Gokler, Mehmet Enes; Unsal, Alaettin; Arslantas, Didem
Background To determine the correlates and the prevalence of infertility in a group of women. Materials and Methods This cross-sectional study was carried out on 570 subjects aged 18-49 years in a town of western Turkey between July and August 2012. Women who have inability to become pregnant despite regular sexual intercourse during the last year were considered to be infertile. UCLA Loneliness Scale was used to assess the severity of loneliness. The data were analyzed by Kruskal-Wallis, Mann Whitney U and Chi-square tests. Results The mean age of the participants was 35.48 ± 8.39 years. The frequency of the infertility in our study was 12.8% (n=73). The prevalence of infertility was higher in those with a history of gynecological disease or gynecologic surgery and in those with menstrual irregularity (p<0.05; for each). The mean score on the UCLA Loneliness Scale was 32.16 ± 9.49 (from 20 to 70). In this study, no difference was found between the level of loneliness and who is responsible for infertility among infertile/fertile women (p≥0.05). Level of loneliness among the women with primary infertility was higher compared to the women with secondary infertility (p<0.05). Conclusion The prevalence of infertility among the women was relatively high. It was concluded that prospective studies are needed in order to expose the relationship between the infertility and the level of loneliness in women. PMID:25083180
van der Velde, Jeroen H P M; Savelberg, Hans H C M; Schaper, Nicolaas C; Koster, Annemarie
This cross-sectional study is one of the first to examine and compare the independent associations of objectively measured sedentary time, moderate to vigorous physical activity (MVPA) and fitness with cardio-metabolic risk factors. We studied 543 men and women (aged 18-49 years) from the NHANES 2003-2004 survey. Sedentary time and MVPA were measured by accelerometry. Fitness was assessed with a submaximal treadmill test. Cardio-metabolic risk factors included: waist circumference (WC), BMI, blood pressure, fasting glucose, HDL- and non HDL cholesterol, triglycerides (TG), and C-reactive protein (CRP). Sedentary time, MVPA and fitness were used as predictors for the cardio-metabolic outcomes in a multiple regression analysis. Standardized regression coefficients were computed. Results show that sedentary time was associated with HDL-cholesterol (β=-0.080, p=0.05) and TG (β=0.080, p=0.03). These results became non-significant after adjustment for MVPA and fitness. MVPA was associated with WC (β=-0.226), BMI (β=-0.239), TG (β=-0.108) and HDL-cholesterol (β=0.144) (all p<0.05). These results remained significant after adjustment for sedentary time and fitness. Fitness was associated with WC (β=-0.287), BMI (β=-0.266), systolic blood pressure (β=-0.159), TG (β=-0.092), and CRP (β=-0.130) (all p<0.05). After adjustment for sedentary time and MVPA these results remained significant. These differences in relative importance of sedentary time, MVPA and fitness on cardio-metabolic-risk are important in the design of prevention programs. In this population, the strength of the associations between MVPA and fitness with cardio-metabolic markers appeared to be similar; both MVPA and fitness showed independent associations with cardio-metabolic risk factors. In contrast, sedentary time showed no independent associations with cardio-metabolic risk after correction for fitness and MVPA.
... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Connection boxes on machines. 18.49 Section 18... Design Requirements § 18.49 Connection boxes on machines. Connection boxes used to facilitate replacement of cables or machine components shall be explosion-proof. Portable-cable terminals on cable...
... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Connection boxes on machines. 18.49 Section 18... Design Requirements § 18.49 Connection boxes on machines. Connection boxes used to facilitate replacement of cables or machine components shall be explosion-proof. Portable-cable terminals on cable...
... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Connection boxes on machines. 18.49 Section 18... Design Requirements § 18.49 Connection boxes on machines. Connection boxes used to facilitate replacement of cables or machine components shall be explosion-proof. Portable-cable terminals on cable...
... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Connection boxes on machines. 18.49 Section 18... Design Requirements § 18.49 Connection boxes on machines. Connection boxes used to facilitate replacement of cables or machine components shall be explosion-proof. Portable-cable terminals on cable...
... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Connection boxes on machines. 18.49 Section 18... Design Requirements § 18.49 Connection boxes on machines. Connection boxes used to facilitate replacement of cables or machine components shall be explosion-proof. Portable-cable terminals on cable...
Wilson, J. L. J.
In examining thirty-eight years in adult education, this document refers to nineteenth- and twentieth-century adult education, which was influenced by some dynamic factors; personal and social dissatisfactions; an urgent desire for freedom and liberation; and a determination to change things for the better, for personal and social reasons. The…
Gunn, Deborah; Eason, Richard
This catalog contains information on 272 adult education projects conducted during fiscal year 1981. The projects are grouped in the following 20 categories: administration, adult basic education, adult performance level/life skills, assessment/testing, community linkage, competency-based adult education, corrections education, counseling,…
Woodman, Ashley C.; Mailick, Marsha R.; Anderson, Kristy A.; Esbensen, Anna J.
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…
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…
Williams, Walter W; Lu, Peng-Jun; Lindley, Megan C; Kennedy, Erin D; Singleton, James A
In the United States, annual influenza epidemics typically occur during the late fall through early spring. During these epidemics, rates of serious illness and death are highest among adults aged ≥65 years, children aged <2 years, and persons of any age who have medical conditions that increase their risk for complications from influenza. Adults aged 50-64 years who have underlying medical conditions have a substantially increased risk for hospitalization during the influenza season. Influenza illness among healthy adults aged 18-64 years typically is not as severe as the illness among adults aged ≥65 years, pregnant women, or persons with chronic medical conditions and less frequently results in hospitalization. However, influenza among healthy adults aged 18-49 years is an important cause of outpatient medical visits and worker absenteeism. An economic analysis estimated an annual average of approximately 5 million illnesses, 2.4 million outpatient visits, 32,000 hospitalizations, and 680 deaths from influenza among adults aged 18-49 years who did not have a medical condition that increased their risk for influenza complications. In this analysis, adults aged 18-49 years accounted for 10% of the total economic cost from influenza, or approximately $8.7 billion.
... page: //medlineplus.gov/ency/presentations/100222.htm Choking first aid - adult or child over 1 year - series—Part ... occur in as little as 4 minutes. Rapid first aid for choking can save a life. The universal ...
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…
Woodman, Ashley C.; Mailick, Marsha R.; Anderson, Kristy A.; Esbensen, Anna J.
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
Tsang, Peter; Gorse, Geoffrey J; Strout, Cynthia B; Sperling, Malcolm; Greenberg, David P; Ozol-Godfrey, Ayca; DiazGranados, Carlos; Landolfi, Victoria
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).
Pinto, Jayant M.; Wroblewski, Kristen E.; Kern, David W.; Schumm, L. Philip; McClintock, Martha K.
Prediction of mortality has focused on disease and frailty, although antecedent biomarkers may herald broad physiological decline. Olfaction, an ancestral chemical system, is a strong candidate biomarker because it is linked to diverse physiological processes. We sought to determine if olfactory dysfunction is a harbinger of 5-year mortality in the National Social Life, Health and Aging Project [NSHAP], a nationally representative sample of older U.S. adults. 3,005 community-dwelling adults aged 57–85 were studied in 2005–6 (Wave 1) and their mortality determined in 2010–11 (Wave 2). Olfactory dysfunction, determined objectively at Wave 1, was used to estimate the odds of 5-year, all cause mortality via logistic regression, controlling for demographics and health factors. Mortality for anosmic older adults was four times that of normosmic individuals while hyposmic individuals had intermediate mortality (p<0.001), a “dose-dependent” effect present across the age range. In a comprehensive model that included potential confounding factors, anosmic older adults had over three times the odds of death compared to normosmic individuals (OR, 3.37 [95%CI 2.04, 5.57]), higher than and independent of known leading causes of death, and did not result from the following mechanisms: nutrition, cognitive function, mental health, smoking and alcohol abuse or frailty. Olfactory function is thus one of the strongest predictors of 5-year mortality and may serve as a bellwether for slowed cellular regeneration or as a marker of cumulative toxic environmental exposures. This finding provides clues for pinpointing an underlying mechanism related to a fundamental component of the aging process. PMID:25271633
Pinto, Jayant M; Wroblewski, Kristen E; Kern, David W; Schumm, L Philip; McClintock, Martha K
Prediction of mortality has focused on disease and frailty, although antecedent biomarkers may herald broad physiological decline. Olfaction, an ancestral chemical system, is a strong candidate biomarker because it is linked to diverse physiological processes. We sought to determine if olfactory dysfunction is a harbinger of 5-year mortality in the National Social Life, Health and Aging Project [NSHAP], a nationally representative sample of older U.S. adults. 3,005 community-dwelling adults aged 57-85 were studied in 2005-6 (Wave 1) and their mortality determined in 2010-11 (Wave 2). Olfactory dysfunction, determined objectively at Wave 1, was used to estimate the odds of 5-year, all cause mortality via logistic regression, controlling for demographics and health factors. Mortality for anosmic older adults was four times that of normosmic individuals while hyposmic individuals had intermediate mortality (p<0.001), a "dose-dependent" effect present across the age range. In a comprehensive model that included potential confounding factors, anosmic older adults had over three times the odds of death compared to normosmic individuals (OR, 3.37 [95%CI 2.04, 5.57]), higher than and independent of known leading causes of death, and did not result from the following mechanisms: nutrition, cognitive function, mental health, smoking and alcohol abuse or frailty. Olfactory function is thus one of the strongest predictors of 5-year mortality and may serve as a bellwether for slowed cellular regeneration or as a marker of cumulative toxic environmental exposures. This finding provides clues for pinpointing an underlying mechanism related to a fundamental component of the aging process.
Aoyagi, Shigeaki; Yoshitake, Kiyonobu; Matsuo, Atsutoshi; Tayama, Kei-Ichiro; Hida, Satoru; Mito, Takahiro
Ebstein's anomaly (EA) is a rare congenital heart disease of the tricuspid valve, and less than 5% of patients with EA survive beyond the age of 50. We report two unoperated cases of EA in adult patients aged over 50 years. Two patients, a 70-year-old Japanese woman and a 59-year-old Chinese woman, were referred to us for tachyarrhythmias. Transthoracic echocardiography demonstrated apical displacement (>8 mm/m(2) body surface area) of the septal leaflet of the tricuspid valve from the atrioventricular ring with tricuspid regurgitation in both patients. The former suddenly expired 20 months later after suffering from repetitive supraventricular tachyarrhythmias and/or heart failure, and the latter is alive with minimal signs of heart failure 12 months after the diagnosis of EA. Although the natural history of EA is extremely variable, these two patients are exceptional in that they tolerated EA well for over 50 years without any surgical intervention.
Wick, Regula; Gilbert, John D; Simpson, Ellie; Byard, Roger W
A retrospective study was undertaken of all cases of death in adults (>16 years) due to electrocution which were autopsied at Forensic Science SA, Adelaide, Australia, over a 30-year period from 1973 to 2002. A total of 96 cases were identified with 87 males (91%) (mean age=41.6 years; range 17 to 86 years) and nine females (9%) (mean age=49.2 years; range 20 to 76 years). Deaths were due to accidents in 66 cases (69%; M:F = 63:3), suicides in 28 cases (29%; M:F=24:4) and homicides in two cases (2%). Both homicide victims were females, with females accounting for only 5% of the accidents and 14% of suicides. The number of accidental deaths increased until the early 1990s and then declined, whereas suicidal electrocutions were only found in the last 20 years of the study. Most deaths (N = 80; 83%) were due to low voltage circuits (<1000 volts), with deaths due to high voltages occurring in 15 cases (16%). One death was due to lightning (1%). While suicides were evenly distributed throughout the year, most accidental deaths occurred in late spring and summer (N = 42; 64%) with the lowest number of accidental deaths occurring in winter and early spring. This report demonstrates a significantly higher rate of electrocution deaths among males, with a summer predominance of accidental deaths, most likely due to increased outdoor activities in better weather. The reduction in cases over the last decade of the study may be a reflection of the success of workplace and domestic safety campaigns. Female electrocution suicides and electrocution homicides were rare events.
Lee, Ing-Kit; Yang, Wen-Chou; Liu, Jien-Wei
Twenty-nine adults (mean age, 59.9 +/- 13.5 years) with scrotal tuberculosis (TB) were retrospectively analyzed. The mean interval from emergence of symptoms suggestive of scrotal TB to diagnosis established was 142.44 +/- 227.66 days. Scrotal TB was initially suspected in only five (17.2%) patients, and infection caused by bacteria other than Mycobacterium tuberculosis (55.2%) was the leading presumptive diagnosis. Of 28 patients with chest radiographs available, 7 (25%) disclosed active pulmonary TB, and 9 (32.1%) showed a TB scar. All patients received anti-TB chemotherapy; 20 (69%) additionally underwent surgery. Pathologic examination of resected tissue at therapeutic surgery, biopsy, or polymerase chain reaction assay of urine led to rapid diagnosis of scrotal TB. Although evidence of scrotal TB was easily obtainable, the lack of alertness made clinicians avert from the appropriate diagnostic approaches and rendered a delayed diagnosis. Our report underscores the urgent need for improving clinicians' awareness of scrotal TB.
Concern over short life expectancy in developing societies (such as in Nigeria), the generally poor economic plight of the elderly, and the ignorance and hardship being experienced by aging adults prompted an investigation into the determinants of longevity in 1984, with a view to seeking ways of increasing life span through the provision of appropriate education for the elderly. Since 1984 332 elders of 65 years and above in Nigeria have thus been interviewed. A study of 458 retired persons in Lagos State by a doctoral student was used to support the investigation. Observation of the responses shows that longevity is determined by several factors and combinations of factors ranging over closeness to and faith in God, heredity, modest living, moderation in everything, contentment and so on. The investigation also showed that most of the illiterate elders are poor and are going through the aging process in discomfort while the literate ones are experiencing aging gracefully. It was also found that most retirees were ill prepared for retirement and are maladjusting in post-retirement life.
Bryce, Cyralene; Waber, Deborah P.; Zichlin, Miriam L.; Fitzmaurice, Garret M.; Eaglesfield, David
OBJECTIVE: Lifelong functional, adaptive, and economic outcomes of moderate to severe infantile malnutrition are not well known. We assessed social status and income at midlife in a cohort of Barbadian adults, hospitalized for protein-energy malnutrition (PEM) during the first year of life, with good nutrition and health thereafter, in the context of a 40-year longitudinal case-control study. We also examined to what extent childhood IQ mediated any group differences. METHODS: Educational achievement, occupational status, and standard of living were assessed by the Hollingshead scales and a site-specific Ecology Questionnaire in Barbadian adults (aged 37–43 years) with a history of malnutrition (n = 80) and a matched healthy control group (n = 63), classmates of the index cases. Malnutrition effects, adjusted for childhood standard of living, were estimated by longitudinal multiple regression analyses, with and without childhood IQ, in the models. RESULTS: PEM predicted poorer socioeconomic outcomes with medium to large effect sizes (0.50–0.94), but childhood IQ substantially attenuated the magnitude of these effects (adjusted effect sizes: 0.17–0.34). The gap in weekly household income between the PEM and control groups increased substantially over the life span (P < .001). CONCLUSIONS: Moderate to severe PEM during the first year of life with adequate nutrition and health care thereafter is associated with significant depression of socioeconomic outcomes in adulthood, mediated in part by cognitive compromise in affected individuals. This finding underscores the potential long-term economic burden of infant malnutrition, which is of major concern given the continued high prevalence of malnutrition worldwide. PMID:22732170
Proietti, Valentina; Pavone, Sarah; Ricciardelli, Paola; Macchi Cassia, Viola
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.
Kilpela, Lisa Smith; Becker, Carolyn Black; Wesley, Nicole; Stewart, Tiffany
In spite of copious literature investigating body dissatisfaction and its correlates in adolescents and young adult women, exploration of body image disturbances in adult women remains an underrepresented domain in the literature. Yet, there are many reasons to suspect that body image in adult women both may differ from and possibly be more complex than that of younger women. Adult women face myriad factors influencing body image beyond those delineated in the body image literature on adolescents and young adult women. For instance, aging-related physiological changes shift the female body further away from the thin-young-ideal, which is the societal standard of female beauty. Further, life priorities and psychological factors evolve with age as well. As such, adult women encounter changes that may differentially affect body image across the lifespan. This paper aims to provide an up-to-date review of the current literature on the relationship between body image and associated mental and physical health problems and behaviors in adult women. In addition, we explore factors that may influence body image in adult women. Lastly, we use this review to identify significant gaps in the existing literature with the aim of identifying critical targets for future research. PMID:26052476
Iowa Department of Education, 2016
This report is Iowa's response to the four questions that the United States Department of Education, Office of Career, Technical, and Adult Education (OCTAE), requires of all states and territories receiving federal funding through the Workforce Investment Act (WIA), Title II, Adult Education and Family Literacy Act (AEFLA). The overall goal of…
Iowa Department of Education, 2014
The Division of Community Colleges of the Iowa Department of Education has a variety of diverse programs that enhance Iowa's educational system. Adult Education has a rich history in Iowa of providing services that assist adults in improving their skills, achieving their educational goals, and transitioning to further education or employment.…
Prasher, V.; Ninan, S.; Haque, S.
Background: The natural history of thyroid function in adults with Down syndrome is relatively unknown with limited long-term follow-up data. Method: This study investigated annual thyroid function tests in 200 adults with Down syndrome over a 15-year period. Results: For healthy adults with Down syndrome there is a gradual increase in thyroxine…
Werner, Evelyn, Comp.
This document contains descriptions of 66 adult education experimental demonstration projects and 18 adult education staff development projects conducted in Pennsylvania in fiscal year 1992. The projects are funded through Section 353 of the Adult Education Act of 1988. Each description includes a project number, project costs, contact person with…
Kincaid, Harry V.; Rink, Dan L.
U. S. Office of Education funding has been provided to Region Nine for fiscal year 1973 for an Adult Basic Education (ABE) staff development effort, aimed at improving the delivery of adult education services to meet target population needs and Federal program goals through preservice and inservice training of personnel engaged in adult education…
Proietti, Valentina; Pisacane, Antonella; Macchi Cassia, Viola
Just like other face dimensions, age influences the way faces are processed by adults as well as by children. However, it remains unclear under what conditions exactly such influence occurs at both ages, in that there is some mixed evidence concerning the presence of a systematic processing advantage for peer faces (own-age bias) across the lifespan. Inconsistency in the results may stem from the fact that the individual's face representation adapts to represent the most predominant age traits of the faces present in the environment, which is reflective of the individual's specific living conditions and social experience. In the current study we investigated the processing of younger and older adult faces in two groups of adults (Experiment 1) and two groups of 3-year-old children (Experiment 2) who accumulated different amounts of experience with elderly people. Contact with elderly adults influenced the extent to which both adult and child participants showed greater discrimination abilities and stronger sensitivity to configural/featural cues in younger versus older adult faces, as measured by the size of the inversion effect. In children, the size of the inversion effect for older adult faces was also significantly correlated with the amount of contact with elderly people. These results show that, in both adults and children, visual experience with older adult faces can tune perceptual processing strategies to the point of abolishing the discrimination disadvantage that participants typically manifest for those faces in comparison to younger adult faces.
Prasher, V.; Gomez, G.
Background: The natural history of thyroid function in adults with Down syndrome (DS) is unknown. Method: This study investigated annual thyroid function tests in 200 adults with DS over a 10-year period. Results: Transient and persistent thyroid dysfunction was common. The 5- and 10-year incidence of definite hypothyroidism was 0.9%-1.64% and…
Smith Staley, Charlesetta
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…
Fuchs, Eberhard; Flügge, Gabriele
Within the last four decades, our view of the mature vertebrate brain has changed significantly. Today it is generally accepted that the adult brain is far from being fixed. A number of factors such as stress, adrenal and gonadal hormones, neurotransmitters, growth factors, certain drugs, environmental stimulation, learning, and aging change neuronal structures and functions. The processes that these factors may induce are morphological alterations in brain areas, changes in neuron morphology, network alterations including changes in neuronal connectivity, the generation of new neurons (neurogenesis), and neurobiochemical changes. Here we review several aspects of neuroplasticity and discuss the functional implications of the neuroplastic capacities of the adult and differentiated brain with reference to the history of their discovery. PMID:24883212
Choi, Sunha; Hasche, Leslie; Nguyen, Duy
This study investigated changes in depression status over 2 years and examined whether having depression in Year 1 is associated with greater healthcare expenditures in Year 2 among community-dwelling older adults. This study analyzed the Medical Expenditure Panel Survey (Panel 13, 2008-2009) for a nationally representative sample of 1,740 older adults (65+). The two self-reported depression measures used were the ICD-9-CM (depression) and Patient Health Questionnaire-2 (potential depression, scores 3 or higher). Using the combined two-part models, additional healthcare costs at Year 2 associated with the Year 1 depression status were calculated by the service type after adjusting for predisposing, enabling, and need covariates assessed at Year 2. Over 7.9% of older adults reported depression and an additional 6.5% presented with potential depression. The ICD-9 depression status was relatively stable; 84% continued reporting depression during Year 2. Those with depression at Year 1 spent $3,855 more on total healthcare, $1,053 more on office-based visits, and $929 more on prescription drugs during Year 2 compared with non-depressed people after controlling for other covariates, including healthcare needs (p < .05). While potential depression was less persistent (31.1% remained potentially depressed at Year 2), potential depression was associated with lower socio-economic status and greater healthcare expenditures from home health services and emergency department visits during Year 2. These results indicate the importance of monitoring depression in older adults, considering its impacts on the increases in healthcare expenditures in the following year even after controlling for co-occurring health conditions.
Kischke, Martina I.
This document presents a collection of brief articles about children which were written in West Germany and compiled for the International Year of the Child. Topics covered include: (1) the importance of children's early years, (2) child abuse, (3) family planning, (4) the need for playgrounds, (5) the German Children's Protection Federation, (6)…
Whitbourne, Susan Krauss; Ellenberg, Stacy; Akimoto, Kyoko
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.
Romesburg, James Eric
This dissertation explores the role first-year composition (FYC) courses play in the academic lives of working-class adult students in the University of Louisville, an institution that, during portions of its long history, has been a valuable educational resource for working adults in the Louisville area. A confluence of political and…
Ito, Kiwako; Jincho, Nobuyuki; Minai, Utako; Yamane, Naoto; Mazuka, Reiko
Two eye-tracking experiments tested how pitch prominence on a prenominal adjective affects contrast resolution in Japanese adult and 6-year old listeners. Participants located two animals in succession on displays with multiple colored animals. In Experiment 1, adults' fixations to the contrastive target (pink cat [right arrow] GREEN cat) were…
Grabowski, Stanley M.
Futurism for adult and continuing education in the next ten years is the focus of this information analysis paper intended for adult educators and researchers. The paper is based on (1) literature practices in the field, (2) discussions with colleagues, (3) personal observations and experiences, (4) participation in futures conferences about adult…
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF DEFENSE Office of the Secretary TRICARE; Calendar Year 2014 TRICARE Young Adult Program Premium Update AGENCY: Office of the Secretary of Defense, DoD. ACTION: Notice of Updated TRICARE Young Adult Premiums...
Kim, Su Hyun; Kjervik, Diane; Belyea, Michael; Choi, Eun Sook
This study was performed to identify the patterns and mechanisms of the development of personal strength of bereaved older adults over a 4-year period after spousal death. The findings showed that while bereaved older adults, on average, experienced a moderate level of personal strength at 6 months post-spousal death with a slight increase over a…
Cherrstrom, Catherine A.; Robbins, Stacey E.; Bixby, John
Academic publications provide insights into a discipline's history, knowledge base, and research norms, and thus analyzing publication activity provides learning about the field of study. To learn more about the field of adult and continuing education, this study used content analysis to examine 10 years of "Adult Learning" from 2006…
Objective: The purpose of this study was to identify determinants of comprehension of an educational pamphlet on colon cancer, by adults at least 50 years of age living in the United States. Design: Data were analysed from the "2003 National Assessment of Adult Literacy" survey. The survey was designed to assess functional English…
Ireland, Timothy Denis, Comp.; Spezia, Carlos Humberto, Comp.
The present document on the Sixty Years of CONFINTEA was inspired by the desire to register the long fecund history of a global movement which has spanned six decades. Official records and documents produced by and for the conferences, in particular the final reports, elaborated by UNESCO were used as an important source. This process of…
Stahl, Norman A.; Smith-Burke, M. Trika
Delves into the birth, childhood, and adolescence of the National Reading Conference, with direct attention given to the germination of the "Journal of Reading Behavior," the former title of this journal. Notes the National Reading Conference has a long and honored history spanning a period of nearly 50 years. (RS)
Bauer, Patricia J; Larkina, Marina
Preservation and loss to forgetting of autobiographical memories is a focus in both the adult and developmental literatures. In both, there are comparative arguments regarding rates of forgetting. Children are assumed to forget autobiographical memories more rapidly than adults, and younger children are assumed to forget more rapidly than older children. Yet few studies can directly inform these comparisons: few feature children and adults, and few prospectively track the survival of specific autobiographical memories over time. In a 4-year prospective study, we obtained autobiographical memories from children 4, 6, and 8 years, and adults. We tested recall of different subsets of the events after 1, 2, and 3 years. Accelerated rates of forgetting were apparent among all child groups relative to adults; within the child groups, 4- and 6-year-olds had accelerated forgetting relative to 8-year-olds. The differences were especially pronounced in open-ended recall. The thematic coherence of initial memory reports also was a significant predictor of the survival of specific memories. The pattern of findings is consistent with suggestions that the adult distribution of autobiographical memories is achieved as the quality of memory traces increases (here measured by thematic coherence) and the rate of forgetting decreases.
CASAS - Comprehensive Adult Student Assessment Systems (NJ1), 2007
The 285 adult schools in California enrolled 1,206,864 adult learners supported through state apportionment funds in program year 2006-07. This report presents the results of data collected by the Comprehensive Adult Student Assessment Systems (CASAS) from all learners enrolled in California adult schools. The report analysis was prepared by…
Graham, Andrew; Reid, Greg
Examined changes in physical fitness of middle-aged adults with mental retardation over 13 years. The subjects had participated in a physical fitness study in 1983. They were re-evaluated for cardiovascular endurance, muscular strength, muscular endurance, flexibility, and body composition. Fitness levels declined over the 13 years and were low…
Holt, E.A.; Rautenstrauch, K.R.
We studied the home-range size and site fidelity of adult desert tortoises (Gopherus agassizii) at Yucca Mountain, Nevada, during 1992-1994. Of 67 adult tortoises monitored at Yucca Mountain during this period, we evaluated the movements of 22 female and 16 male radiomarked tortoises that were located >50 times during each of the 1992, 1993, and 1994 activity seasons. We measured annual and three-year home range sizes by either 100% minimum convex polygon (MCP) or by 95% cluster.
Ward, Brian W; Martinez, Michael E
The purpose of this research was to examine the relationship between psychological distress and aspects of health insurance status, including lack of coverage, types of coverage and disruption in coverage, among US adults. Data from the 2001-2010 National Health Interview Survey were used to conduct analyses representative of the US adult population aged 18-64 years. Multivariate analyses regressed psychological distress on health insurance status while controlling for covariates. Adults with private or no health insurance coverage had lower levels of psychological distress than those with public/other coverage. Adults who recently (≤1 year) experienced a change in health insurance status had higher levels of distress than those who had not recently experienced a change. An interaction effect indicated that the relationship between recent change in health insurance status and distress was not dependent on whether an adult had private versus public/other coverage. However, for adults who had not experienced a change in status in the past year, the average absolute level of distress is higher among those with no coverage versus private coverage. Although significant relationships between psychological distress and health insurance status were identified, their strength was modest, with other demographic and health condition covariates also being potential sources of distress. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.
Hudson, Alexandra; Blake, Kim
Feeding and swallowing difficulties are common among individuals with CHARGE syndrome. Many children require gastrostomy tube feeding in their early years and often undergo a delay in feeding and oral-motor skill development. There is little information available on adults with CHARGE syndrome, and the feeding difficulties they face. The present case describes newly emerging mouth over-stuffing feeding behaviors and feeding difficulties in a 33-year-old adult with CHARGE syndrome who had not undergone feeding therapy since childhood. PMID:26668685
Warner, Sarah E; Shriver, W Gregory; Olsen, Brian J; Greenberg, Russell G; Taylor, Robert J
We estimated mercury exposure and bioaccumulation in sparrow feathers to determine variation among age groups, between sparrow species, and between feather types. Results of feather mercury studies in piscivorous birds indicate that mercury concentrations tend to increase with age and differ between feather types; however, data for insectivorous birds are lacking. We estimated mercury exposure of two insectivorous and sympatric tidal marsh sparrows: coastal plain swamp sparrow (Melospiza georgiana nigrescens), and seaside sparrow (Ammodramous maritimus). Tidal marshes have favorable conditions for mercury methlyation, thus it is likely that tidal marsh sparrows are exposed to methylmercury. We found no difference in mercury concentrations between males and female birds of both species. Adult swamp sparrow feather mercury concentrations did not differ among adult age groups; therefore, mercury was not found to increase with age in sparrows at the site. Hatch-year birds had significantly greater feather mercury concentrations compared with adult birds for both species. Mercury concentrations in adult seaside sparrows were twice as high as those in adult swamp sparrows suggesting species-specific variation, although concentrations in hatch-year sparrow species did not differ. Mercury concentrations differed between feather types in adults of both species. The first primary feather of both species had at least three times greater mercury concentrations than the outer tail feather possibly reflecting varying depuration rates with feather type.
Peykarjou, Stefanie; Westerlund, Alissa; Macchi Cassia, Viola; Kuefner, Dana; Nelson, Charles A.
The current study examines the processing of upright and inverted faces in 3-year-old children (n = 35). Event-related potentials (ERPs) were recorded during a passive-looking paradigm including adult and newborn face stimuli. We observed three face-sensitive components, the P1, the N170 and the P400. Inverted faces elicited shorter P1 latency and larger P400 amplitude. P1 and N170 amplitudes were larger for adult faces. To examine the role of experience in the development of face processing, the processing of adult and newborn faces was compared for children with a younger sibling (n = 23) and children without a younger sibling (n = 12). Age of sibling at test correlated negatively with P1 amplitude for adult and newborn faces. This may indicate more efficient processing of different face ages in children with a younger sibling and potentially reflects a more flexible face representation. PMID:24118716
Yusuf, Hussain R; Reyes, Nimia; Zhang, Qing C; Okoroh, Ekwutosi M; Siddiqi, Azfar-E-Alam; Tsai, James
We assessed the rates, trends, and factors associated with venous thromboembolism (VTE) diagnosis among hospitalizations of adults ≥60 years of age during the period 2001 to 2010. Data from the National Hospital Discharge Survey were used for this study. During the period 2001 to 2010, the estimated annual number of hospitalizations in which a VTE diagnosis was recorded, among adults ≥ 60 years of age, ranged from approximately 2 70 000 in 2001 to 4 23 000 in 2010. The rate of such hospitalizations per 1 00 000 US population ≥60 years of age ranged from 581 in 2001 to 739 in 2010. During the period 2001 to 2004, there was a significant increasing trend in the rate of hospitalizations with VTE among women ≥60 years of age. The factors positively associated with an increased risk of VTE diagnosis were female sex, summer and autumn seasons (compared with spring), venous catheterization, cancer, and greater length of hospital stay.
Floyd, Mark; Rohen, Noelle; Shackelford, Jodie A. M.; Hubbard, Karen L.; Parnell, Marsha B.; Scogin, Forrest; Coates, Adriana
This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre- and posttreatment scores with follow-up scores…
MICHAEL, DONALD N.
TO COUNSEL ADULTS WITHIN THE NEXT 20 YEARS, ADVANCED PLANNING AND ACTION BASED ON LONG-RANGE ASSESSMENTS MUST TAKE PLACE NOW. HIGHLY RATIONALIZED MANAGEMENT TECHNOLOGIES, CYBERNATION, SOCIAL ENGINEERING, AND BIOLOGICAL ENGINEERING CAN POTENTIALLY AFFECT THIS PLANNING. SOCIAL AND DEMOGRAPHIC CONDITIONS INTERACTING WITH THESE TECHNOLOGIES WILL…
Vaalimaa, Taina T.; Sorri, Martti J.; Laitakari, Jaakko; Sivonen, Ville; Muhli, Arto
This study investigated adult cochlear implant users' (n == 39) vowel recognition and confusions by an open-set syllable test during 4 years of implant use, in a prospective repeated-measures design. Subjects' responses were coded for phoneme errors and estimated by the generalized mixed model. Improvement in overall vowel recognition was highest…
Bugos, Jennifer A.
The purpose of this project was to examine adult learning perceptions of a model music program with group piano instruction and group percussion ensemble for beginning-level musicians (ages 60-86 years). Participants were matched by age and education to two 16-week music programs. Forty participants completed a post-training questionnaire related…
Division of Community Colleges and Workforce Preparation, Iowa Department of Education, 2007
The purpose of this publication is to present Iowa's adult literacy program approved projected benchmark percentage levels for Program Year 2006 (July 1, 2005-June 30, 2006). The passage of the Workforce Investment Act of 1998 (WIA) [Public Law 105-220] by the 105th Congress has ushered in a new era of collaboration, coordinator, cooperation and…
Li, Min; Xu, Jiuping; He, Yuan; Wu, Zhibin
Resilience, the ability to spring back from adversity and successfully adapt to it, is becoming an increasingly popular focus in research on the intervention and prevention of mental breakdown. This article aims to assess the resilience of adults exposed to the 2008 Wenchuan earthquake 1 year after the occurrence of the earthquake, to explore the…
Service, Elisabet; Yli-Kaitala, Hely; Maury, Sini; Kim, Jeong-Young
Although the significance of age in second language acquisition is one of the most hotly debated issues in the field, very few studies have directly addressed age differences in the language learning process. The present study investigated learning in a foreign-word repetition task. Young Finnish adults and 8-year-olds repeated back Korean words.…
Frisen, Ann; Holmqvist, Kristina; Oscarsson, Daniel
This study formed the second wave of a longitudinal research project examining bullying from the students' perspective. A sample of 877 Swedish 13-year-olds filled out a questionnaire regarding the definition of bullying, reasons for why some students are bullied and the experience of adults' response to bullying. In their definitions, girls were…
Eke, Paul I; Wei, Liang; Borgnakke, Wenche S; Thornton-Evans, Gina; Zhang, Xingyou; Lu, Hua; McGuire, Lisa C; Genco, Robert J
The older adult population is growing rapidly in the USA and it is expected that by 2040 the number of adults ≥ 65 years of age will have increased by about 50%. With the growth of this subpopulation, oral health status, and periodontal status in particular, becomes important in the quest to maintain an adequate quality of life. Poor oral health can have a major impact, leading to tooth loss, pain and discomfort, and may prevent older adults from chewing food properly, often leading to poor nutrition. Periodontitis is monitored in the USA at the national level as part of the Healthy People 2020 initiative. In this report, we provide estimates of the overall burden of periodontitis among adults ≥ 65 years of age and after stratification according to sociodemographic factors, modifiable risk factors (such as smoking status), the presence of other systemic conditions (such as diabetes) and access to dental care. We also estimated the burden of periodontitis within this age group at the state and local levels. Data from the National Health and Nutrition Examination Survey 2009/2010 and 2011/2012 cycles were analyzed. Periodontal measures from both survey cycles were based on a full-mouth periodontal examination. Nineteen per cent of adults in this subpopulation were edentulous. The mean age was 73 years, 7% were current smokers, 8% lived below the 100% Federal Poverty Level and < 40% had seen a dentist in the past year. Almost two-thirds (62.3%) had one or more sites with ≥ 5 mm of clinical attachment loss and almost half had at least one site with probing pocket depth of ≥ 4 mm. We estimated the lowest prevalence of periodontitis in Utah (62.3%) and New Hampshire (62.6%) and the highest in New Mexico, Hawaii, and the District of Columbia each with a prevalence of higher than 70%. Overall, periodontitis is highly prevalent in this subpopulation, with two-thirds of dentate older adults affected at any geographic level. These findings provide an
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
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).
Castrucci, Brian C; Clark, Jamie; Lewis, Kayan; Samsel, Rachel; Mirchandani, Gita
To investigate sociodemographic factors associated with adolescent females ages 14-16 years having children fathered by males age 20 years or older and identify differences in correlates across rural, urban, and border areas. The method section was a cross-sectional study using Texas birth record data. From 2000 through 2004, there were 29,186 births to adolescent females aged 14-16 years with valid paternal age. Prevalence of and adjusted odds of paternal age of 20 years or older were identified by paternal and maternal factors. The Results section Having both parents born outside of the U.S. was associated with a 5.29 (95% CI: 4.82, 5.80) times increase in the odds of paternal age of 20 years or older as compared to having both parents born in the U.S. Parental place of birth was associated with greater odds of paternal age of 20 years or older in urban areas compared to rural or border areas. Compared to those with average or high educational attainment relative to age, low educational attainment relative to age was associated with an increase in the odds of paternal age of 20 years or older. This association was present whether maternal or paternal educational attainment was low relative to age. Messages are needed to help adolescent females avoid pregnancy with adult males. In addressing this specific prevention challenge, it is important to consider maternal/paternal place of birth and its association with adolescent births with adult males.
Mondloch, Catherine J; Robbins, Rachel; Maurer, Daphne
In previous studies we created 8 new versions of a single face: 4 differed only in the spacing among features and 4 differed in the shape of the eyes and mouth. Compared to the spacing set, results for this feature set indicated little impairment by inversion, earlier adult-like accuracy (Mondloch et al, 2002 Perception 31 553-566), and normal performance after a history of early visual deprivation from bilateral congenital cataract (Le Grand et al, 2001 Nature 410 890, 412 786). Here we addressed the possibility that this pattern might have resulted from our having inadvertently selected easily discriminated features or including some faces with make-up. We created 20 featural versions of a single female face and asked adults, 10-year-old children, and patients treated for bilateral congenital cataract to make same/different judgments for 120 pairings (half different). The results confirm that adults easily discriminate facial features, even after early visual deprivation from cataract, and that inversion has only a small effect. By the age of 10 years, children are close to, but not quite at, adult levels of accuracy. The previous findings cannot be attributed to our having inadvertently created a feature set that was unusually easy to discriminate.
Waters, Debra L.; Ward, Aimee L.; Villareal, Dennis T.
Obesity in older adults is ubiquitous in many developed countries and is related to various negative health outcomes, making it an important public health target for intervention. However, treatment approaches for obesity in older adults remain controversial due to concerns surrounding the difficulty of behavior change with advancing age, exacerbating the age-related loss of skeletal muscle and bone, and the feasibility of long-term weight maintenance and related health consequences. This review serves to systematically examine the evidence regarding weight loss interventions with a focus on obese (body mass index 30 kg/m2 and above) older adults (aged 65 years and older) and some proposed mechanisms associated with exercise and caloric restriction (lifestyle intervention). Our findings indicate that healthy weight loss in this age group can be achieved through lifestyle interventions of up to a one-year period. Most interventions reviewed reported a loss of lean body mass and bone mineral density with weight loss. Paradoxically muscle quality and physical function improved. Inflammatory molecules and metabolic markers also improved, although the independent and additive effects of exercise and weight loss on these pathways are poorly understood. Using our review inclusion criteria, only one small pilot study investigating long-term weight maintenance and associated health implications was found in the literature. Future research on lifestyle interventions for obese older adults should address the loss of bone and lean body mass, inflammatory mechanisms, and include sufficient follow up to assess long-term weight maintenance and health outcomes. PMID:23403042
Peykarjou, Stefanie; Westerlund, Alissa; Cassia, Viola Macchi; Kuefner, Dana; Nelson, Charles A.
The current study examines the processing of upright and inverted faces in 3-year-old children (n = 35). Event-related potentials (ERPs) were recorded during a passive looking paradigm including adult and newborn face stimuli. We observed three face-sensitive components, the P1, the N170 and the P400. Inverted faces elicited shorter P1 latency and…
Bernabé, E; Newton, J T; Uutela, A; Aromaa, A; Suominen, A L
This study assesses whether sense of coherence (SOC) predicts incidence of tooth decay over 4 years and the role of dental behaviours in explaining the effect of SOC on incidence of tooth decay. Data from 994 adults who participated in both the Health 2000 survey and the Follow-Up Study of Finnish Adults' Oral Health were analysed for this study. At baseline, participants provided information on demographic characteristics, education level, the SOC scale and dental behaviours (tooth brushing frequency, dental attendance and sugar intake frequency). The 4-year incidence of tooth decay was calculated using data from baseline and follow-up clinical oral examinations. Baseline SOC was significantly related to 4-year incidence of tooth decay after adjustment for demographic factors and education (relative risk: 0.79, 95% CI: 0.63-0.98). This effect was fully attenuated after further adjustment for the three dental behaviours. Tooth brushing frequency and dental attendance were the only dental behaviours significantly related to incidence of tooth decay. This prospective study suggests that SOC predicts incidence of tooth decay and that dental behaviours may help explaining why adults with strong SOC have lower risk of developing tooth decay than those with weak SOC.
Hsiao, Pao Ying; Mitchell, Diane C; Wood, G Craig; Jensen, Gordon L; Still, Christopher D; Hartman, Terryl J
Little is known about the relationship between weight change and dietary patterns (DP) in older adults, especially in those of advanced age (≥ 75 years). We examined the association of DP with obesity and five-year weight change in community-dwelling older adults (n = 270; mean ± SD age: 78.6 ± 3.9 years). Dietary data were collected from four, random, 24-hour dietary recalls over a 10-month period. Weight change was examined as: (1) 10-pound weight loss; (2) 10-pound weight gain; (3) 10% weight loss; and (4) 10% weight gain. Cluster analysis was used to derive 3 DP ("Health-conscious," "Sweets and dairy," and "Western"). Kaplan-Meier plots and Cox proportional hazards regression models were used. About 39% of participants lost at least 10 pounds during follow up. In the unadjusted model, five-year weight loss was not associated with dietary pattern. However, when stratified by gender, females who were characterized by the Sweets and Dairy and the Western DP were three and two times more likely to lose 10 pounds, respectively, compared to those in the Health-conscious DP (P < 0.05). These observations suggest that it is appropriate to recommend a Health-conscious DP for women 75 years and older who may be at risk for weight loss.
Russac, R J; Gatliff, Colleen; Reece, Mimi; Spottswood, Diahann
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 the second study, 113 women between 18 and 85 years completed the Templer Death Anxiety Scale. Death anxiety displayed the same bimodal distribution and significant decline with age seen in Study 1. The results suggest that more emphasis should be placed on the cause of increased death anxiety among 20-year-olds and on why women, but not men, experience a second anxiety spike during their 50s.
Eikendal, Anouk L M; Groenewegen, Karlijn A; Anderson, Todd J; Britton, Annie R; Engström, Gunnar; Evans, Greg W; de Graaf, Jacqueline; Grobbee, Diederick E; Hedblad, Bo; Holewijn, Suzanne; Ikeda, Ai; Kitagawa, Kazuo; Kitamura, Akihiko; Lonn, Eva M; Lorenz, Matthias W; Mathiesen, Ellisiv B; Nijpels, Giel; Dekker, Jacqueline M; Okazaki, Shuhei; O'Leary, Daniel H; Polak, Joseph F; Price, Jacqueline F; Robertson, Christine; Rembold, Christopher M; Rosvall, Maria; Rundek, Tatjana; Salonen, Jukka T; Sitzer, Matthias; Stehouwer, Coen D A; Hoefer, Imo E; Peters, Sanne A E; Bots, Michiel L; den Ruijter, Hester M
Although atherosclerosis starts in early life, evidence on risk factors and atherosclerosis in individuals aged <45 years is scarce. Therefore, we studied the relationship between risk factors, common carotid intima-media thickness (CIMT), and first-time cardiovascular events in adults aged <45 years. Our study population consisted of 3067 adults aged <45 years free from symptomatic cardiovascular disease at baseline, derived from 6 cohorts that are part of the USE-IMT initiative, an individual participant data meta-analysis of general-population-based cohort studies evaluating CIMT measurements. Information on risk factors, CIMT measurements, and follow-up of the combined end point (first-time myocardial infarction or stroke) was obtained. We assessed the relationship between risk factors and CIMT and the relationship between CIMT and first-time myocardial infarction or stroke using a multivariable linear mixed-effects model and a Cox proportional-hazards model, respectively. During a follow-up of 16.3 years, 55 first-time myocardial infarctions or strokes occurred. Median CIMT was 0.63 mm. Of the risk factors under study, age, sex, diastolic blood pressure, body mass index, total cholesterol, and high-density lipoprotein cholesterol related to CIMT. Furthermore, CIMT related to first-time myocardial infarction or stroke with a hazard ratio of 1.40 per SD increase in CIMT, independent of risk factors (95% confidence interval, 1.11-1.76). CIMT may be a valuable marker for cardiovascular risk in adults aged <45 years who are not yet eligible for standard cardiovascular risk screening. This is especially relevant in those with an increased, unfavorable risk factor burden.
Kim, David K; Bridges, Carolyn B; Harriman, Kathleen H
In October 2015, the Advisory Committee on Immunization Practices (ACIP)* approved the Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States, 2016. This schedule provides a summary of ACIP recommendations for the use of vaccines routinely recommended for adults aged 19 years or older in two figures, footnotes for each vaccine, and a table that describes primary contraindications and precautions for commonly used vaccines for adults. Although the figures in the adult immunization schedule illustrate recommended vaccinations that begin at age 19 years, the footnotes contain information on vaccines that are recommended for adults that may begin at age younger than age 19 years. The footnotes also contain vaccine dosing, intervals between doses, and other important information and should be read with the figures.
Legrand, Agathe; Doré Mazars, Karine; Lemoine, Christelle; Nougier, Vincent; Olivier, Isabelle
Several studies in adults having observed the effect of eye movements on postural control provided contradictory results. In the present study, we explored the effect of various oculomotor tasks on postural control and the effect of different postural tasks on eye movements in eleven children (7.8 ± 0.5 years) and nine adults (30.4 ± 6.3 years). To vary the difficulty of the oculomotor task, three conditions were tested: fixation, prosaccades (reactive saccades made toward the target) and antisaccades (voluntary saccades made in the direction opposite to the visual target). To vary the difficulty of postural control, two postural tasks were tested: Standard Romberg (SR) and Tandem Romberg (TR). Postural difficulty did not affect oculomotor behavior, except by lengthening adults' latencies in the prosaccade task. For both groups, postural control was altered in the antisaccade task as compared to fixation and prosaccade tasks. Moreover, a ceiling effect was found in the more complex postural task. This study highlighted a cortical interference between oculomotor and postural control systems.
Couperus, Jane W; Hunt, Ruskin H; Nelson, Charles A; Thomas, Kathleen M
The development of contextual cueing specifically in relation to attention was examined in two experiments. Adult and 10-year-old participants completed a context cueing visual search task (Jiang & Chun, The Quarterly Journal of Experimental Psychology, 54A(4), 1105-1124, 2001) containing stimuli presented in an attended (e.g., red) and unattended (e.g., green) color. When the spatial configuration of stimuli in the attended and unattended color was invariant and consistently paired with the target location, adult reaction times improved, demonstrating learning. Learning also occurred if only the attended stimuli's configuration remained fixed. In contrast, while 10 year olds, like adults, showed incrementally slower reaction times as the number of attended stimuli increased, they did not show learning in the standard paradigm. However, they did show learning when the ratio of attended to unattended stimuli was high, irrespective of the total number of attended stimuli. Findings suggest children show efficient attentional guidance by color in visual search but differences in contextual cueing.
Teixido-Tura, Gisela; Almeida, Andre L C; Choi, Eui-Young; Gjesdal, Ola; Jacobs, David R; Dietz, Harry C; Liu, Kiang; Sidney, Stephen; Lewis, Cora E; Garcia-Dorado, David; Evangelista, Artur; Gidding, Samuel; Lima, João A C
Aortic size increases with age, but factors related to such dilatation in healthy young adult population have not been studied. We aim to evaluate changes in aortic dimensions and its principal correlates among young adults over a 20-year time period. Reference values for aortic dimensions in young adults by echocardiography are also provided. Healthy Coronary Artery Risk Development in Young Adults (CARDIA) study participants aged 23 to 35 years in 1990-1991 (n=3051) were included after excluding 18 individuals with significant valvular dysfunction. Aortic root diameter (ARD) by M-mode echocardiography at year-5 (43.7% men; age, 30.2 ± 3.6 years) and year-25 CARDIA exams was obtained. Univariable and multivariable analyses were performed to assess associations of ARD with clinical data at years-5 and -25. ARD from year-5 was used to establish reference values of ARD in healthy young adults. ARD at year-25 was greater in men (33.3 ± 3.7 versus 28.7 ± 3.4 mm; P<0.001) and in whites (30.9 ± 4.3 versus 30.5 ± 4.1 mm; P=0.006). On multivariable analysis, ARD at year-25 was positively correlated with male sex, white ethnicity, age, height, weight, 20-year gain in weight, active smoking at baseline, and 20-year increase in diastolic, systolic, and mean arterial pressure. A figure showing the estimated 95th percentile of ARD by age and body surface area stratified by race and sex is provided. This study demonstrates that smoking, blood pressure, and increase in body weight are the main modifiable correlates of aortic root dilation during young adulthood. Our study also provides reference values for ARD in young adults.
Krauss, Gregory; Faught, Edward; Foroozan, Rod; Pellock, John M; Sergott, Robert C; Shields, W Donald; Ziemann, Adam; Dribinsky, Yekaterina; Lee, Deborah; Torri, Sarah; Othman, Feisal; Isojarvi, Jouko
Vigabatrin (Sabril®), approved in the US in 2009, is currently indicated as adjunctive therapy for refractory complex partial seizures (rCPS) in patients ≥ 10 years old who have responded inadequately to several alternative treatments and as monotherapy for infantile spasms (IS) in patients 1 month to 2 years of age. Because of reports of vision loss following vigabatrin exposure, FDA approval required a risk evaluation mitigation strategy (REMS) program. Vigabatrin is only available in the US through Support, Help, And Resources for Epilepsy (SHARE), which includes a mandated registry. This article describes 5 years of demographic and treatment exposure data from adult patients (≥ 17 years old) in the US treated with vigabatrin and monitored in the ongoing Sabril® registry. Registry participation is mandatory for all US Sabril® prescribers and patients. A benefit-risk assessment must be documented by the physician for a patient to progress to maintenance therapy, defined as 1 month of vigabatrin treatment for patients with IS and 3 months for patients with rCPS. Ophthalmologic assessments must be documented during and after completion of therapy. As of August 26, 2014, a total of 6823 patients were enrolled in the registry, of which 1200 were adults at enrollment. Of these patients, 1031 (86%) were naïve to vigabatrin. The majority of adult patients (n=783, 65%) had previously been prescribed ≥ 4 AEDs, and 719 (60%) were receiving ≥ 3 concomitant AEDs at vigabatrin initiation. Prescribers submitted an initial ophthalmological assessment form for 863 patients; an ophthalmologic exam was not completed for 300 (35%) patients and thus, were considered exempted from vision testing. Of these patients, 128 (43%) were exempted for neurologic disabilities. Clinicians discontinued treatment in 8 patients because of visual field deficits (VFD) (5 patients naïve to vigabatrin and 3 patients previously exposed). Based on Kaplan-Meier survival estimates, it is
Ganio, Matthew S; Pearson, James; Schlader, Zachary J; Brothers, Robert Matthew; Lucas, Rebekah A I; Rivas, Eric; Kowalske, Karen J; Crandall, Craig G
A maximal aerobic capacity below the 20th percentile is associated with an increased risk of all-cause mortality (Blair 1995). Adult Adult burn survivors have a lower aerobic capacity compared with nonburned adults when evaluated 38 ± 23 days postinjury (deLateur 2007). However, it is unknown whether burn survivors with well-healed skin grafts (ie, multiple years postinjury) also have low aerobic capacity. This project tested the hypothesis that aerobic fitness, as measured by maximal aerobic capacity (VO2max), is reduced in well-healed adult burn survivors when compared with normative values from nonburned individuals. Twenty-five burn survivors (36 ± 12 years old; 13 females) with well-healed split-thickness grafts (median, 16 years postinjury; range, 1-51 years) covering at least 17% of their BSA (mean, 40 ± 16%; range, 17-75%) performed a graded cycle ergometry exercise to test volitional fatigue. Expired gases and minute ventilation were measured via a metabolic cart for the determination of VO2max. Each subject's VO2max was compared with sex- and age-matched normative values from population data published by the American College of Sports Medicine, the American Heart Association, and recent epidemiological data (Aspenes 2011). Subjects had a VO2max of 29.4 ± 10.1 ml O2/kg body mass/min (median, 27.5; range, 15.9-53.3). The use of American College of Sports Medicine normative values showed that mean VO2max of the subjects was in the lower 24th percentile (median, 10th percentile). A total of 88% of the subjects had a VO2max below American Heart Association age-adjusted normative values. Similarly, 20 of the 25 subjects had a VO2max in the lower 25% percentile of recent epidemiological data. Relative to nongrafted subjects, 80 to 88% of the evaluated skin-graft subjects had a very low aerobic capacity. On the basis of these findings, adult burn survivors are disproportionally unfit relative to the general U.S. population, and this puts
Floyd, Mark; Rohen, Noelle; Shackelford, Jodie A M; Hubbard, Karen L; Parnell, Marsha B; Scogin, Forrest; Coates, Adriana
This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre-and posttreatment scores with follow-up scores on the Hamilton Rating Scale for Depression (HRSD) and the Geriatric Depression Scale (GDS). Results indicated that treatment gains from baseline to the 2-year follow-up period were maintained on the HRSD and GDS, and there was not a significant decline from posttreatment to follow-up. There were no significant differences between the treatments on the GDS or HRSD at the 2-year follow-up; however, bibliotherapy participants had significantly more recurrences of depression during the follow-up period.
Tsalas, Nike; Paulus, Markus; Sodian, Beate
The current study investigated the development of metacognitive monitoring-based control of spacing choices in children and adults. Moreover, we assessed whether metacognitive learning decisions are influenced by the effects of previous metacognitive decisions. We tested groups of 7-year-olds, 10-year-olds, and adults in a task with two learning blocks in which they needed to monitor their learning through judgments of learning (JoL) and in which they then needed to decide whether to space their study, mass it, or terminate it. Extending previous findings, our study provides the first evidence that already by 7 years of age children can make metacognitive controlled scheduling decisions. The results also revealed that adults had more clearly differentiated strategies related to their JoL. Furthermore, our study provides evidence that participants of all age groups improved their relative monitoring accuracy in the second learning block and adjusted their JoL. However, only adults changed their strategy choices.
Schwetz, Verena; Horvath, Karl; Kump, Patrizia; Lackner, Carolin; Perren, Aurel; Forrer, Flavio; Pieber, Thomas R.; Treiber, Gerlies; Sourij, Harald; Mader, Julia K.
Abstract Nesidioblastosis is a rare cause of endogenous hyperinsulinemic hypoglycemia in adults. Diagnosis is often challenging and therapeutic options are scarce. In 2009, a 46-year-old female patient presented with recurrent severe hypoglycemia and immediate recovery after glucose ingestion. Although 72-h-fasting test was positive, various imaging technologies (sonography, computed tomography, somatostatin receptor scintigraphy, dopamine receptor positron emission tomography [DOPA-PET]) were negative. Endoscopic ultrasound revealed a lesion in the pancreatic corpus, whereas selective arterial calcium stimulation test, portal venous sampling and GLP-1-receptor scintigraphy were indicative of a lesion in the pancreatic tail, which was surgically removed. The histopathologic examination revealed beta cell hyperplasia and microadenomas expressing glucagon. After surgery, the patient was free of symptoms for 6 months, after which hypoglycemic episodes recurred. After unsuccessful treatment with corticosteroids and somatostatin analogs, treatment with pasireotide, a novel somatostatin analog with high affinity to somatostatin receptor 5 and a possible side effect of hyperglycemia, was initiated (0.6 mg BID). To date, our patient has been free of severe hypoglycemic episodes ever since. Yearly repeated imaging procedures have shown no abnormities over the last 3 years. We report for the first time that pasireotide was successfully used in the treatment of adult nesidioblastosis. PMID:27057885
Iwasaki, M; Yoshihara, A; Ogawa, H; Sato, M; Muramatsu, K; Watanabe, R; Ansai, T; Miyazaki, H
Limited information is available on the temporal association between dentition status and dietary intake. The aim of this 5-year prospective cohort study was to investigate whether impaired dentition was associated with subsequent decline in dietary intake in older Japanese adults. Two hundred and eighty-six community-dwelling Japanese individuals, all aged 75 years at baseline, were included in the study. Functional tooth units (FTUs), defined as a pair of opposing natural or prosthetic teeth excluding third molars (range: 0-14), were counted on the basis of baseline dental examinations. Individuals with ≤5 FTUs were defined as having impaired dentition. Dietary intake was assessed at baseline and 5 years later, using a validated dietary questionnaire. Robust regression analyses were used to evaluate the differences in change in dietary intake between participants with and without impaired functional dentition, after adjustment for potential confounders. Sixty-one study participants (21·3 %) were defined as having impaired dentition. Overall, mean values for all estimated dietary variables (energy, nutrients and food groups) declined over time. Notably, individuals with impaired dentition demonstrated a significantly (P < 0·05) greater degree of decline in the intake of multiple nutrients (protein, sodium, potassium, calcium, vitamin A, vitamin E and dietary fibre) and food groups (vegetable and meat) than those without impaired dentition, after adjusting for potential confounders. The results of this study describe the temporal association of impaired dentition with the decline in selected nutrient and food group intake among older Japanese adults.
Kapatsinski, Vsevolod; Olejarczuk, Paul; Redford, Melissa A
We report on rapid perceptual learning of intonation contour categories in adults and 9- to 11-year-old children. Intonation contours are temporally extended patterns, whose perception requires temporal integration and therefore poses significant working memory challenges. Both children and adults form relatively abstract representations of intonation contours: Previously encountered and novel exemplars are categorized together equally often, as long as distance from the prototype is controlled. However, age-related differences in categorization performance also exist. Given the same experience, adults form narrower categories than children. In addition, adults pay more attention to the end of the contour, while children appear to pay equal attention to the beginning and the end. The age range we examine appears to capture the tail-end of the developmental trajectory for learning intonation contour categories: There is a continuous effect of age on category breadth within the child group, but the oldest children (older than 10;3) are adult-like.
Hrostowski, Susan; Rehner, Timothy
The purpose of this study was to examine the resilience of older adult survivors of Hurricane Katrina in light of their traumatic experiences and multiple losses. Ten Mississippi Gulf Coast residents who have survived Hurricane Katrina and its aftermath were interviewed. The participants were 65 years old or older. Their responses were audiotaped and transcribed. The transcripts were analyzed using phenomenological methodology and NVivo 2.5 software. Three major themes emerged. Participants described finding personal gratification, realizing their ability to cope, and developing a new interest in life through their novel experiences.
Sale, Joanna; Badley, Elizabeth M.; Jaglal, Susan B.; Davis, Aileen M.
Objective While osteoarthritis (OA) has mainly been viewed as a disease affecting older people, its prevalence in younger adults is substantial. However, there is limited research on how younger adults understand knee symptoms. This article explores the meaning of knee symptoms to adults ages 35–65 years. Methods This qualitative study comprised 6 focus groups and 10 one‐on‐one interviews with 51 participants (median age 49, 61% female), who self‐reported knee OA or reported knee symptoms (i.e., pain, aching, or stiffness) on most days of the past month. Constructivist grounded theory guided the sampling, data collection, and analysis. Data were analyzed using a constant comparative method. Results Central to participants’ understanding of knee symptoms was the perception that symptoms were preventable, meaning that there was the potential to prevent the onset of symptoms and to alter the course of symptoms. This understanding was demonstrated in participants’ explanation of symptoms. Participants commented on the cause, prevention, and course of symptoms. Moreover, participants reflected on their experience with symptoms, indicating that symptoms made them feel older than their current age. However, they did not perceive their symptoms as normal or acceptable. Conclusion Participants interpreted knee symptoms as potentially preventable, suggesting that they may be open to primary and secondary prevention strategies. PMID:26238409
Nualnim, Nantinee; Parkhurst, Kristin; Dhindsa, Mandeep; Tarumi, Takashi; Vavrek, Jackie; Tanaka, Hirofumi
Swimming is ideal for older adults because it includes minimum weight-bearing stress and decreased heat load. However, there is very little information available concerning the effects of regular swimming exercise on vascular risks. We determined if regular swimming exercise would decrease arterial blood pressure (BP) and improve vascular function. Forty-three otherwise healthy adults >50 years old (60 ± 2) with prehypertension or stage 1 hypertension and not on any medication were randomly assigned to 12 weeks of swimming exercise or attention time controls. Before the intervention period there were no significant differences in any of the variables between groups. Body mass, adiposity, and plasma concentrations of glucose and cholesterol did not change in either group throughout the intervention period. Casual systolic BP decreased significantly from 131 ± 3 to 122 ± 4 mm Hg in the swimming training group. Significant decreases in systolic BP were also observed in ambulatory (daytime) and central (carotid) BP measurements. Swimming exercise produced a 21% increase in carotid artery compliance (p <0.05). Flow-mediated dilation and cardiovagal baroreflex sensitivity improved after the swim training program (p <0.05). There were no significant changes in any measurements in the control group that performed gentle relaxation exercises. In conclusion, swimming exercise elicits hypotensive effects and improvements in vascular function in previously sedentary older adults.
Hacienda La Puente Unified School District, City of Industry, CA. Outreach and Technical Assistance Network.
