The Association of Kidney Function and Inflammatory Biomarkers with Epithelial Ovarian Cancer Risk.

BACKGROUND: One of the mechanisms of ovarian tumorigenesis is through inflammation. Kidney dysfunction is associated with increased inflammation; thus, we assessed its relationship with ovarian cancer risk. METHODS: In prospectively collected samples, we evaluated the association of kidney function markers and C-reactive protein (CRP) with ovarian cancer risk in the UK Biobank. We used multivariable-adjusted Cox proportional hazards models to evaluate quartiles of serum and urine markers with ovarian cancer risk overall and by histology. We assessed effect modification by CRP (≤3.0, >3.0 mg/L). RESULTS: Among 232,908 women (1,110 ovarian cancer cases diagnosed from 2006-2020), we observed no association between estimated glomerular filtration rate and ovarian cancer risk (Q4 vs. Q1: HR, 1.00; 95% confidence intervals, 0.83-1.22). Potassium was associated with endometrioid (Q4 vs. Q1: 0.33, 0.11-0.98) and clear cell (4.74, 1.39-16.16) tumors. Poor kidney function was associated with a nonsignificant increase in ovarian cancer risk among women with CRP>3.0 mg/L (e.g., uric acid Q4 vs. Q1; 1.23, 0.81-1.86), but not CRP≤3.0 mg/L (0.83, 0.66-1.05). Other associations did not vary across CRP categories. CONCLUSIONS: Kidney function was not clearly associated with ovarian cancer risk. Larger studies are needed to evaluate possible histology specific associations. Given the suggestive trend for increased ovarian cancer risk in women with poor kidney function and high CRP, future work is needed, particularly in populations with a high prevalence of inflammatory conditions. IMPACT: This study provided the first evaluation of markers of kidney function in relation to ovarian cancer risk.

Racial and Ethnic Disparities of Social Participation After Tetraplegia Injury: A Regression Analysis.

OBJECTIVE: The first aim of this study was to determine whether the use of computers, internet, and computer assistive technology (AT) increased social participation after tetraplegia spinal cord injury. The second aim was to determine whether racial or ethnic disparities of technology use were experienced. DESIGN: A secondary analysis of data collected by the National Spinal Cord Injury Models Systems Study (NSCIMS), an ongoing observational cohort study, was performed on a sample of 3096 participants who experienced a traumatic tetraplegic injury. PARTICIPANTS: Participants included were at least 1-year posttraumatic tetraplegia injury and participated in NSCIMS between 2011 and 2016 (N=3096). SETTING: NSCIMS observational data were originally collected via in-person or phone interviews. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): A binary logistic regression was conducted to determine whether self-reported use of computers or similar device, the internet, computer AT, race, ethnicity, and other demographics predicted high (≥80) vs low/medium (<80) social participation, measured by the Craig Handicap and Reporting Technique social integration standardized measure. RESULTS: Combined use of a computer, AT, and the internet predicted greater social integration by almost 175% (95% confidence interval [CI], 2.0-3.78; P<.001) compared with no device or internet use. Racial and ethnic disparities were discovered. Black participants had 28% lower odds of high social integration than White participants (95% CI, 0.56-0.92; P<.01). Hispanic ethnicity predicted 40% lower odds of high social integration compared with non-Hispanic participants (95% CI, 0.39-0.91; P=.018). CONCLUSIONS: The internet presents an opportunity to reduce barriers to social participation and increase overall social integration after tetraplegia. However, race, ethnic, and income inequities prevent or limit access to the internet, computers, and AT after tetraplegia for Black and Hispanic people.

Relationship of Exercise and Hospital Readmission After Spinal Cord Injury: A Secondary Analysis.

IMPORTANCE: After spinal cord injury (SCI), as many as 45% of people experience at least one hospital readmission within 1 yr. Identification of feasible low-cost interventions to reduce hospital readmissions after SCI is needed. OBJECTIVE: To explore whether a relationship exists between routine exercise and hospital readmission rates 1 yr after SCI. DESIGN: We conducted a secondary analysis of data from the SCIRehab Project, a prospective cohort study. SETTING: Five SCI inpatient rehabilitation facilities across the United States. PARTICIPANTS: Participants were people age 12 yr and older who had sustained an SCI, were admitted to a participating inpatient rehabilitation facility, completed the 12-mo postinjury interview, and reported exercising either monthly or not at all since discharge (N = 520). Outcomes and Measures: The SCIRehab Project conducted 12-mo post-inpatient rehabilitation discharge interviews. As part of the interviews, self-reported hospital readmissions and exercise frequencies since discharge (self-reported number of months, average days per week, and average minutes per day of exercise participation) were collected and analyzed. RESULTS: A χ2 analysis determined that a significant correlation (φ = -.091, p = .038) exists between monthly exercise and hospital readmissions 1 yr postinjury. Compared with those who did not exercise, participants who exercised monthly had 8.4% fewer hospital readmissions. CONCLUSIONS AND RELEVANCE: A relationship exists between exercise and hospital readmission, but follow-up research is needed to determine whether regular exercise reduces hospital readmissions among this population. What This Article Adds: After discharge, 44% of the participants did not exercise during the first year after injury. Identifying or implementing accessible community exercise programs is an area of opportunity for occupational therapy practitioners and future researchers to explore.

Psychosocial and Behavioral Correlates of Internalized Homonegativity in Midlife and Older Gay and Bisexual Men.

This study investigated psychosocial and demographic variables that might influence internalized homonegativity (IH) in midlife and older gay and bisexual men (GBM). Data were collected from 802 community-dwelling GBM aged 40 to 94 years (M = 54.8) through an anonymous questionnaire that assessed levels of IH, coping self-efficacy, self-silencing, and other characteristics. Multivariate logistic regression analysis successfully explained 22% of the variance in predicting IH, which was significantly related to coping self-efficacy, self-silencing, gay community volunteering, partnership status, and race, F = 59.74, p < .001. IH scores were highest in participants who were single, had lower education levels, were non-White, were less involved in gay community volunteering, experienced less coping self-efficacy, and reported higher levels of self-silencing behaviors. These data underscore the need for more tailored programming approaches for midlife and older GBM, focusing on underlying factors contributing to IH that include skill-building to increase coping self-efficacy, community involvement, and decrease self-silencing behaviors in this overlooked population.

Body Image, Weight, and Self-Concept in Men.

In the traditional debate between biological and environmental determinants of body weight, the body has most often been explored in terms of its anatomical, genetic, or hormonal influences on personality, experience, and behavior. While obesity has been identified as a threat to our public health, correlating attitudes toward body image and self-concept have been explored within women to a limited extent, and even less so in relation to men. Consequently, men's body image will be discussed in light of current literature reveals for women. For men, as for women, as the social pressure to attain an "ideal" physique increases, the discrepancy between that ideal and one's body increases as well. This dynamic is more readily recognized for women than for men. As men are socialized not to discuss their body image concerns, negative self-concept and esteem may reinforce behaviors resulting in weight gain. In recent years, the proliferation of media has served to reinforce messaging related to one's body. This review of existing data and literature suggests that body image and self-concept are related to body weight in men (as with women) and need to be addressed as part of healthy weight management practices.