Temporal Trends in Childhood Household Income Among Applicants and Matriculants to Medical School and the Likelihood of Acceptance by Income, 2014-2019.
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ABSTRACT:
SUBMITTER: Nguyen M
PROVIDER: S-EPMC10176183 | biostudies-literature | 2023 Jun
REPOSITORIES: biostudies-literature
Publications
Temporal Trends in Childhood Household Income Among Applicants and Matriculants to Medical School and the Likelihood of Acceptance by Income, 2014-2019.
Nguyen Mytien M Desai Mayur M MM Fancher Tonya L TL Chaudhry Sarwat I SI Mason Hyacinth R C HRC Boatright Dowin D
JAMA 20230601 21
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Project description:Obesity prevalence varies by income and education level, although patterns might differ among adults and youths (1-3). Previous analyses of national data showed that the prevalence of childhood obesity by income and education of household head varied across race/Hispanic origin groups (4). CDC analyzed 2011-2014 data from the National Health and Nutrition Examination Survey (NHANES) to obtain estimates of childhood obesity prevalence by household income (?130%, >130% to ?350%, and >350% of the federal poverty level [FPL]) and head of household education level (high school graduate or less, some college, and college graduate). During 2011-2014 the prevalence of obesity among U.S. youths (persons aged 2-19 years) was 17.0%, and was lower in the highest income group (10.9%) than in the other groups (19.9% and 18.9%) and also lower in the highest education group (9.6%) than in the other groups (18.3% and 21.6%). Continued progress is needed to reduce disparities, a goal of Healthy People 2020. The overall Healthy People 2020 target for childhood obesity prevalence is <14.5% (5).
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Project description:ImportanceDisparities in representation between sexes have been shown at multiple career stages in medicine despite increasing representation in the overall physician workforce.ObjectiveTo assess sex representation of applicants to the Canadian R-1 entry match for postgraduate training programs from 1995 to 2019, comparing distribution between different specialties as well as applied vs matched applicants.Design, setting, and participantsThis cross-sectional analysis of aggregate data provided by the Canadian Resident Matching Service between 1995 and 2019 analyzed aggregate data for the Canadian R-1 residency match from 1995 through 2019.ExposuresApplicant sex as reported in the Canadian Resident Matching Service database.Main outcomes and measuresThe sex representation of applicants was compared and the longitudinal trends in sex representation were analyzed by specialty between 1995 and 2019. The sex representation of overall applicants to the Canadian R-1 entry match were compared with matched applicants, and both were stratified by specialty.ResultsA total of 48 424 applicants were identified (26 407 [54.5%] female applicants), of which 41 037 were matched applicants. Using specialty groupings, female applicants were most highly represented in obstetrics and gynecology (1776 of 2090 [85.0%]) and least represented in radiology (658 of 2055 [32.0%]). Within individual subspecialties, female applicants had the lowest representation in neurosurgery (90 of 394 [22.8%]). While female applicants represented an increasing proportion of the overall applicant population between 1995 and 2019 (z = 2.71; P = .007), significant increases were seen in some, but not all, individual specialties. Differences by sex were found among Canadian medical graduate match rates to their top-ranked specialty: female applicants had a lower likelihood of being rejected for family medicine (rejection of male applicants: OR, 0.46; 95% CI, 0.39-0.54; P < .001) and psychiatry (OR, 0.59; 95% CI, 0.46-0.76; P < .001) and were more likely to be rejected for all-encompassing surgery (acceptance of male applicants: OR, 1.19; 95% CI, 1.10-1.28; P < .001).Conclusions and relevanceIncreasing representation of female residency applicants over time was seen in some, but not all, medical specialties in Canada, and sex-based differences in successful match rates were observed in some specialties. The reasons for these disparities require further investigation for corrective strategies to be identified.