The Outreach and Technical Assistance Network (OTAN) was developed to disseminate resources to California adult educators. During the project's third year, staff development and information services were provided to 321 funded agencies. In collaboration with the Educational Telecommunications Network, OTAN staff organized the Adult Learning…
Clifford, Earle W., Ed.; And Others
"The Best of Ten Years," a publication of the Tenth Annual Conference for the Adult Student Personnel Association, Inc. (ASPA), contains prophesies for the future in addition to a chronicle of concerns of the decade. Articles included are: Financial Aid for Evening Students (Sol Jacobson); The Programming and Counseling of Adult Transfer Students…
Maliszewski, Tomasz; Solarczyk-Szwec, Hanna
The purpose of this article is to present the changes that have taken place in Polish adult education in the years 1989-2013 under the influence of multiple factors, i.e. social, economic, political and those relating to civilization on the whole. This article is an attempt to answer the following questions: does modern adult education in Poland…
Taga, Arens; Russo, Marco; Manzoni, Gian Camillo; Torelli, Paola
Headache is a widespread disorder and therefore it has a strong impact on quality of life. In the present work we focused on lifetime and past-year prevalence of headache in general and by gender, in a population-based sample in Parma. A total of 904 subjects representative of Parma's adult general population were interviewed face-to-face by a physician from the Parma Headache Centre, using a validated questionnaire. The lifetime prevalence of headache was 69.1%, i.e. 75.8% in women and 60.6% in men; the crude past-year prevalence of headache was 42.8%, i.e. 52.0% in women and 31.1% in men. Both lifetime and past-year prevalence rates were significantly higher in females than in males (odds ratio, respectively, 2.0 and 2.4). In our study, past-year prevalence decreased after age 50 in both genders. Most people suffer from one headache subtype. In over 80% of cases, headache starts before age 40 and therefore people were not very likely to develop headache after 50 years. The past-year and lifetime prevalence rate of headache in general that we found in our study falls within the lower range of values for headache prevalence in European countries. Further researches need to be set in the Italian epidemiological background.
Zureik, Mahmoud; Galan, Pilar; Bertrais, Sandrine; Courbon, Dominique; Czernichow, Sébastien; Blacher, Jacques; Ducimetière, Pierre; Safar, Michel E; Hercberg, Serge
In this report, we examined the cross-sectional and the 7-year longitudinal changes in blood pressures in adult offspring according to parental longevity. A population of volunteers free of symptomatic cardiovascular diseases who participated to the Supplementation en Vitamines et en Minéraux Antioxydants (SUVIMAX) Vascular Study (mean age 52.3 years; 48.3% women) were examined at baseline and 7 years later. Paternal (n=994) and maternal (n=896) longevity were analyzed separately. The prevalence of hypertension at baseline in subjects whose father died at <65 years of age, in those whose fathers were alive by age 65 but died by 80 years of age, and in those whose fathers were alive by age 80 was respectively 34.9%, 28.5%, and 20.2% (P<0.001). The means of systolic blood pressure in the 3 groups of paternal longevity were respectively 128.4 (+/-16.0), 125.3 (+/-14.2), and 123.6 (+/-14.4) mm Hg (P<0.001). During the follow-up, the mean systolic blood pressure increases in the 3 groups of paternal longevity were respectively 5.3 (+/-17.0), 4.2 (+/-14.0), and 1.6 (+/-13.2) mm Hg (P<0.001). In subjects without hypertension at baseline, hypertension occurred during the follow-up in 26.6%, 17.7%, and 15.3% (P<0.009), respectively. Multivariate analyses adjusted for baseline or changes in cardiovascular risk factors did not modify these results. In contrast, there was no relationship between maternal longevity and blood pressure measurements in either cross-sectional or longitudinal analyses. This study suggests that paternal premature death was associated with accelerated progression of systolic blood pressure and higher occurrence of hypertension in offspring. These results indicate that there are dynamic and continuous processes linking paternal longevity to blood pressure in adults.
Background Age-related cataract is the major cause of blindness in humans throughout the world. The majority of previous studies of cataract in Down's syndrome (which usually results from trisomy 21) have reported that the prevalence of this ocular abnormality is higher for a given age range than in the general population. The objective of the present study was to study the prevalence of cataract in a well-defined population of adults with Down's syndrome. Methods An in-patient population of 68 adults (35 males and 33 females) with Down's syndrome, aged between 28.9 and 83.3 years, underwent ophthalmological examination for the presence of cataracts. Results Overall, the prevalence of cataract was 16.2%, with no significant difference in the prevalence between males (17.1%) and females (15.2%). In those aged between 45 and 64 years, the prevalence was 16.7%, rising in those aged between 65 and 75 years to 28.6%. Conclusion Compared with the general population, the prevalence of cataract in Down's syndrome was raised in those aged 45 to 64, but not in those aged 65 to 75 years; the latter might be a function of the relatively small number of patients in this age group. The increased prevalence of cataract found in those in the 45- to 64-year-old age group may be the result of increased levels of the copper- and zinc-containing superoxide dismutase enzyme (CuZnSOD), in turn resulting from the location of the associated five exons of SOD1 on chromosome 21. These elevated levels of superoxide dismutase may give rise to increased levels of reactive species, including hydrogen peroxide and hydroxyl radicals, which may increase the risk of cataractogenesis. It is suggested that nutritional supplementation with antioxidants may therefore help reduce the prevalence of cataract in Down's syndrome. PMID:18034878
Li, Juan; Xu, Hanzhang; Pan, Wei; Wu, Bei
Objectives To examine the association between the number of teeth remaining and cognitive decline among Chinese older adults over a 13-year period. Design A large national longitudinal survey of Chinese older adults Setting The Chinese Longitudinal Healthy Longevity Survey (CLHLS) (1998–2011). Participants A total of 8,153 eligible participants aged 60+ interviewed in up to six waves. Measurements Cognitive function and teeth number were measured at each interview. Cognitive function was measured by the Mini-Mental Status Examination (MMSE). Number of natural teeth was self-reported. Individuals with severe cognitive impairment were excluded. Covariates included demographic characteristics, adult socioeconomic status characteristics, childhood socioeconomic status, health conditions, and health behaviors. Linear mixed models were applied in the analysis. Results The mean teeth number at baseline was 17.5(SD = 0.1), and the mean of baseline cognitive function was 27.3(SD = 0.0). Cognitive function declined over time (β = -0.19, P < .001) after controlling covariates. But, regardless of time, more teeth were associated with better cognitive function (β = 0.01, P < .001). The interaction of teeth number and time was significant (β = 0.01, P < .001), suggesting that the participants who had more teeth showed a slower pace of cognitive decline over time than those with fewer teeth after controlling for other covariates. Conclusion This study showed that tooth loss was associated with cognitive decline among Chinese older adults. Further studies are needed to examine the linkages between cognitive decline and oral health status using clinical examination data. PMID:28158261
Goldstein, Risë B.; Grant, Bridget F.
Objective To present nationally representative findings on total antisocial personality disorder (ASPD) symptoms, major violations of others’ rights (MVOR), and violent symptoms over a 3-year follow-up in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions among adults diagnosed at Wave 1 with ASPD versus syndromal adult antisocial behavior without conduct disorder before age 15 (AABS, not a codable DSM-IV disorder). Method Face-to-face interviews were conducted with 34,653 respondents 18 years and older. Antisocial syndromes and comorbid lifetime substance use, mood, and 6 additional personality disorders were diagnosed at Wave 1 using the Alcohol Use Disorder and Associated Disabilities Interview Schedule - DSM-IV Version. The Wave 2 Alcohol Use Disorder and Associated Disabilities Interview Schedule - DSM-IV Version assessed antisocial symptoms over follow-up, lifetime attention-deficit/hyperactivity (ADHD) and posttraumatic stress disorders, and borderline, narcissistic, and schizotypal personality disorders. Results In unadjusted analyses, respondents with ASPD reported significantly more total, MVOR, and violent symptoms over follow-up than respondents with AABS. Adjustment for baseline sociodemographics and psychiatric comorbidity attenuated these associations; after further adjustment for parallel antisocial symptom counts from age 15 to Wave 1, associations with antisocial syndromes disappeared. Independent Wave 1 predictors of persistent antisociality over follow-up included male sex, not being married or cohabiting, low income, high school or less education, and lifetime drug use disorders, additional personality disorders, and ADHD. Conclusions The distinction between ASPD and AABS holds limited value in predicting short-term course of antisocial symptomatology among adults. However, the prediction of persistent antisociality by psychiatric comorbidity argues for comprehensive diagnostic assessments, treatment of all
Maziak, W; Tabbah, K
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.
Ni, Cuiping; Chow, Meyrick Chum Ming; Jiang, Xiaolian; Li, Sijian; Pang, Samantha Mei Che
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
Simons-Morton, Bruce; Haynie, Denise; O'Brien, Fearghal; Lipsky, Leah; Bible, Joe; Liu, Danping
Objective: To examine changes in health behaviors among US emerging adults 1 year after high school. Participants: The national sample of participants (N = 1,927), including those attending 4-year college/university (n = 884), 2-year colleges/technical schools (n = 588), and no college (n = 455), participated in annual spring surveys 2013-2014.…
Terran, Jamie; McHugh, Brian J.; Fischer, Charla R.; Lonner, Baron; Warren, Daniel; Glassman, Steven; Bridwell, Keith; Schwab, Frank; Lafage, Virginie
Background In the United States, expenditures related to spine care are estimated to account for $86 billion annually. Policy makers have set a cost-effectiveness benchmark of less than $100,000/quality adjusted life year (QALY), forcing surgeons to defend their choices economically. This study projects the cost/QALY for surgical treatment of adult spinal deformity at 5-year follow-up based on 2-year cost- and health-related quality-of-life (HRQOL) data. Methods In a review of 541 patients with adult spinal deformity, the patients who underwent revision or were likely to undergo revision were identified and cost of surgery was doubled to account for the second procedure; all other patients maintained the cost of the initial surgery. Oswestry Disability Index (ODI) was modeled by revision status based on literature findings. Total surgical cost was based on Medicare reimbursement. Chi square and student t tests were utilized to compare cost-effective and non–cost-effective patients. Results The average cost/QALY at 5-year follow-up was $120,311.73. A total of 40.7% of patients fell under the threshold of a cost/QALY <$100,000. Cost-effective patients had higher baseline ODI scores (45% vs 34% [P=0.001]), lower baseline total Scoliosis Research Society scores (2.89 vs 3.00 [P=0.04]), and shorter fusions (8.23 vs 9.87 [P=0.0001]). Conclusion We found 40.7% of patients to be below the threshold of cost effectiveness. Factors associated with reaching the threshold <$100,000/QALY were greater preoperative disability, diagnosis of idiopathic scoliosis, poor preoperative HRQOL scores, and fewer fusion levels. PMID:24688328
Smith, Alexander K.; Ritchie, Christine S.; Miao, Yinghui; Boscardin, W. John; Wallhagen, Margaret L.
Background Epidemiologic data on the prevalence of hearing loss near death is lacking. Objectives To assess the prevalence and correlates of self-reported hearing loss during the last two years of life. Design Observational cohort study. Setting The Health and Retirement Study (HRS) is a longitudinal nationally representative cohort of adults age >50 (2000 to 2013). Participants Older adults Measurements The HRS interview closest to death was used (mean 12.2 months prior to death). Participants rated their hearing (excellent, very good, good, fair, or poor), and if they used hearing aids. We describe the prevalence and correlates of fair/poor ratings adjusted for age and gender. Results Of 5,895 participants (mean age at death 78 years, 53% women, 20% non-white), overall, 32% rated their hearing as fair/poor (95% Confidence Interval [CI] 31–34%), but 60% (95% CI 57–64%) of the 7% of participants that used hearing aids rated hearing as fair/poor. The prevalence of fair/poor hearing was highest among participants interviewed closest to death (29% 19–24 months prior to death, 36% 1–6 months prior to death, p for trend = 0.01). Correlates of fair/poor hearing during the last two years of life included: age at death (age 50–59 22%, 60–69 21%, 70–79 26%, 80–89 38%, ≥90 50%), gender (men 35%, women 30%), ethnicity (Latino 42%, white 33%), wealth (lowest quartile 38%, highest quartile 27%), history of heart disease (yes 38%, no 27%), dependence in activities of daily living (yes 42%, no 26%), difficulty taking medications (yes 46%, no 29%), and probable dementia (yes 44%, no cognitive impairment 24%). Conclusion Self-reported hearing loss increases during the last two years of life and is associated with physical and social vulnerability. PMID:27341383
Woi, Pui Juan; Kaur, Sharanjeet; Waugh, Sarah J.; Hairol, Mohd Izzuddin
The human visual system is sensitive in detecting objects that have different luminance level from their background, known as first-order or luminance-modulated (LM) stimuli. We are also able to detect objects that have the same mean luminance as their background, only differing in contrast (or other attributes). Such objects are known as second-order or contrast-modulated (CM), stimuli. CM stimuli are thought to be processed in higher visual areas compared to LM stimuli, and may be more susceptible to ageing. We compared visual acuities (VA) of five healthy older adults (54.0±1.83 years old) and five healthy younger adults (25.4±1.29 years old) with LM and CM letters under monocular and binocular viewing. For monocular viewing, age had no effect on VA [F(1, 8)= 2.50, p> 0.05]. However, there was a significant main effect of age on VA under binocular viewing [F(1, 8)= 5.67, p< 0.05]. Binocular VA with CM letters in younger adults was approximately two lines better than that in older adults. For LM, binocular summation ratios were similar for older (1.16±0.21) and younger (1.15±0.06) adults. For CM, younger adults had higher binocular summation ratio (1.39±0.08) compared to older adults (1.12±0.09). Binocular viewing improved VA with LM letters for both groups similarly. However, in older adults, binocular viewing did not improve VA with CM letters as much as in younger adults. This could reflect a decline of higher visual areas due to ageing process, most likely higher than V1, which may be missed if measured with luminance-based stimuli alone. PMID:28184281
Woi, Pui Juan; Kaur, Sharanjeet; Waugh, Sarah J; Hairol, Mohd Izzuddin
The human visual system is sensitive in detecting objects that have different luminance level from their background, known as first-order or luminance-modulated (LM) stimuli. We are also able to detect objects that have the same mean luminance as their background, only differing in contrast (or other attributes). Such objects are known as second-order or contrast-modulated (CM), stimuli. CM stimuli are thought to be processed in higher visual areas compared to LM stimuli, and may be more susceptible to ageing. We compared visual acuities (VA) of five healthy older adults (54.0±1.83 years old) and five healthy younger adults (25.4±1.29 years old) with LM and CM letters under monocular and binocular viewing. For monocular viewing, age had no effect on VA [F(1, 8)= 2.50, p> 0.05]. However, there was a significant main effect of age on VA under binocular viewing [F(1, 8)= 5.67, p< 0.05]. Binocular VA with CM letters in younger adults was approximately two lines better than that in older adults. For LM, binocular summation ratios were similar for older (1.16±0.21) and younger (1.15±0.06) adults. For CM, younger adults had higher binocular summation ratio (1.39±0.08) compared to older adults (1.12±0.09). Binocular viewing improved VA with LM letters for both groups similarly. However, in older adults, binocular viewing did not improve VA with CM letters as much as in younger adults. This could reflect a decline of higher visual areas due to ageing process, most likely higher than V1, which may be missed if measured with luminance-based stimuli alone.
Hudson, Frederic M.
This book identifies skills and competencies that can empower adults throughout the life cycle. Part 1 focuses on the emerging adult. Chapter 1 contrasts new opportunities for adult living with the negative belief that the United States' best days are behind. Chapter 2 makes a case for a cyclical pattern for understanding adult life. Part 2…
Boston Univ., MA. School of Education.
The Women's Leadership Project represents an initial effort to combat discrimination against women in adult education, with special emphasis on adult basic education. Overall goals involved leadership development, impact, and support to: (1) recruit and prepare 10 qualified women adult educators for leadership positions in adult education, (2)…
Chen, X M; Chen, S M; Yue, H X; Lin, L; Wu, Y B; Liu, B; Jiang, M; Ma, Y X
The influence of the Wenchuan earthquake on semen quality of adult male survivors is unclear. We investigated the semen quality included 673 male survivors from the worse-affected counties in the earthquake between Aug 2008 and July 2013. Semen parameters including pH, volume, concentration, motility and morphology were measured according to the World Health Organization (WHO) criteria. Kruskal-Wallis analysis of variance was used to examine the statistical differences between years, and a logistic regression was used to analyse the impacts caused by earthquake on the changes of semen quality. We found the medians (5th and 95th) were 2.5 ml (0.6-5.5) for semen volume, 59.0 × 10(6) ml(-1) [(13.0-133.0)] × 10(6) ml(-1) for semen concentration, 46% (13-64%) for sperm progressive motility and 3.0% (0-17.5%) for normal morphology for adult male survivors. Semen concentration, the percentage of sperm progressive motility, total motility and sperm normal morphology were all decreased in the first 3 years, and the differences among years 1, 2 and 3 were significant except the percentage of sperm progressive motility (P < 0.05). The casualties and heavy housing damage caused by earthquake had a negative effect on semen quality. The main findings will provide further diagnosis and therapy basis of male fertility by data, for affected populations in the earthquake.
Caetano, Karlla Antonieta Amorim; Del-Rios, Nativa Helena Alves; Pinheiro, Raquel Silva; Bergamaschi, Fabiana Perez Rodrigues; Carneiro, Megmar Aparecida Dos Santos; Teles, Sheila Araujo
The Brazilian recombinant hepatitis B vaccine (VrHB-IB) is based on the expression of the recombinant antigen in Hansenula polymorpha yeast cells. Currently, data on the immunogenicity of this vaccine in older adults are nonexistent. This study aimed to evaluate the immunogenicity of VrHB-IB in adults over 40 years of age. From May to October 2011, 235 rural settlers between 2 and 93 years of age from the State of Goias in Brazil were eligible for vaccination. Of these, 180 accepted the first dose of the vaccine and 106 (58.9%) completed the vaccination schedule. Multivariate analysis revealed that individuals ≥ 40 years of age responded significantly less well to vaccination than younger adults. Also, a greater proportion of male nonresponders was observed (versus women; P = 0.02). These results point to the need for better evaluation of the immunogenicity of VrHB-IB in older adults.
Kant, Ashima K.; Graubard, Barry I.
Background Understanding of changes in profiles of eating behaviors over time may provide insights into contributors to upward trajectories of obesity in the United States population. Yet, little is known about whether characteristics of meal and snack eating behaviors reported by adult Americans have changed over time. Objective This study examined time trends in the distribution of day’s intake into individual meal and snack behaviors and related attributes in the United States adult population. Design The study was observational with cross-sectional data from national surveys fielded over 40 years. Participant/setting Nationally representative dietary data from nine National Health and Nutrition Examination Surveys conducted from 1971–74 to 2009–2010 (n=62298; age 20–74 years) were used to describe eating behaviors. Outcomes examined The respondent-labeled eating behaviors examined included main meals (breakfast, lunch, and dinner), and snacks (before breakfast, between breakfast and lunch, between lunch and dinner, after dinner, or other). For each eating behavior, percent of reporters; relative contribution to 24-hour energy intake; the clock time of report; and intermeal/snack intervals were examined. Statistical Analysis Multivariable logistic and linear regression methods for analysis of complex survey data adjusted for characteristics of respondents in each survey. Results Over the 40-year span examined: 1) reports of each individual named main meal (or all three main meals) declined, but reports of only two out of three meals or the same meal more than once increased; 2) the percentage of 24-hour energy from snacks reported between lunch and dinner or snacks that displaced meals increased; 3) clock times of breakfast and lunch were later, and intervals between dinner and after dinner snack were shorter. Changes in several snack reporting behaviors (e.g., report of any snack or ≥2 snacks), were significant in women only. Conclusions Several meal
Scheiman, Simeon; Moghaddas, Hossein S; Björnstig, Ulf; Bylund, Per-Olof; Saveman, Britt-Inger
Bicycles are a common mode of transportation and injured bicyclists cause a substantial burden on the medical sector. In Sweden, about half of fatally injured bicyclists are 65 years or older. This study analyzes the injury mechanisms, injuries, and consequences among bicyclists 65 years or older and compare with younger bicyclists (< or =64) and older adults as passenger car drivers, to give a basis for an injury preventive discussion for this age group. Umeå University Hospital's primary catchments area had 142,000 inhabitants in 2006. Nearly all injured road users in the well-defined geographic area are treated at this hospital and a 10-year data set (N=456) of injured bicyclists aged 65+ from the hospital's continuous injury registration (1997-2006) was analyzed. The results show that the annual injury incidence was 2.4 and 2.2 per 1000 men and women, respectively, aged 65 or older. For men the incidence rate was constant in the three age groups 65-74, 75-84 and 85+, while it decreased strongly for women. The incidence rate for old adults as passenger car drivers and younger bicyclists was 1.0 and 4.6, respectively. Most frequent injury mechanisms were falls when getting on or off a bicycle (20%) and by potholes or irregularities on the ground, edge of a sidewalk, or similar (13%). Only 6% were hit by cars, trucks, or buses. Half of the injured suffered fractures or dislocations, and 10% suffered concussion or more serious intracranial injuries. Getting on or off the bicycle caused most fractures (especially a high fraction of the hip and femur fractures) and resulted in 27% of all inpatient days in hospital. Three individuals died. One-third of the injured were treated as inpatients for a total of 1413 days (on average 9 days), with 69% of the days being caused by fractures. The cost for out- and inpatient acute treatment was approximately USD 4700 (SEK 33,000) per injured. The results merit an interest for this target group; bicycle injuries among older
Laska, Melissa N; Sevcik, Sarah M; Moe, Stacey G; Petrich, Christine A; Nanney, Marilyn S; Linde, Jennifer A; Lytle, Leslie A
Our objective was to conduct a process evaluation of the CHOICES (Choosing Healthy Options in College Environments and Settings) study, a large, randomized, controlled trial designed to prevent unhealthy weight gain in young adults (aged 18-35) attending 2-year community colleges in the USA. The 24-month intervention consisted of participation in an academic course and a social networking and support website. Among intervention participants, completion rates for most course activities were >80%, reflecting a high level of dose received. Course retention and participant satisfaction were also high. Engagement results, however, were mixed with less than half of participants in the online and hybrid sections of the course reporting that they interacted with course materials ≥3 h/week, but 50-75% reporting that they completed required lessons 'all/very thoroughly'. Engagement in the website activities was also mixed with more than half of intervention participants logging onto the website during the first month, but then declining to 25-40% during the following 23 months of the intervention. Intervention engagement is a challenge of online interventions and a challenge of working with the young adult age group in general. Additional research is needed to explore strategies to support engagement among this population, particularly for relatively long intervention durations.
Shulman, Shmuel; Vasalampi, Kati; Barr, Tamuz; Livne, Yaara; Nurmi, Jari-Erik; Pratt, Michael W
The present study examined career adaptability in 100 Israeli emerging adults who were followed from ages 22 to 29. Participants were given an in depth interview and were asked to talk about their current work, difficulties they might have had in the past and how they coped with them. In addition they were asked to elaborate on the extent to which their job fits their interests and is meaningful to them. Analyses of interviews yielded three distinctive career adaptability patterns that were associated with different levels of concurrent wellbeing: Integrated, Compromised, and Vague. A lower level of identified motivation measured seven years earlier predicted membership in the Compromised pattern. A higher level of extrinsic motivation combined with decreased parental support predicted membership in the Vague pattern. Findings are discussed within the framework of the occupational adaptations and compromises that young people must make when approaching the age of 30.
Saitz, Richard; Gaeta, Jessie; Cheng, Debbie M; Richardson, Jessica M; Larson, Mary Jo; Samet, Jeffrey H
The objective of this analysis was to assess the mortality rate and risk factors in adults, with substance dependence, who are not receiving primary medical care (PC). Date and cause of death were identified using the National Death Index data and death certificates for 470 adults without PC over a period of almost 4 years after detailed clinical assessment after detoxification. Factors associated with risk of mortality were determined using stepwise Cox proportional hazards models. Subjects were 76% male, 47% homeless, and 47% with chronic medical illness; 40% reported alcohol, 27% heroin, and 33% cocaine as substance of choice. Median age was 35. During a period of up to 4 years, 27 (6%) subjects died. Median age at death was 39. Causes included: poisoning by any substance (40.9% of deaths), trauma (13%), cardiovascular disease (13.6%), and exposure to cold (9.1%). The age adjusted mortality rate was 4.4 times that of the general population in the same city. Among these individuals without PC in a detoxification unit, risk factors associated with death were the following: drug of choice [heroin: hazard ratio (HR) 6.9 (95% confidence interval (CI) 1.6-31.1]; alcohol: HR 3.7 (95% CI 0.79-16.9) compared to cocaine); past suicide attempt (HR 2.1, 95% CI 0.96-4.5); persistent homelessness (HR 2.4, 95% CI 1.1-5.3); and history of any chronic medical illness (HR 2.1, 95% CI 0.93-4.7). Receipt of primary care was not significantly associated with death (HR 0.85, 95% CI 0.34-2.1). Risk of mortality is high in patients with addictions and risk factors identifiable when these patients seek help from the health care system (i.e., for detoxification) may help identify those at highest risk for whom interventions could be targeted.
Kim, David K; Riley, Laura E; Harriman, Kathleen H; Hunter, Paul; Bridges, Carolyn B
In October 2016, the Advisory Committee on Immunization Practices (ACIP) voted to approve the Recommended Adult Immunization Schedule for Adults Aged 19 Years or Older-United States, 2017. The 2017 adult immunization schedule summarizes ACIP recommendations in two figures, footnotes for the figures, and a table of contraindications and precautions for vaccines recommended for adults. These documents are available at https://www.cdc.gov/vaccines/schedules. The full ACIP recommendations for each vaccine can be found at https://www.cdc.gov/vaccines/hcp/acip-recs/index.html. The 2017 adult immunization schedule was also reviewed and approved by the American College of Physicians (https://www.acponline.org), the American Academy of Family Physicians (https://www.aafp.org), the American College of Obstetricians and Gynecologists (http://www.acog.org), and the American College of Nurse-Midwives (http://www.midwife.org).
Berner, Jessica; Rennemark, Mikael; Jogréus, Claes; Anderberg, Peter; Sköldunger, Anders; Wahlberg, Maria; Elmståhl, Sölve; Berglund, Johan
Older adults living in rural and urban areas have shown to distinguish themselves in technology adoption; a clearer profile of their Internet use is important in order to provide better technological and health-care solutions. Older adults' Internet use was investigated across large to midsize cities and rural Sweden. The sample consisted of 7181 older adults ranging from 59 to 100 years old. Internet use was investigated with age, education, gender, household economy, cognition, living alone/or with someone and rural/urban living. Logistic regression was used. Those living in rural areas used the Internet less than their urban counterparts. Being younger and higher educated influenced Internet use; for older urban adults, these factors as well as living with someone and having good cognitive functioning were influential. Solutions are needed to avoid the exclusion of some older adults by a society that is today being shaped by the Internet.
Salthouse, Timothy A.; Schroeder, David H.; Ferrer, Emilio
Several analyses were conducted on data from samples of adults between 18 and 58 years of age who completed the same cognitive tests after an interval ranging from less than 1 week to 35 years. Because the retest interval varied across individuals, it was possible to determine the length of time needed before the gains associated with a retest…
Guam Community Coll., Agana. Office of the State Agency for Vocational and Adult Education.
The 1992 activities in support of the goals described in the Guam State Plan for Adult Education focused on curriculum development and evaluation. Three major programs offered 48 daytime and 101 evening classes for students at 6 sites. The primary components of the adult education instructional programs were adult high school, General Educational…
Fountain, Daniel M.; Kolias, Angelos G.; Lecky, Fiona E.; Bouamra, Omar; Lawrence, Thomas; Adams, Hadie; Bond, Simon J.; Hutchinson, Peter J.
Objective: We sought to determine 30-day survival trends and prognostic factors following surgery for acute subdural hematomas (ASDHs) in England and Wales over a 20-year period. Summary of Background Data: ASDHs are still considered the most lethal type of traumatic brain injury. It remains unclear whether the adjusted odds of survival have improved significantly over time. Methods: Using the Trauma Audit and Research Network (TARN) database, we analyzed ASDH cases in the adult population (>16 yrs) treated surgically between 1994 and 2013. Two thousand four hundred ninety-eight eligible cases were identified. Univariable and multiple logistic regression analyses were performed, using multiple imputation for missing data. Results: The cohort was 74% male with a median age of 48.9 years. Over half of patients were comatose at presentation (53%). Mechanism of injury was due to a fall (<2 m 34%, >2 m 24%), road traffic collision (25%), and other (17%). Thirty-six per cent of patients presented with polytrauma. Gross survival increased from 59% in 1994 to 1998 to 73% in 2009 to 2013. Under multivariable analysis, variables independently associated with survival were year of injury, Glasgow Coma Scale, Injury Severity Score, age, and pupil reactivity. The time interval from injury to craniotomy and direct admission to a neurosurgical unit were not found to be significant prognostic factors. Conclusions: A significant improvement in survival over the last 20 years was observed after controlling for multiple prognostic factors. Prospective trials and cohort studies are expected to elucidate the distribution of functional outcome in survivors. PMID:27172128
Lococo, Filippo; Bajocchi, Gianluigi; Caruso, Andrea; Valli, Riccardo; Ricchetti, Tommaso; Sgarbi, Giorgio; Salvarani, Carlo
Abstract Background: Thymoma is a T cell neoplasm arising from the thymic epithelium that due to its immunological role, frequently undercover derangements of immunity such a tumors and autoimmune diseases. Methods: Herein, we report, to the best of our knowledge, the first description of an association between thymoma and adult onset Still disease (AOSD) in a 47-year-old man. The first one was occasionally detected 4 years later the diagnosis of AOSD, and surgically removed via right lateral thoracotomy. Histology confirmed an encapsulated thymic tumor (type AB sec. WHO-classification). Results: The AOSD was particularly resistant to the therapy, requiring a combination of immunosuppressant followed by anti-IL1R, that was the only steroids-sparing treatment capable to induce and maintain the remission. The differential diagnosis was particularly challenging because of the severe myasthenic-like symptoms that, with normal laboratory tests, were initially misinterpreted as fibromyalgia. The pathogenic link of this association could be a thymus escape of autoreactive T lymphocytes causing autoimmunity. Conclusion: Clinicians should be always include the possibility of a thymoma in the differential diagnosis of an unusual new onset of weakness and normal laboratories data, in particular once autoimmune disease is present in the medical history. PMID:27603335
Stokes, L.; Letz, R.; Gerr, F.; Kolczak, M.; McNeill, F. E.; Chettle, D. R.; Kaye, W. E.
OBJECTIVES: An epidemiological study of young adults was conducted to determine whether environmental exposure to lead during childhood was associated with current adverse neurobehavioural effects. METHODS: The exposed group consisted of 281 young adults who had been exposed environmentally to lead as children and the unexposed referent group consisted of 287 age and sex frequency matched subjects. Information on demographics, past and current health, and past exposures to neurotoxicants, and responses to the Swedish Q16 questionnaire were collected by interview. Standard neurobehavioural and neurophysiological tests were administered by computer or trained technicians. K x ray fluorescence was used to estimate tibial bone lead concentrations among the exposed and unexposed groups. Associations were examined between the exposed group and referents and tibial bone lead concentration and the neurobehavioural and neurophysiological outcomes of interest. RESULTS: Among the measures of peripheral nerve function, after controlling for confounders, sural sensory nerve evoked response amplitude, peroneal motor nerve compound motor action potential amplitude, vibrotactile thresholds of fingers and toes, and standing steadiness were significantly associated with exposure group. Among the neurobehavioural tests, hand-eye coordination, simple reaction time latency, trails B latency, symbol digit latency, serial digit, and learning error score were also significantly associated with exposure group after controlling for confounders. Exposed subjects had significantly more neuropsychiatric symptoms than the referents. Associations between tibial bone lead concentration and scores for vocabulary, vibrotactile thresholds of the fingers, and vibrotactile thresholds of the toes approached significance. CONCLUSIONS: Significant adverse central and peripheral neurological effects were found in a group of young adults 20 years after childhood environmental exposure to lead when compared
Qadeer, Ejaz; Fatima, Razia; Yaqoob, Aashifa; Tahseen, Sabira; Ul Haq, Mahboob; Ghafoor, Abdul; Asif, Muhammad; Straetemans, Masja; Tiemersma, Edine W.
Background We aimed to determine the prevalence of pulmonary tuberculosis (TB) amongst the adult population in 2010–2011 in Pakistan. Method A nationwide cross-sectional survey with multistage cluster sampling was conducted among adults (≥15 years) in 95 clusters in 2010–2011. All consenting participants were screened for cough and by chest X-ray. Participants with presumptive TB submitted two sputum samples for smear microscopy, culture, and molecular testing if needed. The TB prevalence estimates were adjusted for missing data and the cluster design. Result Of 131,329 eligible individuals, 105,913 (81%) participated in the survey, of whom 10,471 (9.9%) were eligible for sputum examination. We found 341 bacteriologically positive TB cases of whom 233 had sputum smear-positive TB. The adjusted prevalence estimates for smear and bacteriologically positive TB were 270/100,000 (95% confidence interval (CI) 217–323), and 398/100,000 (95% CI 333–463), respectively. Only 61% of the diagnosed TB cases screened positive on symptoms (cough >2wks), whereas the other TB cases were detected based on X-ray abnormalities. The TB prevalence increased with age and was 1.8 times higher among men than women. The prevalence-to-notification ratio of smear-positive TB was 3.1 (95% CI 2.5–3.7), was higher among men than women, and increased with age. Conclusion Our data suggest that there is under-detection and/or -notification of TB, especially among men and elderly. TB control should be strengthened specifically in these risk groups. X-ray examination should be combined with symptom screening to enhance case detection. PMID:26863617
Jovanovic, Bianca; Drewing, Knut
When participants are given the opportunity to simultaneously feel an object and see it through a magnifying or reducing lens, adults estimate object size to be in-between visual and haptic size. Studies with young children, however, seem to demonstrate that their estimates are dominated by a single sense. In the present study, we examined whether this age difference observed in previous studies, can be accounted for by the large discrepancy between felt and seen size in the stimuli used in those studies. In addition, we studied the processes involved in combining the visual and haptic inputs. Adults and 6-year-old children judged objects that were presented to vision, haptics or simultaneously to both senses. The seen object length was reduced or magnified by different lenses. In the condition inducing large intersensory discrepancies, children's judgments in visuo-haptic conditions were almost dominated by vision, whereas adults weighted vision just by ~40%. Neither the adults' nor the children's discrimination thresholds were predicted by models of visuo-haptic integration. With smaller discrepancies, the children's visual weight approximated that of the adults and both the children's and adults' discrimination thresholds were well predicted by an integration model, which assumes that both visual and haptic inputs contribute to each single judgment. We conclude that children integrate seemingly corresponding multisensory information in similar ways as adults do, but focus on a single sense, when information from different senses is strongly discrepant.
Gonzales, Gilbert; Shippee, Tetyana P.
Objectives. We examined whether and how lesbian, gay, and bisexual (LGB) adults between 40 and 65 years of age differ from heterosexual adults in long-term care (LTC) expectations. Methods. Our data were derived from the 2013 National Health Interview Survey. We used ordered logistic regression to compare the odds of expected future use of LTC among LGB (n = 297) and heterosexual (n = 13 120) adults. We also used logistic regression models to assess the odds of expecting to use specific sources of care. All models controlled for key socioeconomic characteristics. Results. Although LGB adults had greater expectations of needing LTC in the future than their heterosexual counterparts, that association was largely explained by sociodemographic and health differences. After control for these differentials, LGB adults were less likely to expect care from family and more likely to expect to use institutional care in old age. Conclusions. LGB adults may rely more heavily than heterosexual adults on formal systems of care. As the older population continues to diversify, nursing homes and assisted living facilities should work to ensure safety and culturally sensitive best practices for older LGB groups. PMID:26378822
Sigal, J J; Weinfeld, M
Anecdotal reports suggest that child survivors of the Nazi persecution are functioning well as adults. Ratings of their parents by a randomly selected community sample of young adult Ashkenazi Jews on a scale that measured Schizoid, Paranoid, Depressive/Masochistic and Type A/Normal Aggressive symptoms permitted verification of these reports. Among the parents were groups who were children, adolescents, or young adults in 1945, at the end of World War II. Child-survivor parents did not differ from native-born parents on these measures 40 years later, whereas, consistent with the empirical findings of others, survivors who were adolescents or young adults at the end of the war manifested more paranoid and depressive/masochistic symptoms than native-born parents. To explain this possible greater long-term resilience among those who were child survivors, reference is made to later caretakers, endowment, cognitive and social development, and psychodynamics.
Kim, David K; Bridges, Carolyn B; Harriman, Kathleen H
In October 2014, the Advisory Committee on Immunization Practices (ACIP) approved the Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States, 2015. This schedule provides a summary of ACIP recommendations for the use of vaccines routinely recommended for adults aged 19 years or older in two figures, footnotes for each vaccine, and a table that describes primary contraindications and precautions for commonly used vaccines for adults. Changes in the 2015 adult immunization schedule from the 2014 schedule included the August 2014 recommendation for routine administration of the 13-valent pneumococcal conjugate vaccine (PCV13) in series with the 23-valent pneumococcal polysaccharide vaccine (PPSV23) for all adults aged 65 years or older, the August 2014 revision on contraindications and precautions for the live attenuated influenza vaccine (LAIV), and the October 2014 approval by the Food and Drug Administration to expand the approved age for use of recombinant influenza vaccine (RIV). These revisions were also reviewed and approved by the American College of Physicians, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, and American College of Nurse-Midwives.
The UK has an ageing population, but this is not being matched by a similar increase in healthy life expectancy. The greatest challenge in the 21st century will be to improve the quality of life as ageing occurs. Health is the most important prerequisite for people to enjoy life in their older years (Brundtland, 1988). Diet is one factor that is believed to play a key role in the prevention and treatment of chronic diseases associated with ageing. The third and final part of this series addressing the concept of nutrition through the lifespan seeks to educate health-care professionals as to what constitutes a healthy diet for the elderly population, and gives practical guidance as to how to try and prevent the ever-growing problem of malnutrition within this age group. It is suggested that when the older adult is hospitalized their risk of malnutrition increases. Therefore, some guidance for the use of oral nutritional supplements in this population is given. Good nutrition and physical exercise are essential for healthy ageing from both a physical and psychological perspective (NICE, 2008). Therefore a multidisciplinary life course approach to ageing is vital to minimizing its complications for quality of life and subsequent public health (Denny, 2008).
Vilallonga, Ramon; Ciudin, Andrea; Fort, José Manuel; Baena, Juan Antonio; Gonzalez, Oscar; Armengol, Manuel; Mesa, Jordi; Ruiz Marcellán, Mari Carmen
Thyroid gland involvement as the unique presentation of Langerhans cell histiocytosis is a rare phenomenon that can result in misdiagnosis. We report a case of Langerhans cell histiocytosis (LCH) presenting as a thyroid mass. It is a 52-year-old woman who presented an enlarged, diffusely firm, nontender, nonmobile, and not particularly nodular thyroid gland with mild compressive symptoms. Ultrasound and fine-needle aspiration showed a unique right node with benign signs. Patient was referred to our Ambulatory Surgery Department, where a hemithyroidectomy was performed. Histologic evaluation of the right thyroid gland revealed an involvement by LCH, confirmed by immunohistochemical analysis showing Langerhans cells that were positive for CD1a. LCH was a completely incidental occult finding apparent only after surgical resection and examination of the gland. Patient was evaluated, and no evidence of systemic affectation was found. LCH can rarely involve the thyroid gland in adults. Few cases have been reported in the literature. Most patients had evidence of LCH involving other anatomic sites. PMID:21461403
Carriedo, Nuria; Corral, Antonio; Montoro, Pedro R; Herrero, Laura; Rucián, Mercedes
Updating information in working memory (WM) is a critical executive function responsible both for continuously replacing outdated information with new relevant data and to suppress or inhibit content that is no longer relevant according to task demands. The goal of the present research is twofold: First, we aimed to study updating development in 548 participants of 4 different age ranges--7-, 11-, and 15-year-olds and young adults--using the updating task devised by R. De Beni and P. Palladino (2004), which allows differentiating maintenance and inhibition processes. Second, we attempted to determine the relation between these processes across development as well as the differentiation among different types of inhibition processes tapped by this task. Results showed that there was an improvement of memory performance with age along with an upgrading of inhibitory efficiency. However, whereas in memory performance, a progressive increase was observed until the age of 15 years followed by stabilization, in inhibition, a continuous progressive increase was observed until young adulthood. Importantly, results showed that development of the different inhibitory mechanisms does not progress equally. All the groups committed more errors related to inefficient suppression mechanisms in WM than errors related to control of long-term memory interference. Principal component analysis showed that updating implies different subprocesses: active maintenance/suppression of information in WM and control of proactive interference. Developmental trajectories showed that the maintenance/suppression of information in the WM component continues to develop far beyond adolescence but that proactive interference control is responsible for variations in updating across development.
Moniruzzaman, A.; Fazel, S.; Procyshyn, R.; Somers, J. M.
Purpose The purpose of this study was to investigate the level of adherence to antipsychotic prescription medication in a well-defined homeless cohort over a 15-year period. We hypothesized that adherence would be well below the recommended threshold for clinical effectiveness (80 %), and that it would be strongly associated with modifiable risk factors in the social environment in which homeless people live. Method Linked baseline data (including comprehensive population-level administrative prescription records) were examined in a subpopulation of participants from two pragmatic-randomized trials that investigated Housing First for homeless and mentally ill adults. Adherence to antipsychotic medication was operationalized using the medication possession ratio. Multivariable logistic regression was used to estimate effect sizes between socio-demographic, homelessness-related and illness factors, and medication possession ratio. Results Among the 290 participants who met inclusion criteria for the current analysis, adherence to antipsychotic prescription was significantly associated with: history of psychiatric hospitalization; receipt of primary medical services; long-acting injectable antipsychotic formulations; and duration of homelessness. Mean medication possession ratio in the pre-randomization period was 0.41. Socio-demographic characteristics previously correlated with antipsychotic non-adherence were not significantly related to medication possession ratio. Conclusions This is the first study to quantify the very low level of adherence to antipsychotic medication among homeless people over an extended observation period of 15 years. Each of the four factors found to be significantly associated with adherence presents opportunities for intervention. Strategies to end homelessness for this population may represent the greatest opportunity to improve adherence to antipsychotic medication. PMID:27338740
Jackson, S E; Steptoe, A; Beeken, R J; Croker, H; Wardle, J
Background: Despite a wealth of experimental studies on weight bias, little is known about weight discrimination at the population level. This study examined the prevalence and socio-demographic correlates of perceived weight discrimination in a large population-based sample of older adults. Methods: Data were from 5307 adults in the English Longitudinal Study of Ageing; a population-based cohort of men and women aged ⩾50 years. Weight discrimination was reported for five domains (less respect/courtesy; treated as less clever; poorer treatment in medical settings; poorer service in restaurants/stores; threatened/harassed) at wave 5 (2010–2011). Height and weight were measured at wave 4 (2008–2009). We used logistic regression to test the odds of weight discrimination in relation to weight status, age, sex, wealth, education and marital status. Results: Perceived weight discrimination in any domain was reported by 4.6% of participants, ranging from 0.8% in the normal-weight participants through 0.9, 6.7, 24.2 and 35.1% in individuals who were overweight or met criteria for class I, II and III obesity. Overall, and in each situation, odds of perceived weight discrimination were higher in younger and less wealthy individuals. There was no interaction between weight status and any socio-demographic variable. Relative to normal-weight participants, odds ratios for any perceived weight discrimination were 1.13 (95% confidence interval 0.53–2.40) in those who were overweight, 8.86 (4.65–16.88) in those with class I obesity, 35.06 (18.30–67.16) in class II obese and 56.43 (27.72–114.87) in class III obese. Conclusions: Our results indicate that rates of perceived weight discrimination are comparatively low in individuals who are overweight or have class I obesity, but for those with class II/III obesity, >10% had experienced discrimination in each domain, and >20% had been treated with less respect or courtesy. These findings have implications for public
Gellis, Zvi D.; Sherman, Susan; Lawrance, Frances
Results of the Aging Semantic Differential and Facts on Aging Quiz II for 96 social work graduate students indicated they had limited contact with older adults and knowledge of aging; they displayed negative attitudes about older adults' productivity, adaptability, independence, and optimism. Multivariate analysis showed male and younger students'…
Gilbert, Howard; Prew, Helen
This document presents a series of reflections on the development, mission, and accomplishments of the National Institute for Adult Continuing Education (NIACE), which has worked to influence policy concerning adult education and other areas of social and cultural life in the United Kingdom since its founding in 1921 as the British Institute of…
Charters, Alexander N.
The first meeting of the Coalition of Adult Education Organizations (CAEO) was held in Syracuse in 1964 as a Conference of Adult Education Organizations. Its purpose was to obtain input to help determine the development of the Library of Continuing Education (LCE). Presidents, other officers or leaders of 17 organizations in Canada and the United…
Texas State Occupational Information Coordinating Committee, Austin.
The Texas Automated Student and Adult Learner Follow-Up System was developed as part of a larger effort to improve and coordinate the delivery of education and training of a skilled work force. The primary task of the Follow-Up System in Program Year 1993-94 was to obtain outcome information on the former students and participants of the work…
Chou, Y-C.; Pu, C.; Kroger, T.; Lee, W.; Chang, S.
Background: The Taiwanese government launched a new programme in November 2004 to support adults with intellectual disabilities living in smaller facilities. This paper aims to evaluate the service outcomes of this new residential scheme over 2 years including those residents who moved from an institution and those who moved from their family.…
Questions relating to knowledge of basic health concerns were the foundation of a survey of two groups of individuals: 17-year-old school students and adults between the ages of 26 and 35. The questions were grouped into two general categories--accident prevention and emergency care skills, and good health practices. Each of these topics contained…
Ito, Kiwako; Bibyk, Sarah A.; Wagner, Laura; Speer, Shari R.
Both off-line and on-line comprehension studies suggest not only toddlers and preschoolers, but also older school-age children have trouble interpreting contrast-marking pitch prominence. To test whether children achieve adult-like proficiency in processing contrast-marking prosody during school years, an eye-tracking experiment examined the…
Kittler, P.; Krinsky-McHale, S. J.; Devenny, D. A.
The aim of this study was to explore changes related to sex differences on the Wechsler Intelligence Scale for Children Revised (WISC-R) subtest performance over a 7-year interval in middle-aged adults with intellectual disability (ID). Cognitive sex differences have been extensively studied in the general population, but there are few reports…
French, Simone A.; Mitchell, Nathan R.; Hannan, Peter J.
Objective: To examine associations between television viewing, sugar-sweetened beverage consumption, eating out, physical activity, and body weight change over 1 year. Design: Secondary data analysis from randomized intervention trial. Setting: Households in the community. Participants: Adults (n = 153) and adolescents (n = 72) from the same…
Iowa Department of Education, 2004
The purpose of this publication is to present the Executive Summary of the Program Year 2004 report on Iowa's adult literacy program benchmarks. The passage of the Workforce Investment Act (WIA) of 1998 [Public Law 105-220] by the 105th Congress ushered in a new era of collaboration, coordination, cooperation and accountability. The overall goal…
O'Neill, Audrey Myerson
Background: This longitudinal study of 20 average and bright adults with parents with cognitive difficulties follows a study 20 years earlier of their childhood adaptation to their parents. Method: Semistructured interviews about life situation and changes and perception of family-of-origin. Results: The participants' socioeconomic status changed…
Nondahl, David M.; Cruickshanks, Karen J.; Wiley, Terry L.; Tweed, Ted S.; Dalton, Dayna S.
Purpose: The primary purpose of this study was to measure the 16-year change in peak compensated static acoustic admittance (Peak Y[subscript tm]) in a population-based cohort of older adults, and to determine whether age was associated with any observed change in Peak Y[subscript tm]. Other tympanometric measures also were taken and analyzed.…
Langtimm, C.A.; Beck, C.A.
The endangered Florida manatee (Trichechus manatus latirostris) inhabits the subtropical waters of the southeastern United States, where hurricanes are a regular occurrence. Using mark-resighting statistical models, we analyzed 19 years of photo-identification data and detected significant annual variation in adult survival for a subpopulation in northwest Florida where human impact is low. That variation coincided with years when intense hurricanes (Category 3 or greater on the Saffir-Simpson Hurricane Scale) and a major winter storm occurred in the northern Gulf of Mexico. Mean survival probability during years with no or low intensity storms was 0.972 (approximate 95% confidence interval = 0.961-0.980) but dropped to 0.936 (0.864-0.971) in 1985 with Hurricanes Elena, Kate, and Juan; to 0.909 (0.837-0.951) in 1993 with the March "Storm of the Century"; and to 0.817 (0.735-0.878) in 1995 with Hurricanes Opal, Erin, and Allison. These drops in survival probability were not catastrophic in magnitude and were detected because of the use of state-of-the-art statistical techniques and the quality of the data. Because individuals of this small population range extensively along the north Gulf coast of Florida, it was possible to resolve storm effects on a regional scale rather than the site-specific local scale common to studies of more sedentary species. This is the first empirical evidence in support of storm effects on manatee survival and suggests a cause-effect relationship. The decreases in survival could be due to direct mortality, indirect mortality, and/or emigration from the region as a consequence of storms. Future impacts to the population by a single catastrophic hurricane, or series of smaller hurricanes, could increase the probability of extinction. With the advent in 1995 of a new 25- to 50-yr cycle of greater hurricane activity, and longer term change possible with global climate change, it becomes all the more important to reduce mortality and injury
Crookes, Kate; Robbins, Rachel A
Performance on laboratory face tasks improves across childhood, not reaching adult levels until adolescence. Debate surrounds the source of this development, with recent reviews suggesting that underlying face processing mechanisms are mature early in childhood and that the improvement seen on experimental tasks instead results from general cognitive/perceptual development. One face processing mechanism that has been argued to develop slowly is the ability to encode faces in a view-invariant manner (i.e., allowing recognition across changes in viewpoint). However, many previous studies have not controlled for general cognitive factors. In the current study, 8-year-olds and adults performed a recognition memory task with two study-test viewpoint conditions: same view (study front view, test front view) and change view (study front view, test three-quarter view). To allow quantitative comparison between children and adults, performance in the same view condition was matched across the groups by increasing the learning set size for adults. Results showed poorer memory in the change view condition than in the same view condition for both adults and children. Importantly, there was no quantitative difference between children and adults in the size of decrement in memory performance resulting from a change in viewpoint. This finding adds to growing evidence that face processing mechanisms are mature early in childhood.
Witkop, Michelle; Guelcher, Christine; Forsyth, Angela; Hawk, Sarah; Curtis, Randall; Kelley, Laureen; Frick, Neil; Rice, Michelle; Rosu, Gabriela; Cooper, David L
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.
Scinicariello, Franco; Buser, Melanie C.
Background Genetic and environmental factors contribute to the risk of depression and several studies have noted an association between tobacco smoke and depression. Cadmium is a neurotoxicant, and the main source of non-occupational exposure is tobacco smoke. Methods We conducted a cross-sectional analysis of data from 2892 young adult (20-39 years) participants of the National Health and Nutrition Examination Survey (NHANES) 2007-2010. Multivariate logistic regressions – adjusted for age, sex, race/ethnicity, education, poverty-income ratio, obesity, alcohol intake, blood lead, and smoking status – were used to analyze the association between blood cadmium and depressive symptoms, as determined by score on the PHQ-9. Results Individuals in the highest quartile of blood cadmium had higher odds of having depressive symptoms (OR=2.79; 95% CI, 1.84, 4.25) compared to those in the lowest blood cadmium quartile. Smoking status was statistically significantly associated with depressive symptoms while blood lead was not. Stratification by smoking status found that blood cadmium was significantly associated with depressive symptoms in both non-smokers (OR=2.91; 95% CI, 1.12, 7.58) and current smokers (OR=2.69; 95% CI, 1.13, 6.42). Conclusions This is the first study reporting an association of blood cadmium levels with depressive symptoms using a nationally representative sample. The association of cadmium with depressive symptoms was independent of smoking status. If this association is further confirmed, the continued efforts at reducing cadmium exposures, mainly through tobacco smoking cessation programs, may decrease the incidence of depression. PMID:25115444
Chlibek, Roman; von Sonnenburg, Frank; Van Damme, Pierre; Smetana, Jan; Tichy, Petr; Gunapalaiah, Bhavyashree; Leyssen, Maarten; Jacquet, Jeanne-Marie
Persistence of immune response was assessed in adults aged >40 years (N = 596) following primary vaccination with combined hepatitis A/B vaccine or concomitant monovalent hepatitis A and B vaccines. Anti-hepatitis A virus antibody responses persisted for at least 4 years regardless of the vaccine used, with anti-hepatitis B surface antibody responses higher and more sustained in subjects who received the combined hepatitis A/B vaccine. Response rates to an additional dose of the same vaccine(s) used for priming were high.
Warren, E. Theodore
The Adult Education Project, conducted for four years at what is now the Vigo County Public Library, Terre Haute, Indiana, was an attempt to discover what could be done to improve a community's informal adult education programs by adding a doctorate-level adult educator to the staff of the public library and by making his services available to the…
de Wijs, Ruth, Ed.; Keijzer, Jose, Ed.
Presentations and presenters include "What Are the Effects of Courses with Unemployed Adults in Their Mid-Life Years?" (Weinberg); "Combining Education and Training of Unemployed Adults " (Sellin); "The Changing Role of Adult Education in the Post-Industrial Society" (Jocher); "The REPLAN Programme in England and…
Bedolla-Pulido, Tonatiuh Ramses; Camacho-Peña, Alan Salvador; González-García, Estefanía; Morales-Romero, Jaime
Purpose There is limited epidemiological evidence of food hypersensitivity (FH) in the adult population. We aimed to determine the prevalence of FH in Mexican adults, their clinical features and to establish common food involved in its appearance. Methods We designed a cross-sectional study using a fixed quota sampling; 1,126 subjects answered a structured survey to gather information related to FH. Results The prevalence of FH in adults was 16.7% (95% CI, 14.5% to 18.8%), without statistical significant differences related to gender (women, 17.5% and men, 15.9%) or residential location. The most common clinical manifestations in adults with FH were oral allergy syndrome (70 of 1,126) and urticaria (55 of 1,126). According to category, fruits and vegetables were the most frequent foods to trigger FH (6.12%) and were individually related to shrimp (4.0%), and cow milk (1.5%). Adults under age 25 had a higher frequency of FH (OR, 1.39; 95% CI, 1.01 to 1.91, P <0.001). Personal history of any atopic disease was significantly associated with FH (P <0.0001). Conclusions The prevalence of FH is relatively high in Mexican adults, and FH is significantly associated with atopic diseases. PMID:25374750
Sharma, Rajiv; Ahlm, Clas; Ostergaard, Lars; Dowell, Anthony; Tran, Clément; Thomas, Stéphane; Eymin, Cécile
Hepatitis B vaccines do not generate protective immune responses in older adults as effectively as they do in children and young adults. Improved formulations of existing vaccines may have the potential to improve this. This study investigated the persistence of serum antibodies against hepatitis B surface antigens (anti-HBs) 3.1–3.5 years following primary vaccination with 3 doses of HBvaxPRO® or Engerix B™ in healthy adults aged ≥50 years who were further challenged with 1 dose of recombinant hepatitis B antigen. This was an open-label extension study. Individuals (N = 204) with a mean (standard deviation) age at enrollment of 63.7 (7.0) years receiving HBvaxPRO® or Engerix B™ in a randomized, double-blind primary study were challenged with 1 dose of HBvaxPRO® (10 μg). Anti-HBs were measured pre- and 30 days post-challenge. 45.5% (34.8, 56.4 [95% CI]) of individuals who received HBvaxPRO® in the per protocol set (PPS) had anti-HBs titers ≥10 mIU/mL pre-challenge and 85.2% (76.1, 91.9) 1-month post-challenge. In those who received Engerix B™ in the primary vaccination series, the results were 58.8% (48.6, 68.5) and 88.3% (80.5, 93.8), respectively. The challenge dose of HBvaxPRO® was generally well tolerated. Subjects aged ≥50 years receiving a challenge dose of HBvaxPRO® demonstrated immune memory against hepatitis B 3 years after a 3-dose primary. The safety profile of this challenge dose of HBvaxPRO® was consistent with the well-established safety profile of the vaccine HBvaxPRO®. PMID:25996838
Pietrzak, Robert H; Scott, J Cobb; Neumeister, Alexander; Lim, Yen Ying; Ames, David; Ellis, Kathryn A; Harrington, Karra; Lautenschlager, Nicola T; Szoeke, Cassandra; Martins, Ralph N; Masters, Colin L; Villemagne, Victor L; Rowe, Christopher C; Maruff, Paul
Although beta-amyloid, anxiety and depression have linked cross-sectionally to reduced memory function in healthy older adults without dementia, prospective data evaluating these associations are lacking. Using data an observational cohort study of 178 healthy older adults without dementia followed for 3 years, we found that anxiety symptoms significantly moderated the relationship between beta-amyloid level and decline in verbal (Cohen's d = 0.65) and episodic (Cohen's d = 0.38) memory. Anxiety symptoms were additionally linked to greater decline in executive function, irrespective of beta-amyloid and other risk factors. These findings suggest that interventions to mitigate anxiety symptoms may help delay memory decline in otherwise healthy older adults with elevated beta-amyloid.
Choi, Ji Young; Kim, Young-Nam; Cho, Youn-Ok
A recent Korea National Health and Nutrition Survey indicated inadequate riboflavin intake in Koreans, but there is limited research regarding riboflavin status in South Korea. The purpose of this study was to determine riboflavin intake and status of Korean adults. Three consecutive 24-h food recalls were collected from 412 (145 men and 267 women) healthy adults, aged 20-64 years, living in South Korea and urine samples were collected from 149 subjects of all subjects. The dietary and total (dietary plus supplemental) riboflavin intake was 1.33 ± 0.34 and 2.87 ± 6.29 mg/day, respectively. Approximately 28% of the subjects consumed total riboflavin less than the Estimated Average Requirement. Urinary riboflavin excretion was 205.1 ± 190.1 μg/g creatinine. Total riboflavin intake was significantly positively correlated to the urinary riboflavin excretion. (r = 0.17171, p = 0.0363). About 11% of the Korean adults had urinary riboflavin <27 μg/g creatinine indicating a riboflavin deficiency and 21% had low status of riboflavin (27 μg/g creatinine ≤ urinary riboflavin < 80 μg/g creatinine). Thus, one-third of Korean adults in this study had inadequate riboflavin status. In some adults in Korea, consumption of riboflavin-rich food sources should be encouraged.
Reisinger, Keith S.; Kerzner, Boris; Stek, Jon E.; Sausser, Timothy A.; Xu, Jin; Wang, William W.; Chan, Ivan S.F.; Annunziato, Paula W.; Parrino, Janie
Objective To evaluate the general safety of zoster vaccine (ZV) in adults ≥60 years old. Patients/Methods Subjects were enrolled in a 1:1 ratio to receive 1 dose of ZV or placebo. Subjects were followed for serious adverse experiences (SAEs) for 42 days (primary follow-up period) and 182 days (secondary follow-up period) postvaccination. Relative-risks (ZV/placebo) for SAEs during both safety periods were calculated. Study period: 17-Sep‑2007 to 09-Jan-2009. Results Overall, 5,983 subjects received ZV and 5,997 received placebo. Within the primary 42-day follow-up period, 84 ZV subjects and 67 placebo subjects reported SAEs. The estimated risk of SAEs within 42 days was 1.41% for ZV versus 1.12% for placebo, with a relative-risk of 1.26 (95% CI 0.91,1.73); indicating no statistically significant difference between groups, meeting the pre-specified success criterion. During the 182-day follow-up period, 340 ZV subjects and 300 placebo subjects reported SAEs. The estimated risk of SAEs within 182 days was 5.68% for ZV versus 5.01% for placebo, with a relative-risk of 1.13 (95% CI 0.98,1.32), indicating no statistically significant difference between groups. Two subjects in the ZV group reported SAEs deemed by the investigator to be vaccine-related (uveitis and sciatica; onset Day 5 and 4, respectively). One subject in the placebo group reported a SAE deemed by the investigator to be vaccine-related (lumbar radiculopathy; onset Day 51). There were 24 fatal SAEs in the ZV group and 17 in the placebo group (relative risk = 1.41; CI: 0.77, 2.60); 6 and 5, respectively, with SAE onset during the primary 42-day follow-up period. No deaths were deemed vaccine-related. Conclusions ZV and placebo groups had similar safety profiles in terms of SAEs during the primary (Day 1 to 42) and secondary (Day 1 to 182) follow-up periods. PMID:22048110
Background There is little information regarding the trends in body mass index (BMI) and obesity in the overall Portuguese population, namely if these trends are similar according to educational level. In this study, we assessed the trends in the prevalence of overweight and obesity in the Portuguese population, overall and by educational level. Methods Cross-sectional national health interview surveys conducted in 1995-6 (n = 38,504), 1998-9 (n = 38,688) and 2005-6 (n = 25,348). Data were derived from the population and housing census of 1991 and two geographically-based strata were defined. The sampling unit was the house, and all subjects living in the sampling unit were surveyed. Height and weight were self-reported; the effects of gender, age group and educational level were also assessed by self-reported structured questionnaires. Bivariate comparisons were performed using Chi-square or analysis of variance (ANOVA). Trends in BMI levels were assessed by linear regression analysis, while trends in the prevalence of obesity were assessed by logistic regression. Results Mean (±standard deviation) BMI increased from 25.2 ± 4.0 in 1995-6 to 25.7 ± 4.5 kg/m2 in 2005-6. Prevalence of overweight remained stable (36.1% in 1995-6 and 36.4% in 2005) while prevalence of obesity increased (11.5% in 1995-6 and 15.1% in 2005-6). Similar findings were observed according to age group. Mean age-adjusted BMI increase (expressed in kg/m2/year and 95% confidence interval) was 0.073 (0.062, 0.084), 0.016 (0.000, 0.031) and 0.073 (0.049, 0.098) in men with primary, secondary and university levels, respectively; the corresponding values in women were 0.085 (0.073, 0.097), 0.052 (0.035, 0.069) and 0.062 (0.038, 0.084). Relative to 1995-6, obesity rates increased by 48%, 41% and 59% in men and by 40%, 75% and 177% in women with primary, secondary and university levels, respectively. The corresponding values for overweight were 6%, 1% and 23% in men and 5%, 7% and 65% in women
Chung, Kevin C.; Squitieri, Lee; Kim, H. Myra
Purpose Despite the high prevalence and impact of distal radius fractures (DRFs) on older patients, the current available literature regarding DRFs in older adults lacks adequate comparative treatment data. The purpose of this prospective, controlled outcomes study is to compare outcomes using the volar locking plating system (VLPS) for DRFs in both older and younger adults. Methods Consecutive, eligible patients were enrolled into our prospective study over a two-year period on the basis of strict inclusion/exclusion criteria. Subjects were entered into two cohorts based on age: 20–40 years and ≥ 60 years. Patient outcomes and complication rates were evaluated at three, six and twelve months after surgery. Outcome measures included the Michigan Hand Outcomes Questionnaire (MHQ), grip strength, active wrist and forearm range of motion, the Jebsen-Taylor test, and radiographic parameters. Results 55 patients (30 young and 25 older adults) with unilateral, inadequately reduced DRFs were enrolled and received surgical treatment with the VLPS. We observed no statistically significant difference in any of the outcomes for all three follow-up periods. While older age patients continued to improve throughout their twelve month postoperative visits, younger patients achieved their maximum recovery during the six month follow-up period, suggesting different recovery patterns. At the twelve-month assessment, older patients were able to achieve a higher mean MHQ score than their younger counterparts (normalized mean: 85% and 82%, respectively). Complication rates were similar between the two groups for all three time periods, with most occurring on or before the three month postoperative visit. Conclusions This study indicates that the VLPS is successful in managing DRFs in older patients and without increased complications compared to younger patients. For the older patients without prohibitive surgical risks, internal fixation using the VLPS yields comparable outcomes
Zanarini, Mary C; Temes, Christina M; Ivey, Alexandra M; Cohn, Danielle M; Conkey, Lindsey C; Frankenburg, Frances R; Fitzmaurice, Garrett M
This study had two aims. The first was to assess and compare various types of aggressive behavior toward others reported by borderline patients and axis II comparison subjects over time. The second was to determine the best baseline and time-varying predictors of aggressive behavior in these borderline patients. At baseline, a series of interviews and self-report measures were administered to 290 borderline patients and 72 axis II comparison subjects. Measures assessing aggression toward others, axis I and II disorders as well as adult adversity were re-administered every two years over the course of ten years. It was found that borderline patients reported significantly higher rates of verbal, emotional, and physical aggression toward others than comparison subjects but the rates of these forms of aggression toward others declined significantly for those in both study groups. Multivariate analyses indicated that the strongest predictors of adult aggression towards others were severity of adult adversity and a substance use disorder. Taken together, these results suggest that borderline patients commonly report aggression toward others but that this aggression declines significantly over time. These results also suggest that this aggression toward others is most strongly associated with adult experiences of adversity and concurrent substance abuse.
