164 Hispanic Ethnicity and Socioeconomic Status are Independently Associated with Improved Prognosis in Glioblastoma Patients

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 241-241
Author(s):  
Kevin J Moore ◽  
Angela Richardson ◽  
Tulay Koru-Sengul ◽  
Michael E Ivan

Abstract INTRODUCTION Significant racial and social disparities have previously been identified in outcomes from glioblastoma. Although some epidemiologic studies have shown Hispanic ethnicity to be protective, other studies have not replicated this finding. As many studies do not consider race separately from ethnicity, the role of Hispanic ethnicity in glioblastoma survival is not well understood. Florida has one of the largest Hispanic populations in the United States. Using a population-based cancer database, this study examines sociodemographic and survival disparities in glioblastoma patients. METHODS Data from the Florida Cancer Data System (FCDS) and the US Census were linked for adult (>18 yrs) glioblastoma patients to determine disease burden and survival. A multivariable Cox regression model was used to model patient survival adjusting for sociodemographic, tumor, and clinical characteristics. Adjusted hazard ratios (aHR) and 95% confidence intervals (95% CI) were calculated for overall sample. All statistical analyses were completed with SAS v.9.4. RESULTS >In total, 16,180 Florida adults were diagnosed with glioblastoma between 1981 and 2013. The majority were male (56.0%) and white (93.0%), and 11.2% of glioblastoma patients identified as Hispanic with 2.4% self-identifying as Cuban. Hispanics had significantly better survival compared to non-Hispanics (aHR 0.84; 95% CI 0.78 0.90). Current smokers fared significantly worse (aHR 1.11; 95% CI 1.04 1.18). Higher socioeconomic status was also associated with increased survival (aHR 0.91, 95% CI 0.84 0.99). Younger age at diagnosis, surgical resection, chemotherapy, radiation therapy, and female sex were also associated with significantly improved outcomes. CONCLUSION This study demonstrates clear sociodemographic and survival disparities for glioblastoma patients. This analysis considers race and ethnicity as two distinct variables and shows improved survival outcomes for Hispanic patients. Additionally patients from neighborhoods with higher socioeconomic status have increased survival. Further analysis is needed to assess the role of histologic and molecular subtypes in these ethnic groups.

Author(s):  
Tsung Yu ◽  
Yueh-Ju Lien ◽  
Fu-Wen Liang ◽  
Pao-Lin Kuo

Abstract Studies from the United States have shown increasing incidence of autism spectrum disorder (ASD) with increasing socioeconomic status (SES), whereas in Scandinavian countries, no such relation was identified. We investigated how ASD risk in offspring varied according to parental SES in Taiwan, where we have universal healthcare. Through linking birth reporting data and data from Taiwan’s National Health Insurance program, we studied 706,111 singleton births from 2004 to 2007 and followed them until 2015. Parental SES was determined by monthly salary at the time of childbirth, and child neuropsychiatric outcomes were defined using International Classification of Diseases codes. We identified 7,323 ASD cases and 7,438 intellectual disability (ID) cases; 17% of ASD cases had co-occurring ID. In multivariable Cox regression analysis, higher SES was independently associated with higher risk of ASD after we took into account urbanization levels, child sex, parental age and other covariates. By contrast, higher SES was independently associated with lower risk of ID. Besides the SES disparity in ASD case ascertainment and in the access to healthcare, findings from Taiwan suggest that other social, environmental, biological and immunological factors linked with parental SES levels may contribute to the positive relation of SES and ASD risk.


2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Olga V. Sorokina

Abstract While the large disparities in educational attainment by socioeconomic status in the United States point towards the importance of credit constraints, there is no consensus in the economic literature regarding their pervasiveness. To evaluate how subjective information can enhance our understanding of the role of credit constraints in education, I focus on NLSY79 respondents' assessments of financial obstacles to schooling. About 12 percent of young adults in the data expect to underinvest in education because of financial reasons or the need to work. Using this information in a regression model of educational attainment shows that it provides valuable behavioral insights, above and beyond standard measures of income and family background.


2021 ◽  
pp. 088506662110537
Author(s):  
Po-Yang Tsou ◽  
Chia-Hung Yo ◽  
Yenh-Chen Hsein ◽  
Gregory Yungtum ◽  
Wan-Ting Hsu ◽  
...  

Background Epidemiologic studies are needed for monitoring population-level trends in sepsis. This study examines sepsis-causing microorganisms from 2006 to 2014 in the United States using data from the Nationwide Inpatient Sample database. Methods 7 860 686 adults hospitalized with sepsis were identified using a validated ICD-9 coding approach. Associated microorganisms were identified by ICD-9 code and classified by major groups (Gram-positive, Gram-negative, fungi, anaerobes) and specific species for analysis of their incidence and mortality. Results The rate of sepsis incidence has increased for all four major categories of pathogens, while the mortality rate decreased. In 2014, Gram-negative pathogens had a higher incidence than Gram-positives. Anaerobes increased the fastest with an average annual increase of 20.17% (p < 0.001). Fungi had the highest mortality (19.28%) and the slowest annual decrease of mortality (−2.31%, p = 0.006) in 2013, while anaerobic sepsis had the highest hazard of mortality (adjusted HR 1.60, 95% CI 1.53-1.66). Conclusions Gram-negative pathogens have replaced Gram-positives as the leading cause of sepsis in the United States in 2014 during the study period (2006-2014). The incidence of anaerobic sepsis has an annual increase of 20%, while the mortality of fungal sepsis has not decreased at the same rate as other microorganisms. These findings should inform the diagnosis and management of septic patients, as well as the implementation of public health programs.


