Lung function in type 2 diabetes: the Normative Aging Study.

PubMed

Litonjua, Augusto A; Lazarus, Ross; Sparrow, David; Demolles, Debbie; Weiss, Scott T

2005-12-01

Cross-sectional studies have noted that subjects with diabetes have lower lung function than non-diabetic subjects. We conducted this analysis to determine whether diabetic subjects have different rates of lung function change compared with non-diabetic subjects. We conducted a nested case-control analysis in 352 men who developed diabetes and 352 non-diabetic subjects in a longitudinal observational study of aging in men. We assessed lung function among cases and controls at three time points: Time0, prior to meeting the definition of diabetes; Time1, the point when the definition of diabetes was met; and Time2, the most recent follow-up exam. Cases had lower forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC) at all time points, even with adjustment for age, height, weight, and smoking. In multiple linear regression models adjusting for relevant covariates, there were no differences in rates of FEV1 or FVC change over time between cases and controls. Men who are predisposed to develop diabetes have decreased lung function many years prior to the diagnosis, compared with men who do not develop diabetes. This decrement in lung function remains after the development of diabetes. We postulate that mechanisms involved in the insulin resistant state contribute to the diminished lung function observed in our subjects.

High Frequency of Early Repolarization and Brugada-Type Electrocardiograms in Hypercalcemia.

PubMed

Sonoda, Keiko; Watanabe, Hiroshi; Hisamatsu, Takashi; Ashihara, Takashi; Ohno, Seiko; Hayashi, Hideki; Horie, Minoru; Minamino, Tohru

2016-01-01

J wave, or early repolarization has recently been associated with an increased risk of lethal arrhythmia and sudden death, both in idiopathic ventricular fibrillation and in the general population. Hypercalcemia is one of the causes of J point and ST segment elevation, but the relationship has not been well studied. The aim of this study was to examine the effects of hypercalcemia on J point elevation. Electrocardiographic findings were compared in 89 patients with hypercalcemia and 267 age- and sex-matched healthy controls with normocalcemia. The association of J point elevation with arrhythmia events in patients with hypercalcemia was also studied. The PR interval and the QRS duration were longer in patients with hypercalcemia than in normocalcemic controls. Both the QT and the corrected QT intervals were shorter in patients with hypercalcemia compared with normocalcemic controls. Conduction disorders, ST-T abnormalities, and J point elevation were more common in patients with hypercalcemia than normocalcemic controls. Following the resolution of hypercalcemia, the frequency of J point elevation decreased to a level similar to that noted in controls. During hospitalization, no arrhythmia event occurred in patients with hypercalcemia. Hypercalcemia was associated with J point elevation. © 2015 Wiley Periodicals, Inc.

Atrial fibrillation.

PubMed

Medi, Caroline; Hankey, Graeme J; Freedman, Saul B

2007-02-19

The incidence and prevalence of atrial fibrillation are increasing because of both population ageing and an age-adjusted increase in incidence of atrial fibrillation. Deciding between a rate control or rhythm control approach depends on patient age and comorbidities, symptoms and haemodynamic consequences of the arrhythmia, but either approach is acceptable. Digoxin is no longer a first-line drug for rate control: beta-blockers and verapamil and diltiazem control heart rate better during exercise. Anti-arrhythmic drugs have only a 40%-60% success rate of maintaining sinus rhythm at 1 year, and have significant side effects. The selection of optimal antithrombotic prophylaxis depends on the patient's risk of ischaemic stroke and the benefits and risks of long-term warfarin versus aspirin, but is independent of rate or rhythm control strategy. Ischaemic stroke risk is best estimated with the CHADS2 score (Congestive heart failure, Hypertension, Age > or = 75 years, Diabetes, 1 point each; prior Stroke or transient ischaemic attack, 2 points). For patients with valvular atrial fibrillation or a CHADS(2) score > or = 2, anticoagulation with warfarin is recommended (INR 2-3, higher for mechanical valves) unless contraindicated or annual major bleeding risk > 3%. Aspirin or warfarin may be used when the CHADS(2) score = 1. Aspirin, 81-325 mg daily, is recommended in patients with a CHADS(2) score of 0 or if warfarin is contraindicated. Stroke rate is similar for paroxysmal, persistent, and permanent atrial fibrillation, and probably for atrial flutter.

Influence of hip and knee osteoarthritis on dynamic postural control parameters among older fallers.

PubMed

Mat, Sumaiyah; Ng, Chin Teck; Tan, Maw Pin

2017-03-06

To compare the relationship between postural control and knee and hip osteoarthritis in older adults with and without a history of falls. Fallers were those with ≥ 2 falls or 1 injurious fall over 12 months. Non-fallers were volunteers with no falls in the past year. Radiological evidence of osteoarthritis with no reported symptoms was considered "asymptomatic osteoarthritis", while "symptomatic osteoarthritis" was defined as radiographic osteoarthritis with pain or stiffness. Dynamic postural control was quantified with the limits of stability test measured on a balance platform (Neurocom® Balancemaster, California, USA). Parameters assessed were end-point excursion, maximal excursion, and directional control. A total of 102 older individuals, mean age 73 years (standard deviation 5.7) years were included. The association between falls and poor performance in maximal excursion and directional control was confounded by age and comorbidities. In the same linear equation model with falls, symptomatic osteoarthritis remained independently associated with poor end-point excursion (β-coefficient (95% confidence interval) -6.80 (-12.14 to -1.42)). Poor performance in dynamic postural control (maximal excursion and directional control) among fallers was not accounted for by hip/knee osteoarthritis, but was confounded by old age and comorbidities. Loss of postural control due to hip/knee osteoarthritis is not a risk factor for falls among community-dwelling older adults.

The Feasibility and Potential Impact of Brain Training Games on Cognitive and Emotional Functioning in Middle-Aged Adults

PubMed Central

Curtis, Ashley F.; Branscombe-Caird, Laura M.; Comrie, Janna K.; Murtha, Susan J.E.

2018-01-01

Abstract Objectives:To investigate whether a commercially available brain training program is feasible to use with a middle-aged population and has a potential impact on cognition and emotional well-being (proof of concept). Method: Fourteen participants (ages 46–55) completed two 6-week training conditions using a crossover (counterbalanced) design: (1) experimental brain training condition and (2) active control “find answers to trivia questions online” condition. A comprehensive neurocognitive battery and a self-report measure of depression and anxiety were administered at baseline (first time point, before training) and after completing each training condition (second time point at 6 weeks, and third time point at 12 weeks). Cognitive composite scores were calculated for participants at each time point. Results: Study completion and protocol adherence demonstrated good feasibility of this brain training protocol in healthy middle-aged adults. Exploratory analyses suggested that brain training was associated with neurocognitive improvements related to executive attention, as well as improvements in mood. Conclusion: Overall, our findings suggest that brain training programs are feasible in middle-aged cohorts. We propose that brain training games may be linked to improvements in executive attention and affect by promoting cognitive self-efficacy in middle-aged adults. PMID:29189046

The Aged Residential Care Healthcare Utilization Study (ARCHUS): a multidisciplinary, cluster randomized controlled trial designed to reduce acute avoidable hospitalizations from long-term care facilities.

PubMed

Connolly, Martin J; Boyd, Michal; Broad, Joanna B; Kerse, Ngaire; Lumley, Thomas; Whitehead, Noeline; Foster, Susan

2015-01-01

To assess effect of a complex, multidisciplinary intervention aimed at reducing avoidable acute hospitalization of residents of residential aged care (RAC) facilities. Cluster randomized controlled trial. RAC facilities with higher than expected hospitalizations in Auckland, New Zealand, were recruited and randomized to intervention or control. A total of 1998 residents of 18 intervention facilities and 18 control facilities. A facility-based complex intervention of 9 months' duration. The intervention comprised gerontology nurse specialist (GNS)-led staff education, facility bench-marking, GNS resident review, and multidisciplinary (geriatrician, primary-care physician, pharmacist, GNS, and facility nurse) discussion of residents selected using standard criteria. Primary end point was avoidable hospitalizations. Secondary end points were all acute admissions, mortality, and acute bed-days. Follow-up was for a total of 14 months. The intervention did not affect main study end points: number of acute avoidable hospital admissions (RR 1.07; 95% CI 0.85-1.36; P = .59) or mortality (RR 1.11; 95% CI 0.76-1.61; P = .62). This multidisciplinary intervention, packaging selected case review, and staff education had no overall impact on acute hospital admissions or mortality. This may have considerable implications for resourcing in the acute and RAC sectors in the face of population aging. Australian and New Zealand Clinical Trials Registry (ACTRN12611000187943). Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Association of the Affordable Care Act Dependent Coverage Provision With Prenatal Care Use and Birth Outcomes.

PubMed

Daw, Jamie R; Sommers, Benjamin D

2018-02-13

The effect of the Affordable Care Act (ACA) dependent coverage provision on pregnancy-related health care and health outcomes is unknown. To determine whether the dependent coverage provision was associated with changes in payment for birth, prenatal care, and birth outcomes. Retrospective cohort study, using a differences-in-differences analysis of individual-level birth certificate data comparing live births among US women aged 24 to 25 years (exposure group) and women aged 27 to 28 years (control group) before (2009) and after (2011-2013) enactment of the dependent coverage provision. Results were stratified by marital status. The dependent coverage provision of the ACA, which allowed young adults to stay on their parent's health insurance until age 26 years. Primary outcomes were payment source for birth, early prenatal care (first visit in first trimester), and adequate prenatal care (a first trimester visit and 80% of expected visits). Secondary outcomes were cesarean delivery, premature birth, low birth weight, and infant neonatal intensive care unit (NICU) admission. The study population included 1 379 005 births among women aged 24-25 years (exposure group; 299 024 in 2009; 1 079 981 in 2011-2013), and 1 551 192 births among women aged 27-28 years (control group; 325 564 in 2009; 1 225 628 in 2011-2013). From 2011-2013, compared with 2009, private insurance payment for births increased in the exposure group (36.9% to 35.9% [difference, -1.0%]) compared with the control group (52.4% to 51.1% [difference, -1.3%]), adjusted difference-in-differences, 1.9 percentage points (95% CI, 1.6 to 2.1). Medicaid payment decreased in the exposure group (51.6% to 53.6% [difference, 2.0%]) compared with the control group (37.4% to 39.4% [difference, 1.9%]), adjusted difference-in-differences, -1.4 percentage points (95% CI, -1.7 to -1.2). Self-payment for births decreased in the exposure group (5.2% to 4.3% [difference, -0.9%]) compared with the control group (4.9% to 4.3% [difference, -0.5%]), adjusted difference-in-differences, -0.3 percentage points (95% CI, -0.4 to -0.1). Early prenatal care increased from 70% to 71.6% (difference, 1.6%) in the exposure group and from 75.7% to 76.8% (difference, 0.6%) in the control group (adjusted difference-in-differences, 0.6 percentage points [95% CI, 0.3 to 0.8]). Adequate prenatal care increased from 73.5% to 74.8% (difference, 1.3%) in the exposure group and from 77.5% to 78.8% (difference, 1.3%) in the control group (adjusted difference-in-differences, 0.4 percentage points [95% CI, 0.2 to 0.6]). Preterm birth decreased from 9.4% to 9.1% in the exposure group (difference, -0.3%) and from 9.1% to 8.9% in the control group (difference, -0.2%) (adjusted difference-in-differences, -0.2 percentage points (95% CI, -0.3 to -0.03). Overall, there were no significant changes in low birth weight, NICU admission, or cesarean delivery. In stratified analyses, changes in payment for birth, prenatal care, and preterm birth were concentrated among unmarried women. In this study of nearly 3 million births among women aged 24 to 25 years vs those aged 27 to 28 years, the Affordable Care Act dependent coverage provision was associated with increased private insurance payment for birth, increased use of prenatal care, and modest reduction in preterm births, but was not associated with changes in cesarean delivery rates, low birth weight, or NICU admission.

Characteristics of Clinical Studies Used for US Food and Drug Administration Approval of High-Risk Medical Device Supplements.

PubMed

Zheng, Sarah Y; Dhruva, Sanket S; Redberg, Rita F

2017-08-15

High-risk medical devices often undergo modifications, which are approved by the US Food and Drug Administration (FDA) through various kinds of premarket approval (PMA) supplements. There have been multiple high-profile recalls of devices approved as PMA supplements. To characterize the quality of the clinical studies and data (strength of evidence) used to support FDA approval of panel-track supplements (a type of PMA supplement pathway that is used for significant changes in a device or indication for use and always requires clinical data). Descriptive study of clinical studies supporting panel-track supplements approved by the FDA between April 19, 2006, and October 9, 2015. Panel-track supplement approval. Methodological quality of studies including randomization, blinding, type of controls, clinical vs surrogate primary end points, use of post hoc analyses, and reporting of age and sex. Eighty-three clinical studies supported the approval of 78 panel-track supplements, with 71 panel-track supplements (91%) supported by a single study. Of the 83 studies, 37 (45%) were randomized clinical trials and 25 (30%) were blinded. The median number of patients per study was 185 (interquartile range, 75-305), and the median follow-up duration was 180 days (interquartile range, 84-270 days). There were a total of 150 primary end points (mean [SD], 1.8 [1.2] per study), and 57 primary end points (38%) were compared with controls. Of primary end points with controls, 6 (11%) were retrospective controls and 51 (89%) were active controls. One hundred twenty-one primary end points (81%) were surrogate end points. Thirty-three studies (40%) did not report age and 25 (30%) did not report sex for all enrolled patients. The FDA required postapproval studies for 29 of 78 (37%) panel-track supplements. Among clinical studies used to support FDA approval of high-risk medical device modifications, fewer than half were randomized, blinded, or controlled, and most primary outcomes were based on surrogate end points. These findings suggest that the quality of studies and data evaluated to support approval by the FDA of modifications of high-risk devices should be improved.

Patterns and sources of personality development in old age.

PubMed

Kandler, Christian; Kornadt, Anna E; Hagemeyer, Birk; Neyer, Franz J

2015-07-01

Despite abundant evidence that personality development continues in adulthood, little is known about the patterns and sources of personality development in old age. We thus investigated mean-level trends and individual differences in change as well as the genetic and environmental sources of rank-order continuity and change in several personality traits (neuroticism, extraversion, openness, agreeableness, conscientiousness, perceived control, and affect intensity) and well-being. In addition, we analyzed the interrelation between perceived control and change in other personality traits as well as between change in personality traits and change in well-being. We analyzed data from older adult twins, aged 64-85 years at Time 1 (N = 410; 135 males and 275 females; 134 monozygotic and 63 dizygotic twin pairs), collected at 2 different time points about 5 years apart. On average, neuroticism increased, whereas extraversion, conscientiousness, and perceived control significantly decreased over time. Change in perceived control was associated with change in neuroticism and conscientiousness, pointing to particular adaptation mechanisms specific to old age. Whereas individual differences in personality traits were fairly stable due to both genetic and environmental sources, individual differences in change were primarily due to environmental sources (beyond random error) indicating plasticity in old age. Even though the average level of well-being did not significantly change over time, individual well-being tended to decrease with strongly increasing levels of neuroticism as well as decreasing extraversion, conscientiousness, and perceived control, indicating that personality traits predict well-being but not vice versa. We discuss implications for theory on personality development across the lifespan. (c) 2015 APA, all rights reserved).

Sister chromatid exchange in children of Seventh-Day Adventists and matched controls.

PubMed

Hermansen, R; Waksvik, H; Fønnebø, V

1991-03-01

The low risk of cancer in Seventh-Day Adventists (SDAs) has been suggested to be due to genetic selection. To investigate this claim we examined the sister chromatid exchange (SCE) frequency in peripheral blood lymphocytes in 16 SDA children in Tromsø, all aged 0.5-8 years and 16 controls matched for sex and age. In 12 of 16 pairs, the SDA children had a lower SCE frequency than the controls. The mean difference was 4.06 (95% confidence interval -17.02-8.89, P = 0.51). There was no sex difference, and no correlation between age and SCE frequency. The genetic starting point with regard to SCE frequency seems to be the same for SDA children and controls.

Impact of External Cue Validity on Driving Performance in Parkinson's Disease

PubMed Central

Scally, Karen; Charlton, Judith L.; Iansek, Robert; Bradshaw, John L.; Moss, Simon; Georgiou-Karistianis, Nellie

2011-01-01

This study sought to investigate the impact of external cue validity on simulated driving performance in 19 Parkinson's disease (PD) patients and 19 healthy age-matched controls. Braking points and distance between deceleration point and braking point were analysed for red traffic signals preceded either by Valid Cues (correctly predicting signal), Invalid Cues (incorrectly predicting signal), and No Cues. Results showed that PD drivers braked significantly later and travelled significantly further between deceleration and braking points compared with controls for Invalid and No-Cue conditions. No significant group differences were observed for driving performance in response to Valid Cues. The benefit of Valid Cues relative to Invalid Cues and No Cues was significantly greater for PD drivers compared with controls. Trail Making Test (B-A) scores correlated with driving performance for PDs only. These results highlight the importance of external cues and higher cognitive functioning for driving performance in mild to moderate PD. PMID:21789275

Measurement of asthma control according to Global Initiative for Asthma guidelines: a comparison with the Asthma Control Questionnaire.

PubMed

Olaguibel, José María; Quirce, Santiago; Juliá, Berta; Fernández, Cristina; Fortuna, Ana María; Molina, Jesús; Plaza, Vicente

2012-06-22

Asthma Control Questionnaire (ACQ) is a validated tool to measure asthma control. Cut-off points that best discriminate "well-controlled" or "not well-controlled" asthma have been suggested from the analysis of a large randomized clinical trial but they may not be adequate for daily clinical practice. To establish cut-off points of the ACQ that best discriminate the level of control according to Global Initiative for Asthma (GINA) 2006 guidelines in patients with asthma managed at Allergology and Pulmonology Departments as well as Primary Care Centers in Spain. An epidemiological descriptive study, with prospective data collection. Asthma control following GINA-2006 classification and 7-item ACQ was assessed. The study population was split in two parts: 2/3 for finding the cut-off points (development population) and 1/3 for validating the results (validation population). A total of 1,363 stable asthmatic patients were included (mean age 38 ± 14 years, 60.3% women; 69.1% non-smokers). Patient classification according to GINA-defined asthma control was: controlled 13.6%, partially controlled 34.2%, and uncontrolled 52.3%. The ACQ cut-off points that better agreed with GINA-defined asthma control categories were calculated using receiver operating curves (ROC). The analysis showed that ACQ < 0.5 was the optimal cut-off point for "controlled asthma" (sensitivity 74.1%, specificity 77.5%) and 1.00 for "uncontrolled asthma" (sensitivity 73%, specificity 88.2%). Kappa index between GINA categories and ACQ was 0.62 (p < 0.001). The ACQ cut-off points associated with GINA-defined asthma control in a real-life setting were <0.5 for controlled asthma and ≥1 for uncontrolled asthma.

100-point scale evaluating job satisfaction and the results of the 12-item General Health Questionnaire in occupational workers.

PubMed

Kawada, Tomoyuki; Yamada, Natsuki

2012-01-01

Job satisfaction is an important factor in the occupational lives of workers. In this study, the relationship between one-dimensional scale of job satisfaction and psychological wellbeing was evaluated. A total of 1,742 workers (1,191 men and 551 women) participated. 100-point scale evaluating job satisfaction (0 [extremely dissatisfied] to 100 [extremely satisfied]) and the General Health Questionnaire, 12-item version (GHQ-12) evaluating psychological wellbeing were used. A multiple regression analysis was then used, controlling for gender and age. The change in the GHQ-12 and job satisfaction scores after a two-year interval was also evaluated. The mean age for the subjects was 42.2 years for the men and 36.2 years for the women. The GHQ-12 and job satisfaction scores were significantly correlated in each generation. The partial correlation coefficients between the changes in the two variables, controlling for age, were -0.395 for men and -0.435 for women (p< 0.001). A multiple regression analysis revealed that the 100-point job satisfaction score was associated with the GHQ-12 results (p< 0.001). The adjusted multiple correlation coefficient was 0.275. The 100-point scale, which is a simple and easy tool for evaluating job satisfaction, was significantly associated with psychological wellbeing as judged using the GHQ-12.

Simulated annealing model of acupuncture

NASA Astrophysics Data System (ADS)

Shang, Charles; Szu, Harold

2015-05-01

The growth control singularity model suggests that acupuncture points (acupoints) originate from organizers in embryogenesis. Organizers are singular points in growth control. Acupuncture can cause perturbation of a system with effects similar to simulated annealing. In clinical trial, the goal of a treatment is to relieve certain disorder which corresponds to reaching certain local optimum in simulated annealing. The self-organizing effect of the system is limited and related to the person's general health and age. Perturbation at acupoints can lead a stronger local excitation (analogous to higher annealing temperature) compared to perturbation at non-singular points (placebo control points). Such difference diminishes as the number of perturbed points increases due to the wider distribution of the limited self-organizing activity. This model explains the following facts from systematic reviews of acupuncture trials: 1. Properly chosen single acupoint treatment for certain disorder can lead to highly repeatable efficacy above placebo 2. When multiple acupoints are used, the result can be highly repeatable if the patients are relatively healthy and young but are usually mixed if the patients are old, frail and have multiple disorders at the same time as the number of local optima or comorbidities increases. 3. As number of acupoints used increases, the efficacy difference between sham and real acupuncture often diminishes. It predicted that the efficacy of acupuncture is negatively correlated to the disease chronicity, severity and patient's age. This is the first biological - physical model of acupuncture which can predict and guide clinical acupuncture research.

Categorical analysis of the impact of aerobic and resistance exercise training, alone and in combination, on cardiorespiratory fitness levels in patients with type 2 diabetes: results from the HART-D study.

PubMed

Johannsen, Neil M; Swift, Damon L; Lavie, Carl J; Earnest, Conrad P; Blair, Steven N; Church, Timothy S

2013-10-01

Low cardiorespiratory fitness (CRF) is an independent risk factor for cardiovascular disease (CVD), especially in individuals with type 2 diabetes. Age-predicted, sex-stratified, and maximal MET cut points have been developed to determine the risk of CVD events and mortality in low CRF categories. We examined the proportion of Health Benefits of Aerobic and Resistance Training in Individuals With Type 2 Diabetes (HART-D) participants above these cut points before and after 9 months of aerobic training (AT), resistance training (RT), or a combination of both (ATRT). Participants from the HART-D study (n=196) who were randomly assigned to exercise training (AT, RT, or ATRT) or to a nonexercise control group between April 2007 and August 2009 were used in this ancillary study. Cut points were previously established for age-predicted METs (>100% and >85%, mean and increased CVD risk, respectively), age- and sex-stratified METs (Aerobic Center Longitudinal Study), and clinically discernible METs (men>8.0, women>6.5). Baseline prevalence of participants above these cut points was similar for all intervention groups (P>0.50) and ranged from 11.9% (>100% age predicted) to 55.1% (>85% age predicted). Baseline prevalence and age-, sex-, and race/ethnic group-adjusted percentage of participants above each cut point increased significantly after AT and ATRT (P<0.05 for all). Structured exercise training, especially the AT component, was associated with a greater number of participants moving above established cut points indicative of low CRF. These results have public health and clinical implications for the growing number of patients with type 2 diabetes at high risk for CVD.

Prevalence of urinary incontinence and lower urinary tract symptoms in school-age children.

PubMed

Akil, Ipek Ozunan; Ozmen, Dilek; Cetinkaya, Aynur Cakmakci

2014-07-08

To investigate the prevalence of lower urinary tract symptoms (LUTS) and urinary incontinence (UI) in elementary school aged children in Manisa. Dysfunctional Voiding and Incontinence Scoring System (DVIS) which was developed in Turkey is used. A total of 416 children, 216 (51.9%) male and 200 (48.1%) female were recruited in this study. Mean age of children was 10.35 ± 2.44 years (median10 years). Daytime UI frequency was 6.7% (28 child), nocturnal incontinence 16.6% (69 child) and combined daytime and nocturnal incontinence 4.1% (17 child). There was no statistically significant difference in the prevalence of nocturnal and or daytime UI between male and female gender. Mean DVIS score was 2.65 ± 3.95 and gender did not affect total DVIS points. The mean ages of achieving daytime bowel and bladder control were all significantly correlated with DVIS points. DVIS points were positively correlated with the history of UI of the family. Total points were increased when the father was unemployed. UI negatively influences health related quality of life of the family and child, so it is important that awareness of the UI and symptoms of lower urinary tract dysfunction.

Effect of in-home fortification of complementary feeding on intellectual development of Chinese children.

PubMed

Chen, Chun-Ming; Wang, Yu-Ying; Chang, Su-Ying

2010-04-01

To explore the effect of in-home fortification of complementary feeding on intellectual development of Chinese children aged below 24 months. One thousand and four hundred seventy eight children aged 4-12 months were recruited and divided into study groups (formula 1 group and formula 2 group) and control group. In two study groups, in addition to the usual complementary food, children were fed with a sachet of fortified food supplement each day. Protein and micronutrients were provided in formula 1 group. Formula 2 group had the same energy intake as the formula 1 group . In addition to measurement of physical growth and detection of hemoglobin level, Development Quotient (DQ) or Intelligence Quotient (IQ) was assessed. The DQ of children aged below 24 months was 97.2, 95.5, and 93.8 in formula 1 group, formula 2 group and control group, respectively, and the differences were statistically significant (P < 0.05). The DQ of children in formula 1 group, formula 2 group, and control group was 92.7, 90.4, and 88.3 respectively in the first follow up showing statistically significant differences (P < 0.05). And, DQ of children in formula 1 group, formula 2 group and control group were 96.7, 94.5, and 93.7 respectively in the second follow up, showing statistically significant differences (P < 0.05). Full-IQ of children in the formula 1 group was 3.1 and 4.5 points higher than that in formula 2 group and in control group respectively. Verbal IQ of children in the formula 1 group was 2.1 and 5 points higher than that in formula 2 group and control group respectively. Performance IQ was 2.5 and 3.1 points higher than that in formula 2 group and control group respectively. All above mentioned comparisons were statistically significant. Fortification of complementary feeding showed persistent effect on intelligence development of young children which could persist to 6 years of age. The critical time for correction of anemia could be under 18 months.

Measurement of asthma control according to global initiative for asthma guidelines: a comparison with the asthma control questionnaire

PubMed Central

2012-01-01

Introduction Asthma Control Questionnaire (ACQ) is a validated tool to measure asthma control. Cut-off points that best discriminate “well-controlled” or “not well-controlled” asthma have been suggested from the analysis of a large randomized clinical trial but they may not be adequate for daily clinical practice. Aims To establish cut-off points of the ACQ that best discriminate the level of control according to Global Initiative for Asthma (GINA) 2006 guidelines in patients with asthma managed at Allergology and Pulmonology Departments as well as Primary Care Centers in Spain. Patients and methods An epidemiological descriptive study, with prospective data collection. Asthma control following GINA-2006 classification and 7-item ACQ was assessed. The study population was split in two parts: 2/3 for finding the cut-off points (development population) and 1/3 for validating the results (validation population). Results A total of 1,363 stable asthmatic patients were included (mean age 38 ± 14 years, 60.3% women; 69.1% non-smokers). Patient classification according to GINA-defined asthma control was: controlled 13.6%, partially controlled 34.2%, and uncontrolled 52.3%. The ACQ cut-off points that better agreed with GINA-defined asthma control categories were calculated using receiver operating curves (ROC). The analysis showed that ACQ < 0.5 was the optimal cut-off point for “controlled asthma” (sensitivity 74.1%, specificity 77.5%) and 1.00 for “uncontrolled asthma” (sensitivity 73%, specificity 88.2%). Kappa index between GINA categories and ACQ was 0.62 (p < 0.001). Conclusion The ACQ cut-off points associated with GINA-defined asthma control in a real-life setting were <0.5 for controlled asthma and ≥1 for uncontrolled asthma. PMID:22726416

Helping Seniors Plan for Posthospital Discharge Needs Before a Hospitalization Occurs: Results from the Randomized Control Trial of PlanYourLifespan.org.

PubMed

Lindquist, Lee A; Ramirez-Zohfeld, Vanessa; Sunkara, Priya D; Forcucci, Chris; Campbell, Dianne S; Mitzen, Phyllis; Ciolino, Jody D; Kricke, Gayle; Seltzer, Anne; Ramirez, Ana V; Cameron, Kenzie A

2017-11-01

Investigate the effect of PlanYourLifespan.org (PYL) on knowledge of posthospital discharge options. Multisite randomized controlled trial. Nonhospitalized adults, aged =65 years, living in urban, suburban, and rural areas of Texas, Illinois, and Indiana. PYL is a national, publicly available tool that provides education on posthospital therapy choices and local home-based resources. Participants completed an in-person baseline survey, followed by exposure to intervention or attention control (AC) websites, then 1-month and 3-month telephone surveys. The primary knowledge outcome was measured with 6 items (possible 0-6 points) pertaining to hospital discharge needs. Among 385 participants randomized, mean age was 71.9 years (standard deviation 5.6) and 79.5% of participants were female. At 1 month, the intervention group had a 0.6 point change (standard deviation = 1.6) versus the AC group who had a -0.1 point change in knowledge score. Linear mixed modeling results suggest sex, health literacy level, level of education, income, and history of high blood pressure/kidney disease were significant predictors of knowledge over time. Controlling for these variables, treatment effect remained significant (P < 0.0001). Seniors who used PYL demonstrated an increased understanding of posthospitalization and home services compared to the control group. © 2017 Society of Hospital Medicine

Populating a Control Point Database: A cooperative effort between the USGS, Grand Canyon Monitoring and Research Center and the Grand Canyon Youth Organization

NASA Astrophysics Data System (ADS)

Brown, K. M.; Fritzinger, C.; Wharton, E.

2004-12-01

The Grand Canyon Monitoring and Research Center measures the effects of Glen Canyon Dam operations on the resources along the Colorado River from Glen Canyon Dam to Lake Mead in support of the Grand Canyon Adaptive Management Program. Control points are integral for geo-referencing the myriad of data collected in the Grand Canyon including aerial photography, topographic and bathymetric data used for classification and change-detection analysis of physical, biologic and cultural resources. The survey department has compiled a list of 870 control points installed by various organizations needing to establish a consistent reference for data collected at field sites along the 240 mile stretch of Colorado River in the Grand Canyon. This list is the foundation for the Control Point Database established primarily for researchers, to locate control points and independently geo-reference collected field data. The database has the potential to be a valuable mapping tool for assisting researchers to easily locate a control point and reduce the occurrance of unknowingly installing new control points within close proximity of an existing control point. The database is missing photographs and accurate site description information. Current site descriptions do not accurately define the location of the point but refer to the project that used the point, or some other interesting fact associated with the point. The Grand Canyon Monitoring and Research Center (GCMRC) resolved this problem by turning the data collection effort into an educational exercise for the participants of the Grand Canyon Youth organization. Grand Canyon Youth is a non-profit organization providing experiential education for middle and high school aged youth. GCMRC and the Grand Canyon Youth formed a partnership where GCMRC provided the logistical support, equipment, and training to conduct the field work, and the Grand Canyon Youth provided the time and personnel to complete the field work. Two data collection efforts were conducted during the 2004 summer allowing 40 youth the opportunity to contribute valuable information to the Control Point Database. This information included: verification of point existence, photographs, accurate site descriptions concisely describing the location of the point, how to reach the point, the specific point location and detailed bearings to visible and obvious land marks. The youth learned to locate themselves and find the points using 1:1000 airphotos, write detailed site descriptions, take bearings with a compass, measure vertical and horizontal distances, and use a digital camera. The youth found information for 252 control points (29% of the total points).

The use of oral sucrose for procedural pain relief in infants up to six months of age: a randomized controlled trial.

PubMed

Wilson, Sally; Bremner, Alexandra P; Mathews, Judy; Pearson, Diane

2013-12-01

The aim of this study was to evaluate the effectiveness of oral sucrose in decreasing pain during minor procedures in infants of 1-6 months corrected age. A blinded randomized controlled trial with infants aged 4-26 weeks who underwent venipuncture, heel lance or intravenous cannulation were stratified by corrected age into > 4-12 weeks and > 12-26 weeks. They received 2 mL of either 25% sucrose or sterile water orally 2 minutes before the painful procedure. Nonnutritional sucking and parental comfort, provided in adherence to hospital guidelines, were recorded. Pain behavior was recorded using a validated 10 point scale at baseline, during and following the procedure. Data collectors were blinded to the intervention. A total of 21 and 20 infants received sucrose and water, respectively, in the > 4-12-week age group, and 21 and 22, respectively, in the > 12-26-week age group. No statistical differences were found in pain scores between treatment and control groups at any data collection points in either age group. Infants aged > 4-12 weeks who did nonnutritional sucking showed statistically significantly lower median pain scores at 1, 2, and 3 minutes after the procedure than those who did not suck. Infants aged > 4-26 weeks exhibited pain behavior scores that indicated moderate to large pain during painful procedures; however, there was insufficient evidence to show that 2 mL 25% sucrose had a statistically significant effect in decreasing pain. Infants should be offered nonnutritional sucking in compliance with the Baby Friendly Health Initiative during painful procedures. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Growth responses of male broilers subjected to increasing air velocities at high ambient temperatures and a high dew point.

PubMed

Dozier, W A; Lott, B D; Branton, S L

2005-06-01

This study examined live performance responses of male broilers to increasing air velocity of 120 and 180 m/min reared under high cyclic temperatures (25-35-25 degrees C) with a 23 degrees C dew point from 21 to 49 d. Birds were reared in an environmental facility containing 2 wind tunnels (4 pens/tunnel) and 6 floor pens (control). At 21 d, 53 birds were placed in each pen of the wind tunnels and control group, respectively, and growth performance was determined weekly. Increasing air velocity from 120 to 180 m/min improved BW and BW gain from 29 to 35, 36 to 42, and 43 to 49 d of age leading to a cumulative advantage of 287 g in BW gain and a 10-point difference in feed conversion from 21 to 49 d of age. Subjecting birds to air velocity improved growth rate, feed consumption, and feed conversion at each weekly interval from 28 to 49 d over the control birds. These results indicate that male broilers approximating 2.0 to 3.0 kg respond to an air velocity of 180 m/min when exposed to high cyclic temperatures.

Dance Therapy with Physical Therapy for Children with Down Syndrome.

ERIC Educational Resources Information Center

Dupont, Blanche Burt; Schulmann, Diana

This study sought to investigate effects of a dance program on bilateral toe-standing balance and single-point static balance skills of a group of children with Down Syndrome. Thirteen experimental and 10 control group students between the ages of 3 and 13 years were assessed on toe-standing balance and single-point standing balance on the right…

Lower limb muscle strength is associated with poor balance in middle-aged women: linear and nonlinear analyses.

PubMed

Wu, F; Callisaya, M; Laslett, L L; Wills, K; Zhou, Y; Jones, G; Winzenberg, T

2016-07-01

This was the first study investigating both linear associations between lower limb muscle strength and balance in middle-aged women and the potential for thresholds for the associations. There was strong evidence that even in middle-aged women, poorer LMS was associated with reduced balance. However, no evidence was found for thresholds. Decline in balance begins in middle age, yet, the role of muscle strength in balance is rarely examined in this age group. We aimed to determine the association between lower limb muscle strength (LMS) and balance in middle-aged women and investigate whether cut-points of LMS exist that might identify women at risk of poorer balance. Cross-sectional analysis of 345 women aged 36-57 years was done. Associations between LMS and balance tests (timed up and go (TUG), step test (ST), functional reach test (FRT), and lateral reach test (LRT)) were assessed using linear regression. Nonlinear associations were explored using locally weighted regression smoothing (LOWESS) and potential cut-points identified using nonlinear least-squares estimation. Segmented regression was used to estimate associations above and below the identified cut-points. Weaker LMS was associated with poorer performance on the TUG (β -0.008 (95 % CI: -0.010, -0.005) second/kg), ST (β 0.031 (0.011, 0.051) step/kg), FRT (β 0.071 (0.047, 0.096) cm/kg), and LRT (β 0.028 (0.011, 0.044) cm/kg), independent of confounders. Potential nonlinear associations were evident from LOWESS results; significant cut-points of LMS were identified for all balance tests (29-50 kg). However, excepting ST, cut-points did not persist after excluding potentially influential data points. In middle-aged women, poorer LMS is associated with reduced balance. Therefore, improving muscle strength in middle-age may be a useful strategy to improve balance and reduce falls risk in later life. Middle-aged women with low muscle strength may be an effective target group for future randomized controlled trials. Australian New Zealand Clinical Trials Registry (ANZCTR) NCT00273260.

A case-control study of self-reported health, quality-of-life and general functioning among recent immigrants and age- and sex-matched Swedish-born controls.

PubMed

Löfvander, Monica; Rosenblad, Andreas; Wiklund, Tony; Bennström, Halina; Leppert, Jerzy

2014-12-01

To examine whether new immigrants had inferior quality-of-life, well-being and general functioning compared with Swedish age- and sex-matched controls. A prospective case-control study was designed including immigrants from non-European countries, 18-65 years of age, with recent Permanent Permits to Stay (PPS) in Sweden, and age- and sex-matched Swedish-born (SB) persons from the general population in Västmanland County, Sweden. The General Health Questionnaire (GHQ-12), the brief version of the World Health Organization Quality-of-Life (WHOQOL-BREF) Scale and the General Activity Functioning Assessment Scale (GAF) from DSM-IV were posted (SB), or applied in personal interviews (PPS) with interpreters. Differences between the PPS and SB groups were measured using McNemar's test and Wilcoxon signed-rank test conducted separately for observations at baseline, 6- and 12-month follow-up. There were 93 pairs (mean age 36 years). Persons from Somalia (67%) and Iraq (27%) dominated the PPS group. The differences between the groups were statistically significant for all time points for the Psychological health and Social relationship domains of WHOQOL-BREF, and for the baseline and 6-month follow-up time points of GHQ-12 where the PPS-group had a higher degree of well-being, health and quality-of-life than the SB. This tendency applied for both sexes in the immigrant group. These new immigrants did not have inferior physical or psychological health, quality-of-life, well-being or social functioning compared with their age- and sex-matched Swedish born pairs during a 1-year follow-up. Thus, there is reason to advocate immigrants' fast integration into society. © 2014 the Nordic Societies of Public Health.

Facilitating sunscreen use in women by a theory-based online intervention: a randomized controlled trial.

PubMed

Craciun, Catrinel; Schüz, Natalie; Lippke, Sonia; Schwarzer, Ralf

2012-03-01

This study compares a motivational skin cancer prevention approach with a volitional planning and self-efficacy intervention to enhance regular sunscreen use. A randomized controlled trial (RCT) was conducted with 205 women (mean age 25 years) in three groups: motivational; volitional; and control. Sunscreen use, action planning, coping planning and coping self-efficacy were assessed at three points in time. The volitional intervention improved sunscreen use. Coping planning emerged as the only mediator between the intervention and sunscreen use at Time 3. Findings point to the role played by coping planning as an ingredient of sun protection interventions.

Effect of Latent Myofascial Trigger Points on Strength Measurements of the Upper Trapezius: A Case-Controlled Trial

PubMed Central

Anshul

2011-01-01

ABSTRACT Purpose: The purpose of this article was to determine whether strength is altered in the upper trapezius in the presence of latent myofascial trigger points (MTrP). Methods: This study was case controlled and used convenience sampling. The sample recruited was homogeneous with respect to age, sex, height, and body mass. Participants were assessed for the presence of latent MTrP in the upper trapezius and placed into two groups: an experimental group that had latent MTrP in the upper trapezius and a control group that did not. Eighteen women (mean age 21.4 y, SD 1.89; mean height 156.9 cm, SD 4.03; and mean body mass 51.7 kg, SD 5.84) made up the experimental group, and 19 women (mean age 20.3 y, SD 1.86; mean height 158.6 cm, SD 3.14; and mean body mass 53.2 kg, SD 5.17) made up the control group. We obtained strength measurements of the non-dominant arm using a handheld dynamometer and compared them between the two groups. Results: The difference in the strength measurements between the two groups was not statistically significant (p=0.59). Conclusions: The presence of latent MTrPs may not affect the strength of the upper trapezius. PMID:22942517

Revisiting self-regulatory techniques to promote physical activity in older adults: null-findings from a randomised controlled trial.

PubMed

Warner, Lisa M; Wolff, Julia K; Ziegelmann, Jochen P; Schwarzer, Ralf; Wurm, Susanne

2016-10-01

A randomised controlled trial (RCT) was conducted to evaluate a three-hour face-to-face physical activity (PA) intervention in community-dwelling older German adults with four groups: The intervention group (IG) received behaviour change techniques (BCTs) based on the health action process approach plus a views-on-ageing component to increase PA. The second intervention group 'planning' (IGpl) contained the same BCTs, only substituted the views-on-ageing component against an additional planning task. An active control group received the same BCTs, however, targeting volunteering instead of PA. A passive control group (PCG) received no intervention. The RCT comprised 5 time-points over 14 months in N = 310 participants aged 64+. Self-reported as well as accelerometer-assessed PA. Neither PA measure increased in the IG as compared to the other groups at any point in time. Bayes analyses supported these null-effects. A possible explanation for this null-finding in line with a recent meta-analysis is that some self-regulatory BCTs may be ineffective or even negatively associated with PA in interventions for older adults as they are assumed to be less acceptable for older adults. This interpretation was supported by observed reluctance to participate in self-regulatory BCTs in the current study.

Task control and cognitive abilities of self and spouse in collaboration in middle-aged and older couples.

PubMed

Berg, Cynthia A; Smith, Timothy W; Ko, Kelly J; Beveridge, Ryan M; Story, Nathan; Henry, Nancy J M; Florsheim, Paul; Pearce, Gale; Uchino, Bert N; Skinner, Michelle A; Glazer, Kelly

2007-09-01

Collaborative problem solving may be used by older couples to optimize cognitive functioning, with some suggestion that older couples exhibit greater collaborative expertise. The study explored age differences in 2 aspects of collaborative expertise: spouses' knowledge of their own and their spouse's cognitive abilities and the ability to fit task control to these cognitive abilities. The participants were 300 middle-aged and older couples who completed a hypothetical errand task. The interactions were coded for control asserted by husbands and wives. Fluid intelligence was assessed, and spouses rated their own and their spouse's cognitive abilities. The results revealed no age differences in couple expertise, either in the ability to predict their own and their spouse's cognitive abilities or in the ability to fit task control to abilities. However, gender differences were found. Women fit task control to their own and their spouse's cognitive abilities; men only fit task control to their spouse's cognitive abilities. For women only, the fit between control and abilities was associated with better performance. The results indicate no age differences in couple expertise but point to gender as a factor in optimal collaboration. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

The Contribution of Adolescent Effortful Control to Early Adult Educational Attainment

PubMed Central

Véronneau, Marie-Hélène; Racer, Kristina Hiatt; Fosco, Gregory M.; Dishion, Thomas J.

2014-01-01

Effortful control has been proposed as a set of neurocognitive competencies that is relevant to self-regulation and educational attainment (Posner & Rothbart, 2007). This study tested the hypothesis that a multiagent report of adolescents’ effortful control (age 17) would be predictive of academic persistence and educational attainment (age 23–25), after controlling for other established predictors (family factors, problem behavior, grade point average, and substance use). Participants were 997 students recruited in 6th grade from 3 urban public middle schools (53% males; 42.4% European American; 29.2% African American). Consistent with the hypothesis, the unique association of effortful control with future educational attainment was comparable in strength to that of parental education and students’ past grade point average, suggesting that effortful control contributes to this outcome above and beyond well-established predictors. Path coefficients were equivalent across gender and ethnicity (European Americans and African Americans). Effortful control appears to be a core feature of the self-regulatory competencies associated with achievement of educational success in early adulthood. These findings suggest that the promotion of self-regulation in general and effortful control in particular may be an important focus not only for resilience to stress and avoidance of problem behavior, but also for growth in academic competence. PMID:25308996

Gaining control: changing relations between executive control and processing speed and their relevance for mathematics achievement over course of the preschool period

PubMed Central

Clark, Caron A. C.; Nelson, Jennifer Mize; Garza, John; Sheffield, Tiffany D.; Wiebe, Sandra A.; Espy, Kimberly Andrews

2014-01-01

Early executive control (EC) predicts a range of academic outcomes and shows particularly strong associations with children's mathematics achievement. Nonetheless, a major challenge for EC research lies in distinguishing EC from related cognitive constructs that also are linked to achievement outcomes. Developmental cascade models suggest that children's information processing speed is a driving mechanism in cognitive development that supports gains in working memory, inhibitory control and associated cognitive abilities. Accordingly, individual differences in early executive task performance and their relation to mathematics may reflect, at least in part, underlying variation in children's processing speed. The aims of this study were to: (1) examine the degree of overlap between EC and processing speed at different preschool age points; and (2) determine whether EC uniquely predicts children's mathematics achievement after accounting for individual differences in processing speed. As part of a longitudinal, cohort-sequential study, 388 children (50% boys; 44% from low income households) completed the same battery of EC tasks at ages 3, 3.75, 4.5, and 5.25 years. Several of the tasks incorporated baseline speeded naming conditions with minimal EC demands. Multidimensional latent models were used to isolate the variance in executive task performance that did not overlap with baseline processing speed, covarying for child language proficiency. Models for separate age points showed that, while EC did not form a coherent latent factor independent of processing speed at age 3 years, it did emerge as a distinct factor by age 5.25. Although EC at age 3 showed no distinct relation with mathematics achievement independent of processing speed, EC at ages 3.75, 4.5, and 5.25 showed independent, prospective links with mathematics achievement. Findings suggest that EC and processing speed are tightly intertwined in early childhood. As EC becomes progressively decoupled from processing speed with age, it begins to take on unique, discriminative importance for children's mathematics achievement. PMID:24596563

Parenting and the development of effortful control from early childhood to early adolescence: A transactional developmental model.

PubMed

Tiberio, Stacey S; Capaldi, Deborah M; Kerr, David C R; Bertrand, Maria; Pears, Katherine C; Owen, Lee

2016-08-01

Poor effortful control is a key temperamental factor underlying behavioral problems. The bidirectional association of child effortful control with both positive parenting and negative discipline was examined from ages approximately 3 to 13-14 years, involving five time points, and using data from parents and children in the Oregon Youth Study-Three Generational Study (N = 318 children from 150 families). Based on a dynamic developmental systems approach, it was hypothesized that there would be concurrent associations between parenting and child effortful control and bidirectional effects across time from each aspect of parenting to effortful control and from effortful control to each aspect of parenting. It was also hypothesized that associations would be more robust in early childhood, from ages 3 to 7 years, and would diminish as indicated by significantly weaker effects at the older ages, 11-12 to 13-14 years. Longitudinal feedback or mediated effects were also tested. The findings supported (a) stability in each construct over multiple developmental periods; (b) concurrent associations, which were significantly weaker at the older ages; (c) bidirectional effects, consistent with the interpretation that at younger ages children's effortful control influenced parenting, whereas at older child ages, parenting influenced effortful control; and (d) a transactional effect, such that maternal parenting in late childhood was a mechanism explaining children's development of effortful control from middle childhood to early adolescence.

Parenting and the Development of Effortful Control from Early Childhood to Early Adolescence: A Transactional Developmental Model

PubMed Central

Capaldi, Deborah M.; Kerr, David C. R.; Bertrand, Maria; Pears, Katherine C.; Owen, Lee

2016-01-01

Poor effortful control is a key temperamental factor underlying behavioral problems. The bidirectional association of child effortful control with both positive parenting and negative discipline was examined from ages approximately 3 to 13–14 years, involving 5 time points, and using data from parents and children in the Oregon Youth Study-Three Generational Study (N = 318 children from 150 families). Based on a dynamic developmental systems approach, it was hypothesized that there would be concurrent associations between parenting and child effortful control and bidirectional effects across time from each aspect of parenting to effortful control and from effortful control to each aspect of parenting. It was also hypothesized that associations would be more robust in early childhood, from ages 3 to 7 years, and would diminish as indicated by significantly weaker effects at the older ages, 11–12 to 13–14 years. Longitudinal feedback or mediated effects were also tested. Findings supported (a) stability in each construct over multiple developmental periods; (b) concurrent associations, which were significantly weaker at the older ages; (c) bidirectional effects, consistent with the interpretation that at younger ages children’s effortful control influenced parenting, whereas at older child ages, parenting influenced effortful control; and (d) a transactional effect, such that maternal parenting in late childhood was a mechanism explaining children’s development of effortful control from midchildhood to early adolescence. PMID:27427809

Caregiver's depressive symptoms and asthma control in children from an underserved community.

PubMed

Rioseco, Andrea; Serrano, Carolina; Celedón, Juan C; Padilla, Oslando; Puschel, Klaus; Castro-Rodriguez, Jose A

2017-12-01

Caregiver's or maternal depression has been associated with increased asthma morbidity in children from prosperous nations, but little is known about this link in low and middle-income countries. To examine if caregiver's depressive symptoms are associated with poor asthma control and abnormal immune responses in school-aged children. Case-control study of 87 asthmatic children (aged 4-11 years) attending a primary care clinic in an underserved area of Santiago (Chile). Cases were children with poor asthma control (Child Asthma Control Test [cACT] <20 points) and controls were children with adequate asthma control (cACT ≥20 points). The Beck Depression Inventory-II (BDI) and a locally validated family health vulnerability test (SALUFAM) were used to assess caregivers' depression and family health vulnerability. Serum from participating children was assayed for IFN-γ, IL-4, IL-13, TGF-β, cortisol, and total IgE. The mean (SD) age of study participants was 8.23 (2.15 years), and 55.2% were females. Use of inhaled corticosteroids (ICS), family health vulnerability, and caregiver's depressive symptoms were significantly more common in cases than in controls (65.4% vs. 34.6%, p = 0.003; 41.3% vs. 24.8%, p = 0.07; and 39.1% vs. 19.5%, p = 0.04, respectively). There was no significant difference in the level of any serum biomarkers between groups. In a multivariate analysis, only ICS use was significantly associated with better asthma control (OR = 3.56 [1.34-9.48], p = 0.01). Presence of caregiver's depressive symptoms is associated with poor asthma control among children from an underserved community, but this association was no longer significant after accounting for ICS use.

A Participatory Randomized Controlled Trial in Knowledge Translation (KT) to Promote the Adoption of Self-Monitoring of Blood Glucose for Type 2 Diabetes Mellitus Patients in An Urban District of Thailand.

PubMed

Suriyawongpaisal, Paibul; Tansirisithikul, Rassamee; Sakulpipat, Thida; Charoensuk, Phikul; Aekplakorn, Wichai

2016-02-01

To examine effectiveness of self-monitoring of blood glucose (SMBG) in glycemic control for poor control diabetes patients, and test whether the glycemic outcome for those with the 7-point SMBG was better than those with 5-point SMBG or usual care. Randomized-controlled trial (RCT) of patients with type 2 diabetes mellitus aged 30 years or older HbA1c > 7. Patients were randomly allocated to one of three groups; 7-point SMBG 5-point SBMG and control group. Differences in HbA1c at 6 months and baseline were compared among groups. A total of 191 patients with poor control of diabetes were included. Compared with baseline, at 6 months, average change in HbAlc among control, 7-point, and 5-point SMBG were -0.38, -0.87, and -0.99 (p = 0.04), respectively. The corresponding percentages of patients with reduced HbA1c were 57.1%, 77.6% and 75.5%, respectively (p = 0.03). Using different cut-off values for HbA1c (< 7 and < 7.5) resulted in different percentage distribution of T2DM patients among the 3 groups, yet the differences were not statistically significant. Reductions in body weight were observed in both SMBG groups but not in the control group. Using RCT on participatory basis, SMBG with individual dietary counseling was effective in short term. Further engagement with the provider team, the patients/care takers and the health care financing agency to integrate SMBG in the care protocol for poor control diabetes should be considered.

A Randomized Trial Evaluating Short-term Effectiveness of Overminus Lenses in Children 3 to 6 Years of Age with Intermittent Exotropia.

PubMed

Chen, Angela M; Holmes, Jonathan M; Chandler, Danielle L; Patel, Reena A; Gray, Michael E; Erzurum, S Ayse; Wallace, David K; Kraker, Raymond T; Jensen, Allison A

2016-10-01

To evaluate the short-term effectiveness of overminus spectacles in improving control of childhood intermittent exotropia (IXT). Randomized, clinical trial. A total of 58 children aged 3 to <7 years with IXT. Eligibility criteria included a distance control score of 2 or worse (mean of 3 measures during a single examination) on a scale of 0 (exophoria) to 5 (constant exotropia) and spherical equivalent refractive error between -6.00 diopters (D) and +1.00 D. Children were randomly assigned to overminus spectacles (-2.50 D over cycloplegic refraction) or observation (non-overminus spectacles if needed or no spectacles) for 8 weeks. The primary outcome was distance control score for each child (mean of 3 measures during a single examination) assessed by a masked examiner at 8 weeks. Outcome testing was conducted with children wearing their study spectacles or plano spectacles for the children in the observation group who did not need spectacles. The primary analysis compared mean 8-week distance control score between treatment groups using an analysis of covariance model that adjusted for baseline distance control, baseline near control, prestudy spectacle wear, and prior IXT treatment. Treatment side effects were evaluated using questionnaires completed by parents. At 8 weeks, mean distance control was better in the 27 children treated with overminus spectacles than in the 31 children who were observed without treatment (2.0 vs. 2.8 points, adjusted difference = -0.75 points favoring the overminus group; 2-sided 95% confidence interval, -1.42 to -0.07 points). Side effects of headaches, eyestrain, avoidance of near activities, and blur appeared similar between treatment groups. In a pilot randomized clinical trial, overminus spectacles improved distance control at 8 weeks in children aged 3 to <7 years with IXT. A larger and longer randomized trial is warranted to assess the effectiveness of overminus spectacles in treating IXT, particularly the effect on control after overminus treatment has been discontinued. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

The effectiveness of dry-cupping in preventing post-operative nausea and vomiting by P6 acupoint stimulation: A randomized controlled trial.

PubMed

Farhadi, Khosro; Choubsaz, Mansour; Setayeshi, Khosro; Kameli, Mohammad; Bazargan-Hejazi, Shahrzad; Heidari Zadie, Zahra; Ahmadi, Alireza

2016-09-01

Postoperative nausea and vomiting (PONV) is a common complication after general anesthesia, and the prevalence ranges between 25% and 30%. The aim of this study was to determine the preventive effects of dry cupping on PONV by stimulating point P6 in the wrist. This was a randomized controlled trial conducted at the Imam Reza Hospital in Kermanshah, Iran. The final study sample included 206 patients (107 experimental and 99 controls). Inclusion criteria included the following: female sex; age>18 years; ASA Class I-II; type of surgery: laparoscopic cholecystectomy; type of anesthesia: general anesthesia. Exclusion criteria included: change in the type of surgery, that is, from laparoscopic cholecystectomy to laparotomy, and ASA-classification III or more. Interventions are as follows: pre surgery, before the induction of anesthesia, the experimental group received dry cupping on point P6 of the dominant hand's wrist with activation of intermittent negative pressure. The sham group received cupping without activation of negative pressure at the same point. Main outcome was that the visual analogue scale was used to measure the severity of PONV. The experimental group who received dry cupping had significantly lower levels of PONV severity after surgery (P < 0.001) than the control group. The differences in measure were maintained after controlling for age and ASA in regression models (P < 0.01). Traditional dry cupping delivered in an operation room setting prevented PONV in laparoscopic cholecystectomy patients.

Measuring the development of inhibitory control: The challenge of heterotypic continuity

PubMed Central

Petersen, Isaac T.; Hoyniak, Caroline P.; McQuillan, Maureen E.; Bates, John E.; Staples, Angela D.

2016-01-01

Inhibitory control is thought to demonstrate heterotypic continuity, in other words, continuity in its purpose or function but changes in its behavioral manifestation over time. This creates major methodological challenges for studying the development of inhibitory control in childhood including construct validity, developmental appropriateness and sensitivity of measures, and longitudinal factorial invariance. We meta-analyzed 198 studies using measures of inhibitory control, a key aspect of self-regulation, to estimate age ranges of usefulness for each measure. The inhibitory control measures showed limited age ranges of usefulness owing to ceiling/floor effects. Tasks were useful, on average, for a developmental span of less than 3 years. This suggests that measuring inhibitory control over longer spans of development may require use of different measures at different time points, seeking to measure heterotypic continuity. We suggest ways to study the development of inhibitory control, with overlapping measurement in a structural equation modeling framework and tests of longitudinal factorial or measurement invariance. However, as valuable as this would be for the area, we also point out that establishing longitudinal factorial invariance is neither sufficient nor necessary for examining developmental change. Any study of developmental change should be guided by theory and construct validity, aiming toward a better empirical and theoretical approach to the selection and combination of measures. PMID:27346906

Brain activation to negative stimuli mediates a relationship between adolescent marijuana use and later emotional functioning.

PubMed

Heitzeg, Mary M; Cope, Lora M; Martz, Meghan E; Hardee, Jillian E; Zucker, Robert A

2015-12-01

This work investigated the impact of heavy marijuana use during adolescence on emotional functioning, as well as the brain functional mediators of this effect. Participants (n=40) were recruited from the Michigan Longitudinal Study (MLS). Data on marijuana use were collected prospectively beginning in childhood as part of the MLS. Participants were classified as heavy marijuana users (n=20) or controls with minimal marijuana use. Two facets of emotional functioning-negative emotionality and resiliency (a self-regulatory mechanism)-were assessed as part of the MLS at three time points: mean age 13.4, mean age 19.6, and mean age 23.1. Functional neuroimaging data during an emotion-arousal word task were collected at mean age 20.2. Negative emotionality decreased and resiliency increased across the three time points in controls but not heavy marijuana users. Compared with controls, heavy marijuana users had less activation to negative words in temporal, prefrontal, and occipital cortices, insula, and amygdala. Activation of dorsolateral prefrontal cortex to negative words mediated an association between marijuana group and later negative emotionality. Activation of the cuneus/lingual gyrus mediated an association between marijuana group and later resiliency. Results support growing evidence that heavy marijuana use during adolescence affects later emotional outcomes. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Generalised Joint Hypermobility in Caucasian Girls with Idiopathic Scoliosis: Relation with Age, Curve Size, and Curve Pattern

PubMed Central

2014-01-01

The aim of the study was to assess the prevalence of generalised joint hypermobility (GJH) in 155 girls with idiopathic scoliosis (IS) (age 9–18 years, mean 13.8 ± 2.3). The control group included 201 healthy girls. The presence of GJH was assessed with Beighton (B) test. GJH was diagnosed in 23.2% of IS girls and in 13.4% of controls (P = 0.02). The prevalence of GJH was significantly (P = 0.01) lower in IS girls aged 16–18 years in comparison with younger individuals. There was no difference regarding GJH occurrence between girls with mild (11–24°), moderate (25–40°), and severe scoliosis (>40°) (P = 0.78), between girls with single thoracic, single lumbar, and double curve scoliosis (P = 0.59), and between girls with thoracic scoliosis length ≤7 and >7 vertebrae (P = 0.25). No correlation between the number of points in B and the Cobb angle (P = 0.93), as well as between the number of points in B and the number of the vertebrae within thoracic scoliosis (P = 0.63), was noticed. GJH appeared more often in IS girls than in healthy controls. Its prevalence decreased with age. No relation between GJH prevalence and curve size, curve pattern, or scoliosis length was found. PMID:24550704

Target blood pressure for treatment of isolated systolic hypertension in the elderly: valsartan in elderly isolated systolic hypertension study.

