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2.
Diabetologia ; 64(11): 2458-2465, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34345973

RESUMO

AIMS/HYPOTHESIS: The aim of this work was to assess the association between diabetes and risk for infection-related hospitalisation and mortality. METHODS: We conducted a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study. Diabetes was defined as a fasting glucose ≥7 mmol/l or non-fasting glucose ≥11.1 mmol/l, self-report of a diagnosis of diabetes by a physician, or current diabetes medication use. Hospitalisation for infection was ascertained from hospital discharge records. Participants were followed from 1987-1989 to 2019. RESULTS: We included 12,379 participants (mean age 54.5 years; 24.7% Black race; 54.3% female sex). During a median follow-up of 23.8 years, there were 4229 new hospitalisations for infection. After adjusting for potential confounders, people with (vs without) diabetes at baseline had a higher risk for hospitalisation for infection (HR 1.67 [95% CI 1.52, 1.83]). Results were generally consistent across infection type but the association was especially pronounced for foot infection (HR 5.99 [95% CI 4.38, 8.19]). Diabetes was more strongly associated with hospitalisation for infection in younger participants and Black people. Overall infection mortality was low (362 deaths due to infection) but the adjusted risk was increased for people with diabetes (HR 1.72 [95% CI 1.28, 2.31]). CONCLUSIONS/INTERPRETATION: Diabetes confers significant risk for infection-related hospitalisation. Enhancing prevention and early treatment of infection in those with diabetes is needed to reduce infection-related morbidity and mortality.

3.
N Engl J Med ; 384(23): 2219-2228, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34107181

RESUMO

BACKGROUND: Documenting current trends in diabetes treatment and risk-factor control may inform public health policy and planning. METHODS: We conducted a cross-sectional analysis of data from adults with diabetes in the United States participating in the National Health and Nutrition Examination Survey (NHANES) to assess national trends in diabetes treatment and risk-factor control from 1999 through 2018. RESULTS: Diabetes control improved from 1999 to the early 2010s among the participants but subsequently stalled and declined. Between the 2007-2010 period and the 2015-2018 period, the percentage of adult NHANES participants with diabetes in whom glycemic control (glycated hemoglobin level, <7%) was achieved declined from 57.4% (95% confidence interval [CI], 52.9 to 61.8) to 50.5% (95% CI, 45.8 to 55.3). After major improvements in lipid control (non-high-density lipoprotein cholesterol level, <130 mg per deciliter) in the early 2000s, minimal improvement was seen from 2007-2010 (52.3%; 95% CI, 49.2 to 55.3) to 2015-2018 (55.7%; 95% CI, 50.8 to 60.5). From 2011-2014 to 2015-2018, the percentage of participants in whom blood-pressure control (<140/90 mm Hg) was achieved decreased from 74.2% (95% CI, 70.7 to 77.4) to 70.4% (95% CI, 66.7 to 73.8). The percentage of participants in whom all three targets were simultaneously achieved plateaued after 2010 and was 22.2% (95% CI, 17.9 to 27.3) in 2015-2018. The percentages of participants who used any glucose-lowering medication or any blood-pressure-lowering medication were unchanged after 2010, and the percentage who used statins plateaued after 2014. After 2010, the use of combination therapy declined in participants with uncontrolled blood pressure and plateaued for those with poor glycemic control. CONCLUSIONS: After more than a decade of progress from 1999 to the early 2010s, glycemic and blood-pressure control declined in adult NHANES participants with diabetes, while lipid control leveled off. (Funded by the National Heart, Lung, and Blood Institute.).


