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Racial Differences in Colorectal Adenomas at Screening Colonoscopy in the United States
No full textBackground: Black Americans experience a higher incidence of colorectal cancer than Whites despite undergoing prevention screenings similar to those of Whites since 2010. We compared the colorectal adenoma status of Black and White patients at screening colonoscopy, a measure of colorectal cancer risk. Methods: Using cross-sectional, observational data, we studied colorectal adenomas at first-time screening colonoscopy in average-risk patients aged 40 to 89 years, screened between September 2001 and July 2016 in South Carolina. We analyzed the age-adjusted odds of Black men and women (vs. White) having adenomas, advanced adenomas, ≥3 nonadvanced adenomas, and right hyperplastic polyps, and compared their total polyp burden (the sum of the diameters of all adenomas and right polyps detected). Results: Among 28,100 patients (58.4% Black and 53.8% women), we found that Black patients had lower age- and gender-adjusted odds than White patients of having adenoma (OR ¼ 0.88, P \u3c 0.01) and right hyperplastic polyp (OR ¼ 0.74, P \u3c 0.01), with a similar pattern within gender groups. Black and White patients were similar about advanced adenoma and 3+ nonadvanced adenoma. Among patients with lesions, mean polyp burden ranged from 8.5 mm (±7.2) for Black women aged 40 to 49 years to 12.3 mm (±7.4) for Black men aged more than 70 years. Age-adjusted polyp burden was 0.4 mm higher for Black men than for White men and 0.3 mm lower for Black women than for White women patient groups (P \u3c 0.01). Conclusions: In a large, racially balanced patient sample, Black and White patients showed similar polyp profiles. Impact: Given similar adenoma status, other evidence-supported clinical factors associated with suboptimal polyp detection should be explored to understand the continuing colorectal cancer disparities affecting Black Americans
Achieving Empowerment in Transition: Advice from Former Female Athletes
No full textScholars have highlighted the various challenges college athletes encounter in their transition from sport. Yet, the strategies athletes adopt to navigate this transitory period require further examination. Thus, we leveraged Zimmerman’s Psychological Empowerment Model and Schlossberg’s Transition Theory to explore these strategies and associated processes in-depth. The sample for this study consisted of 20 former female athletes from the U.S. who played a college sport. Data was collected through semi-structured interviews. Findings revealed numerous strategies current and future female college athletes implement to mitigate the challenges present in their transition, specifically: Finding Acceptance, Be Proactive, Don’t Stop 100%, Embrace the Rebuilding Process, and Leverage Social Supports. This work yields impactful implications including theoretical advances in understanding mechanisms of change, as well as practical advances for athletes and sport managers in calls for improved institutional support, and athletes’ active efforts to empower themselves in the absence of institutional support
Cancer Survivorship and Subjective Cognitive Decline in the United States
No full textPURPOSE: Studies examining the link between cancer survivorship and subjective cognitive decline (SCD) are lacking. Therefore, the current study aimed to determine the association between cancer survivorship and SCD among a nationally representative sample of middle-aged and older adults. METHOD: Data were obtained from the 2021 Behavioral Risk Factor Surveillance System Survey. Crude and adjusted logistic regression models, controlling for age, gender, race/ethnicity, educational level, income, and work status, were used to determine the association between cancer survivorship characteristics and SCD. RESULTS: Respondents who were currently undergoing treatment had 86% higher odds of SCD (adjusted odds ratio [aOR] = 1.86; 95% confidence interval [CI] [1.06, 3.27]) compared to respondents who completed treatment. However, those who refused treatment were less likely to report SCD (aOR = 0.006; 95% CI [\u3c 0.001, 0.059]) compared to respondents who completed treatment. CONCLUSION: Cognition interventions may be helpful for individuals diagnosed with cancer who are undergoing treatment, middle-aged, and have not started treatment
Challenges to School Success Among Children in U.S. Military Families
No full textIntroduction More than 90% of children in military families attend civilian schools that may lack understanding of the unique experiences and stressors of military life. School success in children of military families has important implications on future academic achievement, health outcomes, and military groups; yet there has not been an examination of challenges of school success among children of military families in the United States using nationally representative data. Materials and Methods Data captured in the 2021-2022 National Survey of Children\u27s Health, limited to children aged 6 to 17 years, were used to examine the association between child\u27s caregiver military status and challenges of school success: lack of school engagement measured through caring about school and completing schoolwork, school absenteeism, and grade repetition (n = 60,599). Weighted to be nationally representative, bivariate analyses used chi-squared tests to examine estimates between selected variables and caregiver military status. Multivariable regression analyses were used to examine the association between caregiver military status and challenges of school success measures. Results In both unadjusted and adjusted analyses, we found that children of military families were more likely to not be engaged in school (adjusted odds ratios 1.35; 95% CI 1.19-1.53) and more likely to repeat a grade (adjusted odds ratios 1.33; 95% CI 1.09-1.64) than their civilian counterparts. There were no statistically significant differences in school absenteeism between children of military families and of civilian families. Conclusions This study extends beyond previous research findings that have focused primarily on academic achievement by including school engagement, attendance, and grade repetition for a more holistic and complete understanding of school success of children in military families. Our findings can be informational for school systems and policymakers to create educational and connective interventions for children in military families to improve school success
