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Background: Suboptimal rest-activity patterns in adolescence are associated with worse health outcomes in adulthood. Understanding sociodemographic factors associated with rest-activity rhythms may help identify subgroups who may benefit from interventions. This study aimed to investigate the association of rest-activity rhythm with demographic and socioeconomic characteristics in adolescents. Methods: Using cross-sectional data from the nationally representative National Health and Nutrition Examination Survey (NHANES) 2011–2014 adolescents (N = 1814), this study derived rest-activity profiles from 7-day 24-hour accelerometer data using functional principal component analysis. Multiple linear regression was used to assess the association between participant characteristics and rest-activity profiles. Weekday and weekend specific analyses were performed in addition to the overall analysis. Results: Four rest-activity rhythm profiles were identified, which explained a total of 82.7% of variance in the study sample, including (1) High amplitude profile; (2) Early activity window profile; (3) Early activity peak profile; and (4) Prolonged activity/reduced rest window profile. The rest-activity profiles were associated with subgroups of age, sex, race/ethnicity, and household income. On average, older age was associated with a lower value for the high amplitude and early activity window profiles, but a higher value for the early activity peak and prolonged activity/reduced rest window profiles. Compared to boys, girls had a higher value for the prolonged activity/reduced rest window profiles. When compared to Non-Hispanic White adolescents, Asian showed a lower value for the high amplitude profile, Mexican American group showed a higher value for the early activity window profile, and the Non-Hispanic Black group showed a higher value for the prolonged activity/reduced rest window profiles. Adolescents reported the lowest household income had the lowest average value for the early activity window profile. Conclusions: This study characterized main rest-activity profiles among the US adolescents, and demonstrated that demographic and socioeconomic status factors may shape rest-activity behaviors in this population. [ABSTRACT FROM AUTHOR]

Summary: Sleep behaviour is an important contributing factor in healthy human ageing and cognitive function. Previous studies have linked sleep deficiency with cognitive decline in older adults. However, there is need for more prospective investigations that focus on specific domains of cognitive function. The present study analysed cross‐sectional and prospective associations between self‐reported sleep and cognitive function in the Midlife in the United States (MIDUS) study. Weekday and weekend sleep duration and habitual sleep quality were obtained via questionnaire data. Brief Test of Adult Cognition by Telephone was conducted to assess overall cognitive function, as well as episodic memory and executive function. We found significant trend for both long weekday and weekend sleep (>8 hr) and lower episodic memory scores in the overall sample. Sex‐specific cross‐sectional analysis demonstrated men with longer weekend sleep duration have lower overall cognitive function scores, and a negative association between weekend sleep and episodic memory scores. Women demonstrated a positive association between weekend sleep duration and executive function scores. There was no prospective significance for overall or sex‐specific analysis. Our present results suggest that sleep duration may contribute to cognitive function, and future studies should include objective sleep measurements and focus on the potential cognitive benefits of improving sleep to further elucidate this association. [ABSTRACT FROM AUTHOR]

Low neighborhood socioeconomic status has been linked to adverse health outcomes. However, it is unclear whether changing the neighborhood may influence health. We examined 10-year change in neighborhood socioeconomic deprivation in relation to mortality rate among 288,555 participants aged 51–70 years who enrolled in the National Institutes of Health-AARP Diet and Health Study in 1995–1996 (baseline) and did not move during the study. Changes in neighborhood socioeconomic deprivation between 1990 and 2000 were measured by US Census data at the census tract level. All-cause, cardiovascular disease, and cancer deaths were ascertained through annual linkage to the Social Security Administration Death Master File between 2000 and 2011. Overall, our results suggested that improvement in neighborhood socioeconomic status was associated with a lower mortality rate, while deterioration was associated with a higher mortality rate. More specially, a 30-percentile-point reduction in neighborhood deprivation among more deprived neighborhoods was associated with 11% and 19% reductions in the total mortality rate among men and women, respectively. On the other hand, a 30-point increase in neighborhood deprivation in less deprived neighborhoods was associated with an 11% increase in the mortality rate among men. Our findings support a longitudinal association between changing neighborhood conditions and mortality. [ABSTRACT FROM AUTHOR]

Background: Neighborhood characteristics play a critical role in health. Self-rated health (SRH) is an important indicator of quality of life and a strong predictor of premature death. Prospective study on neighborhood deprivation and SRH is limited.Methods: We examined neighborhood socioeconomic deprivation with reporting fair/poor SRH at follow-up (2004-2006) in 249,265 men and women (age 50-71) who reported SRH as good or better at baseline (1995-1996) in the NIH-AARP Health and Diet Study. Baseline addresses were geocoded and linked to 2000 Census. Census tract level variables were used to generate a socioeconomic deprivation index by principle component analysis.Results: Residents of more deprived neighborhoods had a higher risk of developing poor/fair SRH at follow-up, even after adjusting for individual-level factors (Odds ratio (95% confidence interval) Q5 vs Q1: 1.26 (1.20, 1.32), p-trend: <0.0001). The results were largely consistent across subgroups with different demographics, health behaviors, and disease conditions and after excluding participants who moved away from their baseline address.Conclusion: Neighborhood disadvantage predicts SRH over 10 years. [ABSTRACT FROM AUTHOR]

