49 CFR 18.41 - Financial reporting.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Financial reporting. 18.41 Section 18.41... Enforcement § 18.41 Financial reporting. (a) General. (1) Except as provided in paragraphs (a) (2) and (5) of...) Submitting financial reports to Federal agencies, or (ii) Requesting advances or reimbursements when letters...

49 CFR 18.41 - Financial reporting.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Financial reporting. 18.41 Section 18.41... Enforcement § 18.41 Financial reporting. (a) General. (1) Except as provided in paragraphs (a) (2) and (5) of...) Submitting financial reports to Federal agencies, or (ii) Requesting advances or reimbursements when letters...

30 CFR 18.49 - Connection boxes on machines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Connection boxes on machines. 18.49 Section 18.49 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS ELECTRIC MOTOR-DRIVEN MINE EQUIPMENT AND ACCESSORIES Construction and...

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.

49 CFR 18.44 - Termination for convenience.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Termination for convenience. 18.44 Section 18.44 Transportation Office of the Secretary of Transportation UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND... Enforcement § 18.44 Termination for convenience. Except as provided in § 18.43 awards may be terminated in...

49 CFR 1103.18 - Withdrawal from employment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false Withdrawal from employment. 1103.18 Section 1103.18 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION... Duties and Responsibilities Toward A Client § 1103.18 Withdrawal from employment. The right of a...

49 CFR 18.31 - Real property.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 1 2014-10-01 2014-10-01 false Real property. 18.31 Section 18.31 Transportation... Real property. (a) Title. Subject to the obligations and conditions set forth in this section, title to real property acquired under a grant or subgrant will vest upon acquisition in the grantee or...

49 CFR 18.31 - Real property.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 1 2012-10-01 2012-10-01 false Real property. 18.31 Section 18.31 Transportation... Real property. (a) Title. Subject to the obligations and conditions set forth in this section, title to real property acquired under a grant or subgrant will vest upon acquisition in the grantee or...

49 CFR 18.31 - Real property.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Real property. 18.31 Section 18.31 Transportation... Real property. (a) Title. Subject to the obligations and conditions set forth in this section, title to real property acquired under a grant or subgrant will vest upon acquisition in the grantee or...

49 CFR 18.31 - Real property.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 1 2013-10-01 2013-10-01 false Real property. 18.31 Section 18.31 Transportation... Real property. (a) Title. Subject to the obligations and conditions set forth in this section, title to real property acquired under a grant or subgrant will vest upon acquisition in the grantee or...

49 CFR 18.31 - Real property.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Real property. 18.31 Section 18.31 Transportation... Real property. (a) Title. Subject to the obligations and conditions set forth in this section, title to real property acquired under a grant or subgrant will vest upon acquisition in the grantee or...

49 CFR 18.25 - Program income.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Program income. 18.25 Section 18.25 Transportation... income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real or personal property...

Reasons for playing casual video games and perceived benefits among adults 18 to 80 years old.

PubMed

Whitbourne, Susan Krauss; Ellenberg, Stacy; Akimoto, Kyoko

2013-12-01

Casual video games (CVGs) are becoming increasingly popular among middle-aged and older adults, yet there are few studies documenting why adults of different ages play these games, what benefits they perceive, and how regularly they play. The present study compared the online survey responses of 10,308 adults ranging from 18 to 80 years of age to questions regarding PopCap's popular free online game, Bejeweled Blitz (BJB). All respondents cited playing against friends as their main reason for playing. However, there were differences by age in the second most frequently cited reason. Middle-aged adults cited stress relief, and older adults reported that they seek the game's challenges. As a result of playing CVGs, younger adults noted that they felt sharper and experienced improved memory; older adults were more likely to feel that their visuospatial skills and response time benefited. Adults aged 60 and older had heavier patterns of game play than did adults under the age of 60 years. A significant number of respondents (14.7%) spontaneously noted that they felt that BJB had addictive qualities. CVG players seem to be drawn into this activity by its social nature and to a certain extent by its reinforcing properties. Once involved, however, they believe that they derive a number of benefits that, for older adults, appear to offset declines in age-sensitive cognitive functions.

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

30 CFR 49.18 - Training for mine rescue teams.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Training for mine rescue teams. 49.18 Section... TRAINING MINE RESCUE TEAMS Mine Rescue Teams for Underground Coal Mines § 49.18 Training for mine rescue teams. (a) Prior to serving on a mine rescue team each member shall complete, at a minimum, an initial...

30 CFR 49.18 - Training for mine rescue teams.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Training for mine rescue teams. 49.18 Section... TRAINING MINE RESCUE TEAMS Mine Rescue Teams for Underground Coal Mines § 49.18 Training for mine rescue teams. (a) Prior to serving on a mine rescue team each member shall complete, at a minimum, an initial...

30 CFR 49.18 - Training for mine rescue teams.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Training for mine rescue teams. 49.18 Section... TRAINING MINE RESCUE TEAMS Mine Rescue Teams for Underground Coal Mines § 49.18 Training for mine rescue teams. (a) Prior to serving on a mine rescue team each member shall complete, at a minimum, an initial...

30 CFR 49.18 - Training for mine rescue teams.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Training for mine rescue teams. 49.18 Section... TRAINING MINE RESCUE TEAMS Mine Rescue Teams for Underground Coal Mines § 49.18 Training for mine rescue teams. (a) Prior to serving on a mine rescue team each member shall complete, at a minimum, an initial...

30 CFR 49.18 - Training for mine rescue teams.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Training for mine rescue teams. 49.18 Section... TRAINING MINE RESCUE TEAMS Mine Rescue Teams for Underground Coal Mines § 49.18 Training for mine rescue teams. (a) Prior to serving on a mine rescue team each member shall complete, at a minimum, an initial...

Awareness of Cardiovascular Risk Factors in U.S. Young Adults Aged 18–39 Years

PubMed Central

Bucholz, Emily M.; Gooding, Holly C.; de Ferranti, Sarah D.

2018-01-01

Introduction Young adults with hyperlipidemia, hypertension, and diabetes are at increased risk of developing heart disease later in life. Despite emphasis on early screening, little is known about awareness of these risk factors in young adulthood. Methods Data from the nationally representative cross-sectional survey National Health and Nutrition Examination Survey 2011–2014 were analyzed in 2017 to estimate the prevalence of self-reported awareness of hypercholesterolemia, hypertension, and diabetes in U.S. young adults aged 18–39 years (n=11,083). Prevalence estimates were weighted to population estimates using survey procedures, and predictors of awareness were identified using weighted logistic regression. Results Among U.S. young adults, the prevalence of hypercholesterolemia, hypertension, and diabetes was 8.8% (SE=0.4%), 7.3% (SE=0.3%), and 2.6% (SE=0.2%), respectively. The prevalence of borderline high cholesterol, blood pressure, and blood glucose were substantially higher (21.6% [SE= 0.6%], 26.9% [SE=0.7%], and 18.9% [SE=0.6%], respectively). Awareness was low for hypercholesterolemia (56.9% [SE=2.4%]) and moderate for hypertension and diabetes (62.7% [SE=2.4%] and 70.0% [SE=2.7%]); <25% of young adults with borderline levels of these risk factors were aware of their risk. Correlates of risk factor awareness included older age, insurance status, family income above the poverty line, U.S. origin, having a usual source of health care, and the presence of comorbid conditions. Conclusions Despite the high prevalence of cardiovascular risk factors in U.S. young adults, awareness remains less than ideal. Interventions that target access may increase awareness and facilitate achieving treatment goals in young adults. PMID:29433955

38 CFR 18.438 - Adult education.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Adult education. 18.438 Section 18.438 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Adult Education § 18.438 Adult education. A recipient that provides adult education may not, on the...

38 CFR 18.438 - Adult education.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Adult education. 18.438 Section 18.438 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Adult Education § 18.438 Adult education. A recipient that provides adult education may not, on the...

38 CFR 18.438 - Adult education.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Adult education. 18.438 Section 18.438 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Adult Education § 18.438 Adult education. A recipient that provides adult education may not, on the...

38 CFR 18.438 - Adult education.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Adult education. 18.438 Section 18.438 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Adult Education § 18.438 Adult education. A recipient that provides adult education may not, on the...

38 CFR 18.438 - Adult education.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Adult education. 18.438 Section 18.438 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Adult Education § 18.438 Adult education. A recipient that provides adult education may not, on the...

49 CFR 225.18 - Alcohol or drug involvement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Alcohol or drug involvement. 225.18 Section 225.18....18 Alcohol or drug involvement. (a) In preparing Form FRA F 6180.54, “Rail Equipment Accident... the circumstances into the possible involvement of alcohol or drug use or impairment in such accident...

49 CFR 225.18 - Alcohol or drug involvement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Alcohol or drug involvement. 225.18 Section 225.18....18 Alcohol or drug involvement. (a) In preparing Form FRA F 6180.54, “Rail Equipment Accident... the circumstances into the possible involvement of alcohol or drug use or impairment in such accident...

49 CFR 225.18 - Alcohol or drug involvement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Alcohol or drug involvement. 225.18 Section 225.18....18 Alcohol or drug involvement. (a) In preparing Form FRA F 6180.54, “Rail Equipment Accident... the circumstances into the possible involvement of alcohol or drug use or impairment in such accident...

49 CFR 231.18 - Cars of special construction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Cars of special construction. 231.18 Section 231... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD SAFETY APPLIANCE STANDARDS § 231.18 Cars of special construction. Cars of construction not covered specifically in the foregoing sections in this part, relative to...

49 CFR 231.18 - Cars of special construction.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Cars of special construction. 231.18 Section 231... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD SAFETY APPLIANCE STANDARDS § 231.18 Cars of special construction. Cars of construction not covered specifically in the foregoing sections in this part, relative to...

49 CFR 231.18 - Cars of special construction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Cars of special construction. 231.18 Section 231... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD SAFETY APPLIANCE STANDARDS § 231.18 Cars of special construction. Cars of construction not covered specifically in the foregoing sections in this part, relative to...

49 CFR 231.18 - Cars of special construction.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Cars of special construction. 231.18 Section 231... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD SAFETY APPLIANCE STANDARDS § 231.18 Cars of special construction. Cars of construction not covered specifically in the foregoing sections in this part, relative to...

49 CFR 231.18 - Cars of special construction.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Cars of special construction. 231.18 Section 231... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD SAFETY APPLIANCE STANDARDS § 231.18 Cars of special construction. Cars of construction not covered specifically in the foregoing sections in this part, relative to...

An Evaluation of Functional Sit-to-Stand Power in Cohorts of Healthy Adults Aged 18-97 Years.

PubMed

Glenn, Jordan M; Gray, Michelle; Vincenzo, Jennifer; Paulson, Sally; Powers, Melissa

2017-04-01

This investigation examined differences in functional sit-to-stand power/velocity between cohorts of adults aged 18-97 years. This study included 264 healthy adults classified into four cohorts (18-40, C1; 60-69, C2; 70-79, C2; ≥ 80, C4). Participants completed the sit-to-stand task five times. Power and velocity were measured via the TENDO power analyzer. Absolute average power was maintained from C1-C3, but decreased (p < .01) in C4. Absolute peak power decreased between C1-C2 (p < .01), was similar between C2-C3, and decreased in C4 (p < .01). Relative (to body weight) average and peak power decreased between C1-C2 (p < .01), was similar between C2-C3, and decreased in C4 (p < .01). Average velocity was similar between C1 and C2, but decreased in C3 (p < .01) and C4 (p < .01), respectively. Peak velocity was significantly different between all cohorts (p < .01). Declines in functional power may plateau during the seventh and eighth decades, accelerating after 80 years.

49 CFR 587.18 - Dimensions of fixed rigid barrier.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Dimensions of fixed rigid barrier. 587.18 Section 587.18 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY... Deformable Barrier § 587.18 Dimensions of fixed rigid barrier. (a) The fixed rigid barrier has a mass of not...

49 CFR 587.18 - Dimensions of fixed rigid barrier.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Dimensions of fixed rigid barrier. 587.18 Section 587.18 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY... Deformable Barrier § 587.18 Dimensions of fixed rigid barrier. (a) The fixed rigid barrier has a mass of not...

49 CFR 587.18 - Dimensions of fixed rigid barrier.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Dimensions of fixed rigid barrier. 587.18 Section 587.18 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY... Deformable Barrier § 587.18 Dimensions of fixed rigid barrier. (a) The fixed rigid barrier has a mass of not...

49 CFR 587.18 - Dimensions of fixed rigid barrier.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Dimensions of fixed rigid barrier. 587.18 Section 587.18 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY... Deformable Barrier § 587.18 Dimensions of fixed rigid barrier. (a) The fixed rigid barrier has a mass of not...

49 CFR 236.18 - Software management control plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Software management control plan. 236.18 Section... Instructions: All Systems General § 236.18 Software management control plan. (a) Within 6 months of June 6, 2005, each railroad shall develop and adopt a software management control plan for its signal and train...

49 CFR 236.18 - Software management control plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Software management control plan. 236.18 Section... Instructions: All Systems General § 236.18 Software management control plan. (a) Within 6 months of June 6, 2005, each railroad shall develop and adopt a software management control plan for its signal and train...

49 CFR 236.18 - Software management control plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Software management control plan. 236.18 Section... Instructions: All Systems General § 236.18 Software management control plan. (a) Within 6 months of June 6, 2005, each railroad shall develop and adopt a software management control plan for its signal and train...

49 CFR 236.18 - Software management control plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Software management control plan. 236.18 Section... Instructions: All Systems General § 236.18 Software management control plan. (a) Within 6 months of June 6, 2005, each railroad shall develop and adopt a software management control plan for its signal and train...

49 CFR 236.18 - Software management control plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Software management control plan. 236.18 Section... Instructions: All Systems General § 236.18 Software management control plan. (a) Within 6 months of June 6, 2005, each railroad shall develop and adopt a software management control plan for its signal and train...

49 CFR 179.400-18 - Test of inner tank.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Test of inner tank. 179.400-18 Section 179.400-18... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113 and 107A) § 179.400-18 Test of inner tank...

Communication and Your 13-to 18-Year-Old

MedlinePlus

... Staying Safe Videos for Educators Search English Español Communication and Your 13- to 18-Year-Old KidsHealth / ... games, and talking about current events. Vocabulary and Communication Teens essentially communicate as adults, with increasing maturity ...

49 CFR 18.20 - Standards for financial management systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Standards for financial management systems. 18.20... FOR GRANTS AND COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 18.20 Standards for financial management systems. (a) A State must expand and account for grant...

49 CFR 587.18 - Dimensions of fixed rigid barrier.

Code of Federal Regulations, 2010 CFR

2010-10-01

... TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) DEFORMABLE BARRIERS Offset Deformable Barrier § 587.18 Dimensions of fixed rigid barrier. (a) The fixed rigid barrier has a mass of not... 49 Transportation 7 2010-10-01 2010-10-01 false Dimensions of fixed rigid barrier. 587.18 Section...

49 CFR 18.20 - Standards for financial management systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., payrolls, time and attendance records, contract and subgrant award documents, etc. (7) Cash management... 49 Transportation 1 2013-10-01 2013-10-01 false Standards for financial management systems. 18.20... Administration § 18.20 Standards for financial management systems. (a) A State must expand and account for grant...

49 CFR 18.20 - Standards for financial management systems.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., payrolls, time and attendance records, contract and subgrant award documents, etc. (7) Cash management... 49 Transportation 1 2011-10-01 2011-10-01 false Standards for financial management systems. 18.20... Administration § 18.20 Standards for financial management systems. (a) A State must expand and account for grant...

49 CFR 18.20 - Standards for financial management systems.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 1 2014-10-01 2014-10-01 false Standards for financial management systems. 18.20... Administration § 18.20 Standards for financial management systems. (a) A State must expand and account for grant... statutes. (b) The financial management systems of other grantees and subgrantees must meet the following...

49 CFR 18.20 - Standards for financial management systems.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 1 2012-10-01 2012-10-01 false Standards for financial management systems. 18.20... Administration § 18.20 Standards for financial management systems. (a) A State must expand and account for grant... statutes. (b) The financial management systems of other grantees and subgrantees must meet the following...

[Intake of liquid beverage among Chinese adults aged 18-59 years old in 15 provinces, 2015].

PubMed

Wang, Yun; Jia, Xiaofang; Du, Wenwen; Huang, Feifei; Zhang, Ji; Jiang, Hongru; Su, Chang; Zhang, Jiguo; Li, Li; Ouyang, Yifei; Wang, Zhihong; Zhang, Bing; Wang, Huijun

2018-03-01

To understand the current status of liquid beverage consumption of adult residents in 15 provinces and cities in China, and discuss relevant factors that may affect the consumption of liquid beverage of adult residents, and provide data support to guide the rational consumption of liquid beverage. Using data from China Nutritional Transition Cohort Survey in 2015 on the subjects aged 18 to 59 years old in 15 provinces and cities in China with complete 24-hour-dietary for 3 days and food consumption frequency method, chi-square was used to analyze liquid beverage consumption rate, nonparametric test was used to analyze beverage consumption intake levels of different gender, age, education degree, urban and rural areas, income, region. The factors affecting the consumption of liquid beverage were analyzed by Logistic regression model. The result of complete 24-hour-dietary for 3 days showed that the consumption rate of liquid beverage was 2. 8% and the 99 th consumption of liquid beverage was 93. 3 g/d for adult residents in 15 provinces and cities in 2015. The consumption rate and P99 intake of liquid beverage increased gradually with the increase of educational degree and income; the city was higher than the rural areas; the eastern was higher than the central and west region. Logistic analysis showed that the distribution of education, urban and rural areas and region were the influencing factors of whether adult residents drank liquid beverage. The 50 th consumption of liquid beverage in the consumer group was 70. 0 g/d. Among them, 18-44 years old youth group was higher than 45-59 years old middle age group; junior middle school education was highest lowest; the rural was higher than the city; the central was higher than west and east region. The result of food consumption frequency showed that 25. 8% of adults were reported consumed liquid beverage in 2015. The main types of beverages were fruit juice and fruit juice beverages, carbonated drinks, accounting for

Treatment outcomes, quality of life, and impact of hemophilia on young adults (aged 18-30 years) with hemophilia.

PubMed

Witkop, Michelle; Guelcher, Christine; Forsyth, Angela; Hawk, Sarah; Curtis, Randall; Kelley, Laureen; Frick, Neil; Rice, Michelle; Rosu, Gabriela; Cooper, David L

2015-12-01

The Hemophilia Experiences, Results and Opportunities (HERO) initiative assessed psychosocial issues reported by people with moderate to severe hemophilia and was led by a multidisciplinary international advisory board. This analysis reports data from young adult respondents (aged 18-30 years), including both US and overall global (including US respondents) results, and investigates treatment outcomes, quality of life, and impacts of hemophilia on relationships. More young adults in HERO received prophylaxis than on-demand treatment, although a majority reported not using factor products exactly as prescribed, and 50% of global respondents and 26% of US respondents reported issues with access to factor replacement therapy in the previous 5 years. Many young adults with hemophilia reported comorbidities, including bone/skeletal arthritis, chronic pain, and viral infections, and nearly half of young adults reported anxiety/depression. Most reported pain interference with daily activities in the past 4 weeks, although a majority reported participating in lower-risk activities and approximately half in intermediate-risk activities. Most young adults were very or quite satisfied with the support of partners/spouses, family, and friends, although roughly one-third reported that hemophilia affected their ability to develop close relationships with a partner. A majority of young adults reported that hemophilia has had a negative impact on employment, and 62% of global respondents and 78% of US respondents were employed at least part-time. Together these data highlight the psychosocial issues experienced by young adults with hemophilia and suggest that increased focus on these issues may improve comprehensive care during the transition to adulthood. © 2015 Wiley Periodicals, Inc.

Creative Thinking and Creative Performance in Adolescents as Predictors of Creative Attainments in Adults: A Follow-Up Study after 18 Years.

ERIC Educational Resources Information Center

Milgram, Roberta M.; Hong, Eunsook

1993-01-01

Results of an 18-year longitudinal study of 48 Israeli high school students who were seniors at the study's start suggest that measures of creative thinking and creative leisure activities were more important than school-oriented predictors of intelligence and school grades in predicting creative attainments in adults. (DB)

Safety of quadrivalent live attenuated influenza vaccine in subjects aged 2-49years.

PubMed

Baxter, Roger; Eaton, Abigail; Hansen, John; Aukes, Laurie; Caspard, Herve; Ambrose, Christopher S

2017-03-01

Quadrivalent live attenuated influenza vaccine (Q/LAIV) was licensed in 2012 and replaced trivalent live attenuated influenza vaccine in the United States during the 2013-2014 influenza season. This study assessed the safety of Q/LAIV in children and adults aged 2-49years. This was a prospective observational cohort study using data collected from Kaiser Permanente Northern California. Post-vaccination events of interest were any hospitalization, hospitalization for lower respiratory tract infection, and the following medically attended events: hypersensitivity, seizures/convulsions, lower respiratory tract infection, wheezing, Guillain-Barré syndrome, Bell's palsy, encephalitis, neuritis, vasculitis, and narcolepsy/cataplexy. The rates of these events during the risk interval post-vaccination were compared with rates observed during reference periods later in the follow-up (within-cohort analysis) and with rates observed in frequency-matched unvaccinated controls and inactivated influenza vaccine (IIV) recipients. A total of 62,040 eligible Q/LAIV recipients were identified during the 2013-2014 influenza season. Within-cohort comparisons of all Q/LAIV recipients as well as comparisons between Q/LAIV recipients and unvaccinated controls or IIV recipients did not show any significantly higher risk of hospitalizations or medically attended events following administration of Q/LAIV. Additional analyses by setting (clinic visits, emergency department visits, and hospital admissions) and age group (2-4, 5-8, 9-17, and 18-49years) also did not reveal clinically consistent findings that suggested any increased risk after administration of Q/LAIV. In this large population study of individuals aged 2-49years, no safety signals associated with the administration of Q/LAIV were observed. A much larger study population would be needed to confidently reject any association between Q/LAIV and very rare events, specifically those with an incidence of <1 event/10,000 person-years

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.

49 CFR 605.18 - Comments by private school bus operators.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Comments by private school bus operators. 605.18... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION SCHOOL BUS OPERATIONS School Bus Agreements § 605.18 Comments by private school bus operators. Private school bus operators may file written comments on an applicant's...

49 CFR 605.18 - Comments by private school bus operators.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Comments by private school bus operators. 605.18... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION SCHOOL BUS OPERATIONS School Bus Agreements § 605.18 Comments by private school bus operators. Private school bus operators may file written comments on an applicant's...

W18O49 nanowires assembled on carbon felt for application to supercapacitors

NASA Astrophysics Data System (ADS)

Jung, Jinjoo; Kim, Do Hyung

2018-03-01

For supercapacitor applications, W18O49 nanowires have been extensively grown on graphitic carbon felt using a facile solvothermal method. The diameter and length of the nanowires are about 7 and 300 nm, respectively. The nanowires consist of monoclinic W18O49 grown along the [010] direction, as shown by TEM and XRD analyses. The W18O49 nanowires, assembled on carbon felt, exhibit a high capacity of 588.33 F/g at a current density of 1 A/g together with an excellent cycle performance, and a low internal resistance during the electrochemical tests. This outstanding performance may originate from the three-dimensional porous nanostructure of these W18O49 nanowires, which leads to a reduction in the resistance and fast reaction kinetics due to the high specific surface area and electrolyte accessibility. Furthermore, sufficient oxygen deficiencies of the substoichiometric tungsten oxide can also contribute to the electrochemical activity, which can be confirmed by comparison of CV and EIS data with WO3 nanowires.

49 CFR 1242.18 - Communication systems (account XX-19-20).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Communication systems (account XX-19-20). 1242.18... Structures § 1242.18 Communication systems (account XX-19-20). Separate common expenses on the basis of the... (accounts XX-19-02 to XX-19-04, inclusive) Equipment—Administration—Locomotives and Other Equipment...

Hepatitis B vaccination coverage among adults aged ≥18 years traveling to a country of high or intermediate endemicity, United States, 2015.

PubMed

Lu, Peng-Jun; O'Halloran, Alissa C; Williams, Walter W; Nelson, Noele P

2018-04-28

Persons from the United States who travel to developing countries are at substantial risk for hepatitis B virus (HBV) infection. Hepatitis B vaccine has been recommended for adults at increased risk for infection, including travelers to high or intermediate hepatitis B endemic countries. To assess hepatitis B vaccination coverage among adults ≥18 years traveling to a country of high or intermediate endemicity from the United States. Data from the 2015 National Health Interview Survey (NHIS) were analyzed to determine hepatitis B vaccination coverage (≥1 dose) and series completion (≥3 doses) among persons aged ≥18 years who reported traveling to a country of high or intermediate hepatitis B endemicity. Multivariable logistic regression and predictive marginal analyses were conducted to identify factors independently associated with hepatitis B vaccination. In 2015, hepatitis B vaccination coverage (≥1 dose) among adults aged ≥18 years who reported traveling to high or intermediate hepatitis B endemic countries was 38.6%, significantly higher compared with 25.9% among non-travelers. Series completion (≥3 doses) was 31.7% and 21.2%, respectively (P < 0.05). On multivariable analysis among all respondents, travel status was significantly associated with hepatitis B vaccination coverage and series completion. Other characteristics independently associated with vaccination (≥1 dose, and ≥3 doses) among travelers included age, race/ethnicity, educational level, duration of US residence, number of physician contacts in the past year, status of ever being tested for HIV, and healthcare personnel status. Although travel to a country of high or intermediate hepatitis B endemicity was associated with higher likelihood of hepatitis B vaccination, hepatitis B vaccination coverage was low among adult travelers to these areas. Healthcare providers should ask their patients about travel plans and recommend and offer travel related vaccinations to their

[Management of patients under 18years of age by adult intensive care unit professionals: Level of training, workload, and specific challenges].

PubMed

Brossier, D; Villedieu, F; Letouzé, N; Pinto Da Costa, N; Jokic, M

2017-03-01

In routine practice, intensive care physicians rarely have to manage children under 18years of age, particularly those under 15. This study's objectives were to assess the quality of training in pediatrics of adult intensive care teams, to document the workload generated by care of pediatric patients, and to identify the difficulties encountered in managing minors as patients. A survey was administered in Lower Normandy from 4 April 2012 to 1 September 2012. Physicians, residents, nurses, and nurses' aides practicing in one of the nine intensive care units of Lower Normandy were asked to complete an electronic or paper format questionnaire. This questionnaire assessed their level of pediatric training, the workload management of pediatric patients entailed, and the challenges posed by these patients. One hundred and nine questionnaires were returned (by 26 attending physicians, 18 residents, 38 nurses, and 27 nurses' aides). Eighty-three of the respondents (76%) had no experience in a pediatric unit of any kind. Forty-two percent thought that the pediatric age range lies between 3months and 15years of age. However, more than 50% of respondents would like the upper limit to be 16years or even older. Ninety-three respondents (85%) estimated having some exposure to pediatric patients in their routine practice, but this activity remained quite low. Seventy-three (67%) reported difficulties with the management of these young patients. This survey provides current information regarding the level of training of adult intensive care unit professionals and their concerns about managing patients under 18years of age, both in terms of workload and specific challenges. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Diagnostic value of 18F-FDG-PET/CT for the follow-up and restaging of soft tissue sarcomas in adults.

PubMed

Kassem, T W; Abdelaziz, O; Emad-Eldin, S

2017-10-01

The purpose of this study was to evaluate the clinical utility of 2-[ 18 F] fluoro-2-deoxy-D-glucose ( 18 FDG) positron emission tomography (PET)/computed tomography (CT) ( 18 F-FDG-PET/CT) in the follow-up of adult patients with soft tissue sarcomas. We prospectively evaluated 37 consecutive patients with known soft tissue sarcoma with 18 F-FDG-PET/CT examination for suspected recurrence of disease. They were 21 men and 16 women with a mean age of 49.6±10.6 (SD) years (range, 34-75years). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 18 F-FDG-PET/CT examination were calculated on a per patient basis. 18 F-FDG-PET/CT showed an overall diagnostic accuracy of 91.8%, sensitivity of 90% and a specificity of 100%. The positive predictive value and negative predictive value were 100 and 70%, respectively. The 18 F-FDG-PET/CT interpretations were correct in 34/37 patients (91.8%). Incorrect interpretations occurred in three patients (8.1%). Reasons for false negative findings were low 18 F-FDG uptake of local recurrence in one patient and low 18 F-FDG uptake of subcentimetric inguinal lymph node metastases. 18 F-FDG-PET/CT has a high diagnostic value in the follow-up of patients with soft tissue sarcoma. Copyright © 2017 Editions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Independent and additive association of prenatal famine exposure and intermediary life conditions with adult mortality between age 18-63 years.

PubMed

Ekamper, P; van Poppel, F; Stein, A D; Lumey, L H

2014-10-01

To quantify the relation between prenatal famine exposure and adult mortality, taking into account mediating effects of intermediary life conditions. Historical follow-up study. The Dutch famine (Hunger Winter) of 1944-1945 which occurred towards the end of WWII in occupied Netherlands. From 408,015 Dutch male births born 1944-1947, examined for military service at age 18, we selected for follow-up all men born at the time of the famine in six affected cities in the Western Netherlands (n=25,283), and a sample of unexposed time (n=10,667) and place (n=9087) controls. These men were traced and followed for mortality through the national population and death record systems. All-cause mortality between ages 18 and 63 years using Cox proportional hazards models adjusted for intermediary life conditions. An increase in mortality was seen after famine exposure in early gestation (HR 1.12; 95% confidence interval (CI): 1.01-1.24) but not late gestation (HR 1.04; 95% CI: 0.96-1.13). Among intermediary life conditions at age 18 years, educational level was inversely associated with mortality and mortality was elevated in men with fathers with manual versus non-manual occupations (HR 1.08; CI: 1.02-1.16) and in men who were declared unfit for military service (HR 1.44; CI: 1.31-1.58). Associations of intermediate factors with mortality were independent of famine exposure in early life and associations between prenatal famine exposure and adult mortality were independent of social class and education at age 18. Timing of exposure in relation to the stage of pregnancy may be of critical importance for later health outcomes independent of intermediary life conditions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Suicidal Ideation Among Community-Dwelling Adults in the United States

PubMed Central

McKeon, Richard; Gfroerer, Joe

2014-01-01

Objectives. We examined the prevalence and correlates of past-year suicidal ideation among US community-dwelling adults. Methods. We examined data from 183 100 persons aged 18 years or older (including 9800 sampled adults with past-year suicidal ideation) who participated in the 2008–2011 National Survey on Drug Use and Health. We applied descriptive analyses and pooled and stratified (by age and major depression) multivariate logistic regression models. Results. The prevalence of past-year suicidal ideation among younger adults (6.6% among those aged 18–25 years and 4.0% among those aged 26–49 years) was higher than was that among adults aged 50 years or older (2.5%). The prevalence of suicidal ideation was high among adults with major depression (26.3%), adults with both major depression and substance use disorder (37.7%), and adults who received mental health treatment but perceived unmet treatment need (33.5%). Conclusions. Many risk and protective factors of suicidal ideation are dynamic and vary by age or major depression. These results have important implications for developing specific suicide prevention strategies that help screen, assess, and treat suicidal adults at the earliest possible time. PMID:24432951

Acute Myeloid Leukemia in Adolescents and Young Adults Treated in Pediatric and Adult Departments in the Nordic Countries.

PubMed

Wennström, Lovisa; Edslev, Pernille Wendtland; Abrahamsson, Jonas; Nørgaard, Jan Maxwell; Fløisand, Yngvar; Forestier, Erik; Gustafsson, Göran; Heldrup, Jesper; Hovi, Liisa; Jahnukainen, Kirsi; Jonsson, Olafur Gisli; Lausen, Birgitte; Palle, Josefine; Zeller, Bernward; Holmberg, Erik; Juliusson, Gunnar; Stockelberg, Dick; Hasle, Henrik

2016-01-01

Studies on adolescents and young adults with acute lymphoblastic leukemia suggest better results when using pediatric protocols for adult patients, while corresponding data for acute myeloid leukemia (AML) are limited. We investigated disease characteristics and outcome for de novo AML patients 10-30 years old treated in pediatric or adult departments. We included 166 patients 10-18 years of age with AML treated according to the pediatric NOPHO-protocols (1993-2009) compared with 253 patients aged 15-30 years treated in hematology departments (1996-2009) in the Nordic countries. The incidence of AML was 4.9/million/year for the age group 10-14 years, 6.5 for 15-18 years, and 6.9 for 19-30 years. Acute promyelocytic leukemia (APL) was more frequent in adults and in females of all ages. Pediatric patients with APL had similar overall survival as pediatric patients without APL. Overall survival at 5 years was 60% (52-68%) for pediatric patients compared to 65% (58-70%) for adult patients. Cytogenetics and presenting white blood cell count were the only independent prognostic factors for overall survival. Age was not an independent prognostic factor. No difference was found in outcome for AML patients age 10-30 years treated according to pediatric as compared to adult protocols. © 2015 Wiley Periodicals, Inc.

Knowledge of influenza vaccination recommendation and early vaccination uptake during the 2015-16 season among adults aged ≥18years - United States.

PubMed

Lu, Peng-Jun; Srivastav, Anup; Santibanez, Tammy A; Christopher Stringer, M; Bostwick, Michael; Dever, Jill A; Stanley Kurtz, Marshica; Williams, Walter W

2017-08-03

Since 2010, the Advisory Committee on Immunization Practices (ACIP) has recommended that all persons aged ≥6months receive annual influenza vaccination. We analyzed data from the 2015 National Internet Flu Survey (NIFS), to assess knowledge and awareness of the influenza vaccination recommendation and early influenza vaccination coverage during the 2015-16 season among adults. Predictive marginals from a multivariable logistic regression model were used to identify factors independently associated with adults' knowledge and awareness of the vaccination recommendation and early vaccine uptake during the 2015-16 influenza season. Among the 3301 respondents aged ≥18years, 19.6% indicated knowing that influenza vaccination is recommended for all persons aged ≥6months. Of respondents, 62.3% indicated awareness that there was a recommendation for influenza vaccination, but did not indicate correct knowledge of the recommended age group. Overall, 39.9% of adults aged ≥18years reported having an influenza vaccination. Age 65years and older, being female, having a college or higher education, not being in work force, having annual household income ≥$75,000, reporting having received an influenza vaccination early in the 2015-16 season, having children aged ≤17years in the household, and having high-risk conditions were independently associated with a higher correct knowledge of the influenza vaccination recommendation. Approximately 1 in 5 had correct knowledge of the recommendation that all persons aged ≥6months should receive an influenza vaccination annually, with some socio-economic groups being even less aware. Clinic based education in combination with strategies known to increase uptake of recommended vaccines, such as patient reminder/recall systems and other healthcare system-based interventions are needed to improve vaccination, which could also improve awareness. Published by Elsevier Ltd.

Growth And Gas Sensing Properties Of Dielectrophoretically Isolated CuO-W{sub 18}O{sub 49} Heterostructures

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

Jain, Chhavi; Mukund, Vignesh; Kaur, Manmeet

2010-12-01

Hierarchical heterostructures consisting of W{sub 18}O{sub 49} nanowires grown on CuO nanowires have been prepared and studied for their gas sensing properties. SEM images show that W{sub 18}O{sub 49} initially grow as an shell over core CuO nanowire with protusion like branches whose thickness depends on oxygen partial pressure. These CuO:W{sub 18}O{sub 49} structures were dielectrophoretically isolated and studied for their gas sensing properties. The results show potential of use of tailored hierarchical heterostructures for the fabrication of gas sensors.

Sugar-sweetened beverage consumption among adults -- 18 states, 2012.

PubMed

Kumar, Gayathri S; Pan, Liping; Park, Sohyun; Lee-Kwan, Seung Hee; Onufrak, Stephen; Blanck, Heidi M

2014-08-15

Reducing consumption of calories from added sugars is a recommendation of the 2010 Dietary Guidelines for Americans and an objective of Healthy People 2020. Sugar-sweetened beverages (SSB) are major sources of added sugars in the diets of U.S. residents. Daily SSB consumption is associated with obesity and other chronic health conditions, including diabetes and cardiovascular disease. U.S. adults consumed an estimated average of 151 kcal/day of SSB during 2009-2010, with regular (i.e., nondiet) soda and fruit drinks representing the leading sources of SSB energy intake. However, there is limited information on state-specific prevalence of SSB consumption. To assess regular soda and fruit drink consumption among adults in 18 states, CDC analyzed data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS). Among the 18 states surveyed, 26.3% of adults consumed regular soda or fruit drinks or both ≥1 times daily. By state, the prevalence ranged from 20.4% to 41.4%. Overall, consumption of regular soda or fruit drinks was most common among persons aged 18‒34 years (24.5% for regular soda and 16.6% for fruit drinks), men (21.0% and 12.3%), non-Hispanic blacks (20.9% and 21.9%), and Hispanics (22.6% and 18.5%). Persons who want to reduce added sugars in their diets can decrease their consumption of foods high in added sugars such as candy, certain dairy and grain desserts, sweetened cereals, regular soda, fruit drinks, sweetened tea and coffee drinks, and other SSBs. States and health departments can collaborate with worksites and other community venues to increase access to water and other healthful beverages.

Hepatitis B vaccination coverage among adults aged ≥ 18 years traveling to a country of high or intermediate endemicity, United States, 2015.

PubMed

Lu, Peng-Jun; O'Halloran, Alissa C; Williams, Walter W; Nelson, Noele P

2018-04-25

Persons from the United States who travel to developing countries are at substantial risk for hepatitis B virus (HBV) infection. Hepatitis B vaccine has been recommended for adults at increased risk for infection, including travelers to high or intermediate hepatitis B endemic countries. To assess hepatitis B vaccination coverage among adults ≥ 18 years traveling to a country of high or intermediate endemicity from the United States. Data from the 2015 National Health Interview Survey (NHIS) were analyzed to determine hepatitis B vaccination coverage (≥1 dose) and series completion (≥3 doses) among persons aged ≥ 18 years who reported traveling to a country of high or intermediate hepatitis B endemicity. Multivariable logistic regression and predictive marginal analyses were conducted to identify factors independently associated with hepatitis B vaccination. In 2015, hepatitis B vaccination coverage (≥1 dose) among adults aged ≥ 18 years who reported traveling to high or intermediate hepatitis B endemic countries was 38.6%, significantly higher compared with 25.9% among non-travelers. Series completion (≥3 doses) was 31.7% and 21.2%, respectively (P < 0.05). On multivariable analysis among all respondents, travel status was significantly associated with hepatitis B vaccination coverage and series completion. Other characteristics independently associated with vaccination (≥1 dose, and ≥ 3 doses) among travelers included age, race/ethnicity, educational level, duration of U.S. residence, number of physician contacts in the past year, status of ever being tested for HIV, and healthcare personnel status. Although travel to a country of high or intermediate hepatitis B endemicity was associated with higher likelihood of hepatitis B vaccination, hepatitis B vaccination coverage was low among adult travelers to these areas. Healthcare providers should ask their patients about travel plans and recommend and offer travel related

Mortality in the Year Following Antiretroviral Therapy Initiation in HIV-Infected Adults and Children in Uganda and Zimbabwe

PubMed Central

Walker, A. Sarah; Prendergast, Andrew J.; Mugyenyi, Peter; Munderi, Paula; Hakim, James; Kekitiinwa, Addy; Katabira, Elly; Gilks, Charles F.; Kityo, Cissy; Nahirya-Ntege, Patricia; Nathoo, Kusum; Gibb, Diana M.

2012-01-01

Background. Adult mortality in the first 3 months on antiretroviral therapy (ART) is higher in low-income than in high-income countries, with more similar mortality after 6 months. However, the specific patterns of changing risk and causes of death have rarely been investigated in adults, nor compared with children in low-income countries. Methods. We used flexible parametric hazard models to investigate how mortality risks varied over the first year on ART in human immunodeficiency virus–infected adults (aged 18–73 years) and children (aged 4 months to 15 years) in 2 trials in Zimbabwe and Uganda. Results. One hundred seventy-nine of 3316 (5.4%) adults and 39 of 1199 (3.3%) children died; half of adult/pediatric deaths occurred in the first 3 months. Mortality variation over year 1 was similar; at all CD4 counts/CD4%, mortality risk was greatest between days 30 and 50, declined rapidly to day 180, then declined more slowly. One-year mortality after initiating ART with 0–49, 50–99 or ≥100 CD4 cells/μL was 9.4%, 4.5%, and 2.9%, respectively, in adults, and 10.1%, 4.4%, and 1.3%, respectively, in children aged 4–15 years. Mortality in children aged 4 months to 3 years initiating ART in equivalent CD4% strata was also similar (0%–4%: 9.1%; 5%–9%: 4.5%; ≥10%: 2.8%). Only 10 of 179 (6%) adult deaths and 1 of 39 (3%) child deaths were probably medication-related. The most common cause of death was septicemia/meningitis in adults (20%, median 76 days) and children (36%, median 79 days); pneumonia also commonly caused child deaths (28%, median 41 days). Conclusions. Children ≥4 years and adults with low CD4 values have remarkably similar, and high, mortality risks in the first 3 months after ART initiation in low-income countries, similar to cohorts of untreated individuals. Bacterial infections are a major cause of death in both adults and children; targeted interventions could have important benefits. PMID:22972859

49 CFR 821.18 - Motion for a more definite statement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... defects complained of and the details sought. If the motion is granted and the law judge's order is not... moving party shall file an answer within 10 days after service of the law judge's order on the motion. (b... 49 Transportation 7 2012-10-01 2012-10-01 false Motion for a more definite statement. 821.18...

49 CFR 821.18 - Motion for a more definite statement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... defects complained of and the details sought. If the motion is granted and the law judge's order is not... moving party shall file an answer within 10 days after service of the law judge's order on the motion. (b... 49 Transportation 7 2010-10-01 2010-10-01 false Motion for a more definite statement. 821.18...

49 CFR 821.18 - Motion for a more definite statement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... defects complained of and the details sought. If the motion is granted and the law judge's order is not... moving party shall file an answer within 10 days after service of the law judge's order on the motion. (b... 49 Transportation 7 2011-10-01 2011-10-01 false Motion for a more definite statement. 821.18...

49 CFR 821.18 - Motion for a more definite statement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... defects complained of and the details sought. If the motion is granted and the law judge's order is not... moving party shall file an answer within 10 days after service of the law judge's order on the motion. (b... 49 Transportation 7 2014-10-01 2014-10-01 false Motion for a more definite statement. 821.18...

49 CFR 821.18 - Motion for a more definite statement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... defects complained of and the details sought. If the motion is granted and the law judge's order is not... moving party shall file an answer within 10 days after service of the law judge's order on the motion. (b... 49 Transportation 7 2013-10-01 2013-10-01 false Motion for a more definite statement. 821.18...

Synthesis of nanowire bundle-like WO3-W18O49 heterostructures for highly sensitive NH3 sensor application.

PubMed

Xiong, Ya; Zhu, Zongye; Guo, Tianchao; Li, Hui; Xue, Qingzhong

2018-04-14

Heterojunctions are very promising structures due to their hybrid properties, which are usually obtained via a multistep growth process. However, in this paper, WO 3 -W 18 O 49 heterostructures are synthesized via a novel one-step approach by using isopropanol as reaction media and are applied in NH 3 gas detection for the first time. The obtained WO 3 -W 18 O 49 heterostructures with loose nanowire bundle-like morphology show a response value of 23.3 toward 500 ppm NH 3 at 250 °C, which is 5.63 times higher than that of pristine W 18 O 49 . In addition, the WO 3 -W 18 O 49 sensor also exhibits great dynamic response/recovery characteristics (13 s/49 s @ 500 ppm NH 3 ), superb selectivity and low detection limit of 460 ppb. The substantial improvement in the response of WO 3 -W 18 O 49 heterostructures toward NH 3 can be explained by the formation of n-WO 3 /n-W 18 O 49 heterojunctions that facilitate the generation of a more extended depletion layer as well as the enhancement of specific surface area and pore volume. Our research results open an easy pathway for facile one-step preparation of heterojunctions with high response and low cost, which can be used for the development of other high-performance gas sensors. Copyright © 2018 Elsevier B.V. All rights reserved.

Dairy Intake Enhances Body Weight and Composition Changes during Energy Restriction in 18-50-Year-Old Adults-A Meta-Analysis of Randomized Controlled Trials.

PubMed

Stonehouse, Welma; Wycherley, Thomas; Luscombe-Marsh, Natalie; Taylor, Pennie; Brinkworth, Grant; Riley, Malcolm

2016-07-01

A meta-analysis of randomized controlled trials (RCTs) was performed to investigate the effects of dairy food or supplements during energy restriction on body weight and composition in 18-50-year-old. RCTs ≥ 4 weeks comparing the effect of dairy consumption (whole food or supplements) with control diets lower in dairy during energy restriction on body weight, fat and lean mass were identified by searching MEDLINE, EMBASE, Pubmed, Cochrane Central and World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) until March 2016. Reports were identified and critically appraised in duplicate. Data were pooled using random-effects meta-analysis. Chi²- and I²-statistics indicated heterogeneity. Dose effect was assessed using meta-regression analysis. GRADE guidelines were used to rate the quality (QR) of the evidence considering risk of bias, inconsistency, indirectness, imprecision, publication bias and effect estimates. 27 RCTs were reviewed. Participants consumed between 2 and 4 standard servings/day of dairy food or 20-84 g/day of whey protein compared to low dairy control diets, over a median of 16 weeks. A greater reduction in body weight (-1.16 kg [-1.66, -0.66 kg], p < 0.001, I² = 11%, QR = high, n = 644) and body fat mass (-1.49 kg [-2.06, -0.92 kg], p < 0.001, I² = 21%, n = 521, QR = high) were found in studies largely including women (90% women). These effects were absent in studies that imposed resistance training (QR = low-moderate). Dairy intake resulted in smaller loss of lean mass (all trials pooled: 0.36 kg [0.01, 0.71 kg], p = 0.04, I² = 64%, n = 651, QR = moderate). No between study dose-response effects were seen. Increased dairy intake as part of energy restricted diets resulted in greater loss in bodyweight and fat mass while attenuating lean mass loss in 18-50-year-old adults. Further research in males is needed to investigate sex effects.

Incidence and survival of hematological cancers among adults ages ≥75 years.

PubMed

Krok-Schoen, Jessica L; Fisher, James L; Stephens, Julie A; Mims, Alice; Ayyappan, Sabarish; Woyach, Jennifer A; Rosko, Ashley E

2018-04-13

Evaluating population-based data of hematologic malignancies (HMs) in older adults provides prognostic information for this growing demographic. Incidence rates and one- and five-year relative survival rates were examined for specific HMs among adults ages ≥75 years using data from the Surveillance, Epidemiology and End Results (SEER) Program. Hematologic malignancy cases (Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), multiple myeloma (MM), acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), and chronic myeloid leukemia (CML)) were reported to one of 18 SEER registries. Recent average annual (2010-2014) incidence rates and incidence trends from 1973 to 2014 were examined for cases ages ≥75 years. One- and five-year relative cancer survival rates were examined for adults ages ≥75 years diagnosed 2007-2013, with follow-up into 2014. From 1973 to 2014, incidence rates increased for NHL, MM, and AML, decreased for HL, and remained relatively stable for ALL, CLL, and CML among adults ages ≥75 years. The highest one- and five-year relative survival rates were observed among adults with CLL ages 75-84 years (1 year: 91.8% (95% CI = 91.8-90.8)) and 5 years: 76.5% (95% CI = 74.2-78.6)). The lowest one- and five-year survival rates were observed among adults with AML ages 75-84 (1 year: 18.2% (95% CI = 74.2-78.6) and 5 years: 2.7% (95% CI = 2.0-3.6)). Survival for older adults ages ≥75 years with HMs is poor, particularly for acute leukemia. Understanding the heterogeneity in HM outcomes among older patients may help clinicians better address the hematological cancer burden and mortality in the aging population. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

A Developmental Perspective in Mental Health Services Use Among Adults with Mental Disorders.

PubMed

Huỳnh, Christophe; Caron, Jean; Pelletier, Marilou; Liu, Aihua; Fleury, Marie-Josée

2018-07-01

This study examined factors associated with mental health services (MHS) use by individuals with mental disorders within a developmental perspective of adulthood. Bivariate and multivariate analyses were conducted separately for each developmental stage on independent variables using the Andersen's behavioral health service model. For 18-29-year-old emerging adults (n = 141), autonomy, daily life/relations, Internet searching, alcohol dependence, cognitive impulsiveness, number of stressful events, and self-harm were associated with MHS use. For 30-49-year olds (n = 292), being female, country of origin, being on welfare, social integration, Internet searching, and number of stressful events were associated with MHS use. For 50-64-year-old middle-aged adults (n = 126), current occupation was associated with MHS use. Developing online resources for emerging adults may increase MHS use. For 30-49-year olds, outreach should target male, immigrants, and individuals less socially integrated and on welfare. For middle-aged adults, workplace programs that reduce stigma and offer psychological help could increase MHS use.

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.

W{sub 18}O{sub 49} nanorods decorated with Ag/AgCl nanoparticles as highly-sensitive gas-sensing material and visible-light-driven photocatalyst

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

Sun Shibin; Chang Xueting, E-mail: xuetingchang@yahoo.cn; Dong Lihua

2011-08-15

A novel gas-sensing material and photocatalyst was successfully obtained by decorating Ag/AgCl nanoparticles on the W{sub 18}O{sub 49} nanorods through a clean photochemical route. The as-prepared samples were characterized using combined techniques of X-ray diffractometry, electron microscopy, energy dispersive X-ray spectrometry, and X-ray photoelectron spectroscopy. Gas-sensing measurements indicate that the Ag/AgCl/W{sub 18}O{sub 49} NRs sensors exhibit superior reducing gas-sensing properties to those of bare W{sub 18}O{sub 49} NRs, and they are highly selective and sensitive to NH{sub 3}, acetone, and H{sub 2}S with short response and recovery times. The Ag/AgCl/W{sub 18}O{sub 49} NRs photocatlysts also possess higher photocatalytic performance thanmore » bare W{sub 18}O{sub 49} NRs for degradation of methyl orange under simulated sunlight irradiation. Possible mechanisms concerning the enhancement of gas-sensing and photocatalytic activities of the Ag/AgCl/W{sub 18}O{sub 49} NRs composite were proposed. - Graphical Abstract: The Ag/AgCl nanoparticles adhered well to the W{sub 18}O{sub 49} nanorod. The Ag could act as transfer center of the photoexcited carriers, prohibiting their recombinations in both W{sub 18}O{sub 49} and AgCl. Highlights: > Ag/AgCl/W{sub 18}O{sub 49} NRs were successfully obtained via a clean photochemical route. > The Ag/AgCl nanoparticles decorated on the W{sub 18}O{sub 49} NRs possessed cladding structure. > The Ag/AgCl/W{sub 18}O{sub 49} NRs exhibited excellent gas-sensing and photocatalytic properties.« less

Diffuse Lung Disease in Biopsied Children 2 to 18 Years of Age. Application of the chILD Classification Scheme.