PubMed

Ogihara, Toshio; Saruta, Takao; Rakugi, Hiromi; Matsuoka, Hiroaki; Shimamoto, Kazuaki; Shimada, Kazuyuki; Imai, Yutaka; Kikuchi, Kenjiro; Ito, Sadayoshi; Eto, Tanenao; Kimura, Genjiro; Imaizumi, Tsutomu; Takishita, Shuichi; Ueshima, Hirotsugu

2010-08-01

In this prospective, randomized, open-label, blinded end point study, we aimed to establish whether strict blood pressure control (<140 mm Hg) is superior to moderate blood pressure control (> or =140 mm Hg to <150 mm Hg) in reducing cardiovascular mortality and morbidity in elderly patients with isolated systolic hypertension. We divided 3260 patients aged 70 to 84 years with isolated systolic hypertension (sitting blood pressure 160 to 199 mm Hg) into 2 groups, according to strict or moderate blood pressure treatment. A composite of cardiovascular events was evaluated for > or =2 years. The strict control (1545 patients) and moderate control (1534 patients) groups were well matched (mean age: 76.1 years; mean blood pressure: 169.5/81.5 mm Hg). Median follow-up was 3.07 years. At 3 years, blood pressure reached 136.6/74.8 mm Hg and 142.0/76.5 mm Hg, respectively. The blood pressure difference between the 2 groups was 5.4/1.7 mm Hg. The overall rate of the primary composite end point was 10.6 per 1000 patient-years in the strict control group and 12.0 per 1000 patient-years in the moderate control group (hazard ratio: 0.89; [95% CI: 0.60 to 1.34]; P=0.38). In summary, blood pressure targets of <140 mm Hg are safely achievable in relatively healthy patients > or = 70 years of age with isolated systolic hypertension, although our trial was underpowered to definitively determine whether strict control was superior to less stringent blood pressure targets.

Quantitative CT scans of lung parenchymal pathology in premature infants ages 0-6 years.

PubMed

Spielberg, David R; Walkup, Laura L; Stein, Jill M; Crotty, Eric J; Rattan, Mantosh S; Hossain, Md Monir; Brody, Alan S; Woods, Jason C

2018-03-01

Bronchopulmonary dysplasia (BPD) is a common, heterogeneous disease in premature infants. We hypothesized that quantitative CT techniques could assess lung parenchymal heterogeneity in BPD patients across a broad age range and demonstrate how pathologies change over time. A cross-sectional, retrospective study of children age 0-6 years with non-contrast chest CT scans was conducted. BPD subjects met NICHD/NHLBI diagnostic criteria for BPD and were excluded for congenital lung/airway abnormalities or other known/suspected pulmonary diagnoses; control subjects were not premature and had normal CT scan findings. Radiologic opacities, lucencies, and spatial heterogeneity were quantified via: 1) thresholding using CT-attenuation (HU); 2) manual segmentation; and 3) Ochiai reader-scoring system. Clinical outcomes included BPD severity by NICHD/NHLBI criteria, respiratory support at NICU discharge, wheezing, and respiratory exacerbations. Heterogeneity (standard deviation) of lung attenuation in BPD was significantly greater than in controls (difference 36.4 HU [26.1-46.7 HU], P < 0.001); the difference between the groups decreased 0.58 HU per month of age (0.08-1.07 HU per month, P = 0.02). BPD patients had greater amounts of opacities and lucencies than controls except with automated quantification of lucencies. Cross-sectionally, lucencies per Ochiai score and opacities per manual segmentation decreased with time. No approach measured a statistically significant relationship to BPD clinical severity. Opacities, lucencies, and overall heterogeneity of lungs via quantitative CT can distinguish BPD patients from healthy controls, and these abnormalities decrease with age across BPD patients. Defining BPD severity by clinical outcomes such as respiratory support at several time points (vs a single time point, per current guidelines) may be meaningful. © 2017 Wiley Periodicals, Inc.

[Quantification of the gnostic sensitivity via measurement of the vibration threshold and of finger tip sensation].

PubMed

Oosterhuis, H J; Bouwsma, C; van Halsema, B; Hollander, R A; Kros, C J; Tombroek, I

1992-10-03

Quantification of vibration perception and fingertip sensation in routine neurological examination. Neurological Clinic, University Hospital, Groningen, the Netherlands. Prospective, controlled investigation. Vibration perception and fingertip sensation were quantified in a large group of normal control persons of various ages and in neurological patients and compared with the usual sensory tests at routine neurological examination. The vibration perception limit was measured with a biothesiometer without accelerometer, the fingertip sensation with a device for two-point discrimination slightly modified according to Renfrew ('Renfrew meter'). Concordance of the tests was studied by calculating kappa values. The normal values of both sensory qualities had a log-normal distribution and increased with age. The values obtained with the Renfrew meter correlated well with those of the two-point discrimination and stereognosis but were systematically higher than those indicated by Renfrew. Both methods appear useful at routine neurological examination if certain measuring precautions are taken.

Dengue vaccine safety signal: Immune enhancement, waning immunity, or chance occurrence?

PubMed

Gessner, Bradford D; Halsey, Neal

2017-06-14

A new dengue vaccine was associated with increased risk of hospitalized virologically-confirmed disease during year 3 of follow-up among children age 2-5years. Among hypotheses to explain this finding, we could not distinguish definitively between antibody dependent enhancement, waning immunity, or chance occurrence. However, any theory must account for the following: (a) the signal occurred mainly because of decreased dengue among controls rather than increased dengue among vaccinees; (b) among 48 data points, a statistically significant increase in hospitalization among vaccinated children occurred for only one age group, during one year, and in one region; (c) cumulative risk was similar for vaccinated vs. control children age 2-5years at the end of year 5 and lower for vaccinated vs. control children among older age groups; (d) the protective effect of vaccine against hospitalization decreased from years 1-2 to years 3-5 of follow-up for all age groups and regions. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

PAHA study: Psychological Active and Healthy Aging: psychological wellbeing, proactive attitude and happiness effects of whole-body vibration versus Multicomponent Training in aged women: study protocol for a randomized controlled trial

PubMed Central

2014-01-01

Background Evidence demonstrates that physical exercise and psychological wellbeing are closely interlinked, particularly in older-aged women. However, research investigating how different forms of exercise influence mental health in older-aged women is underdeveloped. Methods/Design A randomized controlled trial (N = 300) will assess the relative effectiveness of two different exercise programs (whole-body vibration and Multicomponent Training) for improving psychological wellbeing in older-aged women. The following outcomes will be assessed at three time points (that is, pre, post, and follow-up): psychological wellbeing, proactive attitude, quality of life, and happiness. Discussion Results will have important implications for preventing psychological and physiological disease in older-aged women and for managing health-related costs for this population group. Trial registration Number NCT01966562 on Clinical Gov database the 8 October 2013 PMID:24886107

Analysis of the environmental behavior of farmers for non-point source pollution control and management in a water source protection area in China.

PubMed

Wang, Yandong; Yang, Jun; Liang, Jiping; Qiang, Yanfang; Fang, Shanqi; Gao, Minxue; Fan, Xiaoyu; Yang, Gaihe; Zhang, Baowen; Feng, Yongzhong

2018-08-15

The environmental behavior of farmers plays an important role in exploring the causes of non-point source pollution and taking scientific control and management measures. Based on the theory of planned behavior (TPB), the present study investigated the environmental behavior of farmers in the Water Source Area of the Middle Route of the South-to-North Water Diversion Project in China. Results showed that TPB could explain farmers' environmental behavior (SMC=0.26) and intention (SMC=0.36) well. Furthermore, the farmers' attitude towards behavior (AB), subjective norm (SN), and perceived behavioral control (PBC) positively and significantly influenced their environmental intention; their environmental intention further impacted their behavior. SN was proved to be the main key factor indirectly influencing the farmers' environmental behavior, while PBC had no significant and direct effect. Moreover, environmental knowledge following as a moderator, gender and age was used as control variables to conduct the environmental knowledge on TPB construct moderated mediation analysis. It demonstrated that gender had a significant controlling effect on environmental behavior; that is, males engage in more environmentally friendly behaviors. However, age showed a significant negative controlling effect on pro-environmental intention and an opposite effect on pro-environmental behavior. In addition, environmental knowledge could negatively moderate the relationship between PBC and environmental intention. PBC had a greater impact on the environmental intention of farmers with poor environmental knowledge, compared to those with plenty environmental knowledge. Altogether, the present study could provide a theoretical basis for non-point source pollution control and management. Copyright © 2018 Elsevier B.V. All rights reserved.

Kinetics of Static Strain Aging in Polycrystalline NiAl-based Alloys

NASA Technical Reports Server (NTRS)

Weaver, M. L.; Kaufman, M. J.; Noebe, R. D.

1996-01-01

The kinetics of yield point return have been studied in two NiAl-based alloys as a function of aging time at temperatures between 300 and 700 K. The results indicate that the upper yield stress increment, Delta sigma(sub u) (i.e., stress difference between the upper yield point and the final flow stress achieved during prestraining), in conventional purity (CP-NiAl) and in high purity carbon-doped (NiAl-C) material first increased with a t(exp 2/3) relationship before reaching a plateau. This behavior suggests that a Cottrell locking mechanism is the cause for yield points in NiAl. In addition, positive y-axis intercepts were observed in plots of Delta sigma(sub u) versus t(exp 2/3) suggesting the operation of a Snoek mechanism. Analysis according to the Cottrell Bilby model of atmosphere formation around dislocations yields an activation energy for yield point return in the range 70 to 76 kJ/mol which is comparable to the activation energy for diffusion of interstitial impurities in bcc metals. It is, thus, concluded that the kinetics of static strain aging in NiAl are controlled by the locking of dislocations by Cottrell atmospheres of carbon atoms around dislocations.

Age-related skeletal muscle decline is similar in HIV-infected and uninfected individuals.

PubMed

Yarasheski, Kevin E; Scherzer, Rebecca; Kotler, Donald P; Dobs, Adrian S; Tien, Phyllis C; Lewis, Cora E; Kronmal, Richard A; Heymsfield, Steven B; Bacchetti, Peter; Grunfeld, Carl

2011-03-01

Skeletal muscle (SM) mass decreases with advanced age and with disease in HIV infection. It is unknown whether age-related muscle loss is accelerated in the current era of antiretroviral therapy and which factors might contribute to muscle loss among HIV-infected adults. We hypothesized that muscle mass would be lower and decline faster in HIV-infected adults than in similar-aged controls. Whole-body (1)H-magnetic resonance imaging was used to quantify regional and total SM in 399 HIV-infected and 204 control men and women at baseline and 5 years later. Multivariable regression identified associated factors. At baseline and Year 5, total SM was lower in HIV-infected than control men. HIV-infected women were similar to control women at both time points. After adjusting for demographics, lifestyle factors, and total adipose tissue, HIV infection was associated with lower Year 5 SM in men and higher SM in women compared with controls. Average overall 5-year change in total SM was small and age related, but rate of change was similar in HIV-infected and control men and women. CD4 count and efavirenz use in HIV-infected participants were associated with increasing SM, whereas age and stavudine use were associated with decreasing SM. Muscle mass was lower in HIV-infected men compared with controls, whereas HIV-infected women had slightly higher SM than control women after multivariable adjustment. We found evidence against substantially faster SM decline in HIV infected versus similar-aged controls. SM gain was associated with increasing CD4 count, whereas stavudine use may contribute to SM loss.

Brain-derived neurotrophic factor (BDNF) in children with ASD and their parents: a 3-year follow-up.

PubMed

Francis, K; Dougali, A; Sideri, K; Kroupis, C; Vasdekis, V; Dima, K; Douzenis, A

2018-05-01

Several lines of evidence point to a probable relationship between brain-derived neurotrophic factor (BDNF) and autism spectrum disorder (ASD), but studies have yielded inconsistent findings on the BDNF serum level in ASD. The study aimed to assess those levels in children with ASD and their families. BDNF serum levels were measured in 45 ASD children without intellectual disability (ID) and allergies, age 30-42 months and age-matched normal controls. BDNF serum levels in the parents of the ASD subjects were compared to normal controls. BDNF serum levels in the ASD subjects were followed up for 3 years and correlated with adaptive functioning changes. BDNF serum levels were measured to be lower in children with ASD and independent of all the major baseline characteristics of the subjects. Having a child with ASD raises the BDNF levels in parents comparing to controls. Prospectively, no correlation between the change of BDNF variables in time and the change of the Vineland scores was found. Our results contradict those from recent published meta-analyses with the age, the presence of ID and allergies being possible contributing factors. The parents' data indeed point to a role of BDNF in the pathophysiology of ASD. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Thin-plate spline analysis of mandibular shape changes induced by functional appliances in Class II malocclusion : A long-term evaluation.

PubMed

Franchi, Lorenzo; Pavoni, Chiara; Faltin, Kurt; Bigliazzi, Renato; Gazzani, Francesca; Cozza, Paola

2016-09-01

The purpose of this work was to evaluate the long-term morphological mandibular changes induced by functional treatment of Class II malocclusion with mandibular retrusion. Forty patients (20 females, 20 males) with Class II malocclusion consecutively treated with either a Bionator or an Activator followed by fixed appliances were compared with a control group of 40 subjects (19 females, 21 males) with untreated Class II malocclusion. Lateral cephalograms were available at the start of treatment (T1, mean age 9.9 years), at the end of treatment with functional appliances (T2, mean age 12.2 years), and for long-term follow-up (T3, mean age 18.3 years). Mandibular shape changes were analyzed on lateral cephalograms of the subjects in both groups via thin-plate spline (TPS) analysis. Shape differences were statistically analyzed by conducting permutation tests on Goodall F statistics. In the long term, both the treated and control groups exhibited significant longitudinal mandibular shape changes characterized by upward and forward dislocation of point Co associated with a vertical extension in the gonial region and backward dislocation of point B. Functional appliances induced mandible's significant posterior morphogenetic rotation over the short term. The treated and control groups demonstrated similar mandibular shape over the long term.

Medium-Chain Triglycerides in Combination with Leucine and Vitamin D Benefit Cognition in Frail Elderly Adults: A Randomized Controlled Trial.

PubMed

Abe, Sakiko; Ezaki, Osamu; Suzuki, Motohisa

2017-01-01

The combined supplementation of medium-chain triglycerides (MCTs), L-leucine-rich amino acids, and cholecalciferol (vitamin D 3 ) increase muscle strength and function in frail elderly individuals. However, their effects on cognition are unknown. We enrolled 38 elderly nursing home residents (mean age±SD, 86.6±4.8 y) in a 3-mo randomized, controlled, parallel group trial. The participants were randomly allocated to 3 groups: the first group received a L-leucine (1.2 g)- and cholecalciferol (20 μg)-enriched supplement with 6 g of MCT (LD+MCT); the second group received the same supplement with 6 g of long-chain triglycerides (LD+LCT); and the third group did not receive any supplements (control). Cognition was assessed at baseline and after the 3-mo intervention. The difference in changes among the groups was assessed with ANCOVA, adjusting for age and the baseline value as covariates. After 3 mo, the Mini-Mental State Examination (MMSE) score in the LD+MCT group increased by 10.6% (from 16.6 to 18.4 points, p<0.05). After 3 mo, the Nishimura geriatric rating scale for mental status (NM scale) score in the LD+MCT group increased by 30.6% (from 24.6 to 32.2 points, p<0.001), whereas that in the LD+LCT and control groups decreased by 11.2% (from 31.2 to 27.7 points, p<0.05) and 26.1% (from 27.2 to 20.1 points, p<0.001), respectively. The combined supplementation of MCTs (6 g), L-leucine-rich amino acids, and cholecalciferol may improve cognitive function in frail elderly individuals.

VALFORTA: a randomised trial to validate the FORTA (Fit fOR The Aged) classification.

PubMed

Wehling, Martin; Burkhardt, Heinrich; Kuhn-Thiel, Alexandra; Pazan, Farhad; Throm, Christina; Weiss, Christel; Frohnhofen, Helmut

2016-03-01

to further validate the FORTA (Fit fOR The Aged) concept, a bicentric randomised, controlled trial was run in two geriatric clinics. patients (≥65 years, ≥3 drugs or ≥60 years, ≥6 drugs) with three relevant diseases and hospitalisation for ≥5 days were randomised. In the intervention, but not the control group, a FORTA team instructed ward physicians on FORTA. FORTA is the first positive/negative listing approach labelling medications used to treat chronic illnesses in older patients from A (indispensable), B (beneficial), C (questionable) to D (avoid). The primary end point was the FORTA score: sum of medication errors classified as over-, under- and mistreatment. Consecutive patients were randomised to the intervention and control ward; outcome assessment was blinded. four hundred and nine patients (age 81.5 years, 64% female, hospitalisation 17.4 days) were included. The primary end point was significantly (P < 0.0001) more reduced in the intervention versus control groups (2.7 ± 2.25 versus 1 ± 1.8, mean ± SD, intergroup comparison of admission/discharge differences). Over- and under-treatment scores and use of A (increase) and D (decrease) drugs were significantly improved (P < 0.01). The total number of adverse drug reactions (ADRs) was significantly reduced by FORTA (P < 0.05, number needed to treat is 5). Activities of daily living and renal failure improved significantly (P < 0.05). Blood pressure remained constant in the intervention, but decreased significantly in the control group. applying FORTA to hospitalised geriatric patients leads to improvement of medication quality and may improve secondary clinical end points (e.g. ADRs). The concept is amenable to successful communication and implementation. Registration (DRKS-ID): DRKS00000531. DFG-German Research Foundation (WE 1184/15-1). © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Language development of internationally adopted children: Adverse early experiences outweigh the age of acquisition effect.

PubMed

Rakhlin, Natalia; Hein, Sascha; Doyle, Niamh; Hart, Lesley; Macomber, Donna; Ruchkin, Vladislav; Tan, Mei; Grigorenko, Elena L

2015-01-01

We compared English language and cognitive skills between internationally adopted children (IA; mean age at adoption=2.24, SD=1.8) and their non-adopted peers from the US reared in biological families (BF) at two time points. We also examined the relationships between outcome measures and age at initial institutionalization, length of institutionalization, and age at adoption. On measures of general language, early literacy, and non-verbal IQ, the IA group performed significantly below their age-peers reared in biological families at both time points, but the group differences disappeared on receptive vocabulary and kindergarten concept knowledge at the second time point. Furthermore, the majority of children reached normative age expectations between 1 and 2 years post-adoption on all standardized measures. Although the age at adoption, age of institutionalization, length of institutionalization, and time in the adoptive family all demonstrated significant correlations with one or more outcome measures, the negative relationship between length of institutionalization and child outcomes remained most robust after controlling for the other variables. Results point to much flexibility and resilience in children's capacity for language acquisition as well as the potential primacy of length of institutionalization in explaining individual variation in IA children's outcomes. (1) Readers will be able to understand the importance of pre-adoption environment on language and early literacy development in internationally adopted children. (2) Readers will be able to compare the strength of the association between the length of institutionalization and language outcomes with the strength of the association between the latter and the age at adoption. (3) Readers will be able to understand that internationally adopted children are able to reach age expectations on expressive and receptive language measures despite adverse early experiences and a replacement of their first language with an adoptive language. Copyright © 2015 Elsevier Inc. All rights reserved.

Postural control in chronic obstructive pulmonary disease: a systematic review.

PubMed

Porto, E F; Castro, A A M; Schmidt, V G S; Rabelo, H M; Kümpel, C; Nascimento, O A; Jardim, J R

2015-01-01

Patients with chronic obstructive pulmonary disease (COPD) fall frequently, although the risk of falls may seem less important than the respiratory consequences of the disease. Nevertheless, falls are associated to increased mortality, decreased independence and physical activity levels, and worsening of quality of life. The aims of this systematic review was to evaluate information in the literature with regard to whether impaired postural control is more prevalent in COPD patients than in healthy age-matched subjects, and to assess the main characteristics these patients present that contribute to impaired postural control. Five databases were searched with no dates or language limits. The MEDLINE, PubMed, EMBASE, Web of Science, and PEDro databases were searched using "balance", "postural control", and "COPD" as keywords. The search strategies were oriented and guided by a health science librarian and were performed on March 27, 2014. The studies included were those that evaluated postural control in COPD patients as their main outcome and scored more than five points on the PEDro scale. Studies supplied by the database search strategy were assessed independently by two blinded researchers. A total of 484 manuscripts were found using the "balance in COPD or postural control in COPD" keywords. Forty-three manuscripts appeared more than once, and 397 did not evaluate postural control in COPD patients as the primary outcome. Thus, only 14 studies had postural control as their primary outcome. Our study examiners found only seven studies that had a PEDro score higher than five points. The examiners' interrater agreement was 76.4%. Six of those studies were accomplished with a control group and one study used their patients as their own controls. The studies were published between 2004 and 2013. Patients with COPD present postural control impairment when compared with age-matched healthy controls. Associated factors contributing to impaired postural control were muscle weakness, physical inactivity, elderly age, need for supplemental oxygen, and limited mobility.

The effectiveness of dry-cupping in preventing post-operative nausea and vomiting by P6 acupoint stimulation

PubMed Central

Farhadi, Khosro; Choubsaz, Mansour; Setayeshi, Khosro; Kameli, Mohammad; Bazargan-Hejazi, Shahrzad; Zadie, Zahra H.; Ahmadi, Alireza

2016-01-01

Abstract Background: Postoperative nausea and vomiting (PONV) is a common complication after general anesthesia, and the prevalence ranges between 25% and 30%. The aim of this study was to determine the preventive effects of dry cupping on PONV by stimulating point P6 in the wrist. Methods: This was a randomized controlled trial conducted at the Imam Reza Hospital in Kermanshah, Iran. The final study sample included 206 patients (107 experimental and 99 controls). Inclusion criteria included the following: female sex; age>18 years; ASA Class I-II; type of surgery: laparoscopic cholecystectomy; type of anesthesia: general anesthesia. Exclusion criteria included: change in the type of surgery, that is, from laparoscopic cholecystectomy to laparotomy, and ASA-classification III or more. Interventions are as follows: pre surgery, before the induction of anesthesia, the experimental group received dry cupping on point P6 of the dominant hand's wrist with activation of intermittent negative pressure. The sham group received cupping without activation of negative pressure at the same point. Main outcome was that the visual analogue scale was used to measure the severity of PONV. Results: The experimental group who received dry cupping had significantly lower levels of PONV severity after surgery (P < 0.001) than the control group. The differences in measure were maintained after controlling for age and ASA in regression models (P < 0.01). Conclusion: Traditional dry cupping delivered in an operation room setting prevented PONV in laparoscopic cholecystectomy patients. PMID:27661022

Subjective insomnia is associated with low sleep efficiency and fatigue in middle-aged women.

PubMed

Hirose, A; Terauchi, M; Akiyoshi, M; Owa, Y; Kato, K; Kubota, T

2016-08-01

Many middle-aged women are affected by sleep disturbance. We investigated how subjective insomnia is associated with objective sleep parameters and other background characteristics. This cross-sectional study used baseline data obtained from 95 women aged 40-59 years who participated in another study assessing the effects of a dietary supplement. Participants wore an actigraph unit for 3 days to collect information concerning physical activities and objective sleep parameters and were then evaluated for body composition, cardiovascular parameters, and menopausal symptoms including insomnia and fatigue, and lifestyle factors. Stratifying Athens Insomnia Scale scores as low (0-5 points, control group) and high (≥ 6 points, subjective insomnia group), we sought to identify the parameters that are independently associated with subjective insomnia. Women with subjective insomnia (n = 30) had lower sleep efficiency than did the controls. They were also older; had more live births, lower height, higher body mass index, lower ankle brachial index, and more severe menopausal symptoms including fatigue; took more naps; smoked more cigarettes; and more of them were full-time workers. Multivariate logistic regression analysis revealed that low sleep efficiency (adjusted odds ratio, 1.44 per 1% decrease in sleep efficiency; 95% confidence interval 1.06-2.05) and fatigue assessed with Brief Fatigue Inventory (BFI) (adjusted odds ratio, 1.57 per 1-point increase in BFI score; 95% confidence interval 1.19-2.13) were independent contributors to subjective insomnia. Low sleep efficiency and feeling of fatigue were found to be independently associated with subjective insomnia in middle-aged women.

The Hand: Shall We Ever Understand How it Works?

PubMed

Latash, Mark L

2015-04-01

The target article presents a review of the neural control of the human hand. The review emphasizes the physical approach to motor control. It focuses on such concepts as equilibrium-point control, control with referent body configurations, uncontrolled manifold hypothesis, principle of abundance, hierarchical control, multidigit synergies, and anticipatory synergy adjustments. Changes in aspects of the hand neural control with age and neurological disorder are discussed. The target article is followed by six commentaries written by Alexander Aruin, Kelly Cole, Monica Perez, Robert Sainburg, Marco Sanello, and Wei Zhang.

[Clinical observation on auricular point magnetotherapy for treatment of senile low back pain].

PubMed

Sun, Gui-Ping

2007-02-01

To compare the therapeutic effects of auricular point magnetotherapy and auricular point sticking of Vaccaria seed on senile low back pain. Sixty cases, aged 60 or over 60 years with back pain, were randomly divided into 2 groups, a control group and a test group. The control group were treated with auricular sticking of Vaccaria seed with no pressing, and the test group with sticking magnetic bead of 66 gauss each piece with no pressing. Auricular points, Shenmen, Kidney, Bladder, Yaodizhui, Gluteus, Liver and Spleen were selected. Three weeks constituted one course. The effects before, during and after the course were assessed by questionnaire about back pain. Compared with the control group, in the test group the back pain was more effectively improved, including reducing pain and numbness in the back and the legs, decreasing the disorder of physical strength induced by this disease, and improving daily life quality of the patient. Follow-up survey for 2-4 weeks showed the effects still were kept. Auricular magnetotherapy can effectively improve senile back pain.

Long-Term Effectiveness of Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality in Women and Men: A Randomized Trial.

PubMed

Holme, Øyvind; Løberg, Magnus; Kalager, Mette; Bretthauer, Michael; Hernán, Miguel A; Aas, Eline; Eide, Tor J; Skovlund, Eva; Lekven, Jon; Schneede, Jörn; Tveit, Kjell Magne; Vatn, Morten; Ursin, Giske; Hoff, Geir

2018-06-05

The long-term effects of sigmoidoscopy screening on colorectal cancer (CRC) incidence and mortality in women and men are unclear. To determine the effectiveness of flexible sigmoidoscopy screening after 15 years of follow-up in women and men. Randomized controlled trial. (ClinicalTrials.gov: NCT00119912). Oslo and Telemark County, Norway. Adults aged 50 to 64 years at baseline without prior CRC. Screening (between 1999 and 2001) with flexible sigmoidoscopy with and without additional fecal blood testing versus no screening. Participants with positive screening results were offered colonoscopy. Age-adjusted CRC incidence and mortality stratified by sex. Of 98 678 persons, 20 552 were randomly assigned to screening and 78 126 to no screening. Adherence rates were 64.7% in women and 61.4% in men. Median follow-up was 14.8 years. The absolute risks for CRC in women were 1.86% in the screening group and 2.05% in the control group (risk difference, -0.19 percentage point [95% CI, -0.49 to 0.11 percentage point]; HR, 0.92 [CI, 0.79 to 1.07]). In men, the corresponding risks were 1.72% and 2.50%, respectively (risk difference, -0.78 percentage point [CI, -1.08 to -0.48 percentage points]; hazard ratio [HR], 0.66 [CI, 0.57 to 0.78]) (P for heterogeneity = 0.004). The absolute risks for death from CRC in women were 0.60% in the screening group and 0.59% in the control group (risk difference, 0.01 percentage point [CI, -0.16 to 0.18 percentage point]; HR, 1.01 [CI, 0.77 to 1.33]). The corresponding risks for death from CRC in men were 0.49% and 0.81%, respectively (risk difference, -0.33 percentage point [CI, -0.49 to -0.16 percentage point]; HR, 0.63 [CI, 0.47 to 0.83]) (P for heterogeneity = 0.014). Follow-up through national registries. Offering sigmoidoscopy screening in Norway reduced CRC incidence and mortality in men but had little or no effect in women. Norwegian government and Norwegian Cancer Society.

Criterion validity of a Wechsler-III Scale Short Form in a sample of brazilian elderly.

PubMed

Banhato, Eliane Ferreira Carvalho; Leite, Isabel Cristina Gonçalves; Guedes, Danielle Viveiros; Chaoubah, Alfredo

2010-01-01

Although a normative process, changes in cognitive functioning vary among older adults. The differential diagnosis between normal and pathological aging must be made early using psychometrically adequate measures. To assess the evidence of criterion validity of a Short Form (SF) of the Wechsler-III Scale containing eight subtests (SF8) by determining its sensitivity, specificity, positive and negative predictive values and cut-off points for Brazilian elderly from different age groups. 168 individuals, aged 60 years or above, living in the community or in an institution, were assigned to case and control groups, and investigated according to age range. Measures included a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), Verbal Fluency Test, Clock-Drawing Test and the SF8. More than two thirds of the sample was women (73.8%), mean age was 74.5 years (SD=8.9), mean education was 6.2 years (SD=4.8) and 40.5% were widows/widowers. In the total sample, the best cut-off point for the SF8 was 142 while cut offs among individuals aged 60 to 69 years, 70 to 79 years, and more than 80 years were 160, 129 and 129, respectively. The results demonstrated the importance of different cut-off points for different age ranges. Sensitivity and specificity values of the SF8 were sufficiently high to warrant the use of the SF8 as an instrument to identify cognitive impairment in the elderly.

Criterion validity of a Wechsler-III Scale Short Form in a sample of brazilian elderly

PubMed Central

Banhato, Eliane Ferreira Carvalho; Leite, Isabel Cristina Gonçalves; Guedes, Danielle Viveiros; Chaoubah, Alfredo

2010-01-01

Although a normative process, changes in cognitive functioning vary among older adults. The differential diagnosis between normal and pathological aging must be made early using psychometrically adequate measures. Objectives To assess the evidence of criterion validity of a Short Form (SF) of the Wechsler-III Scale containing eight subtests (SF8) by determining its sensitivity, specificity, positive and negative predictive values and cut-off points for Brazilian elderly from different age groups. Methods 168 individuals, aged 60 years or above, living in the community or in an institution, were assigned to case and control groups, and investigated according to age range. Measures included a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), Verbal Fluency Test, Clock-Drawing Test and the SF8. Results More than two thirds of the sample was women (73.8%), mean age was 74.5 years (SD=8.9), mean education was 6.2 years (SD=4.8) and 40.5% were widows/widowers. In the total sample, the best cut-off point for the SF8 was 142 while cut offs among individuals aged 60 to 69 years, 70 to 79 years, and more than 80 years were 160, 129 and 129, respectively. Conclusions The results demonstrated the importance of different cut-off points for different age ranges. Sensitivity and specificity values of the SF8 were sufficiently high to warrant the use of the SF8 as an instrument to identify cognitive impairment in the elderly. PMID:29213688

Educational attainment in poor comprehenders

PubMed Central

Ricketts, Jessie; Sperring, Rachael; Nation, Kate

2014-01-01

To date, only one study has investigated educational attainment in poor (reading) comprehenders, providing evidence of poor performance on national UK school tests at age 11 years relative to peers (Cain and Oakhill, 2006). In the present study, we adopted a longitudinal approach, tracking attainment on such tests from 11 years to the end of compulsory schooling in the UK (age 16 years). We aimed to investigate the proposal that educational weaknesses (defined as poor performance on national assessments) might become more pronounced over time, as the curriculum places increasing demands on reading comprehension. Participants comprised 15 poor comprehenders and 15 controls; groups were matched for chronological age, nonverbal reasoning ability and decoding skill. Children were identified at age 9 years using standardized measures of nonverbal reasoning, decoding and reading comprehension. These measures, along with a measure of oral vocabulary knowledge, were repeated at age 11 years. Data on educational attainment were collected from all participants (n = 30) at age 11 and from a subgroup (n = 21) at 16 years. Compared to controls, educational attainment in poor comprehenders was lower at ages 11 and 16 years, an effect that was significant at 11 years. When poor comprehenders were compared to national performance levels, they showed significantly lower performance at both time points. Low educational attainment was not evident for all poor comprehenders. Nonetheless, our findings point to a link between reading comprehension difficulties in mid to late childhood and poor educational outcomes at ages 11 and 16 years. At these ages, pupils in the UK are making key transitions: they move from primary to secondary schools at 11, and out of compulsory schooling at 16. PMID:24904464

A Methodology to Assess the Capability of Engine Designs to Meet Closed-Loop Performance and Operability Requirements

NASA Technical Reports Server (NTRS)

Zinnecker, Alicia M.; Csank, Jeffrey

2015-01-01

Designing a closed-loop controller for an engine requires balancing trade-offs between performance and operability of the system. One such trade-off is the relationship between the 95 percent response time and minimum high-pressure compressor (HPC) surge margin (SM) attained during acceleration from idle to takeoff power. Assuming a controller has been designed to meet some specification on response time and minimum HPC SM for a mid-life (nominal) engine, there is no guarantee that these limits will not be violated as the engine ages, particularly as it reaches the end of its life. A characterization for the uncertainty in this closed-loop system due to aging is proposed that defines elliptical boundaries to estimate worst-case performance levels for a given control design point. The results of this characterization can be used to identify limiting design points that bound the possible controller designs yielding transient results that do not exceed specified limits in response time or minimum HPC SM. This characterization involves performing Monte Carlo simulation of the closed-loop system with controller constructed for a set of trial design points and developing curve fits to describe the size and orientation of each ellipse; a binary search procedure is then employed that uses these fits to identify the limiting design point. The method is demonstrated through application to a generic turbofan engine model in closed-loop with a simplified controller; it is found that the limit for which each controller was designed was exceeded by less than 4.76 percent. Extension of the characterization to another trade-off, that between the maximum high-pressure turbine (HPT) entrance temperature and minimum HPC SM, showed even better results: the maximum HPT temperature was estimated within 0.76 percent. Because of the accuracy in this estimation, this suggests another limit that may be taken into consideration during design and analysis. It also demonstrates the extension of the characterization to other attributes that contribute to the performance or operability of the engine. Metrics are proposed that, together, provide information on the shape of the trade-off between response time and minimum HPC SM, and how much each varies throughout the life cycle, at the limiting design points. These metrics also facilitate comparison of the expected transient behavior for multiple engine models.

Notebook input devices put to the age test: the usability of trackpoint and touchpad for middle-aged adults.

PubMed

Armbrüster, C; Sutter, C; Ziefle, M

2007-03-01

In two experiments, the usability of input devices integrated into computer notebooks was under study. The most common input devices, touchpad (experiment 1) and trackpoint (experiment 2) were examined. So far, the evaluation of mobile input devices has been restricted to younger users. However, due to ongoing demographic change, the main target group of mobile devices will be older users. Therefore, the present study focused on ageing effects. A total of 14 middle-aged (40-65 years) and 20 younger (20-32 years) users were compared regarding speed and accuracy of cursor control in a point-click and a point-drag-drop task. Moreover, the effects of training were addressed by examining the performance increase over time. In total, 640 trials per task and input device were executed. The results show that ageing is a central factor to be considered in input device design. Middle-aged users were significantly slower than younger users when executing the different tasks. Over time, a significant training effect was observed for both devices and both age groups, although the benefit of training was greater for the middle-aged group. Generally, the touchpad performance was higher than the trackpoint performance in both age groups, but the age-related performance decrements were less distinct when using the touchpad.

Age-Related Skeletal Muscle Decline Is Similar in HIV-Infected and Uninfected Individuals

PubMed Central

Yarasheski, Kevin E.; Scherzer, Rebecca; Kotler, Donald P.; Dobs, Adrian S.; Tien, Phyllis C.; Lewis, Cora E.; Kronmal, Richard A.; Heymsfield, Steven B.; Bacchetti, Peter

2011-01-01

Background. Skeletal muscle (SM) mass decreases with advanced age and with disease in HIV infection. It is unknown whether age-related muscle loss is accelerated in the current era of antiretroviral therapy and which factors might contribute to muscle loss among HIV-infected adults. We hypothesized that muscle mass would be lower and decline faster in HIV-infected adults than in similar-aged controls. Methods. Whole-body 1H-magnetic resonance imaging was used to quantify regional and total SM in 399 HIV-infected and 204 control men and women at baseline and 5 years later. Multivariable regression identified associated factors. Results. At baseline and Year 5, total SM was lower in HIV-infected than control men. HIV-infected women were similar to control women at both time points. After adjusting for demographics, lifestyle factors, and total adipose tissue, HIV infection was associated with lower Year 5 SM in men and higher SM in women compared with controls. Average overall 5-year change in total SM was small and age related, but rate of change was similar in HIV-infected and control men and women. CD4 count and efavirenz use in HIV-infected participants were associated with increasing SM, whereas age and stavudine use were associated with decreasing SM. Conclusions. Muscle mass was lower in HIV-infected men compared with controls, whereas HIV-infected women had slightly higher SM than control women after multivariable adjustment. We found evidence against substantially faster SM decline in HIV infected versus similar-aged controls. SM gain was associated with increasing CD4 count, whereas stavudine use may contribute to SM loss. PMID:21310810

Extended physical education in children aged 6-15 years was associated with improved academic achievement in boys.

PubMed

Cöster, M E; Fritz, J; Karlsson, C; Rosengren, B E; Karlsson, M K

2018-06-01

Physical activity (PA) has been associated with enhanced cognition, brain development and concentration. This study evaluated whether increased physical education (PE) improved academic achievement. We recruited 304 children (55% boys) from a Swedish school in Skane County in 1998-2002 when they were six to seven years of age and followed them through all nine mandatory school years. Their PE level was increased from 60 to 200 minutes per week, and their results were compared with 73 885 control children (51% boys) in the county who graduated in the same years and did the standard 60 minutes of PE per week. Their academic achievements were measured as their final grade scores and the proportion of students eligible for upper secondary school. The eligibility for further education increased in the intervention boys by 6.8 percentage points and the mean grade score by 12.1 points, while in the control group as a whole, the eligibility rate decreased by 0.7 percentage points and the mean grade score increased by 1.7 points. No changes in eligibility rates or mean grade scores were seen in the intervention girls. Increasing weekly PE over nine years was associated with improved academic achievement in boys. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Quantitative evaluation of age-related decline in control of preprogramed movement

PubMed Central

Lee, Jongho; Kodama, Mitsuhiko; Kakei, Shinji; Masakado, Yoshihisa

2017-01-01

In this paper, we examined the age-related changes in control of preprogramed movement, with emphasis on its accuracy. Forty-nine healthy subjects participated in this study, and were divided into three groups depending on their ages: the young group (20–39 years) (n = 16), the middle-age group (40–59 years) (n = 16), and the elderly group (60–79 years) (n = 17). We asked the subjects to perform step-tracking movements of the wrist joint with a manipulandum, and recorded the movements. We evaluated the accuracy of control of preprogramed movement in the three groups in terms of the primary submovement, which was identified as the first segment of the step-tracking movement based on the bell-shaped velocity profile, and calculated the distance between the end position of the primary submovement and the target (i.e. error). The error in the young group was found to be significantly smaller than that in the middle-age and elderly groups, i.e., the error was larger for the higher age groups. These results suggest that young subjects have better control of preprogramed movement than middle-age or elderly subjects. Finally, we examined the temporal property of the primary submovement and its age-related changes. The duration of the primary submovement tended to be longer for the aged groups, although significance was reached only for the elderly group. In particular, the ratio of the duration of the primary submovement to total movement time tended to be lower for the aged groups, suggesting that the proportion of additional movements that are required to compensate for the incomplete control in the preprogramed movement, which are under feedback control, was higher for the aged groups. Consequently, our results indicate that the distance between the end point of the primary submovement and the target center (i.e. error) in the step-tracking movement is a useful parameter to evaluate the age-related changes in control of preprogramed movement. PMID:29186168

Quantitative evaluation of age-related decline in control of preprogramed movement.

PubMed

Shimoda, Naoshi; Lee, Jongho; Kodama, Mitsuhiko; Kakei, Shinji; Masakado, Yoshihisa

2017-01-01

In this paper, we examined the age-related changes in control of preprogramed movement, with emphasis on its accuracy. Forty-nine healthy subjects participated in this study, and were divided into three groups depending on their ages: the young group (20-39 years) (n = 16), the middle-age group (40-59 years) (n = 16), and the elderly group (60-79 years) (n = 17). We asked the subjects to perform step-tracking movements of the wrist joint with a manipulandum, and recorded the movements. We evaluated the accuracy of control of preprogramed movement in the three groups in terms of the primary submovement, which was identified as the first segment of the step-tracking movement based on the bell-shaped velocity profile, and calculated the distance between the end position of the primary submovement and the target (i.e. error). The error in the young group was found to be significantly smaller than that in the middle-age and elderly groups, i.e., the error was larger for the higher age groups. These results suggest that young subjects have better control of preprogramed movement than middle-age or elderly subjects. Finally, we examined the temporal property of the primary submovement and its age-related changes. The duration of the primary submovement tended to be longer for the aged groups, although significance was reached only for the elderly group. In particular, the ratio of the duration of the primary submovement to total movement time tended to be lower for the aged groups, suggesting that the proportion of additional movements that are required to compensate for the incomplete control in the preprogramed movement, which are under feedback control, was higher for the aged groups. Consequently, our results indicate that the distance between the end point of the primary submovement and the target center (i.e. error) in the step-tracking movement is a useful parameter to evaluate the age-related changes in control of preprogramed movement.

Distinguishing ischaemic optic neuropathy from optic neuritis by ganglion cell analysis.

PubMed

Erlich-Malona, Natalie; Mendoza-Santiesteban, Carlos E; Hedges, Thomas R; Patel, Nimesh; Monaco, Caitlin; Cole, Emily

2016-12-01

To determine whether a pattern of altitudinal ganglion cell loss, as detected and measured by optical coherence tomography (OCT), can be used to distinguish non-arteritic ischaemic optic neuropathy (NAION) from optic neuritis (ON) during the acute phase, and whether the rate or severity of ganglion cell loss differs between the two diseases. We performed a retrospective, case-control study of 44 patients (50 eyes) with ON or NAION and 44 age-matched controls. Non-arteritic ischaemic optic neuropathy and ON patients had OCT at presentation and four consecutive follow-up visits. Controls had OCT at one point in time. The ganglion cell complex (GCC) was evaluated in the macula, and the retinal nerve fibre layer (RNFL) was evaluated in the peripapillary region. Ganglion cell complex thickness, RNFL thickness and GCC mean superior and inferior hemispheric difference were compared between NAION and ON patients at each time-point using unpaired t-tests and between disease and control subjects at first measurement using paired t-tests. Mean time from onset of symptoms to initial presentation was 10.7 ± 6.6 days in NAION and 11.7 ± 8.6 days in ON (p = 0.67). There was a significantly greater vertical hemispheric difference in GCC thickness in NAION patients than ON patients at all time-points (5.5-10.7 μm versus 3.1-3.6 μm, p = 0.01-0.049). Mean GCC thickness was significantly decreased at less than 2 weeks after onset in NAION compared to age-matched controls (72.1 μm versus 82.1 μm, p < 0.001), as well as in ON compared to age-matched controls (74.3 μm versus 84.5 μm, p < 0.001). Progression and severity of GCC and RNFL loss did not differ significantly between NAION and ON. A quantitative comparison of mean superior and inferior hemispheric GCC thickness with OCT may be used to distinguish NAION from ON. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Wavelet Transform Analysis of the Power Spectrum of Centre of Pressure Signals to Detect the Critical Point Interval of Postural Control

NASA Astrophysics Data System (ADS)

Singh, Neeraj Kumar; Snoussi, Hichem; Hewson, David; Duchêne, Jacques

The aim of this study was to develop a method to detecting the critical point interval (CPI) when sensory feedback is used as part of a closed-loop postural control strategy. Postural balance was evaluated using centre of pressure (COP) displacements from a force plate for 17 control and 10 elderly subjects under eyes open, eyes closed, and vibration conditions. A modified local-maximum-modulus wavelet transform analysis using the power spectrum of COP signals was used to calculate CPI. Lower CPI values indicate increased closed-loop postural control with a quicker response to sensory input. Such a strategy requires greater energy expenditure due to the repeated muscular interventions to remain stable. The CPI for elderly occurred significantly quicker than for controls, indicating tighter control of posture. Similar results were observed for eyes closed and vibration conditions. The CPI parameter can be used to detect differences in postural control due to ageing.

Estimating the Time to Benefit for Preventive Drugs with the Statistical Process Control Method: An Example with Alendronate.

PubMed

van de Glind, Esther M M; Willems, Hanna C; Eslami, Saeid; Abu-Hanna, Ameen; Lems, Willem F; Hooft, Lotty; de Rooij, Sophia E; Black, Dennis M; van Munster, Barbara C

2016-05-01

For physicians dealing with patients with a limited life expectancy, knowing the time to benefit (TTB) of preventive medication is essential to support treatment decisions. The aim of this study was to investigate the usefulness of statistical process control (SPC) for determining the TTB in relation to fracture risk with alendronate versus placebo in postmenopausal women. We performed a post hoc analysis of the Fracture Intervention Trial (FIT), a randomized, controlled trial that investigated the effect of alendronate versus placebo on fracture risk in postmenopausal women. We used SPC, a statistical method used for monitoring processes for quality control, to determine if and when the intervention group benefited significantly more than the control group. SPC discriminated between the normal variations over time in the numbers of fractures in both groups and the variations that were attributable to alendronate. The TTB was defined as the time point from which the cumulative difference in the number of clinical fractures remained greater than the upper control limit on the SPC chart. For the total group, the TTB was defined as 11 months. For patients aged ≥70 years, the TTB was 8 months [absolute risk reduction (ARR) = 1.4%]; for patients aged <70 years, it was 19 months (ARR = 0.7%). SPC is a clear and understandable graphical method to determine the TTB. Its main advantage is that there is no need to define a prespecified time point, as is the case in traditional survival analyses. Prescribing alendronate to patients who are aged ≥70 years is useful because the TTB shows that they will benefit after 8 months. Investigators should report the TTB to simplify clinical decision making.

Diagnostic ultrasound imaging for lateral epicondylalgia: a case-control study.

PubMed

Heales, Luke James; Broadhurst, Nathan; Mellor, Rebecca; Hodges, Paul William; Vicenzino, Bill

2014-11-01

Lateral epicondylalgia (LE) is clinically diagnosed as pain over the lateral elbow that is provoked by gripping. Usually, LE responds well to conservative intervention; however, those who fail such treatment require further evaluation, including musculoskeletal ultrasound. Previous studies of musculoskeletal ultrasound have methodological flaws, such as lack of assessor blinding and failure to control for participant age, sex, and arm dominance. The purpose of this study was to assess the diagnostic use of blinded ultrasound imaging in people with clinically diagnosed LE compared with that in a control group matched for age, sex, and arm dominance. Participants (30 with LE and 30 controls) underwent clinical examination as the criterion standard test. Unilateral LE was defined as pain over the lateral epicondyle, which was provoked by palpation, resisted wrist and finger extension, and gripping. Controls without symptoms were matched for age, sex, and arm dominance. Ultrasound investigations were performed by two sonographers using a standardized protocol. Grayscale images were assessed for signs of tendon pathology and rated on a four-point ordinal scale. Power Doppler was used to assess neovascularity and rated on a five-point ordinal scale. The combination of grayscale and power Doppler imaging revealed an overall sensitivity of 90% and specificity of 47%. The positive and negative likelihood ratios for combined grayscale and power Doppler imaging were 1.69 and 0.21, respectively. Although ultrasound imaging helps confirm the absence of LE, when findings are negative for tendinopathic changes, the high prevalence of tendinopathic changes in pain-free controls challenges the specificity of the measure. The validity of ultrasound imaging to confirm tendon pathology in clinically diagnosed LE requires further study with strong methodology.

Ice Core Depth-Age Relation for Vostok delta-D and Dome Fuji delta-18O Records Based on the Devils Hole Paleotemperature Chronology

USGS Publications Warehouse

Landwehr, Jurate Maciunas

2002-01-01

This report presents the data for the Vostok - Devils Hole chronology, termed V-DH chronology, for the Antarctic Vostok ice core record. This depth - age relation is based on a join between the Vostok deuterium profile (D) and the stable oxygen isotope ratio (18O) record of paleotemperature from a calcitic core at Devils Hole, Nevada, using the algorithm developed by Landwehr and Winograd (2001). Both the control points defining the V-DH chronology and the numeric values for the chronology are given. In addition, a plausible chronology for a deformed bottom portion of the Vostok core developed with this algorithm is presented. Landwehr and Winograd (2001) demonstrated the broader utility of their algorithm by applying it to another appropriate Antarctic paleotemperature record, the Antarctic Dome Fuji ice core 18O record. Control points for this chronology are also presented in this report but deemed preliminary because, to date, investigators have published only the visual trace and not the numeric values for the Dome Fuji 18O record. The total uncertainty that can be associated with the assigned ages is also given.

Splicing regulatory factors, ageing and age-related disease.

PubMed

Latorre, Eva; Harries, Lorna W

2017-07-01

Alternative splicing is a co-transcriptional process, which allows for the production of multiple transcripts from a single gene and is emerging as an important control point for gene expression. Alternatively expressed isoforms often have antagonistic function and differential temporal or spatial expression patterns, yielding enormous plasticity and adaptability to cells and increasing their ability to respond to environmental challenge. The regulation of alternative splicing is critical for numerous cellular functions in both pathological and physiological conditions, and deregulated alternative splicing is a key feature of common chronic diseases. Isoform choice is controlled by a battery of splicing regulatory proteins, which include the serine arginine rich (SRSF) proteins and the heterogeneous ribonucleoprotein (hnRNP) classes of genes. These important splicing regulators have been implicated in age-related disease, and in the ageing process itself. This review will outline the important contribution of splicing regulator proteins to ageing and age-related disease. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of aging and ice structuring proteins on the morphology of frozen hydrated gluten networks.

PubMed

Kontogiorgos, Vassilis; Goff, H Douglas; Kasapis, Stefan

2007-04-01

The present investigation constitutes an attempt to rationalize the effect of aging and ice structuring proteins (ISPs) on the network morphology of frozen hydrated gluten. In doing so, it employs differential scanning calorimetry, time-domain NMR, dynamic oscillation on shear, creep testing, and electron microscopy. Experimentation and first principles modeling allows identification and description of the processes of ice formation and recrystallization in molecular terms. It is demonstrated that in the absence of a readily discernible glass transition temperature in gluten-ice composites, the approach of considering the melting point and aging at constant or fluctuating temperature conditions in the vicinity of this point can provide a valid index of functional quality. A theoretical framework supporting the concept of capillary confined frozen water in the gluten matrix was advanced, and it was found that ISPs were effective in controlling recrystallization both within these confines and within ice in the bulk.

A Conditional Cash Transfer Program in the Philippines Reduces Severe Stunting.

PubMed

Kandpal, Eeshani; Alderman, Harold; Friedman, Jed; Filmer, Deon; Onishi, Junko; Avalos, Jorge

2016-09-01

Pantawid, a conditional cash transfer (CCT) program in the Philippines, provided grants conditioned on health-related behaviors for children aged 0-5 y and schooling for those aged 10-14 y. We investigated whether Pantawid improved anthropometric measurements in children aged 6-36 mo. We estimated cross-sectional intention-to-treat effects using a 2011 cluster-randomized trial across 130 villages-65 treated and 65 control-with data collected after 31 mo of implementation. Anthropometry characteristics were measured for 241 children in treated areas and 244 children in control areas. Health service use for children aged 6-36 mo and dietary intake for those aged 6-60 mo also were measured. Outcome variables were height-for-age z scores (HAZs) and weight-for-age z scores (WAZs), stunting, severe stunting, underweight, and severely underweight. Impact also was assessed on perinatal care, institutional delivery, presence of skilled birth attendant, breastfeeding practices, immunization, growth monitoring and deworming, care-seeking, and children's intake of protein-rich foods. Pantawid was associated with a significant reduction in severe stunting [<-3 SD from WHO standards for healthy children; β = -10.2 percentage points (95% CI -18.8, -1.6 percentage points); P = 0.020] as well as a marginally significant increase in HAZs [β = 0.284 SDs (95% CI -0.033, 0.602 SDs); P = 0.08]. WAZs, stunting, underweight, and severely underweight status did not change. Concomitantly, several measures of health-seeking behavior increased significantly. To our knowledge, Pantawid is one of few CCT programs worldwide that significantly reduced severe stunting in children aged 6-36 mo; changes in key parenting practices, including children's intake of protein-rich foods and care-seeking behavior, were concurrent. © 2016 American Society for Nutrition.

Clinical and ERG data in a family with autosomal dominant RP and Pro-347-Arg mutation in the rhodopsin gene.

PubMed

Niemeyer, G; Trüb, P; Schinzel, A; Gal, A

1992-01-01

In a family with autosomal dominant retinitis pigmentosa, documented over six generations, a previously undescribed point mutation in the rhodopsin gene could be identified. The mutation found in the six affected members examined but in none of the controls, including healthy members of the family, was a point mutation in codon 347 predicting a substitution of the amino acid arginine for proline, designated Pro-347-Arg. Six affected members from two generations were examined clinically and with ganzfeld rod and cone electroretinography. The cone and, more dramatically, the rod electroretinograms were reduced to residual b-wave amplitudes or were non-detectable as early as ages 18 to 22 years. The Pro-347-Arg mutation resulted in a subjectively and clinically homogeneous phenotype: early onset of night blindness before age 11, relatively preserved usable visual fields until about age 30, blindness at ages 40 to 60, and change from an initial apparently sine pigmento to a hyperpigmented and atrophic fundus picture between 30 and 50 years of age.

Influence of Tönnis Grade on Outcomes of Arthroscopic Management of Symptomatic Femoroacetabular Impingement.

PubMed

Byrd, J W Thomas; Bardowski, Elizabeth A; Jones, Kay S

2018-05-19

To define the outcomes of arthroscopic correction of femoroacetabular impingement (FAI) based on Tönnis findings within a previously reported patient population, including a comparative analysis of Tönnis grade 0 and 1 versus grade 2 changes. Outcomes (modified Harris Hip Score [mHHS]) of a previously published study of arthroscopic correction of FAI were correlated with Tönnis grade. The inclusion criteria were the first 100 consecutive patients undergoing arthroscopic FAI correction with minimum 2-year follow-up. These procedures were performed between December 2003 and May 2006. Grades were determined independently by 2 experienced clinicians. Tönnis grades 0 and 1 were compared with Tönnis grade 2. Independent variables of sex and age were also evaluated. The average age of the entire group was 34.7 years (range, 13-76 years), with 66 male and 34 female patients. Of the patients, 17 had Tönnis grade 0, 49 had Tönnis grade 1, 29 had Tönnis grade 2, and 4 had Tönnis grade 3 (1 unknown). The average mHHS improvement for Tönnis grade 0 was 20.6 points; Tönnis grade 1, 22.2 points; Tönnis grade 2, 14.9 points; and Tönnis grade 3, 18.8 points. The improvement was statistically (P < .01) and clinically (>8 points) significant across all Tönnis grades. There was no difference (P = .077) between Tönnis grades 0 and 1 (21.8 points) versus grade 2 (14.9 points). There was no difference based on sex or age. These data support that statistically and clinically meaningful successful patient-reported outcomes (mHHS) at 2 years can be encountered even in the presence of Tönnis grade 2 radiographic features. Neither age nor sex was an indicator of poorer results within similar Tönnis grades. Level III, case-control study. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Early-life predictors of leisure-time physical inactivity in midadulthood: findings from a prospective British birth cohort.

PubMed

Pinto Pereira, Snehal M; Li, Leah; Power, Chris

2014-12-01

Much adult physical inactivity research ignores early-life factors from which later influences may originate. In the 1958 British birth cohort (followed from 1958 to 2008), leisure-time inactivity, defined as activity frequency of less than once a week, was assessed at ages 33, 42, and 50 years (n = 12,776). Early-life factors (at ages 0-16 years) were categorized into 3 domains (i.e., physical, social, and behavioral). We assessed associations of adult inactivity 1) with factors within domains, 2) with the 3 domains combined, and 3) allowing for adult factors. At each age, approximately 32% of subjects were inactive. When domains were combined, factors associated with inactivity (e.g., at age 50 years) were prepubertal stature (5% lower odds per 1-standard deviation higher height), hand control/coordination problems (14% higher odds per 1-point increase on a 4-point scale), cognition (10% lower odds per 1-standard deviation greater ability), parental divorce (21% higher odds), institutional care (29% higher odds), parental social class at child's birth (9% higher odds per 1-point reduction on a 4-point scale), minimal parental education (13% higher odds), household amenities (2% higher odds per increase (representing poorer amenities) on a 19-point scale), inactivity (8% higher odds per 1-point reduction in activity on a 4-point scale), low sports aptitude (13% higher odds), and externalizing behaviors (i.e., conduct problems) (5% higher odds per 1-standard deviation higher score). Adjustment for adult covariates weakened associations slightly. Factors from early life were associated with adult leisure-time inactivity, allowing for early identification of groups vulnerable to inactivity. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Pressure pain sensitivity topographical maps reveal bilateral hyperalgesia of the hands in patients with unilateral carpal tunnel syndrome.

