Trends in the Association Between Socioeconomic Status and Obesity in U.S. Adults: 2002-2012

Since the 1980s, the prevalence of obesity has more than doubled to over 30 percent of the adult population (Thorpe, 2004). Obesity is a key contributing factor to continually rising national healthcare costs. Addressing its negative implications is essential not only from a cost perspective, but also for the betterment of our nation¿s general health and wellbeing. Obesity is reportedly associated with a 35% increase in inpatient and outpatient spending, as well as a 77% increase in related necessary medications (Sturm, 2002). Obesity, which some have argued should be classified as a disease in itself, has roughly the same association with the development of chronic health conditions as does 20 years of aging (Sturm, 2002). Defined as ambulatory care-sensitive conditions, these obesity-related chronic health diagnoses ¿ like diabetes, cardiovascular disease, and hypertension ¿ are in turn the primary drivers of current healthcare spending, as well as future predicted health expenditures. It is well established that lower socioeconomic status (SES) is associated with higher rates of obesity and the subsequent development of aforementioned obesity-related conditions. Socioeconomic status has traditionally been defined by education, income, and occupation (Adler, 2002); however, this study found empirical evidence for education being the most fundamental of these three SES indicators in determining obesity outcomes. For both men and women, as education levels increased, the likelihood of an individual being obese decreased. However, with less education, there was increased disparity between the obesity rates for men and women. Women consistently saw higher rates of obesity and were more impacted in terms of obesity onset by belonging to a lower SES category than men. In addition, this study assessed whether the impact of one¿s socioeconomic status on obesity-related health outcomes (specifically the negative impact low-SES as measured by education level) has changed over time. Results deriving from annual data from the National Health Interview Survey (NHIS) for all years from 2002 to 2012 indicate that the association between low-socioeconomic status and negative health outcomes has not increased in magnitude over the past decade. Instead, obesity rates have increased across the overall U.S. adult population, most likely due to a number of larger external societal factors resulting in increased caloric intake and decreased energy expenditure across every SES group. In addition, while the association between low-SES and obesity has not worsened, a consequence of the Great Recession has been a larger percentage of the U.S. population in lower-SES, which is still consistently subject to the same worse health outcomes.

Visual and quantitative electroencephalographic analysis of healthy young and adult cats under medetomidine sedation

A study was designed to investigate the effect of medetomidine sedation on quantitative electroencephalography (q-EEG) in healthy young and adult cats to determine objective guidelines for diagnostic EEG recordings and interpretation. Preliminary visual examination of EEG recordings revealed high-voltage low-frequency background activity. Spindles, k-complexes and vertex sharp transients characteristic of sleep or sedation were superimposed on a low background activity. Neither paroxysmal activity nor EEG burst-suppression were observed. The spectral analysis of q-EEG included four parameters, namely, relative power (%), and mean, median and peak frequency (Hz) of all four frequency bands (delta, theta, alpha and beta). The findings showed a prevalence of slow delta and theta rhythms as opposed to fast alpha and beta rhythms in both young (group A) and adult (group B) cats. A posterior gradient was reported for the theta band and an anterior gradient for the alpha and beta bands in both groups, respectively. The relative power value in group B compared to group A was significantly higher for theta, alpha and beta bands, and lower for the delta band. The mean and median frequency values in group B was significantly higher for delta, theta and beta bands and lower for the alpha band. The study has shown that a medetomidine sedation protocol for feline EEG may offer a method for investigating bio-electrical cortical activity. The use of q-EEG analysis showed a decrease in high frequency bands and increased activity of the low frequency band in healthy cats under medetomidine sedation.

