PURPOSE:In 2015, only 13% of radiation oncology residency program websites were found to contain ≥80% of the crucial information sought by applicants. In a "post-COVID-19 world" in which many programs are continuing exclusively virtual interviews, digital resources often serve as first impressions of an organization. Therefore, our objective was to evaluate common website deficiencies and program website comprehensiveness, as well as to assess how they correlate with program characteristics. METHODS AND MATERIALS:Eighty-eight residency programs, their websites, and characteristics, including program size, match rate, accreditation status, and publication percentile, were identified using the FREIDA Residency Program Database, the Doximity Residency Navigator, a list of radiation oncology residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME), and the 2019-2023 National Resident Matching Program data. Website comprehensiveness was evaluated based on 16 criteria, including information on didactics, clinical rotations, application requirements, current residents, alumni, technology and research, and the presence of video resources. Relationships between program characteristics and website comprehensiveness were evaluated using a Kruskal-Wallis t test and linear regression. RESULTS:Comprehensiveness scores had a mean and median of 76.3% and 81.3%, respectively, ranging from 18.8% to 100%. Of the 16 criteria, 9 were present in ≥80% of websites, and 3 (information about call responsibilities, medical student clerkships, and social opportunities) were present in ≤60% of websites. Programs accredited without warning had more comprehensive websites than programs accredited with a warning (P < .01). Programs with more current residents (P = .007), more spots offered in the Match (P = .008), and higher resident publication percentiles (P = .002) had more comprehensive websites. CONCLUSIONS:While the comprehensiveness of US radiation oncology residency program websites has improved significantly on average over the past decade, there is still ample room for further improvement - only 26.1% and 54.5% of websites contained information about call responsibilities and student clerkships, respectively. Future investigations include relationships between match rates and program/location-specific characteristics (eg, region, cost of living, and salary/benefits).

We examined the sex-specific association between education and income with biological age (BA) and by race/ethnicity. The Klemera-Doubal method was used to calculate BA among 6,213 females and 5,938 males aged 30-75 years who were Hispanic, non-Hispanic (NH) White, NH Black (NHB), or NH Asian (NHA). Compared with a college education, less than a high school education was associated with greater BA by 3.06 years (95% CI: 1.58, 4.54) among females only; associations were strongest among NHB, Hispanic, and NHA females. Compared with an annual income of ≥$75,000, an income <$25,000 was associated with greater BA by 4.95 years (95% CI: 3.42, 6.48) among males and 2.76 years among females (95% CI: 1.51, 4.01); associations were strongest among NHW and NHA adults, and Hispanic males. Targeting upstream sources of structural disadvantage among racial/ethnic minority groups, in conjunction with improvements in income and education, may promote healthy aging in these populations.

US construction workers (CWs) have the highest cigarette smoking rate among all occupations (27.2% vs. 15%), yet the lowest coverage of workplace smoking cessation services (14% vs. 29%). This study aims to empower safety managers to implement smoking cessation services in the construction industry. Using participatory research methods, this study aims to: 1) Develop multilevel strategies (MLIs) to implement adaptive smoking cessation programs delivered by the safety manager on construction sites, and 2) conduct a cluster-randomized, hybrid type 1 effectiveness-implementation, 2-phase sequential multiple assignment randomized trial (SMART) to test the programs (ClinicalTrials.gov: NCT06098144). The MLIs include: 1) creating the outer setting (research investigators, stakeholders) and inner setting facilitation (companies' advisory committee, study champion), 2) conducting observational field assessments of workflows, 3) training safety managers to deliver the intervention, and 4) conducting implementation process evaluations. In SMART, 32 construction sites within 8 companies with 608 CWs will be enrolled. In Phase 1, sites will be randomized to A1 (referral to Tobacco Quitline -TQL) or B1 (referral to TQL + nicotine replacement treatment (NRT) + 1 group behavioral counseling session). In Phase 2, responders who quit smoking at 3 months continue with the assessment only, while non-responders will be re-randomized to C (4 counseling sessions + NRT; A1 + C, B1 + C) or an extra dose of Phase 1 treatment (A2, B2). Participants will receive 4 follow-up assessments at 3, 6, 9, and 12 months. Primary outcomes are the effectiveness (12-month biomarker-confirmed prolonged abstinence) and cost-effectiveness (cost/quit, cost/quality-adjusted life-year) of A1 + A2 vs. B1 + B2 and A1 + C vs. B1 + C. The secondary outcome is the feasibility of the program's implementation. We hypothesize that B1 + B2 will outperform A1 + A2, and B1 + C will outperform A1 + C. This project will generate novel scientific evidence on the effectiveness, cost-effectiveness, and implementation feasibility of smoking cessation programs in the construction industry.

