Social Status Factors Research Articles

Chronic constipation: A review of literature.

Background:Chronic constipation is described as a common complication determined by difficult and/or rare passage of stool or both. The difference in definition of constipation has led to a wide range of reported prevalence (i.e., between 1% and 80%). Various factors are involved in the pathogenesis of the disease, including type of diet, genetic predisposition, colonic motility, absorption, social economic status, daily behaviors, and biological and pharmaceutical factors. Diagnostic and therapeutic options play a key role in the treatment of chronic constipation. There are still debates about the timing of these diagnostic and therapeutic algorithms.Methods:A systematic and comprehensive search will be performed using MEDLINE, PubMed, EMBASE, AMED, the Cochrane Library and Google Scholar. Better understanding of the pathophysiology of chronic constipation and efficacy of pharmacological agent can help physicians for treating and managing symptoms.In this study, some of the old and new therapies in the treatment of chronic constipation have been studied based on the controlled studies and strong evidence. We are trying to address some of the controversial issues to manage the disease and to provide appropriate diagnostic options in an efficient and cost-effective way.Results:The results of this systematic review will be published in a peer-reviewed journal.Conclusion:To our knowledge, our study will provide an overall estimate of chronic constipation to assess controversial issues, available diagnostic and therapeutic strategies of chronic constipation.Ethics and dissemination:Ethical approval and informed consent are not required, as the study will be a literature review and will not involve direct contact with patients or alterations to patient care.

Abstract P029: Racial Differences in Sudden Cardiac Death: Findings From the Atherosclerosis Risk in Communities Study (ARIC)

Background: In hospital-based studies and in studies of participants with pre-existing conditions, African Americans have a higher risk of in- and out-of-hospital sudden cardiac death (SCD) compared with Whites. However, the risk of SCD of African Americans and Whites has never been compared in large-scale community-based cohort studies. Objective: To compare the risk of SCD among African Americans and Whites, and to evaluate the risk factors that may explain racial differences in incidence. Methods: Cohort study of 3,838 African Americans and 11,245 Whites participating in ARIC. Race was self-reported. SCD cases were defined as a sudden pulseless condition from a cardiac cause in a previously stable individual and adjudicated by an expert committee. Mediation effect of covariates was calculated using boot-strapping method. Cox proportional hazards models were adjusted for demographics, social economic status, cardiovascular (CVD), and electrocardiographic risk factors. Results: The mean (SD) age was 53.6 (5.8) for African Americans and 54.4 (5.7) years for Whites. During 25.3 years of follow-up, 215 African Americans and 332 Whites experienced SCD. In multivariable-adjusted models, the HRs (95% CI) for SCD comparing African Americans and Whites were 1.70 (1.37, 2.10) overall, 2.00 (1.40, 2.84) in women, and 1.46 (1.10, 1.92) in men (p-value for race by sex interaction 0.02; Table ). CVD and electrocardiographic risk factors explained 36.6% (21.4, 51.8%) of the excess risk of SCD in African Americans, with a large proportion of racial differences unexplained. Conclusions: The risk of SCD in community-dwelling African Americans was significantly higher than in Whites, particularly among women. CVD risk factors, including higher prevalence of obesity, diabetes, hypertension and LV hypertrophy in African Americans, explained only a small fraction of this difference. Further research is needed to identify factors responsible for race differences in SCD and to implement prevention strategies in high-risk minorities.

Advances in Educational Technology and Psychology

To study the characteristics and development trends of various stages of the TV news commentary category in China, four stages of the development of TV news commentary programs were studied. The common rules and characteristics of TV news commentary programs in the development process were summarized. By studying the laws and characteristics of each stage, the social function of the Chinese TV news commentary column in the development of Chinese society was explored. The development factors of foreign TV news commentary columns were analyzed. The characteristics of the TV news commentary in China and the rules of each stage are discussed and compared with foreign countries. The results showed that social development status, audience, media environment and other factors affected the development direction of TV news commentary. Therefore, the development of the TV news commentary category is determined by a variety of factors.

Oral Health-Related Quality of Life Appraised by OHIP-14 Between Urban and Rural Areas in Kutai Kartanegara Regency, Indonesia: Pilot Pathfinder Survey.

