40 CFR 418.64 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 28 2010-07-01 2010-07-01 true [Reserved] 418.64 Section 418.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Ammonium Sulfate Production Subcategory § 418.64 [Reserved] ...

40 CFR 64.2 - Applicability.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Applicability. 64.2 Section 64.2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.2 Applicability. (a) General applicability. Except for backup utility units that...

40 CFR 64.2 - Applicability.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 16 2012-07-01 2012-07-01 false Applicability. 64.2 Section 64.2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.2 Applicability. (a) General applicability. Except for backup utility units that...

40 CFR 64.1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 16 2012-07-01 2012-07-01 false Definitions. 64.1 Section 64.1 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.1 Definitions. The following definitions apply to this part. Except as...

40 CFR 64.1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Definitions. 64.1 Section 64.1 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.1 Definitions. The following definitions apply to this part. Except as...

40 CFR 64.2 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Applicability. 64.2 Section 64.2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.2 Applicability. (a) General applicability. Except for backup utility units that...

Physical Activity and Mental Well-being in a Cohort Aged 60–64 Years

PubMed Central

Black, Stephanie V.; Cooper, Rachel; Martin, Kathryn R.; Brage, Soren; Kuh, Diana; Stafford, Mai

2015-01-01

Introduction Although evidence suggests physical activity (PA) may be associated with mental well-being at older ages, it is unclear whether some types of PA are more important than others. The purpose of this study is to investigate associations of monitored total PA under free-living conditions, self-reported leisure-time PA (LTPA), and walking for pleasure with mental well-being at age 60–64 years. Methods Data on 930 (47%) men and 1,046 (53%) women from the United Kingdom Medical Research Council (MRC) National Survey of Health and Development collected in 2006–2011 at age 60–64 were used in 2013–2014 to test the associations of PA (PA energy expenditure and time spent in different intensities of activity assessed using combined heart rate and acceleration monitors worn for 5 days, self-reported LTPA, and walking for pleasure) with the Warwick-Edinburgh Mental Well-being Scale (WEMWBS; range, 14–70). Results In linear regression models adjusted for gender, long-term limiting illness, smoking, employment, socioeconomic position, personality, and prior PA, those who walked for >1 hour/week had mean WEMWBS scores 1.47 (95% CI=0.60, 2.34) points higher than those who reported no walking. Those who participated in LTPA at least five times/month had WEMWBS scores 1.25 (95% CI=0.34, 2.16) points higher than those who did not engage in LTPA. There were no statistically significant associations between free-living PA and WEMWBS scores. Conclusions In adults aged 60–64 years, participation in self-selected activities such as LTPA and walking are positively related to mental well-being, whereas total levels of free-living PA are not. PMID:26070782

Asthma Mortality Among Persons Aged 15-64 Years, by Industry and Occupation - United States, 1999-2016.

PubMed

Patel, Opal; Syamlal, Girija; Wood, John; Dodd, Katelynn E; Mazurek, Jacek M

2018-01-19

In 2015, an estimated 18.4 million U.S. adults had current asthma, and 3,396 adult asthma deaths were reported (1). An estimated 11%-21% of asthma deaths might be attributable to occupational exposures (2). To describe asthma mortality among persons aged 15-64 years,* CDC analyzed multiple cause-of-death data † for 1999-2016 and industry and occupation information collected from 26 states § for the years 1999, 2003, 2004, and 2007-2012. Proportionate mortality ratios (PMRs) ¶ for asthma among persons aged 15-64 years were calculated. During 1999-2016, a total of 14,296 (42.9%) asthma deaths occurred among males and 19,011 (57.1%) occurred among females. Based on an estimate that 11%-21% of asthma deaths might be related to occupational exposures, during this 18-year period, 1,573-3,002 asthma deaths in males and 2,091-3,992 deaths in females might have resulted from occupational exposures. Some of these deaths might have been averted by instituting measures to prevent potential workplace exposures. The annual age-adjusted asthma death rate** per 1 million persons aged 15-64 years declined from 13.59 in 1999 to 9.34 in 2016 (p<0.001) among females, and from 9.14 (1999) to 7.78 (2016) (p<0.05) among males. The highest significantly elevated asthma PMRs for males were for those in the food, beverage, and tobacco products manufacturing industry (1.82) and for females were for those in the social assistance industry (1.35) and those in community and social services occupations (1.46). Elevated asthma mortality among workers in certain industries and occupations underscores the importance of optimal asthma management and identification and prevention of potential workplace exposures.

Childhood Weight Gain and Thyroid Autoimmunity at Age 60–64 Years: The 1946 British Birth Cohort Study

PubMed Central

Kuh, Diana; Pierce, Mary; Franklyn, Jayne A.

2013-01-01

Background: Complex bidirectional relationships have been described between body weight, thyroid function, and risk of thyroid disorders, including thyroid autoimmunity. We used a life-course approach to examine the potential association of childhood or adult body weight with the risk of thyroid autoimmunity and other thyroid disorders at age 60–64 years in a large population-based birth cohort study. Methods: In the UK Medical Research Council 1946 British Birth Cohort study, at age 60–64 years, 1277 women and 1185 men (78% of the target sample) responded to a postal questionnaire, which included questions on thyroid disease and thyroid medication. Circulating antithyroid peroxidase antibodies, free T4, and TSH concentrations were measured in 1057 women and 997 men at a subsequent clinic visit. Birth weight was recorded, and height and weight were measured at ages 2, 4, 6, 7, 11, 15 years and also repeatedly in adulthood. Results: At age 60–64 years, 10.9% of women (139 of 1277) and 2.3% of men (27 of 1185) reported they were taking T4, and 11.5% of women (122 of 1057) and 3.3% of men (33 of 997) had positive anti-TPO antibodies (>100 IU/mL), consistent with thyroid autoimmunity. Among women, both T4 use and positive anti-TPO antibodies at age 60–64 years were positively associated with childhood body weight, childhood overweight, and adult body mass index. Childhood weight gain between 0 and 14 years of age was positively associated with later T4 use (odds ratio 1.21, 95% confidence interval 1.03–1.42) and positive anti-TPO antibodies (1.21, 1.00–1.47). Women who were overweight or obese at age 14 years (127 of 972) had a higher risk of later positive anti-TPO antibodies (2.05, 1.12–3.76). In men and women without any thyroid disorders, serum free T4 concentrations were inversely associated with concurrent body mass index (P = .002). Conclusions: Childhood weight gain and childhood overweight conferred an increased susceptibility to later

Assistive technology and self-rated health in comparison with age peers: a longitudinal study in 55-64-year-olds.

PubMed

Boons, Christel C L M; van de Kamp, Karline; Deeg, Dorly J H

2014-08-26

Abstract Purpose: To determine changes in self-rated health in comparison with age peers (SRH-AP) among 55-64-year-olds, as affected by (1) initiating, (2) ceasing, and (3) prolonging the use of assistive technology (AT). Methods: Data included two national cohorts of 55-64-year-olds from the Longitudinal Aging Study Amsterdam (total N = 1968), with baseline cycles in 1992-93 and 2002-03 and 3-year follow-ups. The effect of AT use on SRH-AP was studied in analyses of variance for repeated measurements, adjusting for age and self-reported disability. Results: Respondents using AT reported poorer SRH-AP than respondents not using AT. Over time disability increased for respondents prolonging and initiating AT use and decreased for respondents ceasing AT use. No major changes were seen in SRH-AP over time, except for a small improvement for respondents prolonging AT use. Conclusions: AT use had a negative influence on SRH-AP, but this influence subsided over time for prolonged AT use. Despite longitudinal changes in disability, there was a marked stability of SRH-AP over time which may be attributed to AT use. Implications for Rehabilitation Both the proportion of 55-64-year-olds using AT and the proportion reporting disability was significantly higher in the recent cohort as compared to the early cohort. 55-64-Year-olds not using AT rated their health compared with age peers (SRH-AP) better than those using AT. 55-64-Year-olds who prolonged the use of AT reported the poorest ratings of SRH-AP, but also showed the clearest improvement in SRH-AP, suggesting that the initial negative influence of AT use on SRH-AP may subside over time.

Insurance status, comorbidity level, and survival among colorectal cancer patients age 18 to 64 years in the National Cancer Data Base from 2003 to 2005.

PubMed

Robbins, Anthony S; Pavluck, Alexandre L; Fedewa, Stacey A; Chen, Amy Y; Ward, Elizabeth M

2009-08-01

Previous analyses have found that insurance status is a strong predictor of survival among patients with colorectal cancer aged 18 to 64 years. We investigated whether differences in comorbidity level may account in part for the association between insurance status and survival. We used 2003 to 2005 data from the National Cancer Data Base, a national hospital-based cancer registry, to examine the relationship between baseline characteristics and overall survival at 1 year among 64,304 white and black patients with colorectal cancer. In race-specific analyses, we used Cox proportional hazards models to assess 1-year survival by insurance status, controlling first for age, stage, facility type, and neighborhood education level and income, and then further controlling for comorbidity level. RESULTS; Comorbidity level was lowest among those with private insurance, higher for those who were uninsured or insured by Medicaid, and highest for those insured by Medicare. Survival at 1 year was significantly poorer for patients without private insurance, even after adjusting for important covariates. In these multivariate models, risk of death at 1 year was approximately 50% to 90% higher for white and black patients without private insurance. Further adjustment for number of comorbidities had only a modest impact on the association between insurance status and survival. In multivariate analyses, patients with > or = three comorbid conditions had approximately 40% to 50% higher risk of death at 1 year. CONCLUSION Among white and black patients aged 18 to 64 years, differences in comorbidity level do not account for the association between insurance status and survival in patients with colorectal cancer.

Mammography in asymptomatic women aged 40-49 years

PubMed Central

Silva, Flávio Xavier; Katz, Leila; Souza, Alex Sandro Rolland; Amorim, Melania Maria Ramos

2014-01-01

OBJECTIVE To assess findings of mammography of and interventions resulting from breast cancer screening in women aged 40-49 years with no increased risk (typical risk) of breast cancer. METHODS This cross-sectional study evaluated women aged 40-49 years who underwent mammography screening in a mastology reference center in Recife, PE, Northeastern Brazil, between January 2010 and October 2011. Women with breast-related complaints, positive findings in the physical examination, or high risk of breast cancer were excluded. RESULTS The 1,000 mammograms performed were classified into the following Breast Imaging-Reporting and Data System (BI-RADS) categories BI-RADS 0, 232; BI-RADS 1, 294; BI-RADS 2, 294; BI-RADS 3, 16; BI-RADS 4A, 2; BI-RADS 5, 1. There was one case of grade II invasive ductal carcinoma and various interventions, including 469 ultrasound scans, 53 referrals to mastologists, 11 cytological examinations, and 8 biopsies. CONCLUSIONS Mammography screening in women aged 40-49 years with typical risk of breast cancer led to the performance of other interventions. However, it also resulted in increased costs without demonstrable efficacy in decreasing mortality. PMID:26039396

Trends in induced abortion among Nordic women aged 40-44 years

PubMed Central

2011-01-01

Objectives Women aged 40-44 years in 2005 ought to have been subjected to much more influence on attitudes and knowledge on contraceptive methods during their fertile period than women who were in the same age span in 1975 when the abortion laws were introduced. Material From official statistics, the rates of induced abortion and birth rates in women aged 40-44 years were collected for Sweden, Denmark, Norway and Finland for each five-year during the period 1975-2005. Results With the exception of Sweden all other studied Scandinavian countries have lowered their abortion rates since 1975 (p < 0.001) and reduced the proportion of induced abortions in relation to birth rate (p < 0.001). In 2005 these countries also had lower rates of induced abortion than Sweden in the age group 40-44 years (p < 0.001). Conclusion There is a significant change in rates of induced abortion in women aged 40-44 years in Finland, Norway, Denmark, and at status quo in Sweden. 40-44 years in Finland, Norway, Denmark, and at status quo in Sweden. This indicates that family planning programs works well in the Nordic countries. The differences found may be assumed to possible diverging focus on attitudes or ethical considerations. PMID:21846348

SCI Longitudinal Aging Study: 40 Years of Research.

PubMed

Krause, James S; Clark, Jillian M R; Saunders, Lee L

2015-01-01

The Spinal Cord Injury (SCI) Longitudinal Aging Study was initiated in 1973 and has conducted 8 assessments over the past 40 years. It was designed to help rehabilitation professionals understand the life situation of people with SCI, but it has developed into the most long-standing study of aging and SCI and has resulted in over 50 publications. Our purpose was to provide a detailed history of the study, response patterns, utilization of measures, and a summary of key findings reported in the literature. Five participant samples have been incorporated over the 40 years, with enrollment in 1973, 1984, 1993 (2 samples), and 2003. A total of 2,208 participants have completed 6,001 assessments, with a particularly large number of assessments among those who are more than 40 years post injury (n = 349). The overall results have indicated changing patterns of outcomes over time as persons with SCI age, with some notable declines in participation and health. There has been a survivor effect whereby persons who are more active, well-adjusted, and healthier live longer. This study has several important features that are required for longitudinal research including (a) consistency of follow-up, (b) consistency of measures over time, (c) addition of new participant samples to counteract attrition, and (d) inclusion of a large number of individuals who have reached aging milestones unparalleled in the literature. Data from this study can inform the literature on the natural course of aging with SCI.

Anthropometric trends and the risk of cardiovascular disease mortality in a Lithuanian urban population aged 45–64 years

PubMed Central

Luksiene, Dalia; Tamosiunas, Abdonas; Virviciute, Dalia; Bernotiene, Gailute; Peasey, Anne

2015-01-01

Aims: To estimate trends in anthropometric indexes from 1992 to 2008 and to evaluate the risk of cardiovascular disease mortality in relation to anthropometric indexes (body mass index, waist circumference, waist:hip ratio, waist:height ratio). Methods: Data from the three surveys (1992–2008) are presented. A random sample of 5147 subjects aged 45–64 years was selected for statistical analysis. During follow-up there were 141 deaths from cardiovascular disease (excluding those with cardiovascular disease at entry). Cox’s regression was used to estimate the associations between anthropometric indexes and cardiovascular disease mortality. Results: During a 17-year period among men, the prevalence of obesity (body mass index ⩾30 kg/m2) increased from 18.4% to 32.1% (p<0.001) and a high level of waist:hip ratio (>0.9) from 59.3% to 72.9% (p<0.001). The risk profile of obesity did not change in women, but prevalence of a high level of waist:hip ratio (>0.85) increased from 25.9% to 41.5% (p<0.001). Multivariable-adjusted Cox’s regression models showed that body mass index, waist circumference, waist:hip ratio, waist:height ratio were associated with cardiovascular disease mortality risk only in men (hazard ratios 1.40, 1.45, 1.49, 1.46 respectively (p<0.01)). Conclusions: Our data indicate that anthropometric measures such as body mass index, waist circumference, waist:hip ratio and waist:height ratio are good indicators of cardiovascular disease mortality risk only in men aged 45–64 years. PMID:26261188

40 CFR 64.10 - Savings provisions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Savings provisions. 64.10 Section 64.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.10 Savings provisions. (a) Nothing in this part shall: (1) Excuse the...

40 CFR 64.4 - Submittal requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Submittal requirements. 64.4 Section 64.4 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.4 Submittal requirements. (a) The owner or operator shall submit to the...

40 CFR 64.4 - Submittal requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 16 2012-07-01 2012-07-01 false Submittal requirements. 64.4 Section 64.4 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.4 Submittal requirements. (a) The owner or operator shall submit to the...

40 CFR 64.10 - Savings provisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Savings provisions. 64.10 Section 64.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.10 Savings provisions. (a) Nothing in this part shall: (1) Excuse the...

40 CFR 64.4 - Submittal requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Submittal requirements. 64.4 Section 64.4 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.4 Submittal requirements. (a) The owner or operator shall submit to the...

Age-Related 12-Year Changes in Dietary Diversity and Food Intakes among Community-Dwelling Japanese Aged 40 to 79 Years.

PubMed

Otsuka, R; Nishita, Y; Tange, C; Tomida, M; Kato, Y; Imai, T; Ando, F; Shimokata, H

2018-01-01

This study describes trends in dietary diversity and food intake over 12 years according to age at first participation in the study. Prospective cohort study. The National Institute for Longevity Sciences - Longitudinal Study of Aging, a community-based study. Participants included 922 men and 879 women who participated in the first study-wave (age, 40-79 years) and also participated in at least one study-wave from the second to seventh study-wave. Study-waves were conducted biennially. Dietary intake was calculated from 3-day dietary records with photographs. Dietary diversity was determined using the Quantitative Index for Dietary Diversity based on food intake. A mixed-effects model was used to estimate linear changes in dietary diversity and food intake over 12 years according to age at first study-wave. Mean (standard deviation (SD)) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8), respectively. Mean (SD, range) dietary diversity score was 0.86 (0.06, 0.52-0.96) in men and 0.88 (0.04, 0.66-0.96) in women, respectively. Fixed effects for interactions of age and time with dietary diversity score were statistically significant (p<0.05). The slope of dietary diversity among men aged 40 to 55 years increased (40-year-old slope = 0.00093/year, p<0.01; 55-year-old slope = 0.00035/year, p=0.04), with a decreasing trend started at 65 years old, although this trend was not significant (65-year-old slope = -0.00003/year, p=0.88; 79-year-old slope = -0.00057/year, p=0.21). The slope of dietary diversity among women aged 40 to 44 years increased (40-year-old slope = 0.00053/year, p=0.02; 44-year-old slope = 0.00038/year, p=0.04), whereas the slope of dietary diversity among women aged 63 to 79 years decreased (63-year-old slope = -0.00033/year, p=0.03; 79-year-old slope = -0.00092/year, p<0.001). Fruit, milk and dairy intake decreased in men around their 60s; milk and dairy intake decreased in women around their 50s; and beans and fruit

40 CFR 156.64 - Signal word.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Signal word. 156.64 Section 156.64... REQUIREMENTS FOR PESTICIDES AND DEVICES Human Hazard and Precautionary Statements § 156.64 Signal word. (a... signal word, reflecting the highest Toxicity Category (Category I is the highest toxicity category) to...

40 CFR 156.64 - Signal word.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Signal word. 156.64 Section 156.64... REQUIREMENTS FOR PESTICIDES AND DEVICES Human Hazard and Precautionary Statements § 156.64 Signal word. (a... signal word, reflecting the highest Toxicity Category (Category I is the highest toxicity category) to...

40 CFR 156.64 - Signal word.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Signal word. 156.64 Section 156.64... REQUIREMENTS FOR PESTICIDES AND DEVICES Human Hazard and Precautionary Statements § 156.64 Signal word. (a... signal word, reflecting the highest Toxicity Category (Category I is the highest toxicity category) to...

40 CFR 156.64 - Signal word.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Signal word. 156.64 Section 156.64... REQUIREMENTS FOR PESTICIDES AND DEVICES Human Hazard and Precautionary Statements § 156.64 Signal word. (a... signal word, reflecting the highest Toxicity Category (Category I is the highest toxicity category) to...

40 CFR 156.64 - Signal word.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Signal word. 156.64 Section 156.64... REQUIREMENTS FOR PESTICIDES AND DEVICES Human Hazard and Precautionary Statements § 156.64 Signal word. (a... signal word, reflecting the highest Toxicity Category (Category I is the highest toxicity category) to...

Analysis of oxybutynin treatment for hyperhidrosis in patients aged over 40 years

PubMed Central

Wolosker, Nelson; Krutman, Mariana; Teivelis, Marcelo Passos; de Paula, Rafael Pessanha; Kauffman, Paulo; de Campos, Jose Ribas Milanez; Puech-Leão, Pedro

2014-01-01

ABSTRACT Objective: Our aim was to analyze the effectiveness of oxybutynin for hyperhidrosis treatment in patients over 40 years. Methods: Eighty-seven patients aged over 40 years were divided into two groups. One group consisted of 48 (55.2%) patients aged between 40 and 49 years, and another was composed of 39 (44.8%) patients aged over 50 years (50 to 74 years). A comparative analysis of Quality of Life and level of hyperhidrosis between the groups was carried out 6 weeks after a protocol treatment with oxybutynin. A validated clinical questionnaire was used for evaluation. Results: In the younger age group, 75% of patients referred a “partial” or “great” improvement in level of hyperhidrosis after treatment. This number was particularly impressive in patients over 50 years, in which 87.2% of the cases demonstrated similar levels of improvement. Over 77% of patients in both groups demonstrated improvement in Quality of Life. Excellent outcomes were observed in older patients, in which 87.1% of patients presented “slightly better” (41%) or “much better” (46.1%) improvement. Conclusion: Patients aged over 40 years with hyperhidrosis presented excellent results after oxybutynin treatment. These outcomes were particularly impressive in the age group over 50 years, in which most patients had significant improvement in Quality of Life and in level of hyperhidrosis. PMID:24728245

40 CFR 279.64 - Used oil storage.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 28 2013-07-01 2013-07-01 false Used oil storage. 279.64 Section 279... for Energy Recovery § 279.64 Used oil storage. Used oil burners are subject to all applicable Spill.... Used oil burners are also subject to the Underground Storage Tank (40 CFR part 280) standards for used...

40 CFR 279.64 - Used oil storage.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 27 2014-07-01 2014-07-01 false Used oil storage. 279.64 Section 279... for Energy Recovery § 279.64 Used oil storage. Used oil burners are subject to all applicable Spill.... Used oil burners are also subject to the Underground Storage Tank (40 CFR part 280) standards for used...

40 CFR 279.64 - Used oil storage.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 28 2012-07-01 2012-07-01 false Used oil storage. 279.64 Section 279... for Energy Recovery § 279.64 Used oil storage. Used oil burners are subject to all applicable Spill.... Used oil burners are also subject to the Underground Storage Tank (40 CFR part 280) standards for used...

40 CFR 52.64 - Determination of attainment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 3 2013-07-01 2013-07-01 false Determination of attainment. 52.64 Section 52.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Alabama § 52.64 Determination of attainment...

40 CFR 52.64 - Determination of attainment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 3 2012-07-01 2012-07-01 false Determination of attainment. 52.64 Section 52.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Alabama § 52.64 Determination of attainment...

40 CFR 52.64 - Determination of attainment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 3 2014-07-01 2014-07-01 false Determination of attainment. 52.64 Section 52.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Alabama § 52.64 Determination of attainment...

40 CFR 610.64 - Track test procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Track test procedures. 610.64 Section 610.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY RETROFIT DEVICES Test Procedures and Evaluation Criteria Special Test Procedures § 610.64 Track...

40 CFR 64.5 - Deadlines for submittals.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Deadlines for submittals. 64.5 Section 64.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.5 Deadlines for submittals. (a) Large pollutant-specific emissions units...

40 CFR 64.3 - Monitoring design criteria.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Monitoring design criteria. 64.3 Section 64.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.3 Monitoring design criteria. (a) General criteria. To provide a...

40 CFR 64.3 - Monitoring design criteria.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 16 2012-07-01 2012-07-01 false Monitoring design criteria. 64.3 Section 64.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.3 Monitoring design criteria. (a) General criteria. To provide a...

40 CFR 64.5 - Deadlines for submittals.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Deadlines for submittals. 64.5 Section 64.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.5 Deadlines for submittals. (a) Large pollutant-specific emissions units...

Perinatal outcomes in women over 40 years of age compared to those of other gestations

PubMed Central

Canhaço, Evandro Eduardo; Bergamo, Angela Mendes; Lippi, Umberto Gazi; Lopes, Reginaldo Guedes Coelho

2015-01-01

Objective To clarify if older pregnant women were more likely to have adverse perinatal outcomes when compared to women at an ideal age to have a child. Methods The groups were divided according to age groups: under 20 years, ≥20 to <40 years, and ≥40 years. Results During the period from January 1st, 2008, to December 31st, 2008, there were 76 births from patients younger than 20 years and 91 births from patients aged 40 years or over. To form a third group with intermediate age, the data of 92 patients aged 20 to 40 years were obtained, totaling 259 patients. Patients aged 40 or older had a statistically greater number of cesarean sections and less use of forceps or normal deliveries (p<0.001). The use of spinal anesthesia was statistically higher among those aged 40 years or more (p<0.001). The frequency of male newborns was statistically higher in older patients, a group with statistically fewer first pregnancies (p<0.001). The frequency of premature newborns was statistically higher in patients aged 40 years or more (p=0.004). Conclusion It is crucial to give priority to aged women, so that prenatal care will be appropriate, minimizing maternal complications and improving perinatal outcomes in this unique group. PMID:25993070

Suicidal ideation, suicide attempt, and occupations among employed adults aged 18-64years in the United States.

PubMed

Han, Beth; Crosby, Alex E; Ortega, LaVonne A G; Parks, Sharyn E; Compton, Wilson M; Gfroerer, Joseph

2016-04-01

Approximately 70% of all US suicides are among working-age adults. This study was to determine whether and how 12-month suicidal ideation and suicide attempt were associated with specific occupations among currently employed adults aged 18-64 in the U.S. Data were from 184,300 currently employed adults who participated in the 2008-2013 National Surveys on Drug Use and Health (NSDUH). NSDUH provides nationally representative data on suicidal ideation and suicide attempt. Descriptive analyses and multivariable logistic regressions were conducted. Among currently employed adults aged 18-64 in the U.S., 3.5% had suicidal ideation in the past 12months (3.1% had suicidal ideation only, and 0.4% had suicidal ideation and attempted suicide). Compared with adults in farming, fishing, and forestry occupations (model adjusted prevalence (MAP)=1.6%), adults in the following occupations were 3.0-3.6 times more likely to have suicidal ideation in the past year (model adjusted relative risks (MARRs)=3.0-3.6): lawyers, judges, and legal support workers (MAP=4.8%), social scientists and related workers (MAP=5.4%), and media and communication workers (MAP=5.8%). Among employed adults aged 18-64 in the U.S., the 12-month prevalence of suicidal ideation varies by occupations. Adults in occupations that are at elevated risk for suicidal ideation may warrant focused suicide prevention. Published by Elsevier Inc.

40 CFR 72.64 - Statement of basis.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Statement of basis. 72.64 Section 72.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Federal Acid Rain Permit Issuance Procedures § 72.64 Statement of basis. (a) The...

40 CFR 72.64 - Statement of basis.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Statement of basis. 72.64 Section 72.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Federal Acid Rain Permit Issuance Procedures § 72.64 Statement of basis. (a) The...

40 CFR 72.64 - Statement of basis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Statement of basis. 72.64 Section 72.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Federal Acid Rain Permit Issuance Procedures § 72.64 Statement of basis. (a) The...

40 CFR 72.64 - Statement of basis.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 17 2014-07-01 2014-07-01 false Statement of basis. 72.64 Section 72.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Federal Acid Rain Permit Issuance Procedures § 72.64 Statement of basis. (a) The...

40 CFR 72.64 - Statement of basis.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Statement of basis. 72.64 Section 72.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Federal Acid Rain Permit Issuance Procedures § 72.64 Statement of basis. (a) The...

40 CFR 64.6 - Approval of monitoring.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Approval of monitoring. 64.6 Section 64.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.6 Approval of monitoring. (a) Based on an application that includes the...

40 CFR 64.6 - Approval of monitoring.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Approval of monitoring. 64.6 Section 64.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.6 Approval of monitoring. (a) Based on an application that includes the...

Pregnancy Outcome of Multiparous Women Aged over 40 Years

PubMed Central

Ates, Seda; Batmaz, Gonca; Sevket, Osman; Molla, Taner; Dane, Cem; Dane, Banu

2013-01-01

Objective. The aim of this study was to evaluate the effect of maternal age on prenatal and obstetric outcome in multiparaous women. Materials and Methods. A retrospective case control study was conducted, including women aged 40 years and over (study group, n = 97) who delivered at 20 week's gestation or beyond and women aged 20–29 years (control group, n = 97). Results. The mean age of women in the study group was 41.2 ± 1.7 years versus 25.4 ± 2.3 years in the control group. Advanced maternal age was associated with a significantly higher rate of hypertension, diabetes mellitus, fetal complication, and 5-minute Apgar scores <7 (P < 0.05). Caeserean section rate, incidence of placental abruption, preterm delivery, and neonatal intensive care unit admission were more common in the older group, but the differences were not statistically significant. Conclusions. Advanced maternal age is related to maternal and neonatal complications. PMID:25954770

Coeval Ar-40/Ar-39 ages of 65.0 million years ago from Chicxulub crater melt rock and Cretaceous-Tertiary boundary tektites

NASA Technical Reports Server (NTRS)

Swisher, Carl C., III; Grajales-Nishimura, Jose M.; Montanari, Alessandro; Margolis, Stanley V.; Claeys, Philippe; Alvarez, Walter; Renne, Paul; Cedillo-Pardo, Esteban; Maurrasse, Florentin J.-M. R.; Curtis, Garniss H.

1992-01-01

Ar-40/Ar-39 dating of drill-core samples of a glassy melt rock recovered from beneath a massive impact breccia contained with the 180-kilometer subsurface Chicxulub crater yields well-behaved incremental heating spectra with a mean plateau age of 64.98 +/- 0.05 million years ago (Ma). The glassy melt rock of andesitic composition was obtained from core 9 (1390 to 1393 meters) in the Chicxulub 1 well. The age of the melt rock is virtually indistinguishable from Ar-40/Ar-39 ages obtained on tektite glass from Beloc, Haiti, and Arroyo el Mimbral, northeastern Mexico, of 65.01 +/- 0.08 Ma (mean plateau age for Beloc) and 65.07 +/- 0.10 Ma (mean total fusion age for both sites). The Ar-40/Ar-39 ages, in conjunction with geochemical and petrological similarities, strengthen the suggestion that the Chicxulub structure is the source for the Haitian and Mexican tektites and is a viable candidate for the Cretaceous-Tertiary boundary impact site.

Five-year change in refraction and its ocular components in the 40- to 64-year-old population of the Shahroud eye cohort study.

PubMed

Hashemi, Hassan; Khabazkhoob, Mehdi; Iribarren, Rafael; Emamian, Mohammad Hassan; Fotouhi, Akbar

2016-11-01

To assess 5-year refractive changes and their related factors in the 40- to 64-year-old population of Shahroud, Iran. Prospective cohort study. Of the 5190 participants of Phase I, 4737 participated in Phase II (response rate = 91.3%). Participants were tested by refraction, visual acuity, slit-lamp biomicroscopy, ophthalmoscopy and biometry. Myopia was defined as a spherical equivalent more negative than -0.5 dioptre (D) and hyperopia as a spherical equivalent more positive than +0.5 D. Mean 5-year change in spherical equivalent refraction. The mean 5-year change in spherical equivalent refraction was +0.24 D (95% CI: +0.22 to +0.25). After 5 years, 4.77% (95% CI: 4.08 to 5.46) of subjects developed at least 0.5 D of myopia and 22.27% (95% CI: 20.97 to 23.57) developed at least 0.5 D of hyperopia. Five-year changes in refraction included a hyperopic shift in all age groups. The greatest hyperopic shift was seen in middle-aged women. The greatest loss of lens power was observed in hyperopic women and the least in myopic men. Nuclear cataract was associated with a myopic shift in refraction. The axial length and the corneal power had very small changes during this period. Myopes showed the greatest increase in axial length. Corneal power increased by a very small amount in all refractive groups. The most important biometric index related to hyperopic shifts, which were greater in magnitude in women, was loss of lens power, whereas nuclear cataract was associated with myopic shifts. © 2016 Royal Australian and New Zealand College of Ophthalmologists.

40 CFR 64.3 - Monitoring design criteria.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Monitoring design criteria. 64.3 Section 64.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.3 Monitoring design criteria. (a) General criteria. To provide a reasonable assurance of compliance with...

Prevalence of thoracic scoliosis in adults 25 to 64 years of age detected during routine chest radiographs.

PubMed

Chen, James B; Kim, Abraham D; Allan-Blitz, Lao; Shamie, Arya Nick

2016-10-01

To investigate the prevalence of thoracic scoliosis and determine the effect of both age and gender on coronal curve magnitude among asymptomatic adults aged 25-64 years old, using standing posterior-anterior chest radiographs. This was a retrospective, cross-sectional study evaluating 500 randomly selected digital posterior-anterior chest radiographs taken at a single institution on an outpatient basis between January 2010 and December 2011. Males (n = 184) and females (n = 316) ranged in age from 25 to 64 years. Patients with symptoms of back pain; including a history of back pain, spinal instrumentation, or known pre-existing spinal disease were excluded. Radiographs were evaluated using Centricity PACS Web Diagnostic 2.1 system (General Electric Co. Fairfield, CT). Coronal Cobb angle measurements of the thoracic spine were quantified by the authors, with scoliosis defined as coronal curves greater than 10°. Curvatures were subdivided into groups: a control group with coronal curves less than 10°, curves measuring 10° to 19°, 20° to 29°, and greater than 30°. The effect of age and gender on curve magnitude was examined using Pearson correlation analysis and linear regression analysis. There was a 13.4 % (67 patients) prevalence of thoracic scoliosis. The prevalence among asymptomatic males was 10.9 %, while the prevalence among asymptomatic females was 14.9 %. 11.6 % demonstrated a coronal curvature between 10° and 19° (58 patients), 1.6 % between 20° and 29° (8 patients), and 0.2 % greater than 30° (1 patient). Age and gender were not found to be significant independent predictors of curve severity. We found a 13.4 % prevalence of thoracic scoliosis among asymptomatic adults aged 25-64 years on routine outpatient chest radiographs. 11.6 % of patients demonstrated a coronal curvature between 10° and 19°. Unlike prior studies evaluating asymptomatic thoracic curves in elderly patients, age and gender did not significantly affect curve

The cost-effectiveness of influenza vaccination of healthy adults 50-64 years of age.

PubMed

Turner, D A; Wailoo, A J; Cooper, N J; Sutton, A J; Abrams, K R; Nicholson, K G

2006-02-13

Influenza can cause significant morbidity and mortality. Influenza vaccination is an effective and safe strategy in the prevention of influenza. Currently the National Health Service (NHS) vaccinates 'at-risk' individuals only. This definition includes everyone over 65 years of age but excludes individuals 50-64 years of age unless they have an additional risk factor, such as underlying heart disease or lung disease. In order to examine the cost-effectiveness of an extension of the vaccination policy to include this age group we constructed an economic model to estimate the costs and benefits of vaccination from both a health service and a societal perspective. Data to populate the model was obtained from the literature and the outcome measure used was the quality adjusted life year (QALY). Influenza vaccination prevented an estimated 4508 cases (95% CI: 2431-7606) per 100,000 vaccinees per influenza season for a net cost to the NHS of pound653,221 (95% CI: 354,575-1,072,257). The net cost increased to pound1,139,069 (95% CI 27,052-2,030,473) when non-NHS costs were included and the estimated cost-per-QALY were pound6174 and pound10,766 for NHS and all costs respectively. Extension of the current immunisation policy has the potential to generate a significant health benefit at a comparatively low cost.

40 CFR 64.9 - Reporting and recordkeeping requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Reporting and recordkeeping requirements. 64.9 Section 64.9 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.9 Reporting and recordkeeping requirements. (a...

40 CFR 64.9 - Reporting and recordkeeping requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Reporting and recordkeeping requirements. 64.9 Section 64.9 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.9 Reporting and recordkeeping requirements. (a...

The impact of young age on locoregional recurrence after doxorubicin-based breast conservation therapy in patients 40 years old or younger: How young is 'young'?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oh, Julia L.; Bonnen, Mark; Outlaw, Elesyia D.

2006-08-01

Purpose: The aim of this study was to investigate whether patients <35 years old have similar risk of locoregional recurrence after breast conservation therapy compared with patients 35 to 40 years old. Methods and materials: We retrospectively reviewed records of 196 consecutive patients {<=}40 years old who received breast conservation therapy (BCT) from 1987 to 2000 for breast cancer and compared outcomes between patients <35 years old with patients 35 to 40 years old. The majority of patients received neoadjuvant chemotherapy as part of their treatment. Multivariate analysis was performed to assess risk factors for locoregional recurrence. Results: After amore » median follow-up of 64 months, 22 locoregional recurrences (LRR) were observed. Twenty patients developed locoregional recurrence as their first site of relapse. Two patients had bone-only metastases before their locoregional recurrence. On multivariate analysis, age <35 years was associated with a statistically significant increased risk of locoregional recurrence. The 5-year rate of locoregional control was 87.9% in patients <35 years old compared with 91.7% in patients 35 to 40 years old (p = 0.042). Conclusions: Our finding supports an increased risk of locoregional recurrence as a function of younger age after breast conservation therapy, even among young patients 40 years old and younger.« less

Suicide rates in five-year age-bands after the age of 60 years: the international landscape.

PubMed

Shah, Ajit; Bhat, Ravi; Zarate-Escudero, Sofia; DeLeo, Diego; Erlangsen, Annette

2016-01-01

There is paucity of studies examining suicide rates in narrow five-year age-bands after the age of 60 years. This study examined suicide rates in eight five-year age-bands between the age of 60 and 99 years because this will allow more precise comparison between the young old (60-79 years) and the oldest old (80+ years) age groups. Data on the number of suicides (International Classification of Diseases - ICD-10 codes, X60-84) in each of the eight five-year age-bands between the age-bands 60-64 years and 95-99 years in both gender for as many years as possible from 2000 were ascertained from three sources: colleagues with access to national data, national statisics office websites and email contact with the national statistics offices. The population size for the corresponding years and age-bands was estimated for each country using data provided by the United Nations website. In men, suicide rates continued to increase for each of the seven five-year age-bands from 60-64 years to 90-94 years age-band, and then declined slightly for the 95-99 year age-band. In women, suicide rates continued to increase for each of the six five-year age-bands from 60-64 years to 85-89 years age-bands, and then declined slightly for the 90-94 years and 95-99 years age-bands. The overall global suicide rates for each of the eight five-year age-bands are sufficiently large for them to constitute a public health concern. This is especially important given the ongoing rise in the elderly population size and the paucity of data on risk and protective factors for suicide in the five-year age-bands after the age of 60 years.

40 CFR 467.64 - New source performance standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false New source performance standards. 467.64 Section 467.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT... § 467.64 New source performance standards. Any new source subject to this subpart must achieve the...

40 CFR 64.7 - Operation of approved monitoring.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Operation of approved monitoring. 64.7 Section 64.7 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.7 Operation of approved monitoring. (a) Commencement of operation. The...

Suicidal ideation, suicide attempt, and occupations among employed adults aged 18–64 years in the United States

PubMed Central

Han, Beth; Crosby, Alex E.; Ortega, LaVonne A.G.; Parks, Sharyn E.; Compton, Wilson M.; Gfroerer, Joseph

2016-01-01

Objective Approximately 70% of all US suicides are among working-age adults. This study was to determine whether and how 12-month suicidal ideation and suicide attempt were associated with specific occupations among currently employed adults aged 18–64 in the U.S. Methods Data were from 184,300 currently employed adults who participated in the 2008–2013 National Surveys on Drug Use and Health (NSDUH). NSDUH provides nationally representative data on suicidal ideation and suicide attempt. Descriptive analyses and multivariable logistic regressions were conducted. Results Among currently employed adults aged 18–64 in the U.S., 3.5% had suicidal ideation in the past 12 months (3.1% had suicidal ideation only, and 0.4% had suicidal ideation and attempted suicide). Compared with adults in farming, fishing, and forestry occupations (model adjusted prevalence (MAP) = 1.6%), adults in the following occupations were 3.0–3.6 times more likely to have suicidal ideation in the past year (model adjusted relative risks (MARRs) = 3.0–3.6): lawyers, judges, and legal support workers (MAP = 4.8%), social scientists and related workers (MAP = 5.4%), and media and communication workers (MAP = 5.8%). Conclusions Among employed adults aged 18–64 in the U.S., the 12-month prevalence of suicidal ideation varies by occupations. Adults in occupations that are at elevated risk for suicidal ideation may warrant focused suicide prevention. PMID:26995251

40 CFR 610.64 - Track test procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Track test procedures. 610.64 Section 610.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL... necessary to limit testing to times when the wind velocity is less than 5 mph, with gusts less than 10 mph...

40 CFR 610.64 - Track test procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 31 2013-07-01 2013-07-01 false Track test procedures. 610.64 Section 610.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL... necessary to limit testing to times when the wind velocity is less than 5 mph, with gusts less than 10 mph...

40 CFR 280.64 - Free product removal.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Free product removal. 280.64 Section... Substances § 280.64 Free product removal. At sites where investigations under § 280.62(a)(6) indicate the presence of free product, owners and operators must remove free product to the maximum extent practicable...

Predictive value of low BMD for 1-year fracture outcomes is similar for postmenopausal women ages 50-64 and 65 and Older: results from the National Osteoporosis Risk Assessment (NORA).

PubMed

Siris, Ethel S; Brenneman, Susan K; Miller, Paul D; Barrett-Connor, Elizabeth; Chen, Ya-Ting; Sherwood, Louis M; Abbott, Thomas A

2004-08-01

The relationship of low bone mass and fracture in younger postmenopausal women has not been extensively studied. In a large cohort of postmenopausal women > or =50 years of age, we found the relationship of BMD measured at peripheral sites and subsequent 1-year fracture risk to be similar between women <65 and those > or =65 years of age. Low bone mass and fractures are prevalent in older postmenopausal women. However, the frequency of low bone mass and fracture in younger postmenopausal women has not been studied extensively. There are very limited data regarding the association between BMD measurements and fractures in postmenopausal women who are between the ages of 50 and 64. In the National Osteoporosis Risk Assessment (NORA) we studied the frequency of low bone mass and its association with fracture in women 50-64 years of age in comparison with women > or =65 of age. NORA enrolled 200,160 postmenopausal women > or =50 years of age who had no prior diagnosis of osteoporosis. Baseline BMD was measured at the heel, forearm, or finger. A 1-year follow-up survey requesting incident fractures since baseline was completed by 163,935 women, 87,594 (53%) of whom were 50-64 years of age. The association between BMD and fracture was assessed using logistic regression, adjusted for important covariates. Thirty-one percent of women 50-64 years of age had low bone mass (T scores < or = -1.0) compared to 62% of women > or =65 years of age. During the first year of follow-up, 2440 women reported fractures of wrist/forearm, rib, spine, or hip, including 440 hip fractures. Nine hundred four women 50-64 years of age reported fractures, including 86 hip fractures, accounting for 37% of fractures and 20% of hip fractures reported in the entire NORA cohort. Relative risk for osteoporotic fracture was 1.5 for each SD decrease in BMD for both the younger and older groups of women. Low BMD in younger postmenopausal women 50-64 years of age showed a 1-year relative risk of fracture

Mammography Prevalence within 2 Two Years (Age 40+) - Small Area Estimates

Cancer.gov

For mammography, a woman 40 years of age or older must have reported having at least one mammography in her life. Furthermore, she should have had the most recent one within the last two years by the time of interview.

Factors affecting the variability in the observed levels of cadmium in blood and urine among former and current smokers aged 20-64 and ≥ 65years.

PubMed

Jain, Ram B

2017-03-01

Data from National Health and Nutrition Examination Survey for 1999-2012 were used to evaluate factors that affect observed levels of blood cadmium (BCd) and urine cadmium (UCd) among former and current smokers aged 20-64 and ≥65 years. Adjusted levels (AGM) for BCd and UCd were higher among females as compared to males. The order of AGM for BCd by race/ethnicity for 20-64 years old was non-Hispanic white (NHW) < non-Hispanic black (NHB) and NHW > NHB for ≥65 years old. The order of AGMs for UCd for 20-64-year-old current smokers was NHW > NHB and NHW > NHB for former smokers. For 20-64-year-old current smokers, exposure to environmental tobacco smoke at home was associated with higher levels of BCd. Levels of both UCd and BCd increased with age, but the rate of increase was as much as seven times higher among ≥65 years old than 20-64 years old. For current smokers, the number of cigarettes smoked inside home was positively associated with the levels of BCd. For current smokers aged 20-64 years, the number of cigarettes smoked inside home was positively associated with the levels of UCd (p < 0.01), and the number of cigarettes smoked every day on the days they were smoked was also positively associated with the levels of UCd (p < 0.01). Among former smokers, levels of both UCd and BCd were positively associated (p < 0.1) with the number of cigarettes smoked per day at the time of quitting smoking and negatively associated with the time since smoking was quitted (p < 0.01).

Baseline PSA in a Spanish male population aged 40-49 years anticipates detection of prostate cancer.

PubMed

Angulo, J C; Viñas, M A; Gimbernat, H; Fata, F Ramón de; Granados, R; Luján, M

2015-12-01

We researched the usefulness of optimizing prostate cancer (PC) screening in our community using baseline PSA readings in men between 40-49 years of age. A retrospective study was performed that analyzed baseline PSA in the fifth decade of life and its ability to predict the development of PC in a population of Madrid (Spain). An ROC curve was created and a cutoff was proposed. We compared the evolution of PSA from baseline in patients with consecutive readings using the Friedman test. We established baseline PSA ranges with different risks of developing cancer and assessed the diagnostic utility of the annual PSA velocity (PSAV) in this population. Some 4,304 men aged 40-49 years underwent opportunistic screening over the course of 17 years, with at least one serum PSA reading (6,001 readings) and a mean follow-up of 57.1±36.8 months. Of these, 768 underwent biopsy of some organ, and 104 underwent prostate biopsy. Fourteen patients (.33%) were diagnosed with prostate cancer. The median baseline PSA was .74 (.01-58.5) ng/mL for patients without PC and 4.21 (.76-47.4) ng/mL for those with PC. The median time from the reading to diagnosis was 26.8 (1.5-143.8) months. The optimal cutoff for detecting PC was 1.9ng/mL (sensitivity, 92.86%; specificity, 92.54%; PPV, 3.9%; NPV, 99.97%), and the area under the curve was 92.8%. In terms of the repeated reading, the evolution of the PSA showed no statistically significant differences between the patients without cancer (p=.56) and those with cancer (P=.64). However, a PSAV value >.3ng/mL/year revealed high specificity for detecting cancer in this population. A baseline PSA level ≥1.9ng/mL in Spanish men aged 40-49 years predicted the development of PC. This value could therefore be of use for opportunistic screening at an early age. An appropriate follow-up adapted to the risk of this population needs to be defined, but an annual PSAV ≥.3ng/mL/year appears of use for reaching an early diagnosis. Copyright © 2015 AEU

Body mass index gain between ages 20-40 years and lifestyle characteristics of men at ages 40-60 years: The Adventist Health Study-2

PubMed Central

Japas, Claudio; Knutsen, Synnøve; Dehom, Salem; Dos Santos, Hildemar; Tonstad, Serena

2014-01-01

Background Obesity increases risk of premature disease, and may be associated with unfavorable lifestyle changes that add to risk. This study analyzed the association of midlife BMI change with current lifestyle patterns among multiethnic men. Methods Men aged 40-60 years (n=9864) retrospectively reported body weight between ages 20-40 years and current dietary, TV, physical activity and sleep practices in the Adventist Health Study II, a study of church-goers in the US and Canada. In multivariate logistic regression analysis, odds ratios for BMI gain were calculated for each lifestyle practice controlling for sociodemographic and other lifestyle factors and current BMI. Results Men with median or higher BMI gain (2.79 kg/m2) between ages 20-40 years were more likely to consume a non-vegetarian diet, and engage in excessive TV watching and little physical activity and had a shorter sleep duration compared to men with BMI gain below the median (all p<0.001). In multivariate logistic analysis current BMI was significantly associated with all lifestyle factors in multivariate analyses (all p≤0.005). BMI gain was associated with lower odds of vegetarian diet (odds ratio [OR] 0.939; 95% confidence interval [CI] 0.921-0.957) and of physical activity ≥150 minutes/week (OR 0.979, 95% CI 0.960-0.999). Conclusions These findings imply that diet and less physical activity are associated with both gained and attained BMI, while inactivity (TV watching) and short sleep duration correlated only with attained BMI. Unhealthy lifestyle may add risk to that associated with BMI. Longitudinal and intervention studies are needed to infer causal relationships. PMID:25434910

40 CFR 64.8 - Quality improvement plan (QIP) requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Quality improvement plan (QIP) requirements. 64.8 Section 64.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.8 Quality improvement plan (QIP) requirements. (a...

