Diacetyl-Induced Lung Disease

Diacetyl is a diketone flavouring agent that is commonly employed for buttery taste as well as other purposes. Industrial exposure to flavouring agents, particularly diacetyl, has recently been associated with bronchiolitis obliterans, a severe respiratory illness producing fibrosis and obstruction of the small airways. This has been most commonly reported in the microwave popcorn production industry, but it has occurred elsewhere. In addition to bronchiolitis obliterans, spirometry abnormalities (fixed airflow obstruction) and respiratory symptoms have been associated with exposure. A direct effect on the respiratory epithelium with the disorganised fibrotic repair appears most likely as the underlying mechanism. Current data suggest that diacetyl is the agent responsible, although it is possible that diacetyl is simply a marker for another causative agent.     

A household survey of older Iu-Mien refugees in rural California

There is a very sparse literature on the distinct named cultural groupsthat migrated from Southeast Asia to the USA in recent years, especially onthe elderly. People aged 60 or more years from one specific group, Iu-Mienrefugees primarily from the highlands of Laos, are discussed here, through:(a) a review of available information about the traditional roles of olderpeople and adjustment to life in the USA, and (b) a household survey of onecommunity of Iu-Mien in Merced, California. Older people comprise a largerthan expected proportion (7%) of the Iu-Mien community. The largehouseholds remain traditional in composition with many older men acting aspatriarchs to several generations of lineal kin. Women, who are usuallywidows, tend to live with the families of sons or sons-in-law.Intergenerational disaffection has been reported in the literature, in partdue to the status losses by older people and role reversals so common amongrefugees.     

Diacetyl-induced lung disease

Diacetyl is a diketone flavouring agent that is commonly employed for buttery taste as well as other purposes. Industrial exposure to flavouring agents, particularly diacetyl, has recently been associated with bronchiolitis obliterans, a severe respiratory illness producing fibrosis and obstruction of the small airways. This has been most commonly reported in the microwave popcorn production industry, but it has occurred elsewhere. In addition to bronchiolitis obliterans, spirometry abnormalities (fixed airflow obstruction) and respiratory symptoms have been associated with exposure. A direct effect on the respiratory epithelium with the disorganised fibrotic repair appears most likely as the underlying mechanism. Current data suggest that diacetyl is the agent responsible, although it is possible that diacetyl is simply a marker for another causative agent.     

A demographic survey of Iu-Mien in West Coast states of the U.S., 1993

Beginning in 1975, Mien refugees migrated to the United States from the highlands of Southeast Asia, primarily but not exclusively from Laos. Reported here are 1993 data on the basic size and composition of the Iu-Mien population in the West Coast states (Washington, Oregon, and California), the most popular settlement destination for this group. Three-fourths of Mien in this region live in California. Surveys reveal a young population, half being under age 15 years but with a surprisingly large (6.8%) proportion of people aged 60 or older. Approximately half of all Mien households, which typically contain 5–7 members, are two-generation nuclear families, i.e., parents and their school-age or younger children. Through the addition of grandparents, other kin, or unrelated individuals, the remaining households comprise three- or four-generation domestic units. Most (around 90%) Mien households are headed by middle-aged males, although some households in all locations are headed by females. Employment rates for Mien households vary by state and by location in an urban or rural area. State welfare policies as well as differential availability of work for unskilled or poorly educated individuals seem to be major factors accounting for differences in employment.     

Stressors and barriers to using mental health services among diverse groups of first-generation immigrants to the United States

This study examined stressors and barriers to using mental health services among first-generation immigrants in San Jose, California. Focus groups for 30 immigrants from Cambodia, Eastern Europe, Iran, Iraq, Africa, and Vietnam were audio-recorded, translated and transcribed. Two researchers coded the data and identified themes pertaining to mental health stressors and barriers. Six primary stressors were identified: economic, discrimination, acculturation due to language differences, enculturation, parenting differences, and finding suitable employment. Primary barriers included: stigma, lack of a perceived norm in country of origin for using mental health services, competing cultural practices, lack of information, language barriers, and cost. A conceptual model is presented that may be used to inform the design and implementation of mental health services for this population.     

