Young US Research Articles

Caffeine intake is nonlinearly associated with muscle mass in young and middle-aged US adults.

Recent studies have indicated that coffee consumption is inversely correlated with sarcopenia in the elderly population. Data regarding the association between caffeine intake and muscle mass in young adults are scarce. We aimed to investigate how dietary caffeine correlates with muscle mass and sarcopenia in the young and middle-aged people. We performed a cross-sectional study utilizing data from NHANES. Muscle mass was evaluated using DXA and caffeine intake was derived from 24-h dietary recalls. Multivariable regression analysis was adopted to explore association between caffeine and sarcopenia. Restricted cubic spline analysis was conducted to investigate dose-response effect of dietary caffeine on muscle mass. Mediation effect of high-sensitivity C reactive protein was examined by mediation analysis. A total of 9116 adults aged from 20 to 59 years old were included. Higher ingestion of caffeine was not associated with sarcopenia. Association between dietary caffeine and muscle mass was found to be W-shaped in males and U-shaped in young females, wherein mediation effect of hs-CRP was not discovered. Caffeine consumption is associated with muscle mass in a nonlinear pattern. ASMI peaks at a daily caffeine intake of 1.23mg/kg in young adults, while 0.64-1.49mg/kg is recommended for middle-aged men.

Parental Health and Flourishing Among Young US Children

This cross-sectional study investigates the association between parental health and flourishing among children aged 6 months to 5 years in the US.

Transforming luxury: young consumers' motivations towards purchasing virtual luxury non-fungible token wearables

PurposeThis study explores young consumers' motivations for purchasing Virtual Luxury Non-Fungible Token Wearables (VL-NFTs) from luxury brands, which are virtually crafted luxury wearables minted as blockchain-based NFTs. Specifically, it investigates the relationships among consumers' perceived value of VL-NFTs, engagement with NFTs and purchase intention and the mediating effect of consumer engagement with NFTs.Design/methodology/approachData were collected via an online survey of 504 young US consumers who had previously considered purchasing luxury fashion products and NFTs. Structural equation modelling was adopted for analysis.FindingsPerceived economic, functional (uniqueness) and experiential (self-directed pleasure and affiliation) values of VL-NFTs directly influenced consumers' purchase intention. While symbolic value (self-presentation and conspicuousness) did not significantly influence purchase intention, it facilitated consumer engagement with NFTs. Moreover, consumer engagement mediated the relationship between economic and functional values and purchase intention.Research limitations/implicationsThe sample was only comprised of young consumers, limiting the generalizability. Additionally, consumers may perceive VL-NFTs differently because of differences in past experiences and the varying VL-NFT types, necessitating further investigation on consumers' motivations across different types of VL-NFTs.Originality/valueThis study contributes to the existing literature by examining the importance of multifaceted perceived-value dimensions and engagement with NFTs in consumers' motivation for purchasing VL-NFTs through the lens of the customer value framework.

Association of ultra-processed food consumption with muscle mass among young and middle-aged US adults.

