Inter- and intrapopulation differences in the association between physical multimorbidity and depressive symptoms

BACKGROUND

The association between physical multimorbidity and depression differs by populations. However, no direct inter- or intrapopulation comparison of the association has been conducted. Thus, this study aims to estimate the association in China and the United States and reveal inter- and intrapopulation differences in the association.

METHODS

Middle-aged and older adults from the China Health and Retirement Longitudinal Study and the Health and Retirement Study were included. Physical multimorbidity was defined as the simultaneous presence of two or more chronic physical conditions and depressive symptoms was measured by the Center for Epidemiologic Studies Depression Scale. Generalized estimating equation model and stratification multilevel method were the main statistical models.

RESULTS

The presence of physical multimorbidity was associated with a higher risk of depression in both China (RR = 1.360 [95 % CI: 1.325-1.395]) and the US (RR = 1.613 [95 % CI: 1.529-1.701]). For individuals at a low risk of multimorbidity, multimorbidity was associated with 47.4 % (95 % CI: 1.377-1.579) and 71.1 % (95 % CI: 1.412-2.074) increases in the likelihood of depression in China and the US. The effect size was smaller for individuals at a moderate or high risk. However, the cross-national differences were greater for those with a high risk of multimorbidity.

LIMITATIONS

The self-report measures, attribution bias.

CONCLUSIONS

Compared to Chinese adults, the presence of physical multimorbidity led to an additional increase in depressive symptoms for American counterparts. The association was stronger for individuals at a low risk of multimorbidity, but cross-national differences were observed mostly among individuals at a high risk.

Racial/ethnic disparities in the cause of death among patients with prostate cancer in the United States from 1995 to 2019: a population-based retrospective cohort study

Background

Racial/ethnic disparities in prostate cancer are reported in the United States (US). However, long-term trends and contributors of racial/ethnic disparities in all-cause and cause-specific death among patients with prostate cancer remain unclear. We analysed the trends and contributors of racial/ethnic disparities in prostate cancer survivors according to the cause of death in the US over 25 years.

Methods

In this retrospective, population-based longitudinal cohort study, we identified patients diagnosed with first primary prostate cancer between 1995 and 2019, with follow-up until Dec 31, 2019, using population-based cancer registries' data from the Surveillance, Epidemiology, and End Results (SEER) Program. We calculated the cumulative incidence of death for each racial/ethnic group (Black, white, Hispanic, Asian or Pacific Islander [API], and American Indian or Alaska Native [AI/AN] people), by diagnostic period and cause of death. We quantified absolute disparities using rate changes for the 5-year cumulative incidence of death between racial/ethnic groups and diagnostic periods. We estimated relative (Hazard ratios [HR]) racial/ethnic disparities and the percentage of potential factors contributed to racial/ethnic disparities using Cox regression models.

Findings

Despite a decreasing trend in the cumulative risk of death across five racial/ethnic groups, AI/AN and Black patients consistently had the highest rate of death between 1995 and 2019 with an adjusted HR of 1.48 (1.40-1.58) and 1.40 (1.38-1.42) respectively. The disparities in all-cause mortality between AI/AN and white patients increased over time, with adjusted HR 1.32 (1.17-1.49) in 1995-1999 and 1.95 (1.53-2.49) in 2015-2019. Adjustment of stage at diagnosis, initial treatment, tumor grade, and household income explained 33% and 24% of the AI/AN-white and Black-white disparities in all-cause death among patients with prostate cancer.

Interpretation

The enduring racial/ethnic disparities in patients with prostate cancer, call for new interventions to eliminate health disparities. Our study provides important evidence and ways to address racial/ethnic inequality.

Funding

National Key R&D Program of China, National Natural Science Foundation of China, Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support, the Open Research Fund from Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Key Projects of Philosophy and Social Sciences Research, Ministry of Education of China.