PubMed

Fernández-de-Las-Peñas, César; Madeleine, Pascal; Martínez-Perez, Almudena; Arendt-Nielsen, Lars; Jiménez-García, Rodrigo; Pareja, Juan A

2010-08-01

To assess topographical pressure pain sensitivity maps of the hand in patients with unilateral carpal tunnel syndrome (CTS) as compared with healthy subjects. A total of 20 women with CTS (ages 32-52 years) and 20 healthy matched women (ages 32-51 years) were recruited. Pressure pain thresholds (PPTs) were measured bilaterally over 30 locations of the palm of each hand by an assessor blinded to the subjects' conditions. Patients showed lower PPTs in both hands in all of the measurement points as compared with controls (P < 0.001 for all). PPTs were lower in those points over the proximal phalanx of the fingers and the thenar eminency as compared with those points located over the distal phalanx of the fingers (P < 0.001). CTS patients showed lower PPT levels in dermatomes C6, C7, and C8 when compared with healthy controls (P < 0.001 for all), but without differences between dermatomes (P = 0.4). PPT was negatively correlated with both hand pain intensity and duration of symptoms (P < 0.001 for all). Our findings revealed bilateral generalized pressure pain hyperalgesia in unilateral CTS because lower PPT levels were found in all of the points. The pressure pain hyperalgesia was not uniformly distributed since PPTs were lower in points over the proximal phalanx of the fingers and the thenar eminency as compared with those points located over the distal phalanx of the fingers. The decrease in PPT levels was associated with the intensity and the duration of the pain symptoms, supporting a role of both peripheral and central sensitization mechanisms in this pain condition.

High Frequency of Fibromyalgia in Patients With Acne Vulgaris.

PubMed

Yazmalar, Levent; Çelepkolu, Tahsin; Batmaz, İbrahim; Sariyildiz, Mustafa Akif; Sula, Bilal; Alpayci, Mahmut; An, İsa; Burkan, Yahya Kemal; Uçak, Haydar; Çevik, Remzi

2016-06-01

This study aims to investigate the frequency of fibromyalgia syndrome and to specify fibromyalgia syndrome-associated clinical symptoms in patients with acne vulgaris. Eighty-eight patients (28 males, 60 females; mean age 23.2±5.1 years; range 18 to 40 years) with acne vulgaris and age, sex- and body mass index-similar 76 healthy controls (14 males, 62 females; mean age 24.5±2.9 years; range 18 to 35 years) were included. Acne vulgaris was evaluated by using the Global Acne Scale, while Hospital Anxiety and Depression Scale was used to evaluate anxiety. Fibromyalgia-associated pain, sleep disturbance, anxiety, and menstrual cycle disturbance were significantly more frequent in patients with acne vulgaris than controls. Also, the severity of anxiety and the number of tender points were significantly higher in the acne vulgaris patients than controls. This study indicates that patients with acne vulgaris have increased frequency of fibromyalgia syndrome than healthy controls (21.6% versus 5.3%, respectively).

The Efficiency of Reproduction Health Education Given to Adolescents during the Postpartum Period.

PubMed

Topatan, Serap; Demirci, Nurdan

2015-10-01

Our research, partly experimental and partly prospective, was conducted for the purpose of evaluating the efficiency of reproductive health education given to adolescents during the postpartum period. The study comprised with 120 adolescents aged 15 to 19 (60 experimental group, 60 control group). Follow-up was conducted every 3 months for a total of 12 months, and the study concluded with 55 individuals from the experimental group and 46 individuals from the control group having participated fully, for the full 12 months. At the end of the research, it was found that the reproductive health knowledge of the experimental (103.10 ± 11.43) and control (99.15 ± 9.53) groups were similar before education. A statistically significant difference was also found between the total points for the scale determining the reproductive health of the experimental and control groups before and after education (P < .001). The socio-demographic variables affecting the total points for the scale determining the reproductive health-protective behavior of women were evaluated by multiple regression analysis; the most effective variables were found to be age and educational status. A statistically significant difference was also found between the total points for the family planning behavior scale of the experimental and control groups before and after education (P < .001). From this, it was understood that reproductive health education given during the postpartum and follow-up periods has a positive effect on adolescents' developing reproductive health behaviors and on creating knowledge and awareness related to family planning behavior. But there needs to be follow-up and supporting specific for adolescents in the current health system. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Infection Control Practice in the Operating Room: Staff Adherence to Existing Policies in a Developing Country

PubMed Central

Cawich, Shamir O; Tennant, Ingrid A; McGaw, Clarence D; Harding, Hyacinth; Walters, Christine A; Crandon, Ivor W

2013-01-01

Context: Infection control interventions are important for containing surgery-related infections. For this reason, the modern operating room (OR) should have well-developed infection control policies. The efficacy of these policies depends on how well the OR staff adhere to them. There is a lack of available data documenting adherence to infection control policies. Objective: To evaluate OR staff adherence to existing infection control policies in Jamaica. Methods: We administered a questionnaire to all OR staff to assess their training, knowledge of local infection control protocols, and practice with regard to 8 randomly selected guidelines. Adherence to each guideline was rated with fixed-choice items on a 4-point Likert scale. The sum of points determined the adherence score. Two respondent groups were defined: adherent (score > 26) and nonadherent (score ≤ 26). We evaluated the relationship between respondent group and age, sex, occupational rank, and time since completion of basic medical training. We used χ2 and Fisher exact tests to assess associations and t tests to compare means between variables of interest. Results: The sample comprised 132 participants (90 physicians and 42 nurses) with a mean age of 36 (standard deviation ± 9.5) years. Overall, 40.1% were adherent to existing protocols. There was no significant association between the distribution of adherence scores and sex (p = 0.319), time since completion of basic training (p = 0.595), occupational rank (p = 0.461), or age (p = 0.949). Overall, 19% felt their knowledge of infection control practices was inadequate. Those with working knowledge of infection control practices attained it mostly through informal communication (80.4%) and self-directed research (62.6%). Conclusion: New approaches to the problem of nonadherence to infection control guidelines are needed in the Caribbean. Several unique cultural, financial, and environmental factors influence adherence in this region, in contrast to conditions in developed countries. PMID:24355900

Depression or depressiveness in patients diagnosed with Anorexia Nervosa and Bulimia Nervosa - pilot research.

PubMed

Dêbska, Ewa; Janas, Adam; Bañczyk, Wojciech; Janas-Kozik, Małgorzata

2011-09-01

The target of this work is to consider if depressive symptoms intercurrent with patients suffering from Anorexia Nervosa (AN) and Bulimia Nervosa (BN) form a depression complex or whether they are physiological depression accompanying adolescence. We wished to observe the perception of these patients,of their functioning, both social and within their families and also looking for common point in the issues mentioned above trying to locate them within the course of the basic illness. We studied 19 patients suffering from eating disorders, and aged between 12 and 24 years old. 15 of them suffered from the restrictive form of AN and 4 suffered from BN. The control group consisted of 30 healthy girls in the same age interval. In the study authors used the Beck Depression Inventory (BDI) and the Quebec Quality of Life Questionnaire. Comparison of a number of points acquired in the survey using Beck Depression Scale revealed statistic significance at the level p<0.001 which points to a more frequent occurrence of depression symptoms among persons with eating disorders comparing to control group. The survey using the Questionnaire for Social Quality showed no statistically significant differences between study and control groups (p>0.05). The authors observed a statistically significant increased frequency of suicidal thoughts in the study group compared to the controls. To diagnose depression, depressive symptoms presented by the patients must give the image of depression at the clinical level. The result of the Beck's scale needs to be confronted with the clinical picture. Depression in adolescence requires differentiation from depressiveness.

Public Support for Family Smoking Prevention and Tobacco Control Act Point-of-Sale Provisions: Results of a National Study.

PubMed

Rose, Shyanika W; Emery, Sherry L; Ennett, Susan; McNaughton Reyes, Heath Luz; Scott, John C; Ribisl, Kurt M

2015-10-01

We assessed public and smoker support for enacted and potential point-of-sale (POS) tobacco-control policies under the Family Smoking Prevention and Tobacco Control Act. We surveyed a US nationally representative sample of 17, 507 respondents (6595 smokers) in January through February 2013, and used linear regression to calculate weighted point estimates and identify factors associated with support for POS policies among adults and smokers. Overall, nonsmokers were more supportive than were smokers. Regardless of smoking status, African Americans, Hispanics, women, and those of older ages were more supportive than White, male, and younger respondents, respectively. Policy support varied by provision. More than 80% of respondents supported minors' access restrictions and more than 45% supported graphic warnings. Support was lowest for plain packaging (23%), black-and-white advertising (26%), and a ban on menthol cigarettes (36%). Public support for marketing and POS provisions is low relative to other areas of tobacco control. Tobacco-control advocates and the Food and Drug Administration should build on existing levels of public support to promote and maintain evidence-based, but controversial, policy changes in the retail environment.

Public Support for Family Smoking Prevention and Tobacco Control Act Point-of-Sale Provisions: Results of a National Study

PubMed Central

Emery, Sherry L.; Ennett, Susan; McNaughton Reyes, Heath Luz; Scott, John C.; Ribisl, Kurt M.

2015-01-01

Objectives. We assessed public and smoker support for enacted and potential point-of-sale (POS) tobacco-control policies under the Family Smoking Prevention and Tobacco Control Act. Methods. We surveyed a US nationally representative sample of 17 507 respondents (6595 smokers) in January through February 2013, and used linear regression to calculate weighted point estimates and identify factors associated with support for POS policies among adults and smokers. Results. Overall, nonsmokers were more supportive than were smokers. Regardless of smoking status, African Americans, Hispanics, women, and those of older ages were more supportive than White, male, and younger respondents, respectively. Policy support varied by provision. More than 80% of respondents supported minors’ access restrictions and more than 45% supported graphic warnings. Support was lowest for plain packaging (23%), black-and-white advertising (26%), and a ban on menthol cigarettes (36%). Conclusions. Public support for marketing and POS provisions is low relative to other areas of tobacco control. Tobacco-control advocates and the Food and Drug Administration should build on existing levels of public support to promote and maintain evidence-based, but controversial, policy changes in the retail environment. PMID:26270303

A Methodology to Assess the Capability of Engine Designs to Meet Closed-loop Performance and Operability Requirements

NASA Technical Reports Server (NTRS)

Zinnecker, Alicia M.; Csank, Jeffrey T.

2015-01-01

Designing a closed-loop controller for an engine requires balancing trade-offs between performance and operability of the system. One such trade-off is the relationship between the 95% response time and minimum high-pressure compressor (HPC) surge margin (SM) attained during acceleration from idle to takeoff power. Assuming a controller has been designed to meet some specification on response time and minimum HPC SM for a mid-life (nominal) engine, there is no guarantee that these limits will not be violated as the engine ages, particularly as it reaches the end of its life. A characterization for the uncertainty in this closed-loop system due to aging is proposed that defines elliptical boundaries to estimate worst-case performance levels for a given control design point. The results of this characterization can be used to identify limiting design points that bound the possible con- troller designs yielding transient results that do not exceed specified limits in response time or minimum HPC SM. This characterization involves performing Monte Carlo simulation of the closed-loop system with controller constructed for a set of trial design points and developing curve fits to describe the size and orientation of each ellipse; a binary search procedure is then employed that uses these fits to identify the limiting design point. The method is demonstrated through application to a generic turbofan engine model in closed- loop with a simplified controller; it is found that the limit for which each controller was designed was exceeded by less than 4.76%. Extension of the characterization to another trade-off, that between the maximum high-pressure turbine (HPT) entrance temperature and minimum HPC SM, showed even better results: the maximum HPT temperature was estimated within 0.76%. Because of the accuracy in this estimation, this suggests another limit that may be taken into consideration during design and analysis. It also demonstrates the extension of the characterization to other attributes that contribute to the performance or operability of the engine. Metrics are proposed that, together, provide information on the shape of the trade-off between response time and minimum HPC SM, and how much each varies throughout the life cycle, at the limiting design points. These metrics also facilitate comparison of the expected transient behavior for multiple engine models.

The impact of childhood malnutrition on schooling: evidence from Bangladesh.

PubMed

Khanam, Rasheda; Nghiem, Hong Son; Rahman, Mohammad Mafizur

2011-07-01

This paper examines the impact of childhood malnutrition on schooling performance in rural Bangladesh. The results reveal that malnourished children are less likely to enrol in school on time and achieve an age-appropriate grade by 26 percentage points and 31 percentage points, respectively. Other important determinants of schooling outcomes include infrastructure and education level of parents. One major contribution of this paper is the control for the endogeneity of malnutrition status, which otherwise might lead to bias estimates. © Cambridge University Press, 2011

Cost-effectiveness of point-of-care testing for dehydration in the pediatric ED.

PubMed

Whitney, Rachel E; Santucci, Karen; Hsiao, Allen; Chen, Lei

2016-08-01

Acute gastroenteritis (AGE) and subsequent dehydration account for a large proportion of pediatric emergency department (PED) visits. Point-of-care (POC) testing has been used in conjunction with clinical assessment to determine the degree of dehydration. Despite the wide acceptance of POC testing, little formal cost-effective analysis of POC testing in the PED exists. We aim to examine the cost-effectiveness of using POC electrolyte testing vs traditional serum chemistry testing in the PED for children with AGE. This was a cost-effective analysis using data from a randomized control trial of children with AGE. A decision analysis model was constructed to calculate cost-savings from the point of view of the payer and the provider. We used parameters obtained from the trial, including cost of testing, admission rates, cost of admission, and length of stay. Sensitivity analyses were performed to evaluate the stability of our model. Using the data set of 225 subjects, POC testing results in a cost savings of $303.30 per patient compared with traditional serum testing from the point of the view of the payer. From the point-of-view of the provider, POC testing results in consistent mean savings of $36.32 ($8.29-$64.35) per patient. Sensitivity analyses demonstrated the stability of the model and consistent savings. This decision analysis provides evidence that POC testing in children with gastroenteritis-related moderate dehydration results in significant cost savings from the points of view of payers and providers compared to traditional serum chemistry testing. Copyright © 2016 Elsevier Inc. All rights reserved.

[Postural control characteristics in elderly women with fallers].

PubMed

Gudkov, A B; Dyomin, A V; Gribanov, A V

Using computer posturografic (stabilometric) complex a study of postural control peculiarities was carried out in 108 women aged 65-74 years who had experienced two or more falls during the year (fallers). These tests were: Sensory Organization Test, Motor Control Test, Rhythmic Weight Shift. It was found that elderly women with fallers had a decrease of sensory information (somatosensory - by 1,8 %, of the visual - by 6 %, and of the vestibular - by 10,1 %), the neurophysiological mechanisms of postural control (by 5,7 points), violation of adaptation possibilities of sensory and motor components of the legs to respond quickly to changes in the center of gravity within the support base of its footing (7,3 ms), as well as reducing balance control in the frontal (by 7,2 %) and sagittal (by 23,2 % ) planes compared with the women of the same age without fallers.

Is There an Association Between Lumbosacral Radiculopathy and Painful Gluteal Trigger Points?: A Cross-sectional Study.

PubMed

Adelmanesh, Farhad; Jalali, Ali; Jazayeri Shooshtari, Seyed Mostafa; Raissi, Gholam Reza; Ketabchi, Seyed Mehdi; Shir, Yoram

2015-10-01

The objective of this study was to compare the prevalence of gluteal trigger point in patients with lumbosacral radiculopathy with that in healthy volunteers. In a cross-sectional, multistage sampling method, patients with clinical, electromyographic, and magnetic resonance imaging findings consistent with lumbosacral radiculopathy were examined for the presence of gluteal trigger point. Age- and sex-matched clusters of healthy volunteers were selected as the control group. The primary outcome of the study was the presence or absence of gluteal trigger point in the gluteal region of the patients and the control group. Of 441 screened patients, 271 met all the inclusion criteria for lumbosacral radiculopathy and were included in the study. Gluteal trigger point was identified in 207 (76.4%) of the 271 patients with radiculopathy, compared with 3 (1.9%) of 152 healthy volunteers (P < 0.001). The location of gluteal trigger point matched the side of painful radiculopathy in 74.6% of patients with a unilateral radicular pain. There was a significant correlation between the side of the gluteal trigger point and the side of patients' radicular pain (P < 0.001). Although rare in the healthy volunteers, most of the patients with lumbosacral radiculopathy had gluteal trigger point, located at the painful side. Further studies are required to test the hypothesis that specific gluteal trigger point therapy could be beneficial in these patients.

Assessing the use of immersive virtual reality, mouse and touchscreen in pointing and dragging-and-dropping tasks among young, middle-aged and older adults.

PubMed

Chen, Jiayin; Or, Calvin

2017-11-01

This study assessed the use of an immersive virtual reality (VR), a mouse and a touchscreen for one-directional pointing, multi-directional pointing, and dragging-and-dropping tasks involving targets of smaller and larger widths by young (n = 18; 18-30 years), middle-aged (n = 18; 40-55 years) and older adults (n = 18; 65-75 years). A three-way, mixed-factorial design was used for data collection. The dependent variables were the movement time required and the error rate. Our main findings were that the participants took more time and made more errors in using the VR input interface than in using the mouse or the touchscreen. This pattern applied in all three age groups in all tasks, except for multi-directional pointing with a larger target width among the older group. Overall, older adults took longer to complete the tasks and made more errors than young or middle-aged adults. Larger target widths yielded shorter movement times and lower error rates in pointing tasks, but larger targets yielded higher rates of error in dragging-and-dropping tasks. Our study indicated that any other virtual environments that are similar to those we tested may be more suitable for displaying scenes than for manipulating objects that are small and require fine control. Although interacting with VR is relatively difficult, especially for older adults, there is still potential for older adults to adapt to that interface. Furthermore, adjusting the width of objects according to the type of manipulation required might be an effective way to promote performance. Copyright © 2017 Elsevier Ltd. All rights reserved.

Point shear wave elastography of the pancreas in patients with cystic fibrosis: a comparison with healthy controls.

PubMed

Pfahler, Matthias Hermann Christian; Kratzer, Wolfgang; Leichsenring, Michael; Graeter, Tilmann; Schmidt, Stefan Andreas; Wendlik, Inka; Lormes, Elisabeth; Schmidberger, Julian; Fabricius, Dorit

2018-02-19

Manifestations of cystic fibrosis in the pancreas are gaining in clinical importance as patients live longer. Conventional ultrasonography and point shear wave elastography (pSWE) imaging are non-invasive and readily available diagnostic methods that are easy to perform. The aim of this study was to perform conventional ultrasonography and obtain pSWE values in the pancreases of patients with cystic fibrosis and to compare the findings with those of healthy controls. 27 patients with cystic fibrosis (13 women/14 men; mean age 27.7 ± 13.7 years; range 9-58 years) and 60 healthy control subjects (30 women/30 men; mean age 30.3 ± 10.0 years; range 22-55 years) underwent examinations of the pancreas with conventional ultrasound and pSWE imaging. Patients with cystic fibrosis have an echogenic pancreatic parenchyma. We found cystic lesions of the pancreas in six patients. pSWE imaging of the pancreatic parenchyma gave significantly lower shear wave velocities in patients with cystic fibrosis than in the control group (1.01 m/s vs 1.30 m/s; p < 0.001). Using pSWE imaging in vivo, we have shown that the pancreas is considerably softer in patients with cystic fibrosis than in a healthy control population.

Aging and the circadian rhythm of melatonin: a cross-sectional study of Chinese subjects 30-110 yr of age.

PubMed

Zhao, Zi-Yan; Xie, Yi; Fu, Yue-Rong; Bogdan, André; Touitou, Yvan

2002-11-01

Although previous reports indicate that nocturnal plasma melatonin secretion declines with age, some recent findings do not support this point. In the present cross-sectional study, we documented serum melatonin concentrations at two time points, 02:00 and 08:00 h, in 144 persons aged 30-110 yr and found a significant age-related decline. It began around the age of 60 and reached a very significantly lower level in subjects in their 70s and over 80 yr of age (P < 0.01, when compared with age <60 yr). Nocturnal melatonin levels were higher among (post-menopausal only) women than men overall (P < 0.05). In the older age-groups, nocturnal melatonin levels did not differ between healthy controls and subjects with high blood pressure or ischemic heart disease. To further check these results, we also assessed the circadian pattern of serum melatonin in four subgroups of healthy men, aged 30-39, 40-49, 50-59, and 60-69 yr: blood samples were taken at 2 h intervals from 08:00 to 22:00 h and hourly from 22:00 to 08:00 h. Our results showed generally similar circadian melatonin patterns that peaked at night with very low levels during the daytime. No significant difference was found among the three younger groups, but nocturnal melatonin levels were significantly lower in the men in their 60s.

Long-term Psychiatric Impact of Peer Victimization in Adults Born at Extremely Low Birth Weight.

PubMed

Day, Kimberly L; Schmidt, Louis A; Vaillancourt, Tracy; Saigal, Saroj; Boyle, Michael H; Van Lieshout, Ryan J

2016-03-01

While children born at extremely low birth weight (ELBW; <1000 g) are at elevated risk for peer victimization, no research has examined its effects on mental health in adulthood. ELBW survivors and matched normal birth weight (NBW; >2500 g) controls were part of a prospective, population-based study in Ontario, Canada. Peer victimization before age 16 was self-reported at age 22 to 26 years by using a 10-point measure. Presence of psychiatric disorders was examined at age 22 to 26 years (ELBW n = 142, NBW n = 133) and age 29 to 36 years (ELBW n = 84, NBW n = 90). After adjustment for confounding variables, for each 1-point increase in the peer victimization score, ELBW survivors had increased odds of current depressive (odds ratio [OR] = 1.67, 95% confidence interval [CI], 1.23-2.28), anxiety (OR = 1.36, 95% CI, 1.05-1.76), avoidant (OR = 1.39, 95% CI, 1.08-1.79), antisocial (OR = 1.92, 95% CI, 1.06-2.87), and attention-deficit/hyperactivity (OR = 1.39, 95% CI, 1.06-1.83) problems at age 22 to 26 years. At age 29 to 36 years, peer victimization score predicted increased odds of current panic disorder (OR = 1.69, 95% CI, 1.01-2.83) and obsessive-compulsive disorder (OR = 3.56, 95% CI, 1.25-10.09). For NBW controls, peer victimization predicted increased odds of antisocial problems at age 22 to 26 years. ELBW survivorsand NBW participants are vulnerable to the adverse psychiatric effects of childhood peer victimization in adulthood. Copyright © 2016 by the American Academy of Pediatrics.

In utero exposure to levetiracetam vs valproate: development and language at 3 years of age.

PubMed

Shallcross, R; Bromley, R L; Cheyne, C P; García-Fiñana, M; Irwin, B; Morrow, J; Baker, G A

2014-01-21

To compare the cognitive and language development of children born to women with epilepsy (WWE) exposed in utero to levetiracetam (LEV) or sodium valproate (VPA) and control children born to women without epilepsy not taking medication during pregnancy. The children, aged between 36 and 54 months, were recruited from the United Kingdom and assessed using the Griffiths Mental Development Scales and the Reynell Language Development Scale. Maternal demographic and epilepsy information was also collected for use in statistical regression. This is an observational study with researchers not involved in the clinical management of the mothers enrolled. After controlling for confounding variables, children exposed to LEV in utero (n = 53) did not differ from unexposed control children (n = 131) on any scale administered. Children exposed to VPA (n = 44) in utero scored, on average, 15.8 points below children exposed to LEV on measures of gross motor skills (95% confidence interval [CI] -24.5 to -7.1, p < 0.001), 6.4 points below on comprehension language abilities (95% CI -11.0 to -1.8, p = 0.005), and 9.5 points below on expressive language abilities (95% CI -14.7 to -4.4, p < 0.001). The current study indicates that children exposed to LEV in utero were superior in their language and motor development in comparison to children exposed to VPA. This information should be used collaboratively between health care professionals and WWE when deciding on women's preferred choice of antiepileptic drug.

Early Probiotic Supplementation for Eczema and Asthma Prevention: A Randomized Controlled Trial.

PubMed

Cabana, Michael D; McKean, Michelle; Caughey, Aaron B; Fong, Lawrence; Lynch, Susan; Wong, Angela; Leong, Russell; Boushey, Homer A; Hilton, Joan F

2017-09-01

To determine if probiotic administration during the first 6 months of life decreases childhood asthma and eczema. We conducted a randomized, double-blind controlled trial of Lactobacillus rhamnosus GG (LGG) supplementation on the cumulative incidence of eczema (primary end point) and asthma and rhinitis (secondary end points) in high-risk infants. For the first 6 months of life, intervention infants ( n = 92) received a daily dose of 10 billion colony-forming units of LGG and 225 mg of inulin (Amerifit Brands, Cromwell, CT), and control infants ( n = 92) received 325 mg of inulin alone. We used survival analysis methods to estimate disease incidences in the presence or absence of LGG and to estimate the efficacy of LGG in delaying or preventing these diseases. Infants were accrued over a 6-year period (median follow-up: 4.6 years; 95% retention rate at 2 years). At 2 years of age, the estimated cumulative incidence of eczema was 30.9% (95% confidence interval [CI], 21.4%-40.4%) in the control arm and 28.7% (95% CI, 19.4%-38.0%) in the LGG arm, for a hazard ratio of 0.95 (95% CI, 0.59-1.53) (log-rank P = .83). At 5 years of age, the cumulative incidence of asthma was 17.4% (95% CI, 7.6%-27.1%) in the control arm and 9.7% (95% CI, 2.7%-16.6%) in the LGG arm, for a hazard ratio of 0.88 (95% CI, 0.41-1.87) (log-rank P = .25). For high-risk infants, early LGG supplementation for the first 6 months of life does not appear to prevent the development of eczema or asthma at 2 years of age. Copyright © 2017 by the American Academy of Pediatrics.

Lunch Lessons

ERIC Educational Resources Information Center

Cooper, Ann

2011-01-01

The obesity level and related health problems in American children have risen to the point where the Centers for Disease Control predicts the current generation may be the first to die at younger ages than their parents. Ann Cooper, a chef and long-time advocate for healthier food choices and health education for children, argues that child…

Personal Media and the Human Community.

ERIC Educational Resources Information Center

Miyagawa, Shigeru

2002-01-01

Discussion of how the information age may alter forms and use of media focuses on personal media, or community media, as opposed to mass media. Topics include controlling the point of view; the idea of appropriation; storytelling, or narrative; and the need to bring technology and humanism back together. (LRW)

Parents' education and child body weight in France: The trajectory of the gradient in the early years.

PubMed

Apouey, Bénédicte H; Geoffard, Pierre-Yves

2016-03-01

This paper explores the relationship between parental education and offspring body weight in France. Using two large datasets spanning the 1991-2010 period, we examine the existence of inequalities in maternal and paternal education and reported child body weight measures, as well as their evolution across childhood. Our empirical specification is flexible and allows this evolution to be non-monotonic. Significant inequalities are observed for both parents' education--maternal (respectively paternal) high education is associated with a 7.20 (resp. 7.10) percentage points decrease in the probability that the child is reported to be overweight or obese, on average for children of all ages. The gradient with respect to parents' education follows an inverted U-shape across childhood, meaning that the association between parental education and child body weight widens from birth to age 8, and narrows afterward. Specifically, maternal high education is correlated with a 5.30 percentage points decrease in the probability that the child is reported to be overweight or obese at age 2, but a 9.62 percentage points decrease at age 8, and a 1.25 percentage point decrease at age 17. The figures for paternal high education are respectively 5.87, 9.11, and 4.52. This pattern seems robust, since it is found in the two datasets, when alternative variables for parental education and reported child body weight are employed, and when controls for potential confounding factors are included. The findings for the trajectory of the income gradient corroborate those of the education gradient. The results may be explained by an equalization in actual body weight across socioeconomic groups during youth, or by changes in reporting styles of height and weight. Copyright © 2015 Elsevier B.V. All rights reserved.

Nusinersen versus Sham Control in Later-Onset Spinal Muscular Atrophy.

PubMed

Mercuri, Eugenio; Darras, Basil T; Chiriboga, Claudia A; Day, John W; Campbell, Craig; Connolly, Anne M; Iannaccone, Susan T; Kirschner, Janbernd; Kuntz, Nancy L; Saito, Kayoko; Shieh, Perry B; Tulinius, Már; Mazzone, Elena S; Montes, Jacqueline; Bishop, Kathie M; Yang, Qingqing; Foster, Richard; Gheuens, Sarah; Bennett, C Frank; Farwell, Wildon; Schneider, Eugene; De Vivo, Darryl C; Finkel, Richard S

2018-02-15

Nusinersen is an antisense oligonucleotide drug that modulates pre-messenger RNA splicing of the survival motor neuron 2 ( SMN2) gene. It has been developed for the treatment of spinal muscular atrophy (SMA). We conducted a multicenter, double-blind, sham-controlled, phase 3 trial of nusinersen in 126 children with SMA who had symptom onset after 6 months of age. The children were randomly assigned, in a 2:1 ratio, to undergo intrathecal administration of nusinersen at a dose of 12 mg (nusinersen group) or a sham procedure (control group) on days 1, 29, 85, and 274. The primary end point was the least-squares mean change from baseline in the Hammersmith Functional Motor Scale-Expanded (HFMSE) score at 15 months of treatment; HFMSE scores range from 0 to 66, with higher scores indicating better motor function. Secondary end points included the percentage of children with a clinically meaningful increase from baseline in the HFMSE score (≥3 points), an outcome that indicates improvement in at least two motor skills. In the prespecified interim analysis, there was a least-squares mean increase from baseline to month 15 in the HFMSE score in the nusinersen group (by 4.0 points) and a least-squares mean decrease in the control group (by -1.9 points), with a significant between-group difference favoring nusinersen (least-squares mean difference in change, 5.9 points; 95% confidence interval, 3.7 to 8.1; P<0.001). This result prompted early termination of the trial. Results of the final analysis were consistent with results of the interim analysis. In the final analysis, 57% of the children in the nusinersen group as compared with 26% in the control group had an increase from baseline to month 15 in the HFMSE score of at least 3 points (P<0.001), and the overall incidence of adverse events was similar in the nusinersen group and the control group (93% and 100%, respectively). Among children with later-onset SMA, those who received nusinersen had significant and clinically meaningful improvement in motor function as compared with those in the control group. (Funded by Biogen and Ionis Pharmaceuticals; CHERISH ClinicalTrials.gov number, NCT02292537 .).

Cortical Thickness Change in Autism during Early Childhood

PubMed Central

Smith, Elizabeth; Thurm, Audrey; Greenstein, Deanna; Farmer, Cristan; Swedo, Susan; Giedd, Jay; Raznahan, Armin

2016-01-01

Structural magnetic resonance imaging (MRI) scans at high spatial resolution can detect potential foci of early brain dysmaturation in children with autism spectrum disorders (ASD). In addition, comparison between MRI and behavior measures over time can identify patterns of brain change accompanying specific outcomes. We report structural MRI data from two time points for a total of 84 scans in children with ASD and 30 scans in typical controls (mean age time one=4.1 years, mean age at time two=6.6 years). Surface-based cortical morphometry and linear mixed effects models were used to link changes in cortical anatomy to both diagnostic status and individual differences in changes in language and autism severity. Compared to controls, children with ASD showed accelerated gray matter volume gain with age, which was driven by a lack of typical age-related cortical thickness (CT) decrease within ten cortical regions involved in language, social cognition and behavioral control. Greater expressive communication gains with age in children with ASD were associated with greater CT gains in a set of right hemisphere homologues to dominant language cortices, potentially identifying a compensatory system for closer translational study. PMID:27061356

Flexibility of the elderly after one-year practice of yoga and calisthenics.

PubMed

Farinatti, Paulo T V; Rubini, Ercole C; Silva, Elirez B; Vanfraechem, Jacques H

Flexibility training responses to distinct stretching techniques are not well defined, especially in the elderly. This study compared the flexibility of elderly individuals before and after having practiced hatha yoga and calisthenics for 1 year (52 weeks), at least 3 times/week. Sixty-six subjects (12 men) measured and assigned to 3 groups: control (n = 24, age = 67.7±6.9 years), hatha yoga (n = 22, age = 61.2±4.8 years), and calisthenics (n = 20, age = 69.0±5.8 years). The maximal range of passive motion of 13 movements in 7 joints was assessed by the Flexitest, comparing the range obtained with standard charts representing each arc of movement on a discontinuous and non-dimensional scale from 0 to 4. Results of individual movements were summed to define 4 indexes (ankle+knee, hip+trunk, wrist+elbow, and shoulder) and total flexibility (Flexindex). Results showed significant increases of total flexibility in the hatha yoga group (by 22.5 points) and the calisthenics group (by 5.8 points) (p < 0.01 for each) and a decrease in the control group (by 2.1 points) (p < 0.01) after one year of intervention. Between-group comparison showed that increases in the hatha yoga group were greater than in the calisthenics group for most flexibility indexes, particularly the overall flexibility (p <0.05). In conclusion, the practice of hatha yoga (i.e., slow/passive movements) was more effective in improving flexibility compared to calisthenics (i.e., fast/dynamic movements), but calisthenics was able to prevent flexibility losses observed in sedentary elderly subjects.

Kinetic measures of restabilisation during volitional stepping reveal age-related alterations in the control of mediolateral dynamic stability.

PubMed

Singer, Jonathan C; McIlroy, William E; Prentice, Stephen D

2014-11-07

Research examining age-related changes in dynamic stability during stepping has recognised the importance of the restabilisation phase, subsequent to foot-contact. While regulation of the net ground reaction force (GRFnet) line of action is believed to influence dynamic stability during steady-state locomotion, such control during restabilisation remains unknown. This work explored the origins of age-related decline in mediolateral dynamic stability by examining the line of action of GRFnet relative to the centre of mass (COM) during restabilisation following voluntary stepping. Healthy younger and older adults (n=20 per group) performed three single-step tasks (varying speed and step placement), altering the challenge to stability control. Age-related differences in magnitude and intertrial variability of the angle of divergence of GRFnet line of action relative to the COM were quantified, along with the peak mediolateral and vertical GRFnet components. The angle of divergence was further examined at discrete points during restabilisation, to uncover events of potential importance to stability control. Older adults exhibited a reduced angle of divergence throughout restabilisation. Temporal and spatial constraints on stepping increased the magnitude and intertrial variability of the angle of divergence, although not differentially among the older adults. Analysis of the time-varying angle of divergence revealed age-related reductions in magnitude, with increases in timing and intertrial timing variability during the later phase of restabilisation. This work further supports the idea that age-related challenges in lateral stability control emerge during restabilisation. Age-related alterations during the later phase of restabilisation may signify challenges with reactive control. Copyright © 2014 Elsevier Ltd. All rights reserved.

Differential effects of enriched environment at work on cognitive decline in old age.

PubMed

Then, Francisca S; Luck, Tobias; Luppa, Melanie; König, Hans-Helmut; Angermeyer, Matthias C; Riedel-Heller, Steffi G

2015-05-26

The aim of the present study was to investigate how different mentally demanding work conditions during the professional life-i.e., enriched environments at work-might influence the rate of cognitive decline in old age. Individuals (n = 1,054) of the Leipzig Longitudinal Study of the Aged, a representative population-based cohort study of individuals aged 75 years and older, underwent cognitive testing via the Mini-Mental State Examination (MMSE) in up to 6 measurement waves. Type and level of mentally demanding work conditions in the participants' former professional life were classified based on the O*NET job descriptor database. In multivariate mixed-model analyses (controlling for sociodemographic and health-related factors), a high level of mentally demanding work tasks stimulating verbal intelligence was significantly associated with a better cognitive functioning at baseline (on average 5 MMSE points higher) as well as a lower rate of cognitive decline (on average 2 MMSE points less) over the 8-year follow-up period compared with a low level. The rate of cognitive decline in old age was also significantly lower (on average 3 MMSE points less) in individuals who had a high level of mentally demanding work tasks stimulating executive functions than those who had a low level. The results suggest that a professional life enriched with work tasks stimulating verbal intelligence and executive functions may help to sustain a good cognitive functioning in old age (75+ years). The findings thus emphasize that today's challenging work conditions may also promote positive health effects. © 2015 American Academy of Neurology.

The Development of Memory Efficiency and Value-Directed Remembering Across the Lifespan: A Cross-Sectional Study of Memory and Selectivity

PubMed Central

Castel, Alan D.; Humphreys, Kathryn L.; Lee, Steve S.; Galván, Adriana; Balota, David A.; McCabe, David P.

2012-01-01

Although attentional control and memory change considerably across the lifespan, no research has examined how the ability to strategically remember important information (i.e., value-directed remembering) changes from childhood to old age. The present study examined this in different age groups across the lifespan (N=320, 5 to 96 years old). We employed a selectivity task where participants were asked to study and recall items worth different point values in order to maximize their point score. This procedure allowed for measures of memory quantity/capacity (number of words recalled) and memory efficiency/selectivity (the recall of high-value items relative to low-value items). Age-related differences were found for memory capacity, as young adults recalled more words than the other groups. However, in terms of selectivity, younger and older adults were more selective than adolescents and children. The dissociation between these measures across the lifespan illustrates important age-related differences in terms of memory capacity and the ability to selectively remember high-value information. PMID:21942664

The development of memory efficiency and value-directed remembering across the life span: a cross-sectional study of memory and selectivity.

PubMed

Castel, Alan D; Humphreys, Kathryn L; Lee, Steve S; Galván, Adriana; Balota, David A; McCabe, David P

2011-11-01

Although attentional control and memory change considerably across the life span, no research has examined how the ability to strategically remember important information (i.e., value-directed remembering) changes from childhood to old age. The present study examined this in different age groups across the life span (N = 320, 5-96 years old). A selectivity task was used in which participants were asked to study and recall items worth different point values in order to maximize their point score. This procedure allowed for measures of memory quantity/capacity (number of words recalled) and memory efficiency/selectivity (the recall of high-value items relative to low-value items). Age-related differences were found for memory capacity, as young adults recalled more words than the other groups. However, in terms of selectivity, younger and older adults were more selective than adolescents and children. The dissociation between these measures across the life span illustrates important age-related differences in terms of memory capacity and the ability to selectively remember high-value information.

Repeatability of Retinal Sensitivity Measurements Using a Medmont Dark-Adapted Chromatic Perimeter in Healthy and Age-Related Macular Degeneration Cases.

PubMed

Tan, Rose S; Guymer, Robyn H; Luu, Chi D

2018-05-01

To determine the intrasession and intersession test-retest repeatability of retinal sensitivity measurements using a dark-adapted chromatic perimeter (DACP). For intrasession testing, retinal sensitivity within the central 24° for the 505-nm stimulus was measured after 20, 30, and 40 minutes of dark adaptation (DA) and for the 625-nm stimulus was measured after the first and second 505-nm tests. For intersession testing, retinal sensitivity for both stimuli was measured after 30 minutes of DA at baseline and 1 month. The point-wise sensitivity (PWS) difference and coefficient of repeatability (CoR) of each stimulus and group were determined. For intrasession testing, 10 age-related macular degeneration (AMD) and eight control subjects were recruited. The overall CoR for the 505-nm stimulus was 8.4 dB for control subjects and 9.1 dB for AMD cases, and for the 625-nm stimulus was 6.7 dB for control subjects and 9.5 dB for AMD cases. For intersession testing, seven AMD cases and 13 control subjects returned an overall CoR for the 505-nm stimulus of 8.2 dB for the control and 11.7 dB for the AMD group. For the 625-nm stimulus the CoR was 6.2 dB for the control group and 8.4 dB for the AMD group. Approximately 80% of all test points had a PWS difference of ±5 dB between the two intrasession or intersession measurements for both stimuli. The CoR for the DACP is larger than that reported for scotopic perimeters; however, the majority of test points had a PWS difference of ±5 dB between tests. The DACP offers an opportunity to measure static and dynamic rod function at multiple locations with an acceptable reproducibility level.

One session of high-intensity interval training (HIIT) every 5 days, improves muscle power but not static balance in lifelong sedentary ageing men: A randomized controlled trial.

PubMed

Sculthorpe, Nicholas F; Herbert, Peter; Grace, Fergal

2017-02-01

Declining muscle power during advancing age predicts falls and loss of independence. High-intensity interval training (HIIT) may improve muscle power, but remains largely unstudied in ageing participants. This randomized controlled trial (RCT) investigated the efficacy of a low-frequency HIIT (LfHIIT) intervention on peak muscle power (peak power output [PPO]), body composition, and balance in lifelong sedentary but otherwise healthy males. Thirty-three lifelong sedentary ageing men were randomly assigned to either intervention (INT; n = 22, age 62.3 ± 4.1 years) or control (n = 11, age 61.6 ± 5.0 years) who were both assessed at 3 distinct measurement points (phase A), after 6 weeks of conditioning exercise (phase B), and after 6 weeks of HIIT once every 5 days in INT (phase C), where control remained inactive throughout the study. Static balance remained unaffected, and both absolute and relative PPO were not different between groups at phases A or B, but increased significantly in INT after LfHIIT (P < 0.01). Lean body mass displayed a significant interaction (P < 0.01) due to an increase in INT between phases B and C (P < 0.05). 6 weeks of LfHIIT exercise feasible and effective method to induce clinically relevant improvements in absolute and relative PPO, but does not improve static balance in sedentary ageing men.

PlanYourLifeSpan.org - an intervention to help seniors make choices for their fourth quarter of life: Results from the randomized clinical trial.

PubMed

Lindquist, Lee A; Ramirez-Zohfeld, Vanessa; Sunkara, Priya D; Forcucci, Chris; Campbell, Dianne S; Mitzen, Phyllis; Ciolino, Jody D; Gregory, Dyanna; Kricke, Gayle; Cameron, Kenzie A

2017-11-01

Few older adults contemplate their home support and health needs that may be required for aging-in-place. We sought to assess the efficacy of PlanYourLifespan.org (PYL), in influencing seniors' planning behaviors, perception of the importance of planning, and confidence accessing services. Randomized controlled trial, of adults, age ≥65 years in urban, suburban, rural areas of Texas, Illinois, Indiana. Among 385 participants, mean age was 71.9 years, 79.5% female. Between baseline and one-month follow-up, average planning behavior score increased 0.22 points in the PYL arm when compared to the attention control (AC) arm. After controlling for baseline, mean one-month planning behavior score was significantly higher in the PYL arm than in the AC arm (1.25 points, CI 0.37-2.12, p=0.005). Secondary analyses via longitudinal linear mixed modelling suggested a study arm-by-time interaction effect for both planning behavior (p=0.047 and perception of importance (p=0.05). Significant baseline covariates included self-efficacy, education, perceived social support, power of attorney, and history of stroke. PlanYourLifespan.org demonstrated efficacy in helping seniors plan for and communicate their health support needs. This free, nationally available tool may help individuals understand, plan, and communicate their options for their future support needs. Copyright © 2017 Elsevier B.V. All rights reserved.

The possible societal impact of the decrease in U.S. blood lead levels on adult IQ.

PubMed

Kaufman, Alan S; Zhou, Xiaobin; Reynolds, Matthew R; Kaufman, Nadeen L; Green, Garo P; Weiss, Lawrence G

2014-07-01

The dramatic decrease in U.S. blood lead levels (BLLs) since the 1970s has been documented--however, the anticipated societal impact on intelligence quotient (IQ) has not. The objectives of this study were to determine whether mean IQs of American adults, adjusted for demographics, have increased in concert with society's decreasing BLL. Mean IQs of eight normal adult cohorts (N=800), tested individually in 2007 by trained clinicians, were compared using ANCOVA and correlation analysis. Cohorts ranged in mean societal BLLs from 4 1/2 μg/dL (born 1985-1987) to 19 μg/dL (born 1963-1972). IQs were adjusted for confounders-education, gender, ethnicity, region, urban status. To control for age, we analyzed IQ data for a second adult sample (N=800), tested in 1995-all born when BLLs were high (1951-1975, BLL ≥ 15 μg/dL). When controlling for education, gender, ethnicity, and region, the regression of IQs on BLLs was significant (r=-0.84, p<0.01); the modeled change in BLLs from 20 to 4 μg/dL suggests predicted increases of 3.8 IQ points (95% CI, 1.4-6.2). Also controlling for urban status produced significance (r=-0.88, p<0.01) with predicted increases of 5.2 points (95% CI, 2.4-8.0). Control analyses ruled out aging as a confounder. The dramatic societal decreases in BLLs in the U.S. since the 1970s were associated with a 4-5-point increase in the mean IQs of Americans. This effect is consistent with researchers' predictions; however, other variables (e.g., medical advances) may have contributed to the IQ gains. Copyright © 2014 Elsevier Inc. All rights reserved.

Language development at 18 months is related to multimodal communicative strategies at 12 months.

PubMed

Igualada, Alfonso; Bosch, Laura; Prieto, Pilar

2015-05-01

The present study investigated the degree to which an infants' use of simultaneous gesture-speech combinations during controlled social interactions predicts later language development. Nineteen infants participated in a declarative pointing task involving three different social conditions: two experimental conditions (a) available, when the adult was visually attending to the infant but did not attend to the object of reference jointly with the child, and (b) unavailable, when the adult was not visually attending to neither the infant nor the object; and (c) a baseline condition, when the adult jointly engaged with the infant's object of reference. At 12 months of age measures related to infants' speech-only productions, pointing-only gestures, and simultaneous pointing-speech combinations were obtained in each of the three social conditions. Each child's lexical and grammatical output was assessed at 18 months of age through parental report. Results revealed a significant interaction between social condition and type of communicative production. Specifically, only simultaneous pointing-speech combinations increased in frequency during the available condition compared to baseline, while no differences were found for speech-only and pointing-only productions. Moreover, simultaneous pointing-speech combinations in the available condition at 12 months positively correlated with lexical and grammatical development at 18 months of age. The ability to selectively use this multimodal communicative strategy to engage the adult in joint attention by drawing his attention toward an unseen event or object reveals 12-month-olds' clear understanding of referential cues that are relevant for language development. This strategy to successfully initiate and maintain joint attention is related to language development as it increases learning opportunities from social interactions. Copyright © 2015 Elsevier Inc. All rights reserved.

Adolescent self-control behavior predicts body weight through the life course: a prospective birth cohort study

PubMed Central

Koike, S; Hardy, R; Richards, M

2016-01-01

Background: Weight gain has become one of the biggest issues for healthy aging in middle- and high-income countries. Self-control of emotional reward cues is an important behavioral factor for regulation of weight gain through voluntary diet control and physical activity. Methods: We tested the associations between teacher-rated self-control at ages 13 and 15 years, and measured body mass index (BMI) between ages 15 and 60–64 years, controlling for confounding factors such as affective symptoms and cognition, using 3873 study members in the Medical Research Council National Survey of Health and Development, also known as the British 1946 birth cohort. Results: Multivariable regression analysis after adjustment for all covariates showed that lower self-control was associated with higher BMI in all measure points (P<0.05). Multilevel modeling using a cubic model showed that there was an association between self-control and BMI at 15 years in females (male: BMI=−0.00 kg m−2 per 1 s.d. on the self-control score (95% confidence interval (CI): −0.12 to 0.11), P =0.94; female: BMI=−0.27 (−0.42 to −0.11), P<0.001). The association became stronger with age in both sexes (BMI=−0.065 (−0.082 to −0.048), P<0.001; BMI=−0.036 (−0.057 to −0.015), P<0.001). By age 60–64 years, the association between self-control and BMI in men had increased to −0.70 (−0.96 to −0.44) and −0.67 (−1.04 to −0.30) in women. Conclusions: Lower adolescent self-control was associated with higher BMI through the life course, and this becomes stronger with age. Investigations to test whether intervention to self-control improves obesity are recommended. PMID:26449420

Racial microstressors, racial self-concept, and depressive symptoms among male African Americans during the transition to adulthood.

PubMed

Kogan, Steven M; Yu, Tianyi; Allen, Kimberly A; Brody, Gene H

2015-04-01

Racial discrimination is a pervasive stressor that can undermine mental health among African American youth and young adults. Several studies identify links between racial discrimination and depressive symptoms; however, this research base does not focus on male African American youth who experience significant racism-related stress during the transition to young adulthood. Moreover, few prospective studies consider significant confounding variables that affect exposure to and perception of discriminatory treatment. In response to this need, we examined the effect of exposure to racial discrimination from ages 16 to 18 on depressive symptoms among male African Americans at age 20. Racial self-concept, one's sense of positivity about one's race, was examined as a mediator and self-control as a moderator. Hypotheses were tested with 222 participants, age 16 at baseline and age 20 at the endpoint. Participants provided self-report data at five time points. Exposure to racial discrimination from ages 16 to 18 predicted depressive symptoms at age 20, net of confounding influences. Racial self-concept mediated this effect. Self-control moderated the influence of discrimination on racial self-concept. This study underscores the salience of racial discrimination in the development of depressive symptoms among African American male youth and the clinical utility of interventions targeting racial pride and self-control.

Safe driving and executive functions in healthy middle-aged drivers.

PubMed

León-Domínguez, Umberto; Solís-Marcos, Ignacio; Barrio-Álvarez, Elena; Barroso Y Martín, Juan Manuel; León-Carrión, José

2017-01-01

The introduction of the point system driver's license in several European countries could offer a valid framework for evaluating driving skills. This is the first study to use this framework to assess the functional integrity of executive functions in middle-aged drivers with full points, partial points or no points on their driver's license (N = 270). The purpose of this study is to find differences in executive functions that could be determinants in safe driving. Cognitive tests were used to assess attention processes, processing speed, planning, cognitive flexibility, and inhibitory control. Analyses for covariance (ANCOVAS) were used for group comparisons while adjusting for education level. The Bonferroni method was used for correcting for multiple comparisons. Overall, drivers with the full points on their license showed better scores than the other two groups. In particular, significant differences were found in reaction times on Simple and Conditioned Attention tasks (both p-values < 0.001) and in number of type-III errors on the Tower of Hanoi task (p = 0.026). Differences in reaction time on attention tasks could serve as neuropsychological markers for safe driving. Further analysis should be conducted in order to determine the behavioral impact of impaired executive functioning on driving ability.

A 12-year anthropometric evaluation of the nose in bilateral cleft lip-cleft palate patients following nasoalveolar molding and cutting bilateral cleft lip and nose reconstruction.

PubMed

Garfinkle, Judah S; King, Timothy W; Grayson, Barry H; Brecht, Lawrence E; Cutting, Court B

2011-04-01

Patients with bilateral cleft lip-cleft palate have nasal deformities including reduced nasal tip projection, widened ala base, and a deficient or absent columella. The authors compare the nasal morphology of patients treated with presurgical nasoalveolar molding followed by primary lip/nasal reconstruction with age-matched noncleft controls. A longitudinal, retrospective review of 77 nonsyndromic patients with bilateral cleft lip-cleft palate was performed. Nasal tip protrusion, alar base width, alar width, columella length, and columella width were measured at five time points spanning 12.5 years. A one-sample t test was used for statistical comparison to an age-matched noncleft population published by Farkas. All five measurements demonstrated parallel, proportional growth in the treatment group relative to the noncleft group. The nasal tip protrusion, alar base width, alar width, columella length, and columella width were not statistically different from those of the noncleft, age-matched control group at age 12.5 years. The nasal tip protrusion also showed no difference in length at 7 and 12.5 years. The alar width and alar base width were significantly wider at the first four time points. This is the first study to describe nasal morphology following nasoalveolar molding and primary surgical repair in patients with bilateral cleft lip-cleft palate through the age of 12.5 years. In this investigation, the authors have shown that patients with bilateral cleft lip-cleft palate treated at their institution with nasoalveolar molding and primary nasal reconstruction, performed at the time of their lip repair, attained nearly normal nasal morphology through 12.5 years of age.

Age and mortality after injury: is the association linear?

PubMed

Friese, R S; Wynne, J; Joseph, B; Hashmi, A; Diven, C; Pandit, V; O'Keeffe, T; Zangbar, B; Kulvatunyou, N; Rhee, P

2014-10-01

Multiple studies have demonstrated a linear association between advancing age and mortality after injury. An inflection point, or an age at which outcomes begin to differ, has not been previously described. We hypothesized that the relationship between age and mortality after injury is non-linear and an inflection point exists. We performed a retrospective cohort analysis at our urban level I center from 2007 through 2009. All patients aged 65 years and older with the admission diagnosis of injury were included. Non-parametric logistic regression was used to identify the functional form between mortality and age. Multivariate logistic regression was utilized to explore the association between age and mortality. Age 65 years was used as the reference. Significance was defined as p < 0.05. A total of 1,107 patients were included in the analysis. One-third required intensive care unit (ICU) admission and 48 % had traumatic brain injury. 229 patients (20.6 %) were 84 years of age or older. The overall mortality was 7.2 %. Our model indicates that mortality is a quadratic function of age. After controlling for confounders, age is associated with mortality with a regression coefficient of 1.08 for the linear term (p = 0.02) and a regression coefficient of -0.006 for the quadratic term (p = 0.03). The model identified 84.4 years of age as the inflection point at which mortality rates begin to decline. The risk of death after injury varies linearly with age until 84 years. After 84 years of age, the mortality rates decline. These findings may reflect the varying severity of comorbidities and differences in baseline functional status in elderly trauma patients. Specifically, a proportion of our injured patient population less than 84 years old may be more frail, contributing to increased mortality after trauma, whereas a larger proportion of our injured patients over 84 years old, by virtue of reaching this advanced age, may, in fact, be less frail, contributing to less risk of death.

An Examination of Incentive Strategies to Increase Participation in Outcomes Research for an Adolescent Inpatient Unit.

PubMed

Ha, Carolyn; Madan, Alok; Long, Tessa A; Sharp, Carla

2016-05-01

Tracking adolescent outcomes after inpatient hospitalization is important in informing clinical care for this age group, as inpatient care is one of the most expensive treatment modalities. This study examined 4 incentive strategies used to maintain adolescent participation in follow-up research (at 6, 12, and 18 mo) after their discharge from the hospital (N=267). A generalized estimation equation approach was taken to investigate whether different incentive strategies predicted adolescent completion of the follow-up assessments at each time point. Findings demonstrate that implementation of social worker contact significantly differed from other incentive strategies in increasing adolescent completion of follow-up assessments (Z=2.51, P=0.012) over the 3 time points, even when controlling for age and sex. Although these findings ultimately need to be confirmed through a randomized controlled study of incentive strategies, they provide preliminary support for the notion that relational incentives, such as maintaining contact with a member of the clinical team at the hospital, may be particularly important in promoting adolescent participation in outcomes research.

Increasing Childhood Influenza Vaccination

PubMed Central

Nowalk, Mary Patricia; Lin, Chyongchiou J.; Hannibal, Kristin; Reis, Evelyn C.; Gallik, Gregory; Moehling, Krissy K.; Huang, Hsin-Hui; Allred, Norma J.; Wolfson, David H.; Zimmerman, Richard K.

2014-01-01

Background Since the 2008 inception of universal childhood influenza vaccination, national rates have risen more dramatically among younger children than older children and reported rates across racial/ethnic groups are inconsistent. Interventions may be needed to address age and racial disparities to achieve the recommended childhood influenza vaccination target of 70%. Purpose To evaluate an intervention to increase childhood influenza vaccination across age and racial groups. Methods In 2011–2012, 20 primary care practices treating children were randomly assigned to Intervention and Control arms of a cluster randomized controlled trial to increase childhood influenza vaccination uptake using a toolkit and other strategies including early delivery of donated vaccine, in-service staff meetings, and publicity. Results The average vaccination differences from pre-intervention to the intervention year were significantly larger in the Intervention arm (n=10 practices) than the Control arm (n=10 practices), for children aged 2–8 years (10.2 percentage points (pct pts) Intervention vs 3.6 pct pts Control) and 9–18 years (11.1 pct pts Intervention vs 4.3 pct pts Control, p<0.05), for non-white children (16.7 pct pts Intervention vs 4.6 pct pts Control, p<0.001), and overall (9.9 pct pts Intervention vs 4.2 pct pts Control, p<0.01). In multi-level modeling that accounted for person- and practice-level variables and the interactions among age, race and intervention, the likelihood of vaccination increased with younger age group (6–23 months), white race, commercial insurance, the practice’s pre-intervention vaccination rate, and being in the Intervention arm. Estimates of the interaction terms indicated that the intervention increased the likelihood of vaccination for non-white children in all age groups and white children aged 9–18 years. Conclusions A multi-strategy intervention that includes a practice improvement toolkit can significantly improve influenza vaccination uptake across age and racial groups without targeting specific groups, especially in practices with large percentages of minority children. PMID:25113138

[Validation of a Spanish version of the Childhood Asthma Control Test (Sc-ACT) for use in Spain].

PubMed

Pérez-Yarza, E G; Castro-Rodriguez, J A; Villa Asensi, J R; Garde Garde, J; Hidalgo Bermejo, F J

2015-08-01

The Childhood Asthma Control Test (c-ACT) is a validated tool for determining pediatric asthma control. However, it is not validated in the Spanish language in Spain. We evaluated the psychometric properties of the Spanish version of the Childhood Asthma Control Test (Sc-ACT) for assessing asthma control in children ages 4 to11. This national, multicentre, prospective study was conducted in Spain with asthmatic children and their caregivers. Patients were assessed at 3 visits (Baseline, 2 Weeks, and 4 Months). Clinical variables included: symptoms, exacerbations, FEV1, asthma classification, PAQLQ and PACQLQ questionnaire scores, and asthma control as perceived by physicians, patients and caregivers. The Sc-ACT feasibility, validity, reliability, and sensitivity to change were assessed. A total of 394 children were included; mean (SD) time to complete the Sc-ACT was 5.3 (4.4) minutes. Sc-ACT score was correlated with asthma control as perceived by physician (-0.52), patient (-0.53), and caregiver (-0.51) and with the PAQLQ (0.56) and PACQLQ (0.55) scores. Sc-ACT was found to be significantly related to intensity and frequency of asthma symptoms. Cronbach alpha coefficient α was 0.81 and intraclass correlation coefficient was ≥0.85 for all of the items. The global effect size of Sc-ACT was 0.55. The cutoff point scores of 21 or higher indicated a good asthma control and their MCID was 4 points. The Spanish version of the c-ACT was found to be a reliable and valid questionnaire for evaluating asthma control in Spanish-speaking children ages 4 to 11 in Spain. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Free radicals and antioxidants in primary fibromyalgia: an oxidative stress disorder?

PubMed

Bagis, Selda; Tamer, Lulufer; Sahin, Gunsah; Bilgin, Ramazan; Guler, Hayal; Ercan, Bahadir; Erdogan, Canan

2005-04-01

The role of free radicals in fibromyalgia is controversial. In this study, 85 female patients with primary fibromyalgia and 80 age-, height-, and weight-matched healthy women were evaluated for oxidant/antioxidant balance. Malondialdehyde is a toxic metabolite of lipid peroxidation used as a marker of free radical damage. Superoxide dismutase is an intracellular antioxidant enzyme and shows antioxidant capacity. Pain was assessed by visual analog scale. Tender points were assessed by palpation. Age, smoking, body mass index (BMI), and duration of disease were also recorded. Malondialdehyde levels were significantly higher and superoxide dismutase levels significantly lower in fibromyalgic patients than controls. Age, BMI, smoking, and duration of disease did not affect these parameters. We found no correlation between pain and number of tender points. In conclusion, oxidant/antioxidant balances were changed in fibromyalgia. Increased free radical levels may be responsible for the development of fibromyalgia. These findings may support the hypothesis of fibromyalgia as an oxidative disorder.