Objective: Estimate ever using marijuana in a sample of US career first responders. Methods: Health survey cohort data collected between 2018 and 2024 from employed and retired US first responders were analyzed for frequency of ever using marijuana. Binary logistic regression models estimated the association between ever using marijuana and first responder demographics, employment status, and risky health behaviors. Results: Among 1310 current/retired first responders, 15.3% reported ever using marijuana (80.0% seldom, 18.0% often, and 2.0% always). Currently employed firefighter/paramedic/emergency medical technicians had the highest (45.5%), whereas Battalion/EMS/Deputy/Fire Chiefs had the lowest use (3.0%). First responders who binge drink (adjusted odds ratio [aOR] = 1.45; 95% confidence interval [CI]: 1.03-2.03; P = 0.033), former-smoker (aOR = 2.42; 95% CI: 1.68-3.47; P < 0.001), or current-smokers (aOR = 3.61; 95% CI: 1.01-12.93; P = 0.049), and were retired (aOR = 1.85; 95% CI: 1.20-2.87) were significantly more likely to report ever using marijuana. Conclusions: Ever using marijuana was highest among those rank firefighter/paramedics/emergency medical technician and significantly associated with binge drinking, retirement, and smoking behaviors.

OBJECTIVE:There is limited information on the risk of multiple primary cancers (MPCs) among firefighters. We evaluated the distribution and relative risk of MPC for male career firefighters versus nonfirefighters for the second, third, or fourth diagnosed cancers. METHODS:This population-based study employed linked data (1981-2014) from three sources in Florida to report the distribution and relative risk of MPC. RESULTS:There are 290,624 (20.81%) MPCs (n = 1054 career firefighters, n = 289,570 nonfirefighters). Firefighters have 1.14 times (95% CI, 1.00-1.30; P = 0.047) greater number of MPC compared to nonfirefighters. The distribution of MPC sites was relatively similar. Compared to nonfirefighters, firefighters had a higher risk of melanoma of the skin, all melanomas for both the first and second MPCs. CONCLUSION:Future research is warranted to investigate melanoma risk as MPC and to identify associated occupational hazards.

PURPOSE:Visual impairment (VI) is prevalent in older adults and associated with cognitive decline. However, the mechanisms through which visual impairment affects cognitive functioning during the aging process are poorly understood. Our study aims to estimate the direct effect of visual acuity on cognitive function and its indirect effect through social isolation and depressive symptoms by sex and age. DESIGN:Cross-sectional study. PARTICIPANTS:117,231 individuals aged 40-70 participated in the UK Biobank baseline and ocular assessment. Of these, 81% were white, 54% were female, and 45.6% were aged 60-70. The mean age was 56.8 (SD 8.1) years. METHODS:Path analyses with multiple equations were conducted to examine the direct and indirect effects of visual acuity (VA). Stratified analyses by gender and age were performed. MAIN OUTCOME MEASURES:LogMAR VA was the exposure, with social isolation and depressive symptoms as mediators. Cognitive functions, including visual memory, verbal-numerical reasoning, processing speed, and prospective memory, were the outcomes. RESULTS:VA had a direct effect on cognitive function (β = -0.979 for reasoning and OR = 0.67 for prospective memory). VA also influenced cognition indirectly through social isolation and depressive symptoms. The direct effect of VA on cognitive function was similar in men vs. women and middle-aged vs. older. However, there is a marked difference in the mediating effect via social isolation and depressive symptoms by age and sex. The mediating effect of VI on cognition via social isolation was stronger in older adults than middle-aged and in men than women; while the mediating effect via depressive symptoms was stronger in women and middle-aged individuals. VI had the largest mediating effect via social isolation in older males. CONCLUSION AND RELEVANCE:Vision, social isolation, and depressive symptoms are modifiable factors and can be treated to preserve cognition. Encouraging social engagement among male and older adults with VI and promoting mental health awareness in women and middle-aged individuals with VI will reduce the negative impact of VI on cognition, lower dementia risk, and improve the well-being of aging adults.