Tiebout Choice and the Voucher

This paper examines who is likely to gain and who is likely to lose under a universal voucher program. Following Epple and Romano (1998, 2003), and Nechyba (2000, 2003a), we focus on the idea that gains and losses under a universal voucher depend on two effects: changes in peer group composition and changes in housing values. We show that the direction and magnitude of each of these effects hinges critically on market structure, i.e., the amount of school choice that already exists in the public sector. In markets with little or no Tiebout choice, potential changes in peer group composition create an incentive for high-socioeconomic (SES) households to vote for the voucher and for low-SES households to vote against voucher. In contrast, in markets with significant Tiebout choice, potential changes in housing values create an incentive for high-SES households to vote against the voucher and for low-SES households to vote for the voucher. Using data on vote outcomes from California's 2000 voucher initiative, we find evidence consistent with those predictions.

The influence of socioeconomic status on the relationship between diabetes and amputations: A systematic review of the literature

This paper synthesizes the current knowledge available regarding the impact of socioeconomic status on diabetes and amputations. In September 2009, searches in the OVID Medline and PubMed databases were performed using keywords associated with race/ethnicity, educational level, insurance status, veteran status, low income, diabetes, and lower extremity amputation. Articles published between 1996 and the search date were used. The pertinent articles were analyzed, summarized, and synthesized. ^ The majority of the articles agreed that African American, American Indian, and Latino minorities experience significantly higher rates of diabetes-related lower extremity amputation (LEA) when compared to whites. Few articles suggested that the disparity experienced by minorities and others of low SES was due to biology; most articles link it to a combination of lower income, lower educational attainment, uninsured or underinsured status, and a greater prevalence of detrimental health behaviors such as smoking. These, in turn, are linked to decreased knowledge of self-care, delayed health care seeking, delayed diagnoses and treatment, discrimination, and low quality health care. Interventions focused on patient education, established regimens of treatment, foot care, and control of diabetes have been shown to be effective, although none have lowered the rate of diabetes-related LEA to rates found in the general population.^

Ethnicity as a risk factor for diabetes incidence in a population of diagnosed hypertensives

Significant racial/ethnic differences exist in prevalence of hypertension (HTN) and non-insulin dependent diabetes mellitus (NIDDM). Hypertension is more common in diabetics than in non-diabetics, and an etiologic link between the two conditions has been proposed. Since there are few longitudinal studies of persons with both HTN and NIDDM, a retrospective cohort study was conducted to determine if ethnicity (Black, Hispanic (Mexican-American), and non-Hispanic White) was related to NIDDM incidence in a low-SES, multi-ethnic clinic population of diagnosed hypertensives. Two thousand nine hundred forty-one hypertensives free of NIDDM at baseline were followed for up to 10 years. Mean baseline age was 56 $\pm$ 12 years, M:F percent was 33:67, and Black:Hispanic:White percent was 63:17:20. There were 236 incident cases of NIDDM. In Cox proportional hazards analysis, the risk of developing NIDDM over 10 years was not related to ethnicity after controlling for significant covariates, including age, baseline blood glucose and body mass index (adjusted RR for Blacks compared to Whites =.82, 95 percent CI =.57-1.18; adjusted RR for Hispanics compared to Whites =.84, 95 percent CI =.51-1.38). This result contrasts with the increased risk of NIDDM among Blacks and Hispanics compared to Whites found in the general population. The study suggests that a diagnosis of hypertension equalizes the risk of developing NIDDM among the three ethnic groups. ^