Accuracy of body mass index for age to diagnose obesity in Mexican schoolchildren.

PubMed

Mendoza Pablo, Pedro A; Valdés, Jesús; Ortiz-Hernández, Luis

2015-06-01

To compare the accuracy of three BMI-forage references (World Health Organization reference, WHO; the updated International Obesity Task Force reference, IOTF; and Centers for Disease Control and Prevention (CDC) growth charts) to diagnose obesity in Mexican children. A convenience sample of Mexican schoolchildren (n = 218) was assessed. The gold standard was the percentage of body fat estimated by deuterium dilution technique. Sensitivity and specificity of the classical cutoff point of BMI-for-age to identify obesity (i.e. > 2.00 standard deviation, SD) were estimated. The accuracy (i.e. area under the curve, AUC) of three BMI-for-age references for the diagnosis of obesity was estimated with the receiver operating characteristic (ROC) curves method. The optimal cutoff point (OCP) was determined. The cutoff points to identify obesity had low (WHO reference: 57.6%, CDC: 53.5%) to very low (IOTF reference: 40.4%) sensitivities, but adequate specificities (91.6%, 95.0%, and, 97.5%, respectively). The AUC of the three references were adequate (0.89). For the IOTF reference, the AUC was lower among the older children. The OCP for the CDC reference (1.24 SD) was lower than the OCP for WHO (1.53 SD) and IOTF charts (1.47 SD). The classical cutoff point for obesity has low sensitivity--especially for the IOTF reference. The accuracy of the three references was similar. However, to obtain comparable diagnosis of obesity different cutoff points should be used depending of the reference. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Long-term hematopoietic stem cell damage in a murine model of the hematopoietic syndrome of the acute radiation syndrome.

PubMed

Chua, Hui Lin; Plett, P Artur; Sampson, Carol H; Joshi, Mandar; Tabbey, Rebeka; Katz, Barry P; MacVittie, Thomas J; Orschell, Christie M

2012-10-01

Residual bone marrow damage (RBMD) persists for years following exposure to radiation and is believed to be due to decreased self-renewal potential of radiation-damaged hematopoietic stem cells (HSC). Current literature has examined primarily sublethal doses of radiation and time points within a few months of exposure. In this study, the authors examined RBMD in mice surviving lethal doses of total body ionizing irradiation (TBI) in a murine model of the Hematopoietic Syndrome of the Acute Radiation Syndrome (H-ARS). Survivors were analyzed at various time points up to 19 mo post-TBI for hematopoietic function. The competitive bone marrow (BM) repopulating potential of 150 purified c-Kit+ Sca-1+ lineage- CD150+ cells (KSLCD150+) remained severely deficient throughout the study compared to KSLCD150+ cells from non-TBI age-matched controls. The minimal engraftment from these TBI HSCs is predominantly myeloid, with minimal production of lymphocytes both in vitro and in vivo. All classes of blood cells as well as BM cellularity were significantly decreased in TBI mice, especially at later time points as mice aged. Primitive BM hematopoietic cells (KSLCD150+) displayed significantly increased cell cycling in TBI mice at all time points, which may be a physiological attempt to maintain HSC numbers in the post-irradiation state. Taken together, these data suggest that the increased cycling among primitive hematopoietic cells in survivors of lethal radiation may contribute to long-term HSC exhaustion and subsequent RBMD, exacerbated by the added insult of aging at later time points.

Individually Tailored Dietary Counseling among Old Home Care Clients - Effects on Nutritional Status.

PubMed

Pölönen, S; Tiihonen, M; Hartikainen, S; Nykänen, I

2017-01-01

To evaluate the effect of individually tailored dietary counseling on nutritional status among home care clients aged 75 years or older. Non-randomised controlled study. The study sample consisted of 224 home care clients (≥ 75 years) (intervention group, n = 127; control group, n = 100) who were at protein-energy malnutrition (PEM) or risk of PEM (MNA score <24 and plasma albumin <35 g/L). Individually tailored dietary counseling; the persons were instructed to increase their food intake with energy-dense food items, the number of meals they ate and their consumption of energy-, protein- and nutrient-rich snacks for six months. The Mini Nutritional Assessment (MNA), Body Mass Index (BMI) and plasma albumin were used to determine nutritional status at the baseline and after the six-month intervention. The mean age of the home care clients was 84.3 (SD 5.5) in the intervention group and 84.4 (SD 5.3) in the control group, and 70 percent were women in both groups. After the six-month nutritional intervention, the MNA score increased 2.3 points and plasma albumin 1.6 g/L in the intervention group, against MNA score decreased -0.2 points and plasma albumin -0.1 g/L in the control group. Individually tailored dietary counseling may improve nutritional status among older home care clients.

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

PubMed Central

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

2016-01-01

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

Return to Sport and Performance After Microfracture in the Knees of National Basketball Association Players

PubMed Central

Harris, Joshua D.; Walton, David M.; Erickson, Brandon J.; Verma, Nikhil N.; Abrams, Geoffrey D.; Bush-Joseph, Charles A.; Bach, Bernard R.; Cole, Brian J.

2013-01-01

Background: Use of microfracture in the knees of National Basketball Association (NBA) players is controversial. Hypotheses: (1) There would be a high rate of return to sport (RTS) in NBA players following microfracture, (2) players would RTS the season following surgery, (3) preoperative player performance would not be significantly different on RTS, and (4) there would be no significant difference in RTS rate or postoperative performance in players undergoing microfracture in comparison with an age-, position-, NBA experience–, and performance-matched control group. Study Design: Cohort study; Level of evidence, 3. Methods: NBA players undergoing microfracture were evaluated. Age-, body mass index–, position-, NBA experience–, and performance-matched controls were selected from the NBA during the same years as those undergoing microfracture. An index year was selected (controls) to match the number of seasons of NBA experience in microfracture cases. RTS and performance were analyzed and compared between cases and controls. Student t tests were performed for analysis of within- and between-group variables. Results: A total of 41 NBA players underwent microfracture and were compared with 41 demographic- and performance-matched controls. Rate of RTS after microfracture was 73% in the NBA and 83% in professional basketball (NBA, D-league, and International Basketball Federation [FIBA]). Time to RTS in NBA was 9.20 ± 4.88 months. Seventy-one percent (29/41) of players RTS the season following microfracture. Length of NBA career following microfracture (4.10 ± 3.91 years) was not significantly different from controls. After microfracture, case athletes played fewer games per season and with fewer points and steals per game (relative to premicrofracture; P < .05). Performance was better in control (after index year) versus case players (after microfracture) with regard to points per game, games played per season, and field goal and free throw percentage (P < .05). Conclusion: Eighty-three percent of NBA players undergoing microfracture returned to professional basketball. Career length was not significantly different between players undergoing microfracture and controls. However, following microfracture, players competed in fewer games per season with fewer points and steals. PMID:26535256

Return to Sport and Performance After Microfracture in the Knees of National Basketball Association Players.

PubMed

Harris, Joshua D; Walton, David M; Erickson, Brandon J; Verma, Nikhil N; Abrams, Geoffrey D; Bush-Joseph, Charles A; Bach, Bernard R; Cole, Brian J

2013-11-01

Use of microfracture in the knees of National Basketball Association (NBA) players is controversial. (1) There would be a high rate of return to sport (RTS) in NBA players following microfracture, (2) players would RTS the season following surgery, (3) preoperative player performance would not be significantly different on RTS, and (4) there would be no significant difference in RTS rate or postoperative performance in players undergoing microfracture in comparison with an age-, position-, NBA experience-, and performance-matched control group. Cohort study; Level of evidence, 3. NBA players undergoing microfracture were evaluated. Age-, body mass index-, position-, NBA experience-, and performance-matched controls were selected from the NBA during the same years as those undergoing microfracture. An index year was selected (controls) to match the number of seasons of NBA experience in microfracture cases. RTS and performance were analyzed and compared between cases and controls. Student t tests were performed for analysis of within- and between-group variables. A total of 41 NBA players underwent microfracture and were compared with 41 demographic- and performance-matched controls. Rate of RTS after microfracture was 73% in the NBA and 83% in professional basketball (NBA, D-league, and International Basketball Federation [FIBA]). Time to RTS in NBA was 9.20 ± 4.88 months. Seventy-one percent (29/41) of players RTS the season following microfracture. Length of NBA career following microfracture (4.10 ± 3.91 years) was not significantly different from controls. After microfracture, case athletes played fewer games per season and with fewer points and steals per game (relative to premicrofracture; P < .05). Performance was better in control (after index year) versus case players (after microfracture) with regard to points per game, games played per season, and field goal and free throw percentage (P < .05). Eighty-three percent of NBA players undergoing microfracture returned to professional basketball. Career length was not significantly different between players undergoing microfracture and controls. However, following microfracture, players competed in fewer games per season with fewer points and steals.

Randomized trial of the effect of zinc supplementation on the mental health of school-age children in Guatemala123

PubMed Central

DiGirolamo, Ann M; Ramirez-Zea, Manuel; Wang, Meng; Flores-Ayala, Rafael; Martorell, Reynaldo; Neufeld, Lynnette M; Ramakrishnan, Usha; Sellen, Daniel; Black, Maureen M; Stein, Aryeh D

2010-01-01

Background: Rates of mental illness in children are increasing throughout the world. Observational studies of depression, anxiety, and attention-deficit hyperactivity disorder suggest that zinc is an alternative treatment. Objective: We examined the effect of zinc supplementation on the mental health of school-age children in Guatemala. Design: From January to October 2006, we conducted a 6-mo randomized, double-blind, controlled trial comparing zinc supplementation (10 mg ZnO/d for 5 d/wk) with a placebo (10 mg glucose) in 674 Guatemalan children in grades 1–4. Outcome measures included internalizing (ie, depression and anxiety) and externalizing (ie, hyperactivity and conduct disorder) problem behaviors, positive behaviors (ie, socialization and leadership), and serum zinc concentrations. Results: Zinc and placebo groups did not differ significantly in any behavioral measures at baseline or at follow-up. At baseline, 21.4% of children had serum zinc concentrations <65 μg/dL. At follow-up, both groups improved significantly, and zinc concentrations were higher in the zinc group. Increases in serum zinc concentrations were inversely associated with decreases in depressive symptoms (estimate: −0.01 points per μg Zn/dL; P = 0.01), anxiety (estimate: −0.012 points per μg Zn/dL; P = 0.02), internalizing symptoms (estimate: −0.021 points per μg Zn/dL; P = 0.02), and social skills (estimate: −0.019 points per μg Zn/dL; P = 0.01) in adjusted models that were controlled for child age, sex, socioeconomic status, household, and treatment group. Conclusions: Six months of zinc supplementation did not induce differences in mental health outcomes between zinc and placebo groups. However, increases in serum zinc concentrations were associated with decreases in internalizing symptoms (ie, depression and anxiety) in a community-based sample of children at risk of zinc deficiency. This trial was registered at clinicaltrials.gov as NCT00283660. PMID:20881069

Self-efficacy, action control, and social support explain physical activity changes among Costa Rican older adults.

PubMed

Reyes Fernández, Benjamin; Montenegro Montenegro, Esteban; Knoll, Nina; Schwarzer, Ralf

2014-11-01

Self-efficacy, action control, and social support are considered to influence changes in physical activity levels in older adults. This study examines the relationship among these variables and explores the putative mediating and moderating mechanisms that might account for activity changes. A longitudinal study with 54 older adults (≥ 50 years of age) was carried out in Costa Rica. In a moderated mediation analysis, action control was specified as a mediator between self-efficacy and physical activity, whereas social support was specified as a moderator between self-efficacy and action control. Baseline physical activity, age, and sex were specified as covariates. Action control mediated between self-efficacy and physical activity. An interaction between social support and self-efficacy on action control pointed to a synergistic effect at the first stage of the mediating process. The effect of self-efficacy on physical activity was partly explained by action control, providing evidence of action control as a proximal mediator of physical activity. Moreover, the moderator role of social support was confirmed: high social support appeared to compensate for low levels of self-efficacy.

Site-Dependent Reference Point Microindentation Complements Clinical Measures for Improved Fracture Risk Assessment at the Human Femoral Neck.

PubMed

Jenkins, Thomas; Coutts, Louise V; D'Angelo, Stefania; Dunlop, Douglas G; Oreffo, Richard O C; Cooper, Cyrus; Harvey, Nicholas C; Thurner, Phillipp J

2016-01-01

In contrast to traditional approaches to fracture risk assessment using clinical risk factors and bone mineral density (BMD), a new technique, reference point microindentation (RPI), permits direct assessment of bone quality; in vivo tibial RPI measurements appear to discriminate patients with a fragility fracture from controls. However, it is unclear how this relates to the site of the most clinically devastating fracture, the femoral neck, and whether RPI provides information complementary to that from existing assessments. Femoral neck samples were collected at surgery after low-trauma hip fracture (n = 46; 17 male; aged 83 [interquartile range 77-87] years) and compared, using RPI (Biodent Hfc), with 16 cadaveric control samples, free from bone disease (7 male; aged 65 [IQR 61-74] years). A subset of fracture patients returned for dual-energy X-ray absorptiometry (DXA) assessment (Hologic Discovery) and, for the controls, a micro-computed tomography setup (HMX, Nikon) was used to replicate DXA scans. The indentation depth was greater in femoral neck samples from osteoporotic fracture patients than controls (p < 0.001), which persisted with adjustment for age, sex, body mass index (BMI), and height (p < 0.001) but was site-dependent, being less pronounced in the inferomedial region. RPI demonstrated good discrimination between fracture and controls using receiver-operating characteristic (ROC) analyses (area under the curve [AUC] = 0.79 to 0.89), and a model combining RPI to clinical risk factors or BMD performed better than the individual components (AUC = 0.88 to 0.99). In conclusion, RPI at the femoral neck discriminated fracture cases from controls independent of BMD and traditional risk factors but dependent on location. The clinical RPI device may, therefore, supplement risk assessment and requires testing in prospective cohorts and comparison between the clinically accessible tibia and the femoral neck. © 2015 American Society for Bone and Mineral Research. © 2015 American Society for Bone and Mineral Research.

Measurement characteristics of the childhood Asthma-Control Test and a shortened, child-only version

PubMed Central

Bime, Christian; Gerald, Joe K; Wei, Christine Y; Holbrook, Janet T; Teague, William G; Wise, Robert A; Gerald, Lynn B

2016-01-01

The childhood Asthma-Control Test (C-ACT) is validated for assessing asthma control in paediatric asthma. Among children aged 4–11 years, the C-ACT requires the simultaneous presence of both parent and child. There is an unmet need for a tool that can be used to assess asthma control in children when parents or caregivers are not present such as in the school setting. We assessed the psychometric properties and estimated the minimally important difference (MID) of the C-ACT and a modified version, comprising only the child responses (C-ACTc). Asthma patients aged 6–11 years (n=161) from a previously completed multicenter randomised trial were included. Demographic information, spirometry and questionnaire scores were obtained at baseline and during follow-up. Participants or their guardians kept a daily asthma diary. Internal consistency reliabilities of the C-ACT and C-ACTc were 0.76 and 0.67 (Cronbach’s α), respectively. Test–retest reliabilities of the C-ACT and C-ACTc were 0.72 and 0.66 (intra-class correlation), respectively. Significant correlations were noted between C-ACT scores and ACQ scores (Spearman’s correlation r=−0.56, 95% CI (−0.66, −0.44), P<0.001). The strength of the correlation between C-ACTc scores and ACQ scores was weaker (Spearman’s correlation r=−0.46, 95% CI (−0.58, −0.33), P<0.001). We estimated the MID for the C-ACT and C-ACTc to be 2 points and 1 point, respectively. Among asthma patients aged 6–11 years, the C-ACT had good psychometric properties. The psychometric properties of a shortened child-only version (C-ACTc), although acceptable, are not as strong. PMID:27763622

Presymptomatic Diagnosis of Celiac Disease in Predisposed Children: The Role of Gene Expression Profile.

PubMed

Galatola, Martina; Cielo, Donatella; Panico, Camilla; Stellato, Pio; Malamisura, Basilio; Carbone, Lorenzo; Gianfrani, Carmen; Troncone, Riccardo; Greco, Luigi; Auricchio, Renata

2017-09-01

The prevalence of celiac disease (CD) has increased significantly in recent years, and risk prediction and early diagnosis have become imperative especially in at-risk families. In a previous study, we identified individuals with CD based on the expression profile of a set of candidate genes in peripheral blood monocytes. Here we evaluated the expression of a panel of CD candidate genes in peripheral blood mononuclear cells from at-risk infants long time before any symptom or production of antibodies. We analyzed the gene expression of a set of 9 candidate genes, associated with CD, in 22 human leukocyte antigen predisposed children from at-risk families for CD, studied from birth to 6 years of age. Nine of them developed CD (patients) and 13 did not (controls). We analyzed gene expression at 3 different time points (age matched in the 2 groups): 4-19 months before diagnosis, at the time of CD diagnosis, and after at least 1 year of a gluten-free diet. At similar age points, controls were also evaluated. Three genes (KIAA, TAGAP [T-cell Activation GTPase Activating Protein], and SH2B3 [SH2B Adaptor Protein 3]) were overexpressed in patients, compared with controls, at least 9 months before CD diagnosis. At a stepwise discriminant analysis, 4 genes (RGS1 [Regulator of G-protein signaling 1], TAGAP, TNFSF14 [Tumor Necrosis Factor (Ligand) Superfamily member 14], and SH2B3) differentiate patients from controls before serum antibodies production and clinical symptoms. Multivariate equation correctly classified CD from non-CD children in 95.5% of patients. The expression of a small set of candidate genes in peripheral blood mononuclear cells can predict CD at least 9 months before the appearance of any clinical and serological signs of the disease.

Transcoronary infusion of cardiac progenitor cells in hypoplastic left heart syndrome: Three-year follow-up of the Transcoronary Infusion of Cardiac Progenitor Cells in Patients With Single-Ventricle Physiology (TICAP) trial.

PubMed

Tarui, Suguru; Ishigami, Shuta; Ousaka, Daiki; Kasahara, Shingo; Ohtsuki, Shinichi; Sano, Shunji; Oh, Hidemasa

2015-11-01

Our aim was to assess midterm safety and clinical outcomes of intracoronary infusion of cardiosphere-derived cells (CDCs) after staged palliation in patients with hypoplastic left heart syndrome (HLHS). In this prospective, controlled study, 14 consecutive patients with HLHS who were undergoing 2- or 3-stage surgical palliations were assigned to receive intracoronary CDC infusion 1 month after cardiac surgery (n = 7), followed by 7 patients allocated to a control group with standard care alone. The primary end point was to assess procedural feasibility and safety; the secondary end point was to evaluate cardiac function and heart failure status through 36-month follow-up. No complications, including tumor formation, were reported within 36 months after CDC infusion. Echocardiography showed significantly greater improvement in right ventricular ejection fraction (RVEF) in infants receiving CDCs than in controls at 36 months (+8.0% ± 4.7% vs +2.2% ± 4.3%; P = .03). These cardiac function improvements resulted in reduced brain natriuretic peptide levels (P = .04), lower incidence of unplanned catheter interventions (P = .04), and higher weight-for-age z score (P = .02) at 36 months relative to controls. As independent predictors of treatment responsiveness, absolute changes in RVEF at 36 months were negatively correlated with age, weight-for-age z score, and RVEF at CDC infusion. Intracoronary CDC infusion after staged procedure in patients with HLHS is safe and improves RVEF, which persists during 36-month follow-up. This therapeutic strategy may enhance somatic growth and reduce incidence of heart failure. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Periods of Child Growth up to age 8 Years in Ethiopia, India, Peru and Vietnam: Key Distal Household and Community Factors

PubMed Central

Schott, Whitney B.; Crookston, Benjamin T.; Lundeen, Elizabeth A.; Stein, Aryeh D.; Behrman, Jere R.

2013-01-01

Recent research has demonstrated some growth recovery among children stunted in infancy. Less is known about key age ranges for such growth recovery, and what factors are correlates with this growth. This study characterized child growth up to age 1 year, and from ages 1 to 5 and 5 to 8 years controlling for initial height-for-age z-score (HAZ), and identified key distal household and community factors associated with these growth measures using longitudinal data on 7,266 children in the Young Lives (YL) study in Ethiopia, India, Peru and Vietnam. HAZ at about age 1 year and age in months predicted much of the variation in HAZ at age 5 years, but 40 to 71% was not predicted. Similarly, HAZ at age 5 years and age in months did not predict 26 to 47% of variation in HAZ at 8 years. Multiple regression analysis suggests that parental schooling, consumption, and mothers’ height are key correlates of HAZ at about age 1 and also are associated with unpredicted change in HAZ from ages 1 to 5 and 5 to 8 years, given initial HAZ. These results underline the importance of a child’s starting point in infancy in determining his or her growth, point to key distal household and community factors that may determine early growth in early life and subsequent growth recovery and growth failure, and indicate that these factors vary some by country, urban/rural designation, and child sex. PMID:23769211

Periods of child growth up to age 8 years in Ethiopia, India, Peru and Vietnam: key distal household and community factors.

PubMed

Schott, Whitney B; Crookston, Benjamin T; Lundeen, Elizabeth A; Stein, Aryeh D; Behrman, Jere R

2013-11-01

Recent research has demonstrated some growth recovery among children stunted in infancy. Less is known about key age ranges for such growth recovery, and what factors are correlates with this growth. This study characterized child growth up to age 1 year, and from ages 1 to 5 and 5 to 8 years controlling for initial height-for-age z-score (HAZ), and identified key distal household and community factors associated with these growth measures using longitudinal data on 7266 children in the Young Lives (YL) study in Ethiopia, India, Peru and Vietnam. HAZ at about age 1 year and age in months predicted much of the variation in HAZ at age 5 years, but 40-71% was not predicted. Similarly, HAZ at age 5 years and age in months did not predict 26-47% of variation in HAZ at 8 years. Multiple regression analysis suggests that parental schooling, consumption, and mothers' height are key correlates of HAZ at about age 1 and also are associated with unpredicted change in HAZ from ages 1 to 5 and 5 to 8 years, given initial HAZ. These results underline the importance of a child's starting point in infancy in determining his or her growth, point to key distal household and community factors that may determine early growth in early life and subsequent growth recovery and growth failure, and indicate that these factors vary some by country, urban/rural designation, and child sex. Copyright © 2013 Elsevier Ltd. All rights reserved.

Age-related T2 changes in hindlimb muscles of mdx mice.

PubMed

Vohra, Ravneet S; Mathur, Sunita; Bryant, Nathan D; Forbes, Sean C; Vandenborne, Krista; Walter, Glenn A

2016-01-01

Magnetic resonance imaging (MRI) was used to monitor changes in the transverse relaxation time constant (T2) in lower hindlimb muscles of mdx mice at different ages. Young (5 weeks), adult (44 weeks), and old mdx (96 weeks), and age-matched control mice were studied. Young mdx mice were imaged longitudinally, whereas adult and old mdx mice were imaged at a single time-point. Mean muscle T2 and percent of pixels with elevated T2 were significantly different between mdx and control mice at all ages. In young mdx mice, mean muscle T2 peaked at 7-8 weeks and declined at 9-11 weeks. In old mdx mice, mean muscle T2 was decreased compared with young and adult mice, which could be attributed to fibrosis. MRI captured longitudinal changes in skeletal muscle integrity of mdx mice. This information will be valuable for pre-clinical testing of potential therapeutic interventions for muscular dystrophy. © 2015 Wiley Periodicals, Inc.

Cross Talk of Proteostasis and Mitostasis in Cellular Homeodynamics, Ageing, and Disease

PubMed Central

Gumeni, Sentiljana; Trougakos, Ioannis P.

2016-01-01

Mitochondria are highly dynamic organelles that provide essential metabolic functions and represent the major bioenergetic hub of eukaryotic cell. Therefore, maintenance of mitochondria activity is necessary for the proper cellular function and survival. To this end, several mechanisms that act at different levels and time points have been developed to ensure mitochondria quality control. An interconnected highly integrated system of mitochondrial and cytosolic chaperones and proteases along with the fission/fusion machinery represents the surveillance scaffold of mitostasis. Moreover, nonreversible mitochondrial damage targets the organelle to a specific autophagic removal, namely, mitophagy. Beyond the organelle dynamics, the constant interaction with the ubiquitin-proteasome-system (UPS) has become an emerging aspect of healthy mitochondria. Dysfunction of mitochondria and UPS increases with age and correlates with many age-related diseases including cancer and neurodegeneration. In this review, we discuss the functional cross talk of proteostasis and mitostasis in cellular homeodynamics and the impairment of mitochondrial quality control during ageing, cancer, and neurodegeneration. PMID:26977249

A Prospective Study on Cardiovascular Dysfunction in Patients with Hyperthyroidism and Its Reversal After Surgical Cure.

PubMed

Muthukumar, Sankaran; Sadacharan, Dhalapathy; Ravikumar, Krishnan; Mohanapriya, Gajarajan; Hussain, Zahir; Suresh, R V

2016-03-01

Cardiovascular dysfunction (CVD) is a major cause of mortality and morbidity in hyperthyroidism. CVD and its reversibility after total thyroidectomy (TT) are not adequately addressed. This prospective case-control study evaluates the effect of hyperthyroidism on myocardium and its reversibility after TT. Surgical candidates of new onset hyperthyroidism, Group A (n = 41, age < 60 years) was evaluated with 2D Echocardiography, serum n-terminal probrain natriuretic peptide (NT-proBNP) at the time of diagnosis (Point A), after achieving euthyroidism (Point B) with antithyroid drugs, and 3 months after TT (Point C). 20 patients with nontoxic benign thyroid nodules undergoing TT served as controls (Group B). Both groups were age and sex matched. Group A (n = 41) comprises Graves disease (n = 22) and Toxic Multinodular goiter (n = 19). At point A, CVD was evident in 26/41(63.4%), pulmonary hypertension (PHT) in 24/41(58.5%)--mild in 17/41(41.4%) and moderate in 7/41(17%)--dilated cardiomyopathy (DCM) in 8/41(19.5%), heart failure in 4/41(9.7%), and NT-proBNP elevated in 28/41(68.3%). At point B, recovery was observed in PHT 19/26(73.1%), DCM 4/8(50%), heart failure 4/4(100%), NT-proBNP in 3/28(10.7%). At Point C, further improvement occurred in PHT 23/24(95.8%), DCM 7/8(87.5%), heart failure 4/4(100%), and NT-proBNP in 24/28(85.7%). Pulmonary hypertension is completely reversible at 3 months after TT and is the most common cardiac event in Hyperthyroidism. Various parameters of CVD improved consistently after surgical cure. NT-proBNP levels correlated well with the severity and duration of CVD and hence can be an objective tool in monitoring of hyperthyroid cardiac dysfunction.

Aging-related renal injury and inflammation are associated with downregulation of Klotho and induction of RIG-I/NF-κB signaling pathway in senescence-accelerated mice.

PubMed

Zeng, Yi; Wang, Ping-Han; Zhang, Mao; Du, Jun-Rong

2016-02-01

The predominant distribution of the antiaging Klotho protein in both the kidneys and brain may point to its essential role in protecting against dysfunction of the kidney-brain axis during the aging process. Our previous study showed that the downregulation of Klotho was involved in aging-related cognitive impairment in aged senescence-accelerated mouse prone-8 (SAMP8) mice. The present study investigated the potential role of Klotho in aging-associated inflammation and renal injury. Age- and gender-matched groups of SAMP8 mice and their corresponding normal control senescence-accelerated mouse resistant-1 (SAMR1) were used to investigate the potential role of Klotho in aging-associated inflammation and renal injury. Compared with aged SAMR1 controls, early-stage chronic kidney disease (CKD), which is associated with an increase in the urinary albumin-to-creatinine ratio, inflammatory cell infiltration, glomerulosclerosis, and tubulointerstitial fibrosis, was observed in aged SAMP8 mice. Furthermore, the aging-related loss of Klotho-induced activation of the retinoic acid-inducible gene 1/nuclear factor-κB (RIG-I/NF-κB) signaling pathway and subsequent production of the proinflammatory mediators tumor necrosis factor α, interleukin-6, and inducible nitric oxide synthase in the kidneys of aged SAMP8 mice compared with SAMR1 controls. The present results suggest that aging-related inflammation and the development of early-stage CKD are likely associated with the downregulation of Klotho and induction of the RIG-I/NF-κB signaling pathway in 12-month-old SAMP8 mice. Moreover, aged SAMP8 mice with cognitive deficits and renal damage may be a potential mouse model for investigating the kidney-brain axis in the aging process.

Declining performance of master athletes: silhouettes of the trajectory of healthy human ageing?

PubMed

Lazarus, Norman R; Harridge, Stephen D R

2017-05-01

Analysis of world record performances by master athletes suggests an essentially linear decline with age until around the eighth decade after which performance decline accelerates. Because these records are obtained from highly trained individuals they can be viewed as being reflective of the diminution of integrative physiological prowess that occurs solely as a result of ageing, unaffected by the confounding effects of inactivity. It can also be argued that these performance profiles mirror and provide an insight into the trajectory of the physiology of the human ageing process. Here we propose a set point theory that hypothesises that a given threshold of physical activity is needed to age optimally and to maximise the 'healthspan'. Exercising at levels below the set point will result in ageing being contaminated by the unpredictable and pathological effects of inactivity. Exercise above this threshold stimulates adaptations towards maximising athletic performance, but is unlikely to have further beneficial effects on health. Thus the decades-long, controlled diminution in athletic performance, should not be seen as a disease process. The ageing process is separate from, and independent of, exercise-mediated processes that maintain or adapt physiological function. Whether an understanding of these mechanisms will also help uncover mechanisms underpinning the ageing process itself is open to question. However, any model which does not take into account the effects of activity will not adequately describe the inherent ageing process. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

[Brain Perfusion, Cognitive Functions, and Vascular Age in Middle Aged Patients With Essential Arterial Hypertension].

PubMed

Parfenov, V A; Ostroumova, T M; Pеrepelova, E M; Perepelov, V A; Kochetkov, A I; Ostroumova, O D

2018-05-01

This study aimed to assess the cognitive functions and cerebral blood flow measured with arterial spin labeling (ASL) and their possible correlations with vascular age in untreated middle-aged patients with grade 1-2 essential arterial hypertension (EAH). We examined 73 subjects aged 40-59 years (33 with EAH and 40 healthy volunteers [controls]). Neuropsychological assessment included Montreal Cognitive Assessment (MoCA), Trail Making test (part A and part B), Stroop Color and Word Test, verbal fluency test (phonemic verbal fluency and semantic verbal fluency), 10‑item word list learning task. All subjects underwent brain MRI. MRI protocol included ASL. Vascular age was calculated by two techniques - using Framingham Heart Study risk tables and SCORE project scales. Patients with EAH had lower performance on phonemic verbal fluency test and lower mean MoCA score (29.2±1.4 vs. 28.1±1.7 points) compared to controls (13.4±3.2, р=0.002; 29.2±1.4, p=0.001, respectively). White matter hyperintensities (WMH) were present in 7.5 % controls and in 51.5 % EAH patients (р=0.0002). Cerebral blood flow (CBF) in EAH patients was lower in both right (39.1±5.6 vs. 45.8±3.2 ml / 100 g / min) and left frontal lobes of the brain (39.2±6.2 и 45.2±3.6 ml / 100 g / min, respectively) compared to controls (р.

Cloud-based BP system integrated with CPOE improves self-management of the hypertensive patients: A randomized controlled trial.

PubMed

Lee, Peisan; Liu, Ju-Chi; Hsieh, Ming-Hsiung; Hao, Wen-Rui; Tseng, Yuan-Teng; Liu, Shuen-Hsin; Lin, Yung-Kuo; Sung, Li-Chin; Huang, Jen-Hung; Yang, Hung-Yu; Ye, Jong-Shiuan; Zheng, He-Shun; Hsu, Min-Huei; Syed-Abdul, Shabbir; Lu, Richard; Nguyen, Phung-Anh; Iqbal, Usman; Huang, Chih-Wei; Jian, Wen-Shan; Li, Yu-Chuan Jack

2016-08-01

Less than 50% of patients with hypertensive disease manage to maintain their blood pressure (BP) within normal levels. The aim of this study is to evaluate whether cloud BP system integrated with computerized physician order entry (CPOE) can improve BP management as compared with traditional care. A randomized controlled trial done on a random sample of 382 adults recruited from 786 patients who had been diagnosed with hypertension and receiving treatment for hypertension in two district hospitals in the north of Taiwan. Physicians had access to cloud BP data from CPOE. Neither patients nor physicians were blinded to group assignment. The study was conducted over a period of seven months. At baseline, the enrollees were 50% male with a mean (SD) age of 58.18 (10.83) years. The mean sitting BP of both arms was no different. The proportion of patients with BP control at two, four and six months was significantly greater in the intervention group than in the control group. The average capture rates of blood pressure in the intervention group were also significantly higher than the control group in all three check-points. Cloud-based BP system integrated with CPOE at the point of care achieved better BP control compared to traditional care. This system does not require any technical skills and is therefore suitable for every age group. The praise and assurance to the patients from the physicians after reviewing the Cloud BP records positively reinforced both BP measuring and medication adherence behaviors. Copyright © 2016. Published by Elsevier Ireland Ltd.

Perceived Social Support Change in Patients with Early-stage Breast Cancer and Controls

PubMed Central

Thompson, Tess; Rodebaugh, Thomas L.; Pérez, Maria; Schootman, Mario; Jeffe, Donna B.

2014-01-01

Objective To identify variables associated with levels of and change in social support in a cohort of early-stage breast cancer patients and age-matched controls. Methods Telephone interviews measuring perceived social support and other demographic and psychosocial variables were conducted at 4–6 weeks and 6, 12, and 24 months after surgery (patients) or a normal/benign screening mammogram (controls). A latent trajectory model was used to model the intercept (starting point) and slope (changing) aspects of social support. Results Participants included 542 controls and 541 patients (77% White, 23% African American; mean age 57.7 [SD = 10.6]). Most participants reported high social support. Patients reported significantly higher levels of social support at baseline than controls. For patients, social support had a significant negative slope that significantly varied between individuals; the intercept of social support also varied significantly. Predictors of lower social support intercept in patients included not being married/partnered, being White, having lower perceived general health, and having higher negative affect (modeled as a latent variable defined by anxiety and depression symptom severity). Patients who were African American (vs. White) or had mastectomy (vs. lumpectomy) had steeper social support declines, and participants with both these characteristics had lower starting points as well as steeper declines. Social support among controls did not change significantly. Conclusions Clinicians might consider psychosocial interventions for patients reporting low social support around the time of diagnosis and surgical treatment, and for patients at risk for steeper declines in support, such as African Americans and women undergoing mastectomy. PMID:23477582

Effects of In and Ni Addition on Microstructure of Sn-58Bi Solder Joint

NASA Astrophysics Data System (ADS)

Mokhtari, Omid; Nishikawa, Hiroshi

2014-11-01

In this study, the effect of adding 0.5 wt.% and 1 wt.% In and Ni to Sn-58Bi solder on intermetallic compound (IMC) layers at the interface and the microstructure of the solder alloys were investigated during reflow and thermal aging by scanning electron microscopy and electron probe micro-analysis. The results showed that the addition of minor elements was not effective in suppressing the IMC growth during the reflow; however, the addition of 0.5 wt.% In and Ni was effective in suppressing the IMC layer growth during thermal aging. The thickening kinetics of the total IMC layer was analyzed by plotting the mean thickness versus the aging time on log-log coordinates, and the results showed the transition point from grain boundary diffusion control to a volume diffusion control mechanism. The results also showed that the minor addition of In can significantly suppress the coarsening of the Bi phase.

Intelligence and Academic Achievement With Asymptomatic Congenital Cytomegalovirus Infection.

PubMed

Lopez, Adriana S; Lanzieri, Tatiana M; Claussen, Angelika H; Vinson, Sherry S; Turcich, Marie R; Iovino, Isabella R; Voigt, Robert G; Caviness, A Chantal; Miller, Jerry A; Williamson, W Daniel; Hales, Craig M; Bialek, Stephanie R; Demmler-Harrison, Gail

2017-11-01

To examine intelligence, language, and academic achievement through 18 years of age among children with congenital cytomegalovirus infection identified through hospital-based newborn screening who were asymptomatic at birth compared with uninfected infants. We used growth curve modeling to analyze trends in IQ (full-scale, verbal, and nonverbal intelligence), receptive and expressive vocabulary, and academic achievement in math and reading. Separate models were fit for each outcome, modeling the change in overall scores with increasing age for patients with normal hearing ( n = 78) or with sensorineural hearing loss (SNHL) diagnosed by 2 years of age ( n = 11) and controls ( n = 40). Patients with SNHL had full-scale intelligence and receptive vocabulary scores that were 7.0 and 13.1 points lower, respectively, compared with controls, but no significant differences were noted in these scores among patients with normal hearing and controls. No significant differences were noted in scores for verbal and nonverbal intelligence, expressive vocabulary, and academic achievement in math and reading among patients with normal hearing or with SNHL and controls. Infants with asymptomatic congenital cytomegalovirus infection identified through newborn screening with normal hearing by age 2 years do not appear to have differences in IQ, vocabulary or academic achievement scores during childhood, or adolescence compared with uninfected children. Copyright © 2017 by the American Academy of Pediatrics.

The influences of accelerated aging on mechanical properties of veneering ceramics used for zirconia restorations.

PubMed

Luo, Huinan; Tang, Xuehua; Dong, Zhen; Tang, Hui; Nakamura, Takashi; Yatani, Hirofumi

2016-01-01

This study evaluated the influences of accelerated aging on the mechanical properties of veneering ceramics used for zirconia frameworks. Five different veneering ceramics for zirconia frameworks were used. Twenty specimens were fabricated for each veneering ceramic. All specimens were divided into two groups. One was subjected to accelerated aging and the other was used as a control. Accelerated aging was performed in distilled water for 5 h at 200ºC and 2 atm. The density, open porosity, surface roughness, three-point flexural strength, and Vickers hardness were measured. The results showed that the density, open porosity, and surface roughness of all examined veneering ceramics were changed by the accelerated aging process. Accelerated aging was also found to have a positive effect on strength and a negative effect on the hardness.

High frequency of discordance between antimüllerian hormone and follicle-stimulating hormone levels in serum from estradiol-confirmed days 2 to 4 of the menstrual cycle from 5,354 women in U.S. fertility centers.

PubMed

Leader, Benjamin; Hegde, Aparna; Baca, Quentin; Stone, Kimberly; Lannon, Benjamin; Seifer, David B; Broekmans, Frank; Baker, Valerie L

2012-10-01

To determine the frequency of clinical discordance between antimüllerian hormone (AMH, ng/mL) and follicle-stimulating hormone (FSH, IU/L) by use of cut points defined by response to controlled ovarian stimulation in the same serum samples drawn on estradiol-confirmed, menstrual cycle days 2 to 4. Retrospective analysis. Fertility centers in 30 U.S. states and a single reference laboratory with uniform testing protocols. 5,354 women, 20 to 45 years of age. None. Frequency of discordance between serum AMH and FSH values. Of the 5,354 women tested, 1 in 5 had discordant AMH and FSH values defined as AMH <0.8 (concerning) with FSH <10 (reassuring) or AMH ≥ 0.8 (reassuring) with FSH ≥ 10 (concerning). Of the women with reassuring FSH values (n = 4,469), the concerning AMH values were found in 1 in 5 women in a highly age-dependent fashion, ranging from 1 in 11 women under 35 years of age to 1 in 3 women above 40 years of age. On the other hand, of the women with reassuring AMH values (n = 3,742), 1 in 18 had concerning FSH values, a frequency that did not vary in a statistically significant fashion by age. Clinical discordance in serum AMH and FSH values was frequent and age dependent using common clinical cut points, a large patient population, one reference laboratory, and uniform testing methodology. This conclusion is generalizable to women undergoing fertility evaluation, although AMH testing has not been standardized among laboratories, and the cut points presented are specific to the laboratory in this study. Copyright © 2012. Published by Elsevier Inc.

Self-Regulated Learning in Younger and Older Adults: Does Aging Affect Metacognitive Control?

PubMed Central

Price, Jodi; Hertzog, Christopher; Dunlosky, John

2011-01-01

Two experiments examined whether younger and older adults’ self-regulated study (item selection and study time) conformed to the region of proximal learning (RPL) model when studying normatively easy, medium, and difficult vocabulary pairs. Experiment 2 manipulated the value of recalling different pairs and provided learning goals for words recalled and points earned. Younger and older adults in both experiments selected items for study in an easy-to-difficult order, indicating the RPL model applies to older adults’ self-regulated study. Individuals allocated more time to difficult items, but prioritized easier items when given less time or point values favoring difficult items. Older adults studied more items for longer but realized lower recall than did younger adults. Older adults’ lower memory self-efficacy and perceived control correlated with their greater item restudy and avoidance of difficult items with high point values. Results are discussed in terms of RPL and agenda-based regulation models. PMID:19866382

The Prevalence and Incidence of Mental Ill-Health in Adults with Autism and Intellectual Disabilities

ERIC Educational Resources Information Center

Melville, Craig A.; Cooper, Sally-Ann; Morrison, Jill; Smiley, Elita; Allan, Linda; Jackson, Alison; Finlayson, Janet; Mantry, Dipali

2008-01-01

The prevalence, and incidence, of mental ill-health in adults with intellectual disabilities and autism were compared with the whole population with intellectual disabilities, and with controls, matched individually for age, gender, ability-level, and Down syndrome. Although the adults with autism had a higher point prevalence of problem…

"Clickers" and HACCP: Educating a Diverse Food Industry Audience with Technology

ERIC Educational Resources Information Center

Shaw, Angela; Mendonca, Aubrey; Daraba, Aura

2015-01-01

Hazard Analysis Critical Control Points (HACCP) is a systematic approach to food safety education for the food industry. To receive a HACCP certificate, participants must receive an 80% or higher on the final examination. Language barriers, educational levels, and age have been noted as primary reasons for not passing the final examination.…

The Sources and Manifestations of Stress amongst School-Aged Dyslexics, Compared with Sibling Controls

ERIC Educational Resources Information Center

Alexander-Passe, Neil

2008-01-01

All school children experience stress at some point in their school careers. This study investigates whether dyslexic children, by way of their educational and social difficulties, experience higher levels of stress at school. The School Situation Survey was used to investigate both the sources and manifestations of stress amongst dyslexic…

Assessment of sella turcica area and skeletal maturation patterns of children with unilateral cleft lip and palate.

PubMed

Cesur, E; Altug, A T; Toygar-Memikoglu, U; Gumru-Celikel, D; Tagrikulu, B; Erbay, E

2018-05-01

The aim of this case-control study was to assess sella turcica area and skeletal maturity in children with unilateral cleft lip and palate (UCLP) and compare with those of non-cleft children. A total of 85 UCLP patients aged 7.5-17.08 years (Group 1: age 7-11 years, Group 2: age 11-14 years and Group 3: age 14-18 years) were compared with 85 control subjects without clefts who were divided into similar age groups. Hand-wrist radiographs and cervical vertebra maturation stages (CVMS) were used to evaluate growth. Lateral cephalograms were traced, and reference points of sella were determined. Sella turcica area was measured using a digital planimeter. Comparison of overall growth on hand-wrist radiographs revealed no significant difference between cleft and non-cleft subjects. However, according to the chronological age groups, Group 1-UCLP showed statistically significant delay in skeletal maturation when compared with the age-matched control subjects (P = .05). This difference was due to the delay among male subjects (P = .05). As for CVMS, more significant maturation delay was observed in Group 1-UCLP (P = .001) and was attributable to both male and female subjects (P = .05). Comparison of sella turcica area showed no significant difference between UCLP patients and controls. Although children with CLP showed significant delay in growth when they are younger compared with the non-cleft children, sella turcica area measurements were similar for individuals in both groups. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of a spirituality informed e-mental health tool as an intervention for major depressive disorder in adolescents and young adults - a randomized controlled pilot trial.

PubMed

Rickhi, Badri; Kania-Richmond, Ania; Moritz, Sabine; Cohen, Jordan; Paccagnan, Patricia; Dennis, Charlotte; Liu, Mingfu; Malhotra, Sonya; Steele, Patricia; Toews, John

2015-12-24

Depression in adolescents and young adults is a major mental health condition that requires attention. Research suggests that approaches that include spiritual concepts and are delivered through an online platform are a potentially beneficial approach to treating/managing depression in this population. The purpose of this study was to evaluate the effectiveness of an 8-week online spirituality informed e-mental health intervention (the LEAP Project) on depression severity, and secondary outcomes of spiritual well-being and self-concept, in adolescents and young adults with major depressive disorder of mild to moderate severity. A parallel group, randomized, waitlist controlled, assessor-blinded clinical pilot trial was conducted in Calgary, Alberta, Canada. The sample of 62 participants with major depressive disorder (DSM-IV-TR) was defined by two age subgroups: adolescents (ages 13 to 18 years; n = 31) and young adults (ages 19 to 24 years; n = 31). Participants in each age subgroup were randomized into the study arm (intervention initiated upon enrolment) or the waitlist control arm (intervention initiated after an 8-week wait period). Comparisons were made between the study and waitlist control arms at week 8 (the point where study arm had completed the intervention and the waitlist control arm had not) and within each arm at four time points over 24-week follow-up period. At baseline, there was no statistical difference between study and waitlist participants for both age subgroups for all three outcomes of interest. After the intervention, depression severity was significantly reduced; comparison across arms at week 8 and over time within each arm and both age subgroups. Spiritual well-being changes were not significant, with the exception of an improvement over time for the younger participants in the study arm (p = 0.01 at week 16 and p = 0.0305 at week 24). Self-concept improved significantly for younger participants immediately after the intervention (p = 0.045 comparison across arms at week 8; p = 0.0175 in the waitlist control arm) and over time in the study arm (p = 0.0025 at week 16). In the older participants, change was minimal, with the exception of a significant improvement in one of six factors (vulnerability) in study arm over time (p = 0.025 at week 24). The results of the LEAP Project pilot trial suggest that it is an effective, online intervention for youth ages 13 to 24 with mild to moderate major depressive disorder with various life situations and in a limited way on spiritual well-being and self-concept. ClinicalTrials.gov NCT00985686. Registered 24 September 2009.

Patterns of emergency room visits, admissions and death following recommended pediatric vaccinations - a population based study of 969,519 vaccination events.

PubMed

Wilson, Kumanan; Hawken, Steven; Potter, Beth K; Chakraborty, Pranesh; Kwong, Jeff; Crowcroft, Natasha; Rothwell, Deanna; Manuel, Doug

2011-05-12

The risk of immediate adverse events due to the inflammation created by a vaccine is a potential concern for pediatric vaccine programs. We analyzed data on children born between March 2006 and March 2009 in the province of Ontario. Using the self-controlled case series design, we examined the risk of the combined endpoint of emergency room visit and hospital admission in the immediate 3 days post vaccination to a control period 9-18 days after vaccination. We examined the end points of emergency room visits, hospital admissions and death separately as secondary outcomes. We examined 969,519 separate vaccination events. The relative incidence of our combined end point was 0.85 (0.80-0.90) for vaccination at age 2 months, 0.74 (0.69-0.79) at age 4 months and 0.68 (0.63-0.72) at age 6 months. The relative incidence was reduced for the individual endpoints of emergency room visits, admissions and death. There were 5 or fewer deaths in the risk interval of all 969,519 vaccination events. In a post hoc analysis we observed a large reduction in events in the immediate 3 days prior to vaccination suggesting a large healthy vaccinee effect. There was no increased incidence of the combined end point of emergency room visits and hospitalizations in the 3-day period immediately following vaccination, nor for individual endpoints or death. The health vaccinee effect could create the perception of worsening health following vaccines in the absence of any vaccine adverse effect and could also mask an effect in the immediate post-vaccination period. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Effect of Age on Improvements in Vestibulo-Ocular Reflexes and Balance Control after Acute Unilateral Peripheral Vestibular Loss.

PubMed

Scheltinga, Alja; Honegger, Flurin; Timmermans, Dionne P H; Allum, John H J

2016-01-01

An acute unilateral peripheral vestibular loss (aUVL) initially causes severe gaze and balance control problems. However, vestibulo-ocular reflexes (VOR) and balance control are nearly normal 3 months later as a result of peripheral recovery and/or central compensation. As pre-existing vestibular sensory loss is assumed to be greater in the healthy elderly, this study investigated whether improvements in VOR and balance function over time after aUVL are different for the elderly than for the young. Thirty aUVL patients divided into three age-groups were studied (8 age range 23-35, 10 with range 43-58, and 12 with range 60-74 years). To measure VOR function eye movements were recorded during caloric irrigation, rotating chair (ROT), and head impulse tests. Balance control during stance and gait was recorded as lower trunk angular velocity in the pitch and roll planes. Measurements were taken at deficit onset, and 3, 6, and 13 weeks later. There was one difference in VOR improvements over time between the age-groups: Low acceleration ROT responses were less at onset in the elderly group. Deficit side VOR responses and asymmetries in each group improved to within ranges of healthy controls at 13 weeks. Trunk sway of the elderly was greater for stance and gait at onset when compared to healthy age-matched controls and the young and greater than that of the young and controls during gait tasks at 13 weeks. The sway of the young was not different from controls at either time point. Balance control for the elderly improved slower than for the young. These results indicate that VOR improvement after an aUVL does not differ with age, except for low accelerations. Recovery rates are different between age-groups for balance control tests. Balance control in the elderly is more abnormal at aUVL onset for stance and gait tasks with the gait abnormalities remaining after 13 weeks. Thus, we conclude that balance control in the elderly is more affected by the UVL than for the young, and the young overcome balance deficits more rapidly. These differences with age should be taken into account when planning rehabilitation.

A quantitative study on accumulation of age mass around stagnation points in nested flow systems

NASA Astrophysics Data System (ADS)

Jiang, Xiao-Wei; Wan, Li; Ge, Shemin; Cao, Guo-Liang; Hou, Guang-Cai; Hu, Fu-Sheng; Wang, Xu-Sheng; Li, Hailong; Liang, Si-Hai

2012-12-01

The stagnant zones in nested flow systems have been assumed to be critical to accumulation of transported matter, such as metallic ions and hydrocarbons in drainage basins. However, little quantitative research has been devoted to prove this assumption. In this paper, the transport of age mass is used as an example to demonstrate that transported matter could accumulate around stagnation points. The spatial distribution of model age is analyzed in a series of drainage basins of different depths. We found that groundwater age has a local or regional maximum value around each stagnation point, which proves the accumulation of age mass. In basins where local, intermediate and regional flow systems are all well developed, the regional maximum groundwater age occurs at the regional stagnation point below the basin valley. This can be attributed to the long travel distances of regional flow systems as well as stagnancy of the water. However, when local flow systems dominate, the maximum groundwater age in the basin can be located around the local stagnation points due to stagnancy, which are far away from the basin valley. A case study is presented to illustrate groundwater flow and age in the Ordos Plateau, northwestern China. The accumulation of age mass around stagnation points is confirmed by tracer age determined by 14C dating in two boreholes and simulated age near local stagnation points under different dispersivities. The results will help shed light on the relationship between groundwater flow and distributions of groundwater age, hydrochemistry, mineral resources, and hydrocarbons in drainage basins.

An fMRI study of somatosensory-implicated acupuncture points in stable somatosensory stroke patients.

PubMed

Li, Geng; Jack, Clifford R; Yang, Edward S

2006-11-01

To assess differences in brain responses between stroke patients and controls to tactile and electrical acupuncture stimulation using functional MRI (fMRI). A total of 12 male, clinically stable stroke patients with left side somatosensory deficits, and 12 age-matched male control subjects were studied. fMRI was performed with two different paradigms; namely, tactile stimuli and electrical stimulation at acupuncture points LI4 and LI11 on the affected side of the body. fMRI data were analyzed using SPM99. Tactile stimulation in both patients and controls produced significant activation in primary and secondary sensory and motor cortical areas and cerebellum. Greater activation was present in patients than controls in the somatosensory cortex with both the tactile task and the acupuncture point (acupoint) stimulation. Activation was greater during the tactile task than the acupuncture stimulation in patients and normal controls. Differences observed between patients and controls on both tasks may indicate compensatory over recruitment of neocortical areas involved in somatosensory perception in the stroke patients. The observed differences between patients and controls on the acupoint stimulation task may also indicate that stimulation of acupoints used therapeutically to enhance recovery from stroke, selectively activates areas thought to be involved in mediating recovery from stroke via functional plasticity. fMRI of acupoint stimulation may illustrate the functional substrate of the therapeutically beneficial effect of acupuncture in stroke rehabilitation. Copyright (c) 2006 Wiley-Liss, Inc.

[Knowledge and destiny or longevity and old age: the heritage of Homo sapiens].

PubMed

Goddio, A S

1994-12-01

Several theories have been proposed to explain ageing: limitation of the number of cell divisions or Hayflick's limit, the genetic theory, the action of free radicals, immune deficiency, etc. All of these theories share several points in common: their genetic determinism or repercussions which appear to be part of the heritage of complex organisms. Progress in genetics with chromosome decoding to localise genes and genetic manipulations or control of gene expression will probably allow an increased life expectancy, perhaps in the near future.

Rule-Based Category Learning in Children: The Role of Age and Executive Functioning

PubMed Central

Rabi, Rahel; Minda, John Paul

2014-01-01

Rule-based category learning was examined in 4–11 year-olds and adults. Participants were asked to learn a set of novel perceptual categories in a classification learning task. Categorization performance improved with age, with younger children showing the strongest rule-based deficit relative to older children and adults. Model-based analyses provided insight regarding the type of strategy being used to solve the categorization task, demonstrating that the use of the task appropriate strategy increased with age. When children and adults who identified the correct categorization rule were compared, the performance deficit was no longer evident. Executive functions were also measured. While both working memory and inhibitory control were related to rule-based categorization and improved with age, working memory specifically was found to marginally mediate the age-related improvements in categorization. When analyses focused only on the sample of children, results showed that working memory ability and inhibitory control were associated with categorization performance and strategy use. The current findings track changes in categorization performance across childhood, demonstrating at which points performance begins to mature and resemble that of adults. Additionally, findings highlight the potential role that working memory and inhibitory control may play in rule-based category learning. PMID:24489658

Time Spent Outdoors at Midday and Children’s Body Mass Index

PubMed Central

Milne, Elizabeth; Simpson, Julie A.; Johnston, Robyn; Giles-Corti, Billie; English, Dallas R.

2007-01-01

Objectives. We investigated whether the Kidskin sun protection intervention increased children’s body mass index by reducing the time spent outdoors at midday. Methods. The Kidskin sun protection intervention involved 1614 Australian school children assigned to 1 of 3 groups: a control group, a moderate-intervention group, or a high-intervention group. Schools in the control group received the standard health curriculum and schools in the intervention groups received a multicomponent intervention. Outcomes included time spent outdoors and nevus development (a marker of melanoma risk). Height and weight were measured at 3 time points. Body mass index was transformed into age- and gender-specific z scores; z scores at each age were modeled simultaneously. Time spent outdoors at ages 10 and 12 years was analyzed using a linear mixed effects modeling. Results. The proportion of children who were overweight or obese increased with age. The moderate-intervention and control groups had a minimal increase in z score over time, and the z score for the high-intervention group decreased over time. There were no differences among groups with respect to total time outdoors at any age. Conclusions. It is possible to reduce the time children spend outdoors when ultraviolet radiation is high without producing an unfavorable effect on the children’s body mass index. PMID:17194858

[Quality of life in patients with age-related macular degeneration - medical and social problem].

PubMed

Muzyka-Woźniak, Maria; Misiuk-Hojło, Marta; Wesolowska, Alicja

2011-01-01

Age-related macular degeneration (AMD) is a leading cause of blindness over the age of 50 in western countries. People with AMD are suffering from serious vision-related disability and their social life is compromised. The aim of our study was to assess quality of life (QoL) in patients with exudative AMD. The study group was 100 patients treated for AMD, the control group were 30 age and sex matched subjects without ophthalmic disorders. Patients were treated with anti-VEGF therapy, by means of National Eye Institute Visual Function Questionnaire (NEI VFQ-25). As well as visual function, the NEI-VFQ investigates social functioning, mental health and dependency. There was statistically significant difference in QoL overall score between study group and control group. Patients with AMD obtained 51.1 (+/- 20.5 ) overall score, control group reached 83.7 (+/- 11.7) overall score, p = 0.001. Detailed analysis of study group revealed low acceptance of the disease and strong dependency. QoL in patients with AMD assessed with NEI VFQ-25, is significantly impaired. Low quality of life and difficulties in performing daily activities point at the need of formal psychological and social care.

Positive association of personal distress with testosterone in opiate-addicted patients.

PubMed

Stange, Katrin; Krüger, Mathias; Janke, Eva; Lichtinghagen, Ralf; Bleich, Stefan; Hillemacher, Thomas; Heberlein, Annemarie

2017-01-01

Clinical studies report that substance addictions are associated with sociocognitive impairments. Regarding opiate-addicted patients, the few existing studies point to deficits in empathic abilities. Previous research suggests that testosterone might be a relevant biomarker of these impairments. The authors aimed to investigate whether opiate-addicted patients show specific impairments in emotional (empathic concern, personal distress) and cognitive empathy compared to healthy controls. Furthermore, the authors aimed to assess possible associations of testosterone levels with impaired empathic abilities in the patients' group. In this cross-sectional study, 27 opiate-addicted, diacetylmorphine-maintained patients (21 males, age mean 41.67 years, standard deviation 8.814) and 31 healthy controls (23 males, age mean 40.77 years, standard deviation 8.401) matched in age, sex, and educational level were examined. Cognitive and emotional empathy were measured via the German version of the Interpersonal Reactivity Index and salivary testosterone levels were assessed. The authors found higher personal distress scores (p < 0.01, d = 0.817) and higher testosterone (p < 0.001, d = 1.093) in the patients' group compared to controls. Moreover, a positive correlation was found between testosterone and personal distress among the patients' group (r = 0.399, p < 0.05). Opiate-addicted patients show specific impairments in emotional empathy, namely higher personal distress, which has clinical implications regarding social cognition rehabilitation and relapse prevention. The current data point toward testosterone as a possible biomarker for these sociocognitive impairments and suggest that high personal distress and high testosterone during withdrawal are possible markers for severe opiate addiction.