PubMed

Fan, Leland L; Dishop, Megan K; Galambos, Csaba; Askin, Frederic B; White, Frances V; Langston, Claire; Liptzin, Deborah R; Kroehl, Miranda E; Deutsch, Gail H; Young, Lisa R; Kurland, Geoffrey; Hagood, James; Dell, Sharon; Trapnell, Bruce C; Deterding, Robin R

2015-10-01

Children's Interstitial and Diffuse Lung Disease (chILD) is a heterogeneous group of disorders that is challenging to categorize. In previous study, a classification scheme was successfully applied to children 0 to 2 years of age who underwent lung biopsies for chILD. This classification scheme has not been evaluated in children 2 to 18 years of age. This multicenter interdisciplinary study sought to describe the spectrum of biopsy-proven chILD in North America and to apply a previously reported classification scheme in children 2 to 18 years of age. Mortality and risk factors for mortality were also assessed. Patients 2 to 18 years of age who underwent lung biopsies for diffuse lung disease from 12 North American institutions were included. Demographic and clinical data were collected and described. The lung biopsies were reviewed by pediatric lung pathologists with expertise in diffuse lung disease and were classified by the chILD classification scheme. Logistic regression was used to determine risk factors for mortality. A total of 191 cases were included in the final analysis. Number of biopsies varied by center (5-49 biopsies; mean, 15.8) and by age (2-18 yr; mean, 10.6 yr). The most common classification category in this cohort was Disorders of the Immunocompromised Host (40.8%), and the least common was Disorders of Infancy (4.7%). Immunocompromised patients suffered the highest mortality (52.8%). Additional associations with mortality included mechanical ventilation, worse clinical status at time of biopsy, tachypnea, hemoptysis, and crackles. Pulmonary hypertension was found to be a risk factor for mortality but only in the immunocompetent patients. In patients 2 to 18 years of age who underwent lung biopsies for diffuse lung disease, there were far fewer diagnoses prevalent in infancy and more overlap with adult diagnoses. Immunocompromised patients with diffuse lung disease who underwent lung biopsies had less than 50% survival at time of last follow-up.

[Trends of vegetables and fruits consumption among Chinese adults aged 18 to 44 years old from 1991 to 2011].

PubMed

Xiao, Yingting; Su, Chang; Ouyang, Yifei; Zhang, Bing

2015-03-01

To identify the trends of vegetables and fruits consumption among Chinese adults aged 18 to 44 years old from 1991 to 2011. Twenty four hour dietary recall data from China Health and Nutrition Survey (1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011) were used to identify the trends of vegetables and fruits consumption among Chinese between 18 and 44 years old. From 1991 to 2011, the proportion of daily consumption of vegetables rarely varied, while the vegetables intake declined significantly; and the proportion of daily consumption and intake of fruits kept increasing as follows. By 2011, the proportion of daily consumption and intake of vegetables and fruits among the respondents were 99.7%, 48.0%, 321.6 g/d, and 90.1 g/d respectively. A significant drop was found in the vegetables intake among the respondents against the vegetables intake as recommended by the Chinese dietary guidelines, up to 50.2% in 2011; a significant rise was found in the fruits intake of the respondents against the fruits intake as recommended by the said guidelines, up to 17.4% in 2011. The average daily intake of vegetables and fruits of young and middle-aged residents (18-44 age group) in nine provinces in China was found lower than that recommended in the Chinese dietary guidelines; in view of the high proportion of people having less vegetables and fruits intake that those recommended by the Chinese dietary guidelines, further measures are expected to encourage their vegetables and fruits intake.

Intanza® 9 µg intradermal seasonal influenza vaccine for adults 18 to 59 years of age

PubMed Central

Leroux-Roels, Isabel; Weber, Françoise

2013-01-01

Seasonal influenza in healthy working-age adults accounts for a substantial part of the socioeconomic burden of this disease. Intanza® 9 μg (sanofi pasteur) is a microneedle-delivered intradermal trivalent inactivated influenza vaccine approved in 2009 for the prevention of seasonal influenza in adults 18 to 59 y of age. The microneedle system reliably and reproducibly delivers the vaccine to the dermis. Clinical studies show that Intanza 9 μg is as immunogenic and as well tolerated in working-age adults as a reference intramuscular trivalent inactivated vaccine. Local reactions to Intanza 9 μg, mainly erythema, are transient, mostly mild or moderate, and do not affect acceptability. Intanza 9 μg is considered satisfactory by at least 95% of both vaccinees and prescribers, especially because of the short needle and rapid administration. Because Intanza® 9 μg offers an alternative to intramuscular vaccines, it might help increase influenza vaccine coverage rates. PMID:23442585

Development of horizontal tooth wear in maxillary anterior teeth from five to 18 years of age.

PubMed

Nyström, M; Könönen, M; Alaluusua, S; Evälahti, M; Vartiovaara, J

1990-11-01

Sizes of horizontal wear facets of maxillary anterior teeth were studied longitudinally from the primary dentition at age five to the young adult dentition at the age of 18 years. By a planimetric method, we calculated the wear areas on dental casts taken at the ages of five, ten, 14, and 18 years from the dentition of 39 healthy, orthodontically untreated subjects with good morphological occlusion. For young adults, we also studied the association between the amount of wear and reported parafunctions, maximal bite force, salivary buffer capacity, salivary flow rate, and some cephalometric variables. Size of wear facets on all anterior teeth increased with age. Significant correlations were found between the total wear areas of the six anterior primary teeth at five years of age and those of their permanent successors at age 14 (r = 0.44) and 18 (r = 0.39). For an individual, tooth wear at five years of age was, however, of low predictive value for tooth wear in young adulthood, whereas tooth wear at 14 years of age predicted it well (r = 0.89). Highest correlations between tooth wear and background factors at 18 years of age were found for maximal anterior bite force (r = 0.44) and for the size of the gonial angle (r = -0.31). Wear of anterior teeth was not associated with reported parafunctions in young adulthood.

Educational and vocational outcomes of adults with childhood- and adult-onset systemic lupus erythematosus: nine years of followup.

PubMed

Lawson, Erica F; Hersh, Aimee O; Trupin, Laura; von Scheven, Emily; Okumura, Megumi J; Yazdany, Jinoos; Yelin, Edward H

2014-05-01

To compare educational and vocational outcomes among adults with childhood-onset systemic lupus erythematosus (SLE) and adult-onset SLE. We used data derived from the 2002–2010 cycles of the Lupus Outcomes Study, a longitudinal cohort of 1,204 adult subjects with SLE. Subjects ages 18–60 years living in the US (n = 929) were included in the analysis and were classified as childhood-onset SLE if age at diagnosis was <18 years (n = 115). Logistic regression was used to assess the unadjusted and adjusted effect of childhood-onset SLE, sex, race/ethnicity, baseline age, urban or rural location, and US region on the likelihood of completing a bachelor's degree. Generalized estimating equations were used to assess the effect of childhood-onset SLE, demographics, education, and disease-related factors on the odds of employment, accounting for multiple observations over the study period. Subjects with childhood-onset SLE were on average younger (mean ± SD 29 ± 10 years versus 44 ± 9 years), with longer disease duration (mean ± SD 15 ± 10 years versus 11 ± 8 years). Subjects with adult-onset SLE and childhood-onset SLE subjects were equally likely to complete a bachelor's degree. However, subjects with childhood-onset SLE were significantly less likely to be employed, independent of demographic and disease characteristics (odds ratio 0.62, 95% confidence interval 0.42–0.91). While subjects with SLE are just as likely as those with adult-onset SLE to complete college education, childhood-onset SLE significantly increases the risk of not working in adulthood, even when controlling for disease and demographic factors. Exploring reasons for low rates of employment and providing vocational support may be important to maximize long-term functional outcomes in patients with childhood-onset SLE.

Citric acid induced W18O49 electrochromic films with enhanced optical modulation

NASA Astrophysics Data System (ADS)

Xie, Junliang; Song, Bin; Zhao, Gaoling; Han, Gaorong

2018-06-01

Electrochromic materials exhibit promising applications in energy-saving fields for their ability to control heat from outdoors. Nanostructured W18O49 has drawn attention for its one-dimensional structure to transfer charge efficiently as a remarkable electrochromic material. W18O49 bi-layer films were fabricated through a facile one-step solvothermal process with citric acid as a chelating agent. The addition of citric acid improved the deposition on the substance, and a nanostructured film with a denser layer at the bottom and a tussock-like upper layer was obtained. The bi-layer film exhibited an enhanced optical modulation of 68.7%, a coloration efficiency of 82.1 cm2/C with stability over 400 cycles, and fast response times (1.4 s and 2.3 s for bleaching and coloring), with expectation to be applied in the electrochromic field.

Neurologic outcomes of toxic oil syndrome patients 18 years after the epidemic.

PubMed Central

de la Paz, Manuel Posada; Philen, Rossanne M; Gerr, Fredric; Letz, Richard; Ferrari Arroyo, Maria José; Vela, Lydia; Izquierdo, Maravillas; Arribas, Concepción Martín; Borda, Ignacio Abaitua; Ramos, Alejandro; Mora, Cristina; Matesanz, Gloria; Roldán, Maria Teresa; Pareja, Juan

2003-01-01

Toxic oil syndrome (TOS) resulted from consumption of rapeseed oil denatured with 2% aniline and affected more than 20,000 persons. Eighteen years after the epidemic, many patients continue to report neurologic symptoms that are difficult to evaluate using conventional techniques. We conducted an epidemiologic study to determine whether an exposure to toxic oil 18 years ago was associated with current adverse neurobehavioral effects. We studied a case group of 80 adults exposed to toxic oil 18 years ago and a referent group of 79 adult age- and sex-frequency-matched unexposed subjects. We interviewed subjects for demographics, health status, exposures to neurotoxicants, and responses to the Kaufman Brief Intelligence Test (K-BIT), Programa Integrado de Exploracion Neuropsicologica (PIEN), and Goldberg depression questionnaires and administered quantitative neurobehavioral and neurophysiologic tests by computer or trained nurses. The groups did not differ with respect to educational background or other critical variables. We examined associations between case and referent groups and the neurobehavioral and neurophysiologic outcomes of interest. Decreased distal strength of the dominant and nondominant hands and increased vibrotactile thresholds of the fingers and toes were significantly associated with exposure to toxic oil. Finger tapping, simple reaction time latency, sequence B latency, symbol digit latency, and auditory digit span were also significantly associated with exposure. Case subjects also had statistically significantly more neuropsychologic symptoms compared with referents. Using quantitative neurologic tests, we found significant adverse central and peripheral neurologic effects in a group of TOS patients 18 years after exposure to toxic oil when compared with a nonexposed referent group. These effects were not documented by standard clinical examination and were found more frequently in women. PMID:12896854

Neurologic outcomes of toxic oil syndrome patients 18 years after the epidemic.

PubMed

de la Paz, Manuel Posada; Philen, Rossanne M; Gerr, Fredric; Letz, Richard; Ferrari Arroyo, Maria José; Vela, Lydia; Izquierdo, Maravillas; Arribas, Concepción Martín; Borda, Ignacio Abaitua; Ramos, Alejandro; Mora, Cristina; Matesanz, Gloria; Roldán, Maria Teresa; Pareja, Juan

2003-08-01

Toxic oil syndrome (TOS) resulted from consumption of rapeseed oil denatured with 2% aniline and affected more than 20,000 persons. Eighteen years after the epidemic, many patients continue to report neurologic symptoms that are difficult to evaluate using conventional techniques. We conducted an epidemiologic study to determine whether an exposure to toxic oil 18 years ago was associated with current adverse neurobehavioral effects. We studied a case group of 80 adults exposed to toxic oil 18 years ago and a referent group of 79 adult age- and sex-frequency-matched unexposed subjects. We interviewed subjects for demographics, health status, exposures to neurotoxicants, and responses to the Kaufman Brief Intelligence Test (K-BIT), Programa Integrado de Exploracion Neuropsicologica (PIEN), and Goldberg depression questionnaires and administered quantitative neurobehavioral and neurophysiologic tests by computer or trained nurses. The groups did not differ with respect to educational background or other critical variables. We examined associations between case and referent groups and the neurobehavioral and neurophysiologic outcomes of interest. Decreased distal strength of the dominant and nondominant hands and increased vibrotactile thresholds of the fingers and toes were significantly associated with exposure to toxic oil. Finger tapping, simple reaction time latency, sequence B latency, symbol digit latency, and auditory digit span were also significantly associated with exposure. Case subjects also had statistically significantly more neuropsychologic symptoms compared with referents. Using quantitative neurologic tests, we found significant adverse central and peripheral neurologic effects in a group of TOS patients 18 years after exposure to toxic oil when compared with a nonexposed referent group. These effects were not documented by standard clinical examination and were found more frequently in women.

Deterioration of Speech Recognition Ability Over a Period of 5 Years in Adults Ages 18 to 70 Years: Results of the Dutch Online Speech-in-Noise Test.

PubMed

Stam, Mariska; Smits, Cas; Twisk, Jos W R; Lemke, Ulrike; Festen, Joost M; Kramer, Sophia E

2015-01-01

deterioration of speech recognition in noise over 5 years can also be detected in adults ages 18 to 70 years. This rather small numeric change might represent a relevant impact on an individual's ability to understand speech in everyday life.

Prospective Study of Optimal Obesity Index Cut-Off Values for Predicting Incidence of Hypertension in 18–65-Year-Old Chinese Adults

PubMed Central

Ren, Qian; Su, Chang; Wang, Huijun; Wang, Zhihong; Du, Wenwen; Zhang, Bing

2016-01-01

Background Overweight and obesity increase the risk of elevated blood pressure; most of the studies that serve as a background for the debates on the optimal obesity index cut-off values used cross-sectional samples. The aim of this study was to determine the cut-off values of anthropometric markers for detecting hypertension in Chinese adults with data from prospective cohort. Methods This study determines the best cut-off values for the obesity indices that represent elevated incidence of hypertension in 18–65-year-old Chinese adults using data from the China Health and Nutrition Survey (CHNS) 2006–2011 prospective cohort. Individual body mass index (BMI), waist circumference (WC), waist:hip ratio (WHR) and waist:stature ratio (WSR) were assessed. ROC curves for these obesity indices were plotted to estimate and compare the usefulness of these obesity indices and the corresponding values for the maximum of the Youden indices were considered the optimal cut-off values. Results Five-year cumulative incidences of hypertension were 21.5% (95% CI: 19.4–23.6) in men and 16.5% (95% CI: 14.7–18.2) in women, and there was a significant trend of increased incidence of hypertension with an increase in BMI, WC, WHR or WSR (P for trend < 0.001) in both men and women. The Youden index indicated that the optimal BMI, WC, WHR, WSR cut-off values were 23.53 kg/m2, 83.7 cm, 0.90, and 0.51 among men. The optimal BMI, WC, WHR, WSR cut-off values were 24.25 kg/m2, 79.9 cm, 0.85 and 0.52 among women. Conclusions Our study supported the hypothesis that the cut-off values for BMI and WC that were recently developed by the Working Group on Obesity in China (WGOC), the cut-off values for WHR that were developed by the World Health Organization (WHO), and a global WSR cut-off value of 0.50 may be the appropriate upper limits for Chinese adults. PMID:26934390

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

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

Keep on brushing: a longitudinal study of motivational text messaging in young adults aged 18-24 years receiving Work and Income Support.

PubMed

Schluter, Philip; Lee, Martin; Hamilton, Greg; Coe, Gill; Messer-Perkins, Heather; Smith, Belinda

2015-01-01

Using text messaging, underpinned by the Health Belief Model, this study aimed to improve tooth brushing frequencies among unemployed young adults aged 18-24 years. Set within Work and Income's Linwood Community Link office (one Christchurch branch of the New Zealand Government's employment and beneficiary services), unemployed young adults aged 18-24 years with access to a mobile phone were recruited using either a purpose-built computer kiosk or Work and Income's Facebook site. Participants completed a baseline survey and then received and responded to a series of motivational text messages over 10 weeks. Self-reported tooth brushing frequency was the primary outcome variable. Important socio-demographic (age, gender, ethnicity, employment status) and method-specific (level of attrition, distribution of successful text messages deliveries, active withdrawal) variables were also collected. Longitudinal analyses of these responses employed generalized estimating equation (GEE) models. Four hundred and three registered for the trial, of whom 171 (42%) were eligible. Self-reported tooth brushing twice or more per day increased from 51% at baseline to 70% at week 3, 74% at week 6, and 73% at week 9 - an increase significant in crude (P<0.001) and adjusted (P<0.001) GEE analyses. No important differences were noted between age, gender, or ethnic groups, although attrition was relatively high with only 26% participating by week 9. However, no evidence of differential attrition was observed. Invention through motivational text messaging improved the measured oral health self-care behavior in a hard-to-reach group carrying a disproportionately heavy oral health burden. This intervention warrants further investigation. © 2014 American Association of Public Health Dentistry.

Doxorubicin Loaded Chitosan-W18 O49 Hybrid Nanoparticles for Combined Photothermal-Chemotherapy.

PubMed

Yuan, Shanmei; Hua, Jisong; Zhou, Yinyin; Ding, Yin; Hu, Yong

2017-08-01

Combined treatment is more effective than single treatment against most forms of cancer. In this work, doxorubicin loaded chitosan-W 18 O 49 nanoparticles combined with the photothermal therapy and chemotherapy are fabricated through the electrostatic interaction between positively charged chitosan and negatively charged W 18 O 49 nanoparticles. The in vitro and in vivo behaviors of these nanoparticles are examined by dynamic light scattering, transmission electron microscopy, cytotoxicity, near-infrared fluorescence imaging, and tumor growth inhibition experiment. These nanoparticles have a mean size around 110 nm and show a pH sensitive drug release behavior. After irradiation by the 980 nm laser, these nanoparticles show more pronounced cytotoxicity against HeLa cells than that of free doxorubicin or photothermal therapy alone. The in vivo experiments confirm that their antitumor ability is significantly improved, resulting in superior efficiency in impeding tumor growth and extension of the lifetime of mice. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Fertility intentions among HIV positive women aged 18-49 years in Addis Ababa Ethiopia: a cross sectional study.

PubMed

Asfaw, Hussen Mekonnen; Gashe, Fikre Enquselassie

2014-05-20

Given the degree of HIV epidemic among women and the current antiretroviral therapy (ART) scale up in Ethiopia; considering the issue of fertility is vital to ensure the delivery of integrated reproductive health along with prevention services provided to positive women. This study was aimed to assess fertility intentions of women living with HIV attending public health institutions (hospitals & health centers) in Addis Ababa, Ethiopia. Institution based cross sectional survey was conducted, among 1855 HIV positive, women aged 18-49 years selected from different public health facilities in Addis Ababa; from June to October 2012. Information was gathered by using interviewer administered questionnaires. Data were double entered in EPI Info version 3.5.2 software, cleaned finally exported to IBM SPSS statistics version 20 for analysis. Logistic regression models were used to predict the association of study variables and adjusted for possible confounders. Overall, 44% of women reported fertility intention. ART users had higher fertility intention (AOR; 1.26, 95%CI; 1.01 to 1.60) than ART naïve. In addition to this, having partner being on sexual relationship, young age, being single and having fewer or no children were found to be predictors of fertility intentions. The presence of ART, improvement of health condition and the influence of husband were the main reasons for childbearing intentions of women in the study area. A considerable proportion of women reported fertility intention. There was an association between fertility intentions and ART use. It is important for health care providers and policy makers to strengthen the fertility need of HIV positive women along with HIV care so that women may decide freely and responsibly on their fertility issues.

Point-of-sale cigarette purchase patterns among U.S. adult smokers-National Adult Tobacco Survey, 2012-2014.

PubMed

Kruger, Judy; Jama, Amal; Lee, Joseph G L; Kennedy, Sara; Banks, Asha; Sharapova, Saida; Agaku, Israel

2017-08-01

Tobacco products are ubiquitous in most U.S. retail environments. Given that data on preferred point-of-sale purchase locations among U.S. adult tobacco users are limited, an enhanced understanding of tobacco purchase locations can help inform tobacco control policy, planning, and practice. We investigated prevalence and sociodemographic characteristics associated with cigarette purchase location among U.S. adult smokers. Pooled data came from the 2012-2013 (N=60,192) and 2013-2014 (N=75,233) National Adult Tobacco Surveys. Current cigarette smokers (n=18,005) aged ≥18 were asked if they purchased cigarettes within the previous 30days (n=15,182) and, if so, where they last purchased cigarettes. In 2016, logistic regression adjusted for sex, age, race/ethnicity, education level and annual household income was used to assess characteristics associated with purchase location. Among current smokers, 90.2% reported purchasing cigarettes in the past 30days. The most common purchase locations were convenience stores/gas stations (69.1%), tobacco discount stores (9.9%), drug stores (5.0%), supermarkets (4.9%), and liquor stores (3.6%). The odds of purchasing cigarettes at convenience stores/gas stations were higher among men (adjusted odds ratio (AOR)=1.4; 95% confidence interval (CI)=1.2-1.5) than women; and among adults aged 18-24 (AOR=3.1; 95% CI=2.4-3.9), 25-44 (AOR=3.1; 95% CI=2.7-3.7), and 45-64years (AOR=1.8 95% CI=1.6-2.1) than adults aged ≥65years. Over two-thirds of U.S. smokers last purchased cigarettes from convenience stores/gas stations. Understanding the relationship between purchase location and smoker characteristics may inform tobacco control strategies in the retail environment. Published by Elsevier Inc.

Self-reported Hearing Trouble in Adults Aged 18 and Over: United States, 2014.

PubMed

Zelaya, Carla E; Lucas, Jacqueline W; Hoffman, Howard J

2015-09-01

Age is typically the most significant determinant of hearing loss (5,6). Among U.S. adults in 2014, self-reported hearing loss was most prevalent among adults aged 70 and over (43.2%), compared with adults aged 40-69 (19.0%) and aged 18-39 (5.5%). Age-related hearing loss is often overlooked due to its deceptively slow progression, lack of attention from providers, and public acceptance as a condition that is perceived to be a "normal" consequence of aging (7). Among U.S. adults aged 70 and over who had any trouble hearing, 56.8% had seen a doctor or other health care professional about their hearing or ear problems in the past 5 years, but only 42.0% had ever used a hearing aid. Younger adults (aged 18-39) who had any trouble hearing were even less likely to have seen a doctor or used a hearing aid, but they were more likely to have used other assistive technology because of their hearing compared with adults aged 40-69 or 70 and over. Among U.S. adults who had any trouble hearing without a hearing aid, 1.7% were deaf, but the majority (62.6%) had mild hearing loss (defined as "a little trouble hearing"). Men were more likely than women to have self-reported trouble hearing, a sex disparity that has been documented globally among all age groups (8). Men were also more likely than women to state they had moderate trouble hearing. 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.

QuickStats: Percentage* of Adults Aged ≥18 Years Who Cannot or Find It Very Difficult to Stand or Be on Their Feet for About 2 Hours Without Using Special Equipment,† by Age Group and Sex - National Health Interview Survey,§ United States, 2015.

PubMed

2016-12-02

A reported 10.2% of adults aged ≥18 years cannot, or find it very difficult to, stand or be on their feet for about 2 hours without using special equipment. The percentage of adults who reported this difficulty increased with age: 2.9% of those aged 18-44 years, 11.8% of those aged 45-64 years, 19.1% of those 65-74 years, and 33.2% of those aged ≥75 years. Overall, women were more likely (11.9%) than men (8.3%) to report this difficulty, and higher percentages were noted for women within each age group.

Stages in third molar development and eruption to estimate the 18-year threshold Malay juvenile.

PubMed

Mohd Yusof, Mohd Yusmiaidil Putera; Cauwels, Rita; Martens, Luc

2015-10-01

Age 18 years is considered as the age of majority by most countries. To ascertain the age of interest, both third molar development (TMD) and eruption (TME) staging scores are beneficial without needing multiple imaging modalities. This study aimed to assess the chronological course of TMD and TME in a Malay sub-adult population and evaluate predictions when specific stage(s) of TMD and TME have been attained that are pertinent to the age group of interest (<18 years or ≥18 years). A sample of 714 digital panoramic images for subjects stratified by age between 14.1 and 23.9 years was retrospectively collected. The techniques described by Gleiser and Hunt (modified by Kohler) and Olze were employed to stage TMD and TME, respectively. A binary logistic regression was performed to predict the 18-year threshold with staging score as predictors. Stages 4-6 (TMD) and A-B (TME) for males and stages 4 (TMD) and A (TME) for females were found to discriminate the <18-year group. For both genders, stages 9-10 (TMD) and D (TME) can be used as reference stages to estimate whether a subject is likely to be ≥18 years, with 94.74-100% and 85.88-96.38% correct predictions, respectively. Stages 4 (TMD) and A (TME) can also be used to identify juveniles (<18 years) with a high degree of correct predictions, 100%. The juvenility of an individual is easily anticipated by using the specific staging scores of both third molar variables (TMD and TME) without complex calculations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prevalence and correlates of past 12-month suicide attempt among adults with past-year suicidal ideation in the United States.

PubMed

Han, Beth; Compton, Wilson M; Gfroerer, Joseph; McKeon, Richard

2015-03-01

To examine the prevalence and correlates of attempting suicide in the past 12 months among adults with past-year suicidal ideation in the United States. Data were from 229,600 persons aged 18 years or older who participated in the 2008-2012 National Survey on Drug Use and Health. Among them, 12,300 reported having past-year suicidal ideation, and over 2,000 of those reported attempting suicide within the past 12 months prior to survey interview. Descriptive analyses and pooled and stratified (by suicide plan and major depressive episode [MDE]) multivariate logistic regression models were applied. Major depressive episode was based on assessments of individual diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Among persons aged 18 years or older in the United States, 3.8% reported having suicidal ideation in the past 12 months. Among past-year suicidal ideators, 13.2% attempted suicide in the past 12 months. The prevalence of past 12-month suicide attempt among past-year ideators with MDE was higher than among those without MDE (14.1% vs 12.0%). Past 12-month suicide attempt was more common among ideators with a suicide plan than among ideators without a plan (37.0% vs 3.7%). However, the prevalence of suicide attempt was higher among ideators with a plan but without MDE than among ideators with a plan and MDE (42.1% vs 32.9%). Compared with ideators without a plan, ideators with a plan had a higher (adjusted odds ratio [AOR] = 2.2; 95% confidence interval [CI], 1.47-3.45) suicide attempt risk among those without MDE (AOR = 22.4; 95% CI,16.55-30.27) than among those with MDE (AOR = 10.7; 95% CI, 7.91-14.49). Among adult suicidal ideators, factors associated with their progression from ideation to suicide attempt may vary by their suicide plan and major depression status. Focusing attention on high-risk subgroups may be warranted. © Copyright 2015 Physicians Postgraduate Press, Inc.

The effects of a brief educational intervention on human papillomavirus knowledge and intention to initiate HPV vaccination in 18-26 year old young adults.

PubMed

Kester, Laura M; Shedd-Steele, Rivienne B; Dotson-Roberts, Crystal A; Smith, Jennifer; Zimet, Gregory D

2014-03-01

Despite the Advisory Committee on Immunization Practices (ACIP) recommendations for young adult females and males to receive the three-dose human papillomavirus (HPV) vaccine, most recent findings show that only 30% of the U.S. females aged 19-26, 2.8% of males aged 19-21, and only 1.7% of males aged 22-26 are initiating vaccination. This study evaluates the effects of a brief (5-10 min) group HPV educational intervention on knowledge and intent to vaccinate among young adults. A sample of 131 18-26 year old females and males was recruited from the 2012 INShape Black and Minority Health Fair in Indiana. We randomized participants into one of two groups: (1) survey completion prior to education (control group) or (2) survey completion following education (intervention group). Written surveys assessed HPV knowledge, vaccination history, and vaccination intent (for unvaccinated participants). Respondents were primarily female (70%), single (85%), and the majority self-identified as non-Hispanic Black (77%). Thirty-seven percent had initiated HPV vaccination (≥1 dose) and 19% had completed the series. The intervention group had higher HPV knowledge scores (M=9.1; SD=1.8) than the control group (M=7.0; SD=2.9; F=22.53). Among unvaccinated individuals (n=79), the intervention group had higher HPV vaccination intent (86%) compared to the control group (67%) (OR=3.09; 95%CI=1.02-9.36). Despite ACIP recommendations, young adults continue to have low awareness of vaccine benefits and low vaccination rates. This study suggests that educational interventions to increase HPV awareness and vaccination may help to boost vaccination rates. Copyright © 2013. Published by Elsevier Inc.

Generalised equations for the prediction of percentage body fat by anthropometry in adult men and women aged 18-81 years.

PubMed

Leahy, Siobhan; O'Neill, Cian; Sohun, Rhoda; Toomey, Clodagh; Jakeman, Philip

2013-02-28

Anthropometric data indicate that the human phenotype is changing. Today's adult is greater in stature, body mass and fat mass. Accurate measurement of body composition is necessary to maintain surveillance of obesity within the population and to evaluate associated interventions. The aim of the present study was to construct and validate generalised equations for percentage body fat (%BF) prediction from anthropometry in 1136 adult men and women. Reference values for %BF were obtained using dual-energy X-ray absorptiometry. Skinfold thickness (SF) at ten sites and girth (G) at seven sites were measured on 736 men and women aged 18-81 years (%BF 5·1-56·8%). Quantile regression was employed to construct prediction equations from age and log-transformed SF and G measures. These equations were then cross-validated on a cohort of 400 subjects of similar age and fatness. The following generalised equations were found to most accurately predict %BF: Men: (age x 0·1) + (logtricepsSF x 7·6) + (logmidaxillaSF x 8·8) + (logsuprspinaleSF x 11·9) - 11·3 (standard error of the estimate: 2·5%, 95% limits of agreement: - 4·8, + 4·9) Women: (age x 0·1) + (logabdominalG x 39·4) + (logmidaxillaSF x 4·9) + (logbicepsSF x 11·0) + (logmedialcalfSF x 9·1) - 73·5 (standard error of the estimate: 3·0%, 95% limits of agreement: - 5·7, + 5·9) These generalised anthropometric equations accurately predict %BF and are suitable for the measurement of %BF in adult men and women of varying levels of fatness across the lifespan.

Death Anxiety across the Adult Years: An Examination of Age and Gender Effects

ERIC Educational Resources Information Center

Russac, R. J.; Gatliff, Colleen; Reece, Mimi; Spottswood, Diahann

2007-01-01

Two studies examined death anxiety across the adult years. In the first study, 304 men and women between 18 and 87 years completed the Collett-Lester Fear of Death scale. Death anxiety peaked in both men and women during their 20s and declined significantly thereafter. However, women displayed a secondary spike during their 50s not seen in men. In…

49 CFR 1242.29 - Fringe benefits (accounts 12-17-00, 12-18-00, and 12-19-00).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Fringe benefits (accounts 12-17-00, 12-18-00, and... RAILROADS 1 Operating Expenses-Way and Structures § 1242.29 Fringe benefits (accounts 12-17-00, 12-18-00, and 12-19-00). Separate common expenses in the running subactivity in the same proportion as the...

Adolescent and young adult female determinants of visceral adipose tissue at ages 26-28 years.

PubMed

Glueck, Charles J; Wang, Ping; Woo, Jessica G; Morrison, John A; Khoury, Philip R; Daniels, Stephen R

2015-04-01

To assess adolescent and young adult determinants of visceral adipose tissue (VAT) at ages 26-28 years. Prospective study (ages 9-28 years) of cardiometabolic measures, menarche age, menses irregularities, metabolic syndrome, impaired fasting glucose-type 2 diabetes mellitus, and VAT in 400 girls (248 black, 152 white). Adolescent (age 14-19) independent variables for greater VAT at ages 26-28 included larger mean waist circumference (partial R(2) = 30.8%), earlier age at menarche (0.9%), and white race (1.8%). Young adult (ages 20-28 years) independent variables for greater VAT included larger mean waist circumference (partial R(2) = 61.7%), greater triglyceride levels (3.3%), lower high-density lipoprotein cholesterol (1.0%), and greater insulin resistance (homeostasis model assessment-estimated insulin resistance; 0.4%). Independent variables for greater VAT when both adolescent and young adult variables were used included waist (tertile rank change from adolescence to young adulthood, partial R(2) = 58.3%), greater young adult triglyceride levels (4.4%), white race (1.8%), greater young adult homeostasis model assessment-estimated insulin resistance (age 20-28, 2.4%), and earlier menarche age (0.7%). Menses irregularities were not independently associated with young adult VAT. Adolescent girls with early menarche and larger waist circumference should be targets for primary prevention of accretion of VAT. In young adulthood, VAT is associated with dysregulated cardiometabolic profiles, which is greater for those with waist circumference increases from adolescence to adulthood. Waist circumference during young adulthood, and to a lesser degree during adolescence, is an inexpensive surrogate for VAT at ages 26-28 years. Copyright © 2015 Elsevier Inc. All rights reserved.

Diet Quality Associated with Total Sodium Intake among US Adults Aged ≥18 Years-National Health and Nutrition Examination Survey, 2009-2012.

PubMed

Mercado, Carla I; Cogswell, Mary E; Perrine, Cria G; Gillespie, Cathleen

2017-10-25

Diet quality or macronutrient composition of total daily sodium intake (dNa) <2300 mg/day in the United States (US) is unknown. Using data from 2011-2014 NHANES (National Health and Nutrition Examination Survey), we examined 24-h dietary recalls ( n = 10,142) from adults aged ≥18 years and investigated how diet composition and quality are associated with dNa. Diet quality was assessed using components of macronutrients and Healthy Eating Index 2010 (HEI-2010). Associations were tested using linear regression analysis adjusted for total energy (kcal), age, gender, and race/ethnicity. One-day dNa in the lower quartiles were more likely reported among women, older adults (≥65 years old), and lower quartiles of total energy (kcal) ( p -values ≤ 0.001). With increasing dNa, there was an increase in the mean protein, fiber, and total fat densities, while total carbohydrates densities decreased. As dNa increased, meat protein, refined grains, dairy, and total vegetables, greens and beans densities increased; while total fruit and whole fruit densities decreased. Modified HEI-2010 total score (total score without sodium component) increased as dNa increased (adjusted coefficient: 0.11, 95% confidence interval = 0.07, 0.15). Although diet quality, based on modified HEI-2010 total score, increased on days with greater dNa, there is much room for improvement with mean diet quality of about half of the optimal level.

Childhood adversity, early-onset depressive/anxiety disorders, and adult-onset asthma.

PubMed

Scott, Kate M; Von Korff, Michael; Alonso, Jordi; Angermeyer, Matthias C; Benjet, Corina; Bruffaerts, Ronny; de Girolamo, Giovanni; Haro, Josep Maria; Kessler, Ronald C; Kovess, Viviane; Ono, Yutaka; Ormel, Johan; Posada-Villa, José

2008-11-01

To investigate a) whether childhood adversity predicts adult-onset asthma; b) whether early-onset depressive/anxiety disorders predict adult-onset asthma; and c) whether childhood adversity and early-onset depressive/anxiety disorders predict adult-onset asthma independently of each other. Previous research has suggested, but not established, that childhood adversity may predict adult-onset asthma and, moreover, that the association between mental disorders and asthma may be a function of shared risk factors, such as childhood adversity. Ten cross-sectional population surveys of household-residing adults (>18 years, n = 18,303) assessed mental disorders with the Composite International Diagnostic Interview (CIDI 3.0) as part of the World Mental Health surveys. Assessment of a range of childhood family adversities was included. Asthma was ascertained by self-report of lifetime diagnosis and age of diagnosis. Survival analyses calculated hazard ratios (HRs) for risk of adult-onset (>age 20 years) asthma as a function of number and type of childhood adversities and early-onset (years) depressive and anxiety disorders, adjusting for current age, sex, country, education, and current smoking. Childhood adversities predicted adult-onset asthma with risk increasing with the number of adversities experienced (HRs = 1.49-1.71). Early-onset depressive and anxiety disorders also predicted adult-onset asthma (HRs = 1.67-2.11). Childhood adversities and early-onset depressive and anxiety disorders both predicted adult-onset asthma after mutual adjustment (HRs = 1.43-1.91). Childhood adversities and early-onset depressive/anxiety disorders independently predict adult-onset asthma, suggesting that the mental disorder-asthma relationship is not a function of a shared background of childhood adversity.

Who requests their sperm donor's identity? The first ten years of information releases to adults with open-identity donors.

PubMed

Scheib, Joanna E; Ruby, Alice; Benward, Jean

2017-02-01

To report findings from 10 years of requests from adults eligible to obtain their open-identity sperm donor's information. Analysis of archived family and donor data. Semistructured interviews at information releases. Not applicable. A total of 85 DI adults requesting 43 donor identities; program data on 256 DI families. None. We identified [1] demographic predictors of requesting donor identities, [2] information release timing and length, and [3] request motives. Just >35% of eligible DI adults requested their donor's identity. Adults ranged from 18-27 years, requesting at median age 18 years. More women than men requested. Proportionally fewer adults requested when they had heterosexual-couple parents, and proportionally more when they had one rather than two parents. In interviews, the common theme was wanting to know more about the donor, especially about shared characteristics. Most adults planned to contact their donor. More than 94% of adults had donors who were open to contact; adults expressed modest expectations about this contact. In 2001, the first adults became eligible to obtain their open-identity sperm donor's information. Ten years of identity requests at one program indicates that information about one's donor is important to a significant proportion of these DI adults. Most requested their donor's identity soon after becoming eligible, suggesting some urgency to wanting the information. Interview data highlighted the role of donor information in helping adults better understand themselves and their ancestry. Findings hold important implications for practice and policy. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Vestibular involvement in adults with HIV/AIDS.

PubMed

Heinze, Barbara M; Vinck, Bart M; Hofmeyr, Louis M; Swanepoel, De Wet

2014-04-01

HIV/AIDS is responsible for widespread clinical manifestations involving the head, and neck. The prevalence and nature of vestibular involvement is still largely unknown. This study, aimed to describe and compare the occurrence and nature of vestibular involvement among a group of, adults infected with HIV compared to a control group. It also aimed to compare the vestibular function, of symptomatic and asymptomatic HIV positive adults who receive antiretroviral (ARV) therapies to, subjects not receiving ARV. A cross-sectional study was conducted on 53 adults (29 male, 24 female, aged 23-49 years, mean=38.5, SD=4.4) infected with HIV, compared to a control group of 38 HIV negative adults (18, male, 20 female, aged 20-49 years, mean=36.9, SD=8.2). A structured interview probed the subjective, perception of vestibular symptoms. Medical records were reviewed for CD4+ cell counts and the use of, ARV medication. An otologic assessment and a comprehensive vestibular assessment (bedside, assessments, vestibular evoked myogenic potentials, ocular motor and positional tests and bithermal, caloric irrigation) were conducted. Vestibular involvement occurred in 79.2% of subjects with HIV in all categories of disease, progression, compared to 18.4% in those without HIV. Vestibular involvement increased from 18.9% in CDC category 1 to 30.2% in category 2. Vestibular involvement was 30.1% in category 3. There were, vestibular involvement in 35.9% of symptomatic HIV positive subjects, and 41.5% in asymptomatic, HIV positive subjects. There was no significant difference in the occurrence of vestibular involvement, in subjects receiving ARV therapies compared to those not receiving ARV therapies (p=.914; chi-square, test). The odds ratio indicates that individuals with HIV have a 16.61 times higher risk of developing, vestibular involvement during their lifetime of living with the disease and that it may occur despite, being asymptomatic. Vestibular involvement was significantly more

An Accurate VO[subscript 2]max Nonexercise Regression Model for 18-65-Year-Old Adults

ERIC Educational Resources Information Center

Bradshaw, Danielle I.; George, James D.; Hyde, Annette; LaMonte, Michael J.; Vehrs, Pat R.; Hager, Ronald L.; Yanowitz, Frank G.

2005-01-01

The purpose of this study was to develop a regression equation to predict maximal oxygen uptake (VO[subscript 2]max) based on nonexercise (N-EX) data. All participants (N = 100), ages 18-65 years, successfully completed a maximal graded exercise test (GXT) to assess VO[subscript 2]max (M = 39.96 mL[middle dot]kg[superscript -1][middle…

49 CFR 1242.20 - Highway grade crossings (accounts XX-17-22 and XX-18-22).

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 9 2011-10-01 2011-10-01 false Highway grade crossings (accounts XX-17-22 and XX-18-22). 1242.20 Section 1242.20 Transportation Other Regulations Relating to Transportation... RAILROADS 1 Operating Expenses-Way and Structures § 1242.20 Highway grade crossings (accounts XX-17-22 and...

49 CFR 1242.20 - Highway grade crossings (accounts XX-17-22 and XX-18-22).

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 9 2012-10-01 2012-10-01 false Highway grade crossings (accounts XX-17-22 and XX-18-22). 1242.20 Section 1242.20 Transportation Other Regulations Relating to Transportation... RAILROADS 1 Operating Expenses-Way and Structures § 1242.20 Highway grade crossings (accounts XX-17-22 and...

49 CFR 1242.20 - Highway grade crossings (accounts XX-17-22 and XX-18-22).

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 9 2014-10-01 2014-10-01 false Highway grade crossings (accounts XX-17-22 and XX-18-22). 1242.20 Section 1242.20 Transportation Other Regulations Relating to Transportation... RAILROADS 1 Operating Expenses-Way and Structures § 1242.20 Highway grade crossings (accounts XX-17-22 and...

49 CFR 1242.20 - Highway grade crossings (accounts XX-17-22 and XX-18-22).

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 9 2013-10-01 2013-10-01 false Highway grade crossings (accounts XX-17-22 and XX-18-22). 1242.20 Section 1242.20 Transportation Other Regulations Relating to Transportation... RAILROADS 1 Operating Expenses-Way and Structures § 1242.20 Highway grade crossings (accounts XX-17-22 and...

Comparative cervical profiles of adult and under-18 front-row rugby players: implications for playing policy.

PubMed

Hamilton, D F; Gatherer, D; Robson, J; Graham, N; Rennie, N; Maclean, J G B; Simpson, A H R W

2014-05-05

To compare the cervical isometric strength, fatigue endurance and range of motion of adult and under-18 age-grade front-row rugby players to inform the development of a safe age group policy with particular reference to scrummaging. Cross-sectional cohort study. 'Field testing' at Murrayfield stadium. 30 high-performance under-18 players and 22 adult front-row rugby players. Isometric neck strength, height, weight and grip strength. Youth players demonstrated the same height and grip strength as the adult players; however, the adults were significantly heavier and demonstrated substantially greater isometric strength (p<0.001). Only two of the 'elite' younger players could match the adult mean cervical isometric strength value. In contrast to school age players in general, grip strength was poorly associated with neck strength (r=0.2) in front-row players; instead, player weight (r=0.4) and the number of years' experience of playing in the front row (r=0.5) were the only relevant factors in multivariate modelling of cervical strength (R(2)=0.3). Extreme forces are generated between opposing front rows in the scrum and avoidance of mismatch is important if the risk of injury is to be minimised. Although elite youth front-row rugby players demonstrate the same peripheral strength as their adult counterparts on grip testing, the adults demonstrate significantly greater cervical strength. If older youths and adults are to play together, such findings have to be noted in the development of age group policies with particular reference to the scrum.

49 CFR 1242.20 - Highway grade crossings (accounts XX-17-22 and XX-18-22).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Highway grade crossings (accounts XX-17-22 and XX... RAILROADS 1 Operating Expenses-Way and Structures § 1242.20 Highway grade crossings (accounts XX-17-22 and XX-18-22). Separate running and switching common expenses according to distribution of the running...

Trends in insomnia and excessive daytime sleepiness among U.S. adults from 2002 to 2012.

PubMed

Ford, Earl S; Cunningham, Timothy J; Giles, Wayne H; Croft, Janet B

2015-03-01

Insomnia is a prevalent disorder in the United States and elsewhere. It has been associated with a range of somatic and psychiatric conditions, and adversely affects quality of life, productivity at work, and school performance. The objective of this study was to examine the trend in self-reported insomnia and excessive daytime sleepiness among US adults. We used data of participants aged ≥18 years from the National Health Interview Survey for the years 2002 (30,970 participants), 2007 (23,344 participants), and 2012 (34,509 participants). The unadjusted prevalence of insomnia or trouble sleeping increased from 17.5% (representing 37.5 million adults) in 2002 to 19.2% (representing 46.2 million adults) in 2012 (relative increase: +8.0%) (P trend <0.001). The age-adjusted prevalence increased from 17.4% to 18.8%. Significant increases were present among participants aged 18-24, 25-34, 55-64, and 65-74 years, men, women, whites, Hispanics, participants with diabetes, and participants with joint pain. Large relative increases occurred among participants aged 18-24 years (+30.9%) and participants with diabetes (+27.0%). The age-adjusted percentage of participants who reported regularly having excessive daytime sleepiness increased from 9.8% to 12.7% (P trend <0.001). Significant increases were present in most demographic groups. The largest relative increase was among participants aged 25-34 years (+49%). Increases were also found among participants with hypertension, chronic obstructive pulmonary disease, asthma, and joint pain. Given the deleterious effects of insomnia on health and performance, the increasing prevalence of insomnia and excessive daytime sleepiness among US adults is a potentially troubling development. Published by Elsevier B.V.

[Body mass index charts of Algerian children and adolescents (6-18 years)].

PubMed

Bahchachi, N; Dahel-Mekhancha, C-C; Rolland-Cachera, M-F; Roelants, M; Hauspie, R; Nezzal, L

2017-12-01

The body mass index (BMI) is widely accepted as a measure of overweight and obesity in children. There are no BMI reference charts for Algerian children and adolescents. The purpose of this study was to construct BMI percentile curves appropriate for children aged 6-18 years in Algeria. The weight and height of 7772 (54.9% girls) healthy schoolchildren from Constantine (eastern Algeria) were measured in 2008/2009. Weight and height for age curves based on the same sample were published previously. The BMI for age percentile curves were estimated in girls and boys separately using the LMS smoothing method. In both sexes, the median BMI increased with age. Girls had lower BMI values than boys before the age of 10 years but they were higher after this age until 18 years of age. Within the study population, the prevalence of overweight (including obesity) and obesity in girls and boys together was 13.7% and 3.0%, respectively, according to the International Obesity Task Force (IOTF) and 16.9% and 4.9% according to the World Health Organization (WHO) (2007). The median BMI curves of Algerian girls and boys were generally lower than those observed in other Arab countries. Compared with other references, the median BMI values of girls were lower than those of a Belgian Flemish population and WHO 2007 until 14 years of age and higher than the French reference between 7 and 18 years of age. The BMI values of Algerian boys were close to the Belgian (Flemish population), French and WHO 2007 references between 6 and 9 years of age and generally lower thereafter. These BMI curves are complementary to the height and weight charts published previously for the assessment of growth in children and adolescents. They were developed according to international guidelines and could serve as a national reference. They could be used as a complement to the 0- to 5-year-old WHO 2006 standards. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Physical activity and quality of life in older adults: an 18-month panel analysis.

PubMed

Phillips, Siobhan M; Wójcicki, Thomas R; McAuley, Edward

2013-09-01

Although physical activity has been associated with quality of life (QOL), the empirical evidence regarding the mechanisms underlying this relationship is limited. In the present study, we examined the mediating roles played by self-efficacy and health status in the physical activity-QOL relationship from baseline to 18-month follow-up in a sample of community-dwelling older adults. Community-dwelling adults (N = 321, M age = 63.8 years) were recruited to participate in a cross-sectional study and were later contacted to participate in an 18-month follow-up. Individuals completed a battery of questionnaires assessing physical activity, self-efficacy, physical self-worth, disability limitations, and quality of life. A panel analysis within a covariance modeling framework was used to analyze the data. Overall, the model was a good fit to the data (χ(2) = 61.00, df = 29, p < 0.001, standardized root mean residual = 0.05, Comparative Fit Index = 0.97) with changes in physical activity indirectly influencing change in life satisfaction from baseline to 18 months via changes in exercise self-efficacy, physical self-worth, and disability limitations independent of baseline relationships and demographic factors. Specifically, increases in physical activity were associated with increases in exercise self-efficacy which, in turn, was associated with higher physical self-worth and fewer disability limitations which were associated with greater life satisfaction. The findings from this study suggest the relationship between physical activity and global QOL in older adults may be mediated by more proximal modifiable outcomes that can be targeted in physical activity programs and interventions.

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

Verbal learning changes in older adults across 18 months.

PubMed

Zimprich, Daniel; Rast, Philippe

2009-07-01

The major aim of this study was to investigate individual changes in verbal learning across a period of 18 months. Individual differences in verbal learning have largely been neglected in the last years and, even more so, individual differences in change in verbal learning. The sample for this study comes from the Zurich Longitudinal Study on Cognitive Aging (ZULU; Zimprich et al., 2008a) and comprised 336 older adults in the age range of 65-80 years at first measurement occasion. In order to address change in verbal learning we used a latent change model of structured latent growth curves to account for the non-linearity of the verbal learning data. The individual learning trajectories were captured by a hyperbolic function which yielded three psychologically distinct parameters: initial performance, learning rate, and asymptotic performance. We found that average performance increased with respect to initial performance, but not in learning rate or in asymptotic performance. Further, variances and covariances remained stable across both measurement occasions, indicating that the amount of individual differences in the three parameters remained stable, as did the relationships among them. Moreover, older adults differed reliably in their amount of change in initial performance and asymptotic performance. Eventually, changes in asymptotic performance and learning rate were strongly negatively correlated. It thus appears as if change in verbal learning in old age is a constrained process: an increase in total learning capacity implies that it takes longer to learn. Together, these results point to the significance of individual differences in change of verbal learning in the elderly.

Frequency, associated features, and burden of neurological disorders in older adult inpatients in Brazil: a retrospective cross-sectional study.

PubMed

Bacellar, Aroldo; Pedreira, Bruno B; Costa, Gersonita; Assis, Telma

2017-07-24

The burden of neurological disorders (NDs) in older adult inpatients is often underestimated. We studied diagnostic frequency and comorbidity of NDs among inpatients aged ≥60 years. We compared rates of hospital mortality, length of stay (LOS), and readmission with younger patient counterparts (aged 18-59 years) and older adult non-neurological patients. This was a retrospective cross-sectional study of inpatients in a tertiary care center in Brazil. We compiled data for all patients admitted between 1 January 2009 and 31 December 2010, and selected those aged ≥18 years for inclusion in the study. We collected data for inpatients under care of a clinical neurologist who were discharged with primary diagnoses of NDs or underlying acute clinical disorders, and data for complications in clinical or surgical inpatients. Patients who remained hospitalized for more than 9 days were categorized as having long LOS. Older adult inpatients with NDs (n = 798) represented 56% of all neurological inpatients aged ≥18 years (n = 1430), and 14% of all geriatric inpatients (n = 5587). The mean age of older adult inpatients was 75 ± 9.1 years. Women represented 55% of participants. The most common NDs were cerebrovascular diseases (51%), although multimorbidity was observed. Hospital mortality rate was 18% (95% confidence interval [CI], 15-21) and readmission rate was 31% (95% CI, 28-35), with 40% of patients readmitted 1.8 ± 1.5 times. The long LOS rate was 51% and the median LOS was 9 days (interquartile interval, 1-20 days). In younger inpatients mortality rate was 1.4%, readmission rate was 34%, and long LOS rate was 14%. In older adult non-neurological inpatients, mortality rate was 22%, readmission rate was 49%, and long LOS rate was 30%. Older adult neurological inpatients had the highest long LOS rate of all patient groups, and a higher mortality rate than neurological patients aged 18-59 years. Readmissions were high in all groups studied

Lifetime Increased Risk of Adult Onset Atopic Dermatitis in Adolescent and Adult Patients with Food Allergy.