The Dark Side of the Internet: The Facilitation of CSAM by Social Media Companies and What Should Be Done about It
No full textCommunity and School Programs, Policies and Environments Related to Child Dietary Intake:The Healthy Communities Study
No full textBackground
To reverse the epidemic of unhealthy eating and related chronic disease in the United States, intervening early in life is essential. Objective
Identify features of community- and school-based programmes, policies and environments related to child intake of fruits and vegetables (FV) and sugar-sweetened beverages (SSB). Methods
Dietary intake of children 4–15 years old (n = 5138) from elementary and middle schools in 130 US communities was collected by survey (of parent and/or child) in 2013–2015. Features of community programs and policies (CPPs) and school environments were collected by staff surveys, direct observation, key informant interviews, and/or document review. Community characteristics included socioeconomic status and predominant race/ethnicity. Classification and regression trees identified CPP and school environment features related to child dietary intake. Results
Community sociodemographic characteristics were the first-selected variables related to child intakes. Children in communities with lower socioeconomic status and larger proportions of African Americans tended to have lower FV and higher SSB intakes. Associations of dietary intake with race/ethnicity varied with SES. CPPs that addressed certain social determinants of health were related to higher FV intake among community race/ethnicity–SES sub-groups. Few other CPPs and no school environment characteristics were related to child FV or SSB intake. Conclusion
Findings suggest the importance of addressing social determinants of health such as education, poverty and transportation to reduce disparities in dietary intake, and the need to tailor interventions to community characteristics. More research is needed to explore the interaction of race/ethnicity and SES on dietary intake and intervention effectiveness
Revitalizing Passenger Rail: A Sustainable Solution to Environmental and Public Health Challenges in South Carolina
No full textSouth Carolina, a historic leader in passenger rail, has become a heavily vehicle-dependent state. As the population rapidly grows, so does the number of vehicles, vehicle miles traveled, and vehicle emissions, including the greenhouse gas pollutants carbon dioxide (CO2), nitrous oxide (N2O), and particulate matter (PM2.5), significantly contributing to air pollution and deteriorating health and environmental outcomes. Despite this, mass transit is nonexistent for the three largest cities in South Carolina, Charleston, Columbia, and Greenville, forcing residents and travelers to drive. This study evaluates the feasibility and the environmental, public health, environmental justice, and economic implications of a passenger rail line linking these cities. Developing this rail line could reduce emissions by 1,888,056,327 kilograms (kg) of CO2, 61,620.94 kg of N2O, and between 9,979 and 130,337 kg of PM2.5 annually. These reductions would improve air quality, reduce pollution-related health outcomes, influence land use practices, reduce highway maintenance, travel time, and congestion, improve environmental injustice, and boost economies throughout the state. Despite the benefits, South Carolina officials state that a lack of public interest drives the lack of investment. This thesis challenges this belief through a stakeholder survey (n=31) regarding the public perception of public transportation and this specific rail line. The results of this survey indicated both a high level of understanding of the implications of expanded rail as well as high levels of interest and support, with 100% of respondents indicating at least a moderate level of support and over 90% of respondents stating that they were at least moderately willing to travel on this rail line. This contradicts the sentiment of South Carolina officials. However, the current South Carolina passenger rail does not have the infrastructure to attract interest, typically only providing one service per day at inconvenient times, largely between midnight and 7 a.m. Conversely, North Carolina has been adaptive and willing, decreasing the structural barriers, exhibited in the recently added fifth daily service connecting Charlotte to Raleigh. As a result, North Carolina has a disproportionately higher ridership. Revitalizing passenger rail through these structural changes to South Carolina passenger rail could build interest and increase ridership, spurring investment and reducing vehicle emissions, reducing highway traffic, ultimately resulting in improved public health and environmental health outcomes while returning the state to its historic role as a leader in passenger rail
The Impact of Ballet Techniques on Singing Performers