Background: The importance of nutrition in optimizing the health and performance of professional soccer players has been well established. Despite published practical recommendations for the dietary requirements for professional soccer players, many players fail to meet these guidelines. Thus, the primary purpose of this study was to assess the impact of targeted nutritional education and behavior change interventions on dietary intake in professional football players. Additionally, previous research within this population has reported elevations in resting metabolic rate (RMR) following match-play. Therefore, a further aim of this study was to examine whether any changes in dietary intake would influence RMR following match-play. Methods: Twenty players from the professional development phase in an English Premier League club (age: 18.4 +/- 1.0 years; body mass: 76.1 +/- 6.0 kg; stature: 1.80 +/- 0.07 m) were randomly assigned to an "Intervention" (INT) group (n = 10), who received numerous nutritional education and behavior change interventions, or a "Control" (CON) group (n = 10), who received no nutrition support. Dietary intake was assessed daily throughout the match-week (Match Day (MD)-2, MD-1, MD, MD + 1, and MD + 2), whilst RMR was assessed on MD-1, MD + 1, and MD + 2. Statistical analyses on the intervention effects on dietary intake and RMR were carried out using a two factor (group and day) analysis of variance (ANOVA) with a subsequent Bonferroni post-hoc test. Results: Mean energy (3393 +/- 852 vs. 2572 +/- 577 kcal day(-1)) and CHO (5.36 +/- 1.9 vs. 3.47 +/- 1.1 g kg(-1) BW day(-1)) intake was significantly higher (p < 0.001) in the INT vs. CON group. Furthermore, the INT group implemented nutrition periodization practices as CHO intake was significantly increased on MD-1 (7.0 +/- 1.7 g kg(-1) BM day(-1)), MD (7.1 +/- 1.4 g kg(-1) BM day(-1)) and MD + 1 (5.1 +/- 0.8 g kg(-1) BM day(-1)). However, the CON group did not periodize their CHO intake and failed to meet the CHO recommendations on MD-1, MD, and MD + 1 (<4 g kg(-1) BM day(-1)). Compared to MD-1, the RMR increased on MD + 1 and MD + 2 in both groups, although it was only statistically significant for the INT group (MD + 1 = +243 kcal day(-1); MD + 2 = +179 kcal day(-1)). Conclusions: The implementation of targeted nutritional education and behavior change interventions resulted in improved dietary practices in professional football players and enabled better adherence to recommended guidelines. However, despite this, RMR was still elevated in the 24-48 h following match play. Thus, in order to optimize recovery, this finding further reinforces the need for professional football players to adopt strategies to meet energy, and particularly CHO, requirements in the acute period following a match in order to account for this increase in energy requirement.

