Prevalence and Patterns of Injury-Related Mortality in Nevada

Too many lives are lost to injury in the United States and in Nevada. Nearly 200,000 people in our country die each year from injuries, which is equivalent to one death every three minutes (CDC 2017b). Each of these deaths not only extinguishes a life, but also affects the friends, family, and community of the deceased. And deaths from injury are costly: researchers estimate that costs from fatal injuries exceed $200 billion (CDC 2017b). Injury refers to damage to the body from some external force, such as from a car crash or a fall, including kinetic, chemical, electrical, thermal or other forces. There are multiple types of death from injury. Health researchers and policymakers classify injuries as unintentional or intentional, and if intentional, injury deaths are further classified as either suicide or homicide. Researchers and policymakers further categorize injuries by the mechanism or circumstances of the injury (such as motor vehicle crash, poisoning, or firearm)

Ebola and War in the Democratic Republic of Congo: Avoiding Failure and Thinking Ahead

The Ebola epidemic in the Democratic Republic of Congo (DRC) is exceptionally dangerous, occurring within active armed conflict and geopolitical volatility, including a million displaced persons. With 421 cases, 240 deaths, and the numbers increasing, this Ebola outbreak is the second deadliest in history. Recent spread to Butembo, home to 1.2 million people, raised concerns. The DRC, World Health Organization (WHO), and partners are leading a vigorous international response, yet despite deploying an experimental vaccine, cases doubled in October 2018 and many cases had unknown origin. Uncontrolled Ebola outbreaks can expand quickly, as occurred in West Africa in 2014. Averting that outcome in the DRC requires rapid action including a strengthened public health response, security, and community outreach. If violence escalates, it could compromise a fragile response. Yet resources are insufficient. The United States and other countries are not permitting personnel deployment to the epicenter, including from the Centers for Disease Control and Prevention (CDC) and US Agency for International Development (USAID). In this Viewpoint, we review recommendations of experts convened by Georgetown University and listed at the end of this article. The United States and international community should launch high-level political mobilization, with diplomatic, human, and economic resources. It is critical to recognize that future health crises will occur in fragile, insecure settings. To prepare, the international community needs long-term planning and enhanced capacities to improve the safety and effectiveness of epidemic response operations

School Influences on Parents’ Educational Expectations

This study seeks to determine the social origins of parents\u27 educational expectations for their children and explore how the effects of sociodemographic background characteristics differ across schools. Using data from the Early Childhood Longitudinal Study - Kindergarten (ECLS-K) and a multilevel approach, the results indicate that race, socioeconomic status (SES), child academic abilities, and school composition are all important predictors of parental educational expectations of 8th grade children. Having higher SES, being black or Hispanic, and attending a school with a high percentage of minority students all increase parental expectations. Furthermore, the positive effect of having higher levels of parental education or household income is weakened by attending a school with a higher level of students coming from a minority racial background. This study demonstrates that school effects extend beyond the child and that researchers should continue to explore family-school interactions

Decentralization and Access to Agricultural Extension Services in Kenya

The form and content of decentralization has dominated development discourse and public sector reform agenda in Kenya in the last two decades. The case of agricultural extension service presents decentralization in a difficult context partly due to lack of information on its possible diverse impacts especially on resource poor farmers. This paper explores the effect of decentralization of agricultural extension on access, accountability and empowerment, and efficiency of delivering services to farmers. Secondary data, participatory research methods and primary data from a random sample of 250 farmers were used. Data was analyzed using descriptive statistics, multivariate analysis and logistic regression. The results show that there is improved access to extension services with increasing level of decentralization. Farmers from areas with higher decentralized extension also showed enhanced level of awareness of different channels for delivery of extension services. This improved knowledge, being an important component of empowerment of the farming community, resulted from the increase of service providers, who displayed synergy in their multiple methods of operation. Public delivery channels were the most affordable and were also ranked first for quality. Income, literacy levels, distance from towns and access to telephone significantly influenced access to extension services. Gender of the household-head was a key determinant for seeking out extension services in areas with high concentration of agricultural activities. For a pluralistic system to work there is need for better co-ordination between the various groups. Although there is evidence of partnership and synergy between service providers, there appeared to be little effective co-ordination of the groups involved. The government and other stakeholders should work towards developing a strong institutional framework that will guide and enhance this mutually beneficial partnership.extension services, decentralization, partnerships, policy reform, Kenya, Teaching/Communication/Extension/Profession,

