Project description:The United States opioid epidemic is a nationwide public health crisis. Initially driven by increased consumption and availability of pharmaceutical opioids, an increasing number of opioid overdoses are now related to heroin and illicitly manufactured fentanyl and fentanyl analogs. Addressing this epidemic requires addressing the stigma associated with opioid use disorders and its treatment, improving access to efficacious treatment options, specifically methadone and buprenorphine, and reducing opioid overdose fatalities with distribution of the opioid antagonist and overdose reversal agent naloxone.
Project description:Grandparenting varies enormously in the United States and here we discuss that growing diversity. Relying on exchange and reciprocity, feminist, and political economic theoretical perspectives, we begin by exploring the increasing need for grandchild care and assistance in the United States and the dearth of federal and employer supports for working families. Assessing the impact of sociodemographic trends, notably the rise in single parenting and the increase in employment among grandparents, we assess the intensification of grandparenting. Then we turn to issues related to proximity, examining the pleasures and challenges of coresidential, custodial, long distance, and transnational grandparenting. Finally, we turn to the impact of grandparenting on the emotional, physical, and financial wellbeing of grandparents.
Project description:This research demonstrates wide variation in tightness-looseness (the strength of punishment and degree of latitude/permissiveness) at the state level in the United States, as well as its association with a variety of ecological and historical factors, psychological characteristics, and state-level outcomes. Consistent with theory and past research, ecological and man-made threats--such as a higher incidence of natural disasters, greater disease prevalence, fewer natural resources, and greater degree of external threat--predicted increased tightness at the state level. Tightness is also associated with higher trait conscientiousness and lower trait openness, as well as a wide array of outcomes at the state level. Compared with loose states, tight states have higher levels of social stability, including lowered drug and alcohol use, lower rates of homelessness, and lower social disorganization. However, tight states also have higher incarceration rates, greater discrimination and inequality, lower creativity, and lower happiness relative to loose states. In all, tightness-looseness provides a parsimonious explanation of the wide variation we see across the 50 states of the United States of America.
Project description:Although incidence rates of end-stage renal disease (ESRD) in the United States are reported routinely by the US Renal Data System (USRDS), risks (probabilities) are not reported. Short- and long-term risk estimates need to be updated and expanded to minority populations, including Native Americans, Asian/Pacific Islanders, and Hispanics.Risk estimation from surveillance data in large populations using life-table methods. A competing-risks framework was applied by constructing a hypothetical cohort followed from birth to death.Total US population. Incidence and mortality rates of ESRD were obtained from the USRDS; all-cause mortality rates were obtained from CDC WONDER.Age, sex, race/ethnicity, and year.10-year to lifetime risks (cumulative incidence) of ESRD.Among males, lifetime risks of ESRD from birth using 2013 data were 3.1% (95% CI, 3.0%-3.1%) for non-Hispanic whites, 8.0% (95% CI, 7.9%-8.2%) for non-Hispanic blacks, 3.8% (95% CI, 3.4%-4.9%) for non-Hispanic Native Americans, 5.1% (95% CI, 4.8%-5.4%) for non-Hispanic Asians/Pacific Islanders, and 6.2% (95% CI, 6.1%-6.4%) for Hispanics. Among females, lifetime risks were 2.0% (95% CI, 2.0%-2.1%) for non-Hispanic whites, 6.8% (95% CI, 6.7%-6.9%) for non-Hispanic blacks, 3.6% (95% CI, 3.3%-4.2%) for non-Hispanic Native Americans, 3.8% (95% CI, 3.6%-4.0%) for non-Hispanic Asian/Pacific Islanders, and 4.3% (95% CI, 4.2%-4.5%) for Hispanics. Lifetime risk of ESRD from birth increased from 3.5% in 2000 to 4.0% in 2013 in males and decreased from 3.0% to 2.8% in females.Standard life-time assumption of fixed age-specific rates over time and possible ESRD misclassification. To be useful in clinical practice, this application will require additional predictors (eg, comorbid conditions and chronic kidney disease stage).ESRD risk in the United States varies more than 2-fold among racial/ethnic groups for both sexes.