Nelson, Melissa C; Larson, Nicole I; Barr-Anderson, Daheia; Neumark-Sztainer, Dianne; Story, Mary
We examined whether young adult meal patterning, dietary intake, and home food availability differed among nonstudents, 2-year college students, and 4-year college students (N = 1687; mean age = 20.5 years). Unadjusted analyses showed that few young adults consumed optimal diets and, compared with 4-year college students, nonstudents and 2-year students consumed fewer meals and poorer diets. After controlling for sociodemographics and living arrangements, we found that over half of the observed associations remained significant (P < .05). Nutrition interventions are needed for young adults, particularly specific at-risk groups.
Martin, Jennifer L.; Fiorentino, Lavinia; Jouldjian, Stella; Mitchell, Michael; Josephson, Karen R.; Alessi, Cathy A.
Study Objective: To evaluate the association between self-reported sleep quality among older adults during inpatient post-acute rehabilitation and one-year survival. Design: Prospective, observational cohort study. Setting: Two inpatient post-acute rehabilitation sites (one community and one Veterans Administration). Participants: Older patients (aged ≥ 65 years, n = 245) admitted for inpatient post-acute rehabilitation. Interventions: None. Measurements and Results: Within one year of post-acute rehabilitation, 57 participants (23%) were deceased. Cox proportional hazards models showed that worse Pittsburgh Sleep Quality Index (PSQI) total scores during the post-acute care stay were associated with increased mortality risk when controlling for amount of rehabilitation therapy received, comorbidities, and cognitive functioning (Hazard ratio [95% CI] = 1.11 [1.02-1.20]). Actigraphically estimated sleep was unrelated to mortality risk. Conclusions: Poorer self-reported sleep quality, but not objectively estimated sleep parameters, during post-acute rehabilitation was associated with shorter survival among older adults. This suggests self-reported poor sleep may be an important and potentially modifiable risk factor for negative outcomes in these vulnerable older adults. Studies of interventions to improve sleep quality during inpatient rehabilitation should therefore be undertaken, and the long-term health benefits of improved sleep should be explored. Citation: Martin JL; Fiorentino L; Jouldjian S; Mitchell M; Josephson KR; Alessi CA. Poor self-reported sleep quality predicts mortality within one year of inpatient post-acute rehabilitation among older adults. SLEEP 2011;34(12):1715-1721. PMID:22131610
Frey, Patricia; And Others
This report describes the progress of the Michigan Adult Literacy Initiative (MALI), adopted by the Michigan Board of Education in 1985, through 1990. It covers the collaborative accomplishments of a statewide team of literacy supporters that represents a comprehensive spectrum of public and private concerns. Part I is an introduction that…
Osness, Wayne H.; And Others
This field test to assess the functional fitness of adults over 60 covers of the following areas: (1) body composition; (2) body weight; (3) standing height measurement; (4) flexibility; (5) agility/dynamic balance; (6) coordination; (7) strength; and (8) endurance. Posttest activities are suggested, and a data sheet and exercise consent form are…
Satterfield, James H.; Faller, Katherine J.; Crinella, Francis M.; Schell, Anne M.; Swanson, James M.; Homer, Louis D.
Objective: To compare the official arrest records for a large number of hyperactive boys (N = 179), most with conduct problems, and 75 control boys; to examine childhood IQ, socioeconomic status, and parent reports of childhood hyperactivity and conduct problems for their contribution to criminal behavior in adulthood; and to compare adult outcome…
Cheng, Helen; Furnham, Adrian
This study explored a longitudinal data set of nearly 5000 adults examining the effects of childhood cognitive ability (measured at age 11), parental social class (measured at birth), and personality on current occupational prestige (all measured at age 50), taking account the effects of education and the previous occupational levels (both…
Division of Community Colleges and Workforce Preparation, Iowa Department of Education, 2007
This comprehensive document replaces the previously published Benchmark Report, Benchmark Report Executive Summary, Iowa's Community College Basic Literacy Skills Credential Report, Iowa GED Statistical Report, GED Annual Performance Report and Iowa's Adult Literacy Program National Reporting System Annual Performance Report (Graphic…
Illinois Community College Board, 2007
The Illinois Community College Board has developed this Provider Manual as an easy reference to: (1) existing laws and regulations, both State and Federal; (2) best practices in the field of Adult Education; and to (3) act as a desk reference for both new and existing program administrators. The Manual describes: (1) the purpose of the Federal…
Shapiro, Joan; Rich, Rebecca
This text provides information on learning disabilities in adults and offers practical ways to compensate. Chapters address: (1) definitions of learning disability; (2) etiology of learning disabilities; (3) our cognitive or thinking systems; (4) different assessment settings and some of the tests used to diagnose a learning disability; (5)…
Farry, James K; Flombaum, Carlos D; Latcha, Sheron
Ifosfamide is indicated as first line treatment in a variety of solid tumours in adults. It is known to be nephrotoxic and is often used following therapy with, or as concomitant therapy with other potent nephrotoxins. To date, there are sparse case reports on the incidence of acute kidney injury (AKI) or chronic kidney disease (CKD) in adults exposed to ifosfamide. The available data on the long term renal complications for patients exposed to ifosfamide are thus based entirely on the paediatric population. The aim of this study was to assess the long term effects of ifosfamide exposure on renal function in an adult population and to determine if there are any treatment or patient specific factors that contribute to long term nephrotoxicity. The mean decline in estimated glomerular filtration rate (eGFR) following the first cycle of ifosfamide was 15 ml/min/1.73 m(2). Thereafter, there was a slower but steady decline in eGFR. No patient progressed to end stage renal disease (ESRD). Patient age and concomitant exposure to carboplatin were the only two factors which significantly affected eGFR. This represents the only long term study on the nephrotoxicity of ifosfamide in adults.
AN OCCUPATIONAL DAY CENTER FOR MENTALLY RETARDED ADULTS WAS ESTABLISHED TO PROVIDE COMMUNITY SERVICES FOR RETARDED PERSONS WHO LIVE AT HOME AND, ALTHOUGH BEYOND SCHOOL AGE, ARE UNABLE TO PARTICIPATE IN SHELTERED WORKSHOP ACTIVITIES. THE STAFF INCLUDES A DIRECTOR, A SOCIAL WORKER, FIVE INSTRUCTORS, A TRAINING SUPERVISOR, AN OFFICE WORKER, AND A…
Lappi, Shelly J.
This study examined the relationship between dependent and independent variables and the effects relationships have on K-12 students as they struggle through life stressors. Thus, the research study was based upon this over arching question: How does having positive student-adult relationships impact a student's ability to cope with life…
Howlin, Patricia; Savage, Sarah; Moss, Philippa; Tempier, Althea; Rutter, Michael
Background: It is well established that very few individuals with autism spectrum disorders (ASD) and an IQ below 70 are able to live independently as adults. However, even amongst children with an IQ in the normal range, outcome is very variable. Childhood factors that predict later stability, improvement or decline in cognitive functioning…
This document describes the number of enrollees, graduates and placements connected with Postsecondary Adult Vocational Education (PSAV) programs at Miami-Dade Community College, and in the Florida Community College System. Data for Miami-Dade relate mostly to the 1994-95 through 1997-98 timeframe, while Florida system data span 1989-90 through…
Angell, Maureen E.; Stoner, Julia B.; Fulk, Barbara M.
Essentially, the goal of the P-16 educational process is to teach students to become self-determined adults. Unfortunately, educational systems sometimes fail in addressing these factors and in educating students with various disabilities in the area of self-determination. In this article, the authors present the major findings that emerged from…
Maracle, David Kanatawakhon; Richards, Merle
An adult immersion program in the Mohawk language took place in an Iroquois community in southern Ontario. The class was limited to 12 students who had taken a readiness course that introduced them to basic grammar and vocabulary. The class met daily in the relaxed setting of a house. The preparation and sharing of meals, the presence of fluent…
Fuentes, Dahlia; Aranda, María P.
While there is strong evidence in support of geriatric depression treatments, much less is available with regard to older U.S. racial and ethnic minorities. The objectives of this review are to identify and appraise depression treatment studies tested with samples of U.S. racial and ethnic minority older adults. We include an appraisal of sociocultural adaptations made to the depression treatments in studies meeting our final criteria. Systematic search methods were utilized to identify research published between 1990 and 2010 that describe depression treatment outcomes for older adults by racial/ethnic group, or for samples of older adults that are primarily (i.e., >50%) racial/ethnic minorities. Twenty-three unduplicated articles included older adults and seven met all inclusion criteria. Favorable depression treatment effects were observed for older minorities across five studies based on diverse settings and varying levels of sociocultural adaptations. The effectiveness of depression care remains mixed although collaborative or integrated care shows promise for African Americans and Latinos. The degree to which the findings generalize to non-English-speaking, low acculturated, and low income older persons, and to other older minority groups (i.e., Asian and Pacific Islanders, and American Indian and Alaska Natives) remains unclear. Given the high disease burden among older minorities with depression, it is imperative to provide timely, accessible, and effective depression treatments. Increasing their participation in behavioral health research should be a national priority. PMID:22828202
A project was undertaken to provide computer-assisted instruction (CAI) to 92 native adult students in the Keewatin region of the Northwest Territories of Canada. The project's principal goals were as follows: attract and maintain the interest of a greater segment of the target population, produce faster progress in academic training, help program…
Zhang, Yang; Lorenzi, Maria F; Goddard, Karen; Spinelli, John J; Gotay, Carolyn; McBride, Mary L
To estimate the risk of late morbidity leading to hospitalization among young adult cancer 5-year survivors compared to the general population and to examine the long-term effects of demographic and disease-related factors on late morbidity, a retrospective cohort of 902 five-year survivors of young adult cancer diagnosed between 1981 and 1999 was identified from British Columbia (BC) Cancer Registry. A matched comparison group (N = 9020) was randomly selected from the provincial health insurance plan. All hospitalizations until the end of 2006 were determined from the BC health insurance plan hospitalization records. The Poisson regression model was used to estimate the rate ratios for late morbidity leading to hospitalization except pregnancy after adjusting for sociodemographic and clinical risk factors. Overall, 455 (50.4%) survivors and 3,419 (37.9%) individuals in the comparison group had at least one type of late morbidity leading to hospitalization. The adjusted risk of this morbidity for survivors was 1.4 times higher than for the comparison group (95% CI = 1.22-1.54). The highest risks were found for hospitalization due to blood disease (RR = 4.2; 95% CI = 1.98-8.78) and neoplasm (RR = 4.3; 95% CI = 3.41-5.33). Survivors with three treatment modalities had three-fold higher risk of having any type of late morbidity (RR = 3.22; 95% CI = 2.09-4.94) than the comparators. These findings emphasize that young adult cancer survivors still have high risks of a wide range of late morbidities.
Meinhardt-Injac, Bozana; Persike, Malte; Meinhardt, Günter
Investigation of whole-part and composite effects in 4- to 6-year-old children gave rise to claims that face perception is fully mature within the first decade of life (Crookes & McKone, 2009). However, only internal features were tested, and the role of external features was not addressed, although external features are highly relevant for holistic face perception (Sinha & Poggio, 1996; Axelrod & Yovel, 2010, 2011). In this study, 8- to 10-year-old children and adults performed a same-different matching task with faces and watches. In this task participants attended to either internal or external features. Holistic face perception was tested using a congruency paradigm, in which face and non-face stimuli either agreed or disagreed in both features (congruent contexts) or just in the attended ones (incongruent contexts). In both age groups, pronounced context congruency and inversion effects were found for faces, but not for watches. These findings indicate holistic feature integration for faces. While inversion effects were highly similar in both age groups, context congruency effects were stronger for children. Moreover, children's face matching performance was generally better when attending to external compared to internal features. Adults tended to perform better when attending to internal features. Our results indicate that both adults and 8- to 10-year-old children integrate external and internal facial features into holistic face representations. However, in children's face representations external features are much more relevant. These findings suggest that face perception is holistic but still not adult-like at the end of the first decade of life.
Montag, Jessica L.; MacDonald, Maryellen C.
There is still much debate about the nature of the experiential and maturational changes that take place during childhood to bring about the sophisticated language abilities of an adult. The present study investigated text exposure as a possible source of linguistic experience that plays a role in the development of adult-like language abilities. Corpus analyses of object and passive relative clauses (Object: The book that the woman carried; Passive: The book that was carried by the woman) established the frequencies of these sentence types in child-directed speech and children's literature. We found that relative clauses of either type were more frequent in the written corpus, and that the ratio of passive to object relatives was much higher in the written corpus as well. This analysis suggests that passive relative clauses are much more frequent in a child's linguistic environment if they have high rates of text exposure. We then elicited object and passive relative clauses using a picture-description production task with eight and twelve year old children and adults. Both group and individual differences were consistent with the corpus analyses, such that older individuals and individuals with more text exposure produced more passive relative clauses. These findings suggest that the qualitatively different patterns of text versus speech may be an important source of linguistic experience for the development of adult-like language behavior. PMID:25844625
Cowan, Nelson; Morey, Candice C.; AuBuchon, Angela M.; Zwilling, Christopher E.; Gilchrist, Amanda L.
Previous studies indicate that visual working memory performance increases with age in childhood but it is not clear why. One main hypothesis has been that younger children are less efficient in their attention, specifically less able to exclude irrelevant items from working memory to make room for relevant items. We examined this hypothesis by measuring visual working memory capacity under a continuum of 5 attention conditions. A recognition advantage was found for items to be attended as opposed to ignored. The size of this attention-related effect was adult-like in young children with small arrays, suggesting that their attention processes are efficient even though their working memory capacity is smaller than that of older children and adults. With a larger working memory load, this efficiency in young children is compromised. The efficiency of attention cannot be the sole explanation for the capacity difference. PMID:20121868
Tian, Qu; Simonsick, Eleanor M; Erickson, Kirk I; Aizenstein, Howard J; Glynn, Nancy W; Boudreau, Robert M; Newman, Anne B; Kritchevsky, Stephen B; Yaffe, Kristine; Harris, Tamara; Rosano, Caterina
A positive association between cardiorespiratory fitness (CRF) and white matter integrity has been consistently reported in older adults. However, it is unknown whether this association exists in adults over 80 with a range of chronic disease conditions and low physical activity participation, which can influence both CRF and brain health. This study examined whether higher CRF was associated with greater microstructural integrity of gray and white matter in areas related to memory and information processing in adults over 80 and examined moderating effects of chronic diseases and physical activity. CRF was measured as time to walk 400 m as quickly as possible with concurrent 3T diffusion tensor imaging in 164 participants (57.1% female, 40.3% black). Fractional anisotropy (FA) was computed for cingulum, uncinate and superior longitudinal fasciculi. Mean diffusivity (MD) was computed for dorsolateral prefrontal cortex, hippocampus, parahippocampus, and entorhinal cortex. Moderating effects were tested using hierarchical regression models. Higher CRF was associated with higher FA in cingulum and lower MD in hippocampus and entorhinal cortex (β, sex-adjusted p: -0.182, 0.019; 0.165, 0.035; and 0.220, 0.006, respectively). Hypertension attenuated the association with MD in entorhinal cortex. Moderating effects of chronic diseases and physical activity in walking and climbing stairs on these associations were not significant. The association of higher CRF with greater microstructural integrity in selected subcortical areas appears robust, even among very old adults with a range of chronic diseases. Intervention studies should investigate whether increasing CRF can preserve memory and information processing by improving microstructure and potential effects of hypertension management.
Cunningham, Charles E.; Walker, John R.; Eastwood, John D.; Westra, Henny; Rimas, Heather; Chen, Yvonne; Marcus, Madalyn; Swinson, Richard P.; Bracken, Keyna
Although most young adults with mood and anxiety disorders do not seek treatment, those who are better informed about mental health problems are more likely to use services. The authors used conjoint analysis to model strategies for providing information about anxiety and depression to young adults. Participants (N = 1,035) completed 17 choice tasks presenting combinations of 15 four-level attributes of a mental health information strategy. Latent class analysis yielded 3 segments. The virtual segment (28.7%) preferred working independently on the Internet to obtain information recommended by young adults who had experienced anxiety or depression. Self-assessment options and links to service providers were more important to this segment. Conventional participants (30.1%) preferred books or pamphlets recommended by a doctor, endorsed by mental health professionals, and used with a doctor's support. They would devote more time to information acquisition but were less likely to use Internet social networking options. Brief sources of information were more important to the low interest segment (41.2%). All segments preferred information about alternative ways to reduce anxiety or depression rather than psychological approaches or medication. Maximizing the use of information requires active and passive approaches delivered through old-media (e.g. books) and new-media (e.g., Internet) channels. PMID:24266450
United Nations Educational, Scientific, and Cultural Organization, Paris (France). Div. of Primary Educ., Literacy & Adult Educ., Educ. in Rural Areas
This issue contains several articles dealing with the International Literacy Year (ILY) proclaimed the United Nations (UN) for the year 1990. The first article, "1990, Proclaimed International Literacy Year by the United Nations," discusses the purpose of the observance of the ILY, namely the contribution to greater understanding by…
Adeyemo, Wasiu L; Ogunlewe, Mobolanle O; Desalu, Ibironke; Ladeinde, Akinola L; Mofikoya, Bolaji O; Adeyemi, Michael O; Adepoju, Adegbenga A; Hassan, Olufemi O
In developing countries, untreated cleft lips and palates are found with increasing frequency and patients often present to the surgeon far past the optimal time for closure of the cleft deformities. A prospective study was conducted between March 2007 and September 2009, to identify the reasons and treatment challenges of delayed presentation of cleft lip and palate deformities at the Lagos University Teaching Hospital, Nigeria. Out of a total of 150 patients with cleft defects during the period, 43 (28.7%) were adults and children aged over six years. The mean age of these patients at the time of presentation was 17.3 years. The most common reasons for late presentation were lack of money (56.7%), lack of health care services nearby (18.4%), and lack of awareness of treatment availability (13.3%). Common challenges in these patients included surgical, orthodontic, speech, anesthetic, and psychological. Although adult clefts were significantly enlarged in three dimensions the anatomic landmarks were easier to discern than in an infant. However, extensive soft tissue dissection in adult cleft lip repair resulted in significant postoperative edema. Closure of wide palatal cleft often required the use of adjunct intraoral flaps. Despite late presentation, surgical outcome of these patients was satisfactory and comparable to cleft repair in infants. PMID:23674906
Ito, Kiwako; Bibyk, Sarah A; Wagner, Laura; Speer, Shari R
Both off-line and on-line comprehension studies suggest not only toddlers and preschoolers, but also older school-age children have trouble interpreting contrast-marking pitch prominence. To test whether children achieve adult-like proficiency in processing contrast-marking prosody during school years, an eye-tracking experiment examined the effect of accent on referential resolution in six- to eleven-year-old children and adults. In all age groups, a prominent accent facilitated the detection of a target in contrastive discourse sequences (pink cat → green cat), whereas it led to a garden path in non-contrastive sequences (pink rabbit → green monkey: the initial fixations were on rabbits). While the data indicate that children as young as age six immediately interpret contrastive accent, even the oldest child group showed delayed fixations compared to adults. We argue that the children's slower recovery from the garden path reflects the gradual development in cognitive flexibility that matures independently of general oculomotor control.
Taylor, Julie Lounds; Mailick, Marsha R
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 years at the start of the study; M = 30.9) 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. After controlling for personal characteristics, receipt of more services was marginally related to greater improvement in vocational independence.
Kyrou, Ioannis; Kollia, Natasa; Panagiotakos, Demosthenes; Georgousopoulou, Ekavi; Chrysohoou, Christina; Tsigos, Constantine; Randeva, Harpal S; Yannakoulia, Mary; Stefanadis, Christodoulos; Papageorgiou, Charalabos; Pitsavos, Christos
Background Chronic stress frequently manifests with anxiety and/or depressive symptomatology and may have detrimental cardiometabolic effects over time. As such, recognising the potential links between stress-related psychological disorders and cardiovascular disease (CVD) is becoming increasingly important in cardiovascular epidemiology research. The primary aim of this study was to explore prospectively potential associations between clinically relevant depressive symptomatology and anxiety levels and the 10-year CVD incidence among apparently healthy Greek adults. Design A population-based, health and nutrition prospective survey. Methods In the context of the ATTICA Study (2002-2012), 853 adult participants without previous CVD history (453 men (45 ± 13 years) and 400 women (44 ± 18 years)) underwent psychological evaluations through validated, self-reporting depression and anxiety questionnaires. Results After adjustment for multiple established CVD risk factors, both reported depression and anxiety levels were positively and independently associated with the 10-year CVD incidence, with depression markedly increasing the CVD risk by approximately fourfold (adjusted odds ratio (95% confidence interval) 3.6 (1.3, 11) for depression status; 1.03 (1.0, 1.1) for anxiety levels). Conclusions Our findings indicate that standardised psychological assessments focusing on depression and anxiety should be considered as an additional and distinct aspect in the context of CVD preventive strategies that are designed and implemented by health authorities at the general population level.
Stroud, Laura R.; Papandonatos, George; Shenassa, Edmond; Rodriguez, Daniel; Niaura, Raymond; LeWinn, Kaja; Lipsitt, Lewis P.; Buka, Stephen L.
Background Maternal smoking during pregnancy (MSDP) is an independent risk factor for offspring nicotine dependence (ND), but mechanisms remain unknown. We investigated prenatal glucocorticoid (cortisol) and androgen (testosterone) associations with offspring ND over 40 years, and the possibility that prenatal glucocorticoids and androgens would mediate links between MSDP and offspring ND. Methods Participants were 1,086 mother-adult offspring pairs (59% female) from the New England Family Study, a 40-year longitudinal follow up of the Collaborative Perinatal Project. MSDP was assessed prospectively at each prenatal visit. Maternal cortisol, testosterone, and cotinine (nicotine metabolite), were assayed from third trimester maternal sera. Offspring lifetime ND was assessed via structured interview. Results Significant bivariate associations emerged for: a) MSDP/cotinine and lifetime ND, and b) maternal cortisol and lifetime ND, for daughters only. In multivariate models, maternal cortisol and MSDP/cotinine remained significantly and independently associated with increased odds of daughters’ lifetime ND. However, cortisol did not mediate the MSDP-lifetime ND relation. No associations emerged between maternal testosterone and offspring ND. Conclusions Results provide the first evidence in support of prenatal glucocorticoid programming of adult ND over 40 years in daughters only. Our study highlights two independent prenatal pathways leading to increased risk for ND in daughters: elevated prenatal glucocorticoids and MSDP/nicotine exposure. Daughter-specific effects of glucocorticoid and MSDP programming over 40 years highlight the breadth and persistence of sexually dimorphic programming effects in humans. Results do not support androgen programming of offspring ND. PMID:24034414
Nong, Qingjiao; Zhang, Yiyi; Guallar, Eliseo; Zhong, Qiuan
This study was to evaluate the association of urine arsenic with predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk in U.S. adults with hypertension. Cross-sectional analysis was conducted in 1570 hypertensive adults aged 40–79 years in the 2003–2012 National Health and Nutrition Examination Survey (NHANES) with determinations of urine arsenic. Predicted 10-year ASCVD risk was estimated by the Pooled Cohort Equations, developed by the American College of Cardiology/American Heart Association in 2013. For men, after adjustment for sociodemographic factors, urine dilution, ASCVD risk factors and organic arsenic intake from seafood, participants in the highest quartiles of urine arsenic had higher 10-year predicted ASCVD risk than in the lowest quartiles; the increases were 24% (95% confidence interval (CI): 2%, 53%) for total arsenic, 13% (95% CI: 2%, 25%) for dimethylarsinate and 22% (95% CI: 5%, 40%) for total arsenic minus arsenobetaine separately. For women, the corresponding increases were 5% (95% CI: −15%, 29%), 10% (95% CI: −8%, 30%) and 0% (95% CI: −15%, 19%), respectively. Arsenic exposure, even at low levels, may contribute to increased ASCVD risk in men with hypertension. Furthermore, our findings suggest that particular circumstances need urgently to be considered while elucidating cardiovascular effects of low inorganic arsenic levels. PMID:27828001
Yamamuro, Kazuhiko; Okada, Koji; Kishimoto, Naoko; Ota, Toyosaku; Iida, Junzo; Kishimoto, Toshifumi
Aim Earlier brain imaging research studies have suggested that brain abnormalities in obsessive-compulsive disorder (OCD) normalize as clinical symptoms improve. However, although many studies have investigated event-related potentials (ERPs) in patients with OCD compared with healthy control subjects, it is currently unknown whether ERP changes reflect pharmacological and psychotherapeutic effects. As such, the current study examined the neurocognitive components of OCD to elucidate the pathophysiological abnormalities involved in the disorder, including the frontal-subcortical circuits. Methods The Yale-Brown Obsessive-Compulsive Scale was used to evaluate 14 adult patients with OCD. The present study also included ten age-, sex-, and IQ-matched controls. The P300 and mismatch negativity (MMN) components during an auditory oddball task at baseline for both groups and after 1 year of treatment for patients with OCD were measured. Results Compared with controls, P300 amplitude was attenuated in the OCD group at Cz and C4 at baseline. Pharmacotherapy and psychotherapy treatment for 1 year reduced OCD symptomology. P300 amplitude after 1 year of treatment was significantly increased, indicating normalization compared with baseline at Fz, Cz, C3, and C4. We found no differences in P300 latency, MMN amplitude, or MMN latency between baseline and after one year of treatment. Conclusion ERPs may be a useful tool for evaluating pharmacological and cognitive behavioral therapy in adult patients with OCD. PMID:27713631
Daugherty, Ana M; Raz, Naftali
Age-related declines in spatial navigation are associated with deficits in procedural and episodic memory and deterioration of their neural substrates. For the lack of longitudinal evidence, the pace and magnitude of these declines and their neural mediators remain unclear. Here we examined virtual navigation in healthy adults (N=213, age 18-77 years) tested twice, two years apart, with complementary indices of navigation performance (path length and complexity) measured over six learning trials at each occasion. Slopes of skill acquisition curves and longitudinal change therein were estimated in structural equation modeling, together with change in regional brain volumes and iron content (R2* relaxometry). Although performance on the first trial did not differ between occasions separated by two years, the slope of path length improvement over trials was shallower and end-of-session performance worse at follow-up. Advanced age, higher pulse pressure, smaller cerebellar and caudate volumes, and greater caudate iron content were associated with longer search paths, i.e. poorer navigation performance. In contrast, path complexity diminished faster over trials at follow-up, albeit less so in older adults. Improvement in path complexity after two years was predicted by lower baseline hippocampal iron content and larger parahippocampal volume. Thus, navigation path length behaves as an index of perceptual-motor skill that is vulnerable to age-related decline, whereas path complexity may reflect cognitive mapping in episodic memory that improves with repeated testing, although not enough to overcome age-related deficits.
Brannon, Ernest L; Maki, Alan W; Moulton, Lawrence L; Parker, Keith R
For sixteen years following the 1989 Exxon Valdez oil spill adult returns of pink salmon in Prince William Sound, Alaska were monitored to assess spill effects on survival. No evidence of spill effects was detected for either intertidal or whole-stream spawning fish. From 1989 through 2004 mean densities for oiled and reference streams tracked each other, illustrating similar responses of oiled and reference stream adult populations to naturally changing oceanographic and climactic conditions. Hatchery fish strayed into the study streams, but similar incursions occurred in oiled and reference streams, and their presence was compensated for to eliminate their influence on determining the success of the returning natural populations. These results, showing no detectable effects of oiling on pink salmon spawning populations, are supported by published field studies on pink salmon incubation success in oiled streams.
Taylor, Philip D.
Using a broad-scale automated telemetry array, we explored post-fledging movements of blackpoll warblers breeding in Atlantic Canada. We sought to determine the full spatial scale of post-fledging dispersal, to assess support for three hypotheses for regional-scale post-fledging movement, and to determine whether learning influenced movement during this period. We demonstrated that both young and adults moved over distances more than 200 km prior to initiating migration. Adults moved southwest, crossing the Gulf of Maine (GOM), consistent with the commencement of migration hypothesis. Hatch-year birds exhibited less directional movements constrained geographically by the GOM. Their movements were most consistent with exploration hypotheses—that young birds develop a regional-scale map to aid in habitat selection, natal dispersal and subsequent migrations. PMID:26631243
Detry, O; De Roover, A; Delwaide, J; Coimbra, C; Kaba, A; Joris, J; Damas, P; Meurisse, M; Honoré, P
Living related liver transplantation (LRLT) in adult recipients has been recently developed to overcome the organ donor shortage, but LRLT leaves the healthy donors at risk of serious post-operative complications, or even death. The aim of this paper is to report the prospective evaluation of the initial experience of adult LRLT at the University of Liège. From March 2002 till March 2003, in a consecutive series of 35 adult liver transplantations, five recipients (mean age: 51 years) underwent LRLT, including one retransplantation. Indications for transplantation were autoimmune hepatitis, hepatitis B virus related cirrhosis with hepatocarcinoma (two cases), hepatitis C virus related cirrhosis with hepatocarcinoma, and ischemic intrahepatic bile duct necrosis 10 years after primary liver transplantation. Mean age of the donors was 34 years (range: 21-53 years). All donation cases were intra familial at first degree. The right lobe was used as a graft in four cases and the left lobe in one case. All right lobe donors developed transient hyperbilirubinemia and hypocoagulation for 4 to 6 days. No severe complication (transfusion, bile duct fistula, reintervention, rehospitalization) nor significant long-term sequelae were observed in the donors. In the recipients, graft function was immediate, and there was no small-for-size syndrome. One recipient developed biliary fistula treated by reoperation. One recipient died from invasive aspergillosis 11 days after the procedure. The four other recipients were alive without recurrence of the disease at follow-up. This report confirmed that LRLT may be a valuable alternative to cadaveric liver transplantation in the era of organ donor shortage. However, even if there was no severe complication for the donors in our preliminary experience, LRLT puts healthy living donors at risk of significant morbidity and even death.
Zhang, Q; Li, Z X; Yang, Y; Wang, C X; Wang, L M; Wang, L H
Objective: To understand the correlation between self-reported gingival bleeding and type 2 diabetes mellitus (T2DM) in adults in China. Methods: The database of China' s 2010 Chronic Disease and Risk Factor Surveillance (CCDRFS) survey among people aged ≥18 years was used to analyze the demographic characteristics of subjects with self-reporting gingival bleeding and the prevalence of major chronic diseases among adults. Correlation and interaction analyses were conducted on the relationships between frequent gingival bleeding and T2DM, hypertension and dyslipidemia, and interaction of age and gingival bleeding, age and hypertension, age and dyslipidemia, age and gender on the prevalence of T2DM. Results: Among 93 647 adults surveyed, 87.4% were in Han ethnic group. The incidence of frequent gingival bleeding was higher in females (63.6%) than in males (36.4%). The incidence of frequent gingival bleeding was highest (30.1%) in adults with middle school education level. Among the adults aged 45-60 years, 12.8%(2 839/22 179) had T2MD but no gingival bleeding, 15.6% (163/1 044) had both frequent gingival bleeding and T2DM, frequent gingival bleeding was correlated with T2DM (OR=1.29, 95%CI: 1.08-1.54) and the interaction with age had influence on T2DM (P<0.005). In males, frequent gingival bleeding was correlated with T2DM (OR=1.30, 95% CI: 1.08-1.56, P=0.005). In hypertension group, frequent gingival bleeding was correlated with T2DM (OR=1.25, 95% CI: 1.07-1.46), and interaction of hypertension and gingival bleeding had influence on T2DM (P<0.05). Conclusions: The positive correlation between frequent gingival bleeding and T2DM was observed in adults surveyed, and the interaction of age and hypertension had influence on prevalence of T2DM. Frequent gingival bleeding was correlated with T2DM in males either.
Background Listeria monocytogenes is the third most frequent cause of bacterial meningitis. The aim of this study is to know the incidence and risk factors associated with development of acute community-acquired Lm meningitis in adult patients and to evaluate the clinical features, management, and outcome in this prospective case series. Methods A descriptive, prospective, and multicentric study carried out in 9 hospitals in the Spanish Network for Research in Infectious Diseases (REIPI) over a 39-month period. All adults patients admitted to the participating hospitals with the diagnosis of acute community-acquired bacterial meningitis (Ac-ABM) were included in this study. All these cases were diagnosed on the basis of a compatible clinical picture and a positive cerebrospinal fluid (CSF) culture or blood culture. The patients were followed up until death or discharge from hospital. Results Two hundred and seventy-eight patients with Ac-ABM were included. Forty-six episodes of Lm meningitis were identified in 46 adult patients. In the multivariate analysis only age (OR 1.026; 95% CI 1.00-1.05; p = 0.042), immunosupression (OR 2.520; 95% CI 1.05-6.00; p = 0.037), and CSF/blood glucose ratio (OR 39.42; 95% CI 4.01-387.50; p = 0.002) were independently associated with a Lm meningitis. The classic triad of fever, neck stiffness and altered mental status was present in 21 (49%) patients, 32% had focal neurological findings at presentation, 12% presented cerebellum dysfunction, and 9% had seizures. Twenty-nine (68%) patients were immunocompromised. Empirical antimicrobial therapy was intravenous ampicillin for 34 (79%) of 43 patients, in 11 (32%) of them associated to aminoglycosides. Definitive ampicillin plus gentamicin therapy was significantly associated with unfavourable outcome (67% vs 28%; p = 0.024) and a higher mortality (67% vs 32%; p = 0.040).The mortality rate was 28% (12 of 43 patients) and 5 of 31 (16.1%) surviving patients developed adverse clinical
Cleland, Verity; Sodergren, Marita; Otahal, Petr; Timperio, Anna; Ball, Kylie; Crawford, David; Salmon, Jo; McNaughton, Sarah A
This study aimed to determine whether associations between the perceived environment and physical activity are moderated by urban-rural status among midolder aged adults. Environmental (safety, aesthetics, physical activity environment) and physical activity (total, leisure, transport) data from 3,888 adults (55 to 65 years) from urban and rural areas of Victoria, Australia, were analyzed. Multinomial logistic regression examined interactions between urban-rural status and environments in associations with physical activity. Significant (P < .05) interactions were evident and indicated positive associations only among older rural adults for both safety and aesthetics with total and transport physical activity (e.g., rural adults reporting higher safety were 91% to 118% more likely to have higher activity than rural adults reporting low safety). In contrast, the physical activity environment was positively associated with leisure activity among only urban adults. Findings suggest that some tailoring of physical activity promotion strategies targeting the environment may be required for urban and rural midolder aged adults.
Tseng, Hung Fu; Harpaz, Rafael; Luo, Yi; Hales, Craig M; Sy, Lina S; Tartof, Sara Y; Bialek, Stephanie; Hechter, Rulin C; Jacobsen, Steven J
Understanding long-term effectiveness of herpes zoster (HZ) vaccine is critical for determining vaccine policy. 176 078 members of Kaiser Permanente ≥60 years vaccinated with HZ vaccine and three matched unvaccinated members were included. Hazard ratios and 95% confidence intervals (CIs) associated with vaccination at each year following vaccination were estimated by Cox regression model. The effectiveness of HZ vaccine decreased from 68.7% (95% CI, 66.3%-70.9%) in the first year to 4.2% (95% CI, -24.0% to 25.9%) in the eighth year. This rapid decline in effectiveness of HZ vaccine suggests that a revaccination strategy may be needed, if feasible.
Mellis, M G; Ingle, L; Carroll, S
This study assessed the longer-term (12-month) variability in post-exercise heart rate recovery following a submaximal exercise test. Longitudinal data was analysed for 97 healthy middle-aged adults (74 male, 23 female) from 2 occasions, 12 months apart. Participants were retrospectively selected if they had stable physical activity habits, submaximal treadmill fitness and anthropometric measurements between the 2 assessment visits. A submaximal Bruce treadmill test was performed to at least 85% age-predicted maximum heart rate. Absolute heart rate and Δ heart rate recovery (change from peak exercise heart rate) were recorded for 1 and 2 min post-exercise in an immediate supine position. Heart rate recovery at both time-points was shown to be reliable with intra-class correlation coefficient values ≥ 0.714. Absolute heart rate 1-min post-exercise showed the strongest agreement between repeat tests (r = 0.867, P < 0.001). Lower coefficient of variation (≤ 10.2%) and narrower limits of agreement were found for actual heart rate values rather than Δ heart rate recovery, and for 1-min rather than 2-min post-exercise recovery time points. Log-transformed values generated better variability with acceptable coefficient of variation for all measures (2.2-10%). Overall, 1 min post-exercise heart rate recovery data had least variability over the 12-month period in apparently healthy middle-aged adults.
Gopinath, Bamini; Flood, Victoria M; Kifley, Annette; Liew, Gerald; Mitchell, Paul
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.
Grayson, Nancy Mathea
Scope and Method of Study: The overall purpose of the study was to describe the perceptions regarding how AAYAF over 16 years of age plan and make career decisions. The study participants included ten AAYAF over 16 years of age. The young women were interviewed fact-to-face using a semi-structured open-ended questionnaire. The questionnaire was…
Nogueira, Jordana de Almeida; Silva, Antônia Oliveira; de Sá, Laísa Ribeiro; de Almeida, Sandra Aparecida; Monroe, Aline Aparecida; Villa, Tereza Cristina Scatena
Objective to analyze the sociodemographic characteristics, epidemic trend and spatial distribution of the risk of AIDS in adults 50 years of age and over. Method population-based, ecological study, that used secondary data from the Notifiable Disease Information System (Sinan/AIDS) of Paraíba state from the period January 2000 to December 2010. Results during the study period, 307 cases of AIDS were reported among people 50 years of age or over. There was a predominance of males (205/66, 8%), mixed race, and low education levels. The municipalities with populations above 100 thousand inhabitants reported 58.5% of the cases. There was a progressive increase in cases among women; an increasing trend in the incidence (positive linear correlation); and an advance in the geographical spread of the disease, with expansion to the coastal region and to the interior of the state, reaching municipalities with populations below 30 thousand inhabitants. In some locations the risk of disease was 100 times greater than the relative risk for the state. Conclusion aging, with the feminization and interiorization of the epidemic in adults 50 years of age and over, confirms the need for the induction of affirmative policies targeted toward this age group. PMID:25029044
Metti, Andrea L.; Aizenstein, Howard; Yaffe, Kristine; Boudreau, Robert M.; Newman, Anne; Launer, Lenore; Gianaros, Peter J.; Lopez, Oscar L.; Saxton, Judith; Ives, Diane G.; Kritchevsky, Stephen; Vallejo, Abbe N.; Rosano, Caterina
We aimed to investigate if trajectory components (baseline level, slope and variability) of peripheral IL-6 over time were related to cognitive impairment and smaller hippocampal volume, and if hippocampal volume explained the associations between IL-6 and cognitive impairment. Multivariable regression models were used to test the association between IL-6 trajectory components with change in neuroimaging measures of the hippocampus, and with cognitive impairment among 135 older adults (70–79 years at baseline) from the Healthy Brain Project over 14 years. IL-6 variability was positively associated with cognitive impairment (OR = 5.86, 95% CI:1.24, 27.61) and with greater decrease per year of gray matter volume of the hippocampus (β=−0.008, SE=0.004, p=0.03). After adjustment for hippocampal volume, the odds ratio of cognitive impairment decreased for each unit of IL-6 variability, and confidence intervals widened (OR=4.36, 95% CI: 0.67, 28.29). Neither baseline levels nor slopes of IL-6 were related to cognitive impairment or hippocampal volume. We believe this has potential clinical and public health implications by suggesting adults with stable levels of peripheral IL-6 may be better targets for intervention studies for slowing or preventing cognitive decline. PMID:26279115
Chrisoulidou, A; Beshyah, S A; Rutherford, O; Spinks, T J; Mayet, J; Kyd, P; Anyaoku, V; Haida, A; Ariff, B; Murphy, M; Thomas, E; Robinson, S; Foale, R; Johnston, D G
Short-term studies of GH replacement in adult hypopituitarism have usually demonstrated beneficial effects on body composition and circulating lipids, with neutral or occasionally adverse effects on glucose tolerance. Fasting hyperinsulinemia has been reported. GH effects on cardiac function have been variable. The effects of long-term GH therapy, taking into account the consequences of increasing age, are not fully known. Thirty-three hypopituitary, initially middle-aged adults were studied over a 7-yr period; 12 patients took GH therapy (mean, 0.7 mg daily) continuously (group A); 11 took GH for only 6-18 months, a minimum of 5 yr previously (group B); and 10 patients never received GH therapy (group C). Other pituitary replacement was maintained. Effects on anthropometry, body composition (by bioimpedance analysis, total body potassium, and dual energy x-ray absorptiometry), circulating lipids, glucose and insulin concentrations, cardiac 2-dimensional and Doppler echocardiography, and exercise tolerance were assessed before and after the treatment period. Continuous GH therapy had no significant effect on body weight, but it prevented the increase in waist circumference and waist to hip ratio that occurred in the patients without GH substitution (waist to hip ratio, group A, 0.87+/-0.08 at baseline, 0.85+/-0.09 at 7 yr; group B, 0.89+/-0.11 at baseline, 0.94+/-0.11 at 7 yr; P < 0.005 for GH effect; group C, 0.87+/-0.10 at baseline, 0.92+/-0.10 at 7 yr; P < 0.005 for GH effect). A GH-induced decrease in subscapular skinfold thickness was also observed. By bioimpedance analysis, GH therapy caused an increase in total body water and fat-free mass, and a decrease in the percent body fat. Although changes occurred with time in all groups, no significant additional GH therapy effects were observed on glucose tolerance, insulin concentrations, lipid levels, cardiac dimensions, echocardiographic diastolic function, or exercise tolerance. In conclusion, prolonged GH
Rueda, M Rosario; Posner, Michael I; Rothbart, Mary K; Davis-Stober, Clintin P
Background Tasks involving conflict are widely used to study executive attention. In the flanker task, a target stimulus is surrounded by distracting information that can be congruent or incongruent with the correct response. Developmental differences in the time course of brain activations involved in conflict processing were examined for 22 four year old children and 18 adults. Subjects performed a child-friendly flanker task while their brain activity was registered using a high-density electroencephalography system. Results General differences were found in the amplitude and time course of event-related potentials (ERPs) between children and adults that are consistent with their differences in reaction time. In addition, the congruency of flankers affected both the amplitude and latency of some of the ERP components. These effects were delayed and sustained for longer periods of time in the children compared to the adults. Conclusions These differences constitute neural correlates of children's greater difficulty in monitoring and resolving conflict in this and similar tasks. PMID:15500693
Mendivil Alvarado, Herminia; Villegas Valle, Rosa Consuelo; Díaz Zavala, Rolando Giovanni; Antunez Roman, Lesley E; Valencia Juillerat, Mauro E
Currently, bone distances are used to predict standing height in adults that might not be able to achieve a correct standing position. Knee length based algorithms for estimating standing height have been proposed and designed for specific populations. However, equations for other populations may not necessarily reflect environmental and genetic factors for the group of interest. The aim of this study was to develop and validate predictive models for standing height in Mexican adults. For this purpose, 240 male and female adults aged 20 to 59 years, with no apparent spine problems were measured. We measured weight, height and knee length, using an anthropometer of our own design and a glass fiber metric measuring tape. A predictive model for each measuring instrument was developed. Model selection and development of equations were carried out by "all possible regressions and multiple regression" procedures. The predictive models for standing height by the anthropometer and by the measuring tape did not show significant differences between measured and estimated height. The R2 for the two models were 0.93 and 0.92, with a standard error of the estimator (EE) of 2.30 and 2.40 cm, for the anthropometer and the measuring tape, respectively. Both methods were acceptable in terms of concordance, accuracy and precision; however, at very high and low predicted height values, both models showed significant bias, which should be considered when applying these algorithms in different populations.
Jepsen, Randi; Aadland, Eivind; Robertson, Lesley; Kristiansen, Merete; Andersen, John Roger; Natvig, Gerd Karin
Objective. This study of severely obese adults participating in a two-year lifestyle intervention investigates associations between the independent variables: change in self-efficacy for physical activity (PA) in the face of psychological barriers, perceived behavioural control over PA, and PA self-identity and the dependent variable of change in objectively assessed PA. The intervention comprised four residential periods in a rehabilitation centre and combined diet, physical activity, and cognitive behavioural therapy. Materials and Methods. Forty-nine severely obese adults (37 women, mean body mass index 42.1 kg/m(2)) were included in the study. Assessment was done four times using questionnaires and an accelerometer. A linear mixed model based on restricted maximum likelihood was used in analyses for change over time. Associations were studied using linear regression analyses. Age, gender, and change in body mass index were used as control variables. Results. In the adjusted analyses, change in perceived behavioural control over PA was associated with change in PA (Stand. coeff. = 0.32, p = .005). Change in PA was not associated with either change in self-efficacy over PA in the face of psychological barriers (Stand. coeff. = 0.13, p = .259) or PA self-identity (Stand. coeff. = -0.07, p = .538). Conclusion. Perceived behavioural control may be a valid target to increase and maintain PA in severely obese adults participating in lifestyle interventions. More research is needed to investigate the process of behaviour change in this population.
Mannuzza, Salvatore; Castellanos, Francisco X.; Roizen, Erica R.; Hutchison, Jesse A.; Lashua, Erin C.; Klein, Rachel G.
Objective: To investigate the relationship between ADHD symptoms and impairment among adults diagnosed as having ADHD in childhood (ages 6-12). Method: Clinicians blindly interviewed 121 White males; the mean age was 41 years across the sample. "DSM-IV" adult ADHD behaviors were systematically rated, and impairment resulting from…
Hawkins, Sarah; Tatham, M. A. A.
The perception of duration in consonant segments is compared with their produced durations, and adults' and children's performance in this respect are compared. The temporal organization imposed by adults on initial consonant clusters was often not imposed by children from four to eight years of age, even though the cluster was produced…
Vanderberg, Laura E.; Pierce, Margaret E.; Disney, Laurel J.
This study reports on an examination of the effectiveness of a reading intervention for adults with disabilities in a vocational rehabilitation setting. Participants were 57 adults with disabilities and low reading skills enrolled at the Reading Clinic at the Michigan Career and Technical Institute. As part of a 3-year research and demonstration…
Schaffer, Joseph Michael
This non-experimental, quantitative study examined the extent selected state sociopolitical factors relate to adult participation in public two-year colleges, and assessed how Montana compares to those states enrolling the most adult students. Utilizing archived data from the National Center for Education Statistics' (NCES) Integrated…
Desai, Chintan S; Bartz, Traci M; Gottdiener, John S; Lloyd-Jones, Donald M; Gardin, Julius M
Left ventricular (LV) mass and geometry are associated with risk of cardiovascular disease (CVD). We sought to determine whether LV mass and geometry contribute to risk prediction for CVD in adults aged ≥65 years of the Cardiovascular Health Study. We indexed LV mass to body size, denoted as LV mass index (echo-LVMI), and we defined LV geometry as normal, concentric remodeling, and eccentric or concentric LV hypertrophy. We added echo-LVMI and LV geometry to separate 10-year risk prediction models containing traditional risk factors and determined the net reclassification improvement (NRI) for incident coronary heart disease (CHD), CVD (CHD, heart failure [HF], and stroke), and HF alone. Over 10 years of follow-up in 2,577 participants (64% women, 15% black, mean age 72 years) for CHD and CVD, the adjusted hazards ratios for a 1-SD higher echo-LVMI were 1.25 (95% CI 1.14 to 1.37), 1.24 (1.15 to 1.33), and 1.51 (1.40 to 1.62), respectively. Addition of echo-LVMI to the standard model for CHD resulted in an event NRI of -0.011 (95% CI -0.037 to 0.028) and nonevent NRI of 0.034 (95% CI 0.008 to 0.076). Addition of echo-LVMI and LV geometry to the standard model for CVD resulted in an event NRI of 0.013 (95% CI -0.0335 to 0.0311) and a nonevent NRI of 0.043 (95% CI 0.011 to 0.09). The nonevent NRI was also significant with addition of echo-LVMI for HF risk prediction (0.10, 95% CI 0.057 to 0.16). In conclusion, in adults aged ≥65 years, echo-LVMI improved risk prediction for CHD, CVD, and HF, driven primarily by improved reclassification of nonevents.
Bonomi, Alberto G.; Westerterp, Klaas R.
Background Ageing is associated with a declining physical activity level (PAL) and changes in the diurnal activity pattern. Changes in the activity pattern might help explaining the age-associated reduction of physical activity. Objective The aims were to investigate diurnal activity patterns within groups of older adults classified by PAL, to investigate diurnal activity patterns within age-groups and to investigate the association between the drop in activity and aerobic fitness. Methods Thirty-one healthy subjects aged between 52 and 83y were recruited for the study. Subjects were divided in sedentary (PAL<1.75), moderately active (1.75
Zhang, Yan; Ma, Wei; Fan, Fangfang; Wang, Binyan; Xing, Houxun; Tang, Genfu; Wang, Xiaobin; Xu, Xin; Xu, Xiping; Huo, Yong
Objective This study examined the prevalence of impaired fasting glucose (IFG) and diabetes and their associated factors in 17,184 Chinese hypertensive adults aged 45–75 years. Methods A cross-sectional investigation was carried out in a rural area of Lianyungang, China. Previously undiagnosed diabetes [fasting plasma glucose (FPG) ≥7.0mmol/l] and IFG (6.1–6.9mmol/l) were defined based on FPG concentration. Previously diagnosed diabetes was determined on the basis of self-report. Total diabetes included both previously diagnosed diabetes and previously undiagnosed diabetes. Results The prevalence of previously diagnosed diabetes, undiagnosed diabetes, and IFG were 3.4%, 9.8%, and 14.1%, respectively. About 74.2% of the participants with diabetes had not previously been diagnosed. In the multivariable logistic-regression model, older age, men, antihypertensive treatment, obesity (BMI ≥25kg/m2), abdominal obesity (waist circumference ≥90cm for men and ≥80cm for women), non-current smoking, a family history of diabetes, higher heart rate, lower physical activity levels, and inland residence (versus coastal) were significantly associated with both total diabetes and previously undiagnosed diabetes. Furthermore, methylene- tetrahydrofolate reductase (MTHFR) 677 TT genotype was an independent associated factor for total diabetes, and current alcohol drinking was an independent associated factor for previously undiagnosed diabetes. At the same time, older age, men, abdominal obesity, non-current smoking, current alcohol drinking, a family history of diabetes, higher heart rate, and inland residence (versus coastal) were important independent associated factors for IFG. Conclusion In conclusion, we found a high prevalence of diabetes in Chinese hypertensive adults. Furthermore, about three out of every four diabetic adults were undiagnosed. Our results suggest that population-level measures aimed at the prevention, identification (even if only based on the FPG
Tennant, Mark; Pogson, Philip
Aimed at adult education practitioners engaged in graduate study, this book draws on the field of developmental psychology to provide new insights into the critical connections between experience and learning in adult education and training. Chapter 1 introduces the role of psychological development in adult learning, investment of "self" in…
Suarez-Lopez, Jose R.; Lee, Duk-Hee; Porta, Miquel; Steffes, Michael W.; Jacobs, David R.
Objectives Substantial evidence associates persistent organic pollutants (POP) with metabolic disturbances related to diabetes, but longitudinal studies with repeated measures are scarce. We aimed to characterize the association between background exposures to POPs with repeated measures of glucose homeostasis over 23-years. Methods Within the Coronary Artery Risk Development in Young Adults study (year 0 ages: 18–30 years), we measured POPs in serum obtained in 1987–88 (follow-up year 2) in 90 non-diabetic controls and 90 cases diabetes-free at year 2 who became diabetic by year 20. We analyzed 32 POPs detectable in ≥75% of participants and created summary scores for 32 POPs, 23 polychlorinated biphenyls (PCB), and 8 organochlorine pesticides (OCP). Dependent variables were measures of glucose homeostasis at years 0–25 (up to 8 examinations). We explored associations using repeated measures regression adjusted for race, sex, concurrent body mass index (BMI), examination center and period, separately for cases and controls. Results The associations between the three summary scores and measures of glucose homeostasis were present for observations at ages 40–55 years, and particularly between 48–55 years: the 23 PCB summary was associated with HbA1c (never-diabetics: slope [value per unit of summary score], β=0.008, p=0.02; diabetics: β=0.03, p=0.07), fasting glucose (never-diabetics: β=0.24, p=0.003; diabetics: β=1.10, p=0.03), and insulin sensitivity% (never-diabetics: β=−2.82, p < 0.001, diabetics: β=−0.31, p=0.30). No associations were observed at younger ages. Conclusions Glucose homeostasis may worsen after decades of exposure to PCBs and OCPs at background environmental levels, independent of BMI and after participants reached the 5th decade of life. PMID:25706918
Cooper, Zara; Mitchell, Susan L.; Gorges, Rebecca J.; Rosenthal, Ronnie A.; Lipsitz, Stuart R.; Kelley, Amy S.
Background The number of older patients who undergo emergent major abdominal procedures is expected to increase yet little is known about mortality beyond 30 days after surgery. Objective Identify factors associated with mortality among older patients at 30, 180 and 365 days after emergency major abdominal surgery. Design A retrospective study of the Health and Retirement Study (HRS) linked to Medicare Claims from 2000-2010. Setting N/A Participants Medicare beneficiaries > 65.5 years enrolled in the Health and Retirement Study (HRS) from 2000-2010, with at least one urgent/emergent major abdominal surgery and a core interview from the HRS within 3 years prior to surgery. Main Outcomes and Measures Survival analysis was used to describe all-cause mortality at 30, 180 and 365 days after surgery. Complementary log-log regression was used to identify patient characteristics and postoperative events associated with worse survival. Results 400 patients had one of the urgent/emergent surgeries of interest. Of these 24% were > 85 years; 50% had coronary artery disease, 48% had cancer, and 33% had congestive heart failure; and 37% experienced a postoperative complication. Postoperative mortality was 20%, 31% and 34% at 30, 180 days and 365 days. Among those > 85 years, 50% were dead one year after surgery. After multivariate adjustment including postoperative complications, dementia (Hazard ratio (HR) 2.02, 95%CI 1.24-3.31), hospitalization within 6 months before surgery (HR 1.63, 95% CI 1.12-2.28) and complications (HR 3.45, 95%CI (2.32-5.13) were independently associated with worse one-year survival. Conclusion Overall mortality is high up to one year after surgery in many older patients undergoing emergency major abdominal surgery. The occurrence of a complication is the clinical factor most strongly associated with worse survival. PMID:26661929
González-Barranco, J; Ríos-Torres, J M; Castillo-Martínez, L; López-Alvarenga, J C; Aguilar-Salinas, C A; Bouchard, C; Deprès, J P; Tremblay, A
There is evidence linking intrauterine growth retardation with increased cardiovascular risk and diabetes mellitus (DM) later in life. However, little is known about the association between malnutrition during the first year of life and metabolic abnormalities in adulthood. The objective of this study was to assess the effect of documented malnutrition during the first year of life on glucose tolerance, plasma insulin, lipid profile, and blood pressure in early adulthood, as well as to assess the interaction between body mass index (BMI) and malnutrition on these variables. A study group of young men with a documented history of malnutrition during their first year of life was recruited from 4 pediatric hospitals in Mexico City and compared with a control group. Subjects included were 52 men, aged 20.2 +/- 3.6 years, with a mean birth weight of 3.0 +/- 0.7 kg and documented malnutrition in their first year of life; controls were 50 men, aged 23.3 +/- 1.8 years, with a mean birth weight of 3.2 +/- 0.5 kg. Insulin and glucose concentrations, fasting and in response to an oral glucose load, plasma lipids, blood pressure, and an insulin sensitivity index (ISI) were measured. The areas under the curves of glucose (AUCG) and insulin (AUCI) were significantly higher in cases (P =.012 and <.002, respectively), independent of birth weight, BMI, or age. BMI was significantly associated with fasting plasma insulin (FPI), AUCI, ISI, triglyceride, and high-density lipoprotein (HDL)-cholesterol concentrations in cases, but not in controls. These data suggest that early malnutrition in extrauterine life, independently of birth weight, has an adverse effect on insulin metabolism and glucose tolerance in young men, and it worsens as body mass increases even within the normal range of BMI. Therefore, it is advisable to prevent obesity in individuals exposed to early malnutrition.
Reisberg, Barry; Shulman, Melanie B.; Torossian, Carol; Leng, Ling; Zhu, Wei
Background Subjective cognitive impairment (SCI) in older persons without manifest symptomatology is a common condition with a largely unclear prognosis. We hypothesized that (1) examining outcome for a sufficient period by using conversion to mild cognitive impairment (MCI) or dementia would clarify SCI prognosis, and (2) with the aforementioned procedures, the prognosis of SCI subjects would differ significantly from that of demographically matched healthy subjects, free of SCI, termed no cognitive impairment (NCI) subjects. Methods A consecutive series of healthy subjects, aged ≥40 years, presenting with NCI or SCI to a brain aging and dementia research center during a 14-year interval, were studied and followed up during an 18-year observation window. The study population (60 NCI, 200 SCI, 60% female) had a mean age of 67.2 ± 9.1 years, was well-educated (mean, 15.5 ± 2.7 years), and cognitively normal (Mini-Mental State Examination, 29.1 ± 1.2). Results A total of 213 subjects (81.9% of the study population) were followed up. Follow-up occurred during a mean period of 6.8 ± 3.4 years, and subjects had a mean of 2.9 ± 1.6 follow-up visits. Seven NCI (14.9%) and 90 SCI (54.2%) subjects declined (P < .0001). Of NCI decliners, five declined to MCI and two to probable Alzheimer’s disease. Of SCI decliners, 71 declined to MCI and 19 to dementia diagnoses. Controlling for baseline demographic variables and follow-up time, Weibull proportional hazards model revealed increased decline in SCI subjects (hazard ratio, 4.5; 95% confidence interval, 1.9–10.3), whereas the accelerated failure time model analysis with an underlying Weibull survival function showed that SCI subjects declined more rapidly, at 60% of the rate of NCI subjects (95% confidence interval, 0.45–0.80). Furthermore, mean time to decline was 3.5 years longer for NCI than for SCI subjects (P = .0003). Conclusions These results indicate that SCI in subjects with normal cognition is a harbinger
Stephan, Karen; McClure, Rod; Seubsman, Sam-ang; Kelly, Matthew; Yiengprugsawan, Vasoontara; Bain, Christopher; Sleigh, Adrian
Countries need epidemiological information about population injury statistics to devise preventive strategies. To generate such information we estimated the one-year incidence and distribution of injury in a group of 87,134 adult Sukhothai Thammathirat Open University distance-learning students residing throughout Thailand. Those who participated joined the study by filling out a baseline questionnaire in 2005 which included a one-year recall of injuries serious enough to interfere with daily activities and/or require medical treatment. The more serious injuries were categorised by location, mechanism and intentionality. We collected sociodemographic information about the participants. Nearly 22% of participants reported at least one injury during the previous 12 months. Males, those with lower income and the less educated, had higher injury rates. Home injuries were more common among females. Sports, road and workplace injuries were more common among males. Transport injuries decreased with age and falls increased with age. Most injuries were unintentional. Injury rates among Thai adults are high. We identified at risk groups by injury mechanism and setting. Before interventions can be devised more research is needed regarding exposure and vulnerability in at risk socio-demographic groups.
Nordstrand, L.; Eliasson, A. C.
The aim is to describe the development of hand function in young adults with unilateral cerebral palsy (CP), who participated in a 2-week Constraint Induced Movement Therapy (CIMT) camp 6 years earlier. Eleven participants, 16-21 years at follow-up, were assessed at three occasions during 2005 and once in 2011. At the 6-year follow-up, performance…
Marcus, R. E.; Catovsky, D.; Johnson, S. A.; Gregory, W. M.; Talavera, J. G.; Goldman, J. M.; Galton, D. A.
