Population-Level Surveillance of Domestic Assaults in the Home Using the National Emergency Medical Services Information System (NEMSIS).

Violence in the home, including partner violence, child abuse, and elder abuse, is pervasive in the United States. An informatics approach allowing automated analysis of administrative data to identify domestic assaults and release timely and localized data would assist preventionists to identify geographic and demographic populations of need and design tailored interventions. This study examines the use of an established national dataset, the NEMSIS 2019, as a potential annual automated data source for domestic assault surveillance. An algorithm was used to identify individuals who utilized emergency medical services (EMS) for a physical assault in a private residence (N = 176,931). Descriptive analyses were conducted to define the identified population and disposition of patients. A logistic regression was performed to predict which characteristics were associated with consistent domestic assault identification by the on-scene EMS clinician and dispatcher. The sample was majority female (52.2%), White (44.7%), urban (85.5%), and 21-29 years old (24.4%). A disproportionate number of those found dead on scene were men (74.5%), and female patients more often refused treatment (57.8%) or were treated and then released against medical advice (58.4%). Domestic assaults against children and seniors had higher odds of being consistently identified by both the dispatcher and EMS clinician than those 21-49, and women had lower odds of consistent identification than men. While a more specific field to identify the type of domestic assault (e.g., intimate partner) would help inform specialized intervention planning, these data indicate an opportunity to systematically track domestic assaults in communities and describe population-specific needs.

Addressing patient's unmet social needs: disparities in access to social services in the United States from 1990 to 2014, a national times series study.

BACKGROUND: To address patient's unmet social needs and improve health outcomes, health systems have developed programs to refer patients in need to social service agencies. However, the capacity to respond to patient referrals varies tremendously across communities. This study assesses the emergence of disparities in spatial access to social services from 1990 to 2014. METHODS: Social service providers in the lower 48 continental U.S. states were identified annually from 1990 to 2014 from the National Establishment Times Series (NETS) database. The addresses of providers were linked in each year to 2010 US Census tract geometries. Time series analyses of annual counts of services per Km2 were conducted using Generalized Estimating Equations with tracts stratified into tertiles of 1990 population density, quartiles of 1990 poverty rate and quartiles of 1990 to 2010 change in median household income. RESULTS: Throughout the period, social service agencies/Km2 increased across tracts. For high population density tracts, in the top quartile of 1990 poverty rate, compared to tracts that experienced the steepest declines in median household income from 1990 to 2010, tracts that experienced the largest increases in income had more services (+ 1.53/Km2, 95% CI 1.23, 1.83) in 1990 and also experienced the steepest increases in services from 1990 to 2010: a 0.09 services/Km2/year greater increase (95% CI 0.07, 0.11). Similar results were observed for high poverty tracts in the middle third of population density, but not in tracts in the lowest third of population density, where there were very few providers. CONCLUSION: From 1990 to 2014 a spatial mismatch emerged between the availability of social services and the expected need for social services as the population characteristics of neighborhoods changed. High poverty tracts that experienced further economic decline from 1990 to 2010, began the period with the lowest access to services and experienced the smallest increases in access to services. Access was highest and grew the fastest in high poverty tracts that experienced the largest increases in median household income. We theorize that agglomeration benefits and the marketization of welfare may explain the emergence of this spatial mismatch.

Physicochemical Properties of Meat Batter Added with Edible Silkworm Pupae (Bombyx mori) and Transglutaminase.

This study was conducted to investigate the physicochemical properties of meat batters prepared with fresh pork meat, back fat, water, and salt and formulated with three different amounts (5%, 10%, and 15%) of silkworm pupae (Bombyx mori) powder and transglutaminase (TG). Meat batters formulated with silkworm pupae powder showed significantly higher contents of protein and ash than control batter. Addition of silkworm pupae to batter also showed significantly lower cooking loss than the control. Moreover, meat batter containing 15% silkworm pupae showed no significant difference in redness value compared to the control. In addition, pH, viscosity, hardness, gumminess, and chewiness were improved after the addition of silkworm pupae. Furthermore, meat batter formulated with TG and silkworm pupae showed improved hardness, gumminess, chewiness and viscosity compared to control batter. Addition of 1% TG with 15% silkworm pupae to meat batter resulted in significantly higher pH, textures, and viscosity. Our data suggest that both silkworm pupae and TG can be added to meat batter to improve its physicochemical properties. Therefore, combination of silkworm pupae and TG could be a new nutritional and functional source for meat products.