40 CFR 64.8 - Quality improvement plan (QIP) requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Quality improvement plan (QIP) requirements. 64.8 Section 64.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.8 Quality improvement plan (QIP) requirements. (a...

40 CFR 98.64 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Monitoring and QA/QC requirements. 98.64 Section 98.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Aluminum Production § 98.64 Monitoring and QA/QC requirements...

40 CFR 53.64 - Test procedure: Static fractionator test.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 5 2011-07-01 2011-07-01 false Test procedure: Static fractionator test. 53.64 Section 53.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Performance Characteristics of Class II Equivalent Methods for PM2.5 § 53.64 Test procedure: Static...

40 CFR 53.64 - Test procedure: Static fractionator test.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Test procedure: Static fractionator test. 53.64 Section 53.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Performance Characteristics of Class II Equivalent Methods for PM2.5 § 53.64 Test procedure: Static...

40 CFR 98.64 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Monitoring and QA/QC requirements. 98.64 Section 98.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Aluminum Production § 98.64 Monitoring and QA/QC requirements...

[Workplace stress and its impact on the 16-year risk of myocardial infarction and stroke in an open female population aged 25-64 years in Russia/Siberia (WHO MONICA-psychosocial program)].

PubMed

Gafarov, V V; Panov, D O; Gromova, E A; Gagulin, I V; Gafarova, A V

2015-01-01

To determine the impact of workplace stress on the hazard ratio (HR) of myocardial infarction (M) and stroke in an open female population aged 25-64 years in Russia/Siberia (Novosibirsk) for 16 years. A random representative sample of 25-64-year-old women (n=870) residing in a Novosibirsk district was surveyed within the framework of the WHO program. Workplace stress was investigated using the Karasek scale; an attitude towards work and health prophylactic examinations was studied applying the Health Awareness and Attitude questionnaire of the WHO program. For 16 years (1994 to 2010), a cohort of all new cases of MI and stroke was examined employing the WHO program and all possible medical records. The Cox regression model was used to determine HR for MI and stroke in the open female population aged 25-64 years for 16 years. The prevalence of high-level stress in the open female population aged 25-64 years was 31.6%. The high level of job stress was associated with a high responsibility, impossibility to have a rest at the end of a working day, frequent professional dissatisfaction, and a reduced work capacity. During 16 years, the women having high-level job stress showed a 3.22- and 1.96-fold increases in the HR of MI (p<0.05) and stroke (p<0.05), respectively. The incidence of MI and stroke was higher in married women expressing job stress as managers or manual laborers and having high and low educational attainment. The prevalence of high-level workplace stress was substantial in the open population of 25-64-year-old women in Russia/Siberia (Novosibirsk). The stress-related HR of Ml and stroke was 3-2 times higher than in those without high-level stress. The HR of MI and stroke is affected by a social gradient.

Economic costs of chronic disease through lost productive life years (PLYs) among Australians aged 45-64 years from 2015 to 2030: results from a microsimulation model.

PubMed

Schofield, Deborah; Shrestha, Rupendra N; Cunich, Michelle M; Tanton, Robert; Veerman, Lennert; Kelly, Simon J; Passey, Megan E

2016-09-22

To project the number of older workers with lost productive life years (PLYs) due to chronic disease and resultant lost income; and lost taxes and increased welfare payments from 2015 to 2030. Using a microsimulation model, Health&WealthMOD2030, the costs of chronic disease in Australians aged 45-64 were projected to 2030. The model integrates household survey data from the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers (SDACs) 2003 and 2009, output from long-standing microsimulation models (STINMOD (Static Incomes Model) and APPSIM (Australian Population and Policy Simulation Model)) used by various government departments, population and labour force growth data from Treasury, and disease trends data from the Australian Burden of Disease and Injury Study (2003). Respondents aged 45-64 years in the SDACs 2003 and 2009 formed the base population. Lost PLYs due to chronic disease; resultant lost income, lost taxes and increased welfare payments in 2015, 2020, 2025 and 2030. We projected 380 000 (6.4%) people aged 45-64 years with lost PLYs in 2015, increasing to 462 000 (6.5%) in 2030-a 22% increase in absolute numbers. Those with lost PLYs experience the largest reduction in income than any other group in each year compared to those employed full time without a chronic disease, and this income gap widens over time. The total economic loss due to lost PLYs consisted of lost income modelled at $A12.6 billion in 2015, increasing to $A20.5 billion in 2030-a 62.7% increase. Additional costs to the government consisted of increased welfare payments at $A6.2 billion in 2015, increasing to $A7.3 billion in 2030-a 17.7% increase; and a loss of $A3.1 billion in taxes in 2015, increasing to $A4.7 billion in 2030-a growth of 51.6%. There is a need for greater investment in effective preventive health interventions which improve workers' health and work capacity. Published by the BMJ Publishing Group Limited. For permission to use (where not

Safety and immunogenicity of high-dose trivalent inactivated influenza vaccine in adults 50-64 years of age.

PubMed

DiazGranados, Carlos A; Saway, William; Gouaux, James; Baron, Mira; Baker, Jeffrey; Denis, Martine; Jordanov, Emilia; Landolfi, Victoria; Yau, Eddy

2015-12-16

Individuals 50-64 years of age have reduced immune responses to influenza vaccines. The current study examined whether a high-dose inactivated trivalent influenza vaccine (IIV3-HD) might improve immune responses over a standard-dose inactivated influenza vaccine (IIV3-SD) in this age group. This was a multicenter, observer-blinded, randomized, active-controlled phase II trial. Adults 50-64 years of age were randomized 1:1 to receive IIV3-HD or IIV3-SD. Hemagglutination inhibition titers were measured before and 28 days after vaccination. Reactogenicity was recorded for 7 days after vaccination and adverse events for 28 days. 148 participants received IIV3-HD and 152 received IIV3-SD. For all vaccine strains, day 28 geometric mean hemagglutination inhibition titers were significantly higher in the IIV3-HD group than in the IIV3-SD group (geometric mean titer ratio [95% confidence interval (CI)]=1.43 [1.04-1.97] for A/H1N1, 1.65 [1.21-2.25] for A/H3N2, and 1.60 [1.23-2.08] for B). Seroconversion rates were significantly higher in the IIV3-HD group than in the IIV3-SD group for strains A/H3N2 and B but not A/H1N1 (difference [95% CI]=13.5% [4.76-22.0] for A/H3N2, 23.1% [11.7-33.6] for B, and -0.2% [-9.66 to 9.18] for A/H1N1). The post-vaccination seroprotection rate was significantly higher in the IIV3-HD group than in the IIV3-SD group for strain B but not for strains A/H1N1 or A/H3N2 (difference=9.1% [2.95-15.7] for B, 2.0% [-0.907 to 5.68] for A/H1N1, and 0.6% [-3.14 to 4.43] for A/H3N2). Reactogenicity was higher in the IIV3-HD group than in the IIV3-SD group, but reactions were mostly of low intensity, transient, and self-limited. Rates of unsolicited adverse events were similar between groups. No serious AEs, AEs leading to early withdrawal, or deaths were reported. The study suggests that in adults 50-64 years of age, IIV3-HD may improve immunogenicity compared to IIV3-SD while maintaining an acceptable safety profile. Copyright © 2015 The Authors. Published

The prevalence of erectile dysfunction among hypertensive and prehypertensive men aged 25-40 years.

PubMed

Heruti, Rafi J; Sharabi, Yehonatan; Arbel, Yaron; Shochat, Tzipi; Swartzon, Michael; Brenner, Galit; Justo, Dan

2007-05-01

Erectile dysfunction (ED) and hypertension (HTN) are common and associated among men aged 40-70 years. Data on the prevalence of ED among younger hypertensive and prehypertensive men are limited. To study the prevalence of ED in a large-scale population of hypertensive and prehypertensive men aged 25-40 years. ED severity, systolic blood pressures (SBPs), diastolic blood pressures (DBPs), and mean arterial blood pressures (MAPs). Israel Defense Force personnel, aged 25 years and older, go through routine health checks at the Staff Periodic Health Examination Center (SPEC) every 3-5 years, including measuring blood pressure and completing the Sexual Health Inventory for Men (SHIM) questionnaire in order to detect HTN and ED, respectively, and assess its severity. Pre-HTN was defined as SBP 120-139 mm Hg or DBP 80-89 mm Hg. HTN was defined as SBP >/or140 mm Hg and/or DBP >or=90 mm Hg. During 2001-2004, an overall of 11,252 men, aged 25-40 years, reported to the SPEC, and 5,860 (52.1%) men filled out the SHIM questionnaire. Among responders to the SHIM questionnaire, 1,278 (21.8%) men had low scores (aged 25-40 years. Moreover, higher blood pressures are not associated with worse erections among all men in this age group. Apparently, it takes years for HTN to cause ED.

The impact of diabetes on the labour force participation and income poverty of workers aged 45-64 years in Australia.

PubMed

Schofield, Deborah J; Cunich, Michelle; Shrestha, Rupendra N; Callander, Emily J; Passey, Megan E; Kelly, Simon J; Tanton, Robert; Veerman, Lennert

2014-01-01

To quantify the poverty status and level of disadvantage experienced by Australians aged 45-64 years who have left the labour force due to diabetes in 2010. A purpose-built microsimulation model, Health&WealthMOD2030, was used to estimate the poverty status and level of disadvantage of those aged 45-64 years who prematurely retire from the workforce due to diabetes. A multiple regression model was used to identify significant differences in rates of income poverty and the degree of disadvantage between those out of the labour force due to diabetes and those employed full- or part-time with no diabetes. 63.9% of people aged 45-64 years who were out of the labour force due to diabetes were in poverty in 2010. The odds of being in poverty for those with no diabetes and employed full-time (OR of being in poverty 0.02 95%CI: 0.01-0.04) or part-time (OR of being in poverty 0.10 95%CI: 0.05-0.23) are significantly lower than those for persons not in the labour force due to diabetes. Amongst those with diabetes, those who were able to stay in either full- or part-time employment were as much as 97% less likely to be in poverty than those who had to retire early because of the condition. Sensitivity analysis was used to assess impacts of different poverty line thresholds and key socioeconomic predictors of poverty. This study has shown that having diabetes and not being in the labour force because of this condition significantly increases the chances of living in poverty. Intervening to prevent or delay the onset of diabetes is likely to improve their living standards.

Cost-effectiveness of vaccination against invasive pneumococcal disease among people 50 through 64 years of age: role of comorbid conditions and race.

PubMed

Sisk, Jane E; Whang, William; Butler, Jay C; Sneller, Vishnu-Priya; Whitney, Cynthia G

2003-06-17

Guidelines are increasingly recommending preventive services starting at 50 years of age, and policymakers are considering such a recommendation for pneumococcal polysaccharide vaccination. The finding that pneumococcal vaccination is cost-saving for people 65 years of age or older raises the question of the vaccination's implications for other older adults, especially black people, whose disease incidence exceeds that of nonblack people, and those with high-risk conditions. To assess the implications of vaccinating black and nonblack people 50 through 64 years of age against invasive pneumococcal disease. Cost-effectiveness analysis. Published literature for vaccination effectiveness and cost estimates; data on disease incidence and case-fatality rates from the Centers for Disease Control and Prevention. Hypothetical cohort 50 through 64 years of age with the 1995 U.S. age distribution. Lifetime. Societal. Pneumococcal polysaccharide vaccination compared with no vaccination. Incremental medical costs and health effects, in quality-adjusted life-years per vaccinee. Vaccination saved medical costs and improved health among high-risk black people (27.55 dollars savings per vaccinee) and nonblack people (5.92 dollars savings per vaccinee), excluding survivors' future costs. For low-risk black and nonblack people and the overall general population, vaccination cost 2477 dollars, 8195 dollars, and 3434 dollars, respectively, to gain 1 year of healthy life. Excluding survivors' future costs, in the general immunocompetent population, cost per quality-adjusted life-year in global worst-case results ranged from 21 513 dollars for black people to 68 871 dollars for nonblack people; in the high-risk population, cost ranged from 11 548 dollars for black people to 39 000 dollars for nonblack people. In the global best case, vaccination was cost-saving for black and nonblack people in the general immunocompetent and high-risk populations, excluding survivors' future costs. The

The cost-effectiveness of influenza vaccination for people aged 50 to 64 years: an international model.

PubMed

Aballéa, Samuel; Chancellor, Jeremy; Martin, Monique; Wutzler, Peter; Carrat, Fabrice; Gasparini, Roberto; Toniolo-Neto, Joao; Drummond, Michael; Weinstein, Milton

2007-01-01

Routine influenza vaccination is currently recommended in several countries for people aged more than 60 or 65 years or with high risk of complications. A lower age threshold of 50 years has been recommended in the United States since 1999. To help policymakers consider whether such a policy should be adopted more widely, we conducted an economic evaluation of lowering the age limit for routine influenza vaccination to 50 years in Brazil, France, Germany, and Italy. The probabilistic model was designed to compare in a single season the costs and clinical outcomes associated with two alternative vaccination policies for persons aged 50 to 64 years: reimbursement only for people at high risk of complications (current policy), and reimbursement for all individuals in this age group (proposed policy). Two perspectives were considered: third-party payer (TPP) and societal. Model inputs were obtained primarily from the published literature and validated through expert opinion. The historical distribution of annual influenza-like illness (ILI) incidence was used to simulate the uncertain incidence in any given season. We estimated gains in unadjusted and quality-adjusted life expectancy, and the cost per quality-adjusted life-year (QALY) gained. Deterministic and probabilistic sensitivity analyses were conducted. Comparing the proposed to the current policy, the estimated mean costs per QALY gained were R$4,100, EURO 13,200, EURO 31,400 and EURO 15,700 for Brazil, France, Germany, and Italy, respectively, from a TPP perspective. From the societal perspective, the age-based policy is predicted to yield net cost savings in Germany and Italy, whereas the cost per QALY decreased to R$2800 for Brazil and EURO 8000 for France. The results were particularly sensitive to the ILI incidence rate, vaccine uptake, influenza fatality rate, and the costs of administering vaccination. Assuming a cost-effectiveness threshold ratio of EURO 50,000 per QALY gained, the probabilities of the

40 CFR 64.7 - Operation of approved monitoring.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Operation of approved monitoring. 64.7...) COMPLIANCE ASSURANCE MONITORING § 64.7 Operation of approved monitoring. (a) Commencement of operation. The owner or operator shall conduct the monitoring required under this part upon issuance of a part 70 or 71...

40 CFR 64.7 - Operation of approved monitoring.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 16 2012-07-01 2012-07-01 false Operation of approved monitoring. 64.7...) COMPLIANCE ASSURANCE MONITORING § 64.7 Operation of approved monitoring. (a) Commencement of operation. The owner or operator shall conduct the monitoring required under this part upon issuance of a part 70 or 71...

40 CFR 64.7 - Operation of approved monitoring.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Operation of approved monitoring. 64.7...) COMPLIANCE ASSURANCE MONITORING § 64.7 Operation of approved monitoring. (a) Commencement of operation. The owner or operator shall conduct the monitoring required under this part upon issuance of a part 70 or 71...

40 CFR 64.7 - Operation of approved monitoring.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 16 2013-07-01 2013-07-01 false Operation of approved monitoring. 64.7...) COMPLIANCE ASSURANCE MONITORING § 64.7 Operation of approved monitoring. (a) Commencement of operation. The owner or operator shall conduct the monitoring required under this part upon issuance of a part 70 or 71...

Prevalence and risk factors of advanced colorectal neoplasms in asymptomatic Korean people between 40 and 49 years of age.

PubMed

Koo, Ja Eun; Kim, Kyung-Jo; Park, Hye Won; Kim, Hong-Kyu; Choe, Jae Won; Chang, Hye-Sook; Lee, Ji Young; Myung, Seung-Jae; Yang, Suk-Kyun; Kim, Jin-Ho

2017-01-01

Current guidelines recommend colon cancer screening for persons aged over 50 years. However, there are few data on colorectal cancer screening in 40- to 49-year-olds. This study assessed the prevalence and risk factors of colorectal neoplasms in 40- to 49-year-old Koreans. We analyzed the results of screening colonoscopies of 6680 persons 40-59 years of age (2206 aged 40-49 and 4474 aged 50-59 years). The prevalence of overall and advanced neoplasms in the 40- to 49-year age group was lower than in the 50- to 59-year age group (26.7% and 2.4% vs 37.8% and 3.5%, respectively). However, the prevalence of overall and advanced neoplasms increased to 39.1% and 5.4%, respectively, in 45- to 49-year-old individuals with metabolic syndrome. In the 40- to 49-year age group, age, current smoking, and metabolic syndrome were associated with an increased risk of advanced neoplasms (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.04-1.30; OR 3.12, 95% CI 1.20-8.12; and OR 2.00, 95% CI 1.09-3.67, respectively). Individuals aged 40-49 years had a lower prevalence of colorectal neoplasms than those aged 50-59 years, but some 40- to 49-year-olds showed a similar prevalence to those aged 50-59 years. Age, current smoking habits, and metabolic syndrome are associated with an increased risk of advanced neoplasms in subjects aged 40-49 years. Further studies are needed to stratify the risks of colon cancer and guide targeted screening in persons younger than 50 years old. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in southwest China

PubMed Central

Liu, Ya; Hu, Rong; Ouyang, Ling-yun; Liu, Jian-xiong; Li, Xiu-jun; Yi, Yan-jing; Wang, Tzung-Dau; Zhao, Shui-ping

2017-01-01

This study aimed to assess the prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in Southwest China. From September 2013 to March 2014, a cross-sectional survey was conducted in 4021 hypertensive patients aged 40 to 79 years living in Chengdu and Chongqing, China. Fasting plasma glucose (FPG) and 2h plasma glucose (2-hPG) in an oral glucose-tolerance test (OGTT) were used for assessments. Whether the patients previously had diabetes (DM) was determined by their own reports. The survey was carried out by the same questionnaire for all respondents. DM prevalence was 32.0% in hypertensive patients aged 40 to 79 years in Southwest China, with the rates of 29.6% and 33.5% in men and women, respectively (P<0.001). DM prevalence increased with age age and body-mass index. DM prevalence rates were 16.9%, 24.7%, 38.2% and 41.9% in hypertensive patients aged 40–49, 50–59, 60–69 and over 70, respectively. DM prevalence were 30.6%, 27.9%, 37.1%, and 37.4%, for BMI<18.5, 18.5–24.9, 25.0–29.9, and ≥30, respectively. Prevalence of unrecognized DM were 20.8% in hypertensive patients aged 40 to 79 years in Southwest China. Using only fasting blood glucose testing without OGTT would have resulted in 65.0% of missed DM diagnosis in these newly diagnosed patients. The prevalence of DM and unrecognized DM were high in hypertensive patients aged 40 to 79 years in Southwest China.These findings indicate that hypertensive patients aged 40 to 79 years should regularly submit to community-based OGTT screening for timely DM diagnosis. PMID:28192474

Economic costs of chronic disease through lost productive life years (PLYs) among Australians aged 45–64 years from 2015 to 2030: results from a microsimulation model

PubMed Central

Schofield, Deborah; Shrestha, Rupendra N; Cunich, Michelle M; Tanton, Robert; Veerman, Lennert; Kelly, Simon J

2016-01-01

Objectives To project the number of older workers with lost productive life years (PLYs) due to chronic disease and resultant lost income; and lost taxes and increased welfare payments from 2015 to 2030. Design, setting and participants Using a microsimulation model, Health&WealthMOD2030, the costs of chronic disease in Australians aged 45–64 were projected to 2030. The model integrates household survey data from the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers (SDACs) 2003 and 2009, output from long-standing microsimulation models (STINMOD (Static Incomes Model) and APPSIM (Australian Population and Policy Simulation Model)) used by various government departments, population and labour force growth data from Treasury, and disease trends data from the Australian Burden of Disease and Injury Study (2003). Respondents aged 45–64 years in the SDACs 2003 and 2009 formed the base population. Main outcome measures Lost PLYs due to chronic disease; resultant lost income, lost taxes and increased welfare payments in 2015, 2020, 2025 and 2030. Results We projected 380 000 (6.4%) people aged 45–64 years with lost PLYs in 2015, increasing to 462 000 (6.5%) in 2030—a 22% increase in absolute numbers. Those with lost PLYs experience the largest reduction in income than any other group in each year compared to those employed full time without a chronic disease, and this income gap widens over time. The total economic loss due to lost PLYs consisted of lost income modelled at $A12.6 billion in 2015, increasing to $A20.5 billion in 2030—a 62.7% increase. Additional costs to the government consisted of increased welfare payments at $A6.2 billion in 2015, increasing to $A7.3 billion in 2030—a 17.7% increase; and a loss of $A3.1 billion in taxes in 2015, increasing to $A4.7 billion in 2030—a growth of 51.6%. Conclusions There is a need for greater investment in effective preventive health interventions which improve workers’ health

40 CFR 427.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Pretreatment standards for existing sources. 427.64 Section 427.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) ASBESTOS MANUFACTURING POINT SOURCE CATEGORY Asbestos Roofing...

40 CFR 427.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Pretreatment standards for existing sources. 427.64 Section 427.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ASBESTOS MANUFACTURING POINT SOURCE CATEGORY Asbestos Roofing Subcategory...

40 CFR 427.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 31 2013-07-01 2013-07-01 false Pretreatment standards for existing sources. 427.64 Section 427.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) ASBESTOS MANUFACTURING POINT SOURCE CATEGORY Asbestos Roofing...

40 CFR 427.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Pretreatment standards for existing sources. 427.64 Section 427.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ASBESTOS MANUFACTURING POINT SOURCE CATEGORY Asbestos Roofing Subcategory...

40 CFR 427.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Pretreatment standards for existing sources. 427.64 Section 427.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) ASBESTOS MANUFACTURING POINT SOURCE CATEGORY Asbestos Roofing...

40 CFR 426.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Pretreatment standards for existing sources. 426.64 Section 426.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) GLASS MANUFACTURING POINT SOURCE CATEGORY Automotive Glass...

40 CFR 426.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 31 2013-07-01 2013-07-01 false Pretreatment standards for existing sources. 426.64 Section 426.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) GLASS MANUFACTURING POINT SOURCE CATEGORY Automotive Glass...

40 CFR 426.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Pretreatment standards for existing sources. 426.64 Section 426.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GLASS MANUFACTURING POINT SOURCE CATEGORY Automotive Glass Tempering...

40 CFR 426.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Pretreatment standards for existing sources. 426.64 Section 426.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GLASS MANUFACTURING POINT SOURCE CATEGORY Automotive Glass Tempering...

Oxidative Stress Function in Women over 40 Years of Age, Considering Their Lifestyle.

PubMed

Gonçalves Mota, Maria Paula; Santos, Zirlene; Soares, Jorge; Pereira, Ana; Fonseca, Sandra; Peixoto, Francisco; Gaivão, Isabel; Oliveira, Maria

2017-01-01

Aging is dependent on biological processes that determine the aging of the organism at the cellular level. The Oxidative Stress Theory of Aging might explain some of the age-related changes in cell macromolecules. Moreover, exposome and lifestyle may also induce changes in cell damage induced by oxidative stress. The aim of the present study was to analyze the related redox changes in lymphocyte function of healthy women over 40 years old. Three groups: younger (YG: 40-49 years), middle aged (MAG: 50-59 years), and older (OG: ≥60 years) were evaluated on anthropometric variables, blood pressure, cardiovascular fitness, lifestyle habits, perceived stress, DNA damage, malondialdehyde, catalase activity, and total antioxidant capacity. Physical activity and cardiovascular fitness were significantly higher in YG and MAG as compared to the OG. Systolic blood pressure increased significantly with group age. Frequency and total amount of alcohol intake were lower in the OG and higher in the MAG. No significant differences were observed between the three groups in oxidative stress parameters. Only alcohol consumption was associated with the higher DNA FPG-sensitive sites, and only in the YG ( p  < 0.05). Healthy lifestyle is critical to avoiding major ailments associated with aging. This may be inferred from the lack of significant differences in the various oxidative stress parameters measured in the healthy women over the age of 40 who took part in the study. Conscious lifestyle behaviors (decrease in alcohol and smoking habits) could have impaired the expected age-related oxidative stress increase.

40 CFR 406.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Pretreatment standards for existing sources. 406.64 Section 406.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Parboiled Rice Processing Subcategory...

40 CFR 420.64 - New source performance standards (NSPS).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 28 2010-07-01 2010-07-01 true New source performance standards (NSPS). 420.64 Section 420.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS IRON AND STEEL MANUFACTURING POINT SOURCE CATEGORY Continuous Casting Subcategory...

40 CFR 406.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 29 2011-07-01 2009-07-01 true Pretreatment standards for existing sources. 406.64 Section 406.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Parboiled Rice Processing Subcategory...

Influenza A (H1N1) 2009 monovalent and seasonal influenza vaccination among adults 25 to 64 years of age with high-risk conditions—United States, 2010

PubMed Central

Lu, Peng-jun; Gonzalez-Feliciano, Amparo; Ding, Helen; Bryan, Leah N.; Yankey, David; Monsell, Elizabeth A.; Greby, Stacie M.; Euler, Gary L.

2018-01-01

Background Seasonal influenza vaccination has been routinely recommended for adults with high-risk conditions. The Advisory Committee on Immunization Practices recommended that persons 25 to 64 years of age with high-risk conditions be one of the initial target groups to receive H1N1 vaccination during the 2009-2010 season. Methods We used data from the 2009-2010 Behavioral Risk Factor Surveillance System survey. Vaccination levels of H1N1 and seasonal influenza vaccination among respondents 25 to 64 years with high-risk conditions were assessed. Multivariable logistic regression models were performed to identify factors independently associated with vaccination. Results Overall, 24.8% of adults 25 to 64 years of age were identified to have high-risk conditions. Among adults 25 to 64 years of age with high-risk conditions, H1N1 and seasonal vaccination coverage were 26.3% and 47.6%, respectively. Characteristics independently associated with an increased likelihood of H1N1 vaccination were as follows: higher age; Hispanic race/ethnicity; medical insurance; ability to see a doctor if needed; having a primary doctor; a routine checkup in the previous year; not being a current smoker; and having high-risk conditions other than asthma, diabetes, and heart disease. Characteristics independently associated with seasonal influenza vaccination were similar compared with factors associated with H1N1 vaccination. Conclusion Immunization programs should work with provider organizations to review efforts made to reach adults with high-risk conditions during the recent pandemic and assess how and where they can increase vaccination coverage during future pandemics. PMID:23419613

40 CFR 425.64 - New source performance standards (NSPS).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false New source performance standards (NSPS). 425.64 Section 425.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) LEATHER TANNING AND FINISHING POINT SOURCE CATEGORY Through-the-Blue...

40 CFR 425.64 - New source performance standards (NSPS).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false New source performance standards (NSPS). 425.64 Section 425.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) LEATHER TANNING AND FINISHING POINT SOURCE CATEGORY Through-the-Blue...

40 CFR 425.64 - New source performance standards (NSPS).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false New source performance standards (NSPS). 425.64 Section 425.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS LEATHER TANNING AND FINISHING POINT SOURCE CATEGORY Through-the-Blue Subcategory...

40 CFR 425.64 - New source performance standards (NSPS).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 31 2013-07-01 2013-07-01 false New source performance standards (NSPS). 425.64 Section 425.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) LEATHER TANNING AND FINISHING POINT SOURCE CATEGORY Through-the-Blue...

40 CFR 414.64 - New source performance standards (NSPS)

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 29 2011-07-01 2009-07-01 true New source performance standards (NSPS) 414.64 Section 414.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORGANIC CHEMICALS, PLASTICS, AND SYNTHETIC FIBERS Commodity Organic Chemicals § 414...

40 CFR 414.64 - New source performance standards (NSPS).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 29 2014-07-01 2012-07-01 true New source performance standards (NSPS). 414.64 Section 414.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORGANIC CHEMICALS, PLASTICS, AND SYNTHETIC FIBERS Commodity Organic Chemicals § 414...

40 CFR 414.64 - New source performance standards (NSPS)

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 28 2010-07-01 2010-07-01 true New source performance standards (NSPS) 414.64 Section 414.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORGANIC CHEMICALS, PLASTICS, AND SYNTHETIC FIBERS Commodity Organic Chemicals § 414...

40 CFR 414.64 - New source performance standards (NSPS).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 30 2013-07-01 2012-07-01 true New source performance standards (NSPS). 414.64 Section 414.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORGANIC CHEMICALS, PLASTICS, AND SYNTHETIC FIBERS Commodity Organic Chemicals § 414...

40 CFR 414.64 - New source performance standards (NSPS).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 30 2012-07-01 2012-07-01 false New source performance standards (NSPS). 414.64 Section 414.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORGANIC CHEMICALS, PLASTICS, AND SYNTHETIC FIBERS Commodity Organic Chemicals § 414...

40 CFR 425.64 - New source performance standards (NSPS).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false New source performance standards (NSPS). 425.64 Section 425.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS LEATHER TANNING AND FINISHING POINT SOURCE CATEGORY Through-the-Blue Subcategory...

The Impact of Diabetes on the Labour Force Participation and Income Poverty of Workers Aged 45–64 Years in Australia

PubMed Central

Schofield, Deborah J.; Cunich, Michelle; Shrestha, Rupendra N.; Callander, Emily J.; Passey, Megan E.; Kelly, Simon J.; Tanton, Robert; Veerman, Lennert

2014-01-01

Objective To quantify the poverty status and level of disadvantage experienced by Australians aged 45–64 years who have left the labour force due to diabetes in 2010. Research Design and Methods A purpose-built microsimulation model, Health&WealthMOD2030, was used to estimate the poverty status and level of disadvantage of those aged 45–64 years who prematurely retire from the workforce due to diabetes. A multiple regression model was used to identify significant differences in rates of income poverty and the degree of disadvantage between those out of the labour force due to diabetes and those employed full- or part-time with no diabetes. Results 63.9% of people aged 45–64 years who were out of the labour force due to diabetes were in poverty in 2010. The odds of being in poverty for those with no diabetes and employed full-time (OR of being in poverty 0.02 95%CI: 0.01–0.04) or part-time (OR of being in poverty 0.10 95%CI: 0.05–0.23) are significantly lower than those for persons not in the labour force due to diabetes. Amongst those with diabetes, those who were able to stay in either full- or part-time employment were as much as 97% less likely to be in poverty than those who had to retire early because of the condition. Sensitivity analysis was used to assess impacts of different poverty line thresholds and key socioeconomic predictors of poverty. Conclusions This study has shown that having diabetes and not being in the labour force because of this condition significantly increases the chances of living in poverty. Intervening to prevent or delay the onset of diabetes is likely to improve their living standards. PMID:24586716

Malnutrition in the First Year of Life and Personality at Age 40

ERIC Educational Resources Information Center

Galler, Janina R.; Bryce, Cyralene P.; Zichlin, Miriam L.; Waber, Deborah P.; Exner, Natalie; Fitzmaurice, Garrett M.; Costa, Paul T.

2013-01-01

Background: Early childhood malnutrition is associated with cognitive and behavioral impairment during childhood and adolescence, but studies in adulthood are limited. Methods: Using the NEO-PI-R personality inventory, we compared personality profiles at 37-43 years of age ("M" 40.3 years, "SD" 1.9) of Barbadian adults who had…

Lifelong patterns of BMI and cardiovascular phenotype in individuals aged 60-64 years in the 1946 British birth cohort study: an epidemiological study.

PubMed

Charakida, Marietta; Khan, Tauseef; Johnson, William; Finer, Nick; Woodside, John; Whincup, Peter H; Sattar, Naveed; Kuh, Diana; Hardy, Rebecca; Deanfield, John

2014-08-01

Excess body fat is associated with an increase in risk of type 2 diabetes and hypertension in adulthood and these risks can adversely affect progression of arterial disease. We aimed to assess the impact of lifelong patterns of adiposity on cardiovascular risk factors and carotid intima media thickness (cIMT) in later life in participants in the 1946 British birth cohort study. The National Survey of Health and Development Study was a nationally representative sample of 5362 singleton births to married parents in England, Scotland, and Wales, stratified by social class, during 1 week in March 1946. Our present study is based on the 60% of participants still alive and with a known present address in England, Scotland, or Wales who attended a clinic assessment after invitation aged 60-64 years. We included participants with lifetime adiposity measures, cardiovascular risk factors, and cIMT measured at 60-64 years. Participants were classified as normal weight or overweight or obese at each age (36, 43, 53, and 60-64 years) in adulthood, and childhood overweight was defined. Patterns of BMI change were identified and we used BMI to define adiposity status. We used multivariable linear regression to establish the cross-sectional association of BMI category at age 60-64 years with cIMT, adjusted for various confounders. We included 1273 (45%) of 2856 participants eligible in 2006-10 (at age 60-64 years) in this study. Compared with normal weight, overweight and obesity were associated with higher cIMT (0·029 mm, 95% CI 0·014-0·043) and systolic blood pressure (7·95 mm Hg, 5·86-10·0). Increased cIMT, systolic blood pressure, leptin, prevalence of diabetes, and reduced adiponectin were all associated with duration of exposure to adult adiposity (p<0·0001 for all). We noted little additional effect of childhood overweight. Individuals who dropped a BMI category in adulthood had lower cIMT (-0·034 mm, -0·056 to -0·013) and leptin concentrations (-0·4 ng/mL, -0�

Malnutrition in the First Year of Life and Personality at Age 40

PubMed Central

Galler, Janina R.; Bryce, Cyralene P.; Zichlin, Miriam L.; Waber, Deborah P.; Exner, Natalie; Fitzmaurice, Garrett M.; Costa, Paul T.

2013-01-01

Background Early childhood malnutrition is associated with cognitive and behavioral impairment during childhood and adolescence, but studies in adulthood are limited. Methods Using the NEO-PI-R personality inventory, we compared personality profiles at 37–43 years of age (mean 40.3 years, SD 1.9) of Barbadian adults who had experienced moderate to severe protein-energy malnutrition (PEM) in the first year of life (n=77) with healthy controls, who were former classmates of the index cases and were matched for age, sex and handedness in childhood (n=57). The previously malnourished participants had been rehabilitated, with good health and nutrition documented to 12 years of age, and study participants were followed longitudinally from childhood to 40 y. Group comparisons were adjusted for childhood and adolescent standard of living, with and without correcting for IQ. Results At the broad domain or factor level, previously malnourished participants had higher scores on Neuroticism and lower scores on Extraversion, Openness, Agreeableness and Conscientiousness than did the healthy controls At the sub-domain or facet level, previously malnourished participants reported more anxiety, vulnerability, shyness and lowered sociability, less intellectual curiosity, greater suspiciousness of others, a more egocentric than altruistic orientation, and a lowered sense of efficacy or competence. Conclusions Malnutrition limited to the first year of life with good health and nutrition documented to 12 years of age, is associated with a significant overrepresentation of adult personality trait scores outside of the average range. This outcome has important implications for a variety of important life and mental health outcomes. PMID:23488644

Malnutrition in the first year of life and personality at age 40.

PubMed

Galler, Janina R; Bryce, Cyralene P; Zichlin, Miriam L; Waber, Deborah P; Exner, Natalie; Fitzmaurice, Garrett M; Costa, Paul T

2013-08-01

Early childhood malnutrition is associated with cognitive and behavioral impairment during childhood and adolescence, but studies in adulthood are limited. Using the NEO-PI-R personality inventory, we compared personality profiles at 37-43 years of age (M 40.3 years, SD 1.9) of Barbadian adults who had experienced moderate-to-severe protein-energy malnutrition (PEM) in the first year of life (n = 77) with healthy controls, who were former classmates of the index cases and were matched for age, gender, and handedness in childhood (n = 57). The previously malnourished participants had been rehabilitated, with good health and nutrition documented up to 12 years of age, and study participants were followed longitudinally from childhood to 40 years. Group comparisons were adjusted for childhood and adolescent standard of living, with and without correcting for IQ. At the broad domain or factor level, previously malnourished participants had higher scores on Neuroticism and lower scores on Extraversion, Openness, Agreeableness, and Conscientiousness than did the healthy controls. At the subdomain or facet level, previously malnourished participants reported more anxiety, vulnerability, shyness and lowered sociability, less intellectual curiosity, greater suspiciousness of others, a more egocentric than altruistic orientation, and a lowered sense of efficacy or competence. Malnutrition limited to the first year of life with good health and nutrition documented up to 12 years of age is associated with a significant overrepresentation of adult personality trait scores outside of the average range. This outcome has important implications for a variety of important life and mental health outcomes. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

Neighborhood socioeconomic status at the age of 40 years and ischemic stroke before the age of 50 years: A nationwide cohort study from Sweden.

PubMed

Carlsson, Axel C; Li, Xinjun; Holzmann, Martin J; Ärnlöv, Johan; Wändell, Per; Gasevic, Danijela; Sundquist, Jan; Sundquist, Kristina

2017-10-01

Objective We aimed to study the association between neighborhood socioeconomic status at the age of 40 years and risk of ischemic stroke before the age of 50 years. Methods All individuals in Sweden were included if their 40th birthday occurred between 1998 and 2010. National registers were used to categorize neighborhood socioeconomic status into high, middle, and low and to retrieve information on incident ischemic strokes. Hazard ratios and their 95% confidence intervals were estimated. Results A total of 1,153,451 adults (women 48.9%) were followed for a mean of 5.5 years (SD 3.5 years), during which 1777 (0.30%) strokes among men and 1374 (0.24%) strokes among women were recorded. After adjustment for sex, marital status, education level, immigrant status, region of residence, and neighborhood services, there was a lower risk of stroke in residents from high-socioeconomic status neighborhoods (hazard ratio 0.87, 95% confidence interval 0.78-0.96), and an increased risk of stroke in adults from low-socioeconomic status neighborhoods (hazard ratio 1.16, 95% confidence interval 1.06-1.27), compared to their counterparts living in middle-socioeconomic status neighborhoods. After further adjustment for hospital diagnoses of hypertension, diabetes, heart failure, and atrial fibrillation prior to the age of 40, the higher risk in neighborhoods with low socioeconomic status was attenuated, but remained significant (hazard ratio 1.12, 95% confidence interval 1.02-1.23). Conclusions In a nationwide study of individuals between 40 and 50 years, we found that the risk of ischemic stroke differed depending on neighborhood socioeconomic status, which calls for increased efforts to prevent cardiovascular diseases in low socioeconomic status neighborhoods.

40 CFR 461.64 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Pretreatment standards for existing sources (PSES). 461.64 Section 461.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Magnesium...

40 CFR 461.64 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Pretreatment standards for existing sources (PSES). 461.64 Section 461.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Magnesium Subcategory § 461...

40 CFR 421.64 - Standards of performance for new sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Standards of performance for new sources. 421.64 Section 421.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS NONFERROUS METALS MANUFACTURING POINT SOURCE CATEGORY Secondary Copper...

40 CFR 421.64 - Standards of performance for new sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 29 2011-07-01 2009-07-01 true Standards of performance for new sources. 421.64 Section 421.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS NONFERROUS METALS MANUFACTURING POINT SOURCE CATEGORY Secondary Copper...

Prevalence of General Obesity and Abdominal Obesity in the Spanish Adult Population (Aged 25-64 Years) 2014-2015: The ENPE Study.

PubMed

Aranceta-Bartrina, Javier; Pérez-Rodrigo, Carmen; Alberdi-Aresti, Goiuri; Ramos-Carrera, Natalia; Lázaro-Masedo, Sonia

2016-06-01

According to the 2013 analysis of the Institute of Health Metrics, high body mass index values are the most important risk factor for disease in Spain. Consequently, we describe the prevalence of total obesity and abdominal obesity in the Spanish adult population (25-64 years) for 2014-2015. The sample was taken from the ENPE study, a cross-sectional study with a representative sample of the noninstitutionalized population (n = 6800) carried out between May 2014 and May 2015. This analysis refers to the population between age 25 and 64 years (n = 3966). The anthropometric measurements were performed by trained observers at participants' homes according to standard international protocols. Body mass index ≥ 25 was defined as overweight and ≥ 30 as obesity. Abdominal obesity was classified as waist > 102 cm in men and > 88 cm in women. The estimated prevalence of overweight in the Spanish adult population (25-64 years) was 39.3% 95% confidence interval [95%CI], 35.7%-42.9%). The prevalence of general obesity was 21.6% (95%CI, 19.0%-24.2%) and, more specifically, was 22.8% (95%CI, 20.6%-25.0%) among men and 20.5% (95%CI, 18.5%-22.5%) among women, and rose with age. The prevalence of abdominal obesity was estimated at 33.4% (95%CI, 31.1%-35.7%) and was higher among women (43.3%; 95%CI, 41.1%-45.8%) than among men (23.3%; 95%CI, 20.9%-25.5%), and also rose with age. The prevalence of general obesity and abdominal obesity in Spain is high, although the distribution differs according to autonomous community. A comparison with earlier data reveals a considerable increase in overweight, indicating the need for routine monitoring and comprehensive initiatives. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

38 CFR 6.4 - Proof of age, relationship and marriage.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Proof of age, relationship and marriage. 6.4 Section 6.4 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS....4 Proof of age, relationship and marriage. Whenever it is necessary for a claimant to prove age...

38 CFR 6.4 - Proof of age, relationship and marriage.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Proof of age, relationship and marriage. 6.4 Section 6.4 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS....4 Proof of age, relationship and marriage. Whenever it is necessary for a claimant to prove age...

38 CFR 6.4 - Proof of age, relationship and marriage.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Proof of age, relationship and marriage. 6.4 Section 6.4 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS....4 Proof of age, relationship and marriage. Whenever it is necessary for a claimant to prove age...

Job Loss, Unemployment and the Incidence of Hazardous Drinking during the Late 2000s Recession in Europe among Adults Aged 50-64 Years.

PubMed

Bosque-Prous, Marina; Espelt, Albert; Sordo, Luis; Guitart, Anna M; Brugal, M Teresa; Bravo, Maria J

2015-01-01

To estimate the incidence of hazardous drinking in middle-aged people during an economic recession and ascertain whether individual job loss and contextual changes in unemployment influence the incidence rate in that period. Longitudinal study based on two waves of the SHARE project (Survey of Health, Ageing and Retirement in Europe). Individuals aged 50-64 years from 11 European countries, who were not hazardous drinkers at baseline (n = 7,615), were selected for this study. We estimated the cumulative incidence of hazardous drinking (≥40g and ≥20g of pure alcohol on average in men and women, respectively) between 2006 and 2012. Furthermore, in the statistical analysis, multilevel Poisson regression models with robust variance were fitted and obtained Risk Ratios (RR) and their 95% Confidence Intervals (95%CI). Over a 6-year period, 505 subjects became hazardous drinkers, with cumulative incidence of 6.6 per 100 persons between 2006 and 2012 (95%CI:6.1-7.2). Age [RR = 1.02 (95%CI:1.00-1.04)] and becoming unemployed [RR = 1.55 (95%CI:1.08-2.23)] were independently associated with higher risk of becoming a hazardous drinker. Conversely, having poorer self-perceived health was associated with lower risk of becoming a hazardous drinker [RR = 0.75 (95%CI:0.60-0.95)]. At country-level, an increase in the unemployment rate during the study period [RR = 1.32 (95%CI:1.17-1.50)] and greater increases in the household disposable income [RR = 0.97 (95%CI:0.95-0.99)] were associated with risk of becoming a hazardous drinker. Job loss among middle-aged individuals during the economic recession was positively associated with becoming a hazardous drinker. Changes in country-level variables were also related to this drinking pattern.

Influenza vaccination health impact and cost effectiveness among adults aged 50 to 64 and 65 and older.

PubMed

Maciosek, Michael V; Solberg, Leif I; Coffield, Ashley B; Edwards, Nichol M; Goodman, Michael J

2006-07-01

Influenza causes approximately 36,000 deaths per year in the United States despite the presence of an effective vaccine. This assessment of the value of influenza vaccination to the U.S. population is part of an update to the 2001 ranking of clinical preventive services recommended by the U.S. Preventive Services Task Force. The forthcoming ranking will include the new recommendation of the Advisory Committee on Immunization Practices to extend influenza vaccination to adults aged 50 to 64 years. This service is evaluated on the two most important dimensions: burden of disease prevented and cost effectiveness. Study methods, described in a companion article, are designed to ensure consistency across many services. Over the lifetime of a birth cohort of 4 million, it is estimated that about 275,000 quality-adjusted life years (QALYs) would be saved if influenza vaccination were offered annually to all people after age 50. Eighty percent of the QALYs saved (220,000) would be achieved by offering the vaccine only to persons aged 65 and older. In year 2000 dollars, the cost effectiveness of influenza vaccination is $980 per QALY saved in persons aged 65 and older, and $28,000 per QALY saved in persons aged 50 to 64. When the costs of patient time and travel are excluded, the cost effectiveness ratio of vaccinating 50- to 64-year-olds decreases to $7200 per QALY saved, and vaccinating those aged 65 and older saves $17 per person vaccinated. Influenza vaccination is a high-impact, cost-effective service for persons aged 65 and older. Vaccinations are also cost effective for persons aged 50 to 64.