Survival differences between the USA and an urban population from China for all cancer types and 20 individual cancers: a population-based study

Background

The systematic comparison of cancer survival between China and the USA is rare. Here we aimed to assess the magnitude of survival disparities and disentangle the impact of the stage at diagnosis between a Chinese metropolitan city and the USA on cancer survival.

Methods

We included 11,046 newly diagnosed cancer patients in Dalian Cancer Registry, China, 2015, with the follow-up data for vital status until December 2020. We estimated age-standardised 5-year relative survival and quantified the excess hazard ratio (EHR) of death using generalised linear models for all cancers and 20 individual cancers. We compared these estimates with 17 cancer registries' data from the USA, using the Surveillance, Epidemiology, and End Results database. We further estimated the stage-specific survival for five major cancers by region.

Findings

Age-standardised 5-year relative survival for all patients in Dalian was lower than that in the USA (49.9% vs 67.9%). By cancer types, twelve cancers with poorer prognosis were observed in Dalian compared to the USA, with the largest gap seen in prostate cancer (Dalian: 55.8% vs USA: 96.0%). However, Dalian had a better survival for lung cancer, cervical cancer, and bladder cancer. Dalian patients had a lower percentage of stage Ⅰ colorectal cancer (Dalian: 17.9% vs USA: 24.2%) and female breast cancer (Dalian: 40.9% vs USA: 48.9%). However, we observed better stage-specific survival among stage Ⅰ-Ⅱ lung cancer patients in Dalian than in the USA.

Interpretation

This study suggests that although the overall prognosis for patients was better in the USA than in Dalian, China, survival deficits existed in both countries. Improvement in cancer early detection and cancer care are needed in both countries.

Funding

National Key R&D Program (2021YFC2501900, 2022YFC3600805), Major State Basic Innovation Program of the Chinese Academy of Medical Sciences (2021-I2M-1-010, 2021-I2M-1-046), and Talent Incentive Program of Cancer Hospital of Chinese Academy of Medical Sciences.

Asymmetric effects of economic policy uncertainty and environmental policy stringency on environmental quality: evidence from China and the United States

The importance of economic policy uncertainty (EPU) and environmental policy stringency (EPS) in affecting environmental quality is gaining great attention in the literature. However, none of the existing studies has thought to investigate their combined effects on carbon dioxide (CO₂) emissions. Additionally, the individual investigations into the nexuses EPU-emissions and EPS-emissions primarily took a symmetric assumption between these variables into consideration. The current paper is an early attempt to close these gaps by examining the combined effects of economic policy uncertainty and environmental policy stringency on CO₂ emissions within asymmetric (nonlinear) frameworks in China and the United States (US). The empirical findings indicate that an improvement in EPU degrades the environmental quality in both countries. However, a negative shift in EPU decreases emissions in China while increasing them in the US. In terms of EPS, the estimates in the two nations led to similar results. A positive change in EPS is conducive to fewer emissions, whereas a negative change worsens environmental damage. These findings still hold with the sensitivity analysis using ecological footprint as an alternative gauge of environmental destruction. This study, therefore, suggests that both nations adopt stricter environmental policies. Additionally, Chinese policymakers should work to lessen uncertainty shocks, while the US government should promote more transparent economic policies.

Effects of High Temperature on COVID-19 Deaths in U.S. Counties

The United States of America (USA) was afflicted by extreme heat in the summer of 2021 and some states experienced a record-hot or top-10 hottest summer. Meanwhile, the United States was also one of the countries impacted most by the coronavirus disease 2019 (COVID-19) pandemic. Growing numbers of studies have revealed that meteorological factors such as temperature may influence the number of confirmed COVID-19 cases and deaths. However, the associations between temperature and COVID-19 severity differ in various study areas and periods, especially in periods of high temperatures. Here we choose 119 US counties with large counts of COVID-19 deaths during the summer of 2021 to examine the relationship between COVID-19 deaths and temperature by applying a two-stage epidemiological analytical approach. We also calculate the years of life lost (YLL) owing to COVID-19 and the corresponding values attributable to high temperature exposure. The daily mean temperature is approximately positively correlated with COVID-19 deaths nationwide, with a relative risk of 1.108 (95% confidence interval: 1.046, 1.173) in the 90th percentile of the mean temperature distribution compared with the median temperature. In addition, 0.02 YLL per COVID-19 death attributable to high temperature are estimated at the national level, and distinct spatial variability from -0.10 to 0.08 years is observed in different states. Our results provide new evidence on the relationship between high temperature and COVID-19 deaths, which might help us to understand the underlying modulation of the COVID-19 pandemic by meteorological variables and to develop epidemic policy response strategies.

