National Representative Sample Research Articles

Gender and business creation: similarities and differences

PurposeThis paper explores the scope and impact of gender in the process of starting new businesses, with a particular focus on understanding how participation, motivations and outcomes differ between men and women entrepreneurs.Design/methodology/approachThis paper utilizes data from the Global Entrepreneurship Monitor (GEM) and the Panel Studies of Entrepreneurial Dynamics (PSED). The GEM data provide a global overview, drawing from representative national samples across over 100 countries to assess the extent of business creation activity and gender participation globally. The longitudinal PSED data set provides information on the business creation process and outcomes.FindingsOver the last 20 years, the presence of women in the early stages of starting a business in the United States of America has seen a notable increase, doubling their representation among entrepreneurs and nearing parity with men, who also saw growth but at a slower rate. This shift marks a significant move towards greater gender balance in the entrepreneurial landscape.Originality/valueThe originality of this paper lies in its comprehensive analysis of the evolving landscape of gender dynamics within entrepreneurship over two decades, particularly highlighting the significant increase in women's participation in business creation.

Ethnic bias, economic achievement and trust between large ethnic groups: A study in Germany and the U.S

Evidence for ingroup bias is extensive, yet the distinct patterns of discrimination among dominant ethnic groups in the diverse societies of modern industrial nations such as the United States and Germany remain largely unexplored. Incentivized trust games in nationally-representative samples from both countries reveal biases of roughly equal size by non-Hispanic White Americans, Hispanic Americans, and African Americans against each outgroup. In Germany, the majority demonstrates twice as much bias against Turkish minorities compared to Eastern Europeans. Interestingly, both minority groups send similar amounts to ethnic Germans and members of their own groups. We examine the notion that outgroup discrimination by majority group members stems from stereotypes of minorities as economically unsuccessful, employing trust games with high-income counterparts. We find that majority senders’ bias against minority receivers declines when receivers are known to have high incomes, in line with that idea. Interestingly, some minority groups, especially Turkish descendants, display a negative propensity to transfer to rich members of their ingroup in comparison with outgroup members, relative to baseline. While we focus on differences in sending by ethnic pairing, we note that all participants send less to second movers identified as high income, and discuss possible explanations. We estimate that four-fifths of the observed ingroup bias is taste-based rather than due to expected trustworthiness differences. This estimation is robust to identifying the purely altruistic component of trust game sending toward each ethnic group, including one's own.

Mediating and moderating factors between economic pressure and turnover intention among school teachers in Lebanon during the ongoing crisis era

BackgroundThe Lebanese ongoing crisis has exposed big challenges for the education system, including low teachers’ salaries and their desire to leave their jobs. Identifying key contributing factors to teacher turnover intention may help policymakers develop and implement appropriate and informed retention strategies aiming at preserving the struggling Lebanese educational system and saving costs. The present study aimed to examine the mediating role of three potential factors, i.e. job satisfaction, work-related fatigue, and psychological distress, and the moderating role of employment sector, in the relationship between economic pressure and turnover intention among teachers who work in Lebanon during the economic crisis. MethodsWe carried-out a cross-sectional, web-based study targeting a nationally-representative sample of Lebanese teachers (N = 3779, mean age = 38.33 years, 86.7 % females). ResultsThe results of mediation analyses showed that physical/emotional/mental work fatigue, psychological distress and job satisfaction mediated the relationship between perceived economic pressure and turnover intentions among Lebanese teachers. Economic pressure was significantly associated with higher work fatigue, more distress, less job satisfaction and more turnover intentions. Also, more work fatigue, higher distress levels and less job satisfaction were significantly associated with higher turnover intentions. Finally, more economic pressure was significantly associated with more turnover intentions. On the other hand, the moderating effect of teachers’ sector of employment (Private versus Public) was not significant. ConclusionThis is among the first studies to link economic pressure, job satisfaction, work fatigue, psychological distress and turnover intentions in the teachers' psychology literature. This is also the first study on this topic in Lebanon, a country that offers a unique context and opportunity to understand the link between teachers' economic pressure and turnover intentions. The results expand on past research by showing that work-related fatigue, job satisfaction and psychological distress are three factors that underline the cross-sectional relationship between economic pressure and teachers’ turnover intention. This implies that further attention of policy makers and school officials should be paid to enhance job satisfaction, decrease work fatigue and prevent psychological distress in order to retain and attract teachers at schools in Lebanon.