Background:Health-Related Quality of Life (HRQoL) periphrastically has a significant impact on oral health. A recent study has shown the significant facts of the oral health-related quality of life based on many factors such as individual, social status, household management, daily habits, and local factors. The differences in the oral health status possibly occur in between countries, different regions, and topographical areas frequently and indirectly contributing to oral health status.Objective:The objective is to evaluate the difference of Oral Health-Related Quality of Life (OHRQoL) and to assess the main affected dimension between rural and urban areas in Kutai Kartanegara Regency.Methods:This study uses pilot pathfinder design. The respondents comprised of 214 adults who were elder than 18 years and were randomly selected from urban and rural areas in Kutai Kartanegara Regency, Indonesia. The data were collected by 103 samples from the rural area and 111 respondents from the urban area. Oral Health Impacts Profile (OHIP-14) has been translated to Bahasa (Indonesia version). OHIP-14 was used to assess the subjects’ oral health-related impact. Shapiro-Wilk and Mann Whitney tests were used to analyze the data, and p-value was set at P < 0.05.Results:The mean OHIP scores in the urban and the rural areas were 25.4 and 28.8, respectively. The overall OHIP-14 score showed a significant statistical difference P= 0,009 (P < 0.05) between rural and urban area.Conclusion:This study illustrates that oral health-related quality of life in the urban area is better than in the rural area. Physical pain components of the OHRQoL are the major oral problems associated with both the areas.

Social Status, Discrimination, and Minority Individuals' Mental Health: a Secondary Analysis of US National Surveys.

Our study measured minority individuals' social status factors and frequency of discrimination experiences, in order to delineate social mechanisms linking race/ethnicity to mental status (specifically, to current mood/anxiety disorder and self-rated mental health). In this nationally representative secondary research, our data analyses drew on the cross-sectional "Collaborative Psychiatric Epidemiology Surveys," dating 2001-2003. The sample for the final model numbered 9368 respondents (2016 Asians, 2676 Latinos, 4676 blacks). Across races/ethnicities, better mental health was associated with male gender, higher income, marriage, more education, and less-frequent discrimination experiences; discrimination experiences could impair health, especially among blacks. Marriage's strong contribution to Asians' mental health did not hold among blacks; education's contribution to Latinos' mental health did not hold among blacks either. Blacks' mental health was unaffected by immigration status, but Asian and Latino immigrants showed less-robust mental health than native-born counterparts. Across the three racial/ethnic groups studied, differences were noted in relationships between self-reported mental health status and the employed social status and discrimination factors.

Social status and housing factors affect reproductive performance of pregnant sows in groups.

Group-housing systems for pregnant sows are considered a welfare-promoting alternative to the individual stall. A major concern associated with pregnant sows housed in group pens is increased aggression at mixing and at feeding, which may cause chronic stress among some of the sows in the group due to low feed intake and social stress. Prolonged activation of the stress axis, based on elevated cortisol levels, may inhibit or impair reproductive success via disruption of the reproductive axis. Mixing sows into groups shortly after insemination evokes a stress response, which may affect fertilization and implantation due to sustained, elevated cortisol levels that disrupt reproductive processes. Yet, most studies reported minimal effects of group housing sows during pregnancy on reproduction or cortisol-related stress response. Differences between housing systems-in terms of group size, floor-space allowance, feeding system, and genetics-could account for these unexpected results. Indeed, interrupted feed intake, especially in early pregnancy, and sustained aggression in late pregnancy are two unfavorable social stresses that deserve special attention in order to achieve good reproductive performance. Unfortunately, most studies do not consider other factors, such as social rank and parity, which may interactively affect reproductive success and aggressive behavior of sows, especially in group-pen systems.

A matter of perception: Perceived socio-economic status and cortisol on the island of Utila, Honduras.