BACKGROUND:Individual cardiovascular disease (CVD) risk factors (RFs) have been associated with hearing loss (HL). The relationship to aggregate risk is poorly understood and has not been explored in the Hispanic/Latino population. PURPOSE:The aim of this study was to characterize the association between aggregate CVD RF burden and hearing among Hispanics/Latinos. RESEARCH DESIGN:Cross-sectional examination. STUDY SAMPLE:Participants (18-74 years; n = 12,766) in the Hispanic Community Health Study/Study of Latinos. DATA COLLECTION AND ANALYSIS:Thresholds (0.5-8 kHz) were obtained, and HL was defined dichotomously as pure-tone average (PTA0.5,1, 2,4) > 25 dB HL. Optimal CVD risk burden was defined as follows: systolic blood pressure (SBP) < 120 mm Hg and diastolic blood pressure (DBP) < 80 mm Hg; total cholesterol < 180 mg/dL; nonsmoking; and no diabetes. Major CVD RFs were diabetes, currently smoking, SBP >160 or DBP > 100 mm Hg (or antihypertensives), and total cholesterol > 240 mg/dL (or statins). Thresholds were estimated by age (18-44 and ≥45 years) and sex using linear regression. The association between CVD risk burden and HL was assessed using multivariable logistic regression. Models were adjusted for age, sex, Hispanic/Latino background, center, education, income, alcohol use, body mass index, and noise exposure. RESULTS:In the target population, 53.03% were female and 18.81% and 8.52% had all RFs optimal and ≥2 major RFs, respectively. Elevated BP (SBP 120-139 mm Hg or DBP 80-89 mm Hg) was associated with HL in females < 45 years (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.14-4.16). Diabetes (OR, 1.37; 95% CI, 1.01-1.84) and tobacco smoking (OR, 1.44; 95% CI, 1.03-2.01) were associated with HL in females ≥ 45 years. The odds of HL were higher for females ≥ 45 years with ≥2 RFs versus those with all RFs optimal (OR, 1.99; 95% CI, 1.12-3.53). Elevated BP (SBP 140-159 mm Hg or DBP 90-99 mm Hg), but not aggregate risk burden, was associated with HL in males ≥ 45 years (OR, 1.49; 95% CI, 1.02-2.19). No relationships with major CVD RFs were significant in males < 45 years. CONCLUSIONS:HL is associated with elevated BP in females < 45 years, with diabetes and hypertension in males ≥ 45 years, and with diabetes, smoking, and having ≥2 major CVD RFs in females ≥ 45 years. Future studies are needed to examine if these factors are associated with incident HL.

Background: From 2018 to 2060 the proportion of US seniors (age 65+) will increase from 16% to 23%, with much of this growth driven by Hispanic/Latino seniors. Adverse social determinants of health (SDoHs) are drivers of poor health outcomes and accelerated aging. Objective: To examine the association between SDoHs (education, income, and nativity) and aging speed among Hispanic/Latino adults. Methods: The Hispanic Community Health Study/Study of Latinos is a longitudinal cohort of Hispanic/Latino adults from four US urban communities. Participants completed questionnaires, underwent clinic examinations, and provided biospecimens at visit 1 (V1: 2008-2011) and visit 2 (V2: 2014-2017). Education, income, and nativity were self-reported at V1. The Klemera-Doubal Method, an algorithm consisting of equations using biomarkers from different organ systems (waist-to-hip ratio, pulse pressure, lipids, glycosylated hemoglobin, alanine aminotransferase, cystatin C, and albumin-to-creatinine ratio), was used to calculate biological age (BA) among 5,316 females and 3,087 males ages 30 to 75 at either V1 or V2. Aging speed was defined as the difference between change in BA from V1 to V2 and follow-up time from V1 to V2. We used multivariable linear regression models to determine the sex-specific association between each SDoH with aging speed. Results: At V1, mean chronological age was 47 years for females and 46 years for males. Over an average of six years, females aged biologically by 5 years and males aged biologically by 4 years. Compared with having more than a high school education, aging speed was greater by 0.69 years (95% CI: 0.45, 0.94) among females with less than a high school education but not among males (ß=0.57, 95% CI: -0.04, 1.17). Compared with an income ≥$50K, aging speed was greater by 0.67 years (95% CI: 0.30, 1.04) among females with an income <$30K but not among males (ß=0.62, 95% CI: -0.08, 1.31). Compared to those born in the 50 US states/DC, being foreign born was associated with slower aging speed by 0.39 years (95% CI: -0.72, -0.06) among females but not among males (ß=0.52, 95% CI: -0.35, 1.39). Conclusion: Over six years, Hispanic/Latino males and females demonstrated slower biological aging compared with chronological aging. Lower income, lower educational attainment, and being born in the 50 US states/DC were associated with greater biological aging (faster aging speed) among Hispanic/Latino females.