2019 ◽  
pp. 088626051986165
Author(s):  
Cara L. Frankenfeld ◽  
Timothy F. Leslie

Cross-racial violence is a high-profile issue in the United States; however, there is little empirical research on the epidemiology of cross-racial homicides. The objective of this work was to use national-level data to evaluate the characteristics of homicides in which the victim and suspect are of the same or different race or Hispanic ethnicity. Victims and suspects from National Violent Death Reporting System data (2005-2015) were classified into seven-categories on the basis of race/ethnicity (six non-Hispanic races or Hispanic ethnicity), and 51,454 homicide events were classified as concordant (same race or ethnicity), discordant (different race or ethnicity), or unknown (missing race or ethnicity or no suspect information). While discordancy was observed to be similar across all race and ethnicity groups, it was less likely with relatives, romantic partners, and relatives of romantic partners; less likely to occur at home; less likely to occur in intimate partner violence–related homicides; less likely when the homicide was preceded by an argument over money or property; less likely when the homicide was associated with a family problem; more likely among rival gangs and strangers than other known person relationships; and more likely with drug-involved homicides. There were differences for victims of non-Hispanic Black race. Notably, discordance was more likely for justifiable self-defense and more likely with victim having used a weapon. These results suggest that discordant homicides may follow patterns of peer groups and close relationships in society regardless of victim race/ethnicity, that is, individuals may form closer relationships with individuals of the same race/ethnicity.


2009 ◽  
Vol 27 (1) ◽  
pp. 365-391 ◽  
Author(s):  
Ellen J. Hahn ◽  
Kristin B. Ashford ◽  
Chizimuzo T. C. Okoli ◽  
Mary Kay Rayens ◽  
S. Lee Ridner ◽  
...  

Secondhand smoke (SHS) is the third leading cause of preventable death in the United States and a major source of indoor air pollution, accounting for an estimated 53,000 deaths per year among nonsmokers. Secondhand smoke exposure varies by gender, race/ethnicity, and socioeconomic status. The most effective public health intervention to reduce SHS exposure is to implement and enforce smoke-free workplace policies that protect entire populations including all workers regardless of occupation, race/ethnicity, gender, age, and socioeconomic status. This chapter summarizes community and population-based nursing research to reduce SHS exposure. Most of the nursing research in this area has been policy outcome studies, documenting improvement in indoor air quality, worker’s health, public opinion, and reduction in Emergency Department visits for asthma, acute myocardial infarction among women, and adult smoking prevalence. These findings suggest a differential health effect by strength of law. Further, smoke-free laws do not harm business or employee turnover, nor are revenues from charitable gaming affected. Additionally, smoke-free laws may eventually have a positive effect on cessation among adults. There is emerging nursing science exploring the link between SHS exposure to nicotine and tobacco dependence, suggesting one reason that SHS reduction is a quit smoking strategy. Other nursing research studies address community readiness for smoke-free policy, and examine factors that build capacity for smoke-free policy. Emerging trends in the field include tobacco free health care and college campuses. A growing body of nursing research provides an excellent opportunity to conduct and participate in community and population-based research to reduce SHS exposure for both vulnerable populations and society at large.


2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Manoocher Soleimani ◽  
Pooneh Alborzi

Metabolic syndrome, as manifested by visceral obesity, hypertension, insulin resistance, and dyslipidemia, is reaching epidemic proportions in the Western World, specifically the United States. Epidemiologic studies suggest that the increased prevalence of metabolic syndrome directly correlates with an increase in the consumption of fructose, mainly in the form of high-fructose corn syrup. This inexpensive alternative to traditional sugar has been increasingly utilized by the food industry as a sweetener since the 1960s. While augmented caloric intake and sedentary lifestyles play important roles in the increasing prevalence of obesity, the pathogenesis of hypertension in metabolic syndrome remains controversial. One intriguing observation points to the role of salt in fructose-induced hypertension. Recent studies in rodents demonstrate that increased dietary fructose intake stimulates salt absorption in the small intestine and kidney tubules, resulting in a state of salt overload, thus setting in motion a cascade of events that will lead to hypertension. These studies point to a novel interaction between the fructose-absorbing transporter, Glut5, and the salt transporters, NHE3 and PAT1, in the intestine and kidney proximal tubule. This paper will focus on synergistic roles of fructose and salt in the pathogenesis of hypertension resulting from salt overload.


Sign in / Sign up

Export Citation Format

Share Document