A locational analytics approach to COVID-19 discrimination and inequality against minorities across the United States

A major challenge in managing disasters during a pandemic is assessing the inequalities in society and protecting vulnerable people. The objective of this paper is to geographically understand the discrimination and inequality against minorities by COVID-19. This study designed a locational discrimination index (LDI) to measure COVID-19 discrimination against minorities at county-level in the US. LDI is the difference between the death proportion of a minority and the proportion of a minority's population. If LDI >0 is significant, COVID-19 discrimination is identified against a minority in a county. I further developed a locational minority inequality index (LMII), and LMII of a minority is directly quantified by comparing its LDI with the LDI of the majority population (i.e., the White population in the US). If LMII>0 is significant, a significant health inequality is confirmed against a minority in a county. In the US, I found 157 counties with significant discrimination against Black people, and 103 counties with significant inequality against Black people; 58 counties with significant discrimination against the American Indian population, but 38 counties with significant inequality against the American Indian population; 17 counties with significant discrimination against Native Hawaiians, but only 8 counties with significant inequality; for Hispanic people, 47 counties had significant discrimination, and 64 counties had significant inequality; for Asians, 7 counties had significant discrimination, but 28 had significant inequality. LDI, LMII, and the thematic mapping provide novel insight into COVID-19 discrimination and inequalities. To the best of our knowledge, this is the first time anyone has quantitatively and statistically defined and mapped COVID-19 discrimination and inequality against minorities at a county-level across the US. Based on this, governments and communities could make efficient decisions and take effective action to addressthe significant discrimination and inequality against Black, American Indian, Native Hawaiian, Hispanic, and Asian people, which can be applied to other pandemics or public health disasters in the USA or other countries.

Dynamics and controls of inland water CH4 emissions across the Conterminous United States: 1860-2019

Inland waters (rivers, lakes, and reservoirs) have been recognized as hotspots of methane (CH₄) emissions. However, the magnitude and spatiotemporal pattern of CH₄ emissions and their underlying mechanisms remain largely unknown due to a lack of process-based quantification of CH₄ production, consumption, and evasion within the aquatic ecosystem. Here we developed a process-based aquatic CH₄ module within the framework of the Dynamic Land Ecosystem Model (DLEM) to explicitly simulate inland water carbon fluxes and the associated CH₄ processes. We further applied this model to assess the inland-water CH₄ emissions across the conterminous United States (CONUS) as affected by the climate variability, land use, fertilizer nitrogen (N) application, atmospheric N deposition, and rising atmospheric CO₂ concentration during 1860-2019. The inland water CH₄ emissions across the CONUS had doubled from the 1860s (1.65±0.18 Tg CH₄-C∙yr^-1) to the 2010s (3.73±0.36 Tg CH₄-C∙yr^-1). In the 2000s, inland water accounts for 8% of the regional CH₄ budget that offsets 11∼14% of the terrestrial C uptake across the CONUS. Our study showed that the small headwater streams (1^st -3^rd order) account for 49% of the diffusive CH₄, and reservoirs constitute 50% of the ebullitive CH₄ emissions during the 2010s. Climate change and variability played a dominant role in the increased CH₄ emissions from rivers and lakes. This study implies that effective mitigation strategies to reduce CH4 emissions should pay much attention to global climate change and headwater stream management.