BACKGROUND: Cognitive impairment is a frequently reported side-effect of cancer therapies affecting attention, concentration, memory, and executive function. However, the long-term impacts of cancer and its treatments on cognitive function and cognitive decline in Hispanics/Latinos is unknown. Herein, we examined the associations between a self-reported history of cancer and cognitive test performance cross-sectionally and longitudinally among middle-aged and older Hispanic/Latino adults. METHODS: Participants included 9,639 Hispanic/Latino adults [mean age=56.4 (SE=0.14); 54.7% female] of diverse backgrounds [30.8% Mexican, 27.2% Cuban, and 18.1% Puerto Rican; 10.0% Central American; 9.0% Dominican; and 7% South American] from the population-based, prospective, multi-site Hispanic Community Health Study/Study of Latinos. At enrollment in 2008-2011 (Visit 1), participants self-reported their history of cancer (yes/no) and cancer site(s). Cognitive function was assessed at Visit 1 and again at a 7-year follow-up assessment (Visit 2) using the Brief-Spanish English Verbal Learning Test (BSEVLT-Sum, episodic learning; and BSEVLT-Recall, memory), the Word Fluency Test (WF, verbal fluency), and the Digit Symbol Substitution Test (DSS, processing speed and executive functioning) via the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA). Changes in cognitive test performance were calculated using survey linear regression models predicting cognitive performance at Visit 2 as a function of Visit 1 cognitive performance with adjustment for time between assessments. Test scores/changes in tests scores were standardized and averaged as composites of global cognition/cognitive change. We used survey linear regression models to estimate the adjusted associations between history of cancer and baseline and longitudinal cognitive test performance. We examined these associations overall and by sex and for the most prevalent sex-specific cancers [i.e., cervical (n=121), breast (n=115), uterine (n=67), and prostate (n=48) cancers]. RESULTS: Cross-sectionally, a history of cancer (n=546) versus no history of cancer (n=9,093) was associated with higher WF scores (β=0.13, SE=0.06; P=0.03) and global cognition (β=0.08, SE=0.04; P=0.06) among all participants overall. Among men, but not among women, a history of cancer was associated with longitudinal increases in SEVLT-Sum (β=0.29, SE=0.14; P=0.04; PInteraction=0.04), and SEVLT-Recall (β=0.36, SE=0.15; P=0.02; PInteraction=0.01) scores. Among women, a history of cervical cancer was associated with longitudinal decreases in SEVLT-Recall scores (β=-0.30, SE=0.13; P=0.03) and among men, a history of prostate cancer was associated with higher baseline WF scores (β=0.29, SE=0.12; P=0.02). CONCLUSION: Cancer or its treatments may influence long-term cognition among Hispanics/Latino cancer survivors. The potential impacts of cancer or cancer treatment on cognition may vary by sex or cancer type. Citation Format: Humberto Parada Jr., Margaret Pichardo, Linda C. Gallo, Frank J. Penedo, David J. Lee, Gregory A. Talavera, Hector M. Gonzalez. Cognitive performance and cognitive decline following cancer among middle-aged and older adults in the study of Latinos-investigation of neurocognitive aging and HCHS/SOL [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B116.

