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Background: Non-Hispanic (NH) Black older adults experience substantially higher rates of potentially avoidable hospitalization compared to NH White older adults. This study explores the top three chronic conditions preceding hospitalization and potentially avoidable hospitalization among NH White and NH Black Medicare beneficiaries in the United States.Methods: Data on 4993 individuals (4,420 NH White and 573 NH Black individuals) aged ≥ 65 years from 2014 Medicare claims were linked with sociodemographic data from previous rounds of the Health and Retirement Study. Conditional inference random forests were used to rank the importance of chronic conditions in predicting hospitalization and potentially avoidable hospitalization separately for NH White and NH Black beneficiaries. Multivariable logistic regression with the top three chronic diseases for each outcome adjusted for sociodemographic characteristics were conducted to quantify the associations.Results: In total, 22.1% of NH White and 24.9% of NH Black beneficiaries had at least one hospitalization during 2014. Among those with hospitalization, 21.3% of NH White and 29.6% of NH Black beneficiaries experienced at least one potentially avoidable hospitalization. For hospitalizations, chronic kidney disease, heart failure, and atrial fibrillation were the top three contributors among NH White beneficiaries and acute myocardial infarction, chronic obstructive pulmonary disease (COPD), and chronic kidney disease were the top three contributors among NH Black beneficiaries. These chronic conditions were associated with increased odds of hospitalization for both groups. For potentially avoidable hospitalizations, asthma, COPD, and heart failure were the top three contributors among NH White beneficiaries and fibromyalgia/chronic pain/fatigue, COPD, and asthma were the top three contributors among NH Black beneficiaries. COPD and heart failure were associated with increased odds of potentially avoidable hospitalization among NH White beneficiaries, whereas only COPD was associated with increased odds of potentially avoidable hospitalizations among NH Black beneficiaries.Conclusion: Having at least one hospitalization and at least one potentially avoidable hospitalization was more prevalent among NH Black than NH White Medicare beneficiaries. This suggests greater opportunity for increasing prevention efforts among NH Black beneficiaries. The importance of COPD for potentially avoidable hospitalizations further highlights the need to focus on prevention of exacerbations for patients with COPD, possibly through greater access to primary care and continuity of care. [ABSTRACT FROM AUTHOR]

The article discusses a study on weight loss and the influence of linear growth in a group of children during a residential weight-loss program focusing on nutrition and physical activity in the U.S. The researchers found no negative effect on linear growth during the treatment, but linear growth increased during the stay as the average increase in height was 2.38 centimeters (cm) corresponding to 11.4cm per year. The children shed almost 1 kilogram (km) per week during the program without any negative effect on linear growth.

This article focuses on the practice of evidence-based treatments followed by obstetricians, under conditions that differ highly from the conditions under which the treatments were scientifically evaluated. Today, all over the western world, the frequency of cesarean section (CS) is increasing steadily, and both in relation to the delivery of breeches and HIV-positive pregnancies, it is assumed that there is sufficient evidence to justify an almost 100% use of operative delivery. At least in the U.S., the idea that vaginal births after CS should be substituted by another CS is becoming still more common.