Vényköteles (Rx), vény nélkül kapható (OTC) gyógyszerek és étrend-kiegészítők vásárlási mintázata magyar fogyasztók körében

Over-the-Counter (OTC) medicines and food supplements plays an important role in healthcare. It is generally accepted that, when used properly, OTC medicines save consumers time and money. In this paper we looked into the purchasing behavior of the Hungarian population regarding OTC drugs and food supplements, highlighting the significance of self-medication. Using a quantitative online survey in March 2022 with a national representative sample, the research aimed to measure the out-of-pocket health expenditures, focusing on OTC drugs and food supplements. The analysis showed that the population spends more money on OTC drugs and food supplements than the co-payment of prescription (Rx) drugs, and the combined expenditures on OTC drugs and food supplements significantly contribute to the household's total healthcare costs, representing 45% of this budget. Three hypotheses were formulated to investigate the relationships between the spending on Rx medications, OTC drugs, food supplements, and various demographic factors. The analysis showed significant correlations, indicating that as expenditures on Rx medications increase, so do the purchases of OTC drugs and food supplements. Demographic analysis indicated that the younger demographic age group (18-35 years) tends to spend the least on both Rx, OTC drugs and food supplements, while the 36-50 age group exhibits the highest expenditure on food supplements. However, no significant difference in OTC drug purchases was found among those older than 36 years. The study raises further questions regarding the purchasing behavior of chronic patients, the differentiation between OTC drugs and food supplements by consumers, the influence of minors in the household on purchasing decisions, and whether the primary target demographic for these products should be expanded beyond the 35-50 aged women as it is defined nowadays.JEL Codes: I11, I12, M31

Sleep insufficiency and bedtime irregularity in children with ADHD: A population-based analysis

BackgroundSleep is impaired in children with attention-deficit/hyperactivity disorder (ADHD). However, population-based examination of indicators of sleep insufficiency and bedtime irregularity is limited. This investigation examined associations between ADHD, weeknight sleep insufficiency, and bedtime irregularity in a nationally-representative child sample, and indicators of these sleep outcomes in ADHD. MethodsParents of children aged 3–17 years with ADHD (n = 7671) were surveyed through the 2020–2021 National Survey of Children's Health. Inverse probability of treatment weighting generated a weighted matched control sample (n = 51,572). Weighted generalized linear models were performed without and with age-stratification to examine associations between ADHD and sleep, adjusting for sociodemographics in the full sample, and between nineteen sociodemographic and clinical variables and sleep in ADHD. ResultsHaving ADHD was associated with increased odds of sleep insufficiency and bedtime irregularity relative to controls, even after adjusting for sociodemographic variables. In ADHD, older age was associated with lower sleep insufficiency and greater bedtime irregularity. Black race, increased poverty, higher ADHD severity, depression, and increased screen time were associated with greater sleep insufficiency and bedtime irregularity. Adverse childhood experiences (ACEs) were associated with greater sleep insufficiency. Behavioral/conduct problems, female sex, and absence of both ADHD medication use and ASD diagnosis were associated with poorer bedtime irregularity. Age-stratified results are reported in text. ConclusionsChildren with ADHD face heightened risk for insufficient sleep and irregular bedtimes. Findings suggest intervention targets (e.g., Black race, poverty, depression, screen time) to improve both sleep insufficiency and bedtime irregularity. Results highlight ACEs and behavioral/conduct problems as targets to improve sleep insufficiency and bedtime regularity, respectively. Age-stratified findings are discussed.