Assuntos
Anti-Hipertensivos/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipoglicemiantes/uso terapêutico , Adulto , Fatores Etários , Idoso , Peso Corporal , Colesterol/sangue , Estudos Transversais , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Quimioterapia Combinada/tendências , Uso de Medicamentos/tendências , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
4.
Commun Biol ; 4(1): 563, 2021 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-33980982

RESUMO

Innate Lymphoid Cells (ILCs) are immune cells typically found on mucosal surfaces and in secondary lymphoid organs where they regulate the immune response to pathogens. Despite their key role in the immune response, there are still fundamental gaps in our understanding of ILCs. Here we report a human ILC population present in the follicles of tonsils and lymph nodes termed follicular regulatory ILCs (ILCFR) that to our knowledge has not been previously identified. ILCFR have a distinct phenotype and transcriptional program when compared to other defined ILCs. Surprisingly, ILCFR inhibit the ability of follicular helper T (Tfh) cells to provide B cell help. The localization of ILCFR to the germinal centers suggests these cells may interfere with germinal center B cell (GC-B) and germinal center Tfh cell (GC-Tfh) interactions through the production of transforming growth factor beta (TGF-ß. Intriguingly, under conditions of impaired GC-Tfh-GC-B cell interactions, such as human immunodeficiency virus (HIV) infection, the frequency of these cells is increased. Overall, we predict a role for ILCFR in regulating GC-Tfh-GC-B cell interactions and propose they expand in chronic inflammatory conditions.


Assuntos
Centro Germinativo/imunologia , Centro Germinativo/fisiologia , Linfócitos/imunologia , Adolescente , Adulto , Linfócitos B/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Imunidade Inata/imunologia , Linfonodos/imunologia , Linfonodos/metabolismo , Ativação Linfocitária/imunologia , Linfócitos/metabolismo , Masculino , Tonsila Palatina/imunologia , Tonsila Palatina/metabolismo , Células T Auxiliares Foliculares/imunologia
5.
Diabetes Care ; 44(3): 699-706, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33419932

RESUMO

OBJECTIVE: To assess the prevalence of and trends in complications among U.S. adults with newly diagnosed diabetes. RESEARCH DESIGN AND METHODS: We included 1,486 nonpregnant adults (aged ≥20 years) with newly diagnosed diabetes (diagnosed within the past 2 years) from the 1988-1994 and 1999-2018 National Health and Nutrition Examination Survey. We estimated trends in albuminuria (albumin-to-creatinine ratio ≥30 mg/g), reduced estimated glomerular filtration rate (eGFR <60 mL/min/1.73 m2), retinopathy (any retinal microaneurysms or blot hemorrhages), and self-reported cardiovascular disease (history of congestive heart failure, heart attack, or stroke). RESULTS: From 1988-1994 to 2011-2018, there was a significant decrease in the prevalence of albuminuria (38.9 to 18.7%, P for trend <0.001) but no change in the prevalence of reduced eGFR (7.5 to 9.9%, P for trend = 0.30), retinopathy (1988-1994 to 1999-2008 only; 13.2 to 12.1%, P for trend = 0.86), or self-reported cardiovascular disease (19.0 to 16.5%, P for trend = 0.64). There were improvements in glycemic, blood pressure, and lipid control in the population, and these partially explained the decline in albuminuria. Complications were more common at the time of diabetes diagnosis for adults who were older, lower income, less educated, and obese. CONCLUSIONS: Over the past three decades, there have been encouraging reductions in albuminuria and risk factor control in adults with newly diagnosed diabetes. However, the overall burden of complications around the time of the diagnosis remains high.


Assuntos
Diabetes Mellitus Tipo 2 , Infarto do Miocárdio , Adulto , Albuminúria/epidemiologia , Albuminúria/etiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Taxa de Filtração Glomerular , Humanos , Inquéritos Nutricionais , Prevalência , Fatores de Risco
8.
Diabetes Care ; 43(7): 1456-1461, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32327419