Tuberculosis in Texas correctional facilities between 2005--2009

It has been well documented that inmates incarcerated in prisons and correctional facilities exhibit higher incidence and prevalence of mycobacterium tuberculosis (TB) disease than the general population. This has public health implications because correctional systems may serve as reservoirs for TB disease that can lead to TB outbreaks in the facilities or can be spread to the general public once inmates are released. Although Texas has one of the largest correctional systems in both the US and the world, little is known about TB prevalence and incidence among Texas inmates. The purpose of this study was to elucidate the relationship between TB incidence and incarceration in Texas correctional facilities and investigate differences in various demographic factors. ^ The study used the national TB database from the US Centers for Disease Control and Prevention (CDC) to calculate and compare the overall incidences of TB disease among correctional facility inmates and similar non-inmates in Texas during 2005–2009. Data were also stratified by age, gender, race/ethnicity, birth status, and HIV status and compared between inmates and non-inmates using chi-squared analysis and relative risks with 95% confidence intervals to assess any significant differences. ^ Results suggest that the overall TB incidence among Texas correctional facility inmates per year (88.6 per 100,000) was significantly higher than that of Texas non-inmates (6.3 per 100,000); a 14 fold difference. Relative risk analyses by gender, race/ethnicity, and those with HIV infection found that the TB incidences for all these demographics were significantly and consistently higher in inmates compared to non-inmates. In particular, Hispanic inmates were more likely to develop TB than their non-inmate counterparts by a relative risk of 23.9 (95% CI 19.4–29.4). Likewise, both male and female inmates were more likely to develop TB than non-inmates (RR = 10.2, 95% CI 8.5–12.2; RR = 20.8, 95% CI 12.2–25.3, respectively), although female inmates unconventionally exhibited a higher TB incidence and relative risk than males inmates, which has not been shown. Among those with HIV infections, correctional facility inmates were 2.6 times were likely to develop TB disease than non-inmates (95% CI 1.5–4.4). ^ Inmates in Texas correctional facilities have a higher incidence of TB than non-inmates. Part of this higher risk may be because a large proportion of inmates come from populations already at high risks for TB, such as foreign born immigrants, those infected with HIV, and low SES groups such as many racial/ethnic minorities. Thus, these results may be used as a basis for more controlled and detailed research in the area, and to further characterize incarceration as a risk factor for TB incidence. They may also bring much needed attention about this health disparity to public health officials, legislators, and health administrators to expand and improve TB control in Texas correctional facilities, particularly among inmates released to the community, and reduce the risk of TB transmission to the general population.^

Major element oxides of minerals from a lava pond at ODP Site 206-1256

At Ocean Drilling Program Site 1256 (6°44.2'N, 91°56.1'W), during Leg 206, a thick massive unit was cored in two neighboring penetrations of the uppermost basement, Holes 1256C and 1256D. This thick massive lava flow, commonly referred to as the "Lava Pond," is identified as Unit 18 (>30 m thick) in Hole 1256C and Unit 1 (>74.2 m thick) in Hole 1256D (Wilson et al., 2003, doi:10.2973/odp.proc.ir.206.2003). In the coarse-grained basalt that comprises this lithological unit, low-temperature "background" alteration events are present. This report provides microprobe analyses of both primary and secondary minerals present in this massive lava pond. The analyses of typically magmatic minerals (titanomagnetite, plagioclase, and clinopyroxene) are given for comparison with secondary minerals.

Sulphur chemistry of the ODP Site 206-1256 volcanic section

Sulfide mineralogy and the contents and isotope compositions of sulfur were analyzed in a complete oceanic volcanic section from IODP Hole 1256D in the eastern Pacific, in order to investigate the role of microbes and their effect on the sulfur budget in altered upper oceanic crust. Basalts in the 800 m thick volcanic section are affected by a pervasive low-temperature background alteration and have mean sulfur contents of 530 ppm, reflecting loss of sulfur relative to fresh glass through degassing during eruption and alteration by seawater. Alteration halos along fractures average 155 ppm sulfur and are more oxidized, have high SO4/Sum S ratios (0.43), and lost sulfur through oxidation by seawater compared to host rocks. Although sulfur was lost locally, sulfur was subsequently gained through fixation of seawater-derived sulfur in secondary pyrite and marcasite in veins and in concentrations at the boundary between alteration halos and host rocks. Negative d34S[sulfide-S] values (down to -30 per mil) and low temperatures of alteration (down to ~40 °C) point to microbial reduction of seawater sulfate as the process resulting in local additions of sulfide-S. Mass balance calculations indicate that 15-20% of the sulfur in the volcanic section is microbially derived, with the bulk altered volcanic section containing 940 ppm S, and with d34S shifted to -6.0 per mil from the mantle value (0 per mil). The bulk volcanic section may have gained or lost sulfur overall. The annual flux of microbial sulfur into oceanic basement based on Hole 1256D is 3-4 * 10**10 mol S/yr, within an order of magnitude of the riverine sulfate source and the sedimentary pyrite sink. Results indicate a flux of bacterially derived sulfur that is fixed in upper ocean basement of 7-8 * 10**-8 mol/cm**-2/yr1 over 15 m.y. This is comparable to that in open ocean sediment sites, but is one to two orders of magnitude less than for ocean margin sediments. The global annual subduction of sulfur in altered oceanic basalt lavas based on Hole 1256D is 1.5-2.0 * 10**11 mol/yr, comparable to the subduction of sulfide in sediments, and could contribute to sediment-like sulfur isotope heterogeneities in the mantle.

