjust the PID controller parameters until modeled sway metrics did not differ significantly from experimental metrics at p ≤ 0.01. Simulations did not show significant changes in the AP sway controller parameters among the 3 sensory test conditions. The model did show significant changes in ML sway controller parameters, namely stiffness and time delay. Significant differences were also seen in the experimental sway metrics under the three different sensory test conditions. The multi-sensory evaluation and bidirectional sway model offer unique insight for further exploration of postural pathology, control mechanisms and planar coupling that includes both ankle and hip strategies.

Quality of life in Mexican-American children following a weight management program.

OBJECTIVE: The objective was to evaluate quality of life (QOL) in at-risk-for-overweight and overweight Mexican-American children after participating in 6 months of intensive weight management or self-help. RESEARCH METHODS AND PROCEDURES: Eighty sixth- and seventh-grade at-risk-for-overweight (BMI >or=85th to <95th percentile) and overweight (BMI >or=95th percentile) Mexican-American children were randomly assigned to either intensive instructor-led intervention (ILI) or self-help (SH). The ILI condition included daily participation for 12 weeks in a school-based program comprised of nutrition education, physical activity, and behavior modification, followed by ongoing monthly maintenance. QOL was assessed at baseline and 6 months via child self-report PedsQL. QOL outcomes were compared across treatment groups, and the impact of change in zBMI on change in QOL was evaluated. RESULTS: Children in the ILI condition not only achieved significantly greater weight loss (zBMI, -0.13 +/- 0.14; p < 0.001) but also significantly greater physical QOL improvements than those in the SH condition at 6 months (p < 0.05). Furthermore, physical QOL increases were associated with zBMI reduction (p < 0.05). However, neither psychosocial nor total QOL was significantly impacted by intervention or zBMI change. DISCUSSION: These findings show that even modest decreases in zBMI after weight management result in improved physical QOL in Mexican-American children. These results illustrate the clear need to include evaluation of QOL in the process of identifying effective weight management programs.