Between 1974 and 1984 69 adults with acute lymphoblastic leukaemia (ALL) were treated with two different protocols. Fifty-four (78%) of the patients entered complete remission (CR); 27 of these then received a consolidation protocol consisting of daunorubicin, cytosine arabinoside and 6-thioguanine, followed by two courses of intravenous methotrexate 500 mg m-2 with folinic acid rescue. All patients received intrathecal methotrexate and cranial irradiation (24 Gy) followed by maintenance therapy with 6-mercaptopurine and methotrexate for at least 2 years. The median survival for all patients was 23 months from the time of presentation with an actuarial 5-year survival of 21%. The actuarial chance of surviving 5 years in CR for patients receiving the consolidation protocol was 38% compared to 19% for patients receiving no consolidation (P = NS). Only patient age and white cell count at presentation were found to influence the chance of achieving CR and the chance of overall survival. The presence or absence of c-ALL antigen did not influence prognosis. Patients younger than 35 years with low white cell counts at presentation (less than 10 X 10(9)1(-1] had a particularly good prognosis but no patient with T-ALL and no patient older than 50 years old at diagnosis survived more than 18 months. PMID:3456786
Roblot, F; Robin, S; Chubilleau, C; Giraud, J; Bouffard, B; Ingrand, P
We aimed to assess vaccination coverage (VC) in 17-year-old French young adults (YAs) participating in one mandatory Day of Defence and Citizenship (DDC). Between June 2010 and May 2011, YAs participating in 43 randomly selected mandatory sessions of the DDC programme in Poitou-Charentes (France) were asked to provide their personal vaccination record. Tetanus, diphtheria, polio, hepatitis B, Haemophilus influenzae b, pertussis, measles, mumps and rubella vaccination status were assessed at ages 2, 6, 13 and 17 years. Of 2610 participants, 2111 (81%) supplied documents for evaluation. Of these, 1838 (87%, M:F sex ratio 0·96) were aged 17 years (9% of the global population of this age in the area). The assessment of the 17-year-olds demonstrated the following rates of complete vaccination: diphtheria-tetanus-polio 83%; measles, mumps and rubella 83%; pertussis 69%; H. influenzae b 61%; human papillomavirus 47%; and hepatitis B 40%. At age 6 years, only 46% had received two doses of the vaccine against measles. The YAs were not aware of their status but were in favour of vaccination. VC in YAs is insufficient, particularly for hepatitis B, pertussis and measles. Combined vaccines and the simplification of vaccination schedules should improve VC. Preventive messages should focus on YAs.
Awini, Elizabeth; Sarpong, Doris; Adjei, Alexander; Manyeh, Alfred Kwesi; Amu, Alberta; Akweongo, Patricia; Adongo, Philip; Kukula, Vida; Odonkor, Gabriel; Narh, Solomon; Gyapong, Margaret
Background Data needed to estimate causes of death and the pattern of these deaths are scarce in sub-Saharan Africa. Such data are very important for targeting, monitoring, and evaluating health interventions. Objective To estimate the mortality rate and determine causes of death among adults (aged 15 years and older) in a rural district of southern Ghana, using the InterVA-4 model. Design Data used were generated from verbal autopsies conducted for registered adult members of the Dodowa Health and Demographic Surveillance System who died between 2006 and 2010. The InterVA-4 model was used to assign the cause of death. Results Overall, the mortality rate for the period under review was 7.5/1,000 person-years (py) for the general population and 10.4/1,000 py for those aged 15 and older. The leading cause of death was communicable diseases (CDs), with a malaria-specific mortality rate of 1.06/1,000 py. Pulmonary tuberculosis (TB)-specific mortality rate was the next highest (1.01/1,000 py). HIV/AIDS attributed deaths were lower among males than females. Non-communicable diseases (NCDs) contributed to 28.3% of the deaths with cause-specific mortality rate of 2.93/1,000 py. Stroke topped the list with cause-specific mortality rate of 0.69/1,000 py. As expected, young males (15–49 years) contributed to more road traffic accident (RTA) deaths; they had a lower RTA cause-specific mortality rate than older males (50–64 years). Conclusions Data indicate that CDs (e.g. malaria and TB) remain the major cause of death with NCDs (e.g. stroke) following closely behind. Verbal autopsy data can provide the causes of mortality in poorly resourced settings where access to timely and accurate data is scarce. PMID:25377337
Fergusson, David M.; Boden, Joseph M.; Horwood, L. John
This study examined the developmental processes linking childhood bullying to criminal offending in adulthood, using data from a 30-year longitudinal study. The linkages between bullying in childhood and three criminal offending outcomes in adulthood were estimated both before and after control for a range of confounding factors. A series of…
Reef, Joni; van Meurs, Inge; Verhulst, Frank C.; van der Ende, Jan
Objective: The goal of this study was to determine continuities of a broad range of psychopathology from childhood into middle adulthood in a general population sample across a 24-year follow-up. Method: In 1983, parent ratings of children's problems were collected with the Child Behavior Checklist (CBCL) in a general population sample of 2,076…
Koenig, Harold G.; And Others
Notes that low Medicare reimbursement rates are already causing some mental health professionals to turn away elderly patients. Considers baby boomer cohort who, unlike elders today, have high rates of psychiatric illness and are more likely to seek mental health services. Projects increasing gap over next 25 years between need and availability of…
Yano, Yuichiro; Stamler, Jeremiah; Garside, Daniel B.; Daviglus, Martha L.; Franklin, Stanley S.; Carnethon, Mercedes R.; Liu, Kiang; Greenland, Philip; Lloyd-Jones, Donald M.
BACKGROUND Isolated systolic hypertension (ISH), defined as systolic blood pressure (SBP) ≥140 mm Hg and diastolic blood pressure (DBP) <90 mm Hg, in younger and middle-aged adults is increasing in prevalence. OBJECTIVE The aim of this study was to assess the risk for cardiovascular disease (CVD) with ISH in younger and middle-aged adults. METHODS CVD risks were explored in 15,868 men and 11,213 women 18 to 49 years of age (mean age 34 years) at baseline, 85% non-Hispanic white, free of coronary heart disease (CHD) and antihypertensive therapy, from the Chicago Heart Association Detection Project in Industry study. Participant classifications were as follows: 1) optimal-normal blood pressure (BP) (SBP <130 mm Hg and DBP <85 mm Hg); 2) high-normal BP (130 to 139/85 to 89 mm Hg); 3) ISH; 4) isolated diastolic hypertension (SBP <140 mm Hg and DBP ≥90 mm Hg); and 5) systolic diastolic hypertension (SBP ≥140 mm Hg and DBP ≥90 mm Hg). RESULTS During a 31-year average follow-up period (842,600 person-years), there were 1,728 deaths from CVD, 1,168 from CHD, and 223 from stroke. Cox proportional hazards models were adjusted for age, race, education, body mass index, current smoking, total cholesterol, and diabetes. In men, with optimal-normal BP as the reference stratum, hazard ratios for CVD and CHD mortality risk for those with ISH were 1.23 (95% confidence interval [CI]: 1.03 to 1.46) and 1.28 (95% CI: 1.04 to 1.58), respectively. ISH risks were similar to those with high-normal BP and less than those associated with isolated diastolic hypertension and systolic diastolic hypertension. In women with ISH, hazard ratios for CVD and CHD mortality risk were 1.55 (95% CI: 1.18 to 2.05) and 2.12 (95% CI: 1.49 to 3.01), respectively. ISH risks were higher than in those with high-normal BP or isolated diastolic hypertension and less than those associated with systolic diastolic hypertension. CONCLUSIONS Over long-term follow-up, younger and middle-aged adults with ISH
Hindell, Mark A; Lydersen, Christian; Hop, Haakon; Kovacs, Kit M
Changing patterns of sea-ice distribution and extent have measurable effects on polar marine systems. Beyond the obvious impacts of key-habitat loss, it is unclear how such changes will influence ice-associated marine mammals in part because of the logistical difficulties of studying foraging behaviour or other aspects of the ecology of large, mobile animals at sea during the polar winter. This study investigated the diet of pregnant bearded seals (Erignathus barbatus) during three spring breeding periods (2005, 2006 and 2007) with markedly contrasting ice conditions in Svalbard using stable isotopes (δ(13)C and δ(15)N) measured in whiskers collected from their newborn pups. The δ(15)N values in the whiskers of individual seals ranged from 11.95 to 17.45 ‰, spanning almost 2 full trophic levels. Some seals were clearly dietary specialists, despite the species being characterised overall as a generalist predator. This may buffer bearded seal populations from the changes in prey distributions lower in the marine food web which seems to accompany continued changes in temperature and ice cover. Comparisons with isotopic signatures of known prey, suggested that benthic gastropods and decapods were the most common prey. Bayesian isotopic mixing models indicated that diet varied considerably among years. In the year with most fast-ice (2005), the seals had the greatest proportion of pelagic fish and lowest benthic invertebrate content, and during the year with the least ice (2006), the seals ate more benthic invertebrates and less pelagic fish. This suggests that the seals fed further offshore in years with greater ice cover, but moved in to the fjords when ice-cover was minimal, giving them access to different types of prey. Long-term trends of sea ice decline, earlier ice melt, and increased water temperatures in the Arctic are likely to have ecosystem-wide effects, including impacts on the forage bases of pagophilic seals.
Hindell, Mark A.; Lydersen, Christian; Hop, Haakon; Kovacs, Kit M.
Changing patterns of sea-ice distribution and extent have measurable effects on polar marine systems. Beyond the obvious impacts of key-habitat loss, it is unclear how such changes will influence ice-associated marine mammals in part because of the logistical difficulties of studying foraging behaviour or other aspects of the ecology of large, mobile animals at sea during the polar winter. This study investigated the diet of pregnant bearded seals (Erignathus barbatus) during three spring breeding periods (2005, 2006 and 2007) with markedly contrasting ice conditions in Svalbard using stable isotopes (δ13C and δ15N) measured in whiskers collected from their newborn pups. The δ15N values in the whiskers of individual seals ranged from 11.95 to 17.45 ‰, spanning almost 2 full trophic levels. Some seals were clearly dietary specialists, despite the species being characterised overall as a generalist predator. This may buffer bearded seal populations from the changes in prey distributions lower in the marine food web which seems to accompany continued changes in temperature and ice cover. Comparisons with isotopic signatures of known prey, suggested that benthic gastropods and decapods were the most common prey. Bayesian isotopic mixing models indicated that diet varied considerably among years. In the year with most fast-ice (2005), the seals had the greatest proportion of pelagic fish and lowest benthic invertebrate content, and during the year with the least ice (2006), the seals ate more benthic invertebrates and less pelagic fish. This suggests that the seals fed further offshore in years with greater ice cover, but moved in to the fjords when ice-cover was minimal, giving them access to different types of prey. Long-term trends of sea ice decline, earlier ice melt, and increased water temperatures in the Arctic are likely to have ecosystem-wide effects, including impacts on the forage bases of pagophilic seals. PMID:22693616
Gadde, Kishore M.; Kopping, Mariko F.; Wagner, H. Ryan; Yonish, Gretchen M.; Allison, David B.; Bray, George A.
SUMMARY Background Obese individuals who have failed to achieve adequate weight loss with lifestyle changes have limited non-surgical therapeutic options. We evaluated the efficacy and tolerability of zonisamide, an antiepileptic drug, for enhancing weight loss in obese patients receiving diet and lifestyle guidance. Methods This was a 1-year randomized, double-blind, placebo-controlled trial conducted between January 2006 and September 2011 at Duke University Medical Center. Patients were 225 obese (mean [SD] body mass index 37.6 [4.9]) women (134 [59.6%]) and men (91 [40.4%]) without diabetes. Interventions were daily dosing with placebo (n=74), zonisamide 200 mg (n=76), orzonisamide 400 mg (n=75), in addition to diet and lifestyle counseling by a dietitian for 1 year. Primary outcome was change in body weight at 1-year. Results Of the 225 randomized patients, 218 (97%) provided 1-year follow-up assessments. Change(least-squares mean) in body weight was -4.0 kg (−3.7%; 95% CI, −5.8 kg to −2.3 kg) for placebo, −4.4 kg (−3.9%; −6.1 to −2.6, P=.79vs placebo) for zonisamide 200 mg, and −7.3 kg (−6.8%; −9.0 to −5.6, P=.009vs placebo) for zonisamide 400 mg. In the categorical analysis,23 (31%) on placebo, 26 (34%; P=.71) on zonisamide 200 mg, and 41 (55%; P=.007) onzonisamide 400 mg achieved ≥5% weight loss; for ≥10% weight loss, the corresponding numbers were 6 (8%), 17 (22%; P=.022), and 24 (32%; P=.001). Gastrointestinal, nervous system and psychiatric adverse events occurred at a higher incidence with zonisamide than with placebo. Conclusion Zonisamide 400 mg/d moderately enhanced weight loss achieved with diet and lifestyle counseling, but had a high incidence of adverse events. PMID:23147455
Quick, Virginia; Eisenberg, Marla E.; Bucchianeri, Michaela M.; Neumark-Sztainer, Dianne
This study identified longitudinal risk factors for body dissatisfaction (BD) over a 10-year period from adolescence to young adulthood. Participants (N = 2134; age at baseline: M =15.0, SD =1.6 years) provided two waves of survey data. A 6-step hierarchical linear regression analysis examined the predictive contribution of Time 1 BD, weight status, demographics, family and peer environmental factors, and psychological factors. Among females, Asian race/ethnicity, low self-esteem, greater BD, and higher body mass index during adolescence contributed significantly to predicting greater BD at 10-year follow up (R2 = 0.27). Among males, demographics (i.e., Asian, other-mixed ethnicity, education attainment), depressive symptoms, greater BD, higher body mass index, more parent communication, and less peer weight teasing during adolescence contributed to BD at follow-up (R2 = 0.27). Findings indicate who may be at greatest risk for BD in young adulthood and the types of factors that should be addressed during adolescence. PMID:25045599
Orchi, N; Balzano, R; Scognamiglio, P; Navarra, A; De Carli, G; Elia, P; Grisetti, S; Sampaolesi, A; Giuliani, M; De Filippis, A; Puro, V; Ippolito, G; Girardi, E
The prevalence of HIV/AIDS among people in midlife and late adulthood has been increasing in Western countries over the last decade. We analyzed data from a prospective, observational multi-centre study on individuals newly diagnosed with HIV between January 2004 and March 2007 in 10 public counselling and testing sites in Latium, Italy. At diagnosis, routine demographic, epidemiological, clinical and laboratory data are recorded, and patients are asked to complete a questionnaire investigating socio-demographic and psycho-behavioural aspects. To analyze the association of individual characteristics with age, we compared older adults (> or = 50 years) with their younger counterpart (18-49 years). To adjust for potential confounding effect of the epidemiological, clinical and behavioural characteristics, to identify factors associated with older age at HIV diagnosis, multivariate logistic regression analysis was performed. Overall, 1073 individuals were identified, 125 of whom (11.6%) were aged 50 years or above. The questionnaire was completed by 41% (440/1073). Compared with their younger counterparts, a higher proportion of older patients were males, born in Italy, reported heterosexual or unknown HIV risk exposure, were never tested for HIV before and were in a more advanced stage of HIV infection at diagnosis. In addition, older adults had a lower educational level and were more frequently living with their partners or children. With respect to psycho-behavioural characteristics, older patients were more likely to have paid money for sex and have never used recreational drugs. Interestingly, no differences were found regarding condom use, which was poor in both age groups. These findings may have important implications for the management of older adults with HIV, who should be targeted by appropriate public health actions, such as opportunistic screening and easier access to healthcare. Moreover, strategies including information on HIV and prevention of risk
Maahs, David M.; Jalal, Diana; Chonchol, Michel; Johnson, Richard J.; Rewers, Marian; Snell-Bergeon, Janet K.
OBJECTIVE To determine whether baseline estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) independently predict coronary artery calcification (CAC) progression, and to determine how eGFR changes over 6 years in adults with type 1 diabetes compared with nondiabetic adults. RESEARCH DESIGN AND METHODS The Coronary Artery Calcification in Type 1 Diabetes study participants (n = 1,066) with complete data for eGFR assessment at baseline and 6 years were included. Three Chronic Kidney Disease Epidemiology Collaboration equations (serum creatinine, cystatin C, and both) were used to estimate eGFR. The association of baseline ACR and eGFR with CAC progression was analyzed using multiple logistic regression. RESULTS Increasing categorical baseline ACR (<10, 10–30, and >30 µg/mg) predicted CAC progression in participants with type 1 diabetes (odds ratio [OR], 2.15; 95% CI, 1.50–3.09; 7.19 [3.90–13.26]; and 18.09 [8.48–38.62]), respectively, compared with nondiabetic subjects. Baseline eGFR <60 mL/min/1.73 m2 also predicted CAC progression (OR, 5–7, compared with nondiabetic participants). ORs for CAC progression were higher in women than in men when using the cystatin C–based Chronic Kidney Disease Epidemiology Collaboration equations. Participants with type 1 diabetes had greater eGFR decreases over 6 years than nondiabetic participants using cystatin C–based equations. CONCLUSIONS Although increasing ACR or decreasing eGFR predicts CAC progression, coronary atherosclerosis progresses faster in people with type 1 diabetes even in the absence of diabetic kidney disease. These findings emphasize the interaction between kidney disease and cardiovascular disease in type 1 diabetes and highlight the public health importance of lowering cardiorenal risk in people with type 1 diabetes. PMID:23835686
Singer, Richard B
The authors conducted the source study to determine if a brisk corridor walk of 400 meters could be used to classify the performance of active older adults and relate this performance to mortality and other outcomes over a 6-year follow-up. The cohort consisted of 3075 adults resident in designated ZIP codes in Pittsburgh, Pa, and Memphis, Tenn, participating in the Health Aging and Body Composition Study. Out of this cohort, 395 subjects were excluded after evaluation revealed abnormal vital signs or ECG findings, recent cardiac symptoms, recent surgery, recent chest pain, shortness of breath or fainting. Another 356 subjects were unable to complete the 400-meter walk. The 2324 subjects who completed the walk were divided into quartiles according to the time in seconds required for completion (the overall time required ranged widely from 201 to 942 seconds). These 3 groups were designated as "excluded," "stopped," and "completed." Outcomes reported for the 3075 subjects in the total cohort included mortality, new cardiovascular disease events, mobility limitation, and mobility disability. Cardiovascular events were reported for the 2234 subjects (73% of the total) who were free of cardiovascular disease at entry. Results in the article were given in tables and figures and included numbers of entrants, exposures, and events, annual event rates and hazard ratios with SDs. Out of the 3075 entrant subjects, 430 died in the 6 years of follow-up (FU). Excess mortality measured as excess death rate (EDR) was much higher in the excluded and stopped groups (about 22 per 1000 per year) compared with an EDR of 6.4 per 1000 in the completed group. The corresponding mortality ratios (MR), designated as a hazard ratio in the article were about 220% and 135%. Results for comparative morbidity are also given in this abstract.
Lieberman, D.; Schlaeffer, F.; Boldur, I.; Lieberman, D.; Horowitz, S.; Friedman, M. G.; Leiononen, M.; Horovitz, O.; Manor, E.; Porath, A.
BACKGROUND: The purpose of this study was to assess the causes of community-acquired pneumonia in adult patients admitted to hospital. METHODS: A prospective study was performed on 346 consecutive adult patients (54% men) of mean (SD) 49.3 (19.5) years (range 17-94) admitted to a university affiliated regional hospital in southern Israel with community-acquired pneumonia over a period of one year. Convalescent serum samples were obtained from 308 patients (89%). The aetiological diagnosis for community-acquired pneumonia was based on positive blood cultures and/or significant changes in antibody titres to Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, respiratory viruses, Coxiella burnetii, Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella sp. RESULTS: The aetiology of community-acquired pneumonia was identified in 279 patients (80.6%). The distribution of causal agents was as follows: S pneumoniae, 148 patients (42.8%); M pneumoniae, 101 (29.2%); C pneumoniae, 62 (17.9%); Legionella sp, 56 (16.2%); respiratory viruses, 35 (10.1%); C burnetii, 20 (5.8%); H influenzae 19 (5.5%); and other causes, 21 patients (6.0%). In patients above the age of 55 years C pneumoniae was the second most frequent aetiological agent (25.5%). In 133 patients (38.4%) more than one causal agent was found. CONCLUSIONS: The causal agents for community-acquired pneumonia in Israel are different from those described in other parts of the world. In many of the patients more than one causal agent was found. In all these patients treatment should include a macrolide antibiotic, at least in the first stage of their illness. PMID:8711652
Johansson, Annika; Sundbom, Elisabet; Höjerback, Torvald; Bodlund, Owe
This follow-up study evaluated the outcome of sex reassignment as viewed by both clinicians and patients, with an additional focus on the outcome based on sex and subgroups. Of a total of 60 patients approved for sex reassignment, 42 (25 male-to-female [MF] and 17 female-to-male [FM]) transsexuals completed a follow-up assessment after 5 or more years in the process or 2 or more years after completed sex reassignment surgery. Twenty-six (62%) patients had an early onset and 16 (38%) patients had a late onset; 29 (69%) patients had a homosexual sexual orientation and 13 (31%) patients had a non-homosexual sexual orientation (relative to biological sex). At index and follow-up, a semi-structured interview was conducted. At follow-up, 32 patients had completed sex reassignment surgery, five were still in process, and five-following their own decision-had abstained from genital surgery. No one regretted their reassignment. The clinicians rated the global outcome as favorable in 62% of the cases, compared to 95% according to the patients themselves, with no differences between the subgroups. Based on the follow-up interview, more than 90% were stable or improved as regards work situation, partner relations, and sex life, but 5-15% were dissatisfied with the hormonal treatment, results of surgery, total sex reassignment procedure, or their present general health. Most outcome measures were rated positive and substantially equal for MF and FM. Late-onset transsexuals differed from those with early onset in some respects: these were mainly MF (88 vs. 42%), older when applying for sex reassignment (42 vs. 28 years), and non-homosexually oriented (56 vs. 15%). In conclusion, almost all patients were satisfied with the sex reassignment; 86% were assessed by clinicians at follow-up as stable or improved in global functioning.
Ju, Yo-El S
Rapid eye movement (REM) sleep behavior disorder (RBD) occurring prior to age 50 is termed early-onset RBD. Early-onset RBD comprises a substantial minority of cases, and demonstrates the differences in demographics, comorbidities, and clinical considerations from previously described typical RBD with onset >50years. The world literature on RBD is reviewed with specific focus on features that distinguish early-onset RBD, including more gender parity, increased proportion of idiopathic cases, increased proportion of cases associated with narcolepsy, parasomnia overlap disorder, antidepressants, and possibly autoimmune disorders, and clinical presentation.
Yiengprugsawan, V; Horta, B L; Motta, J V S; Gigante, D; Seubsman, S-A; Sleigh, A
Increase in body size has appeared as an epidemic in Western countries and is now rapidly emerging in low- and middle-income countries, contributing to the rise in non-communicable diseases worldwide. Brazil and Thailand have gone through similar economic and health transitions, and this unique comparative study investigates changes in body size (body mass index) in relation to socioeconomic status in two cohorts of similar age followed from 2004/2005 to 2012/2013. At 20–24 years of age, Pelotas cohort members had a much higher prevalence of overweight and obesity (20.7 and 8.6%) than the Thai cohort (6.0 and 1.7%); these proportions rose to 34.6% and 22.9% vs 15.8% and 5.1%, respectively, in their early 30s. An association between a higher socioeconomic status and increase in overweight and obesity was observed among males; but an inverse pattern was noted for females in both cohorts and remained statistically significant after 8 years of follow up. Our comparative longitudinal analyses highlight the relationship between two middle-income settings facing rapid increases in body size (2–3 fold increase in the rate of overweight and obesity). Long-term follow up and a lifecourse approach for effective prevention of obesity will minimize adverse health burdens in later life. PMID:27428871
Duncan, Michael J.; Mota, Jorge; Carvalho, Joana; Nevill, Alan M.
Objective This study compared actual 6 minute walk test (6MWT) performance with predicted 6MWT using previously validated equations and then determined whether allometric modelling offers a sounder alternative to estimating 6MWT in adults aged 50–80 years. Methods We compared actual 6MWT performance against predicted 6MWT in 125 adults aged 50–85 years (62 male, 63 female). In a second sample of 246 adults aged 50–85 years (74 male, 172 female), a new prediction equation for 6MWT performance was developed using allometric modelling. This equation was then cross validated using the same sample that the other prediction equations were compared with. Results Significant relationships were evident between 6MWT actual and 6MWT predicted using all of the commonly available prediction equations (all P<0.05 or better) with the exception of the Alameri et al prediction equation (P>0.05). A series of paired t-tests indicated significant differences between 6MWT actual and 6MWT predicted for all available prediction equations (all P<0.05 or better) with the exception of the Iwama et al equation (P = .540). The Iwama et al equation also had similar bias (79.8m) and a coefficient of variation of over 15%. Using sample 2, a log-linear model significantly predicted 6MWT from the log of body mass and height and age (P = 0.001, adjusted R2 = .526), predicting 52.6% of the variance in actual 6MWT. When this allometric equation was applied to the original sample, the relationship between 6MWT actual and 6MWT predicted was in excess of values reported for the other previously validated prediction equations (r = .706, P = 0.001). There was a significant difference between actual 6MWT and 6MWT predicted using this new equation (P = 0.001) but the bias, standard deviation of differences and coefficient of variation were all less than for the other equations. Conclusions Where actual assessment of the 6MWT is not possible, the allometrically derived equation presented in the current
van Elk, Michiel; Rutjens, Bastiaan T; van der Pligt, Joop
The illusion of control can be defined as the erroneous belief that one's actions cause a specific outcome, whereas sense of agency refers to the subjective feeling of authorship over one's actions. In the present study we investigated the development of illusory control and sense of agency. A novel card-guessing game was developed in which 7- to-12-year old children (Study 1) and adults (Study 2) were required to select a card, and we manipulated the congruence of the outcome with their initial choice (i.e., congruent or incongruent) and the valence of the outcome that was presented (i.e., positive or negative). We found that illusory control and the self-attribution bias (i.e., the bias to attribute positive outcomes to oneself) in the card guessing game decreased, as children get older. In contrast, for both children and adults sense of agency in the task was similarly affected by outcome congruency, suggesting that the ability to relate predicted to observed action outcomes reflects a basic mechanism that helps people to sustain a sense of agency. Thus, while the illusion of control decreases as we get older, the experience of agency as a function of outcome congruency seems to be more stable across development.
Porac, Clare; Searleman, Alan
As a result of the Coren and Halpern (1991) hypothesis that left hand preference may be associated with decreased survival fitness, there has been interest in exploring the relationship between hand preference and indices of health status. In a series of studies of university-aged adults, Hicks and his colleagues found a higher prevalence of accidental injuries, falls, and sleep problems among individuals with mixed, rather than left, hand preference. They argued that hand preference consistency, not side, may be a marker for possible reduction in health and well-being. We looked at the relationship between hand preference consistency and the prevalence of sleep problems, accidental injuries, falls, injuries from falls, and the prevalence of autoimmune and other illnesses in a sample of 1277 adults between the ages of 65 and 100 years. Of those participants who reported a recent fall, mixed-handers were more likely to report a higher number of injuries from these falls when compared to the reports of consistent-handers. In contrast to the previous findings of Hicks et al., and highlighting the value of including broader age ranges, all other comparisons showed no differences between the two hand preference types.
Galletly, Cherrie; Van Hooff, Miranda; McFarlane, Alexander
Childhood adversity has been shown to increase the risk of psychotic symptoms in adult life. However, there are no previous studies looking at the association between experiencing a natural disaster during childhood and the development of psychotic symptoms in young adulthood. Eight hundred and six bushfire-exposed children and 725 control children were evaluated following the 1983 South Australian bushfires. Five hundred and twenty nine (65.6%) of the bushfire group and 464 (64%) controls participated in a follow up study 20 years later. Childhood data on emotional and behavioural disorders and dysfunctional parenting was available. The adult assessment included the Australian National Health and Well-Being psychosis screen and detailed information about trauma, childhood adversity and alcohol and cannabis abuse. 5.6% of subjects responded positively to the psychosis screen and 2.6% responded positively to a further probe question. Psychotic symptoms were more common in subjects exposed to a greater number of traumas, and were associated with higher rates of childhood adversity, emotional and behavioural disturbance, dysfunctional parenting, and alcohol and cannabis abuse. Subjects exposed to bushfires as children did not have a greater risk of psychosis. Our results indicate that exposure to multiple traumas, rather than a single major trauma, increases the risk of later psychosis.
Booij, Linda; Tremblay, Richard E.; Leyton, Marco; Séguin, Jean R.; Vitaro, Frank; Gravel, Paul; Perreau-Linck, Elisabeth; Lévesque, Mélissa L.; Durand, France; Diksic, Mirko; Turecki, Gustavo; Benkelfat, Chawki
Background Adults exhibiting severe impulsive and aggressive behaviors have multiple indices of low serotonin (5-HT) neurotransmission. It remains unclear though whether low 5-HT mediates the behavior or instead reflects a pre-existing vulnerability trait. Methodology/Principal Findings In the present study, positron emission tomography with the tracer alpha-[11C]methyl-L-tryptophan (11C-AMT) was used to compare 5-HT synthesis capacity in two groups of adult males from a 21-year longitudinal study (mean age ± SD: 27.1±0.7): individuals with a history of childhood-limited high physical aggression (C-LHPA; N = 8) and individuals with normal (low) patterns of physical aggression (LPA; N = 18). The C-LHPA males had significantly lower trapping of 11C-AMT bilaterally in the orbitofrontal cortex and self-reported more impulsiveness. Despite this, in adulthood there were no group differences in plasma tryptophan levels, genotyping, aggression, emotional intelligence, working memory, computerized measures of impulsivity, psychosocial functioning/adjustment, and personal and family history of mood and substance abuse disorders. Conclusions/Significance These results force a re-examination of the low 5-HT hypothesis as central in the biology of violence. They suggest that low 5-HT does not mediate current behavior and should be considered a vulnerability factor for impulsive-aggressive behavior that may or may not be expressed depending on other biological factors, experience, and environmental support during development. PMID:20582306
Ashton, M.J.; Layzer, James B.
We characterised microhabitat availability and use by adult and young-of-year (YOY) snail darters (Percina tanasi Etnier 1976) while snorkelling in the French Broad and Hiwassee rivers, TN, USA. Both age groups of snail darters disproportionately used most microhabitat variables compared to their availability. Snail darters primarily occupied moderately deep, swift water over gravel substrates with little macrophyte coverage and no silt. Univariate comparisons indicated that adult and YOY darters occupied different habitat, but there was no marked differences between principal components analysis plots of multivariate microhabitat use within a river. Although the availability of microhabitat variables differed between the French Broad and Hiwassee rivers, univariate means and multivariate plots illustrated that the habitats used were generally similar by age groups of snail darters between rivers. Because our observations of habitat availability and use were constrained to low flow periods and depths <1 m, the transferability of our results to higher flow periods may be limited. However, the similarity in habitat use between rivers suggests that our results can be applied to low-normal flow conditions in other streams.
Ashton, M.J.; Layzer, J.B.
We characterised microhabitat availability and use by adult and young-of-year (YOY) snail darters (Percina tanasiEtnier 1976) while snorkelling in the French Broad and Hiwassee rivers, TN, USA. Both age groups of snail darters disproportionately used most microhabitat variables compared to their availability. Snail darters primarily occupied moderately deep, swift water over gravel substrates with little macrophyte coverage and no silt. Univariate comparisons indicated that adult and YOY darters occupied different habitat, but there was no marked differences between principal components analysis plots of multivariate microhabitat use within a river. Although the availability of microhabitat variables differed between the French Broad and Hiwassee rivers, univariate means and multivariate plots illustrated that the habitats used were generally similar by age groups of snail darters between rivers. Because our observations of habitat availability and use were constrained to low flow periods and depths <1 m, the transferability of our results to higher flow periods may be limited. However, the similarity in habitat use between rivers suggests that our results can be applied to low-normal flow conditions in other streams. ?? Published 2010. This article is a US Government work and is in the public domain in the USA.
Smith-Spark, James H; Moore, Viv; Valentine, Tim; Sherman, Susan M
Matching stimuli across a range of influencing variables is no less important for studies of face recognition than it is for those of word processing. Whereas a number of corpora exist to allow experimenters to select a carefully controlled set of word stimuli, similar databases for famous faces do not exist. This article, therefore, provides researchers in the area of face recognition with a useful resource on which to base their stimulus selection. In the first phase of the investigation, British adults over 40 years of age were requested to generate the names of famous people (or celebrities) that they thought they would recognize and to write these down. The most frequently named celebrities were then rated by adults from the same age population for familiarity, distinctiveness, and age of acquisition. The result is a database of 696 famous people, with an indication of their relative eminence in the public consciousness and rated for these important variables. Phoneme counts are also provided for each famous person, together with family name frequency counts in the general population, where available. Materials and links may be accessed at www.psychonomic.org/archive.
Tunaz, H; Bedick, J C.; Miller, J S.; Hoback, W W.; Rana, R L.; Stanley, D W.
Nodulation is the first and quantitatively most important cellular defense reaction to bacterial infections in insects. Treating adults of the 17-year periodical cicadas, Magicicada septendecim and M. cassini, with eicosanoid biosynthesis inhibitors immediately prior to intrahemocoelic injections of the bacterium, Serratia marcescens, sharply reduced the nodulation response to bacterial challenges. Separate treatments with specific inhibitors of phospholipase A(2), cyclooxygenase, and lipoxygenase reduced nodulation, supporting our view that nodule formation is a multi-step process in which individual steps are separately mediated by lipoxygenase and cyclooxygenase products. The inhibitory influence of dexamethasone was apparent by 2 h after injection, and nodulation was significantly reduced, relative to control insects, over the following 14 h. The dexamethasone effects were reversed by treating bacteria-challenged insects with the eicosanoid-precursor polyunsaturated fatty acid, arachidonic acid. Low levels of arachidonic acid were detected in fat body phospholipids. These findings in adults of an exopterygote insect species with an unusual life history pattern broaden our hypothesis that eicosanoids mediate cellular immune reactions to bacterial infections in most, if not all, insects.
Rybarczyk, B; DeMarco, G; DeLaCruz, M; Lapidos, S; Fortner, B
The authors tested the efficacy of a mind/body wellness intervention for older adults with chronic illness. They randomly assigned 243 physician-referred patients from an urban HMO to a classroom intervention or a wait-list control group. The intervention provided instruction on mind/body relationships; relaxation training; cognitive restructuring; problem-solving; communication; and behavioral treatment for insomnia, nutrition, and exercise. At posttreatment, the intervention group had significant decreases in self-reported sleep difficulties, pain, anxiety, and depression symptoms compared with controls. The intervention also led to a significant decrease in "chance" and "powerful others" health locus of control beliefs. At 1-year follow-up, the intervention group maintained benefits in sleep and health locus of control and also reported a significant increase in health behaviors compared with controls. Pain, anxiety, and depression benefits were not maintained. This type of classroom intervention appears to have some lasting effects on health behaviors and beliefs.
Zvolensky, Michael J; Bakhshaie, Jafar; Sheffer, Christine; Perez, Adriana; Goodwin, Renee D
This study investigated the relation between major depressive disorder (MDD) and smoking relapse in the U.S. over a 10-year period. Data were drawn from the Midlife Development in the United States (MIDUS) Survey Waves I & II. Logistic regression analyses were used to explore the associations between past-year MDD in 1994, past-year MDD in 2005 and persistent depression (1994 and 2005) and risk of smoking relapse in 2005 among former smokers, adjusting for demographics, anxiety disorders, and substance use problems and smoking characteristics. Among former smokers, MDD in 1994, compared to without MDD in 1994, was associated with significantly increased odds of smoking relapse by 2005. Current MDD in 2005 was associated with an even stronger risk of relapse in 2005 and persistent depression even more strongly predicted relapse by 2005. These associations remained significant and were not substantially attenuated by the covariates. In conclusion, MDD appears to confer long-term vulnerability to smoking relapse among adults in the general population. These results suggest interventions for smoking cessation should include screening and treatment for MDD if programs are to be optimally effective at achieving initial quit success as well as enduring abstinence.
Manzoli, L; De Vito, C; Flacco, M E; Marzuillo, C; Boccia, A; Villari, P
In the first half of this year the experts of the Italian Society of Hygiene (SItI), along with those of other National Scientific Societies, agreed with the recommendations made by the USA CDC in 2009, and developed a proposal for a vaccination schedule (Vaccine Schedule for Life), in which influenza vaccination is recommended for all adults aged between 50 and 64 years. In the National Plan for Vaccinal Prevention 2012-2014, which was published just before the issue of the SItI Calendar but concluded earlier (end of 2011), influenza vaccination is recommended "only" for all persons > or = 65 years or included in one of the many at-risk categories. The issue is controversial and has generated considerable debate at national and international level. This short note discusses the logical processes and the scientific evidence in support or against the decision to extend the influenza vaccination. The Authors conclude that the epidemiological approach used by SItI experts is appropriate. In any case, further studies on the topic are strongly needed, and their results should be taken into account in the drafting of future vaccination schedules.
Neiworth, Julie J; Gleichman, Amy J; Olinick, Anne S; Lamp, Kristen E
This study compared adults (Homo sapiens), young children (Homo sapiens), and adult tamarins (Saguinus oedipus) while they discriminated global and local properties of stimuli. Subjects were trained to discriminate a circle made of circle elements from a square made of square elements and were tested with circles made of squares and squares made of circles. Adult humans showed a global bias in testing that was unaffected by the density of the elements in the stimuli. Children showed a global bias with dense displays but discriminated by both local and global properties with sparse displays. Adult tamarins' biases matched those of the children. The striking similarity between the perceptual processing of adult monkeys and humans diagnosed with autism and the difference between this and normatively developing human perception is discussed.
Nadeem, M A; Raza, S N; Malik, M A
Age may have a different contribution to normal lung function values in those aged less than 25 years, as compared to older individuals. We report regression equations predicting ventilatory parameters in this age group, as none have been reported from Pakistan. The study was conducted on students of King Edward Medical College Lahore, Pakistan. Participants had never smoked and reported no respiratory symptoms. In addition to anthropometric data, forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and forced expiratory flow at 50% of FVC (FEF50) were measured. Equations predicting normal values of these parameters were derived using SPSS (Chicago, Illinois, U.S.A.) P < or = 0.05 was treated as statistically significant. Of the students, 519 took part in the study. All four parameters correlated significantly (P < 0.001) and positively with height. FEF50 had a negative correlation with age in both sexes (P < 0.05). The correlation of other parameters with age was variable and not statistically significant. On multiple regression, height featured as an independent predictor in equations for all parameters. The contribution of age as an independent predictor of ventilatory function was, once again, variable. Independent variables were retained in the raw form as their transformation did not improve the goodness of fit of the derived equations. Only height and age emerged as independent predictors of ventilatory function. Values derived from the equations presented in this study were less than those for height and age matched white Caucasians. Such differences were greater than the 'Asian correction factors'.
Shi, Zumin; Yuan, Baojun; Taylor, Anne W; Dal Grande, Eleonora; Wittert, Gary A
The aim of this analysis was to determine the relationship between monosodium glutamate (MSG) intake and change in hemoglobin (Hb) levels and the risk of anemia over 5 years in 1197 Chinese men and women who participated in the Jiangsu Nutrition Study (JIN). MSG intake and Hb were quantitatively assessed in 2002 and followed up in 2007. Diet and lifestyle factors were assessed at both time points. There was a positive association between MSG intake and increase in Hb among men but not women. In the multivariate model adjusting for demographic and lifestyle factors as well as baseline dietary pattern, the beta values and 95% confidence interval for Hb changes across quartiles of MSG intake were 0, 0.67(0.04-1.29), 0.99(0.38-1.60), 0.73(0.13-1.34) among men (p for trend 0.091); 0, -0.01(-0.45-0.43), 0.23(-0.25-0.71), and -0.45(-0.96-0.05) among women (p for trend 0.087). Among anemic participants at baseline, there was a significant inverse association between MSG intake and the risk of anemia at follow-up. Comparing extreme quartiles of MSG intake among those anemic at baseline, the relative risk for persistent anemia at follow-up was 0.49 (95% CI: 0.28-0.86, p < 0.01). The association was independent of dietary patterns and lifestyle factors. A dose-response relationship between MSG intake and increase in Hb levels among anemic participants was seen. MSG intake may have independent Hb-increasing effects, especially among men and those anemic at baseline.
Jaakkola, M S; Ernst, P; Jaakkola, J J; N'gan'ga, L W; Becklake, M R
BACKGROUND: There are few data on the quantitative effects of cigarette smoking on lung function in young adults. These effects are important in the understanding of the early stages of chronic airflow obstruction. METHODS: A longitudinal study over eight years was carried out to estimate quantitatively the effect of cigarette smoking on ventilatory lung function in young adults and to examine the possibility that the effect is modified by other factors. The study population were 15 to 40 years of age at initial examination, when they underwent spirometry and completed an interviewer administered questionnaire on respiratory health. Eight years later 391 of the subjects were re-examined (38% response rate). The quantitative effect of cigarette smoking during the study period on the average change of forced expiratory volume in one second (FEV1) over time (delta FEV1) was estimated in two linear regression models that included potential confounders and other determinants of outcome. RESULTS: The first model showed a significant dose-response relation between the average rate of smoking during the study period and delta FEV1, giving an estimate of annual change in FEV1 of -0.42 ml for each cigarette smoked per day (-8.4 ml for each pack) (p = 0.04). In the second model, which took smoking before the study period as a potential confounder, the effect of smoking during the study period was slightly smaller (-0.33 ml/year for each cigarette smoked per day). This indicated that smoking before the study period had a marginal latent effect on delta FEV1 during the study. However, neither the effect of smoking before the study nor that of smoking during the study was significant, presumably because of collinearity. Interactions between cigarette smoking and gender, wheezing, atopy, and exposure to environmental tobacco smoke during the growth period were not significant with respect to their effect on the relation between cigarette smoking and delta FEV1. CONCLUSION
Gran, James R.
A four-year followup study was conducted among the 1969 graduating class of the Jackson County Adult Evening High School to assess the educational, social, and/or financial benefits of the program. Comparisons were made with the results of the one-year follow study. Results, based on the 90% of questionnaires that were returned, include the…
Baernholdt, Marianne; Yan, Guofen; Hinton, Ivora; Rose, Karen; Mattos, Meghan
Purpose: The proportion of people over 65 years of age is higher in rural areas than in urban areas, and their numbers are expected to increase in the next decade. This study used Andersen's behavioral model to examine quality of life (QOL) in a nationally representative sample of community-dwelling adults 65 years and older according to…
Salvatore, Jessica E.; Haydon, Katherine C.; Simpson, Jeffry A.; Collins, W. Andrew
This study tests a model of young adult romantic quality as a moderator of the effects of early caregiving on anxious-depressed symptoms over a nine-year period in adulthood. Participants (n = 93) were a subsample from a longitudinal study of risk and adaptation. Quality of early caregiving was measured using observational data collected at five points in the first four years of life. Young adult romantic relationship quality was assessed from interviews with participants at age 23. Self-report anxious-depressed symptoms were measured at ages 23, 26, and 32. The results indicated that romantic quality moderated early caregiving to predict symptom levels across this period, with evidence for inoculation, amplification, and compensation effects. A discriminant analysis examining young adult work competence as a moderator provided further evidence for the distinctiveness of romantic relationships in changing the association between early caregiving and adult internalizing symptoms. PMID:23880395
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.
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.
Chen, Tien-Hsing; Hsiao, Yuan-Chuan; Cheng, Chia-Chi; Mao, Chun-Tai; Chen, Dong-Yi; Tsai, Ming-Lung; Yang, Teng-Yao; Lin, Yu-Sheng
Abstract Atrial septal defect (ASD) closure is major therapy for patients with secundum ASD. Although surgical closure (SC) and transcatheter closure (TC) are usually performed in such patients, data on the long-term outcomes comparing TC and SC in adults are limited. Data on the participants of this cohort study were retrieved from Taiwan's National Health Insurance Research Database from 2004 to 2011. Secundum ASD patients > 18 years of age who underwent TC or SC were initially enrolled, and those with associated comorbidities were excluded. After propensity score matching, the clinical outcomes between the TC and SC groups were analyzed. There were 595 patients recruited in the TC group and 308 patients in the SC group. The SC group had a higher incidence of systemic thromboembolism (P < 0.001), ischemic stroke (P = 0.002), and all-cause mortality (P = 0.013) when compared with those of the TC group at the index hospitalization, and similar phenomena could also be seen in a around 4-year follow-up period after the procedures (systemic thromboembolism (P < 0.001, HR = 11.48, 95% CI: 3.29–40.05), ischemic stroke (P = 0.005, HR = 9.28, 95% CI: 1.94–44.39), and all-cause mortality (P = 0.035, HR = 2.28, 95% CI: 1.06–4.89). In addition, atrial fibrillation (P = 0.005) and atrial flutter (P = 0.049) more frequently developed in the SC group than in the TC group at the index hospitalization. The adult secundum ASD patients had lower incidence rates of systemic thromboembolism, ischemic stroke, and all-cause mortality after TC than those after SC in the 4-year follow-up after procedures. Transcatheter ASD closure should therefore be given priority PMID:26402807
Haacke, E. Mark; Raz, Naftali
The accumulation of non-heme iron in the brain has been proposed as a harbinger of neural and cognitive decline in aging and neurodegenerative disease, but support for this proposal has been drawn from cross-sectional studies, which do not provide valid estimates of change. Here, we present longitudinal evidence of subcortical iron accumulation in healthy human adults (age 19–77 at baseline). We used R2* relaxometry to estimate regional iron content twice within a 2 year period, measured volumes of the striatum and the hippocampus by manual segmentation, and assessed cognitive performance by working memory tasks. Two-year change and individual differences in the change of regional volumes, regional iron content, and working memory were examined by latent change score models while taking into account the age at baseline and metabolic risk indicators. Over the examined period, volume reduction occurred in the caudate nucleus and hippocampus, but iron content increased only in the striatum, where it explained shrinkage. Higher iron content in the caudate nucleus at baseline predicted lesser improvement in working memory after repeat testing. Although advanced age and elevated metabolic syndrome risk were associated with greater iron content in the putamen at baseline, neither age nor metabolic risk influenced change in any variable. Thus, longitudinal evidence supports the notion that accumulation of subcortical iron is a risk factor for neural and cognitive decline in normal aging. PMID:25926451
Bender, Andrew R.; Raz, Naftali
Diffusion tensor imaging (DTI) studies show age-related differences in cerebral white matter (WM). However, few have studied WM changes over time, and none evaluated individual differences in change across a wide age range. Here, we examined two-year WM change in 96 healthy adults (baseline age 19-78 years), individual differences in change, and the influence of vascular and metabolic risk thereon. Fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) represented microstructural properties of normal appearing WM within 13 regions. Cross-sectional analyses revealed age-related differences in all WM indices across the regions. In contrast, latent change score analyses showed longitudinal declines in AD in association and projection fibers, and increases in anterior commissural fibers. FA and RD evidenced a less consistent pattern of change. Metabolic risk mediated the effects of age on FA and RD change in corpus callosum body and dorsal cingulum. These findings underscore the importance of longitudinal studies in evaluating individual differences in change, and the role of metabolic factors in shaping trajectories of brain aging. PMID:25771392
Bender, Andrew R.; Völkle, Manuel C.; Raz, Naftali
The few extant reports of longitudinal white matter (WM) changes in healthy aging, using diffusion tensor imaging (DTI), reveal substantial differences in change across brain regions and DTI indices. According to the last-in-first-out hypothesis of brain aging late-developing WM tracts may be particularly vulnerable to advanced age. To test this hypothesis we compared age-related changes in association, commissural and projection WM fiber regions using a skeletonized, region of interest DTI approach. Using linear mixed effects models, we evaluated the influences of age and vascular risk at baseline on seven-year changes in three indices of WM integrity and organization (axial diffusivity, AD, radial diffusivity, RD, and fractional anisotropy, FA) in healthy middle-aged and older adults (mean age = 65.4, SD = 9.0 years). Association fibers showed the most pronounced declines over time. Advanced age was associated with greater longitudinal changes in RD and FA, independent of fiber type. Furthermore, older age was associated with longitudinal RD increases in late-developing, but not early-developing projection fibers. These findings demonstrate the increased vulnerability of later developing WM regions and support the last-in-first-out hypothesis of brain aging. PMID:26481675
Morningstar, Mark W.; Strauchman, Megan N.
Objective Manipulation under anesthesia (MUA) is an outpatient procedure that is performed to restore normal joint kinematics and musculoskeletal function. This article presents a case of a patient with idiopathic lumbar degenerative scoliosis who developed intractable pain as an adult and reports on the outcomes following a trial of MUA. Clinical Features A 59-year-old female patient presented to a chiropractic office with primary subjective symptoms of lower back and bilateral hip pain. Numerical pain rating scores were reported at 8 of 10 for the lower back and 9 of 10 for the sacroiliac joint/gluteal region. A disability score using a functional rating index demonstrated a score of 26 of 40 (or 64% disability). Over the preceding 5 years, the patient had tried a number of conservative therapies to relieve her pain without success. Intervention and Outcome The patient was evaluated for MUA. The patient was scheduled for a serial MUA over 3 days. Numerical pain rating scores 8 weeks after the MUA were 1 of 10 for the lower back and 3 of 10 for the sacroiliac joint. Her disability rating decreased to 11 of 40 (28%). Radiological improvements were also observed. These outcomes were maintained at 6-month follow-up. Conclusion Pain, functional, and radiographic outcomes demonstrated improvements immediately following treatment for this patient. PMID:21629554
Ferrario, Virgilio F; Sforza, Chiarella; Dellavia, Claudia; Colombo, Anna; Ferrari, Raffaella P
A 10-year longitudinal evaluation of the morphology (size and shape) of hard tissue palate was performed in 6 female and 6 male healthy adults (mean age at the second evaluation was 33 years, SD = 2.2). All subjects had a complete permanent dentition, including the second molars, and were free from respiratory problems. Palatal landmarks were digitized with a computerized 3D instrument, and their coordinates were used to derive a mathematical model of palatal form. Palatal shape (size-independent) was assessed by a fourth-grade polynomial in the sagittal and frontal plane projections. Palatal dimensions in the frontal and sagittal planes were computed and compared between the 2 evaluations by paired Student t tests. A great variability was observed, and no significant modifications in size were found (P > .05 for all variables). No variations in shape were observed. Sex had no significant effect for any variable (Student t for independent samples, P > .05). This study showed that in healthy subjects, hard tissue palatal morphology does not seem to change between the third and the fourth decades of life.
Kahn, H S; Tatham, L M; Rodriguez, C; Calle, E E; Thun, M J; Heath, C W
OBJECTIVES: The purpose of this study was to identify behaviors associated with change in body mass index or with weight gain at the waist. METHODS: A cohort of 79236 White, non-Hispanic, healthy adults was questioned in 1982 and 1992 about diet and 10 physical activities. Estimates were made of the mean effects of stable behaviors on 10-year change in body mass index and on odds ratios for gain at the waist. RESULTS: Ten-year changes in body mass index was associated positively with meat consumption and smoking cessation and inversely with vegetable consumption, vitamin E supplementation, continued smoking, and some vigorous activities (e.g., jogging/running). Women's body mass index decreased with walking 4 or more hours per week and with regular alcohol intake, but these behaviors had a smaller effect on men's body mass index. weight gain was inversely associated with high vegetable consumption, walking 4 or more hours per week, and jogging/running 1 to 3 hours per week but not with less demanding physical activities. CONCLUSIONS: Simple derivation of behaviors associated with weight loss or reduced abdominal obesity may enhance programs designed to prevent obesity and chronic diseases. PMID:9184500
Levine, Hagai; Zarka, Salman; Ankol, Omer E; Rozhavski, Vladi; Davidovitch, Nadav; Aboudy, Yair; Balicer, Ran D
Evidence-based vaccination policy is important for the global and local efforts of achieving control over measles. In 2007, the first Israeli birth cohort to be twice vaccinated during childhood with Measles-Mumps-Rubella vaccine reached adulthood. In parallel, Israel experienced its largest measles outbreak since 1994. We aimed to assess the seroprevalence of measles IgG antibodies and concordance with rubella and mumps seroprevalence among young Israeli adults born 1988-9 in comparison to previous birth cohorts, in order to inform evidence based prevention policy. We conducted a seroprevalence study of IgG antibodies among 439 Israeli adults born in 1988-9, based on a representative sample of sera collected at age 18-19 upon recruitment to mandatory military service in 2007. In total, 85.7% were seropositive for measles as compared with 95.6% in the 1996 recruitment (P < 0.001). The absolute decline was significant both for males (8.8%, P = 0.001) and females (12.1%, P < 0.001). There were no significant differences in seropositivity by gender, years of education, country of birth or smoking status. Rubella seropositivity among measles seropositives was 90.4%, significantly (P < 0.001) higher than 72.1% among measles seronegatives. Mumps seropositivity among measles seropositives was 87.0%, significantly (P < 0.001) higher than 62.3% among measles seronegatives. Results were similar for Israeli-born only. Our findings indicate that measles seroprevalence decreased after the last change in vaccination policy and reach sub-optimal level. Until global eradication is reached, a proactive vaccination program to supplement routine childhood vaccination program should be considered in Israel and in other countries.
Punchick, Boris; Freud, Tamar; Press, Yan
Abstract The prevalence of cognitive impairment and orthostatic hypotension (OH) increases with age, but the results of studies that assessed possible associations between them are inconsistent. The aim of this study is to assess possible associations between cognitive impairment and OH in patients ≥65 years of age who underwent a comprehensive geriatric assessment. A retrospective analysis was conducted of the computerized medical records of the study population from 2005 to 2013. Data collected included blood pressure measurements that enabled the calculation of OH, results of the mini-mental state examination (MMSE), results of the Montreal cognitive assessment (MoCA) test, and cognitive diagnoses that were determined over the course of the assessment. The rate of OH in the study population of 571 adults was 32.1%. The mean MMSE score was 22.5 ± 5.2 among participants with OH and 21.6 ± 5.8 among those without OH (P = 0.09). The absence of a significant association between OH and MMSE remained after adjusting the MMSE score for age and education level. The mean MoCA score was 16.4 ± 5.0 among participants with OH and 16.4 ± 4.8 among those without (P = 0.33). The prevalence of OH was 39% among participants without cognitive impairment, 28.9% among those with mild cognitive impairment (MCI), and 30.6% among those with dementia (P = 0.13). There was no association between OH and cognitive impairment in adults who underwent a comprehensive geriatric assessment. PMID:27442658
Hughes, Matthew L; Geraci, Lisa; De Forrest, Ross L
How old one feels-one's subjective age-has been shown to predict important psychological and health outcomes. The current studies examined the effect of taking a standard memory test on older adults' subjective age. Study 1 showed that older adults felt older after taking a standard neuropsychological screening test and participating in a free-recall experiment than they felt at baseline. Study 2 showed that the effect was selective to older adults: Younger adults' subjective age was not affected by participating in the memory experiment. Study 3 showed that the subjective-aging effect was specific to memory, as taking a vocabulary test for a similar amount of time did not affect older adults' subjective age. Finally, Study 4 showed that simply expecting to take a memory test subjectively aged older adults. The results indicate that being in a memory-testing context affects older adults' self-perception by making them feel older.
Yang, Lin; Zhou, Zhi-Guang; Huang, Gan; Ouyang, Ling-Li; Li, Xia; Yan, Xiang
AIM: To investigate the characteristics of the progression of islet β cell function in Chinese latent autoimmune diabetes in adult (LADA) patients with glutamic acid decarboxylase antibody (GAD-Ab) positivity, and to explore the prognostic factors for β cell function. METHODS: Forty-five LADA patients with GAD-Ab positivity screened from phenotypic type 2 diabetic (T2DM) patients and 45 T2DM patients without GAD-Ab matched as controls were followed-up every 6 mo. Sixteen patients in LADA1 and T2DM1 groups respectively have been followed-up for 6 years, while 29 patients in LADA2 and T2DM2 groups respectively for only 1.5 years. GAD-Ab was determined by radioligand assay, and C-peptides (CP) by radioimmune assay. RESULTS: The percentage of patients whose fasting CP (FCP) decreased more than 50% compared with the baseline reached to 25.0% at 1.5th year in LADA1 group, and FCP level decreased (395.8±71.5 vs 572.8±72.3 pmol/L, P<0.05) at 2.5th year and continuously went down to the end of follow-up. No significant changes of the above parameters were found in T2DM1 group. The average decreased percentages of FCP per year in LADA and T2DM patients were 15.8% (4.0-91.0%) and 5.2% (-3.5 to 35.5%, P = 0.000) respectively. The index of GAD-Ab was negatively correlated with the FCP in LADA patients (rs = -0.483, P = 0.000). The decreased percentage of FCP per year in LADA patients were correlated with GAD-Ab index, body mass index (BMI) and age at onset (rs = 0.408, -0.301 and -0.523 respectively, P<0.05). Moreover, GAD-Ab was the only risk factor for predicting β cell failure in LADA patients (B = 1.455, EXP (B) = 4.283, P = 0.023). CONCLUSION: The decreasing rate of islet β cell function in LADA, being highly heterogeneous, is three times that of T2DM patients. The titer of GAD-Ab is an important predictor for the progression of islet β cell function, and age at onset and BMI could also act as the predictors. PMID:15902725
Duncan, Mitch J.; Schoeppe, Stephanie; Rebar, Amanda L.; Vandelanotte, Corneel
Lifestyle behaviours significantly contribute to high levels of chronic disease in older adults. The aims of the study were to compare the prevalence and the prevalence trends of health behaviours (physical activity, fruit and vegetable consumption, fast food consumption, TV viewing, smoking and alcohol consumption), BMI and a summary health behaviour indicator score in older (65+ years) versus younger adults (18–65 years). The self-report outcomes were assessed through the Queensland Social Survey annually between 2007–2014 (n = 12,552). Regression analyses were conducted to compare the proportion of older versus younger adults engaging in health behaviours and of healthy weight in all years combined and examine trends in the proportion of younger and older adults engaging in health behaviours and of healthy weight over time. Older adults were more likely to meet recommended intakes of fruit and vegetable (OR = 1.43, 95%CI = 1.23–1.67), not consume fast food (OR = 2.54, 95%CI = 2.25–2.86) and be non-smokers (OR = 3.02, 95%CI = 2.53–3.60) in comparison to younger adults. Conversely, older adults were less likely to meet the physical activity recommendations (OR = 0.86, 95%CI = 0.78–0.95) and watch less than 14 hours of TV per week (OR = 0.65, 95%CI = 0.58–0.74). Overall, older adults were more likely to report engaging in 3, or at least 4 out of 5 healthy behaviours. The proportion of both older and younger adults meeting the physical activity recommendations (OR = 0.97, 95%CI = 0.95–0.98 and OR = 0.94, 95%CI = 0.91–0.97 respectively), watching less than 14 hours of TV per week (OR = 0.96, 95%CI = 0.94–0.99 and OR = 0.94, 95%CI = 0.90–0.99 respectively) and who were a healthy weight (OR = 0.95, 95%CI = 0.92–0.99 and OR = 0.96, 95%CI = 0.94–0.98 respectively) decreased over time. The proportion of older adults meeting the fruit and vegetable recommendations (OR = 0.90, 95%CI = 0.84–0.96) and not consuming fast food (OR = 0.94, 95%CI = 0
Harenberg, Anke; Begue, Sarah; Mamessier, Audrey; Gimenez-Fourage, Sophie; Ching Seah, Ching; Wei Liang, Ai; Li Ng, Jun; Yun Toh, Xue; Archuleta, Sophia; Wilder-Smith, Annelies; Shek, Lynette P; Wartel-Tram, Anh; Bouckenooghe, Alain; Lang, Jean; Crevat, Denis; Caillet, Catherine; Guy, Bruno
To characterize the cell mediated immunity (CMI) induced by the investigational CYD tetravalent dengue vaccine (TDV), we developed a whole-blood, intracellular cytokine staining (ICS) assay and a multiplex assay, each requiring 3 mL of blood. We assessed CMI before and 28 d after a first and third injection of CYD-TDV and one year after the third injection in a subset of 80 adolescents and adults enrolled in a phase II trial in Singapore (ClinicalTrial.gov NCT NCT00880893). CD4/IFNγ/TNFα responses specific to dengue NS3 were detected before vaccination. Vaccination induced YF-17D-NS3-specific CD8/IFNγ responses, without significant TNFα, and a CYD-specific Th1/Tc1 cellular response in all participants, which was characterized by predominant IFNγ secretion compared with TNFα, associated with low level IL-13 secretion in multiplex analysis of peripheral blood mononuclear cells (PBMC) supernatants after restimulation with each the CYD vaccine viruses. Responses were directed mainly against CYD-4 after the first vaccination, and were more balanced against all four serotypes after the third vaccination. The same qualitative profile was observed one year after the third vaccination, with approximately 2-fold lower NS3-specific responses, and 3-fold lower serotype-specific cellular responses. These findings confirm previous observations regarding both the nature and specificity of cellular responses induced by CYD-TDV, and for the first time demonstrate the persistence of cellular responses after one year. We also established the feasibility of analyzing CMI with small blood samples, allowing such analysis to be considered for pediatric trials.