PubMed

Yu, Hsu-Sheng; Tu, Hung-Pin; Hong, Chien-Hui; Lee, Chih-Hung

2016-12-27

Food allergy can result in life-threatening anaphylaxis. Atopic dermatitis (AD) causes intense itching and impaired quality of life. Previous studies have shown that patients with classical early-onset AD tend to develop food allergy and that 10% of adults with food allergies have concomitant AD. However, it is not known whether late-onset food allergy leads to adult-onset AD, a recently recognized disease entity. Using an initial cohort of one-million subjects, this study retrospectively followed-up 2851 patients with food allergy (age > 12 years) for 14 years and compared them with 11,404 matched controls. While 2.8% (81) of the 2851 food allergy patients developed AD, only 2.0% (227) of the 11,404 controls developed AD. Multivariate regression analysis showed that food allergy patients were more likely to develop AD (adjusted hazard ratio = 2.49, p < 0.0001). Controls had a 1.99% risk of developing AD, while food allergy patients had a significantly higher risk (7.18% and 3.46% for patients with ≥3 and <3 food allergy claims, respectively) of developing adult-onset AD. This is the first study to describe the chronological and dose-dependent associations between food allergy in adolescence and the development of adult-onset AD.

49 CFR 1242.17 - Signals and interlockers (accounts XX-17-19 and XX-18-19).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Signals and interlockers (accounts XX-17-19 and XX... RAILROADS 1 Operating Expenses-Way and Structures § 1242.17 Signals and interlockers (accounts XX-17-19 and XX-18-19). Separate common expenses on the basis of the total train-hours in running service, and/or...

Comparison of Ultrasonography-Guided Central Venous Catheterization Between Adult and Pediatric Populations

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

Tercan, Fahri; Oguzkurt, Levent; Ozkan, Ugur

2008-05-15

The purpose of this study was to compare the technical success and complication rates of ultrasonography-guided central venous catheterization between adult and pediatric patients which have not been reported previously. In a 4-year period, 859 ultrasonography-guided central vein catheterizations in 688 adult patients and 247 catheterizations in 156 pediatric patients were retrospectively evaluated. Mean age was 56.3 years (range, 18 to 95 years) for adults and 3.3 years (range, 0.1 to 16.3 years) for children. The preferred catheterization site was internal jugular vein in 97% of adults and 85% of children. The technical success rate, mean number of punctures, andmore » rate of single wall puncture were 99.4%, 1.04 (range, 1-3), and 83% for adults and 90.3%, 1.25 (range, 1-5), and 49% for children, respectively. All the differences were statistically significant (p < 0.05). Complication rates were 2.3% and 2.4% for adults and children, respectively (p > 0.05). Major complications such as pneumothorax and hemothorax were not seen in any group. In conclusion, ultrasonography-guided central venous catheterization has a high technical success rate, lower puncture attempt rate, and higher single wall puncture rate in adults compared to children. Complication rates are comparable in the two groups.« less

Acute parvovirus B19 infection in adults: a retrospective study of 49 cases.

PubMed

Rodríguez Bandera, A I; Mayor Arenal, M; Vorlicka, K; Ruiz Bravo-Burguilllos, E; Montero Vega, D; Vidaurrázaga Díaz-Arcaya, C

2015-01-01

Our aim was to describe the epidemiologic, clinical, and laboratory characteristics of acute parvovirus B19 infection in adults. This study describes all cases of acute parvovirus B19 infection in patients older than 18 years of age who were treated at Hospital Universitario La Paz in Madrid, Spain, in 2012. Forty-nine adults were treated for acute parvovirus B19 infection. Most were young women who were infected in the spring or early summer. In over half the cases skin lesions were key diagnostic signs.We saw the full range of types of rash of purplish exanthems that were fairly generalized; vasculitis was relatively common (in >18%). Mild or moderate abnormalities in blood counts and indicators of liver dysfunction resolved spontaneously in all but 2 immunocompromised patients, who developed chronic anemia. This is the largest case series of acute parvovirus B19 infection published to date. This infection should be suspected on observing signs of purplish skin rashes, no matter the location or pattern of distribution, or vasculitis, especially if accompanied by fever and joint pain in young women in the spring. Measures to avoid infection should be recommended to individuals at risk. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

Blood Glucose Screening Rates Among Minnesota Adults With Hypertension, Behavioral Risk Factor Surveillance System, 2011

PubMed Central

Peacock, James M.; Smith, Steven A.

2014-01-01

Introduction Many US adults have multiple chronic conditions, and hypertension and diabetes are among the most common dyads. Diabetes and prediabetes prevalence are increasing, and both conditions negatively affect cardiovascular health. Early diagnosis and treatment of diabetes and prediabetes can benefit people with hypertension by preventing cardiovascular complications. Methods We analyzed 2011 Minnesota Behavioral Risk Factor Surveillance System data to describe the proportion of adults with hypertension screened for diabetes according to US Preventive Services Task Force Recommendations for blood glucose testing. Covariates associated with lower odds of recent screening among adults without diabetes were determined using weighted logistic regression. Results Of Minnesota adults with self-reported hypertension, 19.6% had a diagnosis of diabetes and 10.7% had a diagnosis of prediabetes. Nearly one-third of adults with hypertension without diabetes had not received blood glucose screening in the past 3 years. Factors associated with greater odds of not being screened in multivariable models included being aged 18 to 44 years (adjusted odds ratio [AOR], 1.77; 95% confidence interval [CI], 1.23–2.55); being nonobese, with stronger effects for normal body mass index; having no check-up in the past 2 years (AOR, 2.49; 95% CI, 1.49–4.17); having hypertension treated with medication (AOR, 2.01; 95% CI, 1.49–2.71); and completing less than a college degree (AOR, 1.45; 95% CI, 1.14–1.84). Excluding respondents with prediabetes or those not receiving a check-up did not change the results. Conclusions Failure to screen among providers and failure to understand the importance of screening among individuals with hypertension may mean missed opportunities for early detection, clinical management, and prevention of diabetes. PMID:25427315

Flavonoid Intake in European Adults (18 to 64 Years)

PubMed Central

Vogiatzoglou, Anna; Mulligan, Angela A.; Lentjes, Marleen A. H.; Luben, Robert N.; Spencer, Jeremy P. E.; Schroeter, Hagen; Khaw, Kay-Tee; Kuhnle, Gunter G. C.

2015-01-01

Background Flavonoids are a group of phenolic secondary plant metabolites that are ubiquitous in plant-based diets. Data from anthropological, observational and intervention studies have shown that many flavonoids are bioactive. For this reason, there is an increasing interest in investigating the potential health effects of these compounds. The translation of these findings into the context of the health of the general public requires detailed information on habitual dietary intake. However, only limited data are currently available for European populations. Objective The objective of this study is to determine the habitual intake and main sources of anthocyanidins, flavanols, flavanones, flavones, flavonols, proanthocyanidins, theaflavins and thearubigins in the European Union. Design We use food consumption data from the European Food Safety Authority (EFSA) and the FLAVIOLA Food Composition Database to estimate intake of flavonoids. Results Mean (±SEM) intake of total flavonoids in Europe was 428±49 mg/d, of which 136±14 mg/d were monomeric compounds. Gallated flavan-3-ols (53±12 mg/d) were the main contributor. The lowest flavonoid intake was observed in Mediterranean countries (monomeric compounds: 95±11 mg/d). The distribution of intake was skewed in many countries, especially in Germany (monomeric flavonoids; mean intake: 181 mg/d; median intake: 3 mg/d). Conclusions The habitual intake of flavonoids in Europe is below the amounts found to have a significant health effect. PMID:26010916

Immunogenicity and safety of the HPV-16/18 AS04-adjuvanted vaccine in healthy Chinese girls and women aged 9 to 45 years.

PubMed

Zhu, Fengcai; Li, Juan; Hu, Yuemei; Zhang, Xiang; Yang, Xiaoping; Zhao, Hui; Wang, Junzhi; Yang, Jianguo; Xia, Guodong; Dai, Qinyong; Tang, Haiwen; Suryakiran, Pemmaraju; Datta, Sanjoy K; Descamps, Dominique; Bi, Dan; Struyf, Frank

2014-01-01

Immunogenicity and safety of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine were evaluated in healthy Chinese females aged 9-45 years in 2 phase IIIB, randomized, controlled trials. Girls aged 9-17 years (ClinicalTrials.gov, NCT00996125) received vaccine (n = 374) or control (n = 376) and women aged 26-45 years (NCT01277042) received vaccine (n = 606) or control (n = 606) at months 0, 1, and 6. The primary objective was to show non-inferiority of anti-HPV-16 and -18 immune responses in initially seronegative subjects at month 7, compared with Chinese women aged 18-25 years enrolled in a separate phase II/III trial (NCT00779766). Secondary objectives were to describe the anti-HPV-16 and -18 immune response, reactogenicity and safety. At month 7, immune responses were non-inferior for girls (9-17 years) vs. young women (18-25 years): the upper limit of the 95% confidence interval (CI) for the geometric mean titer (GMT) ratio (women/girls) was below the limit of 2 for both anti-HPV-16 (0.37 [95% CI: 0.32, 0.43]) and anti-HPV-18 (0.42 [0.36, 0.49]). Immune responses at month 7 were also non-inferior for 26-45 year-old women vs. 18-25 year-old women: the upper limit of the 95% CI for the difference in seroconversion (18-25 minus 26-45) was below the limit of 5% for both anti-HPV-16 (0.00% [-1.53, 1.10]) and anti-HPV-18 (0.21% [-1.36, 1.68]). GMTs were 2- to 3-fold higher in girls (9-17 years) as compared with young women (18-25 years). The HPV-16/18 AS04-adjuvanted vaccine had an acceptable safety profile when administered to healthy Chinese females aged 9-45 years.

Has Adult Sleep Duration Declined Over the Last 50+ Years?

PubMed Central

Youngstedt, Shawn D.; Goff, Eric E.; Reynolds, Alex M.; Kripke, Daniel F.; Irwin, Michael R.; Bootzin, Richard R.; Khan, Nidha; Jean-Louis, Girardin

2015-01-01

Summary The common assumption that population sleep duration has declined in the past few decades has not been supported by recent reviews, which have been limited to self-reported data. The aim of this review was to assess whether there has been a reduction in objectively recorded sleep duration over the last 50+ years. The literature was searched for studies published from 1960–2013, which assessed objective sleep duration (TST) in healthy normal-sleeping adults. The search found 168 studies that met inclusion criteria, with 257 data points representing 6,052 individuals ages 18–88 years. Data were assessed by comparing the regression lines of age vs. TST in studies conducted between 1960–1989 vs. 1990–2013. Weighted regression analyses assessed the association of year of study with age-adjusted TST across all data points. Regression analyses also assessed the association of year of study with TST separately for 10-year age categories (e.g., ages 18–27 years), and separately for polysomnographic and actigraphic data, and for studies involving a fixed sleep schedule and participants’ customary sleep schedules. Analyses revealed no significant association of sleep duration with study year. The results are consistent with recent reviews of subjective data, which have challenged the notion of a modern epidemic of insufficient sleep. PMID:26478985

The prognostic significance of minimal residual disease in adult Egyptian patients with precursor acute lymphoblastic leukemia.

PubMed

Samra, Mohamed A; Mahmoud, Hossam K; Abdelhamid, Thoraya M; El Sharkawy, Nahla M; Elnahass, Yasser H; Elgammal, Mossaad; Abdelfattah, Rafaat M; Eid, Salem; Ghaleb, Fayek M; Kamel, Azza M

2013-09-01

Minimal residual disease (MRD) studies in adult acute lymphoblastic leukemia (ALL) give highly significant prognostic information superior to other standard criteria as age, gender and total leucocytic count (TLC) in distinguishing patients at high and low risk of relapse. We aimed to determine the value of MRD monitoring by flowcytometry (FCM) in predicting outcome in adult Precursor ALL patients. Bone marrow (BM) samples were analyzed by 4-color FCM collected at diagnosis and after induction therapy (MRD1) to correlate MRD positivity with disease free survival (DFS) and overall survival (OS). Study included 57 adult ALL patients (44 males and 13 females) with a median age of 22 years (18-49). DFS showed no significant difference with age, gender and initial TLC (p=0.838, 0.888 and 0.743, respectively). Cumulative DFS at 2 years was 34% for B-lineage ALL (n: 35) and 57% for T-lineage ALL (n: 18) (p = 0.057). Cumulative DFS at 2 years was 7% for MRD1 positive (high risk, HR) versus 57% for MRD1 negative patients (Low risk, LR) (p < 0.001). Cumulative DFS at 2 years was 29% for HR patients (n: 26) versus 55% for LR (n: 27) according to GMALL classification (p = 0.064). Cumulative OS did not differ according to age, gender and TLC (p = 0.526, 0.594 and 0.513, respectively). Cumulative OS at 2 years was 36% for B ALL (n: 39) versus 77% for TALL (n: 18) (p = 0.016) and was 49% for Philadelphia chromosome (Ph) negative patients versus 0% for Ph-positive patients (p < 0.001). Regarding MRD1, OS at 2 years was 18% for MRD1 HR (n: 17) versus 65% for MRD1 LR (n: 38) (p < 0.001). OS was 35% for high-risk patients (n: 30) and 62% for low-risk patients (n: 27) classified according to GMALL risk stratification (p = 0.017). MRD by FCM is a strong independent predictor of outcome in terms of DFS and OS and is a powerful informative parameter in guiding individual treatment in ALL patients. Copyright © 2013. Production and hosting by Elsevier B.V.

Seven-year trends in sun protection and sunburn among Australian adolescents and adults.

PubMed

Volkov, Angela; Dobbinson, Suzanne; Wakefield, Melanie; Slevin, Terry

2013-02-01

To examine the change in sun protective behaviours and sunburn of Australians over a seven-year period, in the context of sustained skin cancer prevention campaigns and programs. Weekly cross-sectional telephone interviews of Australians were conducted throughout summer in 2010/11 for comparison with 2003/04 and 2006/07. In 2010/11, n=1,367 adolescents (12-17 years) and n=5,412 adults (18-69 years) were interviewed about their sun-related attitudes, weekend sun protection and sunburn. Multivariate analyses adjusted for key demographics, temperature, cloud, wind and ultraviolet radiation (UVR) to assess change in outcomes over time. There were consistent improvements in adolescents' and adults' attitudes, intentional tanning and incidence of sunburn over time. Behavioural changes were variable. Adults spent less time outdoors during peak UVR compared to past surveys, while adolescents were less likely to be outdoors compared with 2006/07. Sunscreen use and wearing of long sleeves increased among adults, but hat wearing decreased for both age groups, as did leg cover by adolescents since 2003/04. There has been a sustained decrease in weekend sunburn among adolescents and adults. The findings suggest improvements in skin cancer prevention attitudes of Australians over time. Australians' compliance with sun protection during summer has improved in some areas, but is still far from ideal. The sustained decrease in weekend sunburn among adolescents and adults is encouraging, but further improvements are required. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Spanish normative studies in young adults (NEURONORMA young adults project): norms for verbal fluency tests.

PubMed

Casals-Coll, M; Sánchez-Benavides, G; Quintana, M; Manero, R M; Rognoni, T; Calvo, L; Palomo, R; Aranciva, F; Tamayo, F; Peña-Casanova, J

2013-01-01

Lexical fluency tests are frequently used in clinical practice to assess language and executive function. As part of the Spanish normative studies project in young adults (NEURONORMA young adults project), we provide age- and education-adjusted normative data for 3 semantic fluency tasks (animals, fruits and vegetables, and kitchen tools), three formal lexical fluency tasks (words beginning with P, M and R), three excluded-letter fluency tasks (words excluding A, E and S) and a verb fluency task. The sample consisted of 179 participants who are cognitively normal and range in age from 18 to 49 years. Tables are provided to convert raw scores to scaled scores. Age- and education-adjusted scores are provided by applying linear regression techniques. The results show that education impacted most of the verbal fluency test scores, with no effects related to age and only minimal effects related to sex. The norms obtained will be extremely useful in the clinical evaluation of young Spanish adults. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Comparative study of the blinking time between young adult and adult video display terminal users in indoor environment.

PubMed

Schaefer, Tânia Mara Cunha; Schaefer, Arthur Rubens Cunha; Abib, Fernando Cesar; José, Newton Kara

2009-01-01

Investigate the average blinking time in conversation and in Video Display Terminal use of young adults and adults in the presbyopic age group. A transversal analytical study in a readily accessible sample consisting of Volkswagen do Brasil - Curitiba, Paraná employees was performed. The cohort group consisted of 108 subjects divided into two age groups: Group 1, the young adult group (age range 20-39): 77 employees, mean age of 30.09 +/- 5.09; Group 2, the presbyopic adult group, (age range 40-53): 31 employees, mean age of 44.17 +/- 3. Subjects under 18 years of age, with a history of ocular disorders, contact lens wearers and computer non-users were excluded. The subjects had their faces filmed for 10 minutes in conversation and VDT reading. Student's t-test was used and the statistical significance level was 95%. The average time between blinks in Group 1 for conversation and VDT reading was 5.16 +/- 1.83 and 10.42 +/- 7.78 seconds, respectively; in Group 2. 4,9 +/- 1.49 and 10.46 +/- 5.54 seconds. In both age groups, the time between blinks in VDT reading situations was higher (p<0.0001). There was no statistically meaningful difference for conversation and VDT reading situations when the two studied age groups were compared (p>0.05). There was an increase in the blinking time between young adults and the presbyopic group in VDT use situations when compared with reading situations. The difference in the blinking frequency between young adults and the presbyopic group in VDT use and reading situations was not statistically significant.

Pneumonia among adults hospitalized with laboratory-confirmed seasonal influenza virus infection-United States, 2005-2008.

PubMed

Garg, Shikha; Jain, Seema; Dawood, Fatimah S; Jhung, Michael; Pérez, Alejandro; D'Mello, Tiffany; Reingold, Arthur; Gershman, Ken; Meek, James; Arnold, Kathryn E; Farley, Monica M; Ryan, Patricia; Lynfield, Ruth; Morin, Craig; Baumbach, Joan; Hancock, Emily B; Zansky, Shelley; Bennett, Nancy; Thomas, Ann; Schaffner, William; Finelli, Lyn

2015-08-26

Influenza and pneumonia combined are the leading causes of death due to infectious diseases in the United States. We describe factors associated with pneumonia among adults hospitalized with influenza. Through the Emerging Infections Program, we identified adults ≥ 18 years, who were hospitalized with laboratory-confirmed influenza during October 2005 through April 2008, and had a chest radiograph (CXR) performed. Pneumonia was defined as the presence of a CXR infiltrate and either an ICD-9-CM code or discharge summary diagnosis of pneumonia. Among 4,765 adults hospitalized with influenza, 1392 (29 %) had pneumonia. In multivariable analysis, factors associated with pneumonia included: age ≥ 75 years, adjusted odds ratio (AOR) 1.27 (95 % confidence interval 1.10-1.46), white race AOR 1.24 (1.03-1.49), nursing home residence AOR 1.37 (1.14-1.66), chronic lung disease AOR 1.37 (1.18-1.59), immunosuppression AOR 1.45 (1.19-1.78), and asthma AOR 0.76 (0.62-0.92). Patients with pneumonia were significantly more likely to require intensive care unit (ICU) admission (27 % vs. 10 %), mechanical ventilation (18 % vs. 5 %), and to die (9 % vs. 2 %). Pneumonia was present in nearly one-third of adults hospitalized with influenza and was associated with ICU admission and death. Among patients hospitalized with influenza, older patients and those with certain underlying conditions are more likely to have pneumonia. Pneumonia is common among adults hospitalized with influenza and should be evaluated and treated promptly.

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

Adult seafood allergy in the Texas Medical Center: A 13-year experience

PubMed Central

Khan, Faria; Orson, Frank; Ogawa, Yoshiko; Parker, Crystal

2011-01-01

There is a paucity of data regarding prevalence and characteristics of adult seafood allergy in United States cohorts. This study was designed to determine the characteristics of patient-reported seafood allergy in a large allergy referral adult population. Retrospective analysis was performed of laboratory and clinical characteristics of seafood-allergic patients in three allergy clinics in the Texas Medical Center between January 1, 1997 and January 30, 2010. Of 5162 patients seen in this adult allergy referral population, 159 had physician-diagnosed seafood allergy with an average age of diagnosis of 50.2 (18–81 years) years. Shellfish allergy (59.1%) was more frequent than fish allergy (13.8%). Crustacean allergy (82.6%) was more frequent than mollusk allergy (7.2%). Shrimp (72.5%), crab (34.8%), and lobster (17.4%) were the most common shellfish allergies and tuna (28.6%), catfish (23.8%), and salmon (23.8%) were the most common fish allergies. One-third of seafood-allergic patients reported reactions to more than one seafood. Shellfish-allergic adults were more likely to experience respiratory symptoms than fish-allergic adults (p < 0.05). The likelihood of having anaphylaxis (32%) was not statistically different between shellfish- and fish-allergic subjects. Severe reactions were 12.9 times more likely to occur within the 1st hour of ingestion compared with nonsevere reactions (p < 0.005). The percentage of seafood allergy in this adult allergy referral population was 3.08%. PMID:22852122

Prevalence, Causes and Social Factors of Visual Impairment among Chinese Adults: Based on a National Survey.

PubMed

Guo, Chao; Wang, Zhenjie; He, Ping; Chen, Gong; Zheng, Xiaoying

2017-09-08

Visual impairment has become a global challenge, especially for developing countries. This study aims to estimate the prevalence, causes and social factors of visual impairment among Chinese adults. Data were from a nationally representative population-based cross-sectional study. The study population were 1,909,199 non-institutionalized adults aged 18 years and older in mainland China. In the survey, low vision and blindness were checked by ophthalmologists according to the WHO best-corrected visual acuity (BCVA) criteria. Population weighted numbers and prevalence of low vision and blindness with 95% confidence intervals (CIs) were estimated where appropriate. Multivariable logistic regression analysis was used to identify the social factors of visual impairment. The weighted prevalence of visual impairment was 17.17 (95% CI, 16.84-17.50) per 1000 Chinese adults aged 18 years and older. Cataract (57.35%), disorders of choroid and retina (9.80%), and disorders of cornea (6.49%) contributed more than 70 percent to the visual impairment in Chinese adults. Older age groups, young or middle-aged male adults, female elders, illiterate, rural dwellers, non-eastern residents, singles, unemployment, and from family with lower income were associated with visual impairment. More efforts are warranted to enhance treatment and rehabilitation among people with eye disorders to prevent visual impairment.

Prevalence, Causes and Social Factors of Visual Impairment among Chinese Adults: Based on a National Survey

PubMed Central

Wang, Zhenjie; He, Ping; Chen, Gong; Zheng, Xiaoying

2017-01-01

Visual impairment has become a global challenge, especially for developing countries. This study aims to estimate the prevalence, causes and social factors of visual impairment among Chinese adults. Data were from a nationally representative population-based cross-sectional study. The study population were 1,909,199 non-institutionalized adults aged 18 years and older in mainland China. In the survey, low vision and blindness were checked by ophthalmologists according to the WHO best-corrected visual acuity (BCVA) criteria. Population weighted numbers and prevalence of low vision and blindness with 95% confidence intervals (CIs) were estimated where appropriate. Multivariable logistic regression analysis was used to identify the social factors of visual impairment. The weighted prevalence of visual impairment was 17.17 (95% CI, 16.84–17.50) per 1000 Chinese adults aged 18 years and older. Cataract (57.35%), disorders of choroid and retina (9.80%), and disorders of cornea (6.49%) contributed more than 70 percent to the visual impairment in Chinese adults. Older age groups, young or middle-aged male adults, female elders, illiterate, rural dwellers, non-eastern residents, singles, unemployment, and from family with lower income were associated with visual impairment. More efforts are warranted to enhance treatment and rehabilitation among people with eye disorders to prevent visual impairment. PMID:28885571

Bullying in elementary school and psychotic experiences at 18 years: a longitudinal, population-based cohort study.

PubMed

Wolke, D; Lereya, S T; Fisher, H L; Lewis, G; Zammit, S

2014-07-01

Victims of bullying are at risk for psychotic experiences in early adolescence. It is unclear if this elevated risk extends into late adolescence. The aim of this study was to test whether bullying perpetration and victimization in elementary school predict psychotic experiences in late adolescence. The current study is based on the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective community-based study. A total of 4720 subjects with bullying perpetration and victimization were repeatedly assessed between the ages of 8 and 11 years by child and mother reports. Suspected or definite psychotic experiences were assessed with the Psychosis-Like Symptoms semi-structured interview at age 18 years. Controlling for child's gender, intelligence quotient at age 8 years, childhood behavioural and emotional problems, and also depression symptoms and psychotic experiences in early adolescence, victims [child report at 10 years: odds ratio (OR) 2.4, 95% confidence interval (CI) 1.6-3.4; mother report: OR 1.6, 95% CI 1.1-2.3], bully/victims (child report at 10 years: OR 3.1, 95% CI 1.7-5.8; mother: OR 2.9, 95% CI 1.7-5.0) and bullies (child report at 10 years: OR 4.9, 95% CI 1.3-17.7; mother: OR 1.2, 95% CI 0.46-3.1, n.s.) had a higher prevalence of psychotic experiences at age 18 years. Path analysis revealed that the association between peer victimization in childhood and psychotic experiences at age 18 years was only partially mediated by psychotic or depression symptoms in early adolescence. Involvement in bullying, whether as victim, bully/victim or bully, may increase the risk of developing psychotic experiences in adolescence. Health professionals should ask routinely during consultations with children about their bullying of and by peers.

Low risk of attrition among adults on antiretroviral therapy in the Rwandan national program: a retrospective cohort analysis of 6, 12, and 18 month outcomes.

PubMed

Nuwagaba-Biribonwoha, Harriet; Jakubowski, Aleksandra; Mugisha, Veronicah; Basinga, Paulin; Asiimwe, Anita; Nash, Denis; Elul, Batya

2014-08-29

We report levels and determinants of attrition in Rwanda, one of the few African countries with universal ART access. We analyzed data abstracted from health facility records of a nationally representative sample of adults [≥ 18 years] who initiated ART 6, 12, and 18 months prior to data collection; and collected facility characteristics with a health facility assessment questionnaire. Weighted proportions and rates of attrition [loss to follow-up or death] were calculated, and patient- and health facility-level factors associated with attrition examined using Cox proportional hazard models. 1678 adults initiated ART 6, 12 and 18 months prior to data collection, with 1508 person-years [PY] on ART. Attrition was 6.8% [95% confidence interval [CI] 6.0-7.8]: 2.9% [2.4-3.5] recorded deaths and 3.9% [3.4-4.5] lost to follow-up. Population attrition rate was 7.5/100 PY [6.1-9.3]. Adjusted hazard ratio [aHR] for attrition was 4.2 [3.0-5.7] among adults enrolled from in-patient wards [vs 2.2 [1.6-3.0] from PMTCT, ref: VCT]. Compared to adults who initiated ART 18 months earlier, aHR for adults who initiated ART 12 and 6 months earlier was 1.8 [1.3-2.5] and 1.3 [0.9-1.9] respectively. Male aHR was 1.4 [1.0-1.8]. AHR of adults enrolled at urban health facilities was 1.4 [1.1-1.8, ref: rural health facilities]. AHR for adults with CD4+ ≥ 200 cells/μL vs <200 cells/μL was 0.8 [0.6-1.0]; and adults attending facilities with performance-based financing since 2004-2006 [vs. 2007-2008] had aHR 0.8 [0.6-0.9]. Attrition was low in the Rwandan national program. The above patient and facility correlates of attrition can be the focus of interventions to sustain high retention.

Education-Related Parameters in High Myopia: Adults versus School Children.

PubMed

Jonas, Jost B; Xu, Liang; Wang, Ya Xing; Bi, Hong Sheng; Wu, Jian Feng; Jiang, Wen Jun; Nangia, Vinay; Sinha, Ajit; Zhu, Dan; Tao, Yong; Guo, Yin; You, Qi Sheng; Wu, Li Juan; Tao, Li Xin; Guo, Xiu Hua; Ohno-Matsui, Kyoko; Panda-Jonas, Songhomitra

2016-01-01

Since high myopia in the younger generation may differ etiologically from high myopia in older generations, we examined whether education-related parameters differ between high myopia in today´s school children and high pathological myopia in today´s elderly generation. The investigation included the adult populations of the population-based Beijing Eye Study (BES) (3468 adults;mean age:64.6±9.8years;range:50-93years) and Central India Eye and Medical Study (CIEMS) (4711 adults;age:49.±13.2years;range:30-100years), and the children and teenager populations of the Shandong Children Eye Study (SCES) (6026 children;age:9.7±3.3years;range:4-18years;cycloplegic refractometry), Gobi Desert Children Eye Study (1565;age:11.9±3.5years;range:6-21 years;cycloplegic refractometry), Beijing Pediatric Eye Study (681 children;age:7.7±1.6years;range:5-13 years;non-cycloplegic refractometry,calculation of axial length to corneal curvature radius ratio), Beijing Children Eye Study (15066 children;age:13.2±3.4years;range:7-18years;non-cycloplegic refractometry), Beijing High School Teenager Eye Study (4677 children;age:16.9±0.7years;range:16-18years;non-cycloplegic refractometry). In the BES and CIEMS, educational level did not differ significantly between, or was significantly lower in the highly myopic group (myopic refractive error ≥6 diopters) than in the non-highly myopic group. In all non-adult study populations, higher prevalence of high myopia was significantly associated with higher degree of education related parameters such as attendance of high-level schools, and more time spent for indoors near work versus time spent outdoors. Comparing associations of old or genetic high myopia in adults with new or acquired high myopia in school children revealed that education-related parameters did not show a clear association with old or genetic high myopia, while in contrast, new high myopia showed strong associations with education. It confirms previous studies that the

Education-Related Parameters in High Myopia: Adults versus School Children

PubMed Central

Xu, Liang; Wang, Ya Xing; Bi, Hong Sheng; Wu, Jian Feng; Jiang, Wen Jun; Nangia, Vinay; Sinha, Ajit; Zhu, Dan; Tao, Yong; Guo, Yin; You, Qi Sheng; Wu, Li Juan; Tao, Li Xin; Guo, Xiu Hua; Ohno-Matsui, Kyoko; Panda-Jonas, Songhomitra

2016-01-01

Purpose Since high myopia in the younger generation may differ etiologically from high myopia in older generations, we examined whether education-related parameters differ between high myopia in today´s school children and high pathological myopia in today´s elderly generation. Methods The investigation included the adult populations of the population-based Beijing Eye Study (BES) (3468 adults;mean age:64.6±9.8years;range:50–93years) and Central India Eye and Medical Study (CIEMS) (4711 adults;age:49.±13.2years;range:30–100years), and the children and teenager populations of the Shandong Children Eye Study (SCES) (6026 children;age:9.7±3.3years;range:4–18years;cycloplegic refractometry), Gobi Desert Children Eye Study (1565;age:11.9±3.5years;range:6–21 years;cycloplegic refractometry), Beijing Pediatric Eye Study (681 children;age:7.7±1.6years;range:5–13 years;non-cycloplegic refractometry,calculation of axial length to corneal curvature radius ratio), Beijing Children Eye Study (15066 children;age:13.2±3.4years;range:7–18years;non-cycloplegic refractometry), Beijing High School Teenager Eye Study (4677 children;age:16.9±0.7years;range:16–18years;non-cycloplegic refractometry). Results In the BES and CIEMS, educational level did not differ significantly between, or was significantly lower in the highly myopic group (myopic refractive error ≥6 diopters) than in the non-highly myopic group. In all non-adult study populations, higher prevalence of high myopia was significantly associated with higher degree of education related parameters such as attendance of high-level schools, and more time spent for indoors near work versus time spent outdoors. Conclusions Comparing associations of old or genetic high myopia in adults with new or acquired high myopia in school children revealed that education-related parameters did not show a clear association with old or genetic high myopia, while in contrast, new high myopia showed strong associations

Long-Term (7 Years) Follow-Up of Roux-en-Y Gastric Bypass on Obese Adolescent Patients (<18 Years).

PubMed

Vilallonga, Ramon; Himpens, Jacques; van de Vrande, Simon

2016-01-01

Few data are available about obesity surgery in adolescent patients. To assess long-term outcomes after laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients <18 years. University Hospital, Europe. A retrospective study of prospectively collected data of patients <18 years (childhood group; ChG) (n = 28) treated by LRYGB of which 19 were available for follow-up between 2.4 and 10.2 years (mean 7.2 years). This group of patients was matched with an adult control group (AdG) of randomly chosen patients with similar characteristics who underwent LRYGB during the same period. The extensive survey included a telephonic questionnaire. 19 (12 females) of the 28 patients (67.9%) were available for follow-up. Preoperatively, 3 had type 2 diabetes mellitus (T2DM), 1 arterial hypertension, 5 dyslipidemia and 1 sleep apnea. In the ChG, average BMI after 7 years dropped from 38.9 kg/m2 preoperatively to 27.5 kg/m2. In the AdG, average BMI decreased from 39.4 to 27.1 kg/m2 in the same time period (nonsignificant between groups). One patient in the ChG needed a reoperation (internal hernia) versus 3 patients in the AdG (1 leak, 2 obstructions). All patients resolved their initial comorbidities. Two of 12 female patients in the ChG became pregnant 6 and 8 years after surgery, respectively, despite seemingly adequate oral contraception. Compliance with postoperative guidelines was good in 16/19 patients in ChG and in 14/18 patients in the AdG. Overall degree of satisfaction was high: 8.2/10 (SD 1.2, range 6-10) in the ChG and 8.9/10 (SD 1.7, range 5-10) in the AdG. LRYGB seems to be safe, provide good weight loss, and cure comorbidities in an adolescent population. Satisfaction degree is high. Inadvertent pregnancy despite conventional contraception is a possible issue. © 2016 S. Karger GmbH, Freiburg.

Secondary Education Systems and the General Skills of Less- and Intermediate-Educated Adults: A Comparison of 18 Countries

ERIC Educational Resources Information Center

Heisig, Jan Paul; Solga, Heike

2015-01-01

We investigate the impact of external differentiation and vocational orientation of (lower and upper) secondary education on country variation in the mean numeracy skills of, and skills gaps between, adults with low and intermediate formal qualifications. We use data on 30- to 44-year-olds in 18 countries from the 2011-12 round of the Program for…

Health-related quality of life and behaviors risky to health among adults aged 18-24 years in secondary or higher education--United States, 2003-2005.

PubMed

Zahran, Hatice S; Zack, Matthew M; Vernon-Smiley, Mary E; Hertz, Marci F

2007-10-01

To identify the demographic characteristics and behaviors risky to health contributing to health-related quality of life (HRQOL), defined as the perceived physical or mental health over time. Information on students aged 18-24 years from the aggregated Behavioral Risk Factor Surveillance System survey (BRFSS) 2003, 2004, and 2005 data for the 50 states and District of Columbia was studied. Selected HRQOL measures, health care access, behaviors risky to health (i.e., leisure-time physical activity or exercise, cigarette smoking, binge drinking, and indicators of risky sex behaviors), and selected health conditions were analyzed. Overall, students aged 18-24 years reported more mentally unhealthy days than physically unhealthy days. Compared with students in secondary education, younger graduate students reported better mental health, self-rated health, and fewer behaviors risky to health. Regardless of educational level, reported physically or mentally unhealthy days differed by selected demographic characteristics, health care access, behaviors risky to health, and health conditions. Behaviors risky to health and their associations with mental health should be recognized and addressed in any health prevention or intervention program for student populations. Public health professionals should promote evidence-based health promotion programs to prevent young adults from initiating risky behaviors, continue to promote risk-reduction and cessation skills to those engaged in these behaviors, and incorporate mental health promotion into risk-reduction intervention programs.

Testing a Matching Hypothesis for Emerging Adults in Project MATCH: During-Treatment and One-Year Outcomes

PubMed Central

Davis, Jordan P.; Bergman, Brandon G.; Smith, Douglas C.; Kelly, John F.

2017-01-01

Objective: Compared with older adults, emerging adults (18-29 years old) entering treatment typically have less severe alcohol use consequences. Also, their unique clinical presentations (e.g., modest initial abstinence motivation) and developmental contexts (e.g., drinking-rich social networks) may make a straightforward implementation of treatments developed for adults less effective. Yet, this has seldom been examined empirically. This study was a secondary analysis of Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) data examining (a) overall differences between emerging adults and older adults (≥30 years old) on outcomes during treatment and at 1-year follow-up, and (b) whether emerging adults had poorer outcomes on any of the three Project MATCH treatments in particular. Method: Participants were 267 emerging adults and 1,459 older adults randomly assigned to individually delivered cognitive-behavioral therapy (CBT), motivational enhancement therapy (MET), or 12-step facilitation (TSF). Multilevel growth curve models tested differences on percentage of days abstinent (PDA) and drinks per drinking day (DDD) by age group and treatment assignment. Results: During treatment, compared with older adults, emerging adults reported more DDD but similar PDA. Further, emerging adults assigned to TSF had less PDA and more DDD than emerging adults and older adults assigned to CBT or MET during treatment (i.e., emerging adults in TSF has poorer outcomes initially), but this matching effect was not evident at 1-year follow-up. Conclusions: This study is among the first to test age group differences across three psychosocial interventions shown to be efficacious treatments for alcohol use disorder. Although emerging adults generally did as well as their older counterparts, they may require a more developmentally sensitive approach to bolster TSF effects during treatment. PMID:27936374

Educational and vocational outcomes of adults with childhood- and adult-onset systemic lupus erythematosus: 9 years of follow-up

PubMed Central

Lawson, Erica F.; Hersh, Aimee O.; Trupin, Laura; von Scheven, Emily; Okumura, Megumi J.; Yazdany, Jinoos; Yelin, Edward H.

2014-01-01

Objective To compare educational and vocational outcomes among adults with childhood-onset SLE (cSLE) and adult-onset SLE (aSLE). Methods Data derive from the 2002–2010 cycles of the Lupus Outcomes Study, a longitudinal cohort of 1204 adult subjects with SLE. Subjects age 18–60 living in the U.S. (N=929) were included in the analysis, and were classified as cSLE if age at diagnosis was <18 years (N=115). Logistic regression was used to assess the unadjusted and adjusted effect of cSLE, gender, race/ethnicity, baseline age, urban or rural location and U.S. region on the likelihood of completing a bachelor’s degree. Generalized estimating equations were used to assess the effect of cSLE, demographics, education, and disease-related factors on the odds of employment, accounting for multiple observations over the study period. Results Subjects with cSLE were on average younger (29±10 versus 44±9 years), with longer disease duration (15±10 versus 11±8 years). Subjects with aSLE and cSLE subjects were equally likely to complete a bachelor’s degree. However, subjects with cSLE were significantly less likely to be employed, independent of demographic and disease characteristics (OR 0.62, 95% CI 0.42–0.91). Conclusion While subjects with SLE are just as likely as those with aSLE to complete college education, cSLE significantly increases the risk of not working in adulthood, even when controlling for disease and demographic factors. Exploring reasons for low rates of employment and providing vocational support may be important to maximize long-term functional outcomes in patients with cSLE. PMID:24877200

Pediatric and adult lung transplantation for cystic fibrosis.

PubMed

Mendeloff, E N; Huddleston, C B; Mallory, G B; Trulock, E P; Cohen, A H; Sweet, S C; Lynch, J; Sundaresan, S; Cooper, J D; Patterson, G A

1998-02-01

This paper was undertaken to review the experience at our institution with bilateral sequential lung transplantation for cystic fibrosis. Since 1989, 103 bilateral sequential lung transplants for cystic fibrosis have been performed (46 pediatric, 48 adult, 9 redo); the mean age was 21 +/- 10 years. Cardiopulmonary bypass was used in all but one pediatric (age <18) transplant, and in 15% of adults. Hospital mortality was 4.9%, with 80% of early deaths related to infection. Bronchial anastomotic complications occurred with equal frequency in the pediatric and the adult populations (7.3%). One- and 3-year actuarial survival are 84% and 61%, respectively (no significant difference between pediatric and adult age groups; average follow-up 2.1 +/- 1.6 years). Mean forced expiratory volume in 1 second increased from 25% +/- 9% before transplantation to 79% +/- 35% 1 year after transplantation. Acute rejection occurred 1.7 times per patient-year, with most episodes taking place within the first 6 months after transplantation. The need for treatment of lower respiratory tract infections occurred 1.2 times per patient in the first year after transplantation. Actuarial freedom from bronchiolitis obliterans was 63% at 2 years and 43% at 3 years. Redo transplantation was performed only in the pediatric population and was associated with an early mortality of 33%. Eight living donor transplants (four primary transplants, four redo transplants) were performed with an early survival of 87.5%. Patients with end-stage cystic fibrosis can undergo bilateral lung transplantation with morbidity and mortality comparable to that seen in pulmonary transplantation for other disease entities.

Data resource profile: the World Health Organization Study on global AGEing and adult health (SAGE).

PubMed

Kowal, Paul; Chatterji, Somnath; Naidoo, Nirmala; Biritwum, Richard; Fan, Wu; Lopez Ridaura, Ruy; Maximova, Tamara; Arokiasamy, Perianayagam; Phaswana-Mafuya, Nancy; Williams, Sharon; Snodgrass, J Josh; Minicuci, Nadia; D'Este, Catherine; Peltzer, Karl; Boerma, J Ties

2012-12-01

Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization's Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18-49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007-2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18-49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO's SAGE website (www.who.int/healthinfo/systems/sage) and WHO's archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata).

Survival in Adult Lung Transplant Recipients Receiving Pediatric Versus Adult Donor Allografts.

PubMed

Hayes, Don; Whitson, Bryan A; Ghadiali, Samir N; Lloyd, Eric A; Tobias, Joseph D; Mansour, Heidi M; Black, Sylvester M

2015-10-01

Recent evidence showed that pediatric donor lungs increased rates of allograft failure in adult lung transplant recipients; however, the influence on survival is unclear. The United Network for Organ Sharing (UNOS) database was queried from 2005 to 2013 for adult lung transplant recipients (≥18 years) to assess survival differences among donor age categories (<18 years, 18 to 29 years, 30 to 59 years, ≥60 years). Of 12,297 adult lung transplants, 12,209 were used for univariate Cox models and Kaplan-Meier (KM) analysis and 11,602 for multivariate Cox models. A total of 1,187 adult recipients received pediatric donor lungs compared with 11,110 receiving adult donor organs. Univariate and multivariate Cox models found no difference in survival between donor ages 0 to 17 and donor ages 18 to 29, whereas donor ages 60 and older were significantly associated with increased mortality hazard, relative to the modal category of donor ages 30 to 59 (adjusted hazard ratio = 1.381; 95% confidence interval = 1.188% to 1.606%; p < 0.001). Interactions between recipient and donor age range found that the oldest donor age range was negatively associated with survival among middle-aged (30 to 59) and older (≥60) lung transplant recipients. Pediatric donor lung allografts were not negatively associated with survival in adult lung transplant recipients; however, the oldest donor age range was associated with increased mortality hazard for adult lung transplant recipients. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Hearing impairment associated with depression in US adults, National Health and Nutrition Examination Survey 2005-2010.

PubMed

Li, Chuan-Ming; Zhang, Xinzhi; Hoffman, Howard J; Cotch, Mary Frances; Themann, Christa L; Wilson, M Roy

2014-04-01

Depression among hearing impaired US adults has not been studied previously. To estimate the prevalence of and risk factors for depression among adults with hearing loss. Adults aged 18 years or older (N = 18 318) who participated in the National Health and Nutrition Examination Survey (NHANES), 2005-2010, a nationally representative sample. Multistage probability sampling of US population. Depression, assessed by the 9-item Patient Health Questionnaire (PHQ-9) scale, and hearing impairment (HI), assessed by self-report and audiometric examination for adults aged 70 years or older. The prevalence of moderate to severe depression (PHQ-9 score, ≥10) was 4.9% for individuals reporting excellent hearing, 7.1% for those with good hearing, and 11.4% for participants who reported a little trouble or greater HI. Using excellent hearing as the reference, after adjusting for all covariates, multivariate odds ratios (ORs) for depression were 1.4 (95% CI, 1.1-1.8) for good hearing, 1.7 (1.3-2.2) for a little trouble, 2.4 (1.7-3.2) for moderate trouble, 1.5 (0.9-2.6) for a lot of trouble, and 0.6 (0.1-2.6) for deaf. Moderate HI (defined by better ear pure-tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz within the range 35- to 49-dB hearing level) was significantly associated with depression among older women (OR, 3.9; 95% CI, 1.3-11.3), after adjusting for age, sex, race/ethnicity, lifestyle characteristics, and selected health conditions. After accounting for health conditions and other factors, including trouble seeing, self-reported HI and audiometrically determined HI were significantly associated with depression, particularly in women. Health care professionals should be aware of an increased risk for depression among adults with hearing loss.

Ocular firework injuries at New Year's eve.

PubMed

Sacu, Stefan; Ségur-Eltz, Nikolaus; Stenng, Karin; Zehetmayer, Martin

2002-01-01

To prospectively study mechanisms and injury characteristics of ocular firework burns. A prospective analysis of all patients with firework injuries attending the Department of Ophthalmology, University of Vienna, between 1994 and 2001. We looked for classes of fireworks and mechanisms of injuries. The number of diagnoses was established and their severity classified. During this period (8 years) we identified 116 eyes of 102 patients. 67/102 (66%) of all injuries were caused by class II and III fireworks. Patients ranged between 4 and 83 years. Ocular injuries occurred more frequently in males (69, 68%) and affected the right eye in 53 patients (52.5%). Ocular firework injuries to minors (under the age of 18 years) occurred in 48 (49%). The most common types of injury were skin and corneal erosions and abrasions (32/116, 28%). 11/116 eyes (10%) had severe injuries. 8 of 11 severe injuries (72%) occurred in minors (<18 years). 2 patients (1.7%) developed permanent blindness. In 32/116 patients (28%), the ocular trauma resulted in visual impairment, mainly due to corneal scars or retinal pathologies. In all patients, the severity index was 1.4 +/- 0.8. In minors the severity index was 1.6 +/- 1.0, in adults 1.2 +/- 0.5 (p = 0.013). Injuries in minors were significantly more severe than those in adults. Possible preventive measures include legislation, education of minors and eye protection. Copyright 2002 S. Karger AG, Basel

Immunogenicity and safety of the HPV-16/18 AS04-adjuvanted vaccine in healthy Chinese girls and women aged 9 to 45 years

PubMed Central

Zhu, Fengcai; Li, Juan; Hu, Yuemei; Zhang, Xiang; Yang, Xiaoping; Zhao, Hui; Wang, Junzhi; Yang, Jianguo; Xia, Guodong; Dai, Qinyong; Tang, Haiwen; V Suryakiran, Pemmaraju; Datta, Sanjoy K; Descamps, Dominique; Bi, Dan; Struyf, Frank

2014-01-01

Immunogenicity and safety of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine were evaluated in healthy Chinese females aged 9–45 years in 2 phase IIIB, randomized, controlled trials. Girls aged 9–17 years (ClinicalTrials.gov, NCT00996125) received vaccine (n = 374) or control (n = 376) and women aged 26–45 years (NCT01277042) received vaccine (n = 606) or control (n = 606) at months 0, 1, and 6. The primary objective was to show non-inferiority of anti-HPV-16 and -18 immune responses in initially seronegative subjects at month 7, compared with Chinese women aged 18–25 years enrolled in a separate phase II/III trial (NCT00779766). Secondary objectives were to describe the anti-HPV-16 and -18 immune response, reactogenicity and safety. At month 7, immune responses were non-inferior for girls (9–17 years) vs. young women (18–25 years): the upper limit of the 95% confidence interval (CI) for the geometric mean titer (GMT) ratio (women/girls) was below the limit of 2 for both anti-HPV-16 (0.37 [95% CI: 0.32, 0.43]) and anti-HPV-18 (0.42 [0.36, 0.49]). Immune responses at month 7 were also non-inferior for 26–45 year-old women vs. 18–25 year-old women: the upper limit of the 95% CI for the difference in seroconversion (18–25 minus 26–45) was below the limit of 5% for both anti-HPV-16 (0.00% [–1.53, 1.10]) and anti-HPV-18 (0.21% [–1.36, 1.68]). GMTs were 2- to 3-fold higher in girls (9–17 years) as compared with young women (18–25 years). The HPV-16/18 AS04-adjuvanted vaccine had an acceptable safety profile when administered to healthy Chinese females aged 9–45 years. PMID:25424785

Learning difficulties: a retrospective study of their co morbidity and continuity as indicators of adult criminal behaviour in 18-70-year-old prisoners.

PubMed

Zakopoulou, Victoria; Pashou, Theodora; Tzavelas, Panagiotis; Christodoulides, Pavlos; Anna, Milona; Iliana, Kolotoura

2013-11-01

The development of learning difficulties is associated with problems in external (executive) and extensive behaviour in a co-occurrence with psycho-emotional problems beginning from pre-school, school age, and adolescence up to adulthood. Through the current survey, we aim to emphasise the early role of learning difficulties during the school age and adolescence of prisoners and their effects on the onset of offending behaviours in adulthood, such as criminal behaviour. Altogether, we studied 117 Greek adult prisoners from 18 to 70 years old who were accused of different types or degrees of offences. Through statistical analyses, the following factors were observed with high statistical significance as early indicators of criminal behaviour in the adult lives of the prisoners: (i) learning difficulties, (ii) family problems, (iii) behaviour disorders, (iv) developmental disorders, and (v) psycho-emotional disorders. As a result, the learning difficulties were assumed to be the most decisive factor in the developmental progression of prisoners because they manifested early in the prisoners' lives, weakened the prisoners to be competitive and robust, provoked a bad self-image and low self-esteem, and, in the frame of a weak or negative family and educational environment, they accompanied antisocial behaviour and psycho-emotional disorders even from adolescence, which continued into adulthood. Copyright © 2013 Elsevier Ltd. All rights reserved.

Distracted driving and implications for injury prevention in adults.

PubMed

Hoff, Jane; Grell, Jennifer; Lohrman, Nicole; Stehly, Christy; Stoltzfus, Jill; Wainwright, Gail; Hoff, William S

2013-01-01

Distracted driving, a significant public safety issue, is typically categorized as cell phone use and texting. The increase of distracted driving behavior (DDB) has resulted in an increase in injury and death. The purpose of this study was to identify the frequency and perception of DDB in adults. A 7-question SurveyMonkey questionnaire was distributed to a convenience sample of adults. Standard demographics included age, gender, and highest levels of education. Primary outcome questions were related to frequency of DDB, and overall perceptions specific to distracted driving. Results were compared on the basis of demographics. Chi-square testing and the Kruskal-Wallis analysis of variance were applied, with statistical significance defined as P ≤ .05. There were 1857 respondents to the survey: 1721 were aged 23-64 years (93%); 1511 were women (81%); 1461 had high school education or greater (79%). A total of 168 respondents (9%) reported being involved in a car accident while distracted. The highest reported frequency of DDB included cell phone use (69%), eating/drinking (67%), and reaching for an object in the care (49%). Younger age (18-34 years) and higher level of education (bachelor's degree or greater) were statistically associated with these DDB; gender demonstrated no statistical significance. Text messaging was reported by 538 respondents (29%), with a statistically significant association with age (18-34 years), higher education (bachelor's degree or greater), and gender (males). A total of 1143 respondents (63%) believed that they could drive safely while distracted. This study demonstrates that DDB in adults is not restricted to reading and sending text messages. Moreover, these results indicated that people fail to perceive the dangers inherent in distracted driving. Prevention and outreach education should not be limited to texting and cell phone use but should target all forms of DDB. The age group 18-34 years should be the primary target in the

Prevalence of self-rated visual impairment among adults with diabetes.

