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Purpose Chronic health conditions and rurality are associated with each other and with higher risks of medical debt. Less is known about the intersection of chronic conditions and health care affordability issues as they relate to rurality. The objective of this study is to determine whether rural/urban differences exist in associations between chronic conditions and health care affordability issues. Methods Using data from the 2022 National Health Interview Survey, we conducted survey-weighted bivariate analyses comparing rates of chronic conditions and multimorbidity by rurality, followed by adjusted multivariate logistic regression models examining associations between health care affordability issues, chronic conditions, and multimorbidity. Major Findings Compared to urban residents, rural residents reported significantly higher rates of nearly all chronic conditions, multimorbidity (3+ chronic conditions: 26.7% vs 18.3%, P<.001), problems paying medical bills (13.7% vs 11.0%, P=.004), and inability to pay medical bills (9.6% vs 6.8%, P<.001). After adjustment, certain chronic conditions and multimorbidity were associated differentially with health care affordability issues across the full, urban-only, and rural-only subsamples. Conclusions Adults living in rural areas of the U.S. may have higher rates of chronic conditions and be more likely to experience health care affordability issues than their urban counterparts. Differing patterns by multimorbidity and rurality indicate that policy interventions addressing medical debt should be targeted to chronic condition types and tailored by rurality.

Shorter leukocyte telomere length (LTL) is an aging biomarker and risk factor for aging‐related diseases, including abdominal aortic aneurysm (AAA). This study aimed to identify plasma proteins causally associated with LTL and investigate their roles in linking LTL to AAA. A proteomics analysis was conducted for LTL and a polygenic risk score (PRS) for LTL using 4955 plasma proteins by SomaScan in self‐identified White participants (N = 7587–8055) from the Atherosclerosis Risk in Communities (ARIC) study. Replications were evaluated in self‐identified Black participants (N = 1668–2094) from ARIC and White participants (N = 2333–2431) from the Cardiovascular Health Study (CHS). Mendelian randomization (MR) analysis assessed causality between LTL and proteins. Survival and mediation analyses explored protein‐mediated associations between LTL and AAA risk. In ARIC White participants, 15 unique proteins were identified for LTL or LTL PRS. Three LTL‐associated proteins (MZB1, PLOD3, COL28A1) replicated in ARIC Black participants, and six (TNFRSF17, MZB1, CHL1, GDF15, THPO and PLOD3) in CHS White participants. Three proteins associated with LTL PRS (THPO, GP1Bα, PEAR1) replicated in CHS White participants. MR analysis supported causal associations between LTL and five proteins (KDR, TNFRSF17, GDF15, ST3GAL6, CHL1) with all except GDF15 being novel to LTL. LTL was associated with AAA risk (HR = 0.873, 95% CI: 0.803–0.950), with GDF15 mediating 12.4% of this association (p = 0.028). We identified five proteins causally influenced by LTL and highlighted GDF15 as a mediator linking LTL to AAA risk, offering novel insights into aging biology and AAA pathogenesis.

The idea for this article occurred to me while sitting in the physical therapy room at St. Lawrence Rehabilitation Center in the middle of my fifth week following a stroke I suffered on March 29, 2007-the morning after I returned from the 2007 MTNA Collaborative Conference in Toronto.

In this third installment of \"AMT's\" Visions series. Ingrid Jacobson Clarfield, NCTM, asks and answers the question. \"Are we really preparing our students for the true and total life of being a musician?\"

Whether one is a first-time conference attendee or a seasoned veteran, this humorous, and extremely accurate, account of what to pack in preparation for this annual event will provide some invaluable insight.

The Canadian Alliance -- the successor to the Reform party -- did this when it merged with the Progressive Conservatives to form the Conservative Party of Canada. So why can't our other esteemed leaders leave rigid egos behind and join forces for the sake of the majority who support ideas other than the Conservatives?

BLINK and you could miss the centuries-old gates of La Foret Enchantee, two luxury retreats hidden deep in a 3.5ha forest backing on to the Margaret River. The opulent il Palazzo is architecturally striking, a symmetrical- shaped building with vaulted ceilings and a mix of natural materials including marble and timbers such as oregon and redgum. Both The Cabin and il Palazzo have reverse-cycle air conditioning, while Villeroy and Boch marble-hued ensuites make bathtime bliss.