Heterogeneity of atmosfpheric ammonia at the landscape scale and consequences for environmental impact assessment.

We examined the consequences of the spatial heterogeneity of atmospheric ammonia (NH3) by measuring and modelling NH3 concentrations and deposition at 25 m grid resolution for a rural landscape containing intensive poultry farming, agricultural grassland, woodland and moorland. The emission pattern gave rise to a high spatial variability of modelled mean annual NH3 concentrations and dry deposition. Largest impacts were predicted for woodland patches located within the agricultural area, while larger moorland areas were at low risk, due to atmospheric dispersion, prevailing wind direction and low NH3 background. These high resolution spatial details are lost in national scale estimates at 1 km resolution due to less detailed emission input maps. The results demonstrate how the spatial arrangement of sources and sinks is critical to defining the NH3 risk to semi-natural ecosystems. These spatial relationships provide the foundation for local spatial planning approaches to reduce environmental impacts of atmospheric NH3.

Social Support Networks and Self-Efficacy of Peruvian Women Diagnosed with Cancer: A Biocultural Analysis of Health Behavior Constructs

Thesis (Ph.D.)--University of Washington, 2016-06

Do socioeconomic gradients in women's health widen over time and with age

A population-based study was conducted to investigate changes over time in women's well-being and health service use by socio-cconomic status and whether these varied by age. Data from 12,328 mid-age women (aged 45-50 years in 1996) and 10,430 older women (aged 70-75 years) from the Australian Longitudinal Study on Women's Health were analysed. The main outcome measures were changes in the eight dimensions of the Short Form General Health Survey (SF-36) adjusted for baseline scores, lifestyle and behavioural factors; health care utilisation at Survey 2; and rate of deaths (older cohort only). Cross-sectional analyses showed clear socioeconomic differentials in well-being for both cohorts. Differential changes in health across tertiles of socioeconomic status (SES) were more evident in the mid-age cohort than in the older cohort. For the mid-aged women in the low SES tertile, declines in physical functioning (adjusted mean change of -2.4, standard error (SE) 1.1) and general health perceptions (-1.5, SE 1.1) were larger than the high SES group (physical functioning -0.8 SE 1.1, general health perceptions -0.8 SE 1.2). In the older cohort, changes in SF-36 scores over time were similar for all SES groups but women in the high SES group had lower death rates than women in the low SES group (relative risk: 0.79, 95% confidence interval 0.64-0.98). Findings suggest that SES differentials in physical health seem to widen during women's mid-adult years but narrow in older age. Nevertheless, SES remains an important predictor of health, health service use and mortality in older Australian women. (C) 2003 Elsevier Ltd. All rights reserved.

Picosecond soliton transmission using concatenated nonlinear optical loop-mirror intensity filters

The issues involved in employing nonlinear optical loop mirrors (NOLMs) as intensity filters in picosecond soliton transmission were examined in detail. It was shown that inserting NOLMs into a periodically amplified transmission line allowed picosecond solitons to be transmitted under conditions considered infeasible until now. The loop mirrors gave dual function, removing low-power background dispersive waves through saturable absorption and applying a negative feedback mechanism to control the amplitude of the solitons. The stochastic characteristics of the pulses that were due to amplifier spontaneous-emission noise were investigated, and a number of new properties were determined. In addition, the mutual interaction between pulses was also significantly different from that observed for longer-duration solitons. The impact of Raman scattering in the computations was included and it was shown that soliton self-frequency shifts may be eliminated by appropriate bandwidth restrictions.