RESUMO

OBJECTIVE: Screening for diabetes is typically done using hemoglobin A1c (HbA1c) or fasting plasma glucose (FPG). The 2019 Endocrine Society guidelines recommend further testing using an oral glucose tolerance test (OGTT) in older adults with prediabetic HbA1c or FPG. We evaluated the impact of this recommendation on diabetes prevalence, eligibility for glucose-lowering treatment, and estimated cost of implementation in a nationally representative sample. RESEARCH DESIGN AND METHODS: We included 2,236 adults aged ≥65 years without known diabetes from the 2005-2016 National Health and Nutrition Examination Survey. Diabetes was defined using: 1) the Endocrine Society approach (HbA1c ≥6.5%, FPG ≥126 mg/dL, or 2-h plasma glucose ≥200 mg/dL among those with HbA1c 5.7-6.4% or FPG 100-125 mg/dL); and 2) a standard approach (HbA1c ≥6.5% or FPG ≥126 mg/dL). Treatment eligibility was defined using HbA1c cut points (≥7% to ≥9%). OGTT screening costs were estimated using Medicare fee schedules. RESULTS: Diabetes prevalence was 15.7% (∼5.0 million) using the Endocrine Society's approach and 7.3% (∼2.3 million) using the standard approach. Treatment eligibility ranged from 5.4% to 0.06% and 11.8% to 1.3% for diabetes cases identified through the Endocrine Society or standard approach, respectively. By definition, diabetes identified exclusively through the Endocrine Society approach had HbA11c <6.5% and would not be recommended for glucose-lowering treatment. Screening all older adults with prediabetic HbA1c/FPG (∼18.3 million) with OGTT could cost between $737 million and $1.7 billion. CONCLUSIONS: Adopting the 2019 Endocrine Society guidelines would substantially increase the number of older adults classified as having diabetes, require significant financial resources, but likely offer limited benefits.


Assuntos
Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Endocrinologia/normas , Programas de Rastreamento/normas , Guias de Prática Clínica como Assunto , Saúde Pública , Fatores Etários , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Glicemia/análise , Diabetes Mellitus/sangue , Endocrinologia/organização & administração , Jejum/sangue , Feminino , Avaliação Geriátrica/métodos , Teste de Tolerância a Glucose/economia , Teste de Tolerância a Glucose/métodos , Teste de Tolerância a Glucose/normas , Hemoglobina A Glicada/análise , Serviços de Saúde para Idosos/normas , História do Século XXI , Humanos , Masculino , Programas de Rastreamento/economia , Programas de Rastreamento/métodos , Inquéritos Nutricionais , Guias de Prática Clínica como Assunto/normas , Estado Pré-Diabético/sangue , Estado Pré-Diabético/diagnóstico , Estado Pré-Diabético/epidemiologia , Prevalência , Saúde Pública/economia , Saúde Pública/história , Saúde Pública/estatística & dados numéricos , Saúde Pública/tendências , Sociedades Médicas/normas , Estados Unidos/epidemiologia
10.
BMC Med Imaging ; 20(1): 3, 2020 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-31924179

RESUMO

BACKGROUND: Successful injection of radiolabeled compounds is critical for positron emission tomography (PET) imaging. A poor quality injection limits the tracer availability in the body and can impact diagnostic results. In this study, we attempt to quantify our infiltration rates, develop an actionable quality improvement plan to reduce potentially compromised injections, and compare injection scoring to PET/CT imaging results. METHODS: A commercially available system that uses external radiation detectors was used to monitor and score injection quality. This system compares the time activity curves of the bolus relative to a control reading in order to provide a score related to the quality of the injection. These injection scores were used to assess infiltration rates at our facility in order to develop and implement a quality improvement plan for our PET imaging center. Injection scores and PET imaging results were reviewed to determine correlations between image-based assessments of infiltration, such as liver SUVs, and injection scoring, as well as to gather infiltration reporting statistics by physicians. RESULTS: A total of 1033 injections were monitored at our center. The phase 1 infiltration rate was 2.1%. In decision tree analysis, patients < 132.5lbs were associated with infiltrations. Additional analyses suggested patients > 127.5 lbs. with non-antecubital injections were associated with lower quality injections. Our phase 2 infiltration rate was 1.9%. Comparison of injection score to SUV showed no significant correlation and indicated that only 63% of suspected infiltrations were visible on PET/CT imaging. CONCLUSIONS: Developing a quality improvement plan and monitoring PET injections can lead to reduced infiltration rates. No significant correlation between reference SUVs and injection score provides evidence that determination of infiltration based on PET images alone may be limited. Results also indicate that the number of infiltrated PET injections is under-reported.


