Multiracial Children and Poverty: Evidence From the Early Childhood Longitudinal Study of Kindergartners

Despite the recent growth in multiracial children among American children, we know very little about their well‐being. Using the Early Childhood Longitudinal Study, Kindergarten Class (N = 17,706), we evaluated the likelihood of living in poverty and near poverty for multiracial and monoracial children. Most multiracial groups have poverty or near poverty rates that are in between Whites and their respective minority monoracial counterparts, with Asian‐Whites reporting a risk of poverty equivalent to Whites and Black‐Hispanics reporting risks as high as Black and Hispanic children. Family structure and educational and occupational attainment characteristics explain some or all of the White/non‐White differentials in poverty for multiracial groups, even as monoracial children still exhibit higher risk than Whites. We consider these patterns' implications for practitioners working with low‐income families.     

A Novel Case of L‐transposition with a Right‐dominant Double Aortic Arch

We describe a case of congenitally corrected transposition with a double aortic arch. This unique combination of lesions highlights the importance of a complete anatomic assessment prior to referral for surgery.     

Health maintenance and screening in breast cancer survivors in the United States

BACKGROUND: The general health maintenance and follow-up of breast cancer survivors has not been well-studied. In a population-based sample we sought to investigate the health practices of breast cancer survivors and to compare rates of screening to women with no history of breast cancer. METHODS: Subjects were participants of the medical expenditure survey in the years 1996 and 1998, years for which information on screening were available. We used a matched cohort design. Breast cancer survivors aged 40 and older were matched (on age and race/ethnicity) to women with no breast cancer history. We performed logistic regression to estimate the odds of receiving appropriate health care services in breast cancer survivors versus women with no breast cancer history. In addition, we examined demographic and socioeconomic differences between breast cancer survivors who reported appropriate screening and survivors who had inadequate screening. RESULTS: A small minority of breast cancer survivors report inadequate mammography (18%) and clinical breast exam (12%) follow-up. A significant portion of breast cancer survivors report inadequate screening for Pap smear (40%), general physical exam (GPE) (30%) and flu shot (33%). The odds of receiving appropriate screening were higher in survivors versus matched women for mammography, clinical breast and cholesterol screening. There were no differences for other screening. Across all health maintenance and screening practices, breast cancer survivors who did not receive appropriate screening were less likely to have private insurance, to be married and to be above the mean income level, though these differences were non-significant. CONCLUSIONS: Although survivors report high levels of screening, a small minority of women report inadequate mammography and clinical breast exam follow-up which is concerning given their risk of recurrence and second primary breast cancer. Additionally, a significant portion of survivors report inadequate screening for general health maintenance issues. Demographic and socioeconomic factors were associated with lower screening rates. However, the deficits in screening among breast cancer survivors appears to be smaller compared to women in the general population.     

Fear of exercise and health-related quality of life in patients with an implantable cardioverter defibrillator

Several studies have reported improved survival rates thanks to the use of an implantable cardioverter defibrillator (ICD) in the treatment of patients with life-threatening arrhythmia. However, the effects of the ICD on health-related quality of life (HR-QoL) of these patients are not clear. The aim of this study is to describe HR-QoL and fear of exercise in ICD patients. Eighty-nine ICD patients from the University Hospital in Groningen, the Netherlands, participated in this study. HR-QoL was measured using the Rand-36 and the Quality of Life After Myocardial Infarction Dutch language version questionnaires. Fear of exercise was measured using the Tampa Scale for Kinesiophobia, Dutch version and the Fear Avoidance Beliefs Questionnaire, Dutch version. Association between outcome variables was analysed by linear regression analyses. Study results show that the HR-QoL of patients with ICDs in our study population is significantly worse than that of normal healthy people. Furthermore, fear of exercise is negatively associated with HR-QoL corrected for sex, age and number of years living with an ICD. After implantation of the ICD, patients with a clear fear of exercise should be identified and interventions should be considered in order to increase their HR-QoL.