PubMed

Saaddine, J B; Narayan, K M; Engelgau, M M; Aubert, R E; Klein, R; Beckles, G L

1999-08-01

This study estimated the prevalence of self-rated visual impairment among US adults with diabetes and identified correlates of such impairment. Self-reported data from the 1995 Behavioral Risk Factor Surveillance System survey of adults 18 years and older with diabetes were analyzed. Correlates of visual impairment were examined by multiple logistic regression analysis. The prevalence of self-rated visual impairment was 24.8% (95% confidence interval [CI] = 22.3%, 27.3%). Among insulin users, multivariable-adjusted odds ratios were 4.9 (95% CI = 2.6, 9.2) for those who had not completed high school and 1.8 (95% CI = 1.0, 2.8) for those who had completed high school compared with those with higher levels of education. Comparable estimates of odds ratios for nonusers of insulin were 2.2 (95% CI = 1.4, 3.4) and 1.3 (95% CI = 0.9, 2.0), respectively. Among nonusers, the adjusted odds for minority adults were 2.4 (95% CI = 1.0, 3.7) times the odds for non-Hispanic Whites. By these data, 1.6 million US adults with diabetes reported having some degree of visual impairment. Future research on the specific causes of visual impairment may help in estimating the avoidable public health burden.

Reference equations for the six-minute walk distance in the healthy Chinese population aged 18–59 years

PubMed Central

Zou, He; Zhu, Xiuruo; Zhang, Jia; Wang, Yi; Wu, Xiaozhen; Liu, Fang; Xie, Xiaofeng

2017-01-01

Background The six-minute walk test (6MWT) is a safe, simple, inexpensive tool for evaluating the functional exercise capacity of patients with chronic respiratory disease. However, there is a lack of standard reference equations for the six-minute walk distance (6MWD) in the healthy Chinese population aged 18–59 years. Aims The purposes of the present study were as follows: 1) to measure the anthropometric data and walking distance of a sample of healthy Chinese Han people aged 18–59 years; 2) to construct reference equations for the 6MWD; 3) to compare the measured 6MWD with previously published equations. Method The anthropometric data, demographic information, lung function, and walking distance of Chinese adults aged 18–59 years were prospectively measured using a standardized protocol. We obtained verbal consent from all the subjects before the test, and the study design was approved by the ethics committee of Wenzhou People's Hospital. The 6MWT was performed twice, and the longer distance was used for further analysis. Results A total of 643 subjects (319 females and 324 males) completed the 6MWT, and average walking distance was 601.6±55.51 m. The walking distance was compared between females and males (578±49.85 m vs. 623±52.53 m; p < 0.0001) and between physically active subjects and sedentary subjects (609.3±56.17 m vs. 592±53.23 m; p < 0.0001). Pearson’s correlation indicated that the 6MWD was significantly correlated with various demographic and the 6MWT variables, such as age, height, weight, body mass index (BMI), heart rate after the test and the difference in the heart rate before and after the test. Stepwise multiple regression analysis showed that age and height were independent predictors associated with the 6MWD. The reference equations from white, Canadian and Chilean populations tended to overestimate the walking distance in our subjects, while Brazilian and Arabian equations tended to underestimate the walking distance. There

Corrosion-resistant amorphous metallic films of Mo49Cr33B18 alloy

NASA Technical Reports Server (NTRS)

Ramesham, R.; Distefano, S.; Fitzgerald, D.; Thakoor, A. P.; Khanna, S. K.

1987-01-01

Corrosion-resistant amorphous metallic alloy films of Mo49Cr33B18 with a crystallization temperature of 590 C were deposited onto glass and quartz substrates by magnetron sputter-quench technique. The amorphous nature of the films was confirmed by their diffuse X-ray diffraction patterns. The deposited films are densely packed (zone T) and exhibit low stress and good adhesion to the substrate. Corrosion current of as-deposited coating of MoCrB amorphous metallic alloy is approximately three orders of magnitude less than the corrosion current of 304 stainless steel in 1N H2SO4 solution.

Comparison of the Handy Eye Chart and the Lea Symbols Chart in a population of deaf children aged 7–18 years

PubMed Central

Gorham, John Paul; Bruce, Beau B.; Hutchinson, Amy K.

2016-01-01

Purpose To compare the results of visual acuity testing in a population of deaf children using the Handy Eye Chart versus the Lea Symbols Chart and to compare testability and preference between charts. Methods A total of 24 participants were recruited at the Atlanta Area School for the Deaf. Visual Acuity was evaluated using the Handy Eye Chart and the Lea Symbols Chart. Patient preference and duration of testing were measured. Results The mean difference between the visual acuity as measured by each chart was –0.02 logMAR (95% CI, −0.06 to 0.03). Testing with the Handy Eye Chart was an average of 13.79 seconds faster than testing with the Lea Symbols Chart (95% CI, 1.1–26.47; P = 0.03). Of the 24 participants, 17 (71%) preferred the Handy Eye Chart (95% CI: 49%–87%; P = 0.07). Conclusions The Handy Eye Chart is a fast, valid, and preferred tool for measuring visual acuity in deaf children age 7–18 years. Additional research is needed to evaluate the utility of the Handy Eye Chart in younger children and deaf adults. PMID:27164427

Fingolimod Prescribed for the Treatment of Multiple Sclerosis in Patients Younger Than Age 18 Years.

PubMed

Fragoso, Yara Dadalti; Alves-Leon, Soniza Vieira; Barreira, Amilton Antunes; Callegaro, Dagoberto; Brito Ferreira, Maria Lucia; Finkelsztejn, Alessandro; Gomes, Sidney; Magno Goncalves, Marcus Vinicius; Moraes Machado, Maria Iris; Marques, Vanessa Daccach; Cunha Matta, Andre Palma; Papais-Alvarenga, Regina Maria; Apostolos Pereira, Samira Luisa; Tauil, Carlos Bernardo

2015-08-01

There have been no clinical trials for approval of medications for treating multiple sclerosis in patients younger than age 18 years. All treatments are based on personal experience and data from open observational studies. Fingolimod is an oral drug for multiple sclerosis that has been shown to be efficient and safe in adults. The aim of our study is to describe patients with multiple sclerosis who started treatment with fingolimod before the age of 18 years. Seventeen patients treated with fingolimod were identified in the Brazilian database of children and adolescents with multiple sclerosis. The average time of use of the drug was 8.6 months. Fingolimod showed a good safety and efficacy profile in these patients, all of whom had very active multiple sclerosis. After starting treatment with fingolimod, only one patient had a relapse and a new lesion on magnetic resonance imaging. The patients' degree of disability did not progress. No major adverse events were reported in relation to the first dose of the drug, nor in the short- and medium-term treatment. No patient has been followed for longer than 18 months, thus limiting long-term conclusions. Off-label use of fingolimod in patients younger than age 18 years may be a good therapeutic option for multiple sclerosis control. Copyright © 2015 Elsevier Inc. All rights reserved.

Comparison of intensive, pediatric-inspired therapy with non-intensive therapy in older adults aged 55-65 years with Philadelphia chromosome-negative acute lymphoblastic leukemia.

PubMed

Ribera, Josep-Maria; García, Olga; Gil, Cristina; Mercadal, Santiago; García-Cadenas, Irene; Montesinos, Pau; Barba, Pere; Vives, Susana; González-Campos, José; Tormo, Mar; Esteve, Jordi; López, Aurelio; Moreno, María José; Ribera, Jordi; Alonso, Natalia; Bermúdez, Arancha; Amigo, María Luz; Genescà, Eulàlia; García, Daniel; Vall-Llovera, Ferran; Bergua, Juan Miguel; Guàrdia, Ramon; Monteserín, María Carmen; Bernal, Teresa; Calbacho, María; Martínez, María Pilar; Feliu, Evarist

2018-05-01

The standardization of treatment of older adults with Philadelphia chromosome negative (Ph-) acute lymphoblastic leukemia (ALL) is challenging, especially in the age range of 55-65 years. This study aimed to compare intensive, pediatric-inspired therapy with non-intensive therapy in this population of patients. The outcomes of 67 patients prospectively included in two consecutive pediatric-inspired intensive protocols (ALL-HR03 and ALL-HR11) from the Spanish PETHEMA Group were compared with those from 44 patients included in a contemporary semi-intensive protocol (ALL-OLD07). Baseline patient and ALL characteristics were similar in both groups, except for a younger median age in the intensive group (medians: 58 vs. 62 years). Patients treated intensively had a higher complete remission rate (85% vs. 64%, p = 0.005), a lower cumulative incidence of relapse (39% [95%CI, 25% to 52%] vs. 60% [95%CI, 38% to 77%], p = .003), a similar cumulative incidence of treatment-related mortality (28% [95% CI, 18%, 40%] vs. 21% [95% CI, 10%, 34%]) and superior event-free survival at 2 years (37% [95%CI, 25%-49%) vs. 21% [8%-34%], p = 0.002). On multivariable analysis the type of protocol was the only variable with independent significance for event-free survival (HR [95% CI]: 2 [1.3, 3], p = .002). Compared with less intensive chemotherapy, pediatric-inspired intensive chemotherapy significantly improves the outcome of older adults with Ph-negative ALL in the age range of 55-65 years. Copyright © 2018 Elsevier Ltd. All rights reserved.

Your Child's Development: 1.5 Years (18 Months)

MedlinePlus

... 5 Years (18 Months) Print en español El desarrollo de su hijo: 1,5 años (18 meses) ... takes off some clothes scribbles with a crayon Social and Emotional Development begins to engage in pretend ...

Pattern of non-trauma emergency department resource utilization in older adults: An 8-year experience in Taiwan.

PubMed

Chang, Julia Chia-Yu; Yuan, Zih-Han; Lee, I-Hsin; Hsu, Teh-Fu; How, Chorng-Kuang; Yen, David Hung-Tsang

2018-06-01

To describe the patterns of non-trauma emergency department (ED) resource utilization, cost of visit, acuity level, and admission rate in older adult patients in Taiwan. This is a retrospective observational cohort study conducted at the Taipei Veterans General Hospital with an annual ED population of 80,000 patients. Patients aged ≥20 years with non-trauma ED visits from 2005 to 2012 were included in the study. We analyzed 441,665 ED visits. Older adult patients had higher ED usage, with the ratio of their ED visit and population being 3.56, 8.34, and 7.64 in the age groups 70-79, 80-89, and ≥90 years, respectively. ED cost, acuity level, and risks of intensive care unit (ICU) admission increased with increasing age. Compared with patients aged 20-29 years, patients aged ≥90 years required almost twice as much ED resources per visit [adjusted risk ratio (aRR), 1.98]. aRRs for high acuity in the age groups 70-79, 80-89, and ≥90 years were 1.96, 1.87, and 1.91, respectively. The risk of ICU admission in the age groups 40-49, 50-59, 70-79, and ≥90 years also increased by 3-fold (aRR, 2.99), 4-fold (aRR, 4.09), >6-fold (aRR, 6.66), and almost 10-fold (aRR, 9.84), respectively, compared with that in the age group 20-29 years. Among patients aged ≥90 years, 2.9% with low acuity still required ICU admission, whereas 25.1% with high acuity required ICU admission. Our study shows that older adult patients are associated with more ED visits and higher acuity, higher ED costs, and higher risks of admission to both the ordinary ward and ICU than younger adult patients. Copyright © 2018. Published by Elsevier Taiwan LLC.

A Maximal Graded Exercise Test to Accurately Predict VO2max in 18-65-Year-Old Adults

ERIC Educational Resources Information Center

George, James D.; Bradshaw, Danielle I.; Hyde, Annette; Vehrs, Pat R.; Hager, Ronald L.; Yanowitz, Frank G.

2007-01-01

The purpose of this study was to develop an age-generalized regression model to predict maximal oxygen uptake (VO sub 2 max) based on a maximal treadmill graded exercise test (GXT; George, 1996). Participants (N = 100), ages 18-65 years, reached a maximal level of exertion (mean plus or minus standard deviation [SD]; maximal heart rate [HR sub…

Choking - unconscious adult or child over 1 year

MedlinePlus

Choking - unconscious adult or child over 1 year; First aid - choking - unconscious adult or child over 1 year; ... or the local emergency number while you begin first aid and CPR. If you are alone, shout for ...

The 48, XXXX/49,XXXXY/49,XXXX,i(Yq) mosaicism in a 3-year-old boy from a twin pregnancy.

PubMed

Kaluzewski, B; Podkul, D; Zaborowska, I; Moruzgala, T; Jakubowski, L

1977-07-26

A 3-year-old boy from twin pregnancy with the features of marked dystrophia from birth, deficient growth, considerable retardation of physical and mental development, numerous somatic defects, suspected congenital heart disease, and hypoplastic external genitalia, is reported. The 48,XXXX/49,XXXXY/49,XXXX,i(Yq) karyotype was diagnosed. The boy's brother, normally developed, had a 46,XY karyotype. It was found on the basis of serologic findings that the brothers were dizygotic twins.

Sequential Cross-Sectional Surveys in Orange Farm, a Township of South Africa, Revealed a Constant Low Voluntary Medical Male Circumcision Uptake among Adults despite Demand Creation Campaigns and High Acceptability

PubMed Central

Marshall, Esaie; Rain-Taljaard, Reathe; Tsepe, Motlalepule; Monkwe, Cornelius; Hlatswayo, Florence; Tshabalala, Simphiwe; Khela, Simphiwe; Xulu, Lindo; Xaba, Dumazile; Molomo, Tebogo; Malinga, Thobile; Puren, Adrian; Auvert, Bertran

2016-01-01

Background WHO recommends a male circumcision (MC) prevalence rate higher than 80% to have a substantial impact on the HIV-AIDS epidemic in Eastern and Southern Africa. Orange Farm, a township in South Africa, has a free-for-service voluntary medical male circumcision (VMMC) clinic in operation since 2008. Following an intense campaign from 2008 to 2010, MC prevalence rate increased to 55.4% (ANRS-12126). Ongoing and past VMMC campaigns focused on youths, through school talks, and adults at a community level. The main objective of the study was to assess the change in MC prevalence rate among adults aged 18–19 and 18–49 years in the past 5 years. Methods A cross-sectional survey (ANRS-12285) was conducted among a random sample of 522 adult men in 2015. MC status and characteristics of participants were collected through a genital examination and a face-to-face questionnaire. Results MC prevalence rate among young adult men aged 18–19 years increased markedly from 61.2% (95%CI: 57.4% to 65.0%) in 2010 to 87.5% (76.0% to 94.6%) in 2015 (p<0.001). In the same period, among men aged 18–49 years, MC prevalence rate varied slightly from 55.4% (53.6% to 57.1%) to 56.7% (52.4% to 60.9%). In 2015, 84.9% (79.2% to 89.5%) of uncircumcised adult men reported that they were willing to be circumcised. However, we estimated that only 4.6% (11/237; 2.5% to 7.9%) of the uncircumcised men underwent circumcision in 2015, despite 117/185 (63.2%; 95%CI: 56.1% to 69.9%) who reported that they were definitely willing to become circumcised. Conclusions In Orange Farm, VMMC campaigns were successful among the youth and led to a sufficiently high MC prevalence rate to have a substantial impact in the future on the HIV-AIDS epidemic. However, despite high acceptability and a free VMMC service, VMMC campaigns since 2010 have failed to increase MC prevalence rate among adults to above 80%. These campaigns should be revisited. PMID:27427957

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

Spanish normative studies in young adults (NEURONORMA young adults project): norms for Stroop Color-Word Interference and Tower of London-Drexel University tests.

PubMed

Rognoni, T; Casals-Coll, M; Sánchez-Benavides, G; Quintana, M; Manero, R M; Calvo, L; Palomo, R; Aranciva, F; Tamayo, F; Peña-Casanova, J

2013-03-01

The Stroop Color-Word Interference Test (Stroop) measures cognitive flexibility, selective attention, cognitive inhibition and information processing speed. The Tower of London-Drexel University version test (TOL) assesses higher-order problem solving and executive planning abilities. In this study, as part of the Spanish normative studies project in young adults (NEURONORMA young adults), we present normative data for the Stroop and young adults TOL tests. The sample consisted of 179 participants who are cognitively normal and range in age from 18 to 49 years. Tables are provided to convert raw scores to scaled scores. Scores adjusted for sociodemographic factors were obtained by applying linear regression techniques. No effects were found for age and sex in either test. Educational level impacted most of the Stroop test variables and some of the TOL scores (Total Moves score and Total Initiation Time score). The norms obtained will be extremely useful in the clinical evaluation of young Spanish adults. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

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.

Ten-Year Trends (2000-2010) of Overweight and Obesity Prevalence among the Young and Middle-Aged Adult Population of the Balearic Islands, a Mediterranean Region.

PubMed

Coll, Josep L; Bibiloni, Maria Del Mar; Salas, Rogelio; Tur, Josep A

2015-01-01

This article aimed at assessing the 10-year trends (2000-2010) in the prevalence of overweight and obesity among the Balearic Islands' adult population. Body mass index (BMI, kg/m2) for young (18-35 year-olds) and middle-aged (36-55 year-olds) adults living in the Balearics was calculated. Data represented 1,089 people during 1999-2000 and 1,081 people during 2009-2010. The BMI categories were as follows: normal weight (18.5 < 25), overweight (25.0 < 30) and obese (≥30). Weighted frequency estimates and logistic regression analysis were used to calculate overweight and obesity trends. While the prevalence of overweight and obesity mostly remained stable over the 2000-2010 period, the prevalence of obesity increased from 5.1 to 8.3% in young adults (aged 18-35), a 1.66-fold increase in prevalence (95% CI 1.02-2.70) over the study period. Total overweight and obesity prevalence remained stable in the Balearic adult population; however, a rising prevalence of obesity has been observed in young adults, which suggests a need to develop and change current strategies in order to reverse the current trends in obesity among this age group. © 2015 S. Karger AG, Basel.

Metabolic signatures of birthweight in 18 288 adolescents and adults

PubMed Central

Würtz, Peter; Wang, Qin; Niironen, Marjo; Tynkkynen, Tuulia; Tiainen, Mika; Drenos, Fotios; Kangas, Antti J; Soininen, Pasi; Skilton, Michael R; Heikkilä, Kauko; Pouta, Anneli; Kähönen, Mika; Lehtimäki, Terho; Rose, Richard J; Kajantie, Eero; Perola, Markus; Kaprio, Jaakko; Eriksson, Johan G; Raitakari, Olli T; Lawlor, Debbie A; Davey Smith, George; Järvelin, Marjo-Riitta; Ala-Korpela, Mika; Auro, Kirsi

2016-01-01

Background: Lower birthweight is associated with increased susceptibility to cardiometabolic diseases in adulthood, but the underlying molecular pathways are incompletely understood. We examined associations of birthweight with a comprehensive metabolic profile measured in adolescents and adults. Methods: High-throughput nuclear magnetic resonance metabolomics and biochemical assays were used to quantify 87 circulating metabolic measures in seven cohorts from Finland and the UK, comprising altogether 18 288 individuals (mean age 26 years, range 15–75). Metabolic associations with birthweight were assessed by linear regression models adjusted for sex, gestational age and age at blood sampling. The metabolic associations with birthweight were compared with the corresponding associations with adult body mass index (BMI). Results: Lower birthweight adjusted for gestational age was adversely associated with cardiometabolic biomarkers, including lipoprotein subclasses, fatty acids, amino acids and markers of inflammation and impaired liver function (P < 0.0015 for 46 measures). Associations were consistent across cohorts with different ages at metabolic profiling, but the magnitudes were weak. The pattern of metabolic deviations associated with lower birthweight resembled the metabolic signature of higher adult BMI (R2 = 0.77) assessed at the same time as the metabolic profiling. The resemblance indicated that 1 kg lower birthweight is associated with similar metabolic aberrations as caused by 0.92 units higher BMI in adulthood. Conclusions: Lower birthweight adjusted for gestational age is associated with adverse biomarker aberrations across multiple metabolic pathways. Coherent metabolic signatures between lower birthweight and higher adult adiposity suggest that shared molecular pathways may potentially underpin the metabolic deviations. However, the magnitudes of metabolic associations with birthweight are modest in comparison to the effects of adiposity, implying

Immunogenicity and safety of Fluzone(®) intradermal and high-dose influenza vaccines in older adults ≥65 years of age: a randomized, controlled, phase II trial.

PubMed

Tsang, Peter; Gorse, Geoffrey J; Strout, Cynthia B; Sperling, Malcolm; Greenberg, David P; Ozol-Godfrey, Ayca; DiazGranados, Carlos; Landolfi, Victoria

2014-05-01

We conducted a randomized, controlled, multicenter, phase II study to evaluate the immunogenicity and safety of an investigational intradermal (ID) trivalent influenza vaccine (TIV) and a high-dose (HD) intramuscular (IM) TIV in older adults (≥65 years of age). Older adult subjects were immunized with ID vaccine containing either 15μg hemagglutinin (HA)/strain (n=636) or 21μg HA/strain (n=634), with HD IM vaccine containing 60μg HA/strain (n=320), or with standard-dose (SD) IM vaccine (Fluzone(®); 15μg HA/strain; n=319). For comparison, younger adults (18-49 years of age) were immunized with SD IM vaccine. In older adults, post-vaccination geometric mean titers induced by the ID vaccines were superior to those induced by the SD IM vaccine for the A/H1N1 and A/H3N2 strains and non-inferior for the B strain. Seroconversion rates induced by the ID vaccines were superior to those induced by the SD IM vaccine in older adults for the A/H1N1 and B strains and non-inferior for the A/H3N2 strain. Results did not differ significantly for the two ID vaccine dosages. Post-vaccination geometric mean titers, seroconversion rates, and most seroprotection rates were significantly higher in HD vaccine recipients than in older adult recipients of the SD IM or ID vaccines and, for most measures, were comparable to those of younger adult SD IM vaccine recipients. Injection-site reactions, but not systemic reactions or unsolicited adverse events, were more common with the ID vaccines than with the IM vaccines. No treatment-related serious adverse events were reported. This study demonstrated that: (1) the ID and HD vaccines were well-tolerated and more immunogenic than the SD IM vaccine in older adults; (2) the HD vaccine was more immunogenic than the ID vaccines in older adults; and (3) the HD vaccine in older adults and the SD IM vaccine in younger adults elicited comparable antibody responses (ClinicalTrials.gov identifier no.: NCT00551031). Copyright © 2014 The Authors

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

Data Resource Profile: The World Health Organization Study on global AGEing and adult health (SAGE)

PubMed Central

Kowal, Paul; Chatterji, Somnath; Naidoo, Nirmala; Biritwum, Richard; Fan, Wu; Lopez Ridaura, Ruy; Maximova, Tamara; Arokiasamy, Perianayagam; Phaswana-Mafuya, Nancy; Williams, Sharon; Snodgrass, J Josh; Minicuci, Nadia; D'Este, Catherine; Peltzer, Karl; Boerma, J Ties; Yawson, A.; Mensah, G.; Yong, J.; Guo, Y.; Zheng, Y.; Parasuraman, P.; Lhungdim, H.; Sekher, TV.; Rosa, R.; Belov, VB.; Lushkina, NP; Peltzer, K.; Makiwane, M.; Zuma, K.; Ramlagan, S.; Davids, A.; Mbelle, N.; Matseke, G.; Schneider, M.; Tabane, C.; Tollman, S.; Kahn, K.; Ng, N.; Juvekar, S.; Sankoh, O.; Debpuur, CY.; Nguyen, TK Chuc; Gomez-Olive, FX.; Hakimi, M.; Hirve, S.; Abdullah, S.; Hodgson, A.; Kyobutungi, C.; Egondi, T.; Mayombana, C.; Minh, HV.; Mwanyangala, MA.; Razzaque, A.; Wilopo, S.; Streatfield, PK.; Byass, P.; Wall, S.; Scholten, F.; Mugisha, J.; Seeley, J.; Kinyanda, E.; Nyirenda, M.; Mutevedzi, P.; Newell, M-L.

2012-01-01

Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization’s Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18–49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007–2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18–49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO’s SAGE website (www.who.int/healthinfo/systems/sage) and WHO’s archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata). PMID:23283715

High resource use among adult congenital heart surgery admissions in adult hospitals: risk factors and association with death and comorbidities.

PubMed

Bhatt, Ami B; Rajabali, Alefiyah; He, Wei; Benavidez, Oscar J

2015-01-01

Adult hospitals are a common location of adult congenital heart disease (ACHD) admissions, including cardiac surgical admissions. Understanding the patterns and predictors of resource use could aid these institutions by identifying and targeting potentially modifiable determinants of high resource use (HRU). Our objectives were to examine resource use during adult congenital heart surgical admissions in adult hospitals, determine the association of HRU with mortality, and identify risk factors for HRU. Population-based retrospective study We obtained data from the Nationwide Inpatient Sample 2005-2009 and examined ACHD surgical admissions ages 18-49 years (n = 16 231). We defined HRU as admissions with >90th percentile for total hospital charges. Despite representing 10% of admissions, HRU admissions accounted for 32% of total charges. HRU admissions had a higher mortality rate (9.7% vs. 1.8%, P < .001). Multivariable analysis demonstrated that HRU is associated with government insurance adjusted odds ratio (AOR) 2.0 (95% confidence interval [CI] 1.6,2.4), emergency admissions AOR 3.9 (95% CI 3.1,4.8), complications AOR 4.2 (95% CI 3.3,5.2), renal failure AOR 1.8 (95% CI 1.4,2.2), congestive heart failure AOR 1.2 (95% CI 1,1.4), surgical complexity risk category-2 AOR 2.0 (95% CI 1.0,3.6), and category-3+ AOR 2.3 (95% CI 1.4,3.8). HRU admissions for adult congenital heart surgery consumed a disproportionate amount of resources and were associated with higher mortality. HRU risk factors included nonelective admissions, government insurance, heart failure, surgical complexity, renal failure, and complications. Complications, if preventable, may be a target for improvement strategies to decrease resource use. Other risk factors may require a broader patient care approach. © 2014 Wiley Periodicals, Inc.

Predictors of non-use of intrauterine contraception among women aged 18-49 years in a general practice setting in the UK.

PubMed

Walker, Susan H; Newton, Victoria L; Hoggart, Lesley; Parker, Mike J

2016-01-01

Our research examined the barriers to the uptake of intrauterine contraception (IUC) by women in a general practice (GP) setting in the UK. This study reports predictors of non-use of IUC in this context. We used a mixed method Qual/Quant approach in which the initial qualitative research provides a framework for subsequent larger quantitative surveys. Utilizing findings derived from 30 qualitative interviews, a quantitative survey was developed and distributed to a pragmatic sample of 1,195 women, aged 18-49 years, who were recruited through 32 participating GP practices in an area of England, UK. Outcome measures were percentage of attributes or responses in the sample and use or non-use of IUC. Results were analyzed using descriptive statistical analysis and binary logistic regression, using use/non-use as a binary response variable. Attitudinal variables, which were the strongest predictors of non-use of IUC, were an adverse opinion on long-acting aspect of IUC (odds ratio [OR]=8.34), disliking the thought of IUC inside the body (OR=3.138), concerns about IUC causing difficulties becoming pregnant in the future (OR=2.587), concerns about womb damage (OR=2.224), having heard adverse opinions about levonorgestrel-releasing intrauterine system (Mirena ® ) (OR=2.551), having an adverse opinion of having light, irregular periods (OR=2.382) and, having an adverse opinion of having no periods (OR=2.018). Concerns about the long-acting nature of IUC and persisting concerns about the safety of IUC may act as barriers to its use. Information for women, tailored to specifically address these concerns, is needed. Clinicians should provide more reassurance and information to potential users of IUC to increase their confidence about the possibility of removing IUC early or on request. They should also specifically seek to alleviate concerns about internal damage, damage to the womb, or damage to future fertility from using the methods.

Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study.

PubMed

Brown, Rebecca T; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B

2016-01-01

Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years), young adulthood (ages 18-25), and middle adulthood (ages 26-49). We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs.

Differences in Long-Term Disease Activity and Treatment of Adult Patients With Childhood-and Adult-Onset Systemic Lupus Erythematosus

PubMed Central

Hersh, Aimee O.; von Scheven, Emily; Yazdany, Jinoos; Panopalis, Pantelis; Trupin, Laura; Julian, Laura; Katz, Patricia; Criswell, Lindsey A.; Yelin, Edward

2009-01-01

Objective To compare differences in long-term outcome between adults with childhood-onset (age at diagnosis <18 years) systemic lupus erythematosus (SLE) and with adult-onset SLE. Methods Data were derived from the University of California Lupus Outcomes Study, a longitudinal cohort of 885 adult subjects with SLE (90 childhood-onset [cSLE], 795 adult-onset [aSLE]). Baseline and 1-year followup data were obtained via structured 1-hour telephone interviews conducted between 2002 and 2006. Using self-report data, differences in organ involvement and disease morbidity, current disease status and activity, past and current medication use, and number of physician visits were compared, based on age at diagnosis of SLE. Results Average disease duration for the cSLE and aSLE subgroups was 16.5 and 13.4 years, respectively, and mean age at followup was 30.5 and 49.9 years, respectively. When compared with aSLE subjects, cSLE subjects had a higher frequency of SLE-related renal disease, whereas aSLE subjects were more likely to report a history of pulmonary disease. Rates of clotting disorders, seizures, and myocardial infarction were similar between the 2 groups. At followup, cSLE subjects had lower overall disease activity, but were more likely to be taking steroids and other immunosuppressive therapies. The total number of yearly physician visits was similar between the 2 groups, although cSLE subjects had a higher number of nephrology visits. Conclusion This study demonstrates important differences in the outcomes of patients with cSLE and aSLE, and provides important prognostic information about long-term SLE disease activity and treatment. PMID:19116979

Driver licensing and reasons for delaying licensure among young adults ages 18-20, United States, 2012.

PubMed

Tefft, Brian C; Williams, Allan F; Grabowski, Jurek G

2014-12-01

Motor vehicle crashes are the leading cause of death for teens and young adults in the United States. Graduated driver licensing (GDL) systems were designed to protect young novice drivers by limiting their exposure to specific risks while they gain experience driving. In the United States, most states' GDL systems only apply to new drivers younger than 18. Some experts suggest that GDL might encourage young people to wait until age 18 to obtain a license, to avoid GDL requirements, resulting in older teenagers having less driving experience and higher crash risk than they might have had without GDL. This study examined the prevalence and timing of licensure among young adults, and explored factors associated with delaying licensure among those not licensed before age 18. An online questionnaire was completed by 1,039 persons aged 18-20 years, recruited from a representative panel of United States households. Main outcome measures were acquisition of driver's license (a) within 12 months of the state minimum age for licensure, (b) before age 18. Associations of timing of licensure with demographic characteristics were assessed using multivariable logistic regression. Respondents not licensed before age 18 were asked to rate the importance of various possible reasons for delaying licensure. 54% of respondents were licensed before age 18. Blacks (37%; adjusted Prevalence Ratio 0.67, 95% Confidence Interval 0.48-0.93) and Hispanics (29%; adjusted Prevalence Ratio 0.60, 95% Confidence Interval 0.45-0.81) were less likely than non-Hispanic whites (67%) to be licensed before age 18. Lower household income was independently associated with delayed licensure (P < .001). The most common self-reported reasons for not becoming licensed sooner were not having a car, being able to get around without driving, and costs associated with driving. There was little evidence that GDL is a major contributor to delayed licensure; however, a substantial minority of young people do

Impact of Georgia's teenage and adult driver responsibility act: 15-year follow-up.

PubMed

Thompson, Nancy J; McGee, Robin E; Feng, Jia

2016-01-01

This study was designed to investigate the 15-year impact of Georgia's graduated drivers' licensing (GDL) law, the "Teenage and Adult Driver Responsibility Act" (TADRA), on fatality crashes among young drivers. Fatality Analysis Reporting System (FARS) data for Georgia and Census denominators were used to determine fatal crash rates (FCRs) of drivers ages 16 through 19 who passed through the Georgia GDL system during the 5.5 years prior to through 15.5 years after TADRA's implementation. FCRs of younger drivers were compared to those of drivers ages 20-54 and 55-75 and compared by gender. Attention was given to speeding- and alcohol-related crashes, 2 foci of TADRA. The decline in FCRs has been maintained and even increased through 15.5 years after passage of the law. Extending the curfew and further limiting passengers (passed in 2001) and driver's education and supervised driving requirements (added in 2007) may have contributed. The greatest declines were among 16- and 17-year-olds; most of the gains were among male drivers. The changes were greatest for alcohol- and speeding-related crashes. Those 18 and 19 years old did not demonstrate an increase in FCR over the period studied. Georgia's graduated licensing law, TADRA, has maintained and in some instances increased in effectiveness over the 15.5 years since its inception. Though national research suggests that GDL laws are associated with increased crash rates among 18- to 19-year-old drivers, this has not occurred in Georgia; 18- and 19-year-olds demonstrated no change or reductions in FCR over the 20.5-year period evaluated. Declines were greatest for those driving behaviors targeted by the law.

Perspectives on care for young adults with type 1 diabetes transitioning from pediatric to adult health systems: A national survey of pediatric endocrinologists.

PubMed

Agarwal, Shivani; Garvey, Katharine C; Raymond, Jennifer K; Schutta, Mark H

2017-11-01

Healthcare transition from pediatric to adult care for young adults (YA) with type 1 diabetes (T1D) is associated with risk of adverse outcomes. Consensus recommendations exist from US professional societies on transition care for YA with T1D, but it is not known whether they have been widely adopted. We describe experiences, barriers, and provider characteristics associated with transition care in a national sample of pediatric endocrinologists. US pediatric endocrinologists identified through the American Medical Association Physician Masterfile were sent an electronic survey. Response rate was 16% (164/1020) representing 32 states. The majority of pediatric endocrinologists (age 44 ± 10; years in practice 12 ± 11) were female (67%) and worked in academic centers (75%). Main reasons for transfer were age (49%) and glycemic control (18%). Barriers to transition included ending long-therapeutic relationships with patients (74%), lack of transition protocols (46%), and perceived deficiencies in adult care (42%). The majority of pediatric endocrinologists reported lack of transition training (68%); those who received training were less likely to have difficulty ending patient relationships [odds ratio (OR) = 0.39, P = .03], more likely to perform patient record transfer to adult systems (OR=1.27, P = .006), and less likely to report patient returns to pediatric care after transfer (OR=0.49, P = .01), independent of endocrinologist gender, years in practice, or practice type. There is wide variation in transition care for YA with T1D among US pediatric endocrinologists despite consensus recommendations. Dissemination of educational programming on transition care and provision of actionable solutions to overcome local health system and perceived barriers is needed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The prevalence of underweight, overweight and obesity and their related socio-demographic and lifestyle factors among adult women in Myanmar, 2015-16

PubMed Central

Hong, Seo Ah; Lwin, Kyi Tun; Aung, La Seng

2018-01-01

Background The aim of the study was to estimate the prevalence of underweight and overweight or obesity and their socio-demographic and lifestyle factors in a female adult population in Myanmar. Material and methods In a national cross-sectional population-based survey in the 2015–16 Myanmar Demographic and Health Survey, 12,160 women aged 18–49 years and not currently pregnant completed questionnaires and anthropometric measurements. Nutritional status was determined using Asian body mass index cut-offs: underweight (BMI<18.5 kg/m2), overweight (23.0–27.4 kg/m2), and obesity (≥27.5 kg/m2). Multinomial logistic regression modelling was used to determine the association between socio-demographic and lifestyle factors and weight status. Results The prevalence of underweight was 14.1%, overweight 28.1% and obesity 13.1%. Among different age groups, the prevalence of underweight was the highest among 18 to 29 year-olds (20.2%), while overweight or obesity was the highest in the age group 30 to 49 years (around 50%). In multinomial logistic regression, being 30 to 49 years old, poorer and richer wealth status, living in all the other regions of Myanmar and ever contraceptive use were inversely and current tobacco use, not working and having less than two children ever born were positively associated with underweight relative to normal weight. Older age, having secondary education, urban residence, wealthier economic status, living with a partner, living in the Northern and Southern regions of Myanmar, having less than two children ever born and having ever used contraceptives were positively and current tobacco use was negatively associated with overweight or obesity relative to normal weight. Conclusions A dual burden of both underweight and overweight or obesity among female adults was found in Myanmar. Sociodemographic and health risk behaviour factors were identified for underweight and overweight or obesity that can guide public health interventions to

Factorial Invariance of the Brief Symptom Inventory-18 (BSI-18) for Adults of Mexican Descent across Nativity Status, Language Format, and Gender

ERIC Educational Resources Information Center

Torres, Lucas; Miller, Matthew J.; Moore, Kelly M.

2013-01-01

The cultural equivalence of psychological outcome measures remains a major area of investigation. The current study sought to test the factor structure and factorial invariance of the Brief Symptom Inventory-18 (BSI-18) with a sample of adult individuals of Mexican descent (N = 923) across nativity status (U.S.- vs. foreign-born), language format…

Adult Literacy and Television: An Annotated Bibliography.

ERIC Educational Resources Information Center

Centre for Literacy, Montreal (Quebec).

This annotated bibliography was developed for the Centre for Literacy of Quebec's 2000 Summer Literacy Institute, "Adult Literacy and Television: Has a Familiar Resource Been Overlooked?" and contains 49 citations of Canadian, British, and American research in the field of adult literacy and television from the 1960s to the year 2000. The…

Demographic Profiles of Adult Trauma During a 5 Year Period (2007-2011) in Kashan, IR Iran.

PubMed

Fazel, Mohammad Reza; Fakharian, Esmaeil; Mahdian, Mehrdad; Mohammadzadeh, Mahdi; Salehfard, Ladan; Ramezani, Maryam

2012-01-01

Trauma, in addition to mortality and disability experienced by an individual, imposes direct and indirect economic and social costs on a community. Traditionally, trauma is a disease of young and middle age adults, an age group which is known to be the most dynamic and economically productive of the community. Increasing our knowledge concerning the etiology and patterns of trauma seems to be the most profitable and accessible way to prevent injuries of this nature. This study was designed to evaluate the epidemiology of adult trauma in Kashan, Iran. The current study used a retrospective cross-sectional approach, enrolling all trauma adults (20 - 60 y) admitted to the Shahid Beheshti Hospital, Kashan, between 2007 and 2011. Age, gender, place of residence, work status, educational level, urban/rural location of the accident, method of transportation to hospital, injured body areas of the victims and therapeutic interventions, were extracted from the data registry and analyzed through descriptive statistics using SPSS software. A total of 22 564 patients were included in this study. Mean age of the victims was 33.18 ± 10.90 years and the male/female ratio was 4:1. Most of the victims were manual workers (61%), and they had completed primary and junior high school level education (49.4%), they were also more likely to be residents of urban areas (88.6%). Regarding the place of injury, most accidents occurred on city streets (43.8%). Approximately 40% of the total victims were transferred to the hospital by emergency medical services (EMS). During the study period, 260 deaths were recorded and among these, 76% were related to traffic accidents. Regarding the high prevalence of trauma found in manual workers with low educational levels and motorbike users, the establishment of an integrated program aimed at improving public knowledge on the use of safety and protective measures in work environments should be implemented. The use of safety protective equipment by

Medication adherence and persistence over time with self-administered TNF-alpha inhibitors among young adult, middle-aged, and older patients with rheumatologic conditions.

PubMed

Calip, Gregory S; Adimadhyam, Sruthi; Xing, Shan; Rincon, Julian C; Lee, Wan-Ju; Anguiano, Rebekah H

2017-10-01

Self-injectable TNF inhibitors are increasingly used early in the chronic treatment of moderate to severe rheumatologic conditions. We estimated medication adherence/persistence over time following initiation in young adult and older adult patients with rheumatoid arthritis, ankylosing spondylitis or psoriatic arthritis. We conducted a retrospective cohort study of patients aged 18+ years newly initiating etanercept, adalimumab, certolizumab pegol, or golimumab using the Truven Health MarketScan Database between 2009 and 2013. Pharmacy dispensing data were used to calculate 12-month medication possession ratios (MPR) and determine adherence (MPR ≥ 0.80) for up to 3 years after starting therapy. Persistence over each 12-month interval was defined as not having a ≥92-day treatment gap. Multivariable generalized estimating equation models were used to calculate odds ratios (OR) and robust 95% confidence intervals (CI) for associations between patient characteristics and repeated adherence/persistence measures over time. Among 53,477 new users, 14% were young adults (18-34 years), 49% middle-aged (35-54 years), and 37% older adults (55+ years). Overall, 37% of patients were adherent and 83% were persistent in the first year of therapy. The lowest adherence (17%) and persistence (70%) were observed among young adult patients by Year +3. Compared to older adults, middle-aged (OR = 0.73, 95% CI: 0.71-0.76) and young adults (OR = 0.50, 95% CI: 0.47-0.53) were less likely to be adherent. Higher Charlson comorbidity scores, hospitalizations, and emergency department visits were associated with non-adherence/non-persistence. We observed low adherence to self-administered TNF inhibitors but most patients remained persistent over time. Further efforts to improve adherence in young adults and patients with greater comorbidity are needed. Copyright © 2017 Elsevier Inc. All rights reserved.

Communications strategies on alcohol and highway safety. Volume 1, Adults 18-55

DOT National Transportation Integrated Search

1975-02-01

The study is in two volumes, the first dealing with adults aged 18-55, the second with high school youth. Both identify target populations and communications strategies for encouraging personal action steps to prevent drunk driving. Fully 54% of adul...

Communications Strategies on Alcohol and Highway Safety. Volume I. Adults 18-55. Final Report.

ERIC Educational Resources Information Center

Grey Advertising, Inc., New York, NY.

The first part of a two-part, two volume study deals with adults aged 18-55 and identifies target populations and communications strategies for encouraging personal action steps to prevent drunk driving. Fully 54% of adult Americans participate once a month in social or business situations where alcohol is served. They are termed Alcohol Related…

Attempts to improve and confidence in improving health behaviour in 40-49 year olds with and without coronary heart disease: The Hordaland Health Study.

PubMed

Solvang, Marte M; Norekvål, Tone M; Tell, Grethe S; Berge, Line I; Iversen, Marjolein M

2016-04-01

While the overall incidence of acute myocardial infarction in Norway decreased in 2001-2009, this was not observed for younger adults. Smoking cessation, physical activity and healthy diet are associated with reduced risk of recurrent cardiovascular events and mortality among individuals with established coronary heart disease (CHD). We investigated whether adults in their 40s with or without CHD had 1) attempted to improve their health behaviour during the previous year, and 2) had confidence in their ability to improve their health behaviour over the next five years. Study participants were 22,019 40-49 year olds from the Hordaland Health Study. Associations between improvements and intentions regarding health behaviours and prevalent CHD were assessed with logistic regression analyses. One hundred and seventy-five (0.8%) participants reported to have CHD. After controlling for demographic, lifestyle and psychosocial variables, attempts to improve health behaviour during the prior year were associated with a threefold increased odds of prevalent CHD (odds ratio 3.07; 95% confidence interval, 1.91-4.95). Confidence in improving health behaviour during the subsequent five years was not associated with increased odds of prevalent CHD. Adults in their 40s with CHD were more likely to have attempted to improve their health behaviour during the past year compared with those without CHD. Healthcare providers should take advantage of these positive attitudes to encourage further positive improvements. © The European Society of Cardiology 2015.

Geriatric-specific triage criteria are more sensitive than standard adult criteria in identifying need for trauma center care in injured older adults.

PubMed

Ichwan, Brian; Darbha, Subrahmanyam; Shah, Manish N; Thompson, Laura; Evans, David C; Boulger, Creagh T; Caterino, Jeffrey M

2015-01-01

We evaluate the sensitivity of Ohio's 2009 emergency medical services (EMS) geriatric trauma triage criteria compared with the previous adult triage criteria in identifying need for trauma center care among older adults. We studied a retrospective cohort of injured patients aged 16 years or older in the 2006 to 2011 Ohio Trauma Registry. Patients aged 70 years or older were considered geriatric. We identified whether each patient met the geriatric and the adult triage criteria. The outcome measure was need for trauma center care, defined by surrogate markers: Injury Severity Score greater than 15, operating room in fewer than 48 hours, any ICU stay, and inhospital mortality. We calculated sensitivity and specificity of both triage criteria for both age groups. We included 101,577 patients; 33,379 (33%) were geriatric. Overall, 57% of patients met adult criteria and 68% met geriatric criteria. Using Injury Severity Score, for older adults geriatric criteria were more sensitive for need for trauma center care (93%; 95% confidence interval [CI] 92% to 93%) than adult criteria (61%; 95% CI 60% to 62%). Geriatric criteria decreased specificity in older adults from 61% (95% CI 61% to 62%) to 49% (95% CI 48% to 49%). Geriatric criteria in older adults (93% sensitivity, 49% specificity) performed similarly to the adult criteria in younger adults (sensitivity 87% and specificity 44%). Similar patterns were observed for other outcomes. Standard adult EMS triage guidelines provide poor sensitivity in older adults. Ohio's geriatric trauma triage guidelines significantly improve sensitivity in identifying Injury Severity Score and other surrogate markers of the need for trauma center care, with modest decreases in specificity for older adults. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Mandibular fractures in a group of Brazilian subjects under 18 years of age: A epidemiological analysis.

PubMed

Muñante-Cárdenas, J L; Asprino, L; De Moraes, M; Albergaria-Barbosa, J R; Moreira, R W F

2010-11-01

This study showed a retrospective analysis of the etiology, incidence and treatment of maxillofacial injuries in a pediatric and adolescent population of the State of Sao Paulo. We analyzed 2986 medical records of victims of facial trauma under 18 years, treated between 1999 and 2008 by the Department of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas, Sao Paulo - Brazil. During this period, 757 patients under 18 were victims of maxillofacial trauma, of which, 112 patients had 139 lines of fracture in the mandible. The most affected age group were male adolescents. The bicycle accidents constituted the main etiology (34.82%). The conservative treatment was used in 51% of cases, and 49% received surgical treatment. Only 5 cases of postoperative complications were identified. The incidence of trauma and mandible fractures in pediatric and adolescent patients was high in the area of study. Bicycle accidents and falls being the main etiological factors. The group of adolescents was most affected. The conservative and surgical treatment was used almost in the same proportion. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Colorectal cancer is a leading cause of cancer incidence and mortality among adults younger than 50 years in the USA: a SEER-based analysis with comparison to other young-onset cancers.

PubMed

Bhandari, Abhishek; Woodhouse, Melissa; Gupta, Samir

2017-02-01

Colorectal cancer (CRC) incidence and mortality are rising among young adults. Our aim was to contrast the relative incidence and mortality of CRC to other common cancers among young adults in the USA. We used Surveillance, Epidemiology, and End Results registry data to compare cancer site-specific and age-specific mortality and incident rates for adults younger than age 50. We summarized extracted data, both overall, and stratified by sex. We found CRC was the third leading cause of cancer death among adults younger than age 50, after breast and lung cancer (1.67 cases per 100,000). Among young women, CRC was the fourth leading cause of cancer death (1.51 per 100,000). Among young men, CRC was the second leading cause of cancer death (1.82 cases per 100,000). CRC was the second most incident cancer among young adults for men and women combined. Among men, CRC was the second most incident cancer after age 30, with 4.9, 9.0, 16.4, and 30.8 cases per 100,000 for ages 30-34, 35-39, 40-44, and 45-49 years, respectively. Among women, CRC incidence was similar with 4.2, 7.6, 15.3, and 25.9 cases per 100,000 for ages 30-34, 35-39, 40-44, and 45-49 years, respectively. These results show that CRC is a leading cause of cancer incidence and mortality among young adults in the USA, relative to other cancers. Given trends toward increasing rates of CRC among young adults, strategies for identifying individuals at risk for young-onset CRC who might benefit from early age of screening initiation merit investigation. Copyright © 2016 American Federation for Medical Research.

Adult scoliosis in patients over sixty-five years of age: outcomes of operative versus nonoperative treatment at a minimum two-year follow-up.

PubMed

Li, Gang; Passias, Peter; Kozanek, Michal; Fu, Eric; Wang, Shaobai; Xia, Qun; Li, Guoan; Rand, Frank E; Wood, Kirkham B

2009-09-15

Retrospective case-control study. The purpose of this study was to compare the self-reported outcomes between operatively and nonoperatively treated patients over the age of 65 with adult scoliosis, using 4 distinct self-assessment questionnaires (SRS-22, SF-12, EQ5D, and Oswestry disability index [ODI]) and standard radiographic measurement parameters. The current spine literature contains no studies that directly compare the self-reported and radiographic outcomes of operatively and nonoperatively treated patients over the age of 65 years with adult scoliosis. We retrospectively analyzed the self-reported outcomes of 83 adult scoliosis in patients over the age of 65 years. A total of 34 patients were treated operatively, whereas 49 patients were managed nonoperatively. For each of these patients, standard radiographic measurements were recorded both before and after treatment, and each patient received 4 questionnaires (SRS-22, SF-12, EQ5D, and ODI) that were completed with a minimum of 2-year follow-up from the time the treatment was initiated. The outcomes of both groups were then statistically compared. As compared to the nonoperative group, the operative group reported significantly better self-assessment scores for the EQ5D index, EQ5D Visual Analogue Score, and SRS-22 questionnaires. However, no statistically significant difference between the groups was detected for the ODI, SF-12 Mental Health Component Summary, and SF-12 PCS. Furthermore, the operative group also had a significant improvement in radiographic measurements. Adult scoliosis patients over the age of 65 years treated operatively had significantly less pain, a better health-related quality of life, self image, mental health, and were more satisfied with their treatment than patients treated conservatively. However, we found no statistically significant differences in their degree of disability as measured by the ODI as well as physical and mental health by the SF-12 instrument. Preoperative

Post-licensure surveillance of trivalent live attenuated influenza vaccine in adults, United States, Vaccine Adverse Event Reporting System (VAERS), July 2005-June 2013.

PubMed

Haber, Penina; Moro, Pedro L; McNeil, Michael M; Lewis, Paige; Woo, Emily Jane; Hughes, Hayley; Shimabukuro, Tom T

2014-11-12

Trivalent live attenuated influenza vaccine (LAIV3) was licensed and recommended for use in 2003 in children and adults 2-49 years of age. Post-licensure safety data have been limited, particularly in adults. We searched Vaccine Adverse Event Reporting System (VAERS) for US reports after LAIV3 from July 1, 2005-June 30, 2013 (eight influenza seasons) in adults aged ≥ 18 years old. We conducted descriptive analyses and clinically reviewed serious reports (i.e., death, life-threatening illness, hospitalization, prolonged hospitalization, or permanent disability) and reports of selected conditions of interest. We used empirical Bayesian data mining to identify adverse events (AEs) that were reported more frequently than expected. We calculated crude AE reporting rates to VAERS by influenza season. During the study period, VAERS received 1207 LAIV3 reports in adults aged 18-49 years old; 107 (8.9%) were serious, including four death reports. The most commonly reported events were expired drug administered (n=207, 17%), headache (n=192, 16%), and fever (n=133, 11%). The most common diagnostic categories for non-fatal serious reports were neurological (n=40, 39%), cardiovascular (n=14, 14%), and other non-infectious conditions (n=20, 19%). We noted a higher proportion of Guillain-Barré syndrome (GBS) and cardiovascular reports in the Department of Defense (DoD) population compared to the civilian population. Data mining detected disproportional reporting of ataxia (n=15); clinical review revealed that ataxia was a component of diverse clinical entities including GBS. Review of VAERS reports are reassuring, the only unexpected safety concern for LAIV3 identified was a higher than expected number of GBS reports in the DoD population, which is being investigated. Reports of administration of expired LAIV3 represent administration errors and indicate the need for education, training and screening regarding the approved indications. Published by Elsevier Ltd.

