The Role Of Race In The Association Between Weight Status And Risk Behaviors Among United States Adolescents

Objective: To evaluate whether race and ethnicity moderate the association between weight status and risk behaviors in a nationally-representative sample of adolescents. Methods: The 2009 and 2011 Youth Risk Behavior Surveys were combined (N = 25,550), and used to compare substance use, risky sexual behaviors, and violent behaviors between healthy weight, overweight, and obese adolescents. In both overall and race-stratified samples, chi-square tests and logistic regression were used to determine associations between weight status and engagement in risk behaviors among White, Black, and Hispanic adolescents. These analyses were performed separately in males and females. Results: Overweight and obese adolescents had a significantly higher prevalence of early cigarette, alcohol, and marijuana use when compared with their healthy weight peers among both males (p=0.004; p=0.004; p=0.045) and females (p=0.006; p\u3c0.001; p\u3c0.001). The same trend emerged for early initiation of sexual intercourse in males (p=0.016) and females (p\u3c0.001) as well. Overweight and obese adolescents also reported increased participation in violence behaviors with males reporting a higher prevalence of ever carrying a weapon (p\u3c0.001) or gun (p=0.019), and females showing elevated rates of ever carrying a weapon (p\u3c0.001) or being in a physical fight (p\u3c0.001). In race-stratified analyses these patterns were statistically significant largely among White adolescents, with overweight and obese Hispanic females trending towards this finding as well. Conclusion: Overweight and obese adolescents may initiate risk behaviors earlier than their healthy weight peers as well as engage in violent behavior at higher rates. These trends vary by race, and appear most saliently among White youth. This work not only highlights early adolescence as a critical time to prevent health risk behaviors, but also the importance of considering gender, weight status, and race in prevention efforts and future research

Movie Making: The Integration of Art and Business

I am enrolled in two very different master programs: The Creative Pulse and Media Arts. Some questioned the load of working toward both graduate degrees simultaneously. Fortunately the programs married each other well and one aided the other. Skills adopted in both were critical to the project foot printed in this paper. Both degrees had a focus in art but The Creative Pulse combined interpersonal and intrapersonal intelligences with leadership taught in groups that changed the way I processed information. We were challenged to use risk and rigor in all endeavors. This was not a suggestion but mandatory. Intense group work was a requirement in this program and the aforementioned skills could only be integrated by participation. I watched lessons unfold in the group work sometimes mere hours after the dispensation of information. I spent concentrated time actively working as a member of a group and assigned to deep reflection upon what behavior worked and didn’t work to the success of these said groups. In Media Arts I learned filmmaking: writing, production, directing and editing—all critical skills to good story telling. It happened that movie making was a highly collaborative process and a well run movie set required immense group work. How well a group meshed could be the determining factor whether a production was successful or not. On a daily basis I used leadership skills taught in The Creative Pulse and applied them in Media Arts. Although this final creative project was based on ideas developed in Media Arts, bar none, it was the group skills honed in The Creative Pulse that held the project together and the dedication to risk and rigor that kept me personally going. Have you wondered what a producer does or had thoughts of writing your own short film? This paper documents my journey in movie making and my development as a producer (a leader). It documents time in both degrees and storyboards the process of my final project; Movie Making: The Integration of Art and Business

Building Innovation Capacity in a Learning Health System: The Innovation Cohort Experience

Introduction: People with ideas about how to improve products and services often benefit from a structured process to test their ideas. The Innovation Cohort was developed to empower staff at MaineHealth to create solutions to unmet needs. This article describes the progress and perspectives gained over 3 years of the program. Methods: The Innovation Cohort was loosely modeled on the National Science Foundation’s iCorp that emphasizes customer discovery and hypothesis testing early during development. Innovation Cohort applicants proposed a specific problem and answered 5 basic questions related to solving that problem. Selected participants shared readings and attended 5 in-person meetings focused on customer discovery, developing prototypes, and testing hypotheses at each step of development. In 5 cycles over 30 months, 62 people applied, and 24 projects were incubated. Results: The projects independently attracted $130,000 in investments to advance the work. Projects were developed into commercial products for sale, published, and continue to iterate in a local accelerator. Connections formed among people and institutions that have not routinely collaborated on projects of this type. Discussion: The Innovation Cohort model is useful for cultivating people and ideas that may impact care, education, and research across a health care system. The most significant challenge to scaling this type of work is not funding, but rather to retain the high intellectual friction and low social friction required to cultivate ideas. Conclusions: With a structured but approachable process, a small team that values ideas and progress over hierarchy, and a little capital that can be deployed quickly, ideas can interact and progress in a learning health system