Evaluating construction land use efficiency under carbon emission constraints: A comparative study of China and the USA

Research on construction land use efficiency with carbon emissions provides valuable insights for effective regulation of land use planning and low-carbon development. This study explores construction land use efficiency (CLUE) in China and the USA by employing a slack-based measure (SBM) that incorporates carbon emissions as undesirable output to evaluate CLUE at the provincial/state level. The abatement potential (AP) of construction land use and carbon emissions through the land utilization process are further explored. We find (1) that the average CLUE in China (0.512) is relatively higher than that in the USA, but the CLUE in both countries is at a relatively low level; (2) that carbon emissions, as undesirable output, have a negative impact on CLUE; and (3) that the average AP for construction land is 0.485 in China and 0.696 in the USA, while the average AP for carbon emissions is 0.500 in China and 0.576 in the USA. Understanding these characteristics can lead to better coordination of emissions reduction policies and land use policies to optimize the construction land inputs in both countries, thereby sustaining land use management while reducing carbon emission.

Quantified impacts of international trade on the United States' carbon intensity

After the USA reached its carbon emission peak in 2007, the share of carbon emissions from its energy activities showed a downward trend. As a country that accounts for even close to 80% of the tertiary industry, the final demands from other industries are usually met by other countries in the form of international trade. While trade is realizing economic transfer, it also realizes the transfer of carbon emissions to a certain extent, helping the country achieve the peaks. From the perspective of combining carbon emission transfer and economic transfer, are there transfers and impacts? In this study, the quantified impact of international trade on the USA's carbon intensity has been investigated by a novel framework, based on a porposed scenario analysis using MRIO. As it gets lower aggregate carbon intensity value under trade scenario, it concludes that international trade is more conducive to the needs of this country for carbon emission reduction and economic development in general. From the different trade patterns, all of them get lower carbon intensity values under trade than no-trade scenario. From trade partners' perspectives, the positive and negative of the intensity gap cannot be kept uniform for all traders. Sectoral driving factors are decomposed by LMDI method, with the sectoral effect of aggrerate value-added structure and sectoral aggregate embodied carbon intensity. Among obvious carbon-intensive sectors, transport sectors always show a negative effect for the gap, and heavy manufacturing and electricity sectors usually give positive effects. As a major trading country in the world, trade and exchanges with other countries are more conducive to this country with a lower carbon intensity, and it also requires the country to shoulder coresponding responsiblities as a great power while enjoying the benefies. It is conducive to the further strengthening of unity of the international community, to jointly address the challenges of climate change and achieve the subsequent carbon neutral targets.

Migration outside large cities: a comparison of the hiring of migrants for the food processing industry in the United States and Japan

Recent studies suggest that the hiring of migrants in the food processing industry has increased the migrant population outside large cities among affluent migrant-receiving countries. This study examines how the U.S. meatpacking industry and the Japanese seafood processing industry, in particular, have developed a dependence on migrants; it does so to identify whether and how a common-thus cross-nationally generalizable-process may account for migration outside large cities. A comparative historical analysis revealed that, with significant national differences between the United States and Japan, including in the legal and institutional contexts of migration, there is little commonality in the processes through which the industries have come to depend on migrants. Yet, there is a similarity in the development of mass production. Such production necessitates an undisrupted availability of full-time as well as low-wage workforce, and migrants on both sides of the Pacific are employed to ensure this availability. Thus, while urban-centered migration studies often emphasize the growth of low-wage services or small-batch manufacturing as an economic driver of migration, this study argues that, outside large cities, a different pattern of industrial transformation is associated with labor migration.