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Project description:PurposeTo identify the changes of school burnout for Finnish adolescents in lower (grades 8-9) and upper secondary schools (grades 10-11) during years 2006-2019; and to examine the associations of personal-(gender, family socioeconomic, and immigrant status) and school-related (school level, urban-rural area) sociodemographic demands and resources in school burnout.MethodsWe used nationally representative data on 949,347 students in secondary school in Finland between 2006 and 2019. Generalized Linear Models were used to assess the effects of year, gender, school level, parental education, unemployment, immigrant status, and urban-rural area and the interactions of year, gender, and school level with each of the remaining sociodemographic variables on school burnout.ResultsSchool burnout increased among girls and slightly declined among boys. The increase intensified in girls and the decline in boys stagnated after 2011. The educational level of the parents had a constant protective impact over time, the gradient for boys slightly larger compared to girls. Urban areas contributed to the trend of increasing school burnout among girls but not among boys. Parental unemployment and immigration background were associated with the increasing trend of school burnout over time, although somewhat mitigated by parental education.ConclusionThe results showed the trends in school burnout are often gendered and appeared to worsen aligned with the school budget cuts after 2011. In addition to considering school burnout related to lower parental education and urbanization, it is important to support those students in families experiencing unemployment and/or immigration, especially when concurring with lower parental education.
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Project description:PurposeOne-third of medical school applicants attend a community college (CC), and they represent a diverse group of applicants. However, they have a lower likelihood of being accepted to medical school. Using application-level data, this study examines how an applicant's CC attendance impacts the likelihood of application acceptance and how 3 medical school characteristics moderate this association.MethodData examined were from 2,179,483 applications submitted to at least one of 146 U.S. Liaison Committee on Medical Education-accredited medical schools by 124,862 applicants between 2018 and 2020. The outcome was application acceptance. The main measures were applicants' CC attendance (no, lower [> 0%-19% of college course hours], or higher [≥ 20%]) and 3 medical school characteristics: geographic region, private versus public control, and admissions policy regarding CC coursework. Multilevel logistic regression models estimated the association between CC attendance and the likelihood of application acceptance and how this association was moderated by school characteristics.ResultsAmong applicants, 23.8% (29,704/124,862) had lower CC attendance and 10.3% (12,819/124,862) had higher CC attendance. Regression results showed that, relative to no CC attendance, applications with lower (adjusted odds ratio [AOR] = .96; 95% confidence internal [CI], .94-.97) and higher (AOR = .78; 95% CI, .76-.81) CC attendance had significantly decreased odds of acceptance when the 3 school characteristics were included. Each of the 3 medical school characteristics significantly moderated the association between an applicant's CC attendance and the likelihood of application acceptance.ConclusionsThe negative association between CC attendance and medical school application acceptance varies by medical school characteristics. Professional development for admissions officers focused on understanding the CC pathway and potential biases related to CC attendance would likely be beneficial in terms of trying to attract and select a diverse cohort of medical students in a holistic and equitable manner.
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Project description:Our aim is to describe variations in the incidence rates of glomerular disease diagnosed by renal biopsies performed in Uruguay over the last 25 years in relation to sex, age, clinical presentation and histological diagnosis. We analyzed all renal biopsies performed in Uruguay during the 25 years period and estimated incidence rates per million people per year (pmp/yr) for the population older than 14 years. Mann Kendall's trend analysis was used to assess incidence trends. In order to identify changes in trends, we compared annual incidence rates with the Joinpoint method. From 1990 to 2014, 3390 biopsies of native kidneys corresponding to glomerular disease were performed in patients older than 14 years. The average biopsy rate was 58 per pmp/yr. The glomerular disease incidence rate increased progressively over the period (p<0.05). Trends analysis over five-year periods demonstrated a progressive increase of IgA nephropathy (3.08 pmp/yr 1990-1994 to 12.53 pmp/yr 2010-2014 p<0.05), membranous nephropathy (2.38 pmp/yr 1990-1994 to 8.04 pmp/yr 2010-2014 p< 0.05) and lupus nephritis (4,23 pmp/yr 1990-1994 to 7,81 pmp/yr 2010-2014 p<0.05). There was a change in the trend of focal segmental glomerular sclerosis (FSGS) which increased until 1996 and decreased afterwards. The incidence rates of glomerular disease have doubled globally in the last quarter of a century in Uruguay, mainly related to the increase of IgA nephropathy, membranous nephropathy and lupus nephritis. There was a change in the slope of the incidence rate of FSGS.
