Examining Race Differences in Blood Pressure Control among People with Chronic Kidney Disease

Of Chronic Kidney Disease (CKD) patients, 20% of them also have hypertension (HTN). African Americans (AA) are known to be more at risk of CKD development and poor HTN control compared to Whites, largely due to their higher prevalence of diabetes and HTN. While those health conditions are a known risk factor to CKD, it is less clear if there is a race difference in HTN control among CKD patients. Using a combined 1999-2014 data set from The National Health and Nutrition Examination Survey (NHANES), we sought to determine if there is an association between race and HTN control among CKD patients. A smaller portion of AA CKD patients (58.2% vs 71.6%; p\u3c0.001) had controlled hypertension than White CKD patients. After adjusting for age, AA had a lower odds of having their hypertension controlled (odds ratio (OR) = 0.58; 95% confidence interval (CI): 0.37-0.92) relative to whites. When adjusting for social factors and medical conditions, we observed that hypertensive African Americans with CKD had similar odds of having their hypertension controlled (OR=0.55; 95% CI= 0.25-1.23) relative their White peers. Social factors and medical conditions account for the race difference in hypertension control among CKD patients. Strategies to control hypertension among AA patients with CKD must include not only efforts for proper health care to treat and control medical conditions, such as diabetes and stroke, but to address social factors. The results highlight the importance of creating interventions specifically focused on chronic disease prevention and management for African American adults to attempt to delay the onset or impede the progression of CKD

Race and “Hotspots” of Preventable Hospitalizations

Abstract Preventable hospitalizations (PHs) are those for ambulatory care-sensitive conditions that indicate insufficiencies in local primary healthcare. PH rates tend to be higher among African Americans, in urban centers, rural areas and areas with more African American residents. The objective of this study is to determine geographic clusters of high PH rates (“spatial clusters”) by race. Data from Maryland hospitals were utilized to determine the rates of PHs in zip code tabulation areas (ZCTAs) by race in 2010. Geographic clusters of ZCTAs with higher than expected PH rates were identified using Scan Statistic and Anselin’s Local Moran’s I. 10 PH spatial clusters were observed among the total population with an average PH rate of 3,046.6 per 100,000 population. Among whites, the average PH rate was 3,339.9 per 100,000 in 11 PH spatial clusters. Only five PH spatial clusters were observed among African Americans with a higher average PH rate (3,710.8 per 100,000). The locations and other characteristics of PH spatial clusters differed by race. These results can be used to target resources to areas with high PH rates. Because PH spatial clusters are observed in differing locations for African Americans, approaches that include cultural tailoring may need to be specifically targeted

A Review of Economic Opportunity and Criminal Justice Programs for Boys and Men of Color

The authors review the evidence on programs and other interventions to address incarceration and lack of economic opportunity for boys and men of color. In addition, the authors review programs and interventions published in the scientific literature as well as reports, white papers, briefs, and other documents from the gray literature. They conclude with recommendations for action and for research

Accelerated aging: A marker for social factors resulting in cardiovascular events?

Background: Medicine and public health are shifting away from a purely personal responsibility model of cardiovascular disease (CVD) prevention towards a societal view targeting social and environmental conditions and how these result in disease. Given the strong association between social conditions and CVD outcomes, we hypothesize that accelerated aging, measuring earlier health decline associated with chronological aging through a combination of biomarkers, may be a marker for the association between social conditions and CVD. Methods: We used data from the Coronary Artery Risk Development in Young Adults study (CARDIA). Accelerated aging was defined as the difference between biological and chronological age. Biological age was derived as a combination of 7 biomarkers (total cholesterol, HDL, glucose, BMI, CRP, FEV1/h(2), MAP), representing the physiological effect of wear and tear usually associated with chronological aging. We studied accelerated aging measured in 2005-06 as a mediator of the association between social factors measured in 2000-01 and 1) any incident CVD event; 2) stroke; and 3) all-cause mortality occurring from 2007 through 18. Results: Among 2978 middle-aged participants, mean (SD) accelerated aging was 3.6 (11.6) years, i.e., the CARDIA cohort appeared to be, on average, 3 years older than its chronological age. Accelerated aging partially mediated the association between social factors and CVD (N=219), stroke (N=36), and mortality (N=59). Accelerated aging mediated 41% of the total effects of racial discrimination on stroke after adjustment for covariates. Accelerated aging also mediated other relationships but to lesser degrees. Conclusion: We provide new evidence that accelerated aging based on easily measurable biomarkers may be a viable marker to partially explain how social factors can lead to cardiovascular outcomes and death

Weight Status: A Predictor of the Receipt of and Interest in Health Promotion Information among College Students

Background: Negative health behaviors such as consumption of excess calories, low intake of fruits and vegetables, sedentariness and weight gain are associated with entry into college. Purpose: To determine if weight status is associated with students’ receipt of health promotion (nutrition, physical activity and stress reduction) information, and students’ interest in receiving these types of information from their college or university. Methods: Data from the Spring 2011 ACHA-NCHA II dataset was used to complete secondary data analyses. Students (N=116,254) from 148 postsecondary institutions completed the Spring 2011 ACHA-NCHA II survey. Logistic regression was used to examine the effect of BMI category on receipt of, and interest in receiving, health promotion information. Results: Approximately 32% of respondents were overweight or obese. Students in the obese class III category were the least likely to receive health promotion information and least likely to be interested in receiving the information. Conclusion: Weight status based on BMI classification is a weak predictor of the dissemination of health promotion information. The largest gaps related to the dissemination appear to be among obese students. Future research is needed to determine factors contributing to the observed gaps and strategies should be developed to reach underserved groups