Veterinary antibiotics in swine and cattle wastewaters of China and the United States: Features and differences

Veterinary antibiotics (VAs) have been widely used in livestock for disease prevention, treatment, and growth promotion. This study compared top 20 VAs in Chinese and US swine and cattle wastewater with published literatures. The sulfonamides (SAs) were found to be predominant, accounting for 62% of the top 20 VAs in Chinese swine wastewater, while tetracyclines (TCs) contributed to about 68.7% of the 18 VAs in US swine wastewater. The average concentration of the 20 major VAs in Chinese swine wastewater was estimated to be 1145 μg/L against 253.6 μg/L in the United States. On the other hand, the five major VAs in Chinese cattle wastewater were identified to be oxytetracycline, nafcillin, apramycin, lincomycin, and amikacin, while monensin was found to be dominant in US cattle wastewater. The average concentration of the top 20 VAs in Chinese and US cattle wastewaters were found to be 54.6 and 46.2 μg/L, respectively. These analyses suggested that VAs were probably over-used in Chinese swine industry, eventually causing the development and spreading of antibiotic resistant-bacteria and genes, which should be paid with attention. PRACTITIONER POINTS: Major veterinary antibiotics (VAs) in swine and cattle wastewater were identified. Top 20 VAs in swine and cattle wastewater of China and the United States were compared. VAs concentration in Chinese swine wastewater was 4.52 times that in the United States. VAs concentration in Chinese cattle wastewater was 1.18 times that of the United States.

Obesity Kuznets curve and the reality of eco-income ellipsoids (EIE)

Health is regarded as a universal asset and how this translates into sustainable development has remained a subject of discourse in the growth and health literature. This disposition is in line with the United Nations Sustainable Development Goals-3, 8, and 13, which highlight the need for good health, sustainable economic growth, and environmental sustainability, respectively, especially for the United States. To this end, this study explores the nexus of turning point such that a subsequent growth in income level decreases the prevalence of obesity. Similarly, the study examined the existence of the minimum turning point after which the increase in the ecological footprint (EFP) escalates the prevalence of obesity. A recent time-series data of annual frequency from 1975 to 2016 are used for econometrics analysis to examine the reality of ellipsoidal hypothesis. The autoregressive distributed lag techniques are adopted for this study. Thus, an empirical investigation revealed that higher income per capita level leads to obesity until a certain threshold. Thus, the inverted U-shaped relationship between income and obesity is validated, while the nexus between EFP and obesity resonates with the U-shaped. The validity of these two forms of (obesity-income-EFP) relationship is captured as the ellipsoidal hypothesis. Additionally, an increase in life expectancy decreases obesity prevalence in the United States. Based on these outcomes, policy mechanisms should be geared toward adopting more sustainable productivity approaches and more push for higher income status for the citizenry.

Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

Background

The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs), such as non-essential business closures and gathering bans, to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is greatly needed to assist in guiding individualized decision making for adjustment of interventions in the US and around the world. However, the impacts of these approaches remain uncertain.

Methods

Based on the reported cases, the effective reproduction number (R_t) of COVID-19 epidemic for 50 states in the US was estimated. Measurements on the effectiveness of nine different NPIs were conducted by assessing risk ratios (RRs) between R_t and NPIs through a generalized linear model (GLM).

Results

Different NPIs were found to have led to different levels of reduction in R_t. Stay-at-home contributed approximately 51% (95% CI 46–57%), wearing (face) masks 29% (15–42%), gathering ban (more than 10 people) 19% (14–24%), non-essential business closure 16% (10–21%), declaration of emergency 13% (8–17%), interstate travel restriction 11% (5–16%), school closure 10% (7–14%), initial business closure 10% (6–14%), and gathering ban (more than 50 people) 7% (2–11%).

Conclusions

This retrospective assessment of NPIs on R_t has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10950-2.