Identifying H-2b-restricted CD4+ T Lymphocyte Recognition Epitopes Within Simian Virus 40 Large Tumor Antigen

CD4+ T lymphocytes play a vital role in immune system function but little is known about their role in controlling SV40 T ag-induced tumors in C57BL/6 mice. In order to better investigate their role in the control of tumors, it is necessary to identify CD4 epitope(s) within the Tag. Four CDS epitopes have been identified but the CD4 epitopes have not been identified. To facilitate the identification of the epitopes, T cell hybridomas containing a Lacz reporter gene were used. CD4+ hybridoma clones capable of recognizing SV 40 Large Tumor Antigen (T ag) were obtained from heterogeneous populations through serial dilution and screening with a colorimetric (CPRG) assay in which bone marrow-derived dendritic cells were pulsed with purified SV 40 T ag protein. To map the location of the epitope target of each clone, four of the clones were chosen for use in a screening assay utilizing a library of overlapping synthetic 15mer peptides representing the entire SV 40 T ag amino acid sequence. The identification of such CD4+ epitopes within the T ag will make it possible to determine the immunogenic and regulatory properties of each epitope (in vivo) and determine whether differences in reactivity demonstrated by the various hybridoma clones against the purified SV 40 T ag protein are epitope or hybrid dependent

Support from Adult Children and Parental Health in Rural America

Adult children are a primary source of care for their aging parents. Parents in rural areas, however, live further from their adult children than parents in urban areas, potentially limiting the support they receive and compromising their health and ability to age in place. We use two waves of the Panel Study of Income Dynamics (2013 and 2017) to investigate the relationships among geographic proximity, adult children’s instrumental and financial support, and parental health. Rural parents live further from their adult children and receive less financial support, but they are more likely to receive instrumental assistance. In addition, rural parents have worse health and more functional limitations than urban parents, and these differences persist after controlling for proximity to and support from adult children. Our findings indicate that factors beyond proximity influence the complex relationships between spatial and social boundaries and their consequences for older adults’ health and well-being

Educational Attainment and Mortality in the United States: Effects of Degrees, Years of Schooling, and Certification

Researchers have extensively documented a strong and consistent education gradient for mortality, with more highly educated individuals living longer than those with less education. This study contributes to our understanding of the education-mortality relationship by determining the effects of years of education and degree attainment on mortality, and by including nondegree certification, an important but understudied dimension of educational attainment. We use data from the mortality-linked restricted-use files of the Panel Study of Income Dynamics (PSID) sample (N=9,821) and Cox proportional hazards models to estimate mortality risk among U.S. adults. Results indicate that more advanced degrees and additional years of education are associated with reduced mortality risk in separate models, but when included simultaneously, only degrees remain influential. Among individuals who have earned a high school diploma only, additional years of schooling (beyond 12) and vocational school certification (or similar accreditation) are both independently associated with reduced risks of death. Degrees appear to be most important for increasing longevity; the findings also suggest that any educational experience can be beneficial. Future research in health and mortality should consider including educational measures beyond a single variable for educational attainment

Desmin common mutation is associated with multi-systemic disease manifestations and depletion of mitochondria and mitochondrial DNA.

