Neighborhood socioeconomic status, Medicaid coverage and medical management of myocardial infarction: Atherosclerosis risk in communities (ARIC) community surveillance

<p>Abstract</p> <p>Background</p> <p>Pharmacologic treatments are efficacious in reducing post-myocardial infarction (MI) morbidity and mortality. The potential influence of socioeconomic factors on the receipt of pharmacologic therapy has not been systematically examined, even though healthcare utilization likely influences morbidity and mortality post-MI. This study aims to investigate the association between socioeconomic factors and receipt of evidence-based treatments post-MI in a community surveillance setting.</p> <p>Methods</p> <p>We evaluated the association of census tract-level neighborhood household income (nINC) and Medicaid coverage with pharmacologic treatments (aspirin, beta [β]-blockers and angiotensin converting enzyme [ACE] inhibitors; optimal therapy, defined as receipt of two or more treatments) received during hospitalization or at discharge among 9,608 MI events in the ARIC community surveillance study (1993-2002). Prevalence ratios (PR, 95% CI), adjusted for the clustering of hospitalized MI events within census tracts and within patients, were estimated using Poisson regression.</p> <p>Results</p> <p>Seventy-eight percent of patients received optimal therapy. Low nINC was associated with a lower likelihood of receiving β-blockers (0.93, 0.87-0.98) and a higher likelihood of receiving ACE inhibitors (1.13, 1.04-1.22), compared to high nINC. Patients with Medicaid coverage were less likely to receive aspirin (0.92, 0.87-0.98), compared to patients without Medicaid coverage. These findings were independent of other key covariates.</p> <p>Conclusions</p> <p>nINC and Medicaid coverage may be two of several socioeconomic factors influencing the complexities of medical care practice patterns.</p

Equitable distribution of open space: Using spatial analysis to evaluate urban parks in Curitiba, Brazil

© 2015 The Author(s). Urban parks are community assets, providing people places to play and rest. Access to parks in urban environments promotes social equity and improves quality of life for surrounding neighborhoods. In this context, social equity is related to accessibility, i.e. the possibility of walking or biking from home to a public park, giving people who do not have access to a variety of entertainment an option that is a public good. This paper examines the spatial distribution of urban parks in the city of Curitiba, Brazil, and how it relates to the socio-economic conditions of surrounding neighborhoods. Curitiba is known for its urban parks; however, no systematic study has been conducted to verify which neighborhoods enjoy park access within walking distance and what the socio-economic differences are between the better and worse served neighborhoods. In addition, we investigate if access to green open space has improved between the last two decennial census, a period marked by unprecedented socio-economic affluence in Brazil. Research questions, to be addressed using spatial analysis, focus on equitable distribution, and spatial evolution of parks and social equity. Variables include measurable walking distances from census tracts to parks, income data from the 2000 and 2010 Brazilian decennial censuses, and qualitative data of urban parks in Curitiba. Findings offer recommendations for future implementation of additional parks in Curitiba so that all areas of the city have adequate green open space and all citizens have equal access to recreation and leisure opportunities

The Effect of Community Gardens on Neighboring Property Values

Cities across the United States that have considerable vacant land are debating whether to foster community gardens on that land, while cities with land shortages are debating when to replace gardens with other uses. Meanwhile, many cities are looking for new ways to finance green spaces. Little empirical evidence about the neighborhood impacts of community gardens is available, however, to inform the debate or to help cities design financing schemes. This article estimates the impact of community gardens on neighborhood property values, using rich data for New York City and a difference-in-difference specification of a hedonic regression model. We find that gardens have significant positive effects, especially in the poorest neighborhoods. Higher-quality gardens have the greatest positive impact. Copyright 2008 American Real Estate and Urban Economics Association

How do children ape? Applying concepts from the study of non-human primates to the developmental study of 'imitation' in children

We highlight two aspects of research into social learning that have been neglected in existing developmental research, namely: (1) The role of social learning in learning to use tools, and (2) Whether children's social learning involves copying the actions themselves ('blind' imitation or mimicry), or alternatively, the effects of those actions (emulation). In Part I of the paper we argue that the failure to distinguish between these different mechanisms is closely related to the lack of research on the social transmission of tool use and that both omissions limit our understanding of early social learning. We conclude Part I by outlining the requirements for an adequate study of these two issues. In Part II, we use this analysis to critically examine data from existing developmental research with children. We also assess the data currently available in the comparative literature which address these issues more directly. We conclude that children learn only what actions to perform via observation ('blind' imitation or mimicry), and not why those actions are effective (emulation). We close by identifying important potential pitfalls and unresolved questions for the future study of the social learning of actions on object

Cephalometric evaluation of adult anterior open bite non-extraction treatment with Invisalign

ABSTRACT Objective: The purpose of this study was to evaluate, by means of cephalometric appraisal, the vertical effects of non-extraction treatment of adult anterior open bite with clear aligners (Invisalign system, Align Technology, Santa Clara, CA, USA). Methods: Lateral cephalograms of 30 adult patients with anterior open bite treated using Invisalign (22 females, 8 males; mean age at start of treatment: 28 years and 10 months; mean anterior open bite at start of treatment: 1.8 mm) were analyzed. Pre- and post-treatment cephalograms were traced to compare the following vertical measurements: SN to maxillary occlusal plane (SN-MxOP), SN to mandibular occlusal plane (SN-MnOP), mandibular plane to mandibular occlusal plane (MP-MnOP), SN to mandibular plane (SN-MP), SN to palatal plane (SN-PP), SN to gonion-gnathion plane (SN-GoGn), upper 1 tip to palatal plane (U1-PP), lower 1 tip to mandibular plane (L1-MP), mesiobuccal cusp of upper 6 to palatal plane (U6-PP), mesiobuccal cusp of lower 6 to mandibular plane (L6-MP), lower anterior facial height (LAFH), and overbite (OB). Paired t-tests and descriptive statistics were utilized to analyze the data and assess any significant changes resulting from treatment. Results: Statistically significant differences were found in overall treatment changes for SN-MxOP, SN-MnOP, MP-MnOP, SN-MP, SN-GoGn, L1-MP, L6-MP, LAFH, and OB. Conclusions: The Invisalign system is a viable therapeutic modality for non-extraction treatment of adult anterior mild open bites. Bite closure was mainly achieved by a combination of counterclockwise rotation of the mandibular plane, lower molar intrusion and lower incisor extrusion