2,423 research outputs found
Racism and the Political Economy of COVID-19: Will We Continue to Resurrect the Past?
COVID-19 is not spreading over a level playing field; structural racism is embedded within the fabric of American culture, infrastructure investments, and public policy, and fundamentally drives inequities. The same racism that has driven the systematic dismantling of the American social safety-net has also created the policy recipe for American structural vulnerability to the impacts of this and other pandemics. The Bronx provides an important case study for investigating the historical roots of structural inequities showcased by this pandemic; current lived experiences of Bronx residents are rooted in the racialized dismantling of New York Cityâs public infrastructure and systematic disinvestment. The story of the Bronx is repeating itself, only this time with a novel virus. In order to address the root causes of inequities in cases and deaths due to COVID-19, we need to focus not just on restarting the economy, but on reimagining the economy, divesting of systems rooted in racism and the devaluation of Black and Brown lives
Short- and long-term associations between widowhood and mortality in the United States: longitudinal analyses
Background
Past research shows that spousal death results in elevated mortality risk for the surviving spouse. However, most prior studies have inadequately controlled for socioeconomic status (SES), and it is unclear whether this âwidowhood effectâ persists over time.
Methods
Health and Retirement Study participants aged 50+ years and married in 1998 (n = 12 316) were followed through 2008 for widowhood status and mortality (2912 deaths). Discrete-time survival analysis was used to compare mortality for the widowed versus the married.
Results
Odds of mortality during the first 3 months post-widowhood were significantly higher than in the continuously married (odds ratio (OR) for men = 1.87, 95% CI: 1.27, 2.75; OR for women = 1.47, 95% CI: 0.96, 2.24) in models adjusted for age, gender, race and baseline SES (education, household wealth and household income), behavioral risk factors and co-morbidities. Twelve months following bereavement, men experienced borderline elevated mortality (OR = 1.16, 95% CI: 1.00, 1.35), whereas women did not (OR = 1.07, 95% CI: 0.90, 1.28), though the gender difference was non-significant.
Conclusion
The âwidowhood effectâ was not fully explained by adjusting for pre-widowhood SES and particularly elevated within the first few months after widowhood. These associations did not differ by sex
Elevated Depressive Symptoms and Incident Stroke in Hispanic, African-American, and White Older Americans
Although depressive symptoms have been linked to stroke, most research has been in relatively ethnically homogeneous, predominantly white, samples. Using the United States based Health and Retirement Study, we compared the relationships between elevated depressive symptoms and incident first stroke for Hispanic, black, or white/other participants (N = 18,648) and estimated the corresponding Population Attributable Fractions. The prevalence of elevated depressive symptoms was higher in blacks (27%) and Hispanics (33%) than whites/others (18%). Elevated depressive symptoms prospectively predicted stroke risk in the whites/other group (HR = 1.53; 95% CI: 1.36â1.73) and among blacks (HR = 1.31; 95% CI: 1.05â1.65). The HR was similar but only marginally statistically significant among Hispanics (HR = 1.33; 95% CI: 0.92â1.91). The Population Attributable Fraction, indicating the percent of first strokes that would be prevented if the incident stroke rate in those with elevated depressive symptoms was the same as the rate for those without depressive symptoms, was 8.3% for whites/others, 7.8% for blacks, and 10.3% for Hispanics
Record Maximum Oscillation Frequency in C-face Epitaxial Graphene Transistors
The maximum oscillation frequency (fmax) quantifies the practical upper bound
for useful circuit operation. We report here an fmax of 70 GHz in transistors
using epitaxial graphene grown on the C-face of SiC. This is a significant
improvement over Si-face epitaxial graphene used in the prior high frequency
transistor studies, exemplifying the superior electronics potential of C-face
epitaxial graphene. Careful transistor design using a high {\kappa} dielectric
T-gate and self-aligned contacts, further contributed to the record-breaking
fmax
Use of high-level health facilities and catastrophic expenditure in Vietnam: can health insurance moderate this relationship?
Background
Overcrowding of high-level health facilities is a major concern in a Vietnamese health system. This may increase an economic burden to the households since health insurance is still insufficient in providing financial risk protection. This paper sought to examine the association between the use of high-level health facilities and household-level expenditure status such as out-of-pocket (OOP), and catastrophic expenditure on health, as well as a moderating effect of health insurances in rural and urban districts of Vietnam.
Methods
Data utilized a health system community survey collected between 2015 and 2017 in two districts of Vietnam (one from rural area in northern part, and the other one from urban area in sourthern part). The world Health Organizations definition of catastrophic expenditure was used. Multivariate tobit and logistic regression were employed for catastrophic expenditure and OOP respectively. Interaction term between health insurance status and visit frequency in high-level facilities was included to investigate the moderating effect of health insurance.
Results
Health insurance status was associated with neither OOP health expenditure nor catastrophic expenditure occurrence, whereas visit frequency of high-level health facilities was strongly associated with both outcomes in both districts(e.g., for catastrophic expenditure, ORs are 1.77 and 1.30 in northern and southern district respecitvely. P values are <â0.001). Significant interaction between health insurance status and use of high-level facilities on catastrophic expenditure occurrence was found in Quoc Oai district (ORâ=â0.68, pâ<â0.05).