AbstractBackgroundCancer patients and survivors often experience acute cognitive impairments; however, the long‐term cognitive impact remains unclear particularly among Hispanics/Latinos. We examined the association between cancer history and neurocognitive test performance among middle‐aged and older Hispanic/Latinos.MethodsParticipants included 9639 Hispanic/Latino adults from the community‐based and prospective Hispanic Community Health Study/Study of Latinos. At baseline (2008–2011; V1), participants self‐reported their cancer history. At V1 and again at a 7‐year follow‐up (2015–2018; V2), trained technicians administered neurocognitive tests including the Brief‐Spanish English Verbal Learning Test (B‐SEVLT), Word Fluency Test (WF), and Digit Symbol Substitution Test (DSS). We used survey linear regression to estimate the overall, sex‐specific, and cancer site‐specific [i.e., cervix, breast, uterus, and prostate] adjusted associations between cancer history and neurocognitive test performance at V1 and changes from V1 to V2.ResultsAt V1, a history of cancer (6.4%) versus no history of cancer (93.6%) was associated with higher WF scores (β = 0.14, SE = 0.06; p = 0.03) and global cognition (β = 0.09, SE = 0.04; p = 0.04). Among women, a history of cervical cancer predicted decreases in SEVLT‐Recall scores (β = −0.31, SE = 0.13; p = 0.02) from V1 to V2, and among men, a history of prostate cancer was associated with higher V1 WF scores (β = 0.29, SE = 0.12; p = 0.02) and predicted increases in SEVLT‐Sum (β = 0.46, SE = 0.22; p = 0.04) from V1 to V2.ConclusionAmong women, a history of cervical cancer was associated with 7‐year memory decline, which may reflect the impacts of systemic cancer therapies. Among men, however, a history of prostate cancer was associated with improvements in cognitive performance, perhaps due in part to engaging in health promoting behaviors following cancer.

The purpose of this study was to estimate the prevalence of occupational noise exposure and risk factors of occupational noise-induced hearing loss (NIHL) in Hispanic/Latino adults included in the baseline wave of the Hispanic Community Health Study/Study of Latinos collected from 2008 to 2011. Sequential multiple linear regression modeled the relationship between occupational NIHL (defined as a 3-, 4-, 6-kHz pure-tone average [PTA]) and occupation type, self-reported noise exposure, cardiovascular disease (CVD) risk score, and hearing protective device (HPD) use. The final model controlled for sex, age, and recreational noise exposure. Among 12,851 included participants, approximately 40% (n = 5036) reported occupational noise exposure "Sometimes" (up to 50% of the time) or "Frequently" (75-100% of the time). In the final fitted model, longest-held occupation and CVD risk were associated with poorer hearing. Specifically, those in non-skilled, service, skilled, and military/police/other job categories had between 2.07- and 3.29-dB worse PTA than professional/office workers. Additionally, a shift in the CVD risk score category from low to medium was associated with a 2.25- and 8.20-dB worse PTA for medium and high CVD risk, respectively. Age and sex were also significantly associated with poorer hearing, such that men presented with 6.08 dB worse PTA than women, and for every one-year increase in age, PTA increased by 0.62 dB (ps < .001). No interactions were seen between noise*sometimes or frequent exposure to other ototoxic agents and PTA (ps = .33 & .92, respectively). The prevalence of occupational noise exposure was high in this cross-sectional investigation of adults from Hispanic/Latino backgrounds. Findings contribute to the extant literature by demonstrating that risk factors for occupational NIHL in adults from varying Hispanic/Latino backgrounds are consistent with those of other previously studied groups.

BackgroundFirefighting is a hazardous occupation that is associated with an increased risk of select cancers. The number of studies has grown in recent years allowing for a synthesis of findings.MethodsFollowing PRISMA guidelines, multiple electronic databases were searched to identify studies on firefighter cancer risk and mortality. We computed pooled standardized incidence risk (SIRE) and standardized mortality estimates (SMRE), tested for publication bias, and conducted moderator analyses.ResultsThirty-eight studies published between 1978 and March 2022 were included for final meta-analysis. Overall, cancer incidence and mortality were significantly lower for firefighters (SIRE = 0.93; 95% CI: 0.91-0.95; SMRE = 0.93; 95% CI: 0.92 - 0.95) compared to the general population. Incident cancer risks were significantly higher for skin melanoma (SIRE = 1.14; 95% CI:1.08 - 1.21), other skin cancers (SIRE = 1.24; 95% CI:1.16-1.32), and prostate cancer (SIRE = 1.09; 95% CI: 1.04-1.14). Firefighters showed higher mortality for rectum (SMRE = 1.18; 95% CI: 1.02-1.36), testis (SMRE = 1.64; 95% CI: 1.00-2.67), and non-Hodgkin lymphoma (SMRE = 1.20; 95% CI: 1.02-1.40). There was evidence of publication bias for SIRE and SMRE estimates. Some moderators explained variations in study effects, including study quality scores.ConclusionFirefighters are at higher risk for several cancers; to the extent that some (e.g., melanoma and prostate) are screening amenable, more study into firefighter-specific recommendations for cancer surveillance is needed. Moreover, longitudinal studies with more detailed data on the specific length and types of exposures are necessary, as well as on unstudied subtypes of cancers (e.g., subtypes of brain cancer and leukemias) are needed.