Live Attenuated Influenza Vaccine, Trivalent, Is Safe in Healthy Children 18 Months to 4 Years, 5 to 9 Years, and 10 to 18 Years of Age in a Community-Based, Nonrandomized, Open-Label Trial

PubMed Central

Piedra, Pedro A.; Gaglani, Manjusha J.; Riggs, Mark; Herschler, Gayla; Fewlass, Charles; Watts, Matt; Kozinetz, Claudia; Hessel, Colin; Glezen, W. Paul

2006-01-01

Objective Influenza-associated deaths in healthy children that were reported during the 2003–2004 influenza season heightened the public awareness of the seriousness of influenza in children. In 1996–1998, a pivotal phase III trial was conducted in children who were 15 to 71 months of age. Live attenuated influenza vaccine, trivalent (LAIV-T), was shown to be safe and efficacious. In a subsequent randomized, double-blind, placebo-controlled LAIV-T trial in children who were 1 to 17 years of age, a statistically significant increase in asthma encounters was observed for children who were younger than 59 months. LAIV-T was not licensed to children who were younger than 5 years because of the concern for asthma. We report on the largest safety study to date of the recently licensed LAIV-T in children 18 months to 4 years, 5 to 9 years, and 10 to 18 years of age in a 4-year (1998–2002) community-based trial that was conducted at Scott & White Memorial Hospital and Clinic (Temple, TX). Methods An open-label, nonrandomized, community-based trial of LAIV-T was conducted before its licensure. Medical records of all children were surveyed for serious adverse events (SAEs) 6 weeks after vaccination. Health care utilization was evaluated by determining the relative risk (RR) of medically attended acute respiratory illness (MAARI) and asthma rates at 0 to 14 and 15 to 42 days after vaccination compared with the rates before vaccination. Medical charts of all visits coded as asthma were reviewed for appropriate classification of events: acute asthma or other. We evaluated the risk for MAARI (health care utilization for acute respiratory illness) 0 to 14 and 15 to 42 days after LAIV-T by a method similar to the postlicensure safety analysis conducted on measles, mumps, and rubella and on diphtheria, tetanus, and whole-cell pertussis vaccines. Results All children regardless of age were administered a single intranasal dose of LAIV-T in each vaccine year. In the 4 years of

Evaluation of anthrax vaccine safety in 18 to 20 year olds: A first step towards age de-escalation studies in adolescents.

PubMed

King, James C; Gao, Yonghong; Quinn, Conrad P; Dreier, Thomas M; Vianney, Cabrini; Espeland, Eric M

2015-05-15

Anthrax vaccine adsorbed (AVA, BioThrax(®)) is recommended for post-exposure prophylaxis administration for the US population in response to large-scale Bacillus anthracis spore exposure. However, no information exists on AVA use in children and ethical barriers exist to performing pre-event pediatric AVA studies. A Presidential Ethics Commission proposed a potential pathway for such studies utilizing an age de-escalation process comparing safety and immunogenicity data from 18 to 20 year-olds to older adults and if acceptable proceeding to evaluations in younger adolescents. We conducted exploratory summary re-analyses of existing databases from 18 to 20 year-olds (n=74) compared to adults aged 21 to 29 years (n=243) who participated in four previous US government funded AVA studies. Data extracted from studies included elicited local injection-site and systemic adverse events (AEs) following AVA doses given subcutaneously at 0, 2, and 4 weeks. Additionally, proportions of subjects with ≥4-fold antibody rises from baseline to post-second and post-third AVA doses (seroresponse) were obtained. Rates of any elicited local AEs were not significantly different between younger and older age groups for local events (79.2% vs. 83.8%, P=0.120) or systemic events (45.4% vs. 50.5%, P=0.188). Robust and similar proportions of seroresponses to vaccination were observed in both age groups. AVA was safe and immunogenic in 18 to 20 year-olds compared to 21 to 29 year-olds. These results provide initial information to anthrax and pediatric specialists if AVA studies in adolescents are required. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pegylated-asparaginase during induction therapy for adult acute lymphoblastic leukaemia: toxicity data from the UKALL14 trial.

PubMed

Patel, B; Kirkwood, A A; Dey, A; Marks, D I; McMillan, A K; Menne, T F; Micklewright, L; Patrick, P; Purnell, S; Rowntree, C J; Smith, P; Fielding, A K

2017-01-01

Safety and efficacy data on pegylated asparaginase (PEG-ASP) in adult acute lymphoblastic leukaemia (ALL) induction regimens are limited. The UK National Cancer Research Institute UKALL14 trial NCT01085617 prospectively evaluated the tolerability of 1000 IU/m 2 PEG-ASP administered on days 4 and 18 as part of a five-drug induction regimen in adults aged 25-65 years with de novo ALL. Median age was 46.5 years. Sixteen of the 90 patients (median age 56 years) suffered treatment-related mortality during initial induction therapy. Eight of the 16 died of sepsis in combination with hepatotoxicity. Age and Philadelphia (Ph) status were independent variables predicting induction death >40 versus ⩽40 years, odds ratio (OR) 18.5 (2.02-169.0), P=0.01; Ph- versus Ph+ disease, OR 13.60 (3.52-52.36), P<0.001. Of the 74 patients who did not die, 37 (50.0%) experienced at least one grade 3/4 PEG-ASP-related adverse event, most commonly hepatotoxicity (36.5%, n=27). A single dose of PEG-ASP achieved trough therapeutic enzyme levels in 42/49 (86%) of the patients tested. Although PEG-ASP delivered prolonged asparaginase activity in adults, it was difficult to administer safely as part of the UKALL14 intensive multiagent regimen to those aged >40 years. It proved extremely toxic in patients with Ph+ ALL, possibly owing to interaction with imatinib.

Pegylated-asparaginase during induction therapy for adult acute lymphoblastic leukaemia: toxicity data from the UKALL14 trial

PubMed Central

Patel, B; Kirkwood, A A; Dey, A; Marks, D I; McMillan, A K; Menne, T F; Micklewright, L; Patrick, P; Purnell, S; Rowntree, C J; Smith, P; Fielding, A K

2017-01-01

Safety and efficacy data on pegylated asparaginase (PEG-ASP) in adult acute lymphoblastic leukaemia (ALL) induction regimens are limited. The UK National Cancer Research Institute UKALL14 trial NCT01085617 prospectively evaluated the tolerability of 1000 IU/m2 PEG-ASP administered on days 4 and 18 as part of a five-drug induction regimen in adults aged 25–65 years with de novo ALL. Median age was 46.5 years. Sixteen of the 90 patients (median age 56 years) suffered treatment-related mortality during initial induction therapy. Eight of the 16 died of sepsis in combination with hepatotoxicity. Age and Philadelphia (Ph) status were independent variables predicting induction death >40 versus ⩽40 years, odds ratio (OR) 18.5 (2.02–169.0), P=0.01; Ph− versus Ph+ disease, OR 13.60 (3.52–52.36), P<0.001. Of the 74 patients who did not die, 37 (50.0%) experienced at least one grade 3/4 PEG-ASP-related adverse event, most commonly hepatotoxicity (36.5%, n=27). A single dose of PEG-ASP achieved trough therapeutic enzyme levels in 42/49 (86%) of the patients tested. Although PEG-ASP delivered prolonged asparaginase activity in adults, it was difficult to administer safely as part of the UKALL14 intensive multiagent regimen to those aged >40 years. It proved extremely toxic in patients with Ph+ ALL, possibly owing to interaction with imatinib. PMID:27480385

Mean systolic and diastolic blood pressure in adults aged 18 and over in the United States, 2001-2008.

PubMed

Wright, Jacqueline D; Hughes, Jeffery P; Ostchega, Yechiam; Yoon, Sung Sug; Nwankwo, Tatiana

2011-03-25

This report presents estimates for the period 2001-2008 of means and selected percentiles of systolic and diastolic blood pressure by sex, race or ethnicity, age, and hypertension status in adults aged 18 and over. Demographic characteristics were collected during a personal interview, and blood pressures were measured during a physician examination. All estimates were calculated using the mean of up to three measurements. The final analytic sample consisted of 19,921 adults aged 18 and over with complete data. Examined sample weights and sample design variables were used to calculate nationally representative estimates and standard error estimates that account for the complex design, using SAS and SUDAAN statistical software. Mean systolic blood pressure was 122 mm Hg for all adults aged 18 and over; it was 116 mm Hg for normotensive adults, 130 mm Hg for treated hypertensive adults, and 146 mm Hg for untreated hypertensive adults. Mean diastolic blood pressure was 71 mm Hg for all adults 18 and over; it was 69 mm Hg for normotensive adults, 75 mm Hg for treated hypertensive adults, and 85 mm Hg for untreated hypertensive adults. There was a trend of increasing systolic blood pressure with increasing age. A more curvilinear trend was seen in diastolic blood pressure, with increasing then decreasing means with age in both men and women. Men had higher mean systolic and diastolic pressures than women. There were some differences in mean blood pressure by race or ethnicity, with non-Hispanic black adults having higher mean systolic and diastolic blood pressures than non-Hispanic white and Mexican-American adults, but these differences were not consistent after stratification by hypertension status and sex. These estimates of the distribution of blood pressure may be useful for policy makers who are considering ways to achieve a downward shift in the population distribution of blood pressure with the goal of reducing morbidity and mortality related to hypertension.

Correlates of human papillomavirus (HPV) vaccination initiation and completion among 18-26 year olds in the United States.

PubMed

Adjei Boakye, Eric; Lew, Daphne; Muthukrishnan, Meera; Tobo, Betelihem B; Rohde, Rebecca L; Varvares, Mark A; Osazuwa-Peters, Nosayaba

2018-04-30

To examine correlates of HPV vaccination uptake in a nationally representative sample of 18-26-year-old adults. Young adults aged 18-26 years were identified from the 2014 and 2015 National Health Interview Survey (n = 7588). Survey-weighted multivariable logistic regression models estimated sociodemographic factors associated with HPV vaccine initiation (≥1 dose) and completion (≥3 doses). Approximately 27% of study participants had initiated the HPV vaccine and 16% had completed the HPV vaccine. Participants were less likely to initiate the vaccine if they were men [(adjusted odds ratio) 0.19; (95% confidence interval) 0.16-0.23], had a high school diploma (0.40; 0.31-0.52) or less (0.46; 0.32-0.64) vs. college graduates, and were born outside the United States (0.52; 0.40-0.69). But, participants were more likely to initiate the HPV vaccine if they visited the doctor's office 1-5 times (2.09; 1.56-2.81), or ≥ 6 times (1.86; 1.48-2.34) within the last 12 months vs. no visits. Odds of completing HPV vaccine uptake followed the same pattern as initiation. And after stratifying the study population by gender and foreign-born status, these variables remained statistically significant. In our nationally representative study, only one out of six 18-26 year olds completed the required vaccine doses. Men, individuals with high school or less education, and those born outside the United States were less likely to initiate and complete the HPV vaccination. Our findings suggest that it may be useful to develop targeted interventions to promote HPV vaccination among those in the catch-up age range.

Revised IAP growth charts for height, weight and body mass index for 5- to 18-year-old Indian children.

PubMed

Khadilkar, Vaman; Yadav, Sangeeta; Agrawal, K K; Tamboli, Suchit; Banerjee, Monidipa; Cherian, Alice; Goyal, Jagdish P; Khadilkar, Anuradha; Kumaravel, V; Mohan, V; Narayanappa, D; Ray, I; Yewale, Vijay

2015-01-01

The need to revise Indian Academy of Pediatrics (IAP) growth charts for 5- to 18-year-old Indian children and adolescents was felt as India is in nutrition transition and previous IAP charts are based on data which are over two decades old. The Growth Chart Committee was formed by IAP in January 2014 to design revised growth charts. Consultative meeting was held in November 2014 in Mumbai. Studies performed on Indian children's growth, nutritional assessment and anthropometry from upper and middle socioeconomic classes in last decade were identified. Committee contacted 13 study groups; total number of children in the age group of 5 to 18 years were 87022 (54086 boys). Data from fourteen cities (Agartala, Ahmadabad, Chandigarh, Chennai, Delhi, Hyderabad, Kochi, Kolkata, Madurai, Mumbai, Mysore, Pune, Raipur and Surat) in India were collated. Data of children with weight for height Z scores >2 SD were removed from analyses. Data on 33148 children (18170 males, 14978 females) were used to construct growth charts using Cole's LMS method. To construct revised IAP growth charts for 5-18 year old Indian children based on collated national data from published studies performed on apparently healthy children and adolescents in the last 10 years. The IAP growth chart committee recommends these revised growth charts for height, weight and body mass index (BMI) for assessment of growth of 5-18 year old Indian children to replace the previous IAP charts; rest of the recommendations for monitoring height and weight remain as per the IAP guidelines published in 2007. To define overweight and obesity in children from 5-18 years of age, adult equivalent of 23 and 27 cut-offs presented in BMI charts may be used. IAP recommends use of WHO standards for growth assessment of children below 5 years of age.

47 CFR 15.233 - Operation within the bands 43.71-44.49 MHz, 46.60-46.98 MHz, 48.75-49.51 MHz and 49.66-50.0 MHz.

Code of Federal Regulations, 2010 CFR

2010-10-01

....100 8 44.160 49.160 9 44.180 49.200 10 44.200 49.240 11 44.320 49.280 12 44.360 49.360 13 44.400 49.400 14 44.460 49.460 15 44.480 49.500 16 46.610 49.670 17 46.630 49.845 18 46.670 49.860 19 46.710 49....970 (c) The field strength of the fundamental emission shall not exceed 10,000 microvolts/meter at 3...

Prenatal famine exposure and adult mortality from cancer, cardiovascular disease, and other causes through age 63 years.

PubMed

Ekamper, Peter; van Poppel, Frans; Stein, Aryeh D; Bijwaard, Govert E; Lumey, L H

2015-02-15

Nutritional conditions in early life may affect adult health, but prior studies of mortality have been limited to small samples. We evaluated the relationship between pre-/perinatal famine exposure during the Dutch Hunger Winter of 1944-1945 and mortality through age 63 years among 41,096 men born in 1944-1947 and examined at age 18 years for universal military service in the Netherlands. Of these men, 22,952 had been born around the time of the Dutch famine in 6 affected cities; the remainder served as unexposed controls. Cox proportional hazards models were used to estimate hazard ratios for death from cancer, heart disease, other natural causes, and external causes. After 1,853,023 person-years of follow-up, we recorded 1,938 deaths from cancer, 1,040 from heart disease, 1,418 from other natural causes, and 523 from external causes. We found no increase in mortality from cancer or cardiovascular disease after prenatal famine exposure. However, there were increases in mortality from other natural causes (hazard ratio = 1.24, 95% confidence interval: 1.03, 1.49) and external causes (hazard ratio = 1.46, 95% confidence interval: 1.09, 1.97) after famine exposure in the first trimester of gestation. Further follow-up of the cohort is needed to provide more accurate risk estimates of mortality from specific causes of death after nutritional disturbances during gestation and very early life. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Spontaneous pneumomediastinum: experience in 18 patients during the last 12 years.

PubMed

Dionísio, Patrícia; Martins, Luís; Moreira, Susana; Manique, Alda; Macedo, Rita; Caeiro, Fátima; Boal, Luísa; Bárbara, Cristina

2017-01-01

To characterize clinically all of the patients with spontaneous pneumomediastinum (SPM) admitted to an adult pulmonology ward in Lisbon, Portugal. This was a retrospective descriptive study of all adult patients (≥ 18 years of age) diagnosed with SPM between January of 2004 and September of 2015. At least one predisposing factor was identified in most (88.9%) of the 18 patients who presented with SPM during the study period. With regard to precipitating factors, bouts of cough were present in 50.0% of the patients. Other precipitating factors included a sudden increase in tobacco consumption, inhaled drug use, occupational inhalation of varnish fumes, intense exercise, and vomiting. The most common complaints were dyspnea (in 83.3%) and chest pain (in 77.8%). Other complaints included cough, neck pain, dysphagia, and odynophagia. Subcutaneous emphysema was found in most of the patients. The diagnosis of SPM was based on chest X-ray findings in 61.1% of the patients. Although SPM is a rare condition, it should be considered in the differential diagnosis of chest pain and dyspnea. It can develop without a triggering event or conclusive findings on a chest X-ray, which is usually sufficient for diagnosis. Caracterizar clinicamente todos os pacientes com pneumomediastino espontâneo (PME) admitidos em uma enfermaria de pneumologia para adultos em Lisboa, Portugal. Estudo descritivo retrospectivo no qual foram analisados todos os pacientes adultos (≥ 18 anos de idade) com diagnóstico de PME entre janeiro de 2004 e setembro de 2015. Pelo menos um fator predisponente foi identificado na maioria (isto é, em 88,9%) dos 18 pacientes que apresentaram PME durante o período de estudo. No tocante a fatores precipitantes, crises de tosse ocorreram em 50,0% dos pacientes. Outros fatores precipitantes foram um aumento repentino do consumo de tabaco, uso de drogas inalatórias, inalação ocupacional de vapores de vernizes, exercício intenso e vômitos. As queixas mais

Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study

PubMed Central

Brown, Rebecca T.; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B.

2016-01-01

Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years), young adulthood (ages 18–25), and middle adulthood (ages 26–49). We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs. PMID:27163478

49 CFR 392.18 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-10-01

... Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS DRIVING OF COMMERCIAL MOTOR VEHICLES Driving of Commercial Motor Vehicles § 392.18 [Reserved] ...

Cyclic stability of superelasticity in the aged [ {bar{1}}23 ]-oriented Ni49Fe18Ga27Co6 single crystals

NASA Astrophysics Data System (ADS)

Panchenko, E. Yu.; Chumlyakov, Yu. I.; Timofeeva, E. E.; Vetoshkina, N. G.; Maier, H.

2013-02-01

The results of investigation of the effect of precipitates of different sizes, from 5 to 300 nm, on the character of stress-induced martensitic transformations, the value of stress hysteresis and cyclic stability of superelasticity in Ni49Fe18Ga27Со6 (at.%) ferromagnetic single crystals oriented along the [ {bar{1}}23 ] axis are presented. It is shown that a martensitic transformation in single crystals of Ni49Fe18Ga27Со6 containing dispersed particles of the γ- and γ'-phases measuring up to 30 nm (ageing at 673 K for 1 and 4 hours) is characterized by storing considerable elastic energy. It is revealed that these single crystals exhibit higher cyclic stability of superelasticity and a narrower stress hysteresis compared to those in the initial state and aged at 823 K for 0.5 hour, the latter containing much larger (150-300 nm) particles.

Costs of treatment and complications of adult type 1 diabetes.

PubMed

Franciosi, M; Lucisano, G; Amoretti, R; Capani, F; Bruttomesso, D; Di Bartolo, P; Girelli, A; Leonetti, F; Morviducci, L; Vitacolonna, E; Nicolucci, A

2013-07-01

Costs associated with diabetes represent a large burden for patients and the health-care system. However, few studies examined the costs for diabetes treatment in adults with type 1 diabetes (T1DM). This analysis was aimed to assess the costs of treatment associated with T1DM among adults in Italy from the national health-care system perspective. Data were collected using a questionnaire assessing resource consumption retrospectively (drugs, visits, diagnostics, hospitalisations and self-monitoring of blood glucose (SMBG)). One-year costs were calculated for the 12 months preceding the survey. Cost estimation, referred to 2006, was carried out using univariate and multivariate Poisson regression models. Fifty-eight centres enrolled 1193 patients (49.5% women; aged between 18 and 55 years, average diabetes duration was 16.1 ± 9.8 years). The average annual cost for an adult patient with TDM1 was € 2450 (95% confidence interval (CI): 2358-2544). Insulin therapy and SMBG accounted together for 71.2% of total costs (35.6% and 35.6%, respectively); the remainder was shared by hospitalisations (18%), visits (4.0%), diagnostics (3.9%) and other drugs (2.9%). Univariate analyses showed that the presence of complications was associated with excess of costs, mainly related to the hospitalisation and drugs. Multivariate analyses confirmed these results showing that the presence of micro-vascular plus macrovascular complications doubles the cost of treatment. Strategies of care for T1DM that can improve disease management and prevent or delay the onset of complications could represent the most important tool to reduce costs in the long term while improving clinical outcomes and quality of life. Copyright © 2012 Elsevier B.V. All rights reserved.

Facts about Meningococcal Disease for Adults

MedlinePlus

... are recommended for routine use in adolescents and young adults through age 18 years. Serogroup B vaccines have ... 2014 and are recommended permissively for adolescents and young adults age 16-23 years. Individuals in this age ...

A 12-year prognosis of adult-onset asthma: Seinäjoki Adult Asthma Study.

PubMed

Tuomisto, Leena E; Ilmarinen, Pinja; Niemelä, Onni; Haanpää, Jussi; Kankaanranta, Terhi; Kankaanranta, Hannu

2016-08-01

Long-term prognosis of adult-onset asthma is poorly known. To evaluate 12-year prognosis of adult-onset asthma and the factors associated with disease prognosis. Seinäjoki Adult-onset Asthma Study (SAAS) is a 12-year real-life single-center follow-up study of new-onset asthma diagnosed at adult age and treated in primary and specialized care. Remission was defined by no symptoms and no asthma medication use for 6 months. Asthma control was evaluated according to Global Initiative for Asthma 2010. Factors associated with current asthma control were analyzed by multinomial multivariate logistic regression. A total of 203 patients (79% of the baseline population) were followed for 12 years. Remission occurred in 6 (3%) patients. In 34% asthma was controlled, in 36% it was partially controlled and in 30% uncontrolled. Uncontrolled asthma was predicted by elevated body-mass index at baseline, smoking (pack-years) and current allergic or persistent rhinitis. Elevated blood eosinophils and good lung function (FEV1) at baseline protected from uncontrolled asthma. In contrast, gender, age at the onset or baseline symptoms (Airways Questionnaire 20) were not significant predictors of uncontrolled disease. During a 12-year follow-up, remission of adult-onset asthma was rare occurring in only 3% of patients. The majority of patients (66%) presented either with uncontrolled or partially controlled asthma. This study is registered at ClinicalTrials.gov with identifier number NCT02733016. Copyright © 2016 Elsevier Ltd. All rights reserved.

Determinants of poor self-rated health among adults in urban Mozambique.

PubMed

Cau, Boaventura M; Falcão, Joana; Arnaldo, Carlos

2016-08-24

Self-rated health is a measure expressing the general condition of health of individuals. Self-rated health studies are common in developed countries and in some developing regions. Despite increasing proportion of adult and older population in sub-Saharan Africa and poor population health indicators, there is a dearth of studies on self-rated health in the region. This study examines factors associated with poor self-rated health among adult individuals in Maputo metropolitan area in Mozambique. Data for this study come from a survey of 1768 individuals aged 18 years or more carried out in Maputo metropolitan area, Mozambique, in 2015. Employing multiple logistic regression, the study used a subsample of 677 female and male respondents aged 40 years or more to estimate the determinants of poor self-rated health. About 54 % of respondents aged 40 years or more believed that their health status was poor. Female respondents [Odds Ratios (OR) = 3.43, p <0.01], single (OR = 4.71, p < 0.05), widow (OR = 1.81, p < 0.05), separated or divorced (OR = 2.08, p < 0.05) and those believing that hypertension or heart problem was a major community health problem (OR = 1.56, p < 0.05) displayed higher odds of reporting poor health than their peers, net of other factors. Furthermore, individuals aged 40-49 years (OR = 0.45, p < 0.01), or 50-59 years (OR = 0.59, p < 0.05), those whose work involves intensive physical activity (OR = 0.60, p < 0.05) and those from households treating drinking water (OR = 0.49, p < 0.01) showed lower odds of reporting poor health, adjusting for other factors. Overall, the results point to the importance of age, gender, marital status, socioeconomic circumstances, individuals' health behaviors and perceived community health problems as key determinants of poor self-rated health among adults in Maputo metropolitan area. Given the growing number of adult and older people in sub

Confirmation of the Three-Factor Model of Problematic Internet Use on Off-Line Adolescent and Adult Samples

PubMed Central

Koronczai, Beatrix; Urbán, Róbert; Kökönyei, Gyöngyi; Paksi, Borbála; Papp, Krisztina; Kun, Bernadette; Arnold, Petra; Kállai, János

2011-01-01

Abstract As the Internet became widely used, problems associated with its excessive use became increasingly apparent. Although for the assessment of these problems several models and related questionnaires have been elaborated, there has been little effort made to confirm them. The aim of the present study was to test the three-factor model of the previously created Problematic Internet Use Questionnaire (PIUQ) by data collection methods formerly not applied (off-line group and face-to-face settings), on the one hand, and by testing on different age groups (adolescent and adult representative samples), on the other hand. Data were collected from 438 high-school students (44.5 percent boys; mean age: 16.0 years; standard deviation=0.7 years) and also from 963 adults (49.9 percent males; mean age: 33.6 years; standard deviation=11.8 years). We applied confirmatory factor analysis to confirm the measurement model of problematic Internet use. The results of the analyses carried out inevitably support the original three-factor model over the possible one-factor solution. Using latent profile analysis, we identified 11 percent of adults and 18 percent of adolescent users characterized by problematic use. Based on exploratory factor analysis, we also suggest a short form of the PIUQ consisting of nine items. Both the original 18-item version of PIUQ and its short 9-item form have satisfactory reliability and validity characteristics, and thus, they are suitable for the assessment of problematic Internet use in future studies. PMID:21711129

Confirmation of the three-factor model of problematic internet use on off-line adolescent and adult samples.

PubMed

Koronczai, Beatrix; Urbán, Róbert; Kökönyei, Gyöngyi; Paksi, Borbála; Papp, Krisztina; Kun, Bernadette; Arnold, Petra; Kállai, János; Demetrovics, Zsolt

2011-11-01

As the Internet became widely used, problems associated with its excessive use became increasingly apparent. Although for the assessment of these problems several models and related questionnaires have been elaborated, there has been little effort made to confirm them. The aim of the present study was to test the three-factor model of the previously created Problematic Internet Use Questionnaire (PIUQ) by data collection methods formerly not applied (off-line group and face-to-face settings), on the one hand, and by testing on different age groups (adolescent and adult representative samples), on the other hand. Data were collected from 438 high-school students (44.5 percent boys; mean age: 16.0 years; standard deviation=0.7 years) and also from 963 adults (49.9 percent males; mean age: 33.6 years; standard deviation=11.8 years). We applied confirmatory factor analysis to confirm the measurement model of problematic Internet use. The results of the analyses carried out inevitably support the original three-factor model over the possible one-factor solution. Using latent profile analysis, we identified 11 percent of adults and 18 percent of adolescent users characterized by problematic use. Based on exploratory factor analysis, we also suggest a short form of the PIUQ consisting of nine items. Both the original 18-item version of PIUQ and its short 9-item form have satisfactory reliability and validity characteristics, and thus, they are suitable for the assessment of problematic Internet use in future studies.

Residential Transitions among Adults with Intellectual Disability across 20 Years

ERIC Educational Resources Information Center

Woodman, Ashley C.; Mailick, Marsha R.; Anderson, Kristy A.; Esbensen, Anna J.

2014-01-01

The present study addresses critical gaps in the literature by examining residential transitions among 303 adults with intellectual disability (ID) over 10 years (Part 1) and 75 adults with Down syndrome over 20 years (Part 2). All adults lived at home at the start of the study, but many moved to a variety of settings. Several characteristics of…

The burden of influenza A and B in Mexico from the year 2010 to 2013: An observational, retrospective, database study, on records from the Directorate General of Epidemiology database.

PubMed

Cortes-Alcala, Ricardo; Dos Santos, Gaël; DeAntonio, Rodrigo; Devadiga, Raghavendra; Ruiz-Matus, Cuitlahuac; Jimenez-Corona, Maria E; Diaz-Quinonez, Jose A; Romano-Mazzotti, Luis; Cervantes-Apolinar, Maria Yolanda; Kuri-Morales, Pablo

2018-05-10

Despite vaccination programs, influenza still represents a significant disease burden in Mexico. We conducted an observational, retrospective analysis to better understand the epidemiological situation of the influenza virus in Mexico. Analysis of the seasonal patterns of influenza A and B were based on the Directorate General of Epidemiology dataset of influenza-like illness(ILI), and severe acute respiratory infection(SARI) that were recorded between January 2010 and December 2013. Our objectives were 1) to describe influenza A and B activity, by age group, and subtype and, 2) to analyze the number of laboratory-confirmed cases presenting with ILI by influenza type, the regional distribution of influenza, and its clinical features. Three periods of influenza activity were captured: August 2010-January 2011, December 2011-March 2012, and October 2012-March 2013. Cases were reported throughout Mexico, with 50.3% (n = 10,320) of cases found in 18-49 year olds. Over the entire capture period, a total of 76,085 ILI/SARI episodes had swab samples analyzed for influenza, 27% were positive. During the same period, influenza A cases were higher in the 18-49 years old, and influenza B cases in both 5-17 and 18-49 age groups. Peak activity occurred in January 2012 (n = 4,159) and December 2012 (n = 348) for influenza A and B respectively. This analysis confirms that influenza is an important respiratory pathogen for children and adults in Mexico despite vaccination recommendations. School-age children and adolescents were more prone to influenza B infection; while younger adults were susceptible to both influenza A and B viruses. Over the seasons, influenza A and B co-circulated.

Whole Lung Irradiation for Adults With Pulmonary Metastases From Ewing Sarcoma

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

Casey, Dana L.; Alektiar, Kaled M.; Gerber, Naamit K.

Purpose: To evaluate feasibility and patterns of failure in adult patients with Ewing sarcoma (ES) treated with whole lung irradiation (WLI) for pulmonary metastases. Methods and Materials: Retrospective review of all ES patients treated at age 18 or older with 12-15 Gy WLI for pulmonary metastases at a single institution between 1990 and 2014. Twenty-six patients met the study criteria. Results: The median age at WLI was 23 years (range, 18-40). The median follow-up time of the surviving patients was 3.8 years (range, 1.0-9.6). The 3-year cumulative incidence of pulmonary relapse (PR) was 55%, with a 3-year cumulative incidence of PR as themore » site of first relapse of 42%. The 3-year event-free survival (EFS) and overall survival (OS) were 38 and 45%, respectively. Patients with exclusively pulmonary metastases had better outcomes than did those with extrapulmonary metastases: the 3-year PR was 45% in those with exclusively lung metastases versus 76% in those with extrapulmonary metastases (P=.01); the 3-year EFS was 49% versus 14% (P=.003); and the 3-year OS was 61% versus 13% (P=.009). Smoking status was a significant prognostic factor for EFS: the 3-year EFS was 61% in nonsmokers versus 11% in smokers (P=.04). Two patients experienced herpes zoster in the radiation field 6 and 12 weeks after radiation. No patients experienced pneumonitis or cardiac toxicity, and no significant acute or late sequelae were observed among the survivors. Conclusion: WLI in adult patients with ES and lung metastases is well tolerated and is associated with freedom from PR of 45% at 3 years. Given its acceptable toxicity and potential therapeutic effect, WLI for pulmonary metastases in ES should be considered for adults, as it is in pediatric patients. All patients should be advised to quit smoking before receiving WLI.« less

Reduced intensity conditioned allograft yields favorable survival for older adults with B-cell acute lymphoblastic leukemia.

PubMed

Rosko, Ashley; Wang, Hai-Lin; de Lima, Marcos; Sandmaier, Brenda; Khoury, H Jean; Artz, Andrew; Brammer, Johnathan; Bredeson, Christopher; Farag, Sherif; Kharfan-Dabaja, Mohamed; Lazarus, Hillard M; Marks, David I; Bufarull, Rodrigo Martino; McGuirk, Joseph; Mohty, Mohamed; Nishihori, Taiga; Nivison-Smith, Ian; Rashidi, Armin; Ringden, Olle; Seftel, Matthew; Weisdorf, Daniel; Bachanova, Veronika; Saber, Wael

2017-01-01

Older adults with B-cell acute lymphoblastic leukemia (B-ALL) have poor survival. We examined the effectiveness of reduced intensity conditioning (RIC) hematopoietic cell transplant (HCT) in adults with B-ALL age 55 years and older and explored prognostic factors associated with long-term outcomes. Using CIBMTR registry data, we evaluated 273 patients (median age 61, range 55-72) with B-ALL with disease status in CR1 (71%), >CR2 (17%) and Primary Induction Failure (PIF)/Relapse (11%), who underwent RIC HCT between 2001 and 2012 using mostly unrelated donor (59%) or HLA-matched sibling (32%). Among patients with available cytogenetic data, the Philadelphia chromosome (Ph+) was present in 50%. The 3-year cumulative incidences of nonrelapse mortality (NRM) and relapse were 25% (95% confidence intervals (CI): 20-31%) and 47% (95% CI: 41-53%), respectively. Three-year overall survival (OS) was 38% (95% CI: 33-44%). Relapse remained the leading cause of death accounting for 49% of all deaths. In univariate analysis, 3 year risk of NRM was significantly higher with reduced Karnofsky performance status (KPS <90: 34% (95% CI: 25-43%) versus KPS ≥90 (18%; 95% CI: 12-24%, P = 0.006). Mortality was increased in older adults (66+ vs. 55-60: Relative Risk [RR] 1.51 95% CI: 1.00-2.29, P = 0.05) and those with advanced disease (RR 2.13; 95% CI: 1.36-3.34, P = 0.001). Survival of patients in CR1 yields 45% (95% CI: 38-52%) at 3 years and no relapse occurred after 2 years. We report promising OS and acceptable NRM using RIC HCT in older patients with B-ALL. Disease status in CR1 and good performance status are associated with improved outcomes. Am. J. Hematol. 92:42-49, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Cognitive Enhancement Therapy for Adults with Autism Spectrum Disorder: Results of an 18-Month Feasibility Study

ERIC Educational Resources Information Center

Eack, Shaun M.; Greenwald, Deborah P.; Hogarty, Susan S.; Bahorik, Amber L.; Litschge, Maralee Y.; Mazefsky, Carla A.; Minshew, Nancy J.

2013-01-01

Adults with autism experience significant impairments in social and non-social information processing for which few treatments have been developed. This study conducted an 18-month uncontrolled trial of Cognitive Enhancement Therapy (CET), a comprehensive cognitive rehabilitation intervention, in 14 verbal adults with autism spectrum disorder to…

[CD(4+) T lymphocyte responses to anti-retroviral therapy, among HIV/AIDS patients aged 18 and over].

PubMed

Guo, X X; Ma, Y; Dou, Z H; Wu, Y S; Zhao, D C; Cai, W P; Li, Y; Dong, X X

2017-06-10

Objective: To compare the differences of CD(4) (+) T lymphocyte (CD(4)) counts between patients aged 18 and over, to explore the effect of age on treatment, 36 months after having received the China National Free AIDS Antiretroviral Treatment on HIV/AIDS. Methods: Through the National ART Information Ssystem, we selected those HIV/AIDS patients who initiated the ART 36 months after the ART, between January 1, 2010 and December 31, 2012 in Guangzhou, Liuzhou and Kunming. Patients were divided into age groups as 18-49, 50-59 and 60 or over year olds, at the baseline of treatment. Under different levels of baseline CD(4) counts, we chose the baseline and different time-point of CD(4) counts as dependent variables, applied mixed linear model to analyze the effects of age, viral suppression, gender, baseline CD(4)/CD(8) ratio and initial treatment regimen. Results: A total of 5 331 HIV/AIDS patients were recruited. No differences were found on age group ratios between different levels of baseline CD(4) counts. At the level of baseline CD(4)<200 cells/μl, both the 50-59 and 60 or above years old groups had lower CD(4) counts than the 18-49 year-old group, within 36 months after the initiation of ART. However, at the baseline CD(4) level of 200-350 cells/μl, no significant differences on CD(4) counts between the 50-59 year-old and 18-49 year-old groups were noticed. CD(4) counts seemed lower in the 60 and above year-old group than in the 18-49 year-old group. Conclusion: Age might serve as an influencing factor on CD(4) counts within 36 months after the initiation of ART, suggesting that earlier initiation of ART might be of help to the recovery of immune function in the 50-59 year-old group.

The Age-Varying Association of Student Status with Excessive Alcohol Use: Ages 18 to 30 Years.

PubMed

Evans-Polce, Rebecca J; Maggs, Jennifer L; Staff, Jeremy; Lanza, Stephanie T

2017-02-01

There is a well-known link between attending college and engaging in excessive alcohol use. This study examines in a national sample how the association between student status and excessive alcohol use changes from late adolescence through young adulthood and whether the association of student status with excessive alcohol use is different for students residing with versus away from parents during the school year. This study used cross-sectional data from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of noninstitutionalized civilian adults residing in the United States. Our analyses included nonhigh school young adults who were ages 18 to 30 years (n = 8,645). Excessive alcohol use included past-year (i) high-intensity drinking (men: ≥10 standard drinks; women: ≥8) and (ii) exceeding weekly drinking guidelines (men: >14 drinks per week; women: >7). Students who resided away from their parents and students who lived with their parents during the school year were compared to nonstudents. Analyses using time-varying effect modeling showed that the relationship of student status with excessive alcohol use varied as a function of age. Overall student status lost its association with excessive alcohol use in the early 20s, after controlling for demographics and other adult social roles. The association between student status and excessive alcohol use also varied considerably across age and depending on whether the student was residing with or away from parents. The association of student status with excessive alcohol use is heterogeneous in terms of both age and living arrangements, suggesting opportunities for interventions targeting problematic alcohol use. Future research should examine additional sources of heterogeneity of students in their risk for excessive alcohol use. Copyright © 2016 by the Research Society on Alcoholism.

Trajectories of problem video gaming among adult regular gamers: an 18-month longitudinal study.

PubMed

King, Daniel L; Delfabbro, Paul H; Griffiths, Mark D

2013-01-01

A three-wave, longitudinal study examined the long-term trajectory of problem gaming symptoms among adult regular video gamers. Potential changes in problem gaming status were assessed at two intervals using an online survey over an 18-month period. Participants (N=117) were recruited by an advertisement posted on the public forums of multiple Australian video game-related websites. Inclusion criteria were being of adult age and having a video gaming history of at least 1 hour of gaming every week over the past 3 months. Two groups of adult video gamers were identified: those players who did (N=37) and those who did not (N=80) identify as having a serious gaming problem at the initial survey intake. The results showed that regular gamers who self-identified as having a video gaming problem at baseline reported more severe problem gaming symptoms than normal gamers, at all time points. However, both groups experienced a significant decline in problem gaming symptoms over an 18-month period, controlling for age, video gaming activity, and psychopathological symptoms.

Validation of fan beam dual energy x ray absorptiometry for body composition assessment in adults aged 18–45 years

PubMed Central

Norcross, J; Van Loan, M D

2004-01-01

Background: Pencil beam dual energy x ray absorptiometry (DXA) has been shown to provide valid estimates of body fat (%BF), but DXA fan beam technology has not been adequately tested to determine its validity. Objective: To compare %BF estimated from fan beam DXA with %BF determined using two and three compartment (2C, 3C) models. Methods: Men (n = 25) and women (n = 31), aged 18–41 years, participated in the study. Body density, from hydrostatic weighing, was used in the 2C estimate of %BF; DXA was used to determine bone mineral content (BMC) for the 3C estimate of %BF calculated using body density and BMC (3CBMC). DXA was also used to determine %BF. Analysis of variance was used to test for significant differences in %BF between sexes and among methods. Results: Women were significantly shorter, weighed less, had less fat free mass, and a higher %BF than men. No significant differences were found among methods (2C, 3CBMC, DXA) for determination of %BF in either sex. Although not significant, Bland-Altman plots showed that DXA gave higher values for %BF than the 2C and 3CBMC methods. Conclusion: DXA determination of %BF was not different from that of the 2C and 3CBMC models in this group of young adults. However, to validate fan beam DXA fully as a method for body composition assessment in a wide range of individuals and populations, comparisons are needed that use a 4C model with a measure of total body water and BMC. PMID:15273189

Educational inequalities in smoking among Japanese adults aged 25-94 years: Nationally representative sex- and age-specific statistics.

PubMed

Tabuchi, Takahiro; Kondo, Naoki

2017-04-01

Few studies have investigated differences in age- and gender-specific educational gradients in tobacco smoking among the whole range of adult age groups. We examined educational inequality in smoking among Japanese adults aged 25-94 years. Using a large nationally representative sample (167,925 men and 186,588 women) in 2010, prevalence of current smoking and heavy smoking among daily smokers and their inequalities attributable to educational attainment were analyzed according to sex and age groups. Among men aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 68.4% (95% confidence interval [CI], 66.0%-70.6%), and graduate school graduates had the lowest at 19.4% (95% CI, 17.2%-21.9%). High school graduates had the second highest current smoking prevalence (e.g., 55.9%; 95% CI, 54.9%-56.8% in men aged 25-34 years). Among men aged 75-94 years, the difference in current smoking across educational categories was small. A similar but steeper educational gradient in current smoking was observed among women. Among women aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 49.3% (95% CI, 46.3%-52.3%), and graduate school graduates had the lowest at 4.8% (95% CI, 2.9%-7.4%). Compared with older age groups, such as 65-94 years, younger age groups, such as 25-54 years, had higher estimates of inequality indicators for educational inequality in both current and heavy smoking in both sexes. Educational inequalities in current and heavy smoking were apparent and large in the young population compared with older generations. The current study provides basic data on educational inequalities in smoking among Japanese adults. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Experience of a year of adult hospital dermatology consultations.

PubMed

Storan, Eoin R; McEvoy, Marian T; Wetter, David A; El-Azhary, Rokea A; Camilleri, Michael J; Bridges, Alina G; Davis, Mark D P

2015-10-01

Dermatology consultations are frequently requested by inpatient hospital services. As inpatient dermatology services in the USA decline, dermatology hospital consultations are becoming increasingly important. We aim to describe the spectrum of skin diseases encountered and the health care subspecialties requesting dermatology hospital consultations. We performed a retrospective chart review of adult patient (age: ≥18 years) dermatology hospital consultations from January 1 to December 31, 2010. We examined patient demographic characteristics, consultation requesting services, and consultation diagnoses. Among dermatology services, 614 patients had 674 separate inpatient dermatology consultations during 2010. Of these patients, 55.9% were male (mean age: 59 years). In total, 205 consultations (30.4%) were requested by the internal medicine subspecialty, 137 (20.3%) by the hematology and oncology subspecialty, and 93 (13.8%) by the surgical subspecialty. The most common conditions seen by the hospital dermatology consulting service were skin infections (n = 125, 18.5%), dermatitis (n = 120, 17.8%), drug eruptions (n = 87, 12.9%), chronic wounds and ulcers (n = 55, 8.1%), cutaneous neoplasms (n = 39, 5.8%), graft-versus-host disease (n = 37, 5.5%), ecchymosis, purpura simplex or petechia (n = 26, 3.8%), intertrigo (n = 21, 3.1%), and urticaria (n = 20, 3.0%). The majority of consultations conducted by the dermatology hospital consulting service were for the management of common skin diseases, such as cutaneous infections, dermatitis, and drug eruptions. Most consultations were requested by the departments of internal medicine, hematology and oncology, and surgical services. © 2014 The International Society of Dermatology.

Year Book of Adult Education in Scotland, 1972-73.

ERIC Educational Resources Information Center

Shearer, J. G. S., Ed.

The Year Book of Adult Education in Scotland for 1972-73 contains: (1) next [new] business; (2) directory of organizations--Scottish Institute of Adult Education, education authorities, the universities, the Workers' Educational Association, Newbattle Abbey College, the Open University, university contribution to adult education H.M. Forces, radio…

Child and Adult Factors Related to Quality of Life in Adults with Autism

ERIC Educational Resources Information Center

Moss, Philippa; Mandy, William; Howlin, Patricia

2017-01-01

The WHO Quality of Life-Brief questionnaire was used to assess quality of life (QoL) among 52 adults with autism (mean age 49 years) followed-up since childhood. Overall, assessments of QOL were more positive than measures of objective social outcome (jobs, independence, relationships etc.) but correlations between caregiver and self-reports were…

Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in adults aged 65 years and older - Advisory Committee on Immunization Practices (ACIP), 2012.

PubMed

2012-06-29

Since 2005, the Advisory Committee on Immunization Practices (ACIP) has recommended a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine booster dose for all adolescents aged 11 through 18 years (preferred at 11 through 12 years) and for those adults aged 19 through 64 years who have not yet received a dose. In October 2010, despite the lack of an approved Tdap vaccine for adults aged 65 years and older, ACIP recommended that unvaccinated adults aged 65 years and older be vaccinated with Tdap if in close contact with an infant, and that other adults aged 65 years and older may receive Tdap. In July 2011, the Food and Drug Administration (FDA) approved expanding the age indication for Boostrix (GlaxoSmithKline Biologicals, Rixensart, Belgium) to aged 65 years and older. In February 2012, ACIP recommended Tdap for all adults aged 65 years and older. This recommendation supersedes previous Tdap recommendations regarding adults aged 65 years and older.

49 CFR 18.36 - Procurement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... should be given to consolidating or breaking out procurements to obtain a more economical purchase. Where... analysis to determine the most economical approach. (5) To foster greater economy and efficiency, grantees... consistent with Federal cost principles (see § 18.22). Grantees may reference their own cost principles that...

BMI Trajectories Associated With Resolution of Elevated Youth BMI and Incident Adult Obesity.

PubMed

Buscot, Marie-Jeanne; Thomson, Russell J; Juonala, Markus; Sabin, Matthew A; Burgner, David P; Lehtimäki, Terho; Hutri-Kähönen, Nina; Viikari, Jorma S A; Jokinen, Eero; Tossavainen, Paivi; Laitinen, Tomi; Raitakari, Olli T; Magnussen, Costan G

2018-01-01

Youth with high BMI who become nonobese adults have the same cardiovascular risk factor burden as those who were never obese. However, the early-life BMI trajectories for overweight or obese youth who avoid becoming obese adults have not been described. We aimed to determine and compare the young-childhood BMI trajectories of participants according to their BMI status in youth and adulthood. Bayesian hierarchical piecewise regression modeling was used to analyze the BMI trajectories of 2717 young adults who had up to 8 measures of BMI from childhood (ages 3-18 years) to adulthood (ages 34-49 years). Compared with those with persistently high BMI, those who resolved their high youth BMI by adulthood had lower average BMI at age 6 years and slower rates of BMI change from young childhood. In addition, their BMI levels started to plateau at 16 years old for females and 21 years old for males, whereas the BMI of those whose high BMI persisted did not stabilize until 25 years old for male subjects and 27 years for female subjects. Compared with those youth who were not overweight or obese and who remained nonobese in adulthood, those who developed obesity had a higher BMI rate of change from 6 years old, and their BMI continued to increase linearly until age 30 years. Efforts to alter BMI trajectories for adult obesity should ideally commence before age 6 years. The natural resolution of high BMI starts in adolescence for males and early adulthood for females, suggesting a critical window for secondary prevention. Copyright © 2018 by the American Academy of Pediatrics.

Adult Education and Literacy. Annual Report. Fiscal Year 1991.

ERIC Educational Resources Information Center

Illinois State Board of Education, Springfield.

This annual report concerning adult education and literacy in Illinois during Fiscal Year 1991 first defines the purpose of adult education, which is to provide adults having less than a high school education with continuing opportunities to function more effectively in society. A section on administration considers state, federal, public…

Drowning in Pretoria, South Africa: A 10-year review.

PubMed

Morris, N K; du Toit-Prinsloo, L; Saayman, G

2016-01-01

Drowning is classified as the 3rd leading cause of accidental deaths worldwide and is deemed to be a preventable cause of death. Bodies retrieved from a water medium pose several challenges to the forensic pathologist with the diagnosis of drowning being primarily one of exclusion. The aim of this study was to do a retrospective descriptive case audit of bodies retrieved from water and immersion related deaths, which were investigated at the Pretoria Medico-Legal Laboratory (PMLL) over a 10 year period (January 2002 through December 2011). A total of 346 cases were identified for inclusion into this study. In 6% (20) of these cases, the death was not related to drowning; in 14% (48) no clear cause of death could be ascertained and in 278 cases (80%) the cause of death was considered to have been due to drowning. Infants (under 1 year, of age) constituted 41 (15%) of the cases; toddlers (aged 1-2 years) comprised 52 (19%) cases; children (aged 2-13 years) 49 (18%) cases; adolescents (aged 13-18 years) comprised 10 (3%) cases; adults (above 18, years) made up 126 (45%) of the cases. The majority of the drownings, occurred in swimming pools [125 cases (38%)]. In infants 23 (56%) of, drownings occurred in swimming pools followed by buckets [7 cases (17%)]. Sixty-nine per cent of toddler drownings (36 cases) occurred in swimming, pools. In the adult population, 40 (32%) of cases occurred in pools and 35 cases (28%) in rivers. Positive blood alcohol results were recorded in 48, (42%) out of 113 cases where the test was requested, 40 (35%) of these, cases higher than 0.05 g per 100 ml. This study suggests that many drowning deaths in Pretoria may be preventable by introducing greater public awareness of the risks and instituting relatively simple, protective measures. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Underdiagnosis of Influenza Virus Infection in Hospitalized Older Adults.

PubMed

Hartman, Lauren; Zhu, Yuwei; Edwards, Kathryn M; Griffin, Marie R; Talbot, H Keipp

2018-03-01

To describe factors associated with provider-ordered influenza testing in hospitalized older adults. Information on participant demographics, symptoms, and provider-ordered influenza testing were collected by questionnaire and chart review. We conducted prospective laboratory-based surveillance using reverse-transcriptase polymerase chain reaction (RT-PCR), the criterion standard for diagnosis of influenza, to determine how participant characteristics and provider-ordered testing affected accurate influenza diagnosis. One academic and three community hospitals in Davidson County, Tennessee. Adults aged 18 and older with acute respiratory illness or nonlocalizing fever (N=1,422). We compared characteristics of participants with and without provider-ordered testing for influenza using the Wilcoxon test and Pearson chi-square test. Multivariable logistic regression models were used to identify factors predictive of provider-ordered influenza testing. Twenty-eight percent (399/1,422) of participants had provider-ordered influenza testing. Participants who were tested were younger than those not tested (58 ± 18 vs 66 ± 15, p<.001) and more likely to have influenza-like illness (ILI) (71% vs 49%, p<.001). ILI decreased with increasing age (aged 18-49, 63%; aged 50-64, 60%; aged ≥65, 48%). ILI and younger age were independent predictors of provider-ordered testing. Of the 136 participants with influenza confirmed using RT-PCR, ILI was the only significant predictor of provider-ordered testing (adjusted odds ratio=3.43, 95% confidence interval=1.22-9.70). Adults aged 65 and older hospitalized with fever or respiratory symptoms during influenza season are less likely to undergo a provider-ordered influenza test than younger adults. Some, but not all, of this disparity is due to a lower likelihood of ILI. Further strategies are needed to increase clinician awareness and testing in this vulnerable group. © 2018, Copyright the Authors Journal compilation © 2018

"Super" Spruce Seedlings Continue Superior Growth for 18 Years

Treesearch

Hans Nienstaedt

1981-01-01

White spruce seedlings--20, 19, 18, and 17 inches tall--were selected among 2-2 transplants; controls from the same beds averaged 7.7 inches tall. After 18 years in the field, the selected seedlings continued to have a 30 percent height growth advantage over the controls. This note discusses how to incorporate super spruce seedlings into a tree breeding program....

Glucose Metabolism Disorders, HIV and Antiretroviral Therapy among Tanzanian Adults

PubMed Central

Maganga, Emmanuel; Smart, Luke R.; Kalluvya, Samuel; Kataraihya, Johannes B.; Saleh, Ahmed M.; Obeid, Lama; Downs, Jennifer A.; Fitzgerald, Daniel W.; Peck, Robert N.