Muscle mass is vital for physical activity and fundamental physiological processes supporting long-term health. While aging is inevitable, certain modifiable factors positively influence muscle preservation and overall well-being. However, the relationship between the consumption of ultra-processed foods (UPF) and muscle mass is not yet clear. This study included 7,173 men and nonpregnant women aged 20-59 years with valid 24-hour dietary recalls and accessible whole-body dual-energy x-ray absorptiometry (DXA) scans from NHANES 2011-2018. UPFs were identified through the NOVA classification system, and the percentage of energy derived from UPF consumption was evaluated in quintiles. Muscle mass measures were derived from DXA scans and quantified by the total and regional muscle mass index (MMI, kg/m²) and appendicular muscle mass index (AMMI, kg/m²). Multivariable-adjusted generalized linear regression models were applied to investigate the association between consumption of UPFs and muscle mass measures overall and by sociodemographic subgroups. The multivariable-adjusted differences of total MMI from the lowest to highest quintile of UPF consumption were 0 (reference), -0.03 (95% CI, -0.13, 0.07), -0.13 (95%CI, -0.24, -0.04), -0.12 (95% CI, -0.23, -0.01), and - 0.17 (95% CI, -0.27, -0.08) (P for trend < 0.001). Subtotal MMI followed a similar magnitude of associational pattern as total MMI. For trunk MMI, corresponding values from the lowest to highest quintiles of UPF consumption were 0 (reference), -0.02 (95% CI, -0.07, 0.02), -0.05 (95%CI, -0.11, 0.00), -0.07 (95% CI, -0.13, -0.01), and - 0.07 (95% CI, -0.12, -0.01). For AMMI, corresponding values from the lowest to highest quintiles of UPF consumption were 0 (reference), -0.004 (95% CI, -0.07, 0.06), -0.08 (95%CI, -0.14, -0.02), -0.05 (95% CI, -0.11, 0.02), and - 0.10 (95% CI, -0.16, -0.04) (All P for trend < 0.001). While most subgroups maintained similar overall patterns, heterogeneous findings were also observed. For example, the multivariable-adjusted differences in total MMI between the lowest and highest quantile of UPF consumption were - 0.19 (95% CI, -0.32, -0.06) for non-Hispanic Whites, 0.18 (95% CI, 0.01, 0.36) for non-Hispanic Blacks, -0.25 (95%CI, -0.45, -0.04) for Hispanics, -0.25 (95% CI, -0.51, 0.05) for non-Hispanic Asians and - 0.32 (95% CI, -0.75, 0.12) for others (P for interaction < 0.001). Higher consumption of UPFs was significantly associated with lower values of total and regional muscle mass. Specifically, comparing the highest quantile of UPF consumption to the lowest, total MMI decreased by 0.93%, trunk MMI decreased by 0.76%, and AMMI decreased by 1.25%. The differences in associational patterns between UPF consumption and muscle mass across sociodemographic subgroups require further investigation.

Breast Cancer Incidence Among US Women Aged 20 to 49 Years by Race, Stage, and Hormone Receptor Status

Breast cancer in young women has a less favorable prognosis compared with older women. Yet, comprehensive data on recent trends and how period and cohort effects may affect these trends among young women are not well-known. To evaluate breast cancer incidence among young women in the US over a 20-year period by race and ethnicity, hormone receptor status (estrogen receptor [ER] and progesterone receptor [PR]), tumor stage, and age at diagnosis, as well as how period and cohort effects may affect these trends. This cross-sectional study used data from Surveillance, Epidemiology, and End Results 17 registries (2000-2019). Women aged 20 to 49 years with a primary invasive breast cancer were included. Data were analyzed between February and June 2023. Age-standardized incidence rates (ASIR), incidence rate ratios (IRR), and average annual percent changes (AAPC) stratified by race and ethnicity, hormone receptor status, tumor stage, and age at diagnosis. Out of 217 815 eligible women (1485 American Indian or Alaska Native [0.7%], 25 210 Asian or Pacific Islander [11.6%], 27 112 non-Hispanic Black [12.4%], 37 048 Hispanic [17.0%], 126 960 non-Hispanic White [58.3%]), the majority were diagnosed with an ER+/PR+ tumor (134 024 [61.5%]) and were diagnosed with a stage I tumor (81 793 [37.6%]). Overall, invasive breast cancer incidence increased (AAPC, 0.79; 95% CI, 0.42 to 1.15), with increasing trends across almost all racial and ethnic groups. ASIR increased for ER+/PR+ (AAPC, 2.72; 95% CI, 2.34 to 3.12) and ER+/PR- tumors (AAPC, 1.43; 95% CI, 1.00 to 1.87), and decreased for ER-/PR+ (AAPC, -3.25; 95% CI, -4.41 to -2.07) and ER-/PR- tumors (AAPC, -0.55; 95% CI, -1.68 to 0.60). For women aged 20 to 29 and 30 to 39 years, ASIRs were highest among non-Hispanic Black women (age 20-29 years: IRR, 1.53; 95% CI, 1.43 to 1.65; age 30-39 years: IRR, 1.15; 95% CI, 1.12 to 1.18). For women aged 40 to 49 years, ASIR was lower for non-Hispanic Black women (IRR, 0.96; 95% CI, 0.94 to 0.97) compared with non-Hispanic White women. Incidence rates increased for stages I and IV tumors but decreased for stage II and III tumors. Age-period-cohort analysis demonstrated both cohort and period effects on breast cancer incidence (P < .001). In this population-based cross-sectional analysis, an increase in breast cancer incidence rates among young US women and age-related crossover between non-Hispanic White and Black women were observed. Prevention efforts in young women need to adopt a targeted approach to address racial disparities in incidence rates observed at different age phases.