Perceptions and Practices of Key Worker Stakeholder Groups in Hospital Animal- Assisted Intervention Programs on Occupational Benefits and Perceived Risks

Background: Animal-assisted intervention (AAI) programs, used widely for patient benefit, have increasingly been used for healthcare workers (HCW) to reduce occupational stress. However, there are barriers to these programs which limit their utilization, for both patients and HCW, specifically infectious disease concerns. The aim of the research project is to identify barriers and facilitators to AAI program use for healthcare worker benefit, and determine knowledge, beliefs, and practices regarding infectious disease risk and control policies, in order to understand the contextual parameters of program implementation. Methods: We collected perceptions of key stakeholders involved with hospital AAI programs (HCW and AAI workers) through semi-structured in-depth interviews. We used framework analysis to guide thematic coding, completed independently by three researchers. Results: We interviewed 37 participants in this study. We divided our themes into two topic areas: program use for HCW and perceived infectious disease risk. Use for healthcare workers included perspectives on the benefits for HCW and program barriers and facilitators (specifically collaboration and leadership). Perceived risk included opinions on infection concerns with AAI, thoughts on control measures to reduce this risk, and responsibility for safety during these programs. Conclusions: While significant benefits were reported for HCW, they were limited by administrative barriers and hazard concerns. Facilitators to surmount these barriers are best implemented with collaboration across the hospital and appropriate leadership roles to direct safe program implementation. By addressing these barriers through targeted facilitators in the form of evidence-backed guidelines, AAI programs can be used to benefit both patients and HCW

The Association Between Depressive Symptoms and Accumulation of Stress Among Black Men in the Health and Retirement Study

Background and Objectives: Among the multiple factors posited to drive the health inequities that black men experience, the fundamental role of stress in the production of poor health is a key component. Allostatic load (AL) is considered to be a byproduct of stressors related to cumulative disadvantage. Exposure to chronic stress is associated with poorer mental health including depressive symptoms. Few studies have investigated how AL contributes to depressive symptoms among black men. The purpose of the cross-sectional study was to examine the association between AL and depressive symptoms among middle- to old age black men. Research Design and Methods: This project used the 2010 and 2012 wave of the Health and Retirement Study enhanced face-to-face interview that included a biomarker assessment and psychosocial questionnaire. Depressive symptoms, assessed by the endorsement of 3 or more symptoms on the Center for Epidemiological Studies—Depression 8-item scale, was the outcome variable. The main independent variable, AL, score was calculated by summing the number values that were in the high range for that particular biomarker value scores ranging from 0 to 7. black men whose AL score was 3 or greater were considered to be in the high AL group. Modified Poisson regression was used to estimate prevalence ratios (PRs) and corresponding 95% confidence intervals (CIs). Results: There was a larger proportion of black men in the high AL group who reported depressive symptoms (30.0% vs.20.0%) compared with black men in the low AL group. After adjusting for age, education, income, drinking, and smoking status, the prevalence of reporting 3 or more depressive symptoms was statistically significant among black men in the high AL group (PR = 1.61 [95% CI: 1.20–2.17]) than black men in the low AL group. Discussion and Implications: Exposure to chronic stress is related to reporting 3 or more depressive symptoms among black men after controlling for potential confounders. Improving the social and economic conditions for which black men work, play, and pray is key to reducing stress, thereby potentially leading to the reporting of fewer depressive symptoms

Search for chargino-neutralino production with mass splittings near the electroweak scale in three-lepton final states in √s=13 TeV pp collisions with the ATLAS detector

A search for supersymmetry through the pair production of electroweakinos with mass splittings near the electroweak scale and decaying via on-shell W and Z bosons is presented for a three-lepton final state. The analyzed proton-proton collision data taken at a center-of-mass energy of √s=13  TeV were collected between 2015 and 2018 by the ATLAS experiment at the Large Hadron Collider, corresponding to an integrated luminosity of 139  fb−1. A search, emulating the recursive jigsaw reconstruction technique with easily reproducible laboratory-frame variables, is performed. The two excesses observed in the 2015–2016 data recursive jigsaw analysis in the low-mass three-lepton phase space are reproduced. Results with the full data set are in agreement with the Standard Model expectations. They are interpreted to set exclusion limits at the 95% confidence level on simplified models of chargino-neutralino pair production for masses up to 345 GeV

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente

A search for the dimuon decay of the Standard Model Higgs boson with the ATLAS detector

A search for the dimuon decay of the Standard Model (SM) Higgs boson is performed using data corresponding to an integrated luminosity of 139 fb(-1) collected with the ATLAS detector in Run 2 pp collisions at root s = 13 TeV at the Large Hadron Collider. The observed (expected) significance over the background-only hypothesis for a Higgs boson with a mass of 125.09 GeV is 2.0 sigma (1.7 sigma). The observed upper limit on the cross section times branching ratio for pp -> H -> mu mu is 2.2 times the SM prediction at 95% confidence level, while the expected limit on a H -> mu mu signal assuming the absence (presence) of a SM signal is 1.1(2.0). The best-fit value of the signal strength parameter, defined as the ratio of the observed signal yield to the one expected in the SM, is mu = 1.2 +/- 0.6. (C) 2020 The Author(s). Published by Elsevier B.V