Double-Bundle Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Hybrid Grafts in Patients Over 40 Years of Age: Comparisons Between Different Age Groups.

PubMed

Nishio, Yusuke; Kondo, Eiji; Onodera, Jun; Onodera, Tomohiro; Yagi, Tomonori; Iwasaki, Norimasa; Yasuda, Kazunori

2018-05-01

Several recent studies have reported that favorable clinical results and a high level of patient satisfaction can generally be obtained with no increased risk of complications after single-bundle anterior cruciate ligament (ACL) reconstruction performed in patients >40 years of age. However, no studies have yet clarified the age-based differences in clinical outcomes after double-bundle reconstruction. To compare clinical outcomes after double-bundle ACL reconstruction using hamstring tendon hybrid grafts between patients in 2 different age groups: ≥40 years and <40 years. Cohort study; Level of evidence, 3. A retrospective study was conducted using 96 patients (48 men, 48 women ; mean age, 37 years) who underwent unilateral ACL reconstruction between 2008 and 2011. These patients were divided into 2 groups: group M included patients ≥40 years of age (n = 40 patients), and group Y included patients <40 years of age (n = 56 patients). All patients underwent the same anatomic double-bundle ACL reconstruction procedure. Clinical outcomes were evaluated at 2 years after surgery. Tunnel enlargement was also evaluated by computed digital radiography at 1 week and 2 years after surgery. Mean postoperative side-to-side differences in anterior laxity were 0.5 ± 1.9 mm and 1.2 ± 1.5 mm in groups M and Y, respectively; there was a significant difference between the 2 groups ( P = .039). There were no significant differences between the groups in Lysholm knee scores, International Knee Documentation Committee (IKDC) scores, or peak muscle torque of the hamstring. On the other hand, peak muscle torque of the quadriceps was significantly lower in group M (81%) than in group Y (89%) ( P = .025). With respect to femoral tunnel enlargement, the posterolateral tunnel in group M was significantly larger than that in group Y on anteroposterior and lateral radiographs ( P = .015 and P = .002, respectively). Equivalent clinical outcomes were seen between the 2 age groups after

Androgenetic alopecia in men aged 40-69 years: prevalence and risk factors.

PubMed

Severi, G; Sinclair, R; Hopper, J L; English, D R; McCredie, M R E; Boyle, P; Giles, G G

2003-12-01

The epidemiology of androgenetic alopecia (AGA) is not fully understood. Although a strong genetic basis has long been identified, little is known of its non-genetic causes. To estimate the prevalence of and to determine risk factors for AGA in men aged 40-69 years in Australia. Men (n = 1390) were recruited at random from the electoral rolls to serve as controls in a population-based case-control study of prostate cancer. All were interviewed in person and direct observations of AGA were made. Men were grouped into the following categories; no AGA, frontal AGA, vertex AGA and full AGA (frontal and vertex AGA). Epidemiological data collected from these men were used for an analysis of risk factors for each AGA category using unconditional logistic regression with AGA category as the response variable adjusting for age, education and country of birth. The prevalence of vertex and full AGA increased with age from 31% (age 40-55 years) to 53% (age 65-69 years). Conversely, the proportion of men with only frontal AGA was very similar across all age groups (31-33%). No associations were found between pubertal growth spurt or acne, reports of adult body size at time of interview, urinary symptom score, marital status, or current smoking status or duration of smoking and the risk of any form of AGA. The consumption of alcohol was associated with a significant increase in risk of frontal and vertex AGA but not full AGA. Men with vertex AGA had fewer female sexual partners but average ejaculatory frequency did not differ between men in different AGA categories. Reported weight and lean body mass at reaching maturity at about 21 years of age were negatively associated with vertex balding (P for trend < 0.05) but not with frontal AGA or full AGA. Evidence for environmental influences on AGA remains very slight. Our study failed to confirm previously reported or hypothesized associations with smoking and benign prostatic hypertrophy. The associations that we found with alcohol

Contraceptive needs after age 40.

PubMed

Blaney, C L

1997-01-01

Men and women are fertile and sexually active beyond age 40 years, with up to 50% of women able to conceive well into their 50s. However, the pregnancy-related risks among women over age 40 are up to 50 times greater than for women in their 20s. An unexpected pregnancy late in life is an unwelcome event for many women, leading many to abort their fetus. In 1992, more than a third of pregnant US women aged 40-44 years chose induced abortion, a higher rate than any other age group except for pregnant women 19 years old and younger. Women over age 40 therefore still need effective contraception and providers should be prepared to help those women choose methods which suit their circumstances and needs. Men can also play an important role by supporting their partners when choosing options or in practicing contraception themselves. Providers must carefully screen for health conditions which may increase the risk of using a contraceptive method. Methods for older couples, the IUD, barrier methods, and hormonal methods are discussed.

38 CFR 6.4 - Proof of age, relationship and marriage.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., relationship and marriage. 6.4 Section 6.4 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS....4 Proof of age, relationship and marriage. Whenever it is necessary for a claimant to prove age, relationship or marriage, the provisions of 38 U.S.C. 103(c) and Part 3 this chapter will be followed. [26 FR...

40 CFR 432.64 - Pretreatment standards for existing sources (PSES). [Reserved

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Pretreatment standards for existing sources (PSES). [Reserved] 432.64 Section 432.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS MEAT AND POULTRY PRODUCTS POINT SOURCE CATEGORY Meat Cutters...

40 CFR 432.64 - Pretreatment standards for existing sources (PSES). [Reserved

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Pretreatment standards for existing sources (PSES). [Reserved] 432.64 Section 432.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS MEAT AND POULTRY PRODUCTS POINT SOURCE CATEGORY Meat Cutters...

Influenza vaccination recommended for all adults aged between 50 and 64 years: conceptual basis and methodological limitations.

PubMed

Manzoli, L; De Vito, C; Flacco, M E; Marzuillo, C; Boccia, A; Villari, P

2012-01-01

In the first half of this year the experts of the Italian Society of Hygiene (SItI), along with those of other National Scientific Societies, agreed with the recommendations made by the USA CDC in 2009, and developed a proposal for a vaccination schedule (Vaccine Schedule for Life), in which influenza vaccination is recommended for all adults aged between 50 and 64 years. In the National Plan for Vaccinal Prevention 2012-2014, which was published just before the issue of the SItI Calendar but concluded earlier (end of 2011), influenza vaccination is recommended "only" for all persons > or = 65 years or included in one of the many at-risk categories. The issue is controversial and has generated considerable debate at national and international level. This short note discusses the logical processes and the scientific evidence in support or against the decision to extend the influenza vaccination. The Authors conclude that the epidemiological approach used by SItI experts is appropriate. In any case, further studies on the topic are strongly needed, and their results should be taken into account in the drafting of future vaccination schedules.

Factors influencing adherence to guidelines for screening mammography among women aged 40 years and older.

PubMed

Rahman, Saleh M M; Dignan, Mark B; Shelton, Brent J

2003-01-01

To explore patterns of adherence to guidelines for screening mammography among participants in the Colorado Mammography Project (CMAP) surveillance database. An algorithm was developed to assess factors associated with adherence to mammography screening guidelines. Of the 27,778 women ranging from 40-90 years of age included in the analysis, 41.4% were adherent with mammography screening guidelines. According to the model tested in this study, race/ethnicity (Black vs White, OR=0.76, 95% CI=0.64-0.91); educational attainment (high school vs 55,000 dollars vs <15,000 dollars, OR 1.14, 95% CI=1.03-1.26) were statistically significant predictors of adherence to guidelines. A significant interaction between age and family history of breast cancer (BC) was also found. Younger females with a family history of BC were less likely to be adherent than their counterparts without a family history (OR=0.93, 95% CI=0.90-0.96). In general, elderly women were more likely to be adherent compared with the youngest group in this cohort (OR=1.21, 95% CI=1.11-1.33). Inclusion or exclusion of women aged 70 years and older did not change the outcome of the analysis. Adherence with screening mammography guidelines was found to be associated with women's personal characteristics including race/ethnicity, age, and family history of BC. In addition, socioeconomic status, as measured by educational level and community economic status, are important predictors of adherence. Efforts to increase adherence may need to be specific to race/ethnic group and age, but the effect of age is mediated by family history of BC and vice versa.

Delivery of preventive services to adults aged 50-64: monitoring performance using a composite measure, 1997-2004.

PubMed

Shenson, Douglas; Adams, Mary; Bolen, Julie

2008-06-01

Population-based rates for the delivery of adult vaccinations or screenings are typically tracked as individual services. The current approach is useful in monitoring progress toward national health goals but does not yield information regarding how many U.S. adults receive a combination of preventive services routinely recommended based on a person's age and gender. A composite measure is important for policymaking, for developing public health interventions, and for monitoring the quality of clinical care. During the period under study, influenza vaccination was newly recommended (2000) to be routinely delivered to adults in this age range. The objective of the study was to compare the delivery of routine clinical preventive services to U.S. adults aged 50-64 years between 1997 and 2004 using a composite measure that includes cancer screenings and vaccinations. Data were collected via telephone surveys in 1997, 2002, and 2004 as part of the Behavioral Risk Factor Surveillance System. The participants were randomly selected adults aged 50-64 years in the 50 states and the District of Columbia in the selected years. Sample sizes ranged from 24,917 to 77,244. The composite measure includes screening for colorectal cancer, cervical cancer, breast cancer, and vaccination against influenza (2002 and 2004 only). The composite measure quantifies the percentage of adults who are up-to-date with the complete set according to recommended schedules. With the inclusion of newly recommended influenza vaccination, the percentage of men and women aged 50-64 who were up-to-date on all selected measures in 2004 was 23.4% and 23.0%, respectively, compared with 37.6% and 30.5% in 1997. Without including influenza vaccination, the percentage of up-to-date adults aged 50-64 would have risen in 2004 to 50.5% (men) and to 44.7% (women). For both sexes, results varied by education, race/ethnicity, marriage status, insurance status, health status, and state. In 2004, the percentage of

Sub-barrier fusion and transfers in the 40Ca + 58,64Ni systems

NASA Astrophysics Data System (ADS)

Bourgin, D.; Courtin, S.; Haas, F.; Goasduff, A.; Stefanini, A. M.; Montagnoli, G.; Montanari, D.; Corradi, L.; Huiming, J.; Scarlassara, F.; Fioretto, E.; Simenel, C.; Rowley, N.; Szilner, S.; Mijatović, T.

2016-05-01

Fusion cross sections have been measured in the 40Ca + 58Ni and 40Ca + 64Ni systems at energies around and below the Coulomb barrier. The 40Ca beam was delivered by the XTU Tandem accelerator of the Laboratori Nazionali di Legnaro and evaporation residues were measured at very forward angles with the LNL electrostatic beam deflector. Coupled-channels calculations were performed which highlight possible strong effects of neutron transfers on the fusion below the barrier in the 40Ca + 64Ni system. Microscopic time-dependent Hartree-Fock calculations have also been performed for both systems. Preliminary results are shown.

Age differences in health care spending, fiscal year 1977.

PubMed

Gibson, R M; Fisher, C R

1979-01-01

This report of health care spending in fiscal year 1977 reveals that of the $142.6 billion spent by the Nation for personal health care in fiscal year 1977, 29 percent was spent for those aged 65 or older, 59 percent for those aged 19-64, and 13 percent for those below age 19. The average health bill reached $1,745 for the aged, $661 for the intermediate age group, and $253 for the young. Public funds financed 67 percent of the health expenses of the aged, with Medicare and Medicaid together accounting for 61 percent. More than two-thirds of the health expenses of the young and 71 percent of the expenses of those aged 19-64 were paid by private sources. Third-party payments met 68 percent of the health expenditures of all those under age 65.

[Behavioral risk factors and readiness in amateur marathon runners 18-64 years of age in Bogotá, Colombia, 2014].

PubMed

Ramírez-Góngora, María Del Pilar; Prieto-Alvarado, Franklyn Edwin

2016-01-01

Participation in amateur street marathons has become increasingly popular and requires prior individual health risk assessment. The objective was to identify risk factors and readiness in registered runners. This was a cross-sectional study in a random sample (n = 510) of registered amateur runners 18-64 years of age, using a digital survey with IPAQ, Par-Q+, and STEPwise, with an expected physical inactivity rate of 35% (±5%). The study explored physical activity, (binge) alcohol consumption, fruit, vegetable, and salt intake, smoking, and readiness. Self-reported rates were: 97.4% recommended level of physical activity, 2.4% optimal fruit and vegetable intake, 3.7% smoking, and 44.1% binge drinking. 19.8% were Par-Q+ positive and 5.7% practiced supervised exercise. The analysis showed differences by age, sex, and socioeconomic status. Recreational runners followed the recommended levels of physical activity but did not score well on other risk factors. Prior evaluation of lifestyle-related risk factors and readiness provides a safer athletic strategy.

78 FR 35631 - Proposed Information Collection Request; Comment Request; 40 CFR Part 64 Compliance Assurance...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-13

... the fact that most facilities are now using electronic monitoring to conduct their recording, thus... Request; Comment Request; 40 CFR Part 64 Compliance Assurance Monitoring Program AGENCY: Environmental... an information collection request, ``40 CFR Part 64 Compliance Assurance Monitoring Program'' (EPA...

Health Care Access and Utilization Among Adults Aged 18-64, by Poverty Level: United States, 2013-2015.

PubMed

Martinez, Michael E; Ward, Brian W

2016-10-01

Data from the National Health Interview Survey, 2013-2015 •From 2013 through 2015, the percentage of adults aged 18-64 who were uninsured at the time of interview decreased for poor (40.0% to 26.2%), near-poor (37.8% to 23.9%), and not-poor (11.7% to 7.7%) adults. •The percentage of adults aged 18-64 who had a usual place to go for medical care increased for poor (66.9% to 73.6%) and near-poor (71.1% to 75.9%) adults. •The percentage of adults aged 18-64 who had seen or talked to a health professional in the past 12 months increased for poor (73.2% to 75.8%) and near-poor (71.9% to 75.9%) adults. •The percentage of adults aged 18-64 who did not obtain needed medical care due to cost at some time during the past 12 months decreased for poor (16.8% to 12.4%), near-poor (14.6% to 11.0%), and not-poor (4.9% to 3.8%) adults. In 2014, U.S. adults could purchase a private health insurance plan through the Health Insurance Marketplace or state-based exchanges established as part of the Affordable Care Act (ACA). Additionally, under ACA some states opted to expand Medicaid coverage to low-income adults. Individuals living in or near poverty may have benefited disproportionately from these changes given their lower rates of health insurance coverage (1). Data from the 2013-2015 National Health Interview Survey (NHIS) are used to describe recent changes in health insurance coverage and selected measures of health care access and utilization for adults aged 18-64 by family poverty level. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

27 CFR 40.64 - Articles of partnership or association.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Articles of partnership or....64 Articles of partnership or association. Every partnership or association, before commencing... § 40.62, a true copy of the articles of partnership or association, if any, or certificate of...

27 CFR 40.64 - Articles of partnership or association.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Articles of partnership or....64 Articles of partnership or association. Every partnership or association, before commencing... § 40.62, a true copy of the articles of partnership or association, if any, or certificate of...

27 CFR 40.64 - Articles of partnership or association.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Articles of partnership or....64 Articles of partnership or association. Every partnership or association, before commencing... § 40.62, a true copy of the articles of partnership or association, if any, or certificate of...

27 CFR 40.64 - Articles of partnership or association.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Articles of partnership or....64 Articles of partnership or association. Every partnership or association, before commencing... § 40.62, a true copy of the articles of partnership or association, if any, or certificate of...

Safety and immunogenicity of revaccination with reduced dose intradermal and standard dose intramuscular influenza vaccines in adults 18-64 years of age.

PubMed

Gorse, Geoffrey J; Falsey, Ann R; Johnson, Carol M; Morrison, Dennis; Fried, David L; Ervin, John E; Greenberg, David P; Ozol-Godfrey, Ayca; Landolfi, Victoria; Tsang, Peter H

2013-12-05

This clinical trial examined the safety and immunogenicity of annual revaccination with Fluzone(®) Intradermal (Sanofi Pasteur, Swiftwater, PA) vaccine compared to a standard intramuscular (IM) split-virion trivalent influenza vaccine (Fluzone(®), Sanofi Pasteur). This phase II, active-controlled, multi-centre, open-label trial was conducted in 2009 and 2010, and enrolled 1250 adults 18-64 years of age who were randomly selected from participants in a phase III influenza vaccine trial the previous year (NCT00772109). Subjects who had previously received the ID vaccine were randomized 2:1 to be revaccinated with the ID or IM vaccine and those who previously received the IM vaccine were randomized 1:1. Solicited reactions were recorded on the day of vaccination and continuing for the next 7 days, non-serious adverse events for 28 days, and serious adverse events for 6 months after vaccination. Hemagglutination inhibition antibody titres were assessed pre-vaccination and at day 28. Reactions were well-tolerated and resolved in the first 7 days, but erythema, induration, swelling, pruritus and ecchymosis were reported by more subjects receiving the ID vaccine than the IM vaccine. Compared to receipt of IM vaccine in the previous year, ID vaccine in the previous year led to statistically higher rates of erythema, swelling and induration after IM vaccine in the second year. Injection-site pain and systemic reactions did not differ between ID and IM vaccines. No treatment-related serious adverse events were reported. Geometric mean antibody titres, seroprotection rates, and seroconversion rates were non-inferior for the ID and IM vaccines for all three viral strains. The ID vaccine was as immunogenic as the IM vaccine, and raised no safety concerns. It can be used interchangeably with the IM vaccine for annual revaccination in adults 18-64 years of age in consecutive years without safety concerns. Copyright © 2013 Elsevier Ltd. All rights reserved.

Risk factors of hypertension among adults aged 35-64 years living in an urban slum Nairobi, Kenya.

PubMed

Olack, Beatrice; Wabwire-Mangen, Fred; Smeeth, Liam; Montgomery, Joel M; Kiwanuka, Noah; Breiman, Robert F

2015-12-17

, 1.2-3.0)], all remained significantly associated with hypertension. Hypertension in the slum is a public health problem affecting at least one in three adults aged 35-64 years. Age, marital status, wealth index, physical inactivity and body mass index are important risk factors associated with hypertension. Prevention measures targeting the modifiable risk factors associated with hypertension are warranted to curb hypertension and its progressive effects.

Prevalence and Determinants of Glaucoma in Citizens of Qatar Aged 40 Years or Older: A Community-Based Survey

PubMed Central

Al-Mansouri, Fatma A.; Kanaan, Aida; Gamra, Hamad; Khandekar, Rajiv; Hashim, Shakeel P.; Al Qahtani, Omar; Ahmed, Mohd. Farouk

2011-01-01

Background: We present the prevalence and determinants of glaucoma among subjects 40 years of age and older in Qatar. Materials and Methods: This community-based survey was held in 2009 at 49 randomly selected clusters. Demographic details and history of glaucoma was collected by the nurses. Ophthalmologists evaluated the optic disc and retina using a digital camera housed in a mobile van. Visual field was tested with an automated perimeter, the intraocular pressure with an applanation tonometer and the angle of the anterior chamber by gonioscopy. A panel of glaucoma experts diagnosed subjects with glaucoma. Results: This survey enrolled 3,149 (97.3%) participants. The age- and sex-adjusted prevalence of glaucoma in the population aged 40 years and older was 1.73% (95% confidence intervals [CI] 1.69-1.77). Accordingly, 5,641 individuals in this age group in Qatar would have glaucoma. Chronological age of 60 years and older (Odds ratio [OR] 11.1) and the presence of myopia (OR 1.78) were predictors of glaucoma. Open-angle glaucoma was diagnosed in 44 (65.7%) individuals with glaucoma. In nine (13.4%) and 15 (20.9%) subjects, angle closure glaucoma and other (post-traumatic, pseudoexfoliation) glaucoma were present. Bilateral blindness (vision <3/60) and severe visual impairment (<6/60) were found in four (6%) and three (4.5%) subjects with glaucoma, respectively. Glaucoma was treated in 36 (54%) subjects. Conclusions: The prevalence of glaucoma among citizens of Qatar aged 40 years and older was 1.71%. Glaucoma was associated with the age of 60 years and older and the presence of myopia. PMID:21731325

Trends and variability in blood lead concentrations among US adults aged 20-64 years and senior citizens aged ≥65 years.

PubMed

Jain, Ram B

2016-07-01

Using data from National Health and Nutrition Examination Survey for the period 2003-2012, the objective of this study was to evaluate trends in blood lead levels (BLL) among adults aged 20-64 years (adults) and seniors aged ≥65 years (seniors). In addition, the contribution of other factors like gender, race/ethnicity, smoking, and exposure to secondhand smoke at home in explaining variability in BLL was also evaluated by fitting regression models with log10 transformed values of BLL as dependent variables. BLL decreased over 2003-2012 (p < 0.01). Irrespective of gender, race/ethnicity, and smoking status, seniors were found to have higher BLL than adults. Based on the magnitude of differences between the 5th and 95th percentiles, variability in the levels of blood lead was found to be substantially higher among seniors than among adults. Males had statistically significantly higher adjusted BLL than females (2.32 vs. 1.76 μg/dL for seniors, p < 0.01 and 1.66 vs. 1.13 μg/dL for adults, p < 0.01). Non-Hispanic whites had statistically significantly lower adjusted BLL than non-Hispanic blacks (1.99 vs. 2.42 μg/dL for seniors, p < 0.01 and 1.22 vs. 1.42 μg/dL for adults, p < 0.01). When compared with non-smokers, smokers had statistically significantly higher BLL (2.19 vs. 1.86 μg/dL for seniors, p < 0.01 and 1.54 vs. 1.22 μg/dL for adults, p < 0.01). Non-obese had statistically significantly higher BLL than obese individuals (2.11 vs. 1.93 μg/dL for seniors, p < 0.01 and 1.48 vs. 1.27 μg/dL for adults, p < 0.01). Exposure to secondhand smoke at home (SHS) was associated with statistically significantly higher BLL than when there was no exposure to SHS (β = 0.0683, p = 0.03 for seniors; β = 0.034, p = 0.034, p < 0.01 for adults).

Access to dental care among 15–64 year old people

PubMed Central

Eslamipour, Faezeh; Heydari, Kamal; Ghaiour, Marzieh; Salehi, Hoda

2018-01-01

INTRODUCTION: The current study aims to study people's access to oral and dental health-care services and their satisfaction with the services provided to them. MATERIALS AND METHODS: A descriptive study with multi-stage sampling was conducted on 1360 people aged 16–64 years residing in Isfahan city, Iran. The required data were collected by a questionnaire which comprised of three main parts: demographic characteristics, patients’ access to oral and dental health-care services and its barriers and participants’ satisfaction with access to services. Data were analyzed by SPSS statistical software. RESULTS: The results showed 40% of participants reported an average level for oral health, and 82% of them did not have any problems regarding access to dental care facilities. The main causes of their dissatisfaction were high cost of services (60%) and insufficient health insurance coverage (40%). About 73% reported that they had to spend 30 min or less to access to a dental health-care facility. In addition, 50% of participants were satisfied with the provided services. The main reported reasons for referring to dentists were oral and dental problems (69%) and regular check-ups (15%). There was no significant relationship between participants’ gender, education level, insurance coverage, and access to dental health-care centers (P > 0.05). CONCLUSION: Most participants were satisfied with access to dental healthcare, but they were dissatisfied with the costs and inadequate insurance coverage. About half of the participants were satisfied with the services provided to them, and the highest level of satisfaction was reported for easy access to health-care centers. PMID:29693027

Age differences in health care spending, fiscal year 1976.

PubMed

Gibson, R M; Mueller, M S; Fisher, C R

1977-08-01

Of the $120.4 billion spent by the Nation for personal health care in fiscal year 1976, 29% was spent for those aged 65 or older, 15% for those under age 19, and the remaining 56% for those aged 19-64. The average health bill reached $1,521 for the aged, $547 for the intermediate age group, and $249 for the young. Public funds financed 68% of the health expenses of the aged with Medicare and Medicaid together accounting for 59%. Private sources paid 74% of the health expenses of the young and 70% of the expenses of those aged 19-64. Third-party payments met 65% of the health expenditures of all those under age 65.

[Controversial attitude to mammography screening in asymptomatic women between 40 and 50 years of age].

PubMed

Frischbier, H J

1994-01-01

The results of screening studies conducted in the United States and in Europe in females between the ages of 40 and 50 are analysed. It is shown, that the results of this study on mortality reduction are less favourable, the poorer the technique of mammography (foregoing of general two-view mammography) and the longer the time interval between two mammography screenings. Arguments are presented, that are brought forward when declining to perform general mammography screening in this age group. The author's own results, obtained in the Hamburg mammography screening study, which included from 1971 to 1986 also premenopausal women, show, that the survival rates of patients below 50 years of age with mammographically detected carcinomas of the breast do not differ from those in patients older than 50 years, according to a relevant age group classification. The advances in the technique of mammography in recent years are analysed on the basis of the author's own patient material. It is evident, that the positive predictive value has been doubled, especially in the age group between 40 and 50. An analysis of the distribution of diagnosed noninvasive carcinomas compared with the invasive carcinomas reveals, that particularly this age group has the highest percentage of identification of prognostically favourable carcinoma stages. Further analyses show, why the randomised European mammography studies could not yield a significant mortality rate improvement. A prerequisite for the inclusion of mammography screening in the legally prescribed early detection of carcinoma examinations, however, are the quality controls, whose realisation, in our health system, will have to be confirmed by the German mammography study.

Multiple skin neoplasms in subjects under 40 years of age in Goiania, Brazil

PubMed Central

Pereira, Samir; Curado, Maria Paula; Ribeiro, Ana Maria Quinteiro

2015-01-01

OBJECTIVE To describe the trend for malignant skin neoplasms in subjects under 40 years of age in a region with high ultraviolet radiation indices. METHODS A descriptive epidemiological study on melanoma and nonmelanoma skin cancers that was conducted in Goiania, Midwest Brazil, with 1,688 people under 40 years of age, between 1988 and 2009. Cases were obtained from Registro de Câncer de Base Populacional de Goiânia (Goiania’s Population-Based Cancer File). Frequency, trends, and incidence of cases with single and multiple lesions were analyzed; transplants and genetic skin diseases were found in cases with multiple lesions. RESULTS Over the period, 1,995 skin cancer cases were observed to found, of which 1,524 (90.3%) cases had single lesions and 164 (9.7%) had multiple lesions. Regarding single lesions, incidence on men was observed to have risen from 2.4 to 3.1/100,000 inhabitants; it differed significantly for women, shifting from 2.3 to 5.3/100,000 (Annual percentage change – [APC] 3.0%, p = 0.006). Regarding multiple lesions, incidence on men was observed to have risen from 0.30 to 0.98/100,000 inhabitants; for women, it rose from 0.43 to 1.16/100,000 (APC 8.6%, p = 0.003). Genetic skin diseases or transplants were found to have been correlated with 10.0% of cases with multiple lesions – an average of 5.1 lesions per patient. The average was 2.5 in cases without that correlation. CONCLUSIONS Skin cancer on women under 40 years of age has been observed to be increasing for both cases with single and multiple lesions. It is not unusual to find multiple tumors in young people – in most cases, they are not associated with genetic skin diseases or transplants. It is necessary to avoid excessive exposure to ultraviolet radiation from childhood. PMID:26465667

The Impact of Diabetes on the Labour Force Participation, Savings and Retirement Income of Workers Aged 45-64 Years in Australia

PubMed Central

Schofield, Deborah; Cunich, Michelle; Kelly, Simon; Passey, Megan E.; Shrestha, Rupendra; Callander, Emily; Tanton, Robert; Veerman, Lennert

2015-01-01

Background Diabetes is a debilitating and costly condition. The costs of reduced labour force participation due to diabetes can have severe economic impacts on individuals by reducing their living standards during working and retirement years. Methods A purpose-built microsimulation model of Australians aged 45-64 years in 2010, Health&WealthMOD2030, was used to estimate the lost savings at age 65 due to premature exit from the labour force because of diabetes. Regression models were used to examine the differences between the projected savings and retirement incomes of people at age 65 for those currently working full or part time with no chronic health condition, full or part time with diabetes, and people not in the labour force due to diabetes. Results All Australians aged 45-65 years who are employed full time in 2010 will have accumulated some savings at age 65; whereas only 90.5% of those who are out of the labour force due to diabetes will have done so. By the time they reach age 65, those who retire from the labour force early due to diabetes have a median projected savings of less than $35,000. This is far lower than the median value of total savings for those who remained in the labour force full time with no chronic condition, projected to have $638,000 at age 65. Conclusions Not only does premature retirement due to diabetes limit the immediate income available to individuals with this condition, but it also reduces their long-term financial capacity by reducing their accumulated savings and the income these savings could generate in retirement. Policies designed to support the labour force participation of those with diabetes, or interventions to prevent the onset of the disease itself, should be a priority to preserve living standards comparable with others who do not suffer from this condition. PMID:25706941

Health Insurance Coverage by Occupation Among Adults Aged 18-64 Years - 17 States, 2013-2014.

PubMed

Boal, Winifred L; Li, Jia; Sussell, Aaron

2018-06-01

Lack of health insurance has been associated with poorer health status and with difficulties accessing preventive health services and obtaining medical care, especially for chronic diseases (1-3). Among workers, the prevalence of chronic conditions, risk behaviors, and having health insurance has been shown to vary by occupation (4,5). CDC used data from the 2013 and 2014 Behavioral Risk Factor Surveillance System (BRFSS) to estimate the prevalence of having no health care coverage (e.g., health insurance, prepaid plans such as health maintenance organizations, government plans such as Medicare, or Indian Health Service) by occupation. Among all workers aged 18-64 years, the prevalence of being uninsured declined significantly (21%) from 16.0% in 2013 to 12.7% in 2014. In both years there were large differences in the prevalence of being uninsured among occupational groups, ranging from 3.6% among the architecture and engineering occupations to 37.9% among the farming, fishing, and forestry occupations in 2013 and 2.7% among community and social services; and education, training, and library occupations to 37.0% among building and grounds cleaning and maintenance occupations in 2014 (p<0.001). In 2014, more than 25% of workers in four occupational groups reported having no health insurance (construction and extraction [29.1%]; farming, fishing, and forestry [34.6%]; food preparation and serving related [35.5%]; and building and grounds cleaning and maintenance [37.0%]). Identifying factors affecting differences in coverage by occupation might help to address health disparities among occupational groups.

Incidence and prevalence of idiopathic pulmonary fibrosis in US adults 18-64 years old.

PubMed

Raghu, Ganesh; Chen, Shih-Yin; Hou, Qiang; Yeh, Wei-Shi; Collard, Harold R

2016-07-01

We sought to present the epidemiology of idiopathic pulmonary fibrosis (IPF) in adults 18-64 years old in the USA.From adults aged 18-64 years in a large administrative claims data in 2004-2010, patients with IPF were identified using diagnosis codes. We estimated annual incidence and cumulative prevalence of IPF over time, and examined potential risk factors for the IPF diagnosis.The annual cumulative prevalence increased steadily in the first few years (from 13.4 cases per 100 000 persons in 2005 to 18.2 cases in 2010 per 100 000 persons), which is likely due to a methodological reason, while the annual incidence of IPF decreased over time (from 7.9 cases per 100 000 person-years in 2005 to 5.8 cases in 2010 per 100 000 person-years). The overall decrease was mainly driven by a decreasing trend in the younger patients (aged 18-44 years), while the incidence in older patients remained stable. Consistent trends were observed in subgroups defined by previously published more restrictive algorithms for diagnosis. Older age and male sex were associated with a higher incidence of disease (p<0.05).In US adults younger than 65 years, we observed a decreasing incidence of IPF over time which may partially explain the plateau of cumulative prevalence in the last few years of our data. Copyright ©ERS 2016.

40 CFR 415.64 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 30 2013-07-01 2012-07-01 true Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Chlor-alkali Subcategory (Chlorine and Sodium or Potassium Hydroxide Production) § 415.64 Pretreatment standards for...

The benefit of myomectomy in women aged 40 years and above: Experience in an urban teaching hospital in Nigeria.

PubMed

Obed, Jesse Y; Bako, Babagana; Kadas, Saidu; Usman, Joshua D; Kullima, Abubakar A; Moruppa, Joel Y

2011-07-01

Abdominal myomectomy remains the mainstay of surgical management of uterine fibroids in our environment. However, its benefit in women aged 40 years and above remains debatable. An 11-year prospective study was conducted involving 98 women, aged 40 years and above, who had abdominal myomectomy for the treatment of uterine fibroid at the University of Maiduguri Teaching Hospital, Maiduguri. They were followed up regularly for 1-6 years to detect conception, resolution of symptoms and obstetrics performance. Data were analyzed using SPSS version 13. The mean age of the patients was 42.6±2.9 years and 77 (78.6%) of them were nulliparous. Lower abdominal swelling was the commonest clinical presentation and the mean uterine size was 18.6±8.5 weeks. Infertility with uterine fibroids was the indication for myomectomy in majority of the cases [48 (48.9%)], while pregnancy complications accounted for 11.2% (11) of the cases Fertility restoration was 10.4% among the infertile patients. There was complete resolution of symptoms in 35.9% of those who required symptomatic relief, and term pregnancies were recorded in 72.7% of patients with pregnancy complications. Myomectomy is the recommended treatment of uterine fibroids in women aged 40 years and above with infertility and who wish to become pregnant. If there is no need for further fertility preservation, hysterectomy should be offered.

40 CFR 87.64 - Sampling and analytical procedures for measuring gaseous exhaust emissions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Sampling and analytical procedures for measuring gaseous exhaust emissions. 87.64 Section 87.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM AIRCRAFT AND AIRCRAFT ENGINES...

40 CFR 256.64 - Requirements for public participation in the open dump inventory.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Requirements for public participation in the open dump inventory. 256.64 Section 256.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE...

40 CFR 256.64 - Requirements for public participation in the open dump inventory.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Requirements for public participation in the open dump inventory. 256.64 Section 256.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE...

40 CFR 256.64 - Requirements for public participation in the open dump inventory.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Requirements for public participation in the open dump inventory. 256.64 Section 256.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE...

40 CFR 256.64 - Requirements for public participation in the open dump inventory.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Requirements for public participation in the open dump inventory. 256.64 Section 256.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE...

40 CFR 256.64 - Requirements for public participation in the open dump inventory.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Requirements for public participation in the open dump inventory. 256.64 Section 256.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE...

40 CFR 87.64 - Sampling and analytical procedures for measuring gaseous exhaust emissions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Sampling and analytical procedures for measuring gaseous exhaust emissions. 87.64 Section 87.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM AIRCRAFT AND AIRCRAFT ENGINES...

Still childless at the age of 28 to 40 years: a cross-sectional study of Swedish women's and men's reproductive intentions.

PubMed

Schytt, E; Nilsen, A B V; Bernhardt, E

2014-03-01

Delayed childbearing is associated with adverse reproductive outcomes. Our aim was to investigate Swedish women's and men's childbearing intentions at the age of 28, 32, 36 and 40 years, in terms of: (1) time point for a first child, (2) number of children, and (3) reasons for not yet having children. Cross-sectional data from the Swedish Young Adult Panel Study, including 365 childless women and 356 childless men aged 28, 32, 36 and 40 years who responded to a questionnaire in 2009. Descriptive and multivariate logistic regression analyses were conducted. Most 28- and 32-year-olds intended to have children, but only 32% of women and 37% of men aged 36/40 years (merged), many of whom still postponed childbearing. Reasons for remaining childless differed by age. Most prominent in the 36/40-year-olds were: lack of a partner (women 60%, men 59%), no desire for children (women 44%, men 44%), not mature enough (women 29%, men 35%), and wanting to do other things before starting a family (women 26%, men 33%). The 36/40-year-olds had the highest odds for infertility problems (OR 3.8; CI 95% 1.8-7.9) and lacking a suitable partner (OR 1.8 CI 95% 1.1-3.0), and lower odds for reasons related to work and financial situation. Many childless 36- and 40-year-olds intended to have children but seemed to overestimate their fecundity. The most prominent reasons for being childless were: not having wanted children up to now, lack of a partner, infertility problems, and prioritising an independent life. Copyright © 2013 Elsevier B.V. All rights reserved.

Healthcare Costs and Utilization for Patients Age 50 to 64 Years with Acute Myeloid Leukemia Treated with Chemotherapy or with Chemotherapy and Allogeneic Hematopoietic Cell Transplantation.

PubMed

Preussler, Jaime M; Meyer, Christa L; Mau, Lih-Wen; Majhail, Navneet S; Denzen, Ellen M; Edsall, Kristen C; Farnia, Stephanie H; Saber, Wael; Burns, Linda J; Vanness, David J

2017-06-01

The primary aim of this study was to describe healthcare costs and utilization during the first year after a diagnosis of acute myeloid leukemia (AML) for privately insured non-Medicare patients in the United States aged 50 to 64 years who were treated with either chemotherapy or chemotherapy and allogeneic hematopoietic cell transplantation (alloHCT). MarketScan (Truven Health Analytics) adjudicated total payments for inpatient, outpatient, and prescription drug claims from 2007 to 2011 were used to estimate costs from the health system perspective. Stabilized inverse propensity score weights were constructed using logistic regression to account for differential selection of alloHCT over chemotherapy. Weighted generalized linear models adjusted costs and utilization (hospitalizations, inpatient days, and outpatient visit-days) for differences in age, sex, diagnosis year, region, insurance plan type, Elixhauser Comorbidity Index), and 60-day prediagnosis costs. Because mortality data were not available, models could not be adjusted for survival times. Among 29,915 patients with a primary diagnosis of AML, 985 patients met inclusion criteria (774 [79%] receiving chemotherapy alone and 211 [21%] alloHCT). Adjusted mean 1-year costs were $280,788 for chemotherapy and $544,178 for alloHCT. Patients receiving chemotherapy alone had a mean of 4 hospitalizations, 52.9 inpatient days, and 52.4 outpatient visits in the year after AML diagnosis; patients receiving alloHCT had 5 hospitalizations, 92.5 inpatient days, and 74.5 outpatient visits. Treating AML in the first year after diagnosis incurs substantial healthcare costs and utilization with chemotherapy alone and with alloHCT. Our analysis informs healthcare providers, policymakers, and payers so they can better understand treatment costs and utilization for privately insured patients aged 50 to 64 with AML. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All

Bone mineral density at distal forearm in men over 40 years of age in Mae Chaem district, Chiang Mai Province, Thailand: a pilot study.

PubMed

Tungjai, Montree; Kaewjaeng, Siriprapa; Jumpee, Chayanit; Sriburee, Sompong; Hongsriti, Pongsiri; Tapanya, Monruedee; Maghanemi, Utumma; Ratanasthien, Kwanchai; Kothan, Suchart

2017-09-01

To study the prevalence of bone mineral density (BMD) and osteoporosis in the distal forearm among Thai men over 40 years of age in Mae Chaem District, Chiang Mai Province, Thailand. The subjects in this study were 194 Thai men, aged between 40 and 87 years who resided in Mae Chaem District, Chiang Mai Province, Thailand. Self-administered questionnaires were used for receiving the demographic characteristics information. BMD was measured by peripheral dual energy X-ray absorptiometry at the nondominant distal forearm in all men. The BMD was highest in the age-group 40-49 years and lowest in the age-group 70-87 years. The average T-score at the distal forearm was also highest in the age-group 40-49 years and lowest in the age-group 70-87 years. The BMD decreased as a function of age-group (p < .05). In contrast, the BMD increased as a function of weight (p < .05). Height had weak impact on the BMD in the distal forearm (p > .05). The percentage of osteopenia and osteoporosis are increased as a function of age-group in, while decreased in that of normal bone density. We found the prevalence of osteoporosis in men who resided in Mae Chaem District, Chiang Mai Province, Thailand.

Comparison of Different Physical Activity Measurement Methods in Adults Aged 45 to 64 Years Under Free-Living Conditions.

PubMed

Lipert, Anna; Jegier, Anna

2017-07-01

To compare physical activity (PA) measured by 4 methods in adults under free-living conditions in relation to selected demographic and anthropometric variables. Cohort study. Department of Sports Medicine. Clinically healthy men (81) and women (69) aged 45 to 64 years. Physical activity monitoring for 7 consecutive days under free-living conditions by pedometer (P) and accelerometer (A) simultaneously and PA questionnaires: International Physical Activity Questionnaire (IPAQ) and Seven-Day Physical Activity Questionnaire Recall (SDPAR) completed after the 7-day PA. Comparison of PA measured by pedometer, IPAQ, and SDPAR with accelerometer with regard to age, body mass, gender, and obesity type. Total energy expenditure (EE) by IPAQ was higher than A (P < 0.001) in both groups regardless of age, body mass, or obesity type. Mean EE value by P was greater than A (P < 0.001) in central-obesity males and lower than A (P < 0.001) in central-obesity females. There were differences in step counts in women, unnoticed in men. SDPAR overestimated total EE in gynoid-obesity males and in central-obesity females compared with A. Ninety-five percent CI was the largest around IPAQ compared with P and SDPAR, with SDPAR showing the best agreement with A. Body mass and obesity type influenced PA measurements. To monitor PA, it is recommended to use pedometer in normal bodyweight and overweight groups while accelerometer is advisable in obese subjects. A combined approach of objective and subjective PA monitoring tools is preferable.

[Vaccination against viral hepatitis A and B in adults aged over 40 years--antibody persistence and immune memory].

PubMed

Chlibek, R; Smetana, J; Bostíková, V; Splino, M

2011-09-01

Primary vaccination with combined vaccine against viral hepatitis A (VHA) and viral hepatitis B (VHB) induces higher anti-hepatitis B surface (anti-HBs) antibody responses and similar anti-hepatitis A virus (anti-HAV) antibody responses in adults aged over 40 years in comparison with concomitant monovalent vaccines against VHA and VHB. Th e objectives were to assess, in a clinical study, persistence of anti-HAV and anti-HBs antibodies in adults aged over 40 years four years after primary VHA/VHB vaccination and antibody response following a booster dose of the vaccine. Five hundred and ninety-six subjects aged > 40 years were vaccinated with three doses of the combined VHA/VHB vaccine at Months 0, 1, 6 (HAB group) or with concomitant VHA and VHB vaccines at Months 0, 6 and 0, 1, 6 (ENG+HAV and HBVX+VAQ, respectively). Blood samples were collected one month following primary vaccination (Month 7) and then at one-year intervals for four years after the booster dose with the same vaccine as used for the primary vaccination. The anti-HBs and anti-HAV antibody levels were determined prior to the booster dose and at days 14 and 30 after the booster dose. At Month 7, > 97% of study subjects were seropositive for anti-HAV antibodies in all groups analyzed. Four years after primary vaccination, anti-HAV antibody seropositivity persisted in > 93% of study subjects, increasing to > 99% after the booster dose. At Month 7, the highest proportion of study subjects with anti-HBs antibody levels > or = 10 mIU/ml was found in the HAB group (91.7% versus 79.7% in the ENG+HAV group versus 71.0% in the HBVX+VAQ group). Four years after vaccination, anti-HBs antibody levels of 10 mIU/ml persisted in 57.1% of the HAB study subjects in comparison with 40.1% and 26.6% of the study subjects in the ENG+HAV and HBVX+VAQ groups, respectively. One month after the booster dose, anti-HBs antibody levels increased and antibody levels > or = 10 mIU/ml was achived in 95.2% of study subjects in the

Medical Injection Use Among Adults and Adolescents Aged 15 to 64 Years in Kenya: Results From a National Survey

PubMed Central

Kimani, Daniel; Kamau, Rachel; Ssempijja, Victor; Robinson, Katherine; Oluoch, Tom; Njeru, Mercy; Mwangi, Jane; Njogu, David; Kim, Andrea A.

2016-01-01

Background Unsafe medical injections remain a potential route of HIV transmission in Kenya. We used data from a national survey in Kenya to study the magnitude of medical injection use, medication preference, and disposal of medical waste in the community. Methods The Kenya AIDS Indicator Survey 2012 was a nationally representative population-based survey. Among participants aged 15–64 years, data were collected regarding medical injections received in the year preceding the interview; blood samples were collected from participants for HIV testing. Results Of the 13,673 participants who answered questions on medical injections, 35.9% [95% confidence interval (CI): 34.5 to 37.3] reported receiving ≥1 injection in the past 12 months and 51.2% (95% CI: 49.7 to 52.8) preferred receiving an injection over a pill. Among those who received an injection from a health care provider, 95.9% (95% CI: 95.2 to 96.7) observed him/her open a new injection pack, and 7.4% (95% CI: 6.4 to 8.4) had seen a used syringe or needle near their home or community in the past 12 months. Men who had received ≥1 injection in the past 12 months (adjusted odds ratio, 3.2; 95% CI: 1.2 to 8.9) and women who had received an injection in the past 12 months, not for family planning purposes (adjusted odds ratio, 2.6; 95% CI: 1.2 to 5.5), were significantly more likely to be HIV infected compared with those who had not received medical injection in the past 12 months. Conclusions Injection preference may contribute to high rates of injections in Kenya. Exposure to unsafe medical waste in the community poses risks for injury and infection. We recommend that community- and facility-based injection safety strategies be integrated in disease prevention programs. PMID:24413041

Lifestyle habits and mortality from all and specific causes of death: 40-year follow-up in the Italian Rural Areas of the Seven Countries Study.