Both short and long durations of sleep are associated with higher mortality, but little is known about the interrelationship between sleep and other modifiable factors in relation to mortality. In the National Institutes of Health-AARP Diet and Health Study (1995–1996), we examined associations between sleep duration and total, cardiovascular disease (CVD), and cancer mortality among 239,896 US men and women aged 51–72 years who were free of cancer, CVD, and respiratory disease. We evaluated the influence of moderate-to-vigorous physical activity, television viewing, and body mass index (BMI; weight (kg)/height (m)2) on the sleep-mortality association and assessed their combined association with mortality. During an average of 14 years of follow-up, we identified 44,100 deaths. Compared with 7–8 hours of sleep per day, both shorter and longer sleep durations were associated with higher total and CVD mortality. We found a greater elevation in CVD mortality associated with shorter sleep among overweight and obese people, suggesting a synergistic interaction between sleep and BMI. People in the unhealthy categories of all 4 risk factors (sleep <7 hours/day, moderate-to-vigorous physical activity ≤1 hour/week, television viewing ≥3 hours/day, and BMI ≥25) had significantly higher all-cause (relative risk (RR) = 1.42, 95% confidence interval (CI): 1.34, 1.52), CVD (RR = 1.90, 95% CI: 1.67, 2.17), and cancer (RR = 1.21, 95% CI: 1.09, 1.34) mortality. Short sleep duration may predict higher mortality, particularly CVD mortality, among overweight and obese people. [ABSTRACT FROM PUBLISHER]

There is limited evidence demonstrating the benefits of physical activity with regard to mortality risk or the harms associated with sedentary behavior in black adults, so we examined the relationships between these health behaviors and cause-specific mortality in a prospective study that had a large proportion of black adults. Participants (40–79 years of age) enrolled in the Southern Community Cohort Study between 2002 and 2009 (n = 63,308) were prospectively followed over 6.4 years, and 3,613 and 1,394 deaths occurred in blacks and whites, respectively. Black adults who reported the highest overall physical activity level (≥32.3 metabolic equivalent-hours/day vs. <9.7 metabolic equivalent-hours/day) had lower risks of death from all causes (hazard ratio (HR) = 0.76. 95% confidence interval (CI): 0.69, 0.85), cardiovascular disease (HR = 0.81, 95% CI: 0.67, 0.98), and cancer (HR = 0.76, 95% CI: 0.62, 0.94). In whites, a higher physical activity level was associated with a lower risk of death from all causes (HR = 0.76, 95% CI: 0.64, 0.90) and cardiovascular disease (HR = 0.69, 95% CI: 0.49, 0.99) but not cancer (HR = 0.95, 95% CI: 0.67, 1.34). Spending more time being sedentary (>12 hours/day vs. <5.76 hours/day) was associated with a 20%–25% increased risk of all-cause mortality in blacks and whites. Blacks who reported the most time spent being sedentary (≥10.5 hours/day) and lowest level of physical activity (<12.6 metabolic equivalent-hours/day) had a greater risk of death (HR = 1.47, 95% CI: 1.25, 1.71). Our study provides evidence that suggests that health promotion efforts to increase physical activity level and decrease sedentary time could help reduce mortality risk in black adults. [ABSTRACT FROM PUBLISHER]

Purpose – The purpose of this paper is to develop and empirically test a new framework that shows how different signals of movie quality along with key control variables affect consumers’ post-consumption evaluations, critics’ reviews (CR), and movie box office revenues. Design/methodology/approach – The data set consists of a sample of 332 movies released between 2000 and 2008. Regression was used to test the study hypotheses. Findings – The results suggest that the three signals of movie quality exhibit different effects on three movie performance measures. Of the three cues, the peripheral quality signal is positive related to movie box, moviegoers’ evaluations (ME), and CR. Furthermore, star performance quality is positive related to both ME and CR. Surprisingly, overall quality signal does not display any influence on movie performances. Research limitations/implications – The primary limitation is the use of cross-sectional study design and future research should apply for time-series technique to test the relationships between movie quality signals and movie performances. Practical implications – The findings suggest that consumers and critics evaluate movie qualities based on various movie quality signals. Furthermore, the characteristics of movies also have mixed impacts on movie performances. Movie studios may take these findings into account to produce better movies. Originality/value – This study proposes and empirically tests the impacts of three groups of movie signals – peripheral quality signal, star performance quality signal, and overall quality signal on motion picture performance. This study contributes to service quality literature and signal theory by categorizing different Academy Awards into three groups of quality signals and by empirically testing the proposed relationships. [ABSTRACT FROM AUTHOR]

The present study was conducted to investigate the factors that may lead the social networking sites' users to have a compelling experience. Built upon the social capital perspective, a general social networking site experience model regarding the impact of the interaction between user-perceived competence and user identification on user satisfaction through playfulness was proposed and examined in the social networking site's context. Data analyses provided general support for (1) the moderating effect of user identification on the relationship of user-perceived competence with user satisfaction, and (2) the mediating role of playfulness through which social network site users' competency and identification factors are transmitted and predict user satisfaction. Theoretical and managerial implications are discussed. [ABSTRACT FROM AUTHOR]

The relationship between sleep and obesity or weight gain in adults, particularly older populations, remains unclear. In a cohort of 83,377 US men and women aged 51–72 years, we prospectively investigated the association between self-reported sleep duration and weight change over an average of 7.5 years of follow-up (1995–2004). Participants were free of cancer, heart disease, and stroke at baseline and throughout the follow-up. We observed an inverse association between sleep duration per night and weight gain in both men (P for trend = 0.02) and women (P for trend < 0.001). Compared with 7–8 hours of sleep, shorter sleep (<5 hours or 5–6 hours) was associated with more weight gain (in kilograms; men: for <5 hours, β = 0.66, 95% confidence interval (CI): 0.19, 1.13, and for 5–6 hours, β = 0.12, 95% CI: −0.02, 0.26; women: for <5 hours, β = 0.43, 95% CI: 0.00, 0.86, and for 5–6 hours, β = 0.23, 95% CI: 0.08, 0.37). Among men and women who were not obese at baseline, participants who reported less than 5 hours of sleep per night had an approximately 40% higher risk of developing obesity than did those who reported 7–8 hours of sleep (for men, odds ratio = 1.45, 95% CI: 1.06, 1.99; for women, odds ratio = 1.37, 95% CI: 1.04, 1.79). The association between short sleep and excess weight gain was generally consistent across different categories of age, educational level, smoking status, baseline body mass index, and physical activity level. [ABSTRACT FROM PUBLISHER]