CareSearch Online palliative care information for GPs

General practitioners occupy a unique place in caring for patients with terminal illnesses who wish to continue living in the community. Supporting and encouraging GPs to offer or continue providing palliative care is not only important for individual patients and their families but for the health system and the whole community. The GP pages in the CareSearch website are designed to provide immediate access to relevant content and palliative care resources to assist GPs in this role.CareSearch has been funded by the Department of Health and Ageing as part of the National Palliative Care Program

Mucus function and crossflow filtration in a fish with gill rakers removed versus intact

Filtration mechanisms are known for only two species of suspension-feeding tilapia, each of which relies on a different method of particle retention. We used high-speed video endoscopy to assess whether a third species of tilapia, Oreochromis aureus, with gill rakers intact as well as surgically removed, uses mucus in the oropharyngeal cavity for hydrosol filtration or uses crossflow filtration to retain particles during suspension feeding. Although a large amount of mucus was visible during feeding with rakers intact, particles were rarely retained in the mucus. The hypothesis that the presence of mucus results in particle entrapment by hydrosol filtration is rejected for O. aureus. Rather than functioning as a sticky filter, mucus is proposed to function in this species to regulate the loss of water between the rakers and between the anterior branchial arches, increasing crossflow speed and thereby increasing the inertial lift force that transports particles radially away from the arches. Gill raker removal resulted in an almost complete lack of observable mucus in the oropharyngeal cavity, probably due to the removal of mucus-secreting cells attached to the gill rakers. However, endoscopic videotapes showed that crossflow filtration continued to operate in the absence of gill rakers and mucus, indicating that the surfaces of the branchial arches play an important role in crossflow filtration

Particle retention in suspension-feeding fish after removal of filtration structures

The suspension-feeding cichlids Oreochromis aureus (blue tilapia) and Oreochromis esculentus (ngege tilapia) are able to selectively retain small food particles. The gill rakers and microbranchiospines of these species have been assumed to function as filters. However, surgical removal of these oral structures, which also removed associated mucus, did not significantly affect the total number of 11–200 μm particles ingested by the fish. This result supports the hypothesis that the branchial arch surfaces themselves play an important role in crossflow filtration. Both species selectively retained microspheres greater than 50 μm with gill rakers and microbranchiospines intact as well as removed, demonstrating that neither these structures nor mucus are necessary for size selectivity to occur during biological crossflow filtration. After removal of the gill rakers and microbranchiospines, O. esculentusretained significantly more microspheres 51–70 μm in diameter and fewer 91–130 μm microspheres compared to retention with intact structures, but the particle size selectivity of O. aureus was not affected significantly. These results support conclusions from previous computational fluid dynamics simulations indicating that particle size can have marked effects on particle trajectory and retention inside the fish oropharyngeal cavity during crossflow filtration. The substantial inter-individual variability in particle retention by suspension-feeding fish is an unexplored area of research with the potential to increase our understanding of the factors influencing particle retention during biological filtration

Intra-oral flow patterns and speeds in a suspension-feeding fish with gill rakers removed versus intact