Forecasting the 20-Year Incidence of Dementia by Socioeconomic Status, Race/Ethnicity, and Region Based on Mid-Life Risk Factors in a U.S. Nationally Representative Sample.

Alzheimer's disease and related dementias (ADRD) incidence varies based on demographics, but mid-life risk factor contribution to this variability requires more research. The purpose of this study is to forecast the 20-year incidence of dementia in the U.S. overall and stratified by race/ethnicity, socioeconomic status (SES), and U.S. geographic region given prior mid-life risk factor prevalence and to examine the extent to which risk factor differences 20 years ago may explain current SES, race/ethnicity, or regional disparities in dementia incidence. We applied the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) prediction model to the 2006 wave of the Health and Retirement Study (HRS) in participants aged 45 to 64 to estimate the 20-year risk of incident ADRD. The 20-year risk of dementia among middle-aged Americans was 3.3% (95% CI: 3.2%, 3.4%). Dementia incidence was forecast to be 1.51 (95% CI: 1.32, 1.71) and 1.27 (95% CI: 1.14, 1.44) times that in Hispanic and Non-Hispanic Black individuals respectively compared statistically to Non-Hispanic White individuals given mid-life risk factors. There was a progressive increase in dementia risk from the lowest versus highest SES quintile. For geographic region, dementia incidence was forecast to be 1.17 (95% CI: 1.06, 1.30) and 1.27 (95% CI: 1.14, 1.43) times that in Midwestern and Southern individuals respectively compared statistically to Western individuals. Some disparities in dementia incidence could be explained by differences in mid-life risk factors and may point toward policy interventions designed to lessen the ADRD disease burden through early prevention.

The impact of exposure to FDA e-cigarette authorization messages on product perceptions and interest - an experiment with adults who smoke and youth.

In the United States, e-cigarettes have entered a new regulatory era, needing authorizations from FDA to remain on or enter the marketplace. This study explored the impact of e-cigarette authorization messages on product perceptions and interest. We conducted an online experiment in June 2022 with nationally-representative samples of adults (21+) who smoke cigarettes (n=866) and youth ages 15-20 (n=859). They were randomized to one of five conditions: viewing an ad for a fictional e-cigarette brand with no reference to FDA (control), an ad with an "authorized for sale by FDA" claim in varying presentation styles (plain text, FDA "approved" stamp, FDA logo), or reading a fictional news excerpt about the product's authorization plus control ad. We compared group differences on product interest, susceptibility, harm perceptions and message perceptions. Among adults who smoke, there were no effects on product interest nor susceptibility, but ratings of the product's harmfulness compared to cigarettes were lower among those in the news versus control condition (β=-0.25, p=.04). Among youth, odds of susceptibility were higher among ever e-cigarette users who viewed the ad with the FDA logo authorization message relative to the control ad (OR=6.3, 95% CI:1.67-23.9, p<0.01). About 40% of all participants agreed the authorization claim makes them think the product is safe to use, but fewer (14-19%) agreed it makes them more interested in trying it. FDA e-cigarette authorization messages may impact some beliefs about product harm. More research is needed to track potential impacts on product use. This study provides new data about the potential impact of messages about FDA authorization of e-cigarette products (presented as ad claims or a news story) on authorized product perceptions, interest and susceptibility among adults who smoke cigarettes and youth. Our results suggest that FDA e-cigarette authorization messages may impact harm-related beliefs among adults who smoke and product susceptibility among youth who have ever used e-cigarettes before, though real-world effects are likely to be impacted by message type and format, and perceived message source and credibility. Authorization messages are likely to be misinterpreted as "FDA approval" by some; therefore, providing clarifications about authorization meaning and standards are relevant where possible.