The present study examines the separate and combined effects of environmental and organizational variables on hospitals' clinical IT sophistication in a multivariate framework. The analyses focused on two distinct but related questions. First, in the context of the bivariate hypotheses, what is the relative significance empirically of each of the environmental and organizational classes of variables? And second, within classes and on an overall basis, which specific variables make the largest contribution to explained variance in the dependent variable hospitals' clinical IT sophistication when all other variables are held constant? Data collected from 99 Texas hospitals are analyzed to assess the effects of the antecedent variables both within and across classes. Our findings suggest the bigger contribution of environmental antecedents to the level of clinical IT sophistication in hospitals, compared to that of organizational antecedents. We end by discussing the limitations and implications of the study. [ABSTRACT FROM AUTHOR]

Previous dietary studies and current dietary guidelines have mainly focused on dietary intake and food patterns. Little is known about the association between eating behaviors such as meal frequency, skipping and intervals, and mortality. The objective was to examine the associations of meal frequency, skipping, and intervals with all-cause and cardiovascular disease (CVD) mortality. This was a prospective study. A total of 24,011 adults (aged ≥40 years) who participated in the National Health and Nutrition Examination Survey 1999-2014 were included in this study. Eating behaviors were assessed using 24-hour recall. Death and underlying causes of death were ascertained by linkage to death records through December 31, 2015. The outcomes were all-cause and CVD mortality. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) of all-cause and CVD mortality. During 185,398 person-years of follow-up period, 4,175 deaths occurred, including 878 cardiovascular deaths. Most participants ate three meals per day. Compared with participants eating three meals per day, the multivariable-adjusted HRs for participants eating one meal per day were 1.30 (95% CI 1.03 to 1.64) for all-cause mortality, and 1.83 (95% CI 1.26 to 2.65) for CVD mortality. Participants who skipped breakfast have multivariable-adjusted HRs 1.40 (95% CI 1.09 to 1.78) for CVD mortality compared with those who did not. The multivariable-adjusted HRs for all-cause mortality were 1.12 (95% CI 1.01 to 1.24) for skipping lunch and 1.16 (95% CI 1.02 to 1.32) for skipping dinner compared with those who did not. Among participants eating three meals per day, the multivariable-adjusted HR for participants with an average interval of ≤4.5 hours in two adjacent meals was 1.17 (95% CI 1.04 to 1.32) for all-cause mortality, comparing with those having a meal interval of 4.6 to 5.5 hours. In this large, prospective study of US adults aged 40 years or older, eating one meal per day was associated with an increased risk of all-cause and CVD mortality. Skipping breakfast was associated with increased risk of CVD mortality, whereas skipping lunch or dinner was associated with increased risk of all-cause mortality. Among participant with three meals per day, a meal interval of ≤4.5 hours in two adjacent meals was associated with higher all-cause mortality. [ABSTRACT FROM AUTHOR]

Introduction: TV viewing is the most prevalent sedentary behavior and is associated with increased risk of cardiovascular disease and cancer mortality, but the association with other leading causes of death is unknown. This study examined the association between TV viewing and leading causes of death in the U.S.Methods: A prospective cohort of 221,426 individuals (57% male) aged 50-71 years who were free of chronic disease at baseline (1995-1996), 93% white, with an average BMI of 26.7 (SD=4.4) kg/m(2) were included. Participants self-reported TV viewing at baseline and were followed until death or December 31, 2011. Hazard ratios (HRs) and 95% CIs for TV viewing and cause-specific mortality were estimated using Cox proportional hazards regression. Analyses were conducted in 2014-2015.Results: After an average follow-up of 14.1 years, adjusted mortality risk for a 2-hour/day increase in TV viewing was significantly higher for the following causes of death (HR [95% CI]): cancer (1.07 [1.03, 1.11]); heart disease (1.23 [1.17, 1.29]); chronic obstructive pulmonary disease (1.28 [1.14, 1.43]); diabetes (1.56 [1.33, 1.83]); influenza/pneumonia (1.24 [1.02, 1.50]); Parkinson disease (1.35 [1.11, 1.65]); liver disease (1.33 [1.05, 1.67]); and suicide (1.43 [1.10, 1.85]. Mortality associations persisted in stratified analyses with important potential confounders, reducing causation concerns.Conclusions: This study shows the breadth of mortality outcomes associated with prolonged TV viewing, and identifies novel associations for several leading causes of death. TV viewing is a prevalent discretionary behavior that may be a more important target for public health intervention than previously recognized.Trial Registration: ClinicalTrials.gov number, NCT00340015. [ABSTRACT FROM AUTHOR]

