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Background Incidence of end-stage renal disease (ESRD) is higher in Israel than the European average. Socio-economic differences in ESRD have been reported globally, but many countries lack a national register. Using national data, we assessed which socio-demographic factors are associated with 5-year incidence of ESRD in Israel, where there is universal access to renal replacement therapy (RRT). Methods Data on all incident ESRD cases aged ≥20 years receiving chronic RRT between 1 January 2014 and 31 December 2018 (N = 7883) were collected from Israel’s National Dialysis & Renal Transplant Register. Individual-level data on ESRD cases requiring RRT included residential area, age, gender, ethnicity (Jewish or Arab) and ESRD cause (diabetes, other, unknown/missing). Area-level data included age and sex distribution, socio-economic status (SES) and proportion of Arab population. The associations between individual-level socio-demographic characteristics and ESRD cause were tested in bivariate comparisons. The risk of developing ESRD during the study period (from all and specific causes) was estimated using multiple Poisson regression models with negative binomial distribution, using four parameters, namely sex, ethnicity, SES category and age strata, based on area-level distribution of these parameters, and with the whole population (aged ≥20 years) as the denominator. Results A socio-economic gradient was seen for ESRD from all causes, more marked for diabetic aetiology [rate ratio (RR)=0.45, 95% CI: 0.39–0.52 highest vs lowest SES categories] than from other (RR = 0.64, 95% CI: 0.55–0.75) or unknown cause (RR = 0.79, 95% CI: 0. 62–0.99). Based on population area-level data, predominantly Arab neighbourhoods showed higher risk for ESRD requiring RRT for all causes, with the strongest association for diabetes (RR = 1.69, 95% CI: 1.53–1.86) adjusted for SES, age and sex. Conclusions A strong socio-economic gradient was demonstrated for ESRD requiring RRT. Arab ethnicity was associated with higher risk for ESRD, especially due to diabetes. Our findings suggest the need for allocation of health resources according to needs and culturally appropriate interventions for improving control of modifiable risk factors for chronic renal failure.

Individuals regularly struggle to save for retirement. Using a large-scale field experiment (N=97,149) in Mexico, we test the effectiveness of several behavioral interventions relative to existing policy and each other geared toward improving voluntary retirement savings contributions. We find that an intervention framing savings as a way to secure one’s family future significantly improves contribution rates. We leverage recursive partitioning techniques and identify that the overall positive treatment effect masks subpopulations where the treatment is even more effective and other groups where the treatment has a significant negative effect, decreasing contribution rates. Accounting for this variation is significant for theoretical and policy development as well as firm profitability. Our work also provides a methodological framework for how to better design, scale, and deploy behavioral interventions to maximize their effectiveness.

This data brief introduces the Friendship and Identity in School (FIS) dataset. The FIS data are school-based longitudinal social network data, which have become increasingly important in recent years. Including information on 2,500 adolescents in nine secondary schools in the German federal state of North Rhine-Westphalia, the FIS data have four important key features that make them uniquely suited for studying the co-evolution of friendship networks and group identities or other time-varying individual characteristics. Specifically, the data include (i) fine-grained multidimensional measures of youth’ ethnic, national, and religious identities, (ii) comparatively large social networks that span multiple classrooms, (iii) up to six waves over four and a half years, and (iv) an ethnoreligiously diverse sample. Besides friendship and identity, the data include other network dimensions such as romantic relations or dislike as well as repeated measurements of various individual attributes ranging from perceived discrimination over intergroup attitudes and religion to leisure time activities and students’ perceptions of parents’ identities and attitudes. In combination, the FIS data provide rich longitudinal information that allows researchers to study the development, change, and interplay of youth’ group identities and friendship networks as well as broader questions concerning intergroup relations, network formation, and peer influence.