Oreochromis aureus, a species of tilapia, is a suspension-feeding fish that employs a pumping action to bring water into its mouth for filtering.To address questions about water flow inside the mouth, we used a microthermistor flow probe to determine the speed of intra-oral flow during suspension feeding in this species before and after surgical removal of gill rakers. Synchronization with high-speed external videotapes of the fish and high-speed video endoscopy inside the oropharyngeal cavity allowed the first correlation of oral actions with intra-oral flow patterns and speeds during feeding. This analysis established the occurrence of a brief reversal of flow (≈80-ms duration) from posterior to anterior in the oropharyngeal cavity prior to every feeding pump (250–500-ms duration). In industrial crossflow filtration, oscillating or pulsatile flow increases filtration performance by enhancing the back-migration of particles from the region near the filter surface to the bulk flow region, thus reducing particle accumulation that can clog the filter. In endoscopic videotapes, these pre-pump reversals, as well as post-pump reversals (≈500-ms duration), were observed to lift mucus and particles from the branchial arches for subsequent transport toward the esophagus. Intra-oral flow speeds were reduced markedly after removal of the gill rakers. We hypothesize that the decrease in crossflow speed during feeding pumps following the removal of gill rakers and mucus could be due to increased loss of water between the anterior branchial arches

Faster Increases in Human Life Expectancy Could Lead to Slower Population Aging

Counterintuitively, faster increases in human life expectancy could lead to slower population aging. The conventional view that faster increases in human life expectancy would lead to faster population aging is based on the assumption that people become old at a fixed chronological age. A preferable alternative is to base measures of aging on people's time left to death, because this is more closely related to the characteristics that are associated with old age. Using this alternative interpretation, we show that faster increases in life expectancy would lead to slower population aging. Among other things, this finding affects the assessment of the speed at which countries will age

Measuring the Speed of Aging across Population Subgroups

People in different subgroups age at different rates. Surveys containing biomarkers can be used to assess these subgroup differences. We illustrate this using hand-grip strength to produce an easily interpretable, physical-based measure that allows us to compare characteristic-based ages across educational subgroups in the United States. Hand-grip strength has been shown to be a good predictor of future mortality and morbidity, and therefore a useful indicator of population aging. Data from the Health and Retirement Survey (HRS) were used. Two education subgroups were distinguished, those with less than a high school diploma and those with more education. Regressions on hand-grip strength were run for each sex and race using age and education, their interactions and other covariates as independent variables. Ages of identical mean hand-grip strength across education groups were compared for people in the age range 60 to 80. The hand-grip strength of 65 year old white males with less education was the equivalent to that of 69.6 (68.2, 70.9) year old white men with more education, indicating that the more educated men had aged more slowly. This is a constant characteristic age, as defined in the Sanderson and Scherbov article "The characteristics approach to the measurement of population aging" published 2013 in Population and Development Review. Sixty-five year old white females with less education had the same average hand-grip strength as 69.4 (68.2, 70.7) year old white women with more education. African-American women at ages 60 and 65 with more education also aged more slowly than their less educated counterparts. African American men with more education aged at about the same rate as those with less education. This paper expands the toolkit of those interested in population aging by showing how survey data can be used to measure the differential extent of aging across subpopulations

How Following Regulatory Guidance Can Increase Auditors’ Litigation Risk Exposure

This study investigates how following explicit regulatory guidance can result, unintentionally, in increased litigation risk exposure for auditors. We do so by examining the unique and specific context where the PCAOB directly instructs auditors how to apply professional judgment - to rely on a client’s competent and objective internal audit function (IAF) during multi-location audits. Consistent with theoretical predictions based on numerosity heuristic processing and norm theory, we find that holding all other factors constant, following explicit regulatory advice not only fails to limit auditors’ litigation risk but can actually increase jurors’ assessments of auditor negligence. Because the numerosity heuristic leads jurors to believe that there is a higher likelihood of misstatement on multi-location compared to single location audits, jurors perceive that auditor reliance on the IAF during multi-location audits is not normal. Accordingly, they judge auditors to be more negligent when they rely on the IAF in multi-location audits than when they do not, but IAF reliance does not impact negligence assessments on single location audits. Our results suggest auditor reluctance to use a qualified IAF, despite client and regulatory pressure, can be a rational and defensible strategy to limit their litigation risk exposure