Assuntos
Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Compostos Radiofarmacêuticos/administração & dosagem , Árvores de Decisões , Cálculos da Dosagem de Medicamento , Feminino , Humanos , Injeções , Masculino , Melhoria de Qualidade
11.
J Gen Intern Med ; 35(5): 1427-1434, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31898135

RESUMO

BACKGROUND: Updating national trends in diabetes management is important for identifying areas of progress and remaining gaps in diabetes care. OBJECTIVE: Evaluate trends in diabetes management. DESIGN: Three nationally representative, serial cross-sectional surveys (National Health and Nutrition Examination Survey [n = 5800], National Health Interview Survey [n = 48,519], and Behavioral Risk Factor Surveillance System [n = 741,497]) were used to estimate trends in diabetes management from 1999 to 2016. PARTICIPANTS: Non-pregnant US adults (aged ≥ 18 years) diagnosed with diabetes. MAIN MEASURES: American Diabetes Association's general recommendations for glycemic and cardiovascular risk factor control, medication usage, physical activity, preventive practices, and dietary intake. KEY RESULTS: From 1999 to 2016, the proportion of US adults with diabetes who attained glycemic control (HbA1c < 7.0%) followed a quadratic trend (49.6% in 1999-2004 to 58.6% in 2005-2010 to 55.8% in 2011-2016, P < 0.05 for trend). Control of blood pressure (< 140/90 mmHg) and lipids (LDL cholesterol < 100 mg/dl) increased by 6.6 and 18.7 percentage points, respectively (P < 0.05 for trends). The proportion that attained glycemic, blood pressure, and lipid control followed a quadratic trend (13.3% in 1999-2004 to 24.8% in 2005-2010 to 20.2% in 2011-2016, P < 0.05 for trend). Use of antidiabetic, antihypertensive, and statin medication among those who were eligible rose by 8.6, 5.0, and 24.0 percentage points, respectively (P < 0.05 for trends). Aerobic inactivity declined 7.1 percentage points, while adherence to aerobic activity (≥ 150 min/week) and resistance training (≥ 2 times/week) recommendations grew 3.4 and 3.2 percentage points, respectively (P < 0.05 for trends). Engagement in preventive practices (e.g., receipt of vaccinations) consistently increased for 6 out of 8 outcomes. However, the adherence to saturated fat (< 10% of total daily calories) and sodium (< 2300 mg/day) recommendations fell by 6.5 and 5.2 percentage points (P < 0.05 for trends). CONCLUSIONS: Despite notable improvements, declines in glycemic control and adherence to dietary recommendations may be growing challenges in diabetes care.


Assuntos
Diabetes Mellitus , Dieta , Adulto , Idoso , LDL-Colesterol , Estudos Transversais , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Humanos , Inquéritos Nutricionais , Estados Unidos/epidemiologia
12.
Nucl Med Biol ; 74-75: 41-48, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31473491

RESUMO

INTRODUCTION: Fluorine-18 labeled radiopharmaceuticals undergo quality control testing for residual phase-transfer-catalyst content. The almost universally used quality-control test is a silica plate spot-test comparison of the radiopharmaceutical beside a 50-ppm standard. Once developed by staining, the radiopharmaceutical spot must be of equal or less intensity to pass the test. There is currently a need for a quantitative, inexpensive, and less subjective quality control method that allows the automatic incorporation of the acquired measurement directly into electronic batch reports. RESULTS: In the developed method, a resazurin test solution is mixed with an aliquot of the radiopharmaceutical analyte along with dichloromethane (DCM). The mixture is vortexed. The potassium resazurin-phase transfer catalyst complex solubilizes into the DCM imparting a blue color. The organic layer is then removed for analysis. Three measurement methods were utilized: visual colorimetry against pre-prepared standards, spectrophotometric measurement of transmittance, and electrical conductance. A simple prototype spectrophotometer and an electrical test cell were constructed to acquire data. Sodium Resazurin dye was found to be a suitable test chromophore for residual phase transfer catalyst analysis of aqueous solutions. Quantitative spectrophotometric measurements are possible in the 0-100-ppm range (18-crown-6) and 0-150-ppm range (Kryptofix® or tetrabutylammonium). Electrical resistance measurements of the phase transfer-catalyst resazurin complex in DCM are also a viable method, allowing quantitative phase transfer catalyst measurements in the 0-100-ppm range. CONCLUSION: The methodologies developed are more quantitative alternatives to the current spot-test method. The spectrophotometric method was determined to be the most accurate method.