Desmin (DES) is a major muscle scaffolding protein that also functions to anchor mitochondria. Pathogenic DES mutations, however, have not previously been recognized as a cause of multi-systemic mitochondrial disease. Here, we describe a 45-year-old man who presented to The Children\u27s Hospital of Philadelphia Mitochondrial-Genetics Diagnostic Clinic for evaluation of progressive cardiac, neuromuscular, gastrointestinal, and mood disorders. Muscle biopsy at age 45 was remarkable for cytoplasmic bodies, as well as ragged red fibers and SDH positive/COX negative fibers that were suggestive of a mitochondrial myopathy. Muscle also showed significant reductions in mitochondrial content (16% of control mean for citrate synthase activity) and mitochondrial DNA (35% of control mean). His family history was significant for cardiac conduction defects and myopathy in multiple maternal relatives. Multiple single gene and panel-based sequencing studies were unrevealing. Whole exome sequencing identified a known pathogenic p.S13F mutation in DES that had previously been associated with desmin-related myopathy. Desmin-related myopathy is an autosomal dominant disorder characterized by right ventricular hypertrophic cardiomyopathy, myopathy, and arrhythmias. However, neuropathy, gastrointestinal dysfunction, and depletion of both mitochondria and mitochondrial DNA have not previously been widely recognized in this disorder. Recognition that mitochondrial dysfunction occurs in desmin-related myopathy clarifies the basis for the multi-systemic manifestations, as are typical of primary mitochondrial disorders. Understanding the mitochondrial pathophysiology of desmin-related myopathy highlights the possibility of new therapies for this otherwise untreatable and often fatal class of disease. We postulate that drug treatments aimed at improving mitochondrial biogenesis or reducing oxidative stress may be effective therapies to ameliorate the effects of desmin-related disease

Does Education Equalize or Reproduce Inequality? Effects of College Degrees on Health Behaviors

Among U.S. adults, college degree earners live much healthier lives than those with less education, but we know little about why. This dissertation examines how, why, and for whom college degrees influence health behaviors, such as smoking, diet, exercising, maintaining of healthy weight status, and drinking. Theories posit that college degrees may exhibit: “transformative” effects if college degrees influence health behaviors independent of selection, “sorting” effects if health behavior advantages are due to selection, “conditional reproduction” if groups of historical advantage receive the greatest benefits, or “conditional equalizing” if groups of historical disadvantage have greater benefits. Three research questions characterize the study’s objectives: (1) Does education improve health behaviors or is the association spurious? (2) Does education have the same benefits for the health behaviors of all social groups? (3) If education does improve health behaviors, how does it do so? The National Longitudinal Study of Adolescent to Adult Health (Add Health) provides longitudinal data on education and health behaviors across adolescence and young adulthood for a cohort of individuals born 1977-1984. The methods include propensity score approaches to estimate causal effects and test for heterogeneity. This study affirms multiple functions of education: it sorts individuals, improves well-being, and stratifies the population into classes. Very little evidence supports the assertion that benefits of college degrees are conditional. College degrees improve health behaviors for all college graduates, leaving those without degrees lagging behind. A sociological understanding of why social groups engage in different behaviors can contribute to efforts in reducing social inequality and improving population health

Alcohol's Collateral Damage: Childhood Exposure to Problem Drinkers and Subsequent Adult Mortality Risk

The importance of childhood circumstances, broadly defined, for shaping adult health and longevity is well-established. But the significance of one of the most prevalent childhood adversities—exposure to problem drinkers—has been understudied from a sociological perspective and remains poorly understood. We address this gap by drawing on cumulative inequality theory, using data from the 1988–2011 National Health Interview Survey-Linked Mortality Files, and estimating Cox proportional hazards models to examine the relationship between exposure to problem drinkers in childhood and adult mortality risk. Childhood exposure to problem drinkers is common (nearly 1 in 5 individuals were exposed) and elevates adult overall and cause-specific mortality risk. Compared to individuals who had not lived with a problem drinker during childhood, those who had done so suffered 17 percent higher risk of death (p<.001) over the follow-up period, net of age, sex, and race/ethnicity. We find compelling evidence that the duration, source, and intensity of exposure to problem drinkers in childhood contributes to inequality in adult mortality risk. Favorable socioeconomic status in adulthood does not ameliorate the consequences of childhood exposure to problem drinkers. The primary intervening mechanisms are risky behaviors, including adult drinking and smoking. The findings—which reveal that the influence of problem drinking is far-reaching and long-term—should inform policies to improve childhood circumstances, reduce detrimental effects of problem drinking, and increase life expectancy