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Project description:Air pollution control has become the top priority of China's "green development" concept since 2013. The Chinese government has enacted a range of policies and statutes to control contaminant emissions and improve air quality. On the basis of the national air quality ground observation database, the spatial and temporal distribution of air quality index value (AQI), fine particulate matter (PM2.5), coarse particles (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) were explored in 336 cities throughout China from 2014 to 2019. AQI and most pollutants (except O3) decreased in concentrations from 2014 to 2019. In 2019, all cities except Henan reached the level 2 of the ambient air quality index, and six cities had a lower ambient air quality index and reached the level 1. Spatially, higher pollutant concentrations were concentrated in large city clusters, whereas the areas with high O3 concentration were found across the country. Furthermore, central heating was shown to have a negative impact on air quality. The observed AQI value, PM2.5, PM10, SO2, NO2, and CO concentrations were highest in north and northwest China and Henan province in central China. The correlations among pollutants suggest that the main sources of pollutants are fossil fuel combustion, industrial production, and motor vehicle emissions. The influence of meteorological factors on air quality, long-distance transportation, and the transformations of pollutants should be explored in future research.Supplementary informationThe online version contains supplementary material available at 10.1007/s11869-021-01043-5.
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Project description:PurposeEffective communication is critical in patient care. Multilingual medical providers, including Physician Assistants (PAs) can contribute to improved health care among patients with limited English proficiency; however, this is contingent upon matriculating multilingual providers. In this study, the association between prospective applicants' self-reported English as second language (ESL) status and their likelihood of matriculation into a PA program was investigated.MethodsParticipants included applicants to five admission cycles of the Centralized Application Service for Physician Assistant from 2012 to 2020. Logistic regression was utilized to investigate association between applicant ESL status and odds of program matriculation in both bivariate and multivariable regression models. Models were adjusted for citizenship status, undergraduate grade point average, gender, age, race/ethnicity, number of programs applied to, and patient care hours.ResultsIn unadjusted and adjusted models, ESL status was associated with a significantly lower odds of matriculation to a PA program across all study years. In adjusted multivariable models, associations were strongest for 2014-2015 where ESL status was associated with a 35% lower odds of matriculation (odds ratio 0.65, 95% confidence interval 0.56, 0.76) when controlling for demographics, citizenship status, patient care experience, and academic achievement. In sensitivity analyses restricting to (a) those with TOEFL scores ≥ 100, and (b) restricting to those ESL applicants without TOEFL scores, we did not observe important changes in our results.ConclusionsResults indicated that non-native English-speaking applicants have lower odds of PA program matriculation. Decrements in matriculation odds were large magnitude, minimally impacted by adjustment for confounders and persistent across the years. These findings suggest that PA program admission processes may disadvantage non-native English-speaking applicants. While there are potential explanations for the observed findings, they are cause for concern. Matriculating and training PAs who have language concordance with underserved populations are important means of improving patient outcomes.