2015-01-01

Introduction Millions of HIV-infected Africans are living longer due to long-term antiretroviral therapy (ART), yet little is known about glucose metabolism disorders in this group. We aimed to compare the prevalence of glucose metabolism disorders among HIV-infected adults on long-term ART to ART-naïve adults and HIV-negative controls, hypothesizing that the odds of glucose metabolism disorders would be 2-fold greater even after adjusting for possible confounders. Methods In this cross-sectional study conducted between October 2012 and April 2013, consecutive adults (>18 years) attending an HIV clinic in Tanzania were enrolled in 3 groups: 153 HIV-negative controls, 151 HIV-infected, ART-naïve, and 150 HIV-infected on ART for ≥ 2 years. The primary outcome was the prevalence of glucose metabolism disorders as determined by oral glucose tolerance testing. We compared glucose metabolism disorder prevalence between each HIV group vs. the control group by Fisher’s exact test and used multivariable logistic regression to determine factors associated with glucose metabolism disorders. Results HIV-infected adults on ART had a higher prevalence of glucose metabolism disorders (49/150 (32.7%) vs.11/153 (7.2%), p<0.001) and frank diabetes mellitus (27/150 (18.0%) vs. 8/153 (5.2%), p = 0.001) than HIV-negative adults, which remained highly significant even after adjusting for age, gender, adiposity and socioeconomic status (OR = 5.72 (2.78–11.77), p<0.001). Glucose metabolism disorders were significantly associated with higher CD4+ T-cell counts. Awareness of diabetes mellitus was <25%. Conclusions HIV-infected adults on long-term ART had 5-fold greater odds of glucose metabolism disorders than HIV-negative controls but were rarely aware of their diagnosis. Intensive glucose metabolism disorder screening and education are needed in HIV clinics in sub-Saharan Africa. Further research should determine how glucose metabolism disorders might be related to immune

Achromobacter xylosoxidans infection in an adult cystic fibrosis unit in Madrid.

PubMed

Llorca Otero, Laura; Girón Moreno, Rosa; Buendía Moreno, Buenaventura; Valenzuela, Claudia; Guiu Martínez, Alba; Alarcón Cavero, Teresa

2016-03-01

Achromobacter xylosoxidans is an emerging pathogen in cystic fibrosis (CF). Although the rate of colonization by this microorganism is variable, prevalence is increasing in CF units. A microbiological/clinical study was conducted on of adult CF patients harboring A. xylosoxidans. Identification and susceptibility testing were performed using MicroScan (Siemens). Decline in lung function was assessed using the variable, annual percentage loss of FEV1 (forced expiratory volume in 1s). A. xylosoxidans was isolated in 18 (19.8%) of 91 patients over a 14-year period. Mean age was 26.6 years (18-39 years). Nine patients (9.8%) were chronically colonized. Piperacillin/tazobactam and imipenem were the most active antibiotics. Mean annual decline in lung function in chronically colonized patients was 2.49%. A. xylosoxidans is a major pathogen in CF. A decreased lung function was observed among patients who were chronically colonized by A. xylosoxidans. Antibiotic therapy should be started early in order to prevent chronic colonization by this microorganism. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Adult-onset intradural spinal teratoma: report of 18 consecutive cases and outcomes in a single center.

PubMed

Wan, Wei; Yang, Cheng; Yan, Wangjun; Liu, Tielong; Yang, Xinghai; Song, Dianwen; Xiao, Jianru

2017-07-01

Eighteen consecutive patients with adult-onset intradural spinal teratoma underwent surgical treatment in our center from 1998 to 2013. Teratoma is defined as a neoplasm composed of elements derived from three germ cell layers (ectoderm, endoderm and mesoderm). Intraspinal teratoma is extremely rare and accounts for 0.2-0.5% of all spinal cord tumors. Moreover, teratoma occurs primarily in neonates and young children. Adult-onset intradural spinal teratoma is even rare. The aim of this study was to discuss the clinical characteristics, diagnosis and therapeutic strategies of adult-onset intradural spinal teratoma. This retrospective study included 18 consecutive adult patients with intradural teratoma who were surgically treated in our center between 1998 and 2013. The clinical features, pathogenesis, diagnostic strategies and surgical outcomes were discussed. Neurological function outcomes were evaluated by the JOA scoring system. Of the 18 included patients, 4 patients received subtotal resection and the other 14 patients received total resection. All the 18 cases were diagnosed with mature teratoma. The mean follow-up period was 79.7 (median 60.5; range 27-208) months. Local recurrence occurred in two of the four patients who underwent subtotal resection and in no patient who underwent total resection. The neurologic status improved in 16 cases and remained unchanged in the other two patients. Adult-onset intradural spinal teratoma is extremely rare. To the best of our knowledge, this is the largest series of patients with this disease. Despite the slow-growth and indolent nature, radical resection remains the recommended treatment to reduce tumor recurrence.

Atomoxetine Treatment for ADHD: Younger Adults Compared with Older Adults

ERIC Educational Resources Information Center

Durell, Todd; Adler, Lenard; Wilens, Timothy; Paczkowski, Martin; Schuh, Kory

2010-01-01

Objective: Atomoxetine is a nonstimulant medication for treating child, adolescent, and adult ADHD. This meta-analysis compared the effects in younger and older adults. Method: A post hoc analysis was conducted using data from two double-blind, placebo-controlled clinical trials. Data from patients aged 18-25 years were compared with data from…

Adolescent and young adult health in a children's hospital: Everybody's business.

PubMed

Tan, Jamie; Cox, Robyn; Shannon, Penny; Payne, Donald

2009-12-01

To guide the development of adolescent health training and the planning of future services, accurate data describing health service use by adolescents and young adults are needed. To describe admission rates for adolescents (12-17 years) and young adults (age 18 years and over) attending a specialist children's hospital over an 8-year period. Specific objectives were to describe the (i) proportion of adolescents and young adults admitted under different specialties; (ii) age range, with emphasis on those 18 years and over; and (iii) proportion of patients admitted to the general adolescent ward. Data on adolescent and young adult admissions to Princess Margaret Hospital (PMH) were collected prospectively from July 2000 to June 2008. Adolescents and young adults accounted for one fifth (range 18-22%) of all admissions to PMH. Over the 8-year period, the number of adolescent and young adult admissions increased from 3935 (54% males) to 4967 (56% males) per year. The proportion admitted to the general adolescent ward ranged from 22% to 36%. The three specialties admitting the most adolescents and young adults were General Surgery (11-13%), Orthopaedics (11-13%) and Oncology/Haematology (10-14%). The age range was: 12-14 years (57-67%); 15-17 (30-39%); 18+ (2-5%). At least 15 patients aged 20 or over were admitted each year, mostly for Dental or Plastic Surgery. Adolescent and young adult health is part of the core business of paediatrics. This should be reflected in the planning of future paediatric services. All trainees require some basic training, regardless of heir specialty area.

What Are Friends for? Friendships and Loneliness Over the Lifespan-From 18 to 79 Years.

PubMed

Nicolaisen, Magnhild; Thorsen, Kirsten

2017-01-01

Preventing and reducing loneliness is crucial to well-being and good health. Social relationships protect people against loneliness. Friendship qualities like intimacy and frequency of contact may vary throughout a person's lifespan. This study explores aspects of friendship and loneliness among people in different age groups: 18 to 29, 30 to 49, 50 to 64, and 65 to 79 years old. Data are from the Norwegian Life Course, Gender and Generations study (N = 14,725). Young people see their friends most often. The proportion of people without confidant friends is higher among older age groups. However, older age groups report higher levels of satisfaction with their contact with friends. Multivariate regression analyses show that the aspiration for contact with friends is more significant to loneliness than actual contact in all age groups. Dissatisfaction with contact with friends is strongly related to loneliness in all age groups. © The Author(s) 2016.

[Metabolic syndrome in adults from 20 to 40 years old in a rural Mexican community].

PubMed

Echavarría-Pinto, Mauro; Hernández-Lomelí, Adrián; Alcocer-Gamba, Marco Antonio; Morales-Flores, Héctor; Vázquez-Mellado, Alberto

2006-01-01

Metabolic syndrome is the main health problem in Mexico. Its two principal complications (ischemic cardiopathy and type-2 diabetes) are the two main causes of death in Mexico since 2000. To describe the prevalence of the metabolic syndrome in adults from 20 to 40 years old in a Mexican rural community (Senegal de Palomas, San Juan del Río, Querétaro) using the National Cholesterol Education Program (NCEP III) definition. A descriptive study with a random sample was carried out. We present a univariate analysis with a 95% confidence interval. 73 cases were studied. The prevalence of the metabolic syndrome was 45.2% slightly higher in men (48.4%) than in women (42.8%). The prevalence of hypertension was 27.3%. The prevalence of obesity was 26.1% using the definition of the WHO and this prevalence rises up to 49.4% using the definition of the Mexican Official Norm. 90.5% of women and 93.5% of men had low HDLc. The prevalence of metabolic syndrome in adults from 20 to 40 years old in this Mexican rural community is much higher than the national mean for the same age cohort. The results show the necessity to increase the research of our rural communities in order to identify the possible causes to this problem and to create therapeutic programs for patients with metabolic syndrome.

Longitudinal patterns of problematic computer game use among adolescents and adults--a 2-year panel study.

PubMed

Scharkow, Michael; Festl, Ruth; Quandt, Thorsten

2014-11-01

To investigate the longitudinal patterns (stability and change) of problematic computer game use and its interdependencies with psychosocial wellbeing in different age groups. Three-wave, annual panel study using computer-assisted telephone surveys. Germany. A total of 112 adolescents aged between 14 and 18 years, 363 younger adults between 19-39 years and 427 adults aged 40 years and older (overall n = 902). Problematic game use was measured with the Gaming Addiction Short Scale (GAS), which covers seven criteria including salience, withdrawal and conflict. Additionally, gaming behaviour and psychosocial wellbeing (social capital and support, life satisfaction and success) were measured in all three panel waves. The generally low GAS scores were very stable in yearly intervals [average autocorrelation across waves and age groups: r = 0.74, confidence interval (CI) = 0.71, 0.77]. Only nine respondents (1%, CI = 0.5, 1.9) consistently exhibited symptoms of problematic game use across all waves, while no respondent could be classified consistently as being addicted according to the GAS criteria. Changes in problematic gaming were not related consistently to changes in psychosocial wellbeing, although some cross-lagged effects were statistically significant in younger and older adult groups. Within a 2-year time-frame, problematic use of computer games appears to be a less stable behaviour than reported previously and not related systematically to negative changes in the gamers' lives. © 2014 Society for the Study of Addiction.

Adults with an epilepsy history, notably those 45-64 years old or at the lowest income levels, more often report heart disease than adults without an epilepsy history.

PubMed

Zack, Matthew; Luncheon, Cecily

2018-06-13

From 95,196 sample adults in the combined 2010, 2013, and 2015 U.S. National Health Interview Survey, we estimated the association between histories of epilepsy and heart disease after accounting for sociodemographic characteristics and behavioral risk factors. Adults 18 years old or older with an epilepsy history reported heart disease (21%) about nine percentage points more often than those without such a history (12%), overall and within levels of characteristics and risk factors. These increases in heart disease history for adults with an epilepsy history compared with adults without such a history were greater in those 45-64 years old or at the lowest family income levels. These increases of heart disease in adults with an epilepsy history highlight two needs-to prevent the occurrence of heart disease and to reduce its consequences. Because comorbidity from heart disease can complicate epilepsy management, physicians caring for those with epilepsy should be aware of these increased risks, identify risk factors for heart disease, and recommend to their patients with epilepsy ways to diminish these risks. Copyright © 2018 Elsevier Inc. All rights reserved.

The prevalence rates of refractive errors among children, adolescents, and adults in Germany.

PubMed

Jobke, Sandra; Kasten, Erich; Vorwerk, Christian

2008-09-01

The prevalence rates of myopia vary between 5% in Australian Aborigines to 84% in Hong Kong and Taiwan, 30% in Norwegian adults, and 49.5% in Swedish schoolchildren. The aim of this study was to determine the prevalence of refractive errors in German children, adolescents, and adults. The parents (aged 24-65 years) and their children (516 subjects aged 2-35 years) were asked to fill out a questionnaire about their refractive error and spectacle use. Emmetropia was defined as refractive status between +0.25D and -0.25D. Myopia was characterized as /=+0.5D. All information concerning refractive error were controlled by asking their opticians. The prevalence rates of myopia differed significantly between all investigated age groups: it was 0% in children aged 2-6 years, 5.5% in children aged 7-11 years, 21.0% in adolescents (aged 12-17 years) and 41.3% in adults aged 18-35 years (Pearson's Chi-square, p = 0.000). Furthermore, 9.8% of children aged 2-6 years were hyperopic, 6.4% of children aged 7-11 years, 3.7% of adolescents, and 2.9% of adults (p = 0.380). The prevalence of myopia in females (23.6%) was significantly higher than in males (14.6%, p = 0.018). The difference between the self-reported and the refractive error reported by their opticians was very small and was not significant (p = 0.850). In Germany, the prevalence of myopia seems to be somewhat lower than in Asia and Europe. There are few comparable studies concerning the prevalence rates of hyperopia.

Injuries at Work in the US Adult Population: Contributions to the Total Injury Burden

PubMed Central

Smith, Gordon S.; Wellman, Helen M.; Sorock, Gary S.; Warner, Margaret; Courtney, Theodore K.; Pransky, Glenn S.; Fingerhut, Lois A.

2005-01-01

Objectives. We estimated the contribution of nonfatal work-related injuries on the injury burden among working-age adults (aged 18–64 years) in the United States. Methods. We used the 1997–1999 National Health Interview Survey (NHIS) to estimate injury rates and proportions of work-related vs non–work-related injuries. Results. An estimated 19.4 million medically treated injuries occurred annually to working-age adults (11.7 episodes per 100 persons; 95% confidence interval [CI]=11.3, 12.1); 29%, or 5.5 million (4.5 per 100 persons; 95% CI=4.2, 4.7), occurred at work and varied by gender, age, and race/ethnicity. Among employed persons, 38% of injuries occurred at work, and among employed men aged 55–64 years, 49% of injuries occurred at work. Conclusions. Injuries at work comprise a substantial part of the injury burden, accounting for nearly half of all injuries in some age groups. The NHIS provides an important source of population-based data with which to determine the work relatedness of injuries. Study estimates of days away from work after injury were 1.8 times higher than the Bureau of Labor Statistics (BLS) workplace-based estimates and 1.4 times as high as BLS estimates for private industry. The prominence of occupational injuries among injuries to working-age adults reinforces the need to examine workplace conditions in efforts to reduce the societal impact of injuries. PMID:15983273

Prevalence, awareness, treatment, control and socio demographic determinants of hypertension in Malaysian adults.

PubMed

Abdul-Razak, Suraya; Daher, Aqil Mohammad; Ramli, Anis Safura; Ariffin, Farnaza; Mazapuspavina, Md Yasin; Ambigga, Krishnapillai S; Miskan, Maizatullifah; Abdul-Hamid, Hasidah; Mat-Nasir, Nafiza; Nor-Ashikin, Mohamed Noor Khan; Ng, Kien Keat; Nawawi, Hapizah; Yusoff, Khalid

2016-04-21

Hypertension is the leading cardiovascular risk factor globally as well as in Malaysia. This study aimed to estimate the prevalence, awareness, treatment, control and the socio demographic determinants of hypertension among Malaysian adults. The analytic sample consisted of 11,288 adults aged ≥ 30 years recruited at baseline in 2007-2011 from the REDISCOVER Study which is an ongoing, prospective cohort study involving 18 urban and 22 rural communities in Malaysia. Socio-demographics, anti-hypertensive treatment details and an average of at least two blood pressure measurements were obtained. The age-adjusted prevalence was 42.0 % (CI: 40.9-43.2) and was higher in men [43.5 % (CI: 41.2-45.0)] than women [41.0 % (CI: 39.8-42.3)]. Participants from rural areas (APR: 1.12, CI: 1.04-1.20); aged at least 40-49 years (APR: 1.86, CI: 1.62-2.14); who were overweight (APR: 1.24, CI: 1.15-1.34) and obese (APR: 1.54, CI: 1.43-1.6) were more likely to have hypertension. The Indigenous ethnic group was less likely to be aware (APR: 0.81, CI: 0.69-0.92) and to be on treatment (APR: 0.66, CI: 0.55-0.79). Those in rural areas were less likely to have their hypertension controlled (APR: 0.61, CI: 0.49-0.75). On the other hand, control was more likely in females (APR: 1.25, CI: 1.01-1.54) and Indigenous group (APR: 1.64, CI: 1.19-2.25). Hypertension is common in the Malaysian adults. The control of hypertension has increased over the years but is still quite low. Public health measures, as well as individual interventions in primary care are crucial to reduce their risk of developing complications.

Association of Autistic Traits With Depression From Childhood to Age 18 Years.

PubMed

Rai, Dheeraj; Culpin, Iryna; Heuvelman, Hein; Magnusson, Cecilia M K; Carpenter, Peter; Jones, Hannah J; Emond, Alan M; Zammit, Stanley; Golding, Jean; Pearson, Rebecca M

2018-06-13

Population-based studies following trajectories of depression in autism spectrum disorders (ASD) from childhood into early adulthood are rare. The role of genetic confounding and of potential environmental intermediaries, such as bullying, in any associations is unclear. To compare trajectories of depressive symptoms from ages 10 to 18 years for children with or without ASD and autistic traits, to assess associations between ASD and autistic traits and an International Statistical Classification of Diseases, 10th Revision (ICD-10) depression diagnosis at age 18 years, and to explore the importance of genetic confounding and bullying. Longitudinal study of participants in the Avon Longitudinal Study of Parents and Children birth cohort in Bristol, United Kingdom, followed up through age 18 years. Data analysis was conducted from January to November 2017. Depressive symptoms were assessed using the Short Mood and Feelings Questionnaire (SMFQ) at 6 time points between ages 10 and 18 years. An ICD-10 depression diagnosis at age 18 years was established using the Clinical Interview Schedule-Revised. Exposures were ASD diagnosis and 4 dichotomized autistic traits (social communication, coherence, repetitive behavior, and sociability). An autism polygenic risk score was derived using the Psychiatric Genomics Consortium autism discovery genome-wide association study summary data. Bullying was assessed at ages 8, 10, and 13 years. The maximum sample with complete data was 6091 for the trajectory analysis (48.8% male) and 3168 for analysis of depression diagnosis at age 18 years (44.4% male). Children with ASD and autistic traits had higher average SMFQ depressive symptom scores than the general population at age 10 years (eg, for social communication 5.55 [95% CI, 5.16-5.95] vs 3.73 [95% CI, 3.61-3.85], for ASD 7.31 [95% CI, 6.22-8.40] vs 3.94 [95% CI, 3.83-4.05], remaining elevated in an upward trajectory until age 18 years (eg, for social communication 7.65 [95% CI, 6

Flight Tests Results from Supersonic Deployment of an 18-Foot Diameter (5.49 meter) Towed Ballute Decelerator

NASA Technical Reports Server (NTRS)

Mayhue, Robert J.; Eckstrom, Clinton V.

1969-01-01

A ram-air-inflated, towed ballute decelerator having a maximum frontal diameter of 18 feet (5.49 meters) was deployed during free flight at a Mach number of 3.15 and a dynamic pressure of 38.5 lb/ft(exp 2) (1843.4 newtons/m(exp 2)). Deployment and extraction of the test ballute were normal but inflation stopped about 1 second after mortar firing and produced an average plateau drag force of 1500 pounds (6.7 kN) for about 1 second. Approximately 30 percent of expected total frontal area was obtained.

Comparative cervical profiles of adult and under-18 front-row rugby players: implications for playing policy

PubMed Central

Hamilton, D F; Gatherer, D; Robson, J; Graham, N; Rennie, N; MacLean, J G B; Simpson, A H R W

2014-01-01

Objective To compare the cervical isometric strength, fatigue endurance and range of motion of adult and under-18 age-grade front-row rugby players to inform the development of a safe age group policy with particular reference to scrummaging. Design Cross-sectional cohort study. Setting ‘Field testing’ at Murrayfield stadium. Participants 30 high-performance under-18 players and 22 adult front-row rugby players. Outcome measures Isometric neck strength, height, weight and grip strength. Results Youth players demonstrated the same height and grip strength as the adult players; however, the adults were significantly heavier and demonstrated substantially greater isometric strength (p<0.001). Only two of the ‘elite’ younger players could match the adult mean cervical isometric strength value. In contrast to school age players in general, grip strength was poorly associated with neck strength (r=0.2) in front-row players; instead, player weight (r=0.4) and the number of years’ experience of playing in the front row (r=0.5) were the only relevant factors in multivariate modelling of cervical strength (R2=0.3). Conclusions Extreme forces are generated between opposing front rows in the scrum and avoidance of mismatch is important if the risk of injury is to be minimised. Although elite youth front-row rugby players demonstrate the same peripheral strength as their adult counterparts on grip testing, the adults demonstrate significantly greater cervical strength. If older youths and adults are to play together, such findings have to be noted in the development of age group policies with particular reference to the scrum. PMID:24797427

Trends in nutritional status and nutrient intakes and correlates of overweight/obesity among rural adult women (≥18-60 years) in India: National Nutrition Monitoring Bureau (NNMB) national surveys.

PubMed

Meshram, I I; Balakrishna, N; Sreeramakrishna, K; Rao, K Mallikharjun; Kumar, R Hari; Arlappa, N; Manohar, G; Reddy, Ch Gal; Ravindranath, M; Kumar, S Sharad; Brahmam, G N V; Laxmaiah, A

2016-04-01

To assess trends in nutrient intakes and nutritional status of rural adult women (≥18-60 years) and the association of sociodemographic characteristics with overweight/obesity. Community-based cross-sectional studies carried out during 1975-79 to 2011-12 by the National Nutrition Monitoring Bureau (NNMB) were used. Anthropometric measurements such as height, weight and waist circumference, carried out during the surveys, were used. Association and logistic regression analyses between sociodemographic characteristics and overweight/obesity and abdominal obesity were conducted using a complex samples procedure. Ten NNMB states of India. Non-pregnant and non-lactating rural women aged ≥18-60 years covered during the above periods from ten states in India. The prevalence of chronic energy deficiency has declined from 52 % during 1975-79 to 34 % during 2011-12, while that of overweight/obesity has increased from 7 % to 24 % during the same period. Median intakes of most of the nutrients have increased over the same period, although they were below recommended levels. The chance of overweight/obesity and abdominal obesity was significantly (P<0·01) higher among women aged 40-60 years, those belonging to Christian religion and other backward communities, women living in pucca houses, literate women, women engaged in service and business, and those having higher per capita income. Prevalence of chronic energy deficiency has declined significantly; however, overweight/obesity has increased during the same period. This increase in overweight/obesity may be attributed to increased consumption of fatty foods, sedentary lifestyle and improved socio-economic status. There is a need to educate the community about regular physical exercise, low intakes of fats and oils, and a balanced diet.

No Clinically Significant Difference Between Adult and Pediatric IKDC Subjective Knee Evaluation Scores in Adults.

PubMed

Stegmeier, Nicole; Oak, Sameer R; O'Rourke, Colin; Strnad, Greg; Spindler, Kurt P; Jones, Morgan; Farrow, Lutul D; Andrish, Jack; Saluan, Paul

Two versions of the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation form currently exist: the original version (1999) and a recently modified pediatric-specific version (2011). Comparison of the pediatric IKDC with the adult version in the adult population may reveal that either version could be used longitudinally. We hypothesize that the scores for the adult IKDC and pediatric IKDC will not be clinically different among adult patients aged 18 to 50 years. Randomized crossover study design. Level 2. The study consisted of 100 participants, aged 18 to 50 years, who presented to orthopaedic outpatient clinics with knee problems. All participants completed both adult and pediatric versions of the IKDC in random order with a 10-minute break in between. We used a paired t test to test for a difference between the scores and a Welch's 2-sample t test to test for equivalence. A least-squares regression model was used to model adult scores as a function of pediatric scores, and vice versa. A paired t test revealed a statistically significant 1.6-point difference between the mean adult and pediatric scores. However, the 95% confidence interval (0.54-2.66) for this difference did not exceed our a priori threshold of 5 points, indicating that this difference was not clinically important. Equivalence testing with an equivalence region of 5 points further supported this finding. The adult and pediatric scores had a linear relationship and were highly correlated with an R 2 of 92.6%. There is no clinically relevant difference between the scores of the adult and pediatric IKDC forms in adults, aged 18 to 50 years, with knee conditions. Either form, adult or pediatric, of the IKDC can be used in this population for longitudinal studies. If the pediatric version is administered in adolescence, it can be used for follow-up into adulthood.

Cognitive abilities predict death during the next 15 years in older Japanese adults.

PubMed

Nishita, Yukiko; Tange, Chikako; Tomida, Makiko; Otsuka, Rei; Ando, Fujiko; Shimokata, Hiroshi

2017-10-01

The longitudinal relationship between cognitive abilities and subsequent death was investigated among community-dwelling older Japanese adults. Participants (n = 1060; age range 60-79 years) comprised the first-wave participants of the National Institute for Longevity Sciences-Longitudinal Study of Aging. Participants' cognitive abilities were measured at baseline using the Japanese Wechsler Adult Intelligence Scale-Revised Short Form, which includes the following tests: Information (general knowledge), Similarities (logical abstract thinking), Picture Completion (visual perception and long-term visual memory) and Digit Symbol (information processing speed). By each cognitive test score, participants were classified into three groups: the high-level group (≥ the mean + 1SD), the low-level group (≤ the mean - 1SD) and the middle-level group. Data on death and moving during the subsequent 15 years were collected and analyzed using the multiple Cox proportional hazard model adjusted for physical and psychosocial covariates. During the follow-up period, 308 participants (29.06%) had died and 93 participants (8.77%) had moved. In the Similarities test, adjusted hazard ratios (HR) of the low-level group to the high-level group were significant (HR 1.49, 95% CI 1.02-2.17, P = 0.038). Furthermore, in the Digit symbol test, the adjusted HR of the low-level group to the high-level group was significant (HR 1.62, 95% CI 1.03-2.58, P = 0.038). Significant adjusted HR were not observed for the Information or Picture Completion tests. It is suggested that a lower level of logical abstract thinking and slower information processing speed are associated with shorter survival among older Japanese adults. Geriatr Gerontol Int 2017; 17: 1654-1660. © 2016 Japan Geriatrics Society.

Identification of Fibroblast Growth Factor-18 as a Molecule to Protect Adult Articular Cartilage by Gene Expression Profiling*

PubMed Central

Mori, Yoshifumi; Saito, Taku; Chang, Song Ho; Kobayashi, Hiroshi; Ladel, Christoph H.; Guehring, Hans; Chung, Ung-il; Kawaguchi, Hiroshi

2014-01-01

To identify genes that maintain the homeostasis of adult articular cartilage and regenerate its lesions, we initially compared four types of chondrocytes: articular (AA) versus growth plate (AG) cartilage chondrocytes in adult rats, and superficial layer (IS) versus deep layer (ID) chondrocytes of epiphyseal cartilage in infant rats. Microarray analyses revealed that 40 and 186 genes had ≥10-fold higher expression ratios of AA/AG and IS/ID, respectively, and 16 genes showed ≥10-fold of both AA/AG and IS/ID ratios. The results were validated by real-time RT-PCR analysis. Among them, Hoxd1, Fgf18, and Esm1 were expressed more strongly in AA than in IS. Fgf18 was the extracellular and secreted factor that decreased glycosaminoglycan release and depletion from the cartilage, and enhanced proliferation of articular chondrocytes. Fgf18 was strongly expressed in the articular cartilage chondrocytes of adult rats. In a surgical rat osteoarthritis model, a once-weekly injection of recombinant human FGF18 (rhFGF18) given 3 weeks after surgery prevented cartilage degeneration in a dose-dependent manner at 6 and 9 weeks after surgery, with significant effect at 10 μg/week of rhFGF18. As the underlying mechanism, rhFGF18 strongly up-regulated Timp1 expression in the cell and organ cultures, and inhibition of aggrecan release by rhFGF18 was restored by addition of an antibody to Timp1. In conclusion, we have identified Fgf18 as a molecule that protects articular cartilage by gene expression profiling, and the anticatabolic effects may at least partially be mediated by the Timp1 expression. PMID:24577103

Surveillance of Vaccination Coverage among Adult Populations - United States, 2015.

PubMed

Williams, Walter W; Lu, Peng-Jun; O'Halloran, Alissa; Kim, David K; Grohskopf, Lisa A; Pilishvili, Tamara; Skoff, Tami H; Nelson, Noele P; Harpaz, Rafael; Markowitz, Lauri E; Rodriguez-Lainz, Alfonso; Fiebelkorn, Amy Parker

2017-05-05

��19 years (a 4.1 percentage point increase to 64.7%). Herpes zoster vaccination coverage in 2015 met the Healthy People 2020 target of 30%. Aside from these modest improvements, vaccination coverage among adults in 2015 was similar to estimates from 2014. Racial/ethnic differences in coverage persisted for all seven vaccines, with higher coverage generally for whites compared with most other groups. Adults without health insurance reported receipt of influenza vaccine (all age groups), pneumococcal vaccine (adults aged 19-64 years at increased risk), Td vaccine (adults aged ≥19 years, 19-64 years, and 50-64 years), Tdap vaccine (adults aged ≥19 years and 19-64 years), hepatitis A vaccine (adults aged ≥19 years overall and among travelers), hepatitis B vaccine (adults aged ≥19 years, 19-49 years, and among travelers), herpes zoster vaccine (adults aged ≥60 years), and HPV vaccine (males and females aged 19-26 years) less often than those with health insurance. Adults who reported having a usual place for health care generally reported receipt of recommended vaccinations more often than those who did not have such a place, regardless of whether they had health insurance. Vaccination coverage was higher among adults reporting one or more physician contacts in the past year compared with those who had not visited a physician in the past year, regardless of whether they had health insurance. Even among adults who had health insurance and ≥10 physician contacts within the past year, depending on the vaccine, 18.2%-85.6% reported not having received vaccinations that were recommended either for all persons or for those with specific indications. Overall, vaccination coverage among U.S.-born adults was higher than that among foreign-born adults, with few exceptions (influenza vaccination [adults aged 19-49 years and 50-64 years], hepatitis A vaccination [adults aged ≥19 years], and hepatitis B vaccination [adults aged ≥19 years with diabetes or chronic liver

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.

Mortality Among Homeless Adults in Boston: Shifts in Causes of Death Over a 15-year Period

PubMed Central

Baggett, Travis P.; Hwang, Stephen W.; O'Connell, James J.; Porneala, Bianca C.; Stringfellow, Erin J.; Orav, E. John; Singer, Daniel E.; Rigotti, Nancy A.

2013-01-01

Background Homeless persons experience excess mortality, but U.S.-based studies on this topic are outdated or lack information about causes of death. No studies have examined shifts in causes of death for this population over time. Methods We assessed all-cause and cause-specific mortality rates in a cohort of 28,033 adults aged 18 years or older who were seen at Boston Health Care for the Homeless Program between January 1, 2003, and December 31, 2008. Deaths were identified through probabilistic linkage to the Massachusetts death occurrence files. We compared mortality rates in this cohort to rates in the 2003–08 Massachusetts population and a 1988–93 cohort of homeless adults in Boston using standardized rate ratios with 95% confidence intervals. Results 1,302 deaths occurred during 90,450 person-years of observation. Drug overdose (n=219), cancer (n=206), and heart disease (n=203) were the major causes of death. Drug overdose accounted for one-third of deaths among adults <45 years old. Opioids were implicated in 81% of overdose deaths. Mortality rates were higher among whites than non-whites. Compared to Massachusetts adults, mortality disparities were most pronounced among younger individuals, with rates about 9-fold higher in 25–44 year olds and 4.5-fold higher in 45–64 year olds. In comparison to 1988–93, reductions in HIV deaths were offset by 3- and 2-fold increases in deaths due to drug overdose and psychoactive substance use disorders, resulting in no significant difference in overall mortality. Conclusions The all-cause mortality rate among homeless adults in Boston remains high and unchanged since 1988–93 despite a major interim expansion in clinical services. Drug overdose has replaced HIV as the emerging epidemic. Interventions to reduce mortality in this population should include behavioral health integration into primary medical care, public health initiatives to prevent and reverse drug overdose, and social policy measures to end

Evidence for a young adult-targeted tobacco control campaign stimulating cessation-related responses among adult smokers and recent quitters.

PubMed

Li, Judy; Guiney, Hayley; Walton, Darren

2016-02-19

Young adults are an important group for tobacco control interventions because of their high smoking prevalence. In 2014, New Zealand launched a young adult-targeted tobacco control campaign: 'Stop Before You Start'. The evaluation undertaken with young adults (aged 18 to 24 years) showed that the campaign exerted positive impacts on this age group. This study aimed to investigate the collateral effects of this campaign on older adults. Data were collected from a fortnightly survey of adult smokers and recent quitters, where respondents were maintained on a panel and interviewed every fortnight, up to six times. This paper reports on data collected over three consecutive fortnights (540 interviews). Ten measures were used to assess campaign effectiveness (eg, felt regret, tried to quit). After adjusting for recent quit attempt status and socio-demographic characteristics, age differences were not found in any of the outcome variables (aged 25-44 years and 45+ years were compared against 18-24 years). Internationally, little is known about the effectiveness of young adult-targeted tobacco control campaigns. Alongside data from the campaign evaluation with young adults, findings from the current study suggest that this young adult-targeted campaign also created a desirable impact on older adults.

Clinically Relevant Cognitive Impairment in Middle-Aged Adults With Childhood-Onset Type 1 Diabetes

PubMed Central

Nunley, Karen A.; Ryan, Christopher M.; Jennings, J. Richard; Aizenstein, Howard J.; Zgibor, Janice C.; Costacou, Tina; Boudreau, Robert M.; Miller, Rachel; Orchard, Trevor J.; Saxton, Judith A.

2015-01-01

OBJECTIVE The aim of this study was to investigate the presence and correlates of clinically relevant cognitive impairment in middle-aged adults with childhood-onset type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS During 2010–2013, 97 adults diagnosed with T1D and aged <18 years (age and duration 49 ± 7 and 41 ± 6 years, respectively; 51% female) and 138 similarly aged adults without T1D (age 49 ± 7 years; 55% female) completed extensive neuropsychological testing. Biomedical data on participants with T1D were collected periodically since 1986–1988. Cognitive impairment status was based on the number of test scores ≥1.5 SD worse than demographically appropriate published norms: none, mild (only one test), or clinically relevant (two or more tests). RESULTS The prevalence of clinically relevant cognitive impairment was five times higher among participants with than without T1D (28% vs. 5%; P < 0.0001), independent of education, age, or blood pressure. Effect sizes were large (Cohen d 0.6–0.9; P < 0.0001) for psychomotor speed and visuoconstruction tasks and were modest (d 0.3–0.6; P < 0.05) for measures of executive function. Among participants with T1D, prevalent cognitive impairment was related to 14-year average A1c >7.5% (58 mmol/mol) (odds ratio [OR] 3.0; P = 0.009), proliferative retinopathy (OR 2.8; P = 0.01), and distal symmetric polyneuropathy (OR 2.6; P = 0.03) measured 5 years earlier; higher BMI (OR 1.1; P = 0.03); and ankle-brachial index ≥1.3 (OR 4.2; P = 0.01) measured 20 years earlier, independent of education. CONCLUSIONS Clinically relevant cognitive impairment is highly prevalent among these middle-aged adults with childhood-onset T1D. In this aging cohort, chronic hyperglycemia and prevalent microvascular disease were associated with cognitive impairment, relationships shown previously in younger populations with T1D. Two additional potentially modifiable risk factors for T1D-related cognitive impairment, vascular health and BMI

49 CFR 1242.30 - Dismantling retired road property and depreciation (accounts XX-17-39, XX-18-39, XX-19-39, 62-17...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Dismantling retired road property and depreciation....30 Dismantling retired road property and depreciation (accounts XX-17-39, XX-18-39, XX-19-39, 62-17..., switching and other) in proportion to the separation of common repair and maintenance expenses associated...

Functional capacities of Polish adults of 60-87 years and risk of losing functional independence.

PubMed

Ignasiak, Zofia; Sławinska, Teresa; Skrzek, Anna; Rożek, Krystyna; Kozieł, Sławomir; Posłuszny, Pawel; Malina, Robert M

2017-09-01

To characterise the functional capacities of Polish men and women aged 60-87 years and evaluate their status relative to criteria for functional independence. Four hundred and thirty-one women and 125 men, aged 60-87 years, who were residents of Wrocław, southwestern Poland, were recruited. Height and weight were measured and BMI was calculated. The Fullerton Functional Fitness Test was administered to test upper and lower body strength, upper and lower body flexibility, agility-dynamic balance and aerobic endurance. The Paffenbarger physical activity questionnaire was completed. Characteristics of individuals classified by the number of tests which equalled or exceeded criterion-referenced standards for functional independence (excluding flexibility) were compared. Polish older adults compared favourably to American reference values. Percentages meeting the criteria for all four, for two or three and for one or no tests were, respectively, 21%, 54% and 25% in women and 37%, 45% and 18% in men. Adults meeting the criteria for all four tests were lighter, with a lower BMI and more physically active than those meeting the criteria on two or three tests and on one or no tests. The majority of Polish older adults were not at risk for loss of physical independence. The most functionally independent adults of both sexes had a lower BMI and less obesity, and were physically more active; the converse was true for those not meeting the criteria.

Mental distress in treatment seeking young adults (18-25 years) with severe obesity compared with population controls of different body mass index levels: cohort study.

PubMed

Dreber, H; Reynisdottir, S; Angelin, B; Tynelius, P; Rasmussen, F; Hemmingsson, E

2017-02-01

Young adults (18-25) with severe obesity constitute a challenging patient group, and there is limited evidence about their mental health status compared to population controls. Mental distress in treatment seeking young adults with severe obesity (n = 121, mean body mass index [BMI] = 39.8 kg m -2 ) was compared with matched (1:3 for age, gender and socioeconomic status) population controls of normal weight (n = 363, mean BMI = 22.4 kg m -2 ), as well as unmatched population controls with class I obesity (n = 105, mean BMI = 32.1 kg m -2 ) or severe obesity (n = 41, mean BMI = 39.7 kg m -2 ). Mental distress was measured by the General Health Questionnaire-12 (GHQ-12), and we quantified physician-diagnosed depression, present anxiety and suicide attempts. Poisson regression and linear regression analysis were used for analysing differences in mental distress between groups. Treatment seekers experienced more mental distress than normal weight controls as measured by continuous (adjusted mean: 3.9 vs. 2.2 points, P <0.001) and categorical (cut-off for mental distress ≥3 points, RR: 1.76, P <0.001) GHQ-12 scores, depression (RR: 2.18, P < 0.001), anxiety (RR: 1.97, P < 0.001) and suicide attempts (RR: 2.04; P = 0.034). Treatment seekers also experienced more mental distress as measured by continuous GHQ-12 than controls with class I obesity (adjusted mean: 2.3 points) or severe obesity (adjusted mean: 2.1; both, P < 0.001). Young adult treatment seekers with severe obesity constitute a risk group for mental distress compared to population controls of different BMI levels. © 2017 World Obesity Federation.

Effect of thyroxine on munc-18 and syntaxin-1 expression in dorsal hippocampus of adult-onset hypothyroid rats

PubMed Central

Zhu, Y.; Ning, D.; Wang, F.; Liu, C.; Xu, Y.; Jia, X.; Zhu, D.

2012-01-01

Adult-onset hypothyroidism induces a variety of impairments on hippocampus- dependent neurocognitive functioningin which many synaptic proteins in hippocampus neurons are involved. Here, we observed the effect of adult-onset hypothyroidism on the expression of syntaxin-1 and munc-18 in the dorsal hippocampus and whether the altered proteins could be restored by levothyroxine (T4) treatment. All rats were separated into 4 groups randomly: hypothyroid group, 5 µg T4 /100 g body weight (BW) treated group, 20 µg T4/100 g BW treated group and control group. The radioimmunoassay kits were applied to assay the levels of serum T3 and T4, and the levels of syntaxin-1 and munc-18 in hippocampus were assessed by immunohistochemistry and Western blot. Both analysis corroborated that syntaxin-1 in the hypothyroid group was significantly higher. Munc-18 was lower in four layers of CA3 and dentate gyrus by immunohistochemistry. After two weeks of treatment with 5 µg T4/100 g BW for hypothyroidism, syntaxin-1 levels were completely restored, whereas the recovery of munc-18 only located in two of the four impaired layers. Twenty µg T4/100 g BW treatment normalized munc-18 levels. These data suggested that adult-onset hypothyroidism induced increment of syntaxin-1 and decrement of munc-18 in the dorsal hippocampus, which could be restored by T4 treatment. Larger dosage of T4 caused more effective restorations. PMID:22688303

Gender Differences in Smoking Among U.S. Working Adults

PubMed Central

Syamlal, Girija; Mazurek, Jacek M.; Dube, Shanta R.

2015-01-01

Background Cigarette smoking remains a leading cause of morbidity and mortality. Although gender differences in cigarette smoking in the U.S. population have been documented, information on these differences among working adults is limited. Purpose To describe the current smoking prevalence by gender among working U.S. adults and examine gender differences in smoking by occupation. Methods The 2004–2011 National Health Interview Survey data for adults aged ≥18 years that were working in the week prior to the interview (N=132,215) were analyzed in 2013. Current cigarette smokers were those who smoked at least 100 cigarettes in their lifetime and currently smoke every day or some days. Results During 2004–2011, an estimated 22.8% of men workers and 18.3% of women workers were current smokers. Of the current smokers, women workers had higher odds of being an everyday smoker (prevalence OR [POR]=1.17, 95% CI=1.09, 1.26); having poor self-rated emotional health (POR=1.28, 95% CI=1.15, 1.41); and having chronic obstructive pulmonary disease (POR=2.45, 95% CI=2.14, 2.80), heart disease (POR=1.27, 95% CI=1.12, 1.45), and current asthma (POR=2.21, 95% CI=1.96, 2.49) compared with men workers. Women in “supervisors, construction, and extraction” (38.9%) occupations and men in “extraction” (40.5%) occupations had the highest smoking prevalence. Conclusion Among working adults, women had lower prevalence of smoking than men, yet women who smoke were more likely than men to have adverse health outcomes, including self-rated poorer physical and emotional health. PMID:25049215

Adults surviving lung cancer two or more years: A systematic review.

PubMed

Rhea, Deborah J; Lockwood, Suzy

Lung cancer has had a low survival rate throughout the years. Some studies have shown that psychological variables such as hardiness and resiliency may play a role in the meaningfulness of survival among lung cancer patients. The objective of this systematic review was to synthesize the best available evidence on the experiences of surviving lung cancer (including psychological/affective well-being dimensions such as resiliency, optimism, quality of life, and coping strategies) in adults over the age of 18, two or more years after diagnosis. The review considered adults (18 years and older) who have survived lung cancer two or more years post diagnosis.The review included studies that examined the experiences (including psychological/affective well-being dimensions such as resiliency, optimism, quality of life, and coping strategies) of surviving lung cancer two or more years post diagnosis.The review considered patients' experiences of surviving lung cancer post two years diagnosis, including the examination of specific psychological/affective well-being aspects such as resiliency, optimism, quality of life and coping strategies.The review included quantitative descriptive studies and qualitative studies. A search for published and unpublished studies in English language from January 1999 through December 2010 was undertaken in multiple databases including MEDLINE, CINAHL, ProQuest and Psyc INFO. Assessment of methodological quality of studies was undertaken using critical appraisal tools from the Joanna Briggs Institute. Data was extracted using the Joanna Briggs Institute Data Extraction forms. Results were presented in a narrative format as the synthesis of qualitative or quantitative data was not appropriate. 13 studies were included in the review: one mixed methods study (including a qualitative research component) and 12 quantitative studies.The qualitative component of the included mixed methods study identified five findings related to the meaningfulness

National Adult Learners Satisfaction-Priorities Report. Research Report, 2011

ERIC Educational Resources Information Center

Noel-Levitz, Inc, 2011

2011-01-01

The 2011 National Adult Learners Satisfaction-Priorities Report presents the responses to the Adult Learner Inventory[TM] (ALI) of 29,679 students from 61 four-year private and public as well as 4,749 students from 18 two-year community and technical colleges. The results include adult learner responses over a three-year time period, from fall of…

Developmental Changes in the Perception of Adult Facial Age

ERIC Educational Resources Information Center

Gross, Thomas F.

2007-01-01

The author studied children's (aged 5-16 years) and young adults' (aged 18-22 years) perception and use of facial features to discriminate the age of mature adult faces. In Experiment 1, participants rated the age of unaltered and transformed (eyes, nose, eyes and nose, and whole face blurred) adult faces (aged 20-80 years). In Experiment 2,…

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.

Achieving Adult Literacy in Florida. Florida Adult Literacy Plan Status Report. Fiscal Year 1995.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. Div. of Applied Tech. and Adult Education.

This report summarizes for fiscal year 1995 the adult education activities implemented throughout the state of Florida in response to and in support of the Florida Model Literacy Program Act of 1978 (Florida Adult Literacy Act). In addition, the report presents a summary of the activities initiated under Blueprint 2000, legislation that…

Age-related self-overestimation of step-over ability in healthy older adults and its relationship to fall risk.

PubMed

Sakurai, Ryota; Fujiwara, Yoshinori; Ishihara, Masami; Higuchi, Takahiro; Uchida, Hayato; Imanaka, Kuniyasu

2013-05-07

Older adults could not safely step over an obstacle unless they correctly estimated their physical ability to be capable of a successful step over action. Thus, incorrect estimation (overestimation) of ability to step over an obstacle could result in severe accident such as falls in older adults. We investigated whether older adults tended to overestimate step-over ability compared with young adults and whether such overestimation in stepping over obstacles was associated with falls. Three groups of adults, young-old (age, 60-74 years; n, 343), old-old (age, >74 years; n, 151), and young (age, 18-35 years; n, 71), performed our original step-over test (SOT). In the SOT, participants observed a horizontal bar at a 7-m distance and estimated the maximum height (EH) that they could step over. After estimation, they performed real SOT trials to measure the actual maximum height (AH). We also identified participants who had experienced falls in the 1 year period before the study. Thirty-nine young-old adults (11.4%) and 49 old-old adults (32.5%) failed to step over the bar at EH (overestimation), whereas all young adults succeeded (underestimation). There was a significant negative correlation between actual performance (AH) and self-estimation error (difference between EH and AH) in the older adults, indicating that older adults with lower AH (SOT ability) tended to overestimate actual ability (EH > AH) and vice versa. Furthermore, the percentage of participants who overestimated SOT ability in the fallers (28%) was almost double larger than that in the non-fallers (16%), with the fallers showing significantly lower SOT ability than the non-fallers. Older adults appear unaware of age-related physical decline and tended to overestimate step-over ability. Both age-related decline in step-over ability, and more importantly, overestimation or decreased underestimation of this ability may raise potential risk of falls.

78 FR 58290 - TRICARE; Calendar Year 2014 TRICARE Young Adult Program Premium Update

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-23

... DEPARTMENT OF DEFENSE Office of the Secretary TRICARE; Calendar Year 2014 TRICARE Young Adult... Young Adult Premiums for Calendar Year 2014. SUMMARY: This notice provides the updated TRICARE Young Adult program premiums for Calendar Year (CY) 2014. DATES: The CY 2014 rates contained in this notice...

49 CFR 661.18 - Intentional violations.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF TRANSPORTATION BUY AMERICA REQUIREMENTS § 661.18 Intentional violations. A person shall be... agency that the person intentionally— (a) Affixed a label bearing a “Made in America” inscription, or an...

49 CFR 661.18 - Intentional violations.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF TRANSPORTATION BUY AMERICA REQUIREMENTS § 661.18 Intentional violations. A person shall be... agency that the person intentionally— (a) Affixed a label bearing a “Made in America” inscription, or an...

49 CFR 661.18 - Intentional violations.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF TRANSPORTATION BUY AMERICA REQUIREMENTS § 661.18 Intentional violations. A person shall be... agency that the person intentionally— (a) Affixed a label bearing a “Made in America” inscription, or an...

49 CFR 661.18 - Intentional violations.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF TRANSPORTATION BUY AMERICA REQUIREMENTS § 661.18 Intentional violations. A person shall be... agency that the person intentionally— (a) Affixed a label bearing a “Made in America” inscription, or an...

Association between adolescent marriage and marital violence among young adult women in India

PubMed Central

Raj, Anita; Saggurti, Niranjan; Lawrence, Danielle; Balaiah, Donta; Silverman, Jay G.

2010-01-01

Objective To assess whether a history of adolescent marriage (<18 years) places women in young adulthood in India at increased risk of physical or sexual marital violence. Methods Cross-sectional analysis was performed on data from a nationally representative household study of 124 385 Indian women aged 15–49 years collected in 2005–2006. The analyses were restricted to married women aged 20–24 years who participated in the marital violence (MV) survey module (n=10 514). Simple regression models and models adjusted for participant demographics were constructed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between adolescent marriage and MV. Results Over half (58%) of the participants were married before 18 years of age; 35% of the women had experienced physical or sexual violence in their marriage; and 27% reported such abuse in the last year. Adjusted regression analyses revealed that women married as minors were significantly more likely than those married as adults to report ever experiencing MV (adjusted OR 1.77; 95% CI, 1.61–1.95) and in the last 12 months (adjusted OR 1.51; 95% CI, 1.36–1.67). Conclusions Women who were married as adolescents remain at increased risk of MV into young adulthood. PMID:20347089

49 CFR 572.198 - Pelvis acetabulum.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Pelvis acetabulum. 572.198 Section 572.198... Test Dummy, Small Adult Female § 572.198 Pelvis acetabulum. (a) The acetabulum is part of the lower... pelvis accelerometer as specified in 49 CFR 572.200(d), acetabulum load cell SA572-S68, mounted as shown...

49 CFR 572.198 - Pelvis acetabulum.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Pelvis acetabulum. 572.198 Section 572.198... Test Dummy, Small Adult Female § 572.198 Pelvis acetabulum. (a) The acetabulum is part of the lower... pelvis accelerometer as specified in 49 CFR 572.200(d), acetabulum load cell SA572-S68, mounted as shown...

Residential Transitions among Adults with Intellectual Disability across 20 Years

PubMed Central

Woodman, Ashley C.; Mailick, Marsha R.; Anderson, Kristy A.; Esbensen, Anna J.

2014-01-01

The present study addresses critical gaps in the literature by examining residential transitions among 303 adults with intellectual disability over 10 years (Part 1) and 75 adults with Down syndrome over 20 years (Part 2). All adults lived at home at the start of the study, but many moved to a variety of settings. Several characteristics of the adults with intellectual disability differed across settings, most notably adaptive behavior and the number of residential transitions, while characteristics such as age, type of disability, and behavior problems were less predictive of residential placements. The number of moves over the course of the study varied widely, with critical links to earlier family dynamics, social relationships, and health and adaptive behavior. PMID:25354121

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

Characteristics of Adults' Use of Facebook and the Potential Impact on Health Behavior: Secondary Data Analysis.