New Zealand's planted forests–Carbon stocks and yield in fast growing exotic tree plantations of the Southern Hemisphere

Every year New Zealand measures 1/5th of the permanent sample plots of the National Planted Forest Inventory administered by the Ministry for the Environment (MFE). This means that all plots are measured once during a five-year cycle to provide the full inventory, while each measurement year in its own right provides a random nationally-representative sample of New Zealand's plantation forests.Land-use change and planted forest area are highly dynamic in New Zealand compared to forests in many northern hemisphere countries and every year new plots are added to the inventory due to new afforestation areas. Over time, old plot data representing stands that have been recently harvested will be replaced with measurements of the new forests growing on these sites or will drop out altogether due to improvements in mapping or deforestation. This means that estimates from a single year's plot measurements can give different results from the previous year due to the changes that the plantation forest estate experiences from year to year.In this paper we analyse results for the latest measurement cycle (Panels 2016 - 2020) and identify any issues or trends in carbon stocks. We use all panel data plus data from previous periodic forest inventories to generate a fully representative yield table for all plantation forests in the sub-categories of Kyoto Protocol-compliant afforestation and other planted forests (“non-Kyoto”). Furthermore, we use an imputation approach to provide a statistically accurate representation of stock changes over time. The yield tables generated are used in MFE's Land Use Carbon Analysis System (LUCAS) to generate estimates of carbon stocks and stock changes for international reporting.The estimated mean carbon sequestration rate over the typical rotation for New Zealand's dominant plantation species is higher than the default range provided by the IPCC (Intergovernmental Panel on Climate Change). Predicted carbon sequestration in non-Kyoto planted forests (10.5 tC ha−1 yr−1) exceeds the estimated carbon sequestration in Kyoto-compliant planted forests (9.8 tC ha−1 yr−1) with both at the upper range of estimates for temperate plantation forests (IPCC). Current mean carbon stocks are significantly larger in Kyoto-compliant plantation forests (169 tC ha−1) than in non-Kyoto planted forests (108 tC ha−1) across New Zealand, largely because they are on average five years older. Estimated Mean annual increment, m3 ha−1 yr−1 expressed as a comparable index (“300Index”) indicates that Kyoto-compliant forest land has slightly higher productivity than non-Kyoto planted forests, but because the latter are composed of younger stands, greater carbon sequestration rates but lower current stocks are estimated. Plots with slower growing tree species such as Douglas-fir, cypresses and coastal redwood are now an increasing part of the Kyoto-compliant estate, reducing the overall sequestration rates for this forest type.

Regular source of primary care and health services utilisation among Brazilian elderly with mental-physical multimorbidity

BackgroundIn ageing populations, multimorbidity is a complex challenge to health systems, especially when the individuals have both mental and physical morbidities. Although a regular source of primary care (RSPC) is associated with better health outcomes, its relation with health service utilisation in elderly patients with mental-physical multimorbidity (MP-MM) is scarce.ObjectiveThis study explored the relations among health service utilisation, presence of RSPC and MP-MM among elderly Brazilians.MethodsA national cross-sectional study performed with data from national representative samples from the Brazilian National Health Research (PNS, in Portuguese; Pesquisa Nacional de Saúde) carried out in 2013 with 11,177 elderly Brazilian people. MP-MM was defined as the presence of two or more morbidities, including at least one mental morbidity, and was evaluated using a list of 16 physical and mental morbidities. The RSPC was analysed by the presence of regular font of care in primary care and health service utilisation according to the demand for health services ≤ 15 days, medical consultation ≤ 12 months, and hospitalisation ≤ 1 year. Frequency description of variables and bivariate association were performed using Stata v.15.2 software.ResultsThe majority of individuals was female (56.4%), and their mean age was 69.8 years. The observed prevalence of MP-MM was 12.2%. Individuals with MP-MM had higher utilisation of health services when compared to those without MP-MM. RSPC was present at 36.5% and was higher in women (37.8% vs. 34.9%). There was a lower occurrence of hospitalisation ≤ 1 year among MP-MM individuals with RSPC and without a private plan of health.ConclusionOur findings demonstrate that RSPC can be an important component of care in elderly individuals with MP-MM because it was associated with lower occurrence of hospitalisation, mainly in those that have not a private plan of health. Longitudinal studies are necessary to confirm these findings.