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Project description:BackgroundTwitter is becoming an increasingly important avenue for people to seek information about HIV prevention. Tweets about HIV prevention may reflect or influence current norms about the acceptability of different HIV prevention methods. Therefore, it may be useful to empirically investigate trends in the level of attention paid to different HIV prevention topics on Twitter over time.ObjectiveThe primary objective of this study was to investigate temporal trends in the frequency of tweets about different HIV prevention topics on Twitter between 2014 and 2019.MethodsWe used the Twitter application programming interface to obtain English-language tweets employing #HIVPrevention between January 1, 2014, and December 31, 2019 (n=69,197, globally). Using iterative qualitative content analysis on samples of tweets, we developed a keyword list to categorize the tweets into 10 prevention topics (eg, condom use, preexposure prophylaxis [PrEP]) and compared the frequency of tweets mentioning each topic over time. We assessed the overall change in the proportions of #HIVPrevention tweets mentioning each prevention topic in 2019 as compared with 2014 using chi-square and Fisher exact tests. We also conducted descriptive analyses to identify the accounts posting the most original tweets, the accounts retweeted most frequently, the most frequently used word pairings, and the spatial distribution of tweets in the United States compared with the number of state-level HIV cases.ResultsPrEP (13,895 tweets; 20.08% of all included tweets) and HIV testing (7688, 11.11%) were the most frequently mentioned topics, whereas condom use (2941, 4.25%) and postexposure prophylaxis (PEP; 823, 1.19%) were mentioned relatively less frequently. The proportions of tweets mentioning PrEP (327/2251, 14.53%, in 2014, 5067/12,971, 39.1%, in 2019; P≤.001), HIV testing (208/2251, 9.24%, in 2014, 2193/12,971, 16.91% in 2019; P≤.001), and PEP (25/2251, 1.11%, in 2014, 342/12,971, 2.64%, in 2019; P≤.001) were higher in 2019 compared with 2014, whereas the proportions of tweets mentioning abstinence, condom use, circumcision, harm reduction, and gender inequity were lower in 2019 compared with 2014. The top retweeted accounts were mostly UN-affiliated entities; celebrities and HIV advocates were also represented. Geotagged #HIVPrevention tweets in the United States between 2014 and 2019 (n=514) were positively correlated with the number of state-level HIV cases in 2019 (r=0.81, P≤.01).ConclusionsTwitter may be a useful source for identifying HIV prevention trends. During our evaluation period (2014-2019), the most frequently mentioned prevention topics were PrEP and HIV testing in tweets using #HIVPrevention. Strategic responses to these tweets that provide information about where to get tested or how to obtain PrEP may be potential approaches to reduce HIV incidence.
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Project description:BackgroundEvidence suggests that rates of occupational injuries in the US are decreasing. As several different occupational injury surveillance systems are used in the US, more detailed investigation of this trend is merited. Furthermore, studies of this decrease remain descriptive and do not use inferential statistics. The aim of this study was to provide both descriptive and inferential statistics of temporal trends of occupational injuries treated in US emergency departments (EDs) for 2012 to 2019.MethodsMonthly non-fatal occupational injury rates from 2012 to 2019 were estimated using the national electronic injury surveillance system-occupational supplement (NEISS-Work) dataset, a nationally representative sample of ED-treated occupational injuries. Rates were generated for all injuries and by injury event type using monthly full-time worker equivalent (FTE) data from the US Current Population Survey as a denominator. Seasonality indices were used to detect seasonal variation in monthly injury rates. Trend analysis using linear regression adjusted for seasonality was conducted to quantify changes in injury rates from 2012 to 2019.ResultsOccupational injuries occurred at an average rate of 176.2 (95% CI = ± 30.9) per 10,000 FTE during the study period. Rates were highest in 2012 and declined to their lowest level in 2019. All injury event types occurred at their highest rate in summer months (July or August) apart from falls, slips, and trips, which occurred at their highest rate in January. Trend analyses indicated that total injury rates decreased significantly throughout the study period (- 18.5%; 95% CI = ± 14.5%). Significant decreases were also detected for injuries associated with contact with foreign object and equipment (- 26.9%; 95% CI = ± 10.5%), transportation incidents (- 23.2%; 95% CI = ± 14.7%), and falls, slips, and trips (- 18.1%; 95% CI = ± 8.9%).ConclusionsThis study supports evidence that occupational injuries treated in US EDs have decreased since 2012. Potential contributors to this decrease include increased workplace mechanization and automation, as well as changing patterns in US employment and health insurance access.
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Project description: Not available
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