Background: Artificial Light at Night (ALAN) is an emerging health risk factor that has been linked to a wide range of adverse health effects. Recent study suggested that disadvantaged neighborhoods may be exposed to higher levels of ALAN. Understanding how social disadvantage correlates with ALAN levels is essential for identifying the vulnerable populations and for informing lighting policy., Methods: We used satellite data from the National Aeronautics and Space Administration's (NASA) Black Marble data product to quantify annual ALAN levels (2012-2019), and the Center for Disease Control and Prevention's (CDC) Social Vulnerability Index (SVI) to quantify social disadvantage, both at the US census tract level. We examined the relationship between the ALAN and SVI (overall and domain-specific) in over 70,000 tracts in the Contiguous U.S., and investigated the heterogeneities in this relationship by the rural-urban status and US regions (i.e., Northeast, Midwest, South, West)., Results: We found a significant positive relationship between SVI and ALAN levels. On average, the ALAN level in the top 20% most vulnerable communities was 2.46-fold higher than that in the 20% least vulnerable communities (beta coefficient (95% confidence interval) for log-transformed ALAN, 0.90 (0.88, 0.92)). Of the four SVI domains, minority and language status emerged as strong predictors of ALAN levels. Our stratified analysis showed considerable and complex heterogeneities across different rural-urban categories, with the association between greater vulnerability and higher ALAN primarily observed in urban cores and rural areas. We also found regional differences in the association between ALAN and both overall SVI and SVI domains., Conclusions: Our study suggested ALAN as an environmental justice issue that may carry important public health implications. Funding National Aeronautics and Space Administration., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: To examine the association of neighborhood socioeconomic status (SES) with sleep duration among a large cohort of Black and white men and women in the United States., Methods: We used data from the Southern Community Cohort Study (SCCS, N = 75,248). Neighborhood SES was based on census data and sleep duration was measured by self-report. Multinomial logistic regression analysis was performed to assess the association between neighborhood SES and short (<7 hours) and long (≥9 hours) sleep in the overall sample and according to race-sex subgroups., Results: In the total sample, when compared with the highest quintile of neighborhood SES, the lowest quintile was associated with higher odds of both short (adjusted OR Q5 vs. Q1 [95% CI], 1.10 [1.03, 1.17]) and long sleep (1.37 [1.24, 1.52]). In race-sex specific analysis, the association between lower neighborhood SES and short sleep was only observed among white women (1.21 [1.05, 1.40]), but not in other subgroups. On the other hand, the association between lower neighborhood SES and long sleep duration was primarily observed among Black women (1.31 [1.06, 1.60])., Conclusions: The association between neighborhood SES and sleep duration varied among race-and-sex subgroups. These findings provide new evidence on the importance of considering individual sociodemographic characteristics in understanding the potential effects of neighborhood socioeconomic context on sleep health., (Copyright © 2023 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.)

Background: Light at night (LAN) inhibits nighttime secretion of melatonin and may cause circadian disruption, which may be a risk factor for cancer. Recent studies have linked high LAN exposure with elevated breast cancer risk. Given that breast cancer may share a common hormone-dependent etiology with thyroid cancer and that circadian rhythms play a role in regulating thyroid function, the authors hypothesized that exposure to LAN is positively associated with thyroid cancer incidence., Methods: This study examined the association between LAN and thyroid cancer incidence in the National Institutes of Health-American Association of Retired Persons Diet and Health Study. LAN exposure was estimated from satellite data and was linked to residential addresses at the baseline. Incident thyroid cancer cases were ascertained via linkage to state cancer registries. Cox regression was used to determine the relationship between LAN and thyroid cancer risk, with adjustments made for sociodemographic, lifestyle, and other environmental factors., Results: Among 464,371 participants, a positive association was found between LAN and thyroid cancer risk. Specifically, in comparison with the lowest quintile of LAN, the highest quintile was associated with a 55% increase in risk (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.18-2.02). The association was primarily driven by papillary thyroid cancer and was stronger in women (HR, 1.81; 95% CI, 1.26-2.60) than men (HR, 1.29; 95% CI, 0.86-1.94). In women, the association was stronger for localized cancer, whereas in men, the association was stronger for a more advanced stage. Results were consistent across different tumor sizes., Conclusions: LAN was positively associated with thyroid cancer risk. Future studies are needed to confirm this association and identify underlying biological mechanisms., (© 2021 American Cancer Society.)

Circadian disruption may play a role in carcinogenesis. Recent research suggests that light at night (LAN), a circadian disruptor, may be a risk factor for cancer. Moreover, LAN has been linked to obesity and diabetes, two risk factors for pancreatic ductal adenocarcinoma (PDAC). Here we examine the relationship between LAN and PDAC in an epidemiologic study of 464,371 participants from the NIH-AARP Diet and Health Study. LAN was estimated from satellite imagery at baseline (1996), and incident primary PDAC cases were ascertained from state cancer registries. Cox proportional hazards models were used to estimate HRs and two-sided 95% confidence intervals (CI) for the association between quintiles of LAN and PDAC in the overall population stratified by sex. Over up to 16.2 years of follow-up, a total of 2,502 incident PDAC were identified in the cohort. Higher estimated LAN exposure was associated with an elevated PDAC risk. Compared with those living in areas in the lowest LAN quintile, those in areas in the highest quintile had a 27% increase PDAC risk [HR (95% CI), 1.24 (1.03-1.49)], with similar risk for men [1.21 (0.96-1.53)] and women [1.28 (0.94-1.75)]. In addition, stronger associations were observed in normal and overweight groups compared with the obese group ( P interaction = 0.03). Our results support the hypothesis that LAN and circadian disruption may be risk factors for PDAC. SIGNIFICANCE: Our study suggests that higher LAN is a risk factor for pancreatic cancer, contributing to the growing literature that demonstrates the potentially adverse health effects of light pollution., (©2021 American Association for Cancer Research.)

