U.S. health inequities won’t be eliminated by abandoning the use of race and ethnicity in research and clinical practice, since these variables capture key epidemiologic information. But ...incorporating genetic ancestry, genotypes, or biomarkers requires further study.
Objective
To determine adolescent predictors of muscularity‐oriented disordered eating behaviors in young men and women using a nationally representative longitudinal sample in the United States and ...to examine differences by sex.
Method
We used nationally representative longitudinal cohort data collected from baseline (11–18 years old, 1994–1995) and 7‐year follow‐up (18–24 years old, 2001–2002) of the National Longitudinal Study of Adolescent to Adult Health. We examined adolescent demographic, behavioral, and mental health predictors of young adult muscularity‐oriented disordered eating behaviors defined as eating more or differently to gain weight or bulk up, supplements to gain weight or bulk up, or androgenic anabolic steroid use at 7‐year follow‐up.
Results
Of the 14,891 included participants, 22% of males and 5% of females reported any muscularity‐oriented disordered eating behavior at follow‐up in young adulthood. Factors recorded at adolescence that were prospectively associated with higher odds of muscularity‐oriented disordered eating in both sexes included black race, exercising to gain weight, self‐perception of being underweight, and lower body mass index z‐score. In addition, participation in weightlifting; roller‐blading, roller‐skating, skate‐boarding, or bicycling; and alcohol among males and depressive symptoms among females during adolescence were associated with higher odds of muscularity‐oriented disordered eating in young adulthood.
Conclusions
Interventions to prevent muscularity‐oriented disordered eating behaviors may target at‐risk youth, particularly those of black race or who engage in exercise to gain weight. Future research should examine longitudinal health outcomes associated with muscularity‐oriented disordered eating behaviors.
Flanagin et al discuss the implications of the use of writing software for the integrity of scientific publication and medical knowledge. Artificial intelligence (AI) technologies to help authors ...improve the preparation and quality of their manuscripts and published articles are rapidly increasing in number and sophistication. In November 2022, OpenAI released a new open source, natural language processing tool called ChatGPT, which is an evolution of a chatbot that is designed to simulate human conversation in response to prompts or questions. The release has prompted immediate excitement about its many potential uses but also trepidation about potential misuse, such as concerns about using the language model to cheat on homework assignments, write student essays, and take examinations, including medical licensing examinations.
Objective
To determine if unhealthy weight control behaviors or binge‐eating behaviors among young adults with overweight/obesity are associated with body mass index (BMI) change and cardiometabolic ...risk at 7‐year follow‐up.
Methods
We used longitudinal cohort data from 5,552 young adults with overweight/obesity at baseline (18–24 years) with 7‐year follow‐up (24–32 years) from the National Longitudinal Study of Adolescent to Adult Health. Baseline predictors were: (a) unhealthy weight control behaviors such as vomiting, fasting, skipping meals, or laxative/diuretic use to lose weight; or (b) binge‐eating behaviors. Participants reporting either unhealthy weight control behaviors or binge‐eating behaviors were considered to engage in any disordered eating behavior (DEB). Outcomes at 7‐year follow‐up were BMI change, incident diabetes, incident hypertension, and incident hyperlipidemia.
Results
Young adults with overweight/obesity reporting unhealthy weight control behaviors at baseline had higher BMI and weight at 7‐year follow‐up than those without unhealthy weight control behaviors. In regression models adjusting for baseline BMI, race/ethnicity, age, and education, unhealthy weight control behaviors were associated with greater change in BMI in both sexes and binge‐eating behavior at baseline was associated with greater odds of incident hyperlipidemia (odds ratio 1.90, 95% CI 1.29–2.79) at 7‐year follow‐up in males.
Conclusions
The higher risk for increased BMI (in both males and females) and incident hyperlipidemia (in males) over time in young adults with overweight/obesity who engage in DEBs underscores the need to screen for DEBs in this population and provide referrals and tailored interventions as appropriate.
Though SARS-CoV-2 outbreaks have been documented in occupational settings and in-person essential work has been suspected as a risk factor for COVID-19, occupational differences in excess mortality ...have, to date, not been examined. Such information could point to opportunities for intervention, such as vaccine prioritization or regulations to enforce safer work environments.
Using autoregressive integrated moving average models and California Department of Public Health data representing 356,188 decedents 18-65 years of age who died between January 1, 2016 and November 30, 2020, we estimated pandemic-related excess mortality by occupational sector and occupation, with additional stratification of the sector analysis by race/ethnicity. During these first 9 months of the COVID-19 pandemic, working-age adults experienced 11,628 more deaths than expected, corresponding to 22% relative excess and 46 excess deaths per 100,000 living individuals. Sectors with the highest relative and per-capita excess mortality were food/agriculture (39% relative excess; 75 excess deaths per 100,000), transportation/logistics (31%; 91 per 100,000), manufacturing (24%; 61 per 100,000), and facilities (23%; 83 per 100,000). Across racial and ethnic groups, Latino working-age Californians experienced the highest relative excess mortality (37%) with the highest excess mortality among Latino workers in food and agriculture (59%; 97 per 100,000). Black working-age Californians had the highest per-capita excess mortality (110 per 100,000), with relative excess mortality highest among transportation/logistics workers (36%). Asian working-age Californians had lower excess mortality overall, but notable relative excess mortality among health/emergency workers (37%), while White Californians had high per-capita excess deaths among facilities workers (70 per 100,000).