BACKGROUND Visual impairment could worsen sleep/wake disorders and cognitive decline. OBJECTIVE To examine interrelations among self-reported visual impairment, sleep, and cognitive decline in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Miami-site. METHOD HCHS/SOL Miami-site participants ages 45-74 years (n = 665) at Visit-1, who returned for cognitive test 7-years later (SOL-INCA). Participants completed the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ), validated sleep questionnaires and test for obstructive sleep apnea (OSA) at Visit-1. We obtained verbal episodic learning and memory, verbal fluency, processing speed, and executive functioning at Visit-1 and at SOL-INCA. Processing speed/executive functioning were added to SOL-INCA. We examined global cognition and change using a regression-based reliable change index, adjusting for the time lapse between Visit-1 and SOL-INCA. We used regression models to test whether 1) persons with OSA, self-reported sleep duration, insomnia, and sleepiness have an increased risk for visual impairment, 2a) visual impairment is associated with worse cognitive function and/or decline, and 2b) sleep disorders attenuate these associations. RESULT Sleepiness (β= 0.04; p <  0.01) and insomnia (β= 0.04; p <  0.001) were cross-sectionally associated with visual impairment, adjusting for sociodemographic characteristics, behavioral factors, acculturation, and health conditions. Visual impairment was associated with lower global cognitive function at Visit-1 (β= -0.16; p <  0.001) and on average 7-years later (β= -0.18; p <  0.001). Visual impairment was also associated with a change in verbal fluency (β= -0.17; p <  0.01). OSA, self-reported sleep duration, insomnia, and sleepiness did not attenuate any of the associations. CONCLUSION Self-reported visual impairment was independently associated with worse cognitive function and decline.

Introduction: Different patterns of socioeconomic mobility (SEM) across the life course may influence the risk of all-cause mortality in adulthood. Lifetime low socioeconomic status and downward social mobility may be associated with a higher risk of mortality. Hypothesis: SEM is associated with mortality, and persons with enduring intergenerational adversity or downward SEM have a higher risk of mortality compared to persons with enduring intergenerational advantage. Methods: This study included 13,459 participants, 18-74 years of age, from the Hispanic Community Health Study/Study of Latinos who participated in the baseline visit (2008-2011) and were not missing key covariate information. Socioeconomic position (SEP) was assessed as parental education in childhood (dichotomized at high school), and a 5-facet index of SEP in adulthood across education, income, employment status, longest held occupation type, and homeownership. The adulthood SEP index was dichotomized at the median value of 2 (range: 0-5). Childhood and adulthood SEP were then combined into a single 4-level measure of SEM (enduring advantage, upward mobility, downward mobility, and enduring adversity). Multivariable sampling weight-adjusted Cox proportional hazards regression was performed to estimate the association between SEM and all-cause mortality. Potential confounders included age, gender, Hispanic/Latino ethnic background, US nativity, years spent in the US, and study center, whereas alcohol and tobacco use, depression score, and BMI were considered potential mediators. Presence of mediation was assessed by calculating total and direct effects via modeling, then evaluating percent change from total to direct effects against a 10% guideline. Results: During the follow-up period of 2008-2019, 515 deaths were recorded. After adjusting for all potential confounders, a significant association was found between adulthood all-cause mortality and SEM overall (F = 7.62, p < 0.0001). Downward mobility had significantly higher hazard of death compared to enduring advantage (aHR: 1.81, 95% CI: 1.17-2.81), although upward mobility and enduring adversity groups were not significant. The direct effect for downward mobility was reduced after adjustment for potential mediators (aHR: 1.49, 95% CI: 0.96, 2.30). Conclusions: Socioeconomic mobility, specifically downward mobility, is associated with all-cause mortality among a diverse cohort of Hispanic/Latino individuals residing in the United States. This association shows evidence of mediation by clinical and behavioral characteristics.