Importance: Studying long-term changes in neighborhood socioeconomic status (SES) may help to better understand the associations between neighborhood exposure and weight outcomes and provide evidence supporting neighborhood interventions. Little previous research has been done to examine associations between neighborhood SES and weight loss, a risk factor associated with poor health outcomes in the older population., Objective: To determine whether improvements in neighborhood SES are associated with reduced likelihoods of excessive weight gain and excessive weight loss and whether declines are associated with increased likelihoods of these weight outcomes., Design, Study, and Participants: This cohort study was conducted using data from the National Institutes of Health-AARP (formerly known as the American Association of Retired Persons) Diet and Health study (1995-2006). The analysis included a cohort of 126 179 adults (aged 50-71 years) whose neighborhoods at baseline (1995-1996) were the same as at follow-up (2004-2006). All analyses were performed from December 2018 through December 2020., Exposures: Living in a neighborhood that experienced 1 of 8 neighborhood SES trajectories defined based on a national neighborhood SES index created using data from the US Census and American Community Survey. The 8 trajectory groups, in which high, or H, indicated rankings at or above the sample median of a specific year and low, or L, indicated rankings below the median, were HHH (ie, high in 1990 to high in 2000 to high in 2010), or stable high; HLL, or early decline; HHL, or late decline; HLH, or transient decline; LLL, or stable low; LHH, or early improvement; LLH, or late improvement; and LHL, or transient improvement., Main Outcomes and Measures: Excessive weight gain and loss were defined as gaining or losing 10% or more of baseline weight., Results: Among 126 179 adults, 76 225 (60.4%) were men and the mean (SD) age was 62.1 (5.3) years. Improvements in neighborhood SES were associated with lower likelihoods of excessive weight gain and weight loss over follow-up, while declines in neighborhood SES were associated with higher likelihoods of excessive weight gain and weight loss. Compared with the stable low group, the risk was significantly reduced for excessive weight gain in the early improvement group (odds ratio [OR], 0.87; 95% CI, 0.79-0.95) and for excessive weight loss in the late improvement group (OR, 0.89; 95% CI, 0.80-1.00). Compared with the stable high group, the risk of excessive weight gain was significantly increased for the early decline group (OR, 1.19; 95% CI, 1.08-1.31) and late decline group (OR, 1.13; 95% CI, 1.04-1.24) and for excessive weight loss in the early decline group (OR, 1.15; 95% CI, 1.02-1.28). The increases in likelihood were greater when the improvement or decline in neighborhood SES occurred early in the study period (ie, 1990-2000) and was substantiated throughout the follow-up (ie, the early decline and early improvement groups). Overall, we found a linear association between changes in neighborhood SES and weight outcomes, in which every 5 percentile decline in neighborhood SES was associated with a 1.2% to 2.4% increase in the risk of excessive weight gain or loss (excessive weight gain: OR, 1.01; 95% CI, 1.00-1.02 for women; OR, 1.02; 95% CI, 1.01-1.03 for men; excessive weight loss: OR, 1.02; 95% CI, 1.01-1.03 for women; OR, 1.02; 95% CI, 1.01-1.03 for men; P for- trend < .0001)., Conclusions and Relevance: These findings suggest that changing neighborhood environment was associated with changes in weight status in older adults.

Childhood obesity increases the risk of adulthood obesity and is associated with other adverse health outcomes later in life. It may be influenced by environmental characteristics of neighborhoods where children live, particularly dietary supply-related environmental factors. This study aimed to systematically review the evidence on the association between access to convenience stores and childhood obesity. We searched and filtered relevant literature in PubMed, Embase, Web of Science, and Cochrane Library published before 1 January 2019. Data on the basic characteristics of studies, measures of access to convenience stores, and associations of convenience stores with weight-related behaviors and outcomes were extracted from 41 included studies. In general, the density of and proximity to convenience stores in children's residential and school neighborhoods were positively associated with unhealthy eating behaviors. However, their associations with children's weight status varied significantly by regions. The association between convenience store access and children's weight status was found to be negative in Canada, rather mixed in the United States and the United Kingdom, and not significant in East Asia. We suggest future research to clearly define the convenience store, better measure the access to convenience store, and also measure children's journey and food purchasing and consumption behaviors, to explain pathways from convenience store access to childhood obesity for designing effective interventions and policies., (© 2019 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Circadian disruption may play a role in breast carcinogenesis. Previous studies reported relationships between outdoor light at night (LAN) and the breast cancer risk, but their findings are mixed. There is also a need to examine LAN and breast cancer incidence according to different individual and environmental characteristics to identify subpopulations at greater risk associated with LAN exposure. We studied residential outdoor LAN estimated from satellite imagery at baseline (1996) in relation to postmenopausal breast cancer incidence over ~16 years of follow-up in 186 981 postmenopausal women including 12 318 incident postmenopausal breast cancer cases in the NIH-AARP Diet and Health Study. We used Cox proportional hazards models to estimate hazard ratios (HR) and two-sided 95% confidence intervals (CI) of the relationship between quintiles of LAN and postmenopausal breast cancer risk, overall and by hormone receptor status and cancer stage. We found that when compared to women in the lowest quintile of baseline LAN, those in the highest quintile had a 10% increase in postmenopausal breast cancer risk (HR (95% CI), 1.10 (1.02, 1.18), P-trend, .002). The association appeared to be stronger for estrogen receptor (ER) positive breast cancer (1.12 [1.02, 1.24], .007) than for ER-negative cancer (1.07 [0.85, 1.34], .66). Our findings also suggested that the relationship between LAN and breast cancer risk may differ by individual characteristics, such as smoking, alcohol drinking, sleep duration and BMI, and neighborhood environment. In conclusion, our study suggests that higher outdoor LAN exposure may be a risk factor for postmenopausal breast cancer., (© 2020 UICC.)