Numerous studies link low objective and subjective socioeconomic status (SES) to chronic activation of the hypothalamic pituitary adrenal (HPA) axis. Here, we examine associations between objective and subjective SES and diurnal salivary cortisol, a primary HPA component, as well as demographic and ecological predictors associated with SES perceptions and changes in diurnal cortisol. Participants were residents (age 18-79, n = 61) of Utila, a Honduran island where economic disparities are overt and geographically contained. Objective SES was measured as a composite of income, education, and occupation. Subjective SES was measured with a MacArthur ladder and a perceived lifestyle discrepancy (PLD) scale. Salivary cortisol was collected three times per day for two days. Questions addressing demographic, social, and household characteristics were assessed as predictors of PLD. Assessed independently, objective SES (P = .06) and PLD (P = .003) were associated with the steepness of diurnal cortisol changes, while PLD was also associated with higher cortisol area under the curve (AUC) (P = .036). Modeled together, only PLD predicted diurnal slope and AUC. PLD was associated with household sanitation, immigration status, food scarcity, objective SES, and owing money. Only access to sanitation and owing money had direct associations with cortisol that were not mediated by PLD. For adults on Utila, perceptions of unmet need outweigh other social and economic status factors in predicting cortisol AUC and slope. In addition, the unmediated effects of access to sanitation and owing money on cortisol suggest that these distinct aspects of inequality are important to consider when seeking to understand how inequality can impact HPA function.

PEMIMPIN INFORMAL DAN DINAMIKA SOSIAL (Studi Kasus Lima tokoh Di Desa Allu Taroawang Kecamatan Batang Kabupaten Jeneponto)

The substance of this research was to find out, to describe, to provide information about roles and statuses by informal leaders in Allu Tarowang village as well as its relationship with social dynamics that occurred. Informal leaders have roles and statuses that is important and strategic in the dynamics of development. This statement was the research result that has been done with use three variabels: identifying the process how to be an informal leader, identifying the ability of informal leaders how to conduct social change and how to problem solving strategies in the dynamics of development. The method which used in this research is descriptive research with case study while techniques of the data collection uses indepth interview and observation afterwards data analysis is qualitative. The research result, in identifying the process how to be an informal leader was obtained two-factors: social needs and social status factors. However, it is reviewed from nature of the informal leaders was included traditional leader type. In identifying the ability of informal leaders how to conduct social change were influenced by attitudes and behavior, alignment of instruction and expectations of the community, means and approaches. And last, In identifying the ability of informal leaders how to problem solving strategies in the dynamics of development were divided three stages, with regards to: (1) looking at the condition and situation of problem, (2) knowing the source of the problem, and (3) finding out the alternative of the solution for the problem. Based on the description above, this researh shows an informal leader as a respected person and a role models in society. other than, they have roles for motivating, mediating and catalysting in the dynamics of development.

"But He's a Star Football Player!": How Social Status Influences Mock Jurors' Perceptions in a Sexual Assault Case.

There have been several recent, high-profile cases in the media that have shed light on the perceived leniency in sentencing defendants in sexual assault cases. In a number of these cases, the defendant was well known within their community (e.g., Brock Turner; People v. Turner) or nationally (e.g., Ghomeshi; R v. Ghomeshi). The purpose of this study was to examine how the social status of the defendant (low vs. high), victim social status (low vs. high), victim gender (male vs. female), and the reason the victim was unconscious during the assault (consuming alcohol vs. consuming cold medicine) influenced mock jurors' decisions in a sexual assault case. Mock jurors (N = 489) read a mock trial transcript depicting an alleged sexual assault. Mock jurors were asked to render a dichotomous verdict, continuous guilt rating, and rate their perceptions of the victim and defendant. There was no influence of the variables on mock jurors' dichotomous verdicts; however, social status influenced guilt ratings. There also was a combined influence of the defendant's social status and the reason the victim was unconscious such that when the defendant was described as low status, and the victim was unconscious due to alcohol consumption, the defendant received higher guilt ratings compared with when the victim was unconscious due to cold medicine. Moreover, the victim was perceived as having more control over the situation when the defendant was the star quarterback (i.e., high status), the victim was female, and she was unconscious due to alcohol consumption compared with cold medicine. These results suggest that victims may be blamed based on their perceived social status and other factors that may have influenced their control over the sexual assault, such as alcohol consumption.

