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Purpose: To identify factors associated with urinary incontinence (UI) in women of various Hispanic/Latina backgrounds., Materials and Methods: We analyzed data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multicenter, community-based cohort study which includes a health-related questionnaire assessing presence and type of UI. Complex survey logistic regression analysis was used to assess the cross-sectional association of Hispanic/Latina backgrounds and other factors of UI. All estimates accounted for HCHS/SOL survey design., Results: Of 5027 women, 33.4% answered "yes" to UI. Rates of any UI ranged from approximately 21.9% to 40.3% in women of Dominican and Puerto-Rican background, respectively. Any UI and UI subtypes were associated with age older than 65 years, increasing body mass index, smoking status, any alcohol use, parity ≥3, and postmenopausal status. After controlling for covariates and when compared with women of Mexican background, women of Dominican background were less likely to have any UI (OR = 0.42, 95% CI 0.30-0.57), as were women of Cuban (OR = 0.48, 95% CI 0.37-0.62), Puerto-Rican (OR = 0.79, 95% CI 0.62-1.0), and mixed (OR = 0.62, 95% CI 0.39-0.99) background; and women of every other background except for South American were less likely to have stress UI. In addition, women of Cuban (OR = 0.53, 95% CI 0.32-0.86) and mixed (OR = 0.38, 95% CI 0.16-0.87) background were less likely to have urge UI than women of Mexican background., Conclusions: Our study demonstrates differences in UI by Hispanic/Latina background, suggesting collective designation of Hispanics/Latinas as a single ethnic group does not adequately describe UI among this diverse group., (© 2023 Wiley Periodicals LLC.)

Purpose of Review: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) has made important contributions on the prevalence of and factors associated with cardiovascular disease (CVD) risk factors among diverse Hispanic/Latino adults in the US. This article summarizes the knowledge gained thus far on major CVD risk factors from this landmark study., Recent Findings: HCHS/SOL demonstrated the sizeable burdens of CVD risk in all major Hispanic/Latino groups in the US, as well as the marked variations in prevalence of hypertension, hypercholesterolemia, diabetes, obesity, and smoking by sex and background. It also identified sociodemographic, lifestyle, and sociocultural characteristics associated with risk factors. HCHS/SOL has yielded an expanding body of literature on characteristics associated with adverse CVD risk factors in this population. Long-term follow-up of this cohort will shed further light on the observed heterogeneity in CVD risk across Hispanic/Latino groups and identify specific risk/protective factors driving these variations., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: In a cross-sectional sample of US Hispanic/Latino adults, we aimed to describe step-based metric distributions, estimate their associations with activity counts and self-report, and calibrate step-based translations of current (2018) US physical activity (PA) guidelines, that is, ≥150 min·wk -1 moderate-to-vigorous PA (MVPA) from accelerometer counts and self-report., Methods: The Hispanic Community Health Study/Study of Latinos enrolled 16,415 Hispanic/Latino adults 18-74 yr from four US cities (2008-2011). Participants completed the Global PA Questionnaire and 1 wk of Actical accelerometer wear ( n = 12,528). Weighted medians were used to describe step-based metrics, and Spearman correlations estimated their relationships with count-based and self-reported PA indicators. Receiver operator characteristic curve analyses were used to examine the ability of each step-based metric to classify participants meeting PA guidelines., Results: Overall, US Hispanic/Latino adults accumulated medians of 6770 steps per day and 6, 18, 236, and 630 min·d -1 at ≥100, ≥70, 1-69, and 0 steps per minute, respectively. Count-based time in MVPA, light PA, and sedentary behavior were most strongly correlated ( rs = 0.79-0.85) with times ≥70, 1-69, and 0 steps per minute, respectively, whereas self-reported MVPA had similar correlations with steps per day and times ≥40 and ≥70 steps per minute ( rs = 0.28-0.29). Time ≥70 steps per minute had the greatest capacity to classify participants meeting PA guidelines with both measures of MVPA., Conclusions: This study provides the first normative values (based on percentiles) of step-based metrics for US Hispanic/Latino adults, which can facilitate surveillance, program planning, research, and data interpretation. Our finding that PA guidelines corresponded to 6000-7000 steps per day or ~20 min·d -1 at ≥70 steps per minute with an Actical accelerometer can be considered alongside dose-response relationships with health outcomes to develop step-based recommendations that are consistent with and better communicate PA guidelines., (Copyright © 2023 by the American College of Sports Medicine.)

Objective: To examine diabetes incidence in a diverse cohort of U.S. Hispanic/Latinos., Research Design and Methods: The Hispanic Community Health Study/Study of Latinos is a prospective cohort study with participants aged 18-74 years from four U.S. metropolitan areas. Participants were assessed for diabetes at the baseline examination (2008-2011), annually via telephone interview, and at a second examination (2014-2017)., Results: A total of 11,619 participants returned for the second examination. The overall age-adjusted diabetes incidence rate was 22.1 cases/1,000 person-years. The incidence was high among those with Puerto Rican and Mexican backgrounds as well as those aged ≥45 years and with a BMI ≥30 kg/m2. Significant differences in diabetes awareness, treatment, and health insurance coverage, but not glycemic control, were observed across Hispanic/Latino background groups, age groups, and BMI categories., Conclusions: Differences in diabetes incidence by Hispanic/Latino background, age, and BMI suggest the susceptibility of these factors., (© 2022 by the American Diabetes Association.)