PubMed

Menotti, A; Puddu, P E; Lanti, M; Maiani, G; Catasta, G; Fidanza, A Alberti

2014-03-01

Three lifestyle factors were investigated in a population study to explore their relationships with a long-term mortality. In a cohort of 1564 men aged 45-64 and examined in 1965 within the Italian Rural Areas of the Seven Countries Study, smoking habits, physical activity at work and eating habits (as derived from factor analysis) were determined. During the follow-up 693 men died in 20 years and 1441 in 40 years. In Cox proportional hazards models men smoking cigarettes (versus never smokers), those having a sedentary activity (versus the very active) and those following the Diet Score 1, indexing an unhealthy Diet (versus men with a Diet close to the healthy Mediterranean style) had highly significant hazards ratios (HR) in relations with 20- and 40-year mortality from all causes, coronary heart disease (CHD), cardiovascular disease (CVD) and cancer. HR for all causes in 40 years were 1.44 (95% confidence intervals, CI, 1.27 and 1.64) for smokers, 1.43 (CI 1.23 and 1.67) for sedentary people, and 1.31 (CI 1.15 and 1.50) for men with unhealthy diet. Larger HR were found for CHD, CVD and cancers deaths. Combination of 3 unhealthy risk factors versus their absence was associated with 4.8-year life loss in the 20-year follow-up and 10.7-year in the 40-year follow-up. Lifestyle behavior linked to physical activity and smoking and eating habits is strongly associated with mortality and survival in middle aged men during long-term follow-up.

Influenza Vaccination Coverage Rate according to the Pulmonary Function of Korean Adults Aged 40 Years and Over: Analysis of the Fifth Korean National Health and Nutrition Examination Survey

PubMed Central

2016-01-01

Influenza vaccination is an effective strategy to reduce morbidity and mortality, particularly for those who have decreased lung functions. This study was to identify the factors that affect vaccination coverage according to the results of pulmonary function tests depending on the age. In this cross-sectional study, data were obtained from 3,224 adults over the age of 40 who participated in the fifth National Health and Nutrition Examination Survey and underwent pulmonary function testing in 2012. To identify the factors that affect vaccination rate, logistic regression analysis was conducted after dividing the subjects into two groups based on the age of 65. Influenza vaccination coverage of the entire subjects was 45.2%, and 76.8% for those aged 65 and over. The group with abnormal pulmonary function had a higher vaccination rate than the normal group, but any pulmonary dysfunction or history of COPD did not affect the vaccination coverage in the multivariate analysis. The subjects who were 40-64 years-old had higher vaccination coverage when they were less educated or with restricted activity level, received health screenings, and had chronic diseases. Those aged 65 and over had significantly higher vaccination coverage only when they received regular health screenings. Any pulmonary dysfunction or having COPD showed no significant correlation with the vaccination coverage in the Korean adult population. PMID:27134491

Delivery outcome after trial of labor in nulliparous women over 40 years of age - a population-based study.

PubMed

Ankarcrona, Victoria; Altman, Daniel; Wikström, Anna-Karin; Jacobsson, Bo; Brismar Wendel, Sophia

2018-05-17

An increasing proportion of nulliparous women are over 40 years and labor is more often induced. The aim of this study was to assess delivery outcome in women over 40 years, accounting for the interaction between age and induction. Population-based study of 1 644 598 nulliparous women with live singleton cephalic term deliveries 1992 to 2011. Risks of intrapartum cesarean section, operative vaginal delivery, obstetric anal sphincter injury (OASIS), and 5-minutes Apgar score <7 were calculated in women ≥40 years with induced or spontaneous labor, and women <40 years with induced labor by unconditional logistic regression, and presented with crude and adjusted odds ratios (aOR) with 95% confidence intervals (95%CI). Women <40 years with spontaneous labor were used as reference. Intrapartum cesarean section was performed in 19.2% (aOR 3.14, 95%CI 2.94-3.35) of women ≥40 years with induced labor, 7.3% (aOR 1.51, 95%CI 1.44-1.58) with spontaneous labor, and 15.6% (aOR 2.48, 95%CI 2.43-2.53) of induced women <40 years, compared to 4.4% in the reference group. Operative vaginal delivery occurred in 9.8% (aOR 1.05, 95%CI 0.96-1.14) of women ≥40 years with induced labor and in 7.3% (aOR 0.94, 95%CI 0.90-0.99) with spontaneous labor. Obstetric anal sphincter injury was not increased in women ≥40 years. Apgar <7 at 5 minutes was similar in all groups. Trial of labor was successful in most women ≥40 years, even after induction of labor. Intrapartum cesarean section was more common compared to women <40, while operative vaginal delivery, obstetric anal sphincter injury, and low Apgar was not. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

[Glenohumeral instability in patients over 40 years-old: injuries, treatment and complications].

PubMed

López-Hualda, A; Marín-Aguado, M A; Valencia-García, H; López-González, D; Gavín-González, C

2014-01-01

Recurrent shoulder dislocation is infrequent after forty years and presents different injuries than younger patients. To compare injuries and complications after surgery between one group older than forty years of age and another younger group. A review was made o all patients who had undergone arthroscopic surgery due to glenohumeral instability from 1999 until 2011. The mean follow-up was 64 months. The case group consisted of all patients older than 40 years at the time of the surgery (n=21), which was compared with a similar sized control group of randomly selected younger patients (n=27). The mean age in the older group was 54 years (SD 11.86), while it was 26 years (SD 5.80) in the younger group. No differences were founded between both groups in labrum injury, Hill-Sachs injury, and bone Bankart lesion (P>.05). Rotator cuff tears were 7.3 times (95% CI; 2.5-21.6) more frequent in the older group (81%) compared to the younger group (P<.05). However, neurological injuries after dislocation were not more frequent in this group. There was no significant difference between the complications after surgery and the age according to the design (P>.05). Anterior recurrent dislocation after forty years of age is usually associated with rotator cuff tears. Arthroscopic treatment of instability was effective with no more postoperative complications. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

Age is associated with asthma phenotypes.

PubMed

Ponte, Eduardo V; Lima, Aline; Almeida, Paula C A; de Jesus, Juliana P V; Lima, Valmar B; Scichilone, Nicola; Souza-Machado, Adelmir; Cruz, Álvaro A

2017-11-01

The relationship between age and asthma phenotypes is important as population is ageing, asthma is becoming common in older ages and recently developed treatments for asthma are guided by phenotypes. The aim of this study is to evaluate whether age is associated with specific asthma phenotypes. This is a cross-sectional study. We included subjects with asthma of varied degrees of severity. Subjects underwent spirometry, skin prick test to aeroallergens, answered the Asthma Control Questionnaire and had blood samples collected. We performed binary logistic regression analysis to evaluate whether age is associated with asthma phenotypes. We enrolled 868 subjects. In comparison with subjects ≤ 40 years, older subjects had high odds of irreversible airway obstruction (from 41 to 64 years, OR: 1.83 (95% CI: 1.32-2.54); ≥65 years, OR: 3.45 (2.12-5.60)) and severe asthma phenotypes (from 41 to 64 years, OR: 3.23 (2.26-4.62); ≥65 years, OR: 4.55 (2.39-8.67)). Older subjects had low odds of atopic (from 41 to 64 years, OR: 0.56 (0.39-0.79); ≥65 years, OR: 0.47 (0.27-0.84)) and eosinophilic phenotypes (from 41 to 64 years, OR: 0.63 (0.46-0.84); ≥65 years, OR: 0.39 (0.24-0.64)). Older subjects with asthma have low odds of atopic and eosinophilic phenotypes, whereas they present high odds of irreversible airway obstruction and severe asthma. © 2017 Asian Pacific Society of Respirology.

A randomized controlled trial on the efficacy of thoracic CT screening for lung cancer in non-smokers and smokers of <30 pack-years aged 50-64 years (JECS study): research design.

PubMed

Sagawa, Motoyasu; Nakayama, Tomio; Tanaka, Makoto; Sakuma, Tsutomu; Sobue, Tomotaka

2012-12-01

In order to assess the efficacy of lung cancer screening using low-dose thoracic computed tomography, compared with chest roentgenography, in people aged 50-64 years with a smoking history of <30 pack-years, a randomized controlled trial is being conducted in Japan. The screening methods are randomly assigned individually. The duration of this trial is 10 years. In the intervention arm, low-dose thoracic computed tomography is performed for each participant in the first and the sixth years. In the control arm, chest roentgenography is performed for each participant in the first year. The participants in both arms are also encouraged to receive routine lung cancer screening using chest roentgenography annually. The interpretation of radiological findings and the follow-up of undiagnosed nodules are to be carried out according to the guidelines published in Japan. The required sample size is calculated to be 17 500 subjects for each arm.

Exploring the influence of transfer channels on fusion reactions: The case of 40 Ca + 58,64 Ni

DOE PAGES

Bourgin, D.; Courtin, S.; Haas, F.; ...

2015-01-29

Fusion cross sections have been measured in the 40Ca + 58Ni and 40Ca + 64Ni systems at beam energies ranging from E lab = 104.75 MeV to 153.5 MeV using the Laboratori Nazionali di Legnaro electrostatic deflector. Distributions of barriers have been extracted from the experimental data. Preliminary coupled channel calculations were performed and hints of effects of neutron transfers on the fusion below the barrier in the 40Ca + 64Ni are discussed.

Erectile dysfunction and correlated factors in Brazilian men aged 18-40 years.

PubMed

Martins, Fernando Gonini; Abdo, Carmita Helena Najjar

2010-06-01

Few population-based studies in erectile dysfunction (ED) included subjects less than 40 years old and analyzed the several factors and consequences potentially associated with this condition. Evaluation of the prevalence of erectile dysfunction (ED) and associated factors in a sample of Brazilian men aged 18 to 40 years old. Cross-sectional study in which subjects were contacted in public places of 18 major Brazilian cities and interviewed using an anonymous questionnaire. Survey data were submitted to chi-squared, student's t-test and logistic regression analyses. The data were collected by means of a self-administered questionnaire with 87 questions about sociodemographic variables, general health, habits and lifestyle-related factors, sexual behavior and sexual difficulties, including ED which was assessed by a single question. Prevalence of ED in 1,947 men was 35.0% (73.7% mild, 26.3% moderate/complete). Greater frequency of ED was seen in subjects that never had information about sex, experienced difficulties in the beginning of sexual life and have never masturbated. ED was associated to lower level of education, but not to race, sexual orientation, employment or marital status. Also, no association was found between ED and smoking, alcoholism, obesity, sedentary life, diabetes, hypertension, cardiovascular disease, hyperlipidemia, depression or anxiety. ED caused negative impact in men's self-esteem, interpersonal relationships, work and leisure activities, and in sexual life satisfaction. Less than 10% of men with ED had received medical treatment for this problem. Prevalence of ED in this young population was high, mostly of mild severity. Low education and psychosocial problems were associated to ED and, due probably to the sample subjects' young age, no association was found with organic problems. Measures in the fields of education and psychosocial difficulties prevention would have a positive impact in the control of erectile dysfunction in the young

Impairment of sexual activity in middle-aged women in Chile.

PubMed

Blümel, Juan Enrique; Castelo-Branco, Camil; Cancelo, María Jesús; Romero, Hernán; Aprikian, Daniel; Sarrá, Salvador

2004-01-01

It has been suggested that approximately 40% of women between 40 and 64 years of age cease their sexual activity. Our objective was to examine the reasons that sexual activity has stopped and to determine the effect that this behavior has on the marital stability of those middle-aged women. A total of 534 healthy women between 40 and 64 years of age who were attending the Southern Metropolitan Health Service in Santiago, Chile, were asked to take part in the study. The main reasons for sexual inactivity in middle-aged women were sexual dysfunction (49.2%), unpleasant personal relationship with a partner (17.9%), and lack of a partner (17.7%). These reasons vary with aging; in women younger than 45 years, the most frequent reason was erectile dysfunction (40.7%); in those between 45 and 59, low sexual desire (40.5%); and, in women older than 60 years, the lack of a partner (32.4%). Sexual inactivity did not affect marital stability because women without sexual relationships (68.2% of the entire sample) were married. Among the divorced women, female sexual dysfunction was responsible for only 11.7% of the separations. Low sexual desire is the main reason for ceasing sexual activity. Nevertheless, stopping sexual relationships does not seem to be important in marital stability.

Evaluation of mammographic surveillance services in women aged 40-49 years with a moderate family history of breast cancer: a single-arm cohort study.

PubMed

Duffy, S W; Mackay, J; Thomas, S; Anderson, E; Chen, T H H; Ellis, I; Evans, G; Fielder, H; Fox, R; Gui, G; Macmillan, D; Moss, S; Rogers, C; Sibbering, M; Wallis, M; Warren, R; Watson, E; Whynes, D; Allgood, P; Caunt, J

2013-03-01

Women with a significant family history of breast cancer are often offered more intensive and earlier surveillance than is offered to the general population in the National Breast Screening Programme. Up to now, this strategy has not been fully evaluated. To evaluate the benefit of mammographic surveillance for women aged 40-49 years at moderate risk of breast cancer due to family history. The study is referred to as FH01. This was a single-arm cohort study with recruitment taking place between January 2003 and February 2007. Recruits were women aged < 50 years with a family history of breast or ovarian cancer conferring at least a 3% risk of breast cancer between ages 40 and 49 years. The women were offered annual mammography for at least 5 years and observed for the occurrence of breast cancer during the surveillance period. The age group 40-44 years was targeted so that they would still be aged < 50 years after 5 years of surveillance. Seventy-four surveillance centres in England, Wales, Scotland and Northern Ireland. A total of 6710 women, 94% of whom were aged < 45 years at recruitment, with a family history of breast cancer estimated to imply at least a 3% risk of the disease between the ages of 40 and 50 years. Annual mammography for at least 5 years. The primary study end point was the predicted risk of death from breast cancer as estimated from the size, lymph node status and grade of the tumours diagnosed. This was compared with the control group from the UK Breast Screening Age Trial (Age Trial), adjusting for the different underlying incidence in the two populations. As of December 2010, there were 165 breast cancers diagnosed in 37,025 person-years of observation and 30,556 mammographic screening episodes. Of these, 122 (74%) were diagnosed at screening. The cancers included 44 (27%) cases of ductal carcinoma in situ. There were 19 predicted deaths in 37,025 person-years in FH01, with an estimated incidence of 6.3 per 1000 per year. The corresponding

BRCA Genetic Testing and Receipt of Preventive Interventions Among Women Aged 18-64 Years with Employer-Sponsored Health Insurance in Nonmetropolitan and Metropolitan Areas - United States, 2009-2014.

PubMed

Kolor, Katherine; Chen, Zhuo; Grosse, Scott D; Rodriguez, Juan L; Green, Ridgely Fisk; Dotson, W David; Bowen, M Scott; Lynch, Julie A; Khoury, Muin J

2017-09-08

Genetic testing for breast cancer 1 (BRCA1) and breast cancer 2 (BRCA2) gene mutations can identify women at increased risk for breast and ovarian cancer. These testing results can be used to select preventive interventions and guide treatment. Differences between nonmetropolitan and metropolitan populations in rates of BRCA testing and receipt of preventive interventions after testing have not previously been examined. 2009-2014. Medical claims data from Truven Health Analytics MarketScan Commercial Claims and Encounters databases were used to estimate rates of BRCA testing and receipt of preventive interventions after BRCA testing among women aged 18-64 years with employer-sponsored health insurance in metropolitan and nonmetropolitan areas of the United States, both nationally and regionally. From 2009 to 2014, BRCA testing rates per 100,000 women aged 18-64 years with employer-sponsored health insurance increased 2.3 times (102.7 to 237.8) in metropolitan areas and 3.0 times (64.8 to 191.3) in nonmetropolitan areas. The relative difference in BRCA testing rates between metropolitan and nonmetropolitan areas decreased from 37% in 2009 (102.7 versus 64.8) to 20% in 2014 (237.8 versus 191.3). The relative difference in BRCA testing rates between metropolitan and nonmetropolitan areas decreased more over time in younger women than in older women and decreased in all regions except the West. Receipt of preventive services 90 days after BRCA testing in metropolitan versus nonmetropolitan areas throughout the period varied by service: the percentage of women who received a mastectomy was similar, the percentage of women who received magnetic resonance imaging of the breast was lower in nonmetropolitan areas (as low as 5.8% in 2014 to as high as 8.2% in 2011) than metropolitan areas (as low as 7.3% in 2014 to as high as 10.3% in 2011), and the percentage of women who received mammography was lower in nonmetropolitan areas in earlier years but was similar in later years

[Prevalence of metabolic syndrome in indigenous people over 40 years of age in Rio Grande do Sul, Brazil].

PubMed

da Rocha, Ana Karina Silva; Bós, Angelo José Gonçalves; Huttner, Edison; Machado, Denise Cantarelli

2011-01-01

To investigate the prevalence of the metabolic syndrome (MS) among indigenous people older than 40 years of age from two cities in the State of Rio Grande do Sul, southern Brazil. A descriptive, analytic, cross-sectional study was conducted in two municipalities, Porto Alegre and Nonoai, between July and August 2009. A total of 150 indigenous people older than 40 years of age (range: 40-104 years), participated in the study. MS prevalence was determined based on National Cholesterol Education Program - Adult Treatment Panel III criteria. Blood samples and anthropometric data were collected. The participants also answered a questionnaire on eating habits, which was then contrasted to the 10 steps to healthy eating proposed by the World Health Organization and recommended by the Brazilian Ministry of Health. MS prevalence was 65.3%, affecting women more than men (P < 0.001). Changes in waist circumference, fasting glucose, and HDL-cholesterol and presence of hypertension, hypertriglyceridemia, and obesity were associated with MS. Age, smoking, and sedentary lifestyle were not associated with MS. Indigenous people with MS had a poor diet, with low intake of fruit and vegetables, low levels of physical activity, high consumption of sweets and soft drinks, and high prevalence of obesity. A high prevalence of MS was observed among the indigenous people surveyed, especially in women. Education and motivation for healthy behaviors is possibly the best way to manage MS and promote health in a population that is still neglected by public health policies.

High Prevalence of Hypertension in a Danish Population Telemedical Home Measurement of Blood Pressure in Citizens Aged 55-64 Years in Holstebro County.

PubMed

Hoffmann-Petersen, Nikolai; Lauritzen, Torsten; Bech, Jesper Nørgaard; Pedersen, Erling Bjerregaard

2016-04-01

Home blood pressure (HBP) is prognostically superior to office BP (OBP) and similar to ambulatory BP measurements. We determined the prevalence of hypertension using HBP with telemedical data transmission in the municipality of Holstebro, Denmark (57,000 citizens). Using the Civil Registration System, we invited citizens aged 55-64 years to have their OBP and HBP measured using telemedical data transmission. Elevated OBP was defined as ≥140/90mm Hg. HBP was measured 3 times daily on 3 consecutive days with 3 measurements on each occasion. HBP was the mean of all measurements on day 1 and 3, and hypertension was defined as ≥135/85mm Hg. We included 3,102 citizens who had performed at least 12 HBP measurements during day 2 and 3. Group 1: (n = 1,464, 47%) had both normal OBP and HBP. Group 2: (n = 838, 27%) had both elevated OBP and HBP indicating persistent hypertension. Group 3: (n = 560, 18%) had elevated OBP and normal HBP indicating white coat hypertension (WCH). Group 4: (n = 240, 8%) had normal OBP and elevated HBP indicating masked hypertension (MH). Thus, 1,078 (35%, groups 2 and 4) were untreated or insufficiently treated. Awareness of hypertension was registered in 950 patients (31%) and of these 49% had a normal HBP. This is the first large-scale study to eliminate completely reporting bias by using telemedical transmission of BP data. One third of citizens in the age group 55-64 years had an abnormally high HBP, and one fourth either had WCH or MH. ClinicalTrials.gov identification number: NCT02355392. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Marital history from age 15 to 40 years and subsequent 10-year mortality: a longitudinal study of Danish males born in 1953.

PubMed

Lund, Rikke; Holstein, Bjørn Evald; Osler, Merete

2004-04-01

The aims of the present study are to analyse the association between marital status at age 24, 29, 34, and 39 years and subsequent mortality in a cohort of men born in 1953 (sensitive period); to study the impact of number of years married, number of years divorced/widowed, and number of marital break-ups on mortality (cumulative effect), and to examine whether these effects were independent of marital status at age 39 (proximity effect). Prospective birth cohort study with follow-up of mortality from 1992 to 2002. Participants were 10891 men born within the metropolitan area of Copenhagen, Denmark. Marital status in 1992 as well as start and termination of all previous marital status events from 1968 to 1992 were retrieved from the Danish Civil Registration System. Were hazard ratios (HR) for all-cause mortality from age 40 to 49 years. We found a strong protective effect of being married compared with never being married or divorced/widowed at every age. The association increased in strength with increasing age. Number of years divorced was associated with increased mortality risk in a dose-dependent manner at age 34 and 39 years. One or more marital break-ups was associated with higher mortality, whereas increasing number of years married was associated with lower mortality. Inclusion of current marital status attenuated the strength of the associations but most of them remained statistically significant. Marital status and cumulated marital periods, especially cumulated periods divorced/widowed are strong independent predictors of mortality among younger males.

[Epidemiology of accidents in a cohort of adults over 64 years old in the Autonomous Community of the Basque Country].

PubMed

de Castro, Visitación; Mokoroa, Olatz; Artieda, Juncal; Muniozguren, Nerea; Etxebarriarteun, Larraitz; Alvarez, Lorea; Garcia Calabuig, Miguel Angel

2015-01-01

Accidents represent a significant health problem for elderly people. The objective of this study was to assess the incidence of accidents in over-64-year-olds in the Basque Country population, and to describe the clinical-epidemiological features leading to them. This was a prospective cohort study of 15,192 non-institutionalised individuals over 64 years of age, conducted under the auspices of the Basque Sentinel Practice Network (Red Vigía) over one year. A questionnaire was completed for each accident. The rates and risks of accidents were calculated by sex and age group of the individuals who had the accidents. The rates of accidents were 46.52 and 81.87 per 1000 men and women, respectively. The most common type of accident was a fall (92%), and the most severe injuries were fractures (17%), with the risk of an accident being significantly higher in women and in the over-75-year-olds. These data reflect the scale of accidents in over-64-year-olds in the Basque Country. The most frequent accident was the fall, which represents a dramatic event among the elderly, being one of the main causes of injury, disability and institutionalisation among this population group. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

High Prevalence of Hypertension in a Danish Population Telemedical Home Measurement of Blood Pressure in Citizens Aged 55–64 Years in Holstebro County

PubMed Central

Lauritzen, Torsten; Bech, Jesper Nørgaard; Pedersen, Erling Bjerregaard

2016-01-01

BACKGROUND Home blood pressure (HBP) is prognostically superior to office BP (OBP) and similar to ambulatory BP measurements. We determined the prevalence of hypertension using HBP with telemedical data transmission in the municipality of Holstebro, Denmark (57,000 citizens). METHODS Using the Civil Registration System, we invited citizens aged 55–64 years to have their OBP and HBP measured using telemedical data transmission. Elevated OBP was defined as ≥140/90mm Hg. HBP was measured 3 times daily on 3 consecutive days with 3 measurements on each occasion. HBP was the mean of all measurements on day 1 and 3, and hypertension was defined as ≥135/85mm Hg. RESULTS We included 3,102 citizens who had performed at least 12 HBP measurements during day 2 and 3. Group 1: (n = 1,464, 47%) had both normal OBP and HBP. Group 2: (n = 838, 27%) had both elevated OBP and HBP indicating persistent hypertension. Group 3: (n = 560, 18%) had elevated OBP and normal HBP indicating white coat hypertension (WCH). Group 4: (n = 240, 8%) had normal OBP and elevated HBP indicating masked hypertension (MH). Thus, 1,078 (35%, groups 2 and 4) were untreated or insufficiently treated. Awareness of hypertension was registered in 950 patients (31%) and of these 49% had a normal HBP. CONCLUSIONS This is the first large-scale study to eliminate completely reporting bias by using telemedical transmission of BP data. One third of citizens in the age group 55–64 years had an abnormally high HBP, and one fourth either had WCH or MH. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov identification number: NCT02355392 PMID:26208671

Intradermally-administered influenza virus vaccine is safe and immunogenic in healthy adults 18-64 years of age.

PubMed

Gorse, Geoffrey J; Falsey, Ann R; Fling, John A; Poling, Terry L; Strout, Cynthia B; Tsang, Peter H

2013-05-01

To increase vaccine acceptance, intradermal (ID) influenza vaccine (Fluzone(®) Intradermal, Sanofi Pasteur Inc.) may be an attractive alternative to intramuscular (IM) vaccination due to smaller needle and volume injected. A multicenter, randomized (2:1 ID vs IM vaccines) study, blinded for ID vaccine lots, was conducted among 4292 adults 18-64 years of age enrolled in October 2008. Three lots of investigational trivalent influenza vaccine containing 9μg hemagglutinin (HA) per strain in 0.1mL administered ID with a 30 gauge, 1.5mm long needle were compared to standard dose vaccine (0.5mL containing 15μg HA/strain) given IM. The post-vaccination antibody geometric mean titers (GMT) for the ID vaccine were similar to the IM vaccine (H1N1: 193.2 vs. 178.3, H3N2: 246.7 vs. 230.7, and B: 102.5 vs. 126.9). Non-inferiority was met for the ID vaccine compared to IM vaccine as assessed by antibody GMT ratios (IM/ID) for all three virus strains (H1N1: 0.92, H3N2: 0.94, and B: 1.24). Seroconversion rates were non-inferior for H1N1 and H3N2, but not for B (ID vs. IM: H1N1: 61.2% vs. 60.5%, H3N2: 75.3% vs. 74.8%, and B: 46.2% vs. 54.2%). Seroprotection (HAI titer ≥1:40) rates were similar between groups (ID vs. IM, H1N1: 91.1% vs. 91.7%, H3N2: 90.7% vs. 91.4%, and B: 87.4% vs. 89.3%). Local injection site reactions overall were more common with ID than IM vaccine (ID vs. IM: 89.2% vs. 60.2%), but were usually grade 1 or 2 and transient. The frequencies of local injection site pain and systemic reactions were similar between vaccine groups, except more myalgia with IM vaccine. The ID vaccine elicited immune responses comparable to IM vaccine except for the seroconversion rate to B virus. With the exception of pain, local injection site reactions were more common with the ID vaccine, but well-tolerated and of short duration. ClinicalTrials.gov identifier: NCT00772109. Copyright © 2013 Elsevier Ltd. All rights reserved.

Morphologic Characteristic of Coronary Artery Disease, with Emphasis on Thromboses, in Patients Younger Than 40 Years of Age

PubMed Central

Tavora, Fabio; Li, Ling; Ripple, Mary; Fowler, David; Burke, Allen

2010-01-01

There are few pathologic descriptions of fatal coronary artery disease in the young. The morphologic characteristics of sudden coronary deaths in 47 hearts from patients younger than 40 years were studied. Numbers of plaques with necrotic cores were quantitated in each heart. Compared to 194 sudden coronary deaths >40 years, heart weight was lower, acute plaque erosions more frequent, and extent of disease less in the ≤40 years group. Plaque burden was less in hearts with erosions, and healed infarcts more common in hearts with stable plaque. The numbers of fibroatheromas increased with age until the 6th decade (P < .0001) as well as the proportion of total plaques that were atheromatous. Plaques in younger patients have fewer lipid-rich cores. Most thrombi show areas of organization, with layering frequent in erosions, suggesting a possible method of plaque enlargement in the absence of necrotic core formation. PMID:21151510

[Seroprevalence of antibodies against hepatitis A virus and hepatitis B virus in nonvaccinated adult population over 40 years of age].

PubMed

Chlíbek, R; Cecetková, B; Smetana, J; Prymula, R; Kohl, I

2006-08-01

To determine prevalence rates of antibodies against hepatitis A virus (HAV) and hepatitis B virus (HBV) in the general adult male and female population over 40 years of age with no history of viral hepatitis A (VHA) and viral hepatitis B (VHB) who have never been vaccinated against hepatitis and to assess the cost-effectiveness of the pre-vaccination serological screening. In 2003-2004, a total of 972 persons of three age categories: 41-50 years, 51-60 years, 61 and more years, were screened. Persons with a history of VHA and/or VHB and those who had been vaccinated against hepatitis were not included in the study. The following four indicators were determined from a 5 ml specimen of whole venous blood by electrochemiluminiscence assay: total anti-HAV antibodies, total anti-HBc antibodies, anti-HBs antibodies and HBsAg, as the most suitable markers of experienced hepatitis or previous vaccination. The prevalence rates of anti-HAV antibodies were lower in females compared to males for all of the three age categories. These antibodies were detected in 16.8%, 52.9% and 77.5% of 41-50-year-olds, 51-60-year-olds and > or = 61-year-olds, respectively. The total prevalence rate for the three age groups was 61.6%. The anti-HBc antibody seroprevalence rates were 1.9%, 5.3% and 6.1%, respectively. The results show high prevalence of VHA in higher age groups. Such a high seroprevalence of antibodies in nonvaccinated persons with no history of viral hepatitis is suggestive of a very frequent incidence of asymptomatic infection. For this reason, the prevaccination screening of anti-HAV antibodies is cost-effective in the population over 50 years of age but is not justified in persons under 40 years of age. Prevaccination screening for anti-HBc antibodies appears not to be cost-effective regardless of age in view of their low prevalence in the Czech population.

Urodynamic characterization of lower urinary tract symptoms in women less than 40 years of age.

PubMed

Jamzadeh, Asha E; Xie, Donghua; Laudano, Melissa A; Elterman, Dean S; Seklehner, Stephan; Shtromvaser, Lucien; Lee, Richard; Kaplan, Steven A; Te, Alexis E; Tyagi, Renuka; Chughtai, Bilal

2014-10-01

Lower urinary tract symptoms (LUTS) in young women is becoming a more recognized urologic issue that can arise from many causes, each with their own management strategy. The purpose of this study was to determine the rates of various etiologies for LUTS in women under 40 years of age. Video urodynamic studies (VUDS) were performed in 70 women age 40 years or less with LUTS for greater than 6 months between March 2005 and June 2012 at Weill Cornell Medical College. Patients with culture-proven bacterial urinary tract infections, pelvic organ prolapse greater than grade I, symptoms for less than 6 months, a history of neurologic disease, or previous urological surgery affecting voiding function, were excluded from the analysis. The mean age of the patients was 31.95 ± 5.57. There were 48 patients that presented with more than one urinary symptom (68.57%). The most frequent complaints included: urinary frequency (n = 42, 34.15%), incontinence (n = 26, 21.14%), and urinary urgency (n = 22, 17.89%). The most common urodynamic abnormality was dysfunctional voiding (n = 25, 28.74%), detrusor overactivity (n = 15, 20.00%), bladder outlet obstruction (n = 8, 11.43%). There were no significant differences seen in complaints or AUA symptom and quality of life scores across diagnosis groups. Persistent LUTS can present in younger women with an unclear etiology, which may be characterized using VUDS. The most common etiology found is dysfunctional voiding followed by detrusor overactivity. This study shows that the etiology can be more accurately determined using VUDs, which can assist in management.

Assessment of Alveolar Bone Status in Middle Aged Chinese (40-59 Years) with Chronic Periodontitis--Using CBCT.

PubMed

Zhao, Haijiao; Li, Chen; Lin, Li; Pan, Yaping; Wang, Hongyan; Zhao, Jian; Tan, Lisi; Pan, Chunling; Song, Jia; Zhang, Dongmei

2015-01-01

This study used con-beam computed tomography (CBCT) to investigate the prevalence and severity of alveolar bone loss in middle-aged (40-59 years) Chinese with chronic periodontitis. The study group comprised 145 dentate individuals aged 40 to 59 years residing in China who suffered from chronic periodontitis. CBCT and the application of NNT software were used to examine the level and location of alveolar bone loss. The study revealed that 40-59 year old patients with chronic periodontitis had severe bone loss. At 5,286 sites (34.7%), alveolar bone loss was mild; severe alveolar bone loss was found at 5,978 sites (39.2%). A comparison of bone loss in different jaws revealed that the area with the highest degree of bone loss was on the lingual side of the maxillary molar (56.3 ± 7.2%), and that the area with the lowest degree was primarily on the lingual side of the mandibular canine (27.5 ± 6.3%). There was a lower degree of alveolar bone loss in males than females. Differences were observed when comparing the incidence of bone loss between males and females (P < 0.05). Menopause in females and smoking in both genders may affect the level of bone loss. Male smokers experienced a greater degree of bone loss (41.67 ± 5.76%) than male non-smokers (32.95 ± 4.31%). A 42.23 ± 6.34% bone loss was found in menopausal females versus 31.35 ± 3.62% in non-menopausal females. The study revealed that different sites and teeth exhibited a diverse degree of bone loss. In middle-aged patients with chronic periodontitis, the highest degrees of bone loss in the incisors, premolars, and molars were on the lingual side, mesial side and lingual side, respectively. Menopause in females and smoking may affect the level of bone loss.

An economic analysis of a pneumococcal vaccine programme in people aged over 64 years in a developed country setting.

PubMed

Mangtani, Punam; Roberts, Jennifer A; Hall, Andrew J; Cutts, Felicity T

2005-06-01

Polysaccharide pneumococcal vaccination for older adults is being introduced in developed country settings. Evidence of protection by this vaccine against pneumococcal pneumonia, or confirmation that illness and death from bacteraemia are prevented, is currently limited. Decisions are often made based on partial information. We examined the policy implications by exploring the potential economic benefit to society and the health sector of pneumococcal vaccination in older adults. A model to estimate the potential cost savings and cost-effectiveness of a polysaccharide pneumococcal vaccine programme was based on costs collected from patients, the literature, and routine health-services data. The effect of a pneumococcal vaccine (compared with no vaccination) was examined in a hypothetical cohort aged over 64 years. The duration of protection was assumed to be 10 years, with or without a booster at 5 years. If it were effective against morbidity from pneumococcal pneumonia, the main burden from pneumococcal disease, the vaccine could be cost-neutral to society or the health sector at low efficacy (28 and 37.5%, respectively, without boosting and with 70% coverage). If it were effective against morbidity from bacteraemia only, the vaccine's efficacy would need to be 75 and 89%, respectively. If protection against both morbidity and mortality from pneumococcal bacteraemia was 50%, the net cost to society would be 2500 pounds per year of life saved ( 3365 pounds from the health-sector perspective). Results were sensitive to incidence, case-fatality rates, and costs of illness. A vaccine with moderate efficacy against bacteraemic illness and death would be cost-effective. If it also protected against pneumonia, it would be cost-effective even if its efficacy were low.

Negative Association of Domestic Activity and Active Commuting with Metabolic Syndrome in a Chinese Population Aged 35-64 Years.

PubMed

Chen, Xiao Rong; Zhang, Jian; Ding, Gang Qiang; Dong, Zhong; Zhang, Xin Wei; Li, Jian Hong; Chen, Bo; Yan, Liu Xia; Mi, Sheng Quan; Zhao, Wen Hua

2015-07-01

To understand the associations of physical activity domains with metabolic syndrome among a middle-aged Chinese population. In all, 3326 professional adults aged 35-64 years from Beijing and Zhejiang province were recruited with a cluster random sampling method. The Global Physical Activity Questionnaire was modified, and the recommended Asia-Pacific cut-offs of waist circumstance were introduced into the criteria for metabolic syndrome from the Adult Treatment Panel III. A binary logistic regression model was applied to examine the association of all physical activity domains with the risk of the syndrome. Participants who engaged in domestic activity for ⋜1176 MET-min/week had a 41.6% less chance of having metabolic syndrome [odds ratio (OR), 0.584; 95% confidence interval (CI), 0.480-0.710] than those without this activity. In adjusted models, adults who actively commuted for ⋜33 MET-min/week but <528 MET-min/week had a 25% less chance of having the syndrome (OR, 0.750; 95% CI, 0.582-0.966) than those who did not. No interaction was detected between the two domains of activity and the syndrome. This study highlighted the independently negative association of traffic and house activity with the prevalence of the syndrome in this sample with a generally low level of moderate activity. Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Effectiveness of population-based service screening with mammography for women ages 40 to 49 years with a high or low risk of breast cancer: socioeconomic status, parity, and age at birth of first child.

PubMed

Hellquist, Barbro Numan; Czene, Kamila; Hjälm, Anna; Nyström, Lennarth; Jonsson, Håkan

2015-01-15

Invitation to mammography screening of women aged 40 to 49 years is a matter of debate in many countries and a cost-effective alternative in countries without screening among women aged 40 to 49 years could be inviting those at higher risk. The relative effectiveness of mammography screening was estimated for subgroups based on the breast cancer risk factors parity, age at time of birth of first child, and socioeconomic status (SES). The SCReening of Young Women (SCRY) database consists of all women aged 40 to 49 years in Sweden between 1986 and 2005 and was split into a study and control group. The study group consisted of women residing in areas in which women aged 40 to 49 years were invited to screening and the control group of women in areas in which women aged 40 to 49 years were not invited to screening. Rate ratio (RR) estimates were calculated for 2 exposures: invitation and attendance. There were striking similarities noted in the RR pattern for women invited to and attending screening and no statistically significant difference or trend in the RR was noted by risk group. The RR estimates increased by increasing parity for parity of 0 to 2 and ranged from 0.55 (95% confidence interval [95% CI], 0.38-0.79) to 0.79 (95% CI, 0.65-0.95) for attending women. The RR for women with high SES was lower than that for women with low SES (RR, 0.72 [95% CI, 0.60-0.86] and RR, 0.79 [95% CI, 0.63-0.99], respectively). For women aged 20 to 24 years at the time of the birth of their first child, the RR was 0.73 (95% CI, 0.58-0.91) and estimates for other ages were similar. There was no statistically significant difference noted in the relative effectiveness of mammography screening by parity, age at the time of birth of the first child, or SES. © 2014 American Cancer Society.

Characteristics and outcomes of patients with multiple myeloma aged 21-40 years versus 41-60 years: a multi-institutional case-control study.

PubMed

Jurczyszyn, Artur; Nahi, Hareth; Avivi, Irit; Gozzetti, Alessandro; Niesvizky, Ruben; Yadlapati, Sujitha; Jayabalan, David S; Robak, Paweł; Pika, Tomas; Andersen, Kristian T; Rasche, Leo; Mądry, Krzysztof; Woszczyk, Dariusz; Raźny, Małgorzata; Usnarska-Zubkiewicz, Lidia; Knopińska-Posłuszny, Wanda; Wojciechowska, Małgorzata; Guzicka-Kazimierczak, Renata; Joks, Monika; Grosicki, Sebastian; Ciepłuch, Hanna; Rymko, Marcin; Vesole, David H; Castillo, Jorge J

2016-12-01

We compared the outcomes of multiple myeloma (MM) patients aged 21-40 and 41-60 years in the novel agent era. This case-control study included 1089 patients between 2000 and 2015. Cases and controls were matched for sex, International Staging System (ISS) stage and institution. There were 173 patients in the younger group and 916 patients in the older group. Younger patients presented with a higher incidence of lytic lesions (82% vs. 72%; P = 0·04) and high-risk cytogenetic abnormalities (83% vs. 68%; P = 0·007), but lower rate of elevated lactate dehydrogenase (21% vs. 44%; P < 0·001). Five- and 10-year overall survival (OS) in younger versus older patients was 83% vs. 67% and 56% vs. 39%, respectively (P < 0·001). Similar results were seen when studying the subset of 780 patients who underwent autologous transplantation. Younger patients with ISS stage 1 had a better OS than older patients (P < 0·001). There was no survival difference between younger and older patients with ISS stage 2 or 3. Younger MM patients, aged 21-40 years, treated in the era of novel agents have a better OS than their counterparts aged 41-60 years, but the survival advantage observed in younger patients was lost in more advanced stages of MM. © 2016 John Wiley & Sons Ltd.

[A cohort study on the predictive value of factors influencing cardio-cerebro vascular death among people over 40 years of age].

PubMed

Yang, Jian-min; Lu, Fang-hong; Jin, Shi-kuan; Sun, Shang-wen; Zhao, Ying-xin; Wang, Shu-jian; Zhou, Xiao-hong

2007-02-01

To explore the factors influencing cardio-cerebro vascular death events among people over 40 years of age in Shandong area, China. Baseline survey was carried out in 1991. A total number of 11,008 adults over 40 years old had been studied in Shandong province. Data on cardiocerebro death was collected. The correlation between influencing factors and cardio-cerebro vascular death events was analyzed by Cox regression model. Totally, 434 cardio-cerebro death events occurred among the 11,008 subjects during the 8-year follow-up study. Cardio-cerebro death events were related to systolic blood pressure, diastolic blood pressure, smoking, stroke history and age. Data from Cox regression analysis showed that the relative risk (RR) for cardio-cerebro vascular death events increased by 2.862 [95% confidence interval (CI): 1.976-4.144] times for those people having stroke history. When systolic blood pressure, diastolic blood pressure increased by every 10 mm Hg, the relative risk for cardio-cerebro vascular death events increased by 1.171 (95% CI: 1.033-1.328), 1.214 (95% CI: 1.044-1.413) respectively. it was found that a 1.239 (95% CI: 1.088-1.553) times higher in smokers than non-smokers on relative risk for cardio-cerebro vascular death events. However, the predictive values of the influencing factors for cardio-cerebro vascular death were different among population of different years of age. The relative risk for cardio-cerebro vascular death events increased by 1.366 (95% CI: 1.102-1.678) times for each 10 mm Hg increase of diastolic blood pressure in 40-59 years old population. However, the effect was taken place by systolic blood pressure in 60-74 years old population,with a relative risk of 1.201 (95% CI: 1.017-1.418) for each 10 mm Hg increase. Age seemed the only significant factor for cardio-cerebro vascular death events on population aged more than 75 years old. Conclusion The predictive values of the risk factors were different among age groups. The different

Hearing in middle age: a population snapshot of 40–69 year olds in the UK

PubMed Central

Dawes, Piers; Fortnum, Heather; Moore, David R.; Emsley, Richard; Norman, Paul; Cruickshanks, Karen; Davis, Adrian; Edmondson-Jones, Mark; McCormack, Abby; Lutman, Mark; Munro, Kevin

2014-01-01

Objective To report population-based prevalence of hearing impairment based on speech recognition in noise testing in a large and inclusive sample of UK adults aged 40 to 69 years. The present study is the first to report such data. Prevalence of tinnitus and use of hearing aids is also reported. Design The research was conducted using the UK Biobank resource. The better-ear unaided speech reception threshold was measured adaptively using the Digit Triplet Test (n = 164,770). Self-report data on tinnitus, hearing aid use, noise exposure as well as demographic variables were collected. Results Overall, 10.7% of adults (95%CI 10.5–10.9%) had significant hearing impairment. Prevalence of tinnitus was 16.9% (95%CI 16.6–17.1%) and hearing aid use was 2.0% (95%CI 1.9–2.1%). Odds of hearing impairment increased with age, with a history of work- and music-related noise exposure, for lower socioeconomic background and for ethnic minority backgrounds. Males were at no higher risk of hearing impairment than females. Conclusion Around 1 in 10 adults aged 40 to 69 years have substantial hearing impairment. The reasons for excess risk of hearing impairment particularly for those from low socioeconomic and ethnic minority backgrounds require identification, as this represents a serious health inequality. The underutilization of hearing aids has altered little since the 1980s, and is a major cause for concern. PMID:24518430

Antibody persistence and immune memory 4 years post-vaccination with combined hepatitis A and B vaccine in adults aged over 40 years.

PubMed

Chlibek, Roman; von Sonnenburg, Frank; Van Damme, Pierre; Smetana, Jan; Tichy, Petr; Gunapalaiah, Bhavyashree; Leyssen, Maarten; Jacquet, Jeanne-Marie

2011-01-01

Persistence of immune response was assessed in adults aged >40 years (N = 596) following primary vaccination with combined hepatitis A/B vaccine or concomitant monovalent hepatitis A and B vaccines. Anti-hepatitis A virus antibody responses persisted for at least 4 years regardless of the vaccine used, with anti-hepatitis B surface antibody responses higher and more sustained in subjects who received the combined hepatitis A/B vaccine. Response rates to an additional dose of the same vaccine(s) used for priming were high. © 2011 International Society of Travel Medicine.