Point-of-decision prompts for increasing park-based physical activity: a crowdsource analysis

PubMed Central

Wilhelm Stanis, Sonja A.; Hipp, J. Aaron

2014-01-01

Objective To examine the potential efficacy of using point-of-decision prompts to influence intentions to be active in a park setting. Methods In June 2013, participants from across the U.S. (n=250) completed an online experiment using Amazon’s Mechanical Turk and Survey Monkey. Participants were randomly exposed to a park photo containing a persuasive, theoretically-based message in the form of a sign (treatment) or an identical photo with no sign (control). Differences in intentions to engage in moderate-to-vigorous physical activity within the park were examined between the two conditions for multiple gender, age, and race groups. Results Participants who were exposed to the park photo with the sign reported significantly greater intentions to be active than those who viewed the photo without a sign. This effect was especially strong for women compared to men, but no differences were observed across age or race groups. Conclusion Point-of-decision prompts are a relatively inexpensive, simple, sustainable, and scalable strategy for evoking behavior change in parks and further testing of diverse messages in actual park settings is warranted. PMID:25204987

Investigating the poverty-obesity paradox in Europe.

PubMed

Salmasi, Luca; Celidoni, Martina

2017-08-01

This paper investigates the effect of income- and wealth-based poverty on the probability of being obese for the elderly in Europe by analysing data drawn from the Survey of Health, Ageing and Retirement (SHARE) and the English Longitudinal Study of Ageing (ELSA). We use early-life economic conditions and regional circumstances as instruments for poverty later in life to account for endogeneity issues. After controlling for a large set of covariates at the individual, household, regional and country level, the results show that poverty significantly increases the probability of being obese and the Body Mass Index (BMI), for men and women. The results show that, accounting for endogeneity with a bivariate probit model, poor individuals are from 10 to 20% points more likely to be obese than non-poor individuals. The effect on BMI ranges from 0.295 points (2.39 kg) to 0.395 points (2.75 kg). These results are robust to a series of checks and suggest that anti-poverty interventions might have positive side effects in terms of reducing food-related health inequalities. Copyright © 2017 Elsevier B.V. All rights reserved.

Self-reported volitional control in adolescents and young adults from a community cohort: Associations with current, past and future mental disorders.

PubMed

Asselmann, Eva; Hilbert, Kevin; Hoyer, Jana; Wittchen, Hans-Ulrich; Lieb, Roselind; Bühringer, Gerhard; Beesdo-Baum, Katja

2017-11-21

Alterations in volitional control have been found for various mental disorders. However, it remains unclear to which degree such alterations vary by type of psychopathology and constitute preceding vulnerabilities or correlates of mental disorders. DSM-IV mental disorders were assessed among adolescents and young adults from the community at baseline (age 14-24) and in up to 3 follow-up assessments over 10 years (n = 2515) using a standardized diagnostic interview (DIA-X/M-CIDI). Self-reported volitional control was assessed at second follow-up (T2) when subjects were aged 17-28 using the German version of the Short Form of the Volitional Components Inventory. Linear regressions adjusted for sex, age and lifetime disorders revealed that anxiety and affective disorders were associated with widespread alterations in self-reported volitional control (lower self regulation, higher self inhibition and volitional inhibition), while substance use disorders were specifically associated with higher volitional inhibition. Logistic regressions adjusted for sex, age and prior lifetime psychopathology revealed that lower self-reported volitional control at T2 predicted incident panic, social phobia and substance use at T3 (follow-up interval M = 4.8 years). Findings point toward at least partly disorder-specific alterations in volitional control in mental disorders, which might be antecedent vulnerability factors and thus useful to guide early recognition and prevention. Copyright © 2017. Published by Elsevier B.V.

Racial Microstressors, Racial Self-Concept, and Depressive Symptoms Among Male African Americans During the Transition to Adulthood

PubMed Central

Kogan, Steven M.; Yu, Tianyi; Allen, Kimberly A.; Brody, Gene H.

2015-01-01

Racial discrimination is a pervasive stressor that can undermine mental health among African American youth and young adults. Several studies identify links between racial discrimination and depressive symptoms; however, this research base does not focus on male African American youth who experience significant racism-related stress during the transition to young adulthood. Moreover, few prospective studies consider significant confounding variables that affect exposure to and perception of discriminatory treatment. In response to this need, we examined the effect of exposure to racial discrimination from ages 16–18 on depressive symptoms among male African Americans at age 20. Racial self-concept, one’s sense of positivity about one’s race, was examined as a mediator and self-control as a moderator. Hypotheses were tested with 222 participants, age 16 at baseline and age 20 at the endpoint. Participants provided self-report data at 5 time points. Exposure to racial discrimination from ages 16–18 predicted depressive symptoms at age 20, net of confounding influences. Racial self-concept mediated this effect. Self-control moderated the influence of discrimination on racial self-concept. This study underscores the salience of racial discrimination in the development of depressive symptoms among African American male youth and the clinical utility of interventions targeting racial pride and self-control. PMID:25344920

Air pollution sources and childhood asthma attacks in Catano, Puerto Rico.

PubMed

Loyo-Berríos, Nilsa I; Irizarry, Rafael; Hennessey, Joseph G; Tao, Xuguang Grant; Matanoski, Genevieve

2007-04-15

Asthma prevalence in the Cataño Air Basin of Puerto Rico is 27% for children aged 13-14 years and 45% for children aged 5-6 years. There is concern that these rates are related to air pollution. The authors conducted a nested case-control study to evaluate whether proximity to air pollution point sources was associated with increased risk of asthma attacks. For 1997-2001, 1,382 asthma-related medical visits (International Classification of Diseases, Ninth Revision, codes 493 and 493.9) in children under 17 were identified through health insurance claims. Controls were children with no asthma attacks who were randomly selected from enrollees in two health insurance companies by incidence density sampling (1:5) and matched to cases on gender, age, insurance company, and event date. The distance from a point source to the subject's residence area represented a surrogate exposure measurement. Odds ratios for a 1-km decrease in distance were obtained by conditional logistic regression. Risk of asthma attack was associated with residing near a grain mill (odds ratio (OR) = 1.35), petroleum refinery (OR = 1.44), asphalt plant (OR = 1.23), or power plant (OR = 1.28) (all p's < 0.05). Residence near major air emissions sources (>100 tons/year) increased asthma attack risk by 108% (p < 0.05). These results showed that proximity to some air pollution sources is associated with increased risks of asthma attacks.

Intercessory prayer and cardiovascular disease progression in a coronary care unit population: a randomized controlled trial.

PubMed

Aviles, J M; Whelan, S E; Hernke, D A; Williams, B A; Kenny, K E; O'Fallon, W M; Kopecky, S L

2001-12-01

To determine the effect of intercessory prayer, a widely practiced complementary therapy, on cardiovascular disease progression after hospital discharge. In this randomized controlled trial conducted between 1997 and 1999, a total of 799 coronary care unit patients were randomized at hospital discharge to the intercessory prayer group or to the control group. Intercessory prayer, ie, prayer by 1 or more persons on behalf of another, was administered at least once a week for 26 weeks by 5 intercessors per patient. The primary end point after 26 weeks was any of the following: death, cardiac arrest, rehospitalization for cardiovascular disease, coronary revascularization, or an emergency department visit for cardiovascular disease. Patients were divided into a high-risk group based on the presence of any of 5 risk factors (age = or >70 years, diabetes mellitus, prior myocardial infarction, cerebrovascular disease, or peripheral vascular disease) or a low-risk group (absence of risk factors) for subsequent primary events. At 26 weeks, a primary end point had occurred in 25.6% of the intercessory prayer group and 29.3% of the control group (odds ratio [OR], 0.83 [95% confidence interval (CI), 0.60-1.14]; P=.25). Among high-risk patients, 31.0% in the prayer group vs 33.3% in the control group (OR, 0.90 [95% CI, 0.60-1.34]; P=.60) experienced a primary end point. Among low-risk patients, a primary end point occurred in 17.0% in the prayer group vs 24.1% in the control group (OR, 0.65 [95% CI, 0.20-1.36]; P=.12). As delivered in this study, intercessory prayer had no significant effect on medical outcomes after hospitalization in a coronary care unit.

Initial brain aging: heterogeneity of mitochondrial size is associated with decline in complex I-linked respiration in cortex and hippocampus.

PubMed

Thomsen, Kirsten; Yokota, Takashi; Hasan-Olive, Md Mahdi; Sherazi, Niloofar; Fakouri, Nima Borhan; Desler, Claus; Regnell, Christine Elisabeth; Larsen, Steen; Rasmussen, Lene Juel; Dela, Flemming; Bergersen, Linda Hildegard; Lauritzen, Martin

2018-01-01

Brain aging is accompanied by declining mitochondrial respiration. We hypothesized that mitochondrial morphology and dynamics would reflect this decline. Using hippocampus and frontal cortex of a segmental progeroid mouse model lacking Cockayne syndrome protein B (CSB m/m ) and C57Bl/6 (WT) controls and comparing young (2-5 months) to middle-aged mice (13-14 months), we found that complex I-linked state 3 respiration (CI) was reduced at middle age in CSB m/m hippocampus, but not in CSB m/m cortex or WT brain. In hippocampus of both genotypes, mitochondrial size heterogeneity increased with age. Notably, an inverse correlation between heterogeneity and CI was found in both genotypes, indicating that heterogeneity reflects mitochondrial dysfunction. The ratio between fission and fusion gene expression reflected age-related alterations in mitochondrial morphology but not heterogeneity. Mitochondrial DNA content was lower, and hypoxia-induced factor 1α mRNA was greater at both ages in CSB m/m compared to WT brain. Our findings show that decreased CI and increased mitochondrial size heterogeneity are highly associated and point to declining mitochondrial quality control as an initial event in brain aging. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of Electrical Current and External Stress on the Electromigration of Intermetallic Compounds Between the Flip-Chip Solder and Copper Substrate

NASA Astrophysics Data System (ADS)

Chen, Wei-Jhen; Lee, Yue-Lin; Wu, Ti-Yuan; Chen, Tzu-Ching; Hsu, Chih-Hui; Lin, Ming-Tzer

2018-01-01

This study investigated the effects of electric current and external stress on electromigration of intermetallic compounds (IMC) between solder and copper substrate. Different samples were tested under three different sets of conditions: (1) thermal aging only, (2) thermal aging with electric current ,where resistivity changes were measured using four-point probe measurements, (3) thermal aging with electric current and external stress provided using a four-point bending apparatus. The micro-structural changes in the samples were observed. The results were closely examined; particularly the coupling effect of electric current and external stress to elucidate the electromigration mechanism, as well as the formation of IMC in the samples. For thermal-aging-only samples, the IMC growth mechanism was controlled by grain boundary diffusion. Meanwhile, for thermal aging and applied electric current samples, the IMC growth mechanism was dominated by volume diffusion and interface reaction. Lastly, the IMC growth mechanism in the electric current and external stress group was dominated by grain boundary diffusion with grain growth. The results reveal that the external stress/strain and electric current play a significant role in the electromigration of copper-tin IMC. The samples exposed to tensile stress have reduced electromigration, while those subjected under compressive stress have enhanced electromigration.

High Phobic Anxiety Is Related to Lower Leukocyte Telomere Length in Women

PubMed Central

Okereke, Olivia I.; Prescott, Jennifer; Wong, Jason Y. Y.; Han, Jiali; Rexrode, Kathryn M.; De Vivo, Immaculata

2012-01-01

Background Chronic psychological distress has been linked to shorter telomeres, an indication of accelerated aging. Yet, little is known about relations of anxiety to telomeres. We examined whether a typically chronic form of anxiety – phobic anxiety – is related to telomere length. Methodology/Principal Findings Relative telomere lengths (RTLs) in peripheral blood leukocytes were measured by quantitative real-time polymerase chain reaction among 5,243 women (aged 42–69 years) who: were participants in the Nurses' Health Study; were controls in prior case-control studies of telomeres and disease, or randomly selected healthy participants in a cognitive function sub-study; had completed the Crown-Crisp phobic index proximal to blood collection. Adjusted least-squares mean RTLs (z-scores) were calculated across phobic categories. Higher phobic anxiety was generally associated with lower RTLs (age-adjusted p-trend = 0.09); this association was similar after adjustment for confounders – paternal age-at-birth, smoking, body mass index (BMI) and physical activity (p-trend = 0.15). Notably, a threshold was identified. Among women with Crown-Crisp<6 points, the multivariable-adjusted least-squares mean RTL z-score = 0.02 standard units; however, among the most phobic women (Crown-Crisp≥6), the multivariable-adjusted least-squares mean RTL z-score = −0.09 standard units (mean difference = −0.10 standard units; p = 0.02). The magnitude of this difference was comparable to that for women 6 years apart in age. Finally, effect modification by BMI, smoking and paternal age was observed: associations were stronger among highly phobic women with BMI≥25 kg/m2, without smoking history, or born to fathers aged ≥40 years. Conclusions/Significance In this large, cross-sectional study high phobic anxiety was associated with shorter telomeres. These results point toward prospective investigations relating anxiety to telomere length change. PMID:22808180

The Effects of Attentional Engagement on Route Learning Performance in a Virtual Environment: An Aging Study

PubMed Central

Hartmeyer, Steffen; Grzeschik, Ramona; Wolbers, Thomas; Wiener, Jan M.

2017-01-01

Route learning is a common navigation task affected by cognitive aging. Here we present a novel experimental paradigm to investigate whether age-related declines in executive control of attention contributes to route learning deficits. A young and an older participant group was repeatedly presented with a route through a virtual maze comprised of 12 decision points (DP) and non-decision points (non-DP). To investigate attentional engagement with the route learning task, participants had to respond to auditory probes at both DP and non-DP. Route knowledge was assessed by showing participants screenshots or landmarks from DPs and non-DPs and asking them to indicate the movement direction required to continue the route. Results demonstrate better performance for DPs than for non-DPs and slower responses to auditory probes at DPs compared to non-DPs. As expected we found slower route learning and slower responses to the auditory probes in the older participant group. Interestingly, differences in response times to the auditory probes between DPs and non-DPs can predict the success of route learning in both age groups and may explain slower knowledge acquisition in the older participant group. PMID:28775689

Evaluation of hepatic steatosis in dogs with congenital portosystemic shunts using Oil Red O staining.

PubMed

Hunt, G B; Luff, J A; Daniel, L; Van den Bergh, R

2013-11-01

The aims of this prospective study were to quantify steatosis in dogs with congenital portosystemic shunts (CPS) using a fat-specific stain, to compare the amount of steatosis in different lobes of the liver, and to evaluate intra- and interobserver variability in lipid point counting. Computer-assisted point counting of lipid droplets was undertaken following Oil Red O staining in 21 dogs with congenital portosystemic shunts and 9 control dogs. Dogs with congenital portosystemic shunts had significantly more small lipid droplets (<6 μ) than control dogs (P = .0013 and .0002, respectively). There was no significant difference in steatosis between liver lobes for either control dogs and CPS dogs. Significant differences were seen between observers for the number of large lipid droplets (>9 μ) and lipogranulomas per tissue point (P = .023 and .01, respectively). In conclusion, computer-assisted counting of lipid droplets following Oil Red O staining of liver biopsy samples allows objective measurement and detection of significant differences between dogs with CPS and normal dogs. This method will allow future evaluation of the relationship between different presentations of CPS (anatomy, age, breed) and lipidosis, as well as the impact of hepatic lipidosis on outcomes following surgical shunt attenuation.

Is the bronchodilator test an useful tool to measure asthma control?

PubMed

Ferrer Galván, Marta; Javier Alvarez Gutiérrez, Francisco; Romero Falcón, Auxiliadora; Romero Romero, Beatriz; Sáez, Antonia; Medina Gallardo, Juan Francisco

2017-05-01

Asthma control includes the control of symptoms and future risk. We sought to evaluate the usefulness of the degree of spirometric reversibility of the forced expiratory volume in one second (FEV 1 ) as the target parameter of control. Patients with bronchial asthma were followed up for one year. The clinical, functional, inflammatory and control parameters of the asthma were collected. The area under the curve (AUC) was estimated to establish the cutoff point of the post-bronchodilator FEV 1 reversibility in relation to non-control asthma. In the univariate analysis, the differences between groups were studied based on the degree of estimated reversibility. Factors with a significance <0.1 were included in the multivariate analysis by binary logistic regression. A total of 407 patients with a mean age of 38.1 ± 16.7 years were included. When the patients were grouped into controlled and non-controlled groups, compared with post-bronchodilator FEV 1 reversibility, the cutoff point obtained for the non-controlled group was ≥10% (sensitivity: 65.8%, specificity: 48.4%, positive predictive value: 69.5%, and AUC: 0.619 [0.533-0.700], p < 0.01). In the year-long follow-up of this group (post-bronchodilator FEV 1 ≥10), an increased use of relief medication was observed, along with a significantly progressive drop in post-bronchodilator FEV 1 and post-bronchodilator FEV 1 /FVC (forced expiratory volume in one second/forced vital capacity). Spirometric reversibility can be useful in assessing control in asthmatic patients and can predict future risk parameters. The cutoff point related to the non-control of asthma found in our work was ≥10%. Copyright © 2017 Elsevier Ltd. All rights reserved.

When can I start pointe work? Guidelines for initiating pointe training.

PubMed

Weiss, David S; Rist, Rachel Anne; Grossman, Gayanne

2009-01-01

The initiation of pointe training for dance students should be determined after careful evaluation of a number of factors. These include: the dance student's stage of physical development; the quality of her (or his) trunk, abdominal and pelvic control ("core" stability); the alignment of her legs (hip-knee-ankle-foot); the strength and flexibility of her feet and ankles; and the duration and frequency of her dance training. For students who meet the requirements related to all of these factors, began ballet training at age eight or later, and who are taking ballet class at least twice per week, pointe work should be initiated in the fourth year of training. Students with poor core stability or hypermobility of the feet and ankles may require additional strengthening to allow them to safely begin pointe training. For those who are only taking ballet classes once per week, or who are not truly pre-professional, pointe training should be discouraged. No student with insufficient ankle and foot plantar flexion range of motion or with poor lower extremity alignment should be allowed to do pointe work.

Phenolic compounds and sensorial characterization of wines aged with alternative to barrel products made of Spanish oak wood (Quercus pyrenaica Willd.).

PubMed

Gallego, L; Del Alamo, M; Nevares, I; Fernández, J A; Fernández de Simón, B; Cadahía, E

2012-04-01

Wood of Quercus pyrenaica has suitable properties for the wine ageing process. However, the forest available for the barrel making from this particular type of tree is very limited. Nevertheless, it is highly advisable to use this kind of wood in order to manufacture alternative oak products. This study presents the results of ageing the same red wine using different pieces of wood (chips and staves) of Spanish oak (Q. pyrenaica), American oak (Quercus alba) and French oak (Quercus petraea) in conjunction with small, controlled amounts of oxygen. In addition, the phenolic parameters, colour and sensory analysis point out that wines aged with Q. pyrenaica pieces have similar enological characteristics to those aged with American or French oak pieces of wood (chips and staves). Furthermore, the total oxygen consumed and its relation with sensory properties also has been studied in this article in order to know how the oxygen behaves in these processes. Besides, it is going to put forward the fact that chips and staves from Q. pyrenaica oak are suitable for the ageing of red wines and better considered than American or French ones, showing higher aromatic intensity, complexity, woody, balsamic and cocoa. Finally, the tasters valued highly the wines with staves, pointing out its flavour and roundness in mouth.

Effect of Victimization on Impulse Control and Binge Drinking among Serious Juvenile Offenders from Adolescence to Young Adulthood.

PubMed

Davis, Jordan P; Dumas, Tara M; Berey, Benjamin L; Merrin, Gabriel J; Cimpian, Joseph R; Roberts, Brent W

2017-07-01

A vast literature has found longitudinal effects of early life stress on substance use and self-regulatory processes. These associations may vary by period-specific development among youth involved in the juvenile justice system. The current study used an accelerated longitudinal design and auto-regressive latent trajectory with structure residuals (ALT-SR) model to examine the within-person cross-lagged associations between binge drinking, impulse control, and victimization from 15 to 25 years of age. A large sample (N = 1100) of justice-involved youth were followed longitudinally for 7 years (M age baseline  = 15.8, M age conclusion  = 22.8). In general, the sample was ethnically diverse (41% Black, 34% Hispanic, 21% White, 4.3% Other) and primarily male (87.2%). Participants reported on their frequency of binge drinking, impulse control, and frequency of victimization at each time point. The results indicated that, during adolescence, victimization and binge drinking attenuated impulse control, which resulted in more binge drinking and victimization during young adulthood. The current study highlights the importance of assessing developmental processes and period-specific transitions among at risk youth, especially for youth experiencing early life stress.

One session of high-intensity interval training (HIIT) every 5 days, improves muscle power but not static balance in lifelong sedentary ageing men

PubMed Central

Sculthorpe, Nicholas F.; Herbert, Peter; Grace, Fergal

2017-01-01

Abstract Background: Declining muscle power during advancing age predicts falls and loss of independence. High-intensity interval training (HIIT) may improve muscle power, but remains largely unstudied in ageing participants. Methods: This randomized controlled trial (RCT) investigated the efficacy of a low-frequency HIIT (LfHIIT) intervention on peak muscle power (peak power output [PPO]), body composition, and balance in lifelong sedentary but otherwise healthy males. Methods: Thirty-three lifelong sedentary ageing men were randomly assigned to either intervention (INT; n = 22, age 62.3 ± 4.1 years) or control (n = 11, age 61.6 ± 5.0 years) who were both assessed at 3 distinct measurement points (phase A), after 6 weeks of conditioning exercise (phase B), and after 6 weeks of HIIT once every 5 days in INT (phase C), where control remained inactive throughout the study. Results: Static balance remained unaffected, and both absolute and relative PPO were not different between groups at phases A or B, but increased significantly in INT after LfHIIT (P < 0.01). Lean body mass displayed a significant interaction (P < 0.01) due to an increase in INT between phases B and C (P < 0.05). Conclusions: 6 weeks of LfHIIT exercise feasible and effective method to induce clinically relevant improvements in absolute and relative PPO, but does not improve static balance in sedentary ageing men. PMID:28178145

Postural control and attentional demand during adolescence.

PubMed

Palluel, Estelle; Nougier, Vincent; Olivier, Isabelle

2010-10-28

In the present study we aimed to determine the attentional cost of postural control during adolescence by studying the influence of a cognitive task on concurrent postural control. 38 teenagers aged 12 to 17years and 13 young adults (mean age=26.1) stood barefoot on a force platform in a semi-tandem position. A dual-task paradigm consisted of performing a Stroop or a COUNTING BACKWARD task while simultaneously standing quietly on a firm or foam support surface. Different centre of pressure (CoP) measures were calculated (90% confidence ellipse area, mean velocity, root mean square on the antero-posterior (AP) and medio-lateral (ML) axes). The number and percentage of correct responses in the cognitive tasks were also recorded. Our results indicate (1) higher values of surface, ML mean velocity and ML RMS in the COUNTING BACKWARD task in adolescents aged 12 to 15 than in teenagers aged 16 to 17 and in adults, regardless of the complexity of the postural task and, (2) better cognitive performances in the Stroop than in the COUNTING BACKWARD task. The difference in the dual-task performance between the different age groups and particularly the existence of a turning point around 14-15years of age might be due to 1) difficulties in properly allocating attentional resources to two simultaneous tasks and/or, 2) the inability to manage increased cognitive requests because of a limited information processing capacity in adolescents aged 14-15years. Copyright © 2010 Elsevier B.V. All rights reserved.

Resistance training improves fatigue and quality of life in previously sedentary breast cancer survivors: a randomised controlled trial.

PubMed

Hagstrom, A D; Marshall, P W M; Lonsdale, C; Cheema, B S; Fiatarone Singh, M A; Green, S

2016-09-01

The primary aim of this study was to evaluate the benefits of resistance training (RT) on quality of life (QOL) and fatigue in breast cancer survivors as an adjunct to usual care. We recruited 39 women who had survived breast cancer [mean age (y) 51.9 ± 8.8; time since diagnosis (m) 11.6 ± 13.2]. Primary outcomes were fatigue as assessed by the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT) scale and QOL as assessed by the Functional Assessment of Cancer Therapy - General (FACT-G) scale. ANCOVA was used to assess the change in the primary outcomes while controlling for baseline values, with effect sizes (ES) displayed as partial Eta squared. The experimental group received supervised RT 3 days per week in a university clinic for 16 weeks. Perceptions of fatigue improved significantly in the RT group compared to controls [mean (SD) 6.7 (7.5) points vs. 1.5 (3.7) points], (P = 0.006, ES = 0.20) as did QOL [6.9 (8.5) points vs. 1.6 (4.4) points], (P = 0.015, ES = 0.16). We demonstrated both statistically and clinically important improvements in fatigue and QOL in response to RT in breast cancer survivors. © 2015 John Wiley & Sons Ltd.

A Comparison of the Hot Spot and the Average Cancer Cell Counting Methods and the Optimal Cutoff Point of the Ki-67 Index for Luminal Type Breast Cancer.

PubMed

Arima, Nobuyuki; Nishimura, Reiki; Osako, Tomofumi; Nishiyama, Yasuyuki; Fujisue, Mamiko; Okumura, Yasuhiro; Nakano, Masahiro; Tashima, Rumiko; Toyozumi, Yasuo

2016-01-01

In this case-control study, we investigated the most suitable cell counting area and the optimal cutoff point of the Ki-67 index. Thirty recurrent cases were selected among hormone receptor (HR)-positive/HER2-negative breast cancer patients. As controls, 90 nonrecurrent cases were randomly selected by allotting 3 controls to each recurrent case based on the following criteria: age, nodal status, tumor size, and adjuvant endocrine therapy alone. Both the hot spot and the average area of the tumor were evaluated on a Ki-67 immunostaining slide. The median Ki-67 index value at the hot spot and average area were 25.0 and 14.5%, respectively. Irrespective of the area counted, the Ki-67 index value was significantly higher in all of the recurrent cases (p < 0.0001). The multivariate analysis revealed that the Ki-67 index value of 20% at the hot spot was the most suitable cutoff point for predicting recurrence. Moreover, higher x0394;Ki-67 index value (the difference between the hot spot and the average area, ≥10%) and lower progesterone receptor expression (<20%) were significantly correlated with recurrence. A higher Ki-67 index value at the hot spot strongly correlated with recurrence, and the optimal cutoff point was found to be 20%. © 2015 S. Karger AG, Basel.

Lesson Two: Terra Australis. Australian Studies High School Series. History Unit.

ERIC Educational Resources Information Center

Waldron, John

This lesson, one of four stand-alone lessons that examine Australia as an aspect of world history, points out that Australia's unique geographic characteristics and history serve as a useful case study of key global concepts. The lesson focuses on exploration and control of trade routes during the Age of Discovery. The lesson has two parts. In…

Orienteering with Adventure Education: New Games for the 21st Century

ERIC Educational Resources Information Center

Hammes, Ryan

2007-01-01

Orienteering is an outdoor pursuit in which participants try to locate a series of different control points, using only a map and compass (Laubach, 1998). It is a life-long skill that can be taught to all ages in both a natural and urban setting. Adventure education is an approach to teaching where an individual is placed in an unfamiliar…

Long-term skeletal effects of high-pull headgear followed by fixed appliances for the treatment of Class II malocclusions.

PubMed

Bilbo, E Erin; Marshall, Steven D; Southard, Karin A; Allareddy, Verrasathpurush; Holton, Nathan; Thames, Allyn M; Otsby, Marlene S; Southard, Thomas E

2018-04-18

The long-term skeletal effects of Class II treatment in growing individuals using high-pull facebow headgear and fixed edgewise appliances have not been reported. The purpose of this study was to evaluate the long-term skeletal effects of treatment using high-pull headgear followed by fixed orthodontic appliances compared to an untreated control group. Changes in anteroposterior and vertical cephalometric measurements of 42 Class II subjects (n = 21, mean age = 10.7 years) before treatment, after headgear correction to Class I molar relationship, after treatment with fixed appliances, and after long-term retention (mean 4.1 years), were compared to similar changes in a matched control group (n = 21, mean age = 10.9 years) by multivariable linear regression models. Compared to control, the study group displayed significant long-term horizontal restriction of A-point (SNA = -1.925°, P < .0001; FH-NA = -3.042°, P < .0001; linear measurement A-point to Vertical Reference = -3.859 mm, P < .0001) and reduction of the ANB angle (-1.767°, P < .0001), with no effect on mandibular horizontal growth or maxillary and mandibular vertical skeletal changes. A-point horizontal restriction and forward mandibular horizontal growth accompanied the study group correction to Class I molar, and these changes were stable long term. One phase treatment for Class II malocclusion with high-pull headgear followed by fixed orthodontic appliances resulted in correction to Class I molar through restriction of horizontal maxillary growth with continued horizontal mandibular growth and vertical skeletal changes unaffected. The anteroposterior molar correction and skeletal effects of this treatment were stable long term.

Early-adulthood cardiovascular disease risk factor profiles among individuals with and without diabetes in the Framingham Heart Study.

PubMed

Preis, Sarah Rosner; Pencina, Michael J; Mann, Devin M; D'Agostino, Ralph B; Savage, Peter J; Fox, Caroline S

2013-06-01

Many studies of diabetes have examined risk factors at the time of diabetes diagnosis instead of considering the lifetime burden of adverse risk factor levels. We examined the 30-year cardiovascular disease (CVD) risk factor burden that participants have up to the time of diabetes diagnosis. Among participants free of CVD, incident diabetes cases (fasting plasma glucose ≥ 126 mg/dL or treatment) occurring at examinations 2 through 8 (1979-2008) of the Framingham Heart Study Offspring cohort were age- and sex-matched 1:2 to controls. CVD risk factors (hypertension, high LDL cholesterol, low HDL cholesterol, high triglycerides, obesity) were measured at the time of diabetes diagnosis and at time points 10, 20, and 30 years prior. Conditional logistic regression was used to compare risk factor levels at each time point between diabetes cases and controls. We identified 525 participants with new-onset diabetes who were matched to 1,049 controls (mean age, 60 years; 40% women). Compared with those without diabetes, individuals who eventually developed diabetes had higher levels of hypertension (odds ratio [OR], 2.2; P = 0.003), high LDL (OR, 1.5; P = 0.04), low HDL (OR, 2.1; P = 0.0001), high triglycerides (OR, 1.7; P = 0.04), and obesity (OR, 3.3; P < 0.0001) at time points 30 years before diabetes diagnosis. After further adjustment for BMI, the ORs for hypertension (OR, 1.9; P = 0.02) and low HDL (OR, 1.7; P = 0.01) remained statistically significant. CVD risk factors are increased up to 30 years before diagnosis of diabetes. These findings highlight the importance of a life course approach to CVD risk factor identification among individuals at risk for diabetes.

Incidence and prediction of falls in dementia: a prospective study in older people.

PubMed

Allan, Louise M; Ballard, Clive G; Rowan, Elise N; Kenny, Rose Anne

2009-01-01

Falls are a major cause of morbidity and mortality in dementia, but there have been no prospective studies of risk factors for falling specific to this patient population, and no successful falls intervention/prevention trials. This prospective study aimed to identify modifiable risk factors for falling in older people with mild to moderate dementia. 179 participants aged over 65 years were recruited from outpatient clinics in the UK (38 Alzheimer's disease (AD), 32 Vascular dementia (VAD), 30 Dementia with Lewy bodies (DLB), 40 Parkinson's disease with dementia (PDD), 39 healthy controls). A multifactorial assessment of baseline risk factors was performed and fall diaries were completed prospectively for 12 months. Dementia participants experienced nearly 8 times more incident falls (9118/1000 person-years) than controls (1023/1000 person-years; incidence density ratio: 7.58, 3.11-18.5). In dementia, significant univariate predictors of sustaining at least one fall included diagnosis of Lewy body disorder (proportional hazard ratio (HR) adjusted for age and sex: 3.33, 2.11-5.26), and history of falls in the preceding 12 months (HR: 2.52, 1.52-4.17). In multivariate analyses, significant potentially modifiable predictors were symptomatic orthostatic hypotension (HR: 2.13, 1.19-3.80), autonomic symptom score (HR per point 0-36: 1.055, 1.012-1.099), and Cornell depression score (HR per point 0-40: 1.053, 1.01-1.099). Higher levels of physical activity were protective (HR per point 0-9: 0.827, 0.716-0.956). The management of symptomatic orthostatic hypotension, autonomic symptoms and depression, and the encouragement of physical activity may provide the core elements for the most fruitful strategy to reduce falls in people with dementia. Randomised controlled trials to assess such a strategy are a priority.

Psychosocial work environment in school and students' somatic health complaints: An analysis of buffering resources.

PubMed

Sonmark, Kristina; Modin, Bitte

2017-02-01

This study explores the association between the psychosocial work environment in school and students' somatic health complaints. With its point of departure from the Demand-Control-Support (DCS) model, the aim was to examine how aspects of decision control and social support can moderate stress-related health implications of high psychological demands. Data come from two cross-sectional waves of the Swedish version of Health Behaviour in School-aged Children (HBSC 2005/2006 and 2009/2010), which consists of a total of 9427 11-, 13- and 15-year-old students. A two-level random intercept model was applied, with school class as the level 2 unit. Findings showed significant associations between school demands and somatic health complaints for all studied age groups, with a slight increase in strength with age. Decision control as well as social support from teachers, parents and peers consistently predicted a favorable association with health. An age pattern emerged in the analyses of stress-moderating resources. For 11 year olds parental support was the only resource that displayed a significant interaction with demands in relation to somatic health complaints, whereas for 13 year olds, decision control and support from teachers and parents all demonstrated moderating effects on student health. For 15 year olds, however, it was peer support that acted as a buffering resource in the studied relationship. The psychosocial work environment is an important predictor of students' health complaints. Overall, social support was a better stress-moderating resource than decision control, but some "buffers" were more important at certain ages than others.

16 CFR § 1500.48 - Technical requirements for determining a sharp point in toys and other articles intended for use...

Code of Federal Regulations, 2013 CFR

2013-01-01

... sharp point in toys and other articles intended for use by children under 8 years of age. § 1500.48... by children under 8 years of age. (a) Objective. The sharp point test prescribed by paragraph (d) of... and other articles intended for use by children under 8 years of age, and such points exposed in...

The Impact of Retail-Sector Delivery of Artemether–Lumefantrine on Malaria Treatment of Children under Five in Kenya: A Cluster Randomized Controlled Trial

PubMed Central

Kangwana, Beth P.; Kedenge, Sarah V.; Noor, Abdisalan M.; Alegana, Victor A.; Nyandigisi, Andrew J.; Pandit, Jayesh; Fegan, Greg W.; Todd, James E.; Brooker, Simon; Snow, Robert W.; Goodman, Catherine A.

2011-01-01

Background It has been proposed that artemisinin-based combination therapy (ACT) be subsidised in the private sector in order to improve affordability and access. This study in western Kenya aimed to evaluate the impact of providing subsidized artemether–lumefantrine (AL) through retail providers on the coverage of prompt, effective antimalarial treatment for febrile children aged 3–59 months. Methods and Findings We used a cluster-randomized, controlled design with nine control and nine intervention sublocations, equally distributed across three districts in western Kenya. Cross-sectional household surveys were conducted before and after the delivery of the intervention. The intervention comprised provision of subsidized packs of paediatric ACT to retail outlets, training of retail outlet staff, and community awareness activities. The primary outcome was defined as the proportion of children aged 3–59 months reporting fever in the past 2 weeks who started treatment with AL on the same day or following day of fever onset. Data were collected using structured questionnaires and analyzed based on cluster-level summaries, comparing control to intervention arms, while adjusting for other covariates. Data were collected on 2,749 children in the target age group at baseline and 2,662 at follow-up. 29% of children experienced fever within 2 weeks before the interview. At follow-up, the percentage of children receiving AL on the day of fever or the following day had risen by 14.6% points in the control arm (from 5.3% [standard deviation (SD): 3.2%] to 19.9% [SD: 10.0%]) and 40.2% points in the intervention arm (from 4.7% [SD: 3.4%] to 44.9% [SD: 11.7%]). The percentage of children receiving AL was significantly greater in the intervention arm at follow-up, with a difference between the arms of 25.0% points (95% confidence interval [CI]: 14.1%, 35.9%; unadjusted p = 0.0002, adjusted p = 0.0001). No significant differences were observed between arms in the proportion of caregivers who sought treatment for their child's fever by source, or in the child's adherence to AL. Conclusions Subsidizing ACT in the retail sector can significantly increase ACT coverage for reported fevers in rural areas. Further research is needed on the impact and cost-effectiveness of such subsidy programmes at a national scale. Trial Registration Current Controlled Trials ISRCTN59275137 and Kenya Pharmacy and Poisons Board Ethical Committee for Clinical Trials PPB/ECCT/08/07. Please see later in the article for the Editors' Summary PMID:21655317

The CLOSED trial; CLOnidine compared with midazolam for SEDation of paediatric patients in the intensive care unit: study protocol for a multicentre randomised controlled trial

PubMed Central

Neubert, Antje; Baarslag, Manuel Alberto; van Dijk, Monique; van Rosmalen, Joost; Standing, Joseph F; Sheng, Yucheng; Rascher, Wolfgang; Roberts, Deborah; Winslade, Jackie; Rawcliffe, Louise; Hanning, Sara M; Metsvaht, Tuuli; Giannuzzi, Viviana; Larsson, Peter; Pokorná, Pavla; Simonetti, Alessandra; Tibboel, Dick

2017-01-01

Introduction Sedation is an essential part of paediatric critical care. Midazolam, often in combination with opioids, is the current gold standard drug. However, as it is a far-from-ideal agent, clonidine is increasingly being used in children. This drug is prescribed off-label for this indication, as many drugs in paediatrics are. Therefore, the CLOSED trial aims to provide data on the pharmacokinetics, safety and efficacy of clonidine for the sedation of mechanically ventilated patients in order to obtain a paediatric-use marketing authorisation. Methods and analysis The CLOSED study is a multicentre, double-blind, randomised, active-controlled non-inferiority trial with a 1:1 randomisation between clonidine and midazolam. Both treatment groups are stratified according to age in three groups with the same size: <28 days (n=100), 28 days to <2 years (n=100) and 2–18 years (n=100). The primary end point is defined as the occurrence of sedation failure within the study period. Secondary end points include a pharmacokinetic/pharmacodynamic relationship, pharmacogenetics, occurrence of delirium and withdrawal syndrome, opioid consumption and neurodevelopment in the neonatal age group. Logistic regression will be used for the primary end point, appropriate statistics will be used for the secondary end points. Ethics Written informed consent will be obtained from the parents/caregivers. Verbal or deferred consent will be used in the sites where national legislation allows. The study has institutional review board approval at recruiting sites. The results will be published in a peer-reviewed journal and shared with the worldwide medical community. Trial Registration EudraCT: 2014-003582-24; Clinicaltrials.gov: NCT02509273; pre-results. PMID:28637741

Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study.

PubMed

Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Wong, Janet Y H; Yu, Esther Y T; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Zhang, Joni; Macfarlane, Duncan; Chung, Louisa M Y

2016-01-01

Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults.

Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study

PubMed Central

Ng, Shamay S. M.; Cheng, Yoyo T. Y.; Yu, Esther Y. T.; Chow, Gary C. C.; Chak, Yvonne T. C.; Chan, Ivy K. Y.; Zhang, Joni; Macfarlane, Duncan

2016-01-01

Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults. PMID:27525020

Upper airway sensory function in children with obstructive sleep apnea syndrome.

PubMed

Tapia, Ignacio E; Bandla, Preetam; Traylor, Joel; Karamessinis, Laurie; Huang, Jingtao; Marcus, Carole L

2010-07-01

Children with the obstructive sleep apnea syndrome (OSAS) have impaired responses to hypercapnia, subatmospheric pressure, and inspiratory resistive loading during sleep. This may be due, in part, to an impairment in the afferent limb of the upper airway sensory pathway. Therefore, we hypothesized that children with OSAS had diminished upper airway sensation compared to controls. Case-control. Academic hospital. Subjects with OSAS aged 6-16 years, and age- and BMI-matched controls. Two-point discrimination (TPD) was measured during wakefulness with modified calipers in the anterior tongue, right interior cheek, and hard palate. Thirteen children with OSAS and 9 controls were tested. The age (mean +/- SD) for OSAS and controls was 11 +/- 4 vs. 13 +/- 2 years (NS); OSAS BMI Z score 2.4 +/- 0.5, controls 2.2 +/- 0.5 (NS); OSAS apnea hypopnea index 31 +/- 48, controls 0.4 +/- 0.5 events/hour (P < 0.001). Children with OSAS had impaired TPD in the anterior tongue (median [range]) = 9 [3-14] mm, controls 3 [1-7], P = 0.002) and hard palate (OSAS 6 [3-9] mm, controls 3 [1-4], P < 0.001). TPD in the cheek was similar between the groups (P = 0.12). TPD in the anterior tongue and hard palate was impaired in children with OSAS during wakefulness. We speculate that this impairment might be due to a primary sensory function abnormality or secondary to nerve damage and/or hypoxemia caused by OSAS. Further studies after treatment of OSAS are needed.

Children with migraine: Provocation of headache via pressure to myofascial trigger points in the trapezius muscle? - A prospective controlled observational study.

PubMed

Landgraf, M N; Biebl, J T; Langhagen, T; Hannibal, I; Eggert, T; Vill, K; Gerstl, L; Albers, L; von Kries, R; Straube, A; Heinen, F

2018-02-01

The objective was to evaluate a supposed clinical interdependency of myofascial trigger points and migraine in children. Such interdependency would support an interaction of spinal and trigeminal afferences in the trigemino-cervical complex as a contributing factor in migraine. Children ≤18 years with the confirmed diagnosis of migraine were prospectively investigated. Comprehensive data on medical history, clinical neurological and psychological status were gathered. Trigger points in the trapezius muscle were identified by palpation and the threshold of pressure pain at these points was measured. Manual pressure was applied to the trigger points, and the occurrence and duration of induced headache were recorded. At a second consultation (4 weeks after the first), manual pressure with the detected pressure threshold was applied to non-trigger points within the same trapezius muscle (control). Headache and related parameters were again recorded and compared to the results of the first consultation. A total of 13 girls and 13 boys with migraine and a median age of 14.5 (Range 6.3-17.8) years took part in the study. Manual pressure to trigger points in the trapezius muscle led to lasting headache after termination of the manual pressure in 13 patients while no patient experienced headache when manual pressure was applied to non-trigger points at the control visit (p < 0.001). Headache was induced significantly more often in children ≥12 years and those with internalizing behavioural disorder. We found an association between trapezius muscle myofascial trigger points and migraine, which might underline the concept of the trigemino-cervical complex, especially in adolescents. In children with migraine headache can often be induced by pressure to myofascial trigger points, but not by pressure to non-trigger points in the trapezius muscle. This supports the hypothesis of a trigemino-cervical-complex in the pathophysiology of migraine, which might have implications for innovative therapies in children with migraine. © 2017 European Pain Federation - EFIC®.

The London Fibromyalgia Epidemiology Study: comparing the demographic and clinical characteristics in 100 random community cases of fibromyalgia versus controls.

PubMed

White, K P; Speechley, M; Harth, M; Ostbye, T

1999-07-01

To identify demographic and clinical features that distinguish fibromyalgia (FM) from other chronic widespread pain. We identified 100 confirmed FM cases, 76 widespread pain controls, and 135 general controls in a random community survey of 3395 noninstitutionalized adults living in London, Ontario. FM cases were distinguished from pain controls using the 1990 American College of Rheumatology (ACR) classification criteria for FM. The mean age of FM cases was 47.8 years (range 19 to 86), the same as for pain controls; 86% of FM cases were female versus 67.1% of pain controls (p < 0.01). FM cases were less educated than general controls (p = 0.03). Male and female FM cases were similar, except females were older and reported more major symptoms (both p = 0.02). FM cases reported more severe pain and fatigue, more symptoms, more major symptoms, and worse overall health than pain controls or general controls. The most commonly reported major symptoms among FM cases were musculoskeletal pain (77.3%), fatigue (77.3%), severe fatigue lasting 24 h after minimal activity (77.0%), nonrestorative sleep (65.7%), and insomnia (56.0%). Subjects with 11-14 tender points were more similar to those with 15-18 tender points than to those with 7-10 points in 11 of 14 clinical variables. On multivariate analysis, 4 symptoms distinguished FM cases from pain controls: pain severity (p = 0.004), severe fatigue lasting 24 h after minimal activity (p = 0.006), weakness (p = 0.008), and self-reported swelling of neck glands (p = 0.01). In the general population, adults who meet the ACR definition of FM appear to have distinct features compared to those with chronic widespread pain who do not meet criteria.

Lack of Postprandial Peak in Brain-Derived Neurotrophic Factor in Adults with Prader-Willi Syndrome

PubMed Central

Bueno, Marta; Esteba-Castillo, Susanna; Novell, Ramon; Giménez-Palop, Olga; Coronas, Ramon; Gabau, Elisabeth; Corripio, Raquel; Baena, Neus; Viñas-Jornet, Marina; Guitart, Míriam; Torrents-Rodas, David; Deus, Joan; Pujol, Jesús; Rigla, Mercedes

2016-01-01

Context Prader-Willi syndrome (PWS) is characterized by severe hyperphagia. Brain-derived neurotrophic factor (BDNF) and leptin are reciprocally involved in energy homeostasis. Objectives To analyze the role of BDNF and leptin in satiety in genetic subtypes of PWS. Design Experimental study. Setting University hospital. Subjects 90 adults: 30 PWS patients; 30 age-sex-BMI-matched obese controls; and 30 age-sex-matched lean controls. Interventions Subjects ingested a liquid meal after fasting ≥10 hours. Main Outcome Measures Leptin and BDNF levels in plasma extracted before ingestion and 30’, 60’, and 120’ after ingestion. Hunger, measured on a 100-point visual analogue scale before ingestion and 60’ and 120’ after ingestion. Results Fasting BDNF levels were lower in PWS than in controls (p = 0.05). Postprandially, PWS patients showed only a truncated early peak in BDNF, and their BDNF levels at 60' and 120' were lower compared with lean controls (p<0.05). Leptin was higher in PWS patients than in controls at all time points (p<0.001). PWS patients were hungrier than controls before and after eating. The probability of being hungry was associated with baseline BDNF levels: every 50-unit increment in BDNF decreased the odds of being hungry by 22% (OR: 0.78, 95%CI: 0.65–0.94). In uniparental disomy, the odds of being hungry decreased by 66% (OR: 0.34, 90%CI: 0.13–0.9). Postprandial leptin patterns did no differ among genetic subtypes. Conclusions Low baseline BDNF levels and lack of postprandial peak may contribute to persistent hunger after meals. Uniparental disomy is the genetic subtype of PWS least affected by these factors. PMID:27685845

The role of a personalized dietary intervention in managing gestational weight gain: a prospective, controlled study in a low-risk antenatal population.

PubMed

Di Carlo, Costantino; Iannotti, Giuseppina; Sparice, Stefania; Chiacchio, Maria Pia; Greco, Elena; Tommaselli, Giovanni Antonio; Nappi, Carmine

2014-04-01

To compare the efficacy of a personal dietary intervention on gestational weight gain control with a general intervention promoting healthy eating. Prospective, controlled study including 154 low-risk pregnant women randomly allocated to two groups: 77 receiving a personalized diet plan and a close follow-up by a dietician (intervention group), 77 receiving standard dietary care by means of a brochure on healthy eating during pregnancy (control group). Pre-pregnancy weight, gestational age, height, weight and BMI at baseline, weight at term, gestational age at delivery and newborn weight were recorded for all participants. The primary end-point was the difference in body weight between baseline and term. Secondary end-points were the difference in body weight between pre-pregnancy and term and in newborn weights. Maternal weight gain at term was significantly lower both as compared to pre-pregnancy weight (8.2 ± 4.0 vs. 13.4 ± 4.2 kg; p < 0.001) and to weight at baseline (7.7 ± 3.8 vs. 13.7 ± 4.3 kg; p < 0.001) in the intervention group as compared to controls. A positive, significant correlation between the delta weight between baseline and term and newborn weight was observed in both groups, but stronger in patients from the intervention group (intervention group R = 0.76, p < 0.001; control group R = 0.35, p = 0.01). This study suggests that a personalized nutritional intervention, in which the dietician plays an active role within the obstetric team, may represent a successful approach in limiting weight gain in pregnant women.

An earlier age of breast cancer diagnosis related to more frequent use of antiperspirants/deodorants and underarm shaving.

PubMed

McGrath, K G

2003-12-01

Breast cancer incidence suggests a lifestyle cause. A lifestyle factor used near the breast is the application of antiperspirants/deodorants accompanied by axillary shaving. A previous study did not support a link with breast cancer. If these habits have a role in breast cancer development, women using antiperspirants/deodorants and shaving their underarms frequently would be expected to have an earlier age of diagnosis than those doing so less often. An earlier age of diagnosis would also be expected in those starting to use deodorants and shaving at an earlier age. This is the first study to investigate the intensity of underarm exposure in a cohort of breast cancer survivors. Four hundred and thirty-seven females diagnosed with breast cancer were surveyed. Once grouped by their frequency of underarm hygiene habits, the mean age of diagnosis was the primary end point. Secondary end points included the overall frequency of these habits, and potential usage group confounding variables were evaluated. All statistical tests were two-sided. Frequency and earlier onset of antiperspirant/deodorant usage with underarm shaving were associated with an earlier age of breast cancer diagnosis. Combined habits are likely for this earlier age of diagnosis. In conclusion, underarm shaving with antiperspirant/deodorant use may play a role in breast cancer. It is not clear which of these components are involved. Reviewed literature insinuates absorption of aluminium salts facilitated by dermal barrier disruption. Case-controlled investigations are needed before alternative underarm hygiene habits are suggested.

The PROPKD Score: A New Algorithm to Predict Renal Survival in Autosomal Dominant Polycystic Kidney Disease.

PubMed

Cornec-Le Gall, Emilie; Audrézet, Marie-Pierre; Rousseau, Annick; Hourmant, Maryvonne; Renaudineau, Eric; Charasse, Christophe; Morin, Marie-Pascale; Moal, Marie-Christine; Dantal, Jacques; Wehbe, Bassem; Perrichot, Régine; Frouget, Thierry; Vigneau, Cécile; Potier, Jérôme; Jousset, Philippe; Guillodo, Marie-Paule; Siohan, Pascale; Terki, Nazim; Sawadogo, Théophile; Legrand, Didier; Menoyo-Calonge, Victorio; Benarbia, Seddik; Besnier, Dominique; Longuet, Hélène; Férec, Claude; Le Meur, Yannick

2016-03-01

The course of autosomal dominant polycystic kidney disease (ADPKD) varies among individuals, with some reaching ESRD before 40 years of age and others never requiring RRT. In this study, we developed a prognostic model to predict renal outcomes in patients with ADPKD on the basis of genetic and clinical data. We conducted a cross-sectional study of 1341 patients from the Genkyst cohort and evaluated the influence of clinical and genetic factors on renal survival. Multivariate survival analysis identified four variables that were significantly associated with age at ESRD onset, and a scoring system from 0 to 9 was developed as follows: being male: 1 point; hypertension before 35 years of age: 2 points; first urologic event before 35 years of age: 2 points; PKD2 mutation: 0 points; nontruncating PKD1 mutation: 2 points; and truncating PKD1 mutation: 4 points. Three risk categories were subsequently defined as low risk (0-3 points), intermediate risk (4-6 points), and high risk (7-9 points) of progression to ESRD, with corresponding median ages for ESRD onset of 70.6, 56.9, and 49 years, respectively. Whereas a score ≤3 eliminates evolution to ESRD before 60 years of age with a negative predictive value of 81.4%, a score >6 forecasts ESRD onset before 60 years of age with a positive predictive value of 90.9%. This new prognostic score accurately predicts renal outcomes in patients with ADPKD and may enable the personalization of therapeutic management of ADPKD. Copyright © 2016 by the American Society of Nephrology.

An islet of social ability in Asperger Syndrome: judging social attributes from faces.

PubMed

White, Sarah; Hill, Elisabeth; Winston, Joel; Frith, Uta

2006-06-01

We asked adults with Asperger Syndrome to judge pictorial stimuli in terms of certain social stereotypes to evaluate to what extent they have access to this type of social knowledge. Sixteen adults with Asperger Syndrome and 24 controls, matched for age and intelligence, were presented with sets of faces, bodies and objects, which had to be rated on a 7-point scale in terms of trustworthiness, attractiveness, social status, and age, or, in the case of objects, price. Despite impaired performance on two important aspects of social cognition (second-order mentalizing and face recognition) the social judgements of the individuals with Asperger Syndrome were just as competent and consistent as those of their matched controls, with only one exception: there was a trend for them to be less able to judge the attractiveness of faces if they were the same sex. We explain this difference in terms of a weakness in mentalizing, specifically the ability to take a different point of view: While all other stereotypic attributions could be made from an egocentric point of view, judging the attractiveness of faces of one's own sex requires taking the perspective of someone of the opposite sex, a challenge for people with mentalizing problems. We conclude that individuals with Asperger Syndrome show preserved aspects of social knowledge, as revealed in the attribution of stereotypes to pictures of people. These findings suggest that there are dissociable subcomponents to social cognition and that not all of these are compromised in Asperger Syndrome.

Malnutrition at age 3 years and lower cognitive ability at age 11 years: independence from psychosocial adversity.

PubMed

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

2003-06-01

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

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

PubMed Central

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

2014-01-01

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

The (lack of) relation between straylight and visual acuity. Two domains of the point-spread-function.

PubMed

van den Berg, Thomas J T P

2017-05-01

The effect of cataract and other media opacities on functional vision is typically assessed clinically using visual acuity. In both clinical and basic research, straylight (the functional result of light scattering in the eye) is commonly measured. The purpose of the present study was to determine the link between these two measures: is visual acuity in cataract and other media opacities related to straylight? Interdependence between acuity and straylight is addressed from three different points of view: (1) Methodological: can acuity differences affect the measurement value of straylight, and vice versa? (2) Basic optics: does the optical process of light scattering in the human eye affect both straylight and visual acuity? (3) Statistical: how strongly are acuity and straylight correlated in the practice of important clinical conditions? Experimental and theoretical aspects will be considered, with a focus on normal ageing and cataract formation. (1) Methodological: testing potential effects of acuity, artificially manipulated with positive trial lenses, showed no effect on measured straylight values. Since light scattering in the eye involves a low percentage of the light and has large angular spreading, contrast reduction due to straylight is limited, resulting in virtually absent acuity effects. (2) Basic optics: light scattering from the human donor eye lens is found to have virtually no effect in the centre of the point-spread-function, also for cataractous lenses, resulting in virtually absent acuity effects. (3) Statistical: literature data on straylight and visual acuity show a weak correlation for the important groups of normal ageing and cataract populations. The point-spread-function of the normal ageing and cataractous human eye is built upon two rather independent basic parts. Aberrations control the central peak. Light scattering controls the periphery from about 1° onwards. The way acuity and straylight are measured ensures no confounding between them. Statistically within the normal ageing and cataract populations, visual acuity and straylight vary quite independently from each other. Visual acuity losses with cataract and other media opacities are not due to straylight, but caused by aberrations and micro-aberrations. Straylight defines disability glare, and causes symptoms of glare, haloes, hazy vision etc. Overall, visual acuity and straylight are rather independent aspects of quality of vision. © 2017 The Author Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

Dissociating Effects of Global SWS Disruption and Healthy Aging on Waking Performance and Daytime Sleepiness

PubMed Central

Groeger, John A.; Stanley, Neil; Deacon, Stephen; Dijk, Derk-Jan

2014-01-01

Study Objective: To contrast the effects of slow wave sleep (SWS) disruption and age on daytime functioning. Design: Daytime functioning was contrasted in three age cohorts, across two parallel 4-night randomized groups (baseline, two nights of SWS disruption or control, recovery sleep). Setting: Sleep research laboratory. Participants: 44 healthy young (20-30 y), 35 middle-aged (40-55 y), and 31 older (66-83 y) men and women. Interventions: Acoustic stimulation contingent on appearance of slow waves. Measurements and Results: Cognitive performance was assessed before sleep latency tests at five daily time-points. SWS disruption resulted in less positive affect, slower or impaired information processing and sustained attention, less precise motor control, and erroneous implementation, rather than inhibition, of well-practiced actions. These performance impairments had far smaller effect sizes than the increase in daytime sleepiness and differed from baseline to the same extent for each age group. At baseline, younger participants performed better than older participants across many cognitive domains, with largest effects on executive function, response time, sustained attention, and motor control. At baseline, the young were sleepier than other age groups. Conclusions: SWS has been considered a potential mediator of age-related decline in performance, although the effects of SWS disruption on daytime functioning have not been quantified across different cognitive domains nor directly compared to age-related changes in performance. The data imply that two nights of SWS disruption primarily leads to an increase in sleepiness with minor effects on other aspects of daytime functioning, which are different from the substantial effects of age. Citation: Groeger JA, Stanley N, Deacon S, Dijk DJ. Dissociating effects of global sws disruption and healthy aging on waking performance and daytime sleepiness. SLEEP 2014;37(6):1127-1142. PMID:24882908

Scoring Systems to Estimate Intracerebral Control and Survival Rates of Patients Irradiated for Brain Metastases;Brain metastases; Radiation therapy; Local control; Survival; Prognostic scores

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

Rades, Dirk, E-mail: Rades.Dirk@gmx.net; Dziggel, Liesa; Haatanen, Tiina

2011-07-15

Purpose: To create and validate scoring systems for intracerebral control (IC) and overall survival (OS) of patients irradiated for brain metastases. Methods and Materials: In this study, 1,797 patients were randomly assigned to the test (n = 1,198) or the validation group (n = 599). Two scoring systems were developed, one for IC and another for OS. The scores included prognostic factors found significant on multivariate analyses. Age, performance status, extracerebral metastases, interval tumor diagnosis to RT, and number of brain metastases were associated with OS. Tumor type, performance status, interval, and number of brain metastases were associated with IC.more » The score for each factor was determined by dividing the 6-month IC or OS rate (given in percent) by 10. The total score represented the sum of the scores for each factor. The score groups of the test group were compared with the corresponding score groups of the validation group. Results: In the test group, 6-month IC rates were 17% for 14-18 points, 49% for 19-23 points, and 77% for 24-27 points (p < 0.0001). IC rates in the validation group were 19%, 52%, and 77%, respectively (p < 0.0001). In the test group, 6-month OS rates were 9% for 15-19 points, 41% for 20-25 points, and 78% for 26-30 points (p < 0.0001). OS rates in the validation group were 7%, 39%, and 79%, respectively (p < 0.0001). Conclusions: Patients irradiated for brain metastases can be given scores to estimate OS and IC. IC and OS rates of the validation group were similar to the test group demonstrating the validity and reproducibility of both scores.« less

Prevalence of musculoskeletal disorders and rheumatic diseases in Cuenca, Ecuador: a WHO-ILAR COPCORD study.