Barriers to vaccination for coronavirus disease 2019 (COVID-19) control: experience from the United States

To date, the United States (U.S.) has been the most heavily impacted country by the coronavirus disease 2019 (COVID-19). By November 30, 2020, when this paper was written, 13.5 million cases were reported in the U.S. with over 268 000 deaths. Historically, vaccines have been one of the most effective and efficient technical tools for controlling a communicable disease. While the development of these vaccines has certainly been a challenge, it could be more challenging to achieve robust vaccine uptake because of many barriers. In this review, we focused on two types of barriers documented from long-term experience in the U.S.: structural and attitudinal. Structural barriers are systemic issues that impact one's ability to access a service, and they include time, transportation, cost, and clinic or outlet location; while attitudinal barriers are beliefs or perceptions that impact the willingness of at-risk individuals to seek out and/or accept a service. In the context of vaccination they include beliefs about the communicable disease, beliefs about vaccines, fear, and trust in healthcare and governmental agencies. Of the attitudinal barriers, public trust is a barrier that is of particular importance. In addition to affecting reception of vaccines, it may exacerbate disparities and reduce the likelihood of success of a vaccination program. Recommendations are made to overcome attitudinal barriers to help improve the effectiveness of vaccination programs for COVID-19 control in the U.S., such as building public support through bipartisan endorsements and leveraging social media platforms to promote vaccination.

Patient privacy and autonomy: a comparative analysis of cases of ethical dilemmas in China and the United States

Background

Respect for patients’ autonomy is usually considered to be an important ethical principle in Western countries; privacy is one of the implications of such respect. Healthcare professionals frequently encounter ethical dilemmas during their practice. The past few decades have seen an increased use of courts to resolve intractable ethical dilemmas across both the developed and the developing world. However, Chinese and American bioethics differ largely due to the influence of Chinese Confucianism and Western religions, respectively, and there is a dearth of comparative studies that explore cases of ethical dilemmas between China and the United States.

Methods

This paper discusses four typical cases with significant social impact. First, it compares two cases concerning patient privacy: the “Shihezi University Hospital Case”, in which a patient was used as a clinical teaching object without her permission, and the “New York-Presbyterian Hospital Case”, in which the hospital allowed the filming of a patient’s treatment without his consent. Second, it compares two cases regarding patient autonomy and potentially life-saving medical procedures: the “Case of Ms. L”, concerning a cohabitant’s refusal to sign a consent form for a pregnant woman’s caesarean, and the “Case of Mrs. V”, concerning a hospital’s insistence upon a blood transfusion for a dissenting patient. This paper introduces the supporting and opposing views for each case and discusses their social impact. It then compares and analyses the differences between China and the United States from cultural and legislative perspectives.

Conclusions

Ethical dilemmas have often occurred in China due to the late development of bioethics. However, the presence of bioethics earlier in the US than in China has not spared the US of ethical dilemmas. This paper highlights lessons and inspiration from the cases for healthcare professionals and introduces readers to the role and weight of privacy and autonomy in China and in the US from the perspectives of different cultures, religions and laws.

How the US Sanctions Are Affecting the Health Research System in Iran?

BACKGROUND

In November 2018, the United States withdrew from the Joint Comprehensive Plan of Action (JCPOA), known commonly as the Iran nuclear deal, and imposed severe sanctions on Iran. This study explores the impact of US sanctions in Iran's health research system.

METHODS

This phenomenological study interviewed 24 Iranian health science scholars through purposeful sampling to learn about their experiences and thoughts regarding the impact of US sanctions on Iran's health research system.

RESULTS

The impact of sanctions on Iran's health research system were classified into five categories: (a) financial issues, (b) difficulty in supplying laboratory materials and (c) equipment, (d) disruption in international research collaboration and activities, and (e) other issues (e.g., increased stress and workload).

CONCLUSION

This study indicated that since research centers in Iran are highly dependent on governmental budgets, sanctions have greatly affected the health research system in Iran. Financial and economic problems, restrictions in transferring funds, and the disruption in political and international relations have created many challenges for supplying medical laboratory materials and equipment for medical and health research centers in Iran.

Comparison of immunization systems in Japan and the United States - What can be learned?