The costs of diabetes among Australians aged 45–64 years from 2015 to 2030: projections of lost productive life years (PLYs), lost personal income, lost taxation revenue, extra welfare payments and lost gross domestic product from Health&WealthMOD2030

PubMed Central

Schofield, Deborah; Shrestha, Rupendra N; Cunich, Michelle M; Veerman, Lennert; Tanton, Robert; Kelly, Simon J

2017-01-01

Objectives To project the number of people aged 45–64 years with lost productive life years (PLYs) due to diabetes and related costs (lost income, extra welfare payments, lost taxation revenue); and lost gross domestic product (GDP) attributable to diabetes in Australia from 2015 to 2030. Design A simulation study of how the number of people aged 45–64 years with diabetes increases over time (based on population growth and disease trend data) and the economic losses incurred by individuals and the government. Cross-sectional outputs of a microsimulation model (Health&WealthMOD2030) which used the Australian Bureau of Statistics’ Survey of Disability, Ageing and Carers 2003 and 2009 as a base population and integrated outputs from two microsimulation models (Static Incomes Model and Australian Population and Policy Simulation Model), Treasury's population and labour force projections, and chronic disease trends data. Setting Australian population aged 45–64 years in 2015, 2020, 2025 and 2030. Outcome measures Lost PLYs, lost income, extra welfare payments, lost taxation revenue, lost GDP. Results 18 100 people are out of the labour force due to diabetes in 2015, increasing to 21 400 in 2030 (18% increase). National costs consisted of a loss of $A467 million in annual income in 2015, increasing to $A807 million in 2030 (73% increase). For the government, extra annual welfare payments increased from $A311 million in 2015 to $A350 million in 2030 (13% increase); and lost annual taxation revenue increased from $A102 million in 2015 to $A166 million in 2030 (63% increase). A loss of $A2.1 billion in GDP was projected for 2015, increasing to $A2.9 billion in 2030 attributable to diabetes through its impact on PLYs. Conclusions Individuals incur significant costs of diabetes through lost PLYs and lost income in addition to disease burden through human suffering and healthcare costs. The government incurs extra welfare payments, lost taxation revenue and

Association of daily physical activity level with health-related factors by gender and age-specific differences among Korean adults based on the sixth (2014-2015) Korea national health and nutrition examination survey

PubMed

Chung, Nana; Park, Hun-Young; Park, Mi-Young; Hwang, Yoon-Young; Lee, Chi-Ho; Han, Jin-Soo; So, Jaemoo; Kim, Jisu; Park, Jonghoon; Lim, Kiwon

2017-06-30

This study examined the effects of daily physical activity level on health-related factors according to gender and identified age-specific differences among Korean adults. Using data from the Korea National Health and Nutrition Examination Survey VI (2014-2015), we selected adults aged 19-64 years who participated in both a health examination and health interview survey. The study included 6,457 participants 19-64 years of age (2,611 men, 3,846 women). Assessment of the differences in health-related factors according to age and physical activity in men and women by repeated two-way analysis of variance (ANOVA) revealed significant interaction effects on total cholesterol (TC) and triglyceride (TG) levels and diastolic blood pressure (DBP) in male participants, but there were no significant interaction effects for any health-related factors in female participants. The group of female participants aged 40-64 years with daily physical activity levels over 200 kcal showed a significantly increased prevalence of 46% for dyslipidemia compared to that in female participants with daily physical activity levels below 200 kcal. Physical activity was positively correlated with weight and high-density lipoprotein cholesterol (HDL-C) levels in men 19-39 years of age, compared to weight, waist circumference (WC), body mass index (BMI), and DBP in men 40-64 years of age, and weight, WC, BMI, glycated hemoglobin (HbA1c) and triglyceride (TG) levels in women 19-39 years of age. In women 40- 64 years of age, physical activity was especially significantly positively correlated with weight, BMI, HDL-C and negatively correlated with fasting glucose and TG levels. In male and female participants, the 40-64-year age group showed negative results for health-related factors compared to those in the 19-39-year age group. The higher the weight, WC, BMI, the higher is the physical activity level. Physical activity levels were significantly positively correlated with health-related variables

Association of daily physical activity level with health-related factors by gender and age-specific differences among Korean adults based on the sixth (2014-2015) Korea national health and nutrition examination survey

PubMed Central

Chung, Nana; Park, Hun-Young; Park, Mi-Young; Hwang, Yoon-Young; Lee, Chi-Ho; Han, Jin-Soo; So, Jaemoo; Kim, Jisu; Park, Jonghoon; Lim, Kiwon

2017-01-01

[Purpose] This study examined the effects of daily physical activity level on health-related factors according to gender and identified age-specific differences among Korean adults. [Methods] Using data from the Korea National Health and Nutrition Examination Survey VI (2014-2015), we selected adults aged 19-64 years who participated in both a health examination and health interview survey. The study included 6,457 participants 19-64 years of age (2,611 men, 3,846 women). [Results] Assessment of the differences in health-related factors according to age and physical activity in men and women by repeated two-way analysis of variance (ANOVA) revealed significant interaction effects on total cholesterol (TC) and triglyceride (TG) levels and diastolic blood pressure (DBP) in male participants, but there were no significant interaction effects for any health-related factors in female participants. The group of female participants aged 40-64 years with daily physical activity levels over 200 kcal showed a significantly increased prevalence of 46% for dyslipidemia compared to that in female participants with daily physical activity levels below 200 kcal. Physical activity was positively correlated with weight and high-density lipoprotein cholesterol (HDL-C) levels in men 19-39 years of age, compared to weight, waist circumference (WC), body mass index (BMI), and DBP in men 40-64 years of age, and weight, WC, BMI, glycated hemoglobin (HbA1c) and triglyceride (TG) levels in women 19-39 years of age. In women 40- 64 years of age, physical activity was especially significantly positively correlated with weight, BMI, HDL-C and negatively correlated with fasting glucose and TG levels. [Conclusion] In male and female participants, the 40-64-year age group showed negative results for health-related factors compared to those in the 19-39-year age group. The higher the weight, WC, BMI, the higher is the physical activity level. Physical activity levels were significantly positively

Extremely preterm infants small for gestational age are at risk for motor impairment at 3 years corrected age.

PubMed

Kato, Takeshi; Mandai, Tsurue; Iwatani, Sota; Koda, Tsubasa; Nagasaka, Miwako; Fujita, Kaori; Kurokawa, Daisuke; Yamana, Keiji; Nishida, Kosuke; Taniguchi-Ikeda, Mariko; Tanimura, Kenji; Deguchi, Masashi; Yamada, Hideto; Iijima, Kazumoto; Morioka, Ichiro

2016-02-01

Few studies have targeted psychomotor development and associated perinatal risk factors in Japanese very low birth weight (VLBW) infants who are severely small for gestational age (SGA). A single-center study was conducted in 104 Japanese VLBW infants who were born preterm, due to maternal, umbilical cord, or placental abnormalities, between 2000 and 2007. Psychomotor development as a developmental quotient (DQ) was assessed using the Kyoto Scale of Psychological Development at 3 years corrected age. Severely SGA was defined as birth weight or length below -2 standard deviation values of the mean values at the same gestation. VLBW infants were divided into 2 subgroups based on gestational age at birth: ⩾28 weeks (n=64) and <28 weeks (n=40). DQs of infants with severe SGA were compared with those of infants who were appropriate for gestational age (AGA). Factors associated with developmental disabilities in VLBW infants with severe SGA (n=23) were determined. In the group born at ⩾28 weeks gestation, infants with severe SGA had normal DQ values and did not significantly differ from those with AGA. However, in the group born at <28 weeks gestation, severe SGA infants had significantly lower postural-motor DQ values than AGA infants. Gestational age <28 weeks was an independent factor for low postural-motor DQ, regardless of the cause of severe SGA or pregnancy termination. Extremely preterm newborns with severe SGA are at risk of motor developmental disability at age 3 years. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

The costs of diabetes among Australians aged 45-64 years from 2015 to 2030: projections of lost productive life years (PLYs), lost personal income, lost taxation revenue, extra welfare payments and lost gross domestic product from Health&WealthMOD2030.

PubMed

Schofield, Deborah; Shrestha, Rupendra N; Cunich, Michelle M; Passey, Megan E; Veerman, Lennert; Tanton, Robert; Kelly, Simon J

2017-01-09

To project the number of people aged 45-64 years with lost productive life years (PLYs) due to diabetes and related costs (lost income, extra welfare payments, lost taxation revenue); and lost gross domestic product (GDP) attributable to diabetes in Australia from 2015 to 2030. A simulation study of how the number of people aged 45-64 years with diabetes increases over time (based on population growth and disease trend data) and the economic losses incurred by individuals and the government. Cross-sectional outputs of a microsimulation model (Health&WealthMOD2030) which used the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers 2003 and 2009 as a base population and integrated outputs from two microsimulation models (Static Incomes Model and Australian Population and Policy Simulation Model), Treasury's population and labour force projections, and chronic disease trends data. Australian population aged 45-64 years in 2015, 2020, 2025 and 2030. Lost PLYs, lost income, extra welfare payments, lost taxation revenue, lost GDP. 18 100 people are out of the labour force due to diabetes in 2015, increasing to 21 400 in 2030 (18% increase). National costs consisted of a loss of $A467 million in annual income in 2015, increasing to $A807 million in 2030 (73% increase). For the government, extra annual welfare payments increased from $A311 million in 2015 to $A350 million in 2030 (13% increase); and lost annual taxation revenue increased from $A102 million in 2015 to $A166 million in 2030 (63% increase). A loss of $A2.1 billion in GDP was projected for 2015, increasing to $A2.9 billion in 2030 attributable to diabetes through its impact on PLYs. Individuals incur significant costs of diabetes through lost PLYs and lost income in addition to disease burden through human suffering and healthcare costs. The government incurs extra welfare payments, lost taxation revenue and lost GDP, along with direct healthcare costs. Published by the BMJ

Oral health condition and reasons for tooth extraction among an adult population (20-64 years old).

PubMed

Silva-Junior, Manoelito Ferreira; Sousa, Anne Caroline Correia de; Batista, Marília Jesus; Sousa, Maria da Luz Rosário de

2017-08-01

The study characterized the oral health condition and main self-reported reasons for tooth extraction in an adult population. The cross-sectional study examined 248 adults aged 20-64 years, representative of the population of Piracicaba, São Paulo, Brazil. The oral examination conducted in households used the DMFT and CPI indexes, use and necessity of prosthodontics according to the WHO criteria and the presence of visible biofilm. Demographic and socioeconomic data were collected along with reasons for tooth extraction through a questionnaire. Descriptive analysis was stratified by age in groups: 20-44 and 45-64 years old. The average DMFT was 20.37 (EP = 0.50), P = 3.34 (EP = 0.33) for young adults and P = 13.41 (EP = 1.45) for the older adults. Gingival pockets (CPI ≥ 3) were found on 20.5% of young adults and 53.0% of the older ones. While 38.8% used upper prosthesis, 46.7% needed lower prosthesis. Pain was the most prevalent self-reported reason for tooth extraction (37.5%), being this choice primarily because of lack of another treatment option (52%) and done in the private sector (47.2%). We concluded that young adults (20-44 years old) showed less missing teeth, periodontal diseases, and need for prosthetic use. Pain and lack of options of other treatments were the main self-reported reasons for performing tooth extractions.

Domestic work and self-rated health among women and men aged 25-64 years: results from a population-based survey in Sweden.

PubMed

Molarius, Anu; Granström, Fredrik; Lindén-Boström, Margareta; Elo, Sirkka

2014-02-01

This study investigated the association between domestic work and self-rated health among women and men in the general population. The study is based on women (N = 12,910) and men (N = 9784) aged 25-64 years, who responded to a survey questionnaire in 2008 (response rate 56%). Logistic regression models were used to assess the association adjusting for age, educational level, employment status, family status and longstanding illness. Population attributable risks (PAR) were calculated to assess the contribution of domestic work to the prevalence of suboptimal self-rated health. More women (29%) than men (12%) spent more than 20 hours per week in domestic work. Women also experienced domestic work more often as burdensome. Disability pensioners and single mothers reported highest levels of burdensome domestic work. There was a strong independent association between burdensome domestic work and suboptimal self-rated health both in women and men. The PAR for burdensome domestic work was 21% in women and 12% in men and comparable to other major risk factors. The results suggest that domestic work should not be omitted when considering factors that affect self-rated health in the general population.

Breast cancer screening initiation after turning 40 years of age within the PROSPR consortium.

PubMed

Beaber, Elisabeth F; Tosteson, Anna N A; Haas, Jennifer S; Onega, Tracy; Sprague, Brian L; Weaver, Donald L; McCarthy, Anne Marie; Doubeni, Chyke A; Quinn, Virginia P; Skinner, Celette Sugg; Zauber, Ann G; Barlow, William E

2016-11-01

Although United States clinical guidelines differ, the earliest recommended age for average risk breast cancer screening is 40 years. Little is known about factors influencing screening initiation. We conducted a cohort study within the National Cancer Institute-funded Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium. We identified 3413 women on their 40th birthday in primary care networks at Geisel School of Medicine at Dartmouth (DH) and Brigham and Women's Hospital (BWH) during 2011-2013 with no prior breast imaging or breast cancer. Cumulative incidence curves and Cox modeling were used to determine time from the 40th birthday to first breast cancer screening, cohort exit, or 42nd birthday. We calculated hazards ratios and 95 % confidence intervals from multivariable Cox proportional hazards models. Breast cancer screening cumulative incidence by the 42nd birthday was 62.9 % (BWH) and 39.8 % (DH). Factors associated with screening initiation were: a primary care visit within a year (HR 4.99, 95 % CI 4.23-5.89), an increasing number of primary care visits within a year (p for trend <0.0001), ZIP code of residence annual median household income ≤$52,000 (HR 0.79, 95 % CI 0.68-0.92), and health insurance type (Medicaid HR 0.72, 95 % CI 0.58-0.88; Medicare HR 0.55, 95 % CI 0.39-0.77; uninsured HR 0.37, 95 % CI 0.25-0.57). Breast cancer screening uptake after the 40th birthday varies by health system, primary care visits, median household income, and health insurance type, suggesting the need for further exploration. Future research should evaluate screening performance metrics after initiation and consider cumulative benefits and risks associated with breast cancer screening over time.

Relation between speech-in-noise threshold, hearing loss and cognition from 40-69 years of age.

PubMed

Moore, David R; Edmondson-Jones, Mark; Dawes, Piers; Fortnum, Heather; McCormack, Abby; Pierzycki, Robert H; Munro, Kevin J

2014-01-01

Healthy hearing depends on sensitive ears and adequate brain processing. Essential aspects of both hearing and cognition decline with advancing age, but it is largely unknown how one influences the other. The current standard measure of hearing, the pure-tone audiogram is not very cognitively demanding and does not predict well the most important yet challenging use of hearing, listening to speech in noisy environments. We analysed data from UK Biobank that asked 40-69 year olds about their hearing, and assessed their ability on tests of speech-in-noise hearing and cognition. About half a million volunteers were recruited through NHS registers. Respondents completed 'whole-body' testing in purpose-designed, community-based test centres across the UK. Objective hearing (spoken digit recognition in noise) and cognitive (reasoning, memory, processing speed) data were analysed using logistic and multiple regression methods. Speech hearing in noise declined exponentially with age for both sexes from about 50 years, differing from previous audiogram data that showed a more linear decline from <40 years for men, and consistently less hearing loss for women. The decline in speech-in-noise hearing was especially dramatic among those with lower cognitive scores. Decreasing cognitive ability and increasing age were both independently associated with decreasing ability to hear speech-in-noise (0.70 and 0.89 dB, respectively) among the population studied. Men subjectively reported up to 60% higher rates of difficulty hearing than women. Workplace noise history associated with difficulty in both subjective hearing and objective speech hearing in noise. Leisure noise history was associated with subjective, but not with objective difficulty hearing. Older people have declining cognitive processing ability associated with reduced ability to hear speech in noise, measured by recognition of recorded spoken digits. Subjective reports of hearing difficulty generally show a higher

Liver Transplantation Results by Donor Age.

PubMed

Rabelo, A V; Bastante, M D; Raya, A M; Méndez, C S M; Ramirez, A R G; Suarez, Y F

2016-11-01

The objective of this study was to compare liver transplantation outcomes as a function of donor age. We performed 212 liver transplantations between 2008 and 2014. We described a prospective cohort study and grouped the patients by liver donor age. We compared quantitative and categorical variables using statistical analysis. No statistically significant differences were found among any graft age groups in gender (always more males), time on waiting list, age, height, Child Pugh Turcotte (CHILD) score, Model for End-stage Liver Disease (MELD) score, need for intraoperative blood products, or intensive care unit stay. The most frequent etiology of liver failure was alcohol. A brain-dead donor was the most frequent type in all groups. The whole graft was used except in 4 cases. No statistically significant differences were found among groups in the surgical technique, postreperfusion syndrome, arterial complications, biliary complications, venous complications, acute rejection, and retransplantation. The 3-year patient survival rate was 64% in the <60-year graft age group, 48% in the 60- to 69-year group, 64% in the 70- to 79-year group, and 40% in the ≥80-year group (P = .264). The 3-year graft survival rate was 62% in the <60-year graft age group, 47% in the 60- to 69-year group, 65% in the 70- to 79-year group, and 40% in the ≥80-year group (P = .295). Given the need to increase the pool of liver donors, older donors should be considered as a source for liver transplantation, although careful selection is required. Copyright © 2016 Elsevier Inc. All rights reserved.

Balance and ankle range of motion in community-dwelling women aged 64 to 87 years: a correlational study.

PubMed

Mecagni, C; Smith, J P; Roberts, K E; O'Sullivan, S B

2000-10-01

This study investigated the relationship between balance measures and ankle range of motion (ROM) in community-dwelling elderly women with no health problems. Identification of modifiable factors associated with balance may enable clinicians to design treatments to help reduce the risk of falls in elderly people. The sample consisted of 34 women between the ages of 64 and 87 years (mean=74.7, SD=6.0). Goniometry was used to determine bilateral ankle active-assistive range of motion (AAROM) and passive range of motion. Balance capabilities were measured with the Functional Reach Test (FRT) and the Tinetti Performance-Oriented Mobility Assessment (POMA). Balance data for the FRT, POMA balance subtest, POMA gait subtest, and POMA total score were correlated with ankle ROM using the Pearson product moment correlation coefficient (PCC). Correlations between ROM and balance scores were found, ranging from.29 to.63. The POMA gait subtest and FRT resulted in higher correlations with ROM than did the POMA balance subtest (left total AAROM PCC=.63,.51, and.31). Correlations using composite ankle ROM scores were higher than individual motions. The strongest correlation existed between bilateral, total ankle AAROM and the POMA gait subtest scores (PCC=. 63) Correlations exist between ankle ROM and balance in community-dwelling elderly women. Additional research is needed to determine whether treatment directed at increasing ankle ROM can improve balance.

Colonoscopy screening among US adults aged 40 or older with a family history of colorectal cancer.

PubMed

Tsai, Meng-Han; Xirasagar, Sudha; Li, Yi-Jhen; de Groen, Piet C

2015-05-21

Colonoscopy screening reduces colorectal cancer (CRC) incidence and mortality. CRC screening is recommended at age 50 for average-risk people. Screening of first-degree relatives of CRC patients is recommended to begin at age 40 or 10 years before the age at diagnosis of the youngest relative diagnosed with CRC. CRC incidence has increased recently among younger Americans while it has declined among older Americans. The objective of this study was to determine whether first-degree relatives of CRC patients are being screened according to recommended guidelines. We studied colonoscopy screening rates among the US population reporting a CRC family history using 2005 and 2010 National Health Interview Survey data. Of 26,064 study-eligible respondents, 2,470 reported a CRC family history; of those with a family history, 45.6% had a colonoscopy (25.2% in 2005 and 65.8% 2010). The colonoscopy rate among first-degree relatives aged 40 to 49 in 2010 (38.3%) was about half that of first-degree relatives aged 50 or older (69.7%). First-degree relatives were nearly twice as likely as nonfirst-degree relatives to have a colonoscopy (adjusted odds ratio [AOR], 1.7; 95% confidence interval, 1.5-1.9), but those aged 40 to 49 were less likely to have a colonoscopy than those in older age groups (AOR, 2.6 for age 50-64; AOR, 3.6 for age ≥65). Interactions with age, insurance, and race/ethnicity were not significant. Having health insurance tripled the likelihood of screening. Despite a 5-fold increase in colonoscopy screening rates since 2005, rates among first-degree relatives younger than the conventional screening age have lagged. Screening promotion targeted to this group may halt the recent rising trend of CRC among younger Americans.

Ten Years' Growth of Pruned and Unpruned Cottonwood Planted at 40- by 40-Foot Spacing

Treesearch

Roger M. Krinard

1985-01-01

Diameters at age 10 of cottonwood (Populus deltoides Bartr. ex Marsh.) select clone Stoneville 66 planted at 40- by 40-foot spacing varied from 13.4 to 16.4 inches depending on height of pruning. Pruning treatments, applied from the 2nd through 8th years, were (1) unpruned, (2) pruned to a third of height yearly, (3) pruned to half of height yearly...

Urodynamic characterization of lower urinary tract symptoms in men less than 40 years of age.

PubMed

Jamzadeh, Asha E; Xie, Donghua; Laudano, Melissa; Seklehner, Stephan; Elterman, Dean S; Shtromvaser, Lucien; Lee, Richard; Kaplan, Steven A; Te, Alexis E; Chughtai, Bilal

2014-04-01

Lower urinary tract symptoms (LUTS) in young men are becoming a more recognized urologic issue that can arise from many causes, each with their own management strategy. The purpose of this study was to determine the rates and types of voiding dysfunction causing LUTS in men under 40 years. Videourodynamic studies (VUDS) of 87 men 40 years of age or less with LUTS for greater than 6 months, performed between July 2004 and June 2012 at Weill Cornell Medical College, were retrospectively analyzed. Patients with culture-proven bacterial prostatitis, symptoms for less than 6 months, a history of neurologic disease, or previous urological surgery affecting voiding function were excluded from the analysis. The mean age of the patients was 31.84 ± 5.78. There were 37 patients that presented with more than one urinary symptom (42.5 %). The most frequent complaints included: urinary frequency (N = 42, 48.28 %), difficulty with urination (N = 41, 47.13 %), and urinary urgency (N = 21, 24.14 %). The most common urodynamic abnormality was bladder outlet obstruction (BOO) (N = 37, 42.53 %), dysfunctional voiding (N = 25, 28.74 %), detrusor underactivity (N = 10, 11.49 %), and detrusor overactivity (N = 7, 8.05 %). There were no differences seen in AUA symptom and quality of life scores across diagnosis groups. Lower urinary tract symptoms can present in younger men with a variety of types of voiding dysfunction. This study uses VUDS to show that the most common types of voiding dysfunction in this population with chronic LUTS are BOO followed by dysfunctional voiding.

Age-Group and Gender Differences in Stroke Knowledge in an Israeli Jewish Adult Population.

PubMed

Melnikov, Semyon; Itzhaki, Michal; Koton, Silvia

Stroke is a leading cause of long-term disability and the fifth leading cause of death in Israel. Knowledge of stroke warning signs has been linked to early seeking of medical help. Little is known about knowledge of stroke warning signs in Israeli Jewish adults. Stroke knowledge was examined among Jewish Israeli adults. Using a structured questionnaire, registered nurses interviewed a convenience sample of the respondents, 18 years or older, with no stroke history. Stroke knowledge and demographics were examined by 3 age groups (<45, 45-64, and >64 years) in men and women. In total, 1137 Jewish Israelis were interviewed, 457 (40.2%) men and 680 women (59.8%); 493 (43.4%) were younger than 45 years, 541 (47.6%) were aged 45 to 64 years, and 102 (9%) were older than 64 years; 1 (0.1%) did not report age. On average, each interview lasted for 25 to 30 minutes. Participants younger than 45 years showed the lowest knowledge of stroke cause. Women younger than 45 years were less likely to identify at least 2 stroke warning signs. Participants younger than 45 years were less likely to identify at least 2 risk factors, compared with participants aged 45 to 64 years and older than 64 years. Women younger than 45 years were less likely to identify at least 2 stroke prevention strategies. Participants younger than 45 years showed the lowest levels of stroke knowledge. The highest stroke knowledge was found in the 45 to 64 years age group. Stroke knowledge among different age groups was similar in both genders. Educational campaigns aimed at increasing knowledge of stroke among the general population and targeting the younger population are recommended.

Yellow fever vaccine 17D administered to healthy women aged between 40 and 54 years halves breast cancer risk: an observational study.

PubMed

Mastrangelo, Giuseppe; Pavanello, Sofia; Fadda, Emanuela; Buja, Alessandra; Fedeli, Ugo

2016-11-18

Transcripts of human endogenous retrovirus K are expressed in most breast cancers (BCs). Yellow fever vaccine 17D (YFV) expresses a protein with a closely homologous epitope. Cross-reactive immunity could hypothetically inhibit BC growth at least in women aged around 50 years at diagnosis, in whom the prognosis of BC was found to be better than that in women younger or older. A cohort of 12 804 women who received YFV in the Veneto Region, Italy, was divided into two subcohorts according to age at vaccination and followed up through the Veneto Tumor Registry. The time since vaccination until cancer incidence was categorized (≤1.9; 2-3.9; 4-5.9; 6-7.9; 8-10.9; ≥11 years) and, using the lowest class as a reference, the incidence rate ratio for BC with a 95% confidence interval and P-value was estimated by Poisson regression in each time since vaccination class, adjusting for age and calendar period. In 3140 women vaccinated at 40-54 years of age, YFV administration resulted in a protective effect of long duration slowly fading over time with a U-shaped pattern of response. Overall, BC risk was reduced by about 50% (incidence rate ratio=0.46; 95% confidence interval=0.26-0.83; P=0.009) 2 years after vaccination. Cross-reactive antigens could not be the mechanism because no protection was observed in women vaccinated before 40 or after 54 years of age. BC cells in a microscopic stage of disease can be destroyed or severely damaged by YFV if BC is not very aggressive. To prove that treatment is truly effective, a placebo-controlled double-blind trial should be conducted.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.

[The changing profile of caregivers of persons aged 65 years and over with disabilities within a persisting family care model].

PubMed

Zueras, Pilar; Spijker, Jeroen; Blanes, Amand

The increasing participation of women in the workforce may make it difficult to sustain the current model of elderly care. The aim of this article was to determine the changing sociodemographic profile of informal elderly caregivers with disabilities, the interaction between employment and care, and the view of the public on the responsibility of that care. Cross-sectional analysis of secondary data from four national surveys were used: the disability surveys held in 1999 (N=3,936) and 2008 (N=5,257), the 2011-12 National Health Survey (N=439), and the Family and Gender survey of 2012 (N=1,359). They were analysed using contingency tables based on gender and age. Half of the informal caregivers were women aged 45 to 64 years. Between 1999 and 2011-12 they became more concentrated in the 55-64 age-bracket, among whom participation in the workforce doubled from 20% to 40%. Increased care for men was associated with unemployment. Care work had a negative impact on working life, with greater impact among women and those who cared for elderly people with severe disabilities. Less likely to consider that elderly care provision should rest on family are 45-54 year-old economically active women (only 42%) or those who are more educated (40%), compared to 60% of economically inactive women and 55% of less educated women. Economically active and educated women are less inclined to family-based care, but assume it independently of their workforce participation, whereas males do so according to their availability. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Use of smokeless tobacco by Indian women aged 18-40 years during pregnancy and reproductive years.

PubMed

Nair, Saritha; Schensul, Jean J; Begum, Shahina; Pednekar, Mangesh S; Oncken, Cheryl; Bilgi, Sameena M; Pasi, Achhelal R; Donta, Balaiah

2015-01-01

This paper discusses patterns of daily smokeless tobacco (SLT) use and correlates of poly SLT use among married women aged 18-40 years in a Mumbai slum community with implications for tobacco control. Using a mixed methods approach, the study included a structured survey with 409 daily SLT users and in-depth interviews with 42 women. Participants for the survey were selected using a systematic sampling procedure (one woman in every fourth eligible household). Univariate and bivariate analysis, and multiple logistic regressions were conducted to identify demographic and social factors associated with women's use of poly SLT products. To illustrate survey results, in-depth interviews were analyzed using Atlas ti software. Sixty-four percent of the women surveyed used only one type of SLT; of these, 30% used mishri, 32% used pan with tobacco and the rest used chewed tobacco (11%), gul (17%) or gutkha (10%). Thirty-six percent used more than one type of SLT. Poly SLT users chewed or rubbed 50% more tobacco as compared to single users (mean consumption of tobacco per day: 9.54 vs. 6.49 grams; p<0.001). Women were more likely to be poly SLT users if they were illiterate as compared to literate (adjusted odds ratio [AOR]=1.67; 95% confidence interval [CI]=1.07-2.71), if they had lived in Mumbai for 10 years or more, versus less than ten years (AOR=1.67, 95% CI=1.03-2.71); and if their husband was a poly SLT user as compared to a non SLT user (AOR=2.78, 95% CI=1.63-4.76). No differences were noted between pregnant and non-pregnant women in SLT consumption patterns. Tobacco control policies and programs must focus specifically on both social context and use patterns to address SLT use among women of reproductive age with special attention to poly SLT users, an understudied and vulnerable population.

United States national prevalence of electrocardiographic abnormalities in black and white middle-age (45- to 64-Year) and older (≥65-Year) adults (from the Reasons for Geographic and Racial Differences in Stroke Study).

PubMed

Prineas, Ronald J; Le, Anh; Soliman, Elsayed Z; Zhang, Zhu-Ming; Howard, Virginia J; Ostchega, Yechiam; Howard, George

2012-04-15

A United States national sample of 20,962 participants (57% women, 44% blacks) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study provided general population estimates for electrocardiographic (ECG) abnormalities among black and white men and women. The participants were recruited from 2003 to 2007 by random selection from a commercially available nationwide list, with oversampling of blacks and those from the stroke belt, with a cooperation rate of 49%. The measurement of risk factors and 12-lead electrocardiograms (centrally coded using Minnesota code criteria) showed 28% had ≥1 major ECG abnormality. The prevalence of abnormalities was greater (≥35%) for those ≥65 years old, with no differences between blacks and whites. However, among men <65 years, blacks had more major abnormalities than whites, most notably for atrial fibrillation, major Q waves, and left ventricular hypertrophy. Men generally had more ECG abnormalities than women. The most common ECG abnormalities were T-wave abnormalities. The average heart rate-corrected QT interval was longer in women than in men, similar in whites and blacks, and increased with age. However, the average heart rate was greater in women than in men and in blacks than in whites and decreased with age. The prevalence of ECG abnormalities was related to the presence of hypertension, diabetes, blood pressure, and age. In conclusion, black men and women in the United States have a significantly greater prevalence of ECG abnormalities than white men and women at age 45 to 64 years; however, these proportions, although larger, tended to equalize or reverse after age 65. Copyright © 2012 Elsevier Inc. All rights reserved.

What Fraction of Papers in Astronomy and Physics Are Not Cited in 40 Years?

NASA Astrophysics Data System (ADS)

Abt, Helmut A.

2018-07-01

Of 4000 papers published in astronomy and in physics in the past 40 years, 40.3%, and 23.4%, respectively, have not been cited (referenced). However, if we limit this to the final research papers (excluding announcements, book reviews, proposals for funding, and observing time, obituaries, etc.), the fractions are 1.4% and 1.5%, respectively. So virtually all the papers in these two sciences are useful. These data also tell us that the productivities of astronomers peak at age 40.4 years. and that 43.0% were published after the age of 50 years. For physicists, the peak occurs at 36.6 years. and only 33.7% were published after the age of 50 years. Therefore physicists peak about four years earlier than astronomers and they produce 9% fewer citations after the age of 50 years.

Student Characteristics and Behaviors at Age 12 Predict Occupational Success 40 Years Later over and above Childhood IQ and Parental Socioeconomic Status

ERIC Educational Resources Information Center

Spengler, Marion; Brunner, Martin; Damian, Rodica I.; Lüdtke, Oliver; Martin, Romain; Roberts, Brent W.

2015-01-01

Drawing on a 2-wave longitudinal sample spanning 40 years from childhood (age 12) to middle adulthood (age 52), the present study was designed to examine how student characteristics and behaviors in late childhood (assessed in Wave 1 in 1968) predict career success in adulthood (assessed in Wave 2 in 2008). We examined the influence of parental…

Obesity History and Daily Patterns of Physical Activity at Age 60-64 Years: Findings From the MRC National Survey of Health and Development.

PubMed

Cooper, Rachel; Huang, Lei; Hardy, Rebecca; Crainiceanu, Adina; Harris, Tamara; Schrack, Jennifer A; Crainiceanu, Ciprian; Kuh, Diana

2017-10-01

The aim of this study was to investigate associations of current body mass index (BMI) and obesity history with daily patterns of physical activity. At age 60-64, participants from a British birth cohort study wore accelerometers for 5 days. Accelerometry counts were log-transformed and mean log-counts were used to derive a summary variable indicating total daily log-activity counts. Among those with complete data (n = 1,388) the associations of current BMI and age of first obesity were examined with: (a) total daily log-activity counts and (b) total log-activity counts in four segments of the day. Higher current BMI and younger age at obesity were strongly associated with lower levels of total daily activity at age 60-64 even after adjustment for sex, socioeconomic factors, and health status. The fully-adjusted mean difference in total daily log-activity counts was -581.7 (95% confidence interval: -757.2, -406.3) when comparing BMI ≥35 kg/m2 with <25 kg/m2, representing an 18.4% difference. Participants who had been obese since early adulthood had the lowest levels of activity (mean difference in total daily log-activity counts was -413.1 (-638.1, -188.2) when comparing those who were obese by age 26 or 36 with those who were never obese, representing a 13.1% difference). Obese older adults may require targeted interventions and additional support to improve their daily activity levels. As younger generations with greater lifetime exposure to obesity reach old age the proportion of adults achieving sufficient levels of activity to realize its associated health benefits is likely to decline. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America.

Increasing age and tear size reduce rotator cuff repair healing rate at 1 year.

PubMed

Rashid, Mustafa S; Cooper, Cushla; Cook, Jonathan; Cooper, David; Dakin, Stephanie G; Snelling, Sarah; Carr, Andrew J

2017-12-01

Background and purpose - There is a need to understand the reasons why a high proportion of rotator cuff repairs fail to heal. Using data from a large randomized clinical trial, we evaluated age and tear size as risk factors for failure of rotator cuff repair. Patients and methods - Between 2007 and 2014, 65 surgeons from 47 hospitals in the National Health Service (NHS) recruited 447 patients with atraumatic rotator cuff tendon tears to the United Kingdom Rotator Cuff Trial (UKUFF) and 256 underwent rotator cuff repair. Cuff integrity was assessed by imaging in 217 patients, at 12 months post-operation. Logistic regression analysis was used to determine the influence of age and intra-operative tear size on healing. Hand dominance, sex, and previous steroid injections were controlled for. Results - The overall healing rate was 122/217 (56%) at 12 months. Healing rate decreased with increasing tear size (small tears 66%, medium tears 68%, large tears 47%, and massive tears 27% healed). The mean age of patients with a healed repair was 61 years compared with 64 years for those with a non-healed repair. Mean age increased with larger tear sizes (small tears 59 years, medium tears 62 years, large tears 64 years, and massive tears 66 years). Increasing age was an independent factor that negatively influenced healing, even after controlling for tear size. Only massive tears were an independent predictor of non-healing, after controlling for age. Interpretation - Although increasing age and larger tear size are both risks for failure of rotator cuff repair healing, age is the dominant risk factor.

The prevalence and bother of lower urinary tract symptoms in men and women aged 40 years or over in Taiwan.

PubMed

Liu, Shih-Ping; Chuang, Yao-Chi; Sumarsono, Budiwan; Chang, Hui-Chen

2018-04-11

The prevalence of lower urinary tract symptoms (LUTS) in men and women in the general population in Taiwan is unclear. Community-based data on the epidemiology and effects of LUTS would therefore help improve understanding of the condition in this country. This study was an internet-based, self-administered survey, conducted in randomly selected adults aged ≥40 years. Participants answered questions on International Continence Society (ICS) symptom definitions, the International Prostate Symptom Score (IPSS) and the overactive bladder (OAB) symptom score. The study population comprised 2068 adults (51.4% women) with a mean age of 55 years. Using criteria from the ICS, LUTS were present in 60% of men and 57% of women. The prevalence of LUTS increased with age in both men and women. The most bothersome symptoms were terminal dribble, incomplete emptying and nocturia in men, and nocturia, perceived frequency and urgency in women. In the overall population, according to IPSS, 30% had at least moderate symptoms. OAB prevalence was 16% in both men and women. The likelihood of consulting a healthcare professional about urinary symptoms was low and not significantly different between men and women with LUTS (17% and 14%, respectively). More than half of men and women aged ≥40 years in Taiwan are affected by LUTS, and these symptoms are often bothersome. However, few individuals with LUTS consult healthcare professionals about their symptoms. Improved diagnosis and treatment of LUTS in Taiwan are needed to reduce the deleterious effects of the condition. CLINICALTRIALS. NCT02618421. Copyright © 2018. Published by Elsevier B.V.

Increased risk of pregnancy-induced hypertension and operative delivery after conception induced by in vitro fertilization/intracytoplasmic sperm injection in women aged 40 years and older.

PubMed

Toshimitsu, Masatake; Nagamatsu, Takeshi; Nagasaka, Takaaki; Iwasawa-Kawai, Yuki; Komatsu, Atsushi; Yamashita, Takahiro; Osuga, Yutaka; Fujii, Tomoyuki

2014-10-01

To clarify the association between preconception fertility status and obstetric outcomes in women aged 40 years and older. Retrospective study by reviewing medical records. Tertiary perinatal center in a university hospital. 330 women aged 40 years and older who delivered a singleton from 2006 to 2010, and 450 women aged 30 to 34 years who delivered at the same facility as controls. None. Incidence of pregnancy-induced hypertension, gestational diabetes mellitus, preterm birth, low birth weight, and mode of delivery assessed based on the mode of conception; spontaneous conception (SC) and in vitro fertilization/intracytoplasmic sperm injection conception (IVF-ICSI). The incidence of pregnancy-induced hypertension was statistically significantly higher in IVF-ICSI group than the SC group. This gap was commonly observed in both the women aged 40 years and older and those in the 30 to 34 age group. No statistically significant difference was observed in the frequency of gestational diabetes mellitus, preterm birth, or low birth weight. As a characteristic of nulliparous women of advanced age, the rate of operative delivery, which includes emergency cesarean section and instrumental delivery, was statistically significantly higher in IVF-ICSI group than in the SC group. Detailed investigation into the medical indications for operative delivery revealed that the difference was attributable to the elevated incidence of labor protraction and arrest. Preconception fertility status can be a predicting factor of the incidence of pregnancy-induced hypertension and labor outcome, especially for women aged 40 years and older. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Sports engagement and age at first myocardial infarction in men under 55 years of age.

PubMed

Janggen, Christoph; Gräni, Christoph; Brunner, Jonas; Trachsel, Lukas D; Windecker, Stephan; Eser, Prisca; Räber, Lorenz; Wilhelm, Matthias

2017-01-01

Low levels of physical activity in childhood are associated with clustering of cardiovascular risk factors (CVRF) as predisposition for atherosclerosis. We assessed the association between sports engagement and age at first myocardial infarction (MI) in a cohort of men under 55 years of age. The Bern percutaneous coronary intervention Registry (NCT 02241291) was analyzed from March 2009 until January 2012. Male patients with first MI, age 18 to 54 years and body mass index ≤25kg/m2 were included. Patients were stratified into two groups based on their starting age with organized sports ≥1 h/week outside school (EARLY: <18, CONTROL: ≥18 years or never). We assessed age at time of first MI, CVRF, and volume of sports training. Of 4,394 consecutive patients, 123 fulfilled the inclusion criteria (EARLY n = 81, CONTROL n = 42). Age at the time of first MI was 3 years younger in the EARLY compared to the CONTROL group (46.8±6.0 vs. 49.8±4.6 years, p = 0.006). Total lifetime training hours, and average yearly training hours, both, before and after age 18, were significantly greater in the EARLY group. Years of training <18 years were weakly inversely correlated with age at first MI (r2 = 0.075, p = 0.002). The proportion of sports-related MI was not different between EARLY and CONTROL (13.6% vs. 11.9%). Patients in the EARLY group had fewer CVRF (2 vs. 3; p = 0.001). Prevalence of smoking was equally high in both groups (63.0% and 64.3%). In our patients aged 54 and younger, the first MI occurred 3 years earlier in those who started regular sports activity before age 18, despite a more active lifestyle and favorable CVRF profile.

Tailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening Outcomes.

PubMed

Trentham-Dietz, Amy; Kerlikowske, Karla; Stout, Natasha K; Miglioretti, Diana L; Schechter, Clyde B; Ergun, Mehmet Ali; van den Broek, Jeroen J; Alagoz, Oguzhan; Sprague, Brian L; van Ravesteyn, Nicolien T; Near, Aimee M; Gangnon, Ronald E; Hampton, John M; Chandler, Young; de Koning, Harry J; Mandelblatt, Jeanne S; Tosteson, Anna N A

2016-11-15

Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored screening may provide greater benefits. To estimate outcomes for various screening intervals after age 50 years based on breast density and risk for breast cancer. Collaborative simulation modeling using national incidence, breast density, and screening performance data. United States. Women aged 50 years or older with various combinations of breast density and relative risk (RR) of 1.0, 1.3, 2.0, or 4.0. Annual, biennial, or triennial digital mammography screening from ages 50 to 74 years (vs. no screening) and ages 65 to 74 years (vs. biennial digital mammography from ages 50 to 64 years). Lifetime breast cancer deaths, life expectancy and quality-adjusted life-years (QALYs), false-positive mammograms, benign biopsy results, overdiagnosis, cost-effectiveness, and ratio of false-positive results to breast cancer deaths averted. Screening benefits and overdiagnosis increase with breast density and RR. False-positive mammograms and benign results on biopsy decrease with increasing risk. Among women with fatty breasts or scattered fibroglandular density and an RR of 1.0 or 1.3, breast cancer deaths averted were similar for triennial versus biennial screening for both age groups (50 to 74 years, median of 3.4 to 5.1 vs. 4.1 to 6.5 deaths averted; 65 to 74 years, median of 1.5 to 2.1 vs. 1.8 to 2.6 deaths averted). Breast cancer deaths averted increased with annual versus biennial screening for women aged 50 to 74 years at all levels of breast density and an RR of 4.0, and those aged 65 to 74 years with heterogeneously or extremely dense breasts and an RR of 4.0. However, harms were almost 2-fold higher. Triennial screening for the average-risk subgroup and annual screening for the highest-risk subgroup cost less than $100 000 per QALY gained. Models did not consider women younger than 50 years, those with an RR less than 1, or other imaging methods. Average-risk women

Exercise capacity and all-cause mortality in male veterans with hypertension aged ≥70 years.

PubMed

Faselis, Charles; Doumas, Michael; Pittaras, Andreas; Narayan, Puneet; Myers, Jonathan; Tsimploulis, Apostolos; Kokkinos, Peter

2014-07-01

Aging, even in otherwise healthy subjects, is associated with declines in muscle mass, strength, and aerobic capacity. Older individuals respond favorably to exercise, suggesting that physical inactivity plays an important role in age-related functional decline. Conversely, physical activity and improved exercise capacity are associated with lower mortality risk in hypertensive individuals. However, the effect of exercise capacity in older hypertensive individuals has not been investigated extensively. A total of 2153 men with hypertension, aged ≥70 years (mean, 75 ± 4) from the Washington, DC, and Palo Alto Veterans Affairs Medical Centers, underwent routine exercise tolerance testing. Peak workload was estimated in metabolic equivalents (METs). Fitness categories were established based on peak METs achieved, adjusted for age: very-low-fit, 2.0 to 4.0 METs (n=386); low-fit, 4.1 to 6.0 METs (n=1058); moderate-fit, 6.1 to 8.0 METs (n=495); high-fit >8.0 METs (n=214). Cox proportional hazard models were applied after adjusting for age, body mass index, race, cardiovascular disease, cardiovascular medications, and risk factors. All-cause mortality was quantified during a mean follow-up period of 9.0 ± 5.5 years. There were a total of 1039 deaths or 51.2 deaths per 1000 person-years of follow-up. Mortality risk was 11% lower (hazard ratio, 0.89; 95% confidence interval, 0.86-0.93; P<0.001) for every 1-MET increase in exercise capacity. When compared with those achieving ≤4.0 METs, mortality risk was 18% lower (hazard ratio, 0.82; 95% confidence interval, 0.70-0.95; P=0.011) for the low-fit, 36% for the moderate-fit (hazard ratio, 0.64; 95% confidence interval, 0.52-0.78; P<0.001), and 48% for the high-fit individuals (hazard ratio, 0.52; 95% confidence interval, 0.39-0.69; P<0.001). These findings suggest that exercise capacity is associated with lower mortality risk in elderly men with hypertension. © 2014 American Heart Association, Inc.

Brain volumes in healthy adults aged 40 years and over: a voxel-based morphometry study.

PubMed

Riello, Roberta; Sabattoli, Francesca; Beltramello, Alberto; Bonetti, Matteo; Bono, Giorgio; Falini, Andrea; Magnani, Giuseppe; Minonzio, Giorgio; Piovan, Enrico; Alaimo, Giuseppina; Ettori, Monica; Galluzzi, Samantha; Locatelli, Enrico; Noiszewska, Malgorzata; Testa, Cristina; Frisoni, Giovanni B

2005-08-01

Gender and age effect on brain morphology have been extensively investigated. However, the great variety in methods applied to morphology partly explain the conflicting results of linear patterns of tissue changes and lateral asymmetry in men and women. The aim of the present study was to assess the effect of age, gender and laterality on the volumes of gray matter (GM) and white matter (WM) in a large group of healthy adults by means of voxel-based morphometry. This technique, based on observer-independent algorithms, automatically segments the 3 types of tissue and computes the amount of tissue in each single voxel. Subjects were 229 healthy subjects of 40 years of age or older, who underwent magnetic resonance (MR) for reasons other than cognitive impairment. MR images were reoriented following the AC-PC line and, after removing the voxels below the cerebellum, were processed by Statistical Parametric Mapping (SPM99). GM and WM volumes were normalized for intracranial volume. Women had more fractional GM and WM volumes than men. Age was negatively correlated with both fractional GM and WM, and a gender x age interaction effect was found for WM, men having greater WM loss with advancing age. Pairwise differences between left and right GM were negative (greater GM in right hemisphere) in men, and positive (greater GM in left hemisphere) in women (-0.56+/-4.2 vs 0.99+/-4.8; p=0.019). These results support side-specific accelerated WM loss in men, and may help our better understanding of changes in regional brain structures associated with pathological aging.

Use of Smokeless Tobacco by Indian Women Aged 18–40 Years during Pregnancy and Reproductive Years

PubMed Central

Nair, Saritha; Schensul, Jean J.; Begum, Shahina; Pednekar, Mangesh S.; Oncken, Cheryl; Bilgi, Sameena M.; Pasi, Achhelal R.; Donta, Balaiah

2015-01-01

Objectives This paper discusses patterns of daily smokeless tobacco (SLT) use and correlates of poly SLT use among married women aged 18–40 years in a Mumbai slum community with implications for tobacco control. Methods Using a mixed methods approach, the study included a structured survey with 409 daily SLT users and in-depth interviews with 42 women. Participants for the survey were selected using a systematic sampling procedure (one woman in every fourth eligible household). Univariate and bivariate analysis, and multiple logistic regressions were conducted to identify demographic and social factors associated with women’s use of poly SLT products. To illustrate survey results, in-depth interviews were analyzed using Atlas ti software. Results Sixty-four percent of the women surveyed used only one type of SLT; of these, 30% used mishri, 32% used pan with tobacco and the rest used chewed tobacco (11%), gul (17%) or gutkha (10%). Thirty-six percent used more than one type of SLT. Poly SLT users chewed or rubbed 50% more tobacco as compared to single users (mean consumption of tobacco per day: 9.54 vs. 6.49 grams; p<0.001). Women were more likely to be poly SLT users if they were illiterate as compared to literate (adjusted odds ratio [AOR]=1.67; 95% confidence interval [CI]=1.07-2.71), if they had lived in Mumbai for 10 years or more, versus less than ten years (AOR=1.67, 95% CI=1.03-2.71); and if their husband was a poly SLT user as compared to a non SLT user (AOR=2.78, 95% CI=1.63-4.76). No differences were noted between pregnant and non-pregnant women in SLT consumption patterns. Conclusions Tobacco control policies and programs must focus specifically on both social context and use patterns to address SLT use among women of reproductive age with special attention to poly SLT users, an understudied and vulnerable population. PMID:25786247

Relation between Speech-in-Noise Threshold, Hearing Loss and Cognition from 40–69 Years of Age

PubMed Central

Moore, David R.; Edmondson-Jones, Mark; Dawes, Piers; Fortnum, Heather; McCormack, Abby; Pierzycki, Robert H.; Munro, Kevin J.