Adverse Childhood Experiences and Developmental Delay in Young US Children.

Adverse childhood experiences (ACEs) are common and have been associated with poor developmental outcomes. We aimed to investigate the relationship between early ACE exposure, subsequent diagnosis of developmental delay, and receipt of developmental delay services by young children. In addition, we aimed to assess the impact of health-promoting behaviors such as breastfeeding and daily reading on these relationships. In this cross-sectional analysis of nationally-representative data from the 2017-2018 National Survey of Children's Health, we examined the relationship between ACEs, prior breastfeeding, daily reading, and developmental delay diagnosis among 7837 children aged 3-5 years, using multivariate logistic regression to adjust for family, personal, and sociodemographic characteristics. We found a dose-dependent relationship between ACEs and developmental delay diagnosis; compared to those without ACEs, developmental delay was more common among those with either one ACE (aOR = 2.03, 95% CI 1.17-3.52) or two or more ACEs (aOR = 2.34, 95% CI 1.25-4.37). Neither breastfeeding (exclusively breastfed for 6 months vs. never breastfed aOR = 0.70, 95% CI 0.33-1.46) nor daily reading (no reading versus daily reading aOR = 1.15, CI 0.57-2.33) were associated with incidence of developmental delay among study participants. There was no significant difference in receipt of services intended to meet developmental needs between children with and without ACEs. Children with very early ACE exposure are at increased risk for diagnosis of developmental delay. Early screening for ACEs and developmental delay may mitigate the early developmental manifestations of ACE exposure in vulnerable children.

The world was their laboratory: how two pioneer scientist-administrators, James Watt and Zdenek Fejfar, advanced methods and international collaboration in cardiovascular disease epidemiology during the Cold War.

In 1952, James Watt, a young US Public Health Service (PHS) infectious disease epidemiologist, was appointed-amid wide surprise-director of the US National Heart Institute (NHI) where he served until 1961. He skillfully advanced epidemiologic research methods and study conduct nationally while also establishing epidemiology in the administrative hierarchy of the institute. Watt soon turned to development of an effective program in international cardiovascular disease (CVD) epidemiology under auspices of the World Health Organization (WHO) at the United Nations in Geneva. That effort resulted in the 1959 appointment of Zdenek Fejfar, a young Czech clinical investigator, as director of the WHO CVD Unit. The coming together of Watt and Fejfar, with a joint focus on improved methods and population comparisons, helped establish a vigorous international community of CVD epidemiology. Their collaboration and friendship remained active and close throughout their career assignments and thereafter, as documented in this story.

The rise and fall of tobacco smoking and associated rise and fall of coronary atherosclerosis the lethal role of tobacco.