PubMed

Bosak, Kelly; Park, Shin Hye

2018-06-14

Social influences are a primary factor in the adoption of health behaviors. Social media platforms, such as Facebook, disseminate information, raise awareness, and provide motivation and support for positive health behaviors. Facebook has evolved rapidly and is now a part of many individuals' daily routine. The high degree of individual engagement and low attrition rate of this platform necessitate consideration for a potentially positive impact on health behavior. The aim of this paper is to investigate the use of Facebook by adults. Knowledge is limited to the unique characteristics of Facebook users, including time spent on Facebook by adults of various age groups. Characteristics of Facebook users are important to understand to direct efforts to engage adults in future health behavior interventions. Institutional Review Board approval was obtained for this secondary analysis of existing de-identified survey data collected for the Pew Research Center. The sample included adults age 18-65 years and above. Binomial logistic regression was performed for the model of age group and Facebook use, controlling for other demographics. A multinomial logistic regression model was used for the variable of time spent on Facebook. Based on the regression models, we computed and reported the marginal effects on Facebook use and time spent of adults age groups, including age groups 18-29, 30-49, 50-64, and 65 and over. We discuss these findings in the context of the implications for promoting positive health behaviors. The demographics of the final sample (N=730) included adults age 18-65 years and above (mean 48.2 yrs, SD 18.3 yrs). The majority of the participants were female (372/730, 50.9%), white (591/730, 80.9%) and non-Hispanic (671/730, 91.9%). Bivariate analysis indicated that Facebook users and nonusers differed significantly by age group (χ 2 =76.71, P<.001) and sex (χ 2 =9.04, P=.003). Among subjects aged 50 and above, the predicted probability was 66% for

Syndromes of collateral-reported psychopathology for ages 18-59 in 18 Societies

PubMed Central

Ivanova, Masha Y.; Achenbach, Thomas M.; Rescorla, Leslie A.; Turner, Lori V.; Árnadóttir, Hervör Alma; Au, Alma; Caldas, J. Carlos; Chaalal, Nebia; Chen, Yi Chuen; da Rocha, Marina M.; Decoster, Jeroen; Fontaine, Johnny R.J.; Funabiki, Yasuko; Guðmundsson, Halldór S.; Kim, Young Ah; Leung, Patrick; Liu, Jianghong; Malykh, Sergey; Marković, Jasminka; Oh, Kyung Ja; Petot, Jean-Michel; Samaniego, Virginia C.; Silvares, Edwiges Ferreira de Mattos; Šimulionienė, Roma; Šobot, Valentina; Sokoli, Elvisa; Sun, Guiju; Talcott, Joel B.; Vázquez, Natalia; Zasępa, Ewa

2017-01-01

The purpose was to advance research and clinical methodology for assessing psychopathology by testing the international generalizability of an 8-syndrome model derived from collateral ratings of adult behavioral, emotional, social, and thought problems. Collateral informants rated 8,582 18–59-year-old residents of 18 societies on the Adult Behavior Checklist (ABCL). Confirmatory factor analyses tested the fit of the 8-syndrome model to ratings from each society. The primary model fit index (Root Mean Square Error of Approximation) showed good model fit for all societies, while secondary indices (Tucker Lewis Index, Comparative Fit Index) showed acceptable to good fit for 17 societies. Factor loadings were robust across societies and items. Of the 5,007 estimated parameters, 4 (0.08%) were outside the admissible parameter space, but 95% confidence intervals included the admissible space, indicating that the 4 deviant parameters could be due to sampling fluctuations. The findings are consistent with previous evidence for the generalizability of the 8-syndrome model in self-ratings from 29 societies, and support the 8-syndrome model for operationalizing phenotypes of adult psychopathology from multi-informant ratings in diverse societies. PMID:29399019

Cognitive enhancement therapy for adult autism spectrum disorder: Results of an 18-month randomized clinical trial.

PubMed

Eack, Shaun M; Hogarty, Susan S; Greenwald, Deborah P; Litschge, Maralee Y; Porton, Shannondora A; Mazefsky, Carla A; Minshew, Nancy J

2018-03-01

Cognitive remediation is a promising approach to treating core cognitive deficits in adults with autism, but rigorously controlled trials of comprehensive interventions that target both social and non-social cognition over a sufficient period of time to impact functioning are lacking. This study examined the efficacy of cognitive enhancement therapy (CET) for improving core cognitive and employment outcomes in adult autism. Verbal adult outpatients with autism spectrum disorder (N = 54) were randomized to an 18-month, single-blind trial of CET, a cognitive remediation approach that integrates computer-based neurocognitive training with group-based training in social cognition, or an active enriched supportive therapy (EST) comparison focused on psychoeducation and condition management. Primary outcomes were composite indexes of neurocognitive and social-cognitive change. Competitive employment was a secondary outcome. Intent-to-treat analyses indicated that CET produced significant differential increases in neurocognitive function relative to EST (d = .46, P = .013). Both CET and EST were associated with large social-cognitive improvements, with CET demonstrating an advantage at 9 (d = .58, P = 0.020), but not 18 months (d = .27, P = 0.298). Effects on employment indicated that participants treated with CET were significantly more likely to gain competitive employment than those in EST, OR = 6.21, P = 0.023, which was mediated by cognitive improvement. CET is a feasible and potentially effective treatment for core cognitive deficits in adult autism spectrum disorder. The treatment of cognitive impairments in this population can contribute to meaningful improvements in adult outcomes. Autism Res 2018, 11: 519-530. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Cognitive enhancement therapy (CET), an 18-month cognitive remediation intervention designed to improve thinking and social understanding, was

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.

Smoking among adults in Syria: proxy reporting by 13-14 year olds.

PubMed

Maziak, W; Tabbah, K

2005-07-01

Despite active epidemiological research related to smoking in Syria in the past few years, there is currently no population-based prevalence data for adult smoking in this country. This study presents the first such figures based on information about the smoking habits of 3066 couples in Aleppo, Syria collected during a survey on respiratory morbidity among 13-14-year-old youths. Reports from the young people indicated levels of parental smoking to be 54% for men and 18% for women. This figure for women is twice that reported previously. The mean number of smokers within the studied households was one smoker per household. Smoking among women was found to be strongly associated with their educational status and their spouse's smoking status. This information is of major importance for public health efforts to deal with the smoking epidemic in Syria, as it indicates a hidden epidemic of smoking among women, most likely due to under-reporting.

Age Variation in the Association Between Obesity and Mortality in Adults.

PubMed

Wang, Zhiqiang; Peng, Yang; Liu, Meina

2017-12-01

The aim of this study was to evaluate the previously reported finding that the association between obesity and mortality strengthens with increasing age. The data were derived from the National Health Interview Survey. Age-specific hazard ratios of mortality for grade 2/3 obesity (BMI ≥ 35 kg/m 2 ), relative to a BMI of 18.5 kg/m 2 to < 25 kg/m 2 , were calculated by using a flexible parametric survival model (240,184 white men) and Cox proportional hazard models (51,697 matched pairs). When the model included interaction terms between obesity and age at the survey, hazard ratios appeared to increase with age if those interaction terms were ignored by fixing age at the survey as a single value. However, when recalculated for adults with various ages at the survey, according to model specifications, hazard ratios were higher for younger adults than for older adults with the same follow-up duration. Based on matched data, hazard ratios were also higher for younger adults (2.14 [95% CI: 1.90-2.40] for those 40-49 years of age) than for older adults (1.22 [95%: 0.91-1.63] for those 90+ years of age). For any given follow-up duration, the association between obesity and mortality weakens with age. The previously reported strengthening of the obesity-mortality association with increasing age was caused by the failure to take all the model specifications into consideration when calculating adjusted hazard ratios. © 2017 The Obesity Society.

Spanish normative studies in young adults (NEURONORMA young adults project): norms for the Rey-Osterrieth Complex Figure (copy and memory) and Free and Cued Selective Reminding Test.

PubMed

Palomo, R; Casals-Coll, M; Sánchez-Benavides, G; Quintana, M; Manero, R M; Rognoni, T; Calvo, L; Aranciva, F; Tamayo, F; Peña-Casanova, J

2013-05-01

The Rey-Osterrieth Complex Figure (ROCF) and the Free and Cued Selective Reminding Test (FCSRT) are widely used in clinical practice. The ROCF assesses visual perception, constructional praxis, and visuo-spatial memory. The FCSRT assesses verbal learning and memory. In this study, as part of the Spanish normative studies project in young adults (NEURONORMA young adults), we present age- and education-adjusted normative data for both tests obtained by using linear regression techniques. The sample consisted of 179 healthy participants ranging in age from 18 to 49 years. We provide tables for converting raw scores to scaled scores in addition to tables with scores adjusted by socio-demographic factors. The results showed that education affects scores for some of the memory tests and the figure-copying task. Age was only found to have an effect on the performance of visuo-spatial memory tests, and the effect of sex was negligible. The normative data obtained will be extremely useful in the clinical neuropsychological evaluation of young Spanish adults. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Efficacy of the Herpes Zoster Subunit Vaccine in Adults 70 Years of Age or Older.

PubMed

Cunningham, Anthony L; Lal, Himal; Kovac, Martina; Chlibek, Roman; Hwang, Shinn-Jang; Díez-Domingo, Javier; Godeaux, Olivier; Levin, Myron J; McElhaney, Janet E; Puig-Barberà, Joan; Vanden Abeele, Carline; Vesikari, Timo; Watanabe, Daisuke; Zahaf, Toufik; Ahonen, Anitta; Athan, Eugene; Barba-Gomez, Jose F; Campora, Laura; de Looze, Ferdinandus; Downey, H Jackson; Ghesquiere, Wayne; Gorfinkel, Iris; Korhonen, Tiina; Leung, Edward; McNeil, Shelly A; Oostvogels, Lidia; Rombo, Lars; Smetana, Jan; Weckx, Lily; Yeo, Wilfred; Heineman, Thomas C

2016-09-15

A trial involving adults 50 years of age or older (ZOE-50) showed that the herpes zoster subunit vaccine (HZ/su) containing recombinant varicella-zoster virus glycoprotein E and the AS01B adjuvant system was associated with a risk of herpes zoster that was 97.2% lower than that associated with placebo. A second trial was performed concurrently at the same sites and examined the safety and efficacy of HZ/su in adults 70 years of age or older (ZOE-70). This randomized, placebo-controlled, phase 3 trial was conducted in 18 countries and involved adults 70 years of age or older. Participants received two doses of HZ/su or placebo (assigned in a 1:1 ratio) administered intramuscularly 2 months apart. Vaccine efficacy against herpes zoster and postherpetic neuralgia was assessed in participants from ZOE-70 and in participants pooled from ZOE-70 and ZOE-50. In ZOE-70, 13,900 participants who could be evaluated (mean age, 75.6 years) received either HZ/su (6950 participants) or placebo (6950 participants). During a mean follow-up period of 3.7 years, herpes zoster occurred in 23 HZ/su recipients and in 223 placebo recipients (0.9 vs. 9.2 per 1000 person-years). Vaccine efficacy against herpes zoster was 89.8% (95% confidence interval [CI], 84.2 to 93.7; P<0.001) and was similar in participants 70 to 79 years of age (90.0%) and participants 80 years of age or older (89.1%). In pooled analyses of data from participants 70 years of age or older in ZOE-50 and ZOE-70 (16,596 participants), vaccine efficacy against herpes zoster was 91.3% (95% CI, 86.8 to 94.5; P<0.001), and vaccine efficacy against postherpetic neuralgia was 88.8% (95% CI, 68.7 to 97.1; P<0.001). Solicited reports of injection-site and systemic reactions within 7 days after injection were more frequent among HZ/su recipients than among placebo recipients (79.0% vs. 29.5%). Serious adverse events, potential immune-mediated diseases, and deaths occurred with similar frequencies in the two study groups. In our

Out-of-home placement to age 18 years in children exposed to a postpartum mental disorder.

PubMed

Vigod, Simone N; Laursen, Thomas Munk; Ranning, Anne; Nordentoft, Merete; Munk-Olsen, Trine

2018-04-17

Little is known about risk of custody loss or out-of-home placement among children whose mothers experience postpartum mental disorders, and whether this risk differs from that of children whose mothers had earlier onset of their mental disorder. National Danish registers comprising 1 868 467 births (1982-2012) were used to determine how the timing of maternal illness onset influences out-of-home placement risk up to age 18 years among children exposed to a maternal mental disorder. Compared to children unexposed to maternal mental illness, risk was higher for children exposed to a maternal mental disorder whose mothers had a first contact for a mental disorder in the 0-12 months of predelivery (8.17/1000 person-years; aIRR 4.56, 95% CI 4.08-5.09), the first 3 months postpartum (4.60/1000 person-years; 3.55, 2.95-4.26) and 4-12 months postpartum (6.49/1000 person-years; 3.93, 3.50-4.41). Risk was even higher for children exposed to a maternal mental disorder when illness onset was more than 1-year predelivery (9.11/1000 person-years; 5.48, 5.32-5.66). Risk of out-home placement in children exposed to mothers with a new-onset postpartum mental disorder is almost as high as in children whose mothers have long-standing illness. A better understanding of the trajectories of these mothers and children is warranted. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Motivational characteristics and resistance training in older adults: a randomized controlled trial and 1-year follow-up.

PubMed

Kekäläinen, Tiia; Kokko, Katja; Tammelin, Tuija; Sipilä, Sarianna; Walker, Simon

2018-06-07

The aim of this study was to investigate the effects of a nine-month supervised resistance training intervention on motivational and volitional characteristics related to exercise, and whether the absolute level and/or intervention-induced change in these characteristics predict self-directed continuation of resistance training one year after the intervention. Community-dwelling older adults aged 65-75, who did not fulfill physical activity recommendations, were randomized into resistance training intervention groups: training once- (n=26), twice- (n=27), three-times-a-week (n=28) or non-training control group (n=25). Training groups participated in supervised resistance training for nine months: during months 1-3 all groups trained twice-a-week and then with allocated frequencies during months 4-9. Exercise-related motivation, self-efficacy and planning were measured with questionnaires at baseline, month-3 and month-9. The continuance of resistance training was determined by interviews six and twelve months after the end of the intervention. The intervention improved action and coping planning as well as intrinsic motivation (group×time p<.05). During one-year follow-up, 54% of participants did not continue self-directed regular resistance training, 22% continued regular resistance training once-a-week and 24% twice-a-week. Increases in exercise self-efficacy and intrinsic motivation related to training during the intervention predicted continuation of resistance training twice-a-week. Resistance training improved exercise-related motivational and volitional characteristics in older adults. These improvements were linked to continuing resistance training one year after the supervised intervention. The role of these characteristics should be taken into account when promoting long-term resistance training participation among older adults. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

No Clinically Significant Difference Between Adult and Pediatric IKDC Subjective Knee Evaluation Scores in Adults

PubMed Central

Stegmeier, Nicole; Oak, Sameer R.; O’Rourke, Colin; Strnad, Greg; Spindler, Kurt P.; Jones, Morgan; Farrow, Lutul D.; Andrish, Jack; Saluan, Paul

2017-01-01

Background: Two versions of the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation form currently exist: the original version (1999) and a recently modified pediatric-specific version (2011). Comparison of the pediatric IKDC with the adult version in the adult population may reveal that either version could be used longitudinally. Hypothesis: We hypothesize that the scores for the adult IKDC and pediatric IKDC will not be clinically different among adult patients aged 18 to 50 years. Study Design: Randomized crossover study design. Level of Evidence: Level 2. Methods: The study consisted of 100 participants, aged 18 to 50 years, who presented to orthopaedic outpatient clinics with knee problems. All participants completed both adult and pediatric versions of the IKDC in random order with a 10-minute break in between. We used a paired t test to test for a difference between the scores and a Welch’s 2-sample t test to test for equivalence. A least-squares regression model was used to model adult scores as a function of pediatric scores, and vice versa. Results: A paired t test revealed a statistically significant 1.6-point difference between the mean adult and pediatric scores. However, the 95% confidence interval (0.54-2.66) for this difference did not exceed our a priori threshold of 5 points, indicating that this difference was not clinically important. Equivalence testing with an equivalence region of 5 points further supported this finding. The adult and pediatric scores had a linear relationship and were highly correlated with an R2 of 92.6%. Conclusion: There is no clinically relevant difference between the scores of the adult and pediatric IKDC forms in adults, aged 18 to 50 years, with knee conditions. Clinical Relevance: Either form, adult or pediatric, of the IKDC can be used in this population for longitudinal studies. If the pediatric version is administered in adolescence, it can be used for follow-up into adulthood. PMID

Hierarchical Forms Processing in Adults and Children

ERIC Educational Resources Information Center

Harrison, Tamara B.; Stiles, Joan

2009-01-01

Two experiments examined child and adult processing of hierarchical stimuli composed of geometric forms. Adults (ages 18-23 years) and children (ages 7-10 years) performed a forced-choice task gauging similarity between visual stimuli consisting of large geometric objects (global level) composed of small geometric objects (local level). The…

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

Viral Hepatitis A in 108 Adult Patients During an Eight-Year Observation at a Single Center in Poland.

PubMed

Bura, Maciej; Michalak, Michał; Chojnicki, Michał K; Kowala-Piaskowska, Arleta; Mozer-Lisewska, Iwona

2015-01-01

Hepatitis A is related to significant morbidity and occasional mortality. Based on data from the Polish National Institute of Hygiene, from 2000 to 2013 a mean of 213 hepatitis A cases were reported yearly. The aim of the study was to assess selected data in adults hospitalized for symptomatic hepatitis A during an eight-year period in a single center in the Wielkopolska Region of Poland. All the hepatitis A patients hospitalized in the center from 2005 to 2013 were analyzed retrospectively. Data were extracted from the medical records of these individuals. The disease was confirmed by anti-HAV IgM testing. In total, 108 patients (71 men and 37 women), aged 18-65 years, were identified. All but 1 patient recovered (99.1%) and in 6 cases (5.6%) a relapse occurred. Risk factors for hepatitis A were identified in 56 patients (52%), with travel abroad being the most common one (32 patients); 19 cases were secondary and 5 patients were men who have sex with men. One hepatitis A outbreak was noted in the region during the study period. Acalculous cholecystitis was found in 33.3% of the patients who underwent abdominal ultrasound. This tended to be more common among older individuals (47.8% in patients over 40 vs. 22.6% in patients aged 18-40, p=0.0521). Patients with this finding had significantly higher mean peak ALT in comparison to those with no gallbladder abnormalities. Although hepatitis A in adults is typically a benign, self-limited disease, it can occasionally have a fatal course. In a significant proportion of patients with an evident risk factor for hepatitis A, the possibility of active prophylaxis was not used. Hepatitis A should be regarded as a sexually transmitted infection. Acalculous cholecystitis is a frequent finding among adults with symptomatic hepatitis A.

Factors Associated with Resilience of Adult Survivors Five Years after the 2008 Sichuan Earthquake in China

PubMed Central

Ni, Cuiping; Chow, Meyrick Chum Ming; Jiang, Xiaolian; Li, Sijian; Pang, Samantha Mei Che

2015-01-01

Given the paucity of quantitative empirical research on survivors’ resilience and its predictors in the context of long-term recovery after disasters, we examined how resilience predictors differed by gender among adult survivors five years after the Sichuan earthquake. This was a cross-sectional survey study of adult survivors (N = 495; aged 18–60) living in reconstructed communities five years into the recovery process after the Wenchuan earthquake. The instruments we used included assessments of sociodemographic characteristics and earthquake exposure level, the Connor-Davidson Resilience Scale, and the Social Support Rating Scale. Support-seeking behaviors emerged as a significant predictor of male survivors’ resilience, while subjective support and marital status were found to be predictors of female survivors’ resilience. Annual household income and chronic disease were predictors for both male and female groups. The findings of this study can be used in devising methods to boost survivors’ resilience by promoting their satisfaction with social support and their ability to obtain effective support. Additionally, the results suggest how to assist survivors who may have relatively poor resilience. PMID:25811775

49 CFR 18.22 - Allowable costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Procedures, or uniform cost accounting standards that comply with cost principles acceptable to the Federal... COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 18.22... cost principles. For each kind of organization, there is a set of Federal principles for determining...

The left perceptual bias for adult and infant faces in adults and 5-year-old children: face age matters.

PubMed

Proietti, Valentina; Pavone, Sarah; Ricciardelli, Paola; Macchi Cassia, Viola

2015-01-01

A large number of studies have shown that adults rely more heavily on information conveyed by the left side of the face in judging emotional state, gender and identity. This phenomenon, called left perceptual bias (LPB), suggests a right hemisphere lateralization of face processing mechanisms. Although specialization of neural mechanisms for processing over-experienced face categories begins during the first year of life, little is known about the developmental trajectory of the LPB and whether or when the bias becomes selective for specific face categories as a result of experience. To address these questions we tested adults (Experiment 1) and 5-year-old children (Experiment 2) with null or limited experience with infants in an identity matching-to-sample task with chimeric adult and infant faces, for which both adults and children have been shown to manifest differential processing abilities. Results showed that 5-year-olds manifest a leftward bias selective for adult faces, and the magnitude of the bias is larger for adult compared to infant faces in adults. This evidence is in line with earlier demonstrations of a perceptual processing advantage for adult faces in adults and children and points to the role of experience in shaping neurocognitive specialization for face processing.

Attention problems, inhibitory control, and intelligence index overlapping genetic factors: a study in 9-, 12-, and 18-year-old twins.

PubMed

Polderman, Tinca J C; de Geus, Eco J C; Hoekstra, Rosa A; Bartels, Meike; van Leeuwen, Marieke; Verhulst, Frank C; Posthuma, Danielle; Boomsma, Dorret I

2009-05-01

It is assumed that attention problems (AP) are related to impaired executive functioning. We investigated the association between AP and inhibitory control and tested to what extent the association was due to genetic factors shared with IQ. Data were available from 3 independent samples of 9-, 12-, and 18-year-old twins and their siblings (1,209 participants). AP were assessed with checklists completed by multiple informants. Inhibitory control was measured with the Stroop Color Word Task (Stroop, 1935), and IQ with the Wechsler Intelligence Scale for Children (Wechsler et al., 2002) or Wechsler Adult Intelligence Scale (Wechsler, 1997). AP and inhibitory control were only correlated in the 12-year-old cohort (r = .18), but appeared non-significant after controlling for IQ. Significant correlations existed between AP and IQ in 9- and 12-year olds (r = -.26/-.34). Inhibitory control and IQ were correlated in all cohorts (r = -.16, -.24 and -.35, respectively). Genetic factors that influenced IQ also influenced inhibitory control. We conclude that the association between AP and inhibitory control as reported in the literature may largely derive from genetic factors that are shared with IQ.

Physical activity during hospitalization: Activities and preferences of adults versus older adults.

PubMed

Meesters, Jorit; Conijn, D; Vermeulen, H M; Vliet Vlieland, Tpm

2018-04-16

Inactivity during hospitalization leads to a functional decline and an increased risk of complications. To date, studies focused on older adults. This study aims to compare the physical activities performed by older adult and adult hospitalized patients. Patients hospitalized for >3 days at a university hospital completed a questionnaire regarding their physical activities (% of days on which an activity was performed divided by the length of stay) and physical activity needs during hospitalization. Crude and adjusted comparisons of older adult (>60 years) and adult (≤60 years) patients were performed using parametric testing and regression analyses. Of 524 patients, 336 (64%) completed the questionnaire, including 166 (49%) older adult patients. On average, the patients were physically active on 35% or less of the days during their hospitalization. Linear regression analysis showed no significant associations between being an older adult and performing physical activities after adjusting for gender, length of stay, surgical intervention, and meeting physical activity recommendations prior to hospitalization. Most patients were well informed regarding physical activity during hospitalization; however, the older adult patients reported a need for information regarding physical activities after hospitalization more frequently (odds ratios, 2.47) after adjusting for educational level, gender, and physical therapy during hospitalization. Both older adult and adult patients are physically inactive during hospitalization, and older adult patients express a greater need for additional information regarding physical activity after hospitalization than adult patients. Therefore, personalized strategies that inform and motivate patients to resume physical activities during hospitalization are needed regardless of age.

49 CFR 178.338-18 - Marking.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Containers for Motor Vehicle Transportation § 178.338-18 Marking. (a) General. Each cargo tank certified... plate permanently attached to the cargo tank by brazing, welding, or other suitable means on the left side near the front, in a place accessible for inspection. If the specification plate is attached...

49 CFR 178.338-18 - Marking.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Containers for Motor Vehicle Transportation § 178.338-18 Marking. (a) General. Each cargo tank certified... plate permanently attached to the cargo tank by brazing, welding, or other suitable means on the left side near the front, in a place accessible for inspection. If the specification plate is attached...

49 CFR 178.338-18 - Marking.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Containers for Motor Vehicle Transportation § 178.338-18 Marking. (a) General. Each cargo tank certified... plate permanently attached to the cargo tank by brazing, welding, or other suitable means on the left side near the front, in a place accessible for inspection. If the specification plate is attached...

49 CFR 178.338-18 - Marking.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Containers for Motor Vehicle Transportation § 178.338-18 Marking. (a) General. Each cargo tank certified... plate permanently attached to the cargo tank by brazing, welding, or other suitable means on the left side near the front, in a place accessible for inspection. If the specification plate is attached...

Dairy Intake Enhances Body Weight and Composition Changes during Energy Restriction in 18–50-Year-Old Adults—A Meta-Analysis of Randomized Controlled Trials

PubMed Central

Stonehouse, Welma; Wycherley, Thomas; Luscombe-Marsh, Natalie; Taylor, Pennie; Brinkworth, Grant; Riley, Malcolm

2016-01-01

Background/Aims: A meta-analysis of randomized controlled trials (RCTs) was performed to investigate the effects of dairy food or supplements during energy restriction on body weight and composition in 18–50-year-old. Methods: RCTs ≥ 4 weeks comparing the effect of dairy consumption (whole food or supplements) with control diets lower in dairy during energy restriction on body weight, fat and lean mass were identified by searching MEDLINE, EMBASE, Pubmed, Cochrane Central and World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) until March 2016. Reports were identified and critically appraised in duplicate. Data were pooled using random-effects meta-analysis. Chi2- and I2-statistics indicated heterogeneity. Dose effect was assessed using meta-regression analysis. GRADE guidelines were used to rate the quality (QR) of the evidence considering risk of bias, inconsistency, indirectness, imprecision, publication bias and effect estimates. Results: 27 RCTs were reviewed. Participants consumed between 2 and 4 standard servings/day of dairy food or 20–84 g/day of whey protein compared to low dairy control diets, over a median of 16 weeks. A greater reduction in body weight (−1.16 kg [−1.66, −0.66 kg], p < 0.001, I2 = 11%, QR = high, n = 644) and body fat mass (−1.49 kg [−2.06, −0.92 kg], p < 0.001, I2 = 21%, n = 521, QR = high) were found in studies largely including women (90% women). These effects were absent in studies that imposed resistance training (QR = low-moderate). Dairy intake resulted in smaller loss of lean mass (all trials pooled: 0.36 kg [0.01, 0.71 kg], p = 0.04, I2 = 64%, n = 651, QR = moderate). No between study dose-response effects were seen. Conclusions: Increased dairy intake as part of energy restricted diets resulted in greater loss in bodyweight and fat mass while attenuating lean mass loss in 18–50-year-old adults. Further research in males is needed to investigate sex effects. PMID:27376321

Individual- and Family-Level Determinants of Risky Sexual Behavior Among Swedish- and Foreign-Born Young Adults 18-30 Years of Age, Residing in Skåne, Sweden.

PubMed

Asamoah, Benedict Oppong; Agardh, Anette

2018-02-01

In Sweden, various public health interventions have been performed to reduce risky sexual behaviors among young people and promote safer and positive approaches to sexuality, while attempting to bridge the gap between the less privileged or more vulnerable young people and their more privileged peers. This study aimed to compare the individual- and familial-level determinants of risky sexual behavior among foreign-born and Swedish-born young adults 18-30 years of age residing in Skåne, the south of Sweden. This was a cross-sectional study that used a questionnaire to collect data from 2968 randomly selected respondents between 18 and 30 years between January and March 2013. The associations were analyzed using chi-square tests, and simple and multiple logistic regression analyses. Younger age, i.e., individual-level factor, and living with only one parent or another person while growing up, i.e., familial-level factor, increased the risk of engaging in sexual risk taking for both Swedish- and foreign-born youth. Male gender was related to a higher risk of engaging in sexual risk-taking behaviors among foreign-born youth but was not as important as influence on sexual risk taking among Swedish-born youth. Parental education level, on the other hand, was significantly associated with sexual intercourse on the "first night" and early sexual debut solely among Swedish-born youth. Condom use was not associated with any family-level factor among both Swedish-born and foreign-born youth. The design of sexual reproductive health and rights messages and interventions to target risky sexual behavior among Swedish youth should take into consideration immigration status (for example, being Swedish-born or foreign-born), individual- and family-level characteristics, as well as the type of behavioral change or outcome desired.

Multiracial Children's and Adults' Categorizations of Multiracial Individuals

ERIC Educational Resources Information Center

Roberts, Steven O.; Gelman, Susan A.

2017-01-01

Research has explored how multiracial individuals are categorized by monoracial individuals, but it has not yet explored how they are categorized by multiracial individuals themselves. We examined how multiracial children (aged 4-9 years old) and adults categorized multiracial targets (presented with and without parentage information). When…

Risk factors for mortality before age 18 years in cystic fibrosis.

PubMed

McColley, Susanna A; Schechter, Michael S; Morgan, Wayne J; Pasta, David J; Craib, Marcia L; Konstan, Michael W

2017-07-01

Understanding early-life risk factors for childhood death in cystic fibrosis (CF) is important for clinical care, including the identification of effective interventions. Data from the Epidemiologic Study of Cystic Fibrosis (ESCF) collected 1994-2005 were linked with the Cystic Fibrosis Foundation Patient Registry (CFFPR) demographic and mortality data from 2013. Inclusion criteria were ≥1 visit annually at age 3-5 years and ≥1 FEV 1 measurement at age 6-8 years. Demographic data, nutritional parameters, pulmonary signs and symptoms, microbiology, and FEV 1 were evaluated as risk factors for death before age 18 years. Multivariable Cox proportional hazards regression was used to model the simultaneous effects of risk factors associated with death before age 18 years. Among 5365 patients enrolled in ESCF who met inclusion criteria, 3880 (72%) were linked to the CFFPR. Among these, 191 (5.7%) died before age 18 years; median age at death was 13.4 ± 3.1 years. Multivariable regression showed clubbing, crackles, female sex, unknown CFTR genotype, minority race or ethnicity, Medicaid insurance (a proxy of low socioeconomic status), Pseudomonas aeruginosa on 2 or more cultures, and weight-for-age <50th percentile were significant risk factors for death regardless of inclusion of FEV 1 at age 6-8 years in the model. We identified multiple risk factors for childhood death of patients with CF, all of which remained important after incorporating FEV 1 at age 6-8 years. Among the factors identified were the presence of clubbing or crackles at age 3-5 years, signs which are not routinely collected in registries. © 2017 Wiley Periodicals, Inc.

49 CFR 178.338-18 - Marking.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Specifications for Containers for Motor Vehicle Transportation § 178.338-18 Marking. (a) General. Each cargo tank... specification plate permanently attached to the cargo tank by brazing, welding, or other suitable means on the left side near the front, in a place accessible for inspection. If the specification plate is attached...

Anomalous origin of the left coronary artery from the pulmonary artery in adults: a comprehensive review of 151 adult cases and a new diagnosis in a 53-year-old woman.

PubMed

Yau, James M; Singh, Rajiv; Halpern, Ethan J; Fischman, David

2011-04-01

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary abnormality associated with early infant mortality and adult sudden death. As it predominantly presents in the first year of life, diagnosis in living adults is extremely rare. Current management is based on limited case series or extrapolated from pediatric cases. Modern advances in noninvasive cardiac imaging have substantially increased the number of diagnoses, uncovering a large adult population that has not been reviewed. The availability of newer diagnostic modalities correlates with an increasing incidence in an older cohort, and true association between sudden death and ALCAPA may be lower, especially among older patients. A comprehensive literature search was performed for all case reports of ALCAPA on MEDLINE and PubMed using the keywords ALCAPA, Bland-White-Garland, and coronary anomaly; and augmented by references from published case reports from 1908 to 2008. All adult cases, defined by age 18 years and older, were reviewed for this article. One hundred fifty-one adult cases of ALCAPA are described, in addition to the case of an asymptomatic 53-year-old woman. The average reported age was 41 years old with the oldest being 83. Sixty-six percent of the patients presented with symptoms of angina, dyspnea, palpitations, or fatigue; 17% presented with ventricular arrhythmia, syncope, or sudden death; and 14% were asymptomatic. Twelve percent were diagnosed at autopsy. The majority had some form of surgical correction during their clinical course. ALCAPA is a rare and life-threatening condition in adults. The availability of newer, less invasive diagnostic modalities has resulted in more frequent identification of this condition in an older cohort. © 2011 Wiley Periodicals, Inc.

Impaired IQ and academic skills in adults who experienced moderate to severe infantile malnutrition: a 40-year study.

PubMed

Waber, Deborah P; Bryce, Cyralene P; Girard, Jonathan M; Zichlin, Miriam; Fitzmaurice, Garrett M; Galler, Janina R

2014-02-01

To evaluate IQ and academic skills in adults who experienced an episode of moderate-to-severe infantile malnutrition and a healthy control group, all followed since childhood in the Barbados Nutrition Study. IQ and academic skills were assessed in 77 previously malnourished adults (mean age = 38.4 years; 53% male) and 59 controls (mean age = 38.1 years; 54% male). Group comparisons were carried out by multiple regression and logistic regression, adjusted for childhood socioeconomic factors. The previously malnourished group showed substantial deficits on all outcomes relative to healthy controls (P < 0.0001). IQ scores in the intellectual disability range (< 70) were nine times more prevalent in the previously malnourished group (odds ratio = 9.18; 95% confidence interval = 3.50-24.13). Group differences in IQ of approximately one standard deviation were stable from adolescence through mid-life. Moderate-to-severe malnutrition during infancy is associated with a significantly elevated incidence of impaired IQ in adulthood, even when physical growth is completely rehabilitated. An episode of malnutrition during the first year of life carries risk for significant lifelong functional morbidity.

Surveillance of Vaccination Coverage among Adult Populations — United States, 2015

PubMed Central

Lu, Peng-Jun; O’Halloran, Alissa; Kim, David K.; Grohskopf, Lisa A.; Pilishvili, Tamara; Skoff, Tami H.; Nelson, Noele P.; Harpaz, Rafael; Markowitz, Lauri E.; Rodriguez-Lainz, Alfonso; Fiebelkorn, Amy Parker

2017-01-01

.2%, respectively), and hepatitis B vaccine among health care personnel (HCP) aged ≥19 years (a 4.1 percentage point increase to 64.7%). Herpes zoster vaccination coverage in 2015 met the Healthy People 2020 target of 30%. Aside from these modest improvements, vaccination coverage among adults in 2015 was similar to estimates from 2014. Racial/ethnic differences in coverage persisted for all seven vaccines, with higher coverage generally for whites compared with most other groups. Adults without health insurance reported receipt of influenza vaccine (all age groups), pneumococcal vaccine (adults aged 19–64 years at increased risk), Td vaccine (adults aged ≥19 years, 19–64 years, and 50–64 years), Tdap vaccine (adults aged ≥19 years and 19–64 years), hepatitis A vaccine (adults aged ≥19 years overall and among travelers), hepatitis B vaccine (adults aged ≥19 years, 19–49 years, and among travelers), herpes zoster vaccine (adults aged ≥60 years), and HPV vaccine (males and females aged 19–26 years) less often than those with health insurance. Adults who reported having a usual place for health care generally reported receipt of recommended vaccinations more often than those who did not have such a place, regardless of whether they had health insurance. Vaccination coverage was higher among adults reporting one or more physician contacts in the past year compared with those who had not visited a physician in the past year, regardless of whether they had health insurance. Even among adults who had health insurance and ≥10 physician contacts within the past year, depending on the vaccine, 18.2%–85.6% reported not having received vaccinations that were recommended either for all persons or for those with specific indications. Overall, vaccination coverage among U.S.-born adults was higher than that among foreign-born adults, with few exceptions (influenza vaccination [adults aged 19–49 years and 50–64 years], hepatitis A vaccination [adults aged ≥19

A foraminiferal δ(18)O record covering the last 2,200 years.

PubMed

Taricco, Carla; Alessio, Silvia; Rubinetti, Sara; Vivaldo, Gianna; Mancuso, Salvatore

2016-06-21

Thanks to the precise core dating and the high sedimentation rate of the drilling site (Gallipoli Terrace, Ionian Sea) we were able to measure a foraminiferal δ(18)O series covering the last 2,200 years with a time resolution shorter than 4 years. In order to support the quality of this data-set we link the δ(18)O values measured in the foraminifera shells to temperature and salinity measurements available for the last thirty years covered by the core. Moreover, we describe in detail the dating procedures based on the presence of volcanic markers along the core and on the measurement of (210)Pb and (137)Cs activity in the most recent sediment layers. The high time resolution allows for detecting a δ(18)O decennial-scale oscillation, together with centennial and multicentennial components. Due to the dependence of foraminiferal δ(18)O on environmental conditions, these oscillations can provide information about temperature and salinity variations in past millennia. The strategic location of the drilling area makes this record a unique tool for climate and oceanographic studies of the Central Mediterranean.

A cross-sectional survey of the relationship between walking, biking, and the built environment for adults aged over 70 years.

PubMed

Takahashi, Paul Y; Baker, Mitzi A; Cha, Stephan; Targonski, Paul V

2012-01-01

Determine the relationship between walkability scores (using the Walk Score(®)) and activity levels (both bicycle and walking) in adults aged between 70 and 85 years in Rochester, Minnesota. This was a self-reported cross-sectional survey in adults aged over 70 years living in Rochester, Minnesota. Analysis used t-tests or chi-square analysis as appropriate. The primary endpoint was bicycle use or walking. The predictor variables were the Walk Score(®) as determined by their address, Charlson index, Duke Activity Status Index (DASI), and a 12-item short-form survey (SF-12) scores. Secondary analysis used an outcome of functional status (using the DASI) and walkability scores. Fifty-three individuals completed the surveys (48% return rate). The average age in the overall cohort was 77.02 years. Eighty-nine percent of individuals could walk at least a block and 15.1% rode their bicycles. The Walk Scores(®) did not differ between those who walked (38.9 ± 27.4) and those that did not (40.0 ± 36.08; P = 0.93). In a similar fashion, the Walk Scores(®) were not different for those who biked (36.38 ± 27.68) and those that did not (39.44 ± 28.49; P = 0.78). There was no relationship between Walk Scores(®) and DASI; however, a decreased DASI score was associated with increased age and comorbid illness (Charlson Score). In this small pilot survey, there was no difference in Walk Scores(®) between those older adults who walked or biked, compared to those that did not. The Walk Scores(®) were low in both groups, which may indicate the lack of accessibility for all older adults living in Rochester, Minnesota. The functional status seemed to be more related to age or comorbid conditions than the built environment.

Deprivation, timing of preschool infections and H. pylori seropositivity at age 49-51 years: the Newcastle thousand families birth cohort

PubMed Central

2013-01-01

Background Helicobacter pylori infection is acquired in early childhood and persists for life (or until eradication treatment is taken). Seropositivity of H. pylori at age 49-51 years was assessed in relation to socio-economic deprivation in early life and the timing of other childhood infections common at that time. Methods Prospectively collected socio-economic and morbidity data from the Newcastle Thousand Families study, a birth cohort established in 1947. H. pylori IgG seropositivity was assessed at 49-51 years and examined in relation to both whether the individual had been diagnosed with one of measles, mumps or chicken pox, and, if so, the age at first infection. This was done in logistic regression models, allowing adjustment for socio-economic status and housing quality in childhood. Results Adult H. pylori status was strongly linked to disadvantaged socio-economic status in early life (p ≤ 0.002), unlike measles, mumps and chicken pox which showed no associations. Early measles infection was independently associated with H. pylori seropositivity (p = 0.01). Conclusions Of the four infectious diseases that we have studied, it appears that H. pylori differs from the others by the strength of association with socio economic deprivation in early childhood. Our findings further highlight the complex interaction between measles, childhood infections and other non-microbiological factors that occur within a whole population. These data suggest a strong association between H. pylori and deprivation and raise the possibility of an interaction between early measles exposure and increased risk of exposure to H. pylori infection. PMID:24010891

Recent cocaine use is a significant risk factor for sudden cardiovascular death in 15-49-year-old subjects: a forensic case-control study.

PubMed

Morentin, Benito; Ballesteros, Javier; Callado, Luis F; Meana, J Javier

2014-12-01

The aims of the present study were to: (i) evaluate the prevalence of recent cocaine use in adolescents and young adults who had died by sudden cardiovascular death (SCVD); (ii) assess if recent cocaine use was associated with an increased risk of SCVD; and (iii) determine the demographic, clinical-pathological and toxicological characteristics of SCVD related to recent cocaine use. This was a case-control autopsy-based observational retrospective study. Cases were all SCVD in individuals aged between 15 and 49 years during the period ranging from 1 January 2003 to 31 December 2009, with autopsies performed in Biscay, Spain. Medico-legal sudden deaths not due to cardiovascular diseases (SnoCVD) were used as the control group. In all deaths a complete autopsy and toxicological and histopathological studies were carried out. Recent cocaine use was considered when cocaine and/or benzoylecgonine were detected in blood. The risk for SCVD according to demographic variables (sex and age), cardiovascular risk factors (obesity, hypertension, diabetes and smoking) and toxicological variables (opioids, benzodiazepines, amphetamines, cannabis and alcohol) was analysed using three logistic regression models. We also estimated the prevalence of recent cocaine use in the general population aged 15-49 years based on the projection of population surveys. Recent cocaine use was significantly higher in the SCVD group (27 of 311 subjects, 9%) than in the SnoCVD group (three of 126 subjects, 2%). In a full logistic regression controlling for all recorded covariates, the main risk factor for SCVD was recent cocaine use (odds ratio 4.10; 95% confidence interval 1.12-15.0). Compared with the estimated data in the general population, the prevalence of recent cocaine use was 13-58 times higher in people with SCVD. Recent cocaine use is associated significantly with an increased risk for sudden cardiovascular death in people aged 15-49 years. © 2014 Society for the Study of Addiction.

A Longitudinal Examination of 10-year Change in Vocational and Educational Activities for Adults with Autism Spectrum Disorders

PubMed Central

Taylor, Julie Lounds; Center, Vanderbilt Kennedy; Mailick, Marsha R.

2014-01-01

The transition from adolescence to adulthood has been shown to be a time of amplified risk for individuals with autism spectrum disorders (ASD). It is unknown, however, whether problems in educational attainment and employment in the years after high school exit represent “momentary perturbations” in development or a “turning point” with long-lasting effects throughout adulthood. The present study addressed this question by examining 10-year trajectories of vocational and educational activities for adults with ASD, as well as the personal characteristics and environmental resources that predicted these activities. Participants were 161 adults with ASD (ages 18-52 at the start of the study, M=30.9 years) who were part of a larger longitudinal study. Data were collected at 6 time points over a 10-year period. Results indicated significant declines in the level of independence and engagement in vocational/educational activities over the study period, particularly for women. Greater independence in vocational activities was found for those with more independence in activities of daily living. Net of personal characteristics, receipt of more services was marginally related to greater improvement in vocational independence. PMID:24001150

Computer skills and internet use in adults aged 50-74 years: influence of hearing difficulties.

PubMed

Henshaw, Helen; Clark, Daniel P A; Kang, Sujin; Ferguson, Melanie A

2012-08-24

greater odds of PC use compared to those with no hearing difficulties (odds ratio [OR]=1.57, 95% confidence interval [CI] 1.06-2.30, P=.02). Those with moderate+ hearing difficulties had lower odds of PC use compared with those with no hearing difficulties, both overall (OR=0.58, 95% CI 0.39-0.87, P=.008) and in the younger group (OR=0.49, 95% CI 0.26-0.86, P=.008). Similar results were demonstrated for Internet use by age group (older: OR=1.57, 95% CI 0.99-2.47, P=.05; younger: OR=0.32, 95% CI 0.16-0.62, P=.001). Hearing health care is of particular relevance to older adults because of the prevalence of age-related hearing loss. Our data show that older adults experiencing slight hearing difficulty have increased odds of greater PC skill and Internet use than those reporting no difficulty. These findings suggest that PC and Internet delivery of hearing screening, information, and intervention is feasible for people between 50-74 years who have hearing loss, but who would not typically present to an audiologist.

Computer Skills and Internet Use in Adults Aged 50-74 Years: Influence of Hearing Difficulties

PubMed Central

Clark, Daniel P A; Kang, Sujin; Ferguson, Melanie A

2012-01-01

difficulties in the older group had significantly greater odds of PC use compared to those with no hearing difficulties (odds ratio [OR]=1.57, 95% confidence interval [CI] 1.06-2.30, P=.02). Those with moderate+ hearing difficulties had lower odds of PC use compared with those with no hearing difficulties, both overall (OR=0.58, 95% CI 0.39-0.87, P=.008) and in the younger group (OR=0.49, 95% CI 0.26-0.86, P=.008). Similar results were demonstrated for Internet use by age group (older: OR=1.57, 95% CI 0.99-2.47, P=.05; younger: OR=0.32, 95% CI 0.16-0.62, P=.001). Conclusions Hearing health care is of particular relevance to older adults because of the prevalence of age-related hearing loss. Our data show that older adults experiencing slight hearing difficulty have increased odds of greater PC skill and Internet use than those reporting no difficulty. These findings suggest that PC and Internet delivery of hearing screening, information, and intervention is feasible for people between 50-74 years who have hearing loss, but who would not typically present to an audiologist. PMID:22954484

A Web-Based, Social Networking Beginners’ Running Intervention for Adults Aged 18 to 50 Years Delivered via a Facebook Group: Randomized Controlled Trial

PubMed Central

Boshoff, Kobie; Maher, Carol

2018-01-01

Background Online social networks continue to grow in popularity, with 1.7 billion users worldwide accessing Facebook each month. The use of social networking sites such as Facebook for the delivery of health behavior programs is relatively new. Objective The primary aim of this study was to determine the effectiveness of a Web-based beginners’ running program for adults aged 18 to 50 years, delivered via a Facebook group, in increasing physical activity (PA) and cardiorespiratory fitness. Methods A total of 89 adults with a mean age of 35.2 years (SD 10.9) were recruited online and via print media. Participants were randomly allocated to receive the UniSA Run Free program, an 8-week Web-based beginners’ running intervention, delivered via a closed Facebook group (n=41) that included daily interactive posts (information with links, motivational quotes, opinion polls, or questions) and details of the running sessions; or to the control group who received a hard copy of the running program (n=48). Assessments were completed online at baseline, 2 months, and 5 months. The primary outcome measures were self-reported weekly moderate to vigorous physical activity (MVPA) and objectively measured cardiorespiratory fitness. Secondary outcomes were social support, exercise attitudes, and self-efficacy. Analyses were undertaken using random effects mixed modeling. Compliance with the running program and engagement with the Facebook group were analyzed descriptively. Results Both groups significantly increased MVPA across the study period (P=.004); however, this was significantly higher in the Facebook group (P=.04). The Facebook group increased their MVPA from baseline by 140 min/week versus 91 min for the control at 2 months. MVPA remained elevated for the Facebook group (from baseline) by 129 min/week versus a 50 min/week decrease for the control at 5 months. Both groups had significant increases in social support scores at 2 months (P=.02); however, there were no group

Mental Health Problems in Adults with Down Syndrome and Their Association with Life Circumstances

ERIC Educational Resources Information Center

Mallardo, Mariarosa; Cuskelly, Monica; White, Paul; Jobling, Anne

2014-01-01

This study focused on current life circumstances, previous life events, and engagement with productive and enjoyable activities. It examined the association of these variables with mental health problems and mood in a cohort of young adults with Down syndrome. Participants were 49 adults with Down syndrome (age range 20-31 years) and their…

[Waist circumference reference values in Beijing versus the national values in detecting cardiovascular risk factors in 7-18 years old children].

PubMed

Meng, Ling-hui; Luo, Na; Cheng, Hong; Hou, Dong-qing; Zhao, Xiao-yuan; Mi, Jie

2011-08-01

intervals (CI) of the 90(th) WC percentiles of Beijing and China school children were 6.3 (5.2 - 7.7) and 6.0 (4.9 - 7.4) in predicting hypertension. Both predictive ORs and their 95%CIs were 1.3 (1.1 - 1.5) in predicting impaired fasting glucose and the both were 2.9 (2.5 - 3.4) for dyslipidemia. In predicting NAFLD the ORs and their 95%CIs were 49.1 (12.0 - 201.6) and 69.8 (9.7 - 504.2) for Beijing and China WC optimal references, separately. Compared with Chinese WC reference, WC reference of Beijing had high Sps in screening cardiovascular risk factors in 7 - 18 years old children. The predictive values were not significant different between Beijing and China WC references for almost all cardiovascular risk factors except NAFLD. The WC reference in Beijing was more practical and handy for reference in Beijing and other north developed metropolises.

Acoustics of Clear and Noise-Adapted Speech in Children, Young, and Older Adults

ERIC Educational Resources Information Center

Smiljanic, Rajka; Gilbert, Rachael C.

2017-01-01

Purpose: This study investigated acoustic-phonetic modifications produced in noise-adapted speech (NAS) and clear speech (CS) by children, young adults, and older adults. Method: Ten children (11-13 years of age), 10 young adults (18-29 years of age), and 10 older adults (60-84 years of age) read sentences in conversational and clear speaking…

[Study of Basal metabolic rate of 81 young adults aged 20-29 years old in Changsha].

PubMed

Zhou, X; Mao, D Q; Luo, J Y; Wu, J H; Zhuo, Q; Li, Y M

2017-07-06

Objective: To determine the basal metabolic rate (BMR) of young adults aged between 20-29 years old in Changsha. Methods: We recruited volunteers to join in our research project from April to May, 2015. All recruited volunteers must meet the inclusion criteria: aged 20-29 years old, height between 164-180 centimeters in males and 154-167 centimeters in females, in good health condition, and with no habit of regular physical exercise in last year. Finally, 81 qualified volunteers were selected as research objects, including 43 males and 38 females. The BMR, resting lying metabolism rate and resting sitting metabolism rate of the subjects were detected, and the determined BMR was compared with the calculated results: from the adjusted Schofield equation. Results The BMR, resting lying metabolism rate and resting sitting metabolism rate among males were (166.10±22.09), (174.22±24.56), and (179.54±23.35) kJ·m(-2)·h(-1), respectively, which were all higher than those among females were (137.70±20.04), (149.79±19.25), and (167.78±26.02) kJ·m(-2)·h(-1), respectively, ( P< 0.001). The BMR of males and females calculated from the adjusted Schofield equation were (160.83±3.93), and (140.29±4.18) kJ·m(-2)·h(-1), respectively, and there was no significantly statistical difference found between the determined BMR and the calculated results from Schofield equation (adjusted) classified by sex, all P values >0.05. Conclusion: The BMR of young adults aged 20-29 years old in Changsha was in the national average level, and the adjusted Schofield equation displayed fine accuracy in predicting BMR of young adults aged 20-29 years old in Changsha.

Sealing occlusal caries lesions in adults referred for restorative treatment: 2-3 years of follow-up.

