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AbstractObjectiveMethodsResultsConclusionsMarginalized racial/ethnic populations showed higher rates of asthma prevalence and high-cost healthcare utilization for asthma. However, few studies investigated the disproportionate financial burden of asthma among the underrepresented racial/ethnic groups. This study aims to estimate the direct cost of asthma by severity and race/ethnicity and examine the moderating effects of race/ethnicity on the relationship between asthma severity and the cost.This study employs a retrospective study design to estimate the direct cost of asthma for hospitalizations, ED visits, and outpatient visits. Nevada claims data was used from Q4 2015 to Q4 2021. Generalized Linear Models were used to estimate the direct cost of asthma and test the moderating effects of race/ethnicity.The direct cost increased as asthma severity intensified across the three settings. The direct cost rose from $42148 (Hospitalizations), $4291 (ED visits), and $2177 (Outpatient visits) among those with mild asthma to $60464, $10857, and $7116 among those with severe asthma. The direct cost increased if patients were older, African Americans, or diagnosed with severe asthma. The incremental cost was greater among African American and Asian patients for ED visits, indicating the moderating effect of race/ethnicity.We found an incremental cost for severe asthma and the moderating effect of race/ethnicity on the relationship between asthma severity and the cost of ED and outpatient visits. The higher incremental costs among marginalized racial/ethnic groups imply that the financial burden of asthma increases on a larger scale among those racial/ethnic groups than among White patients. [ABSTRACT FROM AUTHOR]

Background: Telehealth has emerged as a vital alternative to traditional healthcare delivery, particularly for rural and underserved populations. While efforts to enhance telehealth accessibility have primarily focused on technological solutions, the effectiveness of its telehealth and the role of physician training in bridging racial and ethnic disparities in telehealth usage remains underexplored. This study evaluates the impact of a trained-physician-delivered, age-friendly telehealth model on healthcare accessibility and outcomes. Methods: A retrospective analysis was conducted on 214 older patients (60+) at an urban primary care facility in Nevada, USA. Patients received telehealth services from either trained or non-trained physicians, with the trained group utilizing a 4M-based telehealth model focusing on Medication, Mentation, Mobility, and What Matters. Results: Findings revealed lower exposure to both general and 4M-based telehealth among Hispanic and Asian patients compared to their white counterparts. Telehealth usage did not significantly reduce hospital or emergency department visits overall. However, certain types of 4M-based telehealth, such as What Matters and Medications, reduced hospital and ED visits. Implications: The development and implementation of telehealth education curricula for healthcare providers could make telehealth more accessible to minority patients, potentially reducing unnecessary emergency department visits and addressing disparities in telehealth access. [ABSTRACT FROM AUTHOR]

Objective: This study examined the mediating effects of lifelong learning on the association between self-rated health and educational attainment among a nationally representative sample of US residents aged 50 years and older. Setting: Socioeconomic disparities in health are a major public health concern in economically developed nations where improving socioeconomic status (e.g. formal educational attainment) at the population level is challenging. In the light of population ageing, alternative approaches to improve health through malleable factors are urgently needed. Recent research suggests that participation in organised learning activities -- lifelong learning -- could attenuate the lack of formal educational attainment on health. Methods: Data come from the 2012 wave of the US Health and Retirement Study. Structural equation models with bootstrapping were used to estimate the mediation effect of lifelong learning activity in the relationship between self-rated health and formal educational attainment. Results: Approximately 3%-5% of the effect of formal education on self-rated health was mediated by lifelong learning activity. Findings from this study support the notion that ongoing participation in organised learning activities is beneficial for health in later life. Conclusion: Lifelong learning reflects a promising autonomous and sustainable strategy to improve health in later life. Future public health and education policy as well as education institutions should consider providing more learning opportunities for older populations.

Health literacy skills are known to be a key mediator of the relationship between education and health in the general population. However, one aspect of health literacy skills--individuals' actual literacy activities--remains understudied, especially among older adults. Health disparities that are driven by inequalities in education and level of health literacy skills are particularly problematic for older adults since they are exacerbated in old age by disadvantages that accumulate over the life course. This study examined a nationally representative sample of US adults age 50 years and older (n = 2,573) using data from the 2014 Program for International Assessment of Adult Competencies (PIAAC). Parallel mediation analysis was conducted to examine the partial mediation effects of health literacy skills and literacy activity (i.e., reading at home) on the relationship between education and health. Results showed that both health literacy skills and literacy activity mediated the education--health relationship. On average, literacy skills mediated 31.89% and literacy activities mediated 9.59% of the effect of education of self-rated health. Literacy activity, such as reading, is an easily accessible, autonomous, and sustainable option for promoting health in later life. Policies that support the intersection of public health and education may promote lifelong learning and well-being among US adults.

Purpose Anatomic variations complicate surface landmark-guided needle placement, thereby increasing nerve blockade failure rate. However, little is understood about how anatomic distances change under different clinical conditions. As the cricoid cartilage is an easy and accurate landmark, we investigated changes in distance between the sixth or seventh cervical transverse processes (C6TP or C7TP) and the cricoid cartilage in neutral and extended supine positions. Methods Forty-two patients (16 men, 26 women) were included in this study. Distances between the cricoid cartilage and C6TP/C7TP were measured using ultrasonography with the patient in neutral and extended supine positions. Results C6TP and C7TP were caudally located at 6.0 ± 8.1 and 15.1 ± 7.2 mm, respectively, from the cricoid cartilage in the neutral supine position, and at 15.2 ± 8.0 and 25.3 ± 8.0 mm, respectively, in the extended supine position. In the extended supine position, the cricoid cartilage was more cephalad than C6TP and C7TP in all patients. The distance from the cricoid cartilage to C6TP was 12.1 ± 7.6 mm in men and 17.2 ± 7.7 mm in women. Conclusion C6TP and C7TP are located approximately 15 and 25 mm, respectively, caudal to the cricoid cartilage in the extended supine position. Our results highlight the fact that there can be significant anatomic variation between the extended and neutral supine positions used in stellate ganglion block, which should be kept in mind when devising easily identifiable and palpable surface landmarks., Author(s): Jiwon An[sup.1] , Youn-Woo Lee[sup.1] , Woo Young Park[sup.2] [sup.3] , Sungchul Park[sup.4] , Hyungbae Park[sup.4] , Ji Won Yoo[sup.5] , Jong Bum Choi[sup.4] Author Affiliations: (1) Department of [...]