Recently, efforts have been made to fill a so-called "vaccine gap" between Japan and other countries; however, more work remains. Concerns about adverse events following immunization (AEFI) resulted in an historically passive approach to policy making in the National Immunization Program (NIP). For example, reports of AEFI following human papillomavirus vaccine (HPVV) in 2013 led the Japanese government to withdraw its proactive recommendations, resulting in a sharp drop in HPVV coverage rate to less than 1.0%. In this report, we review key historical incidents that led to the current immunization system in Japan, compare it to that in the United States, and discuss strategies for improving the Japanese immunization system. By strengthening existing policies and programs, such as National Immunization Technical Advisory Groups and AEFI reporting, compensation laws, and immunization education, the remaining vaccine gap in Japan could be filled.

Traumatic brain injury mortality among U.S. children and adolescents ages 0-19 years, 1999-2017

INTRODUCTION

To examine recent traumatic brain injury (TBI) mortality changes among Americans aged 0-19 years by sex, age, urbanicity, state, and intent/causes of injury.

METHOD

TBI mortality per 100,000 population and average annual percent changes (AAPCs), plus 95% confidence intervals (CIs) based on Joinpoint regression models.

RESULTS

Age-adjusted TBI mortality among Americans aged 0-19 years declined consistently, though at varying rates between 1999 and 2013 (AAPC = -4.8%, 95%CI: -6.3%, -3.2%), and then significantly increased from 4.42 per 100,000 population in 2013 to 5.17 per 100,000 population in 2017 (AAPC = 3.4%, 95% CI: 1.7%, 5.1%). During the study time period, boys, rural children, and youth aged 15-19 years had higher TBI mortality rates than girls, urban children, and younger children, respectively. TBI mortality from unintentional transport crashes decreased substantially in all age groups between 1999 and 2017, and especially from 1999 to 2010. TBI mortality from suicide increased significantly from 2008 to 2017 in the 10-14-year age group (AAPC = 14.6%, 95% CI: 12.6%, 16.6%) and from 2007 to 2017 in the 15-19-year age group (AAPC = 6.3%, 95% CI: 3.8%, 8.7%). Unintentional transport crashes were the leading cause of TBI-related mortality in 46 states in 1999, but by 2017, suicide became the first leading cause in 14 states.

CONCLUSIONS

Pediatric TBI mortality declined consistently between 1999 and 2013 and increased significantly from 2013 to 2017, driven primarily by the mortality decrease from unintentional transport crashes and increase in suicide mortality. The spectrum of leading causes of pediatric TBI mortality changed across age groups and over time from 1999 to 2017. Practical Applications: TBI mortality increases in the United States since 2013 are driven primarily by increasing suicide rates, a trend that merits the attention of policy-makers and injury researchers. Action should be taken to curb growing TBI mortality rates among adolescents aged 10-19 years.

Determinants of Vietnamese footwear exporting firms' market selection: A multinomial logistic analysis of panel data

The literature on export activities is dominated by studies on the determinants of export performance, we contribute to this literature by investigating the determinants of selection of markets by using panel data of Vietnam's footwear firms for the 2006-2010 period. Since no variance was found between firms, a pooled multinomial logit model is consequently preferable. Among the notable results, export value shows a positive correlation with footwear firms serving the US and EU markets. Although Vietnamese footwear firms are less likely to export to the ASEAN countries, they tend to focus on diversifying their products in this market. Both private and FDI firms are less likely to export to the EU compared with their state-owned counterparts (SOEs). However, private firms outperform SOEs in the U.S market.

The Effects of Parental Warmth on Adolescent Delinquency in the United States and South Korea: a Cross-Cultural Perspective

Despite the prevalence of delinquency during adolescence and the influence of culture on parenting behaviors and adolescent outcomes, few studies have examined the association between parental warmth and adolescent delinquency cross-culturally. Thus, this study sought to identify cultural differences in the levels of delinquency and their associations with parental warmth. First, the levels of delinquency and the protective effect of parental warmth on delinquency were examined using a U.S. sample from the Longitudinal Study of Adolescent Health (Add Health). Next, the same two research questions were investigated using a Korean sample from the Korean Youth Panel Survey (KYPS). Finally, differences in such associations were examined between the samples from the U.S. and South Korea. The findings from the independent sample t-test revealed that the levels of delinquency were lower for Korean adolescents than American adolescents. The results from multiple regression also demonstrated the protective effect of parental warmth on delinquency for American adolescents. Further, parental warmth by country interaction suggested that the protective effect of parental warmth was statistically stronger for American adolescents than Korean adolescents. Implications of the findings suggested cultural differences in perceptions of parental warmth and its role in reducing adolescent delinquency.