Background Nutritional intake is important for young football players; however, little is known about the factors that influence their nutritional adherence. Purpose The aim of this study was to investigate players', sports nutritionists',and coaches' perspectives of the barriers and enablers to adhering to nutritional recommendations within a professional football club. Method Individual interviews, based on the Capability, Opportunity, Motivation - Behaviour (COM-B) model and Theoretical Domains Framework (TDF), were conducted with 13 players (18 +/- 1.3 years), 12 sports nutritionists, and 10 coaches from 2, 12, and 10 professional football clubs, respectively. Thematic analysis was used to interpret the data. Results Seven key themes were generated relating to the players' barriers and enablers to nutritional adherence: (1) Capability: (a) Nutritional Knowledge; (b) Cooking Skills; (2) Opportunity: (c) Training Venue Food Provision; (d) Nutritionist Accessibility and Approachability; (e) Living Status: (3) Motivation: (f) Performance Implications; and (g) Role Modelling. Conclusion Inadequate food provision within the training and home environment, and limited time with the sports nutritionist were key barriers to nutritional adherence in youth football players. Football clubs should allocate more time for sports nutritionists to deliver nutrition support and sports nutritionists should aim to control the players environment to support optimal nutritional intake.

The landmark, multicenter HCHS/SOL (Hispanic Community Health Study/Study of Latinos) is the largest, most comprehensive, longitudinal community-based cohort study to date of diverse Hispanic/Latino persons in the United States. The HCHS/SOL aimed to address the dearth of comprehensive data on risk factors for cardiovascular disease (CVD) and other chronic diseases in this population and has expanded considerably in scope since its inception. This paper describes the aims/objectives and data collection of the HCHS/SOL and its ancillary studies to date and highlights the critical and sizable contributions made by the study to understanding the prevalence of and changes in CVD risk/protective factors and the burden of CVD and related chronic conditions among adults of diverse Hispanic/Latino backgrounds. The continued follow-up of this cohort will allow in-depth investigations on cardiovascular and pulmonary outcomes in this population, and data from the ongoing ancillary studies will facilitate generation of new hypotheses and study questions.

Resting metabolic rate (RMR) is an important component of total daily energy expenditure; however, it is currently not understood how it varies across a typical competitive match week in professional soccer players. For the first time, we aimed to assess RMR throughout an in-season competitive week in professional soccer players. Additionally, we aimed to assess energy and carbohydrate intake across the same week. Twenty-four professional soccer players from an English Premier League club (age: 18 ± 1.6 years) completed the study. RMR was assessed each morning of a typical competitive match week (match day [MD] -3, -2, -1, +1, +2, and + 3), and dietary intake (including MD) was assessed daily via the remote food photography method and 24-hr recall. Daily training load was quantified using Global Positioning System, daily muscle soreness ratings were recorded, and body composition was assessed via dual-energy X-ray absorptiometry. There was a significant (p = .0004) increase in mean RMR of ∼261 kcal/day on MD + 1, compared with MD - 1. Additionally, volume of oxygen consumed significantly increased at MD + 1 (p = .0002) versus MD - 1. There were no significant differences in daily energy or carbohydrate intake across the competitive week (p > .05), with inadequate carbohydrate intakes on MD - 1 (∼3.9 g/kg body mass), MD (∼4.2 g/kg body mass), and MD + 1 (∼3.6 g/kg body mass) in relation to current recommendations. We report, for the first time, that RMR is significantly increased following a competitive match in professional soccer players. In addition, we confirm previous findings to reinforce that players exhibit inadequate nutrition periodization practices, which may impair physical performance and recovery.