Projected volume of primary total joint arthroplasty in the USA from 2019 to 2060.

The global incidence of total joint arthroplasty (TJA) has consistently risen over time, and while various forecasts differ in magnitude, future projections suggest a continued increase in these procedures. Differences in future United States projections may arise from the modeling method selected, the nature of the national arthroplasty registry employed, or the representativeness of the specific hospital discharge records utilized. In addition, many models have not accounted for ambulatory surgery as well as all payer types. Therefore, to attempt to make a more accurate model, we utilized a national representative sample that included outpatient arthroplasties and all insurance types to predict the volumes of primary TJA in the USA from 2019 to 2060. A national, all-payer database was queried. All patients who underwent primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) from January 1, 2010, to December 31, 2019, were identified using international classification of disease Ninth Revision (9) and Tenth Revision (10) codes and current procedure terminology codes. Absolute frequencies and incidence rates were calculated per 100,000 for both THA and TKA procedures, with 95% confidence intervals. Mean growth in absolute frequency and incidence rates were calculated for each procedure from 2010 to 2014, and 2010 to 2019, with 95% confidence intervals (CI). The overall increase in THA and TKA procedures are expected to grow + 10 and + 36%, respectively, using linear regressions and + 9 and + 37%, respectively. The most positive mean growth in procedure frequency occurred from 2010 to 2014 for THA (+ 24, 95% Confidence Interval (CI): + 21, + 27) and 2010-2019 for TKA (+ 11%, 95% CI: + 9, + 14). There positive trend patterns in incidence rate growth for both procedures, with similar 2010-2019 incidence rates + 6%) for THA (+ 3%, 95% CI: + 0, + 6%) and TKA (+ 3%, 95% CI: + 1%, + 6%). Utilizing a nationally representative database, we demonstrated that TJA procedures would continue with an increased growth pattern to 2060, though slightly decreased from the surge from 2014 to 2019. While this finding applies to the representativeness of the population at hand, the inclusion of outpatient arthroplasty and all payer types validates an approach that has not been undertaken in previous projection studies.

Drinking contexts, coping motive, simultaneous cannabis use, and high-intensity drinking among adults in the United States

Abstract Aims High-intensity drinking (HID), extreme drinking considerably above the level of heavy episodic drinking (HED), is associated with long-term health and social consequences. There is limited understanding of HID beyond young adulthood. This study aims to identify concurrent risk factors for HID, comparing age differences among all adults. Methods Multinomial logistic and linear regression modeling was performed using a nationally-representative sample of adults (analytic n = 7956) from the 2015 and 2020 National Alcohol Surveys. The outcomes were any HID of 8–11 drinks and 12+ drinks for men, and 8+ drinks for women, and corresponding frequencies. Concurrent risk factors included coping motive, sensation seeking, simultaneous use of alcohol and cannabis (SAC), and drinking at a bar or party. Analyses were stratified by age (18–29 vs. older) and sex. Results For younger men, sensation-seeking was significantly associated with HID (vs. no HED) at both levels and frequency of HID 8–11 drinks, while drinking to cope was only significant for 12+ drinks. For older men, drinking to cope was a consistent predictor for both HID level and its frequency, but sensation-seeking was not significant. Both coping and sensation-seeking were significantly associated with any HID for all women, while coping was significant for HID frequency for younger women. Frequent drinking at bars and parties were associated with greater odds of HID for all adults. With HED as referent, similar patterns of (though fewer significant) associations were observed. Conclusions Younger and older adults share similar risk factors for HID, with coping more consistent for older men.