Assuntos
Calorimetria/métodos , Radioisótopos de Flúor/análise , Indicadores e Reagentes/química , Oxazinas/química , Compostos Radiofarmacêuticos/análise , Solventes/química , Espectrofotometria/métodos , Xantenos/química , Humanos
13.
Opt Express ; 27(10): 14009-14029, 2019 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-31163856

RESUMO

For the benefit of designing scalable, fault resistant optical neural networks (ONNs), we investigate the effects architectural designs have on the ONNs' robustness to imprecise components. We train two ONNs - one with a more tunable design (GridNet) and one with better fault tolerance (FFTNet) - to classify handwritten digits. When simulated without any imperfections, GridNet yields a better accuracy (∼98%) than FFTNet (∼95%). However, under a small amount of error in their photonic components, the more fault tolerant FFTNet overtakes GridNet. We further provide thorough quantitative and qualitative analyses of ONNs' sensitivity to varying levels and types of imprecisions. Our results offer guidelines for the principled design of fault-tolerant ONNs as well as a foundation for further research.

14.
Nicotine Tob Res ; 21(12): 1629-1635, 2019 11 19.
Artigo em Inglês | MEDLINE | ID: mdl-30184216

RESUMO

INTRODUCTION: Studies increasingly find a prospective association between adolescent weight status and adverse physical health outcomes. However, less is known about the long-term consequences of adolescent body weight on the adoption of health-risk behaviors. This study sought to determine whether adolescent body mass index (BMI) was associated with cigarette smoking in adulthood. METHODS: Six thousand six hundred eighty-three nonsmoking adolescents were interviewed at baseline (1996, age 11-20) and at follow-up (2008, age 24-32) as part of the National Longitudinal Survey of Adolescent Health. Logistic and fractional regression models tested the association between adolescent BMI and smoking status and frequency in adulthood. Respondent weight and height were measured at baseline and converted into age and sex-specific BMI z-scores. Being a smoker was defined as smoking at least once in the past 30 days, while smoking frequency was defined as the proportion of days smoked over the past 30 days. Both outcomes were measured at follow-up. RESULTS: Adolescent BMI was positively associated with the transition from nonsmoking to smoking 12 years later for women but not men. Adolescent BMI was also positively associated with smoking frequency among women smokers. Both associations persisted after adjusting for established risk factors and were robust to sensitivity analyses. CONCLUSIONS: Adolescent BMI was strongly associated with increased cigarette smoking behavior in adulthood for women, even after adjusting for important risk factors. IMPLICATIONS: Using a large, nationally representative sample, this study found that adolescent BMI was positively associated with smoking behavior during adulthood for women but not men. These results have potentially important public health implications for future smoking rates in the United States, as the prevalence of overweight and obesity among US adolescent females continues to grow. Thus, it may be important for smoking prevention interventions to prioritize overweight adolescent females moving forward.