Background Health behaviors are important contributors to cardiovascular health (CVH) across populations. Little data exist regarding the association between attaining health behavior goals and long-term health outcomes. Methods Ideal CVH behaviors (no tobacco smoking, normal body mass index, engagement in leisure physical activity and healthy dietary habits) based on the American Heart Association definition, were evaluated in a random Israeli population sample (N=1079) stratified by sex, ethnicity (Arabs and Jews) and age (range: 25–74 years). Negative binomial models were used for testing associations with health service utilization counts and the Cox proportional hazard models for the associations with major adverse cardiovascular events (MACE) and mortality. Median follow-up was 15.6 years (interquartile [IQ] rage: 12.9–16.1) for mortality and 9.7 (IQ range: 7.7–10.2) otherwise. Results None of the participants had all four ideal health behaviors at baseline, 68 (6%) had three, 308 (28%) had two, 547 (51%) had one, and 156 (14%) had none. Mean [standard deviation; SD] participant age was 49 [12], 51 [14], 52 [15] and 47 [15] for participants with 0, 1, 2 and 3 ideal health behaviors, respectively. With each additional ideal health behavior, the prevalence of male (range: 83% of subjects with no ideal behaviors to 40% of subjects with three), Arab (61% to 21%) and married (92% to 65%) participants decreased, and the prevalence of participants with higher socioeconomic determinants increased. A higher number of ideal health behavior was associated with lower baseline diastolic blood pressure (mean [SD]: 82 [9] mmHg for none, to 76 [9] mmHg for three ideal behaviors), and a more favorable baseline lipid profile. Adjusting for age, sex, ethnicity, marital status, education years, professional prestige and comorbidities (Charlson index), each additional ideal health behavior was associated with reduced risk of developing diabetes (Hazard Ratio [HR]: 0.73, 95% confidence interval [CI]: 0.58–0.91), hypertension (HR: 0.86, 95% CI: 0.71–1.03) and dyslipidemia (HR: 0.85, 95% CI: 0.74–0.98). Controlling for the same variables, the addition of one ideal health behavior was associated with fewer hospitalizations (rate ratio [RR]: 0.80; 95% CI: 0.69–0.93), and cardiology clinic visits (RR: 0.88; 95% CI: 0.75–1.03). The hazard ratio was 0.84 (95% CI: 0.62–1.14) for MACE and 0.82 (95% CI: 0.66–1.03) for all-cause mortality. Conclusion Attainment of all four cardiovascular health behaviors goals is rare across the population. A higher number of ideal health behaviors is associated with a lower risk of long-term diabetes, hypertension and dyslipidemia, fewer health service utilizations and a lower MACE and mortality risk.

Background/Introduction Despite better patient-management and technological improvements, patients with heart failure (HF) have poor prognosis and impaired health-related quality of life (HRQoL). HF patients also experience significant non-cardiovascular morbidity leading to higher disease burden and recurrent hospitalizations, which also put a heavy burden on healthcare systems. Purpose To describe causes and risk factors for non-cardiovascular hospital readmissions among HF patients. Methods We analyzed 3,172 hospital discharge summaries for 927 patients enrolled in a clinical trial testing the efficacy of a disease management program compared to usual care between August 2007 and June 2011. The study intervention had no effect on hospital admission and mortality rates. Baseline information on patient characteristics included age, gender, LVEF, NYHA classification, 6-minute walk test, BNP level, BMI, chronic comorbidity and HRQoL score. Analysis of hospital discharge summaries included identification and coding of the primary hospital admission cause. These causes were further grouped to HF-related, other cardiovascular disease-related and non-cardiovascular causes. Information on follow-up prescription purchases of HF drugs was also collected. Factors associated with non-cardiovascular hospital admission rate were tested in multivariable models, adjusted for study group, study period and year of recruitment. Results Non-cardiovascular hospital admissions (of which 77% were non-elective) accounted for 45% of all hospital readmissions. Of these hospitalizations, 23% were due to infectious diseases, 13% due to gastrointestinal causes, 12% due to respiratory causes and 8% due to falls and associated trauma. Patients with two or more non-cardiovascular hospital admissions during follow-up were significantly older, more commonly female, had higher proportion of preserved LVEF (≥50%), worse baseline functional capacity and HRQoL score, and higher co-morbidity score, BNP level and mortality rates compared to other patients. Factors significantly and independently associated with higher acute non-cardiovascular hospitalization rate included [rate ratios (RRs), 95% confidence intervals (CIs)]: non-preserved vs. reduced LVEF [1.48 (1.14, 1.92)]; higher baseline comorbidity score [1.14 (1.08, 1.21) per 1-point increment]; and higher loop diuretics, beta-adrenergic receptor blockers and ACE-I/ARBs treatment level during follow-up; 4th vs. 1st quartiles: 4.13 (2.93, 6.32), 1.51 (1.07, 2.13) and 1.32 (0.96, 1.82), respectively. Baseline overweight/obesity and greater 6-min. walking distance [0.93 (0.89, 0.93) per 50m increment] were found protective. Conclusion This study indicates a higher disease burden and mortality rate among HF patients with recurrent non-cardiovascular hospital admissions. It provides pertinent information needed for the design and implementation of effective interventions to reduce disease burden in HF patients.