Ku, Po-Wen; Stevinson, Clare; Chen, Li-Jung
Background Few studies have explored the relations between naturally occurring changes in physical activity and cognitive performance in later life. This study examined prospective associations between changes in physical activity and cognitive performance in a population-based sample of Taiwanese older adults during an 11-year period. Methods Analyses were based on nationally representative data from the Taiwan Health and Living Status of the Elderly Survey collected in 1996, 1999, 2003, and 2007. Data from a fixed cohort of 1160 participants who were aged 67 years or older in 1996 and followed for 11 years were included. Cognitive performance (outcome) was assessed using 5 questions from the Short Portable Mental Status Questionnaire. Physical activity (exposure) was self-reported as number of sessions per week. The latent growth model was used to examine associations between changes in physical activity and cognitive performance after controlling for sociodemographic variables, lifestyle behaviors, and health status. Results With multivariate adjustment, higher initial levels of physical activity were significantly associated with better initial cognitive performance (standardized coefficient β = 0.17). A higher level of physical activity at baseline (1996) was significantly related to slower decline in cognitive performance, as compared with a lower level of activity (β = 0.22). The association between changes in physical activity and changes in cognitive performance was stronger (β = 0.36) than the previous 2 associations. The effect remained after excluding participants with cognitive decline before baseline. Conclusions Physical activity in later life is associated with slower age-related cognitive decline. PMID:22343329
Mehrpour, Saeed Reza; Nabian, Mohammad Hossein; Oryadi Zanjani, Leila; Foroughmand-Araabi, Mohammad-Hadi; Shahryar Kamrani, Reza
Background: Basic epidemiological data can provide estimates when discussing disease burden and in the planning and provision of healthcare strategies. There is little quantitative information in the literature regarding prevalence of traumatic injuries from developing countries. Objectives: The aim of the current preliminary study was to reveal the prevalence and age and gender distribution of various traumatic injuries in a tertiary referral orthopedic hospital in Iran. Patients and Methods: In a prospective descriptive study, all traumatic injured patients attending the Orthopedic Trauma Unit of our center in a five year period were included. Demographic details, the cause of injury, injury classification and treatment were recorded. For each of the five-year age groups and each gender we calculated the numbers with fractures, dislocations, soft tissue injuries, ligamentous injuries and lacerations and derived average age and gender-specific prevalence as well as seasonal variations. Results: A total of 18890 adults were admitted, 13870 (73.4%) males and 5020 (26.6%) females. There were 8204 (43.4%) fractures. The male fracture age distribution curve was unimodal and there was a detectable bimodal pattern in females. Under 65 years males are 3 times more likely to sustain a fracture than females which decreases to equal risk over the age of 65. The most common fracture site was distal radius/ulna (13.8%), followed by tibial diaphysis (8.8%), proximal femur (7.8%), finger phalanges (6.4%), metacarpals (6%) and metatarsals (5.9%). There were seasonal variations in fracture incidence with peaks in February, March and October. The least number of fractures occurred in June. Conclusions: The risk of traumatic injuries is higher among specific age groups with different patterns emerging for men and women. Thus, the descriptive epidemiology will provide useful information for treatment or injury prevention strategies, resource allocation, and training priorities. PMID
Söderström, Lisa; Rosenblad, Andreas; Adolfsson, Eva T; Wolk, Alicja; Håkansson, Niclas; Bergkvist, Leif
A higher fat content in the diet could be an advantage for preventing malnutrition among older adults. However, there is sparse scientific evidence to determine the optimal fat intake among older adults. This prospective cohort study examined whether a high energy intake of dietary fat among middle-aged and older adults is associated with the risk of malnutrition 10 years later. The study population comprised 725 Swedish men and women aged 53-80 years who had completed a questionnaire about dietary intake and lifestyle factors in 1997 (baseline) and whose nutritional status was assessed when admitted to the hospital in 2008-2009 (follow-up). At the follow-up, 383 (52.8%) participants were identified as being at risk of malnutrition and fifty-two (7.2%) were identified as malnourished. Multinomial logistic regression models were used to analyse the association between previous dietary fat intake and nutritional status later in life. Contrary to what was expected, a high energy intake from total fat, saturated fat and monounsaturated fat among middle-aged and older adults increased the risk of exhibiting malnutrition 10 years later. However, this applied only to individuals with a BMI<25 kg/m² at the baseline. In conclusion, these findings suggest that preventive actions to counteract malnutrition in older adults should focus on limiting the intake of total fat in the diet by reducing consumption of food with a high content of saturated and monounsaturated fat.
Smith, Justin S; Klineberg, Eric; Lafage, Virginie; Shaffrey, Christopher I; Schwab, Frank; Lafage, Renaud; Hostin, Richard; Mundis, Gregory M; Errico, Thomas J; Kim, Han Jo; Protopsaltis, Themistocles S; Hamilton, D Kojo; Scheer, Justin K; Soroceanu, Alex; Kelly, Michael P; Line, Breton; Gupta, Munish; Deviren, Vedat; Hart, Robert; Burton, Douglas C; Bess, Shay; Ames, Christopher P
OBJECTIVE Although multiple reports have documented significant benefit from surgical treatment of adult spinal deformity (ASD), these procedures can have high complication rates. Previously reported complications rates associated with ASD surgery are limited by retrospective design, single-surgeon or single-center cohorts, lack of rigorous data on complications, and/or limited follow-up. Accurate definition of complications associated with ASD surgery is important and may serve as a resource for patient counseling and efforts to improve the safety of patient care. The authors conducted a study to prospectively assess the rates of complications associated with ASD surgery with a minimum 2-year follow-up based on a multicenter study design that incorporated standardized data-collection forms, on-site study coordinators, and regular auditing of data to help ensure complete and accurate reporting of complications. In addition, they report age stratification of complication rates and provide a general assessment of factors that may be associated with the occurrence of complications. METHODS As part of a prospective, multicenter ASD database, standardized forms were used to collect data on surgery-related complications. On-site coordinators and central auditing helped ensure complete capture of complication data. Inclusion criteria were age older than 18 years, ASD, and plan for operative treatment. Complications were classified as perioperative (within 6 weeks of surgery) or delayed (between 6 weeks after surgery and time of last follow-up), and as minor or major. The primary focus for analyses was on patients who reached a minimum follow-up of 2 years. RESULTS Of 346 patients who met the inclusion criteria, 291 (84%) had a minimum 2-year follow-up (mean 2.1 years); their mean age was 56.2 years. The vast majority (99%) had treatment including a posterior procedure, 25% had an anterior procedure, and 19% had a 3-column osteotomy. At least 1 revision was required in 82
Erb, Christopher D; Moher, Jeff; Song, Joo-Hyun; Sobel, David M
Researchers have proposed that two processes featuring distinct types of inhibition support inhibitory control: a response threshold adjustment process involving the global inhibition of motor output and a conflict resolution process involving competitive inhibition among co-active response alternatives. To target the development of these processes, we measured the reaching behavior of 5- to 10-year-olds (Experiment 1) and adults (Experiment 2) as they performed an Eriksen flanker task. This method provided two key measures: initiation time (the time elapsed between stimulus onset and movement onset) and reach curvature (the degree to which a movement deviates from a direct path to the selected target). We suggest that initiation time reflects the response threshold adjustment process by indexing the degree of motoric stopping experienced before a movement is started, while reach curvature reflects the conflict resolution process by indexing the degree of co-activation between response alternatives over the course of a movement. Our results support this claim, revealing different patterns effects in initiation time and curvature, and divergent developmental trajectories between childhood and adulthood. These findings provide behavioral evidence for the dissociation between global and competitive inhibition, and offer new insight into the development of inhibitory control.
Tumanan-Mendoza, Bernadette A; Mendoza, Victor L; Bermudez–Delos Santos, April Ann A; Punzalan, Felix Eduardo R; Pestaño, Noemi S; Natividad, Rudy Boy; Shiu, Louie Alfred; Macabeo, Renelene
Objectives The study determined the prevalence of hospitalisation due to congestive heart failure (CHF) among adult patients aged 19 years and above in the Philippines and its 17 regions in 2014. It also determined the demographic profile of these patients, aetiology and type of CHF, comorbidities, duration of hospitalisation and the overall in-hospital mortality rate. Methods Data collection was done using the hospitalisation claims database of the Philippine Health Insurance Corporation (PhilHealth). All patient claims for CHF, that is, patients who were admitted from 1 January to 31 December 2014, were included. Descriptive statistics were utilised to obtain the results. Results The prevalence rate was 1.6% or 1648 cases of CHF for every 100 000 patient claims for medical conditions in 2014. The mean age was 52.6±15.1 years. There was no sex predilection. Only 22.67% of the hospitalisation claims for CHF listed possible specific aetiologies, the most common of which was hypertensive heart disease (86.7%). There were more cases of systolic compared to diastolic heart failure. The mean length of hospital stay was 5.9 days (+8.2) days (median 4 days), with an overall in-hospital mortality rate of 8.2%. Conclusions There were 16 cases of heart failure for every 1000 Filipino patients admitted due to a medical condition in 2014. Hypertension was possibly the most common aetiologic factor. Compared to western and Asia-Pacific countries, the local mortality rate was relatively higher.
In Which Neighborhoods Are Older Adult Populations Expanding? Sociodemographic and Built Environment Characteristics Across Neighborhood Trajectory Classes of Older Adult Populations in Four U.S. Cities Over 30 Years
Rummo, Pasquale E.; Hirsch, Jana A.; Howard, Annie Green; Gordon-Larsen, Penny
Objective: We sought to examine characteristics of neighborhoods with changing older adult populations. Method: We used 30 years (1980-2011) of data from four U.S. cities (n = 392 neighborhoods; Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; Oakland, California) and finite mixture modeling to identify trajectory classes: neighborhoods with “stable,” declining, or increasing older adult populations (≥65 years). We then compared mean baseline and change in their characteristics. Results: Neighborhoods with an increasing (vs. “stable”) percentage of older adult populations had lower initial poverty and greater increases in education and income, with lower increases in road connectivity, population density, and housing prices/debt over time. The same was true for neighborhoods with declining older adult populations, with the exception of having higher increases in housing prices/debt. We observed few significant differences in neighborhood amenities or parks across classes. Conclusion: Our results emphasize the need to consider built and social environments when planning communities for older adults. PMID:27774501
Geraghty, Adam W A; Kirby, Sarah; Essery, Rosie; Little, Paul; Bronstein, Adolfo; Turner, David; Stuart, Beth; Andersson, Gerhard; Carlbring, Per; Yardley, Lucy
Introduction Dizziness is highly prevalent in older adults and can lead to falls, fear of falling, loss of confidence, anxiety and depression. Vestibular rehabilitation (VR) exercises are effective in reducing dizziness due to vestibular dysfunction, but access to trained therapists is limited. Providing dizzy patients with booklets teaching them how to carry out VR exercises has been shown to be a cost-effective way of managing dizziness in primary care. Internet-based intervention delivery has many advantages over paper-based methods, including the provision of video instructions, automated tailoring and symptom-related feedback. This trial will examine whether an internet-based VR intervention is (1) effective in reducing dizziness and (2) a cost-effective primary care treatment option. Methods/analysis This will be a single blind, randomised controlled trial carried out in UK primary care. A stand-alone internet-based VR intervention will be compared with routine care in 262 dizzy patients aged 50 years and over. Measures will be taken at baseline, 3 and 6 months. Our primary outcome measure will be the effectiveness of the intervention in reducing dizziness symptoms compared with routine care at 6 months. Cost-effectiveness will be examined along with the effect of the intervention on dizziness-related disability and symptoms of depression and anxiety. Psychological process variables including expectancy, self-efficacy and acceptance will be explored in relation to adherence and symptom reduction. Ethics/dissemination This trial has undergone ethical scrutiny and been approved by an NHS Research Ethics Committee, Southampton A REC Reference: 13/SC/0119. The findings of this trial will be disseminated to the scientific community through presentations at national and international conferences, and by publishing in peer review journals. Findings will be disseminated to the public through targeted press releases. This trial will provide valuable information on
Kim, Sungah; Kim, Young-Nam
Dietary intakes and plasma concentrations of retinol and carotenoids were estimated in assessing the vitamin A status of Korean adults living in Seoul and the metropolitan area. Three consecutive 24-h food recalls were collected from 106 healthy subjects (33 males and 73 females) aged 20-59 years. Fasting blood samples of the subjects were obtained and plasma retinol and carotenoids were analyzed. The daily vitamin A intakes (mean ± SD) were 887.77 ± 401.35 µg retinol equivalents or 531.84 ± 226.42 µg retinol activity equivalents. There were no significant differences in vitamin A intakes among age groups. The retinol intake of subjects was 175.92 ± 129.87 µg/day. The retinol intake of the subjects in their 50's was significantly lower than those in their 20's and 30's (P < 0.05). Provitamin A carotenoid intakes were 3,828.37 ± 2,196.29 µg/day β-carotene, 472.57 ± 316.68 µg/day α-carotene, and 412.83 ± 306.46 µg/day β-cryptoxanthin. Approximately 17% of the subjects consumed vitamin A less than the Korean Estimated Average Requirements for vitamin A. The plasma retinol concentration was 1.22 ± 0.34 µmol/L. There was no significant difference in plasma retinol concentrations among age groups. However, the concentrations of β-carotene, lycopene, and lutein of subjects in their 50's were significantly higher than those of in their 20's. Only one subject had a plasma retinol concentration < 0.70 µmol/L indicating marginal vitamin A status. Plasma retinol concentration in 30% of the subjects was 0.70- < 1.05 µmol/L, which is interpreted as the concentration possibly responsive to greater intake of vitamin A. In conclusion, dietary intakes and status of vitamin A were generally adequate in Korean adults examined in this study. PMID:22413040
Pennsylvania State Dept. of Education, Harrisburg. Bureau of Adult Basic and Literacy Education.
This document contains project abstracts for 29 adult basic and literacy education (ABLE) demonstration programs that were conducted in Pennsylvania in 1997-1998 through grants funded under Section 353 of the Adult Education Act. Each abstract includes the following: project name, number, purpose, impact, outcomes, conclusions/recommendations,…
Aglan, Azza; Kerfoot, Michael; Pickles, Andrew
Background: Prospective studies show that the adult outcomes of adolescents who deliberately harm themselves are marked by high rates of adversity and psychiatric disorders. The goal of this study was to identify pathways linking childhood risk factors to early adult outcomes of suicidal adolescents. Methods: A clinical sample of 158 adolescents…
The study described in the Technical Report was conducted to answer specific questions from the 2010 Dietary Guidelines Advisory Committee, Ethanol Subcommittee. The study uses data from three different instruments pertaining to alcoholic beverage intakes of adults 21 years and older in the Nationa...
Conway, Francine; Magai, Carol; Jones, Samuel; Fiori, Katherine; Gillespie, Michael
This study explores dynamic changes in network size and composition by examining patterns of older adults' social network change over time, that is: types of movements; the reason for the loss of network members; and the relation of movement and composition in concert. This study is a 6-year follow up of changes in the social networks of U.S.-Born…
Scanlan, Peter A.; Dokecki, Paul R.
This paper reports a research design guided by the hypothesis that adult constraint and peer cooperation exert conflicting forces on the development of racial awareness attitudes of 3-, 4-, and 5-year-olds. Subjects were 60 preschoolers from Tennessee, with an equal number of white and black children at each age. Methodology used was a modified…
OBJECTIVES: C terminal Agrin Fragment (CAF) has been proposed as a potential circulating biomarker for predicting changes in physical function among older adults. To determine the effect of a one year PA intervention on changes in CAF concentrations and to evaluate baseline and longitudinal associat...
This study estimated and compared the prevalence of the Metabolic Syndrome and its individual components in young adults (ages 20-39 years) in the US and Korea using 2003-2004 US and 2005 Korean National Health and Nutrition Examination Survey data. The mean body mass index and rate of metabolic abn...
Diet and lifestyle factors of young adults and their relationship to health risk factors are understudied. Data from the Bogalusa Heart Study population (n = 1214; 19-39 years; 74.1% white; 60.8% female) were used to study associations of lifestyle, health risk factors, and reported health problems ...
Biswas, Radha Roy
This report describes the "Year Up" program, an innovative technology training program, that prepares and places low-income, urban young adults in entry-level IT jobs while also preparing them for college. The program targets recent high school graduates and GED recipients between the ages of 18 and 24 who are either unemployed or…
Ghenadenik, Adrian E; Frohlich, Katherine L; Gauvin, Lise
Young adults have the highest prevalence of smoking amongst all age groups. Significant uptake occurs after high school age. Although neighborhood exposures have been found to be associated with smoking behavior, research on neighborhood exposures and the smoking trajectories among young adults, and on the role of geographic scale in shaping findings, is scarce. We examined associations between neighborhood exposures across two nested, increasingly large spatial units and smoking trajectory over two years among young adults living in Montreal, Canada. A sample of 2093 participants aged 18-25 years from the Interdisciplinary Study of Inequalities in Smoking (ISIS) was surveyed. The dependent variable was self-reported smoking trajectory over the course of two years. Residential addresses, data on presence of tobacco retail outlets, and the presence of smoking accommodation facilities were coded and linked to spatial units. Three-level multinomial models were used to examine associations. The likelihood of being a smoker for 2+ years was significantly greater among those living in larger spatial unit neighborhoods that had a greater presence of smoking accommodation. This association was not statistically significant at the smaller spatial units. Our findings highlight the importance of studying young adults' smoking trajectories in addition to static smoking outcomes, and point to the relevance of considering spatial scale in studies of neighborhoods and smoking.
Song, Yeong-Jun; Lim, Jiseun; Park, Woong-Sub; Sohn, Haesook; Lee, Moo-Sik; Shin, Dong-Hoon; Kim, Chun-Bae; Kim, Hwasung; Oh, Gyung-Jae; Ki, Moran
We previously observed 80.7% seropositivity and a significant interaction between gender and hepatitis A virus (HAV) vaccine type (Havrix vs. Epaxal) on the seropositivity approximately 11 months after single-dose HAV vaccinations in Korean young adults. Our objective was to evaluate seropositivity approximately 2 years after a single-dose HAV vaccination and the influence of demographic characteristics on seropositivity, including the interaction between gender and vaccine type. Seronegative medical school students were randomly vaccinated with Havrix or Epaxal. Based on a total serum anti-HAV antibody titer cutoff of 20 IU/mL, 338 participants (76.0%) of the 445 vaccinees were seropositive 20-25 months after a single-dose HAV vaccination. The seropositive rates were similar after vaccination with Havrix (77.0%) and Epaxal (74.9%). Univariate analysis indicated that female (p = 0.052) and less obese (p < 0.001) participants had a higher seropositive rate, whereas other characteristics such as age, alcohol use, smoking history, vaccine type, and follow-up duration were not associated with seropositivity. Multivariate analysis indicated that women (p = 0.026) and participants with moderate alcohol use (p < 0.001) showed significantly higher seropositive rates than men and participants with no or low alcohol use, respectively. The seropositive rates after vaccination with Havrix and Epaxal were 70.9% and 67.5% in men and 87.7% and 91.3% in women, respectively (p for interaction = 0.304). Compared with the seropositive rate approximately 11 months after vaccination, the seropositive rate decreased substantially only in men in the Havrix group (11.0% points), and consequently, the interaction between gender and vaccine type disappeared while seropositivity remained high (87.7% and 91.3% in Havrix and Epaxal groups, respectively) among women approximately 2 years after vaccination. Further studies are needed to assess whether the seropositive rate would be maintained in
Hokkanen, Laura; Launes, Jyrki; Michelsson, Katarina
.0001) and inattention (p < 0.02) were more common in HB groups, but in adulthood the symptoms were equal. The affected HB had lower scores in parameters reflecting life satisfaction, less controlled drinking, but not increased substance abuse. Discussion. Our results indicate that neonatal HB has negative consequences in adult age. A prospectively collected cohort with strict inclusion criteria enables to control most of the bias factors involved with retrospective data. The control and HB groups were remarkably similar at birth in terms of medical data, and the growth environment of the children, as well as the parents' social groups, education, size of family, type of housing at birth and at 9 years of age. Our findings bear resemblance to disorders of the fronto-striatal network, and also symptoms of the ADHD spectrum were frequent in the HB group suggesting a link of HB to other neurodevelopmental disorders.
Antonova, A A; Absatova, K A; Korneev, A A; Kurgansky, A V
The production of drawing movements was studied in 29 right-handed children of 9-to-11 years old. The movements were the sequences of horizontal and vertical linear stokes conjoined at right angle (open polygonal chains) referred to throughout the paper as trajectories. The length of a trajectory varied from 4 to 6. The trajectories were presented visually to a subject in static (linedrawing) and dynamic (moving cursor that leaves no trace) modes. The subjects were asked to draw (copy) a trajectory in response to delayed go-signal (short click) as fast as possible without lifting the pen. The production latency time, the average movement duration along a trajectory segment, and overall number of errors committed by a subject during trajectory production were analyzed. A comparison of children's data with similar data in adults (16 subjects) shows the following. First, a substantial reduction in error rate is observed in the age range between 9 and 11 years old for both static and dynamic modes of trajectory presentation, with children of 11 still committing more error than adults. Second, the averaged movement duration shortens with age while the latency time tends to increase. Third, unlike the adults, the children of 9-11 do not show any difference in latency time between static and dynamic modes of visual presentation of trajectories. The difference in trajectory production between adult and children is attributed to the predominant involvement of on-line programming in children and pre-programming in adults.
Conway, Francine; Magai, Carol; Jones, Samuel; Fiori, Katherine; Gillespie, Michael
This study explores dynamic changes in network size and composition by examining patterns of older adults' social network change over time, that is: types of movements; the reason for the loss of network members; and the relation of movement and composition in concert. This study is a 6-year follow up of changes in the social networks of U.S.-Born Caucasian, African-American, and Caribbean older adults. One hundred and twenty-four community-dwelling older adults were interviewed during 2 data collection points over a 6-year period. Differences between Wave 1 and Wave 2 data were examined using paired sample t-tests confirmed with post-hoc tests and multivariate analyses. Results regarding types of movement showed that network changes were attributed to attrition--the "loss" of network members and a novel movement--the "addition" of network members not heretofore discussed. The results show an interaction between kinship status, ethnicity, and time--the attrition of non-kin members was underscored by ethnic differences. The type of network change was specific for type of network affiliation, such that children were more likely to be added to the networks of the young-old and kin were more likely to be lost in networks of the old-old. Older adults engage in social network interactions marked by compensatory processes beyond loss of network members such as social promotion and demotion. These social network processes are of emotional and functional significance for the older adult.
Broekemier, Greg M.
Surveyed adult college students regarding their motivation for attending college and the relative importance of college choice criteria. Getting better jobs, gaining general knowledge, and enhancement of self-esteem were most frequently mentioned. Availability of desired programs, days/times of needed classes, locations of courses, cost, and…
Majumder, Mondrita; Saha, Indranil; Chaudhuri, Debnath
This study was conducted to profile nutritional risk factors in a population of community-dwelling older adults in Kolkata, India. We applied the short version of the Mini Nutritional Assessment-Short Form (MNA-SF) questionnaire among 500 participants (65 to 75 years)--263 males and 237 females. The prevalence of undernutrition was 8.8% in females and 4.9% in males; a risk of undernutrition was found in 24.5% females and 17.5% males. All those with undernutrition or at-risk were studied further using the full version of the MNA. Data regarding education, occupation, socioeconomic status, and food intake pattern were also collected. Females had a significantly lower (P < 0.01) education level than males; 73.4% males were financially independent, whereas 72.7% females were financially dependent on others. Moderate appetite loss was commonly found (64.9%), and in 24.3% of the participants appetite loss was severe. Digestive and chewing problems were present in 32.4% and 21.6% of study participants, respectively. The rate of psychological stress and/or acute disease 3 months prior to study was 47%, and 62.2% of the study population were taking 3 or more medicines per day. Weight loss of greater than 3 kg and of 1 to 3 kg during past 3 months of the study period was observed in 27% and 32.5% of the population, respectively. Undernourished individuals were also found to consume fewer protein-rich foods. We hypothesize that low education levels and lack of financial independence were the strongest underlying causes of high undernutrition in this population, particularly, among females.
Esquivel, Amanda O.; Bruder, Adrienne; Ratkowiak, Kaitlyn; Lemos, Stephen E.
Background: An increase in soccer-related injuries occurred in the United States between 2000 and 2012; however, most studies of soccer-related injuries have only examined the pediatric population and not adults. Hypothesis: The number of soccer injuries is increasing in both the pediatric and adult populations. There are differences in injury types and counts when comparing male and female players within various age groups. Study Design: Descriptive epidemiology study. Level of Evidence: Level 4. Methods: This retrospective analysis surveyed the US Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) database from 2000 to 2012 for soccer-related injuries in children and adults aged 5 to 49 years. Results: From 2000 to 2012, there were an estimated 2,472,066 soccer-related injuries among 5- to 49-year-olds; 629,994 (25.5%) in adults (aged 20-49 years). The overall estimated pediatric injury count increased significantly over the time period (R2 = 0.764, P < 0.001). In the 20- to 49-year age range, there was also a significant increase in the estimated number of injuries over the 13-year period, from 41,292 injuries in 2000 to 55,743 in 2012 (R2 = 0.719, P < 0.001). The estimated injury counts for male players were significantly higher than female players in any given year for all age groups (P < 0.001). Girls aged 5 to 19 years were more likely to have lower extremity injuries than boys (odds ratio [OR], 1.256; 95% CI, 1.214-1.299; P < 0.001). The most common injuries reported were strain/sprains (33.3%), fractures (23.7%), and contusions and abrasions (17.4%) within the 5- to 49-year age category. In both sexes, strains and sprains were significantly lower among 5- to 19-year-olds in comparison with 20- to 49-year-olds (OR, 0.740; 95% CI, 0.714-0.766; P < 0.001). Conclusion: There are age- and sex-related differences in estimated injury count, body part injured, type of injury, and hospital admissions for soccer. Also
Bridges, Carolyn B; Coyne-Beasley, Tamera
Vaccines are recommended for adults on the basis of their age, prior vaccinations, health conditions, lifestyle, occupation, and travel. Reasons for current low levels of vaccination coverage for adult vaccines are multifactorial and include limited awareness among the public about vaccines for adults and gaps in incorporation of regular assessments of vaccine needs and vaccination into routine medical care. Updated standards for immunization of adults were approved by the National Vaccine Advisory Committee (NVAC) in September 2013. These standards acknowledge the current low levels of vaccination coverage among adults and the role that all health-care providers, including those who do not offer all recommended adult vaccines in their practices, have in ensuring that their patients are up-to-date on recommended vaccines. NVAC recommends that providers assess vaccination needs for their patients at each visit, recommend needed vaccines, and then, ideally, offer the vaccine or, if the provider does not stock the needed vaccines, refer the patient to a provider who does vaccinate. Vaccinating providers should also ensure that patients and their referring health-care providers have documentation of the vaccination.
Adachi, Paul J C; Willoughby, Teena
Given the extreme popularity of video games among older adolescents and emerging adults, the investigation of positive outcomes of video game play during these developmental periods is crucial. An important direction for research in this area is the investigation of a link between sports video game play and involvement in real-life sports among youth. Yet, this association has not been examined in the long-term among older adolescents and emerging adults, and thus represents an exciting new area for discovery. The primary goal of the current study, therefore, was to examine the long-term association between sports video game play and involvement in real-life sports clubs among older adolescents and emerging adults. In addition, we examined whether self-esteem was an underlying mechanism of this longitudinal association. We surveyed older adolescents and emerging adults (N = 1132; 70.6 % female; M age = 19.06 years, range of 17-25 years at the first assessment) annually over 3 years about their video game play, self-esteem, and involvement in real-life sports. We found a long-term predictive effect of sports video game play on increased involvement in real-life sports over the 3 years. Furthermore, we demonstrated that self-esteem was an underlying mechanism of this long-term association. Our findings make an important contribution to an emerging body of literature on the positive outcomes of video game play, as they suggest that sports video game play may be an effective tool to promote real-life sports participation and physical activity among older adolescents and emerging adults.
Numa, Soichiro; Kasai, Takashi; Kondo, Takayuki; Kushimura, Yukie; Kimura, Ayaka; Takahashi, Hisashi; Morita, Kanako; Tanaka, Akihiro; Noto, Yu-Ichi; Ohara, Tomoyuki; Nakagawa, Masanori; Mizuno, Toshiki
Acute disseminated encephalomyelitis (ADEM) followed by optic neuritis (ON) has been reported as a distinct phenotype associated with anti-myelin oligodendrocyte protein (MOG) antibody. We herein report the case of a 37-year-old woman who was diagnosed with ADEM at 4 years old of age and who subsequently developed ON followed by recurrent ADEM 33 years after the initial onset. A serum analysis showed anti-MOG antibody positivity. This phenotype has only previously been reported in pediatric cases. Neurologists thus need to be aware that the phenotype may occur in adult patients, in whom it may be assumed to be atypical multiple sclerosis.
Xu, Xianglong; Li, Bing; Liu, Lingli; Zhao, Yong
Culture and national care models matter both in reporting and treatment of pain status. However, most findings on body pain intensity and interference in adults are from Western studies, with little reliable evidence from China. This study aimed to assess body pain intensity and interference and its associations with demographic, socioeconomic characteristics, and health behaviors in adults. A cross-sectional survey was performed to collect data from 1224 adults, who were recruited via multistage stratified random sampling. The SF-36 quality-of-life instrument was used to investigate body pain intensity and interference. Ordinal logistic regression analysis was used in this study. Our results showed that 64.1% of the participants (males: 687; females: 537) reported body pain, and 45.7% of the participants reported body pain interference. Middle-aged respondents who were female, were unmarried/divorced or separated/widowed, had a negative relationship with their family, had poor sleep quality, and were not satisfied with their current living conditions had a higher body pain intensity rating (ordered logistic regression/six-level pain intensity criterion; odds ratios, p < 0.05). Respondents who were unmarried/divorced or separated/widowed, with a low education level, were unemployed, had lower incomes, had a negative relationship with their family, and were not satisfied with their current living conditions had a higher body pain interference rating (ordered logistic regression/five-level pain interference criterion; odds ratios, p < 0.05). In conclusion, an estimated 64.1% of middle-aged adults reported body pain, and 45.7% of middle-aged adults reported body pain interference. These results provide a clue for possible interventions for improving body pain intensity and interference in adults, especially among middle-aged people. These factors should be taken into consideration in the prevention of pain, pain management and treatment planning in order to help
Farber, D A; Machinskaia, R I; Kurganskiĭ, A V; Petrenko, N E
Functional interaction between prefrontal, temporal and tempo-parieto-occipital zones during preparation to recognition of incomplete linedrawings were analyzed in adults (n = 26) and children of 7-8 years old (n = 20). The strength of cortico-cortical interactions was estimated with the imaginary part of the complex-valued coherence at the frequency of alpha-rhythm (Jα). The Jα value was analyzed in the following three experimental conditions which corresponded to different stages of preparation to visual recognition: nonspecific sustained attention in the period preceding the cue (C1); focused attention in the period preceding a not-yet-recognized target stimulus (C2) and focused attention prior the successfully recognized stimulus (C3). When sustained attention changed to focused attention toward a target stimulus Jα increased in adults but decreased in children. Comparing Jα in the subgroups of both adults and children that showed highest recognition scores helped to uncover the age-related pattern of rearrangement of the cortico-cortical functional interactions in alpha-rhythm. That pattern was found to be hemisphere-specific and different at different stages of preparation to recognition of incomplete linedrawings. In adults, the maximal Jα were found in the left hemisphere during the period preceding the recognition of a target stimulus. At this stage of the functional preparatory tuning, in adults, Jα in the left hemisphere was significantly greater than in children. In adults, Jα related to the right hemisphere attained the highest values when attention was directed to not-yet-recognized stimuli. These values were significantly higher than similar values measured in children. In children, Jα reached its highest value during sustained attention. The characteristic pattern of functional interactions among prefrontal, temporal and temporo-parieto-occipital cortices that observed in children of 7-8 years old during preparatory functional tuning for the
Hackney, Madeleine E; Wolf, Steven L
Falls in older adults, which often result from decreased balance and mobility, are an important public health issue. The American College of Sports Medicine recommends multidimensional balance and mobility training to prevent falls. In the past 20 years, Tai Chi Chu'an (tai chi) has been found to be effective in improving balance, reducing falls and fear of falling for older adults. Efficient use of time devoted to exercise is critical; therefore, more research is needed into the underlying mechanisms of balance and mobility improvements in older adults as a result of tai chi practice, so that these interventions can be most targeted and efficient. The purpose of this integrative review is twofold. First, evidence is presented to show that balance and mobility have been improved by tai chi in older adults. Second, potential mechanisms of balance improvement from research conducted in longtime tai chi practitioners, and from clinical research conducted in older adults, are offered. A PubMed search with the terms "tai chi" and "balance" entered simultaneously was conducted. Articles were included if they were systematic reviews, pilot or clinical trials, related to both balance and tai chi, and/or specifically related to determining the mechanisms potentially underlying tai chi's effects. The systematic reviews and meta-analyses show that aspects of tai chi research findings remain equivocal. In spite of the inconclusiveness of these review findings, many researchers have considered tai chi worthy of further investigation. Furthermore, practitioners in the clinic and those who deliver exercise in the community have evidently embraced tai chi as an appropriate exercise for older adults. This review, spanning 2 decades, suggests that tai chi has impacted the health and health behaviors of many older adults. Going forward, informing novel balance and mobility rehabilitation by uncovering mechanisms of tai chi's effects definitively may be the most important area of
Ghenadenik, Adrian E.; Frohlich, Katherine L.; Gauvin, Lise
Young adults have the highest prevalence of smoking amongst all age groups. Significant uptake occurs after high school age. Although neighborhood exposures have been found to be associated with smoking behavior, research on neighborhood exposures and the smoking trajectories among young adults, and on the role of geographic scale in shaping findings, is scarce. We examined associations between neighborhood exposures across two nested, increasingly large spatial units and smoking trajectory over two years among young adults living in Montreal, Canada. A sample of 2093 participants aged 18–25 years from the Interdisciplinary Study of Inequalities in Smoking (ISIS) was surveyed. The dependent variable was self-reported smoking trajectory over the course of two years. Residential addresses, data on presence of tobacco retail outlets, and the presence of smoking accommodation facilities were coded and linked to spatial units. Three-level multinomial models were used to examine associations. The likelihood of being a smoker for 2+ years was significantly greater among those living in larger spatial unit neighborhoods that had a greater presence of smoking accommodation. This association was not statistically significant at the smaller spatial units. Our findings highlight the importance of studying young adults’ smoking trajectories in addition to static smoking outcomes, and point to the relevance of considering spatial scale in studies of neighborhoods and smoking. PMID:26751461
Juergens, Christine; Ruiz Palacios, Guillermo M.; Vazquez-Narvaez, Jorge; Enkerlin-Pauwells, Hermann Leo; Sundaraiyer, Vani; Pathirana, Sudam; Kalinina, Elena; Gruber, William C.; Scott, Daniel A.; Schmoele-Thoma, Beate
This open-label multicenter clinical trial conducted in Mexico assessed the immunogenicity and safety of a 13-valent pneumococcal conjugate vaccine (PCV13) in adults ≥50 years of age not previously vaccinated with the 23-valent pneumococcal polysaccharide vaccine (PPSV23). The PCV13 elicited a robust immune response in this study population, as reflected by the magnitude of fold rises in functional antibody levels measured by serotype-specific opsonophagocytic activity (OPA) assays before and 1 month after vaccination. Although the prevaccination OPA geometric mean titers (GMTs) for the majority of the serotypes were significantly lower in the 50- to 64-year age group than those in the ≥65-year age group, the postvaccination immune responses were generally similar. The overall immune responses were higher for the majority of the serotypes in the Mexican study population than those in similar adult study populations who received the PCV13 in Europe and the United States. PCV13 was well tolerated, and there were no vaccine-related serious adverse events. In conclusion, PCV13 is safe and immunogenic when administered to adults ≥50 years of age in Mexico and has the potential to protect against vaccine-type pneumococcal disease. (This study has been registered at ClinicalTrials.gov under registration no. NCT01432262.) PMID:25499011
van der Giessen, M; Rossouw, E; van Veen, T A; van Loghem, E; Zegers, B J; Sander, P C
The concentration of the four subclasses of IgG was determined in sera of normal adults and healthy children between 4 and 12 years of age, using the radial immunodiffusion technique. A relation between the concentration of IgG subclasses and Gm type was studied in adults. No influence of Gm type on IgG1 concentration could be shown, except that the group of Gm(fb) individuals had a higher level than the others. The mean concentration of IgG2 was higher in sera positive for Gm(n) than in those lacking this genetic marker. High IgG3 concentrations corresponded to the presence of Gm(b). No clearcut evidence was obtained for a relation between IgG4 concentration and Gm factors, although in general Gm(n) positive individuals had higher and Gm (zag) positive individuals lower concentrations of this subclass in their serum. Quantification of IgG subclasses in sera from healthy children of different ages revealed that the amount of IgG2 rises slowly with age, having not yet reached the adult level at the age of 12 years. This also holds for IgG4, although in a lesser degree. No significant differences from the adult level were found for the concentrations of IgG1 and IgG3. PMID:54236
Morrisroe, Shelby N; Rodriguez, Larissa V; Wang, Pin-Chieh; Smith, Ariana L; Trejo, Laura; Sarkisian, Catherine A
The prevalence of urinary incontinence (UI) among older urban Latinos is high. Insight into etiologies of and contributing factors to the development of this condition is needed. This longitudinal cohort study identified correlates of 1-year incidence of UI in older community-dwelling Latino adults participating in a senior center-based physical activity trial in Los Angeles, California. Three hundred twenty-eight Latinos aged 60 to 93 participating in Caminemos, a randomized trial to increase walking, were studied. Participants completed an in-person survey and physical performance measures at baseline and 1 year. UI was measured using the International Consultation on Incontinence item: "How often do you leak urine?" Potential correlates of 1-year incidence of UI included sociodemographic, behavioral, medical, physical, and psychosocial characteristics. The overall incidence of UI at 1 year was 17.4%. Incident UI was associated with age, baseline activity of daily living impairment, health-related quality of life (HRQoL), mean steps per day, and depressive symptoms. Multivariate logistic regression models revealed that improvement in physical performance score (odds ratio (OR) = 0.69, 95% confidence interval (CI) = 0.50-0.95) and high baseline physical (OR = 0.60, 95% CI = 0.40-0.89) and mental (OR = 0.62, 95% CI = 0.43-0.91) HRQoL were independently associated with lower rates of 1-year incident UI. An increase in depressive symptoms at 1 year (OR = 4.48, 95% CI = 1.02-19.68) was independently associated with a higher rate of incident UI. One-year UI incidence in this population of older urban Latino adults participating in a walking trial was high but was lower in those who improved their physical performance. Interventions aimed at improving physical performance may help prevent UI in older Latino adults.
Bent, Tessa; Atagi, Eriko
To acquire language and successfully communicate in multicultural and multilingual societies, children must learn to understand speakers with various accents and dialects. This study investigated adults' and 5- to 8-year-old children's perception of native- and nonnative-accented English sentences in noise. Participants' phonological memory and phonological awareness were assessed to investigate factors associated with individual differences in word recognition. Although both adults and children performed less accurately with nonnative talkers than native talkers, children showed greater performance decrements. Further, phonological memory was more closely tied to perception of native talkers whereas phonological awareness was more closely related to perception of nonnative talkers. These results suggest that the ability to recognize words produced in unfamiliar accents continues to develop beyond the early school-age years. Additionally, the linguistic skills most related to word recognition in adverse listening conditions may differ depending on the source of the challenge (i.e., noise, talker, or a combination).
Miller, Alicia S.; Shepherd, Gary R.; Fratantoni, Paula S.
Black sea bass (Centropristis striata) migrations are believed to play a role in overwinter survival and connectivity between juvenile and adult populations. This study investigated oceanographic drivers of winter habitat choice and regional differences between populations of juvenile and adult black sea bass. Trends in cohort strength, as a result of juvenile survival, were also identified. Oceanographic and fisheries survey data were analyzed using generalized additive models. Among the oceanographic variables investigated, salinity was the main driver in habitat selection with an optimal range of 33–35 practical salinity units (PSU) for both juveniles and adults. Preferred temperature ranges varied between juveniles and adults, but held a similar minimum preference of >8°C. Salinity and temperature ranges also differed by regions north and south of Hudson Canyon. Shelf water volume had less of an effect than temperature or salinity, but showed an overall negative relationship with survey catch. The effect of winter conditions on juvenile abundance was also observed across state and federal survey index trends. A lack of correlation observed among surveys in the fall paired with a strong correlation in the spring identifies the winter period as a factor determining year-class strength of new recruits to the population. A rank order analysis of spring indices identified three of the largest year classes occurring during years with reduced shelf water volumes, warmer winter shelf waters, and a 34 PSU isohaline aligned farther inshore. While greater catches of black sea bass in the northwest Atlantic Ocean remain south of Hudson Canyon, the species’ range has expanded north in recent years. PMID:26824350
Miller, Alicia S; Shepherd, Gary R; Fratantoni, Paula S
Black sea bass (Centropristis striata) migrations are believed to play a role in overwinter survival and connectivity between juvenile and adult populations. This study investigated oceanographic drivers of winter habitat choice and regional differences between populations of juvenile and adult black sea bass. Trends in cohort strength, as a result of juvenile survival, were also identified. Oceanographic and fisheries survey data were analyzed using generalized additive models. Among the oceanographic variables investigated, salinity was the main driver in habitat selection with an optimal range of 33-35 practical salinity units (PSU) for both juveniles and adults. Preferred temperature ranges varied between juveniles and adults, but held a similar minimum preference of >8°C. Salinity and temperature ranges also differed by regions north and south of Hudson Canyon. Shelf water volume had less of an effect than temperature or salinity, but showed an overall negative relationship with survey catch. The effect of winter conditions on juvenile abundance was also observed across state and federal survey index trends. A lack of correlation observed among surveys in the fall paired with a strong correlation in the spring identifies the winter period as a factor determining year-class strength of new recruits to the population. A rank order analysis of spring indices identified three of the largest year classes occurring during years with reduced shelf water volumes, warmer winter shelf waters, and a 34 PSU isohaline aligned farther inshore. While greater catches of black sea bass in the northwest Atlantic Ocean remain south of Hudson Canyon, the species' range has expanded north in recent years.
Kishi, Satoru; Armstrong, Anderson C; Gidding, Samuel S; Jacobs, David R; Sidney, Stephen; Lewis, Cora E; Schreiner, Pamela J; Liu, Kiang; Lima, João A C
Left ventricular (LV) mass and the LV ejection fraction (LVEF) are major independent predictors of future cardiovascular disease. The association of LV mass with the future LVEF in younger populations has not been studied. The aim of this study was to investigate the relation of LV mass index (LVMI) at ages 23 to 35 years to LV function after 20 years of follow-up in the Coronary Artery Risk Development in Young Adults (CARDIA) study. CARDIA is a longitudinal study that enrolled young adults in 1985 and 1986. In this study, participants with echocardiographic examinations at years 5 and 25 were included. LVMI and the LVEF were assessed using M-mode echocardiography at year 5 and using M-mode and 2-dimensional imaging at year 25. Statistical analytic models assessed the correlation between LVMI and LV functional parameters cross-sectionally and longitudinally. A total of 2,339 participants were included. The mean LVEF at year 25 was 62%. Although there was no cross-sectional correlation between LVMI and the LVEF at year 5, there was a small but statistically significant negative correlation between LVMI at year 5 and the LVEF 20 years later (r = -0.10, p <0.0001); this inverse association persisted for LVMI in the multivariate model. High LVMI was an independent predictor of systolic dysfunction (LVEF <50%) 20 years later (odds ratio 1.46, p = 0.0018). In conclusion, LVMI in young adulthood in association with chronic risk exposure affects systolic function in middle age; the antecedents of heart failure may occur at younger ages than previously thought.
Risquez, Angelica; Moore, Sarah; Morley, Michael
This study investigates the process of adjustment among adult learners by focusing on their own perceptions as they make the transition to higher education in an Irish setting, in order to gain a richer understanding about early university experience. The analysis of the journal-based reflections confirms existing insights about the complexity of…
Paxton, Carol L. C.; Leis, Micela; Rimm-Kaufman, Sara E.
This paper describes a mixed-methods pilot study that was conducted in collaboration with the developers of a new adult community-building intervention called "Leading Together" (LT), which focuses on strengthening relational trust among staff. The primary research focus of the collaboration was to gather and share descriptive…
Cooley, William W.; Lohnes, Paul R.
The primary purpose of this monograph is to describe the relationship between adolescent personality and the educational and vocational development of young adults, criteria for the latter being developed from the Project TALENT follow-up studies. This relationship seeking is set in a context of career development theory and a concern for guidance…
Lipman, Ellen L.; Georgiades, Katholiki; Boyle, Michael H.
Objective: Children of teen mothers exhibit adverse outcomes through adolescence. It is unclear whether these adverse outcomes extend to adulthood and apply to all of her children, or only those born when she was a teen. We examine the associations between young adult functioning and being born to a teen mother aged less than or equal to 20 years…
Wilens, Timothy E.; Martelon, MaryKate; Joshi, Gagan; Bateman, Clancey; Fried, Ronna; Petty, Carter; Biederman, Joseph
Objective: High rates of substance-use disorders (SUD) have been found in samples of adolescents and adults with attention-deficit/hyperactivity disorder (ADHD). Predictors of SUD in children with ADHD who are at risk for the development of SUDs remain understudied. The main aims of this study were to identify clinically meaningful characteristics…
Haines, Julie A.; Sigman-Grant, Madeleine; Brown, J. Lynne
Noting that children will adjust their food intake to their energy needs, and that offering a variety of foods often will increase their acceptance of new foods, this guide offers instruction on the proper feeding of children ages 3 to 5 in Pennsylvania's Child and Adult Care Food Program (CACFP). The menus presented in the guide follow the…
Males, Mike; Macallair, Dan
To examine the theory of growing criminality among today's youths, this study analyzes youth and adult crime rates in California from 1975 to 1991. Data were obtained from the California Department of Justice for arrest statistics by age, race, ethnicity, sex, and offense, statewide and by county and from the state department of finance. From 1978…
Keating, Gillian M
The live, attenuated shingles (herpes zoster) vaccine Zostavax(®) is approved in the EU for use in the prevention of herpes zoster and postherpetic neuralgia in adults aged ≥50 years. In adults aged ≥60 years, zoster vaccine reduced the burden of illness associated with herpes zoster, with reductions in the incidence of postherpetic neuralgia and herpes zoster, according to the results of the Shingles Prevention Study. Results of subsequent Short- and Long-Term Persistence Substudies indicate that the efficacy of zoster vaccine is maintained in the longer term, albeit with a gradual decline over time. In the Zostavax Efficacy and Safety Trial, zoster vaccine reduced the incidence of herpes zoster in adults aged 50-59 years. Findings of these studies are supported by the results of large, retrospective, cohort studies. Zoster vaccine was generally well tolerated, with injection-site adverse events being the most commonly reported adverse events. In conclusion, zoster vaccine provides an important opportunity to reduce the burden of illness associated with herpes zoster by reducing the incidence of herpes zoster and postherpetic neuralgia.
de Soárez, Patrícia Coelho; Sartori, Ana Marli Christovam; Freitas, Angela Carvalho; Nishikawa, Álvaro Mitsunori; Novaes, Hillegonda Maria Dutilh
Objective To evaluate the cost-effectiveness of introducing universal vaccination of adults aged 60 years with the 23-valent pneumococcal polysaccharide vaccine (PPV23) into the National Immunization Program (NIP) in Brazil. Methods Economic evaluation using a Markov model to compare two strategies: (1) universal vaccination of adults aged 60 years with one dose of PPV23 and 2) current practice (vaccination of institutionalized elderly and elderly with underlying diseases). The perspective was from the health system and society. Temporal horizon was 10 years. Discount rate of 5% was applied to costs and benefits. Clinical syndromes of interest were invasive pneumococcal disease (IPD) including meningitis, sepsis and others and pneumonia. Vaccine efficacy against IPD was obtained from a meta-analysis of randomized control trials and randomized studies, whereas vaccine effectiveness against pneumonia was obtained from cohort studies. Resource utilization and costs were obtained from the Brazilian Health Information Systems. The primary outcome was cost per life year saved (LYS). Univariate and multivariate sensitivity analysis were performed. Results The universal vaccination strategy avoided 7,810 hospitalizations and 514 deaths, saving 3,787 years of life and costing a total of USD$31,507,012 and USD$44,548,180, respectively, from the health system and societal perspective. The universal immunization would result in ICERs of USD$1,297 per LYS, from the perspective of the health system, and USD$904 per LYS, from the societal perspective. Conclusion The results suggest that universal vaccination of adults aged 60 years with the 23-valent pneumococcal polysaccharide vaccine (PPV23) is a very cost-effective intervention for preventing hospitalization and deaths for IPD and pneumonia is this age group in Brazil. PMID:26114297
Ostojic, Sergej M; Castagna, Carlo; Calleja-González, Julio; Jukic, Igor; Idrizovic, Kemal; Stojanovic, Marko
Talent identification and development in soccer is often biased by maturation-related differences of young athletes. However, there is no information available about success rates for youth maturing at different tempos to achieve success in elite adult soccer. The purposes of this study were to determine the prevalence of different maturational groups among boys playing soccer, and to track them for competence in adult performance. A prospective cohort study design was used to follow 55, 14-year-old boys playing in Serbian youth soccer Division I over eight years. At the age of 14, biological age using skeletal age rates was determined, and participants were categorized as early maturers (EaM), normal maturers (NoM), and late maturers (LaM). Game competence for adult soccer at age 22 was described as elite if an individual played for clubs competing in top-five international soccer leagues (La Liga, Premier League, Bundesliga, Serie A, and Ligue 1), and/or has become a member of an adult National team. Among boys in our study group, 43.8% were categorized as EaM, 35.4% as NoM, and 20.8% as LaM (P = 0.11). A significant difference in biological age was found among maturational groups at age 14, with EaM > NoM > LaM (P > 0.0001). When assessed for adult soccer competence, 33.3% of participants (16 out of 48 players) succeed in achieving elite level. Elite soccer competence acquired 60.1% players from the group of LaM, 38.1% from NoM, and 11.8% from EaM (P > 0.0001). Our comparative analysis suggests that soccer excludes early maturing boys and favors late maturing boys as level of performance increases.
Still's disease - adult; AOSD ... than 1 out of 100,000 people develop adult-onset Still's disease each year. It affects women more often than men. The cause of adult Still's disease is unknown. No risk factors for ...
Konan, K Eugene; Durand-Gasselin, Tristan; Kouadio, Y Justin; Flori, Albert; Rival, Alain; Duval, Yves; Pannetier, Catherine
This study was conducted over a period of 20 years, to assess the problems involved in developing subcultures over a very long period, of oil palm (Elaeis guineensis Jacq.) somatic embryos which were maintained in vitro on a Murashige and Skoog mineral-based culture medium, without growth regulators. Analysis of the proliferation rate of the embryogenic cultures, along with the survivability of the regenerated plantlets after their transfer into soil and of the flowering of the derived adult palms has been conducted for cultures maintained in vitro during 1 to 20 years. From the ninth year of maintenance, the tissue quality of the somatic embryos gradually began to decline. However, after more than 20 years, 30% of the 20 clones tested still continued to proliferate satisfactorily on the same maintenance medium, keeping their multiplication potential intact. Even though a depressive effect of the age of the lines has been observed on the survival capacity of plants under natural conditions, it is noteworthy that among the clones originating from 20-year-old cultures only eight of them (40%) have exhibited the "mantled" floral abnormality. Different hypotheses concerning the origin of the disruptions observed on the in vitro cultures, plantlets and adult palms that occur over a very long period of in vitro conservation are discussed.
Wakefield, Melanie; Coomber, Kerri; Zacher, Meghan; Durkin, Sarah; Brennan, Emily; Scollo, Michelle
Background We assessed whether the Australian plain packs with larger graphic health warnings (GHWs) achieved three specific objectives of reducing the appeal of tobacco, increasing health warning effectiveness and reducing the ability of packaging to mislead about smoking harms. Methods We compared responses from continuous cross-sectional telephone surveys of n=2176 cigarette smokers during pre-plain packaging (April–September 2012, pre-PP) with n=759 surveyed in the transition period (October–November 2012) and n=4240 during the first year of implementation (December 2012–November 2013, PP year 1), using multivariate logistic regression analyses. Results From pre-PP to PP year 1, more smokers disliked their pack (p<0.001), perceived lower pack appeal (p<0.001), lower cigarette quality (p<0.001), lower satisfaction (p<0.001) and lower value (p<0.001) and disagreed brands differed in prestige (p=0.003). There was no change in perceived differences in taste of different brands. More smokers noticed GHWs (p<0.001), attributed much motivation to quit to GHWs (p<0.001), avoided specific GHWs when purchasing (p<0.001), and covered packs (p<0.001), with no change in perceived exaggeration of harms. PP year 1 saw an increased proportion believing that brands do not differ in harmfulness (p=0.004), but no change in the belief that variants do not differ in strength or the perceived harmfulness of cigarettes compared with a year ago. Interactions signified greater change for four outcomes assessing aspects of appeal among young adults and two appeal outcomes among mid-aged adults. Conclusions The specific objectives of plain packaging were achieved and generally sustained among adult smokers up to 12 months after implementation.
Nishimura, Mayu; Robertson, Crystal; Maurer, Daphne
Adapting to a face shifts the perceived identity of a subsequent face in the direction opposite to the adapting face, a phenomenon known as a face identity aftereffect. In the present study, we examined the temporal dynamics of such aftereffects in children at an age when face processing abilities are not yet adult-like. We hypothesized that children's difficulties in face processing may stem from an unstable mental representation of facial identity, which may be especially prone to adaptation aftereffects. Using a novel procedure designed especially for children, we show that both 8-year-olds and adults demonstrate identity aftereffects of similarly small size after just one second of viewing the adapting face, and that the strength of the aftereffect increases logarithmically and similarly with longer adapting durations for both age groups. The findings suggest that the mental representation of facial identity in 8-year-olds is no more malleable than that of adults, at least in response to short-term adaptation.
Neria, Yuval; Gross, Raz; Litz, Brett; Maguen, Shira; Insel, Beverly; Seirmarco, Gretchen; Rosenfeld, Helena; Suh, Eun Jung; Kishon, Ronit; Cook, Joan; Marshall, Randall D
A Web-based survey of adults who experienced loss during the September 11, 2001, terrorist attacks was conducted to examine the prevalence and correlates of complicated grief (CG) 2.5-3.5 years after the attacks. Forty-three percent of a study group of 704 bereaved adults across the United States screened positive for CG. In multivariate analyses, CG was associated with female gender, loss of a child, death of deceased at the World Trade Center, and live exposure to coverage of the attacks on television. Posttraumatic stress disorder, major depression, anxiety, suicidal ideation, and increase in post-9/11 smoking were common among participants with CG. A majority of the participants with CG reported receiving grief counseling and psychiatric medication after 9/11. Clinical and policy implications are discussed.
Lacerte, G; Langlois, M-F; Doyon, M; Brown, C; Carpentier, A C; Hivert, M-F
The aim of the study was to evaluate the influence of weight gain and changes in adiposity distribution on insulin resistance and circulating adiponectin variations over 4 years in free-living normal weight young adults. In this prospective observational cohort (n=42 women, 18 men), anthropometric measurements and blood samples were collected in the fasting state at baseline and at 4 years. Insulin resistance was estimated using the homeostatic model assessment (HOMA-IR). Circulating adiponectin levels were determined by radioimmunoassay. To investigate increase in adiposity more specifically, subsidiary analyses were performed in a subgroup of individuals (n=31) who gained adiposity over the course of the 4-year follow-up (defined as gain >1% in percent body fat). Regression analyses were performed to adjust for sex, age, parental education, lifestyle, and fitness levels. At baseline, the participants were young adults (age=20.0 years old) in the normal weight range [body mass index (BMI)=22.7 kg/m2 (IQR=21.1-24.4)]. Median change in body fat percentage was +1.4% (IQR=-0.3-3.4; p=0.01) and in waist circumference was +1.2 cm (IQR=-2.6-5.3; p=0.05). In the subgroup of individuals who gained more than 1% body fat, increase in HOMA-IR was associated with an increase in BMI (r=0.44; p=0.01; p<0.01 in fully adjusted model), while decrease in adiponectin levels was associated with an increase in waist circumference (r=-0.38; p=0.03) but this was no longer significant after adjustment for sex and other potential confounders (p=0.14). In a population of young adults, small variations in adiposity within the normal weight range were associated with increase in insulin resistance.
Duberstein, Paul R.; Chapman, Benjamin P.; Tindle, Hilary A.; Sink, Kaycee M.; Bamonti, Patricia; Robbins, John; Jerant, Anthony F.; Franks, Peter
We conducted secondary analyses to determine the relationship between longstanding personality traits and risk for Alzheimer’s disease (AD) among 767 participants 72 years of age or older who were followed for more than 6 years. Personality was assessed with the NEO-FFI. We hypothesized that elevated Neuroticism, lower Openness, and lower Conscientiousness would be independently associated with risk of AD. Hypotheses were supported. The finding that AD risk is associated with elevated Neuroticism and lower Conscientiousness can be added to the accumulating literature documenting the pathogenic effects of these two traits. The link between lower Openness and AD risk is consistent with recent findings on cognitive activity and AD risk. Findings have implications for prevention research and for the conceptualization of the etiology of Alzheimer’s Disease. PMID:20973606
Kamath, Veena G.; Kulkarni, Muralidhar M.; Kamath, Asha; Shivalli, Siddharudha
Introduction According to Joint National Committee-7 (JNC-7) guidelines, a systolic blood pressure (SBP) of 120 to 139 mm Hg and/or diastolic blood pressure (DBP) of 80 to 89 mm Hg is considered as pre-hypertension. Existing evidence suggest that the cardiovascular morbidities are increasing among pre-hypertensive individuals compared to normal. Objective To assess the magnitude and factors associated with pre-hypertension among young adults (20–30 years) in coastal villages of Udupi Taluk (an area of land with a city or town that serves as its administrative centre and usually a number of villages), Udupi District, Karnataka state, India. Design Community based cross sectional study Setting 6 (out of total 14) coastal villages of Udupi Taluk, Karnataka state, India. Sample 1,152 young adults (age group: 20–30 years) selected by stratified random sampling in 6 coastal villages of Udupi Taluk, Karnataka state, India Method A semi structured pre-tested questionnaire was used to elicit the details on socio-demographic variables, dietary habits, tobacco use, alcohol consumption, physical activity, family history of hypertension and stress levels. Anthropometric measurements and blood pressure were recorded according to standard protocols. Serum cholesterol was measured in a sub sample of the study population. Multivariate logistic regression was applied to identify the independent correlates of pre-hypertension among young adults (20–30 years). Main Outcome Measures Prevalence, Odds ratio (OR) and adjusted (adj) OR for pre-hypertension among young adults (20–30 years). Results The prevalence of pre-hypertension in the study population was 45.2% (95%CI: 42.4–48). Multivariate logistic regression analysis revealed that age group of 25–30 years (adj OR: 4.25, 95% CI: 2.99–6.05), white collared (adj OR: 2.29, 95% CI: 1.08–4.85) and skilled occupation (adj OR: 3.24, 95% CI: 1.64–6.42), students (adj OR: 2.46, 95% CI: 1.22–4.95), using refined cooking oil
Casagrande, Sarah S.; Menke, Andy; Cowie, Catherine C.
Background The health of younger adults in the U.S. has important public health and economic-related implications. However, previous literature is insufficient to fully understand how the health of this group has changed over time. This study examined generational differences in cardiovascular risk factors of younger adults over the past 40 years. Methods Data were from 6 nationally representative cross-sectional National Health and Nutrition Examination Surveys (1971–2012; N = 44,670). Participants were adults age 20–49 years who self-reported sociodemographic characteristics and health conditions, and had examination/laboratory measures for hypertension, hyperlipidemia, diabetes, obesity, and chronic kidney disease. Prevalences of sociodemographic characteristics and health status were determined by study period. Logistic regression was used to determine the odds [odds ratio (OR), 95% confidence interval] of health conditions by study period: models adjusted only for age, sex, and race, and fully adjusted models additionally adjusted for socioeconomic characteristics, smoking, BMI, diabetes, and/or hypertension (depending on the outcome) were assessed. Results Participants in 2009–2012 were significantly more likely to be obese and have diabetes compared to those in 1971–1975 (OR = 4.98, 3.57–6.97; OR = 3.49, 1.59–7.65, respectively, fully adjusted). Participants in 2009–2012 vs. 1988–1994 were significantly more likely to have had hypertension but uncontrolled hypertension was significantly less likely (OR = 0.67, 0.52–0.86, fully adjusted). There was no difference over time for high cholesterol, but uncontrolled high cholesterol was significantly less likely in 2009–2012 vs. 1988–1994 (OR = 0.80, 0.68–0.94, fully adjusted). The use of hypertensive and cholesterol medications increased while chronic kidney and cardiovascular diseases were relatively stable. Conclusions Cardiovascular risk factors of younger U.S. adults have worsened over
Slopen, Natalie; Kontos, Emily Zobel; Ryff, Carol D.; Ayanian, John Z.; Albert, Michelle A.; Williams, David R.
Purpose Year-to-year decreases in smoking in the US have been observed only sporadically in recent years, which suggest a need for intensified efforts to identify those at risk for persistent smoking. To address this need, we examined the association between a variety of psychosocial stressors and smoking persistence, cessation, and relapse over 9–10 years among adults in the United States (N=4938, ages 25–74). Methods Using information provided at baseline and follow-up, participants were categorized as non-smokers, persistent smokers, ex-smokers, and relapsed smokers. Stressors related to relationships, finances, work-family conflict, perceived inequality, neighborhood, discrimination, and past-year family problems were assessed at baseline and follow-up. Results High stress at both assessments was associated with greater odds of persistent smoking for stressors related to relationships, finances, work, perceived inequality, past-year family problems, and a summary score. Among respondents who were smokers at baseline, high stress at both time-points for relationship stress, perceived inequality, and past-year family problems was associated with nearly double the odds of failure to quit. Conclusions Interventions to address psychosocial stress may be important components within smoking cessation efforts. PMID:23860953
Vela-Bueno, Antonio; Fernandez-Mendoza, Julio; Olavarrieta-Bernardino, Sara; Vgontzas, Alexandros N.; Bixler, Edward O.; de la Cruz-Troca, Juan Jose; Rodriguez-Munoz, Alfredo; Olivan-Palacios, Jesus
Objective: Between November 2002 and March 2003, the authors assessed the prevalence and correlates of napping among Spanish university students. Participants: The sample comprised 1,276 first-year university students; the mean age was 18.74 [plus or minus] 1.24 years, and 35.45% were men. Methods: The study was cross-sectional, and the students…
Rouse, Chaturia; Gittleman, Haley; Ostrom, Quinn T.; Kruchko, Carol; Barnholtz-Sloan, Jill S.
Background Years of potential life lost (YPLL) complement incidence and survival rates by measuring how much a patient's life is likely to be shortened by his or her cancer. In this study, we examine the impact of death due to brain and other central nervous system (CNS) tumors compared to other common cancers in adults by investigating the YPLL of adults in the United States. Methods Mortality and life table data were obtained from the Centers for Disease Control and Prevention's National Center for Health Statistics Vital Statistics Data for 2010. The study population included individuals aged 20 years or older at death who died from one of the selected cancers. YPLL was calculated by taking an individual's age at death and finding the corresponding expected remaining years of life using life table data. Results The cancers with the greatest mean YPLL were other malignant CNS tumors (20.65), malignant brain tumors (19.93), and pancreatic cancer (15.13) for males and malignant brain tumors (20.31), breast cancer (18.78), and other malignant CNS tumors (18.36) for females. For both sexes, non-Hispanic whites had the lowest YPLL, followed by non-Hispanic blacks, and Hispanics. Conclusion Malignant brain and other CNS tumors have the greatest mean YPLL, thereby reflecting their short survival time post diagnosis. These findings will hopefully motivate more research into mitigating the impact of these debilitating tumors. PMID:26459813
Sbarra, David A; Emery, Robert E
Using statistically imputed data to increase available power, this article reevaluated the long-term effects of divorce mediation on adults' psychological adjustment and investigated the relations among coparenting custody conflict, nonacceptance of marital termination, and depression at 2 occasions over a decade apart following marital dissolution. Group comparisons revealed that fathers and parents who mediated their custody disputes reported significantly more nonacceptance at the 12-year follow-up assessment. Significant interactions were observed by gender in regression models predicting nonacceptance at the follow-up; mothers' nonacceptance was positively associated with concurrent depression, whereas fathers' nonacceptance was positively associated with early nonacceptance and negatively associated with concurrent conflict.