In this review two new hypotheses are explored, one, that the decline in coronary heart disease is mainly due to a dramatic decline in the prevalence of underlying atherosclerosis and two, that tobacco smoking has been a much greater influence on atherosclerosis than previously estimated. The major outcome of coronary atherosclerosis is myocardial infarction. Between 1900 and 1960 the prevalence of coronary atherosclerosis dramatically rose in young male soldiers. Between 1960 and 2010 the prevalence of coronary atherosclerosis in young US soldiers equally dramatically fell. Understanding the reasons for this rise and fall offers important insights into the causes of atherosclerosis. In 1960 over 50% of US military personnel were tobacco smokers but by 1988 the rate had reduced to 30%. The increased prevalence of coronary atherosclerosis in young soldiers between 1900 and 1960 was mainly due to increased tobacco smoking. An additional influence was an increase in food and sugar consumption. The fall in atherosclerosis between 1960 and 2010 was probably due to a reduction in tobacco smoking and to a lesser extent, control of hypertension and lowering of high serum total cholesterol. In Western populations up to two thirds of the fall in deaths due to myocardial infarction has been shown to be due to declines in the incidence of heart attacks. Based on the data included in this review it is arguable that the main reason for the fall in the incidence of heart attacks is the fall in the prevalence of underlying coronary atherosclerosis. The adverse influences of tobacco have been well documented. However the enormity of these adverse influences has not been recognised. Over 50% of men continue to smoke tobacco in China, Indonesia, Russia and middle eastern countries. Based on the experience of Western countries over half of these men will die of smoking related conditions.

US South Asian Youths' Perspectives on the Use of Complementary and Alternative Medicine (CAM).

Complementary and alternative medicine (CAM) includes varied medical and healthcare systems, healing practices, and products that are outside of allopathy/biomedicine. The aim of this study was to examine US South Asian youths' beliefs, practices, decision-making, and experiences of using CAM. Ten focus group discussions with 36 participants were conducted. Data were coded deductively and inductively by four coders, working in pairs. Thematic analysis was performed. Disagreements were resolved through consensus. The results showed that CAM was appealing because of its often low cost, ease of access, family traditions to use CAM, and the perception that it was safe to use. Participants exercised pluralistic health choices. Some responses suggested a hierarchy wherein allopathy was used for serious, acute issues, and CAM for much of the remaining issues. The high use of and trust in CAM among young US South Asians raises important issues (e.g., provider support and integration to prevent potential interactions and avoid delaying allopathic treatment). More exploration is needed about the decision-making processes of US South Asian youth, including the perceived benefits/limitations of allopathy and CAM. US healthcare practitioners should familiarize themselves with South Asian social and cultural beliefs about healing to provide culturally-appropriate services and enhance patient care.

1384-P: Trends in Prevalence, Awareness, and Treatment of Diabetes and Prediabetes among Young Adults in the U.S., 1988–2020

Objective: To estimate trends in prevalence, awareness and treatment of diabetes and prediabetes among young adults in the US. Methods: Adults aged 20-44 years except pregnant women were included from the National Health and Nutrition Examination Survey between 1988-1994 and 2017-2020. Primary outcomes were diabetes and prediabetes defined according to self-reported diagnosis, fasting plasma glucose, or hemoglobin A1c. Secondary outcomes were awareness and treatment of diabetes and awareness of prediabetes. The prevalence trends of outcomes were assessed, and grouping variables (e.g., age, sex, race/ethnicity) were selected for subgroup analysis. Results: Among young adults included, the estimated prevalence of diabetes increased from 3.1% [95% CI, 2.5%-3.7%] in 1988-1994 to 4.9% [95% CI, 4.0%-5.8%] in 2017-2020 (P=0.002). The estimated prevalence of prediabetes rose from 21.8% [95% CI, 19.7%-23.9%] in 1988-1994 to 28.7% [95% CI, 24.6%-32.8%] in 2017-2020 (P=0.001). The estimated prevalence of diabetes awareness decreased from 70.8% [95% CI, 60.4%-81.2%] in 1988-1994 to 64.9% [95% CI, 59.0%-70.8%] in 2010-2020 with no significance (P=0.25), and the estimated prevalence of diabetes treatment plateaued (P=0.64). In 2011-2020, among young adults with prediabetes, only 8.8% [95% CI, 6.5%-11.2%] reported being aware of their condition. During the study period, young adults aged 20-29 years had significant decrease in the prevalence of diabetes awareness and diabetes treatment, significant increase in the prevalence of prediabetes, and the lowest prevalence of prediabetes awareness. Conclusions: Among young US adults, the estimated prevalence of diabetes and prediabetes increased significantly from 1988 to 2020, and their awareness of diabetes and prediabetes was insufficient, especially among adults aged 20-29 years. Comprehensive actions are needed to address the continuously rising burden of glycemic control among young adults in the US. Disclosure Y.Huang: None. H.Wang: None. V.W.Zhong: None. Funding Shanghai Municipal Education Commission (QD2020027, GWV-10.1-XK15)