2014-01-01

Background Healthy hearing depends on sensitive ears and adequate brain processing. Essential aspects of both hearing and cognition decline with advancing age, but it is largely unknown how one influences the other. The current standard measure of hearing, the pure-tone audiogram is not very cognitively demanding and does not predict well the most important yet challenging use of hearing, listening to speech in noisy environments. We analysed data from UK Biobank that asked 40–69 year olds about their hearing, and assessed their ability on tests of speech-in-noise hearing and cognition. Methods and Findings About half a million volunteers were recruited through NHS registers. Respondents completed ‘whole-body’ testing in purpose-designed, community-based test centres across the UK. Objective hearing (spoken digit recognition in noise) and cognitive (reasoning, memory, processing speed) data were analysed using logistic and multiple regression methods. Speech hearing in noise declined exponentially with age for both sexes from about 50 years, differing from previous audiogram data that showed a more linear decline from <40 years for men, and consistently less hearing loss for women. The decline in speech-in-noise hearing was especially dramatic among those with lower cognitive scores. Decreasing cognitive ability and increasing age were both independently associated with decreasing ability to hear speech-in-noise (0.70 and 0.89 dB, respectively) among the population studied. Men subjectively reported up to 60% higher rates of difficulty hearing than women. Workplace noise history associated with difficulty in both subjective hearing and objective speech hearing in noise. Leisure noise history was associated with subjective, but not with objective difficulty hearing. Conclusions Older people have declining cognitive processing ability associated with reduced ability to hear speech in noise, measured by recognition of recorded spoken digits. Subjective reports

Increasing age and tear size reduce rotator cuff repair healing rate at 1 year

PubMed Central

Rashid, Mustafa S; Cooper, Cushla; Cook, Jonathan; Cooper, David; Dakin, Stephanie G; Snelling, Sarah; Carr, Andrew J

2017-01-01

Background and purpose — There is a need to understand the reasons why a high proportion of rotator cuff repairs fail to heal. Using data from a large randomized clinical trial, we evaluated age and tear size as risk factors for failure of rotator cuff repair. Patients and methods — Between 2007 and 2014, 65 surgeons from 47 hospitals in the National Health Service (NHS) recruited 447 patients with atraumatic rotator cuff tendon tears to the United Kingdom Rotator Cuff Trial (UKUFF) and 256 underwent rotator cuff repair. Cuff integrity was assessed by imaging in 217 patients, at 12 months post-operation. Logistic regression analysis was used to determine the influence of age and intra-operative tear size on healing. Hand dominance, sex, and previous steroid injections were controlled for. Results — The overall healing rate was 122/217 (56%) at 12 months. Healing rate decreased with increasing tear size (small tears 66%, medium tears 68%, large tears 47%, and massive tears 27% healed). The mean age of patients with a healed repair was 61 years compared with 64 years for those with a non-healed repair. Mean age increased with larger tear sizes (small tears 59 years, medium tears 62 years, large tears 64 years, and massive tears 66 years). Increasing age was an independent factor that negatively influenced healing, even after controlling for tear size. Only massive tears were an independent predictor of non-healing, after controlling for age. Interpretation — Although increasing age and larger tear size are both risks for failure of rotator cuff repair healing, age is the dominant risk factor. PMID:28880113

Suicide Means among Decedents Aged 50+ Years, 2005-2014: Trends and Associations with Sociodemographic and Precipitating Factors.

PubMed

Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan; Kaplan, Mark S; Conwell, Yeates

2017-12-01

To examine 1) temporal trends between 2005 and 2014 in the three most frequently used suicide means (firearms, hanging/suffocation, alcohol/drug/medicine overdose) by decedents aged 50+ years and 2) associations of suicide means with sociodemographic and precipitating factors. The National Violent Death Reporting System, 2005-2014, provided data (N = 46,857). Suicide means were identified from ICD-10 codes for underlying cause of death and coroner/medical examiner (CME) reports. Precipitating factors are based on either CME or law enforcement report. Age-group (50-64 and 65+ years) and gender-separate logistic regression analyses were used to examine study questions. In the 50-64 years age group, each advancing year (i.e., from 2005 to 2014) was associated with a 1% decrease in the odds of firearm use and a 6% increase in the odds of hanging/suffocation among men; a 9% increase in the odds of hanging/suffocation among women; and a 4% decrease in the odds of overdose among each gender. In the 65+ years age group, each advancing year was associated with a 4% increase in the odds of overdose among men. Physical health was a significant factor for firearm use among men (adjusted odds ratio: 1.47; 95% CI: 1.39-1.55) only. Regardless of gender and age, mental health and substance abuse problems and prior suicide attempts were associated with hanging/suffocation and overdose. Firearm use decreased among men aged 50-64 years between 2005 and 2014, but its use did not change among the other gender by age groups. With rapidly growing numbers of older adults, routine suicide risk assessments, firearm safety monitoring, and interventions to improve quality of life are needed. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Age-Specific Prevalence of Visual Impairment and Refractive Error in Children Aged 3-10 Years in Shanghai, China.

PubMed

Ma, Yingyan; Qu, Xiaomei; Zhu, Xiaofeng; Xu, Xun; Zhu, Jianfeng; Sankaridurg, Padmaja; Lin, Senlin; Lu, Lina; Zhao, Rong; Wang, Ling; Shi, Huijing; Tan, Hui; You, Xiaofang; Yuan, Hong; Sun, Sifei; Wang, Mingjin; He, Xiangui; Zou, Haidong; Congdon, Nathan

2016-11-01

We assessed changes in age-specific prevalence of refractive error at the time of starting school, by comparing preschool and school age cohorts in Shanghai, China. A cross-sectional study was done in Jiading District, Shanghai during November and December 2013. We randomly selected 7 kindergartens and 7 primary schools, with probability proportionate to size. Chinese children (n = 8398) aged 3 to 10 years were enumerated, and 8267 (98.4%) were included. Children underwent distance visual acuity assessment and refraction measurement by cycloplegic autorefraction and subjective refraction. The prevalence of uncorrected visual acuity (UCVA), presenting visual acuity, and best-corrected visual acuity in the better eye of ≤20/40 was 19.8%, 15.5%, and 1.7%, respectively. Among those with UCVA ≤ 20/40, 93.2% could achieve visual acuity of ≥20/32 with refraction. Only 28.7% (n = 465) of children with UCVA in the better eye of ≤20/40 wore glasses. Prevalence of myopia (spherical equivalent ≤-0.5 diopters [D] in at least one eye) increased from 1.78% in 3-year-olds to 52.2% in 10-year-olds, while prevalence of hyperopia (spherical equivalent ≥+2.0 D) decreased from 17.8% among 3-year-olds to 2.6% by 10 years of age. After adjusting for age, attending elite "high-level" school was statistically associated with greater myopia prevalence. The prevalence of myopia was lower or comparable to that reported in other populations from age 3 to 5 years, but increased dramatically after 6 years, consistent with a strong environmental role of schooling on myopia development.

27 CFR 5.40 - Statements of age and percentage.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Distilled Spirits § 5.40 Statements of age and percentage. (a) Statements of age and percentage for whisky. In the case of straight whisky bottled in conformity with the bottled in bond labeling requirements and of domestic or foreign whisky, whether or not mixed or blended, all of which is 4 years old or...

27 CFR 5.40 - Statements of age and percentage.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Distilled Spirits § 5.40 Statements of age and percentage. (a) Statements of age and percentage for whisky. In the case of straight whisky bottled in conformity with the bottled in bond labeling requirements and of domestic or foreign whisky, whether or not mixed or blended, all of which is 4 years old or...

The association between chronological age, age at injury and employment: Is there a mediating effect of secondary health conditions?

PubMed

Marti, A; Boes, S; Lay, V; Escorpizo, R; Reuben Escorpizo, P T; Trezzini, B

2016-03-01

Cross-sectional observational study with data from the 2012 community-based survey of the Swiss Spinal Cord Injury Cohort Study. To examine the relationships between chronological age, age at injury, secondary health conditions (SHCs) and paid employment. Community setting in Switzerland. A total of 1159 individuals of working age (16-63 years for women and 64 years for men) with traumatic or non-traumatic spinal cord injury (SCI) were included in the study. Direct and indirect (via SHCs) effects of chronological age and age at injury on paid employment were tested using a decomposition method for logistic regression models. Both chronological age groups (age 35-49 and 50-63/64 years) and the group with age at injury beyond 40 years showed negative direct effects on employment status. A partial indirect effect (mediation) via chronic pain was found in the group with the highest chronological age (>50 years). Furthermore, pressure ulcer, pain and urinary tract infection were negatively related with employment in both models, that is, chronological age and employment and age at injury and employment. Being older and having a higher age at injury directly affects whether an individual is employed. Pain is mediating the relation between chronological age and employment. Furthermore, pressure ulcer, chronic pain and urinary tract infection directly reduce the likelihood to be employed and, therefore, represent important intervention targets in efforts to maintain or engage in employment of individuals with SCI.

ACL reconstruction in patients aged 40 years and older: a systematic review and introduction of a new methodology score for ACL studies.

PubMed

Brown, Christopher A; McAdams, Timothy R; Harris, Alex H S; Maffulli, Nicola; Safran, Marc R

2013-09-01

Treatment of the anterior cruciate ligament (ACL)-deficient knee in older patients remains a core debate. To perform a systematic review of studies that assessed outcomes in patients aged 40 years and older treated with ACL reconstruction and to provide a new methodological scoring system that is directed at critical assessment of studies evaluating ACL surgical outcomes: the ACL Methodology Score (AMS). Systematic review. A comprehensive literature search was performed from 1995 to 2012 using MEDLINE, EMBASE, and Scopus. Inclusion criteria for studies were primary ACL injury, patient age of 40 years and older, and mean follow-up of at least 21 months after reconstruction. Nineteen studies met the inclusion criteria from the 371 abstracts from MEDLINE and 880 abstracts from Scopus. Clinical outcomes (International Knee Documentation Committee [IKDC], Lysholm, and Tegner activity scores), joint stability measures (Lachman test, pivot-shift test, and instrumented knee arthrometer assessment), graft type, complications, and reported chondral or meniscal injury were evaluated in this review. A new methodology scoring system was developed to be specific at critically analyzing ACL outcome studies and used to examine each study design. Nineteen studies describing 627 patients (632 knees; mean age, 49.0 years; range, 42.6-60.0 years) were included in the review. The mean time to surgery was 32.0 months (range, 2.9-88.0 months), with a mean follow-up of 40.2 months (range, 21.0-114.0 months). The IKDC, Lysholm, and Tegner scores and knee laxity assessment indicated favorable results in the studies that reported these outcomes. Patients did not demonstrate a significant difference between graft types and functional outcome scores or stability assessment. The mean AMS was 43.9 ± 7.2 (range, 33.5-57.5). The level of evidence rating did not positively correlate with the AMS, which suggests that the new AMS system may be able to detect errors in methodology or reporting that

Obesity History and Daily Patterns of Physical Activity at Age 60–64 Years: Findings From the MRC National Survey of Health and Development

PubMed Central

Cooper, Rachel; Huang, Lei; Hardy, Rebecca; Crainiceanu, Adina; Harris, Tamara; Schrack, Jennifer A; Crainiceanu, Ciprian; Kuh, Diana

2017-01-01

Abstract Background The aim of this study was to investigate associations of current body mass index (BMI) and obesity history with daily patterns of physical activity. Methods At age 60–64, participants from a British birth cohort study wore accelerometers for 5 days. Accelerometry counts were log-transformed and mean log-counts were used to derive a summary variable indicating total daily log-activity counts. Among those with complete data (n = 1,388) the associations of current BMI and age of first obesity were examined with: (a) total daily log-activity counts and (b) total log-activity counts in four segments of the day. Results Higher current BMI and younger age at obesity were strongly associated with lower levels of total daily activity at age 60–64 even after adjustment for sex, socioeconomic factors, and health status. The fully-adjusted mean difference in total daily log-activity counts was −581.7 (95% confidence interval: −757.2, −406.3) when comparing BMI ≥35 kg/m2 with <25 kg/m2, representing an 18.4% difference. Participants who had been obese since early adulthood had the lowest levels of activity (mean difference in total daily log-activity counts was −413.1 (−638.1, −188.2) when comparing those who were obese by age 26 or 36 with those who were never obese, representing a 13.1% difference). Conclusions Obese older adults may require targeted interventions and additional support to improve their daily activity levels. As younger generations with greater lifetime exposure to obesity reach old age the proportion of adults achieving sufficient levels of activity to realize its associated health benefits is likely to decline. PMID:28329086

Outcomes of labor epidural analgesia among women aged over 40: A single-institution retrospective study.

PubMed

Okazaki, Atsuko; Fukushima, Risa; Nagashima, Sayuri; Mazda, Yusuke; Tamura, Kazumi; Terui, Katsuo; Tanaka, Motoshi

2016-12-01

The purpose of this study was to investigate the effects of labor epidural analgesia (LEA) on maternal and neonatal outcomes among parturients aged 40 years or older. We retrospectively reviewed medical records of all laboring, singleton and cephalic deliveries at ≥36 weeks' gestation at the Saitama Medical Center from April 2003 to September 2012. Women aged ≥40 years who received LEA (≥40 with LEA group) were compared with women aged ≥40 years who delivered without LEA (≥40 without LEA group) and women <40 years who received LEA (<40 with LEA group). Extracted outcomes included mode of delivery, oxytocin augmentation, duration of labor, amount of estimated blood loss, umbilical artery pH, Apgar scores, and neonatal intensive care unit admission. This study included 4441 women. There were 74 women in the ≥40 with LEA group, 369 in the ≥40 without LEA group, and 601 in the <40 with LEA group. The maternal outcomes of emergency cesarean delivery rate (9.5%, 12.5%, 9.0%), instrumental delivery rate (33.8%, 10.3%, 28.3%), duration of labor (521 min, 321 min, 565 min), and estimated blood loss (524 g, 351 g, 412 g) were reported for the ≥40 with LEA, ≥40 without LEA, and <40 with LEA groups, respectively. Neonatal outcomes were not different between these groups. LEA use was not associated with emergency cesarean delivery in the multivariable analysis. Our study showed that parturients aged ≥40 with LEA can expect similar LEA-associated labor outcomes to younger parturients with LEA. © 2016 Japan Society of Obstetrics and Gynecology.

Adult-Onset Asthma Becomes the Dominant Phenotype among Women by Age 40 Years. The Longitudinal CARDIA Study

PubMed Central

Qualls, Clifford; Schuyler, Mark; Arynchyn, Alexander; Alvarado, Jesse H.; Smith, Lewis J.; Jacobs, David R.

2013-01-01

Rationale: Although asthma is usually considered to originate in childhood, adult-onset disease is being increasingly reported. Objectives: To contrast the proportion and natural history of adult-onset versus pediatric-onset asthma in a community-based cohort. We hypothesized that asthma in women is predominantly of adult onset rather than of pediatric onset. Methods: This study used data from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort in the United States over a 25-year period. Adult- and pediatric-onset asthma phenotypes were studied, as defined by age at onset of 18 years or older. Subjects with asthma were categorized by sex, obesity, atopy, smoking, and race by mean age/examination year, using a three-way analysis of covariance model. Natural history of disease was examined using probabilities derived from a Markov chain model. Measurements and Main Results: Asthma of adult onset became the dominant (i.e., exceeded 50%) phenotype in women by age 40 years. The age by which adult-onset asthma became the dominant phenotype was further lowered for obese, nonatopic, ever-smoking, or white women. The prevalence trend with increasing time for adult-onset disease was greater among subjects with nonatopic than atopic asthma among both sexes. Furthermore, adult-onset asthma had remarkable sex-related differences in risk factors. In both sexes, the quiescent state for adult-onset asthma was less frequent and also “less stable” over time than for pediatric-onset asthma. Conclusions: Using a large national cohort, this study challenges the dictum that most asthma in adults originates in childhood. Studies of the differences between pediatric- and adult-onset asthma may provide greater insight into the phenotypic heterogeneity of asthma. PMID:23802814

Age-stratified 5-year risks of cervical precancer among women with enrollment and newly detected HPV infection.

PubMed

Gage, Julia C; Katki, Hormuzd A; Schiffman, Mark; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas; Cheung, Li C; Castle, Philip E; Kinney, Walter K

2015-04-01

It is unclear whether a woman's age influences her risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) upon detection of HPV. A large change in risk as women age would influence vaccination and screening policies. Among 972,029 women age 30-64 undergoing screening with Pap and HPV testing (Hybrid Capture 2, Qiagen, Germantown, MD) at Kaiser Permanente Northern California (KPNC), we calculated age-specific 5-year CIN3+ risks among women with HPV infections detected at enrollment, and among women with "newly detected" HPV infections at their second screening visit. Women (57,899, 6.0%) had an enrollment HPV infection. Among the women testing HPV negative at enrollment with a second screening visit, 16,724 (3.3%) had a newly detected HPV infection at their second visit. Both enrollment and newly detected HPV rates declined with age (p < 0.001). Women with enrollment versus newly detected HPV infection had higher 5-year CIN3+ risks: 8.5% versus 3.9%, (p < 0.0001). Risks did not increase with age but declined slightly from 30-34 years to 60-64 years: 9.4% versus 7.4% (p = 0.017) for enrollment HPV and 5.1% versus 3.5% (p = 0.014) for newly detected HPV. Among women age 30-64 in an established screening program, women with newly detected HPV infections were at lower risk than women with enrollment infections, suggesting reduced benefit vaccinating women at older ages. Although the rates of HPV infection declined dramatically with age, the subsequent CIN3+ risks associated with HPV infection declined only slightly. The CIN3+ risks among older women are sufficiently elevated to warrant continued screening through age 65. © 2014 UICC.

Age-Stratified 5-Year Risks of Cervical Precancer among Women with Enrollment and Newly Detected HPV Infection

PubMed Central

Gage, Julia C.; Katki, Hormuzd A.; Schiffman, Mark; Fetterman, Barbara; Poitras, Nancy E.; Lorey, Thomas; Cheung, Li C.; Castle, Philip E.; Kinney, Walter K.

2014-01-01

It is unclear whether a woman's age influences her risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) upon detection of HPV. A large change in risk as women age would influence vaccination and screening policies. Among 972,029 women age 30-64 undergoing screening with Pap and HPV testing (Hybrid Capture 2, Qiagen, Germantown, MD, USA) at Kaiser Permanente Northern California (KPNC), we calculated age-specific 5-year CIN3+ risks among women with HPV infections detected at enrollment, and among women with “newly detected” HPV infections at their second screening visit. 57,899 women (6.0%) had an enrollment HPV infection. Among the women testing HPV negative at enrollment with a second screening visit, 16,724 (3.3%) had a newly detected HPV infection at their second visit. Both enrollment and newly detected HPV rates declined with age (p<.001). Women with enrollment vs. newly detected HPV infection had higher 5-year CIN3+ risks: 8.5% vs. 3.9%, (p<.0001). Risks did not increase with age but declined slightly from 30-34 years to 60-64 years: 9.4% vs. 7.4% (p=0.017) for enrollment HPV and 5.1% vs. 3.5% (p=0.014) for newly detected HPV. Among women age 30-64 in an established screening program, women with newly detected HPV infections were at lower risk than women with enrollment infections, suggesting reduced benefit vaccinating women at older ages. Although the rates of HPV infection declined dramatically with age, the subsequent CIN3+ risks associated with HPV infection declined only slightly. The CIN3+ risks among older women are sufficiently elevated to warrant continued screening through age 65. PMID:25136967

Surveillance for Health Care Access and Health Services Use, Adults Aged 18-64 Years - Behavioral Risk Factor Surveillance System, United States, 2014.

PubMed

Okoro, Catherine A; Zhao, Guixiang; Fox, Jared B; Eke, Paul I; Greenlund, Kurt J; Town, Machell

2017-02-24

As a result of the 2010 Patient Protection and Affordable Care Act, millions of U.S. adults attained health insurance coverage. However, millions of adults remain uninsured or underinsured. Compared with adults without barriers to health care, adults who lack health insurance coverage, have coverage gaps, or skip or delay care because of limited personal finances might face increased risk for poor physical and mental health and premature mortality. 2014. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. Data are collected from states, the District of Columbia, and participating U.S. territories on health risk behaviors, chronic health conditions, health care access, and use of clinical preventive services (CPS). An optional Health Care Access module was included in the 2014 BRFSS. This report summarizes 2014 BRFSS data from all 50 states and the District of Columbia on health care access and use of selected CPS recommended by the U.S. Preventive Services Task Force or the Advisory Committee on Immunization Practices among working-aged adults (aged 18-64 years), by state, state Medicaid expansion status, expanded geographic region, and federal poverty level (FPL). This report also provides analysis of primary type of health insurance coverage at the time of interview, continuity of health insurance coverage during the preceding 12 months, and other health care access measures (i.e., unmet health care need because of cost, unmet prescription need because of cost, medical debt [medical bills being paid off over time], number of health care visits during the preceding year, and satisfaction with received health care) from 43 states that included questions from the optional BRFSS Health Care Access module. In 2014, health insurance coverage and other health care access measures varied substantially by state, state

When I’m 64: Effects of an Interdisciplinary Gerontology Course on First-Year Undergraduates’ Perceptions of Aging

PubMed Central

Merz, C. Caroline; Stark, Susan; Morrow-Howell, Nancy; Carpenter, Brian

2016-01-01

One challenge for gerontology is getting more students interested in aging at an earlier point in their academic career. This study evaluated the impact of an interdisciplinary course on aging designed for first-year undergraduate students. The course aimed to expand students’ appreciation of the personal and professional relevance of aging issues, with the goal of expanding their aging-related curricular and career interests. Main outcome variables of the study included knowledge of older adults and aging, attitudes toward older adults, and anxiety about personal aging. Participants included an intervention group enrolled in the course and a control group not enrolled in the course. Compared to baseline, at the end of the semester students in the class had more knowledge about aging and more positive explicit attitudes toward older adults, but their implicit attitudes toward older adults and anxiety about aging did not change. Control students showed no changes. These findings suggest that objective knowledge of aging and explicit attitudes improve with curricular intervention, but implicit attitudes and anxiety might be more difficult to change. Gerontology education is a complex undertaking whose diverse goals must be clearly articulated in order to guide curricular interventions and incite curiosity among young undergraduate students. PMID:26886151

Daily Rice Intake Strongly Influences the Incidence of Metabolic Syndrome in Japanese Men Aged 40–59 Years

PubMed Central

Watanabe, Yoko; Saito, Isao; Asada, Yasuhiko; Kishida, Taro; Matsuo, Tatsuhiro; Yamaizumi, Masamitsu; Kato, Tadahiro

2013-01-01

Objectives: The first objective of this study was to classify men aged 40–74 yrs with metabolic syndrome (MetS) according to daily rice intake, and the second was to investigate physical measurements, physiological examinations, blood biochemical assays, intake of food other than rice and lifestyle and environmental factors in the study group. Methods: We analyzed data from 6095 men aged 40–74 yrs who had undergone full medical examinations. The men were classified into 3 age groups: (1) 40–49 yrs, (2) 50–59 yrs, and (3) 60–74 yrs. The men were classified further into 3 groups according to daily rice intake: group 1 (≤300 g), group 2 (300–450 g), and group 3 (≥450 g). The relationship between daily rice intake and the following factors was analyzed in the three age brackets: (1) physical measurements including waist circumference, (2) physiological measurements, (3) serum biochemical indices, (4) whether or not the person was taking medication for hypertension, diabetes mellitus or serum lipid abnormalities, (5) lifestyle, and (6) consumption of foods other than rice. Results: Daily rice intake was related strongly to the occurrence of MetS in all three age brackets. Multiple logistic regression analysis showed (1) a significant increase in the odds ratio for MetS (1.461 times) for group 3 compared with group 1 in men aged 40–49 yrs and (2) a significant increase in the odds ratio for MetS (1.501 times) for group 3 compared with group 1 in men aged 50–59 yrs. However, there was no significant difference in the odds ratio for MetS among rice intake groups in the 60–74 age bracket. Conclusion: In men aged 40–59 yrs, daily rice intake strongly influenced the incidence of MetS, whereas in men aged 60–74 yrs, there was no relationship between daily rice intake and MetS. PMID:25649461

Preschool Gender-Typed Play Behavior at Age 3.5 Years Predicts Physical Aggression at Age 13 Years.

PubMed

Kung, Karson T F; Li, Gu; Golding, Jean; Hines, Melissa

2018-05-01

Gender differences in play behavior and physical aggression have been consistently reported. Theoretical perspectives concerning evolutionary, social, and social-cognitive mechanisms suggest that male-typical play behavior during childhood increases subsequent physical aggression. The evidence supporting these connections is limited, however. The present study investigated the association between gender-typed play behavior in early childhood and physical aggression in early adolescence using a sample drawn from a longitudinal, population study, the Avon Longitudinal Study of Parents and Children. Based on gender-typed play behavior as measured by the Pre-School Activities Inventory at age 3.5 years, samples of masculine (64 boys, 60 girls), feminine (80 boys, 66 girls), and randomly selected control children (55 boys, 67 girls) were recruited at age 13 years and administered the Reinisch Aggression Inventory. After controlling for a range of sociodemographic variables, maternal characteristics, and behavioral problems, including hyperactivity and conduct problems at age 3.5, significant group differences in physical aggression at age 13 were found among children classified as masculine, control, and feminine at age 3.5. Masculine children exhibited significantly more physical aggression than control children or feminine children, and control children exhibited significantly more physical aggression than feminine children. The association between gender-typed play behavior and physical aggression was not moderated by sex. These results suggest that the degree of childhood gender-typed play behavior independently predicts the degree of physical aggression at adolescence in boys and in girls.

42 CFR 435.138 - Disabled widows and widowers aged 60 through 64 who would be eligible for SSI except for early...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Disabled widows and widowers aged 60 through 64 who... ISLANDS, AND AMERICAN SAMOA Mandatory Coverage Mandatory Coverage of the Aged, Blind, and Disabled § 435.138 Disabled widows and widowers aged 60 through 64 who would be eligible for SSI except for early...

42 CFR 435.138 - Disabled widows and widowers aged 60 through 64 who would be eligible for SSI except for early...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Disabled widows and widowers aged 60 through 64 who... ISLANDS, AND AMERICAN SAMOA Mandatory Coverage Mandatory Coverage of the Aged, Blind, and Disabled § 435.138 Disabled widows and widowers aged 60 through 64 who would be eligible for SSI except for early...

Incidence of right-sided colonic tumors (non-appendiceal) in patient's ≥40 years of age presenting with features of acute appendicitis.

PubMed

Khan, Suhail Aslam; Khokhar, Haseeb Anwar; Nasr, A R H; Carton, Eleanor

2013-01-01

Non-appendiceal tumors can mimic and present with clinical features of acute appendicitis in patients of age 40 years or above. The aim of this prospective study is to investigate the incidence of right-sided (non-appendiceal) colonic tumors in patients presenting with clinical features of acute appendicitis. A prospective data analysis of 1662 patients using appendectomy database was performed from 2005 to 2011. Patients above age 40 years or older were included. Patients were compared for demographic data, clinical presentation, radiological findings, operative technique & findings, histo-pathological findings and postoperative complications. The primary outcome was incidence of right-sided colonic (non-appendiceal) tumors presenting with features of acute appendicitis. Secondary outcomes measured were, role of diagnostic radiology, negative appendectomy rate, length of stay and changing trends in operative techniques. From 1662 patients initially reviewed, only 179 patients (10.77%) age 40 years or above mean (56 ± 11.75), median 54 (40-89), with clinical features of acute appendicitis were included in the final analysis. F:M ratio was (1:1.06). CT scan showed in only 1 patient (1.25%, OR = 0.806, p = 0.695), suspicion of cecal tumor and underwent right hemicolectomy. Histological examination of specimen showed, 2 patients (1.11%, OR = 1.10, p = 0.47) had primary appendiceal tumors, in which one patient was histologically reported as appendiceal mucocele (mucinous cystadenoma with low-grade dysplasia), while the other one had appendeceal carcinoid (Goblet cell carcinoid). In the other tumor group one patient had metastatic involvement of appendix from ovarian tumor. The time to appendectomy in radiological group was delayed by (9.2 ± 3.7 h). 131 (73.1%) had laparoscopic while 48 (26.81%) underwent open appendectomy. The negative appendectomy rate was (1.12%) and 30 days complication rate was (11.73%, p = 0.27). Mean length of stay was 3.54�

Mammography use among women ages 40-49 after the 2009 U.S. Preventive Services Task Force recommendation.

PubMed

Block, Lauren D; Jarlenski, Marian P; Wu, Albert W; Bennett, Wendy L

2013-11-01

In 2009, the U.S. Preventive Service Task Force changed its recommendation regarding screening mammography in average-risk women aged 40-49 years. To evaluate the effects of the 2009 recommendation on reported mammogram use in a population-based survey. Secondary data analysis of data collected in the 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System surveys. Women ages 40-74 years in the 50 states and Washington, DC who were not pregnant at time of survey and reported data on mammogram use during the 2006, 2008, or 2010 survey. Mammogram use was compared between women ages 40-49 and women ages 50-74 before and after the recommendation. We performed a difference-in-difference estimation adjusted for access to care, education, race, and health status, and stratified analyses by whether women reported having a routine checkup in the prior year. Reported prevalence of mammogram use in the past year among women ages 40-49 and 50-74 was 53.2 % and 65.2 %, respectively in 2008, and 51.7 % and 62.4 % in 2010. In 2010, mammography use did not significantly decline from 2006-2008 in women ages 40-49 relative to women ages 50-74. There was no reduction in mammography use among younger women in 2010 compared to older women and previous years. Patients and providers may have been hesitant to comply with the 2009 recommendation.

Changes in aerobic power of women, ages 20-64 yr

NASA Technical Reports Server (NTRS)

Jackson, A. S.; Wier, L. T.; Ayers, G. W.; Beard, E. F.; Stuteville, J. E.; Blair, S. N.

1996-01-01

This study quantified and compared the cross-sectional and longitudinal influence of age, self-report physical activity (SR-PA), and body composition (%fat) on the decline of maximal aerobic power (VO2peak) of women. The cross-sectional sample consisted of 409 healthy women, ages 20-64 yr. The 43 women of the longitudinal sample were from the same population and examined twice, the mean time between tests was 3.7 (+/-2.2) yr. Peak oxygen uptake was determined by indirect calorimetry during a maximal treadmill test. The zero-order correlation of -0.742 between VO2peak and %fat was significantly (P < 0.05) higher then the SR-PA (r = 0.626) and age correlations (r = -0.633). Linear regression defined the cross-sectional age-related decline in VO2peak at 0.537 ml.kg-1.min-1.yr-1. Multiple regression analysis (R = 0.851) showed that adding %fat and SR-PA and their interaction to the regression model reduced the age regression weight of -0.537, to -0.265 ml.kg-1.min-1.yr-1. Statistically controlling for time differences between tests, general linear models analysis showed that longitudinal changes in aerobic power were due to independent changes in %fat and SR-PA, confirming the cross-sectional results. These findings are consistent with men's data from the same lab showing that about 50% of the cross-sectional age-related decline in VO2peak was due to %fat and SR-PA.

Liver Transplantation With Old Grafts: A Ten-Year Experience.

PubMed

Roullet, S; Defaye, M; Quinart, A; Adam, J-P; Chiche, L; Laurent, C; Neau-Cransac, M

2017-11-01

The persistent scarcity of donors has prompted liver transplantation teams to find solutions for increasing graft availability. We report our experience of liver transplantations performed with grafts from older donors, specifically over 70 and 80 years old. We analyzed our prospectively maintained single-center database from January 1, 2005, to December 31, 2014, with 380 liver transplantations performed in 354 patients. Six groups were composed according to donor age: <40 (n = 84), 40 to 49 (n = 67), from 50 to 59 (n = 62), from 60 to 69 (n = 76), from 70 to 79 (n = 64), and ≥80 years (n = 27). Donors <40 years of age had a lower body mass index, died more often from trauma, and more often had cardiac arrest and high transaminase levels. In contrast, older donors (≥70 years of age) died more often from stroke. Recipients of grafts from donors <50 years of age were more frequently infected by hepatitis C virus; recipients of oldest grafts more often had hepatocellular carcinoma. Cold ischemia time was the shortest in donors >80 years of age. Patient survival was not significantly different between the groups. In multivariate analysis, factors predicting graft loss were transaminase peak, retransplantation and cold ischemia time but not donor age. Older donors >70 and >80 years of age could provide excellent liver grafts. Copyright © 2017 Elsevier Inc. All rights reserved.

40 CFR 64.4 - Submittal requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... proposed to satisfy § 64.3(b)(2) or (3) include differences from manufacturer recommendations, the owner or operator shall explain the reasons for the differences between the requirements proposed by the owner or... conditions representative of maximum emissions potential under anticipated operating conditions at the...

40 CFR 64.4 - Submittal requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... proposed to satisfy § 64.3(b)(2) or (3) include differences from manufacturer recommendations, the owner or operator shall explain the reasons for the differences between the requirements proposed by the owner or... conditions representative of maximum emissions potential under anticipated operating conditions at the...

Health screening - men - age 40 - 64

MedlinePlus

... Help you get to know your provider in case of an illness Information Even if you feel fine, you should still see your provider for regular checkups. These visits can help you avoid problems in the future. For example, the only way to find out if you ...

Participation restriction and assistance needs in people with spinal cord injuries of more than 40 year duration.

PubMed

Savic, Gordana; Frankel, Hans L; Jamous, Mohamed Ali; Soni, Bakulesh M; Charlifue, Susan

2018-01-01

Prospective observational. Examine changes in participation restriction and assistance needs in a sample of people with long-standing spinal cord injuries (SCIs). Two British spinal centres. The sample consisted of British ageing with SCI study participants who were seen at baseline (1990 or 1993) and in the final follow-up (2010). Outcome measures were the Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) and interview questions about assistance needs. Eighty-five Ageing study participants took part in 2010; their mean age was 67.65 years and the mean time since injury was 46.26 years. The mean CHART-SF physical independence subscore decreased from 97.44 in 1990 to 91.26 in 2010, mobility from 95.58 to 82.10, occupation from 86.82 to 64.49 and social integration from 96.29 to 88.68 (all p  < 0.05). Increasing assistance needs were reported by 10.1% of participants in 1990, by 36.6% in 2010 ( p  < 0.05) and by 62.4% over the entire 20-year study period. Persons requiring more assistance were older and injured longer, had a more severe SCI and lower self-reported quality of life and life satisfaction ( p  < 0.05). In the multivariate logistic regression, the strongest predictor of needing more assistance was injury severity ( p  < 0.05). An increase in participation restriction and in assistance needs was reported over the 20 year follow-up in persons injured more than 40 years ago. SCI severity was the main risk factor for needing more assistance. Clinical awareness of how participation changes with age may help provide timely intervention and offset declines.

Preventive Aspirin and Other Antiplatelet Medication Use Among U.S. Adults Aged ≥40 Years: Data from the National Health and Nutrition Examination Survey, 2011–2012

PubMed Central

Dillon, Charles F.; Eberhardt, Mark S.; Wright, Jacqueline D.; Burt, Vicki L.

2015-01-01

Objective We estimated the prevalence of preventive aspirin and/or other antiplatelet medication use and the dosage of aspirin use in the U.S. adult population. Methods We conducted cross-sectional analyses of a representative sample (n=3,599) of U.S. adults aged ≥40 years from the National Health and Nutrition Examination Survey, 2011–2012. Results In 2011–2012, one-third of U.S. adults aged ≥40 years reported taking preventive aspirin and/or other antiplatelet medications, 97% of whom indicated preventive aspirin use. Preventive aspirin use increased with age (from 11% of those aged 40–49 years to 54% of those ≥80 years of age, p<0.001). Non-Hispanic white (35%) and black (30%) adults were more likely to take preventive aspirin than non-Hispanic Asian (20%, p<0.001) and Hispanic (22%, p=0.013) adults. Adults with, compared with those without health insurance, and adults with ≥2 doctor visits in the past year, diagnosed diabetes, hypertension, or high cholesterol were twice as likely to take preventive aspirin. Among those with cardiovascular disease, 76% reported taking preventive aspirin and/or other antiplatelet medications, of whom 91% were taking preventive aspirin. Among adults without cardiovascular disease, 28% reported taking preventive aspirin. Adherence rates to medically recommended aspirin use were 82% overall, 91% for secondary prevention, and 79% for primary prevention. Among current preventive aspirin users, 70% were taking 81 milligrams (mg) of aspirin daily and 13% were taking 325 mg of aspirin daily. Conclusion The vast majority of antiplatelet therapy is preventive aspirin use. A health-care provider's recommendation to take preventive aspirin is an important determinant of current preventive aspirin use. PMID:26556936

Urban Residence and Higher Education Do Not Protect against Cognitive Decline in Aging and Dementia: 10-Year Follow-Up of the Canadian Study of Health and Aging

ERIC Educational Resources Information Center

Helmes, Edward; Van Gerven, Pascal W. M.

2017-01-01

The construct of cognitive reserve has primarily been defined in terms of a single proxy measure, education. There may, however, be alternative, potentially additive, proxy measures of cognitive reserve, such as rural or urban residence. Using a large sample of 10,263 older Canadians, ranging in age between 64 and 99 years (mean age = 75.7 years,…

Bells Test: Are there differences in performance between adult groups aged 40-59 and 60-75?

PubMed Central

Paiva, Silvio Cesar Escovar; Viapiana, Vanisa Fante; Cardoso, Caroline de Oliveira; Fonseca, Rochele Paz

2017-01-01

Objective To verify whether differences exist between groups of Brazilian adults aged 40-59 and 60-75 in respective performance on the Bells Test, given the dearth of literature investigating the relationship between focused visual attention and the age factor. Methods Eighty-four neurologically healthy adults (half aged 40-59 and half 60-75) with high educational level (40-59 years group: M=17.75 years' education; SD=4.00; 60-75 years group: M=15.85 years education; SD=3.19) were assessed using the Bells Test. Data on accuracy and processing speed were compared between groups by ANCOVA, controlled for the covariates education and frequency of reading and writing habits. Results There were no significant differences between the age groups. Conclusion It is suggested that aging influences sustained and focused attention and speed processing after 75 years of age on visual cancellation paradigms, when executive and attentional changes tend to be more marked. Further studies should investigate healthy older and oldest-old adults, as well as groups with low and intermediate educational backgrounds. In addition, Brazilian clinical populations should also be characterized, particularly those with neurological disorders that might have visual hemineglect. PMID:29213492

Obesity and Survival Among Black Women and White Women 35 to 64 Years of Age at Diagnosis With Invasive Breast Cancer

PubMed Central

Lu, Yani; Ma, Huiyan; Malone, Kathleen E.; Norman, Sandra A.; Sullivan-Halley, Jane; Strom, Brian L.; Marchbanks, Polly A.; Spirtas, Robert; Burkman, Ronald T.; Deapen, Dennis; Folger, Suzanne G.; Simon, Michael S.; Press, Michael F.; McDonald, Jill A.; Bernstein, Leslie

2011-01-01

Purpose To evaluate the effect of obesity on survival among black women and white women with invasive breast cancer and to determine whether obesity explains the poorer survival of black women relative to white women. Patients and Methods We observed 4,538 (1,604 black, 2,934 white) women who were 35 to 64 years of age when diagnosed with incident invasive breast cancer between 1994 and 1998. Multivariate Cox regression models were used to examine the effect of body mass index (BMI, in kilograms per square meter) 5 years before diagnosis on risk of death from any cause and from breast cancer. Results During a median of 8.6 years of follow-up, 1,053 women died (519 black, 534 white), 828 as a result of breast cancer (412 black, 416 white). Black women were more likely to die than white women (multivariate-adjusted relative risk [RR], 1.33; 95% CI, 1.16 to 1.53). Compared with women with BMI of 20 to 24.9 kg/m2, those who were obese (BMI ≥ 30 kg/m2) had a greater risk of all-cause mortality (RR, 1.23; 95% CI, 1.04 to 1.47) and breast cancer–specific mortality (RR, 1.20; 95% CI, 0.99 to 1.46). These associations were observed among white women (all-cause RR, 1.54; 95% CI, 1.21 to 1.96; breast cancer RR, 1.46; 95% CI, 1.11 to 1.92), but not among black women (all-cause RR, 1.03; 95% CI, 0.81 to 1.29; breast cancer RR, 1.02; 95% CI, 0.79 to 1.33). Conclusion Obesity may play an important role in mortality among white but not black patients with breast cancer. It is unlikely that differences in obesity distributions between black women and white women account for the poorer survival of black women. PMID:21788570

Aging in Prader-Willi syndrome: twelve persons over the age of 50 years.

PubMed

Sinnema, Margje; Schrander-Stumpel, Constance T R M; Maaskant, Marian A; Boer, Harm; Curfs, Leopold M G

2012-06-01

The life expectancy of persons with Prader-Willi syndrome (PWS) has increased in recent years. Because of the paucity of reports on older persons with PWS, the natural history, the onset, and type of age-related problems are poorly understood. Twelve persons with a genetically confirmed diagnosis of PWS aged over 50 years are described (4 deletion; 8 mUPD). Data on physical, behavioral, psychiatric, and aging characteristics were collected through semi-structured interviews with the individuals with PWS and their main carers. Cardiovascular diseases, diabetes, dermatological, and orthopedic problems were common physical complaints in older people with PWS. Functioning in activities of daily living, psychological functioning, physical functions, and care dependence were substantially worse in the older age group (50+) compared to the control group (18-49 years). Seven out of eight persons with mUPD had a history of psychiatric illness. Behavioral problems were observed in the older age group. Given the combination of age-related physical morbidity, physical appearance, behavioral and psychiatric problems, and functional decline in our cohort, we hypothesize that premature aging occurs in PWS. The care for older people with PWS requires a lifespan approach that recognizes the presence, progression, and consequences of specific morbidity. Special medical surveillance of people with PWS from 40 years onwards would ensure that intervention and support is offered with respect to specific areas of decline at the earliest possible time. Copyright © 2012 Wiley Periodicals, Inc.

Impact of extreme temperatures on daily mortality in Madrid (Spain) among the 45-64 age-group.

PubMed

Díaz, Julio; Linares, Cristina; Tobías, Aurelio

2006-07-01

This paper analyses the relationship between extreme temperatures and mortality among persons aged 45-64 years. Daily mortality in Madrid was analysed by sex and cause, from January 1986 to December 1997. Quantitative analyses were performed using generalised additive models, with other covariables, such as influenza, air pollution and seasonality, included as controls. Our results showed that impact on mortality was limited for temperatures ranging from the 5th to the 95th percentiles, and increased sharply thereafter. During the summer period, the effect of heat was detected solely among males in the target age group, with an attributable risk (AR) of 13.3% for circulatory causes. Similarly, NO(2) concentrations registered the main statistically significant associations in females, with an AR of 15% when circulatory causes were considered. During winter, the impact of cold was exclusively observed among females having an AR of 7.7%. The magnitude of the AR indicates that the impact of extreme temperature is by no means negligible.

Changes in alcohol consumption in the 50- to 64-year-old European economically active population during an economic crisis.

PubMed

Bosque-Prous, Marina; Kunst, Anton E; Brugal, M Teresa; Espelt, Albert

2017-08-01

The aim was to compare alcohol drinking patterns in economically active people aged 50-64 years before the last economic crisis (2006) and during the crisis (2013). Cross-sectional study with data from 25 479 economically active people aged 50-64 years resident in 11 European countries who participated in wave 2 or wave 5 of the SHARE project (2006 and 2013). The outcome variables were hazardous drinking, abstention in previous 3 months and the weekly average number of drinks per drinker. The prevalence ratios of hazardous drinking and abstention, comparing the prevalence in 2013 vs. 2006, were estimated with Poisson regression models with robust variance, and the changes in the number of drinks per week with Poisson regression models. The prevalence of hazardous drinking decreased among both men (PR = 0.75; 95%CI = 0.63-0.92) and women (PR = 0.91; 95%CI = 0.72-1.15), although the latter decrease was smaller and not statistically significant. The proportion of abstainers increased among both men (PR = 1.11; 95%CI = 0.99-1.29) and women (PR = 1.18; 95%CI = 1.07-1.30), although the former increase was smaller and not statistically significant. The weekly average number of drinks per drinker decreased in men and women. The decreases in consumption were larger in Italy and Spain. From 2006 to 2013, the amount of alcohol consumed by late working age drinkers decreased in Europe, with more pronounced declines in the countries hardest hit by the economic crisis. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

42 CFR 435.138 - Disabled widows and widowers aged 60 through 64 who would be eligible for SSI except for early...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Disabled widows and widowers aged 60 through 64 who..., Blind, and Disabled § 435.138 Disabled widows and widowers aged 60 through 64 who would be eligible for..., blind, or disabled individuals receiving SSI or State supplements, the agency must provide Medicaid to...

42 CFR 435.138 - Disabled widows and widowers aged 60 through 64 who would be eligible for SSI except for early...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Disabled widows and widowers aged 60 through 64 who..., Blind, and Disabled § 435.138 Disabled widows and widowers aged 60 through 64 who would be eligible for..., blind, or disabled individuals receiving SSI or State supplements, the agency must provide Medicaid to...

42 CFR 435.138 - Disabled widows and widowers aged 60 through 64 who would be eligible for SSI except for early...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Disabled widows and widowers aged 60 through 64 who..., Blind, and Disabled § 435.138 Disabled widows and widowers aged 60 through 64 who would be eligible for..., blind, or disabled individuals receiving SSI or State supplements, the agency must provide Medicaid to...

A study on cognitive status of 50 years and above aged non-demented women in a rural area of West Bengal.

PubMed

Saha, Sanjay Kumar; Sanyal, Debasish; Bhattacharyya, Agnihotri; Bhattacharyya, Ranjan; Barman, Neepamanjari; Mukherjee, Anindya

2010-11-01

The prevalence of ageing population is increasing not only in developed countries but also in developing world like India. Epidemiological reports about cognitive impairment or dementia in elderly people from developing countries are scarce. To study the cognitive status of women more than 50 years of age and to study the relationship of sociodemographic factors with cognitive status of the study subjects a descriptive epidemiological, community based cross-sectional survey was done involving 179 old women of 50 years and above in the rural field practice area of All India Institute of Hygiene and Public Health, Kolkata. The data were analysed using Epi-info 6.04, software packages. The mean age of the sample was 64.0 +/- 7.6 years. In the total sample, 53 subjects (29.6%) were in 50-59 years, 83 (43.4%) in 60-69 years, 34 (19%) in 70-79 years and 9 (5%) in women who were more than 80 years old. The cognitive defect was found to be 42.4% in elderly women .The variables like age > 70 years, widowhood, low per capita income, economic dependence, non-support from children, not staying with own children and having no satisfaction with life, were found to be significantly associated with cognitive defect. On (stepwise) multiple regression analysis these factors together contributed to 37% of cognitive impairment among these women. Prevalence of cognitive defect of more than 40% in the elderly women of this study emphasises the need for more attention and more social security measures for this neglected group.