Inflation in 2022 did not affect congressional voting, but abortion did

This study examines voting in the 2022 United States congressional elections, contests that were widely expected to produce a sizable defeat for Democratic candidates for largely economic reasons. Based on a representative national probability sample of voters interviewed in both 2020 and 2022, individuals who changed their vote from one party's congressional candidate to another party's candidate did not do so in response to the salience of inflation or declining economic conditions. Instead, we find strong evidence that views on abortion were central to shifting votes in the midterm elections. Americans who favored (opposed) legal abortions were more likely to shift from voting for Republican (Democratic) candidates in 2020 to Democratic (Republican) candidates in 2022. Since a larger number of Americans supported than opposed legal abortions, the combination of these shifts ultimately improved the electoral prospects of Democratic candidates. New voters were especially likely to weigh abortion views heavily in their vote-shifting calculus. Likewise, those respondents whose confidence in the US Supreme Court declined from 2020 to 2022 were more likely to shift from voting for Republican to Democratic congressional candidates. We provide direct empirical evidence that changes in support for the Supreme Court, a nonpartisan branch of the federal government, are implicated in partisan voting behavior in another branch of government. We explore the implications of these findings for prevalent assumptions about how economic conditions influence voting, as well as for the relationship between the judiciary and electoral politics.

Demographic Correlates of Endometriosis Diagnosis Among United States Women Aged 15-50

To compare demographic characteristics for women with and without a diagnosis of endometriosis. Data were collected from the National Survey of Family Growth - a publicly available survey designed and administered by the Centers for Disease Control, which uses a nationally-representative sample of the United States population. Univariate data were reported as survey-weighted percentages and means, and were analyzed using chi-square, t-tests, and logistic regression. Analyses accounted for complex survey design. United States PARTICIPANTS: Interviews were conducted with 6,141 female respondents, aged 15-50, between 2017 and 2019. Data were collected through in-person interviews. Nationally, 5.7% reported a diagnosis of endometriosis (95% CI 4.6-6.9%). Those with endometriosis were older, with a mean age of 39 (95% CI 38.1-39.9), compared to 31.7 (95% CI 31.2-32.2) among those without (p < 0.0005). Endometriosis diagnosis was significantly associated with race. Compared to non-Hispanic White women, Hispanic women had an adjusted odds ratio (aOR) of 0.37 (95% CI 0.21-0.65) for diagnosis of endometriosis, and non-Hispanic Black women had an aOR of 0.54 (95% CI 0.35-0.84). We also observed a difference in diagnosis by health insurance: compared to those with private insurance or Medi-Gap coverage, those with Medicare or military insurance had an aOR for endometriosis diagnosis of 2.49 (95% CI 1.36-4.55). Finally, compared to those with less than a high school education, those who had completed high school or greater had an aOR for endometriosis diagnosis of 2.84 (95% CI 1.15-6.99). These disparities in endometriosis diagnosis suggest that intersecting barriers may preclude certain groups from accessing timely endometriosis diagnosis and management. Further studies are warranted to explore these hypothesis-generating data, and to identify and address specific barriers to equitable endometriosis diagnosis and management.

Gradients in low birthweight by maternal education: A comparative perspective

BackgroundLongstanding research has shown strong inequalities in low birthweight by household income. However, most such research has focused on Anglophone countries, while evidence emerging from other developed countries suggest a stronger role of education rather than incomes in creating inequalities at birth. This paper compares gradients in low birthweight by maternal education, as well as explores underlying mechanisms contributing to these gradients, in France, the United States, and the United Kingdom. MethodsAnalyses are based on harmonized data from large, nationally-representative samples from France, UK and US. We use regression models and decomposition methods to explore the relative role of several possible mechanisms in producing birthweight inequalities. ResultsInequalities in low birth weight across maternal education groups were relatively similar in the United States, the United Kingdom and France. However, the individual-level mechanisms producing such inequalities varied substantially across the three countries, with income being most important in the US, pregnancy smoking being most evident in France, and the UK occupying an intermediate position. Differences in the mechanisms producing birth health inequalities mirror differences in the policy environment in the three countries. ConclusionWhile inequalities in health appear from the earliest moments in many countries, our results suggest research on birth health inequalities, and therefore policies, is not easily generalizable across national contexts, and call for more scholarship in uncovering the “whys” of health inequalities in a variety of contexts.