PubMed

Guevara-Pacheco, Sergio; Feicán-Alvarado, Astrid; Sanín, Luz Helena; Vintimilla-Ugalde, Jaime; Vintimilla-Moscoso, Fernando; Delgado-Pauta, Jorge; Lliguisaca-Segarra, Angelita; Dután-Erráez, Holger; Guevara-Mosquera, Daniel; Ochoa-Robles, Verónica; Cardiel, Mario H; Peláez-Ballestas, Ingris

2016-09-01

The aim of this study was to determine the prevalence of musculoskeletal pain and rheumatic diseases in subjects over 18 years of age from the canton of Cuenca, Ecuador. Cross-sectional analytical community-based study was conducted in subjects over 18 years of age using the validated Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) questionnaire. Random sampling was used. The questionnaire was administered by standardized health workers. Subjects were visited house by house. Subjects positive for musculoskeletal (MSK) pain in the last 7 days and at some point in life were assessed by rheumatologists to confirm the diagnosis. A total of 4877 subjects participated, with an average age of 42.8 (SD 18.8) years of age; 59.7 % were women; 69.7 % lived in urban areas. 32.5 % reported MSK pain in the last 7 days and 45.7 % at some point in life. The prevalence of knee osteoarthritis was 7.4 %, hand osteoarthritis 5.3 %, low back pain 9.3 %, rheumatoid arthritis 0.8 %, fibromyalgia 2 %, gout 0.4 %, and lupus 0.06 %. Subjects from rural areas reported experiencing more MSK pain in the last 7 days and at some point in life, lower income, poorer health-care coverage, and increased physical activity involving repetitive tasks such as lifting weights or cooking with firewood. MSK pain prevalence was high. Osteoarthritis and low back pain were the most common diseases. Age, sex, physical activity, repetitive tasks, living in a rural area, and lack of health-care coverage were found to be associated with MSK pain.

Heart Failure with Preserved Ejection Fraction: Molecular Pathways of the Aging Myocardium

PubMed Central

Loffredo, Francesco S.; Nikolova, Andriana P.; Pancoast, James R.; Lee, Richard T.

2014-01-01

Age-related diastolic dysfunction is a major factor in the epidemic of heart failure. In patients hospitalized with heart failure, diastolic heart failure is now as common as systolic heart failure. We now have many successful treatments for HFrEF, while specific treatment options for HFpEF patients remain elusive. The lack of treatments for HFpEF reflects our very incomplete understanding of this constellation of diseases. There are many pathophysiological factors in HFpEF, but aging appears to play an important role. Here we propose that aging of the myocardium is itself a specific pathophysiological process. New insights into the aging heart, including hormonal controls and specific molecular pathways such as microRNAs, are pointing to myocardial aging as a potentially reversible process. While the overall process of aging remains mysterious, understanding the molecular pathways of myocardial aging has never been more important. Unraveling these pathways could lead to new therapies for the enormous and growing problem of HFpEF. PMID:24951760

Community perceptions on the community-directed treatment and school-based approaches for the control of schistosomiasis and soil-transmitted helminthiasis among school-age children in Lushoto District, Tanzania.

PubMed

Massa, K; Magnussen, P; Sheshe, A; Ntakamulenga, R; Ndawi, B; Olsen, A

2009-01-01

The success of the Community-Directed Treatment (ComDT) approach in the control of onchocerciasis and filariasis has caught the attention of other disease control programmes. In this study the ComDT approach was implemented and compared with the school-based approach for control of schistosomiasis and soil-transmitted helminthiasis among school-age children in Lushoto District, Tanzania. This was a qualitative study, consisting of in-depth interviews with village leaders, community drug distributors (CDDs) and schoolteachers, as well as focus group discussions with separate groups of mothers and fathers to assess the perceptions and experiences of the villagers on the implementation of the two approaches. It was found that the villagers accepted the ComDT approach and took the responsibility of selecting the CDDs, organizing and implementing their own method of distributing drugs to the school-age children in their villages. The ComDT approach was well received and was successfully implemented in the villages. Although the villagers pointed out the limitation in reaching the non-enrolled children in the school-based approach, they also expressed satisfaction with this approach. This study suggests that the ComDT approach is well accepted and can be implemented effectively to ensure better coverage of especially non-enrolled school-age children.

Demographic and Clinical Characteristics of COPD Patients at Different Blood Eosinophil Levels in the UK Clinical Practice Research Datalink.

PubMed

Landis, Sarah; Suruki, Robert; Maskell, Joe; Bonar, Kerina; Hilton, Emma; Compton, Chris

2018-03-20

Blood eosinophil count may be a useful biomarker for predicting response to inhaled corticosteroids and exacerbation risk in chronic obstructive pulmonary disease (COPD) patients. The optimal cut point for categorizing blood eosinophil counts in these contexts remains unclear. We aimed to determine the distribution of blood eosinophil count in COPD patients and matched non-COPD controls, and to describe demographic and clinical characteristics at different cut points. We identified COPD patients within the UK Clinical Practice Research Database aged ≥40 years with a FEV 1 /FVC <0.7, and ≥1 blood eosinophil count recorded during stable disease between January 1, 2010 and December 31, 2012. COPD patients were matched on age, sex, and smoking status to non-COPD controls. Using all blood eosinophil counts recorded during a 12-month period, COPD patients were categorized as "always above," "fluctuating above and below," and "never above" cut points of 100, 150, and 300 cells/μL. The geometric mean blood eosinophil count was statistically significantly higher in COPD patients versus matched controls (196.6 cells/µL vs. 182.1 cells/µL; mean difference 8%, 95% CI: 6.8, 9.2), and in COPD patients with versus without a history of asthma (205.0 cells/µL vs. 192.2 cells/µL; mean difference 6.7%, 95%, CI: 4.9, 8.5). About half of COPD patients had all blood eosinophil counts above 150 cells/μL; this persistent higher eosinophil phenotype was associated with being male, higher body mass index, and history of asthma. In conclusion, COPD patients demonstrated higher blood eosinophil count than non-COPD controls, although there was substantial overlap in the distributions. COPD patients with a history of asthma had significantly higher blood eosinophil count versus those without.

Movement preparation and execution: differential functional activation patterns after traumatic brain injury.

PubMed

Gooijers, Jolien; Beets, Iseult A M; Albouy, Genevieve; Beeckmans, Kurt; Michiels, Karla; Sunaert, Stefan; Swinnen, Stephan P

2016-09-01

Years following the insult, patients with traumatic brain injury often experience persistent motor control problems, including bimanual coordination deficits. Previous studies revealed that such deficits are related to brain structural white and grey matter abnormalities. Here, we assessed, for the first time, cerebral functional activation patterns during bimanual movement preparation and performance in patients with traumatic brain injury, using functional magnetic resonance imaging. Eighteen patients with moderate-to-severe traumatic brain injury (10 females; aged 26.3 years, standard deviation = 5.2; age range: 18.4-34.6 years) and 26 healthy young adults (15 females; aged 23.6 years, standard deviation = 3.8; age range: 19.5-33 years) performed a complex bimanual tracking task, divided into a preparation (2 s) and execution (9 s) phase, and executed either in the presence or absence of augmented visual feedback. Performance on the bimanual tracking task, expressed as the average target error, was impaired for patients as compared to controls (P < 0.001) and for trials in the absence as compared to the presence of augmented visual feedback (P < 0.001). At the cerebral level, movement preparation was characterized by reduced neural activation in the patient group relative to the control group in frontal (bilateral superior frontal gyrus, right dorsolateral prefrontal cortex), parietal (left inferior parietal lobe) and occipital (right striate and extrastriate visual cortex) areas (P's < 0.05). During the execution phase, however, the opposite pattern emerged, i.e. traumatic brain injury patients showed enhanced activations compared with controls in frontal (left dorsolateral prefrontal cortex, left lateral anterior prefrontal cortex, and left orbitofrontal cortex), parietal (bilateral inferior parietal lobe, bilateral superior parietal lobe, right precuneus, right primary somatosensory cortex), occipital (right striate and extrastriate visual cortices), and subcortical (left cerebellum crus II) areas (P's < 0.05). Moreover, a significant interaction effect between Feedback Condition and Group in the primary motor area (bilaterally) (P < 0.001), the cerebellum (left) (P < 0.001) and caudate (left) (P < 0.05), revealed that controls showed less overlap of activation patterns accompanying the two feedback conditions than patients with traumatic brain injury (i.e. decreased neural differentiation). In sum, our findings point towards poorer predictive control in traumatic brain injury patients in comparison to controls. Moreover, irrespective of the feedback condition, overactivations were observed in traumatically brain injured patients during movement execution, pointing to more controlled processing of motor task performance. © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Family-centered prevention ameliorates the association between adverse childhood experiences and prediabetes status in young black adults.

PubMed

Brody, Gene H; Yu, Tianyi; Chen, Edith; Miller, Gregory E

2017-07-01

Individuals exposed to adverse childhood experiences (ACEs) are vulnerable to various health problems later in life. This study was designed to determine whether participation in an efficacious program to enhance supportive parenting would ameliorate the association between ACEs and prediabetes status at age 25. Rural African American parents and their 11-year-old children (N=390) participated in the Strong African American Families (SAAF) program or a control condition. Each youth at age 25 provided a total ACEs score and a blood sample from which overnight fasting glucose was assayed. Logistic regression equations were used to test the hypotheses. The logistic regression analyses revealed a significant interaction between total ACEs and random assignment to SAAF or control, OR=0.56, 95% CI [0.36, 0.88]. Follow-up analyses indicated that, for participants in the control condition, a 1-point increase in ACEs was associated with a 37.3% increase in risk of having prediabetes. ACEs were not associated with the likelihood of having prediabetes among participants in the SAAF condition. Control participants with high total ACEs scores were 3.54 times more likely to have prediabetes than were SAAF participants with similar scores. This study indicated that participation at age 11 in a randomized controlled trial designed to enhance supportive parenting ameliorated the association of ACEs with prediabetes at age 25. If substantiated, these findings may provide a strategy for preventing negative health consequences of ACEs. Copyright © 2017 Elsevier Inc. All rights reserved.

Cervical curvature variations in patients with infraocclusion.

PubMed

Ando, E; Shigeta, Y; Hirabayashi, R; Ikawa, T; Hirai, S; Katsumura, S; Ogawa, T

2014-08-01

The purpose of this study was to observe the variations of cervical curvature in patients with infraocclusion, and to compare this with the controls. In this study, the infraocclusion criteria were defined with the Pr-id as <17 mm on the cephalometric image. The subjects were 32 patients with infraocclusion, and 28 controls which matched the distribution for gender and age. The six points of inquiry were as follows: (i) cervical vertebra height, (ii) neck alignment, (iii) ratio of lower facial height, (iv) vertical dimension of occlusion, (v) cervical angle and (vi) occlusal angle. In over 90% of the patients with infraocclusion, the cervical curvature was classified as straight or kyphosis. Conversely, in 36% of the control subjects, the cervical curvature was classified as lordosis. There was a weak positive correlation between the vertical dimension of occlusion and the cervical curvature in all subjects. In the control group, there was a significant and strong positive correlation between the age and cervical curvature, and a strong negative correlation between age and cervical angle and occlusal angle. Conversely, in the patients with infraocclusion, age was only correlated with the ratio of lower facial height. The prevalence of non-lordosis in the patients with infraocclusion was higher in comparison with the control group in our study, and the previous large-scale study of Japanese. However, there was merely a weak positive correlation between the cervical curvature and the vertical dimension of occlusion. © 2014 John Wiley & Sons Ltd.

Age-related differences in recommended anthropometric cut-off point validity to identify cardiovascular risk factors in ostensibly healthy women

PubMed Central

Björkelund, Cecilia; Guo, Xinxin; Skoog, Ingmar; Bosaeus, Ingvar; Lissner, Lauren

2014-01-01

Aim: To investigate validity of widely recommended anthropometric and total fat percentage cut-off points in screening for cardiovascular risk factors in women of different ages. Methods: A population-based sample of 1002 Swedish women aged 38, 50, 75 (younger, middle-aged and elderly, respectively) underwent anthropometry, health examinations and blood tests. Total fat was estimated (bioimpedance) in 670 women. Sensitivity, specificity of body mass index (BMI; ≥25 and ≥30), waist circumference (WC; ≥80 cm and ≥88 cm) and total fat percentage (TF; ≥35%) cut-off points for cardiovascular risk factors (dyslipidaemias, hypertension and hyperglycaemia) were calculated for each age. Cut-off points yielding high sensitivity together with modest specificity were considered valid. Women reporting hospital admission for cardiovascular disease were excluded. Results: The sensitivity of WC ≥80 cm for one or more risk factors was ~60% in younger and middle-aged women, and 80% in elderly women. The specificity of WC ≥80 cm for one or more risk factors was 69%, 57% and 40% at the three ages (p < .05 for age trends). WC ≥80 cm yielded ~80% sensitivity for two or more risk factors across all ages. However, specificity decreased with increasing age (p < .0001), being 33% in elderly. WC ≥88 cm provided better specificity in elderly women. BMI and TF % cut-off points were not better than WC. Conclusions: Validity of recommended anthropometric cut-off points in screening asymptomatic women varies with age. In younger and middle-age, WC ≥80 cm yielded high sensitivity and modest specificity for two or more risk factors, however, sensitivity for one or more risk factor was less than optimal. WC ≥88 cm showed better validity than WC ≥80 cm in elderly. Our results support age-specific screening cut-off points for women. PMID:25294689

Age-related differences in recommended anthropometric cut-off point validity to identify cardiovascular risk factors in ostensibly healthy women.

PubMed

Subramoney, Sreevidya; Björkelund, Cecilia; Guo, Xinxin; Skoog, Ingmar; Bosaeus, Ingvar; Lissner, Lauren

2014-12-01

To investigate validity of widely recommended anthropometric and total fat percentage cut-off points in screening for cardiovascular risk factors in women of different ages. A population-based sample of 1002 Swedish women aged 38, 50, 75 (younger, middle-aged and elderly, respectively) underwent anthropometry, health examinations and blood tests. Total fat was estimated (bioimpedance) in 670 women. Sensitivity, specificity of body mass index (BMI; ≥25 and ≥30), waist circumference (WC; ≥80 cm and ≥88 cm) and total fat percentage (TF; ≥35%) cut-off points for cardiovascular risk factors (dyslipidaemias, hypertension and hyperglycaemia) were calculated for each age. Cut-off points yielding high sensitivity together with modest specificity were considered valid. Women reporting hospital admission for cardiovascular disease were excluded. The sensitivity of WC ≥80 cm for one or more risk factors was ~60% in younger and middle-aged women, and 80% in elderly women. The specificity of WC ≥80 cm for one or more risk factors was 69%, 57% and 40% at the three ages (p < .05 for age trends). WC ≥80 cm yielded ~80% sensitivity for two or more risk factors across all ages. However, specificity decreased with increasing age (p < .0001), being 33% in elderly. WC ≥88 cm provided better specificity in elderly women. BMI and TF % cut-off points were not better than WC. Validity of recommended anthropometric cut-off points in screening asymptomatic women varies with age. In younger and middle-age, WC ≥80 cm yielded high sensitivity and modest specificity for two or more risk factors, however, sensitivity for one or more risk factor was less than optimal. WC ≥88 cm showed better validity than WC ≥80 cm in elderly. Our results support age-specific screening cut-off points for women. © 2014 the Nordic Societies of Public Health.

Association of insulin-like growth factor I and insulin-like growth factor-binding protein-3 with intelligence quotient among 8- to 9-year-old children in the Avon Longitudinal Study of Parents and Children.

PubMed

Gunnell, David; Miller, Laura L; Rogers, Imogen; Holly, Jeff M P

2005-11-01

Insulin-like growth factor I (IGF-I) is a hormone that mediates the effects of growth hormone and plays a critical role in somatic growth regulation and organ development. It is hypothesized that it also plays a key role in human brain development. Previous studies have investigated the association of low IGF-I levels attributable to growth hormone receptor deficiency with intelligence but produced mixed results. We are aware of no studies that investigated the association of IGF-I levels with IQ in population samples of normal children. To investigate the association of circulating levels of IGF-I and its principle binding protein, IGF-binding protein-3 (IGFBP-3), in childhood with subsequent measures of IQ. The cohort study was based on data for 547 white singleton boys and girls, members of the Avon Longitudinal Study of Parents and Children, with IGF-I and IGFBP-3 measurements (obtained at a mean age of 8.0 years) and IQ measured with the Wechsler Intelligence Scale for Children (at a mean age of 8.7 years). We also investigated associations with measures of speech and language based on the Wechsler Objective Reading Dimensions test (measured at an age of 7.5 years) and the Wechsler Objective Language Dimensions test (listening comprehension subtest only, measured at an age of 8.7 years). For some children (n = 407), IGF-I (but not IGFBP-3) levels had been measured at approximately 5 years of age in a previous study. Linear regression models were used to investigate associations of the IGF-I system with the measures of cognitive function. Three hundred one boys and 246 girls were included in the sample. IGF-I levels (mean +/- SD) were 142.6 +/- 53.9 ng/mL for boys and 154.4 +/- 51.6 ng/mL for girls. IQ scores (mean +/- SD) were 106.05 +/- 16.6 and 105.27 +/- 15.6 for boys and girls, respectively. IGF-I levels were associated positively with intelligence. For every 100 ng/mL increase in IGF-I, IQ increased by 3.18 points (95% confidence interval [CI]: 0.52 to 5.84 points). These positive associations were seen in relation to the verbal component (coefficient: 4.27; 95% CI: 1.62 to 6.92), rather than the performance component (coefficient: 1.06; 95% CI: -1.67 to 3.78), of IQ. There was no evidence that associations with overall IQ differed between boys and girls. In a data set with complete information on confounders (n = 484), controlling for birth weight (adjusted for gestation), breastfeeding, and BMI slightly strengthened the associations of IGF-I levels with IQ. Additionally controlling for maternal education and IGFBP-3 levels attenuated the associations (change in IQ for every 100 ng/mL increase in IGF-I levels: 2.51 points; 95% CI: -0.42 to 5.44 points). The weakening of associations in models controlling for markers of parental socioeconomic position and education could reflect shared influences of parental IGF levels on parents' own educational attainment and their offspring's IGF-I levels. In unadjusted models examining associations of Wechsler Objective Reading Dimensions and Wechsler Objective Language Dimensions test scores with IGF-I levels, there was no strong evidence that performance on either of these tests was associated with circulating IGF-I levels, although positive associations were seen with both measures. Associations between IGF-I levels measured at age 5 and Wechsler Intelligence Scale for Children scores (n = 407) were similar to those for IGF-I levels measured at age 7 to 8. For every 100 ng/mL increase in IGF-I levels at 5 years of age, IQ increased by 2.3 points (95% CI: -0.21 to 4.89 points). This study provides some preliminary evidence that IGF-I is associated with brain development in childhood. Additional longitudinal research is required to clarify the role of IGF-I in neurodevelopment. Because IGF-I levels are modifiable through diet and other environmental exposures, this may be one pathway through which the childhood environment may influence neurodevelopment.

Selection bias between 2 Medicare capitated benefit programs.

PubMed

Leutz, Walter; Brody, Kathleen K; Nonnenkamp, Lucy L; Perrin, Nancy A

2007-04-01

To assess enrollment selection bias between a standard Medicare health maintenance organization (HMO) and a higher-priced social health maintenance organization (SHMO) offering full prescription drug and unique home-based and community-based benefits and to assess how adverse selection was handled through SHMO finances. Kaiser Permanente Northwest offered the dual-choice option in the greater Portland region from 1985 to 2002. Analysis focused on 3 "choice points" when options were clear and highlighted for beneficiaries. Data collected included age and sex, utilization 1 year before and after the choice points, health status data at enrollment (1999-2002 only), mortality, and cost and revenues. Data were extracted from health plan databases. Hospital, pharmacy, and nursing facility utilization for 1 year before and after the choice points are compared for HMO and SHMO choosers. Health and functional status data are compared from 1999 to 2002. Utilization and mortality data are controlled by age and sex. SHMO joiners evidenced adverse selection, while healthier members tended to stay in the HMO, with leaner benefits. Despite adverse selection, the health plan maintained margins in the SHMO, assisted by frailty-adjusted Medicare payments and member premiums. This high-low option strategy sought to offer the "right care at the right time" and may be a model for managed care organizations to serve aging and disabled beneficiaries under Medicare's new special needs plan option.

Chopper-controlled discharge life cycling studies on lead-acid batteries

NASA Technical Reports Server (NTRS)

Kraml, J. J.; Ames, E. P.

1982-01-01

State-of-the-art 6 volt lead-acid golf car batteries were tested. A daily charge/discharge cycling to failure points under various chopper controlled pulsed dc and continuous current load conditions was undertaken. The cycle life and failure modes were investigated for depth of discharge, average current chopper frequency, and chopper duty cycle. It is shown that battery life is primarily and inversely related to depth of discharge and discharge current. Failure mode is characterized by a gradual capacity loss with consistent evidence of cell element aging.

Contribution of reactive and proactive control to children's working memory performance: Insight from item recall durations in response sequence planning.

PubMed

Chevalier, Nicolas; James, Tiffany D; Wiebe, Sandra A; Nelson, Jennifer Mize; Espy, Kimberly Andrews

2014-07-01

The present study addressed whether developmental improvement in working memory span task performance relies upon a growing ability to proactively plan response sequences during childhood. Two hundred thirteen children completed a working memory span task in which they used a touchscreen to reproduce orally presented sequences of animal names. Children were assessed longitudinally at 7 time points between 3 and 10 years of age. Twenty-one young adults also completed the same task. Proactive response sequence planning was assessed by comparing recall durations for the 1st item (preparatory interval) and subsequent items. At preschool age, the preparatory interval was generally shorter than subsequent item recall durations, whereas it was systematically longer during elementary school and in adults. Although children mostly approached the task reactively at preschool, they proactively planned response sequences with increasing efficiency from age 7 on, like adults. These findings clarify the nature of the changes in executive control that support working memory performance with age. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Oral Fructose Absorption in Obese Children with Non-Alcoholic Fatty Liver Disease

PubMed Central

Sullivan, Jillian S; Le, MyPhuong T; Pan, Zhaoxing; Rivard, Christopher; Love-Osborne, Kathryn; Robbins, Kristen; Johnson, Richard J; Sokol, Ronald J; Sundaram, Shikha S

2014-01-01

Background Fructose intake is associated with NAFLD (Non-Alcoholic Fatty Liver Disease) development. Objective To measure fructose absorption/metabolism in pediatric NAFLD compared to obese and lean controls. Methods Children with histologically proven NAFLD, and obese and lean controls received oral fructose (1 gm/kg ideal body weight). Serum glucose, insulin, uric acid, and fructose, urine uric acid, urine fructose, and breath hydrogen levels were measured at baseline and multiple points until 360 minutes after fructose ingestion. Results Nine NAFLD (89% Hispanic, mean age 14.3 years, mean BMI 35.3 kg/m2), 6 Obese Controls (67% Hispanic, mean age 12.7 years, mean BMI 31.0 kg/m2), and 9 Lean Controls (44% Hispanic, mean age 14.3 years, mean BMI 19.4 kg/m2) were enrolled. Following fructose ingestion, NAFLD vs. Lean Controls had elevated serum glucose, insulin, and uric acid (p<0.05), higher urine uric acid (p=0.001) but lower fructose excretion (p=0.002) and lower breath hydrogen 180-min AUC (p=0.04). NAFLD vs. Obese Controls had similar post-fructose serum glucose, insulin, urine uric acid, and breath hydrogen, but elevated serum uric acid (p<0.05) and lower urine fructose excretion (p=0.02). Conclusions Children with NAFLD absorb and metabolize fructose more effectively than lean subjects, associated with an exacerbated metabolic profile following fructose ingestion. PMID:24961681

Longitudinal Analysis of the Premature Infant Intestinal Microbiome Prior to Necrotizing Enterocolitis: A Case-Control Study

PubMed Central

Zhou, Yanjiao; Shan, Gururaj; Sodergren, Erica; Weinstock, George; Walker, W. Allan; Gregory, Katherine E.

2015-01-01

Necrotizing enterocolitis (NEC) is an inflammatory disease of the newborn bowel, primarily affecting premature infants. Early intestinal colonization has been implicated in the pathogenesis of NEC. The objective of this prospective case-control study was to evaluate differences in the intestinal microbiota between infants who developed NEC and unaffected controls prior to disease onset. We conducted longitudinal analysis of the 16S rRNA genes of 312 samples obtained from 12 NEC cases and 26 age-matched controls with a median frequency of 7 samples per subject and median sampling interval of 3 days. We found that the microbiome undergoes dynamic development during the first two months of life with day of life being the major factor contributing to the colonization process. Depending on when the infant was diagnosed with NEC (i.e. early vs. late onset), the pattern of microbial progression was different for cases and controls. The difference in the microbiota was most overt in early onset NEC cases and controls. In proximity to NEC onset, the abundances of Clostridium sensu stricto from Clostridia class were significantly higher in early onset NEC subjects comparing to controls. In late onset NEC, Escherichia/Shigella among Gammaproteobacteria, showed an increasing pattern prior to disease onset, and was significantly higher in cases than controls six days before NEC onset. Cronobacter from Gammaproteobacteria was also significantly higher in late onset NEC cases than controls 1-3 days prior to NEC onset. Thus, the specific infectious agent associated with NEC may vary by the age of infant at disease onset. We found that intravenously administered antibiotics may have an impact on the microbial diversity present in fecal material. Longitudinal analysis at multiple time points was an important strategy utilized in this study, allowing us to appreciate the dynamics of the premature infant intestinal microbiome while approaching NEC at various points. PMID:25741698

Prevalence of micronutrient deficiency based on results obtained from the national pilot program on control of micronutrient malnutrition.

PubMed

Chakravarty, Indira; Sinha, R K

2002-05-01

Micronutrient deficiency is a serious public health concern in most developing countries. In India, iron deficiency, vitamin A deficiency, and iodine deficiency disorder are of greatest public health significance. In addition, subclinical zinc deficiency, flourosis, and fluoride-deficient dental caries are important areas of concern. The National Pilot Program on Control of Micronutrient Malnutrition was launched in 1995 to address these problems and the Department of Biochemistry and Nutrition of the All India Institute of Hygiene and Public Health (Calcutta) was entrusted to coordinate its activities. The program presently covers one northeastern and four eastern states, namely Assam, Bihar (Jharkhand), Orissa, West Bengal, and Tripura. Baseline analyses were conducted on demographic situation, food and nutrient intake pattern, nutritional deficiency diseases (e.g., iron deficiency anemia), iodine deficiency disorder, and vitamin A deficiency. It was observed that except for cereals, the diet was deficient in all other food groups. Nutrient intake (i.e., energy, protein, vitamins, and minerals) was also deficient in almost the entire state. Anthropometric indices (e.g., weight-for-age and height-for-age data) indicated that large percentages of <5-year-old and 6-14-year-old children were in grade II or III malnutrition. Mean dietary zinc intakes in all the surveyed districts were much lower than the RDA. Large percentages of salt samples had iodine levels less than 15 ppm. The point prevalence of anemia in various age groups was found to be high. Bitot's spot was mainly noted in the age group of 6-71 months. Nightblindness was noted in young children as well as the children 24-71 months old. High prevalence of nightblindness in pregnant women is a point of concern. Actions needed to control micronutrient deficiencies include: intervention strategies, extensive nutrition and health education through innovative IEC materials to support problem-specific programs, strengthening of various state government programs and the role of NGOs.

Quantifying the impact of time-varying baseline risk adjustment in the self-controlled risk interval design.

PubMed

Li, Lingling; Kulldorff, Martin; Russek-Cohen, Estelle; Kawai, Alison Tse; Hua, Wei

2015-12-01

The self-controlled risk interval design is commonly used to assess the association between an acute exposure and an adverse event of interest, implicitly adjusting for fixed, non-time-varying covariates. Explicit adjustment needs to be made for time-varying covariates, for example, age in young children. It can be performed via either a fixed or random adjustment. The random-adjustment approach can provide valid point and interval estimates but requires access to individual-level data for an unexposed baseline sample. The fixed-adjustment approach does not have this requirement and will provide a valid point estimate but may underestimate the variance. We conducted a comprehensive simulation study to evaluate their performance. We designed the simulation study using empirical data from the Food and Drug Administration-sponsored Mini-Sentinel Post-licensure Rapid Immunization Safety Monitoring Rotavirus Vaccines and Intussusception study in children 5-36.9 weeks of age. The time-varying confounder is age. We considered a variety of design parameters including sample size, relative risk, time-varying baseline risks, and risk interval length. The random-adjustment approach has very good performance in almost all considered settings. The fixed-adjustment approach can be used as a good alternative when the number of events used to estimate the time-varying baseline risks is at least the number of events used to estimate the relative risk, which is almost always the case. We successfully identified settings in which the fixed-adjustment approach can be used as a good alternative and provided guidelines on the selection and implementation of appropriate analyses for the self-controlled risk interval design. Copyright © 2015 John Wiley & Sons, Ltd.

Hypothalamic-pituitary-ovarian axis during infancy, early and late prepuberty in an aromatase-deficient girl who is a compound heterocygote for two new point mutations of the CYP19 gene.

PubMed

Belgorosky, Alicia; Pepe, Carolina; Marino, Roxana; Guercio, Gabriela; Saraco, Nora; Vaiani, Elisa; Rivarola, Marco A

2003-11-01

A loss of function mutation of the CYP19 aromatase gene leads to excess circulating androgens in the fetus and in the mother, resulting in ambiguous genitalia in the female fetus. Later on, lack of aromatase is responsible for sexual infantilism, primary amenorrhea, tall stature, and multicystic ovaries, even in preadolescent girls. Up to now, 11 CYP19 aromatase point mutations and 10 well-documented cases have been reported. In the present case, we are reporting the clinical and hormonal follow-up, from birth to 7 yr of age, of an affected girl with ambiguous genitalia. Gene analysis showed that she was a compound heterozygote for two new CYP19 aromatase point mutations. In the father's allele, there was a consensus 5' splice donor sequence mutation, GAA-AAA at cDNA position bp 655 in exon 5, which probably results in a cryptic donor site. In the mother's allele, there was a base A deletion in exon 9 (Delta A GLU 412X), causing a frame shift mutation, and a stop codon after 98 bp (33 codons) downstream, altering the critical heme-binding region. Basal serum LH and FSH levels were high at 8 d of age (42.9 and 51.3 U/liter), 26 d of age (76.2 and 119 U/liter), and 60 d of age (58.7 and 150 U/liter, respectively). Both gonadotropins dropped dramatically between the second and fifth months of age (to 1.79 and 14.9 U/liter) but remained higher than in normal control girls (0.64 and 8.5 U/liter, respectively). Serum testosterone (T) and androstenedione (Delta(4)A) levels were high during the first month, but Delta(4)A was normal at 2 months of age. However, at 5 months of age, along with significant decrements of serum LH and FSH levels and increments in serum Delta(4)A and T levels, a large ovarian cyst was removed from each gonad. Relatively high levels of T [27.3 ng/ml (94.6 nmol/liter); control, 34.9 ng/ml (121 nmol/liter)], but not of estradiol [1.8 ng/ml (6.6 nmol/liter); control 62.9 ng/ml (231 nmol/liter)], and a high T/estradiol ratio [15.2; control < 1] were found in the follicular fluid. Serum Delta(4)A and T levels remained normal from 1-5 yr of age, but they were high at the last visit (late prepuberty). A GnRH test was performed at 3.9, 6, and 7.1 yr of age. At 3.9 yr, a low prepubertal serum LH peak (2.12 U/liter) was found, but at the older ages, higher serum LH peaks (8.25 and 22.5 U/liter, respectively) were observed. Growth pattern and body mass index were normal, but after the age of 5.2 yr, delays in bone age greater than 2 yr were observed. We concluded that: 1) these two new CYP19 aromatase gene mutations are responsible for the phenotype of aromatase deficiency; 2) in girls, aromatase deficiency results in a decrease of the negative feedback of both serum LH and FSH, which can be detected as early as the second week after birth and persists up to the sixth month of life, and of FSH during the rest of prepuberty; and 3) because large ovarian cysts developed when serum LH and FSH dropped, aromatization of androgens might be required to prevent formation of cystic ovaries.

The Effects of Group Play Therapy on Self-Concept Among 7 to 11 Year-Old Children Suffering From Thalassemia Major.

PubMed

Tomaj, Ome Kolsoum; Estebsari, Fatemeh; Taghavi, Taraneh; Borim Nejad, Leili; Dastoorpoor, Maryam; Ghasemi, Afsaneh

2016-04-01

Children suffering from thalassemia have higher levels of depression and lower levels of self-concept. The aim of this study was to determine if group play therapy could significantly increase self-concept among children with thalassemia major ages 7 to 11 years old in teaching hospitals of Golestan province, Iran, in 2012. In this randomized, controlled clinical trial, 60 children with thalassemia major were randomly assigned to intervention (30 children) and control (30 children) groups. The intervention included eight 45 to 60 minute sessions during four weeks, during which the intervention group received group play therapy. The control group received no interventions. Self-concept was measured three times using the Piers-Harris children's self-concept scale: before, immediately after, and a month after the intervention. For the intervention group, results showed that the mean self-concept score was significantly higher at the second point in time compared to the baseline (P < 0.001), going from 60.539 to 69.908. Likewise, comparing the first and third time points, the mean score significantly increased and reached 70.611 (P < 0.001). Furthermore, changes in the mean score from the second to the third time point, though non-significant (P = 0.509), followed the trend, going from 69.908 to 70.611. For the control group, comparing the first, second, and third time points did not result in any significant change in the mean score (P > 0.05). The results showed that group play therapy improves self-concept in children suffering from thalassemia major.

Age-related Associative Memory Deficits in Value-based Remembering: The Contribution of Agenda-based Regulation and Strategy Use

PubMed Central

Ariel, Robert; Price, Jodi; Hertzog, Christopher

2015-01-01

Value-based remembering in free recall tasks may be spared from the typical age-related cognitive decline observed for episodic memory. However, it is unclear whether value-based remembering for associative information is also spared from age-related cognitive decline. The current experiments evaluated the contribution of agenda-based based regulation and strategy use during study to age differences and similarities in value-based remembering of associative information. Participants studied word pairs (Experiments 1-2) or single words (Experiment 2) slated with different point values by moving a mouse controlled cursor to different spatial locations to reveal either items for study or the point value associated with remembering each item. Some participants also provided strategy reports for each item. Younger and older adults allocated greater time to studying high than low valued information, reported using normatively effective encoding strategies to learn high-valued pairs, and avoided study of low-valued pairs. As a consequence, both age groups selectively remembered more high than low-valued items. Despite nearly identical regulatory behavior, an associative memory deficit for older adults was present for high valued pairs. Age differences in value-based remembering did not occur when the materials were word lists. Fluid intelligence also moderated the effectiveness of older adults’ strategy use for high valued pairs (Experiment 2). These results suggest that age differences in associative value-based remembering may be due to some older adults’ gleaning less benefit from using normatively effective encoding strategies rather than age differences in metacognitive self-regulation per se. PMID:26523692

In vivo facial tissue depth for Canadian aboriginal children: a case study from Nova Scotia, Canada.

PubMed

Peckmann, Tanya R; Manhein, Mary H; Listi, Ginesse A; Fournier, Michel

2013-11-01

This study examines facial tissue depth in Canadian Aboriginal children. Using ultrasound, measurements were taken at 19 points on the faces of 392 individuals aged 3-18 years old. The relationships between tissue thickness, age, and sex were investigated. A positive linear trend may exist between tissue thickness and age for Aboriginal females and males at multiple points. No points show significant differences in facial tissue depth between males and females aged 3-8 years old; seven points show significant differences in facial tissue depth between males and females aged 9-13 years old; and five points show significant differences in facial tissue depth between males and females aged 14-18 years old. Comparisons were made with White Americans and African Nova Scotians. These data can assist in 3-D facial reconstructions and aid in establishing an individual's identity. Previously, no data existed for facial tissue thickness in Canadian Aboriginal populations. © 2013 American Academy of Forensic Sciences.

The effectiveness of physical exercise training in pain, mobility, and psychological well-being of older persons living in nursing homes.

PubMed

Tse, Mimi M Y; Tang, Shuk Kwan; Wan, Vanessa T C; Vong, Sinfia K S

2014-12-01

Pain is common in the aging population, particularly among older residents of nursing homes. It has been found that 50% of older people living in the community have been experiencing chronic pain, and the number increased to 80% for older residents of nursing homes. Exercise is an effective non-pharmacological intervention that can reduce pain and improve physical and psychological functions. A quasi-experimental study with a pretest-posttest control group designed was conducted to evaluate the effects of a physical exercise program (PEP) on older residents of nursing homes who have chronic pain. Three-hundred-ninety-six older residents with chronic pain were recruited from 10 nursing homes run by non-governmental organizations in Hong Kong. The average age of the older residents was 85.44 ± 6.29. Five nursing homes were randomized to the experimental group with PEP (n = 225, age = 85.45 ± 6.25); the other five nursing homes were randomized to the control group without the PEP (n = 171, age = 85.44 ± 6.35). PEP was an eight-week training program given by a physiotherapist and nurses once a week. It consisted of warm-up exercises, muscle strengthening, stretching, balancing, and self-administered massage to acupressure points. At the end of each PEP session, pamphlets with pictures illustrating the "exercise of the day" were given to the older residents of nursing homes as a tool to enhance their self-management skills. The control group received no training during the eight weeks. Upon completion of the PEP, the experimental group experienced a significantly greater reduction in pain intensity from 4.19 ± 2.25 (on an 11 point scale) to 2.67 ± 2.08, as compared to the control group (p < .05). In addition, the psychological well-being (happiness, loneliness, life satisfaction, and depression) of the experimental group was significantly improved (p < .05). Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

The Development of Children at Familial Risk for Dyslexia: Birth to Early School Age

ERIC Educational Resources Information Center

Lyytinen, Heikki; Aro, Mikko; Eklund, Kenneth; Erskine, Jane; Guttorm, Tomi; Laakso, Marja-Leena; Leppanen, Paavo H. T.; Lyytinen, Paula; Poikkeus, Anna-Maija; Richardson, Ulla; Torppa, Minna

2004-01-01

Children at risk for familial dyslexia (n = 107) and their controls (n = 93) have been followed from birth to school entry in the Jyvaskyla Longitudinal study of Dyslexia (JLD) on developmental factors linked to reading and dyslexia. At the point of school entry, the majority of the at-risk children displayed decoding ability that fell at least 1…

Spatial point analysis based on dengue surveys at household level in central Brazil

PubMed Central

Siqueira-Junior, João B; Maciel, Ivan J; Barcellos, Christovam; Souza, Wayner V; Carvalho, Marilia S; Nascimento, Nazareth E; Oliveira, Renato M; Morais-Neto, Otaliba; Martelli, Celina MT

2008-01-01

Background Dengue virus (DENV) affects nonimunne human populations in tropical and subtropical regions. In the Americas, dengue has drastically increased in the last two decades and Brazil is considered one of the most affected countries. The high frequency of asymptomatic infection makes difficult to estimate prevalence of infection using registered cases and to locate high risk intra-urban area at population level. The goal of this spatial point analysis was to identify potential high-risk intra-urban areas of dengue, using data collected at household level from surveys. Methods Two household surveys took place in the city of Goiania (~1.1 million population), Central Brazil in the year 2001 and 2002. First survey screened 1,586 asymptomatic individuals older than 5 years of age. Second survey 2,906 asymptomatic volunteers, same age-groups, were selected by multistage sampling (census tracts; blocks; households) using available digital maps. Sera from participants were tested by dengue virus-specific IgM/IgG by EIA. A Generalized Additive Model (GAM) was used to detect the spatial varying risk over the region. Initially without any fixed covariates, to depict the overall risk map, followed by a model including the main covariates and the year, where the resulting maps show the risk associated with living place, controlled for the individual risk factors. This method has the advantage to generate smoothed risk factors maps, adjusted by socio-demographic covariates. Results The prevalence of antibody against dengue infection was 37.3% (95%CI [35.5–39.1]) in the year 2002; 7.8% increase in one-year interval. The spatial variation in risk of dengue infection significantly changed when comparing 2001 with 2002, (ORadjusted = 1.35; p < 0.001), while controlling for potential confounders using GAM model. Also increasing age and low education levels were associated with dengue infection. Conclusion This study showed spatial heterogeneity in the risk areas of dengue when using a spatial multivariate approach in a short time interval. Data from household surveys pointed out that low prevalence areas in 2001 surveys shifted to high-risk area in consecutive year. This mapping of dengue risks should give insights for control interventions in urban areas. PMID:18937868

Hormonal and reproductive risk factors of papillary thyroid cancer: A population-based case-control study in France.

PubMed

Cordina-Duverger, Emilie; Leux, Christophe; Neri, Monica; Tcheandjieu, Catherine; Guizard, Anne-Valérie; Schvartz, Claire; Truong, Thérèse; Guénel, Pascal

2017-06-01

The three times higher incidence of thyroid cancer in women compared to men points to a role of female sex hormones in its etiology. However the effects of these factors are poorly understood. We analyzed the association between thyroid cancer and hormonal and reproductive factors among women enrolled in CATHY, a population-based case-control study conducted in France. The study included 430 cases of papillary thyroid cancer and 505 controls frequency-matched on age and area of residence. The odds ratios for thyroid cancer increased with age at menarche (p trend 0.05). Postmenopausal women were at increased risk, as compared to premenopausal women, particularly if menopause followed an ovariectomy, and for women with age at menopause <55years. In addition, use of oral contraceptives and menopausal hormone therapy reduced the association with thyroid cancer by about one third, and breastfeeding by 27%. Overall, these findings provide evidence that the risk of thyroid cancer increases with later age at menarche and after menopause, and decreases with use of oral contraceptives and menopausal hormone therapy. These findings confirm an implication of hormonal factors in papillary thyroid cancer risk, whose mechanisms need to be elucidated. Copyright © 2017 Elsevier Ltd. All rights reserved.

Kinematic characteristics of tenodesis grasp in C6 quadriplegia.

PubMed

Mateo, S; Revol, P; Fourtassi, M; Rossetti, Y; Collet, C; Rode, G

2013-02-01

Descriptive control case study. To analyze the kinematics of tenodesis grasp in participants with C6 quadriplegia and healthy control participants in a pointing task and two daily life tasks involving a whole hand grip (apple) or a lateral grip (floppy disk). France. Four complete participants with C6 quadriplegia were age matched with four healthy control participants. All participants were right-handed. The measured kinematic parameters were the movement time (MT), the peak velocity (PV), the time of PV (TPV) and the wrist angle in the sagittal plane at movement onset, at the TPV and at the movement end point. The participants with C6 quadriplegia had significantly longer MTs in both prehension tasks. No significant differences in TPV were found between the two groups. Unlike control participants, for both prehension tasks the wrist of participants with C6 quadriplegia was in a neutral position at movement onset, in flexion at the TPV, and in extension at the movement end point. Two main kinematic parameters characterize tenodesis grasp movements in C6 quadriplegics: wrist flexion during reaching and wrist extension during the grasping phase, and increased MT reflecting the time required to adjust the wrist's position to achieve the tenodesis grasp. These characteristics were observed for two different grips (whole hand and lateral grip). These results suggest sequential planning of reaching and tenodesis grasp, and should be taken into account for prehension rehabilitation in patients with quadriplegia.

Effects of a growth check on daily age estimates of age-0 alligator gar

USGS Publications Warehouse

Snow, Richard A.; Long, James M.

2016-01-01

Accurate age and growth information is essential for a complete knowledge of life history, growth rates, age at sexual maturity, and average life span in fishes. Alligator gar are becoming increasingly managed throughout their range and because this species spawns in backwater flooded areas, their offspring are prone to stranding in areas with limited prey, potentially affecting their growth. Because fish growth is tightly linked with otolith growth and annulus formation, the ability to discern marks not indicative of annuli (age checks) in alligator gar would give managers some insight when estimating ages. Previous studies have suggested that checks are often present prior to the first annulus in otoliths of alligator gar, affecting age estimates. We investigated check formation in otoliths of alligator gar in relation to growth and food availability. Sixteen age-0 alligator gar were marked with oxytetracycline (OTC) to give a reference point and divided equitably into two groups: a control group with abundant prey and an experimental group with limited prey. The experimental group was given 2 g of food per week for 20 days and then given the same prey availability as the control group for the next 20 days. After 40 days, the gar were measured, sacrificed, and their sagittae removed to determine if checks were present. Checks were visible on 14 of the 16 otoliths in the experimental group, associated with low growth during the first 20 days when prey was limited and accelerated growth after prey availability was increased. No checks were observed on otoliths of the control group, where growth and prey availability were consistent. Age estimates of fish in the control group were more accurate than those in the experimental group, showing that fish growth as a function of prey availability likely induced the checks by compressing daily ring formation.

Elimination of Cost Sharing for Screening Mammography in Medicare Advantage Plans.

PubMed

Trivedi, Amal N; Leyva, Bryan; Lee, Yoojin; Panagiotou, Orestis A; Dahabreh, Issa J

2018-01-18

The Affordable Care Act (ACA) required most insurers and the Medicare program to eliminate cost sharing for screening mammography. We conducted a difference-in-differences study of biennial screening mammography among 15,085 women 65 to 74 years of age in 24 Medicare Advantage plans that eliminated cost sharing to provide full coverage for screening mammography, as compared with 52,035 women in 48 matched control plans that had and maintained full coverage. In plans that eliminated cost sharing, adjusted rates of biennial screening mammography increased from 59.9% (95% confidence interval [CI], 54.9 to 65.0) in the 2-year period before cost-sharing elimination to 65.4% (95% CI, 61.8 to 69.0) in the 2-year period thereafter. In control plans, the rates of biennial mammography were 73.1% (95% CI, 69.2 to 77.0) and 72.8% (95% CI, 69.7 to 76.0) during the same periods, yielding a difference in differences of 5.7 percentage points (95% CI, 3.0 to 8.4). The difference in differences was 9.8 percentage points (95% CI, 4.5 to 15.2) among women living in the areas with the highest quartile of educational attainment versus 4.3 percentage points (95% CI, 0.2 to 8.4) among women in the lowest quartile. As indicated by the difference-in-differences estimates, after the elimination of cost sharing, the rate of biennial mammography increased by 6.5 percentage points (95% CI, 3.7 to 9.4) for white women and 8.4 percentage points (95% CI, 2.5 to 14.4) for black women but was almost unchanged for Hispanic women (0.4 percentage points; 95% CI, -7.3 to 8.1). The elimination of cost sharing for screening mammography under the ACA was associated with an increase in rates of use of this service among older women for whom screening is recommended. The effect was attenuated among women living in areas with lower educational attainment and was negligible among Hispanic women. (Funded by the National Institute on Aging.).

The Potential of Established Fitness Cut-off Points for Monitoring Women with Fibromyalgia: The al-Ándalus Project.

PubMed

Castro-Piñero, José; Aparicio, Virginia A; Estévez-López, Fernando; Álvarez-Gallardo, Inmaculada C; Borges-Cosic, Milkana; Soriano-Maldonado, Alberto; Delgado-Fernández, Manuel; Segura-Jiménez, Víctor

2017-05-01

The aim of the present study was to determinate whether fitness cut-off points discriminate the severity of major fibromyalgia symptoms and health-related quality of life. Additionally, we investigated which American Colleague of Rheumatology (ACR) fibromyalgia criteria (1990 vs. modified 2010) better discriminate fibromyalgia symptomatology. A total of 488 women with fibromyalgia and 200 non-fibromyalgia (control) women participated. All participants underwent both the 1990 and the modified 2010 ACR preliminary criteria (hereinafter 1990c and m-2010c, respectively). We used fitness cut-off points (Senior Fitness Tests Battery plus handgrip strength test) to discriminate between presence and absence of fibromyalgia. Additionally, we employed several instruments to assess fibromyalgia symptoms. Fitness cut-off points discriminated between high and low levels of the main symptoms the disease in all age groups (P from <0.001 to 0.01). Overall, the arm-curl and the 30-s chair stand tests presented the highest effect sizes in all symptoms, reinforcing the inclusion of fitness testing as a complementary tool for fibromyalgia diagnosis and monitoring. Moreover, the effect size of the differences in symptoms between women with fibromyalgia and controls were overall larger using the m-2010c compared with the 1990c, except for the tender points count, reflecting better the polysymptomatic distress condition of fibromyalgia. © Georg Thieme Verlag KG Stuttgart · New York.

Investigating the historic long-term population health impact of the US National School Lunch Program.

PubMed

Peterson, Cora

2014-12-01

The present research aimed to compare historic participation in the US National School Lunch Program (NSLP) during childhood and subsequent prevalence of overweight and obesity among adults at the population level. Regression models examined cross-sectional, state- and age-based panel data constructed from multiple sources, including the Behavioural Risk Factor Surveillance System, US Congressional Record, US Census and the US Department of Agriculture. Models controlled for cohorts' racial/ethnic composition and state poverty rates. Adult-age cohorts (18-34, 35-49, 50-64 and 18-64 years) by US state over a 25-year period (1984-2008). The cohorts' prevalence of overweight and obesity was compared with the cohorts' estimated NSLP participation during schooling (1925-2007; the NSLP began in 1946). Among adults aged 18-64 years, a one percentage-point increase in estimated NSLP participation during schooling between 1925 and 2007 was significantly associated with a 0·29 percentage-point increase in the cohort's later prevalence of overweight and obesity. Analysis of narrower age cohorts and different schooling periods produced mixed results. The NSLP might have influenced population health historically. Longitudinal analysis of individuals from studies now underway will likely facilitate more robust conclusions about the NSLP's long-term health impact based on more recent experiences.

Spatial and Alignment Analyses for a Field of Small Volcanic Vents South of Pavonis Mons and Implications for the Tharsis Province, Mars

NASA Technical Reports Server (NTRS)

Bleacher, Jacob E.; Glaze, Lori S.; Greeley, Ronald; Hauber, Ernst; Baloga, Stephen; Sakimoto, Susan E. H.; Williams, David A.; Glotch, Timothy D.

2009-01-01

A field of small volcanic vents south of Pavonis Mons was mapped with each vent assigned a two-dimensional data point. Nearest neighbor and two-point azimuth analyses were applied to the resulting location data. Nearest neighbor results show that vents within this field are spatially random in a Poisson sense, suggesting that the vents formed independently of each other without sharing a centralized magma source at shallow depth. Two-point azimuth results show that the vents display north-trending alignment relationships between one another. This trend corresponds to the trends of faults and fractures of the Noachian-aged Claritas Fossae, which might extend into our study area buried beneath more recently emplaced lava flows. However, individual elongate vent summit structures do not consistently display the same trend. The development of the volcanic field appears to display tectonic control from buried Noachian-aged structural patterns on small, ascending magma bodies while the surface orientations of the linear vents might reflect different, younger tectonic patterns. These results suggest a complex interaction between magma ascension through the crust, and multiple, older, buried Tharsis-related tectonic structures.

Learning skills and academic performance in children and adolescents with absence epilepsy.

PubMed

Talero-Gutiérrez, C; Sánchez-Torres, J M; Velez-van-Meerbeke, A

2015-03-01

Although cognitive and learning disorders have been described in patients with epilepsy, very few studies focus on specific disorders such as absence epilepsy. The aim of this study was to evaluate learning skills and academic performance in children and adolescents with absence epilepsy. Observational case-control study. Cases were chosen from the Central League against Epilepsy's clinic in Bogotá, Colombia. Controls were selected from a private school and matched with cases by age, school year, and sex. Medical history, seizure frequency, antiepileptic treatment, and academic performance were assessed. Academic abilities were tested with Batería de Aptitudes Diferenciales y Generales (BADyG) (a Spanish-language test of differential and general aptitudes). Data were analysed using Student t-test. The sample consisted of 19 cases and 19 controls aged between 7 and 16. In 15 patients, seizures were controlled; all patients had received antiepileptic medication at some point and 78.9% were actively being treated. Although cases had higher rates of academic failure, a greater incidence of grade retention, and more therapeutic interventions than controls, these differences were not significant. Similarly, there were no significant differences on the BADyG test, except for the immediate memory subcategory on which cases scored higher than controls (P=.0006). Children treated pharmacologically for absence epilepsy, whose seizures are controlled, have normal academic abilities and skills for their age. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Intervention in the First Weeks of Life for Infants Born Late Preterm: A Case Series

PubMed Central

Dusing, Stacey C.; Lobo, Michele A.; Lee, Hui-Min; Galloway, James Cole

2013-01-01

Infants born late preterm (34–36 weeks of gestation) account for 350,000 US births per year, are at risk for developmental delays, and are rarely included in intervention studies. Purpose To describe a novel parent delivered movement intervention program for very young infants and outcomes following intervention and to evaluate the feasibility of using a comprehensive set of outcome measures. Summary of Key Points Two infants born late preterm received intervention from 0.5 to 2.0 months of adjusted age. Development, postural control, reaching, and object exploration assessments were completed at 3 time points. The intervention was well tolerated by the family. Improvements in developmental outcomes, postural control, and object exploration are presented. Statement of Conclusion Very early movement experience provided daily by parents may improve development. In combination, norm-referenced and behavioral measures appear sensitive to changes in infant behaviors. PMID:23542201

Development of online use of theory of mind during adolescence: An eye-tracking study.

PubMed

Symeonidou, Irene; Dumontheil, Iroise; Chow, Wing-Yee; Breheny, Richard

2016-09-01

We investigated the development of theory of mind use through eye-tracking in children (9-13years old, n=14), adolescents (14-17.9years old, n=28), and adults (19-29years old, n=23). Participants performed a computerized task in which a director instructed them to move objects placed on a set of shelves. Some of the objects were blocked off from the director's point of view; therefore, participants needed to take into consideration the director's ignorance of these objects when following the director's instructions. In a control condition, participants performed the same task in the absence of the director and were told that the instructions would refer only to items in slots without a back panel, controlling for general cognitive demands of the task. Participants also performed two inhibitory control tasks. We replicated previous findings, namely that in the director-present condition, but not in the control condition, children and adolescents made more errors than adults, suggesting that theory of mind use improves between adolescence and adulthood. Inhibitory control partly accounted for errors on the director task, indicating that it is a factor of developmental change in perspective taking. Eye-tracking data revealed early eye gaze differences between trials where the director's perspective was taken into account and those where it was not. Once differences in accuracy rates were considered, all age groups engaged in the same kind of online processing during perspective taking but differed in how often they engaged in perspective taking. When perspective is correctly taken, all age groups' gaze data point to an early influence of perspective information. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

"Because if you don't put the top on, it will spill": A longitudinal study of sibling teaching in early childhood.

PubMed

Howe, Nina; Della Porta, Sandra; Recchia, Holly; Ross, Hildy

2016-11-01

Naturalistic dyadic sequences of teaching and learning involving older and younger siblings were investigated in 39 middle-class dyads over a 2-year period in early childhood. Siblings were observed during ongoing interactions in the home setting for 6 90-min sessions at both Time 1 (older sibling M age = 4.4 years; younger sibling M age = 2.4 years) and Time 2 (older sibling M age = 6.3 years; younger sibling M age = 4.4 years). Sequences of sibling-directed teaching (T1 n = 353; T2 n = 1,039) were identified from the observation transcripts and coded for teacher/learner roles, initiation of teaching, teaching strategies, and learner response. Older siblings were more likely to engage in teaching at both time points, but the proportion of younger sibling teaching increased significantly from T1 to T2, partially because older siblings requested teaching more often from their younger siblings at T2. Siblings' use of teaching strategies varied across time points, while both older and younger sibling learners generally accepted or complied with the teaching. A final set of analyses examined birth-order effects while controlling for age by comparing older sibling teachers at age 4 (T1) to younger sibling teachers at age 4 (T2). At T1 first-born older siblings (age 4) engaged in a wider range and more sophisticated teaching strategies than second-born younger siblings (age 4) at T2. Findings highlight the bidirectional nature of teacher-learner interactions and are discussed in light of recent theory and research indicating that the sibling relationship is a rich context for children's learning and development. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Mothers of Very Low Birth Weight Children at School Age: Quality of Life Outcomes from the Newborn Lung Project Statewide Cohort Study

PubMed Central

Witt, Whitney P.; Litzelman, Kristin; Spear, Hilary A.; Wisk, Lauren E.; Levin, Nataliya; McManus, Beth M.; Palta, Mari

2012-01-01

Purpose This study aimed to: (1) determine the health-related quality of life (HRQoL) in mothers of five year old very low birth weight (VLBW) and normal birth weight (NBW) children; (2) determine what extent stress mediates the relationship between case status and maternal HRQoL; and (3) examine the pre-pregnancy, pregnancy, birth, and child health-related factors in predicting maternal HRQoL among mothers of five year old VLBW children. Methods A telephone interview was administered to 297 mothers of VLBW children and 290 mothers of NBW children who were enrolled in the Newborn Lung Project Statewide Cohort Study. Results Mothers of VLBW children experienced worse physical and mental HRQoL than mothers of NBW children (52.8 versus 55.3 points, p<0.0001, and 48.9 versus 50.5 points, p=0.02, respectively). Adjusted analyses showed that maternal mental HRQoL was similar between cases and controls while physical HRQoL when children were age five was significantly different between cases and controls (Beta:−2.02, p=0.0006); this relationship was mediated by maternal stress. Among mothers of VLBW children, stress significantly contributed to adverse HRQoL outcomes when children were age five. Child behavior problems at age two were also associated with worse subsequent maternal mental HRQoL (Beta: −1.8 per SD, p=0.004), while each week of neonatal intensive care unit stay was associated with worse physical HRQoL (Beta: −0.26, p=0.02). Conclusions While caring for a VLBW child negatively impacts the HRQoL of mothers, this relationship was partially explained by maternal stress. Addressing maternal stress may be an important way to improve long-term HRQoL. PMID:22161725

Relation between biochemical severity and intelligence in early treated congenital hypothyroidism: a threshold effect.

