Residential Segregation and Overweight/Obesity Among African-American Adults: A Critical Review

The relationship between residential segregation and overweight/obesity among African-American adults remains unclear. Elucidating that relationship is relevant to efforts to prevent and to reduce racial disparities in obesity. This article provides a critical review of the 11 empirical studies of segregation and overweight/obesity among African-American adults. Results revealed that most studies did not use a valid measure of segregation, many did not use a valid measure of overweight/obesity, and many did not control for neighborhood poverty. Only four (36% of the) studies used valid measures of both segregation and overweight/obesity and also controlled for area-poverty. Those four studies suggest that segregation contributes to overweight and obesity among African-American adults, but that conclusion cannot be drawn with certainty in light of the considerable methodologic problems in this area of research. Suggestions for improving research on this topic are provided

LSST: from Science Drivers to Reference Design and Anticipated Data Products

(Abridged) We describe here the most ambitious survey currently planned in the optical, the Large Synoptic Survey Telescope (LSST). A vast array of science will be enabled by a single wide-deep-fast sky survey, and LSST will have unique survey capability in the faint time domain. The LSST design is driven by four main science themes: probing dark energy and dark matter, taking an inventory of the Solar System, exploring the transient optical sky, and mapping the Milky Way. LSST will be a wide-field ground-based system sited at Cerro Pach\'{o}n in northern Chile. The telescope will have an 8.4 m (6.5 m effective) primary mirror, a 9.6 deg$^2$ field of view, and a 3.2 Gigapixel camera. The standard observing sequence will consist of pairs of 15-second exposures in a given field, with two such visits in each pointing in a given night. With these repeats, the LSST system is capable of imaging about 10,000 square degrees of sky in a single filter in three nights. The typical 5$\sigma$ point-source depth in a single visit in $r$ will be $\sim 24.5$ (AB). The project is in the construction phase and will begin regular survey operations by 2022. The survey area will be contained within 30,000 deg$^2$ with $\delta<+34.5^\circ$, and will be imaged multiple times in six bands, $ugrizy$, covering the wavelength range 320--1050 nm. About 90\% of the observing time will be devoted to a deep-wide-fast survey mode which will uniformly observe a 18,000 deg$^2$ region about 800 times (summed over all six bands) during the anticipated 10 years of operations, and yield a coadded map to $r\sim27.5$. The remaining 10\% of the observing time will be allocated to projects such as a Very Deep and Fast time domain survey. The goal is to make LSST data products, including a relational database of about 32 trillion observations of 40 billion objects, available to the public and scientists around the world.Comment: 57 pages, 32 color figures, version with high-resolution figures available from https://www.lsst.org/overvie

The Role of an Enhanced Sleep Hygiene in Reducing Delirium in the ICU

ABSTRACT: Objective:To prove that implementing a sleep hygiene bundle will decrease delirium in critically ill patients as well as improve mortality and morbidity. Data Sources:I searched PubMed, Cochrane Library and Google Scholar for relevant literature. Study Selection:Articles on delirium in the ICU, sleep hygiene practices, and non-medicine sleep aids like melatonin, earplugs and eye masks were selected. Data Extraction:Three different meta-analysis and systematic reviews that were published from 2015-2018 were used to extract data for this scholarly project. Studies included earplugs, eye masks, melatonin, reduced noise, decreased activity at night and reduced medications to evaluate the effect on delirium. Data Synthesis:One systematic review and two randomized controlled trials were evaluated with subjects using earplugs, eye masks, and/or melatonin to help implement sleep. Earplugs were found to have a significant reduction on delirium. Melatonin compared to a placebo did not show a vast difference. However, melatonin compared to just earplugs and eye masks against ICU noise and light showed a major improvement in sleep quality. Conclusions:A sleep hygiene bundle has shown significant improvement in the decreased risk of delirium in ICU. Decreasing delirium in critically ill patients has shown benefits in mortality and morbidity. The ideal approach for improving sleep hygiene and the associated effect on patient-centered outcomes remains uncertain. Keywords: delirium, sleep, intensive care, sleep hygiene, agitation, sedation, melatonin, earplugs, eye masks, critical ill patients, CAM-IC