Social support status and related influential factors of patients with acute coronary syndrome

Objectives: To investigate the social support status, related influential factors and the impact on one year outcome in patients with acute coronary syndrome (ACS), our data might be helpful to provide basis for making new treatment strategy aimed at improving social support for patients with ACS. Methods: From January 2013 to June 2014, a total of 778 hospitalized patients with ACS were enrolled in the study. All patients completed enhancing recovery in coronary heart disease patients social support inventory(ESSI), general anxiety disorder scale(GAD-7), patient health questionnaire(PHQ-9), short-form 12 health survey questionnaire(SF-12), sleep questionnaire and demographic questionnaire within 7 days after admission and at 6 months and one year post discharge. Multiple linear regressions were performed to analyze factors that influenced the social support. Results: The total score of social support was 17.08±3.61, 17.72±3.04, and 17.76±3.05 respectively in patients with ACS at baseline, 6 months and 12 months after discharge. Patients had a higher point of social support at 6 months (t=-2.69, P<0.01) and 12 months (t=-2.86, P<0.01) after discharge than at baseline. Multiple regression analysis for baseline data identified five significant predictors of low social support status: workers or farmers (t=2.82, P<0.01), low family monthly income (t=2.42, P<0.05), anxiety (t=-3.66, P<0.01), depression (t=-3.22, P<0.01) and low quality of life (t=4.38, P<0.01). Conclusions: Social support of patients with ACS is lower in China, and there are significant relationships between low social support and occupation, economic status, anxiety, depression, quality of life of ACS patients.

Intersectionalities of formality of marital status and women’s risk and protective factors for intimate partner violence in Rwanda

abstractIndashyikirwa is an intimate partner violence (IPV) prevention programme being implemented by CARE International Rwanda, Rwanda Women’s Network and Rwanda Men’s Resource Centre in Rwanda. One critical aspect of the programme is a 5-month curriculum to promote equitable, violence-free relationships among formally and informally married heterosexual couples. This article complements existing evidence in Rwanda around how formality of marital status influences women’s access to rights, social status, risk and protective factors for IPV, and highlights barriers to formalising marriage – primarily lack of financial means and gendered inequalities. It draws on research of Indashyikirwa, including interviews with 15 male and 15 female partners of formally and informally married couples, 9 community leaders, 3 women’s space facilitators, 9 staff members, 12 community activists and 24 focus groups with community members. Interviews and focus groups were conducted in Kinyarwanda, transcribed and translated into English, and analysed thematically. The findings indicate poor legal protection and related limited institutional responses for informally married women who experience IPV. An intersectional lens supports recommendations to address such inequalities, including raising awareness among women in informal marriages about strategies to ensure rights for themselves and their children, and to legally acknowledge informal unions after a certain period of cohabitation.

Decrease in Self-Efficacy for Exercise at 12 Weeks after Exercise Education in Diabetic Patients

The purpose of this study was to investigate whether self-efficacy for exercise decreased 12 weeks after educational intervention in diabetic patients and whether this had an effect on glycemic control. Thirty-eight diabetic patients underwent a 2-week educational program and were then followed for 12 weeks after discharge. The intervention program was delivered by several types of medical professionals. Lectures on exercise were given by a physical therapist, who tailored exercise instructions for individual patients. The assessment of self-efficacy for exercise was performed using a scale from a previous study, modified for Japanese people. The scale consisted of four sub-items: physical fatigue, mental stress, lack of time, and poor weather. Measurements were performed at the time of discharge and 12 weeks after discharge. Glycated hemoglobin (HbA1c) levels were assessed as an index of glycemic control, and diabetic status and social status factors were recorded. The physical fatigue and lack of time components of the self-efficacy for exercise scale were significantly decreased 12 weeks after discharge. Positive correlations were found between HbA1c levels at 12 weeks and duration of diabetes, number of educational admissions, and presence of diabetic retinopathy. The results suggest that the factors that are difficult to reproduce during hospital education (physical fatigue and lack of time) are the ones that decrease after discharge. To clarify the relationship between changes in self-efficacy for exercise and glycemic control, further studies with an extended follow-up period (24 weeks or 48 weeks) are needed.