Background: Research has suggested that artificial light at night (LAN) may disrupt circadian rhythms, sleep, and contribute to the development of obesity. However, almost all previous studies are cross-sectional, thus, there is a need for prospective investigations of the association between LAN and obesity risk. The goal of our current study was to examine the association between baseline LAN and the development of obesity over follow-up in a large cohort of American adults., Methods: The study included a sample of 239,781 men and women (aged 50-71) from the NIH-AARP Diet and Health Study who were not obese at baseline (1995-1996). We used multiple logistic regression to examine whether LAN at baseline was associated with the odds of developing obesity at follow-up (2004-2006). Outdoor LAN exposure was estimated from satellite imagery and obesity was measured based on self-reported weight and height., Results: We found that higher outdoor LAN at baseline was associated with higher odds of developing obesity over 10 years. Compared with the lowest quintile of LAN, the highest quintile was associated with 12% and 19% higher odds of developing obesity at follow-up in men (OR (95% CI) = 1.12 (1.00, 1.250)) and women (1.19 (1.04, 1.36)), respectively., Conclusions: Our findings suggest that high LAN exposure could predict a higher risk of developing obesity in middle-to-older aged American adults.

Introduction: Both short and long sleep have been associated with higher mortality. However, most studies are conducted in predominantly White or Asian populations and little is known about the sleep-mortality relationship in Blacks. Given the high prevalence of short and long sleep in Blacks, it is important to examine the health effects of sleep in this population., Methods: We studied sleep duration in relation to all-cause, cardiovascular and cancer mortality in 55,375 participants age 40-79 at enrollment in the Southern Community Cohort Study, of whom ∼2/3 are Black. Weekday and weekend sleep durations were self-reported. Mortality follow up started at baseline (2002-2009) and was regularly updated until 2015 via linkage to Social Security Administration and the National Death Index. We used Cox proportional hazards model adjusting for multiple covariates to estimate relative risks associated with sleep duration., Results: We found U-shaped relationships between weekday and weekend sleep duration and all-cause mortality, with the effects stronger in Whites than Blacks. Risks for all-cause mortality were significantly elevated by about 25% among Whites and about 10% among Blacks reporting either less than 5 hours or more than 9 hours of sleep compared with those reporting 8 hours of sleep. The associations among Whites but not Blacks were even stronger for cardiovascular disease mortality, whereas no association between sleep duration and cancer mortality was found in either group., Conclusions: Our results suggest that short and long sleep durations may be weaker predictors of total and cardiovascular mortality in Blacks than in Whites., (Copyright © 2019 National Sleep Foundation. All rights reserved.)

Background: A growing body of research has demonstrated that individuals who live in neighborhoods with more severe socioeconomic deprivation may have higher risks for colorectal cancer (CRC). However, previous studies have examined neighborhood socioeconomic status (SES) at only 1 point in time, and it is unclear whether changes in neighborhood SES also can influence the risks of CRC., Methods: Cox regression analysis was used to examine different trajectories of change in neighborhood SES over 10 years in relation to the incidence of CRC among 266,804 participants (ages 51-70 years) in the National Institutes of Health-AARP Diet and Health Study. Eligible participants reported living in the same neighborhood at baseline (1995-1996) and from 2004 to 2006 according to a follow-up questionnaire. Changes in neighborhood SES were measured between 1990 and 2000 by SES indices derived from Census data. Neighborhoods were grouped into 4 categories based on median SES indices in 1990 and 2000 (low-low, low-high, high-low, and high-high)., Results: Compared with residents whose neighborhoods were in the higher SES group at both time points (reference category), those whose neighborhoods were consistently in the low SES group had a 7% higher risk of developing CRC (hazard ratio, 1.07; 95% confidence interval, 1.00-1.14). Moreover, the risk of CRC was 15% higher (hazard ratio, 1.15; 95% confidence interval, 1.02-1.28) for those living in neighborhoods with decreasing SES (high-low) over time., Conclusions: The current findings suggest that exposure to consistently low SES neighborhoods and/or a decrease in neighborhood SES over a period of time may be associated with higher risks of CRC., (© 2018 American Cancer Society.)

Study Objectives: Earlier studies have linked neighborhood disadvantage with poor sleep outcomes. However, little is known about the association between changes in one's neighborhood over time and night sleep and napping. In over 300000 middle-to-old aged Americans, we examined neighborhood socioeconomic status (SES) and change in neighborhood SES in relation to nocturnal sleep duration and napping., Methods: Nocturnal sleep duration and daytime napping were self-reported at baseline (1995-1996). Participants also reported baseline residential addresses, which were linked to US censuses. We derived a neighborhood SES index using census variables and calculated the baseline level and change (1990-2000) in neighborhood SES. Multinomial logistic regression was used to estimate the associations between neighborhood SES over time and nocturnal sleep and napping., Results: Lower baseline neighborhood SES was associated with short sleep, long sleep, and napping. When compared with the highest quintile of neighborhood SES, the lowest was associated with 46% and 72% increase in relative risk (RR) of reporting very short (< 5 hours) sleep, 28% and 19% higher RR of long (≥9 hours) sleep and 95% and 85% increase in long (≥1 hours) nap in men and women, respectively. Moreover, a decrease in neighborhood SES was associated with higher RR of reporting very short sleep in women; while an improvement in neighborhood SES was associated with an increase in RR of long sleep in men., Conclusions: Neighborhood disadvantage and worsening neighborhood conditions were associated with unhealthy sleep behaviors. These results reinforce a growing literature on the potential importance of neighborhood context for understanding sleep health.