Stepien, Karolina M; Hendriksz, Christian J; Roberts, Mark; Sharma, Reena
Pompe disease is an autosomal recessive disease resulting from deficiency of the acid alpha-glucosidase (GAA). The late-onset Pompe Disease (LOPD) patients develop muscular and respiratory complications later in life. We describe a retrospective observational cohort study including 22 patients with LOPD. The cohort was assessed at baseline before Enzyme Replacement Therapy (ERT) with alglucosidase alpha (20mg/kg biweekly) was commenced and subsequently relevant information was collected at 2, 4 and 5years later. The median age of the patients at study entry was 44years (16-64years), with median disease duration of 11.5years (4-31years). At baseline, 10 patients (45%) could walk without support, 12 (55%) could walk with unilateral or bilateral support including 3/12 were wheelchair bound. Mean predicted FVC % was 55.7 (95% CI 45-66) of predicted normal at baseline and showed no significant change after 5years (54.6 (95% CI 43-66)), (all p=0.9815). Mean FVC % supine was 41.8 (95% CI 33.8-49) of predicted normal at baseline and remained significantly unchanged at 5years (48.4 (95% CI 37-59.6)), (all p=0.8680). The overnight non-invasive ventilator dependence increased by 18.2% as compared with baseline and requirement of mobility aids increased during this period by 5.2% as compared with the baseline. Mean walking distance at 6min walk test was 411.5 (95% CI 338-485) at baseline, 266.5 (95% CI 187-346) m at 2years, 238.6 (95% CI 162-315) m at 4years and 286.8 (95% CI 203-370) m at 5years (p=0.1981; ANOVA was completed only for 14 patients). A gradual decline in FVC% predicted was noted only in four cases and a decline in FVC% supine in two other. Only one patient showed a decline in both pulmonary function tests. In all remaining cases (17/22) respiratory function remains stable. In conclusion overall pulmonary function tests and mobility remained stable for 5years in majority of patients on ERT. However, in some patients they continued to decline in spite of ERT
Kim, Eric S; Sun, Jennifer K; Park, Nansook; Kubzansky, Laura D; Peterson, Christopher
This study examined whether purpose in life was associated with myocardial infarction among a sample of older adults with coronary heart disease after adjusting for relevant sociodemographic, behavioral, biological, and psychological factors. Prospective data from the Health and Retirement Study-a nationally representative panel study of American adults over the age of 50-were used. Analyses were conducted on the subset of 1,546 individuals who had coronary heart disease at baseline. Greater baseline purpose in life was associated with lower odds of having a myocardial infarction during the 2-year follow-up period. On a six-point purpose in life measure, each unit increase was associated with a multivariate-adjusted odds ratio of 0.73 for myocardial infarction (95% CI, 0.57-0.93, P = .01). The association remained significant after controlling for coronary heart disease severity, self-rated health, and a comprehensive set of possible confounds. Higher purpose in life may play an important role in protecting against myocardial infarction among older American adults with coronary heart disease.
Dumont, Shireen; Marques-Vidal, Pedro; Favrod-Coune, Thierry; Theler, Jean-Marc; Gaspoz, Jean-Michel; Broers, Barbara; Guessous, Idris
Objective Evidence on the impact of legislative changes on individual alcohol consumption is limited. Using an observational study design, we assessed trends in individual alcohol consumption of a Swiss adult population following the public policy changes that took place between 1993 and 2014, while considering individual characteristics and secular trends. Design Cross-sectional study. Setting Swiss general adult population. Participants Data from 18 963 participants were collected between 1993 and 2014 (aged 18–75 years). Outcome measures We used data from the ‘Bus Santé’ study, an annual health survey conducted in random samples of the adult population in the State of Geneva, Switzerland. Individual alcohol intake was assessed using a validated food frequency questionnaire. Individual characteristics including education were self-reported. 7 policy changes (6 about alcohol and 1 about tobacco) that occurred between 1993 and 2014 defined 6 different periods. We predicted alcohol intake using quantile regression with multivariate analysis for each period adjusting for participants' characteristics and tested significance periods. Sensitivity analysis was performed including drinkers only, the 10th centile of highest drinkers and smoker's status. Results Between 1993 and 2014, participants' individual alcohol intake decreased from 7.1 to 5.4 g/day (24% reduction, p<0.001). Men decreased their alcohol intake by 34% compared with 22% for women (p<0.001). The decrease in alcohol intake remained significant when considering drinkers only (28% decrease, p<0.001) and the 10th centile highest drinkers (24% decrease, p<0.001). Consumption of all alcoholic beverages decreased between 1993 and 2014 except for the moderate consumption of beer, which increased. After adjustment for participants' characteristics and secular trends, no independent association between alcohol legislative changes and individual alcohol intake was found. Conclusions Between 1993 and
Hawkley, Louise C.; Thisted, Ronald A.; Masi, Christopher M.; Cacioppo, John T.
Loneliness is a prevalent social problem with serious physiological and health implications. However, much of the research to date is based on cross-sectional data, including our own earlier finding that loneliness was associated with elevated blood pressure. In this study, we tested the hypothesis that the effect of loneliness accumulates to produce greater increases in SBP over a four-year period than are observed in less lonely individuals. A population-based sample of 229 50–68 year-old White, Black, and Hispanic men and women in the Chicago Health, Aging, and Social Relations Study was tested annually for each of five consecutive years. Cross-lagged panel analyses revealed that loneliness at study onset predicted increases in SBP 2, 3, and 4 years later (B = 0.152, SE = 0.091, p < .05, one-tailed). These increases were cumulative such that higher initial levels of loneliness were associated with greater increases in SBP over a 4-year period. The effect of loneliness on SBP was independent of age, gender, race/ethnicity, cardiovascular risk factors, medications, health conditions, and the effects of depressive symptoms, social support, perceived stress, and hostility. PMID:20230134
Hartwig, Andreas; Charman, William Neil; Radhakrishnan, Hema
Purpose To determine whether the initial characteristics of individual patterns of peripheral refraction relate to subsequent changes in refraction over a one-year period. Methods 54 myopic and emmetropic subjects (mean age: 24.9 ± 5.1 years; median 24 years) with normal vision were recruited and underwent conventional non-cycloplegic subjective refraction. Peripheral refraction was also measured at 5° intervals over the central 60° of horizontal visual field, together with axial length. After one year, measurements of subjective refraction and axial length were repeated on the 43 subjects who were still available for examination. Results In agreement with earlier studies, higher myopes tended to show greater relative peripheral hyperopia. There was, however, considerable inter-subject variation in the pattern of relative peripheral refractive error (RPRE) at any level of axial refraction. Across the group, mean one-year changes in axial refraction and axial length did not differ significantly from zero. There was no correlation between changes in these parameters for individual subjects and any characteristic of their RPRE. Conclusion No evidence was found to support the hypothesis that the pattern of RPRE is predictive of subsequent refractive change in this age group. PMID:26188389
Tiba, Fabrice; Nauwelaers, Frans; Traoré, Siaka; Coulibaly, Boubacar; Ouedraogo, Thierry; Compaoré, Adama; Kräusslich, Hans-Georg; Böhler, Thomas
There are no data on the outcome of highly active antiretroviral therapy (HAART) in HIV-infected adults in rural Burkina Faso. We therefore assessed CD4+ T-cell counts and HIV-1 plasma viral load (VL), the proportion of naive T-cells (co-expressing CCR7 and CD45RA) and T-cell activation (expression of CD95 or CD38) in 61 previously untreated adult patients from Nouna, Burkina Faso, at baseline and 2 weeks, 1, 3, 6, 9 and 12 months after starting therapy. Median CD4+ T-cell counts increased from 174 (10th-90th percentile: 33-314) cells/µl at baseline to 300 (114- 505) cells/µl after 3 months and 360 (169-562) cells/µl after 12 months of HAART. Median VL decreased from 5.8 (4.6- 6.6) log10 copies/ml at baseline to 1.6 (1.6-2.3) log10 copies/ml after 12 months. Early CD4+ T-cell recovery was accompanied by a reduction of the expression levels of CD95 and CD38 on T-cells. Out of 42 patients with complete virological follow-up under HAART, 19 (45%) achieved concordant good immunological (gain of ≥100 CD4+ T-cells/µl above baseline) and virological (undetectable VL) responses after 12 months of treatment (intention-to-treat analysis). Neither a decreased expression of the T-cell activation markers CD38 and CD95, nor an increase in the percentage of naive T-cells reliably predicted good virological treatment responses in patients with good CD4+ T-cell reconstitution. Repeated measurement of CD4+ T-cell counts during HAART remains the most important parameter for immunologic monitoring. Substitution of repeated VL testing by determination of T-cell activation levels (e.g., CD38 expression on CD8+ T-cells) should be applied with caution. PMID:22435082
Al-Sobaihi, Saber; Nakamura, Keiko; Kizuki, Masashi
Objective: This study examined the associations between the adequacy of childcare provided by adult caretakers and childhood undernutrition in rural Yemen, independent of household wealth and food consumption. Methods: We analyzed data of 3,549 children under the age of 5 years living in rural areas of Yemen based on the 2013 Yemen Baseline Survey of Mother and Child Health. Nutritional status was evaluated by the presence of underweight, stunting, and wasting according to the World Health Organization child growth standards. The impact of childcare including leaving children alone, putting older children into labor force, and the use of antenatal care while pregnant on child undernutrition was assessed and adjusted for food consumption by children, household composition, demographic and educational background of caretakers, and household wealth. Results: The prevalence of underweight, stunting, and wasting was 46.2%, 62.6%, and 11.1%, respectively. Not leaving children alone, keeping children out of the labor force, and use of antenatal care were associated with a lower risk of underweight (odds ratio [OR] = 0.84, P = 0.016; OR = 0.84, P = 0.036; and OR = 0.85, P = 0.042) and stunting (OR = 0.80, P = 0.004; OR = 0.82, P = 0.024; and OR = 0.78, P = 0.003). After further adjustment for food consumption, the associations between adequate childcare indicators and lower odds of stunting remained significant (OR = 0.73, P = 0.025; OR = 0.72, P = 0.046; and OR = 0.76, P = 0.038). Conclusions: A marked prevalence of stunting among rural children in Yemen was observed. Adequate childcare by adult caretakers in families is associated with a lower incidence of underweight and stunting among children under 5 years of age. Promoting adequate childcare by adult household members is a feasible option for reducing undernutrition among children in rural Yemen. PMID:27928456
Al-Sobaihi, Saber; Nakamura, Keiko; Kizuki, Masashi
Objective: This study examined the associations between the adequacy of childcare provided by adult caretakers and childhood undernutrition in rural Yemen, independent of household wealth and food consumption. Methods: We analyzed data of 3,549 children under the age of 5 years living in rural areas of Yemen based on the 2013 Yemen Baseline Survey of Mother and Child Health. Nutritional status was evaluated by the presence of underweight, stunting, and wasting according to the World Health Organization child growth standards. The impact of childcare including leaving children alone, putting older children into labor force, and the use of antenatal care while pregnant on child undernutrition was assessed and adjusted for food consumption by children, household composition, demographic and educational background of caretakers, and household wealth. Results: The prevalence of underweight, stunting, and wasting was 46.2%, 62.6%, and 11.1%, respectively. Not leaving children alone, keeping children out of the labor force, and use of antenatal care were associated with a lower risk of underweight (odds ratio [OR] = 0.84, P = 0.016; OR = 0.84, P = 0.036; and OR = 0.85, P = 0.042) and stunting (OR = 0.80, P = 0.004; OR = 0.82, P = 0.024; and OR = 0.78, P = 0.003). After further adjustment for food consumption, the associations between adequate childcare indicators and lower odds of stunting remained significant (OR = 0.73, P = 0.025; OR = 0.72, P = 0.046; and OR = 0.76, P = 0.038). Conclusions: A marked prevalence of stunting among rural children in Yemen was observed. Adequate childcare by adult caretakers in families is associated with a lower incidence of underweight and stunting among children under 5 years of age. Promoting adequate childcare by adult household members is a feasible option for reducing undernutrition among children in rural Yemen.
Bai, Jianling; Xun, Pengcheng; Morris, Steve; Jacobs, David R; Liu, Kiang; He, Ka
Studies suggest that chromium deficiency is associated with elevated levels of fasting blood glucose, circulating insulin, cholesterol and triglycerides, and decreased proportion of lean body mass. However, data directly relating chromium levels to metabolic syndrome (MetS) risk are lacking. A total of 3,648 American adults from the Coronary Artery Risk Development in Young Adults (CARDIA) study, aged 20-32 years, were prospectively examined for the incidence of MetS and its five components from 1987-88 to 2010-11. Baseline toenail chromium levels were measured with instrumental neutron-activation analysis. Incident MetS was defined by the NCEP-ATP III criteria. During the 23-year follow-up, 878 incident MetS cases were identified. Baseline toenail chromium was inversely associated with incidence of MetS as well as its blood lipid components. The multivariable-adjusted hazard ratio (HR) (95% confidence interval [CI]) of MetS comparing the highest to the lowest quartiles of toenail chromium levels was 0.80 (0.66-0.98; Plinear trend = 0.006). The adjusted HRs were 0.82 (0.68-0.98; Ptrend = 0.045) for having abnormal triglycerides levels and 0.75 (0.64-0.88; Ptrend = 0.030) for having abnormal HDL cholesterol levels. Toenail chromium levels were inversely and longitudinally associated with incidence of MetS in American young adults. This inverse association was mainly explained by its relation to blood lipids.
Bonar, Erin E; Walton, Maureen A; Epstein-Ngo, Quyen M; Zimmerman, Marc A; Blow, Frederic C; Cunningham, Rebecca M
Among 14-24 year-olds who used drugs and were recruited from an emergency department, we examined 2-year trajectories of sexual risk behaviors. We hypothesized that those in higher risk trajectories would have more severe substance use, mental health concerns, and dating violence involvement at baseline. Analyses identified three behavioral trajectories. Individuals in the highest risk trajectory had a more severe profile of baseline alcohol use, marijuana use, dating violence involvement, and mental health problems. Future research will examine longitudinal differences in risk factors across trajectories. Understanding risk factors for sexual risk behavior trajectories can inform the delivery and tailoring of prevention interventions.
Brossier, D; Villedieu, F; Letouzé, N; Pinto Da Costa, N; Jokic, M
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.
Yen, Irene H.; Flood, Johnna Fandel; Thompson, Hannah; Anderson, Lynda A.; Wong, Geoff
Objective The objective of this study was to determine the environmental features that best support aging in place. Method We conducted a realist synthesis, a theory-driven interpretive method of evidence synthesis, of 120+ articles (published 1991–2011) that attempts to explain how place may influence older adults’ decisions about mobility (e.g., physical activity). We developed an initial program theory, reviewed the literature, identified outcomes, analyzed and synthesized patterns, and created a final program theory. Results Safety was a central mechanism, serving as one of the bridges between environmental components (e.g., connectivity, aesthetics, retail and services) and decisions about mobility. Population density, sidewalk presence, and park proximity did not emerge as key factors. Discussion Safety considerations are one of the most prominent influences of older adults’ decisions about mobility. Street connectivity, pedestrian access and transit, and retail and services were also important. These factors are amenable to change and can help promote mobility for older adults. PMID:24788714
Mathias, Jason Scott; Agrawal, Ankit; Feinglass, Joe; Cooper, Andrew J; Baker, David William; Choudhary, Alok
Objective Incorporating accurate life expectancy predictions into clinical decision making could improve quality and decrease costs, but few providers do this. We sought to use predictive data mining and high dimensional analytics of electronic health record (EHR) data to develop a highly accurate and clinically actionable 5 year life expectancy index. Materials and methods We developed the index using EHR data for 7463 patients ≥50 years old with ≥1 visit(s) in 2003 to a large, academic, multispecialty group practice. We extracted 980 attributes from the EHRs of the practices and affiliated hospitals. Correlation feature selection with greedy stepwise search was used to find the attribute subset with best average merit. Rotation forest ensembling with alternating decision tree as underlying classifier was used to predict 5 year mortality. Model performance was compared with the modified Charlson Comorbidity Index and the Walter life expectancy method. Results Within 5 years of the last visit in 2003, 838 (11%) patients had died. The final model included 24 attributes: two demographic (age, sex), 10 comorbidity (eg, cardiovascular disease), one vital sign (mean diastolic blood pressure), two medications (loop diuretic use, digoxin use), six laboratory (eg, mean albumin), and three healthcare utilization (eg, the number of hospitalizations 1 year prior to the last visit in 2003). The index showed very good discrimination (c-statistic 0.86) and outperformed comparators. Conclusions The EHR based index successfully distinguished adults ≥50 years old with life expectancy >5 years from those with life expectancy ≤5 years. This information could be used clinically to optimize preventive service use (eg, cancer screening in the elderly). PMID:23538722
Ari, Lilac Lev; Shulman, Shmuel
One hundred and fifty Israeli first-year college students were assessed twice: during the first semester following the commencement of their undergraduate studies and toward the end of the second semester. At each semester, participants completed web-based daily diaries for seven consecutive days assessing daily sleep, affective mood, stress, and…
Taylor, Julie Lounds; Mailick, Marsha R.
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…
George, James D.; Bradshaw, Danielle I.; Hyde, Annette; Vehrs, Pat R.; Hager, Ronald L.; Yanowitz, Frank G.
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…
Sussman, Steve; Rohrbach, Louise A.; Spruijt-Metz, Donna; Barnett, Elizabeth; Lisha, Nadra; Sun, Ping
The leading substance of misuse among teens after tobacco, alcohol, and marijuana is the use of pain killers. Very few longitudinal studies on prediction of pain killer use have been conducted among teens. This study examined the 1-year prediction of self-reported last 30-day pain killer use controlling for baseline 30-day painkiller use among…
Holden, Libby; Ware, Robert S.; Lee, Christina
This article used data from 5,171 young women participating in the Australian Longitudinal Study on Women's Health, a nationally representative longitudinal cohort study, to identify longitudinal trajectory patterns of mental health across 6 surveys over 16 years of early adulthood, from age 18-23 to age 34-39. In addition, we identified both…
Hughes, Catherine F.; Ward, Mary; Tracey, Fergal; Hoey, Leane; Molloy, Anne M.; Pentieva, Kristina; McNulty, Helene
Advancing age can be associated with an increase in cognitive dysfunction, a spectrum of disability that ranges in severity from mild cognitive impairment to dementia. Folate and the other B-vitamins involved in one-carbon metabolism are associated with cognition in ageing but the evidence is not entirely clear. The hypothesis addressed in this study was that lower dietary intake or biomarker status of folate and/or the metabolically related B-vitamins would be associated with a greater than expected rate of cognitive decline over a 4-year follow-up period in healthy older adults. Participants (aged 60–88 years; n = 155) who had been previously screened for cognitive function were reassessed four years after initial investigation using the Mini-Mental State Examination (MMSE). At the 4-year follow-up assessment when participants were aged 73.4 ± 7.1 years, mean cognitive MMSE scores had declined from 29.1 ± 1.3 at baseline to 27.5 ± 2.4 (p < 0.001), but some 27% of participants showed a greater than expected rate of cognitive decline (i.e., decrease in MMSE > 0.56 points per year). Lower vitamin B6 status, as measured using pyridoxal-5-phosphate (PLP; <43 nmol/L) was associated with a 3.5 times higher risk of accelerated cognitive decline, after adjustment for age and baseline MMSE score (OR, 3.48; 95% CI, 1.58 to 7.63; p < 0.05). Correspondingly, lower dietary intake (0.9–1.4 mg/day) of vitamin B6 was also associated with a greater rate of cognitive decline (OR, 4.22; 95% CI, 1.28–13.90; p < 0.05). No significant relationships of dietary intake or biomarker status with cognitive decline were observed for the other B-vitamins. In conclusion, lower dietary and biomarker status of vitamin B6 at baseline predicted a greater than expected rate of cognitive decline over a 4-year period in healthy older adults. Vitamin B6 may be an important protective factor in helping maintain cognitive health in ageing. PMID:28075382
Sussman, Steve; Rohrbach, Louise A; Spruijt-Metz, Donna; Barnett, Elizabeth; Lisha, Nadra; Sun, Ping
The leading substance of misuse among teens after tobacco, alcohol, and marijuana is the use of pain killers. Very few longitudinal studies on prediction of pain killer use have been conducted among teens. This study examined the 1-year prediction of self-reported last 30-day pain killer use controlling for baseline 30-day painkiller use among 1186 alternative high school youth in California. Among demographic, behavioral, psychosocial, and environmental predictors, a multivariable model indicated that: (a) relatively higher levels of baseline pain killer use; (b) white ethnicity; (c) relatively lower levels of depressive symptoms (contrary to previous studies); and (d) those who live with both parents were more likely to report use of pain killer medications in the next year. It is speculated that those with relatively greater access to pain medication, within an at-risk social environment, are those who will use it later on.
Marques-Vidal, Pedro; Rousi, Eirini; Paccaud, Fred; Gaspoz, Jean-Michel; Theler, Jean-Marc; Bochud, Murielle; Stringhini, Silvia; Guessous, Idris
We assessed trends in dietary intake according to gender and education using repeated cross-sectional, population-based surveys conducted between 1993 and 2012 in Geneva, Switzerland (17,263 participants, 52.0 ± 10.6 years, 48% male). In 1993-1999, higher educated men had higher monounsaturated fatty acids (MUFA), carotene and vitamin D intakes than lower educated men, and the differences decreased in 2006-2012. In 1993-1999, higher educated women had higher fiber, iron, carotene, vitamin D and alcohol intakes than lower educated women, and the differences decreased in 2006-2012. Total energy, polyunsaturated fatty acids, retinol and alcohol intakes decreased, while mono/disaccharides, MUFA and carotene intake increased in both genders. Lower educated men had stronger decreases in saturated fatty acid (SFA) and calcium intakes than higher educated men: multivariate-adjusted slope and 95% confidence interval -0.11 (-0.15; -0.06) vs. -0.03 (-0.08; 0.02) g/day/year for SFA and -5.2 (-7.8; -2.7) vs. -1.03 (-3.8; 1.8) mg/day/year for calcium, p for interaction <0.05. Higher educated women had a greater decrease in iron intake than lower educated women: -0.03 (-0.04; -0.02) vs. -0.01 (-0.02; 0.00) mg/day/year, p for interaction = 0.002. We conclude that, in Switzerland, dietary intake evolved similarly between 1993 and 2012 in both educational groups. Educational differences present in 1993 persisted in 2012.
Marques-Vidal, Pedro; Rousi, Eirini; Paccaud, Fred; Gaspoz, Jean-Michel; Theler, Jean-Marc; Bochud, Murielle; Stringhini, Silvia; Guessous, Idris
We assessed trends in dietary intake according to gender and education using repeated cross-sectional, population-based surveys conducted between 1993 and 2012 in Geneva, Switzerland (17,263 participants, 52.0 ± 10.6 years, 48% male). In 1993–1999, higher educated men had higher monounsaturated fatty acids (MUFA), carotene and vitamin D intakes than lower educated men, and the differences decreased in 2006–2012. In 1993–1999, higher educated women had higher fiber, iron, carotene, vitamin D and alcohol intakes than lower educated women, and the differences decreased in 2006–2012. Total energy, polyunsaturated fatty acids, retinol and alcohol intakes decreased, while mono/disaccharides, MUFA and carotene intake increased in both genders. Lower educated men had stronger decreases in saturated fatty acid (SFA) and calcium intakes than higher educated men: multivariate-adjusted slope and 95% confidence interval −0.11 (−0.15; −0.06) vs. −0.03 (−0.08; 0.02) g/day/year for SFA and −5.2 (−7.8; −2.7) vs. −1.03 (−3.8; 1.8) mg/day/year for calcium, p for interaction <0.05. Higher educated women had a greater decrease in iron intake than lower educated women: −0.03 (−0.04; −0.02) vs. −0.01 (−0.02; 0.00) mg/day/year, p for interaction = 0.002. We conclude that, in Switzerland, dietary intake evolved similarly between 1993 and 2012 in both educational groups. Educational differences present in 1993 persisted in 2012. PMID:26593944
Bradshaw, Danielle I.; George, James D.; Hyde, Annette; LaMonte, Michael J.; Vehrs, Pat R.; Hager, Ronald L.; Yanowitz, Frank G.
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…
Background To evaluate the on-going scale-up of HIV programs, we assessed trends in patient characteristics at enrolment and ART initiation over 7 years of implementation. Methods Data were from Optimal Models, a prospective open cohort study of HIV-infected (HIV+) adults (≥15 years) and children (<15 years) enrolled from January 2005 to December 2011 at 44 HIV clinics in 3 regions of mainland Tanzania (Kagera, Kigoma, Pwani) and Zanzibar. Comparative statistics for trends in characteristics of patients enrolled in 2005–2007, 2008–2009 and 2010–2011 were examined. Results Overall 62,801 HIV + patients were enrolled: 58,102(92.5%) adults, (66.5% female); 4,699(7.5%) children. Among adults, pregnant women enrolment increased: 6.8%, 2005–2007; 12.1%, 2008–2009; 17.2%, 2010–2011; as did entry into care from prevention of mother-to-child HIV transmission (PMTCT) programs: 6.6%, 2005–2007; 9.5%, 2008–2009; 12.6%, 2010–2011 . WHO stage IV at enrolment declined: 27.1%, 2005–2007; 20.2%, 2008–2009; 11.1% 2010–2011. Of the 42.5% and 29.5% with CD4+ data at enrolment and ART initiation respectively, median CD4+ count increased: 210 cells/μL, 2005–2007; 262 cells/μL, 2008–2009; 266 cells/μL 2010–2011; but median CD4+ at ART initiation did not change (148 cells/μL overall). Stavudine initiation declined: 84.9%, 2005–2007; 43.1%, 2008–2009; 19.7%, 2010–2011. Among children, median age (years) at enrolment decreased from 6.1(IQR:2.7-10.0) in 2005–2007 to 4.8(IQR:1.9-8.6) in 2008–2009, and 4.1(IQR:1.5-8.1) in 2010–2011 and children <24 months increased from 18.5% to 26.1% and 31.5% respectively. Entry from PMTCT was 7.0%, 2005–2007; 10.7%, 2008–2009; 15.0%, 2010–2011. WHO stage IV at enrolment declined from 22.9%, 2005–2007, to 18.3%, 2008–2009 to 13.9%, 2010–2011. Proportion initiating stavudine was 39.8% 2005–2007; 39.5%, 2008–2009; 26.1%, 2010–2011. Median age at ART initiation also declined significantly
Nagata, Keiji; Yoshida, Munehito; Ishimoto, Yuyu; Hashizume, Hiroshi; Yamada, Hiroshi; Yoshimura, Noriko
Although bone loss contributes to osteoporosis (OP) in the elderly, little is known about changes in bone mineral density (BMD) in young adults that lead to bone loss. Here, we evaluated the rate of bone change and risk factors for bone loss in young men and women using data from a 3-year prospective study of Japanese medical students. The study included a self-administrated questionnaire survey, anthropometric measurements, and BMD measurements of the spine (L2-L4) and femoral neck (FN). After 3 years, the BMD of the participants was again measured at the same sites. In all, 458 students (95.4 %; 298 men and 160 women; age range, 18-29 years; mean age, 20.2 years) completed both the baseline and follow-up surveys. The mean L2-L4 BMD value at baseline increased significantly within 3 years. This tendency was also observed for the FN in men but not in women. The annual changes at L2-L4 were 1.78 % in men and 0.97 % in women per year; those for FN were 1.08 % in men and 0.08 % in women per year. However, 20.3 % and 38.5 % of the total freshmen lost BMD in the lumbar spine and FN, respectively. After adjustment for age and body mass index, logistic regression analysis revealed that bone loss in men at L2-L4 at the baseline was affected by skipping breakfast. In contrast, exercise (>2 h/week) increased lumbar spine BMD in both genders. These findings indicate that breakfast and exercise are important for maintaining BMD in young men and women.
CASAS - Comprehensive Adult Student Assessment Systems (NJ1), 2009
The Federal Workforce Investment Act (WIA) Title II, Adult Education and Family Literacy Act provides funding for states and territories to provide instruction in English as a Second Language (ESL), Adult Basic Education (ABE), and Adult Secondary Education (ASE) to adults in need of these literacy services. California State Budget Act language…
CASAS - Comprehensive Adult Student Assessment Systems (NJ1), 2010
The Federal Workforce Investment Act (WIA) Title II, Adult Education and Family Literacy Act provides funding for states and territories to provide instruction in English as a Second Language (ESL), Adult Basic Education (ABE), and Adult Secondary Education (ASE) to adults in need of these literacy services. California State Budget Act language…
CASAS - Comprehensive Adult Student Assessment Systems (NJ1), 2012
The Federal Workforce Investment Act (WIA), Title II: Adult Education and Family Literacy Act (AEFLA) provides funding for states and territories to provide instruction in English as a Second Language (ESL), Adult Basic Education (ABE), and Adult Secondary Education (ASE) to adults in need of these literacy services. California State Budget Act…
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)
Kwaśniewska, Magdalena; Pikala, Małgorzata; Bielecki, Wojciech; Dziankowska-Zaborszczyk, Elżbieta; Rębowska, Ewa; Kozakiewicz, Krystyna; Pająk, Andrzej; Piwoński, Jerzy; Tykarski, Andrzej; Zdrojewski, Tomasz; Drygas, Wojciech
Introduction The aim of the study was to estimate ten-year changes in physical activity (PA) patterns and sociodemographic determinants among adult residents of Poland. Methods 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. Results 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. Conclusions 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. PMID:27272130
Khan, Md. Mobarak Hossain; Gruebner, Oliver; Kraemer, Alexander
Objective To report geographical variations of sex-specific diabetes by place of residence (large cities/city corporations, small towns/other urban areas, rural areas) and region of residence (divided into seven divisions) among general adults (35+ years of age) in Bangladesh. Methods The recent cross-sectional data, extracted from the nationally representative Bangladesh Demographic and Health Survey 2011, was used. A total of 3,720 men and 3,823 women aged 35+ years, who participated in the fasting blood sugar testing, were analysed. Any person with either fasting plasma glucose level (mmol/L) ≥7.0 or taking medication for diabetes was considered as a person with diabetes. Results The prevalence of diabetes was 10.6% in men and 11.3% in women. Bivariable analyses indicated significant variations of diabetes by both geographical variables. The prevalence was highest in city corporations (men 18.0%, women 22.3%), followed by small towns (men 13.6%, women 15.2%) and rural areas (men 9.3%, women 9.5%). Regional disparities in diabetes prevalence were also remarkable, with the highest prevalence in Chittagong division and lowest prevalence in Khulna division. Multivariable logistic regression analyses provided mixed patterns of geographical disparities (depending on the adjusted variables). Some other independent risk factors for diabetes were advancing age, higher level of education and wealth, having TV (a proxy indicator of physical activity), overweight/obesity and hypertension. Conclusions Over 10% of the general adults aged 35 years and older were having diabetes. Most of the persons with diabetes were unaware of this before testing fasting plasma glucose level. Although significant disparities in diabetes prevalence by geographical variables were observed, such disparities are very much influenced by the adjusted variables. Finally, we underscore the necessities of area-specific strategies including early diagnosis and health education programmes for changing
Chen, Tien-Hsing; Hsiao, Yuan-Chuan; Cheng, Chia-Chi; Mao, Chun-Tai; Chen, Dong-Yi; Tsai, Ming-Lung; Yang, Teng-Yao; Lin, Yu-Sheng
Atrial septal defect (ASD) closure is major therapy for patients with secundum ASD. Although surgical closure (SC) and transcatheter closure (TC) are usually performed in such patients, data on the long-term outcomes comparing TC and SC in adults are limited. Data on the participants of this cohort study were retrieved from Taiwan's National Health Insurance Research Database from 2004 to 2011. Secundum ASD patients > 18 years of age who underwent TC or SC were initially enrolled, and those with associated comorbidities were excluded. After propensity score matching, the clinical outcomes between the TC and SC groups were analyzed. There were 595 patients recruited in the TC group and 308 patients in the SC group. The SC group had a higher incidence of systemic thromboembolism (P < 0.001), ischemic stroke (P = 0.002), and all-cause mortality (P = 0.013) when compared with those of the TC group at the index hospitalization, and similar phenomena could also be seen in a around 4-year follow-up period after the procedures (systemic thromboembolism (P < 0.001, HR = 11.48, 95% CI: 3.29-40.05), ischemic stroke (P = 0.005, HR = 9.28, 95% CI: 1.94-44.39), and all-cause mortality (P = 0.035, HR = 2.28, 95% CI: 1.06-4.89). In addition, atrial fibrillation (P = 0.005) and atrial flutter (P = 0.049) more frequently developed in the SC group than in the TC group at the index hospitalization. The adult secundum ASD patients had lower incidence rates of systemic thromboembolism, ischemic stroke, and all-cause mortality after TC than those after SC in the 4-year follow-up after procedures. Transcatheter ASD closure should therefore be given priority.
Armstrong, Anderson C.; Liu, Kiang; Lewis, Cora E.; Sidney, Stephen; Colangelo, Laura A.; Kishi, Satoru; Ambale-Venkatesh, Bharath; Arynchyn, Alex; Jacobs, David R.; Correia, Luís C.L.; Gidding, Samuel S.; Lima, João A.C.
Aims We investigated whether the addition of left atrial (LA) size determined by echocardiography improves cardiovascular risk prediction in young adults over and above the clinically established Framingham 10-year global CV risk score (FRS). Methods and results We included white and black CARDIA participants who had echocardiograms in Year-5 examination (1990–91). The combined endpoint after 20 years was incident fatal or non-fatal cardiovascular disease: myocardial infarction, heart failure, cerebrovascular disease, peripheral artery disease, and atrial fibrillation/flutter. Echocardiography-derived M-mode LA diameter (LAD; n = 4082; 149 events) and 2D four-chamber LA area (LAA; n = 2412; 77 events) were then indexed by height or body surface area (BSA). We used Cox regression, areas under the receiver operating characteristic curves (AUC), and net reclassification improvement (NRI) to assess the prediction power of LA size when added to calculated FRS or FRS covariates. The LAD and LAA cohorts had similar characteristics; mean LAD/height was 2.1 ± 0.3 mm/m and LAA/height 9.3 ± 2.0 mm2/m. After indexing by height and adjusting for FRS covariates, hazard ratios were 1.31 (95% CI 1.12, 1.60) and 1.43 (95% CI 1.13, 1.80) for LAD and LAA, respectively; AUC was 0.77 for LAD and 0.78 for LAA. When LAD and LAA were indexed to BSA, the results were similar but slightly inferior. Both LAD and LAA showed modest reclassification ability, with non-significant NRIs. Conclusion LA size measurements independently predict clinical outcomes. However, it only improves discrimination over clinical parameters modestly without altering risk classification. Indexing LA size by height is at least as robust as by BSA. Further research is needed to assess subgroups of young adults who may benefit from LA size information in risk stratification. PMID:24534011
Suzuki, Yuriko; Tsutsumi, Atsuro; Fukasawa, Maiko; Honma, Hiroko; Someya, Toshiyuki; Kim, Yoshiharu
Background Japan is located in an area prone to natural disasters, and major earthquakes have occurred recently in rural areas where the proportion of elderly adults is high. Although elderly persons are vulnerable members of communities at a time of disaster, the prevalence of mental disorders among this population has yet to be reported in Japan. This study aimed to determine the prevalence of mental disorders and suicidal thoughts among community-dwelling elderly persons 3 years after an earthquake and to identify risk factors associated with their quality of life (QOL). Methods Face-to-face interviews were conducted with 496 community-dwelling persons aged 65 years or older in areas of Japan where 2 major earthquakes had occurred during a 3-year period. The main outcome was diagnosis of a mental disorder or suicidality. Results During the 3-year period after the earthquake, 1.6% of men and 5.5% of women had received a diagnosis of major depression. There were no cases of posttraumatic stress disorder. Women were more likely than men to report suicidality (7.8% vs 3.8%, P = 0.075). Conclusions The prevalence of mental disorders was lower than that reported in previous studies. Despite the low prevalence of mental disorders, the percentage of community-dwelling elderly persons with subclinical mental health symptoms was high. The results indicate that appropriate public health and medical interventions are warranted after a natural disaster. PMID:21325733
Hötting, Kirsten; Schauenburg, Gesche; Röder, Brigitte
A few months of physical exercise have been shown to increase cognition and to modulate brain functions in previously sedentary, mainly older adults. However, whether the preservation of newly gained cognitive capacities requires an active maintenance of the achieved fitness level during the intervention is not yet known. The aim of the present study was to test whether cardiovascular fitness one year after an exercise intervention was linked to cognitive variables. Twenty-five healthy participants (42-57 years of age) took part in a follow-up assessment one year after the end of a supervised exercise intervention. Measurements included a cardiovascular fitness test, psychometric tests of verbal learning and memory and selective attention as well as questionnaires assessing physical activity and self-efficacy beliefs. Recognition scores of participants with higher cardiovascular fitness at follow-up did not change significantly during the follow-up period; however, the scores of participants with lower cardiovascular fitness decreased. One year after the end of the physical training intervention, previously sedentary participants spent more hours exercising than prior to the intervention. The time participants spent exercising correlated with their self-efficacy beliefs. These results demonstrate a direct link between verbal learning and cardiovascular fitness and show that positive effects of physical interventions on learning and memory do need an active maintenance of cardiovascular fitness. PMID:24961197
Yin, Minghui; Augustin, Balekouzou; Shu, Chang; Qin, Tingting; Yin, Ping
The aims of this study are to identify the most important predictors of total diagnosed and undiagnosed diabetes and estimate the mean change in the predicted probability among aged 45+ adults in China. We used baseline data collected from 2011 wave of the China Health and Retirement Longitudinal Study (CHARLS) (n = 9,513). First, we estimated the prevalence of diagnosed, measured, total diagnosed, and undiagnosed diabetes. Second, we used probit models to determine whether individual attributes, socioeconomic characteristics and behavioral health factors, including smoking, alcohol consumption, obesity, central obesity, are associated with total diagnosed and undiagnosed diabetes. We also consider other factors, including contact with medical system, hypertension and urban/rural settings. Third, we estimated average marginal effects of variables in probit models. Among Chinese people aged 45+, the prevalence of diagnosed, measured, total diagnosed and undiagnosed diabetes were 5.8% (95%CI, 5.3%-6.3%), 14.7% (95%CI, 14.0%-15.4%), 17.0% (95%CI, 16.3%-17.7%), 11.3% (95%CI, 10.6%-12.0%), respectively. The probability of total diagnosed diabetes is 3.3% (95% CI, 1.2%-5.3%) and 10.2% (95% CI, 7.0%-13.5%) higher for overweight and obesity than normal BMI, 5.0% (95% CI, 3.0%-7.1%) higher for central obesity than normal waist circumference, 5.4% (95% CI, 3.7%-7.0%) higher for hypertensive than normotensive and 1.8% (95% CI, 0.8%- 2.7%) higher in urban areas than in rural areas, respectively. The probability of undiagnosed diabetes is 2.7% (95% CI, 1.2%-4.2%) and 7.2% (95% CI, 4.7%-9.6%) higher for overweight and obesity than normal BMI, 2.6% (95% CI, 0.9%-4.4%) higher for central obesity than normal waist circumference and 2.6% (95% CI, 1.2%-4.0%) higher for hypertensive than normotensive, respectively, and -1.5% (95% CI, -2.5% to -0.5%) lower for individuals who were in contact with the medical system. Greater focus on prevention of diabetes is necessary for obesity
Veronese, Nicola; Stubbs, Brendon; Trevisan, Caterina; Bolzetta, Francesco; De Rui, Marina; Solmi, Marco; Sartori, Leonardo; Musacchio, Estella; Zambon, Sabina; Perissinotto, Egle; Crepaldi, Gaetano; Manzato, Enzo; Sergi, Giuseppe
Reductions in physical performance, cognitive impairment (CI) and decline (CD), are common in older age, but few prospective cohort studies have considered the relationship between these domains. In this study we investigated whether reduced physical performance and low handgrip/lower limbs strength, could predict a higher incidence of CI/CD during a 4-year follow-up among a cohort of elderly individuals. From 3099 older community-dwelling individuals initially enrolled in the Progetto Veneto Anziani (PRO.V.A.) study, 1249 participants without CI at the baseline were included (mean age 72.2years, 59.5% females). Physical performance measures included the Short Physical Performance Battery (SPPB), 4m gait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute Walking Test (6MWT), categorized in gender-specific tertiles. CI was defined as a Mini-Mental State Examination (MMSE) score below 24; CD a decline of 3 or more points in the MMSE without CI. At baseline, participants developing CI during follow-up scored significantly worse across all physical performance measures compared to those that retained normal cognitive status. After adjusting for potential confounders, a significant trend for MMSE changes was noted for all physical performance tests, except for the SPPB and chair stands time. Multinomial logistic regression revealed that slow gait speed at baseline significantly predicted CD at follow up. Poor SPPB performance and slower gait speed predicted the onset of CI at the follow-up. In conclusion, slow walking speed appears to be the best independent predictor of poor cognitive status over a 4.4-year follow-up, while other items of SPPB were also significantly associated with CI.
Oh, Taemin; Scheer, Justin K; Eastlack, Robert; Smith, Justin S; Lafage, Virginie; Protopsaltis, Themistocles S; Klineberg, Eric; Passias, Peter G; Deviren, Vedat; Hostin, Richard; Gupta, Munish; Bess, Shay; Schwab, Frank; Shaffrey, Christopher I; Ames, Christopher P
OBJECT Alignment changes in the cervical spine that occur following surgical correction for thoracic deformity remain poorly understood. The purpose of this study was to evaluate such changes in a cohort of adults with thoracic deformity treated surgically. METHODS The authors conducted a multicenter retrospective analysis of consecutive patients with thoracic deformity. Inclusion criteria for this study were as follows: corrective osteotomy for thoracic deformity, upper-most instrumented vertebra (UIV) between T-1 and T-4, lower-most instrumented vertebra (LIV) at or above L-5 (LIV ≥ L-5) or at the ilium (LIV-ilium), and a minimum radiographic follow-up of 2 years. Sagittal radiographic parameters were assessed preoperatively as well as at 3 months and 2 years postoperatively, including the C-7 sagittal vertical axis (SVA), C2-7 cervical lordosis (CL), C2-7 SVA, T-1 slope (T1S), T1S minus CL (T1S-CL), T2-12 thoracic kyphosis (TK), apical TK, lumbar lordosis (LL), pelvic incidence (PI), PI-LL, pelvic tilt (PT), and sacral slope (SS). RESULTS Fifty-seven patients with a mean age of 49.1 ± 14.6 years met the study inclusion criteria. The preoperative prevalence of increased CL (CL > 15°) was 48.9%. Both 3-month and 2-year apical TK improved from baseline (p < 0.05, statistically significant). At the 2-year follow-up, only the C2-7 SVA increased significantly from baseline (p = 0.01), whereas LL decreased from baseline (p < 0.01). The prevalence of increased CL was 35.3% at 3 months and 47.8% at 2 years, which did not represent a significant change. Postoperative cervical alignment changes were not significantly different from preoperative values regardless of the LIV (LIV ≥ L-5 or LIV-ilium, p > 0.05 for both). In a subset of patients with a maximum TK ≥ 60° (35 patients) and 3-column osteotomy (38 patients), no significant postoperative cervical changes were seen. CONCLUSION Increased CL is common in adult spinal deformity patients with thoracic deformities
Garcia-Medina, Manuel; Garcia-Medina, Jose Javier; Garrido-Fernandez, Pablo; Galvan-Espinosa, Jose; Martin-Molina, Jesus; Garcia-Maturana, Carlos; Perez-Pardo, Sergio; Pinazo-Duran, Maria Dolores
Objective: To determine the values of, and study the relationships among, central corneal thickness (CCT), intraocular pressure (IOP), and degree of myopia (DM) in an adult myopic population aged 20 to 40 years in Almeria (southeast Spain). To our knowledge this is first study of this kind in this region. Methods: An observational, descriptive, cross-sectional study was done in which a sample of 310 myopic patients (620 eyes) aged 20 to 40 years was selected by gender- and age-stratified sampling, which was proportionally fixed to the size of the population strata for which a 20% prevalence of myopia, 5% epsilon, and a 95% confidence interval were hypothesized. We studied IOP, CCT, and DM and their relationships by calculating the mean, standard deviation, 95% confidence interval for the mean, median, Fisher’s asymmetry coefficient, range (maximum, minimum), and the Brown-Forsythe’s robust test for each variable (IOP, CCT, and DM). Results: In the adult myopic population of Almeria aged 20 to 40 years (mean of 29.8), the mean overall CCT was 550.12 μm. The corneas of men were thicker than those of women (P = 0.014). CCT was stable as no significant differences were seen in the 20- to 40-year-old subjects’ CCT values. The mean overall IOP was 13.60 mmHg. Men had a higher IOP than women (P = 0.002). Subjects over 30 years (13.83) had a higher IOP than those under 30 (13.38) (P = 0.04). The mean overall DM was −4.18 diopters. Men had less myopia than women (P < 0.001). Myopia was stable in the 20- to 40-year-old study population (P = 0.089). A linear relationship was found between CCT and IOP (R2 = 0.152, P ≤ 0.001). CCT influenced the IOP value by 15.2%. However no linear relationship between DM and IOP, or between CCT and DM, was found. Conclusions: CCT was found to be similar to that reported in other studies in different populations. IOP tends to increase after the age of 30 and is not accounted for by alterations in CCT values. PMID:21468330
Leahy, Siobhan; O'Neill, Cian; Sohun, Rhoda; Toomey, Clodagh; Jakeman, Philip
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.
Murillo-Zamora, Efrén; García-Ceballos, Raúl; Delgado-Enciso, Iván; Garza-Guajardo, Raquel; Barboza-Quintana, Oralia; Rodríguez-Sánchez, Irám P; Mendoza-Cano, Oliver
Background Excess body weight has become a major public health problem worldwide, and the burden of overweight and obesity was calculated in this work from a health economics perspective. Objective To estimate the burden of disease attributable to overweight and obesity among males and females aged 20 years and older using years of life lost (YLL) and age-standardized YLL rates (ASYLL), and to rank the leading causes of premature death. Design A cross-sectional study took place (2010-2014) and 6,054 deaths were analyzed. Thirteen basic causes of death associated with overweight or obesity were included. The population attributable fraction (PAF), YLL, and ASYLL were calculated. Results The overall burden attributable to overweight and obesity was 36,087 YLL, and the estimated ASYLL per 10,000 persons was 1,098 and 1,029 in males and females, respectively. Type 2 diabetes mellitus was the main cause of premature death (males, 968 ASYLL; females, 772 ASYLL). Conclusions Overweight and obesity are major risk factors of chronic diseases that are main causes of premature death in the study population. Strategies for preventing overweight and obesity may decrease the incidence and mortality associated with these non-communicable diseases. ASYLL seems to be an indicator that is particularly well adapted to decision-making in public health.
Edmonds, Grant W.; Côté, Hélène C. F.; Hampson, Sarah E.
Leukocyte telomere length (LTL) shortens with age, and is a prospective marker of mortality related to cardiovascular disease. Many health behaviors and social environmental factors have been found to be associated with LTL. Several of these are also associated with conscientiousness, a dispositional personality trait. Conscientiousness is a propensity to be planful, adhere to social norms, and inhibit pre-potent responses. Like LTL, conscientiousness is prospectively related to mortality, possibly through cumulative effects on health over the life course via multiple pathways. As a result, we hypothesized that childhood levels of conscientiousness would predict LTL prospectively in adulthood. We selected a sample of 60 women in the Hawaii Personality and Health Cohort; 30 described by their teachers as high on conscientiousness in childhood and 30 described as low on the trait. Dried blood spot samples collected in adulthood 40 years later were used as sources of DNA for the LTL assay. Conscientiousness was associated with longer LTL (p = .02). Controlling for age did not account for this association. Controlling for education and physiological dysregulation partially attenuated the association, and the effect remained significant when accounting for differences in LTL across cultural groups. These results represent the first evidence that childhood personality prospectively predicts LTL 40 years later in adulthood. Our findings would be consistent with a mediation hypothesis whereby conscientiousness predicts life paths and trajectories of health that are reflected in rates of LTL erosion across the lifespan. PMID:26218760
Colarusso, Calvin A
Four sisters, now in their late fifties and early sixties, were sexually abused during childhood over a four-year span by the same priest. Until recently they told no one about their experience and never received any psychological diagnostic evaluations or treatment. The author conducted detailed psychiatric evaluations of each of the four women while serving as the plaintiffs' expert witness during their lawsuits against the Catholic Church. The suits have been settled, and the women have given written permission to tell their stories. This unique clinical material provides a rare opportunity to describe and understand the ongoing, pervasive effects of untreated, chronic childhood sexual abuse on developmental processes over half a century. In each instance the women were describing the details of the abuse and the effects on their development for the first time. The severity of the pathology and the intense shame and anxiety associated with discussing their experiences after so many years raises questions about the choice of treatment and technique, particularly in regard to transference and countertransference issues.
Edmonds, Grant W; Côté, Hélène C F; Hampson, Sarah E
Leukocyte telomere length (LTL) shortens with age, and is a prospective marker of mortality related to cardiovascular disease. Many health behaviors and social environmental factors have been found to be associated with LTL. Several of these are also associated with conscientiousness, a dispositional personality trait. Conscientiousness is a propensity to be planful, adhere to social norms, and inhibit pre-potent responses. Like LTL, conscientiousness is prospectively related to mortality, possibly through cumulative effects on health over the life course via multiple pathways. As a result, we hypothesized that childhood levels of conscientiousness would predict LTL prospectively in adulthood. We selected a sample of 60 women in the Hawaii Personality and Health Cohort; 30 described by their teachers as high on conscientiousness in childhood and 30 described as low on the trait. Dried blood spot samples collected in adulthood 40 years later were used as sources of DNA for the LTL assay. Conscientiousness was associated with longer LTL (p = .02). Controlling for age did not account for this association. Controlling for education and physiological dysregulation partially attenuated the association, and the effect remained significant when accounting for differences in LTL across cultural groups. These results represent the first evidence that childhood personality prospectively predicts LTL 40 years later in adulthood. Our findings would be consistent with a mediation hypothesis whereby conscientiousness predicts life paths and trajectories of health that are reflected in rates of LTL erosion across the lifespan.
Murillo-Zamora, Efrén; García-Ceballos, Raúl; Delgado-Enciso, Iván; Garza-Guajardo, Raquel; Barboza-Quintana, Oralia; Rodríguez-Sánchez, Irám P.; Mendoza-Cano, Oliver
Background Excess body weight has become a major public health problem worldwide, and the burden of overweight and obesity was calculated in this work from a health economics perspective. Objective To estimate the burden of disease attributable to overweight and obesity among males and females aged 20 years and older using years of life lost (YLL) and age-standardized YLL rates (ASYLL), and to rank the leading causes of premature death. Design A cross-sectional study took place (2010–2014) and 6,054 deaths were analyzed. Thirteen basic causes of death associated with overweight or obesity were included. The population attributable fraction (PAF), YLL, and ASYLL were calculated. Results The overall burden attributable to overweight and obesity was 36,087 YLL, and the estimated ASYLL per 10,000 persons was 1,098 and 1,029 in males and females, respectively. Type 2 diabetes mellitus was the main cause of premature death (males, 968 ASYLL; females, 772 ASYLL). Conclusions Overweight and obesity are major risk factors of chronic diseases that are main causes of premature death in the study population. Strategies for preventing overweight and obesity may decrease the incidence and mortality associated with these non-communicable diseases. ASYLL seems to be an indicator that is particularly well adapted to decision-making in public health. PMID:27606969
Pondering the Printz Award. The Michael L. Printz Award for Excellence in Young Adult Literature; The Making of a Printz; The Truth about Trueman: An Interview with Terry Trueman; "Beautiful"..."Fresh"..."Distinguished" Books: Teen Readers Take on the 2002 Printz Awards; Soap Box: A Young Adult Publisher Speaks Out about Winning the Printz Award; Retro Mock Printz: The Best of the Best of Young Adult Literature from the VOYA Years.
Butts, Peter; Halls, Kelly Milner; Horne, Claire; Roxburgh, Stephen; Cornish, Sarah; Jones, Patrick
Includes six articles that discuss the Michael L. Printz award for excellence in young adult literature, established by the Young Adult Library Services Association (YALSA) of the American Library Association (ALA). Highlights include a list of winners for the past three years; quality versus popularity; and perspectives from authors, teens, and…
Novak, Scott P; Glasheen, Cristie; Roland, Carl L
Background The primary aim of this work was to present the prevalence data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a representative 3-year longitudinal survey (ages 18+ years) that captured information on patterns of self-reported pain interference and prescription pain reliever misuse. A second aim was to assess the degree to which the risk of various types of opioid misuse (onset, desistance, and incidence of dependence) was related to the longitudinal course of self-reported pain interference over the 3-year period. Methods We used a two-wave, nationally representative sample of adults (aged 18+ years) in which the baseline data were collected during 2001–2002 and a single follow-up was obtained ~3 years later (2004–2005 with 34,332 respondents with complete data on study variables for both waves). Results Our findings indicated that ~10% reported high pain interference in the past month at each wave. There was tremendous stability in levels of pain, with ~5% reporting consistent levels of high impairment over the 3-year study, a proxy for chronic pain. Levels of pain were more strongly associated with prescription pain reliever misuse concurrently rather than prospectively, and the association was largely linear, with the likelihood of misuse increasing with levels of pain. Finally, health service factors were also prominent predictors of onset, but not the outcomes, of desistance or transitions to problem use. Conclusion This study is the first to use a nationally representative sample with measures of pain and drug use history collected over an extended period. These results may help provide clinicians with an understanding that the risk of misuse is greatest when pain is active and may help guide the selection of appropriate intervention materials and monitor strategies for those at greatest risk. PMID:27418863
Jensen, Jakob D; Liu, Miao; Carcioppolo, Nick; John, Kevin K; Krakow, Melinda; Sun, Ye
Past research has found that older US adults (aged 50-75 years) exhibit high levels of cancer information overload and cancer worry; however, no study to date has examined whether these perceptions are related to information seeking/scanning. To explore this relationship, older adults (N = 209, Mage = 55.56, SD = 4.24) were recruited to complete a survey measuring seeking, scanning, cancer information overload, and cancer worry. Most participants were high-scan/seekers (40.2%) followed by low-scan/seekers (21.1%), high-scan/no seekers (19.6%), and low-scan/no seekers (19.1%). Low-scan/no seekers had significantly higher cancer information overload compared to all other groups, consistent with the postulate that overload and seeking/scanning are negatively related. Low-scan/no seekers and high-scan/seekers both exhibited higher cancer worry severity, consistent with past research suggesting that cancer worry explains high levels of activity/inactivity.
Zakopoulou, Victoria; Pashou, Theodora; Tzavelas, Panagiotis; Christodoulides, Pavlos; Anna, Milona; Iliana, Kolotoura
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.
Cha, Seung-Hyun; Paik, Jeong-Hun; Lee, Mi-Ra; Yang, Huiho; Park, Seung-Guk; Jeon, Young-Jee; Yoo, Sunmi
Influenza vaccination is an effective strategy to reduce morbidity and mortality, particularly for those who have decreased lung functions. This study was to identify the factors that affect vaccination coverage according to the results of pulmonary function tests depending on the age. In this cross-sectional study, data were obtained from 3,224 adults over the age of 40 who participated in the fifth National Health and Nutrition Examination Survey and underwent pulmonary function testing in 2012. To identify the factors that affect vaccination rate, logistic regression analysis was conducted after dividing the subjects into two groups based on the age of 65. Influenza vaccination coverage of the entire subjects was 45.2%, and 76.8% for those aged 65 and over. The group with abnormal pulmonary function had a higher vaccination rate than the normal group, but any pulmonary dysfunction or history of COPD did not affect the vaccination coverage in the multivariate analysis. The subjects who were 40-64 years-old had higher vaccination coverage when they were less educated or with restricted activity level, received health screenings, and had chronic diseases. Those aged 65 and over had significantly higher vaccination coverage only when they received regular health screenings. Any pulmonary dysfunction or having COPD showed no significant correlation with the vaccination coverage in the Korean adult population.
Wang, Xuan; Zhang, Mingyue; Lui, Guang; Chang, Hong; Zhang, Meilin; Liu, Wei; Li, Ziwei; Liu, Yixin; Huang, Guowei
Older adults can experience glucose metabolism dysfunction, and although manganese may help regulate glucose metabolism, there is little information regarding this association among older people. This cross-sectional study included 2402 Chinese adults who were ≥60 years old in 2013 (Tianjin, China), and evaluated the associations of serum manganese with prediabetes and diabetes. Serum manganese levels were measured using inductively coupled plasma mass spectrometry. Multivariable logistic regression models were used to evaluate the sex-specific associations of manganese levels with diabetes and prediabetes after adjusting for confounding factors (age, sex, life style factors, and health status). Based on the WHO criteria, prediabetes was observed in 15.1% of men and 13.4% of women, while diabetes was observed in 30.0% of men and 34.4% of women. In the final model, the odds ratios (95% confidence interval) for prediabetes according to manganese quartile were 1.000, 0.463 (0.269-0.798), 0.639 (0.383-1.065), and 0.614 (0.365-1.031) among men and 1.000, 0.773 (0.498-1.200), 0.602 (0.382-0.947), and 0.603 (0.381-0.953) among women (p for trend = 0.134 and 0.015, respectively). The lowest prevalence of diabetes among men occurred at a moderate range of serum manganese (p < 0.05). Therefore, appropriate serum manganese levels may help prevent and control prediabetes and diabetes.
Voss, Michelle W; Heo, Susie; Prakash, Ruchika S; Erickson, Kirk I; Alves, Heloisa; Chaddock, Laura; Szabo, Amanda N; Mailey, Emily L; Wójcicki, Thomas R; White, Siobhan M; Gothe, Neha; McAuley, Edward; Sutton, Bradley P; Kramer, Arthur F
Cerebral white matter (WM) degeneration occurs with increasing age and is associated with declining cognitive function. Research has shown that cardiorespiratory fitness and exercise are effective as protective, even restorative, agents against cognitive and neurobiological impairments in older adults. In this study, we investigated whether the beneficial impact of aerobic fitness would extend to WM integrity in the context of a one-year exercise intervention. Further, we examined the pattern of diffusivity changes to better understand the underlying biological mechanisms. Finally, we assessed whether training-induced changes in WM integrity would be associated with improvements in cognitive performance independent of aerobic fitness gains. Results showed that aerobic fitness training did not affect group-level change in WM integrity, executive function, or short-term memory, but that greater aerobic fitness derived from the walking program was associated with greater change in WM integrity in the frontal and temporal lobes, and greater improvement in short-term memory. Increases in WM integrity, however, were not associated with short-term memory improvement, independent of fitness improvements. Therefore, while not all findings are consistent with previous research, we provide novel evidence for correlated change in training-induced aerobic fitness, WM integrity, and cognition among healthy older adults.
Smith, Leann E.; Greenberg, Jan S.; Mailick, Marsha R.
In the present study, we jointly employ and integrate variable- and person-centered approaches to identify groups of individuals with autism spectrum disorders (ASD) who have similar profiles of change over a period of 10 years across three critical domains of functioning: maladaptive behaviors, autism symptoms, and daily living skills. Two distinct developmental profiles were identified. Above and beyond demographic and individual characteristics, aspects of both the educational context (level of inclusion) and the family context (maternal positivity) were found to predict the likelihood of following a positive pattern of change. Implementing evidence-based interventions that target the school and home environments during childhood and adolescence may have lasting impacts on functioning into adulthood for individuals with ASD. PMID:26319253
Assmann, Karen E.; Lassale, Camille; Galan, Pilar; Hercberg, Serge; Kesse-Guyot, Emmanuelle
Background Understanding the role of dietary quality in the progression of adiposity in populations already affected by overweight or obesity is crucial for the guidance of secondary prevention strategies. Objective To examine the association of diet quality, as reflected by the French Nutrition and Health Programme (Programme National Nutrition Santé, PNNS) – Guideline Score (GS), with 6-year-changes in weight and waist circumference. Design and Methods Subjects were 1029 male and 450 female participants of the SUplémentation en VItamines et Minéraux AntioXydants (SU.VI.MAX) cohort (1994–2002) with anthropometric variables at baseline and follow-up and available data for estimating diet quality at baseline. We employed analysis of variance and covariance models to investigate anthropometric changes (% of the initial value) by categories of the PNNS-GS, which contains both dietary components and a physical activity component, and of a modified score (mPNNS-GS) containing dietary components only. Results In men, a low (<6 points) PNNS-GS was associated with greater 6-year weight gain (adjusted mean: 3.63% [95% confidence interval: 2.87%; 4.39%]) as compared to a high (≥9 points) PNNS-GS (2.10% [1.39%; 2.81%]); p = 0.01. Results for the mPNNS-GS were very similar. In women, no associations between diet scores and weight change were observed. No significant relation between dietary quality and change in waist circumference was present among either men or women. Conclusions These results support a beneficial role of high dietary quality – as characterized by good adherence to official French nutritional guidelines – in secondary obesity prevention, among men. PMID:24516542
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
DeChristopher, L R; Uribarri, J; Tucker, K L
Objective: There is a link between joint and gut inflammation of unknown etiology in arthritis. Existing research indicates that regular consumption of high-fructose corn syrup sweetened (HFCS) soft drinks, but not diet soft drinks, may be associated with increased risk of seropositive rheumatoid arthritis (RA) in women, independent of other dietary and lifestyle factors. One unexplored hypothesis for this association is that fructose malabsorption, due to regular consumption of excess free fructose (EFF) and HFCS, contributes to fructose reactivity in the gastrointestinal tract and intestinal in situ formation of enFruAGEs, which once absorbed, travel beyond the intestinal boundaries to other tissues and promote inflammation. In separate studies, the accumulation of advanced glycation end-products has been associated with joint inflammation in RA. Objective of this study was to assess the association between EFF beverages intake and non-age, non-wear and tear-associated arthritis in US young adults. Methods: In this cross sectional study of 1209 adults aged 20–30y, (Nutrition and Health Examination Surveys 2003–2006) exposure variables were high EFF beverages, including HFCS sweetened soft drinks, and any combination of HFCS sweetened soft drinks, fruit drinks (FD) and apple juice, referred to as tEFF. Analyses of diet soda and diet FD were included for comparison. The outcome was self-reported arthritis. Rao Scott Ҳ2 was used for prevalence differences and logistic regression for associations, adjusted for confounders. Results: Young adults consuming any combination of high EFF beverages (tEFF) ⩾5 times/week (but not diet soda) were three times as likely to have arthritis as non/low consumers (odds ratios=3.01; p⩽0.021; 95% confidence intervals=1.20–7.59), independent of all covariates, including physical activity, other dietary factors, blood glucose and smoking. Conclusion: EFF beverage intake is significantly associated with arthritis in US adults
Hanna, Kathleen M; Weaver, Michael T; Slaven, James E; Fortenberry, J Dennis; DiMeglio, Linda A
The roles of glycemic control, diabetes management, diabetes care responsibility, living independently of parents, and time since high school graduation in predicting diabetes-related quality of life (DQOL) were examined in 184 emerging adults with type 1 diabetes. Data were collected at graduation and 1 year later. Analyses controlling for selected covariates were completed using generalized linear mixed models. Better diabetes management was associated with more positive responses on all four dimensions of DQOL. Impact and worry of DQOL were greater in the presence of depressive symptoms, and life satisfaction was lower. DQOL life satisfaction was lower in those living independently of parents. Young women reported poorer diabetes-related health status than did young men. Time since graduation was not linked to DQOL. Further research is needed on ways to improve DQOL in conjunction with diabetes management and on ways that families can support DQOL when youth live independently.