ANALISIS STATUS SOSIAL EKONOMI, CITRA PERGURUAN TINGGI DAN KESEMPATAN KERJA TERHADAP KEPUTUSAN STUDI LANJUT KE PERGURUAN TINGGI PADA SISWA-SISWI KELAS XII MAN JOMBANG TAHUN PELAJARAN 2015-2016

&lt;p&gt;The purpose of this research is: (1) to know the influence of the following factors, namely socio-economic status, the image of College and employment opportunities of further studies into college. (2) to know the most dominant influence toward the decision for knowing some factors further studies into college. For achieving that goal, the researcher used quantitative methods to analysis of the factors. The object of this research is the students of class XII MAN Jombang Lessons year 2015-2016. The data collection techniques used are observation, question form/questionnaire, interview and documents. The data were analyzed by means of test validity, reliability test, test and test the assumptions of classical hypothesis. The results of the reserch showed that: (1) the socio-economic Status of the Factor (X1) influence of 69,3%, Image Factors of higher education (X2) influence of 0.9% and employment opportunities (X3) exert influence by 4% against the decision of further studies into College on students of class XII MAN Jombang Lessons Year 2015-2016. (2) The most dominant factor of its influence on the decision of further studies class XII students MAN Jombang Lesson Years 2015-2016 is a factor of social economic status (X1) and its influence of 69,3%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Keyword&lt;/strong&gt;: Socioeconomic, The College, Employment&lt;/p&gt;

Girişimciliğin Motivasyonel Faktörlerinin Cinsiyet Açısından İncelenmesi: Mikro İşletmelerde Bir Saha Araştırması

Micro-scale enterprises constitute 96% of all enterprises in Turkey. In this&#x0D; paper, the motivational factors of entrepreneurship are quantitatively analyzed based on&#x0D; gender difference as a part of a project in which micro-scale enterprises in Eskisehir are&#x0D; explored with their socio-economic characteristics. Within the scope of the project, the data&#x0D; of 1769 micro-enterprises registered as members in Eskişehir chambers of commerce and&#x0D; artisans, were collected by a questionnaire form. A workshop was organized and opinions of&#x0D; the administrators of chambers of commerce and artisans were taken for the questionnaire&#x0D; development process. Research findings show that general profile of male entrepreneurs in&#x0D; Eskişehir can be defined as; 42-49 age range, graduated from primary school, with average&#x0D; monthly income 2000 (₤). In addition, male entrepreneurs have learned their profession&#x0D; predominantly in the apprenticeship process, and their basic entrepreneurial motivation&#x0D; is earning income. Female entrepreneurs, on the other hand, draw a different profile in&#x0D; some ways, such as at age range of 32-41 years, graduated from a high school and with&#x0D; an average monthly income of 2000 (₤). The source of vocational training and basic&#x0D; entrepreneurship motivation for female entrepreneurs are same as male entrepreneurs.&#x0D; According to the results, male and female entrepreneurs have different characteristics in&#x0D; terms of age range and education levels. Analysis results show that income generation is the&#x0D; first entrepreneurship motivational factor for both gender, male and female entrepreneurs,&#x0D; second entrepreneurship motivational factor for males is dynastic compliance and being&#x0D; independent for females. In this study, frequency analysis, cross tables, Mann-Whitney Test&#x0D; and CHAID analysis were used in data analysis of. The main finding of the study is that&#x0D; according to the Mann-Whitney Test, among the motivation factors for entrepreneurship,only dynastic compliance, valuating spare time and obtaining social status factors showed&#x0D; statistically meaningful differences according to the gender variable. The results of the&#x0D; CHAID analysis show that there is no statistically significant difference between the genders&#x0D; for dynastic compliance motivation factor, but there are statistically significant differences&#x0D; for valuating spare time and gaining social status motivations.

Combined effect of educational status and cardiovascular risk factors on the incidence of coronary heart disease and stroke in European cohorts: Implications for prevention.