Objective: The aim of this study was to compare the 2008 Chinese and the 7th edition of the American Joint Committee on Cancer (AJCC) staging systems for nasopharyngeal carcinoma and to provide proposals for updating T and N staging systems of the present staging system., Methods: Between January 2007 and December 2012, a cohort of 752 patients with biopsy-proven, newly diagnosed, non-metastatic nasopharyngeal carcinoma who were treated with intensity-modulated radiotherapy were retrospectively analysed. Prognoses were compared by T stage, N stage, and clinical stage according to the two staging systems for overall survival (OS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS)., Results: In terms of both the T and N staging systems, the two current staging systems were comparable in predicting OS. The T classification of the 2008 Chinese staging system was better in predicting LRFS, while the N classification of the 7th edition AJCC staging system was superior in predicting DMFS. In the modern era of intensity-modulated radiotherapy, the staging system should be updated by down-staging the current stage T2 to T1, and it might be rational to merge subcategories N1 and N2., Conclusions: The two current staging systems each had advantages in predicting prognosis. It seems reasonable to downstage T2 to T1 and to merge N1 and N2., Competing Interests: The authors have declared that no competing interests exist.

Background: Despite widespread popularity and possible health effects, the prevalence and distribution of coffee consumption in US adults are poorly characterized., Objective: We sought to estimate usual daily coffee intakes from all coffee-containing beverages, including decaffeinated and regular coffee, among US adults according to demographic, socioeconomic, and health-related factors., Methods: Dietary intake data from ≤2 nonconsecutive 24-h dietary recalls and a food-frequency questionnaire administered during the NHANES 2003-2006 were used to estimate the person-specific probability of consuming coffee on a particular day and the usual amount consumed on consumption days. Trends in population mean coffee consumption over time were evaluated by using multiple linear regression and 1-d 24-h recall data from NHANES 2003-2012. Analyses were weighted to be representative of the US adult population aged ≥20 y., Results: An estimated 154 million adults, or 75% of the US population, aged ≥20 y reported drinking coffee; 49% reported drinking coffee daily. Prevalence did not vary by sex, education, income, or self-reported general health (all P ≥ 0.05) but did vary by age, race/ethnicity, smoking status, and alcohol drinking (all P < 0.05). Among coffee drinkers, the mean ± SE usual intake was 14.1 ± 0.5 fluid ounces/d (417 ± 15 mL/d). Mean usual intakes were higher in men than women, in older age groups than in those aged 20 to <30 y, in non-Hispanic whites than in non-Hispanic blacks or Hispanic/other races, in smokers than in never smokers, and in daily alcohol consumers than in nonconsumers (all P < 0.05). Population mean coffee consumption was stable from 2003 to 2012 (P-trend = 0.09)., Conclusions: Coffee is widely consumed in the United States, with usual intakes varying by lifestyle and demographic factors, most notably by age. Longitudinal studies are needed to determine whether observed differences by age reflect birth cohort effects or changes in drinking patterns over the lifetime., Competing Interests: 2 Author disclosures: E Loftfield, ND Freedman, KW Dodd, E Vogtmann, Q Xiao, R Sinha, and BI Graubard, no conflicts of interest., (© 2016 American Society for Nutrition.)

Anorectal melanoma (AM) is a rare type of melanoma that accounts for 0.4% to 1.6% of total malignant melanomas. The incidence of AM increases over time, and it remains highly lethal, with a 5-year survival rate of 6% to 22%. Considering the rare nature of this disease, most studies on AM comprise isolated case reports and single-center trials, which could not provide comprehensive assessment of the disease. Therefore, we conducted a population-based study by using the Surveillance, Epidemiology, and End Results (SEER) program to provide the latest and best available evidence of AM.We extracted all cases of AM registered in the SEER database from 1973 to 2011 (April 2014 release) and calculated age-adjusted incidence. Only cases with active follow-up were included to predict factors associated with prognosis. Survival outcomes were also compared among different types of surgery.We identified 640 AM cases, which consisted of 265 rectal melanoma and 375 anal melanoma. The estimated annual incidence rates of AM per 1 million population were 0.259 in males and 0.407 in females, and it increased with advanced age and over time. Tumor stage and surgical treatment were independent predictors of survival. Results implied that surgery improved the prognosis of patients with local- and regional-stage AM but could not prolong the survival of patients with distant-stage AM. Moreover, the outcome of less extensive excision was not statistically different from that of more extensive excision.This study provides an up-to-date estimation of the incidence and prognosis of AM by using SEER data. The incidence of AM continuously increases over time, despite its rarity. This disease also exhibits poor prognosis. Thus, AM must be further investigated in future studies. We also recommend surgery as the optimal treatment for local- and regional-stage AM patients but not for those with distant metastasis., Competing Interests: The authors have no conflicts of interest to disclose.