No full textSinging performers are tasked to being a multifaceted artist using their acting and even dance skills in a performance. Voice teachers have long incorporated physical activity into training, but traditional ballet techniques—such as core tension and neck elongation—can contradict healthy singing practices. Given ballet’s deep historical connection to opera and stage performance, this study aims to examine whether integrating ballet into vocal training enhances or hinders a singer’s technique and overall performance. This investigation surveyed forty subjects who identified as teachers, singing performers, or students earning a performance degree and interviewing select subjects for further information; results will be discussed
Associations Between Cardiovascular Disease and Utilization of Dental Preventive and Periodontic Services
No full textCardiovascular disease (CVD), including coronary artery disease, heart failure, myocardial infarction, and stroke, remains a leading cause of global mortality, with approximately 20.5 million deaths in 2021. Despite advancements in medical science, CVD prevalence continues to rise, underscoring the need for preventive approaches and increased awareness. CVD is closely associated with oral diseases, and poor oral health is linked to worse cardiovascular outcomes. This study investigates the association between CVD and the utilization of dental preventive and periodontal services using data from the Dental Experience and Research Exchange (DERE) database, which aggregates clinical data from dental practices across the U.S. from 2014 to 2023. The primary objective is to identify differences in dental service utilization between individuals with and without CVD and explore how demographic factors such as age and sex influence these associations. The study employs a cross-sectional design, analyzing 117,646 dental visits from adults aged 21 to 89. Logistic regression models were used to assess the association between self-reported CVD and dental service utilization, adjusting for covariates such as age, sex, race, marital status, diabetes, and geographic region. Results indicate that individuals with CVD were more likely to use preventive dental services (OR: 1.12, 95% CI: 1.01–1.24), particularly among females, older adults, and urban residents. However, no significant association was found between CVD and periodontal service utilization. Interaction analyses revealed that younger adults with CVD and those living in urban areas were more likely to use preventive services, while individuals with both CVD and diabetes were less likely to do so. These findings highlight the importance of integrating oral health into chronic disease management and addressing barriers to dental care access. Future research should explore causal relationships and identify factors influencing dental service utilization among high-risk populations to inform targeted interventions and improve health outcomes
Comprehensive Statistical Frameworks for Copy Number Analysis and Causal Effect Estimation
No full textCopy number variants (CNVs) and single-nucleotide polymorphisms (SNPs) are major sources of genetic variation in genome of both haploid and diploid organisms. CNVs play important roles in human diseases and dynamic evolution of species. Therefore, accurate CNV detection and association testing methods, including causal effect estimation, are warranted. Modern genotyping technologies have experienced rapid development which enable the characterization of CNVs in various resolutions, such as SNP array in the sample level and the whole genome DNA sequencing in a single- or low-cell resolution. In addition, careful calibration of the CNV detection methods is needed to adjust the difference between haploid and diploid organisms, for example, the low breadth and coverage of single-cell sequencing may induce a high degree of DNA amplification bias. However, current statistical methodologies for CNV detection, association testing, and causal effect estimation still face challenges due to various genetic and technological factors that may lead to spurious results. First, most methods are developed for diploid genomes without accounting for the difference from haploid genome, making it unsuitable for application on haploid data. Second, a traditional two-stage strategy, where CNVs are first detected and their association with diseases are then tested, may generate false CNV calls, leading to biased association testing in the second stage. Third, in the Mendelian randomization (MR), correlated horizontal pleiotropy (CHP) and uncorrelated horizontal pleiotropy (UHP) exist when SNPs also affect the outcome through unknown confounders. Conventional methods do not consider CHP or UHP effects or only assume homogenous CHP effects, ignoring the fact that complex diseases are usually caused by multiple exposures, which may lead to heterogenous CHP effects if those exposures are not accounted for. In this study, we developed (1) HapCNV, a comprehensive statistical framework for data normalization and CNV detection in haploid single- or low-cell DNA sequencing data. HapCNV constructs a novel genomic location specific pseudo-reference that selects unbiased references and effectively preserves both rare and common CNV signals after normalization. (2) a one-stage CNV-disease association analysis method, OSCAA, which utilizes a two-dimensional GMM model to assess the association between CNV and disease risk in a known CNVR with a one-stage framework. OSCAA accounts for the probabilities of false CNV calls into the association testing and thus improves statistical power and controls for type I error. (3) a Mendelian randomization method, MR-GFL, that adaptively identifies groups of IVs with distinct CHP effects by using generalized fused lasso and estimate the causal effect using such group information. MR-GFL enables the identification of heterogenous CHP effects, considering which will improve the accuracy and precision of estimated causal effect. The proposed framework provides a broad application platform for consecutive studies on the role of CNVs in human diseases and dynamic evolution of both haploid and diploid organisms, which will inform new approaches for precision medicine