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Background and objectivesStudent-Run Free Clinics (SRFCs) play a significant role in medical education yet there is minimal information about patient outcomes over time in this setting. The purpose of this study was to assess longitudinal outcomes of hypertension management during routine care at four SRFC sites, while comparing control rates with national standards, and examining for characteristics independently associated with uncontrolled hypertension.MethodsThe authors conducted a retrospective medical record review of visits from January 2004 through April 2016 with an initial visit for hypertension and a follow-up visit 9 to 15 months later. Hypertension control was analyzed using descriptive statistics, paired t tests, logistic regression, and a longitudinal linear mixed-effects model.ResultsThis study included 496 patients and 4,798 visits. The mean age was 50.9 (SD 10.8) years old, 71.2% (346) were Latinos, 63.3% (314) were Spanish speaking, and 15.5% (72) were homeless. Mean blood pressure was reduced from 141.6 (SD 21.8)/85.1 (SD 13.2) to 132.1 (SD 17.3)/79.4 (SD10.8), a decrease of 9.5 (CI 7.4, 11.5)/5.7 (CI 4.4, 7.0) mmHg. Blood pressure was significantly reduced within the first month of treatment, and this reduction was sustained throughout the follow-up period. Using the National Health and Nutrition Examination Survey (NHANES) definition (

This study, conducted in the Netherlands, evaluated the association between ethnic background and children’s TV viewing time at multiple time points and its trajectory. We analyzed 4,833 children with a Dutch, Moroccan, Turkish, or Surinamese ethnic background from the Generation R Study, a population-based study in the Netherlands. Parent-reported television viewing time for children at ages 2, 3, 4, 6, and 9 years was collected by questionnaires sent from April 2004 until January 2015. Odds ratios of watching television ≥1 hour/day at each age were calculated for children from the various ethnic backgrounds. Generalized logistic mixed models (GLMMs) were used to assess the association between ethnic background and television viewing time trajectory. The effect modification by family socioeconomic status was examined in cross-sectional and longitudinal analyses. The percentage of children viewing television ≥1 hour/day increased from age 2 to 9 years for children from all ethnic backgrounds. After adjusting for maternal educational level and net household income, children from all ethnic subgroups had greater odds of watching television ≥1 hour/day at some time points compared with children with a Dutch background (Surinamese: all ages; Moroccan: at ages 4 and 6 years; Turkish: at ages 4 and 9 years). The GLMMs indicated that television viewing trajectories differed between ethnic subgroups. The associations between ethnic background and children’s television viewing time were moderated by maternal educational level for child ages 4 and 6 years (p < 0.05). In longitudinal analyses, the ethnic differences in probability of watching television ≥1 hour/day were larger in children from high-educated mothers than in children from low-educated mothers. In conclusion, ethnic differences in television viewing time were present at all measuring time points. The discrepancy between children with a Dutch background and children with another background was larger in high maternal educational subgroups. [ABSTRACT FROM AUTHOR]

Background: Increased weight gain during infancy is a risk factor for obesity and related diseases in later life. The aim of the present study was to investigate the association between socioeconomic status (SES) and weight gain during infancy, and to identify the factors mediating the association between SES and infant weight gain. Methods: Subjects were 2513 parent-child dyads participating in a cluster randomized controlled intervention study. Family SES was indexed by maternal education level. Weight gain in different time windows (infant age 0–3, 0–6, and 6–12 months) was calculated by subtracting the weight for age z-score (WAZ) between the two time-points. Path analysis was performed to examine the mediating pathways linking SES and infant weight gain. Results: On average, infants of low-educated mothers had a lower birth weight and caught-up at approximately 6 months. In the period of 0–6 months, infants with low-educated mothers had an 0.42 (95% CI 0.27–0.57) higher gain in weight for age z-score compared to children with high-educated mothers. The association between maternal education level and increased infant weight gain in the period of 0–6 months can be explained by infant birth weight, gestational age at child birth, duration of breastfeeding, and age at introduction of complementary foods. After adjusting all the mediating factors, there was no association between maternal education level and infant weight gain. Conclusion: Infants with lower SES had an increased weight gain during the first 6 months of infancy, and the effect can be explained by infant birth weight, gestational age at child birth, and infant feeding practices. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the association between family socioeconomic status and repeatedly measured child television viewing time from early childhood to the school period. We analyzed data on 3,561 Dutch children from the Generation R Study, a population-based study in the Netherlands. Parent-reported television viewing time for children aged 2, 3, 4, 6 and 9 years were collected by questionnaires sent from April 2004 until January 2015. Odds ratios of watching television ≥1 hour/day at each age were calculated for children of mothers with low, mid-low, mid-high and high (reference group) education and children from low, middle and high (reference group) income households. A generalized logistic mixed model was used to assess the association between family socioeconomic status and child television viewing time trajectory. The percentage of children watching television ≥1 hour/day increased from age 2 to 9 years for all children (24.2%-85.0% for children of low-educated mothers; 4.7%-61.4% for children of high-educated mothers; 17.2%-74.9% for children from low income households; 6.2%-65.1% for children from high income households). Independent socioeconomic effect in child television viewing time was found for maternal educational level. The interaction between net household income and child age in longitudinal analyses was significant (p = 0.01), indicating that the television viewing time trajectories were different in household income subgroups. However the interaction between maternal educational level and child age was not significant (p = 0.19). Inverse socioeconomic gradients in child television viewing time were found from the preschool period to the late school period. The educational differences between the various educational subgroups remained stable with increasing age, but the differences between household income groups changed over time. Intervention developers and healthcare practitioners need to raise awareness among non-highly educated parents that the socioeconomic gradient in television viewing time has a tracking effect starting from preschool age. [ABSTRACT FROM AUTHOR]