Background The combined effect of social status and risk factors on the absolute risk of cardiovascular disease has been insufficiently investigated, but results provide guidance on who could benefit most through prevention. Methods We followed 77,918 cardiovascular disease-free individuals aged 35-74 years at baseline, from 38 cohorts covering Nordic and Baltic countries, the UK and Central Europe, for a median of 12 years. Using Fine-Gray models in a competing-risks framework we estimated the effect of the interaction of education with smoking, blood pressure and body weight on the cumulative risk of incident acute coronary heart disease and stroke. Results Compared with more educated smokers, the less educated had an added increase in absolute risk of cardiovascular disease of 3.1% (95% confidence interval + 0.1%, +6.2%) in men and of 1.5% (-1.9%, +5.0%) in women, consistent across smoking categories. Conversely, the interaction was negative for overweight: -2.6% (95% CI: -5.6%, +0.3%) and obese: -3.6% (-7.6%, +0.4%) men, suggesting that the more educated would benefit more from the same reduction in body weight. A weaker interaction was observed for body weight in women, and for blood pressure in both genders. Less educated men and women with a cluster of two or more risk factors had an added cardiovascular disease risk of 3.6% (+0.1%, +7.0%) and of 2.6% (-0.5%, +5.6%), respectively, compared with their more educated counterparts. Conclusions Socially disadvantaged subjects have more to gain from lifestyle and blood pressure modification, hopefully reducing both their risk and also social inequality in disease.

Determinants of Quality of Life for Breast Cancer Patients in Shanghai, China.

PurposeTo evaluate the association of social support status, health insurance and clinical factors with the quality of life of Chinese women with breast cancer.MethodsInformation on demographics, clinical characteristics, and social support status was collected from 1,160 women with newly diagnosed breast cancer in Shanghai, China. The Perceived Social Support Scale was used to assess different sources of social support for breast cancer patients. The quality of life was evaluated using the Functional Assessment of Cancer Therapy-Breast Cancer that consisted of five domains: breast cancer-specific, emotional, functional, physical, and social & family well-being. Multivariate linear regression models were used to evaluate the associations of demographic variables, clinical characteristics, and social support status with the quality of life measures.ResultsAdequate social support from family members, friends and neighbors, and higher scores of Perceived Social Support Scale were associated with significantly improved quality of life of breast cancer patients. Higher household income, medical insurance plans with low copayment, and treatment with traditional Chinese medicine for breast cancer all were associated with higher (better) scores of quality of life measures whereas patients receiving chemotherapy had significantly lower scores of quality of life.ConclusionSocial support and financial aids may significantly improve the quality of life of breast cancer survivors.

Socioeconomic Status and Cardiovascular Risk Control in Adults With Diabetes

ObjectiveTo examine the association between subjective social status (SSS) and objective social status (OSS) and cardiovascular disease (CVD) risk factors in adults with type 2 diabetes. MethodsAdult study participants (N = 358) were recruited from 2 primary care settings. The CVD risk factors included hemoglobin A1c (HbA1c), systolic blood pressure and diastolic blood pressure (DBP) and low-density lipoprotein cholesterol (LDL-C). The OSS was assessed by income, education and employment. The SSS was measured using the validated MacArthur Scales of Subjective Social Status to demarcate self-reported perceptions of having the most money, education and respected job using a ladder scale (1 = rung 1, 10 = rung 10). Multiple linear regression was used to examine associations between CVD risk factors and SSC and OSS controlling for age, sex, race or ethnicity, marital status, employment status, income, study site, comorbidity, education and insurance status. ResultsFully adjusted models showed that rung 2 (P = 0.029), rung 3 (P = 0.032), rung 8 (P = 0.049) and rung 9 (P = 0.032) of the SSS to be significantly associated with poorer DBP. Annual income ≥ $75,000 was significantly associated with lower LDL-C (P = 0.021). Employment was associated with lower HbA1c (P = 0.036), but higher LDL-C (P = 0.002). ConclusionsThe SSS and OSSS levels are differentially associated with HbA1c, DBP and LDL-C. Findings provide new information about patients’ perspectives of the relationship between social status and diabetes-related outcomes.