Effect of Swiss Chard (Beta vulgaris var. cicla) as Nitrite Replacement on Color Stability and Shelf-Life of Cooked Pork Patties during Refrigerated Storage.

In this study, the effects of pre-converted nitrite from Swiss chard powder (PS) on the color stability and shelf-life of cooked pork patties during refrigerated storage for 28 d were investigated. Nitrite was added at a concentration of approximately 120 ppm. Five treatments were formulated as follows: Control (120 ppm nitrite), T1 (2% PS), T2 (2% pre-converted nitrite from celery powder; PC), T3 (1% PS + 60 ppm nitrite), and NC (nitrite-free). The T1 and T3 samples had higher nitrosoheme pigment contents, which were associated with the redness of the samples (p<0.05). T1 resulted in the highest redness value (p<0.05). The redness and yellowness of the cooked pork patties increased with increasing PS levels. The pH of the samples subjected to all treatments decreased with progress of the storage period (p<0.05). The pH of the T1 and T3 samples treated with PS was lower (p<0.05) than that obtained with other treatments, as PS has a lower pH value. The treatments in which PS was added were most effective for reducing the level of thiobarbituric acid reactive substances (TBARS) and the residual nitrite content relative to the control. T1 resulted in the highest flavor, off-flavor, and overall acceptability scores during storage (p<0.05). The total viable bacterial count for all treatments was below 1 Log CFU/g, and E. coli and coliform bacteria were not detected during storage. Therefore, these results suggested that pre-converted nitrite from Swiss chard powder is a potential replacement for nitrite in meat products.

Hispanic immigrant women's perspective on healthy foods and the New York City retail food environment: A mixed-method study.

Much has been written about the role of dietary acculturation in the epidemic of obesity among Hispanic immigrants in the United States. Yet little is known about the role of beliefs and preferences in immigrants' dietary practices and their relationship to the retail food environment in which the practices occur. We conducted a mixed-methods convergence study of these issues. Twenty-eight foreign-born Hispanic adult women, recruited from families enrolled in a childhood asthma study and mainly living in New York City took part in 60-90 min, semi-structured interviews regarding their dietary beliefs, preferences, and practices. The findings were then used to formulate hypotheses for analyses of food frequency questionnaire (FFQ) data collected from the 345 New York Hispanic women enrolled in the asthma study. Generalized estimating equations were used to determine whether characteristics of the retail food environment within 0.5 km of the home predicted diet, adjusting for individual and neighborhood socio-demographic characteristics. In the interviews, healthy food was rarely discussed in terms of nutritional content. Instead, considerations of freshness, as indicated by time since harvest or slaughter and thus local sourcing; purity, as indicated by the absence of preservatives and processing; and naturalness, as indicated by chemical free farming practices, were the primary axes around which healthy food was defined. Quantitative results were consistent with the qualitative findings: 1) the presence of a farmers' market within the home neighborhood was associated with consumption of more total servings per day of fruit, vegetables, and juice, and 2) the presence of a farmers' market and/or a livestock market was associated with consumption of more servings per day of meat. Proximity to supermarkets or medium-sized grocery stores was not associated with consumption. The results suggest that the availability of fresh produce and meat from local farms may influence diet among Hispanic women in urban neighborhoods.

Neighbourhood immigrant acculturation and diet among Hispanic female residents of New York City.

OBJECTIVE: To identify predominant dietary patterns among Hispanic women and to determine whether adherence to dietary patterns is predicted by neighbourhood-level factors: linguistic isolation, poverty rate and the retail food environment. DESIGN: Cross-sectional analyses of predictors of adherence to dietary patterns identified from principal component analysis of data collected using the Study of Women's Health Across the Nation FFQ. Census data were used to measure poverty rates and the percentage of Spanish-speaking families in the neighbourhood in which no person aged ≥14 years spoke English very well (linguistic isolation) and the retail food environment was measured using business listings data. SETTING: New York City. SUBJECTS: A total of 345 Hispanic women. RESULTS: Two major dietary patterns were identified: a healthy dietary pattern loading high for vegetables, legumes, potatoes, fish and other seafood, which explained 17 % of the variance in the FFQ data and an energy-dense dietary pattern loading high for red meat, poultry, pizza, french fries and high-energy drinks, which explained 9 % of the variance in the FFQ data. Adherence to the healthy dietary pattern was positively associated with neighbourhood linguistic isolation and negatively associated with neighbourhood poverty. Presence of more fast-food restaurants per square kilometre in the neighbourhood was significantly associated with lower adherence to the healthy diet. Adherence to the energy-dense dietary pattern was inversely, but not significantly, associated with neighbourhood linguistic isolation. CONCLUSIONS: These results are consistent with the hypothesis that living in immigrant enclaves is associated with healthy dietary patterns among Hispanics.