Assuntos
Índice de Massa Corporal , Peso Corporal , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Fumar/epidemiologia , Adolescente , Adulto , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Fatores de Risco , Estados Unidos/epidemiologia , Adulto Jovem
15.
Am J Prev Med ; 55(4): 497-505, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30126668

RESUMO

INTRODUCTION: The prevalence of diabetes has increased substantially over the past three decades. This study sought to estimate recent trends in the prevalence of diabetes among U.S. adults. METHODS: This paper estimated trends in the prevalence of diagnosed, undiagnosed, and total diabetes among U.S. adults from 1999-2000 to 2015-2016 (analyzed in 2017). Data come from 42,554 respondents aged ≥20 years who participated in the National Health and Nutrition Examination Survey. Diagnosed diabetes was measured through self-report, undiagnosed diabetes was measured as never being diagnosed with diabetes but having glycated hemoglobin levels ≥6.5%, and total diabetes was measured as the sum of individuals with diagnosed and undiagnosed diabetes. RESULTS: In the overall U.S. adult population, the unadjusted prevalence of total diabetes increased from 7.7% in 1999-2000 to 13.3% in 2015-2016 (p<0.001 for trend). Growth was observed for all subgroups, though the rate of change was higher in older adults, racial minorities, and those who were obese compared with their peers. Increasing prevalence among Mexican-American adults was particularly pronounced, rising by 10.1 percentage points during the study period (8.3% to 18.4%, p<0.001). Roughly 40% of the increase in total diabetes was accounted for by changes in the age and rates of obesity in the U.S. CONCLUSIONS: From 1999 to 2016, the prevalence of diabetes among U.S. adults increased at a substantial rate. This growth occurred differentially across subgroups, particularly impacting Mexican-American adults, and was driven in large part by population aging and increasing obesity rates.


Assuntos
Diabetes Mellitus/epidemiologia , Americanos Mexicanos/estatística & dados numéricos , Obesidade/epidemiologia , Adulto , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Fatores Etários , Idoso , Grupos de Populações Continentais , Diabetes Mellitus/etnologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Prevalência , Estados Unidos/epidemiologia , Adulto Jovem
16.
Soc Psychiatry Psychiatr Epidemiol ; 53(9): 955-967, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29947861

RESUMO

PURPOSE: Existing theory and empirical work suggest that impoverished school contexts may increase the risk of mental health problems such as suicide. This study tests this hypothesis by investigating the longitudinal association between school income and attempted suicide among American adolescents. METHODS: Logistic regression models were used to estimate the association between school income and suicidal attempts among all adolescents and among those with suicidal thoughts, respectively. Data come from the National Longitudinal Survey of Adolescent Health, a nationally representative sample of American adolescents across 132 middle and high schools (N = 12,920). RESULTS: Among all adolescents, the prevalence of attempted suicide was higher in low-income schools compared to middle-income schools for boys but not girls. Among those with suicidal thoughts, the prevalence of attempted suicide was also higher in low-income schools compared to middle- and high-income schools for boys only. Differences between middle- and high-income schools were not observed, suggesting that school income may only impact attempted suicide when high levels of deprivation are present. These significant associations persisted after adjusting for established risk factors such as prior suicidal attempts. CONCLUSION: Highly impoverished school contexts may increase the risk of attempted suicide for boys. Future research exploring the mechanisms underlying this association may help inform the development of more effective suicide-prevention interventions.


Assuntos
Pobreza/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Feminino , Humanos , Masculino , Risco , Estados Unidos
17.
Annu Rev Sociol ; 41: 331-357, 2015 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-26778893

RESUMO

Improving science, technology, engineering, and mathematics (STEM) education, especially for traditionally disadvantaged groups, is widely recognized as pivotal to the U.S.'s long-term economic growth and security. In this article, we review and discuss current research on STEM education in the U.S., drawing on recent research in sociology and related fields. The reviewed literature shows that different social factors affect the two major components of STEM education attainment: (1) attainment of education in general, and (2) attainment of STEM education relative to non-STEM education conditional on educational attainment. Cognitive and social psychological characteristics matter for both major components, as do structural influences at the neighborhood, school, and broader cultural levels. However, while commonly used measures of socioeconomic status (SES) predict the attainment of general education, social psychological factors are more important influences on participation and achievement in STEM versus non-STEM education. Domestically, disparities by family SES, race, and gender persist in STEM education. Internationally, American students lag behind those in some countries with less economic resources. Explanations for group disparities within the U.S. and the mediocre international ranking of US student performance require more research, a task that is best accomplished through interdisciplinary approaches.

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