Certain occupational sectors are associated with high excess mortality during the pandemic, particularly among racial and ethnic groups also disproportionately affected by COVID-19. In-person essential work is a likely venue of transmission of coronavirus infection and must be addressed through vaccination and strict enforcement of health orders in workplace settings.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Sexual and gender minority (SGM) people—including members of the lesbian, gay, bisexual, transgender, and queer communities—are understudied and underrepresented in research. Current sexual ...orientation and gender identity (SOGI) questions do not sufficiently engage SGM people, and there is a critical gap in understanding how SOGI questions reduce inclusion and accurate empirical representation. We conducted a qualitative study to answer the question, “For SGM people, what are the major limitations with current SOGI questions?” Focus groups probed reactions to SOGI questions adapted from prior national surveys and clinical best practice guidelines. Questions were refined and presented in semi-structured cognitive interviews. Template analysis using a priori themes guided analysis. There were 74 participants: 55 in nine focus groups and 19 in cognitive interviews. Participants were diverse: 51.3% identified as gender minorities, 87.8% as sexual minorities, 8.1% as Hispanic/Latinx, 13.5% as Black or African-American, and 43.2% as Non-white. Two major themes emerged: (1) SOGI questions did not allow for identity fluidity and complexity, reducing inclusion and representation, and (2) SOGI question stems and answer choices were often not clear as to which SOGI dimension was being assessed. To our knowledge, this represents the largest body of qualitative data studying SGM perspectives when responding to SOGI questions. We present recommendations for future development and use of SOGI measures. Attention to these topics may improve meaningful participation of SGM people in research and implementation of such research within and for SGM communities.
Background
Cross‐sectional studies have demonstrated associations between screen time and disruptive behavior disorders (conduct disorder and oppositional defiant disorder); however, prospective ...associations remain unknown. This study's objective was to determine the prospective associations of contemporary screen time modalities with conduct and oppositional defiant disorder in a national cohort of 9–11‐year‐old children.
Methods
We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,875). Modified Poisson regression analyses were conducted to estimate the associations between baseline child‐reported screen time (total and by modality) and parent‐reported conduct or oppositional defiant disorder based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS‐5) at 1‐year follow‐up, adjusting for potential confounders.
Results
Participants reported an average of 4 hr of total screen time per day at baseline. Each hour of total screen time per day was prospectively associated with a 7% higher prevalence of conduct disorder (95% CI 1.03–1.11) and a 5% higher prevalence of oppositional defiant disorder (95% CI 1.03–1.08) at 1‐year follow‐up. Each hour of social media per day was associated with a 62% higher prevalence of conduct disorder (95% CI 1.39–1.87). Each hour of video chat (prevalence ratio PR 1.21, 95% CI 1.06–1.37), texting (PR 1.19, 95% CI 1.07–1.33), television/movies (PR 1.17, 95% CI 1.10–1.25), and video games (PR 1.14, 95% CI 1.07–1.21) per day was associated with a higher prevalence of the oppositional defiant disorder. When examining thresholds, exposure to >4 hr of total screen time per day was associated with a higher prevalence of conduct disorder (69%) and oppositional defiant disorder (46%).
Conclusions
Higher screen time was prospectively associated with a higher prevalence of new‐onset disruptive behavior disorders. The strongest association was between social media and conduct disorder, indicating that future research and interventions may focus on social media platforms to prevent conduct disorder.
Objective Recommendations by health care providers have been found to vary by patient race/ethnicity and socioeconomic status and may contribute to health disparities. This study investigated the ...effect of these factors on recommendations for contraception. Study Design One of 18 videos depicting patients of varying sociodemographic characteristics was shown to each of 524 health care providers. Providers indicated whether they would recommend levonorgestrel intrauterine contraception to the patient shown in the video. Results Low socioeconomic status whites were less likely to have intrauterine contraception recommended than high socioeconomic status whites (odds ratio OR, 0.20; 95% confidence interval CI, 0.06–0.69); whereas, socioeconomic status had no significant effect among Latinas and blacks. By race/ethnicity, low socioeconomic status Latinas and blacks were more likely to have intrauterine contraception recommended than low socioeconomic status whites (OR, 3.4; and 95% CI, 1.1–10.2 and OR, 3.1; 95% CI, 1.0–9.6, respectively), with no effect of race/ethnicity for high socioeconomic status patients. Conclusion Providers may have biases about intrauterine contraception or make assumptions about its use based on patient race/ethnicity and socioeconomic status.
An overview of the five priority development areas for the U.S. healthcare system necessary to integrate social care is presented. The consensus committee of the National Academies of Sciences, ...Engineering and Medicine's recommendations reflect the importance of social factors in determining individual health and the need to recognize the broader environment in which health systems operate.
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