Jose R. Fernandez

Introduction The likelihood of a child participating in a clinical trial is mostly independent of the child’s willingness to participate; children’s lack of autonomy obliges parental involvement, which is concurrently conditional to parental understanding, trust and endorsement of the research study. Objectives To identify potential predictors for allowing children to participate in clinical studies and to evaluate if motivators that promote or prevent parental support of children to participate in clinical studies differed according to racial/ethnic categorization. Methods A stratified sample of 1,057 caregivers of children 1-18 years old who in 2015 resided in South Florida’s Miami-Dade, Broward, and Palm Beach counties were included in the study. Pediatric research participation was analyzed by exploratory unadjusted weighted multinomial association tests. Results There were different reasons for which caregivers will allow or reject children participation in clinical research. The sex of the respondent [OR = 2.48 (1.58 - 3.90)], difficulties accessing health care access [OR = 2.77 (1.60 – 4.80)], and child’s underweight status [OR: 3.22 (1.90 – 5.47)] significantly differed between those very likely and unlikely to participate. Conclusions Caregivers decision to allow children to participate or not in clinical research differ according to race/ethnic classification, gender of caregivers, and weight status of the child.

The present study assessed how the adaptation to American culture by United States (U.S.)-born and foreign-born Hispanics living in the U.S. may influence stress-related physiological aspects that may impair health. Data on 8,360 Hispanics living in the U.S. categorized as U.S.-born (n = 3347) and foreign-born (n = 5013) from NHANES 1999–2010 (ages 18–85) were used. Stress-related physiological impact was measured by the allostatic load index (ALoad). Adaptation to American culture was evaluated through three acculturation-related measures. The average age was 39.39 years in a sample where 51% were males. ALoad was classified as no load (15.41%), low load (55.33%), and high load (29.24%). The U.S.-born Hispanics showed higher ALoad compared to foreign-born Hispanics (p < 0.001). Among foreign-born Hispanics, length of residence (LOR) and age of arrival in the U.S. (AOA) were associated with higher ALoad scores (p < 0.05), and in U.S.-born Hispanics, age and sex were positively associated and education was negatively associated with ALoad scores (p < 0.05). Adaptation to American culture in foreign-born Hispanics living in the U.S. appears to influence levels of ALoad in this population.

Summary: Background: Obesity is a global health concern but the United States has reported a leveling in obesity rates in the pediatric population.Objective: To provide updated waist circumference (WC) percentile values, identify differences across time and discuss differences within the context of reported weight stabilization in a nationally representative sample of American children.Methods: Percentiles for WC in self‐identified African Americans (AA), European Americans (EA) and Mexican Americans (MA) were obtained from 2009–2014 National Health and Nutrition Examination Survey data (NHANES2014). Descriptive trends across time in 10th, 25th, 50th, 75th and 90th percentile WC distributions were identified by comparing NHANES2012 with previously reported NHANESIII (1988–1994).Results: WC increased in a monotonic fashion in AA, EA and MA boys and girls. When compared with NHANESIII data, a clear left shift of percentile categories was observed such that values that used to be in the 90th percentile are now in the 85th percentile. Differences in WC were observed in EA and MA boys during a reported period of weight stabilization.Conclusion and Relevance: WC has changed in the US pediatric population across time, even during times of reported weight stabilization, particularly among children of diverse racial/ethnic backgrounds.

The study examines the association of neighborhood socioeconomic deprivation and metabolic syndrome with inflammation.

Background: Hypertension and dyslipidemia have traditionally been associated with dietary sodium and fat intakes, respectively; however, they have rec

The process of the colonization of the New World that occurred centuries ago served as a natural experiment, creating unique combinations of genetic material in newly formed admixed populations. Through a genetic admixture approach, the identification and genotyping of ancestry informative markers have allowed for the estimation of proportions of ancestral parental populations among individuals in a sample. These admixture estimates have been used in different ways to understand the genetic contributions to individual variation in obesity and body composition parameters, particularly among diverse admixed groups known to differ in obesity prevalence within the United States. Although progress has been made through the use of genetic admixture approaches, further investigations are needed in order to explore the interaction of environmental factors with the degree of genetic ancestry in individuals. A challenge to confront at this time would be to further stratify and define environments in progressively more granular terms, including nutrients, muscle biology, stress responses at the cellular level, and the social and built environments.