Association between the insulin resistance marker TyG index and subsequent adverse long-term cardiovascular events in young and middle-aged US adults based on obesity status

BackgroundA lthough the triglyceride-glucose (TyG) index has been shown to closely correlate with cardiometabolic outcomes and predict cardiovascular events in many groups, it remains unclear whether obese status in young and middle-aged adults is associated with long-term unfavorable cardiovascular events. This warrants further investigation.MethodsThis retrospective cohort study analyzed data from the National Health and Nutrition Examination Survey spanning the years 1999–2018, with follow-up for mortality status until December 31, 2019. To categorize participants based on the TyG level, the optimal critical value was determined through restricted cubic spline function analysis, dividing them into high and low TyG groups. The study assessed the relationship between TyG and cardiovascular events and all-cause mortality in young and middle-aged adults stratified by obesity status. Kaplan‒Meier and Cox proportional risk models were used to analyze the data.ResultsDuring a follow-up period of 123 months, a high TyG index increased the risk of cardiovascular events by 63% (P = 0.040) and the risk of all-cause mortality by 32% (P = 0.010) in individuals after adjusting for all covariates. High TyG was shown to be linked to cardiovascular events in obese people (Model 3: HR = 2.42, 95% CI = 1.13–5.12, P = 0.020); however, there was no significant difference in TyG groups for nonobese adults in Model 3 (P = 0.08).ConclusionsTyG was independently associated with harmful long-term cardiovascular events in young and middle-aged US populations, with a stronger association observed in those who were obese.

The Marquesan Adventure of John Minor Maury

John Minor Maury was a young US navy midshipman, who was found on the South Pacific island of Nuku Hiva by the USS Essex, on 25 October 1813. Decades after the incident, a biographical sketch of Maury appeared which purported to illuminate his adventure, in an account provided by his son. For over 130 years thereafter, the tale of John Maury was based on his son's recollection. In 2020, letters written by Maury and others were discovered and studied, revealing a complex and multi-layered enterprise of which he was a part: it is this new information to which this effort is directed, with the wish to provide a complete and verified account of John Maury and the sandalwood enterprise which brought him to the Marquesas.

Associations Between Product Type and Intensity of Tobacco and Cannabis Co-use on the Same Day Among Young Adult Smokers: Smartphone-Based Daily-Diary Study.