Experimental studies suggested that flavonoids may influence thyroid carcinogenesis, but epidemiologic evidence is sparse. No study has examined different classes of flavonoids in relation to thyroid cancer risk. Using data from the NIH-AARP Diet and Health Study, which enrolled 491,840 U.S. men and women, ages 50 to 71 years at baseline, we prospectively examined the risk of thyroid cancer in relation to dietary intakes of catechins, flavanones, flavonols, anthocyanidins, flavones, isoflavones, and total flavonoids. Dietary intakes were assessed using a food frequency questionnaire. Cancer cases were ascertained by linkage to state cancer registries. Multivariable-adjusted Cox proportional hazard models were used to estimate HRs and 95% confidence intervals (CI). During follow up (mean = 9 years), we identified 586 thyroid cancer cases. Thyroid cancer risk was inversely associated with dietary flavan-3-ols [HRQ5 vs. Q1 (95% CI): 0.70 (0.55, 0.91), PTrend = 0.03], but positively associated with flavanones [HRQ5 vs. Q1 (95% CI): 1.50 (1.14, 1.96), PTrend = 0.004]. Other classes of flavonoids and total flavonoids were not associated with thyroid cancer risk. Similar associations were found for papillary thyroid cancer. Our findings suggest that dietary intake of different classes of dietary flavonoids may have divergent effects on thyroid cancer risk. More studies are needed to clarify a role of flavonoids in thyroid cancer development. Results from our study suggest a potential nutritional etiology of thyroid cancer. Cancer Epidemiol Biomarkers Prev; 23(6); 1102-8. ©2014 AACR., (©2014 American Association for Cancer Research.)

Background: Physical activity and sedentary behavior may influence ovarian cancer risk, but clear evidence is lacking., Methods: We prospectively investigated the relations of self-reported physical activity and sedentary behavior to ovarian cancer incidence in a cohort of 148,892 U.S. women ages 50-71 years at baseline (1995-1996), who were followed through 2006. Multivariate Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI). We also conducted analysis by hormone use, body mass index (BMI), and cancer subtype., Results: We identified 753 incident epithelial ovarian cancers. Overall, neither physical activity nor sedentary behavior at baseline was associated with ovarian cancer risk. Compared with women who never or rarely engaged in vigorous physical activity in the past year, women who reported more than 5 times/week of vigorous physical activity had an RR of 1.05 (95% CI, 0.84-1.32). Women who sat 7+ hours/day had an RR of 1.05 (95% CI, 0.80-1.37) compared with those reporting <3 hours of sitting. The associations were not modified by hormone use or BMI and were similar for both serous and non-serous subtypes., Conclusions: Physical activity and sedentary behavior in middle and older ages were not associated with ovarian cancer risk., Impact: We found no clear support for a role of physical activity and sedentary behavior in ovarian cancer risk., (©2013 AACR.)

Importance: Calcium intake has been promoted because of its proposed benefit on bone health, particularly among the older population. However, concerns have been raised about the potential adverse effect of high calcium intake on cardiovascular health., Objective: To investigate whether intake of dietary and supplemental calcium is associated with mortality from total cardiovascular disease (CVD), heart disease, and cerebrovascular diseases., Design and Setting: Prospective study from 1995 through 1996 in California, Florida, Louisiana, New Jersey, North Carolina, and Pennsylvania and the 2 metropolitan areas of Atlanta, Georgia, and Detroit, Michigan., Participants: A total of 388 229 men and women aged 50 to 71 years from the National Institutes of Health-AARP Diet and Health Study., Main Outcome Measures: Dietary and supplemental calcium intake was assessed at baseline (1995-1996). Supplemental calcium intake included calcium from multivitamins and individual calcium supplements. Cardiovascular disease deaths were ascertained using the National Death Index. Multivariate Cox proportional hazards regression models adjusted for demographic, lifestyle, and dietary variables were used to estimate relative risks (RRs) and 95% CIs., Results: During a mean of 12 years of follow-up, 7904 and 3874 CVD deaths in men and women, respectively, were identified. Supplements containing calcium were used by 51% of men and 70% of women. In men, supplemental calcium intake was associated with an elevated risk of CVD death (RR>1000 vs 0 mg/d, 1.20; 95% CI, 1.05-1.36), more specifically with heart disease death (RR, 1.19; 95% CI, 1.03-1.37) but not significantly with cerebrovascular disease death (RR, 1.14; 95% CI, 0.81-1.61). In women, supplemental calcium intake was not associated with CVD death (RR, 1.06; 95% CI, 0.96-1.18), heart disease death (1.05; 0.93-1.18), or cerebrovascular disease death (1.08; 0.87-1.33). Dietary calcium intake was unrelated to CVD death in either men or women., Conclusions and Relevance: Our findings suggest that high intake of supplemental calcium is associated with an excess risk of CVD death in men but not in women. Additional studies are needed to investigate the effect of supplemental calcium use beyond bone health.

Purpose: The purpose of this paper is to provide a general review about the major programs and factors characteristic of major changes in the health care access, from both consumer and provider perspectives. Customers' perspective emphasizes the fiscal control, with particular focus on the agencies that function as fiscal intermediaries and enablers, such as insurance companies. Providers' perspective concentrates on providers of health care services, such as physicians, nurses, technicians as well as various types of medical care facilities., Design/methodology/approach: Historical approach was adopted to address the health care access issue, a general concept that summarizes the specific dimensions describing the fit between the patient and the health care system., Findings: It is self-evident that reform is needed and that major efforts should be made to remedy shortcomings in order to safeguard the health and welfare of the nation., Originality/value: To achieve the goal of a truly caring commonwealth, we must improve quality and safety in health care, increase access and utilization of technology, promote greater consumer involvement at all stages, restructure the medical malpractice system to reach all who may be injured by systemic errors, and develop sustainable financing less subject to the vagaries of state revenues. However, the access issue still remains a basic and important problem we have to confront.