Prevalence and risk of fracture diagnoses in women across the adult life span: a national cross-sectional study

Summary

In a national sample of women veterans, the rate of lower limb fracture diagnosis was the highest across ages 18–74 years; rates of fracture diagnosis of other skeletal sites peaked in women aged 75+. Women with two or more primary care visits or mental healthcare visits had elevated odds of fracture diagnosis.

Introduction

We assessed the prevalence and healthcare utilization characteristics associated with a diagnosis of any fracture in women of all adult ages within the Veterans Health Administration.

Methods

In 344,488 women during fiscal year 2012, logistic regression models for fracture diagnosis included age, race/ethnicity, residence, number of primary care visits, number of mental healthcare visits, and degree of service-connected disability.

Results

Lower limb fracture diagnosis was most prevalent across ages 18–74 years and peaked in women aged 55–64 years. In women aged 75+, the prevalence rates of fracture diagnosis at the hip (102, 95 % CI?=?88–115 per 10,000 women), upper limb (100, 95 % CI?=?87–114 per 10,000 women), and lower limb (84, 95 % CI?=?72–97 per 10,000 women) were the highest. Fractures at other skeletal sites peaked in those aged 75+?years. Black women had the lowest odds of a fracture diagnosis, followed by Asian/Pacific Islander and Hispanic women compared to non-Hispanic White (by 25–51 %, P?<?0.05). Having two or more primary care visits or any mental health visit was each associated with an increased risk. Women with five or more primary care visits had a 3.36-fold (95 % CI?=?3.02–3.75) greater odds than those with no such visit, and separately, women with five or more mental health visits had a 1.51-fold (95 % CI?=?1.43–1.60) greater odds. Women with a fracture diagnosis had higher overall healthcare costs than those without (P?<?0.001).

Conclusions

Prevalence of fracture diagnosis differed by age, race/ethnicity, and skeletal site of fracture. Fracture diagnosis may identify women veterans with greater overall healthcare needs.

     

Maternal migraine and risk of pediatric cancers

Background

Maternal migraine has been linked to adverse birth outcomes including low birth weight and preterm birth, as well as congenital anomalies in offspring. It has been speculated that this may be due to the use of medications in pregnancy, but lifestyle, genetic, hormonal, and neurochemical factors could also play a role. There is evidence for varying cancer incidences among adults with migraine. Here, we utilized data from national registries in Denmark to examine associations between maternal diagnoses of migraine and risk for cancer in offspring.

Methods

We linked several national registries in Denmark to identify cases from the Cancer Registry among children less than 20 years (diagnoses 1996–2016) and controls from the Central Population Register, matched to cases by birth year and sex (25:1 matching rate). Migraine diagnoses were identified from the National Patient Register using International Classification of Diseases, versions 8 and 10 codes and migraine-specific acute or prophylactic treatment recorded in the National Pharmaceutical Register. We used logistic regression to estimate the risk of childhood cancers associated with maternal migraine.

Results

Maternal migraine was positively associated with risk for non-Hodgkin lymphoma (odds ratio [OR] = 1.70, 95% confidence interval [CI]: 1.01–2.86), central nervous system tumors ([OR = 1.31, 95% CI: 1.02–1.68], particularly glioma [OR = 1.64, 95% CI: 1.12–2.40]), neuroblastoma (OR = 1.75, 95% CI: 1.00–3.08), and osteosarcoma (OR = 2.60, 95% CI: 1.18–5.76).

Conclusions

Associations with maternal migraine were observed for several childhood cancers, including neuronal tumors. Our findings raise questions about the role of lifestyle factors, sex hormones, genetic, and neurochemical factors in the relationship between migraine and childhood cancers.