Co-use of tobacco and cannabis is highly prevalent among young US adults. Same-day co-use of tobacco and cannabis (ie, use of both substances on the same day) may increase the extent of use and negative health consequences among young adults. However, much remains unknown about same-day co-use of tobacco and cannabis, in part due to challenges in measuring this complex behavior. Nuanced understanding of tobacco and cannabis co-use in terms of specific products and intensity (ie, quantity of tobacco and cannabis use within a day) is critical to inform prevention and intervention efforts. We used a daily-diary data collection method via smartphone to capture occurrence of tobacco and cannabis co-use within a day. We examined (1) whether the same route of administration would facilitate co-use of 2 substances on the same day and (2) whether participants would use more tobacco on a day when they use more cannabis. This smartphone-based study collected 2891 daily assessments from 147 cigarette smokers (aged 18-26 years, n=76, 51.7% female) during 30 consecutive days. Daily assessments measured type (ie, cigarette, cigarillo, or e-cigarette) and intensity (ie, number of cigarettes or cigarillos smoked or number of times vaping e-cigarettes per day) of tobacco use and type (ie, combustible, vaporized, or edible) and intensity (ie, number of times used per day) of cannabis use. We estimated multilevel models to examine day-level associations between types of cannabis use and each type of tobacco use, as well as day-level associations between intensities of using cannabis and tobacco. All models controlled for demographic covariates, day-level alcohol use, and time effects (ie, study day and weekend vs weekday). Same-day co-use was reported in 989 of the total 2891 daily assessments (34.2%). Co-use of cigarettes and combustible cannabis (885 of the 2891 daily assessments; 30.6%) was most commonly reported. Participants had higher odds of using cigarettes (adjusted odds ratio [AOR] 1.92, 95% CI 1.31-2.81) and cigarillos (AOR 244.29, 95% CI 35.51-1680.62) on days when they used combustible cannabis. Notably, participants had higher odds of using e-cigarettes on days when they used vaporized cannabis (AOR 23.21, 95% CI 8.66-62.24). Participants reported a greater intensity of using cigarettes (AOR 1.35, 95% CI 1.23-1.48), cigarillos (AOR 2.04, 95% CI 1.70-2.46), and e-cigarettes (AOR 1.48, 95% CI 1.16-1.88) on days when they used more cannabis. Types and intensities of tobacco and cannabis use within a day among young adult smokers were positively correlated, including co-use of vaporized products. Prevention and intervention efforts should address co-use and pay attention to all forms of use and timeframes of co-use (eg, within a day or at the same time), including co-use of e-cigarettes and vaporized cannabis, to reduce negative health outcomes.

Affordable Care Act state Medicaid expansion and human papillomavirus vaccination among adolescent and young adult US women: A national study.

To ascertain the impact of Affordable Care Act (ACA) state Medicaid expansion on human papillomavirus (HPV) vaccination among both adolescent and young adult US women. We used state-level data on ACA Medicaid expansion and individual-level data on US women aged 15-25 years living at or below 138% of the Federal Poverty Level (FPL) from the 2011-2017 waves of the National Survey of Family Growth (N=2408). We conducted a quasi-experimental study examining the association between ACA state Medicaid expansion and HPV vaccination initiation among eligible adolescent and young adult US women. We used linear probability modeling within a difference-in-differences approach, adjusting for individual- and state-level covariates. Adjusting for individual- and state-level covariates, we found a negative association between Medicaid expansion and HPV vaccination among US women aged 15-25 years living in low-income households in the first year post-expansion (coefficient: -15.9 percentage points; 95% confidence interval [CI]: -30.1, -1.6 points). In contrast, we observed a positive association in the third year post-expansion (coefficient: 20.5 percentage points; 95% confidence interval [CI]: -1.8, 42.9 points). Medicaid expansion may have increased HPV vaccination among adolescent and young adult US women over time. Additional research is needed to identify the mechanisms and differential effects of Medicaid expansion on HPV vaccination among diverse subgroups of US women.

Tech Workers Rising: Why are so many young US tech workers embracing labour activism?

Tech Workers Rising: Why are so many young US tech workers embracing labour activism?

Abstract 13611: Association of Poor Mental Health With Cardiovascular Disease and Suboptimal Cardiovascular Health Among Young U.S. Adults