PubMed

Tillotson, S L; Fuggle, P W; Smith, I; Ades, A E; Grant, D B

1994-08-13

To assess whether early treatment of congenital hypothyroidism fully prevents intellectual impairment. A national register of children with congenital hypothyroidism who were compared with unaffected children from the same school classes and matched for age, sex, social class, and first language. First three years (1982-4) of a neonatal screening programme in England, Wales, and Northern Ireland. 361 children with congenital hypothyroidism given early treatment and 315 control children. Intelligence quotient (IQ) measured at school entry at 5 years of age with the Wechsler preschool and primary scale of intelligence. There was a discontinuous relation between IQ and plasma thyroxine concentration at diagnosis, with a threshold at 42.8 nmol/l (95% confidence interval 35.2 to 47.1 nmol/l). Hypothyroid children with thyroxine values below 42.8 nmol/l had a mean IQ 10.3 points (6.9 to 13.7 points) lower than those with higher values and than controls. None of the measures of quality of treatment (age at start of treatment (range 1-173 days), average thyroxine dose (12-76 micrograms in the first year), average thyroxine concentration during treatment (79-234 nmol/l in the first year), and thyroxine concentration less than 103 nmol/l at least once during the first year) influenced IQ at age 5. Despite early treatment in congenital hypothyroidism the disease severity has a threshold effect on brain development, probably determined prenatally. The 55% of infants with more severe disease continue to show clinically significant intellectual impairment; infants with milder disease show no such impairment. The findings predict that 10% of early treated infants with severe hypothyroidism, compared with around 40% of those who presented with symptoms in the period before screening began, are likely to require special education.

Intelligence quotient (IQ) in adolescence and later risk of alcohol-related hospital admissions and deaths--37-year follow-up of Swedish conscripts.

PubMed

Sjölund, Sara; Allebeck, Peter; Hemmingsson, Tomas

2012-01-01

To investigate the relationship between intelligence measured at ages 18-19 and later alcohol-related hospital admission and mortality among men, while controlling for possible confounders. Cohort study. A total of 49,321 Swedish men who were conscripted for military training in 1969-70 and followed until 2007. Intelligence quotient (IQ) measured at conscription is the exposure, while alcohol-related hospital admission and death are the two outcomes. Adjustments for following variables were made: early life circumstances [childhood socio-economic position (SEP), father's drinking], mental health, social adjustment and behavioural factors measured at age 18 (psychiatric diagnosis, contact with police and child care, low emotional control, daily smoking, risky use of alcohol) and adult social position (attained education, SEP and income at age 40). IQ had an inverse and graded association with later alcohol-related problems. For alcohol-related hospital admissions the crude hazard ratio (HR) was 1.29 (95% CI = 1.26-1.31) and for alcohol-related mortality it was 1.21 (95% CI = 1.17-1.24) for every one point decrease on the nine-point IQ scale. Adjustment for risk factors measured at age 18 attenuated the association somewhat for both outcomes. After adjustment for social position as adult, the HR was considerably lower resulting in a HR of 1.06 (95% CI = 1.02-1.10) for alcohol-related hospital admissions and 1.01 (95% CI = 0.95-1.08) for alcohol-related mortality. In Swedish men there is an association between IQ in early adulthood and later alcohol-related hospital admission and death. Social position as adult could be an important contributory factor. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

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

PubMed

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

2017-08-01

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

An educational intervention on drug interactions and contraceptive options for epilepsy patients: a pilot randomized controlled trial.

PubMed

Mody, Sheila K; Haunschild, Carolyn; Farala, John Paul; Honerkamp-Smith, Gordon; Hur, Vivian; Kansal, Leena

2016-01-01

This pilot study investigates whether an educational handout could increase short-term information retention about drug interactions between antiepileptic drugs (AEDs) and hormonal contraceptives among female epilepsy patients of reproductive age. This is a pilot randomized controlled trial of an educational intervention among reproductive-age women with epilepsy in an academic neurology clinic. Investigators measured knowledge before and after participants received either usual care or the educational handout. The 10-question test assessed increased knowledge of which AEDs affected efficacy of certain hormonal contraceptives and was assessed by calculating the improvement in score between the pretest and posttest. The educational handout included the names of AEDs that have drug interactions with certain contraceptives and the efficacy of the contraceptives. A total of 42 epilepsy patients participated in this study. Fourteen participants were taking AEDs that are enzyme p450 inducers and 13 participants were taking Lamotrigine. Twenty women were randomized to receive the educational handout and 22 women were randomized to usual care. We found no statistical difference in the groups with regard to age, ethnicity or level of education. We found a significantly higher improvement in quiz scores in the educational handout group (3.65 point increase) compared to the usual care group (0.68 point increase) as calculated by the Student's two-sample t test (p<.001). An educational handout on drug interactions and contraceptives resulted in increased short-term information retention on this topic among reproductive-age female epilepsy patients. This pilot study highlights the need for further larger studies to evaluate the impact of educational interventions on improving patient knowledge about the drug interaction of AEDs and hormonal contraceptives. Copyright © 2016. Published by Elsevier Inc.

A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia.

PubMed

Beres, Laura K; Tate, Jacqueline E; Njobvu, Lungowe; Chibwe, Bertha; Rudd, Cheryl; Guffey, M Brad; Stringer, Jeffrey S A; Parashar, Umesh D; Chilengi, Roma

2016-05-01

Diarrhea is the third leading cause of child death in Zambia. Up to one-third of diarrhea cases resulting in hospitalization and/or death are caused by vaccine-preventable rotavirus. In January 2012, Zambia initiated a pilot introduction of the Rotarix live, oral rotavirus vaccine in all public health facilities in Lusaka Province. Between July 2012 and October 2013, we conducted a case-control study at 6 public sector sites to estimate rotavirus vaccine effectiveness (VE) in age-eligible children presenting with diarrhea. We computed the odds of having received at least 1 dose of Rotarix among children whose stool was positive for rotavirus antigen (cases) and children whose stool was negative (controls). We adjusted the resulting odds ratio (OR) for patient age, calendar month of presentation, and clinical site, and expressed VE as (1 - adjusted OR) × 100. A total of 91 rotavirus-positive cases and 298 rotavirus-negative controls who had under-5 card-confirmed vaccination status and were ≥6 months of age were included in the case-control analysis. Among rotavirus-positive children who were age-eligible to be vaccinated, 20% were hospitalized. Against rotavirus diarrhea of all severity, the adjusted 2-dose VE was 26% (95% confidence interval [CI], -30% to 58%) among children ≥6 months of age. VE against hospitalized children ≥6 months of age was 56% (95% CI, -34% to 86%). We observed a higher point estimate for VE against increased severity of illness compared with milder disease, but were not powered to detect a low level of VE against milder disease. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Evaluation of hepatic steatosis in dogs with congenital portosystemic shunts using Oil-Red-O staining

PubMed Central

Hunt, GB; Luff, J; Daniel, L; Van den Bergh, R.

2015-01-01

The aims of this prospective study were to quantify steatosis in dogs with congenital portosystemic shunts using a fat-specific stain, to compare the amount of steatosis in different lobes of the liver, and to evaluate intra- and inter-Observer variability in lipid point counting. Computer-assisted point counting of lipid droplets was undertaken following Oil-Red-O staining in 21 dogs with congenital portosystemic shunts and 9 control dogs. Dogs with congenital portosystemic shunts had significantly more small lipid droplets (< 6 μ) than control dogs (p = 0.0013 and 0.0002, respectively). There was no significant difference in steatosis between liver lobes for either control dogs and CPS dogs. Significant differences were seen between observers for the number of large lipid droplets (> 9 μ) and lipogranulomas per tissue point (p = 0.023 and 0.01, respectively). In conclusion, computer-assisted counting of lipid droplets following Oil Red O staining of liver biopsy samples allows objective measurement and detection of significant differences between dogs with CPS and normal dogs. This method will allow future evaluation of the relationship between different presentations of CPS (anatomy, age, breed) and lipidosis, as well as the impact of hepatic lipidosis on outcomes following surgical shunt attenuation. PMID:23528942

Neural correlates of reactive aggression in children with attention-deficit/hyperactivity disorder and comorbid disruptive behaviour disorders.

PubMed

Bubenzer-Busch, S; Herpertz-Dahlmann, B; Kuzmanovic, B; Gaber, T J; Helmbold, K; Ullisch, M G; Baurmann, D; Eickhoff, S B; Fink, G R; Zepf, F D

2016-04-01

Attention deficit hyperactivity disorder (ADHD) is often linked with impulsive and aggressive behaviour, indexed by high comorbidity rates between ADHD and disruptive behaviour disorders (DBD). The present study aimed to investigate underlying neural activity of reactive aggression in children with ADHD and comorbid DBD using functional neuroimaging techniques (fMRI). Eighteen boys with ADHD (age 9-14 years, 10 subjects with comorbid DBD) and 18 healthy controls were administered a modified fMRI-based version of the 'Point Subtraction Aggression Game' to elicit reactive aggressive behaviour. Trials consisted of an 'aggression phase' (punishment for a fictitious opponent) and an 'outcome phase' (presentation of the trial outcome). During the aggression phase, higher aggressive responses of control children were accompanied by higher activation of the ventral anterior cingulate cortex and the temporoparietal junction. Patients displayed inverted results. During the outcome phase, comparison between groups and conditions showed differential activation in the dorsal striatum and bilateral insular when subjects gained points. Losing points was accompanied by differential activation of regions belonging to the insula and the middle temporal sulcus. Data support the hypothesis that deficient inhibitory control mechanisms are related to increased impulsive aggressive behaviour in young people with ADHD and comorbid DBD. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effects of acupressure on progress of labor and cesarean section rate: randomized clinical trial

PubMed Central

Mafetoni, Reginaldo Roque; Shimo, Antonieta Keiko Kakuda

2015-01-01

OBJECTIVE To analyze the effects of acupressure at the SP6 point on labor duration and cesarean section rates in parturients served in a public maternity hospital. METHODS This controlled, randomized, double-blind, pragmatic clinical trial involved 156 participants with gestational age ≥ 37 weeks, cervical dilation ≥ 4 cm, and ≥ 2 contractions in 10 min. The women were randomly divided into an acupressure, placebo, or control group at a university hospital in an inland city in the state of Sao Paulo, Brazil, in 2013. Acupressure was applied to the SP6 point during contractions for 20 min. RESULTS The average labor duration was significantly different between the SP6 acupressure group [221.5 min (SD = 162.4)] versus placebo [397.9 min (SD = 265.6)] and versus control [381.9 min (SD = 358.3)] (p = 0.0047); however, the groups were similar regarding the cesarean section rates (p = 0.2526) and Apgar scores in the first minute (p = 0.9542) and the fifth minute (p = 0.7218) of life of the neonate. CONCLUSIONS The SP6 acupressure point proved to be a complementary measure to induce labor and may shorten the labor duration without causing adverse effects to the mother or the newborn. However, it did not affect the cesarean section rate. PMID:25741644

Is interleukin-17 a proatherogenic biomarker?

PubMed

Cătană, Cristina-Sorina; Cristea, Victor; Miron, Nicolae; Neagoe, Ioana Berindan

2011-01-01

The importance of chronic inflammation in atherogenesis and cytokine involvement in all stages of atherosclerotic plaque development is now obvious. Our approach of the significant cytokines involved in atherogenesis or cardiovascular diseases is based on a correlation between clinical research and experiments on animal models. The contribution of IL-17 in atherogenesis remains controversial. In this study we investigated the role of IL-17 in cardiovascular diseases and in atherosclerosis associated with pathological aging. We performed a case-control study, enrolling subjects aged over 65 years in both groups. We included 40 patients with cardiovascular disorders and 10 healthy volunteers. IL-17 levels were measured in the serum of patients and healthy controls, along with serum total cholesterol and triglycerides. Significantly higher levels of IL-17 were obtained in patients compared to healthy controls (p<0.001). The level of this biomarker correlated significantly with two biochemical parameters - serum total cholesterol and triglycerides (the Pearson coefficient showed statistical significance, p=0.033, respectively p=0.043). We did not find any correlation between IL-17 and these two parameters in the control group. Our study is useful in understanding the physiopathological implications of IL-17 in the atherogenesis process. This could represent a starting point for future studies, including research regarding the therapeutic potential of IL-17 in pathological aging.

Differential effects of bilingualism and culture on early attention: a longitudinal study in the U.S., Argentina, and Vietnam.

PubMed

Tran, Crystal D; Arredondo, Maria M; Yoshida, Hanako

2015-01-01

A large body of literature suggests that bilingualism strongly influences attentional processes among a variety of age groups. Increasing studies, however, indicate that culture may also have measurable effects on attentional processes. Bilinguals are often exposed to multiple cultural backgrounds, therefore, it is unclear if being exposed to multiple languages and culture together influence attentional processes, or if the effect themselves are uniquely linked to different attentional processes. The present study explores the relevancy of different attentional processes-alerting, orienting, and executive control-to language and to culture. In the present study, 97 3-years-old (Mean age = 38.78 months) monolingual and bilingual children from three countries (the U.S., Argentina, and Vietnam) were longitudinally tested for a total of five time points on a commonly used non-linguistic attentional paradigm-the Attention Network Test. Results demonstrate that when other factors are controlled (e.g., socio-economic status, vocabulary knowledge, age), culture plays an important role on the development of the alerting and executive control attentional network, while language status was only significant on the executive control attentional network. The present study indicates that culture may interact with bilingualism to further explain previous reported advantages, as well as elucidate the increasing disparity surrounding cognitive advantages in bilingual literature.

Nature vs nurture: interplay between the genetic control of telomere length and environmental factors.

PubMed

Harari, Yaniv; Romano, Gal-Hagit; Ungar, Lior; Kupiec, Martin

2013-11-15

Telomeres are nucleoprotein structures that cap the ends of the linear eukaryotic chromosomes, thus protecting their stability and integrity. They play important roles in DNA replication and repair and are central to our understanding of aging and cancer development. In rapidly dividing cells, telomere length is maintained by the activity of telomerase. About 400 TLM (telomere length maintenance) genes have been identified in yeast, as participants of an intricate homeostasis network that keeps telomere length constant. Two papers have recently shown that despite this extremely complex control, telomere length can be manipulated by external stimuli. These results have profound implications for our understanding of cellular homeostatic systems in general and of telomere length maintenance in particular. In addition, they point to the possibility of developing aging and cancer therapies based on telomere length manipulation.

Bone mineral status and metabolism in patients with Williams-Beuren syndrome.

PubMed

Stagi, Stefano; Manoni, Cristina; Scalini, Perla; Chiarelli, Francesco; Verrotti, Alberto; Cecchi, Cecilia; Lapi, Elisabetta; Giglio, Sabrina; Romano, Silvia; de Martino, Maurizio

2016-07-01

To evaluate bone mineral status and metabolism in a cohort of patients with Williams-Beuren syndrome (WBS). Thirty-one children (15 females, 16 males; mean age 9.6±2.74 years) and 10 young adults (6 females, 4 males; mean age 21.4±5.11 years) with WBS were cross-sectionally evaluated and compared with two age-, sex-, and body-size-matched paediatric (155 subjects, 75 females and 80 males; mean age 9.7±2.93 years) and adult (50 subjects, 30 females and 20 males; mean age 22.3±5.42 years) healthy controls. We evaluated ionised and total calcium, phosphate, parathyroid hormone (PTH), 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, osteocalcin, bone alkaline phosphatase levels, and urinary deoxypyridinoline concentrations. We also calculated the phalangeal amplitude-dependent speed of sound (AD-SoS) and the bone transmission time (BTT) z-scores. WBS patients showed a significantly reduced AD-SoS z-score (p <0.001) and BTT z-score (p <0.001) compared with the controls. This finding persisted when we divided the sample into paediatric and adult patients. WBS patients also had significantly higher ionised (p <0.001) and total calcium (p <0.001) levels as well as higher PTH levels (p <0.001) compared with the controls. Furthermore, WBS children and adolescents had significantly lower serum osteocalcin levels (p <0.001) and urinary deoxypyridinoline concentrations (p <0.001) than controls. WBS subjects exhibit a significant reduction in bone mineral status and impaired bone metabolism. These findings point to the need for close monitoring of WBS patients.

Total fats, saturated Fatty acids, processed foods and acute coronary syndrome in transitional Albania.

PubMed

Mone, Iris; Bulo, Anyla

2012-01-01

We aimed was to assess the association of acute coronary syndrome (ACS) with selected food groups pertinent to non-Mediterranean prototype in Albania, a transitional post-communist country in Southeast Europe. We conducted a case-control study in Tirana in 2003-2006 including 467 non-fatal consecutive ACS patients (370 men aged 59.1±8.7 years, 97 women aged 63.3±7.1 years; 88% response) and a population-based control group (469 men aged 53.1±10.4 years, 268 women aged 54.0±10.9 years; 69% response). A semi-quantitative food frequency questionnaire including 105 food items was administered to all participants based on which the daily calorie intake for selected food groups (meat products, overall oils and fats, sweets, and junk food) was calculated. General linear model was used to assess the association of food groups with ACS. Mean age-adjusted values of meat products, overall oils and fats, sweets and junk food were all considerably higher in cases than controls in both sexes. Cases had significantly higher mean "non-Mediterranean" diet scores (consisting of junk food, sweets, oils and fats except olive oil) than controls (10.3% vs. 5.9% in men and 15.2% vs. 8.3% in women, P<0.01 for both). In this Albanian population, intake of total fats, in particular saturated fatty acids was associated with a higher risk of ACS in both sexes. Furthermore, the consumption of processed foods was associated with considerable excess coronary risk which points to serious health implications for the Albanian adult population.

Memory consolidation in aging and MCI after 1 week

PubMed Central

Walsh, Christine M; Wilkins, Sarah; Bettcher, Brianne Magouirk; Butler, Christopher R; Miller, Bruce L; Kramer, Joel H

2014-01-01

Objective To assess consolidation in amnestic mild cognitive (aMCI) impairment, controlling for differences in initial learning and using a protracted delay period for recall. Methods Fifteen individuals with MCI were compared to fifteen healthy older adult controls on a story learning task. Subjects were trained to criteria to equalize initial learning across subjects. Recall was tested at both the 30-minute typically used delay and a 1-week delay used to target consolidation. Results Using repeated measures ANOVAs adjusted for age, we found group × time point interactions across the entire task between the final trial and 30-minute delay, and again between the 30-minute and 1-week delay periods, with MCI having greater declines in recall as compared to controls. Significant group main effects were also found, with MCI recalling less than controls. Conclusion Consolidation was impaired in aMCI as compared to controls. Our findings indicate that MCI-related performance typically measured at 30 minutes underestimates MCI-associated memory deficits. This is the first study to isolate consolidation by controlling for initial learning differences and using a protracted delay period to target consolidation in an MCI sample. PMID:24219610

Nociceptor Sensitization Depends on Age and Pain Chronicity123

PubMed Central

Dodge, Amanda K.

2016-01-01

Abstract Peripheral inflammation causes mechanical pain behavior and increased action potential firing. However, most studies examine inflammatory pain at acute, rather than chronic time points, despite the greater burden of chronic pain on patient populations, especially aged individuals. Furthermore, there is disagreement in the field about whether primary afferents contribute to chronic pain. Therefore, we sought to evaluate the contribution of nociceptor activity to the generation of pain behaviors during the acute and chronic phases of inflammation in both young and aged mice. We found that both young (2 months old) and aged (>18 months old) mice exhibited prominent pain behaviors during both acute (2 day) and chronic (8 week) inflammation. However, young mice exhibited greater behavioral sensitization to mechanical stimuli than their aged counterparts. Teased fiber recordings in young animals revealed a twofold mechanical sensitization in C fibers during acute inflammation, but an unexpected twofold reduction in firing during chronic inflammation. Responsiveness to capsaicin and mechanical responsiveness of A-mechanonociceptor (AM) fibers were also reduced chronically. Importantly, this lack of sensitization in afferent firing during chronic inflammation occurred even as these inflamed mice exhibited continued behavioral sensitization. Interestingly, C fibers from inflamed aged animals showed no change in mechanical firing compared with controls during either the acute or chronic inflammatory phases, despite strong behavioral sensitization to mechanical stimuli at these time points. These results reveal the following two important findings: (1) nociceptor sensitization to mechanical stimulation depends on age and the chronicity of injury; and (2) maintenance of chronic inflammatory pain does not rely on enhanced peripheral drive. PMID:26866058

[Effects of garlic oil, age and sex on n-hexane metabolism in rats].

PubMed

Yan, Jie; Yin, Hong-yin; Liu, Zhong; Chi, De-feng; Li, Yang; Fu, Qiang-qiang; Xie, Ke-qin

2011-01-01

To investigate effects of garlic oil (GO), age and sex on n-hexane metabolism in rats. The Wistar rats were used as experimental animals. (1) Intragastric administration: n-hexane group (3000 mg/kg n-hexane), GO treated group (80 mg/kg GO ig. an hour earlier than 3000 mg/kg n-hexane), then blood was taken from tails of rats at 8, 12, 16, 20, 24, 28, 32 h points after n-hexane administration. (2) Intraperitoneal injection: n-hexane group (1000 mg/kg n-hexane), GO treated group (80 mg/kg GO ig. an hour earlier than 1000 mg/kg n-hexane), then took blood was taken from tails of rats at 8, 12, 16, 20, 24, 28 h points after n-hexane injection. (3) 7 rats each group of 6, 8, 10 weeks age were administrated by 3000 mg/kg n-hexane intragastrically, then were taken blood from tails at 16, 20, 24 h points after administration. (4) 7 male and 7 female rats of 8 weeks age were administrated by 3000 mg/kg n-hexane intragastrically, then were taken blood from tails at 16, 20, 24, 28 h points after administration. The gas chromatography was used to determine the metabolite 2, 5-hexanedione concentration of n-hexane in serum and 2, 5-hexanedione concentration was compared between GO and no GO treated rats, different ages and different sexes. (1) Intragastric administration: 2, 5-hexanedione concentrations in serum of n-hexane group and GO treated group had the peak 19.2 and 12.3 µg/ml at 20h and 24 h points. Compared with n-hexane group, the serum 2, 5-hexanedione concentration of GO treated group was lower at time points prior to peak and 2, 5-hexanedione eliminating process was slower after peak. (2) Intraperitoneal injection: effects of GO on the serum 2, 5-hexanedione concentrations was very similar to intragastric administration, 2, 5-hexanedione concentrations in serum of n-hexane group and GO treated group had the peak 15.0 and 6.7 µg/ml at 12 h and 16 h points. (3) Comparison of the serum 2, 5-hexanedione concentrations of different weeks age rats: The serum 2, 5-hexanedione concentrations of 6, 8, 10 weeks age rats were 25.5, 15.0, 12.8 µg/ml each (8, 10 weeks age significantly lower than 6 weeks age) at 16 h point; at 20 h point, they were 24.7, 18.3, 15.0 µg/ml each (10 weeks age significantly lower than 6 weeks age); at 24 h point, they were 11.0, 14.7, 8.1 µg/ml each (10 weeks age significantly lower than 8 weeks age). (4) Comparisons of the serum 2, 5-hexanedione concentrations of different sex rats: the serum 2, 5-hexanedione concentrations of male and female rats were 22.5, 17.2 µg/ml each at 16 h point (different significantly); at 20, 24, 28 h points, they were 27.6, 22.9 µg/ml, 24.6, 19.1 µg/ml, 19.1, 13.8 µg/ml each (different non-significantly). GO reduces production of 2, 5-hexanedione in serum generated by n-hexane in rats; the metabolic capacity of low age rats on n-hexane is stronger than high age ones.

Memory, priority encoding, and overcoming high-value proactive interference in younger and older adults.

PubMed

Friedman, Michael C; Castel, Alan D

2013-01-01

It is often necessary to remember important information while directing attention away from encoding less valuable information. To examine how aging influences the ability to control and update the encoding of high-value information, younger and older adults studied six lists of words that varied in terms of the point values associated with each word. The words were paired with the same high and low point values for three study-test cycles, but on the fourth and subsequent cycles the value-word pairings were switched such that the lowest value pairs became the highest values (and vice versa). For the first three study-test cycles, younger adults outperformed older adults in terms of the number of words recalled and overall point totals, but performance was similar in terms of selectively remembering high-value words. When the values were switched, both groups displayed substantial interference from the previous pairings. Although both groups improved with additional study-test cycles, only younger adults were able to fully recover from the interference effects. A similar, and more pronounced, set of results were obtained when positive and negative point values were paired with the words. The findings are interpreted in a value-directed remembering framework, emphasizing the role of benefits and costs of strategic encoding and age-related differences in the effects of interference on memory.

Aging, Memory Efficiency and the Strategic Control of Attention at Encoding: Impairments of Value-Directed Remembering in Alzheimer's Disease

PubMed Central

Castel, Alan D.; Balota, David A.; McCabe, David P.

2009-01-01

Selecting what is important to remember, attending to this information, and then later recalling it can be thought of in terms of the strategic control of attention and the efficient use of memory. In order to examine whether aging and Alzheimer's disease (AD) influenced this ability, the present study used a selectivity task, where studied items were worth various point values and participants were asked to maximize the value of the items they recalled. Relative to younger adults (N=35) and healthy older adults (N=109), individuals with very mild AD (N=41) and mild AD (N=13) showed impairments in the strategic and efficient encoding and recall of high value items. Although individuals with AD recalled more high value items than low value items, they did not efficiently maximize memory performance (as measured by a selectivity index) relative to healthy older adults. Performance on complex working memory span tasks was related to the recall of the high value items but not low value items. This pattern suggests that relative to healthy aging, AD leads to impairments in strategic control at encoding and value-directed remembering. PMID:19413444

Uranium-Series Ages of Marine Terrace Corals from the Pacific Coast of North America and Implications for Last-Interglacial Sea Level History

USGS Publications Warehouse

Muhs, D.R.; Kennedy, G.L.; Rockwell, T.K.

1994-01-01

Few of the marine terraces along the Pacific coast of North America have been dated using uranium-series techniques. Ten terrace sequences from southern Oregon to southern Baja California Sur have yielded fossil corals in quantities suitable for U-series dating by alpha spectrometry. U-series-dated terraces representing the ???80,000 yr sea-level high stand are identified in five areas (Bandon, Oregon; Point Arena, San Nicolas Island, and Point Loma, California; and Punta Banda, Baja California); terraces representing the ???125,000 yr sea-level high stand are identified in eight areas (Cayucos, San Luis Obispo Bay, San Nicolas Island, San Clemente Island, and Point Loma, California; Punta Bands and Isla Guadalupe, Baja California; and Cabo Pulmo, Baja California Sur). On San Nicolas Island, Point Loma, and Punta Bands, both the ???80,000 and the ???125,000 yr terraces are dated. Terraces that may represent the ???105,000 sea-level high stand are rarely preserved and none has yielded corals for U-series dating. Similarity of coral ages from midlatitude, erosional marine terraces with coral ages from emergent, constructional reefs on tropical coastlines suggests a common forcing mechanism, namely glacioeustatically controlled fluctuations in sea level superimposed on steady tectonic uplift. The low marine terrace dated at ???125,000 yr on Isla Guadalupe, Baja California, presumed to be tectonically stable, supports evidence from other localities for a +6-m sea level at that time. Data from the Pacific Coast and a compilation of data from other coasts indicate that sea levels at ???80,000 and ???105,000 yr may have been closer to present sea level (within a few meters) than previous studies have suggested.

Educational intervention to improve adherence to the Mediterranean diet among parents and their children aged 1-2 years. EniM clinical trial.

PubMed

Roset-Salla, Margarita; Ramon-Cabot, Joana; Salabarnada-Torras, Jordi; Pera, Guillem; Dalmau, Albert

2016-04-01

The objective of the present study was to evaluate the effectiveness of an educational programme on healthy alimentation, carried out in day-care centres and aimed at the parents of children from 1 to 2 years of age, regarding the acquisition of healthy eating habits among themselves and their children. We performed a multicentre, multidisciplinary, randomized controlled study in a community setting. The EniM study (nutritional intervention study among children from Mataró) was performed in twelve day-care centres in Mataró (Spain). Centres were randomized into a control group (CG) and an intervention group (IG). IG received four or five educational workshops on diet, CG did not have workshops. Children, not exclusively breast-fed, from 1 to 2 years of age, in the participating day-care centres and the persons responsible for their alimentation (mother or father). Thirty-five per cent of the IG did not attend the minimum of three workshops and were excluded. The CG included seventy-four children and seventy-two parents and the IG seventy-five children and sixty-seven parents. Both groups were comparable at baseline. Basal adherence to the Mediterranean diet was 56·4 % in parents (Gerber index) and 7·7 points in children (Kidmed test). At 8 months, Mediterranean diet adherence had improved in the IG by 5·8 points in the Gerber index (P=0·01) and 0·6 points in the Kidmed test (P=0·02) compared with the CG. This educational intervention performed in parents at the key period of incorporation of a 1-2-year-old child to the family table showed significant increases in adherence of the parents to the Mediterranean diet, suggesting future improvement in different indicators of health and an expected influence on the diet of their children.

Improvements in diabetes processes of care and intermediate outcomes: United States, 1988-2002.

PubMed

Saaddine, Jinan B; Cadwell, Betsy; Gregg, Edward W; Engelgau, Michael M; Vinicor, Frank; Imperatore, Giuseppina; Narayan, K M Venkat

2006-04-04

Progress of diabetes care is a subject of public health concern. To assess changes in quality of diabetes care in the United States by using standardized measures. National population-based, serial cross-sectional surveys. National Health and Nutrition Examination Survey (1988-1994 and 1999-2002) and the Behavioral Risk Factor Surveillance System (1995 and 2002). Survey participants 18 to 75 years of age who reported a diagnosis of diabetes. Glycemic control, blood pressure, low-density lipoprotein (LDL) cholesterol level, annual cholesterol level monitoring, and annual foot and dilated eye examination, as defined by the National Diabetes Quality Improvement Alliance measures. In the past decade, the proportion of persons with diabetes with poor glycemic control (hemoglobin A1c > 9%) showed a nonstatistically significant decrease of 3.9% (95% CI, -10.4% to 2.5%), while the proportion of persons with fair or good lipid control (LDL cholesterol level < 3.4 mmol/L [<130 mg/dL]) had a statistically significant increase of 21.9% (CI, 12.4% to 31.3%). Mean LDL cholesterol level decreased by 0.5 mmol/L (18.8 mg/dL). Although mean hemoglobin A1c did not change, the proportion of persons with hemoglobin A(1c) of 6% to 8% increased from 34.2% to 47.0%. The blood pressure distribution did not change. Annual lipid testing, dilated eye examination, and foot examination increased by 8.3% (CI, 4.0% to 12.7%), 4.5% (CI, 0.5% to 8.5%), and 3.8% (CI, -0.1% to 7.7%), respectively. The proportion of persons reporting annual influenza vaccination and aspirin use improved by 6.8 percentage points (CI, 2.9 percentage points to 10.7 percentage points) and 13.1 percentage points (CI, 5.4 percentage points to 20.7 percentage points), respectively. Data are self-reported, and the surveys do not have all National Diabetes Quality Improvement Alliance indicators. Diabetes processes of care and intermediate outcomes have improved nationally in the past decade. But 2 in 5 persons with diabetes still have poor LDL cholesterol control, 1 in 3 persons still has poor blood pressure control, and 1 in 5 persons still has poor glycemic control.

Effectiveness of tobacco control television advertising in changing tobacco use in England: a population-based cross-sectional study.

PubMed

Sims, Michelle; Salway, Ruth; Langley, Tessa; Lewis, Sarah; McNeill, Ann; Szatkowski, Lisa; Gilmore, Anna B

2014-06-01

To examine whether government-funded tobacco control television advertising shown in England between 2002 and 2010 reduced adult smoking prevalence and cigarette consumption. Analysis of monthly cross-sectional surveys using generalised additive models. England. More than 80 000 adults aged 18 years or over living in England and interviewed in the Opinions and Lifestyle Survey. Current smoking status, smokers' daily cigarette consumption, tobacco control gross rating points (GRPs-a measure of per capita advertising exposure combining reach and frequency), cigarette costliness, tobacco control activity, socio-demographic variables. After adjusting for other tobacco control policies, cigarette costliness and individual characteristics, we found that a 400-point increase in tobacco control GRPs per month, equivalent to all adults in the population seeing four advertisements per month (although actual individual-level exposure varies according to TV exposure), was associated with 3% lower odds of smoking 2 months later [odds ratio (OR) = 0.97, 95% confidence interval (CI) = 0.95, 0.999] and accounted for 13.5% of the decline in smoking prevalence seen over this period. In smokers, a 400-point increase in GRPs was associated with a 1.80% (95%CI = 0.47, 3.11) reduction in average cigarette consumption in the following month and accounted for 11.2% of the total decline in consumption over the period 2002-09. Government-funded tobacco control television advertising shown in England between 2002 and 2010 was associated with reductions in smoking prevalence and smokers' cigarette consumption. © 2014 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Pharyngeal chemosensitivity in patients with obstructive sleep apnea and healthy subjects.

PubMed

Heiser, Clemens; Zimmermann, Ingo; Sommer, J Ulrich; Hörmann, Karl; Herr, Raphael M; Stuck, Boris A

2013-09-01

Signs of pharyngeal neurodegeneration have been detected in patients with obstructive sleep apnea (OSA). Along with this neurodegeneration, a decreased pharyngeal sensitivity to mechanical stimulation has been described. The decreased sensitivity may play a role in the pathophysiology of this disease. The aim of the study was to investigate the chemosensitivity of the pharyngeal mucosa in patients with OSA compared with controls. Healthy controls and patients with OSA (age: 30-60 years) were included. Testing of oropharyngeal chemosensitivity was performed with subjective intensity ratings of capsaicin (SIR, visual analogue scale 0-10), air puffs (presented with an olfactometer), and stimulation with CO2 at the posterior pharyngeal wall. A 2-point discrimination test at the soft palate, an intensity rating of capsaicin at the tongue, and a nasal lateralization test were performed. Twenty-six patients with OSA and 18 healthy controls were included. No differences were detected in the SIR of capsaicin at the tongue or in the nasal lateralization test. At the pharynx, a decreased sensitivity to capsaicin (OSA: 6.8 ± 2.3; healthy control: 8.6 ± 1.3), air puffs (OSA: 2.8 ± 1.9; healthy control: 4.2 ± 1.6), and stimulation with CO2 (OSA: 1.5 ± 1.7; healthy control: 2.8 ± 1.8) were demonstrated in patients with OSA (all P < 0.05). Two-point discrimination at the soft palate was reduced with statistical significance in the OSA group (OSA: 11.5 ± 5.4 mm; healthy control: 5.0 ± 2.4 mm). The results suggest reduced pharyngeal chemosensitivity in OSA patients in addition to the reduced mechanical pharyngeal sensitivity shown with 2-point discrimination. This demonstrates peripheral neurodegeneration in the context of this disease.

HYC-24L Demonstrates Greater Effectiveness With Less Pain Than CPM-22.5 for Treatment of Perioral Lines in a Randomized Controlled Trial.

PubMed

Butterwick, Kimberly; Marmur, Ellen; Narurkar, Vic; Cox, Sue Ellen; Joseph, John H; Sadick, Neil S; Tedaldi, Ruth; Wheeler, Sarah; Kolodziejczyk, Julia K; Gallagher, Conor J

2015-12-01

This trial compares the effectiveness and safety of HYC-24L (Juvéderm Ultra XC; Allergan plc, Dublin, Ireland) (24 mg/mL of hyaluronic acid, 0.3% lidocaine) and CPM-22.5 (Belotero Balance; Merz Aesthetics, Raleigh, NC) (22.5 mg/mL of hyaluronic acid) for the treatment of perioral lines. Men and women aged 35 years or older with moderate-to-severe perioral lines were recruited for this randomized controlled, rater-blinded, 2-arm trial. The primary endpoint was a comparison of rater-assessed responder rates by the validated 4-point Perioral Lines Severity Scale at Month 6; responders were those who showed a ≥1 point improvement. A secondary endpoint was subject-assessed change in perioral lines measured by the Global Assessment of Change Scale. A total of 136 subjects received treatment and 132 completed the trial (mean age: 58 ± 8 years). Total volume injected was 1.18 mL (HYC-24L) and 1.32 mL (CPM-22.5). At Month 6, a significantly greater proportion of HYC-24L subjects responded to treatment (87%) than CPM-22.5 subjects (72%) (p < .04). At all time points, HYC-24L subjects reported significantly greater improvement in their perioral lines than CPM-22.5 subjects, with the greatest difference at Month 6. No unexpected adverse events occurred. HYC-24L subjects showed a higher response rate and a greater improvement in their perioral lines than CPM-22.5 subjects for up to 6 months.

Variations in Brain Volume and Growth in Young Children With Type 1 Diabetes.

PubMed

Mazaika, Paul K; Weinzimer, Stuart A; Mauras, Nelly; Buckingham, Bruce; White, Neil H; Tsalikian, Eva; Hershey, Tamara; Cato, Allison; Aye, Tandy; Fox, Larry; Wilson, Darrell M; Tansey, Michael J; Tamborlane, William; Peng, Daniel; Raman, Mira; Marzelli, Matthew; Reiss, Allan L

2016-02-01

Early-onset type 1 diabetes may affect the developing brain during a critical window of rapid brain maturation. Structural MRI was performed on 141 children with diabetes (4-10 years of age at study entry) and 69 age-matched control subjects at two time points spaced 18 months apart. For the children with diabetes, the mean (±SD) HbA1c level was 7.9 ± 0.9% (63 ± 9.8 mmol/mol) at both time points. Relative to control subjects, children with diabetes had significantly less growth of cortical gray matter volume and cortical surface area and significantly less growth of white matter volume throughout the cortex and cerebellum. For the population with diabetes, the change in the blood glucose level at the time of scan across longitudinal time points was negatively correlated with the change in gray and white matter volumes, suggesting that fluctuating glucose levels in children with diabetes may be associated with corresponding fluctuations in brain volume. In addition, measures of hyperglycemia and glycemic variation were significantly negatively correlated with the development of surface curvature. These results demonstrate that early-onset type 1 diabetes has widespread effects on the growth of gray and white matter in children whose blood glucose levels are well within the current treatment guidelines for the management of diabetes. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Aging management program of the reactor building concrete at Point Lepreau Generating Station

NASA Astrophysics Data System (ADS)

Aldea, C.-M.; Shenton, B.; Demerchant, M. M.; Gendron, T.

2011-04-01

In order for New Brunswick Power Nuclear (NBPN) to control the risks of degradation of the concrete reactor building at the Point Lepreau Generating Station (PLGS) the development of an aging management plan (AMP) was initiated. The intention of this plan was to determine the requirements for specific structural components of concrete of the reactor building that require regular inspection and maintenance to ensure the safe and reliable operation of the plant. The document is currently in draft form and presents an integrated methodology for the application of an AMP for the concrete of the reactor building. The current AMP addresses the reactor building structure and various components, such as joint sealant and liners that are integral to the structure. It does not include internal components housed within the structure. This paper provides background information regarding the document developed and the strategy developed to manage potential degradation of the concrete of the reactor building, as well as specific programs and preventive and corrective maintenance activities initiated.

Synergistic effect of social support and self-efficacy on physical exercise in older adults.

PubMed

Warner, Lisa M; Ziegelmann, Jochen P; Schüz, Benjamin; Wurm, Susanne; Schwarzer, Ralf

2011-07-01

The purpose of the current study was to examine whether the effects of social support on physical exercise in older adults depend on individual perceptions of self-efficacy. Three hundred nine older German adults (age 65-85) were assessed at 3 points in time (3 months apart). In hierarchical-regression analyses, support received from friends and exercise self-efficacy were specified as predictors of exercise frequency while baseline exercise, sex, age, and physical functioning were controlled for. Besides main effects of self-efficacy and social support, an interaction between social support and self-efficacy emerged. People with low self-efficacy were less likely to be active in spite of having social support. People with low support were less likely to be active even if they were high in self-efficacy. This points to the importance of both social support and self-efficacy and implies that these resources could be targets of interventions to increase older adults' exercise.

Results of a 100-point scale for evaluating job satisfaction and the Occupational Depression Scale questionnaire survey in workers.

PubMed

Kawada, Tomoyuki; Yoshimura, Miwako

2012-04-01

To evaluate the relationship between the score of job satisfaction and depression. A total of 2737 workers (2198 men and 539 women) participated. A 100-point scale for evaluating job satisfaction and the Occupational Depression Scale were used. A logistic regression analysis was applied with adjustment for age. The mean age of the subjects was 42.2 years for men and 36.0 years for women. When the group with the highest job satisfaction score was set as the control, the odds ratios and 95% confidence intervals for depression in the groups with the lowest and second lowest scores were 16.3 (7.51 to 35.2) and 5.90 (2.70 to 12.9) in men and 8.02 (1.78 to 36.1) and 5.68 (1.26 to 25.7) in women, respectively. Job satisfaction was significantly associated with the depressive state, and causality should be clarified by a follow-up study.

Analysis of efficacy and safety of treatment with collagenase Clostridium histolyticum among subgroups of patients with Dupuytren contracture.

PubMed

Raven, Raymond B; Kushner, Harvey; Nguyen, Dat; Naam, Nash; Curtin, Catherine

2014-09-01

Collagenase Clostridium histolyticum (CCH) injection is a nonoperative treatment of hand contractures from Dupuytren disease. This study assessed the efficacy and safety of CCH in several subgroups of patients with increased surgical risk.Data were pooled from 3 randomized, placebo-controlled, double-blind trials. This analysis included 271 patients with metacarpophalangeal (n = 167) or proximal interphalangeal (n = 104) joint contractures greater than or equal to 20 degrees treated with CCH (0.58 mg collagenase per injection). Subgroups included age, sex, and diabetes status. End points included rate of clinical success (reduction in contracture to 0-5 degrees of normal) and percentage of adverse events.There was no significant difference in clinical success by age, diabetes status, or sex with 63% reaching the end point. There was no difference in adverse events among the subgroups, with peripheral edema, contusion, and injection-site hemorrhage being most common.High-risk subgroups do not demonstrate differences in efficacy or safety with CCH treatment of Dupuytren-related contractures.

New observations on maternal age effect on germline de novo mutations.

PubMed

Wong, Wendy S W; Solomon, Benjamin D; Bodian, Dale L; Kothiyal, Prachi; Eley, Greg; Huddleston, Kathi C; Baker, Robin; Thach, Dzung C; Iyer, Ramaswamy K; Vockley, Joseph G; Niederhuber, John E

2016-01-19

Germline mutations are the source of evolution and contribute substantially to many health-related processes. Here we use whole-genome deep sequencing data from 693 parents-offspring trios to examine the de novo point mutations (DNMs) in the offspring. Our estimate for the mutation rate per base pair per generation is 1.05 × 10(-8), well within the range of previous studies. We show that maternal age has a small but significant correlation with the total number of DNMs in the offspring after controlling for paternal age (0.51 additional mutations per year, 95% CI: 0.29, 0.73), which was not detectable in the smaller and younger parental cohorts of earlier studies. Furthermore, while the total number of DNMs increases at a constant rate for paternal age, the contribution from the mother increases at an accelerated rate with age.These observations have implications related to the incidence of de novo mutations relating to maternal age.

TURNING POINTS IN THE LIVES OF LESBIAN AND GAY ADULTS AGE 50 AND OVER

PubMed Central

Fredriksen-Goldsen, Karen I.

2016-01-01

Little is known about how lesbians and gay men perceive the turning points that define their life trajectories. This study uses qualitative interview data to understand which experiences lesbian women and gay men age 50 and older identify as turning points and explore gender differences. In depth, face-to-face qualitative interviews were conducted with a subset of participants (n=33) from the Caring and Aging with Pride survey. The most common turning points identified were relationship and occupation related. Lesbians more frequently identified the break-up of a relationship and occupational and educational related experiences as turning points. Gay men more commonly indicated that the beginning of a relationship and HIV/AIDS related experiences were turning points. The turning points were analyzed according to principles of the life course theory and narrative analysis. PMID:28066158

[The significance of the relationship between external/internal locus of control and adolescent substance use in behavioral medicine].

PubMed

Pikó, Bettina; Kovács, Eszter; Kriston, Pálma

2011-02-27

Prevention and treatment of the addictions are key public health priorities in modern society. In medical practice, in relation to the biochemical processes, mapping the addiction-prone personality traits, like external/internal locus of control are getting more and more attention. Individuals with high level on internal locus of control, for example, tend to take care of their health behavior; the lack of it, on the other hand, may worsen the effectiveness of stress release which may increase the likelihood of turning to substance use. The main goal of the present study was to investigate the relationship between adolescent substance use (both lifetime prevalence and the actual substance user status) and external/internal locus of control). The data collection of the questionnaire survey was going on among 656 high school students in Szeged (age range between 14-21 years, mean = 16.5 years, S.D. = 1.5 years of age, 49.1% of the sample was female). Associations between indicators of substance use (as dependent variables) and scale points of external/internal locus of control (as independent variables) were assessed using odds ratios calculated by logistic regression analyses, whereas gender was used as a controlling variable. Among boys, scale points of external, among girls, those of internal locus of control showed higher values. External locus of control increased, whereas internal locus of control decreased the risk of substance use, however, the relative role of external/internal locus of control was different according to the type of substance use and the prevalence values. In terms of smoking, lifetime prevalence, whereas in terms of marijuana use, the actual user status was influenced. In addition, while the latter one was also affected by gender, it did not play a role at all in the previous one. All these findings suggest that behavioral control may play a particularly important role in prevention of adolescent substance use. For developing this, methods of cognitive therapy would be effective to be completed with autogenic relaxation training as well.

Real-time in situ nanoclustering during initial stages of artificial aging of Al-Cu alloys

NASA Astrophysics Data System (ADS)

Zatsepin, Nadia A.; Dilanian, Ruben A.; Nikulin, Andrei Y.; Gao, Xiang; Muddle, Barry C.; Matveev, Victor N.; Sakata, Osami

2010-01-01

We report an experimental demonstration of real-time in situ x-ray diffraction investigations of clustering and dynamic strain in early stages of nanoparticle growth in Al-Cu alloys. Simulations involving a simplified model of local strain are well correlated with the x-ray diffraction data, suggesting a redistribution of point defects and the formation of nanoscale clusters in the bulk material. A modal, representative nanoparticle size is determined subsequent to the final stage of artificial aging. Such investigations are imperative for the understanding, and ultimately the control, of nanoparticle nucleation and growth in this technologically important alloy.

The Effects of Group Play Therapy on Self-Concept Among 7 to 11 Year-Old Children Suffering From Thalassemia Major

PubMed Central

Tomaj, Ome Kolsoum; Estebsari, Fatemeh; Taghavi, Taraneh; Borim Nejad, Leili; Dastoorpoor, Maryam; Ghasemi, Afsaneh

2016-01-01

Background Children suffering from thalassemia have higher levels of depression and lower levels of self-concept. Objectives The aim of this study was to determine if group play therapy could significantly increase self-concept among children with thalassemia major ages 7 to 11 years old in teaching hospitals of Golestan province, Iran, in 2012. Patients and Methods In this randomized, controlled clinical trial, 60 children with thalassemia major were randomly assigned to intervention (30 children) and control (30 children) groups. The intervention included eight 45 to 60 minute sessions during four weeks, during which the intervention group received group play therapy. The control group received no interventions. Self-concept was measured three times using the Piers-Harris children’s self-concept scale: before, immediately after, and a month after the intervention. Results For the intervention group, results showed that the mean self-concept score was significantly higher at the second point in time compared to the baseline (P < 0.001), going from 60.539 to 69.908. Likewise, comparing the first and third time points, the mean score significantly increased and reached 70.611 (P < 0.001). Furthermore, changes in the mean score from the second to the third time point, though non-significant (P = 0.509), followed the trend, going from 69.908 to 70.611. For the control group, comparing the first, second, and third time points did not result in any significant change in the mean score (P > 0.05). Conclusions The results showed that group play therapy improves self-concept in children suffering from thalassemia major. PMID:27275402

[Prevalence, awareness, status of treatment and control on type 2 diabetes mellitus among Chinese premenopausal women aged 18-49 in 2013].

PubMed

Zhao, Y F; Wang, Z Q; Yang, J; Wang, L M; Zhao, Z P; Zeng, X Y; Wang, L H

2018-02-10

Objective: To analyze the rates on prevalence, awareness, status on treatment and control of type 2 diabetes mellitus among Chinese premenopausal women aged 18-49, in 2013. Methods: Data on China Chronic and Non-Communicable Disease Surveillance in year 2013 was used for analysis. Source of data covered 302 surveillance points which were selected by Multi-stage cluster random sampling method that including 176 534 adults over 18 years of age, with 46 674 premenopausal women aged 18-49. Plasma glucose and hemoglobin A1c levels were determined after a 10-hour overnight fast for all the participants, before a 2-hour oral glucose tolerance test was conducted among participants without a self-reported history of diagnosed diabetes. Diabetes was defined according to the 1999 WHO diagnostic criteria-fasting blood glucose level as ≥7.0 mmol/L and/or 2 hours oral glucose tolerance test (OGTT-2 h) level as ≥11.1 mmol/L. After being weighed, according to complex sampling scheme and post-stratification, the sample was used to estimate the rates of prevalence, awareness, treatment and control of type 2 diabetes mellitus by age, education, urban and rural areas, and geographic locations. Results: The overall prevalence of type 2 diabetes mellitus was 5.6% among the Chinese premenopausal women aged 18-49. No statistical difference on the prevalence rates (5.7% and 5.4%, respectively) was seen, between participants from the rural or the urban areas. Prevalence rates in the eastern, central or western geographic areas were 5.8%, 6.2% and 4.4% respectively. The rates of awareness, treatment and control of diabetes appeared as 29.3%, 27.9% and 29.4% in childbearing women aged 18-49. The rate of treatment was 95.4% among those who knew their diabetic situation in childbearing women aged 18-49 years. The control rate of diabetes was 38.9% among those who had taken measures to control glucose, in 18-49-year-old childbearing women. The rate of awareness on diabetes in childbearing women aged 18-49 years in urban areas was higher than that in the rural areas. There were significantly statistical differences on the treatment rates among groups of different education levels but not in the trend test. Conclusion: The prevalence of type 2 diabetes mellitus in childbearing women aged 18-49 appeared high, but with low rates on awareness, treatment and control. However, statistical difference was seen on awareness, between urban and rural areas.

Subjective Beliefs, Memory and Functional Health: Change and Associations over 12 Years in the Australian Longitudinal Study of Ageing.

PubMed

Luszcz, Mary A; Anstey, Kaarin J; Ghisletta, Paolo

2015-01-01

Neither subjective memory beliefs, nor remembering itself, can be isolated from the overall context in which one is aging, nor are the drivers of memory complaints well specified. Sense of control is an important self-regulatory resource that drives cognitive and physical health over the lifespan. Existing findings are equivocal concerning both the extent of stability or change in control beliefs over time as well as their contribution to changes in behavior. Subjective beliefs may play a role when engaging memory processes or identifying memory complaints, and it has been argued that self-regulatory potential in general may be limited by age-related changes in the domains of health and cognition. We aimed to examine trajectories of change and shed light on relationships among subjective beliefs and indicators of memory and functional health. Participants' data were drawn from four measurement occasions over up to a 12-year period (1992-2004) from the Australian Longitudinal Study of Ageing (ALSA), a population-based study of older adults [age 65-100 years; mean age(SD) at the first and final occasion 78.2 (6.7) and 84.9 (4.9) years, respectively]. Participants completed three questionnaires assessing subjective beliefs concerning (1) memory knowledge and control, (2) health control, and (3) expectancy of control over a range of lifestyle situations. Memory comprised a recall composite. Functional health tapped mobility and disability. Latent growth curve models incorporated informative covariates (baseline age, gender, self-rated health, education, and chronic conditions). While subjective memory control beliefs, but not subjective knowledge of memory tasks, improved over 12 years, neither was associated with level of memory performance. Knowledge of memory tasks was linked to a significant memory decline. Beliefs about memory, health, and lifestyle were interrelated. Declines in remembering and health were also coupled; moreover, changes in both were coupled with change in lifestyle control beliefs. This is the first examination of individual differences in changes in, and relationships among, psychological domains of subjective beliefs about memory, health, and lifestyle, and objective remembering and functional health in very late life. Findings point to a system of coupled changes in memory and health in late life that is related to underlying beliefs about control over lifestyle. © 2015 S. Karger AG, Basel

The influence of birth size on intelligence in healthy children.

PubMed

Broekman, Birit F P; Chan, Yiong-Huak; Chong, Yap-Seng; Quek, Swee-Chye; Fung, Daniel; Low, Yen-Ling; Ooi, Yoon-Phaik; Gluckman, Peter D; Meaney, Michael J; Wong, Tien-Yin; Saw, Seang-Mei

2009-06-01

Birth parameters have been hypothesized to have an influence on IQ. However, studies within the range of normal birth size have been sparse. With this study we examined the associations between birth length, birth weight, head circumference, and gestational age within the normal birth size range in relation to childhood IQ in Asian children. A cohort of 1979 of 2913 Asian children aged 7 to 9 years, recruited from 3 schools in Singapore, were followed yearly from 1999 onward. Birth parameters were recorded by health personnel. Childhood IQ was measured with the Raven's Standard Progressive Matrices at ages 8 to 12. The mean IQ score across the sample (n = 1645) was 114.2. After controlling for multiple confounders for every 1-cm increment in birth length, 1 kg in birth weight, or 1 cm in head circumference, there was a corresponding increase in IQ of 0.49 points (P for trend < .001), 2.19 points (P for trend = .007) and .62 points (P for trend = .003), respectively. These associations persisted even after exclusion of premature children and children with extreme weights and head circumferences. Longer birth length, higher birth weight, or larger head circumferences within the normal birth size range are associated with higher IQ scores in Asian children. Our results suggest that antenatal factors reflected in altered rates of growth but within the normative range of pregnancy experiences play a role in generating cognitive potential. This has implications for targeting early intervention and preventative programs.

Early use of pressure flaking on lithic artifacts at Blombos Cave, South Africa.

PubMed

Mourre, Vincent; Villa, Paola; Henshilwood, Christopher S

2010-10-29

Pressure flaking has been considered to be an Upper Paleolithic innovation dating to ~20,000 years ago (20 ka). Replication experiments show that pressure flaking best explains the morphology of lithic artifacts recovered from the ~75-ka Middle Stone Age levels at Blombos Cave, South Africa. The technique was used during the final shaping of Still Bay bifacial points made on heat-treated silcrete. Application of this innovative technique allowed for a high degree of control during the detachment of individual flakes, resulting in thinner, narrower, and sharper tips on bifacial points. This technology may have been first invented and used sporadically in Africa before its later widespread adoption.

Dynamic Pointing Triggers Shifts of Visual Attention in Young Infants

ERIC Educational Resources Information Center

Rohlfing, Katharina J.; Longo, Matthew R.; Bertenthal, Bennett I.

2012-01-01

Pointing, like eye gaze, is a deictic gesture that can be used to orient the attention of another person towards an object or an event. Previous research suggests that infants first begin to follow a pointing gesture between 10 and 13 months of age. We investigated whether sensitivity to pointing could be seen at younger ages employing a technique…

Lifelong obesity in a polygenic mouse model prevents age- and diet-induced glucose intolerance- obesity is no road to late-onset diabetes in mice.

PubMed

Renne, Ulla; Langhammer, Martina; Brenmoehl, Julia; Walz, Christina; Zeissler, Anja; Tuchscherer, Armin; Piechotta, Marion; Wiesner, Rudolf J; Bielohuby, Maximilian; Hoeflich, Andreas

2013-01-01

Visceral obesity holds a central position in the concept of the metabolic syndrome characterized by glucose intolerance in humans. However, until now it is unclear if obesity by itself is responsible for the development of glucose intolerance. We have used a novel polygenic mouse model characterized by genetically fixed obesity (DU6) and addressed age- and high fat diet-dependent glucose tolerance. Phenotype selection over 146 generations increased body weight by about 2.7-fold in male 12-week DU6 mice (P<0.0001) if compared to unselected controls (Fzt:DU). Absolute epididymal fat mass was particularly responsive to weight selection and increased by more than 5-fold (P<0.0001) in male DU6 mice. At an age of 6 weeks DU6 mice consumed about twice as much food if compared to unselected controls (P<0.001). Absolute food consumption was higher at all time points measured in DU6 mice than in Fzt:DU mice. Between 6 and 12 weeks of age, absolute food intake was reduced by 15% in DU6 mice (P<0.001) but not in Fzt:DU mice. In both mouse lines feeding of the high fat diet elevated body mass if compared to the control diet (P<0.05). In contrast to controls, DU6 mice did not display high fat diet-induced increases of epididymal and renal fat. Control mice progressively developed glucose intolerance with advancing age and even more in response to the high fat diet. In contrast, obese DU6 mice did neither develop a glucose intolerant phenotype with progressive age nor when challenged with a high fat diet. Our results from a polygenic mouse model demonstrate that genetically pre-determined and life-long obesity is no precondition of glucose intolerance later in life.

The effects of contraception on female poverty.

PubMed

Browne, Stephanie P; LaLumia, Sara

2014-01-01

Poverty rates are particularly high among households headed by single women, and childbirth is often the event preceding these households' poverty spells. This paper examines the relationship between legal access to the birth control pill and female poverty. We rely on exogenous cross-state variation in the year in which oral contraception became legally available to young, single women. Using census data from 1960 to 1990, we find that having legal access to the birth control pill by age 20 significantly reduces the probability that a woman is subsequently in poverty. We estimate that early legal access to oral contraception reduces female poverty by 0.5 percentage points, even when controlling for completed education, employment status, and household composition.

SPS antenna pointing control

NASA Technical Reports Server (NTRS)

Hung, J. C.

1980-01-01

The pointing control of a microwave antenna of the Satellite Power System was investigated emphasizing: (1) the SPS antenna pointing error sensing method; (2) a rigid body pointing control design; and (3) approaches for modeling the flexible body characteristics of the solar collector. Accuracy requirements for the antenna pointing control consist of a mechanical pointing control accuracy of three arc-minutes and an electronic phased array pointing accuracy of three arc-seconds. Results based on the factors considered in current analysis, show that the three arc-minute overall pointing control accuracy can be achieved in practice.

Pandemic influenza H1N1 2009 infection in Victoria, Australia: no evidence for harm or benefit following receipt of seasonal influenza vaccine in 2009.