Background Diet and physical activity might help to improve quality of life and maintain remission in patients with inflammatory bowel disease (IBD). In other conditions, interventions in which diet and physical activity are combined seem to be more effective than separate interventions. Therefore, we assessed the effect of a combined lifestyle intervention on the impact of disease on daily life, clinical disease activity, fatigue and quality of life in patients with Crohn’s disease (CD) or ulcerative colitis (UC). Methods A single arm intervention study was performed in IBD patients in remission or with mildly active disease. Participants received personal advice to improve their diet and level of physical activity by a dietician and a physiotherapist in one face-to-face and one telephone consult. These advices were supported by guidelines based on the Dutch dietary and physical activity guidelines, a recipe app and a booklet with physical activity exercises. IBD disability index (IBD-DI) to assess impact of disease on daily life, clinical disease activity questionnaires (P-HBI or P-SCCAI), IBD fatigue (IBD-F) patient self-assessment scale and IBD quality of life questionnaire (IBDQ) were completed. The Eetscore Food Frequency Questionnaire (Eetscore FFQ) and Short Questionnaire to Assess Health-enhancing physical activity (SQUASH) were used to assess diet and physical activity. Changes from baseline to 5 weeks after start were investigated by paired samples t-tests or Wilcoxon signed rank tests. Results We included 29 participants. At time of this preliminary analysis, 25 participants completed baseline and 5-week assessments (11 males, 11 CD, median age 36 years [IQR 29–53], median BMI 25 kg/m2 [IQR 24–28]). After 5 weeks, diet quality had significantly improved (p Conclusion These preliminary results suggest that a combined lifestyle intervention is effective to reduce fatigue and to increase quality of life in patients with IBD, at least in the short term. Impact of disease on daily life and clinical disease activity did not improve significantly. Participants reported their level of physical activity to be restricted due to COVID-19 measures, which could explain the lack of effect on this outcome. This study is still ongoing and we expect follow-up data up till 1 year after start.

Migrant networks are usually regarded as helpful for the labor market integration of recently arrived immigrants. From a general assimilation perspective, however, it has been questioned whether they are really the right sort of ties to help immigrants succeed in the host society, or whether, instead, they constitute some sort of mobility trap. Empirical evidence from available studies is mixed, and a reference to more general social capital theory suggests that the effect might be contingent on the institutional context of the receiving country, the specific immigrant groups involved, and the particular types of jobs. In this paper, we study the impact of migrant networks on the labor market integration of recent immigrants from the former Soviet Union to Germany. This turns out to be a strategic test case, for both theoretical and methodological reasons. Relying on longitudinal data and using discrete event history models, we show that the findings are different for two distinguishable groups involved, Ethnic Germans and Jewish Quota Refugees, and that whether the effects are positive or negative further depends on whether or not these groups seek entry to higher-status jobs in the professional, managerial, or technical occupations.

This paper examines occupational allocation of Turkish and ex-Yugoslav male immigrants in Austria at the end of 1990s. Data from Austrian labour force surveys are utilized to separate the effects of immigrants' individual characteristics from contextual factors related to their spatial location, with particular focus on relative group size. Results largely support the occupational queuing hypothesis, according to which occupational standing of Turks is inversely related to the relative size of the ex-Yugoslav immigrant population, while the occupational fortunes of ex-Yugoslavs are directly proportional to the relative size of the Turkish immigrant population. In addition, it is shown that the occupational standing of Turkish immigrants is positively related to their proportionate size in the labour market, while the opposite is true for ex-Yugoslav immigrants. The native-born Austrian male population seems to have a higher occupational status in areas where the concentration of immigrants is greater.

This study investigates whether the life circumstances of immigrants and natives in Germany have converged in recent decades. To answer this question adequately, the fact that Germany experienced demographic change and educational expansion at the same time has to be taken into account. On the theoretical side, the connection of demographic variables, education, and a basic assimilation argument is derived from an investment and production view of social behaviour. On the empirical side, a method is proposed that combines the multivariate regression approach with common measures of segregation. This technique allows an opportune and convenient assessment of assimilation trends controlling for relevant structural variables. An analysis of scientific use files of population censuses in 1970, 1989, and 1996 indicates that immigrants and Germans clearly converged net of the structural changes, at least over generations. Demographic change plays an ambiguous role within this process. Educational expansion, however, has led to a widening educational gap resulting in barriers to further structural assimilation.

In Europe, organ centres such as Bio Implant Services (BIS) in cooperation with Eurotransplant, play an intermediary role from donation of tissue and organs to allocation and transplantation. They take responsibility for donor medical/safety screening and organize procurement. Tissue banks are autonomous and are responsible for tissue processing and preservation. Allocation of scarce tissues is performed according to rules set by committees of renowned experts in the field. Most frequently donated types of tissues are corneas, heart valves, bone and soft tissue and skin. In this article, optimal serological screening of the donor, and the banking of these tissues in Europe is reviewed in relation to clinical need and volume of transplantable tissues available, number of banks and their organisational level, methods of explantation, processing and preservation, quality standards and new developments.