Synnestvedt, Marie B; Weiner, Mark G
Current cancer screening recommendations often apply coarse age cutoffs for screening requirements without regard to predicted life expectancy. Using these cutoffs, healthier older patients may be under-screened, and sicker younger patients may be screened too often. Mortality risk classification using EHR data could be used to tailor screening reminders to physicians in ways that better align screening recommendations with patients who are more likely to live long enough to benefit from early detection. We have evaluated the performance of an existing prognostic index for 4-year mortality using data readily available in the electronic health record (EHR), and investigated the effect of the index in retrospective cohorts of adults age 65 and older undergoing screening colonoscopy. Risk scores in this adaptation of a four-year prognostic index were found to be associated with actual death rates and consistent with mortality rates from a national sample. Our results demonstrate that data extracted from electronic health records can be used to classify mortality risk. With improvements, including extension to a 5-year mortality model with inclusion of additional variables and extension of variable definitions, informatics methods to implement mortality models may prove to be clinically useful in tailoring screening guidelines.
Raynor, Lewis A.; Schreiner, Pamela J.; Loria, Catherine M.; Carr, J. Jeffrey; Pletcher, Mark J.; Shikany, James M.
Purpose Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, we sought to determine how well lipids measured at baseline and at 20 years predict the presence of subclinical atherosclerosis. Methods Complete risk factor, coronary artery calcification (CAC), and carotid intima media thickness (CIMT) data were available for 2435 participants. Lipids were categorized into quartiles, CAC at Y20 was dichotomized as present/absent, and CIMT was dichotomized as ≥84 or <84th overall percentile. Multivariable logistic regression was used to model the association between lipids and CAC/CIMT. C statistics were used to assess the discriminative value of each lipid measure in predicting the presence of CAC or CIMT at Y20. Results Lipid levels measured in young adulthood as well as middle age were both associated with subclinical disease in middle age. The discriminatory value of lipids was virtually identical at baseline, when participants were 18–30 years of age, and 20 years later. Neither baseline nor Y20 lipid data were strong predictors of Y20 subclinical disease despite statistically significant associations. Conclusions These results are consistent with a growing body of evidence that early-life exposure to nonoptimal lipids matters and lifestyle modifications administered earlier in the lifespan could slow the progress of the atherosclerotic plaques. PMID:23889858
Houghton, David C
Life cycles of 27 caddisfly species were estimated from weekly adult flight periodicity data during 2010-2014 from a forest and a meadow site of a small stream in northern Lower Michigan. Of the 11 species abundant only at the forest site, 10 appeared to be univoltine and 1 appeared bivoltine. Of the 13 species abundant only at the meadow site, 5 appeared univoltine, 5 appeared bivoltine, and 3 were enigmatic due to inconsistent flight peaks between years. Although the sites were separated by ∼400 m, only three species were abundant at both sites due to differences in stream habitat and food availability. Two of these species had notably dissimilar life cycles between sites, reflecting these differences. Despite the study dates encompassing both the warmest and coldest years of the 2000s, most species retained consistent flight periods between years. This consistency with date appeared unrelated to lunar phase. Date was a better predictor of flight periodicity than water temperature for every species except those that emerged earliest in the season. Warming water temperatures appeared to synchronize emergence of species at the meadow site to a greater degree than those of the forest site, probably due to the greater range of temperatures at the meadow site, although date was still the better predictor at both sites. These data suggest that warming water temperatures, although important under certain conditions, may not always be primary life cycle synchronizers in small streams.
Frenz, Patricia; Grabenhenrich, Linus; Keil, Thomas; Tinnemann, Peter
Abstract Objective To assess universal health coverage for adults aged 50 years or older with chronic illness in China, Ghana, India, Mexico, the Russian Federation and South Africa. Methods We obtained data on 16 631 participants aged 50 years or older who had at least one diagnosed chronic condition from the World Health Organization Study on Global Ageing and Adult Health. Access to basic chronic care and financial hardship were assessed and the influence of health insurance and rural or urban residence was determined by logistic regression analysis. Findings The weighted proportion of participants with access to basic chronic care ranged from 20.6% in Mexico to 47.6% in South Africa. Access rates were unequally distributed and disadvantaged poor people, except in South Africa where primary health care is free to all. Rural residence did not affect access. The proportion with catastrophic out-of-pocket expenditure for the last outpatient visit ranged from 14.5% in China to 54.8% in Ghana. Financial hardship was more common among the poor in most countries but affected all income groups. Health insurance generally increased access to care but gave insufficient protection against financial hardship. Conclusion No country provided access to basic chronic care for more than half of the participants with chronic illness. The poor were less likely to receive care and more likely to face financial hardship in most countries. However, inequity of access was not fully determined by the level of economic development or insurance coverage. Future health reforms should aim to improve service quality and increase democratic oversight of health care. PMID:27034521
Fabbro, Diana L; Streiger, Mirtha L; Arias, Enrique D; Bizai, María L; del Barco, Mónica; Amicone, Norberto A
The efficacy of treatment with nifurtimox and/or benznidazole among adults with chronic Chagas disease with no previous electrocardiographic disturbances was evaluated over a mean follow-up of 21 years, by means of conventional serology, xenodiagnosis, clinical examination, electrocardiograms and chest X-ray. One hundred and eleven patients, between 17 and 46 years old, were studied: 54 underwent treatment (nifurtimox 27, benznidazole 27) and 57 remained untreated (control group). Xenodiagnosis was performed on 65% of them: 36/38 of the treated and 9/34 of the untreated patients had previous positive xenodiagnosis. Post-treatment, 133 xenodiagnoses were performed on 41 patients, all resulting negative. In the control group, 29 xenodiagnoses were performed on 14 patients; 2 resulted positive. Sera stored during the follow-up were simultaneously analyzed through conventional serology tests (IHA; DA-2ME; IIF). The serological evolution in the treated group was: a) 37% underwent negative seroconversion (nifurtimox 11, benznidazole 9); b) 27.8% decreased titers (nifurtimox 9, benznidazole 6), 9 showed inconclusive final serology (nifurtimox 7, benznidazole 2); c) 35.2% remained positive with constant titers (nifurtimox 7; benznidazole 12). The control group conserved the initial antibody levels during the follow-up. In the clinical evolution, 2/54 (3.7%) of the treated and 9/57 (15.8%) of the untreated patients showed electrocardiographic disturbances attributable to Chagas myocardiopathy, with a statistically relevant difference (p<0.05). Treatment caused deparasitation in at least 37% of the chronically infected adults and a protective effect on their clinical evolution.
Holden, Libby; Ware, Robert S; Lee, Christina
This article used data from 5,171 young women participating in the Australian Longitudinal Study on Women's Health, a nationally representative longitudinal cohort study, to identify longitudinal trajectory patterns of mental health across 6 surveys over 16 years of early adulthood, from age 18-23 to age 34-39. In addition, we identified both predictors and outcomes of these trajectories. Using group-based trajectory modeling, we identified 4 distinct trajectory groups of mental health. The mental health of most participants (55%) was consistently high, with 12% improving, 24% varying, and 9% frequently low. The authors considered characteristics at the beginning and end of the trajectory period, taking a life-course perspective to understand vulnerabilities to, and outcomes of, low or variable poor mental health trajectories. Financial difficulties, poor general health, and weight or shape dissatisfaction were characteristics at Survey 1 that distinguished all other trajectory groups from those with consistently high mental health. Other differences were specific to 1 or 2 groups. By the end of the trajectory period, the improving mental health group showed few differences from those with consistently high mental health. However, those with varying and low mental health showed evidence of social disadvantage, poor physical and emotional health, and unhealthy behaviors, and were less likely to be mothers. The ability to identify distinct trajectories of mental health in early adulthood, and their correlates, provides evidence to underpin population health interventions targeting the prevention of mental health problems among this population group. (PsycINFO Database Record
Gallo, Agatha M; Wilkie, Diana J; Yao, Yingwei; Molokie, Robert E; Stahl, Christiane; Hershberger, Patricia E; Zhao, Zhongsheng; Suarez, Marie L; Johnson, Bonnye; Angulo, Rigoberto; Carrasco, Jesus; Angulo, Veronica; Thompson, Alexis A
Interventions to assist reproductive health decision-making in populations affected by sickle cell disease (SCD) or trait (SCT) lack proven efficacy over time. Our aim was to compare effects of CHOICES, a Web-based multimedia education program on implementing informed reproductive plans, and usual care education (e-Book) on reproductive knowledge, intention, and behavior over 24 months. We randomized 234 participants with SCD (n = 138) or SCT (n = 96) (age 18-35 years, 35 % male, 94 % African American) to CHOICES and e-Book groups. Participants completed a sickle cell-specific reproductive measure before and four times after the intervention (6, 12, 18 and 24 months). Compared to the e-Book group the CHOICES group had significantly more improvement in knowledge over time (p = .004) but not intention (p = .18) or behavior (p = .69). At baseline, 114 (48.7 %) participants reported having partners who would not put the couple at risk for their children inheriting SCD. Of the 116 (49.6 %) at-risk participants, a higher poroportion of those who were in the CHOICES group chose partners that reduced their risk by the last visit than the e-Book group (p = .04). Study findings provide important insights for designing a national trial of the CHOICES intervention focusing on subjects whose partner status puts them at risk for having a child with SCD.
Kasagi, Fumiyoshi; Yamada, Michiko; Sasaki, Hideo; Fujita, Shoichiro
This study aimed to test whether scored biologic functions can predict individual life expectancies and to investigate the disease-related and time-related differences in evaluated associations. A biologic score was defined as the first principal component score of the five physiological tests. Study participants were 4,871 people aged 35-74 years at baseline examination in 1970-1972 and followed until the end of 1999. We evaluated the prognostic value of the biologic score by Cox proportional hazard analysis. In all age and sex groups, increasing trends of mortality for all diseases by increment of biologic score were observed after adjustment for potential risk factors. The validity of the biologic score was significant throughout the entire study period. Each disease except cancer showed a significant association with biologic score at baseline examination. In conclusion, the biologic score is a valid predictor of life span in this large-scale prospective study of middle-aged and elderly Japanese.
Cameron, C. M.; Purdie, D. M.; Kliewer, E. V.; McClure, R. J.
OBJECTIVE: To quantify long-term health service use (HSU) following non-fatal injury in adults. METHODS: A retrospective, population-based, matched cohort study identified an inception cohort (1988-91) of injured people who had been hospitalized (ICD-9-CM 800-995) aged 18-64 years (n = 21 032) and a matched non-injured comparison group (n = 21 032) from linked administrative data from Manitoba, Canada. HSU data (on hospitalizations, cumulative length of stay, physician claims and placements in extended care services) were obtained for the 12 months before and 10 years after the injury. Negative binomial and Poisson regressions were used to quantify associations between injury and long-term HSU. FINDINGS: Statistically significant differences in the rates of HSU existed between the injured and non-injured cohorts for the pre-injury year and every year of the follow-up period. After controlling for pre-injury HSU, the attributable risk percentage indicated that 38.7% of all post-injury hospitalizations (n = 25 183), 68.9% of all years spent in hospital (n = 1031), 21.9% of physician claims (n = 269 318) and 77.1% of the care home placements (n = 189) in the injured cohort could be attributed to being injured. CONCLUSION: Many people who survive the initial period following injury, face long periods of inpatient care (and frequent readmissions), high levels of contact with physicians and an increased risk of premature placement in institutional care. Population estimates of the burden of injury could be refined by including long-term non-fatal health consequences and controlling for the effect of pre-injury comorbidity. PMID:17128360
Protopsaltis, Themistocles S; Scheer, Justin K; Terran, Jamie S; Smith, Justin S; Hamilton, D Kojo; Kim, Han Jo; Mundis, Greg M; Hart, Robert A; McCarthy, Ian M; Klineberg, Eric; Lafage, Virginie; Bess, Shay; Schwab, Frank; Shaffrey, Christopher I; Ames, Christopher P
OBJECT Regional cervical sagittal alignment (C2-7 sagittal vertical axis [SVA]) has been shown to correlate with health-related quality of life (HRQOL). The study objective was to examine the relationship between cervical and thoracolumbar alignment parameters with HRQOL among patients with operative and nonoperative adult thoracolumbar deformity. METHODS This is a multicenter prospective data collection of consecutive patients with adult thoracolumbar spinal deformity. Clinical measures of disability included the Oswestry Disability Index (ODI), Scoliosis Research Society-22 Patient Questionnaire (SRS-22), and 36-Item Short-Form Health Survey (SF-36). Cervical radiographic parameters were correlated with global sagittal parameters within the nonoperative and operative cohorts. A partial correlation analysis was performed controlling for C-7 SVA. The operative group was subanalyzed by the magnitude of global deformity (C-7 SVA ≥ 5 cm vs < 5 cm). RESULTS A total of 318 patients were included (186 operative and 132 nonoperative). The mean age was 55.4 ± 14.9 years. Operative patients had significantly worse baseline HRQOL and significantly larger C-7 SVA, pelvic tilt (PT), mismatch between pelvic incidence and lumbar lordosis (PI-LL), and C2-7 SVA. The operative patients with baseline C-7 SVA ≥ 5 cm had significantly larger C2-7 lordosis (CL), C2-7 SVA, C-7 SVA, PI-LL, and PT than patients with a normal C-7 SVA. For all patients, baseline C2-7 SVA and CL significantly correlated with baseline ODI, Physical Component Summary (PCS), SRS Activity domain, and SRS Appearance domain. Baseline C2-7 SVA also correlated with SRS Pain and SRS Total. For the operative patients with baseline C-7 SVA ≥ 5 cm, the 2-year C2-7 SVA significantly correlated with 2-year Mental Component Summary, SRS Mental, SRS Satisfaction, and decreases in ODI. Decreases in C2-7 SVA at 2 years significantly correlated with lower ODI at 2 years. Using partial correlations while controlling for
Busschaert, Cedric; Scherrens, Anne-Lore; De Bourdeaudhuij, Ilse; Cardon, Greet; Van Cauwenberg, Jelle; De Cocker, Katrien
Introduction Knowledge about variables associated with context-specific sitting time in older adults is limited. Therefore, this study explored cross-sectional and longitudinal associations of socio-demographic, social-cognitive, physical-environmental and health-related variables with sitting during TV viewing, computer use and motorized transport in older adults. Methods A sample of Belgian older adults completed structured interviews on context-specific sitting time and associated variables using a longitudinal study design. Objective measurements of grip strength and physical performance were also completed. Complete baseline data were available of 258 participants (73.98±6.16 years) of which 229 participants remained in the study at one year follow-up (retention rate: 91.60%). Cross-sectional correlates (baseline data) and longitudinal predictors (change-scores in relation with change in sitting time) were explored through multiple linear regression analyses. Results Per context-specific sitting time, most of the cross-sectional correlates differed from the longitudinal predictors. Increases over time in enjoyment of watching TV (+one unit), encouragement of partner to watch less TV (+one unit) and TV time of partner (+30.0 min/day) were associated with respectively 9.1 min/day (p<0.001), 16.0 min/day (p<0.001) and 12.0 min/day (p<0.001) more sitting during TV viewing at follow-up. Increases over time in enjoyment of using a computer (+one unit), the number of smartphones and tablets (+1) and computer use of the partner (+30.0 min/day) were associated with respectively 5.5 min/day (p < .01), 10.4 min/day (p < .05) and 3.0 min/day (p < .05) more sitting during computer use at follow-up. An increase over time in self-efficacy regarding taking a bicycle or walking was associated with 2.9 min/day (p < .05) less sitting during motorized transport at follow-up. Conclusions The results stressed the importance of looking at separate contexts of sitting. Further, the
Artenstein, Andrew W; Friderici, Jennifer; Holers, Adam; Lewis, Deirdre; Fitzgerald, Jan; Visintainer, Paul
Background. Delayed recognition of spinal epidural abscess (SEA) contributes to poor outcomes from this highly morbid and potentially lethal infection. We performed a case-control study in a regional, high-volume, tertiary care, academic medical center over the years 2005-2015 to assess the potential changing epidemiology, clinical and laboratory manifestations, and course of this disorder and to identify factors that might lead to early identification of SEA. Methods. Diagnostic billing codes consistent with SEA were used to identify inpatient admissions for abstraction. Subjects were categorized as cases or controls based on the results of spinal imaging studies. Characteristics were compared using Fisher's exact or Kruskal-Wallis tests. All P values were 2-sided with a critical threshold of <.05. Results. We identified 162 cases and 88 controls during the study period. The incidence of SEA increased from 2.5 to 8.0 per 10 000 admissions, a 3.3-fold change from 2005 to 2015 (P < .001 for the linear trend). Compared with controls, cases were significantly more likely to have experienced at least 1 previous healthcare visit or received antimicrobials within 30 days of admission; to have comorbidities of injection drug use, alcohol abuse, or obesity; and to manifest fever or rigors. Cases were also more likely to harbor coinfection at a noncontiguous site. When available, inflammatory markers were noted to be markedly elevated in cases. Focal neurologic deficits were seen with similar frequencies in both groups. Conclusions. Based on our analysis, it appears that selected factors noted at the time of clinical presentation may facilitate early recognition of SEA.
Artenstein, Andrew W.; Friderici, Jennifer; Holers, Adam; Lewis, Deirdre; Fitzgerald, Jan; Visintainer, Paul
Background. Delayed recognition of spinal epidural abscess (SEA) contributes to poor outcomes from this highly morbid and potentially lethal infection. We performed a case-control study in a regional, high-volume, tertiary care, academic medical center over the years 2005–2015 to assess the potential changing epidemiology, clinical and laboratory manifestations, and course of this disorder and to identify factors that might lead to early identification of SEA. Methods. Diagnostic billing codes consistent with SEA were used to identify inpatient admissions for abstraction. Subjects were categorized as cases or controls based on the results of spinal imaging studies. Characteristics were compared using Fisher's exact or Kruskal-Wallis tests. All P values were 2-sided with a critical threshold of <.05. Results. We identified 162 cases and 88 controls during the study period. The incidence of SEA increased from 2.5 to 8.0 per 10 000 admissions, a 3.3-fold change from 2005 to 2015 (P < .001 for the linear trend). Compared with controls, cases were significantly more likely to have experienced at least 1 previous healthcare visit or received antimicrobials within 30 days of admission; to have comorbidities of injection drug use, alcohol abuse, or obesity; and to manifest fever or rigors. Cases were also more likely to harbor coinfection at a noncontiguous site. When available, inflammatory markers were noted to be markedly elevated in cases. Focal neurologic deficits were seen with similar frequencies in both groups. Conclusions. Based on our analysis, it appears that selected factors noted at the time of clinical presentation may facilitate early recognition of SEA. PMID:28018923
García Villanueva, Miren Zuriñe; Uterga Valiente, Juan María; Rodríguez-Antigüedad Zarranz, Alfredo
Objectives To analyse the quality of life (QoL) of persons over 60 years of age in Bizkaia (Basque Country, Spain), not institutionalised and without cognitive impairment, and the relation and possible influence of the perception of the state of health with the cognitive level and the activities that they carry out. Subjects and Methods Evaluation of a sample of 317 persons that belong to a longitudinal study. In 269 cases, there was a reliable informant. The general cognitive state was evaluated by means of the Mini-Mental State Examination (MMSE) and the Global Deterioration Scale (GDS). Two GDS, one of the family member (GDSf) and another of the evaluator (GDSe), were used and memory was evaluated by the Text Memory subtest of the Barcelona Test. The QoL was assessed with the SF-36 Health Survey and the mental, physical and social activities that they carry out were recorded. Results In the SF-36, the participants showed values that exceed the reference values of the Spanish population in all dimensions of the SF-36, except in that of bodily pain. There were low correlations between the dimensions of the SF-36 and the mental, physical and social activities. A low correlation was observed between the memory tests and the SF-36. In 59.3% of the cases, there were no differences between the GDSf and the GDSe. Conclusions The participants of this study present a better perception of their state of health than the Spanish population, but this perception is not observed to be influenced by the type or by the quantity of activities that they carry out or by their cognitive state. The informants present a vision very close to the cognitive state of their family members. PMID:25337078
... ACIP Vaccination Recommendations Why Immunize? Vaccines: The Basics Immunization Schedules for Adults in Easy-to-read Formats ... previous immunizations. View or Print a Schedule Recommended Immunizations for Adults (19 Years and Older) by Age ...
Virginia Adult Educators Research Network, Dayton.
This report contains four separate articles of interest to adult English-as-a-second-language (ESL) educators. "Learning Disabilities in Adult ESL: Case Studies and Directions" (Dorothy Almanza, Kate Singleton, Lynda Terrill) looks at three case studies of adult ESL students whom teachers have identified as possibly learning disabled.…
Background Retirement represents a major transitional life stage in middle to older age. Changes in physical activity typically accompany this transition, which has significant consequences for health and well-being. The aim of this systematic review was to evaluate the evidence for the effect of interventions to promote physical activity in adults aged 55 to 70 years, focusing on studies that reported long-term effectiveness. This systematic review adheres to a registered protocol (PROSPERO CRD42011001459). Methods Randomized controlled trials of interventions to promote physical activity behavior with a mean/median sample age of 55 to 70 years, published between 2000 and 2010, were identified. Only trials reporting the long-term effect (≥ 12 months) on objective or self-reported physical activity behavior were included. Trials reporting physiological proxy measures of physical activity were excluded. Meta-analyses were conducted when trials provided sufficient data and sensitivity analyses were conducted to identify potential confounding effects of trials of poor methodological quality or with attrition rates ≥ 30%. Results Of 17,859 publications identified, 32 were included which reported on 21 individual trials. The majority of interventions were multimodal and provided physical activity and lifestyle counselling. Interventions to promote physical activity were effective at 12 months (standardized mean difference (SMD) = 1.08, 95% confidence interval (CI) = 0.16 to 1.99, pedometer step-count, approximating to an increase of 2,197 steps per day; SMD = 0.19, 95% CI = 0.10 to 0.28, self-reported physical activity duration outcome), but not at 24 months based on a small subset of trials. There was no evidence for a relationship between intervention effectiveness and mode of delivery or number of intervention contacts; however, interventions which involved individually tailoring with personalized activity goals or provision of information about local
Katibeh, M; Hosseini, S; Soleimanizad, R; Manaviat, M R; Kheiri, B; Khabazkhoob, M; Daftarian, N; Dehghan, M H
Previous studies on type 2 diabetes mellitus in the Islamic Republic of Iran were mainly performed in provinces with large populations. This study determined the prevalence and risk factors of diabetes mellitus in an adult population (40-80 years old) from Yazd district. Multistage, systematic cluster random sampling was used in a crosssectional, population-based survey. Demographic, clinical and anthropometric data were collected, with diabetes defined as fasting blood sugar ≥ 7 mmol/L or a positive medical history of diabetes. The age- and sex-standardized prevalence of diabetes in 2090 individuals participants was 24.5% (95% CI: 22.2-26.8%), including 10.5% new cases. For each year of ageing, the prevalence of diabetes increased significantly by 4% and this trend was more pronounced in females than males. Low education and hypertension were significantly associated with diabetes prevalence. The prevalence of diabetes mellitus in Yazd is greater than the average levels nationwide and those of nearby countries.
Lewis, C E; Smith, D E; Wallace, D D; Williams, O D; Bild, D E; Jacobs, D R
OBJECTIVES: This study estimated the amount of weight change in a biracial cohort of young adults and the separate components attributable to time-related and aging-related changes, as well as identified possible determinants of weight change. METHODS: In this population-based prospective study of 18- to 30-year-old African-American and White men and women, body weight and prevalence of overweight were measured from 1985/86 to 1992/93. RESULTS: Average weight increased over the 7 years, increases ranging from 5.2 kg (SE = 0.2, n = 811) in White women to 8.5 kg (SE = 0.3, n = 882) in African-American women. Significant time-related increases in weight, ranging from 2.0 kg (SE = 1.0) in White women to 4.8 kg (SE = 1.0, n = 711) in African-American men, accounted for 40% to 60% of the average total weight gain. Aging-related increases were also significant, ranging from 2.6 kg (SE = 0.8, n = 944) in White men to 5.0 kg (SE = 1.1) in African-American women. The prevalence of overweight increased progressively in each group. Decreased physical fitness was most strongly associated with weight gain in both sexes. CONCLUSIONS: The observed dramatic time-related weight gains, most likely due to secular (period-related) trends, are a serious public health concern. PMID:9146444
Theadom, Alice; Rowland, Vickie; Levack, William; Starkey, Nicola; Wilkinson-Meyers, Laura; McPherson, Kathryn
Objectives To explore the experience of fatigue and sleep difficulties over the first 2 years after traumatic brain injury (TBI). Design Longitudinal qualitative descriptive analysis of interviews completed as part of a larger longitudinal study of recovery following TBI. Data relating to the experience of fatigue and/or sleep were extracted and coded by two independent researchers. Setting Community-based study in the Hamilton and Auckland regions of New Zealand. Participants 30 adult participants who had experienced mild, moderate or severe brain injury within the past 6 months (>16 years of age). 15 participants also nominated significant others to take part. Interviews were completed at 6, 12 and 24 months postinjury. Results Participants described feeling unprepared for the intensity, impact and persistent nature of fatigue and sleep difficulties after injury. They struggled to learn how to manage their difficulties by themselves and to adapt strategies in response to changing circumstances over time. Four themes were identified: (1) Making sense of fatigue and sleep after TBI; (2) accepting the need for rest; (3) learning how to rest and; (4) need for rest impacts on ability to engage in life. Conclusions Targeted support to understand, accept and manage the sleep and fatigue difficulties experienced may be crucial to improve recovery and facilitate engagement in everyday life. Advice needs to be timely and revised for relevance over the course of recovery. PMID:27059468
Eriksen, L; Grønbaek, M; Helge, J W; Tolstrup, J S
Our aim was to provide up-to-date cardiorespiratory fitness reference data for adults of all ages and to investigate associations between cardiores-piratory fitness and leisure time physical activity as well as sitting time. In the Danish Health Examination Survey 2007-2008, cardiorespiratory fitness was estimated in 16 025 individuals aged 18-91 years from validated cycle ergometer exercise tests. Level of leisure time physical activity (sedentary, light, moderate, and vigorous) and daily sitting time in hours was obtained from a self-administered questionnaire. Men had 20-33% higher cardiorespiratory fitness than women, depending on age, and cardiorespiratory fitness decreased by 0.26 and 0.23 mL/min/kg per year in men and women, respectively. Cardiorespiratory fitness was higher among participants who reported a high level of physical activity in leisure time compared with participants who were sedentary. Among sedentary or lightly physically active participants, inverse associations between total daily sitting time and cardiorespiratory fitness were found, while there was no association between sitting time and cardiorespiratory fitness among moderately or vigorously physically active participants. These data on cardiorespiratory fitness can serve as useful reference material. Although reluctant to conclude on causality, sitting time might impact cardiorespiratory fitness among individuals with low levels of leisure time physical activity.
Ritter, Philipp S; Höfler, Michael; Wittchen, Hans-Ulrich; Lieb, Roselind; Bauer, Michael; Pfennig, Andrea; Beesdo-Baum, Katja
There is ample data suggesting that individuals with bipolar disorder more frequently suffer from disturbed sleep even when euthymic. Since sleep is a process that is crucial for affective homeostasis, disturbed sleep in healthy individuals may be a risk factor for the subsequent onset of bipolar disorder. Utilizing data from a large cohort of adolescents and young adults, this study tests the hypothesis that disturbed sleep constitutes a risk factor for the later onset of bipolar disorder. A representative community sample of N = 3021 adolescents and young adults (baseline age 14-24) was assessed using the standardized Composite International Diagnostic Interview and followed-up prospectively up to 3 times over up to 10 years. Disturbed sleep at baseline was quantified utilizing the corresponding items from the self-report inventory SCL-90-R. The compound value (insomnia-score) as an ordinal parameter for the severity of sleep disturbances was used to assess associations with the incidence of bipolar disorder among participants free of major mental disorder at baseline (N = 1943) using odds ratios (OR) from logistic regressions. Analyses were adjusted for age, gender, parental mood disorder and lifetime alcohol or cannabis dependence. Poor sleep quality significantly increased the risk for the subsequent development of bipolar disorder (OR = 1.75; p = 0.001). Regarding individual sleep items, trouble falling asleep and early morning awakening were predictive for the subsequent onset of bipolar disorder. Disturbed sleep in persons otherwise free of major mental disorders appears to confer an increased risk for the subsequent onset of bipolar disorder.
Hirve, Siddhivinayak; Gómez-Olivé, Xavier; Oti, Samuel; Debpuur, Cornelius; Juvekar, Sanjay; Tollman, Stephen; Blomstedt, Yulia; Wall, Stig; Ng, Nawi
Background Comparing self-rating health responses across individuals and cultures is misleading due to different reporting behaviors. Anchoring vignettes is a technique that allows identifying and adjusting self-rating responses for reporting heterogeneity (RH). Objective This article aims to test two crucial assumptions of vignette equivalence (VE) and response consistency (RC) that are required to be met before vignettes can be used to adjust self-rating responses for RH. Design We used self-ratings, vignettes, and objective measures covering domains of mobility and cognition from the WHO study on global AGEing and adult health, administered to older adults aged 50 years and above from eight low- and middle-income countries in Africa and Asia. For VE, we specified a hierarchical ordered probit (HOPIT) model to test for equality of perceived vignette locations. For RC, we tested for equality of thresholds that are used to rate vignettes with thresholds derived from objective measures and used to rate their own health function. Results There was evidence of RH in self-rating responses for difficulty in mobility and cognition. Assumptions of VE and RC between countries were violated driven by age, sex, and education. However, within a country context, assumption of VE was met in some countries (mainly in Africa, except Tanzania) and violated in others (mainly in Asia, except India). Conclusion We conclude that violation of assumptions of RC and VE precluded the use of anchoring vignettes to adjust self-rated responses for RH across countries in Asia and Africa. PMID:24011254
Introduction: Youth living with HIV are highly under-represented in the evidence base for adherence interventions, despite their diverse and unique needs and barriers. Objective: This systematic review aimed to identify antiretroviral therapy (ART) adherence interventions specifically targeting adolescents and young adults (defined as ages 13–24) with the goal of characterizing the evidence base. Methods: Articles were identified using the PubMed database and cover work published through September 14, 2015. Inclusion criteria: (1) average age 13 to 24, (2) HIV positive, (3) on or beginning ART, (4) intervention targeted ART adherence in full or in part, (5) reported adherence, viral load, and/or CD4 count outcomes. Strength of evidence was defined as level 1 [randomized controlled trial (RCT) with significance testing on outcomes], 2 (within group studies with statistical testing on outcomes), 3 (RCTs with descriptive results), or 4 (within group studies with descriptive results). Results: Of 151 articles, 10 met inclusion criteria. Published between 2003 and 2014, these studies evaluated diverse intervention approaches. Most were conducted in the US and were small pilots that have yet to be replicated despite promising results. Only 3 studies met criteria for highest level strength of evidence; 2 supported a phone-based counseling approach with adherence monitors and 1 for weekly individual and family counseling. Conclusions: Despite nearly 20 years passing since the wide-scale availability of ART, and clear recognition that adolescents and youth adults fair worse on the cascade of HIV care, the evidence base remains sparse and underdeveloped. Promising approaches need replication and more rigorous studies are desperately needed. PMID:26959190
Wang, Xuan; Zhang, Mingyue; Lui, Guang; Chang, Hong; Zhang, Meilin; Liu, Wei; Li, Ziwei; Liu, Yixin; Huang, Guowei
Older adults can experience glucose metabolism dysfunction, and although manganese may help regulate glucose metabolism, there is little information regarding this association among older people. This cross-sectional study included 2402 Chinese adults who were ≥60 years old in 2013 (Tianjin, China), and evaluated the associations of serum manganese with prediabetes and diabetes. Serum manganese levels were measured using inductively coupled plasma mass spectrometry. Multivariable logistic regression models were used to evaluate the sex-specific associations of manganese levels with diabetes and prediabetes after adjusting for confounding factors (age, sex, life style factors, and health status). Based on the WHO criteria, prediabetes was observed in 15.1% of men and 13.4% of women, while diabetes was observed in 30.0% of men and 34.4% of women. In the final model, the odds ratios (95% confidence interval) for prediabetes according to manganese quartile were 1.000, 0.463 (0.269–0.798), 0.639 (0.383–1.065), and 0.614 (0.365–1.031) among men and 1.000, 0.773 (0.498–1.200), 0.602 (0.382–0.947), and 0.603 (0.381–0.953) among women (p for trend = 0.134 and 0.015, respectively). The lowest prevalence of diabetes among men occurred at a moderate range of serum manganese (p < 0.05). Therefore, appropriate serum manganese levels may help prevent and control prediabetes and diabetes. PMID:27529280
Etemadifar, Mohammad Reza; Hadi, Abdollah; Masouleh, Mehran Feizi
Background: Spondylolisthesis is a common cause of surgery in patients with lower back pain. Although posterolateral fusion and pedicle screw fixation are a relatively common treatment method for the treatment of spondylolisthesis, controversy exists about the necessity of adding interbody fusion to posterolateral fusion. The aim of our study was to assess the functional disability, pain, and complications in patients with spondylolisthesis treated by posterolateral instrumented fusion (PLF) with and without transforaminal lumbar interbody fusion (TLIF) in a randomized clinical trial. Materials and Methods: From February 2007 to February 2011, 50 adult patients with spondylolisthesis were randomly assigned to be treated with PLF or PLF+TLIF techniques (25 patients in each group) by a single surgeon. Back pain, leg pain, and disability were assessed before treatment and until 2 years after surgical treatment using visual analog scale (VAS) and oswestry disability index (ODI). Patients were also evaluated for postoperative complications such as infection, neurological complications, and instrument failure. Results: All patients completed the 24 months of follow-up. Twenty patients were females and 30 were males. Average age of the patients was 53 ± 11 years for the PLF group and 51 ± 13 for the PLF + TLIF group. Back pain, leg pain, and disability score were significantly improved postoperatively compared to preoperative scores (P < 0.001). At 3 months of follow-up, there was no statistically significant difference in VAS score for back pain and leg pain in both groups; however, after 6 months and 1 year and 2 years follow-up, the reported scores for back pain and leg pain were significantly lower in the PLF+TLIF group (P < 0.05). The ODI score was also significantly lower in the PLF+TLIF group at 1 year and 2 years of follow-up (P < 0.05). One screw breakage and one superficial infection occurred in the PLF+TLIF group, which had no statistical significance (P = 0
Kliethermes, Stephanie; Plange-Rhule, Jacob; Tong, Liping; Bovet, Pascal; Forrester, Terrence E.; Lambert, Estelle V.; Schoeller, Dale A.; Durazo-Arvizu, Ramon A.; Shoham, David A.; Cao, Guichan; Brage, Soren; Ekelund, Ulf; Cooper, Richard S.; Luke, Amy
Background Increasing population-levels of physical activity (PA) is a controversial strategy for managing the obesity epidemic, given the conflicting evidence for weight loss from PA alone per se. We measured PA and weight change in a three-year prospective cohort study in young adults from five countries (Ghana, South Africa, Jamaica, Seychelles and USA). Methods A total of 1,944 men and women had baseline data, and at least 1 follow-up examination including measures of anthropometry (weight/BMI), and objective PA (accelerometer, 7-day) following the three-year study period. PA was explored as 1-minute bouts of moderate and vigorous PA (MVPA) as well as daily sedentary time. Results At baseline; Ghanaian and South African men had the lowest body weights (63.4 ± 9.5, 64.9 ± 11.8 kg, respectively) and men and women from the USA the highest (93.6 ± 25.9, 91.7 ± 23.4 kg, respectively). Prevalence of normal weight ranged from 85% in Ghanaian men to 29% in USA men and 52% in Ghanaian women to 15% in USA women. Over the two-year follow-up period, USA men and Jamaican women experienced the smallest yearly weight change rate (0.1 ± 3.3 kg/yr; −0.03 ± 3.0 kg/yr, respectively), compared to South African men and Ghanaian women greatest yearly change (0.6.0 ± 3.0 kg/yr; 1.22 ± 2.6 kg/yr, respectively). Mean yearly weight gain tended to be larger among normal weight participants at baseline than overweight/obese at baseline. Neither baseline MVPA nor sedentary time were associated with weight gain. Using multiple linear regression, only baseline weight, age and gender were significantly associated with weight gain. Discussion From our study it is not evident that higher volumes of PA alone are protective against future weight gain, and by deduction our data suggest that other environmental factors such as the food environment may have a more critical role. PMID:28133575
Mueller-Schotte, Sigrid; Bleijenberg, Nienke; van der Schouw, Yvonne T; Schuurmans, Marieke J
Objectives Decline in the performance of instrumental activities of daily living (IADL) and mobility may be preceded by symptoms the patient experiences, such as fatigue. The aim of this study is to investigate whether self-reported non-task-specific fatigue is a long-term risk factor for IADL-limitations and/or mobility performance in older adults after 10 years. Methods A prospective study from two previously conducted cross-sectional studies with 10-year follow-up was conducted among 285 males and 249 females aged 40–79 years at baseline. Fatigue was measured by asking “Did you feel tired within the past 4 weeks?” (males) and “Do you feel tired?” (females). Self-reported IADLs were assessed at baseline and follow-up. Mobility was assessed by the 6-minute walk test. Gender-specific associations between fatigue and IADL-limitations and mobility were estimated by multivariable logistic and linear regression models. Results A total of 18.6% of males and 28.1% of females were fatigued. After adjustment, the odds ratio for fatigued versus non-fatigued males affected by IADL-limitations was 3.3 (P=0.023). In females, the association was weaker and not statistically significant, with odds ratio being 1.7 (P=0.154). Fatigued males walked 39.1 m shorter distance than those non-fatigued (P=0.048). For fatigued females, the distance was 17.5 m shorter compared to those non-fatigued (P=0.479). Conclusion Our data suggest that self-reported fatigue may be a long-term risk factor for IADL-limitations and mobility performance in middle-aged and elderly males but possibly not in females. PMID:27877027
Heck, Christianne N; King-Stephens, David; Massey, Andrew D; Nair, Dileep R; Jobst, Barbara C; Barkley, Gregory L; Salanova, Vicenta; Cole, Andrew J; Smith, Michael C; Gwinn, Ryder P; Skidmore, Christopher; Van Ness, Paul C; Bergey, Gregory K; Park, Yong D; Miller, Ian; Geller, Eric; Rutecki, Paul A; Zimmerman, Richard; Spencer, David C; Goldman, Alica; Edwards, Jonathan C; Leiphart, James W; Wharen, Robert E; Fessler, James; Fountain, Nathan B; Worrell, Gregory A; Gross, Robert E; Eisenschenk, Stephan; Duckrow, Robert B; Hirsch, Lawrence J; Bazil, Carl; O'Donovan, Cormac A; Sun, Felice T; Courtney, Tracy A; Seale, Cairn G; Morrell, Martha J
Objective To demonstrate the safety and effectiveness of responsive stimulation at the seizure focus as an adjunctive therapy to reduce the frequency of seizures in adults with medically intractable partial onset seizures arising from one or two seizure foci. Methods Randomized multicenter double-blinded controlled trial of responsive focal cortical stimulation (RNS System). Subjects with medically intractable partial onset seizures from one or two foci were implanted, and 1 month postimplant were randomized 1:1 to active or sham stimulation. After the fifth postimplant month, all subjects received responsive stimulation in an open label period (OLP) to complete 2 years of postimplant follow-up. Results All 191 subjects were randomized. The percent change in seizures at the end of the blinded period was −37.9% in the active and −17.3% in the sham stimulation group (p = 0.012, Generalized Estimating Equations). The median percent reduction in seizures in the OLP was 44% at 1 year and 53% at 2 years, which represents a progressive and significant improvement with time (p < 0.0001). The serious adverse event rate was not different between subjects receiving active and sham stimulation. Adverse events were consistent with the known risks of an implanted medical device, seizures, and of other epilepsy treatments. There were no adverse effects on neuropsychological function or mood. Significance Responsive stimulation to the seizure focus reduced the frequency of partial-onset seizures acutely, showed improving seizure reduction over time, was well tolerated, and was acceptably safe. The RNS System provides an additional treatment option for patients with medically intractable partial-onset seizures. PMID:24621228
Sato, Keiko; Adachi, Koichi; Nakamura, Hiroyuki; Asano, Kazuhiro; Watanabe, Akihiro; Adachi, Riri; Kiuchi, Mariko; Kobayashi, Keiju; Matsuki, Taizo; Kaise, Toshihiko; Gopala, Kusuma; Holl, Katsiaryna
Approximately one in three persons will develop herpes zoster during their lifetime, and it can lead to serious complications such as postherpetic neuralgia. However, evidence on burden of herpes zoster and postherpetic neuralgia in Japan is limited. This prospective, observational, multicenter, physician practice-based cohort study was conducted in Kushiro, Hokkaido, Japan (Clinicaltrials.gov identifier NCT01873365) to assess the incidence and hospitalization rates of herpes zoster, and the proportion, clinical burden and risk factors for postherpetic neuralgia in adults aged 60 years or more. Within the study area, 800 subjects developed herpes zoster and 412 were eligible for the study. Herpes zoster incidence was 10.2/1000 person-years and higher among women and older subjects. Subjects with herpes zoster required on average 5.7 outpatient consultations. Herpes zoster-associated hospitalization rate was 3.4% (27/800). The proportion of postherpetic neuralgia and other complications was 9.2% (38/412) and 26.5% (109/412), respectively. Statistically significant association with the development of postherpetic neuralgia was male sex (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.17-5.38), age of 70-74 years (OR, 3.51; 95% CI, 1.09-11.3), immunosuppressive therapy (OR, 6.44; 95% CI, 1.26-32.9), severe herpes zoster pain at first consultation (OR, 3.08; 95% CI, 1.10-8.62) and rash on upper arms (vs no rash on upper arms; OR, 3.46; 95% CI, 1.10-10.9). Considerable herpes zoster and postherpetic neuralgia burden exists among elderly in Japan, and there may be predictive factors at the first visit which could be indicative of the risk of developing postherpetic neuralgia.
Balaž, Miroslav; Ukropcova, Barbara; Kurdiova, Timea; Vlcek, Miroslav; Surova, Martina; Krumpolec, Patrik; Vanuga, Peter; Gašperíková, Daniela; Klimeš, Iwar; Payer, Juraj; Wolfrum, Christian; Ukropec, Jozef
Growth hormone (GH) supplementation therapy to adults with GH deficiency has beneficial effects on adipose tissue lipid metabolism, improving thus adipocyte functional morphology and insulin sensitivity. However, molecular nature of these effects remains unclear. We therefore tested the hypothesis that lipid-mobilizing adipokine zinc-α2-glycoprotein is causally linked to GH effects on adipose tissue lipid metabolism. Seventeen patients with severe GH deficiency examined before and after the 5-year GH replacement therapy were compared with age-, gender- and BMI-matched healthy controls. Euglycemic hyperinsulinemic clamp was used to assess whole-body and adipose tissue-specific insulin sensitivity. Glucose tolerance was determined by oGTT, visceral and subcutaneous abdominal adiposity by MRI, adipocyte size morphometrically after collagenase digestion, lipid accumulation and release was studied in differentiated human primary adipocytes in association with GH treatment and zinc-α2-glycoprotein gene silencing. Five-year GH replacement therapy improved glucose tolerance, adipose tissue insulin sensitivity and reduced adipocyte size without affecting adiposity and whole-body insulin sensitivity. Adipose tissue zinc-α2-glycoprotein expression was positively associated with whole-body and adipose tissue insulin sensitivity and negatively with adipocyte size. GH treatment to adipocytes in vitro increased zinc-α2-glycoprotein expression (>50%) and was paralleled by enhanced lipolysis and decreased triglyceride accumulation (>35%). Moreover, GH treatment improved antilipolytic action of insulin in cultured adipocytes. Most importantly, silencing zinc-α2-glycoprotein eliminated all of the GH effects on adipocyte lipid metabolism. Effects of 5-year GH supplementation therapy on adipose tissue lipid metabolism and insulin sensitivity are associated with zinc-α2-glycoprotein. Presence of this adipokine is required for the GH action on adipocyte lipid metabolism in vitro
Okwechime, Ifechukwude Obiamaka; Roberson, Shamarial; Odoi, Agricola
Background Individuals with pre-diabetes and diabetes have increased risks of developing macro-vascular complications including heart disease and stroke; which are the leading causes of death globally. The objective of this study was to estimate the prevalence of pre-diabetes and diabetes, and to investigate their predictors among adults ≥18 years in Florida. Methods Data covering the time period January-December 2013, were obtained from Florida’s Behavioral Risk Factor Surveillance System (BRFSS). Survey design of the study was declared using SVYSET statement of STATA 13.1. Descriptive analyses were performed to estimate the prevalence of pre-diabetes and diabetes. Predictors of pre-diabetes and diabetes were investigated using multinomial logistic regression model. Model goodness-of-fit was evaluated using both the multinomial goodness-of-fit test proposed by Fagerland, Hosmer, and Bofin, as well as, the Hosmer-Lemeshow’s goodness of fit test. Results There were approximately 2,983 (7.3%) and 5,189 (12.1%) adults in Florida diagnosed with pre-diabetes and diabetes, respectively. Over half of the study respondents were white, married and over the age of 45 years while 36.4% reported being physically inactive, overweight (36.4%) or obese (26.4%), hypertensive (34.6%), hypercholesteremic (40.3%), and 26% were arthritic. Based on the final multivariable multinomial model, only being overweight (Relative Risk Ratio [RRR] = 1.85, 95% Confidence Interval [95% CI] = 1.41, 2.42), obese (RRR = 3.41, 95% CI = 2.61, 4.45), hypertensive (RRR = 1.69, 95% CI = 1.33, 2.15), hypercholesterolemic (RRR = 1.94, 95% CI = 1.55, 2.43), and arthritic (RRR = 1.24, 95% CI = 1.00, 1.55) had significant associations with pre-diabetes. However, more predictors had significant associations with diabetes and the strengths of associations tended to be higher than for the association with pre-diabetes. For instance, the relative risk ratios for the association between diabetes and being
Kozicka, Izabela; Kostka, Tomasz
Purpose To assess the relative role of handgrip strength (HGS), quadriceps muscle power (Pmax), and optimal shortening velocity (υopt) in maintaining functional abilities (FAs) in older adults living in a long-term care home over a 1-year follow-up. Subjects and methods Forty-one inactive older institutionalized adults aged 69.8±9.0 years participated in this study. HGS, Pmax, υopt, cognitive function using the Mini-Mental State Examination, depressive symptoms using the Geriatric Depression Scale, nutritional status using the Mini Nutritional Assessment (MNA), and physical activity (PA) using the Seven-Day Physical Activity Recall Questionnaire were assessed at baseline and at 1-year follow-up. FAs were assessed with activities of daily living (ADL), instrumental ADL, and Timed Up & Go test. Results Both at baseline and at follow-up, FAs were related to age, HGS, Pmax/kg, υopt, MNA, and PA. These associations were generally similar in both sexes. As revealed in multiple regression analysis, υopt was the strongest predictor of FA, followed by Pmax/kg, PA, and MNA. FA deteriorated after 1 year as measured by ADL and Timed Up & Go test. Pmax and υopt, but not HGS, also decreased significantly after 1 year. Nevertheless, 1-year changes in FAs were not related to changes in HGS, Pmax, υopt, or PA. Conclusion The 1-year period of physical inactivity among older institutionalized adults was found to have a negative effect on their FAs, Pmax, and υopt. The present study demonstrates that Pmax and, especially, υopt correlated with FAs of older adults more than HGS, both at baseline and at follow-up. Despite this, 1-year natural fluctuations of PA, Pmax, and υopt are not significant enough to influence FAs in inactive institutionalized older adults. PMID:27307720
Background Seniors need sufficient balance and strength to manage in daily life, and sufficient physical activity is required to achieve and maintain these abilities. This can be a challenge, but fun and motivational exergames can be of help. However, most commercial games are not suited for this age group for several reasons. Many usability studies and user-centered design (UCD) protocols have been developed and applied, but to the best of our knowledge none of them are focusing on seniors’ use of games for physical activity. In GameUp, a European cofunded project, some prototype Kinect exergames to enhance the mobility of seniors were developed in a user-centered approach. Objective In this paper we aim to record lessons learned in 3 years of experience with exergames for seniors, considering both the needs of older adults regarding user-centered development of exergames and participation in UCD. We also provide a UCD protocol for exergames tailored to senior needs. Methods An initial UCD protocol was formed based on literature of previous research outcomes. Senior users participated in UCD following the initial protocol. The users formed a steady group that met every second week for 3 years to play exergames and participate in the UCD during the 4 phases of the protocol. Several methods were applied in the 4 different phases of the UCD protocol; the most important methods were structured and semistructured interviews, observations, and group discussions. Results A total of 16 seniors with an average age above 80 years participated for 3 years in UCD in order to develop the GameUp exergames. As a result of the lessons learned by applying the different methodologies of the UCD protocol, we propose an adjusted UCD protocol providing explanations on how it should be applied for seniors as users. Questionnaires should be turned into semistructured and structured interviews while user consultation sessions should be repeated with the same theme to ensure that the
The percentage of adults aged 45-64 years with limitations in activities of daily living (ADLs) increased from 1.3% in 2000 to 2.0% in 2015, and the percentage with limitations in instrumental activities of daily living (IADLs) increased from 2.8% to 4.0%. Among adults aged ≥65 years, the percentage with limitations in ADLs increased from 6.4% to 6.9%, and the percentage with limitations in IADLs decreased from 12.9% to 11.7%.
Villareal, Dennis T; Fontana, Luigi; Das, Sai Krupa; Redman, Leanne; Smith, Steven R; Saltzman, Edward; Bales, Connie; Rochon, James; Pieper, Carl; Huang, Megan; Lewis, Michael; Schwartz, Ann V
Although caloric restriction (CR) could delay biologic aging in humans, it is unclear if this would occur at the cost of significant bone loss. We evaluated the effect of prolonged CR on bone metabolism and bone mineral density (BMD) in healthy younger adults. Two-hundred eighteen non-obese (body mass index [BMI] 25.1 ± 1.7 kg/m(2) ), younger (age 37.9 ± 7.2 years) adults were randomly assigned to 25% CR (CR group, n = 143) or ad libitum (AL group, n = 75) for 2 years. Main outcomes were BMD and markers of bone turnover. Other outcomes included body composition, bone-active hormones, nutrient intake, and physical activity. Body weight (-7.5 ± 0.4 versus 0.1 ± 0.5 kg), fat mass (-5.3 ± 0.3 versus 0.4 ± 0.4 kg), and fat-free mass (-2.2 ± 0.2 versus -0.2 ± 0.2 kg) decreased in the CR group compared with AL (all between group p < 0.001). Compared with AL, the CR group had greater changes in BMD at 24 months: lumbar spine (-0.013 ± 0.003 versus 0.007 ± 0.004 g/cm(2) ; p < 0.001), total hip (-0.017 ± 0.002 versus 0.001 ± 0.003 g/cm(2) ; p < 0.001), and femoral neck (-0.015 ± 0.003 versus -0.005 ± 0.004 g/cm(2) ; p = 0.03). Changes in bone markers were greater at 12 months for C-telopeptide (0.098 ± 0.012 versus 0.025 ± 0.015 μg/L; p < 0.001), tartrate-resistant acid phosphatase (0.4 ± 0.1 versus 0.2 ± 0.1 U/L; p = 0.004), and bone-specific alkaline phosphatase (BSAP) (-1.4 ± 0.4 versus -0.3 ± 0.5 U/L; p = 0.047) but not procollagen type 1 N-propeptide; at 24 months, only BSAP differed between groups (-1.5 ± 0.4 versus 0.9 ± 0.6 U/L; p = 0.001). The CR group had larger increases in 25-hydroxyvitamin D, cortisol, and adiponectin and decreases in leptin and insulin compared with AL. However, parathyroid hormone and IGF-1 levels did not differ between groups. The CR group also had lower levels of physical activity
Bakhsheshian, Joshua; Scheer, Justin K; Gum, Jeffrey L; Hostin, Richard; Lafage, Virginie; Bess, Shay; Protopsaltis, Themistocles S; Burton, Douglas C; Keefe, Malla Kate; Hart, Robert A; Mundis, Gregory M; Shaffrey, Christopher I; Schwab, Frank; Smith, Justin S; Ames, Christopher P
OBJECTIVE Mental disease burden can have a significant impact on levels of disability and health-related quality of life (HRQOL) measures. Therefore, the authors investigated the significance of mental health status in adults with spinal deformity and poor physical function. METHODS A retrospective analysis of a prospective multicenter database of 365 adult spinal deformity (ASD) patients who had undergone surgical treatment was performed. Health-related QOL variables were examined preoperatively and at the 2-year postoperative follow-up. Patients were grouped by their 36-Item Short Form Health Survey mental component summary (MCS) and physical component summary (PCS) scores. Both groups had PCS scores ≤ 25th percentile for matched norms; however, the low mental health (LMH) group consisted of patients with an MCS score ≤ 25th percentile, and the high mental health (HMH) group included patients with an MCS score ≥ 75th percentile. RESULTS Of the 264 patients (72.3%) with a 2-year follow-up, 104 (28.5%) met the inclusion criteria for LMH and 40 patients (11.0%) met those for HMH. The LMH group had a significantly higher overall rate of comorbidities, specifically leg weakness, depression, hypertension, and self-reported neurological and psychiatric disease processes, and were more likely to be unemployed as compared with the HMH group (p < 0.05 for all). The 2 groups had similar 2-year postoperative improvements in HRQOL (p > 0.05) except for the greater improvements in the MCS and the Scoliosis Research Society-22r questionnaire (SRS-22r) mental domain (p < 0.05) in the LMH group and greater improvements in PCS and SRS-22r satisfaction and back pain domains (p < 0.05) in the HMH group. The LMH group had a higher rate of reaching a minimal clinically important difference (MCID) on the SRS-22r mental domain (p < 0.01), and the HMH group had a higher rate of reaching an MCID on the PCS and SRS-22r activity domain (p < 0.05). On multivariable logistic regression
Bailey, Zinzi D; Slopen, Natalie; Albert, Michelle; Williams, David R
This study examined the relationship between multiple dimensions of religious involvement and transitions of tobacco smoking abstinence, persistence, cessation and relapse over 9-10 years of follow-up in a national sample of adults in the United States. Using data provided at baseline and follow-up, participants were categorized as non-smokers, persistent smokers, ex-smokers, and relapsed smokers. Religious involvement over the two time points were categorized into combinations of "high" and "low" involvement within the domains of (a) religious attendance, (b) religious importance, (c) spiritual importance, (d) religious/spiritual comfort seeking, and (e) religious/spiritual decision-making. High levels of religious involvement across five dimensions (religious attendance, religious importance, spiritual importance, religious/spiritual comfort-seeking, and religious/spiritual decision-making) were associated with lower odds of being a persistent smoker or ex-smoker. Religious involvement was not associated with smoking cessation among smokers at baseline. Interventions to increase smoking abstinence may be more effective if they draw on ties to religious and spiritual organizations and beliefs. Meanwhile, religious involvement is unlikely to affect smoking cessation effectiveness.
Mesa, Maria D.; Olza, Josune; Gonzalez-Anton, Carolina; Aguilera, Concepcion M.; Moreno-Torres, Rosario; Jimenez, Africa; Perez de la Cruz, Antonio; Ruperez, Azahara I.; Gil, Angel
We aim to evaluate whether exclusive feeding of an enteral formula enriched with n-3 long chain polyunsaturated fatty acids (n-3 LC-PUFA) affects oxidative stress and the antioxidant defence system and may improve the levels of some relevant inflammatory, and cardiovascular biomarkers in frail adults over fifty years of age and in elderly subjects. Fifty-five patients were divided into two groups and were exclusively fed a newly designed normoproteic and isocaloric enteral formula enriched with eicosapentaenoic (98 mg/d) and docosahexaenoic acids (46 mg/d) (n = 26) or a reference enteral diet (n = 29). Oxidative, inflammatory and cardiovascular risk biomarkers and red blood cell fatty acid profiles were determined at the beginning and after 90 and 180 days of feeding. The n-3 LC-PUFA percentage tended to be higher (P = 0.053) in the experimental group than in the reference group. Administration of the n-3 LC-PUFA diet did not increase oxidative stress or modify plasma antioxidant capacity but decreased antioxidant enzymatic activities. MMP-9 plasma concentration decreased with both formulae, whereas tPAI-1 tended to decrease (P = 0.116) with the administration of the experimental formula. In conclusion, administration of the new n-3 LC-PUFA-enriched product for 6 months did not negatively alter the oxidative status and improved some cardiovascular risk biomarkers. PMID:26697137
Mesa, Maria D; Olza, Josune; Gonzalez-Anton, Carolina; Aguilera, Concepcion M; Moreno-Torres, Rosario; Jimenez, Africa; Perez de la Cruz, Antonio; Ruperez, Azahara I; Gil, Angel
We aim to evaluate whether exclusive feeding of an enteral formula enriched with n-3 long chain polyunsaturated fatty acids (n-3 LC-PUFA) affects oxidative stress and the antioxidant defence system and may improve the levels of some relevant inflammatory, and cardiovascular biomarkers in frail adults over fifty years of age and in elderly subjects. Fifty-five patients were divided into two groups and were exclusively fed a newly designed normoproteic and isocaloric enteral formula enriched with eicosapentaenoic (98 mg/d) and docosahexaenoic acids (46 mg/d) (n = 26) or a reference enteral diet (n = 29). Oxidative, inflammatory and cardiovascular risk biomarkers and red blood cell fatty acid profiles were determined at the beginning and after 90 and 180 days of feeding. The n-3 LC-PUFA percentage tended to be higher (P = 0.053) in the experimental group than in the reference group. Administration of the n-3 LC-PUFA diet did not increase oxidative stress or modify plasma antioxidant capacity but decreased antioxidant enzymatic activities. MMP-9 plasma concentration decreased with both formulae, whereas tPAI-1 tended to decrease (P = 0.116) with the administration of the experimental formula. In conclusion, administration of the new n-3 LC-PUFA-enriched product for 6 months did not negatively alter the oxidative status and improved some cardiovascular risk biomarkers.