Personal and neighborhood socioeconomic status and indices of neighborhood walk-ability predict body mass index in New York City.

Past research has observed inverse associations between neighborhood and personal level measures of socioeconomic status and body mass index (BMI), but has not assessed how personal and neighborhood-level measures might interact together to predict BMI. Using a sample of 13,102 adult residents of New York City who participated in a health survey, cross-sectional multi-level analyses assessed whether personal income, education and Zip code-level poverty rates were associated with BMI. Demographic, income, education and objectively measured height and weight data were collected in the survey and poverty rates and the proportion of Black and Hispanic residents in the subject's Zip code were retrieved from the 2000 Census. Zip code-level population density and land use mix, indices of neighborhood walk-ability which are often higher in lower income neighborhoods and are associated with lower BMI, were also measured. After controlling for individual and Zip code-level demographic characteristics, increasing income was associated with lower BMI in women but not in men, and college and graduate level education was associated with lower BMI in both men and women. After control for income and individual and Zip code-level demographic characteristics, higher Zip code poverty rate was unassociated with BMI. However, as expected, indices of neighborhood walk-ability acted as substantial inverse confounders in the relationship between Zip code poverty rate and BMI. After further adjustment for indices of neighborhood walk-ability, Zip code poverty rate became significantly, and positively associated with BMI in women. Among women, the inverse association between income and BMI was significantly stronger in richer compared to poorer Zip codes. In men and women, the association between college and graduate education and lower BMI was significantly stronger in richer versus poorer Zip codes. These analyses suggest that neighborhood socioeconomic context influences how personal socioeconomic status interact in predicting boby size.

Place of birth, duration of residence, neighborhood immigrant composition and body mass index in New York City.

BACKGROUND: Past research has suggested that changes in culture explain the substantial weight gain seen in many immigrant groups with length of residence in the U.S. and across generations of residence in the U.S. However, it has been theorized that those settling in immigrant and co-ethnic neighborhoods may be buffered against this acculturative process and will be more likely to maintain home country dietary and physical activity patterns. To investigate this theory we incorporated measures of neighborhood immigrant composition into analyses of individual's body mass index (BMI) and generation of immigration and duration of residence in the U.S. METHODS: Multilevel analyses were performed using objectively measured height and weight and survey data on diet and physical activity from a sample of 13,011 residents of New York City. Census data were used to calculate the proportion of foreign-born residents and extent of household linguistic isolation in a (1/2) mile radial buffer around the subject's home. RESULTS: Foreign birth was associated with a significantly lower BMI (-1.09 BMI units, P < 0.001). This association was weakest among Asians (-0.66 BMI units, P = 0.08) and strongest among Black-Caribbeans (-1.41 BMI units, P = 0.07). After controlling for individual level variables, neighborhood proportion foreign-born was not associated with BMI, but increasing neighborhood linguistic isolation was inversely associated with BMI among Hispanics (-2.97 BMI units, P = 0.03). Furthermore among Hispanics, the association between foreign birth and BMI was stronger in low linguistic isolation neighborhoods (-1.36 BMI units, P < 0.0001) as compared to in high linguistic isolation levels (-0.42 BMI units, P = 0.79). Increasing duration of residence in the U.S. was significantly associated with higher BMI overall and among Hispanics. CONCLUSION: The analyses suggest that acculturation is associated with weight gain, and that neighborhood characteristics are only associated with BMI among Hispanics. However, we suggest that changes in body size currently interpreted as post-migration effects of acculturation to U.S. norms may in fact reflect changes in norms that are taking place internationally.