Alveolar macrophages from humans and several animal species produce factors in vitro that modulate fibroblast growth and have been proposed as mediators of interstitial pulmonary fibrosis. Pulmonary interstitial macrophages (IMs) have not been studied previously in this regard. Pulmonary IMs were isolated from prelavaged rat lungs by enzymatic digestion of tissue and subsequent differential adherence of cells to culture dishes. The ability of IMs to release modulators of fibroblast growth into the culture medium was assessed by measuring [3H]thymidine incorporation into DNA and/or nuclear labeling of early-passage rat lung fibroblasts exposed to medium conditioned by IMs. The percentages of nuclei labeled in fibroblast cultures exposed to interstitial macrophage–conditioned medium (IMCM) alone did not significantly differ from that observed in controls, but fibroblasts exposed to IMCM supplemented with 2% platelet-poor plasma showed a 2.6-fold increase in labeling, indicating that IMCM contains predominantly “competence” growth factor activity. Similar results were obtained using purified human platelet-derived growth factor (PDGF). The level of growth factor activity released by IMs increased in cells that had phagocytized iron spheres during the culture period. In addition, fractionation of IMCM by high-performance liquid chromatography demonstrated most of the growth factor activity at a relative molecular mass of about 35 kd. Subsequent quantitative analysis of the fractions by an enzyme immunoassay for PDGF demonstrated that IMCM contains a homologue of human PDGF. These results show that IMs are capable of producing a PDGF-like growth factor for autologous fibroblasts and that release of this factor is enhanced by exposure to an insoluble inorganic particle. Because PDGF is a potent growth factor for fibroblasts and is released by IMs, it is essential to ask in future studies whether this or similar macrophage products play a significant role in mediating fibroblast proliferation in vivo.

The relation between long-term temporal trends in stillbirth and neonatal death rates and the congenital malformation frequencies in such deaths were analysed, using data from hospital-based European, USA, and Canadian reports published from 1950. In the last 50 years the overall perinatal mortality rate has fairly steadily improved, decreasing by 65-80%. This was accomplished by the control of some serious problems of early life. However, lingering disorders form an ever larger proportion of the causes of perinatal mortality. Among the prominent of these are congenital malformations, accounting for nearly 30% of perinatal deaths at present. However, this figure conceals important differences between stillbirths and early neonatal deaths. For example, although stillbirth and early neonatal mortality rates have decreased to similar extents during these years, congenital malformations, which were almost equally frequent causes of death in both of them at the beginning of this period, are now about twice as common in early neonatal (one week) deaths as in stillbirths. Other differences between them are in birthweight-related malformation frequencies and in characteristic arrays of malformations. The significance of these patterns and of some geographical variations, and the likelihood of continuing improvement in the stillbirth and early neonatal mortality rates are discussed.

To determine the relative roles of coryneform bacteria and Trichosporon beigelii in the pathogenesis of genital white piedra, scrotal hair from 10 subjects was studied. Hairs were examined by light microscopy to determine the relative proportions of each organism, and were also cultured for coryneforms and yeast. Histologically, hair nodules from five out of nine cases showed a mixture of yeasts and bacteria, four had bacteria alone, and none showed yeast alone. Five strains of T. beigelii were cultured, two strains of Saccharomyces cerevisiae and 22 strains of coryneforms. The isolates were tested for synergism by a plate-overlay method. Growth of coryneforms occurred over and around sections of the plate inoculated with T. beigelii but not around the control yeast, S. cerevisiae. There were strain differences in the stimulatory response of both T. beigelii and coryneform strains. In reverse experiments coryneforms did not enhance growth of T. beigelii. It was concluded that white piedra is a mixed infection caused by the synergistic action between T. beigelii and a specific coryneform bacteria resulting in invasion of the hair cuticle and cortex.

Though David Cusick was one of the first Iroquois to record the oral literature of his nation in the alphabetic writing of Western civilization, contemporary Iroquois do not necessarily receive his work with praise. For instance, Seneca-Wyandot scholar Barbara A. Mann points out that Cusick inserted missionary interpretations of Iroquois creation stories into the text of his Sketches of Ancient History of the Six Nations ("Lynx" 427). Yet in a climate where Native American issues continue to receive scant attention, despite their fundamental importance to our understanding of the development of United States cultures, Cusick's work deserves critical investigation. It also deserves consideration as a component of our pedagogy, both as an example of how Iroquois writers attempted to combat a false savagism and as an example of the fissures of subjectivity that US foreign policy and missionary activity created within Iroquois nations. It is because Cusick does not necessarily represent the quintessential Tuscarora that we should study him. Too often, we expect to view entire nations of Native Americans through their most prominent writers. Cusick's ambiguous and perhaps liminal status within his nation, his difference from his peers and from contemporary Iroquois, challenges our expectations of homogeneity and unity in Native America. In writing Sketches, David Cusick denied the validity of both the extinction paradigm of post-Removal era savagism1 and the Hobson's choice of civilization-or-extinction that a slightly earlier version of savagism proffered Indian nations and individuals. As Roy Harvey Pearce established in 1953, savagism was the dominant discourse around Native Americans in Amer-European com