Charles R. Drew University of Medicine and Science

We analyzed data from Mapping Police Violence and the Washington Post, including 7,082 fatal police shootings in 3,125 counties between 2015—2022. We employed negative binomial regression models (NBRG) to estimate the association between income inequality and fatal shootings by race/ethnicity. All models controlled for county population density (population per square mile), age distribution, racial composition, and violent crime rates. We controlled for year and clustered the regression standard errors at the county level. On average at the county level, 0.3 (SD: 0.6) per 10,000 of the White population, 4.6 (SD: 37.4) per 10,000 of the Black population, and 0.8 (SD: 2.6) per 10,000 of the Hispanic population have been fatally shot by police, with an overall average of 0.20 (SD: 0.5) per 10,000 population. Regression findings indicated a strong association between income inequality and fatal police shootings, while violent crimes, and county racial composition were additional predictors. Policymakers must prioritize structural reforms and equitable resource allocation to reduce policing disparities and prevent unnecessary loss of life.

Background:Mediterranean diet (MeDi) has been linked to lower incidence of cardiovascular and neurodegenerative diseases, and overall mortality, in several prospective studies. There is limited data, however, regarding the relationship between MeDi and stroke subtypes. We hypothesized that MeDi would be associated with lower total, ischemic, and hemorrhagic stroke incidence. Methods:The California Teachers Study is a prospective cohort study that comprises 133,477 women who were educators and administrators enrolled in 1995-1996 and followed since. We identified incident strokes using linked California state hospitalization data and national death records from 1996-2020. The MeDi adherence score (range 0-9, higher score indicating better adherence) was calculated based on participants' response to the Block food frequency questionnaire at study baseline. Multivariable Cox proportional hazard models adjusted for socio-demographic, lifestyle and vascular risk variables were constructed to assess the association (hazard ratios and 95% confidence intervals, HR 95% CI) between MeDi score and risk of stroke and its subtypes. Results:105,614 participants were eligible and included in the final analytic cohort (mean age 52.5 ± 13.8 years). Over the follow-up period (average follow-up time was 20.5 years), there were 4,083 incident stroke events (3,358 ischemic; 725 hemorrhagic). In fully-adjusted models for all stroke, ischemic and hemorrhagic subtypes, there was a lower risk of stroke among those with MeDi scores of 6-9 compared to those with scores of 0-2 (all stroke HR 0.82, 95% CI 0.74-0.92; ischemic HR 0.84, 95% CI 0.75 - 0.95; hemorrhagic HR 0.75, 95% CI 0.58-0.97). Discussion:Adherence to the MeDi is associated with lower risk of total, ischemic, and hemorrhagic stroke incidence among women. Potential study limitations include recall bias, misclassification bias, and residual confounding, which would bias our results to the null.

ABSTRACT Motivation plays a central role in driving individuals to participate in clinical trials, and understanding its multifaceted nature is essential for improving trial diversity. This study aimed to (1) identify the different dimensions of motivation for clinical trial participation, (2) examine the sociodemographic and health predictors of motivation, and (3) test whether the predictors differ by gender, race, and ethnicity. Data were drawn from the 2020 Health Information National Trends Survey (HINTS 5, Cycle 4; n = 3865). Eight survey items assessing motivation were analyzed using factor analysis, leading to the creation of three latent domains (general, material, and care‐related motivation) via Structural Equation Modeling (SEM), which served as study outcomes. SEM was applied to estimate associations between predictors and each motivation domain, both in the pooled sample and across gender, race, and ethnic subgroups. In the pooled sample, higher educational attainment (beta = 0.118, p < 0.001) was positively associated, and Black (beta = −0.074, p < 0.05) and other races (beta = −0.122, p < 0.001) were negatively associated with the motivation general outcome. Age (beta = −0.365, p < 0.001) and income (beta = −0.081, p < 0.05) were negatively associated with the motivation material domain. Educational attainment (beta = 0.135, p < 0.001), income (beta = 0.092, p < 0.05), depressive and anxiety symptoms (beta = 0.090, p < 0.01), and cardiometabolic conditions (beta = 0.089, p < 0.01) showed positive associations with the motivation care outcome, while age was negatively associated (beta = −0.089, p < 0.05). Multi‐group SEM showed significant gender‐, race‐, and ethnicity‐specific differences. Motivational patterns differed by gender, race, and ethnicity, emphasizing that understanding these variations can strengthen recruitment, retention, and inclusivity in clinical trials.

Abstract Background Temporary 60-day percutaneous peripheral nerve stimulation (PNS) can relieve pain in refractory occipital neuralgia (ON), but whether it alters acute healthcare utilization relative to the natural trajectory of the disease is unknown, because prior studies have lacked a concurrent comparator. Methods We performed a secondary analysis of prospectively collected data from a tertiary interventional pain center. Adults with medically refractory ON (primary diagnosis occipital neuralgia, ICD-10-CM M54.81) who underwent 60-day occipital PNS (n = 42) were compared with concurrent patients who were clinically eligible for PNS but were denied insurance authorization and continued optimized non-PNS management (usual care; n = 63). Headache-related emergency department (ED) encounters—index (occipital neuralgia) and non-index (other headache/facial-pain diagnoses)—were ascertained over the 12 months before and after the treatment window via the electronic record and the statewide health information exchange. Patients were 1:1 propensity-matched on a priori confounders (age, sex, baseline total headache-related ED utilization, HIT-6, and baseline headache-medication use). The primary analysis was a difference-in-differences (DiD) comparison of the change in headache-related ED utilization, reported as the additive difference (Hodges– Lehmann estimate, distribution-free 95% CI) and, alongside, as a multiplicative rate ratio (RR). Results Thirty-six matched pairs were well balanced. Baseline headache-related ED utilization was nearly identical between matched groups (6.3 vs. 6.2 visits/year). Over the following year, PNS patients’ utilization fell to 2.5 while usual-care patients’ rose to 6.9. The DiD was 5.0 fewer headache-related ED visits per patient (95% CI 3.0–6.0; p < 0.001), corresponding to a rate ratio of 0.36 (95% CI 0.27–0.48; p < 0.001). Results were consistent in the full sample, in covariate-adjusted models, and after excluding controls denied for incomplete conservative-therapy trials. The effect was driven by non-index headache visits. Conclusions Relative to a concurrent, matched usual-care cohort whose headache-related ED utilization rose over time, 60-day occipital PNS was associated with a substantial reduction in acute-care use, strengthening the case for a role of PNS on healthcare utilization in refractory ON.

Abstract Health has traditionally been measured by the presence or absence of disease. However, global initiatives, such as those from the World Health Organization (WHO), emphasize that health also includes functionality, capacity, well-being, and quality of life. Patient-reported outcomes (PROs) capture these dimensions directly from older adults and provide insights that complement clinical and biological markers. Initiatives such as Patient-Centered Outcomes Research Institute similarly promote PROs as core research outcomes. This perspective highlights the role of PROs in geriatric and aging research and presents a conceptual framework linking social determinants, disease burden, and patient-reported health in predicting outcomes. We outline priority research questions, identifying relevant international data sets, and discuss methodological approaches, including nested survival models, event-anchored mixed-effect models, and measurement invariance testing, to study how PROs evolve across populations and over time. Advancing these approaches may help move aging research toward a more holistic, patient-centered model of health.