Height growth of Mexican boys by geographic region: an evaluation based on nationally representative data of ENSANUT 2012 and 2018.

Existing research on human growth in Mexico is regionally focused, creating a gap in the understanding of growth patterns of children and adolescents at national level and regional variation. The objective of the present study was to characterize the height growth curve of the Mexican population by geographic area and to cluster the states of the Mexican Republic according to their somatic maturation characteristics, based on a national representative sample of boys. Data on age, height, socioeconomic level, and geographic area of 18,219 boys were obtained from the National Health and Nutrition Survey 2012 (ENSANUT) and ENSANUT 2018, carried out in 32 Mexican states. Both surveys had representative samples. Preece-Baines 1 model was applied to fit height growth curves. Biological parameters were estimated; principal component analysis and cluster analysis were performed to group Mexican states based on these biological parameters. The estimated age at peak height velocity (PHV) was 12.3 years in the sample. Significant regional differences in the timing and tempo of PHV among Mexican boys were observed. Boys in the northern region experienced PHV at an earlier age and had a shorter duration of growth compared with boys in the central and southern regions. Boys in the central region had a longer duration of growth and a later age of PHV compared with the boys in the southern region. The cluster that included the southern states of the country showed estimated lower adult height and earlier somatic maturation. A lower height was found in the low and low-middle socioeconomic levels compared with the medium-high and high socioeconomic levels. Future research in Mexico should focus on longitudinal studies to analyse the timing and tempo of growth and maturation, considering the impacts of environmental and genetic factors. Public health strategies should account for geographic variations.

Dental Caries and Preventive Dental Visits Among Children in the U.S.: The Impact of Race/Ethnicity and Immigration

Introduction: National data on dental caries and dental service use among immigrant children in US is limited. It is not known whether race/ethnicity would interact with immigration status to increase these disparities. Using a national representative sample, we assessed the interaction effects of immigrant generation status and race/ethnicity on dental caries and dental visits among children in the US. Methods: Data were from the 2020 and 2021 National Survey of Children's Health (NSCH). All data were self-reported by parents/guardians. The two outcomes were (1) dental caries (yes/no) in the past 12 months, and (2) preventive dental visits (yes/no) in the past 12 months. Racial/ethnic groups included non-Hispanic White, Black, Hispanics, and Asian Americans. The analytical sample included 66,167children ages 2-17 years, including 1,243 first generation, 11,017 second generation immigrant children, and 53,907 non-immigrant children. We ran separate multiple logistic regression models for the two outcome variables. All analyses accounted for the survey design of NSCH. Results: First generation immigrant children were more likely to have dental caries than non-immigrant children (AOR=1.44). The interaction of race/ethnicity and immigrant generation status was significant (P =0.04) in the preventive dental visits model, indicating increased challenges in getting dental visits among minority immigrant children in comparison with non-Hispanic White immigrant children, especially among first generation immigrant children of Asian Americans (AOR=0.41) and non-Hispanic Black (AOR=0.37) immigrant children. Conclusions: We found that first generation immigrant children were less likely to see a dentist and more likely to have dental caries than non-immigrants. Moreover, first generation immigrant children from minority racial/ethnic groups were the least likely to seek dental services. To further reduce disparities in oral health and dental use among children in the U.S., culturally sensitive health promotion is warranted to improve oral health literacy and reduce barriers to dental care for immigrants, especially immigrant children of the minority groups.