Previous studies have shown complications of pregnancy, often examined in aggregate, to be associated with autism spectrum disorder (ASD). Results for specific complications, such as maternal diabetes and hypertension, have not been uniformly consistent and should be investigated independently in relation to ASD in a large community-based sample. The Study to Explore Early Development (SEED), a US multisite case-control study, enrolled children born in 2003-2006 at 2-5 years of age. Children were classified into three groups based on confirmation of ASD (n = 698), non-ASD developmental delay (DD; n = 887), or controls drawn from the general population (POP; n = 979). Diagnoses of any diabetes or hypertensive disorder during pregnancy were identified from prenatal medical records and maternal self-report. Logistic regression models estimated adjusted odds ratios (aOR) and confidence intervals (CI) adjusting for maternal age, race/ethnicity, education, smoking during pregnancy, and study site. Models for hypertension were additionally adjusted for parity and plurality. Among 2,564 mothers, we identified 246 (9.6%) with any diabetes and 386 (15.1%) with any hypertension in pregnancy. After adjustment for covariates, any diabetes during pregnancy was not associated with ASD (aOR = 1.10 [95% CI 0.77, 1.56]), but any hypertension was associated with ASD (aOR = 1.69 [95% CI 1.26, 2.26]). Results were similar for DD, and any diabetes (aOR = 1.29 [95% CI 0.94, 1.78]) or any hypertension (aOR = 1.71 [95% CI 1.30, 2.25]). Some pregnancy complications, such as hypertension, may play a role in autism etiology and can possibly serve as a prompt for more vigilant ASD screening efforts. Autism Res 2019, 12: 967-975. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We studied if common complications in pregnancy are associated with autism spectrum disorder (ASD) in a large sample of mothers and children. Our results show an association between conditions marked by high blood pressure and ASD, but no association with conditions marked by high blood sugar and ASD. Associations were similar for children who had a developmental disorder that was not ASD, suggesting that this relationship may not be specific to ASD., (© 2019 International Society for Autism Research, Wiley Periodicals, Inc.)

Most prior studies examining maternal pre-pregnancy body mass index (BMI) in relation to offspring autism spectrum disorders (ASD) have reported an association, though findings are not uniform and few have also examined gestational weight gain (GWG). Therefore, we examined both in the Study to Explore Early Development, a multi-site case-control study of children born in 2003-2006. Children identified from clinics, schools, and birth certificates were enrolled at ages 2-5 year and using standardized developmental evaluations, classified as: ASD, other developmental delays (DD), or population-based controls. Maternal height, weight, and GWG were self-reported during the telephone interview. Three primary weight risk factors were examined: (a) Pre-pregnancy BMI, classified as underweight to obese, (b) GWG continuous and categorized as quintiles, and (c) Institute of Medicine clinical weight-gain recommendations. Odds ratios adjusted (AOR) for sociodemographic and prenatal factors were calculated among term singletons, comparing the ASD (n = 540) or DD (n = 720) groups to the control group (n = 776). The AOR of ASD and maternal obesity was 1.37 (95%CI 0.98-1.92). Associations with higher GWG were stronger (Quintile5 vs. Quintile3 AOR = 1.58, 95%CI 1.08-2.31), and particularly so among overweight/obese women (AOR = 1.90, 95%CI 0.98-3.68). DD was associated with maternal overweight and obesity (obesity AOR = 1.48, 95%CI 1.08-2.02), but not with total GWG or clinical recommendations. High maternal BMI and GWG are risk factors for other pregnancy and child outcomes, and our results suggest they may also represent modifiable risk factors for neurodevelopmental outcomes. Autism Res 2019, 12: 316-327 © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: In a large, national study, we found that children with autism were more likely than unaffected children to have mothers with higher weight gain during pregnancy; risk of autism may be even stronger if mothers were also overweight before pregnancy. Children with other developmental delays were more likely to have mothers who were overweight or obese before pregnancy, but not who gained more weight during pregnancy. Overweight and weight gain may represent factors that could be modified., (© 2018 International Society for Autism Research, Wiley Periodicals, Inc.)

Timing issues will continue to be at the forefront of insurance coverage disputes for a long time, and may impact not only the question of which insurer is responsible for a particular loss, but also whether any coverage exists at all. For example, if a policyholder has self-insured for any period, the timing issue may well determine whether purchased liability insurance will afford any protection for the loss. Though courts have provided useful guidelines, in order to determine coverage the facts of each case must be carefully examined, particularly the policy language and the nature of the injury on which the claim is founded. When there are difficult timing questions, one viable approach may be for the policyholder to select a "target" insurer to sue for coverage, based in part on the timing analysis, and leave to the targeted insurer the task of seeking contribution from all other carriers potentially responsible for covering the loss.

Mercer-B&H survey shows employers, doctors, insurers, and workers do not understand each other's most basic concerns. For example, respondents disagree on such issues as how to define quality care and whether freedom to choose a doctor is important.