Comparison of RN licensure examination: China and the United States

Having the two largest nursing workforces across the globe, both China and the United States have implemented licensure examinations to standardize the qualifications of registered nurse. China established the National Nursing Licensure Examination (NNLE) in 1995. Like the National Council Licensure Examination for Registered Nurses (NCLEX-RN) in the United States, the NNLE has become an important link in the nurse registration process and contributed a lot in quality assurance and development of nursing profession. It may be necessary for the NNLE to learn from NCLEX-RN in several aspects, including increasing the frequency of exam, providing examinees with individualized services, and continuing reforming exam content and format. By better aligning the content and format of the examination with the current nursing paradigm and clinical requirements, nurses may enter the healthcare field better prepared to care for patients. Considering the magnitude of their nursing workforce, both China and the United States have great potential to serve as a role model for other developing countries as they look towards establishing national nursing education programs. As new policies around standardized nurse education in China take form, we urge that the NNLE be included alongside curricular reforms. As these reforms are implemented, continued research will be needed to evaluate the effectiveness of curriculum and licensure exam regulations upon nurse preparedness and quality of nursing care in China.

Changing ideas in forestry: A comparison of concepts in Swedish and American forestry journals during the early twentieth and twenty-first centuries

By combining digital humanities text-mining tools and a qualitative approach, we examine changing concepts in forestry journals in Sweden and the United States (US) in the early twentieth and early twenty-first centuries. Our first hypothesis is that foresters at the beginning of the twentieth century were more concerned with production and less concerned with ecology than foresters at the beginning of the twenty-first century. Our second hypothesis is that US foresters in the early twentieth century were less concerned with local site conditions than Swedish foresters. We find that early foresters in both countries had broader-and often ecologically focused-concerns than hypothesized. Ecological concerns in the forestry literature have increased, but in the Nordic countries, production concerns have increased as well. In both regions and both time periods, timber management is closely connected to concerns about governance and state power, but the forms that governance takes have changed.

Neighborhood commuting environment and obesity in the United States: an urban-rural stratified multilevel analysis

OBJECTIVE

Automobile dependency and longer commuting are associated with current obesity epidemic. We aimed to examine the urban-rural differential effects of neighborhood commuting environment on obesity in the US METHODS: The 1997-2005 National Health Interview Survey (NHIS) were linked to 2000 US Census data to assess the effects of neighborhood commuting environment: census tract-level automobile dependency and commuting time, on individual obesity status.

RESULTS

Higher neighborhood automobile dependency was associated with increased obesity risk in urbanized areas (large central metro (OR 1.11[1.09, 1.12]), large fringe metro (OR 1.17[1.13, 1.22]), medium metro (OR 1.22[1.16, 1.29]), small metro (OR 1.11[1.04, 1.19]), and micropolitan (OR 1.09[1.00, 1.19])), but not in non-core rural areas (OR 1.00[0.92, 1.08]). Longer neighborhood commuting time was associated with increased obesity risk in large central metro (OR 1.09[1.04, 1.13]), and less urbanized areas (small metro (OR 1.08[1.01, 1.16]), micropolitan (OR 1.06[1.01, 1.12]), and non-core rural areas (OR 1.08[1.01, 1.17])), but not in (large fringe metro (OR 1.05[1.00, 1.11]), and medium metro (OR 1.04[0.98, 1.10])).

CONCLUSION

The link between commuting environment and obesity differed across the regional urbanization levels. Urban and regional planning policies may improve current commuting environment and better support healthy behaviors and healthy community development.