PubMed

Bakhshandeh, Azam; Qvist, Vibeke; Ekstrand, Kim R

2012-04-01

The aim of this study was to assess the possibility to arrest occlusal caries lesions in adults by sealant as well as to assess the presence of radiographic progression, arrest, and regression of the sealed lesions. Seventy-two occlusal caries lesions in 52 adult patients referred to restorative treatment by senior lecturers at School of Dentistry, Copenhagen, Denmark were included. In case the patient had more than one occlusal caries lesion, randomization between sealing and restoration was made; otherwise, the lesion was sealed. In total, 60 resin sealants and 12 composite restorations were made. Follow-up period was 25-38 months (mean = 33 months). Data were analyzed using non-parametric statistics including kappa statistics. After 2-3 years, the dropout rate was 15%; two patients did not show up for control and nine previously sealed lesions were restored by the patients' general practitioners. All 12 restorations and 39 of the remaining 49 sealants were well functioning, seven (14%) sealants were repaired/replaced due to failure, and three (6%) sealed lesions were restored due to caries progression (p > 0.05). The radiographic assessment showed caries progression beneath five (10%) sealants, caries regression beneath one (2%) sealant, and unchanged depth beneath 43 (88%) sealants and all restorations (p > 0.05). The majority of the referred lesions were successfully arrested by sealants, indicating the possibility for extending the criteria for sealing occlusal caries lesions in adults. However, a longer observation period is needed for final conclusion. Extending the criteria of therapeutic sealing of occlusal caries lesions in adults will lead to increased dental health.

Prevalence of metabolic syndrome in 8–18-year-old school-going children of Srinagar city of Kashmir India

PubMed Central

Andrabi, Syed M.S.; Bhat, Mohd H.; Andrabi, Syed R.S.; Kamili, Mohd M.A.; Imran, Ali; Nisar, Iqra; Nisar, Umara

2013-01-01

Aim: Obesity is the most common cause of insulin resistance and metabolic syndrome (MS). These are the most important risk factors for coronary heart disease (CHD). No evidence exists regarding the prevalence of the MS in children in sSrinagar city of Kashmir India. We aimed to evaluate the prevalence of MS in 8–18-year-old school-going children of Kashmir, India. Materials and Methods: In this cross-sectional study, 758 respondents in 8–18 years of age were randomly selected using a simple random sampling method. The self-designed questionnaire was individually completed after receiving a written informed consent. The weight, height, waist circumference (WC), body mass index (BMI), and blood pressure were measured using standard tools. Ten milliliters of blood was taken for measuring lipid profile and fasting blood sugar (FBS) of the school children. We determined MS according to the modified Adult Treatment Panel III (ATP III) criteria. Results: The prevalence of the MS was 3.8% (boys: 3.9%, girls: 3.8%) and the prevalence of obesity was 9.9% (boys: 9.9%, girls: 10.6%) among the studied children. Obese subjects had the highest proportion of MS compared with those at risk for overweight and those with normal weight (30.7% vs. 2.5% and 0.5%, respectively; P = 0.000). Conclusion: The MS is prevalent even in young children, so we suggest screening programs for children aged 8–18 years to control obesity and MS in the developing world. PMID:23776859

Trends in overweight or obesity and other anthropometric indices in adults aged 18-60 years in western Saudi Arabia.

PubMed

Azzeh, Firas Sultan; Bukhari, Hassan Mazzhar; Header, Eslam Ahmed; Ghabashi, Mai Adil; Al-Mashi, Salma Saad; Noorwali, Nafeesah Mohammed

2017-01-01

The prevalence of overweight and obesity has increased considerably in Saudi Arabia in the past two decades. We conducted this study because to examine trends in weight gain with age and related anthropometric measurements in Saudi Arabia such data are limited. To determine trends in overweight and obesity and examine anthropometric indices by age group. Analytical cross-sectional study. Universities, malls, and hospitals in the cities of Mecca, Jeddah, and Al-Taif. Participants were selected by convenience sampling. Body weight, body fat percentage, visceral fat percentage, and skeletal muscle percentage were measured with the Omron body composition monitor device. Waist circumference, height, and body mass index (BMI) were also measured. Changes in BMI, body fat percentage, visceral fat percentage, and skel-etal muscle with age for both genders. We selected 2548 Saudis, 1423 males and 1125 females, aged 18 to 60 years. A significant trend (ptrend < .001) for BMI and all anthropometric indices was observed with age for both genders. About 55.1% of the participants were overweight and obese (BMI > 25 kg/m2). Obesity and overweight were more prevalent in men than in women and was observed early in both genders, at the ages of 18-19 in men and 30-39 years for women. In the age range of 40-60 years, muscle mass dropped significantly (P < .05) for both genders. Mean waist circumference and visceral fat were significantly (P < .001) higher in men than in women, but the mean total body fat percentage was higher in females than in males (P < .001). Significant trends were observed for BMI, WC, body fat, visceral fat, and muscle mass for both genders with age. National programs should be maintained to encourage physical activity and weight reduction as well as focusing on obesity-related lifestyle and behaviors at early ages to prevent weight gain and possibly muscle wasting with age. There was an unequal distribution in numbers of subjects between study groups

Neurocognitive and executive functioning in adult survivors of congenital heart disease.

PubMed

Klouda, Leda; Franklin, Wayne J; Saraf, Anita; Parekh, Dhaval R; Schwartz, David D

2017-01-01

Congenital heart disease (CHD) can affect the developing central nervous system, resulting in neurocognitive and behavioral deficits. Preoperative neurological abnormalities as well as sequelae of the open heart operations required to correct structural abnormalities of the heart contribute to these deficits. There are few studies examining the neurocognitive functioning of adults with CHD. This study sought to investigate multiple domains of neurocognitive functioning in adult survivors of CHD who had childhood cardiac surgery with either moderate or severe disease complexity. A total of 48 adults (18-49 years of age) who had undergone cardiac surgery for CHD prior to five years of age participated in the study. CHD severity was classified as moderate or severe according to the 32nd Bethesda Guidelines. A computerized battery of standardized neurocognitive tests (CNS-Vital Signs), a validated rating scale of executive functioning, and demographic questionnaires were administered. There were no significant differences between the moderate CHD group and normative data on any cognitive measure. In contrast, the severe CHD group differed from norms in multiple domains: psychomotor speed, processing speed, complex attention, reaction time, and on the overall neurocognitive index. Number of surgeries was strongly related to worse executive functioning. There was no association between age at first surgery or time since last surgery and neuropsychological functioning. Number of surgeries was also unrelated to neurocognitive test performance. Patients with severe CHD performed significantly worse on measures of processing speed, attention, and executive functioning. These findings may be useful in the long-term care of adults with congenital heart disease. © 2016 Wiley Periodicals, Inc.

Suicide After Deliberate Self-Harm in Adolescents and Young Adults.

PubMed

Olfson, Mark; Wall, Melanie; Wang, Shuai; Crystal, Stephen; Bridge, Jeffrey A; Liu, Shang-Min; Blanco, Carlos

2018-04-01

Among adolescents and young adults with nonfatal self-harm, our objective is to identify risk factors for repeated nonfatal self-harm and suicide death over the following year. A national cohort of patients in the Medicaid program, aged 12 to 24 years ( n = 32 395), was followed for up to 1 year after self-harm. Cause of death information was obtained from the National Death Index. Repeat self-harm per 1000 person-years and suicide deaths per 100 000 person-years were determined. Hazard ratios (HRs) of repeat self-harm and suicide were estimated by Cox proportional hazard models. Suicide standardized mortality rate ratios were derived by comparison with demographically matched general population controls. The 12-month suicide standardized mortality rate ratio after self-harm was significantly higher for adolescents (46.0, 95% confidence interval [CI]: 29.9-67.9) than young adults (19.2, 95% CI: 12.7-28.0). Hazards of suicide after self-harm were significantly higher for American Indians and Alaskan natives than non-Hispanic white patients (HR: 4.69, 95% CI: 2.41-9.13) and for self-harm patients who initially used violent methods (HR: 18.04, 95% CI: 9.92-32.80), especially firearms (HR: 35.73, 95% CI: 15.42-82.79), compared with nonviolent self-harm methods (1.00, reference). The hazards of repeat self-harm were higher for female subjects than male subjects (HR: 1.25, 95% CI: 1.18-1.33); patients with personality disorders (HR: 1.55, 95% CI: 1.42-1.69); and patients whose initial self-harm was treated in an inpatient setting (HR: 1.65, 95% CI: 1.49-1.83) compared with an emergency department (HR: 0.62, 95% CI: 0.55-0.69) or outpatient (1.00, reference) setting. After nonfatal self-harm, adolescents and young adults were at markedly elevated risk of suicide. Among these high-risk patients, those who used violent self-harm methods, particularly firearms, were at especially high risk underscoring the importance of follow-up care to help ensure their safety

Medicaid Coverage Expansions and Cigarette Smoking Cessation Among Low-income Adults.

PubMed

Koma, Jonathan W; Donohue, Julie M; Barry, Colleen L; Huskamp, Haiden A; Jarlenski, Marian

2017-12-01

Expanding Medicaid coverage to low-income adults may have increased smoking cessation through improved access to evidence-based treatments. Our study sought to determine if states' decisions to expand Medicaid increased recent smoking cessation. Using pooled cross-sectional data from the Behavioral Risk Factor Surveillance Survey for the years 2011-2015, we examined the association between state Medicaid coverage and the probability of recent smoking cessation among low-income adults without dependent children who were current or former smokers (n=36,083). We used difference-in-differences estimation to examine the effects of Medicaid coverage on smoking cessation, comparing low-income adult smokers in states with Medicaid coverage to comparable adults in states without Medicaid coverage, with ages 18-64 years to those ages 65 years and above. Analyses were conducted for the full sample and stratified by sex. Residence in a state with Medicaid coverage among low-income adult smokers ages 18-64 years was associated with an increase in recent smoking cessation of 2.1 percentage points (95% confidence interval, 0.25-3.9). In the comparison group of individuals ages 65 years and above, residence in a state with Medicaid coverage expansion was not associated with a change in recent smoking cessation (-0.1 percentage point, 95% confidence interval, -2.1 to 1.8). Similar increases in smoking cessation among those ages 18-64 years were estimated for females and males (1.9 and 2.2 percentage point, respectively). Findings are consistent with the hypothesis that Medicaid coverage expansions may have increased smoking cessation among low-income adults without dependent children via greater access to preventive health care services, including evidence-based smoking cessation services.

Smoking, antioxidant supplementation and dietary intakes among older adults with age-related macular degeneration over 10 years.

PubMed

Gopinath, Bamini; Flood, Victoria M; Kifley, Annette; Liew, Gerald; Mitchell, Paul

2015-01-01

We aimed to compare the micronutrient usage and other lifestyle behaviors over 10 years among those with and without age-related macular degeneration (AMD). 1612 participants aged 49+ years at baseline were re-examined over 10 years, west of Sydney, Australia. AMD was assessed from retinal photographs. Dietary data were collected using a semi-quantitative food frequency questionnaire. Smoking status was self-reported. 56 participants had any AMD at baseline, of these 25% quit smoking at 5 years and were still not smoking at 10-year follow-up. Among participants who had below the recommended intake of vitamins A, C or E supplements at baseline, those who did compared to those who did not develop late AMD over 10 years were more likely to report vitamins A (total), C or E supplement intake above the recommended intake at 10-year follow-up: multivariable-adjusted OR 4.21 (95% CI 1.65-10.73); OR 6.52 (95% CI 2.76-15.41); and OR 5.71 (95% CI 2.42-13.51), respectively. Participants with compared to without AMD did not appreciably increase fish, fruit and vegetable consumption and overall diet quality. Adherence to smoking and dietary recommendations was poor among older adults with AMD. However, uptake of antioxidant supplements increased significantly among those with late AMD.

Prevalence and Risk Factors for Low Back Pain in 1,355 Young Adults: A Cross-Sectional Study.

PubMed

Ganesan, Sudhir; Acharya, Anita Shankar; Chauhan, Ravi; Acharya, Shankar

2017-08-01

Cross-sectional study. To evaluate the prevalence and various risk factors for low back pain (LBP) in young adults in India. LBP is an emerging problem in adolescents, with an incidence that is the highest in the third decade of life worldwide. Various risk factors such as obesity, smoking, family history, stress, and exercise have been described in the literature. This study was conducted because of paucity of data in the Indian literature. A total of 1,355 (741 males and 641 females) young Indian Administrative Service aspirants and medical postgraduate aspirants aged 18-35 years were enrolled in the study. The subjects completed a detailed, semi-structured questionnaire that gathered data regarding their sociodemographic profile and factors considered to be risk factors for LBP. Anthropometric measurements, including height and weight, were measured and body mass index was calculated. Most subjects (90.6%) were aged 20-29 years (mean, 24.49; range, 18-35 years). Results indicated that the following factors were associated with LBP in young adults: marital status, previous history of spine problems, strenuous exercise, job satisfaction, monotony, stress, daily number of studying hours, and family history of spine problems ( p <0.05). However, age, sex, smoking, alcoholism, coffee intake, mode and duration of travel, diet, frequency of weightlifting, wearing heels, studying posture, and frequency and type of sports activities were not associated with LBP. The study identified various modifiable and non-modifiable risk factors that precipitated LBP in young adult Indians. Identifying these risk factors at an early stage will prevent LBP progression to a chronic disease state, thereby improving an individual's quality of life and increasing productivity.

Emergency Department Visits Involving Nonmedical Use of Central Nervous System Stimulants among Adults Aged 18 to 34 ...

MedlinePlus

... Emergency Department Visits Involving Nonmedical Use of Central Nervous System Stimulants among Adults Aged 18 to 34 Increased between 2005 and 2011 Central nervous system (CNS) stimulants include prescription drugs, like those used ...

Major depressive disorder and suicidal behavior among urban dwelling Ethiopian adult outpatients at a general hospital.

PubMed

Whittier, Anjalene B; Gelaye, Bizu; Deyessa, Negussie; Bahretibeb, Yonas; Kelkile, Teshome Shibre; Berhane, Yemane; Williams, Michelle A

2016-06-01

We sought to evaluate the prevalence and correlates of major depressive disorder (MDD) and suicidal behavior among urban dwelling Ethiopian adults. This was a cross-sectional study of 1097 outpatient adults (≥18 years of age) in a major hospital in Addis Ababa, Ethiopia. Sociodemographic and lifestyle characteristics were collected via structured interviews. MDD and suicidal behavior were assessed using the Composite International Diagnostic Interview (CIDI) among all study participants. Multivariable logistic regression models were fitted to estimate odds ratios (OR) and 95% confidence intervals (95% CI). Prevalence estimates for lifetime and 12-month MDD were 18.0% and 6.7%, respectively. The prevalence of suicidal behavior during the previous year (i.e., suicidal ideation, plan or attempt) was 15.2% with approximately 4% having reported attempts. Overall, women were more likely to report suicidal behavior (17.8%) than men (11.3%). MDD odds were 1.53-fold higher among women as compared with men (aOR=1.53, 95% CI 1.05-2.23). Lifetime MDD was significantly associated with age, sex, marital status, and self-reported physical health. Participants reporting poor mental health had approximately 3-fold increased odds of MDD (OR=2.93; 95%CI: 1.05-2.23); those between 35 and 44 years old (aOR=1.92; 95%CI: 1.06-3.49) and those older than 55 years (aOR=2.54; 95%CI: 1.16-5.57) had higher odds of MDD. Similarly suicidal behavior was significantly associated with sex, marital status, and self-reported physical and mental health. This cross-sectional study utilized self-reported data from outpatients. Causality cannot be inferred, and results may not be fully generalizable. Overall results show that MDD and suicidal behavior are highly prevalent among urban-dwelling Ethiopian adults. Women and middle-age adults constitute a high-risk group and may therefore benefit from targeted interventions. Copyright © 2016 Elsevier B.V. All rights reserved.

Neuropsychological Assessment of Adult Offenders

ERIC Educational Resources Information Center

Marceau, Roger; Meghani, Rehana; Reddon, John R.

2008-01-01

This report is primarily concerned with reporting on the normative results obtained on a large sample of serious adult offenders. An expanded Halstead-Reitan Neuropsychological Test Battery was administered to 584 adult offenders (OF), 132 normal controls (NC), and 494 acute psychiatric patients (PP). Subjects were between 18 and 44 years of age.…

Incidence of eye cancer in Taiwan: an 18-year review.

PubMed

Cheng, C-Y; Hsu, W-M

2004-02-01

To describe the incidence and histologic patterns of eye cancers in Chinese in Taiwan. Beginning in 1979, cases of cancer in Taiwan were reported to the Taiwan National Cancer Registry. Information on all Chinese patients diagnosed with eye malignancies under the International Classification of Disease, Ninth Revision, site 190, was retrieved for analysis from the data bank of the Taiwan National Cancer Registry. In all, 733 cases with primary eye cancers were identified from 1979 to 1996, an 18-year period. The average annual age-standardized incidence of eye cancers was 2.46 per million population (2.57 for male and 2.33 for female). For cases less than 15 years of age, the most common eye malignancy was retinoblastoma (86.0%), followed by rhabdomyosarcoma (3.9%) and lymphoma (2.8%). For cases 15 years of age or older, the most common eye malignancy was melanoma (28.6%), followed by squamous cell sarcoma (21.0%) and lymphoma (20.8%). The time trends of the incidence of eye cancers were relatively stable over the 18-year period in Taiwan. Retinobalstoma, melanoma, and lymphoma were the three most common eye cancers in this Chinese population.

25 Years of Teamwork for Adult Education in Iowa.

ERIC Educational Resources Information Center

Stacy, W. H.

This silver anniversary report reviews the history of the Iowa Adult Education Association (IAEA) since its founding on April 7, 1945. IAEA conferences, meetings, workshops, and publications are covered year by year, with particular reference to such activities and concerns as leadership training, professional continuing education, educational…

Access to kidney transplantation in European adults aged 75-84 years and related outcomes: an analysis of the European Renal Association-European Dialysis and Transplant Association Registry.

PubMed

Pippias, Maria; Stel, Vianda S; Kramer, Anneke; Abad Diez, Jose M; Aresté-Fosalba, Nuria; Ayav, Carole; Buturovic, Jadranka; Caskey, Fergus J; Collart, Frederic; Couchoud, Cécile; De Meester, Johan; Heaf, James G; Helanterä, Ilkka; Hemmelder, Marc H; Kostopoulou, Myrto; Noordzij, Marlies; Pascual, Julio; Palsson, Runolfur; Reisaeter, Anna Varberg; Traynor, Jamie P; Massy, Ziad; Jager, Kitty J

2018-05-01

To what extent access to, and allocation of kidney transplants and survival outcomes in patients aged ≥75 years have changed over time in Europe is unclear. We included patients aged ≥75-84 years (termed older adults) receiving renal replacement therapy in thirteen European countries between 2005 and 2014. Country differences and time trends in access to, and allocation of kidney transplants were examined. Survival outcomes were determined by Cox regression analyses. Between 2005 and 2014, 1392 older adult patients received 1406 transplants. Access to kidney transplantation varied from ~0% (Slovenia, Greece and Denmark) to ~4% (Norway and various Spanish regions) of all older adult dialysis patients, and overall increased from 0.3% (2005) to 0.9% (2014). Allocation of kidney transplants to older adults overall increased from 0.8% (2005) to 3.2% (2014). Seven-year unadjusted patient and graft survival probabilities were 49.1% (95% confidence interval, 95% CI: 43.6; 54.4) and 41.7% (95% CI: 36.5; 46.8), respectively, with a temporal trend towards improved survival outcomes. In conclusion, in the European dialysis population aged ≥75-84 years access to kidney transplantation is low, and allocation of kidney transplants remains a rare event. Though both are increasing with time and vary considerably between countries. The trend towards improved survival outcomes is encouraging. This information can aid informed decision-making regarding treatment options. © 2018 Steunstichting ESOT.

Aging results for PRD 49 III/epoxy and Kevlar 49/epoxy composite pressure vessels

NASA Technical Reports Server (NTRS)

Hamstad, M. A.

1983-01-01

Kevlar 49/epoxy composite is growing in use as a structural material because of its high strength-to-weight ratio. Currently, it is used for the Trident rocket motor case and for various pressure vessels on the Space Shuttle. In 1979, the initial results for aging of filament-wound cylindrical pressure vessels which were manufactured with preproduction Kevlar 49 (Hamstad, 1979) were published. This preproduction fiber was called PRD 49 III. This report updates the continuing study to 10-year data and also presents 7.5-year data for spherical pressure vessels wound with production Kevlar 49. For completeness, this report will again describe the specimens of the original study with PRD 49 as well as specimens for the new study with Kevlar 49.

Association of Coronary Artery Calcium in Adults Aged 32 to 46 Years With Incident Coronary Heart Disease and Death

PubMed Central

Jacobs, David R.; Terry, James G.; Shay, Christina M.; Sidney, Stephen; Liu, Kiang; Schreiner, Pamela J.; Lewis, Cora E.; Shikany, James M.; Reis, Jared P.; Goff, David C.

2017-01-01

Importance Coronary artery calcium (CAC) is associated with coronary heart disease (CHD) and cardiovascular disease (CVD); however, prognostic data on CAC are limited in younger adults. Objective To determine if CAC in adults aged 32 to 46 years is associated with incident clinical CHD, CVD, and all-cause mortality during 12.5 years of follow-up. Design, Setting, and Participants The Coronary Artery Risk Development in Young Adults (CARDIA) Study is a prospective community-based study that recruited 5115 black and white participants aged 18 to 30 years from March 25, 1985, to June 7, 1986. The cohort has been under surveillance for 30 years, with CAC measured 15 (n = 3043), 20 (n = 3141), and 25 (n = 3189) years after recruitment. The mean follow-up period for incident events was 12.5 years, from the year 15 computed tomographic scan through August 31, 2014. Main Outcomes and Measures Incident CHD included fatal or nonfatal myocardial infarction, acute coronary syndrome without myocardial infarction, coronary revascularization, or CHD death. Incident CVD included CHD, stroke, heart failure, and peripheral arterial disease. Death included all causes. The probability of developing CAC by age 32 to 56 years was estimated using clinical risk factors measured 7 years apart between ages 18 and 38 years. Results At year 15 of the study among 3043 participants (mean [SD] age, 40.3 [3.6] years; 1383 men and 1660 women), 309 individuals (10.2%) had CAC, with a geometric mean Agatston score of 21.6 (interquartile range, 17.3-26.8). Participants were followed up for 12.5 years, with 57 incident CHD events and 108 incident CVD events observed. After adjusting for demographics, risk factors, and treatments, those with any CAC experienced a 5-fold increase in CHD events (hazard ratio [HR], 5.0; 95% CI, 2.8-8.7) and 3-fold increase in CVD events (HR, 3.0; 95% CI, 1.9-4.7). Within CAC score strata of 1-19, 20-99, and 100 or more, the HRs for CHD were 2.6 (95% CI, 1

Pneumococcal Vaccination Among Medicare Beneficiaries Occurring After the Advisory Committee on Immunization Practices Recommendation for Routine Use Of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine for Adults Aged ≥65 Years.

PubMed

Black, Carla L; Williams, Walter W; Warnock, Rob; Pilishvili, Tamara; Kim, David; Kelman, Jeffrey A

2017-07-14

On September 19, 2014, CDC published the Advisory Committee on Immunization Practices (ACIP) recommendation for the routine use of 13-valent pneumococcal conjugate vaccine (PCV13) among adults aged ≥65 years, to be used in series with 23-valent pneumococcal polysaccharide vaccine (PPSV23) (1). This replaced the previous recommendation that adults aged ≥65 years should be vaccinated with a single dose of PPSV23. As a proxy for estimating PCV13 and PPSV23 vaccination coverage among adults aged ≥65 years before and after implementation of these revised recommendations, CDC analyzed claims for vaccination submitted for reimbursement to the Centers for Medicare & Medicaid Services (CMS). Claims from any time during a beneficiary's enrollment in Medicare Parts A (hospital insurance) and B (medical insurance) since reaching age 65 years were assessed among beneficiaries continuously enrolled in Medicare Parts A and B during annual periods from September 19, 2009, through September 18, 2016. By September 18, 2016, 43.2% of Medicare beneficiaries aged ≥65 years had claims for at least 1 dose of PPSV23 (regardless of PCV13 status), 31.5% had claims for at least 1 dose of PCV13 (regardless of PPSV23 status), and 18.3% had claims for at least 1 dose each of PCV13 and PPSV23. Claims for either type of pneumococcal vaccine were highest among beneficiaries who were older, white, or with chronic and immunocompromising medical conditions than among healthy adults. Implementation of the National Vaccine Advisory Committee's standards for adult immunization practice to assess vaccination status at every patient encounter, recommend needed vaccines, and administer vaccination or refer to a vaccinating provider might help increase pneumococcal vaccination coverage and reduce the risk for pneumonia and invasive pneumococcal disease among older adults (2).

Age-related self-overestimation of step-over ability in healthy older adults and its relationship to fall risk

PubMed Central

2013-01-01

Background Older adults could not safely step over an obstacle unless they correctly estimated their physical ability to be capable of a successful step over action. Thus, incorrect estimation (overestimation) of ability to step over an obstacle could result in severe accident such as falls in older adults. We investigated whether older adults tended to overestimate step-over ability compared with young adults and whether such overestimation in stepping over obstacles was associated with falls. Methods Three groups of adults, young-old (age, 60–74 years; n, 343), old-old (age, >74 years; n, 151), and young (age, 18–35 years; n, 71), performed our original step-over test (SOT). In the SOT, participants observed a horizontal bar at a 7-m distance and estimated the maximum height (EH) that they could step over. After estimation, they performed real SOT trials to measure the actual maximum height (AH). We also identified participants who had experienced falls in the 1 year period before the study. Results Thirty-nine young-old adults (11.4%) and 49 old-old adults (32.5%) failed to step over the bar at EH (overestimation), whereas all young adults succeeded (underestimation). There was a significant negative correlation between actual performance (AH) and self-estimation error (difference between EH and AH) in the older adults, indicating that older adults with lower AH (SOT ability) tended to overestimate actual ability (EH > AH) and vice versa. Furthermore, the percentage of participants who overestimated SOT ability in the fallers (28%) was almost double larger than that in the non-fallers (16%), with the fallers showing significantly lower SOT ability than the non-fallers. Conclusions Older adults appear unaware of age-related physical decline and tended to overestimate step-over ability. Both age-related decline in step-over ability, and more importantly, overestimation or decreased underestimation of this ability may raise potential risk of falls. PMID

Trends in Antibiotic Prescribing for Adults in the United States—1995 to 2002

PubMed Central

Roumie, Christianne L; Halasa, Natasha B; Grijalva, Carlos G; Edwards, Kathryn M; Zhu, Yuwei; Dittus, Robert S; Griffin, Marie R

2005-01-01

Context The impact of national efforts to limit antibiotic prescribing has not been fully evaluated. Objectives To analyze trends in outpatient visits associated with antibiotic prescription for U.S. adults. Design Cross-sectional study of data (1995 to 2002) from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. Participants Adults ≥18 years with an outpatient visit to an office- or hospital-based medical practice or to an emergency department. All visits were classified into 1 of 4 diagnostic categories: (1) acute respiratory infection (ARI)—antibiotics rarely indicated, (2) ARI—antibiotics often indicated, (3) nonrespiratory infection—antibiotics often indicated, and (4) all others. Measurements Trends in: (1) Proportion of outpatient visits associated with an antibiotic prescription; (2) proportion of antibiotic prescriptions that were broad spectrum; and (3) number of visits and antibiotic prescriptions per 1,000 U.S. adults ≥18 years of age. Results From 1995–1996 to 2001–2002, the proportion of all outpatient visits that generated an antibiotic prescription decreased from 17.9% to 15.3% (adjusted odds ratio [OR] 0.84, 95 % confidence interval [CI] 0.76 to 0.92). The entire reduction was because of a decrease in antibiotic prescriptions associated with visits for ARIs where antibiotics are rarely indicated from 59.9% to 49.1% (adjusted OR 0.64 95% CI 0.51 to 0.80). However, the proportion of prescribed antibiotics for these visits that were classified as broad-spectrum antibiotic prescription increased from 41.0% to 76.8%. Overall outpatient visits increased from 1693 to 1986 per 1,000 adults over the 8 years studied, but associated antibiotic prescriptions changed little, from 302 to 304 per 1,000 adults. Conclusion During the study period, outpatient antibiotic prescribing for respiratory infections where antibiotics are rarely indicated has declined, while the proportion of broad

Folate Insufficiency Due to Celiac Disease in a 49-Year-Old Woman of Southeast Asian-Indian Ethnicity

PubMed Central

Datta Mitra, Ananya; Gupta, Asha; Jialal, Ishwarlal

2016-01-01

The clinical presentation of celiac disease has evolved from chronic diarrhea and malnutrition to mild nutrient insufficiencies. Recently diagnosed adults with celiac disease should be assessed for micronutrient deficiencies because early institution of a gluten-free diet (GFD) prevents morbidity and reduces the incidence of gastrointestinal malignant neoplasms and osteoporosis. In this report, we present the case of a 49-year-old woman of Southeast Asian–Indian descent living in the United States who had folate insufficiency, as manifested by low serum and red blood cell (RBC) folate levels. Further investigation, including serologic testing and intestinal biopsy, confirmed a diagnosis of celiac disease and other nutrient deficiencies. Managing the condition of this patient with folate supplements and implementation of a recommended GFD reversed the folate insufficiency. In conclusion, when serum and/or RBC levels are low in a person of Southeast Asian-Indian descent living in a country with folate fortification of the grain supply, such as the United States, the medical team needs to look for an organic cause, as in our patient, to diagnose and manage celiac disease early and, hopefully, forestall complications. PMID:27406144

Impact of moderate and severe hypodontia and amelogenesis imperfecta on quality of life and self-esteem of adult patients.

PubMed

Hashem, Atef; Kelly, Alan; O'Connell, Brian; O'Sullivan, Michael

2013-08-01

The objective of this study was to investigate the impact of moderate and severe hypodontia and amelogenesis imperfecta on the quality of life and self-esteem of affected adult patients. Forty one adult patients (aged 18-45 years) with clinical and radiological diagnoses of moderate to severe hypodontia and twenty seven patients diagnosed with amelogenesis imperfecta were age and gender matched with a control group of patients attending for routine dental care. Subjects completed the Oral Health Impact Profile [OHIP-49] and Rosenberg Self Esteem Scale. A paired t-test was used to analyse data; the test alpha level was set at P ≤ 0.05. The results for hypodontia patients were significantly different from controls in six out of the seven OHIP-49 domains, the exception being the Handicap domain. Total scores were also significantly different between the two groups (P=0.003). Self-esteem was not significantly different between the two groups (P=0.98). For amelogenesis imperfecta patients the results were significantly different from control patients in four out of the seven domains of the OHIP-49 and also in the total scores (P=0.01). When self-esteem was investigated there was no significant differences between the two groups (P=0.92). Moderate to severe hypodontia and amelogenesis imperfecta have marked negative impacts on the Oral Health Related quality of life of this patient population relative to controls. However, self-esteem was not significantly affected. Copyright © 2013 Elsevier Ltd. All rights reserved.

Long-term impact of family arguments and physical violence on adult functioning at age 30 years: findings from the simmons longitudinal study.

PubMed

Paradis, Angela D; Reinherz, Helen Z; Giaconia, Rose M; Beardslee, William R; Ward, Kirsten; Fitzmaurice, Garrett M

2009-03-01

To prospectively examine the extent to which an increase in family arguments by age 15 years and the occurrence of family physical violence by age 18 years are related to deficits in key domains of adult functioning at age 30 years. The 346 participants were part of a single-age cohort from a predominately white working-class community whose psychosocial development has been traced since age 5 years. Family arguments and violence were assessed through self-reports during adolescence. Developmentally relevant areas of current adult functioning were measured by self-reports, structured diagnostic interviews, and clinical interviewer ratings. Both family arguments and physical violence were significantly related to compromised functioning across multiple areas of adult functioning. Although many associations were somewhat attenuated after controlling for sex, other early family adversities, and family history of disorder, most relations retained statistical significance. Both risk factors were linked with later mental health problems and deficits in psychological and occupational/career functioning. Family violence was also linked to poorer physical health at age 30 years. Findings underscore the potential long-term impact of troubled family interactions and highlight the critical importance of early intervention programs for youths experiencing either verbal conflict or physical violence in the home.

Overrated adults: 4-year-olds' false belief understanding is influenced by the believer's age.

PubMed

Seehagen, Sabine; Dreier, Larissa; Zmyj, Norbert

2018-03-01

Children perceive adults as more knowledgeable than peers. We tested whether this general preconception influences preschoolers' performance in a false-belief task. Children (4- and 5-year-olds; N = 146) watched videos showing a peer protagonist or an adult protagonist experiencing events that should lead the protagonist to hold a false belief. Then children were asked to infer the protagonist's perception of the situation. Age of the protagonist influenced 4-year-olds' judgments but not 5-year-olds' judgments. Specifically, 4-year-olds' performance was at chance when presented with a peer protagonist. Their performance dropped further when presented with an adult protagonist and was significantly below chance. Children aged around 5 years performed above chance level regardless of whether they were presented with an adult or peer protagonist. This suggests that in the younger age group, children's tendency to regard adults as experts in general knowledge undermined their ability to accurately judge the possibility that an adult could hold a false belief. Copyright © 2017 Elsevier Inc. All rights reserved.

"Clinicopathological features and treatment outcomes of differentiated thyroid cancer in Saudi children and adults".

PubMed

Al-Qahtani, Khalid Hussain; Tunio, Mutahir A; Al Asiri, Mushabbab; Aljohani, Naji J; Bayoumi, Yasser; Riaz, Khalid; AlShakweer, Wafa

2015-11-06

Age is an important prognostic factor in differentiated thyroid cancer (DTC). Our aim was to evaluate differences in clinicopathological features and treatment outcomes among children and adult patients with DTC. We studied 27 children (below 18 years) with DTC treated during the period 2000-2012 and were compared with (a) 78 adults aged 19-25 years and (b) 52 adults aged 26-30 years treated during the same period in terms of their clinicopathological features and long term treatment outcomes. Locoregional recurrence (LRR), locoregional control (LRC), distant metastasis (DM), distant metastasis control (DMC), disease free survival (DFS) and overall survival (OS) rates were evaluated. Mean age of children was 13.5 years (range: 5-18), while mean age of adults was 24.6 years (range: 19-30). In children, female: male ratio was 2.85:1, and in adults female: male ratio was 7.1:1 (P = 0.041). No significant difference in tumor size was seen between the two groups (P = 0.653). According to American Thyroid Association (ATA) risk stratification classification, the children (85.2 %) were found to have at high risk as compared to adults P = 0.001. Post-thyroidectomy complications and RAI induced toxicities were observed more in children than adults (P = 0.043 and P = 0.041 respectively). LRR occurred in 6 (22.2 %), 9 (11.5 %) and 3 (5.8 %) in age groups of <18 years, 19-25 years and 26-30 years respectively (P = 0.032); while DM was seen in 10 (37.0 %), 9 (10.3 %) and 5 (9.6 %) in age groups of <18 years, 19-25 years and 26-30 years respectively (P = 0.002). Ten year DFS rates were 67.3 % in age group below 18 years, 82.4 % in age group of 19-25 years and 90.1 % in age group of 26-30 years (P = 0.021). At the time of diagnosis, children with DTC were found to have more aggressive clinicopathological characteristics. Comparatively lower LRC, DMC and DFS rates in children warrants further multi-institutional studies.

[Spanish normative studies in a young adult population (NEURONORMA young adults Project): norms for the verbal span, visuospatial span, Letter-Number Sequencing, Trail Making Test and Symbol Digit Modalities Test].

PubMed

Tamayo, F; Casals-Coll, M; Sánchez-Benavides, G; Quintana, M; Manero, R M; Rognoni, T; Calvo, L; Palomo, R; Aranciva, F; Peña-Casanova, J

2012-01-01

Verbal and visuospatial span, Letter-Number Sequencing, Trail Making Test, and Symbol Digit Modalities Test are frequently used in clinical practice to assess attention, executive functions and memory. In the present study, as part of the Spanish normative studies of NEURONORMA young adults Project, normative data adjusted by age and education are provided for digits, Corsi Block-Tapping Task, Letter-Number Sequencing, Trail Making Test, and Symbol Digit Modalities Test. The sample consisted of 179 participants from 18 to 49 years old, who were cognitively normal. Tables to convert raw scores to scaled scores are provided. Age and education adjusted scores are provided by applying linear regressions. Education affected scores in most of the attention tests; age was found to be related to the visuospatial span and to speed of visuomotor tracking, and there was no relationship as regards sex. The data obtained will be useful in the clinical evaluation of young Spanish adults. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Cognitive impairment 18 years before clinical diagnosis of Alzheimer disease dementia

PubMed Central

Wilson, Robert S.; Weuve, Jennifer; Barnes, Lisa L.; Evans, Denis A.

2015-01-01

Objective: To examine the relation of performance on brief cognitive tests to development of clinically diagnosed Alzheimer disease (AD) dementia over the following 18 years in a sample of African Americans and European Americans. Methods: A composite cognitive test score based on tests of episodic memory, executive function, and global cognition was constructed in a prospective population-based sample of 2,125 participants (55% African American and 61% female) aged 65 years and older residing in 4 Chicago neighborhoods. Time before AD dementia diagnosis was categorized into 6 groups corresponding to data collection periods: 0.1–0.9, 1.0–3.9, 4.0–6.9, 7.0–9.9, 10.0–12.9, and 13.0–17.9 years. Results: Of 2,125 participants without clinical AD dementia, 442 (21%) developed clinical AD dementia over 18 years of follow-up. Lower composite cognitive test scores were associated with the development of AD dementia over the duration of the study. The magnitude of association between composite cognitive test score and development of AD dementia increased from an odds ratio of 3.39 (95% confidence interval 1.72, 6.67; p < 0.001) at 13.0–17.9 years to 9.84 (95% confidence interval 7.41, 13.06; p < 0.001) at 0.1–0.9 years, per SD increment. These associations were consistently larger among European Americans than among African Americans. Performance on individual cognitive tests of episodic memory, executive function, and global cognition also significantly predicted the development of AD dementia, with associations exhibiting a similar trend over 18 years. Conclusions: Our findings suggest that cognitive impairment may manifest in the preclinical phase of AD dementia substantially earlier than previously established. PMID:26109713

Cognitive impairment 18 years before clinical diagnosis of Alzheimer disease dementia.

PubMed

Rajan, Kumar B; Wilson, Robert S; Weuve, Jennifer; Barnes, Lisa L; Evans, Denis A

2015-09-08

To examine the relation of performance on brief cognitive tests to development of clinically diagnosed Alzheimer disease (AD) dementia over the following 18 years in a sample of African Americans and European Americans. A composite cognitive test score based on tests of episodic memory, executive function, and global cognition was constructed in a prospective population-based sample of 2,125 participants (55% African American and 61% female) aged 65 years and older residing in 4 Chicago neighborhoods. Time before AD dementia diagnosis was categorized into 6 groups corresponding to data collection periods: 0.1-0.9, 1.0-3.9, 4.0-6.9, 7.0-9.9, 10.0-12.9, and 13.0-17.9 years. Of 2,125 participants without clinical AD dementia, 442 (21%) developed clinical AD dementia over 18 years of follow-up. Lower composite cognitive test scores were associated with the development of AD dementia over the duration of the study. The magnitude of association between composite cognitive test score and development of AD dementia increased from an odds ratio of 3.39 (95% confidence interval 1.72, 6.67; p < 0.001) at 13.0-17.9 years to 9.84 (95% confidence interval 7.41, 13.06; p < 0.001) at 0.1-0.9 years, per SD increment. These associations were consistently larger among European Americans than among African Americans. Performance on individual cognitive tests of episodic memory, executive function, and global cognition also significantly predicted the development of AD dementia, with associations exhibiting a similar trend over 18 years. Our findings suggest that cognitive impairment may manifest in the preclinical phase of AD dementia substantially earlier than previously established. © 2015 American Academy of Neurology.

The Impact of Mentor Leadership Styles on First-Year Adult Student Retention

ERIC Educational Resources Information Center

Smith Staley, Charlesetta

2012-01-01

This quantitative study explored the leadership styles of mentors for retained first-year adult students to analyze whether the prevalent style had a higher impact on first-year adult student retention. The Multifactor Leadership Questionnaire (MLQ) 5x was used to collect data on the mentors' leadership styles from the perspective of retained…

Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States.

PubMed

Hasin, Deborah S; Sarvet, Aaron L; Meyers, Jacquelyn L; Saha, Tulshi D; Ruan, W June; Stohl, Malka; Grant, Bridget F

2018-04-01

No US national data are available on the prevalence and correlates of DSM-5-defined major depressive disorder (MDD) or on MDD specifiers as defined in DSM-5. To present current nationally representative findings on the prevalence, correlates, psychiatric comorbidity, functioning, and treatment of DSM-5 MDD and initial information on the prevalence, severity, and treatment of DSM-5 MDD severity, anxious/distressed specifier, and mixed-features specifier, as well as cases that would have been characterized as bereavement in DSM-IV. In-person interviews with a representative sample of US noninstitutionalized civilian adults (≥18 years) (n = 36 309) who participated in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III). Data were collected from April 2012 to June 2013 and were analyzed in 2016-2017. Prevalence of DSM-5 MDD and the DSM-5 specifiers. Odds ratios (ORs), adjusted ORs (aORs), and 95% CIs indicated associations with demographic characteristics and other psychiatric disorders. Of the 36 309 adult participants in NESARC-III, 12-month and lifetime prevalences of MDD were 10.4% and 20.6%, respectively. Odds of 12-month MDD were significantly lower in men (OR, 0.5; 95% CI, 0.46-0.55) and in African American (OR, 0.6; 95% CI, 0.54-0.68), Asian/Pacific Islander (OR, 0.6; 95% CI, 0.45-0.67), and Hispanic (OR, 0.7; 95% CI, 0.62-0.78) adults than in white adults and were higher in younger adults (age range, 18-29 years; OR, 3.0; 95% CI, 2.48-3.55) and those with low incomes ($19 999 or less; OR, 1.7; 95% CI, 1.49-2.04). Associations of MDD with psychiatric disorders ranged from an aOR of 2.1 (95% CI, 1.84-2.35) for specific phobia to an aOR of 5.7 (95% CI, 4.98-6.50) for generalized anxiety disorder. Associations of MDD with substance use disorders ranged from an aOR of 1.8 (95% CI, 1.63-2.01) for alcohol to an aOR of 3.0 (95% CI, 2.57-3.55) for any drug. Most lifetime MDD cases were moderate (39.7%) or severe

Fifteen-Year Survival of Endoscopic Anterior Cruciate Ligament Reconstruction in Patients Aged 18 Years and Younger.

PubMed

Morgan, Matthew D; Salmon, Lucy J; Waller, Alison; Roe, Justin P; Pinczewski, Leo A

2016-02-01

The current body of literature surrounding anterior cruciate ligament (ACL) survival and the variables contributing to further ACL injuries after primary ACL reconstruction in children and adolescents is limited, with no long-term evidence examining the incidence and contributing factors of further ACL injuries in this younger patient population. To determine the long-term survival of the ACL graft and the contralateral ACL (CACL) after primary reconstruction in patients aged ≤18 years and to identify the factors that increase the odds of subsequent ACL injuries. Case series; Level of evidence, 4. Patients having undergone primary ACL reconstruction at age ≤18 years between 1993 and 1998 who were included in a prospective database by a single surgeon were considered for this study. Single-incision endoscopic ACL reconstruction was performed with either an autologous bone-patellar tendon-bone graft or a hamstring tendon graft. At a minimum of 15 years after ACL reconstruction, patients completed a subjective survey involving the International Knee Documentation Committee (IKDC) questionnaire in addition to questions regarding current symptoms, further ACL injuries, family history of ACL injury, and current level of activity. A total of 288 adolescents (age range, 13-18 years) met the inclusion criteria, of whom 242 (84%) were reviewed at a mean of 16 years and 6 months after ACL reconstruction. Of these patients, 75 (31%) sustained a further ACL injury: 27 (11.2%) suffered an ACL graft rupture, 33 suffered a CACL injury (13.6%), and 15 sustained both an ACL graft rupture and a CACL injury (6.2%) over 15 years. Survival of the ACL graft was 95%, 92%, 88%, 85%, and 83% at 1, 2, 5, 10, and 15 years, respectively, and survival of the CACL was 99%, 98%, 90%, 83%, and 81%, respectively. Survival of the ACL graft was less favorable in those with a family history of ACL injury than in those without a family history (69% vs 90%, respectively; hazard ratio [HR], 3.6; P

Ten-Year Changes in the Prevalence and Socio-Demographic Determinants of Physical Activity among Polish Adults Aged 20 to 74 Years. Results of the National Multicenter Health Surveys WOBASZ (2003-2005) and WOBASZ II (2013-2014).

PubMed

Kwaśniewska, Magdalena; Pikala, Małgorzata; Bielecki, Wojciech; Dziankowska-Zaborszczyk, Elżbieta; Rębowska, Ewa; Kozakiewicz, Krystyna; Pająk, Andrzej; Piwoński, Jerzy; Tykarski, Andrzej; Zdrojewski, Tomasz; Drygas, Wojciech

2016-01-01

The aim of the study was to estimate ten-year changes in physical activity (PA) patterns and sociodemographic determinants among adult residents of Poland. The study comprised two independent samples of randomly selected adults aged 20-74 years participating in the National Multicentre Health Survey WOBASZ (2003-2005; n = 14572) and WOBASZ II (2013-2014; n = 5694). In both surveys the measurements were performed by six academic centers in all 16 voivodships of Poland (108 measurement points in each survey). Sociodemographic data were collected by an interviewer-administered questionnaire in both surveys. Physical activity was assessed in three domains: leisure-time, occupational and commuting physical activity. Leisure-time PA changed substantially between the surveys (p<0.001). The prevalence of subjects being active on most days of week fell in both genders in the years 2003-2014 (37.4% vs 27.3% in men); 32.7% vs 28.3% in women. None or occasional activity increased from 49.6% to 56.8% in men, while remained stable in women (55.2% vs 54.9%). In both WOBASZ surveys the likelihood of physical inactivity was higher in less educated individuals, smokers and those living in large agglomerations (p<0.01). No significant changes were observed in occupational activity in men between the surveys, while in women percentage of sedentary work increased from 43.4% to % 49.4% (p<0.01). Commuting PA decreased significantly in both genders (p<0.001). About 79.3% of men and 71.3% of women reported no active commuting in the WOBASZ II survey. The observed unfavourable changes in PA emphasize the need for novel intervention concepts in order to reverse this direction. Further detailed monitoring of PA patterns in Poland is of particular importance.

Impaired IQ and Academic Skills in Adults Who Experienced Moderate to Severe Infantile Malnutrition: A Forty-Year Study

PubMed Central

Waber, Deborah P.; Bryce, Cyralene P.; Girard, Jonathan M.; Zichlin, Miriam; Fitzmaurice, Garrett M.; Galler, Janina R.

2013-01-01

Objectives To evaluate IQ and academic skills in adults who experienced an episode of moderate to severe infantile malnutrition and a healthy control group, all followed since childhood in the Barbados Nutrition Study. Methods IQ and academic skills were assessed in 77 previously malnourished adults (mean age=38.4 years; 53% male) and 59 controls (mean age=38.1 years; 54% male). Group comparisons were carried out by multiple regression and logistic regression, adjusted for childhood socioeconomic factors. Results The previously malnourished group showed substantial deficits on all outcomes relative to healthy controls (p<0.0001). IQ scores in the Intellectual Disability range (< 70) were 9 times more prevalent in the previously malnourished group (OR=9.18; 95% CI=3.50-24.13). Group differences in IQ of approximately one standard deviation were stable from adolescence through mid-life. Discussion Moderate to severe malnutrition during infancy is associated with a significantly elevated incidence of impaired IQ in adulthood, even when physical growth is completely rehabilitated. An episode of malnutrition during the first year of life carries risk for significant lifelong functional morbidity. PMID:23484464

Alcohol use assessment in young adult cancer survivors.

PubMed

Breitenbach, Katherine; Epstein-Reeves, Marc; Hacker, Eileen; Corte, Colleen; Piano, Mariann R

2014-09-01

To determine whether oncology practitioners assess for alcohol consumption rates and usage patterns among young adult cancer survivors, and to determine drinking patterns and frequency of alcoholic beverage consumption among young adult cancer survivors. Retrospective chart review. Two outpatient cancer clinics. 77 young adult survivors of childhood cancer aged 18-30 years. Charts were selected from June to December 2009 and data were extracted using a structured questionnaire. Oncology practitioner assessment of alcohol use and alcohol consumption of young adult cancer survivors. Alcohol screening was conducted for 48 participants. No significant differences were noted in most variables between those not screened for alcohol use and those screened for alcohol use. Of the 48 screened for alcohol use, 30 reported "no use." For the 18 who reported alcohol use, the terms used to describe the frequency varied and were vague. The key finding of the study was that screening and documentation of alcohol consumption was poorly and inconsistently performed in the authors' sample of young adult cancer survivors. Similar to healthy young adults aged 18-30 years, young adult cancer survivors are at a developmental age where it is likely they will engage in unhealthy drinking; therefore, they should be screened for alcohol use and binge drinking. Practitioners can incorporate simple, short questions into health assessment visits that allow them to screen for unhealthy alcohol use.

Human papillomavirus vaccine uptake among 18- to 26-year-old women in the United States: National Health Interview Survey, 2010.

PubMed

Laz, Tabassum H; Rahman, Mahbubur; Berenson, Abbey B

2013-04-01

Human papillomavirus (HPV) vaccine uptake among young adult women has been reported to be very low. The authors conducted this study to provide an update on HPV vaccine uptake among 18- to 26-year-old women. The authors used the National Health Interview Survey 2010 data to estimate HPV vaccine coverage and their correlates. Overall, 22.7% of women initiated (≥1 dose) and 12.7% completed the vaccine (≥3 doses). Thus, about 56% of women who initiated the vaccine completed it. Multivariate logistic regression analyses showed that younger age, unmarried status, Papanicolaou test, influenza vaccine, lifetime vaccines, and HPV vaccine awareness were positively associated with receiving ≥1 and ≥3 doses. In addition, uninsured women were less likely to receive ≥1 dose (odds ratio [OR], 0.49; 95% confidence interval [CI], 0.28-0.84), and blacks (OR, 0.48; 95% CI, 0.23-0.99) and women with a family income <100% of the federal poverty level (OR, 0.40; 95% CI, 0.21-0.73) were less likely to receive ≥3 doses. Furthermore, based on vaccine initiators, blacks were less likely than whites to complete the vaccine (OR, 0.29; 95% CI, 0.16-0.55). Two thirds of unvaccinated women were not interested in future vaccination. Among those who were interested, >76.4% preferred to receive it free or at a lower cost, whereas 20% would pay the full cost of the vaccine. One in 8 women completed the 3-dose HPV vaccine. Educational and vaccine financing programs are needed to improve the uptake among low-income minority women who are at increased risk for cervical cancer. Copyright © 2012 American Cancer Society.

Cognitive Enhancement Therapy for Adults with Autism Spectrum Disorder: Results of an 18-Month Feasibility Study

PubMed Central

Eack, Shaun M.; Greenwald, Deborah P.; Hogarty, Susan S.; Bahorik, Amber L.; Litschge, Maralee Y.; Mazefsky, Carla A.; Minshew, Nancy J.

2013-01-01

Adults with autism experience significant impairments in social and non-social information processing for which few treatments have been developed. This study conducted an 18-month uncontrolled trial of Cognitive Enhancement Therapy (CET), a comprehensive cognitive rehabilitation intervention, in 14 verbal adults with autism spectrum disorder to investigate its feasibility, acceptability, and initial efficacy in treating these impairments. Results indicated that CET was satisfying to participants, with high treatment attendance and retention. Effects on cognitive deficits and social behavior were also large (d = 1.40 to 2.29) and statistically significant (all p < .001). These findings suggest that CET is a feasible, acceptable, and potentially effective intervention for remediating the social and non-social cognitive impairments in verbal adults with autism. PMID:23619953