The global diet quality score as an indicator of adequate nutrient intake and dietary quality – a nation-wide representative study

BackgroundThe Global Diet Quality Score (GDQS) was developed to be a simple, timely and cost-effective tool to track, simultaneously, nutritional deficiency and non-communicable disease risks from diet in diverse settings. The objective was to investigate the performance of GDQS as an indicator of adequate nutrient intake and dietary quality in a national-representative sample of the Brazilian population.MethodsNationally-representative data from 44,744 men and non-pregnant and non-lactating women aging ≥ 10 years, from the Brazilian National Dietary Survey were used. Dietary data were collected through two 24-h recalls (24HR). The GDQS was calculated and compared to a proxy indicator of nutrient adequate intake (the Minimum Dietary Diversity for Women—MDD-W) and to an indicator of high-risk diet for non-communicable diseases (caloric contribution from ultra-processed foods—UPF). To estimate the odds for overall nutrient inadequacy across MDD-W and GDQS quintiles, a multiple logistic regression was applied, and the two metrics’ performances were compared using Wald’s post-test.ResultsThe mean GDQS for Brazilians was 14.5 (0–49 possible range), and only 1% of the population had a low-risk diet (GDQS ≥ 23). The GDQS mean was higher in women, elderly individuals and in higher-income households. An inverse correlation was found between the GDQS and UPF (rho (95% CI) = -0.20(-0.21;-0.19)). The odds for nutrient inadequacy were lower as quintiles of GDQS and MDD-W were higher (p-trend < 0.001), and MDD-W had a slightly better performance than GDQS (p-diff < 0.001). Having a low-risk GDQS (≥ 23) lowered the odds for nutrient inadequacy by 74% (95% CI:63%-81%).ConclusionThe GDQS is a good indicator of overall nutrient adequacy, and correlates well with UPF in a nationally representative sample of Brazil. Future studies must investigate the relationship between the GDQS and clinical endpoints, strengthening the recommendation to use this metric to surveillance dietary risks.

Referendums as extended arms of the government: evidence from an illiberal regime

ABSTRACT Public support for referendums has been analysed extensively in established democracies, but the topic is investigated less in illiberal settings. This article aims to explain why citizens in an illiberal country (Hungary) support referendums. We argue that in such political regimes, referendums may serve as extended arms of the illiberal government rather than as providing people with direct access to decision-making. Our study uses individual-level data from a survey conducted in May 2022 on a national representative sample. The evidence indicates that those citizens in favour of referendums are characterized by anti-democratic attitudes and support for the initiator.

Discrimination in the Spotlight: The Effects of Political and Religious Bias on Consumer Behaviour and Labour Markets

There has been a surge in concern about political polarization and discrimination based on religious and political attitudes in the workplace. Using a nationally-representative sample of nearly 3,000 respondents, this paper presents new empirical evidence on the incidence of social hostilities in the workplace and the causal effects of providing information on consumer and labor market behavior across a range of indicators. Several empirical patterns emerge. First, nearly half of respondents have not shared their personal views about a social or political issue because of fear that sharing it would harm their career. Second, roughly a fifth of respondents have encountered discrimination for respectfully communicating their religious or political viewpoint. Third, these attitudes are negatively correlated with labor market and social media behavior: 40% of respondents say that perceptions of hostility against religious or political views make them much less likely to apply to a company, and 50% of respondents say that they are “very concerned” or “somewhat concerned” about adverse effects related with posting on social media about their religious and political attitudes. Finally, exposure to information about politicized topics is associated with a decline in respondents’ support for companies taking more activist stances. These results suggest that there are adverse and unintended consequences associated with religious and political discrimination, and companies could realize additional benefits by focusing on their core business activities.

Sleep Apnea Symptoms Are Associated with Memory and Cognitive Symptoms in a Nationally-representative Sample of U.S. Adults (S36.010)

Sleep Apnea Symptoms Are Associated with Memory and Cognitive Symptoms in a Nationally-representative Sample of U.S. Adults (S36.010)