40 CFR 61.64 - Emission standard for polyvinyl chloride plants.

Code of Federal Regulations, 2010 CFR

2010-07-01

... chloride plants. 61.64 Section 61.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Standard for Vinyl Chloride § 61.64 Emission standard for polyvinyl chloride plants. An owner or operator of a polyvinyl chloride plant shall comply with the requirements of this section and § 61.65. (a...

Factorial invariance of child self-report across age subgroups: a confirmatory factor analysis of ages 5 to 16 years utilizing the PedsQL 4.0 Generic Core Scales.

PubMed

Limbers, Christine A; Newman, Daniel A; Varni, James W

2008-01-01

The utilization of health-related quality of life (HRQOL) measurement in an effort to improve pediatric health and well-being and determine the value of health care services has grown dramatically over the past decade. The paradigm shift toward patient-reported outcomes (PROs) in clinical trials has provided the opportunity to emphasize the value and essential need for pediatric patient self-report. In order for HRQOL/PRO comparisons to be meaningful for subgroup analyses, it is essential to demonstrate factorial invariance. This study examined age subgroup factorial invariance of child self-report for ages 5 to 16 years on more than 8,500 children utilizing the PedsQL 4.0 Generic Core Scales. Multigroup Confirmatory Factor Analysis (MGCFA) was performed specifying a five-factor model. Two multigroup structural equation models, one with constrained parameters and the other with unconstrained parameters, were proposed to compare the factor loadings across the age subgroups. Metric invariance (i.e., equal factor loadings) across the age subgroups was demonstrated based on stability of the Comparative Fit Index between the two models, and several additional indices of practical fit including the Root Mean Squared Error of Approximation, the Non-Normed Fit Index, and the Parsimony Normed Fit Index. The findings support an equivalent five-factor structure across the age subgroups. Based on these data, it can be concluded that children across the age subgroups in this study interpreted items on the PedsQL 4.0 Generic Core Scales in a similar manner regardless of their age.

Barrier distributions and signatures of transfer channels in the Ca40+Ni58,64 fusion reactions at energies around and below the Coulomb barrier

NASA Astrophysics Data System (ADS)

Bourgin, D.; Courtin, S.; Haas, F.; Stefanini, A. M.; Montagnoli, G.; Goasduff, A.; Montanari, D.; Corradi, L.; Fioretto, E.; Huiming, J.; Scarlassara, F.; Rowley, N.; Szilner, S.; Mijatović, T.

2014-10-01

Background: The nuclear structure of colliding nuclei is known to influence the fusion process. Couplings of the relative motion to nuclear shape deformations and vibrations lead to an enhancement of the sub-barrier fusion cross section in comparison with the predictions of one-dimensional barrier penetration models. This enhancement is explained by coupled-channels calculations including these couplings. The sub-barrier fusion cross section is also affected by nucleon transfer channels between the colliding nuclei. Purpose: The aim of the present experiment is to investigate the influence of the projectile and target nuclear structures on the fusion cross sections in the Ca40+Ni58 and Ca40+Ni64 systems. Methods: The experimental and theoretical fusion excitation functions as well as the barrier distributions were compared for these two systems. Coupled-channels calculations were performed using the ccfull code. Results: Good agreement was found between the measured and calculated fusion cross sections for the Ca40+Ni58 system. The situation is different for the Ca40+Ni64 system where the coupled-channels calculations with no nucleon transfer clearly underestimate the fusion cross sections below the Coulomb barrier. The fusion excitation function was, however, well reproduced at low and high energies by including the coupling to the neutron pair-transfer channel in the calculations. Conclusions: The nuclear structure of the colliding nuclei influences the fusion cross sections below the Coulomb barrier for both Ca40+Ni58,64 systems. Moreover, we highlighted the effect of the neutron pair-transfer channel on the fusion cross sections in Ca40+Ni64.

Cardiovascular and other causes of death as a function of lifestyle habits in a quasi extinct middle-aged male population. A 50-year follow-up study.

PubMed

Menotti, Alessandro; Puddu, Paolo Emilio; Maiani, Giuseppe; Catasta, Giovina

2016-05-01

To relate major causes of death with lifestyle habits in an almost extinct male middle-aged population. A 40-59 aged male population of 1712 subjects was examined and followed-up for 50 years. Baseline smoking habits, working physical activity and dietary habits were related to 50 years mortality subdivided into 12 simple and 3 composite causes of death by Cox proportional hazard models. Duration of survival was related to the same characteristics by a multiple linear regression model. Death rate in 50 years was of 97.5%. Out of 12 simple groups of causes of death, 6 were related to smoking habits, 3 to physical activity and 4 to dietary habits. Among composite groups of causes of death, hazard ratios (and their 95% confidence limits) of never smokers versus smokers were 0.68 (0.57-0.81) for major cardiovascular diseases; 0.65 (0.52-0.81) for all cancers; and 0.72 (0.64-0.81) for all-cause deaths. Hazard ratios of vigorous physical activity at work versus sedentary physical activity were 0.63 (0.49-0.80) for major cardiovascular diseases; 1.01 (0.72-1.41) for all cancers; and 0.76 (0.64-0.90) for all-cause deaths. Hazard ratios of Mediterranean Diet versus non-Mediterranean Diet were 0.68 (0.54-0.86) for major cardiovascular diseases; 0.54 (0.40-0.73) for all cancers; and 0.67 (0.57-0.78) for all-cause deaths. Expectancy of life was 12 years longer for men with the 3 best behaviors than for those with the 3 worst behaviors. Some lifestyle habits are strongly related to lifetime mortality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Childhood Environment and Mental Wellbeing at Age 60-64 Years: Prospective Evidence from the MRC National Survey of Health and Development.

PubMed

Stafford, Mai; Gale, Catharine R; Mishra, Gita; Richards, Marcus; Black, Stephanie; Kuh, Diana L

2015-01-01

Mental wellbeing, conceptualised as positive affect, life satisfaction and realisation of needs that contribute to psychological growth, captures more than the absence of mental ill health. Several nations now aim to monitor and improve mental wellbeing. Whilst many studies document associations between adverse childhood experiences and mental disorders in adulthood, possible links between childhood experiences and adult mental wellbeing have so far received less attention. Using data from 1976 men and women in the MRC National Survey for Health and Development, we investigated prospective associations between childhood socioeconomic and psychosocial environments and the Warwick Edinburgh Mental Wellbeing Scale, designed to capture both hedonic and eudaimonic facets of wellbeing, at age 60-64. Whilst there was no evidence that childhood socioeconomic circumstances were related to later wellbeing independently of other childhood experiences, elements of childrearing and parenting, parental health and adjustment, and childhood illness were related. More advantaged socioeconomic position was associated with greater wellbeing but this did not explain the links between these childhood exposures and adult wellbeing, suggesting alternative explanatory pathways should be considered. Childhood illness and family psychosocial environment are associated with mental wellbeing in early older age, with effects sizes that are larger or comparable to socioeconomic circumstances in adulthood. Initiatives to improve the nation's mental wellbeing that include programmes targeted to supporting families and children may additionally have benefits that continue into older age.

Correlation between tea consumption and prevalence of hypertension among Singaporean Chinese residents aged ⩾40 years.

PubMed

Li, W; Yang, J; Zhu, X S; Li, S C; Ho, P C

2016-01-01

By a cross-sectional epidemiology study, we attempted to correlate the consumption of tea and/or health supplements, living habits and socio-demographic factors to the prevalence of hypertension among Singaporean Chinese residents. Singaporean Chinese residents aged ⩾40 years were randomly selected and interviewed face-to-face by clinical research assistants. Hypertension was defined as measured systolic blood pressure at least 140 mm Hg and/or diastolic blood pressure at least 90  mmHg or self-reported history/treatment for hypertension. The prevalence of hypertension among the whole investigated population (N=1184, 58.27% females) was 49.73% and the prevalence increased to 66.47% in the sub-population aged ⩾60 years. High risk of hypertension was associated with age ⩾60 years (odds ratio (OR): 4.15-4.19, P<0.01), obesity (body mass index >25 kg m(-2), OR: 2.10-2.11, P<0.01), family history of hypertension (OR: 2.69-2.76, P<0.01), diabetes history (OR: 2.29-2.33, P<0.01), hyperlipidemia history (OR: 1.79-1.80, P<0.01), male (OR: 1.56-1.59, P<0.01) and coffee intake (OR: 1.44-1.46, P<0.05). In contrast, drinking green tea at least 150 ml per week was associated with lower hypertension risk (OR: 0.63, 95% confidence interval (CI): 0.43-0.91, P<0.05). Drinking combination of green tea and British tea was associated with higher reduction in the risk of hypertension (OR: 0.58, 95% CI: 0.39-0.85, P<0.05). This cross-sectional study suggests that consumption of tea, especially green tea and British tea, was associated with lowering the risk of hypertension. On the other hand, consumption of coffee could be a risk factor of hypertension. These findings may provide useful information for health promotion to reduce risk of hypertension and warrant further study to confirm and elucidate such association.

[Pregnancy beyond age 40 in 382 women: a retrospective study in Reunion Island].

PubMed

Roman, H; Robillard, P-Y; Julien, C; Kauffmann, E; Laffitte, A; Gabriele, M; Marpeau, L; Barau, G

2004-11-01

To examine obstetrical and neonatal outcomes among women age 40 years and older. There was a retrospective study including 382 pregnant women at least 40 years of age and 7786 controls aged 20-34, stratified according to parity. Associations between maternal age and pregnancy outcomes were assessed using Pearson's chi(2) test, Fischer exact test, Student test or Mann and Whitney test, as appropriate. Maternal age 40 and over was associated with an increased risk for gestational diabetes (multiparas: OR 3.2, 95%CI 2.2-4.8; grandmultiparas: 2.8, 1.6-5.0), chronic diabetes (multiparas: 3.5, 1.04-10.6), chronic hypertension (multiparas: 3.1, 1.5-6.1; grandmultiparas: 12.1, 3.3-53.2), pregnancy-induced hypertension (nulliparas: 4.6, 1.01-17.3; multiparas: 2.6, 1.3-5.4) and preclampsia (multiparas: 2.9, 1.1-7.2). The risk for cesarean section was 2-fold higher in older multiparas and grandmultiparas. The same was true for the rate of operative vaginal delivery. The rate of fetal chromosomal abnormalities was 7-fold higher in older gravidas. Rates of fetal death were significantly increased in the cohort of older pregnant women (nulliparas: 11.2, 2.9-44.0; multiparas: 3.9, 1.4-10.9). Pregnancy at age 40 and over is associated with high rates of obstetrical complications, cesarean sections and operative vaginal deliveries, emphasizing the importance of rigorous antenatal care.

Retirement intentions of general practitioners aged 45-65 years.

PubMed

Brett, Thomas D; Arnold-Reed, Diane E; Hince, Dana A; Wood, Ian K; Moorhead, Robert G

2009-07-20

To ascertain the retirement intentions of a cohort of Australian general practitioners. Postal questionnaire survey of members of four Divisions of General Practice in Western Australia, sent out November 2007 - January 2008. A sample of 178 GPs aged 45-65 years. Intention to work in general practice until retirement; reasons for retiring before age 65 years; factors that might encourage working beyond chosen retirement age; and perceived obstacles to working in general practice. 63% of GPs intended to work to at least age 65 years, with men more likely to retire early. Of 63 GPs intending to retire early, 46% gave pressure of work, exhaustion and burnout as reasons for early retirement. Better remuneration, better staffing levels and more general support were incentives to continue working for 46% of the 64 GPs who responded to the question about incentives, and more flexible working hours, part-time work and reduced workload for 41%. Of 169 participants, 65% gave increasing bureaucracy, poor job satisfaction and disillusionment with the medical system or Medicare as obstacles to working in general practice in Australia, whereas workforce shortage, increasing patient demands and diminishing lifestyle through overwork were obstacles named by 48%. Many GPs are planning to retire early, reflecting an emerging trend among professionals and society generally. Declining job satisfaction, falling workforce numbers, excessive workload and increasing bureaucracy were recurrent concerns of older WA GPs considering premature retirement.

The use of ultrasonography and digital mammography in women under 40 years with symptomatic breast cancer: a 7-year Irish experience.

PubMed

Redmond, C E; Healy, G M; Murphy, C F; O'Doherty, A; Foster, A

2017-02-01

Breast cancer in women under 40 years of age is rare and typically presents symptomatically. The optimal imaging modality for this patient group is controversial. Most women undergo ultrasonography with/without mammography. Young women typically have dense breasts, which can obscure the features of malignancy on film mammography, however, initial studies have suggested that digital mammography may have a more accurate diagnostic performance in younger women. Ultrasound generally performs well in this age group, although it is poor at detecting carcinoma in situ (DCIS). To evaluate the comparative diagnostic performance of ultrasonography and digital mammography in the initial diagnostic evaluation of women under 40 years of age with symptomatic breast cancer. Retrospective review of all women under the age of 40 years managed at our symptomatic breast cancer unit from January 2009 to December 2015. There were 120 patients that met the inclusion criteria for this study. The sensitivity of ultrasonography and digital mammography for breast cancer in this patient group was 95.8 and 87.5 %, respectively. The patients with a false negative mammographic examination were more likely to have dense breasts (p < 0.01). Five patients had a false negative ultrasonographic examination, withal of whom were diagnosed with DCIS detected by mammography. This study demonstrates the superior sensitivity of ultrasound for breast cancer in women under the age of 40 years, however, the results show that digital mammography has an important complimentary role in the comprehensive assessment of these patients, particularly in the diagnosis of DCIS.

Age Differences in Health Behavior and Weight Changes in Japanese Workers: One-Year Follow-Up Study.

PubMed

Suka, Machi; Yamauchi, Takashi; Yanagisawa, Hiroyuki

2018-05-07

To examine one-year changes in stage of health behavior change and its associations with changes in health behavior and weight in a working population cohort. Using annual health examination data, 57,431 eligible Japanese workers aged 18-64 years were examined for their one-year changes in stage of change, eating and exercise habits, and weight. The stages of change became polarized into the precontemplation and the action/maintenance (i.e. post-action) and became stabilized with increasing age. The one-year change in stage of change was accompanied by changes in eating and exercise habits and weight. The age-dependent tendency towards bipolarization and stabilization of stages of change suggested that workplace health promotion interventions for facilitating health behavior changes should be started at younger ages.

People's Beliefs and Expectations About How Cognitive Skills Change with Age: Evidence From a U.K.-Wide Aging Survey.

PubMed

Vaportzis, Eleftheria; Gow, Alan J

2018-07-01

We conducted a U.K.-wide survey to collect information on people's beliefs, fears, perceptions, and attitudes to cognitive aging. This community-based aging survey included 3,146 adults aged 40 years and over. Respondents believed memory might be the earliest cognitive skill to decline (mean: 59.4 years), followed by speed of thinking (mean: 64.9). Those in their 40s were more pessimistic, because they estimated cognitive changes would start up to 15 years earlier than respondents aged over 70. Having a purpose in life, healthy eating, challenging the mind, sleep, and physical activity ranked higher in terms of perceived importance for maintaining or improving cognitive skills. However, less than 50% engaged in any of these activities. Although 91% believed there are things people can do to maintain or improve their cognitive skills, more than 40% were unsure or did not know how to do so. Respondents who strongly agreed that changes in cognitive skills might be a sign of something more serious were significantly more likely to do various activities to benefit their cognitive skills. Results suggest that people are less aware of the potential cognitive benefits of certain activities, such as exercise and diet. It is important to build awareness about the benefits of lifestyles and activities for cognitive health. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Incidental Finding of Bronchopulmonary Sequestration in a 64-Year-Old Female.

PubMed

Tunsupon, Pichapong; Arshad, Ayesha; Patel, Sumit; Mador, M Jeffery

2017-01-01

Bronchopulmonary sequestration is a congenital abnormality of the primitive foregut. In adults, the typical age at presentation is 20-25 years. A 64-year-old female was referred for evaluation of an 8 × 6-cm right lower lobe cystic lesion. Her medical history was significant for recurrent right lower lobe pneumonia requiring multiple hospitalizations. Her physical examination was significant for crackles at the right lung base. Computed tomography (CT) of the chest with contrast showed cystic changes with thickened septation of the medial segment of the right lower lobe lacking distinct visceral pleura and with arterial supply from the anomalous branch of the thoracic aorta arising near the celiac trunk. Pulmonary angiography confirmed the diagnosis of intralobar pulmonary sequestration. The patient underwent celiac endovascular coil embolization of the anomalous artery to lessen the risk of hemorrhage prior to video-assisted thoracoscopic surgery (VATS) resection of the right lower lobe. She recovered well and was discharged home 1 week after VATS lobectomy. Follow-up CT of the chest 2 months later showed normal postsurgical changes related to right lower lobe lobectomy. The patient remained asymptomatic and resumed her daily activities. Pulmonary sequestration can present with recurrent pneumonia in late adulthood. Physicians must review any previous imaging studies of the chest to identify the structural abnormality and be cognizant of differential diagnoses such as infected cystic bronchiectasis, bronchogenic cyst, congenital diaphragmatic hernia, or cystic adenomatoid malformation that can occur in conjunction with bronchopulmonary sequestration. Pulmonary angiogram is the gold standard to confirm the diagnosis of bronchopulmonary sequestration. Surgical resection is the standard of care.

Age-dependent changes of cerebral copper metabolism in Atp7b -/- knockout mouse model of Wilson's disease by [64Cu]CuCl2-PET/CT.

PubMed

Xie, Fang; Xi, Yin; Pascual, Juan M; Muzik, Otto; Peng, Fangyu

2017-06-01

Copper is a nutritional metal required for brain development and function. Wilson's disease (WD), or hepatolenticular degeneration, is an inherited human copper metabolism disorder caused by a mutation of the ATP7B gene. Many WD patients present with variable neurological and psychiatric symptoms, which may be related to neurodegeneration secondary to copper metabolism imbalance. The objective of this study was to explore the feasibility and use of copper-64 chloride ([ 64 C]CuCl 2 ) as a tracer for noninvasive assessment of age-dependent changes of cerebral copper metabolism in WD using an Atp7b -/- knockout mouse model of WD and positron emission tomography/computed tomography (PET/CT) imaging. Continuing from our recent study of biodistribution and radiation dosimetry of [ 64 C]CuCl 2 in Atp7b -/- knockout mice, PET quantitative analysis revealed low 64 Cu radioactivity in the brains of Atp7b -/- knockout mice at 7th weeks of age, compared with 64 Cu radioactivity in the brains of age- and gender-matched wild type C57BL/6 mice, at 24 h (h) post intravenous injection of [ 64 C]CuCl 2 as a tracer. Furthermore, age-dependent increase of 64 Cu radioactivity was detected in the brains of Atp7b -/- knockout mice from the 13th to 21th weeks of age, based on the data derived from a longitudinal [ 64 C]CuCl 2 -PET/CT study of Atp7b -/- knockout mice with orally administered [ 64 Cu]CuCl 2 as a tracer. The findings of this study support clinical use of [ 64 Cu]CuCl 2 -PET/CT imaging as a tool for noninvasive assessment of age-dependent changes of cerebral copper metabolism in WD patients presenting with variable neurological and psychiatric symptoms.

[The prevalence of obstructive sleep apnea-hypopnea syndrome in adults aged over 20 years in Changchun city].

PubMed

Li, Ming-xian; Wang, Ying; Hua, Shu-cheng; Li, Chun-mei; Wang, Mu-peng; Liu, Yang; Li, Zhong-min; Wang, Chun-yong; Fan, Jin-rong; Wang, Jing-Hua; Kong, Fan-yu; Wang, Min

2005-12-01

To investigate the prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) in adults aged over 20 years in Changchun city, providing epidemiological data for treatment and prevention of the disease. 3,960 subjects were derived from a stratified cluster and random sampling of the population in two districts of Changchun city. They were asked to answer the questions from a questionnaire in their houses. According to the degree of snoring, 200 subjects with a snoring score >or= 2 degree were selected to undergo polysomnography for a whole night and the prevalence of the disease was estimated. A total of 3,648 (97.64%) validated questionnaires was collected. Of them 31.00% had a snoring score >or= 2 degree, the prevalence was higher in males (40.07%) than in females (21.76%). The prevalence of snoring was higher in drivers (42.47%) than in other occupations. The estimated prevalence of OSAHS defined by apnea-hypopnea index (AHI) >or= 5, Epworth sleepiness scale (ESS) >or= 9 and arterial oxygen saturation (SaO(2)) < 90% was 4.81%. The estimated prevalence of OSAHS in adults aged over 20 years in Changchun city was 4.81%. Doctors should pay more attention to the disease and the ordinary people should be informed of the health impact of snoring and OSAHS.

Malnutrition at Age 3 Years and Lower Cognitive Ability at Age 11 Years

PubMed Central

Liu, Jianghong; Raine, Adrian; Venables, Peter H.; Dalais, Cyril; Mednick, Sarnoff A.

2014-01-01

Background Early malnutrition is linked to poor cognition, but long-term effects have not been extensively examined and psychosocial confounds have not always been controlled. Objective To test the hypothesis that malnutrition at age 3 years will be associated with poorer cognitive ability at age 11 years independent of psychosocial confounds. Design A prospective, longitudinal study of a birth cohort of 1559 children originally assessed at age 3 years for malnutrition (low hemoglobin level, angular stomatitis, kwashiorkor, and sparse, thin hair) and followed up to age 11 years. Setting and Participants A community sample of 1559 children (51.4% boys and 48.6% girls) born between September 1, 1969, and August 31, 1970, in 2 towns in the island of Mauritius, with 68.7% Indians and 25.7% Creoles (African origin). Main Outcome Measures Verbal and spatial ability measured at ages 3 and 11 years and reading, scholastic ability, and neuropsychologic performance measured at age 11 years. Results Malnourished children had poorer cognition at both ages. Deficits were stable across time, applied to all sex and ethnic groups, and remained after controlling for multiple measures of psychosocial adversity. Children with 3 indicators of malnutrition had a 15.3-point deficit in IQ at age 11 years. Conclusions Malnutrition at age 3 years is associated with poor cognition at age 11 years independent of psychosocial adversity. Promoting early childhood nutrition could enhance long-term cognitive development and school performance, especially in children with multiple nutritional deficits. PMID:12796242

Prevalence, risk factors and underdiagnosis of asthma and wheezing in adults 40 years and older: A population-based study.

PubMed

Gonzalez-Garcia, Mauricio; Caballero, Andres; Jaramillo, Claudia; Maldonado, Dario; Torres-Duque, Carlos A

2015-10-01

There are differences in the prevalence and risk factors of asthma around the world. The epidemiological situation of adults 40 years and older is not well established. Our aim was to determine the prevalence, underdiagnosis and risk factors of asthma and wheezing in adults in Colombia. A cross-sectional, population-based study including 5539 subjects from 40 to 93 years selected by a probabilistic sampling technique in five cities was conducted. respiratory symptoms and risk factors questionnaire and spirometry. (a) Wheezing: Affirmative answer to the question "have you ever had two or more attacks of "wheezes" causing you to feel short of breath?" (b) Asthma: Wheezing definition and FEV1/FVC post-bronchodilator ≥ 70%. (c) Underdiagnosis: Asthma definition without a physician-diagnosis. Logistic regression was used for exploring risk factors. Prevalence of asthma was 9.0% (95% CI: 8.3-9.8) and wheezing 11.9% (95% CI: 11.0-12.8). Asthma underdiagnosis was 69.9% and increased to 79.0% in subjects 64 years or older. The risk factors related to asthma and/or wheezing were: living in Bogota or Medellin, female gender, first degree relative with asthma, respiratory disease before 16 years of age, obesity, no education, indoor wood smoke exposure and occupational exposure to dust particles, gases or fumes. We described the epidemiologic situation of asthma in adults 40 years and older in Colombia. In addition to some recognized risk factors, our data supports the association of indoor wood smoke and occupational exposures with asthma and wheezing. Underdiagnosis of asthma in adults was high, particularly in older subjects.

The Association of Marital Status and Offers of Employer-based Health Insurance for Employed Women Aged 27-64: United States, 2014-2015.

PubMed

Simpson, Jessica L; Cohen, Robin A

2017-01-01

Data from the National Health Interview Survey •Among employed women aged 27-64, unmarried women (72.2%) were more likely than married women (69.3%) to have been offered health insurance by their employer. •Among employed married women aged 27-64, 16.8% were offered health insurance only through their spouse's employer. •Considering all offers of health insurance (through a woman's employer or her spouse's employer), employed married women aged 27-64 (86.1%) were more likely than employed unmarried women (72.2%) to have had an employer offer of health insurance. •Regardless of educational attainment, and for most income and racial groups, employed married women aged 27-64 were more likely than employed unmarried women to have been offered health insurance by their employer or their spouse's employer. In 2015, women were less likely than men to have been insured through their own employer and more likely to have been covered as a dependent (1). This report describes the association of marital status and the presence of employer-based health insurance offers among employed women in the United States. Analyses are limited to women aged 27-64 to exclude offers associated with parental employment for those under age 27. An offer of employer-based health insurance includes offers by the woman's employer or her spouse's employer. The presence of an offer does not indicate offer take up. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Childhood Environment and Mental Wellbeing at Age 60-64 Years: Prospective Evidence from the MRC National Survey of Health and Development

PubMed Central

Stafford, Mai; Gale, Catharine R.; Mishra, Gita; Richards, Marcus; Black, Stephanie; Kuh, Diana L.

2015-01-01

Background Mental wellbeing, conceptualised as positive affect, life satisfaction and realisation of needs that contribute to psychological growth, captures more than the absence of mental ill health. Several nations now aim to monitor and improve mental wellbeing. Whilst many studies document associations between adverse childhood experiences and mental disorders in adulthood, possible links between childhood experiences and adult mental wellbeing have so far received less attention. Methods Using data from 1976 men and women in the MRC National Survey for Health and Development, we investigated prospective associations between childhood socioeconomic and psychosocial environments and the Warwick Edinburgh Mental Wellbeing Scale, designed to capture both hedonic and eudaimonic facets of wellbeing, at age 60-64. Results Whilst there was no evidence that childhood socioeconomic circumstances were related to later wellbeing independently of other childhood experiences, elements of childrearing and parenting, parental health and adjustment, and childhood illness were related. More advantaged socioeconomic position was associated with greater wellbeing but this did not explain the links between these childhood exposures and adult wellbeing, suggesting alternative explanatory pathways should be considered. Conclusions Childhood illness and family psychosocial environment are associated with mental wellbeing in early older age, with effects sizes that are larger or comparable to socioeconomic circumstances in adulthood. Initiatives to improve the nation’s mental wellbeing that include programmes targeted to supporting families and children may additionally have benefits that continue into older age. PMID:26030929

Age-Related Differences in Influenza B Infection by Lineage in a Community-Based Sentinel System, 2010-2011 to 2015-2016, Canada.

PubMed

Skowronski, Danuta M; Chambers, Catharine; De Serres, Gaston; Sabaiduc, Suzana; Winter, Anne-Luise; Dickinson, James A; Gubbay, Jonathan B; Fonseca, Kevin; Drews, Steven J; Charest, Hugues; Martineau, Christine; Krajden, Mel; Petric, Martin; Bastien, Nathalie; Li, Yan

2017-09-15

Age-related differences in influenza B lineage detection were explored in the community-based Canadian Sentinel Practitioner Surveillance Network (SPSN) from 2010-2011 to 2015-2016. Whereas >80% of B(Victoria) cases were <40 years old, B(Yamagata) cases showed a bimodal age distribution with 27% who were <20 years old and 61% who were 30-64 years old, but with a notable gap in cases between 20 and 29 years old (4%). Overall, the median age was 20 years lower for B(Victoria) vs B(Yamagata) cases (20 vs 40 years; P < .01). Additional phylodynamic and immuno-epidemiological research is needed to understand age-related variation in influenza B risk by lineage, with potential implications for prevention and control across the lifespan. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Is Endoscopy Really Necessary in My Case? A Four Year Retrospective Study.

PubMed

Dinesh, H N; Kumar, Cd Jagadish; Sanjay, H M; Sachin, V; Basavaraju

2015-07-01

About 40% of the general population report dyspepsia at some time in their life making it a fairly common disease. Uncomplicated dyspepsia refers to patients whose dyspepsia is not accompanied by alarm features or associated with NSAIDS usage. To assess the need for UGI Endoscopy and find out the patterns of different endoscopic presentations in patients presenting with uncomplicated dyspepsia. Our study conducted in KR Hospital, Mysore, Department of General Surgery is a retrospective endoscopic study of 1450 patients with uncomplicated dysepsia. A significant 64% of the patients presenting with uncomplicated dyspepsia were found to have findings on endoscopy. The most common age range for positive endoscopic findings was 40-50 years in our hospital. Malignancy was diagnosed in 2.5% patients. We recommend upper GI endoscopy in patients presenting with uncomplicated dyspepsia for patients above 40 years of age in our hospital.

40 CFR 761.64 - Disposal of wastes generated as a result of research and development activities authorized under...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Disposal of wastes generated as a..., AND USE PROHIBITIONS Storage and Disposal § 761.64 Disposal of wastes generated as a result of... section provides disposal requirements for wastes generated during and as a result of research and...

40 CFR 761.64 - Disposal of wastes generated as a result of research and development activities authorized under...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Disposal of wastes generated as a..., AND USE PROHIBITIONS Storage and Disposal § 761.64 Disposal of wastes generated as a result of... section provides disposal requirements for wastes generated during and as a result of research and...

40 CFR 761.64 - Disposal of wastes generated as a result of research and development activities authorized under...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Disposal of wastes generated as a..., AND USE PROHIBITIONS Storage and Disposal § 761.64 Disposal of wastes generated as a result of... section provides disposal requirements for wastes generated during and as a result of research and...

40 CFR 761.64 - Disposal of wastes generated as a result of research and development activities authorized under...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Disposal of wastes generated as a..., AND USE PROHIBITIONS Storage and Disposal § 761.64 Disposal of wastes generated as a result of... section provides disposal requirements for wastes generated during and as a result of research and...

[Prevalence of high-risk HPV and its distribution in cervical precancerous lesions among 35-64 years old women who received cervical cancer screening in Beijing].

PubMed

Shen, J; Gao, L L; Zhang, Y; Han, L L; Wang, J D

2018-05-06

Objective: To study the prevalence of high-risk HPV (HR HPV) in women who accepted cervical cancer screening in Beijing and its distribution in cervical precancerous lesions. Methods: From January 2014 to March 2015, all women aged 35-64 years old and received free screening in institutions of cervical cancer in Beijing were recruited. Stratified cluster random sampling method was used in selecting 31 091 women for gynecological examination and genotyping of HR-HPV. Those positive for HR-HPV (except for HPV 16/18) were examined for cervical cell. For those atypical squamous cells of uncertain significance (ASCUS) and above, who were positive for HPV 16/18 and with uncertain results for cervical cell, were transferred for colposcopy examination. For those with suspicious or abnormal results for colposcopy, were transferred for histopathology. The prevalence of HR-HPV, cervical cancer and precancerous lesions among the participants were analyzed. Results: Totally 31 091 women aged from 35-year-old to 64-year-old, with 44.3% (13 780 women) in the 35-49 age group and 55.7% (17 311 women) in the 50-64 age group. 66.1% (20 536 women) were rural women. The infection rate of HR-HPV was 7.4%(2 305 cases) among the women. High-risk infection rates of HPV except HPV 16/18 were 5.7% (1 758 cases), and multi-infection rate was 1.5% (477 cases). The highest infection rate was 7.9% (1 044 cases) among the 45-49 year-old and 50-54 year-old age groups (χ(2)=14.07, P= 0.015). The rate in rural women was significantly higher than that of the urban women (6.2%, 507 cases; 7.9%, 1 798 cases) (χ(2)=25.75, P< 0.001). The proportion of HPV16, HPV18, HPV52, HPV51, HPV58 was 17.0% (391 cases), 6.9% (161 cases), 8.6% (20 cases), 5.2% (12 cases) and 7.7% (18 cases), respectively. The detection rate of cervical cancer and precancerous lesions in the population was 395.6/100 000 (123 cases). In high-grade squamous intraepithelial lesions (HSIL), HPV16 and 18 infections accounted for 60.5% (72

HIV Diagnoses Among Persons Aged 13-29 Years - United States, 2010-2014.

PubMed

Ocfemia, M Cheryl Bañez; Dunville, Richard; Zhang, Tianchi; Barrios, Lisa C; Oster, Alexandra M

2018-02-23

In 2014, persons aged 13-29 years represented 23% of the U.S. population, yet accounted for 40% of diagnoses of human immunodeficiency virus (HIV) infection during the same year (1). During 2010-2014, the rates of diagnosis of HIV infection decreased among persons aged 15-19 years, were stable among persons aged 20-24 years, and increased among persons aged 25-29 years (1). However, these 5-year age groups encompass multiple developmental stages and potentially mask trends associated with the rapid psychosocial changes during adolescence through young adulthood. To better understand HIV infection among adolescents aged 13-17 years and young adults aged 18-29 years in the United States and identify ideal ages to target primary HIV prevention efforts, CDC analyzed data from the National HIV Surveillance System (NHSS)* using narrow age groups. During 2010-2014, rates of diagnosis of HIV infection per 100,000 population varied substantially among persons aged 13-15 years (0.7), 16-17 years (4.5), 18-19 years (16.5), and 20-21 years (28.6), and were higher, but less variable, among persons aged 22-23 years (34.0), 24-25 years (33.8), 26-27 years (31.3), and 28-29 years (28.7). In light of the remarkable increase in rates between ages 16-17, 18-19, and 20-21 years, and a recent study revealing that infection precedes diagnosis for young persons by an average of 2.7 years (2), these findings demonstrate the importance of targeting primary prevention efforts to persons aged <18 years and continuing through the period of elevated risk in their mid-twenties.

The relationship between health literacy with health status and healthcare utilization in 18-64 years old people in Isfahan.

PubMed

Karimi, Saeed; Keyvanara, Mahmoud; Hosseini, Mohsen; Jazi, Marzie Jafarian; Khorasani, Elahe

2014-01-01

Today, much attention has been paid to the patient role as the central factor in the management of their own health. It is focused on the issue that the patient has a more critical role compared with the health-care provider in controlling the patient own health. defines health literacy as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. The objective of this study was to determine health literacy, health status, healthcare utilization and the relationship between them in 18 - 64 years old people in Isfahan. This study was a descriptive analytical survey, which was conducted on 300 subjects of 18-64 years old in Isfahan with Multi-stage sampling method proportional to selected sample size. For collecting the data, questionnaire adapted from CHAP (Consumer Assessment of Healthcare Providers and Systems) health literacy questionnaire was used. Health status was measured based on an assessment of the physical and mental health over the past 6 months by 5° Likert scale. Data analysis was performed by using SPSS 18, descriptive statistics, Chi-square test and multivariate analysis of variance. There was no significant correlation between health literacy, health status and healthcare utilization. Utilization was less in the urban area No. 6 of the city. In the bachelor's degree group, the health status was lower than the other groups in these cases: Older ages, married, women, large family size, undergraduates, and urban area No. 14. Due to the average prevalence of health literacy in 18-64 years old individuals in Isfahan and low- healthcare utilization, the followings are recommended: Necessity of more attention to the issue of health literacy, improving the physician-patient relationship and community awareness, whether through health promotion programs or media for the optimum use of available resources.

Intravitreal aflibercept for neovascular age-related macular degeneration in patients aged 90 years or older: 2-year visual acuity outcomes.

PubMed

Chatziralli, Irini; Regan, Shane O; Mohamed, Ryian; Talks, James; Sivaprasad, Sobha

2018-06-04

The purpose of this study was to investigate the efficacy of intravitreal aflibercept for neovascular age-related macular degeneration (nAMD) in very elderly patients aged 90 years or older at 2 years after treatment initiation. In this multicentre retrospective data analysis from electronic medical record, consecutive treatment-naive patients with nAMD treated with aflibercept with at least 2 years follow-up were stratified into those aged < 90 years (Group I) and an older cohort aged 90 and over (Group II). We compared the visual acuity (EDTRS letters) outcomes at 4 weekly intervals between the two groups over a 2-year period. The mean visual acuity of Group I at presentation was 56.3 ETDRS letters versus 52.8 letters in Group II. Maximal visual acuity was achieved in both the groups by 6 months after initiating treatment (4.7 vs. 4.0 letters gain). By 2 years, the mean visual acuity of the older cohort fell marginally below their baseline visual acuity (0.8 letter loss), while Group I presented +2.1 letters gain. The number of injections given and the retention rate of the older cohort were no different to the rest of the patients. Very old patients with nAMD benefited from aflibercept, but not to the same degree as the younger patients. The study showed that, on an average, the very elderly patients were able to adhere to the intensive anti-VEGF treatment regimens.

National trends and outcomes of autologous in vitro fertilization cycles among women ages 40 years and older.

PubMed

Hipp, Heather; Crawford, Sara; Kawwass, Jennifer F; Boulet, Sheree L; Grainger, David A; Kissin, Dmitry M; Jamieson, Denise

2017-07-01

The purpose of the study was to describe trends in and investigate variables associated with clinical pregnancy and live birth in autologous in vitro fertilization (IVF) cycles among women ≥40 years. We used autologous IVF cycle data from the National ART Surveillance System (NASS) for women ≥40 years at cycle start. We assessed trends in fresh and frozen cycles (n = 371,536) from 1996 to 2013. We reported perinatal outcomes and determined variables associated with clinical pregnancy and live birth in fresh cycles between 2007 and 2013. From 1996 to 2013, the total number of cycles in women ≥40 years increased from 8672 to 28,883 (p < 0.0001), with frozen cycles almost tripling in the last 8 years. Cycles in women ≥40 years accounted for 16.0% of all cycles in 1996 and 21.0% in 2013 (p < 0.0001). For fresh cycles from 2007 to 2013 (n = 157,890), the cancelation rate was 17.1%. Among cycles resulting in transfer (n = 112,414), the live birth rate was 16.1%. The following were associated with higher live birth rates: multiparity, fewer prior ART cycles, use of standard agonist or antagonist stimulation, lower gonadotropin dose, ovarian hyperstimulation syndrome, more oocytes retrieved, use of pre-implantation genetic screening/diagnosis, transferring more and/or blastocyst stage embryos, and cryopreserving more supernumerary embryos. Of the singleton infants born (n = 14,992), 86.9% were full term and 88.3% normal birth weight. The NASS allows for a comprehensive description of IVF cycles in women ≥40 years in the USA. Although live birth rate is less than 20%, identifying factors associated with IVF success can facilitate treatment option counseling.

40 CFR 141.64 - Maximum contaminant levels for disinfection byproducts.

Code of Federal Regulations, 2010 CFR

2010-07-01

... disinfection byproducts. 141.64 Section 141.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS National Primary Drinking... source water: Disinfection byproduct Best available technology Total trihalomethanes (TTHM) and...

The need for triple assessment and predictors for diagnosis of breast cancer in patients <40 years of age.

PubMed

Mazari, F A K; Sharma, N; Reid, D; Horgan, K

2018-05-03

To assess the safety of selective use of triple assessment with omission of radiological assessment proposed in patients <40-years old. Data were collected retrospectively for all patients seen in the one-stop breast clinic between January 2014 and August 2015. Demographics, symptoms, diagnostics, and treatment details were recorded. Subgroup and logistic regression analysis was performed to identify predictors for breast cancer. Of the 3,305 patients included, 95.6% (n=3,161) were first-time referrals. 57.6% (n=1,903) had a breast lump, and 4% (n=133) had a high-risk family history; 75.6% (n=2,499) underwent imaging and 16.7% (n=552) underwent a biopsy. The median age was 29 years (interquartile range [IQR]=25-34). Breast cancer was diagnosed in 29 cases (0.88%) and 3.2% (n=105) had surgery. Median referral-to-diagnosis time was 13 days (IQR=9-14) and referral-to-surgery time was 44 days (IQR=34-95). Patients with breast cancer were significantly older (33 versus 28 years, p=0.016). All patients were first-time referrals. Most patients had a breast lump with low suspicion on clinical examination and breast cancer identified on imaging. Time-to-diagnosis (12 versus 14 days, p=0.017) and time-to-surgery (37 versus 67 days, p=0.012) was significantly shorter in the breast cancer group. Comparative older age (odds ratio [OR]=1.08, 95% confidence interval [CI]: 1.01-1.15) and breast lump (OR=11.43,95% CI: 2.72-48.07) were the only significant predictors of cancer on uni/multivariate regression. Triple assessment is also the best practice for all patients in the younger age group. This cohort should not be treated any differently regarding one-stop clinic infrastructure as the cancers detected were not clinically malignant. Missed cancers in this age group would have significant personal, clinical, and legal consequences. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Women's economic activity trajectories over the life course: implications for the self-rated health of women aged 64+ in England.

PubMed

Stone, Juliet; Evandrou, Maria; Falkingham, Jane; Vlachantoni, Athina

2015-09-01

Previous research has highlighted the importance of accumulated life-course labour market status and the balancing of multiple roles for understanding inequalities in health in later life. This may be particularly important for women, who are increasingly required to balance work and family life in liberal welfare contexts, such as in Britain. This study analyses retrospective life history data for 2160 women aged 64+ years (born 1909-1943) from the English Longitudinal Study of Ageing, collected in 2006-2007 as part of an ongoing panel study. Optimal matching and cluster analyses are used to produce a taxonomy of women's life-course economic activity trajectories based on their experiences between ages 16 and 64 years. This classification is then used in logistic regression analysis to investigate associations with self-rated health in later life. A set of five trajectories emerge as the dominant patterns of women's economic activity over the life course for those cohorts of English women born prior to 1943: (1) full-time workers; (2) family carers; (3) full-time returners; (4) part-time returners; (5) atypical/inactive. Regression analyses show that women who experience defined periods of full-time work both before and after focusing on family life appear to have the most favourable later life health outcomes. The findings are discussed with reference to the accumulation of social and economic resources over the life course and the balancing of multiple roles in work and family domains. In conclusion, the development of policies that facilitate women, if they wish, to successfully combine paid employment with family life could have a positive impact on their health in later life. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Liberated rivers: lessons from 40 years of dam removal

Treesearch

Marie Oliver; Gordon Grant

2017-01-01

In recent decades, dam removal has emerged as a viable national and international strategy for river restoration. According to American Rivers, a river conservation organization, more than 1,100 dams have been removed in the United States in the past 40 years, and more than half of these were demolished in the past decade. This trend is likely to continue as dams age,...

Novel coronary heart disease risk factors at 60–64 years and life course socioeconomic position: The 1946 British birth cohort

PubMed Central

Jones, Rebecca; Hardy, Rebecca; Sattar, Naveed; Deanfield, John E.; Hughes, Alun; Kuh, Diana; Murray, Emily T.; Whincup, Peter H.; Thomas, Claudia

2015-01-01

Social disadvantage across the life course is associated with a greater risk of coronary heart disease (CHD) and with established CHD risk factors, but less is known about whether novel CHD risk factors show the same patterns. The Medical Research Council National Survey of Health and Development was used to investigate associations between occupational socioeconomic position during childhood, early adulthood and middle age and markers of inflammation (C-reactive protein, interleukin-6), endothelial function (E-selectin, tissue-plasminogen activator), adipocyte function (leptin, adiponectin) and pancreatic beta cell function (proinsulin) measured at 60–64 years. Life course models representing sensitive periods, accumulation of risk and social mobility were compared with a saturated model to ascertain the nature of the relationship between social class across the life course and each of these novel CHD risk factors. For interleukin-6 and leptin, low childhood socioeconomic position alone was associated with high risk factor levels at 60–64 years, while for C-reactive protein and proinsulin, cumulative effects of low socioeconomic position in both childhood and early adulthood were associated with higher (adverse) risk factor levels at 60–64 years. No associations were observed between socioeconomic position at any life period with either endothelial marker or adiponectin. Associations for C-reactive protein, interleukin-6, leptin and proinsulin were reduced considerably by adjustment for body mass index and, to a lesser extent, cigarette smoking. In conclusion, socioeconomic position in early life is an important determinant of several novel CHD risk factors. Body mass index may be an important mediator of these relationships. PMID:25437893

Aging, Fitness, and Marathon Times in a 91 Year-old Man Who Competed in 627 Marathons.

PubMed

Addison, Odessa; Steinbrenner, Gregory; Goldberg, Andrew P; Katzel, Leslie I

Aging is associated with a decline in maximal aerobic capacity (VO 2max ) that may be attenuated by chronic endurance exercise. This case study chronicles the changes in marathon times in a 91 year old man who completed 627 marathons and 117 ultramarathons over 42 years. He began running marathons at age 48. His yearly best times remained fairly constant at ~240 minutes from age 50 - 64 years and then gradually rose to about 260 minutes in his early seventies followed by a curvilinear deterioration as he approached his ninth decade. His times plateaued at ~ 600 minutes in his late eighties. Between ages 68 and 89 his VO 2max declined from 43 to 20 ml/kg/min. His marathon times were highly correlated with his VO 2max (r 2 =0.87). The decline in marathons times and VO 2max may reflect the contributions of biological aging, changes in exercise training volume and intensity, injuries, and comorbid disease.

Seroprevalence of Human Papillomavirus (HPV) Type 6, 11, 16, 18, by Anatomic Site of HPV Infection, in Women Aged 16-64 Years living in the Metropolitan Area of San Juan, Puerto Rico.