Conclusions
The present study demonstrated negative financial impact of utilizing high-level facility on household financial status and weak role of health insurance in decreasing this impact. Multi-faceted approach is called for to mitigate the patients financial burden.This research was financially supported by the JW LEE Center for Global Medicine of Seoul National University College of Medicine, Seoul, South Korea. Researchers in funding body analyzed data and prepared the manuscript but were not directly involved in data collection. Data was collected by Vietnamese research partners
Does the Association Between Depressive Symptoms and Cardiovascular Mortality Risk Vary By Race? Evidence from the Health and Retirement Study
ObjectiveâTo test whether the association between depressive symptoms and cardiovascular
disease (CVD) mortality is stronger among blacks than whites. Design, Setting and Participants:
2,638 black and 15,132 white participants from a prospective, observational study of communitydwelling
Health and Retirement Study participants (a nationally representative sample of U.S.
adults age 50+). Average follow-up was 9.2 years. Outcome Measure: Cause of death (per ICD
codes) and month of death were identified from National Death Index linkages.
MethodsâThe associations between elevated depressive symptoms and mortality from stroke,
ischemic heart disease (IHD), or total CVD were assessed using Cox proportional hazards models
to estimate adjusted hazard ratios (HRs). We used interaction terms for race by depressive
symptoms to assess effect modification (multiplicative scale).
ResultsâFor both whites and blacks, depressive symptoms were associated with a significantly
elevated hazard of total CVD mortality (whites: HR=1.46; 95% CI: 1.33, 1.61; blacks: HR=1.42,
95% CI: 1.10, 1.83). Adjusting for health and socioeconomic covariates, whites with elevated
depressive symptoms had a 13% excess hazard of CVD mortality (HR=1.13, 95% CI: 1.03, 1.25)
compared to whites without elevated depressive symptoms. The HR in blacks was similar,
although the confidence interval included the null (HR=1.12, 95% CI: 0.86, 1.46). The hazard associated with elevated depressive symptoms did not differ significantly by race (p>0.15 for all
comparisons). Patterns were similar in analyses restricted to respondents age 65+.
ConclusionsâClinicians should consider the depressive state of either black or white patients
as a potential CVD mortality risk factor
Widowhood and Mortality: A Meta-Analysis
While the "widowhood effect" is well known, there is substantial heterogeneity in the magnitude of effects reported in different studies. We conducted a meta-analysis of widowhood and mortality, focusing on longitudinal studies with follow-up from the time of bereavement.A random-effects meta-analysis was conducted to calculate the overall relative risk (RR) for subsequent mortality among 2,263,888 subjects from 15 prospective cohort studies. We found a statistically significant positive association between widowhood and mortality, but the widowhood effect was stronger in the period earlier than six months since bereavement (overall RRâ=â1.41, 95% CI: 1.26, 1.57) compared to the effect after six months (overall RRâ=â1.14, 95% CI: 1.10, 1.18). Meta-regression showed that the widowhood effect was not different for those aged younger than 65 years compared to those older than 65 (Pâ=â0.25). There was, however, a difference in the magnitude of the widowhood effect by gender; for women the RR was not statistically significantly different from the null (overall RRâ=â1.04, 95% CI: 1.00, 1.08), while it was for men (overall RRâ=â1.23, 95% CI: 1.18, 1.28).The results suggest that further studies should focus more on the mechanisms that generate this association especially among men
Phenylpropanoid Glycoside Analogues: Enzymatic Synthesis, Antioxidant Activity and Theoretical Study of Their Free Radical Scavenger Mechanism
Phenylpropanoid glycosides (PPGs) are natural compounds present in several medicinal plants that have high antioxidant power and diverse biological activities. Because of their low content in plants (less than 5% w/w), several chemical synthetic routes to produce PPGs have been developed, but their synthesis is a time consuming process and the achieved yields are often low. In this study, an alternative and efficient two-step biosynthetic route to obtain natural PPG analogues is reported for the first time. Two galactosides were initially synthesized from vanillyl alcohol and homovanillyl alcohol by a transgalactosylation reaction catalyzed by Kluyveromyces lactis ÎČ-galactosidase in saturated lactose solutions with a 30%â35% yield. To synthesize PPGs, the galactoconjugates were esterified with saturated and unsaturated hydroxycinnamic acid derivatives using Candida antarctica Lipase B (CaL-B) as a biocatalyst with 40%â60% yields. The scavenging ability of the phenolic raw materials, intermediates and PPGs was evaluated by the 2,2-diphenyl-1-picrylhydrazyl radical (DPPHâą) method. It was found that the biosynthesized PPGs had higher scavenging abilities when compared to ascorbic acid, the reference compound, while their antioxidant activities were found similar to that of natural PPGs. Moreover, density functional theory (DFT) calculations were used to determine that the PPGs antioxidant mechanism proceeds through a sequential proton loss single electron transfer (SPLET). The enzymatic process reported in this study is an efficient and versatile route to obtain PPGs from different phenylpropanoid acids, sugars and phenolic alcohols
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