Creative self-efficacy and individual creativity in teams:cross-level interactions with team informational resources

We propose a cross-level perspective on the relation between creative self-efficacy and individual creativity in which team informational resources, comprising both shared “knowledge of who knows what” (KWKW) and functional background diversity, benefit the creativity of individuals more with higher creative self-efficacy. To test our hypotheses, we conducted a multi-level study with 176 employees working in 34 research and development teams of a multinational company in 4 countries. In support of our hypotheses, the link between creative self-efficacy and individual creativity was more positive with greater shared KWKW, and this interactive effect was pronounced for teams of high rather than low functional background diversity. We discuss implications for the study of creative self-efficacy in team contexts. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

The effect of mastery learning on a course in accounting information system (AIS): A comparison within public and private universities in Taiwan

The Accounting Information System (AIS) is an important course in the Department of Accounting (DoAc) of universities in Taiwan. This course is required for seniors not only because it meets the needs of the profession, but also because it provides continual study for the department's students.^ The scores of The National College and University Joint Entrance Examination (NUEE) show that students with high learning ability are admitted to public universities with high scores, while those with low learning ability are admitted only to private universities. The same situation has been found by the researcher while teaching an AIS course in DoAc of The Public Chun Shin University (CSU) and The Private Chinese Culture University (CCU).^ The purpose of this study was to determine whether low ability students enrolled in private universities in Taiwan in a mastery learning program could attain the same level as high ability students from public universities enrolled in a traditional program. An experimental design was used. The mastery learning method was used to teach three groups of seniors with low learning ability studying in the DoAc at CCU. The traditional method was used to teach the control group which consisted of senior students of DoAc of CSU with high learning ability. As a part of the mastery learning strategy, a formative test, quizzes, and homework were completed by the experimental group only, while the mid-term examination was completed by both groups as part of the course. The dependent variable was the summative test, the final examination. It was completed by both groups upon the course's completion.^ As predicted, there were significant differences between the two groups' results on the pretest. There were no significant differences between the two groups' results on the posttest. These findings support the hypothesis of the study and reveal the effectiveness of mastery learning strategies with low learning ability students. ^

Achievement of generic baccalaureate student nurses using computer -assisted instruction simulations during a nursing review course

The use of computer assisted instruction (CAI) simulations as an instructional strategy provides nursing students with a critical thinking approach for evaluating risks and benefits and choosing correct alternatives in "safe" patient care situations. It was hypothesized that using CAI simulations during an upper level nursing review course would have a positive effect on the students' posttest scores. Subjects (n = 36) were senior nursing students enrolled in a nursing review course in an undergraduate baccalaureate program. A limitation of the study was the small sample size. The study employed a modified group experimental design using the t test for independent samples. The group who received the CAI simulations during the physiological system review demonstrated a significant increase (p $<$.01) in the posttest score mean when compared to the lecture-discussion group score mean. There was no significant difference between high and low clinical grade point average (GPA) students in the CAI and lecture-discussion groups and their score means on the posttest. However, score mean differences of the low clinical GPA students showed a greater increase for the CAI group than the lecture-discussion group. There was no significant difference between the groups in their system content subscore means on the exit examination completed three weeks later. It was concluded that CAI simulations are as effective as lecture-discussion in assisting upper level students to process information for clinical decision making. CAI simulations can be considered as an instructional strategy to supplement or replace lecture content during a review course, allowing more efficient use of faculty time. It is recommended that the study be repeated using a larger sample size. Further investigations are recommended in comparing the effectiveness of computer software formats and various instructional strategies for other learning situations and student populations. ^