PubMed

Pérez-Caraballo, Aixa M; Suarez, Erick; Unger, Elizabeth R; Palefsky, Joel M; Panicker, Gitika; Ortiz, Ana Patricia

2018-03-01

It is unknown if human papillomavirus (HPV) serum antibody responses vary by anatomic site of infection. We aimed to assess the seroprevalence for HPV 6, 11, 16 and 18 in association with HPV DNA detection in different anatomic sites among women. This cross sectional population-based study analyzed data from 524 women aged 16-64 years living in the San Juan metropolitan area of Puerto Rico (PR). Questionnaires were used to assess demographic and lifestyle variables, while anogenital and blood samples were collected for HPV analysis. Logistic regression models were used to estimate the adjusted prevalence odds ratio (POR) in order to determine the association between HPV DNA infection status in the cervix and anus and serum antibody status, controlling for different potential confounders. Overall, 46.9% of women had detectable antibodies to one or more types whereas 8.7% had HPV DNA for one or more of these types detected in cervix (4.0%) or anus (6.5%). Women with cervical HPV detection tended to be more HPV seropositive than women without cervical detection (adjusted POR (95%CI): 2.41 (0.90, 6.47), p=0.078); however the type-specific association between cervical DNA and serum antibodies was only significant for HPV 18 (adjusted POR (95% CI): 5.9 (1.03, 33.98)). No significant association was detected between anal HPV and seropositivity (p>0.10). Differences in the anatomic site of infection could influence seroconversion, however, longitudinal studies will be required for further evaluation. This information will be instrumental in advancing knowledge of immune mechanisms involved in anatomic site response.

QuickStats: Percentage* of Adults Aged ≥20 Years Who Ever Told A Doctor That They Had Trouble Sleeping,† by Age Group and Sex - National Health and Nutrition Examination Survey, 2013-2014.

PubMed

2016-11-25

In 2013-2014, 28.0% of U.S. adults reported that they had told a doctor or other health professional that they had trouble sleeping. A smaller percentage of adults aged 20-39 years (19.2%) reported having trouble sleeping compared with persons aged 40-59 years (32.8%) and ≥60 years (33.2%). This pattern by age group was observed for both men and women, although larger percentages of women aged 40-59 years and ≥60 years reported trouble sleeping compared with men in those age groups.

Studying the burden of community-acquired pneumonia in adults aged ⩾50 years in primary health care: an observational study in rural Crete, Greece

PubMed Central

Bertsias, Antonios; Tsiligianni, Ioanna G; Duijker, George; Siafakas, Nikolaos; Lionis, Christos

2014-01-01

Background: Community-acquired pneumonia (CAP) is a potentially life-threatening condition that often requires hospitalisation particularly in the elderly population or in patients with comorbidities. Aims: The aims of this study were to estimate the CAP frequency and severity in a well-defined primary healthcare setting in rural Crete, to record patient characteristics, their immunisation status and to estimate hospitalisation frequency and determinants. Methods: An observational study was designed and implemented in a rural setting within the prefecture of Heraklion in the island of Crete, Greece. Eligible patients were those aged 50 years or above, presenting with CAP based on signs and symptoms and positive X-ray findings. Results: A total of 124 CAP cases were recorded, 40 of which (32.3%) were hospitalised. Τhe age-standardised CAP incidence was estimated to be 236.7 cases per 100,000 persons aged ⩾50 years. Forty-three patients (35.2%) were vaccinated against pneumococcus. The most frequent chronic illnesses were heart disease (64.5%), chronic obstructive pulmonary disease (32.5%), and type 2 diabetes (21%). Hospitalisation determinants included advanced age (⩾74 years, Odds ratio (OR) 7.13; P value=0.001; 95% confidence interval (CI), 2.23–22.79), obesity (OR 3.36, P=0.037; 95% CI, 1.08–10.52), ⩾40 pack-years of smoking (OR 3.82, P value=0.040; 95% CI, 1.07–18.42), presence of multimorbidity (OR 5.77, P value=0.003; 95% CI, 1.81–18.42) and pneumococcal vaccination (OR 0.29, P value=0.041; 95% CI, 0.09–0.95). Conclusions: This study highlighted patient characteristics and aspects of CAP epidemiology in the context of a rural primary care setting in southern Europe where limited data have been published until now. PMID:24965889

Positive Oct -3/4 and D2-40 Immunohistochemical Expression in Germ Cells and Suspected Histology Pattern of Intratubular Germ Cell Neoplasia in Boys with Cryptorchidism Vanish after the Age of 2 Years.

PubMed

Thorup, Jorgen; Clasen-Linde, Erik; Cortes, Dina

2017-08-01

Introduction  Intratubular germ cell neoplasia (ITGCN) is a precursor to testicular germ cell cancer. Adult germ cell cancer immunohistochemical markers may fail to detect ITGCN in prepubertal boys with congenital cryptorchidism, because positive immunohistochemistry is commonly seen in boys younger than the age of 2 years, where most orchiopexies are performed. The aim of the study was to evaluate the diagnostic challenge to differentiate between a histological pattern of ITGCN and a histological pattern with some atypical germ cells and all positive cancer immunohistochemical markers, but no increased risk of malignancy. Materials and Methods  Histology sections from 373 testicular biopsies from 289 boys aged 1 month to 2 years operated for cryptorchidism were incubated with primary antibodies including anti-placental-like-alkaline phosphatase, antiOct-3/4, anti-C-kit, anti-D2-40, and in case of repeat biopsy with anti-stem cell factor (SCF) receptor. Results  The prevalence of Oct-3/4 and D2-40-positive staining of germ cells in testicular biopsies were in age groups less than 6 months, 100% and 50%; 6-12 months, 60% and 17%; and 1-2 years, 12% and 4%. A 1 year, 1-month-old boy with Prader-Willi syndrome treated with growth hormone had ITGCN in both cryptorchid testes. In another three bilateral nonsyndromic cases, 8 months, 8 months and 1-year-old, a histological pattern in accordance with ITGCN was found. These three boys had a repeat biopsy from both testes performed at the age of 3 years, 4 months, 3.5 years, and 3 years, 10months, respectively. In all cases, the Oct-3/4 and D2-40 positive germ cells turned negative and the histological pattern normalized completely. The primary biopsies had SCF negative germ cells. Conclusion  This study is valuable in identifying the age-related change in Oct-3/4 or D2-40 immunopositive germ cells in seminiferous tubules. An ITGCN-like histological pattern in nonsyndromic cryptorchidism will vanish after the

Socio-demographic factors and psychological distress in Indigenous and non-Indigenous Australian adults aged 18-64 years: analysis of national survey data.

PubMed

Cunningham, Joan; Paradies, Yin C

2012-02-01

Indigenous Australians are known to be at greater risk of morbidity and mortality from mental health related conditions, but most available data relate to the use of mental health services, and little is known about other aspects of social and emotional wellbeing. Using the first available nationally representative data, we examined the prevalence and patterning of psychological distress among Indigenous Australian adults and compared these with corresponding data from the non-Indigenous population. The analysis used weighted data on psychological distress, as measured by a modified Kessler Psychological Distress score (K5), and a range of socio-demographic measures for 5,417 Indigenous and 15,432 non-Indigenous adults aged 18-64 years from two nationally representative surveys. Very high psychological distress (VHPD) was defined as a K5 score ≥ 15 (possible range = 5-25). Indigenous adults were about three times more likely than non-Indigenous adults to be classified with VHPD: 14.5% (95% confidence interval (CI) 12.9-16.0%) versus 5.5% (95% CI 5.0-5.9%). After adjusting for age, most socio-demographic variables were significantly associated with VHPD in both populations, although the relative odds were generally larger among non-Indigenous people. Indigenous people in remote areas had a lower prevalence of VHPD than their non-remote counterparts, and only marital status, main language, and food insecurity were significantly associated with VHPD in remote areas. Higher absolute levels of VHPD combined with smaller socio-demographic gradients in the Indigenous population suggest the importance of risk factors such as interpersonal racism, marginalization and dispossession, chronic stress and exposure to violence that are experienced by Indigenous Australians with common and/or cross-cutting effects across the socioeconomic spectrum. The lower prevalence of VHPD and lack of association with many socio-demographic variables in remote areas suggests either that the

Incidentally detected asplenia in a healthy 64-year-old female live kidney donor.

PubMed

Wolff, Leoniek D; Nijboer, Mijntje N; Vd Wetering, Jacqueline; Dor, Frank J M F

2017-04-01

Heterotaxia syndromes are rare birth defects which can result in developmental malformations. A 64-year-old woman presented to the hospital for preoperative screening for kidney donation; during which she was found to have no gallbladder and no spleen, without any signs of surgical removal. This could be a new description of a heterotaxia syndrome.

Effect of influenza vaccination on hospitalizations in persons aged 50 years and older.

PubMed

Baxter, Roger; Ray, G Thomas; Fireman, Bruce H

2010-10-21

To estimate influenza vaccine effectiveness (VE) in preventing hospitalizations in persons over 50 years of age. We performed a retrospective, population based study, using a "difference-in-differences" approach to determine the association between hospitalization and prior vaccination. We examined this association when influenza was not circulating and compared it to the association found when influenza was circulating. VE was estimated from the difference in the association between hospitalization and prior vaccination, inside vs. outside influenza seasons. Kaiser Permanente in Northern California. Health plan members aged 50 years and older during the September 1997 to August 2008 study period, when there were about 68,000 pneumonia hospitalizations in 10 million person-years. Vaccination was associated with lower risk of hospitalization for pneumonia and influenza, even before flu season, presumably due to unmeasured confounders. When influenza arrived the hospitalization-vaccination association strengthened, yielding an adjusted VE estimate of 12.4% (95% CI: 1.6-22.0) in persons aged 50-64, and 8.5% (95% CI: 3.3-13.5) in those aged 65 years and older. There was no significant effect on hospitalizations for ischemic heart disease (IHD), congestive heart failure (CHF), cerebrovascular disease (CVD), or trauma. Influenza vaccination has a modest but significant effect on prevention of hospitalization for pneumonia and influenza in persons 50 years of age and older. Copyright © 2010 Elsevier Ltd. All rights reserved.

Outcomes of childhood asthma to the age of 50 years.

PubMed

Tai, Andrew; Tran, Haily; Roberts, Mary; Clarke, Nadeene; Gibson, Anne-Marie; Vidmar, Suzanna; Wilson, John; Robertson, Colin F

2014-06-01

In 1964, The Melbourne Asthma Study was established to describe the spectrum and natural history of childhood asthma. To describe the clinical and lung function outcome of childhood asthma to the age of 50 years. Subjects were invited to complete an interviewer-administered questionnaire, skin prick testing, and measurement of lung function from the age of 7 years to the age of 50 years at 7-year intervals. Of 458 survivors (from the original 484 subjects at recruitment), 346 subjects (76%) participated, of whom, 197 completed lung function measurement. Asthma remission at the age of 50 years was 64% in those with wheezy bronchitis, 47% for those with persistent asthma, and 15% for those with severe asthma in childhood. Multivariable analysis identified severe asthma in childhood (odds ratio [OR] 11.9 [95% CI, 3.4-41.8]), female sex (OR 2.0 [95% CI, 1.1-3.6]), and childhood hay fever (OR 2.0 [95% CI, 1.0-4.0]) as risk factors for "current asthma" at age 50 years. There was no evidence of a difference in the rate of decline in FEV1 (mL/y, 95% CI) between the severe asthma group (15 mL/y [95% CI, 9-22 mL/y]) and all the other recruitment groups: control (16 mL/y [95% CI, 12-20 mL/y]), mild wheezy bronchitis (14 mL/y [95% CI, 8-19 mL/y]), wheezy bronchitis (16 mL/y [95% CI, 11-20 mL/y]), and persistent asthma (19 mL/y [95% CI, 13-24 mL/y]). The clinical and lung function outcome in adult life is strongly determined by asthma severity in childhood. The reduced lung function seen in adults is established in childhood and does not appear to decline more rapidly in adult years despite continuing symptoms. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

40Ar/39Ar ages of the AD 79 eruption of Vesuvius, Italy

USGS Publications Warehouse

Lanphere, Marvin A.; Champion, Duane E.; Melluso, Leone; Morra, Vincenzo; Perrotta, Annamaria; Scarpati, Claudio; Tedesco, Dario; Calvert, Andrew T.

2007-01-01

The Italian volcano, Vesuvius, erupted explosively in AD 79. Sanidine from pumice collected at Casti Amanti in Pompeii and Villa Poppea in Oplontis yielded a weighted-mean 40Ar/39Ar age of 1925±66 years in 2004 (1σ uncertainty) from incremental-heating experiments of eight aliquants of sanidine. This is the calendar age of the eruption. Our results together with the work of Renne et al. (1997) and Renne and Min (1998) demonstrate the validity of the 40Ar/39Ar method to reconstruct the recent eruptive history of young, active volcanoes.

Exposure to cooking oil fumes and chronic bronchitis in nonsmoking women aged 40 years and over: a health-care based study.

PubMed

Chen, Huang-Chi; Wu, Chia-Fang; Chong, Inn-Wen; Wu, Ming-Tsang

2018-02-13

Little is known about the effect of exposure to cooking oil fumes (COFs) on the development of non-malignant respiratory diseases in nonsmoking women. This study investigated the relationship between exposure to COFs and chronic bronchitis in female Taiwanese non-smokers. Searching the 1999 claims and registration records maintained by Taiwan's National Health Insurance Program, we identified 1846 women aged 40 years or older diagnosed as having chronic bronchitis (ICD-9 code: 491) at least twice in 1999 as potential study cases and 4624 women who had no diagnosis of chronic bronchitis the same year as potential study controls. We visited randomly selected women from each group in their homes, interviewed to collect related data including cooking habits and kitchen characteristics, and them a spirometry to collect FEV1 and FVC data between 2000 and 2009. After the exclusion of thirty smokers, the women were classified those with chronic bronchitis (n = 53), probable chronic bronchitis (n = 285), and no pulmonary disease (n = 306) based on physician diagnosis and American Thoracic Society criteria. Women who had cooked ≥ 21 times per week between the ages of 20 and 40 years old had a 4.73-fold higher risk of chronic bronchitis than those cooking < 14 times per week (95% CI = 1.65-13.53). Perceived kitchen smokiness was significantly associated with decreased FEV1 (- 137 ml, p = 0.021) and FEV1/FVC ratio (- 7.67%, p = 0.008). Exposure to COF may exacerbate the progression of chronic bronchitis in nonsmoking women.

Student characteristics and behaviors at age 12 predict occupational success 40 years later over and above childhood IQ and parental socioeconomic status.

PubMed

Spengler, Marion; Brunner, Martin; Damian, Rodica I; Lüdtke, Oliver; Martin, Romain; Roberts, Brent W

2015-09-01

Drawing on a 2-wave longitudinal sample spanning 40 years from childhood (age 12) to middle adulthood (age 52), the present study was designed to examine how student characteristics and behaviors in late childhood (assessed in Wave 1 in 1968) predict career success in adulthood (assessed in Wave 2 in 2008). We examined the influence of parental socioeconomic status (SES), childhood intelligence, and student characteristics and behaviors (inattentiveness, school entitlement, responsible student, sense of inferiority, impatience, pessimism, rule breaking and defiance of parental authority, and teacher-rated studiousness) on 2 important real-life outcomes (i.e., occupational success and income). The longitudinal sample consisted of N = 745 persons who participated in 1968 (M = 11.9 years, SD = 0.6; 49.9% female) and 2008 (M = 51.8 years, SD = 0.6; 53.3% female). Regression analyses and path analyses were conducted to evaluate the direct and indirect effects (via education) of the predictors on career success. The results revealed direct and indirect influences of student characteristics (responsible student, rule breaking and defiance of parental authority, and teacher-rated studiousness) across the life span on career success after adjusting for differences in parental SES and IQ at age 12. rd (c) 2015 APA, all rights reserved).

Age-dependent Changes of Cerebral Copper Metabolism in Atp7b−/− Knockout Mouse Model of Wilson’s Disease by [64Cu]CuCl2-PET/CT

PubMed Central

Xie, Fang; Xi, Yin; Pascual, Juan M.; Muzik, Otto; Peng, Fangyu

2017-01-01

Copper is a nutritional metal required for brain development and function. Wilson’s disease (WD), or hepatolenticular degeneration, is an inherited human copper metabolism disorder caused by mutation of ATP7B gene. Many WD patients present with variable neurological and psychiatric symptoms, which may be related to neurodegeneration secondary to copper metabolism imbalance. The objective of this study is to explore feasibility and use of copper-64 chloride ([64C]CuCl2) as a tracer for noninvasive assessment of age-dependence changes of cerebral copper metabolism in WD using an Atp7b−/− knockout mouse model of WD and a positron emission tomography/computed tomography (PET/CT) scanner. Continuing from recent study of biodistribution and radiation dosimetry of [64C]CuCl2 in Atp7b−/− knockout mice, PET quantitative analysis revealed low 64Cu radioactivity in the brains of Atp7b−/− knockout mice at 7th week of age, compared with the 64Cu radioactivity in the brains of age and gender-matched wild type C57BL/6 mice, at 24 hour (h) post intravenous injection of [64C]CuCl2 as a tracer. Furthermore, age-dependent increase of 64Cu radioactivity was detected in the brains of Atp7b−/− knockout mice from 13th to 21th week of age, using the data derived from a longitudinal [64C]CuCl2-PET/CT study of Atp7b−/− knockout mice with orally administered [64Cu]CuCl2 as a tracer. The findings of this study support the use of [64Cu]CuCl2-PET/CT as a tool for noninvasive assessment of age-dependent changes of cerebral copper metabolism in WD patients presenting with variable neurological and psychiatric symptoms. PMID:28130615

[The burden of disease attributed to low bone mineral density among population aged ≥40 years old in China, 1990 and 2013].

PubMed

Zhao, Z P; Ai, H H; Li, Y C; Wang, L M; Yin, P; Zhang, M; Deng, Q; Huang, Z J; Liu, J M; Liu, Y N; Gao, Y J; Zhou, M G

2016-09-06

Objective: To identify cause-specific death and attributed burden of low bone mineral density in China among population aged ≥40 years old , 1990 and 2013. Methods: By using data from Global Burden of Disease(GBD)2013, this study analyzed death caused by low mineral density, and disability-adjusted life years(DALY)among population aged 40 and above in China(not including Taiwan, China). This study also analyzed DALY by composition of injury which due to low bone mineral density. It also analyzed changes in DALY by provinces in China, 1990 and 2013. An average world population age-structure for the period 2000- 2025 was adopted to calculate the age standardized rates. Results: In 2013, there were 38.1 thousands male and 30.7 thousands female who aged 40 and above dead due to low bone mineral density in China. The burden of injury caused by low bone mineral density was more sever in male than female, which accounted for 1.525 million DALY in male and 0.873 million DALY in female. In 1990, low bone mineral density attributed transportation and accidental injury caused 0.794 million and 0.567 million DALY losses, respectively. In 2013, low bone mineral density attributed transportation and accidental injury caused 1.421 million and 0.951 million DALY losses, respectively. Compared to 1990, DALY losses caused by transportation and accidental injury, increased by 79.1% and 67.6%, respectively. In 1990, DALY rate losses due to low bone mineral density attributed transportation and accidental injury were 68.1 per 100 000 and 48.7 per 100 000, respectively. In 2013, DALY rate losses due to low bone mineral density attributed transportation and accidental injury were 102.0 per 100 000 and 68.2 per 100 000, respectively. Compared to 1990, DALY rates which caused by transportation and accidental injury, increased by 49.8% and 40.2%, respectively. According to the ranking of standardized DALY rate in 2013 by provinces, the top 3 provinces, which standardized DALYs attributed

[Analysis on occupational exposure to dust and harmful gas and corresponding protection in adults aged 40 years and older in China, 2014].

PubMed

Wang, B H; Cong, S; Bao, H L; Feng, Y J; Fan, J; Wang, N; Fang, L W; Wang, L H

2018-05-10

Objective: To understand the current status of dust and/or harmful gas exposure in adults aged ≥40 years and corresponding protection in China, and provide evidence for strengthening the occupational protection against dust and harmful gas exposure. Methods: The data were obtained from 2014-2015 COPD surveillance in China. A total of 75 107 adults aged ≥40 years selected through multi-stage stratified cluster sampling from 125 surveillance points in 31 provinces (autonomous regions and municipalities) were surveyed in face to face interviews. Occupational exposure was defined as occupational exposure to dust and/or harmful gas for more than 1 year. The weighted percentages of exposure were estimated by using complex sampling design. Results: Among eligible 71 061 participants, the exposure rate of dust and/or harmful gas was 46.3 % . The exposure rate in rural area (51.7 % ) was significantly higher than that in urban area (40.3 % ), and the exposure rate in the western area was higher than those in the eastern and central areas ( P <0.001). Among the groups with different education level, the exposure rate in those with education level of primary school and below was highest (49.7 % , P <0.001). The exposure protection rate was 26.7 % , and the exposure protection rate was highest in the eastern area (29.9 % ), followed by that in the central area (27.0 % ) and that in the western area (22.9 % ) The exposure protection rate in urban area was significantly higher than that in rural area, and the exposure protection rate was lowest in those with education level of primary school and below. The regular exposure protection was taken by only 50.7 % of the adults surveyed. Conclusion: The exposure rate of dust and/or harmful gas is high in China, while the exposure protection rate is very low. Health education, occupational protection and supervision should be strengthened among those with low education level, and those living in rural area and in the western area.

34 CFR 691.64 - Calculation of a grant for a payment period which occurs in two award years.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 4 2012-07-01 2012-07-01 false Calculation of a grant for a payment period which occurs in two award years. 691.64 Section 691.64 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED...

34 CFR 691.64 - Calculation of a grant for a payment period which occurs in two award years.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 4 2013-07-01 2013-07-01 false Calculation of a grant for a payment period which occurs in two award years. 691.64 Section 691.64 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED...

34 CFR 691.64 - Calculation of a grant for a payment period which occurs in two award years.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Calculation of a grant for a payment period which occurs in two award years. 691.64 Section 691.64 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION ACADEMIC...

34 CFR 691.64 - Calculation of a grant for a payment period which occurs in two award years.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 4 2011-07-01 2011-07-01 false Calculation of a grant for a payment period which occurs in two award years. 691.64 Section 691.64 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED...

34 CFR 691.64 - Calculation of a grant for a payment period which occurs in two award years.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 4 2014-07-01 2014-07-01 false Calculation of a grant for a payment period which occurs in two award years. 691.64 Section 691.64 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED...

The effect of fertility treatment on adverse perinatal outcomes in women aged at least 40 years.

PubMed

Harlev, Avi; Walfisch, Asnat; Oran, Eynan; Har-Vardi, Iris; Friger, Michael; Lunenfeld, Eitan; Levitas, Eliahu

2018-01-01

To compare perinatal outcomes between spontaneous conception and assisted reproductive technologies (ART) among patients of advanced maternal age. The present retrospective study included data from singleton pregnancies of women aged at least 40 years who delivered between January 1, 1991, and December 31, 2013, at Soroka University Medical Center, Beer Sheva, Israel. Demographic, obstetric, and perinatal data were compared between pregnancies conceived with ART (in vitro fertilization [IVF] or ovulation induction) and those conceived spontaneously. Multiple regression models were used to define independent predictors of adverse outcomes. A total of 8244 singleton pregnancies were included; 229 (2.8%) following IVF, 86 (1.0%) following ovulation induction, and 7929 (96.2%) were spontaneous. Preterm delivery (P<0.001), fetal growth restriction (FGR) (P<0.001), and cesarean delivery (P<0.001) demonstrated linear associations with the conception mode; the highest rates for each were observed for IVF, with decreased rates for ovulation induction and spontaneous conception. The incidence of gestational diabetes and hypertensive disorders were highest among pregnancies following ART. No association was observed between conception mode and perinatal mortality. Multivariate logistic regression demonstrated that IVF was independently associated with increased odds of preterm delivery (P<0.001) and FGR (P=0.027) compared with spontaneous conception. Among patients of advanced maternal age, ART were independently associated with increased FGR and preterm delivery rates compared with spontaneous pregnancies; perinatal mortality was comparable. © 2017 International Federation of Gynecology and Obstetrics.

Increasing incidence and importance of HIV/AIDS and gonorrhea among men aged >/= 50 years in the US in the era of erectile dysfunction therapy.

PubMed

Karlovsky, Matthew; Lebed, Brett; Mydlo, Jack H

2004-01-01

With the advent of effective pharmacotherapy for erectile dysfunction, the risk of sexually transmitted diseases is a possible consequence, especially in the older population. We wanted to review the incidence of sexually transmitted diseases in the older population in an attempt to correlate this with the advent of these new drugs. Publicly available information on the incidence of HIV, AIDS and gonorrhea was retrieved from the websites of the Centers for Disease Control (CDC), the State of Florida Department of Health, the Senior HIV Intervention Project and the National Association on HIV Over Fifty. National case incidences of HIV and AIDS in men between 1996 and 2000 were examined for trends. National and Florida state trends were compared and, in Florida, Palm Beach, Broward and Dade counties in particular were selected because of their traditionally large retiree population. In addition, the national and Florida state incidences of gonorrheal infection were examined for trends. Statistics on national sildenafil (Viagra) prescriptions were obtained via a personal communication with a regional healthcare representative from Pfizer. According to the CDC, at the end of 1998 >10% of new AIDS cases nationally were in individuals aged >50 years. In the late 1990s, new AIDS cases rose faster in middle-aged and older adults than in people aged >40 years. Many of the newly diagnosed cases of AIDS may have contracted HIV before the age of 50 years; however, many individuals are newly becoming infected above the age of 50 years. Of the reported AIDS cases in 1996 in individuals aged >/= 50 years, 48% were aged 50-54 years, 26% were aged 55-59 years, 14% were aged 60-64 years and 12% were aged >/= 65 years; 84% of these cases were male, and blacks accounted for the greatest proportion of cases (43%). In the US, 7.5 million prescriptions for sildenafil were written in 1998, 9.5 million in 1999, 12 million in 2000 and 15.5 million in 2001. The age breakdown for these

Bacterial Pathogens Associated with Community-acquired Pneumonia in Children Aged Below Five Years.

PubMed

Das, Anusmita; Patgiri, Saurav J; Saikia, Lahari; Dowerah, Pritikar; Nath, Reema

2016-03-01

To determine the spectrum of bacterial pathogens causing community-acquired pneumonia in children below 5 years of age. Children aged below 5 years satisfying the WHO criteria for pneumonia, severe pneumonia or very severe pneumonia, and with the presence of lung infiltrates on chest X-ray were enrolled. Two respiratory samples, one for culture and the other for PCR analysis, and a blood sample for culture were collected from every child. Of the 180 samples processed, bacterial pathogens were detected in 64.4%. Streptococcus pneumoniae and Hemophilus influenzae were most frequently detected. The performance of PCR analysis and culture were identical for the typical bacterial pathogens; atypical pathogens were detected by PCR analysis only. S. pneumoniae and H. influenza were the most commonly detected organisms from respiratory secretions of children with community acquired pneumonia.

Surveillance for Health Care Access and Health Services Use, Adults Aged 18–64 Years — Behavioral Risk Factor Surveillance System, United States, 2014

PubMed Central

Okoro, Catherine A.; Zhao, Guixiang; Fox, Jared B.; Eke, Paul I.; Greenlund, Kurt J.; Town, Machell

2017-01-01

Problem/Condition As a result of the 2010 Patient Protection and Affordable Care Act, millions of U.S. adults attained health insurance coverage. However, millions of adults remain uninsured or underinsured. Compared with adults without barriers to health care, adults who lack health insurance coverage, have coverage gaps, or skip or delay care because of limited personal finances might face increased risk for poor physical and mental health and premature mortality. Period Covered 2014. Description of System The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. Data are collected from states, the District of Columbia, and participating U.S. territories on health risk behaviors, chronic health conditions, health care access, and use of clinical preventive services (CPS). An optional Health Care Access module was included in the 2014 BRFSS. This report summarizes 2014 BRFSS data from all 50 states and the District of Columbia on health care access and use of selected CPS recommended by the U.S. Preventive Services Task Force or the Advisory Committee on Immunization Practices among working-aged adults (aged 18–64 years), by state, state Medicaid expansion status, expanded geographic region, and federal poverty level (FPL). This report also provides analysis of primary type of health insurance coverage at the time of interview, continuity of health insurance coverage during the preceding 12 months, and other health care access measures (i.e., unmet health care need because of cost, unmet prescription need because of cost, medical debt [medical bills being paid off over time], number of health care visits during the preceding year, and satisfaction with received health care) from 43 states that included questions from the optional BRFSS Health Care Access module. Results In 2014, health insurance coverage and other health

40Ar/39Ar ages of the AD 79 eruption of Vesuvius, Italy

NASA Astrophysics Data System (ADS)

Lanphere, Marvin; Champion, Duane; Melluso, Leone; Morra, Vincenzo; Perrotta, Annamaria; Scarpati, Claudio; Tedesco, Dario; Calvert, Andrew

2007-01-01

The Italian volcano, Vesuvius, erupted explosively in AD 79. Sanidine from pumice collected at Casti Amanti in Pompeii and Villa Poppea in Oplontis yielded a weighted-mean 40Ar/39Ar age of 1925±66 years in 2004 (1σ uncertainty) from incremental-heating experiments of eight aliquants of sanidine. This is the calendar age of the eruption. Our results together with the work of Renne et al. (1997) and Renne and Min (1998) demonstrate the validity of the 40Ar/39Ar method to reconstruct the recent eruptive history of young, active volcanoes.

Evaluation of vitamin B6 intake and status of 20- to 64-year-old Koreans.

PubMed

Kim, Young-Nam; Cho, Youn-Ok

2014-12-01

Recent research regarding vitamin B6 status including biochemical index is limited. Thus, this study estimated intakes and major food sources of vitamin B6; determined plasma pyridoxal 5'-phosphate (PLP); and assessed vitamin B6 status of Korean adults. Three consecutive 24-h diet recalls and fasting blood samples were collected from healthy 20- to 64-year-old adults (n = 254) living in the Seoul metropolitan area, cities of Kwangju and Gumi, Korea. Vitamin B6 intake and plasma PLP were analyzed by gender and by vitamin B6 supplementation. Pearson's correlation coefficient was used to determine associations of vitamin B6 intake and plasma PLP. The mean dietary and total (dietary plus supplemental) vitamin B6 intake was 1.94 ± 0.64 and 2.41 ± 1.45 mg/day, respectively. Median (50th percentile) dietary intake of men and women was 2.062 and 1.706 mg/day. Foods from plant sources provided 70.61% of dietary vitamin B6 intake. Only 6.3% of subjects consumed total vitamin B6 less than Estimated Average Requirements. Plasma PLP concentration of all subjects was 40.03 ± 23.71 nmol/L. The concentration of users of vitamin B6 supplements was significantly higher than that of nonusers (P < 0.001). Approximately 16% of Korean adults had PLP levels < 20 nmol/L, indicating a biochemical deficiency of vitamin B6, while 19.7% had marginal vitamin B6 status. Plasma PLP concentration showed positive correlation with total vitamin B6 intake (r = 0.40984, P < 0.0001). In this study, vitamin B6 intake of Korean adults was generally adequate. However, one-third of subjects had vitamin B6 deficiency or marginal status. Therefore, in some adults in Korea, consumption of vitamin B6-rich food sources should be encouraged.

Neuroticism and Extraversion in Youth Predict Mental Wellbeing and Life Satisfaction 40 Years Later

PubMed Central

Gale, Catharine R; Booth, Tom; Mõttus, René; Kuh, Diana; Deary, Ian J

2014-01-01

Neuroticism and Extraversion are linked with current wellbeing, but it is unclear whether these traits in youth predict wellbeing decades later. We applied structural equation modelling to data from 4583 people from the MRC National Survey of Health and Development. We examined the effects of Neuroticism and Extraversion at ages 16 and 26 years on mental wellbeing and life satisfaction at age 60-64 and explored the mediating roles of psychological and physical health. Extraversion had direct, positive effects on both measures of wellbeing. The impact of Neuroticism on both wellbeing and life satisfaction was largely indirect through susceptibility to psychological distress and physical health problems. Personality dispositions in youth have enduring influence on wellbeing assessed about forty years later. PMID:24563560

Is Endoscopy Really Necessary in My Case? A Four Year Retrospective Study

PubMed Central

Dinesh, HN; Kumar, CD Jagadish; Sachin, V; Basavaraju

2015-01-01

Introduction: About 40% of the general population report dyspepsia at some time in their life making it a fairly common disease. Uncomplicated dyspepsia refers to patients whose dyspepsia is not accompanied by alarm features or associated with NSAIDS usage. Aim: To assess the need for UGI Endoscopy and find out the patterns of different endoscopic presentations in patients presenting with uncomplicated dyspepsia. Materials and Methods: Our study conducted in KR Hospital, Mysore, Department of General Surgery is a retrospective endoscopic study of 1450 patients with uncomplicated dysepsia. Results: A significant 64% of the patients presenting with uncomplicated dyspepsia were found to have findings on endoscopy. The most common age range for positive endoscopic findings was 40-50 years in our hospital. Malignancy was diagnosed in 2.5% patients. Conclusion: We recommend upper GI endoscopy in patients presenting with uncomplicated dyspepsia for patients above 40 years of age in our hospital. PMID:26417553

Age and sex of surgeons and mortality of older surgical patients: observational study

PubMed Central

Jena, Anupam B; Orav, E John; Blumenthal, Daniel M; Tsai, Thomas C; Mehtsun, Winta T; Jha, Ashish K

2018-01-01

Abstract Objective To investigate whether patients’ mortality differs according to the age and sex of surgeons. Design Observational study. Setting US acute care hospitals. Participants 100% of Medicare fee-for-service beneficiaries aged 65-99 years who underwent one of 20 major non-elective surgeries between 2011 and 2014. Main outcome measure Operative mortality rate of patients, defined as death during hospital admission or within 30 days of the operative procedure, after adjustment for patients’ and surgeons’ characteristics and indicator variables for hospitals. Results 892 187 patients who were treated by 45 826 surgeons were included. Patients’ mortality was lower for older surgeons than for younger surgeons: the adjusted operative mortality rates were 6.6% (95% confidence interval 6.5% to 6.7%), 6.5% (6.4% to 6.6%), 6.4% (6.3% to 6.5%), and 6.3% (6.2% to 6.5%) for surgeons aged under 40 years, 40-49 years, 50-59 years, and 60 years or over, respectively (P for trend=0.001). There was no evidence that adjusted operative mortality differed between patients treated by female versus male surgeons (adjusted mortality 6.3% for female surgeons versus 6.5% for male surgeons; adjusted odds ratio 0.97, 95% confidence interval 0.93 to 1.01). After stratification by sex of surgeon, patients’ mortality declined with age of surgeon for both male and female surgeons (except for female surgeons aged 60 or older); female surgeons in their 50s had the lowest operative mortality. Conclusion Using national data on Medicare beneficiaries in the US, this study found that patients treated by older surgeons had lower mortality than patients treated by younger surgeons. There was no evidence that operative mortality differed between male and female surgeons. PMID:29695473

Mobility and muscle strength in male former elite endurance and power athletes aged 66-91 years.

PubMed

Manderoos, S; Wasenius, N; Laine, M K; Kujala, U M; Mälkiä, E; Kaprio, J; Sarna, S; Bäckmand, H M; Kettunen, J A; Heinonen, O J; Jula, A M; Aunola, S; Eriksson, J G

2017-11-01

The aim of this cross-sectional study was to compare mobility and muscle strength in male former elite endurance and power athletes aged 66-91 years (n = 150; 50 men in both former elite athlete groups and in their control group). Agility, dynamic balance, walking speed, chair stand, self-rated balance confidence (ABC-scale), jumping height, and handgrip strength were assessed. Former elite power athletes had better agility performance time than the controls (age- and body mass index, BMI-adjusted mean difference -3.6 s; 95% CI -6.3, -0.8). Adjustment for current leisure time physical activity (LTPA) and prevalence of diseases made this difference non-significant (P = 0.214). The subjects in the power sports group jumped higher than the men in the control group (age- and BMI-adjusted mean differences for vertical squat jump, VSJ 4.4 cm; 95% CI 2.0, 6.8; for countermovement jump, CMJ 4.0 cm; 95% CI 1.7, 6.4). Taking current LTPA and chronic diseases for adjusting process did not improve explorative power of the model. No significant differences between the groups were found in the performances evaluating dynamic balance, walking speed, chair stand, ABC-scale, or handgrip strength. In conclusion, power athletes among the aged former elite sportsmen had greater explosive force production in their lower extremities than the men in the control group. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Age and gender differences among Australian suicide ideators: prevalence and correlates.

PubMed

Fairweather, A Kate; Anstey, Kaarin J; Rodgers, Bryan; Jorm, Anthony F; Christensen, Helen

2007-02-01

We investigated the prevalence and correlates of suicidal ideation in an Australian population sample at three stages of adulthood. Random sampling of a community acquired 7485 participants. Cohorts were 20 to 24, 40 to 44, or 60 to 64 years old. Twelve-month prevalence of suicidal ideation was 8.2%. Suicidal ideation was highest among the youngest cohort. Males with chronic physical illness were more prone to suicidal ideation, as were those aged 20 to 24 and 60 to 64. Furthermore, under-employed subjects 60 to 64 years old were seven times more likely to experience suicidal ideation than their counterparts working full-time. Childhood adversity and rumination had positive associations with suicidality; however, considering oneself more masterful was linked with lower levels of suicidal ideation. Contrary to clinical and popular views, our results highlight that proximal non-mental health variables such as employment, physical health, social factors, and personality are equally important to experiencing suicidal ideation as symptoms of psychological distress.

Socio-demographic factors and psychological distress in Indigenous and non-Indigenous Australian adults aged 18-64 years: analysis of national survey data

PubMed Central

2012-01-01

Background Indigenous Australians are known to be at greater risk of morbidity and mortality from mental health related conditions, but most available data relate to the use of mental health services, and little is known about other aspects of social and emotional wellbeing. Using the first available nationally representative data, we examined the prevalence and patterning of psychological distress among Indigenous Australian adults and compared these with corresponding data from the non-Indigenous population. Methods The analysis used weighted data on psychological distress, as measured by a modified Kessler Psychological Distress score (K5), and a range of socio-demographic measures for 5,417 Indigenous and 15,432 non-Indigenous adults aged 18-64 years from two nationally representative surveys. Very high psychological distress (VHPD) was defined as a K5 score ≥ 15 (possible range = 5-25). Results Indigenous adults were about three times more likely than non-Indigenous adults to be classified with VHPD: 14.5% (95% confidence interval (CI) 12.9-16.0%) versus 5.5% (95% CI 5.0-5.9%). After adjusting for age, most socio-demographic variables were significantly associated with VHPD in both populations, although the relative odds were generally larger among non-Indigenous people. Indigenous people in remote areas had a lower prevalence of VHPD than their non-remote counterparts, and only marital status, main language, and food insecurity were significantly associated with VHPD in remote areas. Conclusions Higher absolute levels of VHPD combined with smaller socio-demographic gradients in the Indigenous population suggest the importance of risk factors such as interpersonal racism, marginalization and dispossession, chronic stress and exposure to violence that are experienced by Indigenous Australians with common and/or cross-cutting effects across the socioeconomic spectrum. The lower prevalence of VHPD and lack of association with many socio-demographic variables in

Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger.

PubMed

Domb, Benjamin G; Linder, Dror; Finley, Zachary; Botser, Itamar B; Chen, Austin; Williamson, Joseph; Gupta, Asheesh

2015-02-01

Age has been suggested as a negative prognostic factor for hip arthroscopy. The purpose of this study was to compare patient characteristics and outcomes after hip arthroscopy in patients aged 50 years or older with a matched control group of patients aged 30 years or younger at a minimum postoperative follow-up of 2 years. Between September 2008 and March 2010, data were prospectively collected on all patients aged 50 years or older undergoing primary hip arthroscopy. Fifty-two patients met our inclusion and matching criteria, of whom all 52 (100%) were available for follow-up at a minimum of 2 years. This cohort was compared with a matched-pair control group of patients aged 30 years or younger who underwent similar procedures. The mean age of the study group was 54.8 years (range, 50 to 69 years), and that of the control group was 20.3 years (range, 13 to 30 years). The groups were matched at a 1:1 ratio, including 18 male patients (34.6%) and 34 female patients (65.4%) in each group, with a mean follow-up period of 32 months (range, 24 to 54 months). In the younger control group, the score improvement from preoperatively to 2 years' follow-up was 62.9 to 84.2 for the modified Harris Hip Score, 60.5 to 84.2 for the Non-Arthritic Hip Score, 63.1 to 86.5 for the Hip Outcome Score-Activities of Daily Living, and 42.2 to 72.7 for the Hip Outcome Score-Sport-Specific Subscale. In the older study group, the score improvement from preoperatively to 2 years' follow-up was 61.2 to 82.2 for the modified Harris Hip Score, 59.9 to 80.4 for the Non-Arthritic Hip Score, 63.9 to 83 for the Hip Outcome Score-Activities of Daily Living, and 41.2 to 64.6 for the Hip Outcome Score-Sport-Specific Subscale. All improvements in both groups were statistically significant at the 2-year postoperative follow-up (P < .001). There was no significant difference for all patient-reported outcome (PRO) scores at final follow-up between both groups. When we compared the change in PRO scores (�

Montreal Communication Evaluation Battery--Portuguese version: age and education effects.

PubMed

Kerr, Mônica de Souza; Pagliarin, Karina Carlesso; Mineiro, Ana; Ferré, Perrine; Joanette, Yves; Fonseca, Rochele Paz

2015-01-01

To verify age and education effects on communication performance of healthy adults in the Montreal Communication Evaluation Battery, Portuguese version (MAC-PT). The sample comprised 90 healthy adults from Portugal, European Portuguese speakers, divided into nine groups according to educational level (4-9, 10-13, and > 13 years of formal schooling) and age (19-40, 41-64, and 65-80 years). The influence of age and education was assessed by comparing mean scores between groups, using a two-way analysis of variance followed by Bonferroni post hoc tests (p ≤ 0.05). The results showed that participants' performance was influenced by age in pragmatic-inferential, discursive, and prosodic tasks. Education had the greatest influence on the performance in all processes evaluated by the MAC-PT. Age and education seem to influence the communicative performance and should be considered in the assessment of neurological patients.

Nutritional transition in children under five years and women of reproductive age: a 15-years trend analysis in Peru.

PubMed

Loret de Mola, Christian; Quispe, Renato; Valle, Giancarlo A; Poterico, Julio A

2014-01-01

Rapid urbanization, increase in food availability, and changes in diet and lifestyle patterns have been changing nutritional profiles in developing nations. We aimed to describe nutritional changes in children under 5 years and women of reproductive age in Peru, during a 15-year period of rapid economic development and social policy enhancement. Trend analyses of anthropometric measures in children of preschool age and women between 15-49 years, using the Peruvian National Demographic and Family Health Surveys (DHS) from 1996 to 2011. WHO growth curves were used to define stunting, underweight, wasting and overweight in children <5 y. We employed the WHO BMI-age standardized curves for teenagers between 15-19 y. In women >19 years, body mass index (BMI) was analyzed both categorically and as a continuous variable. To statistically analyze the trends, we used regression models: Linear and Poisson for continuous and binary outcomes, respectively. We analyzed data from 123 642 women and 64 135 children, from 1996 to 2011. Decreases over time were evidenced for underweight (p<0.001), wasting (p<0.001), and stunting (p<0.001) in children under 5 y. This effect was particularly noted in urban settings. Overweight levels in children reduced (p<0.001), however this reduction stopped, in urban settings, since 2005 (∼12%). Anemia decreased in children and women (p<0.001); with higher reduction in urban (↓43%) than in rural children (↓24%). BMI in women aged 15-19 years increased (p<0.001) across time, with noticeable BMI-curve shift in women older than 30 years. Moreover, obesity doubled during this period in women more than 19 y. Nutrition transition in Peru shows different patterns for urban and rural populations. Public policies should emphasize targeting both malnutrition conditions--undernutrition/stunting, overweight/obesity and anemia--considering age and place of residence in rapid developing societies like Peru.

Analysis by age and sex of efficacy data from placebo-controlled trials of desvenlafaxine in outpatients with major depressive disorder.

PubMed

Kornstein, Susan G; Clayton, Anita H; Soares, Claudio N; Padmanabhan, Sudharshan K; Guico-Pabia, Christine J

2010-06-01

This pooled analysis evaluated the efficacy of desvenlafaxine (administered as desvenlafaxine succinate) for the treatment of major depressive disorder (MDD) in patients grouped by age and sex. Nine clinical trials were pooled. Outpatients 18 years or older with MDD received desvenlafaxine 50, 100, 200, or 400 mg/d (men = 709; women = 1096) or placebo (men = 399; women = 709) for 8 weeks. Data were analyzed by sex and by age groups of 40 years and younger, 41 to 54 years, 55 to 64 years, and 65 years and older. The primary outcome was change from baseline in the 17-item Hamilton Rating Scale for Depression (HAM-D17) total score at the final evaluation. Secondary measures included response (> or =50% reduction in HAM-D17) and remission (HAM-D17 < or =7). No significant sex-treatment, age-treatment, or sex-age-treatment interactions were observed. Differences in the HAM-D17 change from baseline for desvenlafaxine versus placebo were -1.72 for women (P < 0.001) and -2.11 for men (P < 0.001); these changes were significant among women of the 18-to-40 (P = 0.01), 41-to-54 (P = 0.002), and 65-years-and-older subgroups (P = 0.02), and significant among men for the 18-to-40 (P = 0.03) and 41-to-54 subgroups (P = 0.002). The response rates for desvenlafaxine and placebo were 53% and 42% (P < 0.001), respectively, among women, and 53% and 41% (P < 0.001), respectively, among men; the remission rates were 31% and 21% (P < 0.001) and 34% and 26% (P = 0.007), respectively. The response rates were similar across age subgroups, with significant differences from placebo observed in the 18-to-40 (P < or = 0.05), 41-to-54 (P < or = 0.005), and 65-and-older subgroups (P = 0.02). The remission rates were significant versus placebo in the 41-to-54 (P = 0.006), 55-to-64 (P = 0.01), and 65-and-older (P = 0.02) subgroups among women but not in any age subgroup among men. Desvenlafaxine generally improved depressive symptoms across age and sex subgroups.

40 CFR 417.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Soap Flakes and Powders Subcategory § 417.64 Pretreatment standards for existing sources. Any existing...

40 CFR 417.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Soap Flakes and Powders Subcategory § 417.64 Pretreatment standards for existing sources. Any existing...

40 CFR 417.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Soap Flakes and Powders Subcategory § 417.64 Pretreatment standards for existing sources. Any existing...

40 CFR 417.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Soap Flakes and Powders Subcategory § 417.64 Pretreatment standards for existing sources. Any existing...

40 CFR 417.64 - Pretreatment standards for existing sources.