Perret-Guillaume, Christine; Kesse-Guyot, Emmanuelle; Agrinier, Nelly; Hercberg, Serge; Galan, Pilar; Assmann, Karen E.; Briançon, Serge; Rotonda, Christine
Introduction Multimorbid chronic diseases are usually considered separately in trials. Here, we aimed to describe overall multimorbidity patterns in adults aged 55 years or older and assess their effect on health-related quality of life (HRQoL). Methods We used data for 5,647 participants included in the SUpplémentation en VItamines et Minéraux AntioXydants 2 (SU.VI.MAX 2) population-based trial. HRQoL was assessed by the French versions of the Medical Outcome Study Short Form 36 and the Duke Health Profile. An exploratory factor analysis was used to determine multimorbidity patterns, and a multimorbidity score for each resulting pattern was calculated. Adjusted multiple linear regression was used to examine the association between the identified multimorbidity and HRQoL scores by gender and for each age group (55–59, 60–64, 65–69, ≥ 70 years). Results More than 63% of the sample reported two or more chronic conditions (from 55.8% for those 55–59 years to 74.4% for those ≥ 70 years). Multimorbidity was more common among women than men (67.3% vs 60%). Two different multimorbidity patterns were identified. Pattern A was represented mainly by mental illness and bone impairments. Pattern B was represented mainly by cardiovascular and metabolic disorders. After adjusting for covariates, a high pattern A score was associated with reduced HRQoL for the physical and mental components of each HRQoL questionnaire, and a high pattern B score was associated with reduced HRQoL for only the physical component of each questionnaire. These multimorbidity scores affected HRQoL differently by age group. Conclusion Our study used a novel methodological approach to account for multimorbidity patterns in determining the link with chronic conditions. These multimorbidity scores (counted and weighted) can be used in clinical research to control for the effect of multimorbidity on patients’ HRQoL and may be useful for clinical practice. Clinical Trial Registration
Diez-Domingo, Javier; Weinke, Thomas; Garcia de Lomas, Juan; Meyer, Claudius U; Bertrand, Isabelle; Eymin, Cécile; Thomas, Stéphane; Sadorge, Christine
Zostavax(®) is a live, attenuated varicella zoster virus (VZV) vaccine developed specifically for the prevention of HZ and PHN in individuals aged ≥50 years. During the clinical development of Zostavax, which was mainly in the US, the vaccine was administrated by the subcutaneous (SC) route. In Europe, many healthcare professionals prefer administering vaccines by the intramuscular (IM) route. This was an open-label, randomised trial conducted in 354 subjects aged ≥50 years. The primary objectives were to demonstrate that IM administration is both non-inferior to SC administration in terms of 4-week post-vaccination geometric mean titres (GMTs), and elicits an acceptable geometric mean fold-rise (GMFR) of antibody titres measured by glycoprotein enzyme-linked immunosorbent assay. Pre-specified non-inferiority was set as the lower bound of the 95% confidence interval (CI) of the GMT ratio (IM/SC) being >0.67. An acceptable GMFR for the IM route was pre-specified as the lower bound of its 95% CI being >1.4. Description of the VZV immune response using the interferon-gamma enzyme-linked immunospot (IFN-γ ELISPOT) assay and of the safety were secondary objectives. Participants were randomised to IM or SC administration (1:1). The baseline demographics were comparable between groups; mean age: 62.6 years (range: 50.0-90.5). The primary immunogenicity objectives were met (per protocol analysis): GMT ratio (IM/SC): 1.05 (95% CI: 0.93-1.18); GMFR: 2.7 (2.4-3.0). VZV immune response using IFN-γ ELISPOT were comparable between groups. Frequencies of systemic adverse events were comparable between groups. Injection-site reactions were less frequent with IM than SC route: erythema (15.9% versus 52.5%), pain (25.6% versus 39.5%) and swelling (13.6% versus 37.3%), respectively. In adults aged ≥50 years, IM administration of Zostavax elicited similar immune responses to SC administration and was well tolerated, with fewer injection-site reactions than with SC
Kimura, Yuko; Hayashida, Naomi; Takahashi, Jumpei; Rafalsky, Ruslan; Saiko, Alexsey; Gutevich, Alexander; Chorniy, Sergiy; Kudo, Takashi
Background. The Chernobyl Nuclear Power Plant (CNPP) accident exposed a large number of inhabitants to internal 131I radiation. The associations between internal 131I exposure and thyroid autoimmunity and benign thyroid diseases remain controversial in the population living in the contaminated area around the CNNP. In this study, we evaluate the association of 131I with benign thyroid diseases. Methods. We compared the prevalence of Anti-Thyroid Autoantibodies (ATAs), thyroid function, and prevalence of thyroid ultrasound finding outcomes in 300 residents of the contaminated area of Ukraine who were 0–5 years of age at the time of the CNPP accident (group 1) and 300 sex-matched residents who were born after the accident (group 2). Results. We did not find any differences of the prevalence of Antithyroglobulin Antibodies (TGAb) positive, Antithyroid Peroxidase Antibodies (TPOAb) positive, and TGAb and/or TPOAb positive between the study groups. (11.7% vs 10.3%; p = 0.602, 17.3% vs 13.0%; p = 0.136, 21.0% vs 17.3%; p = 0.254, respectively); after adjusting for age and sex, the prevalence was not associated with the 131I exposure status in the study groups. The prevalence of subclinical and overt hypothyroidism cases was not significantly different (p = 0.093 and p = 0.320) in the two groups, nor was the prevalence of goiter (p = 0.482). On the other hand, the prevalence of nodules was significantly higher in group 1 (p = 0.003), though not significantly so after adjustment for age and sex. Discussion. Working 26–27 years after the CNNP accident, we found no increased prevalence of ATAs or benign thyroid diseases in young adults exposed to 131I fallout during early childhood in the contaminated area of Ukraine. Long-term follow-up is needed to clarify the effects of radiation exposure on autoimmunity reaction in the thyroid. PMID:27019779
Bird, Marie-Louise; Pittaway, Jane K; Cuisick, Isobel; Rattray, Megan; Ahuja, Kiran D K
As the population ages, fall rates are expected to increase, leading to a rise in accidental injury and injury-related deaths, and placing an escalating burden on health care systems. Sixty-nine independent community-dwelling adults (60-85 years, 18 males) had their leg strength, physical activity levels and their annual fall rate assessed at two timepoints over three years, (summer 2010 and summer 2013) monitoring balance. Force platform measures of medio-lateral sway range increased significantly under conditions of eyes open (mean difference MD 2.5 cm; 95% CI 2.2 to 2.8 cm) and eyes closed (MD 3.2 cm; 95% CI 2.8 to 3.6 cm), respectively (all p < 0.001) indicating worsening static balance control. Dynamic balance showed similar changes (p < 0.036). Leg strength was not significantly different between visits (p > 0.26). Physical activity reduced significantly (MD -909 Cal/week; 95% CI -347 to -1,470 Cal/week; p = 0.002) during the course of the study. Participants maintained aerobic activities, however resistance and balance exercise levels decreased non-significantly. The likelihood of falling was higher at the end of the study compared to the first timepoint (odds ratio 1.93, 95% CI 0.94 to 3.94; p = 0.07). Results of this study indicate that despite maintenance of leg strength there was an increase in medio-lateral sway over a relatively short time frame, with higher than expected increases in fall rates.
Zimran, Ari; Durán, Gloria; Giraldo, Pilar; Rosenbaum, Hanna; Giona, Fiorina; Petakov, Milan; Terreros Muñoz, Eduardo; Solorio-Meza, Sergio Eduardo; Cooper, Peter A; Varughese, Sheeba; Alon, Sari; Chertkoff, Raul
Taliglucerase alfa, the first available plant cell-expressed recombinant therapeutic protein, is an enzyme replacement therapy approved for Gaucher disease (GD). PB-06-001, a pivotal phase 3, multicenter, randomized, double-blind, parallel-dose study investigated taliglucerase alfa 30 or 60U/kg every other week through 9months in treatment-naïve adults with GD; 30-month extension study PB-06-003 followed. Patients completing PB-06-001 and PB-06-003 could continue treatment in PB-06-007. Nineteen patients enrolled in PB-06-007 (30U/kg, n=8; 60U/kg, n=9; dose adjusted, n=2); 17 completed 5 total years of treatment. In these 3 groups, respectively, taliglucerase alfa resulted in mean decreases in spleen volume (-8.7, -6.9, -12.4 multiples of normal), liver volume (-0.6, -0.4, -0.5 multiples of normal), chitotriosidase activity (-83.1%, -93.4%, -87.9%), and chemokine (CC motif) ligand 18 concentration (-66.7%, -83.3%, -78.9%), as well as mean increases in hemoglobin concentration (+2.1, +2.1, +1.8mg/dL) and platelet count (+31,871, +106,800, +34,000/mm(3)). The most common adverse events were nasopharyngitis and arthralgia. Most adverse events were mild/moderate; no serious adverse events were considered treatment-related. These results demonstrate continued improvement of disease parameters during 5years of taliglucerase alfa therapy in 17 treatment-naive patients with no new safety concerns, extending the taliglucerase alfa clinical efficacy and safety dataset. This study was registered at www.clinicaltrials.gov as NCT01422187.
Kimura, Yuko; Hayashida, Naomi; Takahashi, Jumpei; Rafalsky, Ruslan; Saiko, Alexsey; Gutevich, Alexander; Chorniy, Sergiy; Kudo, Takashi; Takamura, Noboru
Background. The Chernobyl Nuclear Power Plant (CNPP) accident exposed a large number of inhabitants to internal (131)I radiation. The associations between internal (131)I exposure and thyroid autoimmunity and benign thyroid diseases remain controversial in the population living in the contaminated area around the CNNP. In this study, we evaluate the association of (131)I with benign thyroid diseases. Methods. We compared the prevalence of Anti-Thyroid Autoantibodies (ATAs), thyroid function, and prevalence of thyroid ultrasound finding outcomes in 300 residents of the contaminated area of Ukraine who were 0-5 years of age at the time of the CNPP accident (group 1) and 300 sex-matched residents who were born after the accident (group 2). Results. We did not find any differences of the prevalence of Antithyroglobulin Antibodies (TGAb) positive, Antithyroid Peroxidase Antibodies (TPOAb) positive, and TGAb and/or TPOAb positive between the study groups. (11.7% vs 10.3%; p = 0.602, 17.3% vs 13.0%; p = 0.136, 21.0% vs 17.3%; p = 0.254, respectively); after adjusting for age and sex, the prevalence was not associated with the (131)I exposure status in the study groups. The prevalence of subclinical and overt hypothyroidism cases was not significantly different (p = 0.093 and p = 0.320) in the two groups, nor was the prevalence of goiter (p = 0.482). On the other hand, the prevalence of nodules was significantly higher in group 1 (p = 0.003), though not significantly so after adjustment for age and sex. Discussion. Working 26-27 years after the CNNP accident, we found no increased prevalence of ATAs or benign thyroid diseases in young adults exposed to (131)I fallout during early childhood in the contaminated area of Ukraine. Long-term follow-up is needed to clarify the effects of radiation exposure on autoimmunity reaction in the thyroid.
Boecker, Regina; Holz, Nathalie E; Buchmann, Arlette F; Blomeyer, Dorothea; Plichta, Michael M; Wolf, Isabella; Baumeister, Sarah; Meyer-Lindenberg, Andreas; Banaschewski, Tobias; Brandeis, Daniel; Laucht, Manfred
Several lines of evidence have implicated the mesolimbic dopamine reward pathway in altered brain function resulting from exposure to early adversity. The present study examined the impact of early life adversity on different stages of neuronal reward processing later in life and their association with a related behavioral phenotype, i.e. attention deficit/hyperactivity disorder (ADHD). 162 healthy young adults (mean age = 24.4 years; 58% female) from an epidemiological cohort study followed since birth participated in a simultaneous EEG-fMRI study using a monetary incentive delay task. Early life adversity according to an early family adversity index (EFA) and lifetime ADHD symptoms were assessed using standardized parent interviews conducted at the offspring's age of 3 months and between 2 and 15 years, respectively. fMRI region-of-interest analysis revealed a significant effect of EFA during reward anticipation in reward-related areas (i.e. ventral striatum, putamen, thalamus), indicating decreased activation when EFA increased. EEG analysis demonstrated a similar effect for the contingent negative variation (CNV), with the CNV decreasing with the level of EFA. In contrast, during reward delivery, activation of the bilateral insula, right pallidum and bilateral putamen increased with EFA. There was a significant association of lifetime ADHD symptoms with lower activation in the left ventral striatum during reward anticipation and higher activation in the right insula during reward delivery. The present findings indicate a differential long-term impact of early life adversity on reward processing, implicating hyporesponsiveness during reward anticipation and hyperresponsiveness when receiving a reward. Moreover, a similar activation pattern related to lifetime ADHD suggests that the impact of early life stress on ADHD may possibly be mediated by a dysfunctional reward pathway.
Qidong City, China, has had high liver cancer incidence from endemic hepatitis B virus (HBV) infection and dietary exposure to aflatoxin. Based on etiologic studies, we began interventions in 1980 to reduce dietary aflatoxin and initiate neonatal HBV vaccination. We studied trends in liver cancer incidence rates in the 1.1 million inhabitants of Qidong and examined trends in aflatoxin exposure, staple food consumption, HBV infection markers and annual income. Aflatoxin exposure declined greatly in association with economic reform, increased earnings and educational programs to shift staple food consumption in the total population from moldy corn to fresh rice. A controlled neonatal HBV vaccination trial began in 1983 and ended in November, 1990, when vaccination was expanded to all newborns. Liver cancer incidence fell dramatically in young adults. Compared with 1980–83, the age-specific liver cancer incidence rates in 2005–08 significantly decreased 14-fold at ages 20–24, 9-fold at ages 25–29, 4-fold at ages 30–34, 1.5-fold at ages 35–39, 1.2-fold at ages 40–44 and 1.4-fold at ages 45–49, but increased at older ages. The 14-fold reduction at ages 20–24 might reflect the combined effects of reduced aflatoxin exposure and partial neonatal HBV vaccination. Decrease incidence in age groups >25 years could mainly be attributable to rapid aflatoxin reduction. Compared with 1980–83, liver cancer incidence in 1990–93 significantly decreased 3.4-fold at ages 20–24, and 1.9-fold at ages 25–29 when the first vaccinees were <11 years old. PMID:23322152
Kirmayer, Paul, Ed.; And Others
This volume contains 13 articles that reflect the development of adult education in Israel during recent years. The material relates to the principal areas with which the Division of Adult Education deals: formal and nonformal education for adults, language and cultural absorption of new immigrants, and training of facilitators for parental…
Dunicz-Sokolowska, Aldona; Długaszek, Maria; Radomska, Krystyna; Wlaźlak, Edyta; Surkont, Grzegorz; Graczyk, Alfreda
The aim of the present study was to define referential values of 5 basic bioelements (Ca, Mg, Zn, Cu, Fe) and 2 toxic metals (Pb and Cd) in the hair of Polish adults aged 20 to 40 years, based on the research conducted from 1991 to 2006 on a group of 5733 formally healthy subjects of both sexes. The results of our biochemical tests were subjected to statistical analysis and they can be treated as referential norms for the concentrations of analyzed bioelements in the hair of the Polish population. Our analyses confirm significant differences in accumulations of certain elements in women's and men's hair. We established that women's hair Ca, Mg, Zn (p = 0.000000) and hair Cu (p = 0.0001) concentrations are higher than they are in men. A lower mean of hair Fe concentrations in women were confirmed by some tests. Men have significantly higher (p = 0.0000) concentrations of toxic metals (hair Pb and Cd), which keep increasing with age. Analyses of correlations confirm significance (for the assumed level of significance alpha = 0.05) of synergistic interactions between bioelements: Ca-Mg (r = +0.70), Ca-Zn (r = +0.39), Ca-Cu (r = +0.14), Mg-Zn (r = +0.31), Mg-Cu (r = +0.10), Zn-Cu (r = +0.11), Zn-Fe (r = +0.07). Significance (a < 0.05) of antagonistic interactions with toxic metals: Ca-Pb (r = -0.13), Zn-Pb (r = -0.15), Mg-Pb (r = -0.15), Zn-Cd (r =-0.02) was confirmed. Significance (alpha < 0.05) of synergistic effects with toxic metals: Pb-Cd (r = +0.35), Fe-Pb (r = +0.16), Fe-Cd (r = +0.08) was also confirmed. Adults in whose hair bioelements and hair toxic metals concentrations have shown values outlying from reference and who have too many toxic elements and too few bioelements should undergo further diagnostic tests since the results could be a sign of disturbances that could lead to various diseases.
Nguyen, Kimberly; Marshall, LaTisha; Hu, Sean; Neff, Linda
Cigarette smoking and the use of smokeless tobacco both cause substantial morbidity and premature mortality. The concurrent use of these products might increase dependence and the risk for tobacco-related disease and death. State-specific estimates of prevalence and relative percent change in current cigarette smoking, smokeless tobacco use, and concurrent cigarette smoking and smokeless tobacco use among U.S. adults during 2011-2013, developed using data from the Behavioral Risk Factor Surveillance System (BRFSS), indicate statistically significant (p<0.05) changes for all three behaviors. From 2011 to 2013, there was a statistically significant decline in current cigarette smoking prevalence overall and in 26 states. During the same period, use of smokeless tobacco significantly increased in four states: Louisiana, Montana, South Carolina, and West Virginia; significant declines were observed in two states: Ohio and Tennessee. In addition, the use of smokeless tobacco among cigarette smokers (concurrent use) significantly increased in five states (Delaware, Idaho, Nevada, New Mexico, and West Virginia). Although annual decreases in overall cigarette smoking among adults in the United States have occurred in recent years, there is much variability in prevalence of cigarette smoking, smokeless tobacco, and concurrent use across states. In 2013, the prevalence ranged from 10.3% (Utah) to 27.3% (West Virginia) for cigarette smoking; 1.5% (District of Columbia and Massachusetts) to 9.4% (West Virginia) for smokeless tobacco; and 3.1% (Vermont) to 13.5% (Idaho) for concurrent use. These findings highlight the importance of sustained comprehensive state tobacco-control programs funded at CDC-recommended levels, which can accelerate progress toward reducing tobacco-related disease and deaths by promoting evidence-based population-level interventions. These interventions include increasing the price of tobacco products, implementing comprehensive smoke-free laws
Santos Paulo, Ana Cristina; Valadares, Idalina; Martins, Sara; Breia, Fátima; Brito-Avô, António; Morais, Ana; de Lencastre, Hermínia; Sá-Leão, Raquel
Pneumococcal disease is frequent at the extremes of age. While several studies have looked at colonization among young children, much less is known among the elderly. We aimed to evaluate pneumococcal carriage among elderly adults living in Portugal. Between April 2010 and December 2012, nasopharyngeal and oropharyngeal swabs of adults over 60 years of age, living in an urban area (n = 1,945) or in a rural area (n = 1,416), were obtained. Pneumococci were isolated by culture-based standard procedures, identified by optochin susceptibility, bile solubility and PCR screening for lytA and cpsA, and characterized by antibiotype, serotype, and MLST. Associations between pneumococcal carriage, socio-demographic and clinical characteristics were evaluated by univariate analysis and multiple logistic regression. The global prevalence of carriage was 2.3% (95% CI: 1.8–2.8). In the multiple logistic regression analysis, smoking, being at a retirement home, and living in a rural area increased the odds of being a pneumococcal carrier by 4.4-fold (95% CI: 1.9–9.2), 2.0-fold (95% CI: 1.1–3.6) and 2.0-fold (95% CI: 1.2–3.5), respectively. Among the 77 pneumococcal isolates, 26 serotypes and 40 STs were identified. The most prevalent serotypes were (in decreasing order) 19A, 6C, 22F, 23A, 35F, 11A, and 23B, which accounted, in total, for 60.0% of the isolates. Most isolates (93.5%) had STs previously described in the MLST database. Resistance to macrolides, non-susceptibility to penicillin and multidrug resistance were found in 19.5%, 11.7%, and 15.6% of the isolates, respectively. We conclude that the prevalence of pneumococcal carriage in the elderly, in Portugal, as determined by culture-based methods, is low. Serotype and genotype diversity is high. Living in a rural area, in a retirement home, and being a smoker increased the risk of pneumococcal carriage. This study contributes to the establishment of a baseline that may be used to monitor how novel
NHANES data indicate that two-thirds of U.S. adults consume less than the RDA for Mg. A low Mg intake or status has been associated with poor quality sleep and inflammatory stress. Thus, 100 adults (22 males and 78 females) older than 51 yr with a Pittsburgh Sleep Quality Index (PSQI) higher than 5 ...
McLaughlin, Margaret J.; Speirs, Katherine E.; Shenassa, Edmond D.
This study examined the impact of childhood reading disability (RD) on adult educational attainment and income. Participants' (N = 1,344) RD was assessed at age 7, and adult educational attainment and income were assessed in midlife using categorical variables. Participants with RD at age 7 were 74% (95% CI: 0.18, 0.37) less likely to attain a…
Emlet, Charles A.
Purpose: Older adults living with HIV infection may be doubly stigmatized, as they are branded by both age as well as HIV status. Through semistructured interviews, this study sought to examine whether older adults with HIV/AIDS experience both ageism and HIV stigma and how those experiences manifest in their lives. Design and Methods: This was a…
Sanford, Christopher; Newman, Lynn; Wagner, Mary; Cameto, Renee; Knokey, Anne-Marie; Shaver, Debra
The National Longitudinal Transition Study-2 (NLTS2) provides a unique source of information to help in developing an understanding of the experiences of secondary school students with disabilities nationally as they go through their early adult years. NLTS2 addresses questions about youth with disabilities in transition by providing information…
Smith, Justin S; Shaffrey, Christopher I; Klineberg, Eric; Lafage, Virginie; Schwab, Frank; Lafage, Renaud; Kim, Han Jo; Hostin, Richard; Mundis, Gregory M; Gupta, Munish; Liabaud, Barthelemy; Scheer, Justin K; Diebo, Bassel G; Protopsaltis, Themistocles S; Kelly, Michael P; Deviren, Vedat; Hart, Robert; Burton, Doug; Bess, Shay; Ames, Christopher P
OBJECTIVE Although 3-column osteotomy (3CO) can provide powerful alignment correction in adult spinal deformity (ASD), these procedures are complex and associated with high complication rates. The authors' objective was to assess complications associated with ASD surgery that included 3CO based on a prospectively collected multicenter database. METHODS This study is a retrospective review of a prospectively collected multicenter consecutive case registry. ASD patients treated with 3CO and eligible for 2-year follow-up were identified from a prospectively collected multicenter ASD database. Early (≤ 6 weeks after surgery) and delayed (> 6 weeks after surgery) complications were collected using standardized forms and on-site coordinators. RESULTS Of 106 ASD patients treated with 3CO, 82 (77%; 68 treated with pedicle subtraction osteotomy [PSO] and 14 treated with vertebral column resection [VCR]) had 2-year follow-up (76% women, mean age 60.7 years, previous spine fusion in 80%). The mean number of posterior fusion levels was 12.9, and 17% also had an anterior fusion. A total of 76 early (44 minor, 32 major) and 66 delayed (13 minor, 53 major) complications were reported, with 41 patients (50.0%) and 45 patients (54.9%) affected, respectively. Overall, 64 patients (78.0%) had at least 1 complication, and 50 (61.0%) had at least 1 major complication. The most common complications were rod breakage (31.7%), dural tear (20.7%), radiculopathy (9.8%), motor deficit (9.8%), proximal junctional kyphosis (PJK, 9.8%), pleural effusion (8.5%), and deep wound infection (7.3%). Compared with patients who did not experience early or delayed complications, those who had these complications did not differ significantly with regard to age, sex, body mass index, Charlson Comorbidity Index, American Society of Anesthesiologists score, smoking status, history of previous spine surgery or spine fusion, or whether the 3CO performed was a PSO or VCR (p ≥ 0.06). Twenty-seven (33
Lippa, Carol F.
Objectives. We aimed to test the hypothesis that metabolic syndrome (MetS) is significantly associated with cognitive decline (CoD) in elderly adults and further assess whether MetS and inflammation have a significant joint effect on CoD. Methods. Data (n = 2975) from the U.S. National Health and Nutrition Examination Survey (1999–2002) in participants aged ≥60 years who had Digit Symbol Substitution Tests (DSS: a standard measure of cognitive function) were studied. CoD was defined as those in the lowest quintile of DSS score. MetS was defined as having ≥3 of 5 MetS traits (large waist circumference (WC), high blood pressure (BP), elevated glucose, triglycerides, and decreased high density lipoprotein cholesterol). Results. Of 2975 participants, the prevalence of CoD (DSS score <25) was 12.1%. After adjusting covariates, individual large WC, high BP, elevated glucose level, and MetS were significantly associated with CoD in logistic regression models (P < 0.001). There was a significant dose-response relationship between an increased number of MetS traits and CoD (P < 0.001). A significant joint effect of MetS and CRP on the odds of CoD was observed. Conclusion. The study, using a nationally representative sample, extended previous studies by highlighting a significant MetS-CoD relationship and a joint effect of MetS and CRP on CoD. These novel findings add to our understanding of the association of neurometabolic disorders and cognition and have implications that may be relevant to primary care practice. PMID:26317101
Ikeda, Yoshifumi; Okuzumi, Hideyuki; Kokubun, Mitsuru
Inhibitory control is the ability to suppress competing, dominant, automatic, or prepotent cognitive processing at perceptual, intermediate, and output stages. Inhibitory control is a key cognitive function of typical and atypical child development. This study examined age-related trends of Stroop-like interference in 3 to 12-year-old children and young adults by administration of a computerized Stroop-like big-small task with reduced working memory demand. This task used a set of pictures displaying a big and small circle in black and included the same condition and the opposite condition. In the same condition, each participant was instructed to say "big" when viewing the big circle and to say "small" when viewing the small circle. In the opposite condition, each participant was instructed to say "small" when viewing the big circle and to say "big" when viewing the small circle. The opposite condition required participants to inhibit the prepotent response of saying the same, a familiar response to a perceptual stimulus. The results of this study showed that Stroop-like interference decreased markedly in children in terms of error rates and correct response time. There was no deterioration of performance occurring between the early trials and the late trials in the sessions of the day-night task. Moreover, pretest failure rate was relatively low in this study. The Stroop-like big-small task is a useful tool to assess the development of inhibitory control in young children in that the task is easy to understand and has small working memory demand.
Wang, Nan; Ogg, Carol; Crombez, Eric; Cohn, Gabriel M.; Elstein, Deborah
Velaglucerase alfa is a human β‐glucocerebrosidase approved for Gaucher disease type 1 (GD1) treatment. This report summarizes the 7‐year experience of the now‐completed phase I/II and extension studies of adult GD1 patients who received velaglucerase alfa. Ten patients who completed the 9‐month, phase I/II study entered the extension trial TKT025EXT, of which eight completed this study. Doses were reduced after a cumulative treatment period of 15 to 18 months. Although all patients experienced ≥1 adverse event, no patient withdrew due to a drug‐related adverse event or required premedication. No patient developed anti‐drug antibodies, compliance remained high (median 98%), and seven of eight eligible patients transitioned to home infusions under supervision by healthcare professionals. Statistically significant improvements were observed for efficacy parameters: mean percentage changes from baseline (95% confidence intervals) were 18% (12%, 24%) for hemoglobin concentration, 115% (66%, 164%) for platelet counts, and −42% (−53%, −31%) and −78% (−94%, −62%) for liver and spleen volumes, respectively. Improvements were also observed for secondary endpoints chitotriosidase and CCL18 levels and exploratory endpoints (bone mineral density [BMD], bone marrow burden [BMB] scores). Normalization to near‐normalization of individuals' hemoglobin concentrations, platelet counts, liver volumes, and BMB scores was observed, and there were marked improvements in spleen volumes, biomarkers, and BMD. TKT025EXT represents the longest, prospective clinical trial for GD1 treatment to date and suggests that, despite dose reduction within 18 months of initiating therapy, velaglucerase alfa was generally well tolerated and was associated with marked improvement, including near normalization and/or normalization of key GD1 disease parameters. Am. J. Hematol. 90:577–583, 2015. © 2015 The Authors. American Journal of Hematology published by Wiley Periodicals
Mamun, Abdullah Al; Reid, Christopher; Huxley, Rachel R.
Objective Hypertension is the major driver of the cardiovascular epidemic facing Indonesia in the 21st century. Understanding the socioeconomic inequalities associated with hypertension is essential for designing effective intervention strategies. The aim of the current study was to use sub-nationally representative survey data to examine socio-demographic inequalities in the prevalence, diagnosis and management of hypertension in Indonesian adults. Methods We investigated factors associated with hypertension prevalence, diagnosis, treatment and control using data on self-reported diagnosis and treatment, and blood pressure measurements, collected from 9755 respondents aged 40 years and up in the 2007 Indonesian Family Life Survey (IFLS 4). Results Age-standardized prevalence of hypertension among the study participants was 47.8% (95% CI: 46.8, 48.9), of which almost 70% were undiagnosed. Hypertension was significantly higher in women than men (52.3% versus 43.1%, p-value<0.001). Prevalence of hypertension increased significantly with ageing (Pfor trend <0.001). Over 91% (men: 92.1%, women: 90.0%) of hypertension cases were uncontrolled. Gender, education and socioeconomic status had differential impact on the diagnosis of hypertension and in receiving treatment. Conclusions Overall, less than a third were aware of their hypertension and a quarter of those on medication had their blood pressure effectively controlled. Men and those of younger age were more vulnerable to have undiagnosed and untreated hypertension. Substantial effort should be given to improve awareness about the condition and making provision for early diagnosis and treatment. PMID:27556532
Kharitonova, Maria; Winter, Warren; Sheridan, Margaret A
Working memory develops slowly: Even by age 8, children are able to maintain only half the number of items that adults can remember. Neural substrates that support performance on working memory tasks also have a slow developmental trajectory and typically activate to a lesser extent in children, relative to adults. Little is known about why younger participants elicit less neural activation. This may be due to maturational differences, differences in behavioral performance, or both. Here we investigate the neural correlates of working memory capacity in children (ages 5-8) and adults using a visual working memory task with parametrically increasing loads (from one to four items) using fMRI. This task allowed us to estimate working memory capacity limit for each group. We found that both age groups increased the activation of frontoparietal networks with increasing working memory loads, until working memory capacity was reached. Because children's working memory capacity limit was half of that for adults, the plateau occurred at lower loads for children. Had a parametric increase in load not been used, this would have given an impression of less activation overall and less load-dependent activation for children relative to adults. Our findings suggest that young children and adults recruit similar frontoparietal networks at working memory loads that do not exceed capacity and highlight the need to consider behavioral performance differences when interpreting developmental differences in neural activation.
California Community Colleges, Chancellor's Office, 2015
For more than one hundred and fifty years, until 2008, California was an undisputed national leader in its commitment to adult education. The state's investment in adult learners topped $750 million, a sum greater than the combined total of every other state in the nation. However, for the past several years recession and fiscal crisis have left…
Background Alcohol misuse by young people is an important public health issue, and has led to the development of a range of prevention interventions. Evidence concerning the most effective approaches to intervention design and implementation is limited. Parental involvement in school-based interventions is important, but many programmes fail to recruit large numbers of parents. This paper reports findings from an exploratory evaluation of a new alcohol misuse prevention programme - Kids, Adults Together (KAT), which comprised a classroom component, engagement with parents through a fun evening for families with children aged 9-11 years, and a DVD. The evaluation aimed to establish the programme's theoretical basis, explore implementation processes and acceptability, and identify plausible precursors of the intended long-term outcomes. Methods Documentary analysis and interviews with key personnel examined the programme's development. Classroom preparation and KAT family events in two schools were observed. Focus groups with children, and interviews with parents who attended KAT family events were held immediately after programme delivery, and again after three months. Interviews with head teachers and with teachers who delivered the classroom preparation were conducted. Follow-up interviews with programme personnel were undertaken. Questionnaires were sent to parents of all children involved in classroom preparation. Results KAT achieved high levels of acceptability and involvement among both children and parents. Main perceived impacts of the programme were increased pro-social communication within families (including discussions about harmful parental alcohol consumption), heightened knowledge and awareness of the effects of alcohol consumption and key legal and health issues, and changes in parental drinking behaviours. Conclusions KAT demonstrated promise as a prevention intervention, primarily through its impact on knowledge and communication processes within
Ellaway, A; Macdonald, L; Kearns, A
Background It is usually assumed that housing tenure and car access are associated with health simply because they are acting as markers for social class or income and wealth. However, previous studies conducted in the late 1990s found that these household assets were associated with health independently of social class and income. Here, we set out to examine if this is still the case. Methods We use data from our 2010 postal survey of a random sample of adults (n=2092) in 8 local authority areas in the West of Scotland. Self-reported health measures included limiting longstanding illness (LLSI), general health over the last year and the Hospital Anxiety and Depression Scale. Results We found a statistically significant relationship between housing tenure and all 4 health measures, regardless of the inclusion of social class or income as controls. Compared with owner occupiers, social renters were more likely to report ill-health (controlling for social class—LLSI OR: 3.24, general health OR: 2.82, anxiety η2: 0.031, depression η2: 0.048, controlling for income—LLSI OR: 3.28, general health OR: 2.82, anxiety η2: 0.033, depression η2: 0.057) (p<0.001 for all models). Car ownership was independently associated with depression and anxiety, with non-owners at higher risk of both (controlling for income—anxiety η2: 0.010, depression η2: 0.023, controlling for social class—anxiety η2: 0.013, depression η2: 0.033) (p<0.001 for all models). Conclusions Our results show that housing tenure and car ownership are still associated with health, after taking known correlates (age, sex, social class, income) into account. Further research is required to unpack some of the features of these household assets such as the quality of the dwelling and access to and use of different forms of transport to determine what health benefits or disbenefits they may be associated with in different contexts. PMID:27807086
Okwuosa, Tochi M.; Greenland, Philip; Ning, Hongyan; Liu, Kiang; Lloyd-Jones, Donald M.
OBJECTIVES The purpose of this study was to assess the prevalence and distribution of coronary artery calcium (CAC) across Framingham Risk Score (FRS) strata and therefore determine FRS levels at which asymptomatic, young to early middle-age individuals could potentially benefit from CAC screening. BACKGROUND High CAC burden is associated with increased risk of coronary events beyond the FRS. Expert panel recommendations for CAC screening are based on data obtained in middle-age and older individuals. METHODS We included 2,831 CARDIA (Coronary Artery Risk Development in Young Adults) study participants with an age range of 33 to 45 years. The number needed to screen ([NNS] number of people in each FRS stratum who need to be screened to detect 1 person with a CAC score above the specified cut point) was used to assess the yield of screening for CAC. CAC prevalence was compared across FRS strata using a chi-square test. RESULTS CAC scores >0 and ≥100 were present in 9.9% and 1.8% of participants, respectively. CAC prevalence and amount increased across higher FRS strata. A CAC score >0 was observed in 7.3%, 20.2%, 19.1%, and 44.8% of individuals with FRSs of 0 to 2.5%, 2.6% to 5%, 5.1% to 10%, and >10%, respectively (NNS = 14, 5, 5, and 2, respectively). A CAC score of ≥100 was observed in 1.3%, 2.4%, and 3.5% of those with FRSs of 0 to 2.5%, 2.6% to 5%, and 5.1% to 10%, respectively (NNS = 79, 41, and 29, respectively), but in 17.2% of those with an FRS >10% (NNS = 6). Similar trends were observed when findings were stratified by sex and race. CONCLUSIONS In this young to early middle-age cohort, we observed concordance between CAC prevalence/amount and FRS strata. Within this group, the yield of screening and possibility of identifying those with a high CAC burden (CAC score of ≥100) is low in those with an FRS of ≤10%, but considerable in those with an FRS >10%. PMID:22974805
Castelnuovo, Barbara; Kiragga, Agnes; Mubiru, Frank; Kambugu, Andrew; Kamya, Moses; Reynolds, Steven J
Introduction The majority of studies from resource-limited settings only report short-term virological outcomes of patients on antiretroviral treatment (ART). We aim to describe the long-term durability of first-line ART and identify factors associated with long-term virological outcomes. Methods At the Infectious Diseases Institute in Kampala, Uganda, 559 adult patients starting ART in 2004 were enrolled into a research cohort and monitored with viral load (VL) testing every six months for 10 years. We report the proportion and cumulative probability of 1) achieving virologic suppression (at least one VL <400 copies/ml); 2) experiencing virologic failure in patients who achieved suppression (two consecutive VLs >1000 copies/ml or one VL >5000, for those without a subsequent one); 3) treatment failure (not attaining virologic suppression or experiencing virologic failure). We used Cox regression methods to determine the characteristics associated with treatment failure. We included gender, baseline age, WHO stage, body mass index, CD4 count, propensity score for initial ART regimen, VL, time-dependent CD4 count and adherence. Results Of the 559 patients enrolled, 472 (84.8%) had at least one VL (67 died, 13 were lost to follow-up, 4 transferred, 2 had no VL available); 73.6% started on d4T/3TC/nevirapine and 26.4% on AZT/3TC/efavirenz. Patients in the two groups had similar characteristics, except for the higher proportion of patients in WHO Stage 3/4 and higher VL in the efavirenz-based group. Four hundred thirty-nine (93%) patients achieved virologic suppression with a cumulative probability of 0.94 (confidence interval (CI): 0.92–0.96); 74/439 (16.9%) experienced virologic failure with a cumulative probability of 0.18 (CI: 0.15–0.22). In the multivariate analysis, initial d4T/3TC/nevirapine regimen (hazard ratio (HR): 3.02; CI: 3.02 (1.66–5.44, p<0.001)) and baseline VL ≥5 log10 copies/ml (HR: 2.29; CI: 1.29–4.04) were associated with treatment
De Vreese, Luc P.; Mantesso, Ulrico; De Bastiani, Elisa; Weger, Elisabeth; Marangoni, Annachiara C.; Gomiero, Tiziano
Dementia appears at a higher rate among some adults with intellectual disabilities (ID) and this potentially poses a greater risk of nursing home admission. Yet, to date, there is no evidence on the efficacy of general dementia-derived environment-, personnel-, and patient-oriented intervention strategies in delaying onset of dementia or in…
Davidson, J. Cody; Holbrook, Wesley T.
In 2011, the Organisation for Economic Co-operation and Development (OECD) reported that, in the 24 to 54 age range, the United States ranked thirty-fourth among all for individuals with a postsecondary credential. For the United States to increase in rank, adult students, who are projected to increase by 1.9 million in postsecondary enrollment by…
Taylor, Richard, Ed.
This book contains 21 papers detailing the history of adult and continuing education at the University of Leeds (England) since its inception in 1946 as the Department of Extra-Mural Studies. The themes addressed include the appropriate nature of university continuing education and the issue of standards and quality assurance; the roles of…
Roozen, Kevin; Lunsford, Karen J.
This article reflects on where and how empirical research, focusing particularly on college/adult writing and literate practice, has appeared over the last century in the complete runs of "English Journal," "College English," "College Composition and Communication," "Research in the Teaching of English," and "Teaching English in the Two-Year…
Burkheimer, Graham J.; Novak, Thomas P.
A summary is presented of some of the results from the National Longitudinal Study of the High School of 1972, which examined the vocational activities, plans, aspirations, and attitudes of young adults after they leave high school, along with their postsecondary experiences and family and community activities. By October 1979, about one-fourth of…
Paradis, Angela D.; Reinherz, Helen Z.; Giaconia, Rose M.; Beardslee, William R.; Ward, Kirsten; Fitzmaurice, Garrett M.
Family arguments by the age of 15 and family physical violence by the age of 18 is found to significantly compromise key domains of adult functioning at age 30. The findings are based on data from 346 participants whose psychosocial development has been followed since age 5.
Margallo-Lana, M. L.; Moore, P. B.; Kay, D. W. K.; Perry, R. H.; Reid, B. E.; Berney, T. P.; Tyrer, S. P.
Background: The clinical and neuropathological features associated with dementia in Down's syndrome (DS) are not well established. Aims: To examine clinico-pathological correlations and the incidence of cognitive decline in a cohort of adults with DS. Method: A total of 92 hospitalized persons with DS were followed up from 1985 to December 2000.…
Development of a modified prognostic index of patients with aggressive adult T-cell leukemia-lymphoma aged 70 years or younger: a possible risk-adapted management strategies including allogeneic transplantation.
Fuji, Shigeo; Yamaguchi, Takuhiro; Inoue, Yoshitaka; Utsunomiya, Atae; Moriuchi, Yukiyoshi; Uchimaru, Kaoru; Owatari, Satsuki; Miyagi, Takashi; Taguchi, Jun; Choi, Ilseung; Otsuka, Eiichi; Nakachi, Sawako; Yamamoto, Hisashi; Kurosawa, Saiko; Tobinai, Kensei; Fukuda, Takahiro
Adult T-cell leukemia-lymphoma is a distinct type of peripheral T-cell lymphoma caused by human T-cell lymphotropic virus type I. Although allogeneic stem cell transplantation after chemotherapy is a recommended treatment option for patients with aggressive adult T-cell leukemia-lymphoma, there is no consensus about indications for allogeneic stem cell transplantation because there is no established risk stratification system for transplant eligible patients. We conducted a nationwide survey of patients with aggressive adult T-cell leukemia-lymphoma to construct a new large database that includes 1,792 patients aged 70 years or younger with aggressive adult T-cell leukemia-lymphoma who were diagnosed between 2000 and 2013 and received intensive first-line chemotherapy. We randomly divided patients into two groups (training and validation sets). Acute type, poor performance status, high soluble interleukin-2 receptor level (> 5,000 U/mL), high adjusted calcium level (≥ 12 mg/dL), and high C-reactive protein level (≥ 2.5 mg/dL) were independent adverse prognostic factors using the training set. We used these five variables to divide patients into three risk groups. In the validation set, medial overall survival was 626 days, 322 days, and 197 days for the low-, intermediate-, and high-risk groups, respectively. In the intermediate- and high-risk groups, transplanted recipients had significantly better overall survival than non-transplanted patients. We developed a new promising risk stratification system to identify patients aged 70 years or younger with aggressive adult T-cell leukemia-lymphoma who may benefit from upfront allogeneic stem cell transplantation. Prospective studies are warranted to confirm the benefit of this treatment strategy.
... if the administrative law judge so directs, a true copy of such matter in proper form shall be... relevant and material matter offered in evidence is embraced in a document containing other matter not... plainly designate the matter so offered, segregating and excluding insofar as practicable the...
... if the administrative law judge so directs, a true copy of such matter in proper form shall be... relevant and material matter offered in evidence is embraced in a document containing other matter not... plainly designate the matter so offered, segregating and excluding insofar as practicable the...
... administrative law judge so directs, a true copy of such matter in proper form shall be received in evidence as... material matter offered in evidence is embraced in a document containing other matter not material or... the matter so offered, segregating and excluding insofar as practicable the immaterial or...
... if the administrative law judge so directs, a true copy of such matter in proper form shall be... relevant and material matter offered in evidence is embraced in a document containing other matter not... plainly designate the matter so offered, segregating and excluding insofar as practicable the...
Effects of Two-Year Vitamin B12 and Folic Acid Supplementation on Depressive Symptoms and Quality of Life in Older Adults with Elevated Homocysteine Concentrations: Additional Results from the B-PROOF Study, an RCT
de Koning, Elisa J.; van der Zwaluw, Nikita L.; van Wijngaarden, Janneke P.; Sohl, Evelien; Brouwer-Brolsma, Elske M.; van Marwijk, Harm W. J.; Enneman, Anke W.; Swart, Karin M. A.; van Dijk, Suzanne C.; Ham, Annelies C.; van der Velde, Nathalie; Uitterlinden, André G.; Penninx, Brenda W. J. H.; Elders, Petra J. M.; Lips, Paul; Dhonukshe-Rutten, Rosalie A. M.; van Schoor, Natasja M.; de Groot, Lisette C. P. G. M.
Lowering elevated plasma homocysteine (Hcy) concentrations by supplementing vitamin B12 and folic acid may reduce depressive symptoms and improve health-related quality of life (HR-QoL) in older adults. This study aimed to test this hypothesis in a randomized controlled trial. Participants (N = 2919, ≥65 years, Hcy concentrations ≥12 µmol/L) received either 500 µg vitamin B12 and 400 µg folic acid daily or placebo for two years. Both tablets contained 15 µg vitamin D3. Depressive symptoms were measured with the Geriatric Depression Scale-15 (GDS-15). HR-QoL was assessed with the SF-12 Mental and Physical component summary scores and the EQ-5D Index score and Visual Analogue Scale. Differences in two-year change scores were analyzed with Analysis of Covariance (ANCOVA). Hcy concentrations decreased more in the intervention group, but two-year change scores of the GDS-15 and three of four HR-QoL measures did not differ between groups. The EQ-5D Index score declined less in the intervention group than in the placebo group (mean change 0.00 vs. −0.02, p = 0.004). In conclusion, two-year supplementation with vitamin B12 and folic acid in older adults with hyperhomocysteinemia showed that lowering Hcy concentrations does not reduce depressive symptoms, but it may have a small positive effect on HR-QoL. PMID:27886078
Masachessi, Gisela; Ganesh, Balasubramanian; Martinez, Laura C; Giordano, Miguel O; Barril, Patricia A; Isa, Maria B; Paván, Giorgio V; Mateos, Carlos A; Nates, Silvia V
The present work provide data about the maintenance of picobirnavirus (PBV) infection during adulthood in a mammalian host. For this purpose PBV infection was studied in an adult orangutan (Pongo pygmaeus) by PAGE/SS, RT-PCR and nucleotide sequencing. PBV infection in the animal was asymptomatic and was characterized by interspaced silent and high/ low active viral excretion periods. The PBV strains excreted by the studied individual were identified as genogroup I and revealed a nucleotide identity among them of 64-81%. The results obtained allowed to arrive to a deeper understanding of the natural history of PBV infection, which seems to be characterized by new-born, juvenile and adult asymptomatic hosts which persistently excrete closely related strains in their feces. Consequently, picobirnaviruses could be considered frequent inhabitants of the gastrointestinal tract, leaving the question open about the molecular mechanisms governing persistent and asymptomatic coexistence within the host and the potential host suitability to maintain this relationship.
Martin-Storey, Alexa; Serbin, Lisa A; Stack, Dale M; Ledingham, Jane E; Schwartzman, Alex E
While childhood behaviors such as aggression, social withdrawal and likeability have been linked to substance abuse outcomes in adolescence and adulthood, the mechanisms by which these variables relate are not yet well established. Self and peer perceptions of childhood behaviors in men and women were compared to assess the role of context in the prediction of drug and alcohol abuse and dependence. Participants (N=676) in an ongoing longitudinal project examining the relation between childhood behavior and adult mental health outcomes completed the Structured Clinical Interview for the DSM IV regarding their histories of substance abuse in mid-adulthood (mean age=34, SD=2). In women, higher levels of both self and peer reported aggression were associated with drug and alcohol abuse and dependence, and higher levels of peer reported aggression were associated with higher levels of alcohol abuse and dependence. As well, higher levels of self-perceived likeability were protective regarding substance abuse and dependence outcomes. In men, higher levels of peer perceived social withdrawal were protective regarding substance abuse and dependence outcomes. Findings support the comparison of self and peer perceptions of childhood behavior as a method of assessing the mechanisms by which childhood behaviors impact adult outcomes, and suggest the importance of gender in the relation between childhood behaviors and adult substance abuse and dependence.
Skillington, Peter D.; Mokhles, M. Mostafa; Wilson, William; Grigg, Leeanne; Larobina, Marco; O'Keefe, Michael; Takkenberg, Johanna
Background: To report our experience with the Ross operation in patients with predominant aortic stenosis (AS) using an inclusion cylinder (IC) method. Methods: Out of 324 adults undergoing a Ross operation, 204 patients of mean age of 41.3 years (limits 16–62) underwent this procedure for either AS or mixed AS and regurgitation (AS/AR) between October, 1992 and February, 2012, implanting the PA with an IC method. Clinical follow up and serial echo data for this group is 97% complete with late mortality follow up 99% complete. Results: There has been zero (0%) early mortality, and late survival at 15 years is 98% (96%, 100%). Only one re-operation on the aortic valve for progressive aortic regurgitation (AR) has been required with freedom from re-operation on the aortic valve at 15 years being 99% (96%, 100%). The freedom from all re-operations on the aortic and pulmonary valves at 15 years is 97% (94%, 100%). Echo analysis at the most recent study shows that 98% have nil, trivial or mild AR. Aortic root size has remained stable, shown by long-term (15 year) echo follow up. Conclusions: In an experience spanning 19 years, the Ross operation used for predominant AS using the IC method described, results in 99% freedom from re-operation on the aortic valve at 15 years, better than any other tissue or mechanical valve. For adults under 65 years without significant co-morbidities who present with predominant AS, the pulmonary autograft inserted with this technique gives excellent results. PMID:24749112
Magyar, Lóránt; Bellovits, Orsolya; Bujdosó, Györgyi
Studies of the Hungarian child and adult population have revealed striking changes over the past thirty years with respect to body height and body mass, an observation, which has also been confirmed by other investigations (Gyenis & Joubert 2003, Maródi et. al. 2002). Based on these deviations the authors were interested in the variability of some anthropometrical head measures, which are of particular importance for forensic anthropological questions concerning face reconstruction (Editorial 2001, Jayprakash et. al. 2001, Szilvdssy & Kritscher 1997, Szilvdssy et al. 1997). The majority of such reconstruction methods, however, do not take into consideration the process of secular trend. It is the aim of this study to improve the anthropological basis for exact reconstruction methods by elaboration of temporal changes of face, head and body measures of the Hungarian population collected during the past thirty years. For this data from 2353 adults and 861 children investigated in 1974, and 869 adults 287 children investigated between 1994 and 2004 are available.
For over 2 years, Blak Hawk College (Illinois) has provided high school equivalency (GED) candidates and recipients, older returning students, and underprepared high school graduates with a Tech Prep curriculum to give them the skills to make the transition from adult basic education to college or work. The Adult Tech Prep (ATP) core curriculum…
Ever since the first ideas of national independence appeared in Finland, adult education has played an essential role in shaping the destiny of the Finns. With a history of almost 130 years, during which it has continuously increased in quality and quantity, the Finnish adult education system has ensured that Finland stays among the most…
Vaez, Marjan; Hagberg, Jan; Alexanderson, Kristina
Background Little is known about future sick-leave diagnoses among individuals on long-term sickness absence. The aim of this study was to describe the panorama of sick-leave diagnoses over time among young adults initially sick-listed for ≥ 28 days due to back, neck, or shoulder diagnoses Methods An 11-year prospective population-based cohort study including all 213 individuals in a Swedish municipality who, in 1985, were aged 25–34 years and had a new sick-leave spell ≥ 28 days due to neck, shoulder, or back diagnoses. Results Over the 11-year period, the young adults in this cohort had 176,825 sick-leave days in 7,878 sick-leave periods (in 4,610 sick-leave spells) due to disorders in 17 of the 18 ICD-8 diagnostic categories (International Classification of Diseases, Revision 8). Musculoskeletal or mental diagnoses accounted for most of the sick-leave days, whereas most of the sick-leave periods were due to musculoskeletal, respiratory, or infectious disorders, or to unclassified symptoms. Most cohort members had had four to eight different sick-leave diagnoses over the 11 years, although some had had up to 11 diagnoses. Only two individuals (1%) had been sickness absent solely due to musculoskeletal diagnoses. Conclusion Although the young adults initially were sick listed with back, neck, or shoulder diagnoses, their sickness absence during the follow up were due to a wide variety of other medical diagnoses. It might be that the ill-health content of sickness absence due to back pain is greater than usually assumed. More research on prognoses of sick-leave diagnoses among long-term sick listed is warranted.
Laska, Melissa N; Lytle, Leslie A; Nanney, Marilyn S; Moe, Stacey G; Linde, Jennifer A; Hannan, Peter J
Excess weight gain tends to occur in young adulthood. However, research examining effective weight-related interventions for this age group has been limited. As one of seven trials in the EARLY Trials consortium (Early Adult Reduction of weight through LifestYle intervention), the CHOICES Study (Choosing Healthy Options in College Environments and Settings) tested effects of a technology-integrated, young adult weight gain prevention intervention. It was a randomized controlled trial with assessments at baseline (2011) and 4-, 12- and 24-months post-intervention initiation and included 441 participants (ages 18-35) who were students at three Minnesota community colleges. The 24-month intervention included a 1-credit academic course and social networking and support online intervention. This analysis examined effects on 12 secondary behavioral outcomes across three domains: diet (fast food, sugary beverages, breakfast, at-home meal preparation), physical activity/screen time (minutes and energy expenditure in leisure time physical activity, television viewing, leisure time computer use) and sleep (hours of sleep, time required to fall asleep, days not getting enough rest, difficulty staying awake). The intervention resulted in significant reductions in fast food (p=0.007) but increases in difficulty staying awake (p=0.015). There was limited evidence of other behavior changes at 4months (0.05
adults, particularly when addressing multiple weight-related outcomes.
The purpose of this study was to examine the association between objective measures of sleep quality and obesity in older community-dwelling people. This cross-sectional study included 189 community-dwelling adults aged ≥ 80 yr (83.4 ± 2.5 yr [age range, 80-95 yr]). Participants wore an accelerometer (ActiGraph GT3X+) on their non-dominant wrist 24 hr per day for 7 consecutive nights. Sleep parameters measured included total sleep time, sleep efficiency, and wake after sleep onset (WASO) during the night. Associations between sleep parameters and obesity were investigated by using multivariate logistic regression analysis. In multivariate models, those with sleep efficiency lower than 85% had a 2.85-fold increased odds of obesity, compared with those with sleep efficiency of 85% or higher. Similarly, those with WASO of ≥ 60 min (compared with < 60 min) had a 3.13-fold increased odds of obesity. However, there were no significant associations between total sleep time or self-reported napping duration and obesity. We found that poor sleep quality was an independent risk factor for obesity in community-dwelling Japanese adults aged ≥ 80 yr, even after controlling for potential confounding factors, including daily physical activity.
Arteaga, Irma; Humpage, Sarah; Reynolds, Arthur J; Temple, Judy A
Until the last year, public funding for preschool education had been growing rapidly over a decade with most state programs providing one year of preschool for four year olds. Fewer three year olds are enrolled in preschool. To investigate the importance of enrollment duration, this study is the first to estimate long-term dosage effects of years of preschool. We use data from a cohort of 1,500 students in the Chicago Longitudinal Study who enrolled in the Chicago Public Schools in the mid-1980s. Many of these students participated in a high-quality preschool program called Child-Parent Centers (CPC) for one or two years. To address selection with multiple treatments, we employ inverse propensity score weighting. Relative to children who attended one year of CPC preschool, the two-year group is significantly less likely to receive special education or be abused or neglected or to commit crimes. The findings provide support for the long-term benefits of greater exposure to preschool.
Arteaga, Irma; Humpage, Sarah; Reynolds, Arthur J.; Temple, Judy A.
Until the last year, public funding for preschool education had been growing rapidly over a decade with most state programs providing one year of preschool for four year olds. Fewer three year olds are enrolled in preschool. To investigate the importance of enrollment duration, this study is the first to estimate long-term dosage effects of years of preschool. We use data from a cohort of 1,500 students in the Chicago Longitudinal Study who enrolled in the Chicago Public Schools in the mid-1980s. Many of these students participated in a high-quality preschool program called Child-Parent Centers (CPC) for one or two years. To address selection with multiple treatments, we employ inverse propensity score weighting. Relative to children who attended one year of CPC preschool, the two-year group is significantly less likely to receive special education or be abused or neglected or to commit crimes. The findings provide support for the long-term benefits of greater exposure to preschool. PMID:26823640
McCormick, Alexander C., Ed.; Cox, Rebecca D., Ed.
This summer 2003 issue of New Directions for Community Colleges advances the conversation among researchers and practitioners about possible approaches to classifying two-year colleges. The 10 chapters include the following: (1) "Classifying Two-Year Colleges: Purposes, Possibilities and Pitfalls" (Alexander C. McCormick and Rebecca D.…
Utah State Board of Education, Salt Lake City.
Major purposes for the preparation of this report on public school adult education in Utah were: to provide the public with a description of achievements, trends, and needs, and with meaningful cost accounting information; to make comparisons and analyses of adult education by program, school district, and year; and to provide the adult education…
Heiro, Maija; Helenius, Hans; Hurme, Saija; Savunen, Timo; Engblom, Erik; Nikoskelainen, Jukka; Kotilainen, Pirkko
Background Previous studies on factors predicting the prognosis of infective endocarditis have given somewhat conflicting results. Our aim was to define the factors predicting the outcome of patients treated in a Finnish teaching hospital. Methods A total of 326 episodes of infective endocarditis in 303 patients treated during 1980–2004 were evaluated for short-term and 1-year outcome and complications. Results Infection of 2 native valves and the occurrence of neurological complications, peripheral emboli, or heart failure significantly predicted both in-hospital and 1-year mortality, while age ≥65 years or the presence of a major criterion or vegetation on echocardiography predicted death within 1 year. A significant trend was observed between the level of serum C-reactive protein (CRP) on admission and both the short-term and 1-year outcome. In the patients who had CRP values ≥100 mg/l on admission, the hazard ratio for in-hospital death was 2.9-fold and the hazard ratio for 1-year death was 3.9-fold as compared to those with lower CRP values. Male sex and age < 64 years significantly predicted a need for both in-hospital and 1-year surgery, as did the development of heart failure or the presence of a major criterion or vegetation on echocardiography. Peripheral emboli were associated with a need for in-hospital surgery, while Streptococcus pneumoniae as the causative agent or infection of 2 native valves predicted a need for surgery within 1 year from admission. Conclusion Some of the factors (e.g. heart failure, neurological complications, peripheral emboli) predicting a poor prognosis and/or need for surgery were the same observed in previous studies. A new finding was that high CRP values (≥100 mg/l) on admission significantly predicted both short-term and 1-year mortality. PMID:17640339
Calero, Dolores; Navarro, Elena
The main objective of this study was to analyze the similarities and differences in cognitive performance, level of dependency, cognitive plasticity and QoL in a sample of young-old adults and old-old adults, bearing in mind both the age-group (under or over 80 years) and the cognitive status of the participants. The study population consisted of 220 people living in sheltered accommodation for elderly people in the South of Spain, with an average age of 80.75 years. Participants were evaluated by means of cognitive performance tests, a QoL questionnaire, a depression scale and a dependency assessment scale. The results indicate that the main differences in the variables analyzed are due to the cognitive status of the sample and not to the fact that the participants are under or over 80 years of age. The findings show that major inter-individual differences in this stage of life depend not only on age but also on cognitive status, which is thus an important factor to take into account when working with this sector of the population.
Attanasio, Andrea F; Bates, Peter C; Ho, Ken K Y; Webb, Susan M; Ross, Richard J; Strasburger, Christian J; Bouillon, Roger; Crowe, Brenda; Selander, Keith; Valle, Domenico; Lamberts, Steven W J
The Hypopituitary Control and Complications Study is an international surveillance study evaluating efficacy and safety of GH therapy of adult GH-deficient patients in clinical practice. The present report examined baseline data from 1,123 adult onset (AO) and 362 childhood onset (CO) patients, as well as efficacy in 242 patients who had completed 3 yr of GH treatment. At study entry, mean height, body mass index, waist to hip ratio, and lean body mass were significantly (P < 0.001 for each) lower in CO compared with AO patients. After 3 yr on GH, lean body mass was significantly increased in AO males and females and CO males but not CO females, whereas fat mass was significantly decreased in AO males only. Serum total cholesterol was decreased in females (-0.32 +/- 1.00 mmol/liter; P = 0.045) and males (-0.36 +/- 0.96 mmol/liter; P = 0.004). High-density lipoprotein (HDL) cholesterol was increased for females (0.10 +/- 0.26 mmol/liter; P = 0.026) and males (0.10 +/- 0.34 mmol/liter; P = 0.022). The low-density lipoprotein/HDL ratio was decreased in AO males (-0.93 +/- 2.00; P = 0.003), AO females (-0.65 +/- 0.74; P < 0.001), and CO females (-0.69 +/- 0.76; P = 0.038), but the decrease in CO males was not significant (-0.84 +/- 2.85; P = 0.273). In AO patients, lean body mass increase from baseline was greatest in the those younger than 40 yr old, less but still significant in the middle group (40-60 yr) and unchanged in older (>60 yr) patients; conversely, decreases in the low-density lipoprotein/HDL ratio were small and not significant in the younger patients but greater and significant in the middle and older age groups. During the 3-yr treatment, 114 (7.7%) patients discontinued, including 9 (0.6%) for tumor recurrences, 9 (0.6%) for neoplasia, and 9 (0.6%) for side effects. Therefore, these observational data showed significant long-term efficacy of adult GH replacement therapy on body composition and lipid profiles and indicate that age is an important
Adult Education and Development, 1994
The publication is a half-yearly journal for adult education in Africa, Asia, and Latin America. Issue 42 includes the following: "Adult Education for Self-Reliance in Community Health Education Programmes" (Kweka); "Promoting Good Nutrition" (Mangvwat); "Incorporating Health-Improvement Activities in Adult Education…
Part 6: Adult Education. Hearing before the Subcommittee on Elementary, Secondary, and Vocational Education of the Committee on Education and Labor, House of Representatives, Ninety-Fifth Congress, First Session on H.R. 15 to Extend for Five Years Certain Elementary, Secondary, and other Education Programs. (Washington, D.C., July 12, 1977).
Congress of the U.S., Washington, DC. House Committee on Education and Labor.
Reported here are the continuing hearings on H.R. 15 (a bill to extend for five years certain elementary and secondary education programs and the Adult Education Act) which examine the accomplishments and problems of the Adult Education Act since it was last amended in 1976. One-half of the content consists of the testimony, statements, and…
Background Previous research found a high prevalence of depression, along with chronic illnesses and disabilities, among older ED patients. This study examined the relationship between depressive symptom severity and the number of ED visits among low-income homebound older adults who participated in a randomized controlled trial of telehealth problem-solving therapy (PST). Methods The number of and reasons for ED visits were collected from the study participants (n=121 at baseline) at all assessment points—baseline and 12- and 24-week follow-ups. Depressive symptoms were measured with the 24-item Hamilton Rating Scale for Depression (HAMD). All multivariable analyses examining the relationships between ED visits and depressive symptoms were conducted using zero-inflated Poisson regression models. Results Of the participants, 67.7% used the ED at least once and 61% of the visitors made at least one return visit during the approximately 12-month period. Body pain (not from fall injury and not including chest pain) was the most common reason. The ED visit frequency at baseline and at follow-up was significantly positively associated with the HAMD scores at the assessment points. The ED visit frequency at follow-up, controlling for the ED visits at baseline, was also significantly associated with the HAMD score change since baseline. Conclusions The ED visit rate was much higher than those reported in other studies. Better education on self-management of chronic conditions, depression screening by primary care physicians and ED, and depression treatment that includes symptom management and problem-solving skills may be important to reduce ED visits among medically ill, low-income homebound adults. Trial registration ClinicalTrials.gov Identifier: NCT00903019 PMID:23267529
Wong, Ides Y; Smith, Simon S; Sullivan, Karen A
The term driving self-regulation is typically used to describe the practice of drivers who avoid driving in situations that they regard as unsafe because of perceived physical impairment. Older adults report using this strategy to improve safety while retaining mobility. Self-regulation is typically assessed using the driving avoidance items from the driving habits questionnaire (DHQ) and the driver mobility questionnaire (DMQ-A). However, the psychometric properties of these measures are not well understood. Using data from 277 older drivers, exploratory factor analysis was used to test the homogeneity of three driving self-regulation scales: the DHQ, DMQ-A, and an extended DMQ-A. Good internal consistency for each of the scales was identified (all αs≥.9). A one factor solution was identified for two of the measures (DHQ, DMQ-A) and a two factor solution accounting for over 70% of the score variance was identified for the third measure. The two factors assessed situations that may be avoided while driving because of the "external" (e.g., weather-related) or "internal" (e.g., passenger-related) driving environments, respectively. The findings suggest that the interpretation of an overall summated scale score, or single-item interpretations, may not be appropriate. Instead, driving self-regulation may be a multifaceted construct comprised of distinct dimensions that have not been identified previously but can be reliably measured. These data have implications for our understanding of driving self-regulation by older adults and the way in which this behavior is measured.
Fredriksen, Mats; Dahl, Alv A; Martinsen, Egil W; Klungsøyr, Ole; Haavik, Jan; Peleikis, Dawn E
How to generalize from randomized placebo controlled trials of ADHD drug treatment in adults to 'real-world' clinical practice is intriguing. This open-labeled prospective observational study examined the effectiveness of long-term stimulant and non-stimulant medication in adult ADHD including dose, side-effects and comorbidity