국민건강영양조사를 활용한 대사증후군 유병 예측모형 개발을 위한 융복합 연구: 데이터마이닝을 활용하여

The purpose of this study is to investigate the attributes influencing the prevalence of metabolic syndrome and develop the prediction model for metabolic syndrome over 40-aged people from Korea Health and Nutrition Examination Study 2012. The researcher chose the attributes for prediction model through literature review. Also, we used the decision tree, logistic regression, artificial neural network of data mining algorithm through Weka 3.6. As results, social economic status factors of input attributes were ranked higher than health-related factors. Additionally, prediction model using decision tree algorithm showed finally the highest accuracy. This study suggests that, first of all, prevention and management of metabolic syndrome will be approached by aspect of social economic status and health-related factors. Also, decision tree algorithms known from other research are useful in the field of public health due to their usefulness of interpretation.

Sex and Geographic Differences in Health of the Early Inhabitants of the Mariana Islands

The early inhabitants of the Mariana Islands encountered numerous challenges that likely affected their health, including island size, vulnerability to natural disasters, availability of resources, and shifts in climate. Other factors that could have led to differences in health include biological sex, social status, diet, and genetic factors (e.g., host resistance). This article examines the effects of environment and biological sex on the health of the earliest inhabitants of the Mariana Islands through an analysis of indicators of health recorded in skeletons from Guam, Rota, Tinian, and Saipan. The indicators of health investigated include cribra orbitalia (CO), linear enamel hypoplasia (LEH), stature, trauma, infection, and dental disease (antemortem tooth loss [AMTL], dental caries, alveolar defect, dental calculus, and attrition). Betel staining of teeth is also examined. To determine if there are differences attributable to sex, male and female data are compared for each island separately and then for all the islands combined. To examine differences between islands, separate comparisons of these indicators are made for males and females. Examining islands separately, no significant sex differences were observed for CO, spondylolysis, fractures, treponemal infection, AMTL, or dental calculus. Significant sex differences were observed for LEH, betel-stained teeth, and the other dental pathologies. With few exceptions, sex differences in the observed indicators were consistent across islands. Observing male and female health across the islands revealed no significant differences for stature, trauma or infections. For the remaining indicators, significant differences were observed. Similarities in health between Guam and Rota in the south and Tinian and Saipan located farther north suggest that geography, environmental constraints, and social and cultural networking were important variables affecting the health and lives of the early inhabitants of the Mariana Islands.

Frequency and predictors of insufficient chemotherapy use among stage I-III breast cancer patients by molecular subtype.

154 Background: Identification of distinct molecular subtypes has expanded the treatment options for breast cancer, however, chemotherapy remains the common and effective treatment for each subtype. The objective is to compare the frequency and predictors of insufficient chemotherapy use among two subtypes of stage I-III breast cancer patients: luminal A and triple negative breast cancer (TNBC). Methods: We analyzed data from a CDC funded project - Enhancing Cancer Registry Data for Comparative Effectiveness Research (CER) collected by Louisiana Tumor Registry. Women aged &lt; = 70 years, diagnosed in 2011 with stage I-III luminal A or TNBC breast cancer, tumor size &gt; 1cm, were included (N = 1,189). Insufficient chemotherapy (i.e. no chemotherapy use, nonstandard regimen use, and low relative dose intensity (RDI &lt; 85%)) was evaluated respectively. Potential predictors included age, race, insurance, marital status, census tract-poverty, AJCC stage, grade, tumor size, lymph node status, and Charlson comorbidity. Stepwise model selection with p-value for entry at 0.2 and for stay at 0.25 was used to select the most relevant predictors. Results: The frequencies of no chemotherapy use were significantly different (p &lt; .0001) between luminal A (42%, N = 913) and TNBC patients (9%, N = 241). Older age, white race, no insurance, lower stage or grade, and without lymph node involvement were related with no chemotherapy for luminal A patients; older age, not married, and high poverty for TNBC. There were 36% of luminal A and 40% of TNBC patients receiving nonstandard regimen (p = 0.27). Predictors of nonstandard regimen use were increased age, insurance, stage, and grade for luminal A and high poverty level and stage for TNBC. Reduced RDI occurred in 9% luminal A and 10% TNBC patients (p = 0.61). Small cases precluded the prediction model for low RDI. Conclusions: Luminal A patients are less likely to receive chemotherapy than TNBC patients. Low social economic status factors are associated with no chemotherapy use and nonstandard regimens use, especially for TNBC patients.