Introduction: Depression is a non-traditional risk factor for cardiovascular disease (CVD). Data on the association of depression and poor mental health with CVD and suboptimal cardiovascular health (CVH) among young adults are limited. Methods: We utilized data from 593,616 young adults (18-44 years) from the 2017-2020 Behavioral Risk Factor Surveillance System, a nationally representative survey of non-institutionalized US adults. Exposures were self-reported depression and poor mental health days (PMHD, categorized as 0 days, 1-13 days, 14-30 days poor mental health in the past 30 days), and outcomes were self-reported CVD (MI, angina, or stroke) and suboptimal CVH (≥ 2 risk factors: hypertension, hypercholesterolemia, overweight/obesity, current smoker, diabetes, inactivity, and inadequate fruit and vegetable intake). Using logistic regression, we investigated the association of depression and PMHD with CVD and suboptimal CVH adjusted for sociodemographic factors (and CVD risk factors for CVD). Results: The weighted prevalence of CVD was 2.5% (95% CI 2.4%-2.6%), and depression was 19.6% (95% CI 19.4%-19.8%). CVD was more common among young adults with depression than those without (fully adjusted odds ratio [aOR]: 2.28, 95% CI: 2.10-2.48, Fig. 1A). There was a graded association of PMHD with CVD. Compared with individuals with 0 PMHD, the odds of CVD in those with 1-13 PMHD and 14-30 PHMD were 1.49 (95% CI:1.36-1.64) and 2.26 (95% CI: 2.06-2.48)(Fig. 1B), respectively after adjusting for sociodemographic and CV risk factors. Individuals with depression had higher odds of suboptimal CVH (aOR: 1.77, 95% CI: 1.67-1.88)(Fig 1C) compared with those without depression, with a similar graded relationship observed between PMHD and CVH ( Fig 1D). Conclusion: Depression and poor mental health are associated with premature CVD and suboptimal CVH in young US adults. Prioritizing mental health may help reduce CVD risk and improve CVH in young adults.

Adverse Maternal and Delivery Outcomes in Children and Very Young (Age ≤13 Years) US Adolescents Compared With Older Adolescents and Adults

This study uses a US claims database to compare morbidity and delivery outcomes among pregnant 10- to 13-year-olds vs 14- to 17-year-olds and 18- to 19-year-olds.

Progress, Interrupted: American Students of Theodor Leschetizky in Vienna

Abstract Musical training, for the amount of time and the diligence it takes, has often been metaphorized as a long and arduous journey, with Johann Joseph Fux’s 1725 instructional book for piano players, Gradus ad Parnassum, being a case in point. For young US American pianists at the turn of the century, the idea of instrumental training as a gradual progress toward a goal blended in with the actual experience of crossing the ocean to study with European teachers. The Vienna-based pianist Theodor Leschetizky (1830–1915) counted among the most popular teachers for American students. While no musical expedition, whether figurative or real, comes without obstacles, Leschetizky introduced a particular barrier for those interested in making a career in music. He employed assistant teachers that prepared students before they were allowed to proceed and work with him directly. This strategy turned out to be rather rewarding financially, and it also catered to fundamental concepts about artistic achievement and transatlantic relations held by the classical music scene. In this article, I will address the special appeal that Leschetizky’s gatekeeping regimen had for pianists from the United States. I will describe organizational, financial, and aesthetic implications as well as the consequences that accepting or refusing this system had for American students. In doing this, I will draw on unpublished documents from the archive of the New York Leschetizky Association and on reports from Leschetizky students and assistants.

Progress, Interrupted: American Students of Theodor Leschetizky in Vienna

Abstract Musical training, for the amount of time and the diligence it takes, has often been metaphorized as a long and arduous journey, with Johann Joseph Fux’s 1725 instructional book for piano players, Gradus ad Parnassum, being a case in point. For young US American pianists at the turn of the century, the idea of instrumental training as a gradual progress toward a goal blended in with the actual experience of crossing the ocean to study with European teachers. The Vienna-based pianist Theodor Leschetizky (1830–1915) counted among the most popular teachers for American students. While no musical expedition, whether figurative or real, comes without obstacles, Leschetizky introduced a particular barrier for those interested in making a career in music. He employed assistant teachers that prepared students before they were allowed to proceed and work with him directly. This strategy turned out to be rather rewarding financially, and it also catered to fundamental concepts about artistic achievement and transatlantic relations held by the classical music scene. In this article, I will address the special appeal that Leschetizky’s gatekeeping regimen had for pianists from the United States. I will describe organizational, financial, and aesthetic implications as well as the consequences that accepting or refusing this system had for American students. In doing this, I will draw on unpublished documents from the archive of the New York Leschetizky Association and on reports from Leschetizky students and assistants.

Correction to: Sex Differences in Temporal Trends of Cardiovascular Health in Young US Adults.

Correction to: Sex Differences in Temporal Trends of Cardiovascular Health in Young US Adults.