PubMed

Kelly, Heath A; Grant, Kristina A; Fielding, James E; Carville, Kylie S; Looker, Clare O; Tran, Thomas; Jacoby, Peter

2011-08-26

Conflicting findings regarding the level of protection offered by seasonal influenza vaccination against pandemic influenza H1N1 have been reported. We performed a test-negative case control study using sentinel patients from general practices in Victoria to estimate seasonal influenza vaccine effectiveness against laboratory proven infection with pandemic influenza. Cases were defined as patients with an influenza-like illness who tested positive for influenza while controls had an influenza-like illness but tested negative. We found no evidence of significant protection from seasonal vaccine against pandemic influenza virus infection in any age group. Age-stratified point estimates, adjusted for pandemic phase, ranged from 44% in persons aged less than 5 years to -103% (odds ratio=2.03) in persons aged 50-64 years. Vaccine effectiveness, adjusted for age group and pandemic phase, was 3% (95% CI -48 to 37) for all patients. Our study confirms the results from our previous interim report, and other studies, that failed to demonstrate benefit or harm from receipt of seasonal influenza vaccine in patients with confirmed infection with pandemic influenza H1N1 2009. Copyright © 2011 Elsevier Ltd. All rights reserved.

Does surgery or radiation provide the best overall survival in Ewing's sarcoma? A review of the National Cancer Data Base.

PubMed

Miller, Benjamin J; Gao, Yubo; Duchman, Kyle R

2017-09-01

There is continuing debate regarding the ideal modality for local control of the primary tumor for patients with Ewing's sarcoma. The primary aim of this study is to investigate the impact of the method of local control on overall survival in patients with Ewing's sarcoma. The National Cancer Data Base was used to identify patients <40 years of age with high-grade Ewing's sarcoma of bone. A Kaplan-Meier survival analysis was performed at 2, 5, and 10 years. Factors with a level of significance of P < 0.1 at the 5-year time point were included in a multivariate Cox proportional hazards model. Diminished 5-year survival was noted for patients with metastatic disease, local control with radiation alone, age ≥18 years, tumor size >8 cm, and male sex while controlling for tumor site. Surgery alone was consistently the method of local control that resulted in the highest overall survival. Surgery alone resulted in the best overall survival for patients with Ewing's sarcoma of bone. The results of this investigation provide support to the approach of surgical resection with negative margins when possible. © 2017 Wiley Periodicals, Inc.

New optically stimulated luminescence ages provide evidence of MIS3 and MIS2 eolian activity on Black Mesa, northeastern Arizona, USA

USGS Publications Warehouse

Ellwein, A.L.; Mahan, S.A.; McFadden, L.D.

2011-01-01

Eolian deposition on the semiarid southern Colorado Plateau has been attributed to episodic aridity during the Quaternary Period. However, OSL ages from three topographically controlled (e.g. falling) dunes on Black Mesa in northeastern Arizona indicate that eolian sediments there were deposited in deep tributary valleys as early as 35-30. ka, with most sand deposited before 20. ka. In contrast, the oldest OSL ages for sand sheets fall within the Pleistocene-Holocene climatic transition (~. 12-8. ka). Thus most eolian sediment accumulated on Black Mesa under climatic conditions that were in general cooler, moister, and more variable than today, not more arid, pointing to a considerable increase in sediment supply. ?? 2010 University of Washington.

Lichenometry in the Cordillera Blanca, Peru: “Little Ice Age” moraine chronology

NASA Astrophysics Data System (ADS)

Solomina, Olga; Jomelli, Vincent; Kaser, Georg; Ames, Alcides; Berger, Bernhard; Pouyaud, Bernard

2007-10-01

This paper is a comparison and compilation of lichenometric and geomorphic studies performed by two independent teams in the Cordillera Blanca, Peru, in 1996 and 2002 on 66 "Little Ice Age" moraines of 14 glaciers. Using eleven new control points, we recalibrated the initial rapid growth phase of the previously established Rhizocarpon subgenus Rhizocarpon growth curve. This curve was then used to estimate the age of "Little Ice Age" moraines. The time of deposition of the most prominent and numerous terminal and lateral moraines on the Pacific-facing side of the Cordillera Blanca (between AD 1590 and AD 1720) corresponds to the coldest and wettest phase in the tropical Andes as revealed by ice-core data. Less prominent advances occurred between AD 1780 and 1880.

[Try to achieve quickly the blood pressure target in newly diagnosed hypertensive patients is safe and effective].

PubMed

Kichou, B; Henine, N; Kichou, L; Boubchir, M A; Ait Said, M A; Zatout, M; Hammouche, A; Mazeghrane, A; Madiou, A; Benbouabdellah, M

2018-06-01

To compare a so-called an "accelerated" antihypertensive strategy to a "standard" strategy, in terms of blood pressure control rates and adverse events. Prospective open-label randomized controlled trial, which included consecutive hypertensive patients, newly diagnosed, 40 to 70 years old, with no prior antihypertensive treatment. Hypertension was diagnosed if office blood pressure was≥140/90mmHg, confirmed by an increase of Home or a daytime ambulatory blood pressure. The patients were randomly assigned according to 1:1 ratio to an "accelerated" strategy or to a "standard" strategy. The primary end-point was the rate of blood pressure control at 12weeks. The secondary end-point was the rate of adverse events (a safety end-point). We recruited 268 patients (132 in the "accelerated" strategy group), with a mean age of 55 years and 62% of men. The mean office blood pressure at baseline was 168/95mmHg. The clinical characteristics were on average similar between the 2 treatment groups. At 12 weeks, the rates of blood pressure control were 63.6% in the "accelerated" strategy and 38.2% in the "standard" strategy (P<0.001). There was no significantly difference between the rates of adverse events in the 2 strategies (6.06% versus 5.14%; P=0.8). The "accelerated" antihypertensive strategy was more effective than a standard one, in terms of blood pressure control, without an increase in adverse events rate. This could translate into a future cardiovascular events reduction. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Meteorological factors, air pollutants, and emergency department visits for otitis media: a time series study.

PubMed

Gestro, Massimo; Condemi, Vincenzo; Bardi, Luisella; Fantino, Claudio; Solimene, Umberto

2017-10-01

AbstractOtitis media (OM) is a very common disease in children, which results in a significant economic burden to the healthcare system for hospital-based outpatient departments, emergency departments (EDs), unscheduled medical examinations, and antibiotic prescriptions. The aim of this retrospective observational study is to investigate the association between climate variables, air pollutants, and OM visits observed in the 2007-2010 period at the ED of Cuneo, Italy. Measures of meteorological parameters (temperature, humidity, atmospheric pressure, wind) and outdoor air pollutants (particulate matter, ozone, nitrous dioxide) were analyzed at two statistical stages and in several specific steps (crude and adjusted models) according to Poisson's regression. Response variables included daily examinations for age groups 0-3, 0-6, and 0-18. Control variables included upper respiratory infections (URI), flu (FLU), and several calendar factors. A statistical procedure was implemented to capture any delayed effects. Results show a moderate association for temperature (T), age 0-3, and 0-6 with P < 0.05, as well as nitrous dioxide (NO 2 ) with P < 0.005 at age 0-18. Results of subsequent models point out to URI as an important control variable. No statistical association was observed for other pollutants and meteorological variables. The dose-response models (DLNM-final stage) implemented separately on a daily and hourly basis point out to an association between temperature (daily model) and RR 1.44 at age 0-3, CI 1.11-1.88 (lag time 0-1 days) and RR 1.43, CI 1.05-1.94 (lag time 0-3 days). The hourly model confirms a specific dose-response effect for T with RR 1.20, CI 1.04-1.38 (lag time range from 0 to 11 to 0-15 h) and for NO 2 with RR 1.03, CI 1.01-1.05 (lag time range from 0 to 8 to 0-15 h). These results support the hypothesis that the clinical context of URI may be an important risk factor in the onset of OM diagnosed at ED level. The study highlights the relevance of URI as a control variable to be included in the statistical analysis in association with meteorological factors and air pollutants. The study also points out to a moderate association of OM with low temperatures and NO 2 , with specific risk factors for this variable early in life. Further studies are needed to confirm these findings, particularly with respect to air pollutants in larger urban environments.

Meteorological factors, air pollutants, and emergency department visits for otitis media: a time series study

NASA Astrophysics Data System (ADS)

Gestro, Massimo; Condemi, Vincenzo; Bardi, Luisella; Fantino, Claudio; Solimene, Umberto

2017-10-01

Abstract Otitis media (OM) is a very common disease in children, which results in a significant economic burden to the healthcare system for hospital-based outpatient departments, emergency departments (EDs), unscheduled medical examinations, and antibiotic prescriptions. The aim of this retrospective observational study is to investigate the association between climate variables, air pollutants, and OM visits observed in the 2007-2010 period at the ED of Cuneo, Italy. Measures of meteorological parameters (temperature, humidity, atmospheric pressure, wind) and outdoor air pollutants (particulate matter, ozone, nitrous dioxide) were analyzed at two statistical stages and in several specific steps (crude and adjusted models) according to Poisson's regression. Response variables included daily examinations for age groups 0-3, 0-6, and 0-18. Control variables included upper respiratory infections (URI), flu (FLU), and several calendar factors. A statistical procedure was implemented to capture any delayed effects. Results show a moderate association for temperature ( T), age 0-3, and 0-6 with P < 0.05, as well as nitrous dioxide (NO2) with P < 0.005 at age 0-18. Results of subsequent models point out to URI as an important control variable. No statistical association was observed for other pollutants and meteorological variables. The dose-response models (DLNM—final stage) implemented separately on a daily and hourly basis point out to an association between temperature (daily model) and RR 1.44 at age 0-3, CI 1.11-1.88 (lag time 0-1 days) and RR 1.43, CI 1.05-1.94 (lag time 0-3 days). The hourly model confirms a specific dose-response effect for T with RR 1.20, CI 1.04-1.38 (lag time range from 0 to 11 to 0-15 h) and for NO2 with RR 1.03, CI 1.01-1.05 (lag time range from 0 to 8 to 0-15 h). These results support the hypothesis that the clinical context of URI may be an important risk factor in the onset of OM diagnosed at ED level. The study highlights the relevance of URI as a control variable to be included in the statistical analysis in association with meteorological factors and air pollutants. The study also points out to a moderate association of OM with low temperatures and NO2, with specific risk factors for this variable early in life. Further studies are needed to confirm these findings, particularly with respect to air pollutants in larger urban environments.

Physical Therapy for Neurological Conditions in Geriatric Populations.

PubMed

Carmeli, Eli

2017-01-01

With more of the world's population surviving longer, individuals often face age-related neurology disorders and decline of function that can affect lifestyle and well-being. Despite neurophysiological changes affecting the brain function and structure, the aged brain, in some degree, can learn and relearn due to neuroplasticity. Recent advances in rehabilitation techniques have produced better functional outcomes in age-related neurological conditions. Physical therapy (PT) of the elderly individual focuses in particular on sensory-motor impairments, postural control coordination, and prevention of sarcopenia. Geriatric PT has a significant influence on quality of life, independent living, and life expectancy. However, in many developed and developing countries, the profession of PT is underfunded and understaffed. This article provides a brief overview on (a) age-related disease of central nervous system and (b) the principles, approaches, and doctrines of motor skill learning and point out the most common treatment models that PTs use for neurological patients.

Physical Therapy for Neurological Conditions in Geriatric Populations

PubMed Central

Carmeli, Eli

2017-01-01

With more of the world’s population surviving longer, individuals often face age-related neurology disorders and decline of function that can affect lifestyle and well-being. Despite neurophysiological changes affecting the brain function and structure, the aged brain, in some degree, can learn and relearn due to neuroplasticity. Recent advances in rehabilitation techniques have produced better functional outcomes in age-related neurological conditions. Physical therapy (PT) of the elderly individual focuses in particular on sensory–motor impairments, postural control coordination, and prevention of sarcopenia. Geriatric PT has a significant influence on quality of life, independent living, and life expectancy. However, in many developed and developing countries, the profession of PT is underfunded and understaffed. This article provides a brief overview on (a) age-related disease of central nervous system and (b) the principles, approaches, and doctrines of motor skill learning and point out the most common treatment models that PTs use for neurological patients. PMID:29270402

Stability and Change in the Cognitive and Adaptive Behaviour Scores of Preschoolers with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Flanagan, Helen E.; Smith, Isabel M.; Vaillancourt, Tracy; Duku, Eric; Szatmari, Peter; Bryson, Susan; Fombonne, Eric; Mirenda, Pat; Roberts, Wendy; Volden, Joanne; Waddell, Charlotte; Zwaigenbaum, Lonnie; Bennett, Teresa; Elsabbagh, Mayada; Georgiades, Stelios

2015-01-01

We examined the stability of cognitive and adaptive behaviour standard scores in children with autism spectrum disorder (ASD) between diagnosis and school entry approximately age 6. IQ increased 18 points in 2-year-olds, 12 points in 3-year-olds, and 9 points in 4-year-olds (N = 281). Adaptive behaviour scores increased 4 points across age groups…

Laser acupuncture reduces pain in pediatric kidney biopsies: a randomized controlled trial.

PubMed

Oates, Aris; Benedict, Kelly A; Sun, Karen; Brakeman, Paul R; Lim, Jessica; Kim, Cynthia

2017-01-01

Evaluate laser acupuncture (LA) as an adjuvant therapy in pain management during percutaneous kidney biopsy procedure in children and adolescents. This prospective, double-blinded, randomized controlled trial enrolled patients aged 7 to 26 years admitted to a children's hospital for percutaneous kidney biopsy. Patients received LA to treatment points (acupuncture group) or sham points (control group) before the procedure. The laser delivered a dose of 42 J/cm over 10 acupoints. Patients and parents rated the pain during and after the biopsy, and change in pain scores were calculated for each patient. Anxiety, vital signs, sedation medication, and patient's biopsy experience were secondary outcomes. Sixty-nine treatments (33 in the acupuncture group and 36 in the control group) were eligible for analysis. Patients in the acupuncture group reported a significantly improved change in the pain score after the biopsy compared with the controls (0.8 vs -0.5, P = 0.044). Patients in the acupuncture group had a statistically significant decrease in procedure vital signs including heart rate (-1.8 vs 5.6, P = 0.043) and respiratory rate (-2.4 vs 0.4, P = 0.045) when compared with controls. Parents also perceived a correspondingly greater improvement in their child's pain for those in the acupuncture group compared with the controls (2.3 vs 0.3, P = 0.04). Adjunctive LA significantly improved pain after pediatric percutaneous kidney biopsies.

No adverse effect of vincristine on handwriting in children after completion of therapy.

PubMed

Hartman, A; van den Bos, C; van Dartel, N; Stijnen, Th; Pieters, R

2007-11-01

Long-term writing difficulties in children after treatment with vincristine for acute lymphoblastic leukemia, Wilms tumor, B non-Hodgkin lymphoma, and malignant mesenchymal tumors, were investigated. Handwriting of 33 survivors and 33 controls matched for age, sex, and grade, was assessed with the BHK-scale. The examiner was blinded for whether a child was a case or a control. No significant difference in writing speed was found. Mean difference in number of letters produced during 5 min was 6.4 (+/-67.1, range -103 to +169). No significant difference was found in quality of writing scores; mean difference in points was 1.5 (+/-7.7, range -19 to +22). Cumulative vincristine dose, age at diagnosis or time since completion of treatment did not affect writing speed or quality. Chemotherapy, including vincristine, does not lead to long-term problems in speed or quality of writing in children treated for cancer. (c) 2006 Wiley-Liss, Inc.

The Composition and Temperature Effects on the Ultra High Strength Stainless Steel Design

NASA Astrophysics Data System (ADS)

Xu, W.; Del Castillo, P. E. J. Rivera Díaz; van der Zwaag, S.

Alloy composition and heat treatment are of paramount importance to determining alloy properties. Their control is of great importance for new alloy design and industrial fabrication control. A base alloy utilizing MX carbide is designed through a theory guided computational approach coupling a genetic algorithm with optimization criteria based on thermodynamic, kinetic and mechanical principles. The combined effects of 11 alloying elements (Al, C, Co, Cr, Cu, Mo, Nb, Ni, Si, Ti and V) are investigated in terms of the composition optimization criteria: the martensite start (Ms) temperature, the suppression of undesirable phases, the Cr concentration in the matrix and the potency of the precipitation strengthening contribution. The results show the concentration sensitivities of each component and also point out new potential composition domains for further strength increase. The aging temperature effect is studied and the aging temperature industrially followed is recovered.

High burden of rheumatic diseases in Lebanon: a COPCORD study.

PubMed

Chaaya, Monique; Slim, Zeinab N; Habib, Rima R; Arayssi, Thurayya; Dana, Rouwayda; Hamdan, Omar; Assi, Maher; Issa, Zeinab; Uthman, Imad

2012-04-01

To estimate the prevalence of rheumatic diseases in Lebanon and to explore their distribution by geographic location, age, and gender.   Using the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology, a random sample of 3530 individuals aged 15 and above was interviewed from the six Lebanese governorates. Positive respondents were evaluated by rheumatologists using the internationally accepted classification criterion of the American College of Rheumatology for the diagnosis of rheumatic diseases. Prevalence rates of current and past musculoskeletal problems were 24.4% and 8.4%, respectively. Shoulder (14.3%), knee (14.2%) and back (13.6%) were the most common pain sites. Point prevalence of rheumatic diseases was 15.0%. The most frequent types of rheumatic diseases were of mechanical origin, namely soft tissue rheumatism (5.8%) and osteoarthritis (4.0%). Rheumatoid arthritis (1.0%) and spondylathropathies (0.3%) constituted the most common inflammatory diseases. Coastal areas had the lowest prevalence of all diseases except for fibromyalgia. All diseases showed an increasing prevalence pattern with age and a higher prevalence among women than men. This is the first study to give population-based estimates of rheumatic diseases in Lebanon. The high burden calls for public health attention for early detection, control and prevention of these conditions. Point prevalence of individual diseases was within the range of results from other COPCORD surveys with some variations that can be attributed to differences in methodology and geo-ethnic factors. © 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.

[The evil wind of early marriage on Mainland (China)].

PubMed

Dai, W

1971-04-01

China has been an agricultural society for over 2,000 years. Due to its traditionally rich natural resources, large size, and sparse population density, manpower has become a main source of wealth. Consequently, down through the ages, births have been encouraged and early marriages have become a tradition. After the Chinese communists' takeover of the Mainland, planned birth and population control measures were implemented. And in 1962, regulations were set for men to marry only after age 28 and for women after age 25. Furthermore, in rural areas, young men and women were impeded from early marriage through the marriage registration system. However, during the Cultural Revolution, youths of the Mainland were strongly against the excessive restrictions on early marriage. They pointed out that advocating late marriage was a counter-revolutionary move by the bourgeoisie. Under conditions of despair and uncertain future, many youths married early as an escape from reality, establishing small families. Thus, a trend of early marriages was set. This was called "evil wind of early marriage" and was vigorously attacked by Chinese authorities in official publications. To control this "evil wind," the Chinese communists also utilized Mao's thoughts in re-educating the educated youths. They pointed out that youths who married early and concentrated on building a family were selfish because by concentrating on personal matters they could not attend to state matters nor participate in class struggles. It is clear that in attacking early marriage and advocating late marriage, the Chinese communists had both planned birth and politics in mind.

Body balance control deficiencies following ACL reconstruction combined with medial meniscus suture. A preliminary report.

PubMed

Parus, K; Lisiński, P; Huber, J

2015-11-01

Proprioception makes a critical contribution to body balance. The objective of this study was to evaluate static postural control after anterior cruciate ligament (ACL) reconstruction combined with medial meniscus (MM) suture, comparatively to healthy controls. Body balance is adversely affected 2 months after ACL reconstruction combined with MM suture. Fifteen patients (12 males and 3 females) aged 20 to 35 years (mean, 26.4 ± 6.0 years) who underwent ACL reconstruction with MM suture were compared to 20 healthy, physically active controls (16 females and 4 males) aged 19 to 23 years (mean, 21.1 ± 1.8 years), most of whom were physiotherapy students. Mean age was not significantly different between the patients and controls. A balance platform was used to estimate static postural control parameters. Each participant performed four tests, two in normal bipedal stance and two in tandem stance; in each stance, one test was done with the eyes open and the other with the eyes closed. We analysed global scores on a standardised 100-point scale and mean centre of pressure (COP) displacement velocity in the sagittal and frontal planes. Body balance was impaired 2 months after ACL reconstruction with MM suture. Thus, the patients had lower global scores and higher mean COP velocities in both the coronal and sagittal planes. Proprioception is impaired after ACL reconstruction with MM suture. Lack of visual control significantly decreases the ability to maintain balance. A balance platform is a useful diagnostic tool for patients with ACL reconstruction and MM suture. Level II. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Offering Annual Fecal Occult Blood Tests at Annual Flu Shot Clinics Increases Colorectal Cancer Screening Rates

PubMed Central

Potter, Michael B.; Phengrasamy, La; Hudes, Esther S.; McPhee, Stephen J.; Walsh, Judith M.E.

2009-01-01

PURPOSE We wanted to determine whether providing home fecal occult blood test (FOBT) kits to eligible patients during influenza inoculation (flu shot) clinics can contribute to higher colorectal cancer screening (CRCS) rates. METHODS The study was time randomized. On 8 dates of an annual flu shot clinic at the San Francisco General Hospital, patients were offered flu shots as usual (control group) and on 9 other dates, patients were offered both flu shots and FOBT kits (intervention group). RESULTS The study included 514 patients aged 50 to 79 years, with 246 in the control group and 268 in the intervention group. At the conclusion of flu season, FOBT screening rates increased by 4.4 percentage points from 52.9% at baseline to 57.3% (P = .07) in the control group, and increased by 29.8 percentage points from 54.5% to 84.3% (P <.001) in the intervention group, with the change among intervention participants 25.4 percentage points greater than among control participants (P value for change difference <.001). Among patients initially due for CRCS, 20.7% in the control group and 68.0% in the intervention group were up-to-date at the conclusion of the study (P <.001). In multivariate analyses, the odds ratio for becoming up-to-date with screening in the intervention group (vs the control group) was 11.3 (95% CI, 5.8–22.0). CONCLUSIONS Offering FOBT kits during flu shot clinics dramatically increased the CRCS rate for flu shot clinic attendees. Pairing home FOBT kits with annual flu shots may be a useful strategy to improve CRCS rates in other primary care or public health settings. PMID:19139445

[Effects and consequence of recurrent seizures of neonatal rat on the hippocampal neurogenesis].

PubMed

Shi, Xiu-yu; Wang, Ji-wen; Sun, Ruo-peng

2006-04-01

Seizures occur more frequently in the neonatal period than at any other time in life. A controversy which has been debated for the recent years is whether recurrent neonatal seizures can lead to long-term adverse consequences or are simply a reflection of underlying brain dysfunction and are not intrinsically harmful. Despite numerous clinical observations showed that seizures may be detrimental to the developing brain, the pathological mechanism has not yet been completely understood. The goal of this study was to investigate what effect was induced by recurrent seizures in neonatal rats on dentate granule cell neurogenesis. Sixty-four neonatal Wistar rats were randomly divided into seizure group (n = 40) and control group (n = 24). The rats of seizure group were subjected to three times of pilocarpine injections intraperitonealy at postnatal day 1 (P1), 4 (P4) and 7 (P7). Neonatal rats of the control group were given saline injection (i.p.) at the same time points. The rat were sacrificed separately at the next four time points: immediately after the third seizure (P7), the fourth day after the seizure (P11), the fourteenth day (P21) and the forty fifth day (P52), corresponding control group rats were killed accordingly. The rats in both seizure and control groups were given bromodeoxyuridine (BrdU) injection 36 hours before sacrifice to indicate newly generated cells. Brain tissue sections were prepared and subjected to Nissl staining for neuronal loss, by BrdU labeling for cell proliferation and by BrdU + NF200 (neurofilament 200) double labeling for the identification of the newly formed cells. The numbers of BrdU-labeled cells were age-dependent in the control group, decreased with age, and their morphorlogy and distribution changed (P < 0.01). BrdU-labeled cells decreased significantly in the seizure group compared with the matched controls at P7 and P11 (P < 0.01), while at P21 there was no significant difficence between the two groups. On the contrary, BrdU-labeled cells increased significantly in the seizure group compared with the matched controls at P52 (P < 0.01). Most BrdU-labeled cells in granular cell layer (GCL) of both seizure group and control group coexpressed NF200. Recurrent seizures during neonatal period lead to decreased neurogenesis at the early stage after the third seizure, and at later time points increase of neurogenesis. Most of newly generated cells can differentiate into neurons.

Pointing Device Performance in Steering Tasks.

PubMed

Senanayake, Ransalu; Goonetilleke, Ravindra S

2016-06-01

Use of touch-screen-based interactions is growing rapidly. Hence, knowing the maneuvering efficacy of touch screens relative to other pointing devices is of great importance in the context of graphical user interfaces. Movement time, accuracy, and user preferences of four pointing device settings were evaluated on a computer with 14 participants aged 20.1 ± 3.13 years. It was found that, depending on the difficulty of the task, the optimal settings differ for ballistic and visual control tasks. With a touch screen, resting the arm increased movement time for steering tasks. When both performance and comfort are considered, whether to use a mouse or a touch screen for person-computer interaction depends on the steering difficulty. Hence, a input device should be chosen based on the application, and should be optimized to match the graphical user interface. © The Author(s) 2016.

[Validation of the Eating Attitudes Test as a screening instrument for eating disorders in general population].

PubMed

Peláez-Fernández, María Angeles; Ruiz-Lázaro, Pedro Manuel; Labrador, Francisco Javier; Raich, Rosa María

2014-02-20

To validate the best cut-off point of the Eating Attitudes Test (EAT-40), Spanish version, for the screening of eating disorders (ED) in the general population. This was a transversal cross-sectional study. The EAT-40 Spanish version was administered to a representative sample of 1.543 students, age range 12 to 21 years, in the Region of Madrid. Six hundred and two participants (probable cases and a random sample of controls) were interviewed. The best diagnostic prediction was obtained with a cut-off point of 21, with sensitivity: 88.2%; specificity: 62.1%; positive predictive value: 17.7%; negative predictive value: 62.1%. Use of a cut-off point of 21 is recommended in epidemiological studies of eating disorders in the Spanish general population. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Activity of daily living for Morquio A syndrome.

PubMed

Yasuda, Eriko; Suzuki, Yasuyuki; Shimada, Tsutomu; Sawamoto, Kazuki; Mackenzie, William G; Theroux, Mary C; Pizarro, Christian; Xie, Li; Miller, Freeman; Rahman, Tariq; Kecskemethy, Heidi H; Nagao, Kyoko; Morlet, Thierry; Shaffer, Thomas H; Chinen, Yasutsugu; Yabe, Hiromasa; Tanaka, Akemi; Shintaku, Haruo; Orii, Kenji E; Orii, Koji O; Mason, Robert W; Montaño, Adriana M; Fukao, Toshiyuki; Orii, Tadao; Tomatsu, Shunji

2016-06-01

The aim of this study was to evaluate the activity of daily living (ADL) and surgical interventions in patients with mucopolysaccharidosis IVA (MPS IVA). The factor(s) that affect ADL are age, clinical phenotypes, surgical interventions, therapeutic effect, and body mass index. The ADL questionnaire comprises three domains: "Movement," "Movement with cognition," and "Cognition." Each domain has four subcategories rated on a 5-point scale based on the level of assistance. The questionnaire was collected from 145 healthy controls and 82 patients with MPS IVA. The patient cohort consisted of 63 severe and 17 attenuated phenotypes (2 were undefined); 4 patients treated with hematopoietic stem cell transplantation (HSCT), 33 patients treated with enzyme replacement therapy (ERT) for more than a year, and 45 untreated patients. MPS IVA patients show a decline in ADL scores after 10years of age. Patients with a severe phenotype have a lower ADL score than healthy control subjects, and lower scores than patients with an attenuated phenotype in domains of "Movement" and "Movement with cognition." Patients, who underwent HSCT and were followed up for over 10years, had higher ADL scores and fewer surgical interventions than untreated patients. ADL scores for ERT patients (2.5years follow-up on average) were similar with the-age-matched controls below 10years of age, but declined in older patients. Surgical frequency was higher for severe phenotypic patients than attenuated ones. Surgical frequency for patients treated with ERT was not decreased compared to untreated patients. In conclusion, we have shown the utility of the proposed ADL questionnaire and frequency of surgical interventions in patients with MPS IVA to evaluate the clinical severity and therapeutic efficacy compared with age-matched controls. Copyright © 2016. Published by Elsevier Inc.

Glucose tolerance in two unacculturated Indian tribes of Brazil.

PubMed

Spielman, R S; Fajans, S S; Neel, J V; Pek, S; Floyd, J C; Oliver, W J

1982-08-01

Plasma levels of glucose, insulin, growth hormone, and pancreatic polypeptide in response to a standard oral glucose load were studied in the Yanomama and the Marubo, two relatively unacculturated Amerindian tribes of the Brazilian Amazon. The findings in the two tribes differed significantly from each other and in the degree of deviation from control subjects. The average responses in both tribes differed significantly from those of age- and sex-matched Caucasoid control subjects studied in Ann Arbor, Michigan; however, of the two tribes, the Marubo, the more acculturated group, resembled the controls more closely. Plasma concentrations of glucose and the hormones at three time points (fasting, 1 h, 2 h) were compared by means of a multivariate analysis. When the Marubo were compared with the control subjects, the only highly significant difference was in the plasma glucose concentrations (all three points were higher in the Marubo); however, the Yanomama differed significantly from the control subjects with respect to all four plasma indicators (p less than 0.05). Unlike the Marubo, the Yanomama showed no significant rise in plasma glucose at 1 h and no decrease at 2 h. Neither tribe exhibited the bimodality of the 2 h glucose value characteristic of acculturated Amerindians, such as the Pima, but the samples studied were small.

The short-term effects of trigger point therapy, stretching and medicine ball exercises on accuracy and back swing hip turn in elite, male golfers - A randomised controlled trial.

PubMed

Quinn, Samantha-Lynn; Olivier, Benita; Wood, Wendy-Ann

2016-11-01

This study aimed to compare the effect of myofascial trigger point therapy (MTPT) and stretching, MTPT and medicine ball exercises, and no intervention, on hip flexor length (HFL), golf swing biomechanics and performance in elite, male golfers. Single blind, randomised controlled trial with two experimental groups (stretch group: MTPT and stretching; and the ball group: MTPT, a single stretch and medicine ball exercises) and one control group (no intervention). Professional golf academy. One hundred, elite, male golfers aged 16-25 years. HFL, 3D biomechanical analysis of the golf swing, club head speed (CHS), smash ratio, accuracy and distance at baseline and after the interventions. Backswing hip turn (BSHT) improved in the ball group relative to the control group (p = 0.0248). Accuracy in the ball group and the stretch group improved relative to the control group (Fisher's exact = 0.016). Other performance parameters such as: smash ratio, distance and CHS were not compromised by either intervention. This study advocates the use of MTPT combined with medicine ball exercises over MTPT combined with stretching in the treatment of golfers with shortened hip flexors - even immediately preceding a tournament. Copyright © 2016 Elsevier Ltd. All rights reserved.

Examining HIV Viral Load in a Matched Cohort of HIV Positive Individuals With and Without Psoriasis.

PubMed

Wu, Jashin J; Gilbert, Kathleen E; Batech, Michael; Manalo, Iviensan F; Towner, William J; Raposo, Rui André Saraiva; Nixon, Douglas F; Liao, Wilson

2017-04-01

BACKGROUND: HIV-associated psoriasis is well-documented. Genetic, cellular, and cytokine profiles have been used as evidence to suggest psoriasis activates antiviral pathways. There has been a lack of epidemiologic evidence investigating whether psoriasis patients have lower HIV viral counts compared to non-psoriasis patients.

OBJECTIVE: Compare the viral load set point of HIV positive patients with and without psoriasis.

METHODS: A retrospective matched cohort study of HIV positive patients with and without psoriasis using the Kaiser Permanente Southern California Health Plan database.

RESULTS: We identified 101 HIV-positive psoriasis cases; 19 met inclusion criteria and were matched with 3-5 control patients; 94 total patients were analyzed. The mean age was 41.4 (12.07) years and 83% were male. Overall, the median log of the viral load of cases was slightly higher than controls (4.3 vs 4.2; P less than 0.01).

CONCLUSIONS: The serum viral load set point of patients with HIV and psoriasis was slightly higher than the viral load set point of HIV patients without psoriasis.

J Drugs Dermatol. 2017;16(4):372-377.

Point process methods in epidemiology: application to the analysis of human immunodeficiency virus/acquired immunodeficiency syndrome mortality in urban areas.

PubMed

Quesada, Jose Antonio; Melchor, Inmaculada; Nolasco, Andreu

2017-05-26

The analysis of spatio-temporal patterns of disease or death in urban areas has been developed mainly from the ecological studies approach. These designs may have some limitations like the ecological fallacy and instability with few cases. The objective of this study was to apply the point process methodology, as a complement to that of aggregated data, to study HIV/AIDS mortality in men in the city of Alicante (Spain). A case-control study in residents in the city during the period 2004-2011 was designed. Cases were men who died from HIV/AIDS and controls represented the general population, matched by age to cases. The risk surfaces of death over the city were estimated using the log-risk function of intensities, and we contrasted their temporal variations over the two periods. High risk significant areas of death by HIV/AIDS, which coincide with the most deprived areas in the city, were detected. Significant spatial change of the areas at risk between the periods studied was not detected. The point process methodology is a useful tool to analyse the patterns of death by HIV/AIDS in urban areas.

Metformin in severe exacerbations of chronic obstructive pulmonary disease: a randomised controlled trial.

PubMed

Hitchings, Andrew W; Lai, Dilys; Jones, Paul W; Baker, Emma H

2016-07-01

Severe exacerbations of COPD are commonly associated with hyperglycaemia, which predicts adverse outcomes. Metformin is a well-established anti-hyperglycaemic agent in diabetes mellitus, possibly augmented with anti-inflammatory effects, but its effects in COPD are unknown. We investigated accelerated metformin therapy in severe COPD exacerbations, primarily to confirm or refute an anti-hyperglycaemic effect, and secondarily to explore its effects on inflammation and clinical outcome. This was a multicentre, randomised, double-blind, placebo-controlled trial testing accelerated metformin therapy in non-diabetic patients, aged ≥35 years, hospitalised for COPD exacerbations. Participants were assigned in a 2:1 ratio to 1 month of metformin therapy, escalated rapidly to 2 g/day, or matched placebo. The primary end point was mean in-hospital blood glucose concentration. Secondary end points included the concentrations of fructosamine and C reactive protein (CRP), and scores on the COPD Assessment Test and Exacerbations of Chronic Pulmonary Disease Tool. 52 participants (mean (±SD) age 67±9 years) were randomised (34 to metformin, 18 to placebo). All were included in the primary end point analysis. The mean blood glucose concentrations in the metformin and placebo groups were 7.1±0.9 and 8.0±3.3 mmol/L, respectively (difference -0.9 mmol/L, 95% CI -2.1 to +0.3; p=0.273). No significant between-group differences were observed on any of the secondary end points. Adverse reactions, particularly gastrointestinal effects, were more common in metformin-treated participants. Metformin did not ameliorate elevations in blood glucose concentration among non-diabetic patients admitted to hospital for COPD exacerbations, and had no detectable effect on CRP or clinical outcomes. ISRCTN66148745 and NCT01247870. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The CLOSED trial; CLOnidine compared with midazolam for SEDation of paediatric patients in the intensive care unit: study protocol for a multicentre randomised controlled trial.

PubMed

Neubert, Antje; Baarslag, Manuel Alberto; Dijk, Monique van; Rosmalen, Joost van; Standing, Joseph F; Sheng, Yucheng; Rascher, Wolfgang; Roberts, Deborah; Winslade, Jackie; Rawcliffe, Louise; Hanning, Sara M; Metsvaht, Tuuli; Giannuzzi, Viviana; Larsson, Peter; Pokorná, Pavla; Simonetti, Alessandra; Tibboel, Dick

2017-06-21

Sedation is an essential part of paediatric critical care. Midazolam, often in combination with opioids, is the current gold standard drug. However, as it is a far-from-ideal agent, clonidine is increasingly being used in children. This drug is prescribed off-label for this indication, as many drugs in paediatrics are. Therefore, the CLOSED trial aims to provide data on the pharmacokinetics, safety and efficacy of clonidine for the sedation of mechanically ventilated patients in order to obtain a paediatric-use marketing authorisation. The CLOSED study is a multicentre, double-blind, randomised, active-controlled non-inferiority trial with a 1:1 randomisation between clonidine and midazolam. Both treatment groups are stratified according to age in three groups with the same size: <28 days (n=100), 28 days to <2 years (n=100) and 2-18 years (n=100). The primary end point is defined as the occurrence of sedation failure within the study period. Secondary end points include a pharmacokinetic/pharmacodynamic relationship, pharmacogenetics, occurrence of delirium and withdrawal syndrome, opioid consumption and neurodevelopment in the neonatal age group. Logistic regression will be used for the primary end point, appropriate statistics will be used for the secondary end points. Written informed consent will be obtained from the parents/caregivers. Verbal or deferred consent will be used in the sites where national legislation allows. The study has institutional review board approval at recruiting sites. The results will be published in a peer-reviewed journal and shared with the worldwide medical community. EudraCT: 2014-003582-24; Clinicaltrials.gov: NCT02509273; pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Nitrous oxide/oxygen inhalation provides effective analgesia during the administration of tumescent local anaesthesia for endovenous laser ablation.

PubMed

Meier, Thomas Oleg; Jacomella, Vincenzo; Clemens, Robert Karl Josef; Amann-Vesti, Beatrice

2015-11-01

Tumescent anaesthesia (TA) is an important but sometimes very painful step during endovenous thermal ablation of incompetent veins. The aim of this study was to examine whether the use of fixed 50% nitrous oxide/oxygen mixture (N2O/O2), also called equimolar mixture of oxygen and nitrous oxide, reduces pain during the application of TA. Patients undergoing endovenous laser ablation (EVLA) of incompetent saphenous veins were included. Thirty consecutive patients inhaled N2O/O2 during the application of TA. Thirty consecutive patients received TA alone (controls). Patients were asked to complete a questionnaire immediately after the intervention to assess satisfaction with the intervention and pain-levels during the different steps of the intervention (0=not at all, 10=very much). Adverse events during the treatment were monitored. 30 patients (14 men, mean age of 44 years) were included in the N2O/O2 group and 30 patients (9 men, mean age 48 years) were included in the control group. In the N2O/O2 group a significantly lower pain score was noted (mean 2.45 points, range 0-6) compared to the controls (mean 4.3 points, range 1-9, p<0.001). Overall, 64.5% of the patients were perfectly satisfied with the N2O/O2-Inhalation. Only 4 patients receiving N2O/O2 complained of adverse effects such as unpleasant loss of control (2 patients), headache (1 patient) and dizziness (1 patient). N2O/O2 is a safe and effective method to reduce pain during the application of tumescent anaesthesia for EVLA.

The Romhilt-Estes electrocardiographic score predicts sudden cardiac arrest independent of left ventricular mass and ejection fraction.

PubMed

Darouian, Navid; Aro, Aapo L; Narayanan, Kumar; Uy-Evanado, Audrey; Rusinaru, Carmen; Reinier, Kyndaron; Gunson, Karen; Jui, Jonathan; Chugh, Sumeet S

2017-07-01

The Romhilt-Estes point score system (RE) is an established ECG criterion for diagnosing left ventricular hypertrophy (LVH). In this study, we assessed for the first time, whether RE and its components are predictive of sudden cardiac arrest (SCA) independent of left ventricular (LV) mass. Sudden cardiac arrest (SCA) cases occurring between 2002 and 2014 in a Northwestern US metro region (catchment area approx. 1 million) were compared to geographic controls. ECGs and echocardiograms performed prior to the SCA and those of controls were acquired from the medical records and evaluated for the ECG criteria established in the RE score and for LV mass. Two hundred forty-seven SCA cases (age 68.3 ± 14.6, male 64.4%) and 330 controls (age 67.4 ± 11.5, male 63.6) were included in the analysis. RE scores were greater in cases than controls (2.5 ± 2.1 vs. 1.9 ± 1.7, p < .001), and SCA cases were more likely to meet definite LVH criteria (18.6% vs. 7.9%, p < .001). In a multivariable model including echocardiographic LVH and LV function, definite LVH remained independently predictive of SCA (OR 2.04, 95% CI 1.16-3.59, p = .013). The model was replicated with the individual ECG criteria, and only SV 1.2  ≥ 30 mm and delayed intrinsicoid deflection remained significant predictors of SCA. Left ventricular hypertrophy (LVH) as defined by the RE point score system is associated with SCA independent of echocardiographic LVH and reduced LV ejection fraction. These findings support an independent role for purely electrical LVH, in the genesis of lethal ventricular arrhythmias. © 2017 Wiley Periodicals, Inc.

Psychosocial factors in childhood pedestrian injury: a matched case-control study. Kid's'n'Cars Team.

PubMed

Christoffel, K K; Donovan, M; Schofer, J; Wills, K; Lavigne, J V

1996-01-01

Psychosocial factors--such as hyperactivity and low family cohesion--contribute to the risk for child pedestrian injury (PI), even after controlling for known demographic risk factors. Urban PI victims aged 5 to 12 years were recruited from one large, urban pediatric trauma center in a large city. One hundred twenty-eight cases were matched to uninjured children on age, sex, race, location of residence, and parental education. Among matched cases: 70% were male, 41% were black, 33% were Hispanic, and 66% of the mothers had a high school education or less. RESEARCH DESIGN AND MEASUREMENTS: Case-control comparisons on 19 psychosocial variables drawn from interviews and standardized tests, using one-tailed matched-pairs t tests and conditional logistic regression analyses. Cases had higher reported physical quotient [PQ] (P = .01), self-help quotient (P = .04), and family stress (P = .02), and lower family supportiveness (P = .03). Multivariate analyses confirmed that PQ was higher in cases (10-point increase: odds ratio (OR) = 1.32 [90% confidence interval (CI) 1.01-1.76], that stress was higher in cases (1 log increase: OR 2.13, [1.26-3.61]), and that cases had lower family supportiveness (25-point decrease: OR 1.43 [1.25-1.63]). It also identified household crowding as a factor for non-black cases (OR for increase of 0.25 people per room: 2.18, [1.31-3.62]). Even when controlling for demographic risk, several family factors and one child factor place children at risk for PI. Clinicians may choose to use these as indicators for injury prevention counseling. Research on family effects may help clarify means to protect children who are demographically at risk for PI.

The Leganés cognitive test correlates poorly with MRI evidence of global cortical atrophy in an underserved community: A population-based and nested case-control study in rural Ecuador (The Atahualpa Project)

PubMed Central

Brutto, Oscar H. Del; Mera, Robertino M; Zambrano, Mauricio; Lama, Julio

2014-01-01

Objective We aimed to evaluate whether the Leganés cognitive test (LCT) correlates with global cortical atrophy (GCA) and can be used as a surrogate for structural brain damage. Methods Atahualpa residents aged > 60 years identified during a door-to-door survey underwent MRI for grading GCA. Using multivariate generalized linear models, we evaluated whether continuous LCT scores correlated with GCA, after adjusting for demographics, education, cardiovascular health (CVH) status, depression and edentulism. In a nested case-control study, GCA severity was assessed in subjects with LCT scores below the cutoff level for dementia (< 22 points) and in matched controls without dementia. Results Out of 311 eligible subjects, 241 (78%) were enrolled. Mean age was 69.2±7.5 years, 59% were women, 83% had primary school education, 73% had poor CVH status, 12% had symptoms of depression and 43% had edentulism. Average LCT score was 26.7±3, and 23 (9.5%) subjects scored < 22 points. GCA was mild in 108, moderate in 95, and severe in 26 individuals. On the multivariate model, mean LCT score was not associated with GCA severity (β=0.06, SE=0.34, p=0.853). Severe GCA was noted in 6 / 23 case-patients and in 8 / 23 controls (OR: 0.67, 95% CI: 0.14-2.81, p=0.752, McNemar's test). Conclusion The LCT does not correlate with severity of GCA after adjusting for potential confounding variables, and should not be used as a reliable estimate of structural brain damage. PMID:29213925

The Leganés cognitive test correlates poorly with MRI evidence of global cortical atrophy in an underserved community: A population-based and nested case-control study in rural Ecuador (The Atahualpa Project).

PubMed

Brutto, Oscar H Del; Mera, Robertino M; Zambrano, Mauricio; Lama, Julio

2014-01-01

We aimed to evaluate whether the Leganés cognitive test (LCT) correlates with global cortical atrophy (GCA) and can be used as a surrogate for structural brain damage. Atahualpa residents aged > 60 years identified during a door-to-door survey underwent MRI for grading GCA. Using multivariate generalized linear models, we evaluated whether continuous LCT scores correlated with GCA, after adjusting for demographics, education, cardiovascular health (CVH) status, depression and edentulism. In a nested case-control study, GCA severity was assessed in subjects with LCT scores below the cutoff level for dementia (< 22 points) and in matched controls without dementia. Out of 311 eligible subjects, 241 (78%) were enrolled. Mean age was 69.2±7.5 years, 59% were women, 83% had primary school education, 73% had poor CVH status, 12% had symptoms of depression and 43% had edentulism. Average LCT score was 26.7±3, and 23 (9.5%) subjects scored < 22 points. GCA was mild in 108, moderate in 95, and severe in 26 individuals. On the multivariate model, mean LCT score was not associated with GCA severity (β=0.06, SE=0.34, p=0.853). Severe GCA was noted in 6 / 23 case-patients and in 8 / 23 controls (OR: 0.67, 95% CI: 0.14-2.81, p=0.752, McNemar's test). The LCT does not correlate with severity of GCA after adjusting for potential confounding variables, and should not be used as a reliable estimate of structural brain damage.

Neuromodulation of reward-based learning and decision making in human aging

PubMed Central

Eppinger, Ben; Hämmerer, Dorothea; Li, Shu-Chen

2013-01-01

In this paper, we review the current literature to highlight relations between age-associated declines in dopaminergic and serotonergic neuromodulation and adult age differences in adaptive goal-directed behavior. Specifically, we focus on evidence suggesting that deficits in neuromodulation contribute to older adults’ behavioral disadvantages in learning and decision making. These deficits are particularly pronounced when reward information is uncertain or the task context requires flexible adaptations to changing stimulus–reward contingencies. Moreover, emerging evidence points to age-related differences in the sensitivity to rewarding and aversive outcomes during learning and decision making if the acquisition of behavior critically depends on outcome processing. These age-related asymmetries in outcome valuation may be explained by age differences in the interplay of dopaminergic and serotonergic neuromodulation. This hypothesis is based on recent neurocomputational and psychopharmacological approaches, which suggest that dopamine and serotonin serve opponent roles in regulating the balance between approach behavior and inhibitory control. Studying adaptive regulation of behavior across the adult life span may shed new light on how the aging brain changes functionally in response to its diminishing resources. PMID:22023564

Early childhood BMI trajectories in monogenic obesity due to leptin, leptin receptor, and melanocortin 4 receptor deficiency.

PubMed

Kohlsdorf, Katja; Nunziata, Adriana; Funcke, Jan-Bernd; Brandt, Stephanie; von Schnurbein, Julia; Vollbach, Heike; Lennerz, Belinda; Fritsch, Maria; Greber-Platzer, Susanne; Fröhlich-Reiterer, Elke; Luedeke, Manuel; Borck, Guntram; Debatin, Klaus-Michael; Fischer-Posovszky, Pamela; Wabitsch, Martin

2018-02-27

To evaluate whether early childhood body mass index (BMI) is an appropriate indicator for monogenic obesity. A cohort of n = 21 children living in Germany or Austria with monogenic obesity due to congenital leptin deficiency (group LEP, n = 6), leptin receptor deficiency (group LEPR, n = 6) and primarily heterozygous MC4 receptor deficiency (group MC4R, n = 9) was analyzed. A control group (CTRL) was defined that consisted of n = 22 obese adolescents with no mutation in the above mentioned genes. Early childhood (0-5 years) BMI trajectories were compared between the groups at selected time points. The LEP and LEPR group showed a tremendous increase in BMI during the first 2 years of life with all patients displaying a BMI >27 kg/m 2 (27.2-38.4 kg/m 2 ) and %BMI P95 (percentage of the 95th percentile BMI for age and sex) >140% (144.8-198.6%) at the age of 2 years and a BMI > 33 kg/m 2 (33.3-45.9 kg/m 2 ) and %BMI P95  > 184% (184.1-212.6%) at the age of 5 years. The MC4R and CTRL groups had a later onset of obesity with significantly lower BMI values at both time points (p < 0.01). As result of the investigation of early childhood BMI trajectories in this pediatric cohort with monogenic obesity we suggest that BMI values >27.0 kg/m 2 or %BMI P95  > 140% at the age of 2 years and BMI values >33.0 kg/m 2 or %BMI P95  > 184% at the age of 5 years may be useful cut points to identify children who should undergo genetic screening for monogenic obesity due to functionally relevant mutations in the leptin gene or leptin receptor gene.

The relationship between latent trigger points and depression levels in healthy subjects.

PubMed

Celik, Derya; Kaya Mutlu, Ebru

2012-06-01

Our purpose was to study the relationship between latent trigger points (LTrP) and levels of depression in healthy subjects. A total of 76 healthy subjects consisting of 40 men and 36 women (mean age, 25.4 ± 4.8 years; age range, 19-42 years) from the School of Physical Therapy and Rehabilitation and the Orthopaedics and Traumatology Department of Istanbul University Medical Faculty were selected for the study. Latent trigger points on the scapular muscles of each subject were evaluated. The upper and middle trapezius, supraspinatus, serratus anterior, and rhomboideus muscles were examined respectively, by palpation with the thumb, to determine whether there was pain. The first group consisted of 30 subjects (20 men and 10 women; mean age, 24.2 ± 5.02 years) who had previously been diagnosed as negative after an LTrP examination (control group), while the second group consisted of 28 subjects (12 men and 16 women; mean age, 23.6 ± 2.24 years) who had been diagnosed with at least five LTrPs. The third group consisted of 18 subjects (8 men and 10 women; mean age, 26. 9 ± 7.23 years) who had been diagnosed with more than five LTrPs. All groups were assessed, using the Beck Depression Inventory (BDI). The mean BDI value was found to be 8.0 ± 4.2 in the first group, 10.3 ± 3.4 in the second, and 28.5 ± 4.8 in the third. A significant difference was found between the mean BDI values of the first and second groups and also between the first and third groups. The mean BDI values of the second and third groups were also found to be statistically significant (p = 0.042). We observed a close relationship between the presence of LTrPs and depression levels in healthy people.

Associations of Linear Growth and Relative Weight Gain in Early Life with Human Capital at 30 Years of Age.

PubMed

Horta, Bernardo Lessa; Victora, Cesar G; de Mola, Christian Loret; Quevedo, Luciana; Pinheiro, Ricardo Tavares; Gigante, Denise P; Motta, Janaina Vieira Dos Santos; Barros, Fernando C

2017-03-01

To assess the associations of birthweight, nutritional status and growth in childhood with IQ, years of schooling, and monthly income at 30 years of age. In 1982, the 5 maternity hospitals in Pelotas, Brazil, were visited daily and 5914 live births were identified. At 30 years of age, 3701 subjects were interviewed. IQ, years of schooling, and income were measured. On average, their IQ was 98 points, they had 11.4 years of schooling, and the mean income was 1593 reais. After controlling for several confounders, birthweight and attained weight and length/height for age at 2 and 4 years of age were associated positively with IQ, years of years of schooling, and income, except for the association between length at 2 years of age and income. Conditional growth analyses were used to disentangle linear growth from relative weight gain. Conditional length at 2 years of age ≥1 SD score above the expected value, compared with ≥1 SD below the expected, was associated with an increase in IQ (4.28 points; 95% CI, 2.66-5.90), years of schooling (1.58 years; 95% CI, 1.08-2.08), and monthly income (303 Brazilian reais; 95% CI, 44-563). Relative weight gain, above what would be expected from linear growth, was not associated with the outcomes. In a middle-income setting, promotion of linear growth in the first 1000 days of life is likely to increase adult IQ, years of schooling, and income. Weight gain in excess of what is expected from linear growth does not seem to improve human capital. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Satisfaction with life during pregnancy and early motherhood in first-time mothers of advanced age: a population-based longitudinal study.

PubMed

Aasheim, Vigdis; Waldenström, Ulla; Rasmussen, Svein; Espehaug, Birgitte; Schytt, Erica

2014-02-25

The trend to delay motherhood to the age of 30 and beyond is established in most high-income countries but relatively little is known about potential effects on maternal emotional well-being. This study investigates satisfaction with life during pregnancy and the first three years of motherhood in women expecting their first baby at an advanced and very advanced age. The study was based on the National Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Data on 18 565 nulliparous women recruited in the second trimester 1999-2008 were used. Four questionnaires were completed: at around gestational weeks 17 and 30, and at six months and three years after the birth. Medical data were retrieved from the national Medical Birth Register. Advanced age was defined as 32-37 years, very advanced age as ≥38 years and the reference group as 25-31 years. The distribution of satisfaction with life from age 25 to ≥40 years was investigated, and the mean satisfaction with life at the four time points was estimated. Logistic regression analyses based on generalised estimation equations were used to investigate associations between advanced and very advanced age and satisfaction with life when controlling for socio-demographic factors. Satisfaction with life decreased from around age 28 to age 40 and beyond, when measured in gestational weeks 17 and 30, and at six months and three years after the birth. When comparing women of advanced and very advanced age with the reference group, satisfaction with life was slightly reduced in the two older age groups and most of all in women of very advanced age. Women of very advanced age had the lowest scores at all time points and this was most pronounced at three years after the birth. First-time mothers of advanced and very advanced age reported a slightly lower degree of satisfaction with life compared with the reference group of younger women, and the age-related effect was greatest when the child was three years of age.

16 CFR 1500.48 - Technical requirements for determining a sharp point in toys and other articles intended for use...

Code of Federal Regulations, 2012 CFR

2012-01-01

... sharp point in toys and other articles intended for use by children under 8 years of age. 1500.48... requirements for determining a sharp point in toys and other articles intended for use by children under 8... intended for use by children under 8 years of age, and such points exposed in normal use or as a result of...

16 CFR 1500.48 - Technical requirements for determining a sharp point in toys and other articles intended for use...

Code of Federal Regulations, 2011 CFR

2011-01-01

... sharp point in toys and other articles intended for use by children under 8 years of age. 1500.48... requirements for determining a sharp point in toys and other articles intended for use by children under 8... intended for use by children under 8 years of age, and such points exposed in normal use or as a result of...

16 CFR 1500.48 - Technical requirements for determining a sharp point in toys and other articles intended for use...

Code of Federal Regulations, 2014 CFR

2014-01-01

... sharp point in toys and other articles intended for use by children under 8 years of age. 1500.48... requirements for determining a sharp point in toys and other articles intended for use by children under 8... intended for use by children under 8 years of age, and such points exposed in normal use or as a result of...

Optimal Battery Utilization Over Lifetime for Parallel Hybrid Electric Vehicle to Maximize Fuel Economy

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

Patil, Chinmaya; Naghshtabrizi, Payam; Verma, Rajeev

This paper presents a control strategy to maximize fuel economy of a parallel hybrid electric vehicle over a target life of the battery. Many approaches to maximizing fuel economy of parallel hybrid electric vehicle do not consider the effect of control strategy on the life of the battery. This leads to an oversized and underutilized battery. There is a trade-off between how aggressively to use and 'consume' the battery versus to use the engine and consume fuel. The proposed approach addresses this trade-off by exploiting the differences in the fast dynamics of vehicle power management and slow dynamics of batterymore » aging. The control strategy is separated into two parts, (1) Predictive Battery Management (PBM), and (2) Predictive Power Management (PPM). PBM is the higher level control with slow update rate, e.g. once per month, responsible for generating optimal set points for PPM. The considered set points in this paper are the battery power limits and State Of Charge (SOC). The problem of finding the optimal set points over the target battery life that minimize engine fuel consumption is solved using dynamic programming. PPM is the lower level control with high update rate, e.g. a second, responsible for generating the optimal HEV energy management controls and is implemented using model predictive control approach. The PPM objective is to find the engine and battery power commands to achieve the best fuel economy given the battery power and SOC constraints imposed by PBM. Simulation results with a medium duty commercial hybrid electric vehicle and the proposed two-level hierarchical control strategy show that the HEV fuel economy is maximized while meeting a specified target battery life. On the other hand, the optimal unconstrained control strategy achieves marginally higher fuel economy, but fails to meet the target battery life.« less

Does hippotherapy effect use of sensory information for balance in people with multiple sclerosis?

PubMed

Lindroth, Jodi L; Sullivan, Jessica L; Silkwood-Sherer, Debbie

2015-01-01

This case-series study aimed to determine if there were observable changes in sensory processing for postural control in individuals with multiple sclerosis (MS) following physical therapy using hippotherapy (HPOT), or changes in balance and functional gait. This pre-test non-randomized design study, with follow-up assessment at 6 weeks, included two females and one male (age range 37-60 years) with diagnoses of relapse-remitting or progressive MS. The intervention consisted of twelve 40-min physical therapy sessions which included HPOT twice a week for 6 weeks. Sensory organization and balance were assessed by the Sensory Organization Test (SOT) and Berg Balance Scale (BBS). Gait was assessed using the Functional Gait Assessment (FGA). Following the intervention period, all three participants showed improvements in SOT (range 1-8 points), BBS (range 2-6 points), and FGA (average 4 points) scores. These improvements were maintained or continued to improve at follow-up assessment. Two of the three participants no longer over-relied on vision and/or somatosensory information as the primary sensory input for postural control, suggesting improved use of sensory information for balance. The results indicate that HPOT may be a beneficial physical therapy treatment strategy to improve balance, functional gait, and enhance how some individuals with MS process sensory cues for postural control. Randomized clinical trials will be necessary to validate results of this study.

Effect of Spironolactone and Amiloride on Thiazolidinedione-Induced Fluid Retention in South Indian Patients with Type 2 Diabetes

PubMed Central

Viswanathan, Vijay; Mohan, Viswanathan; Subramani, Poongothai; Parthasarathy, Nandakumar; Subramaniyam, Gayathri; Manoharan, Deepa; Sundaramoorthy, Chandru; Gnudi, Luigi; Viberti, Giancarlo

2013-01-01

Summary Background and objectives Thiazolidinediones (pioglitazone and rosiglitazone) induce renal epithelial sodium channel (ENaC)–mediated sodium reabsorption, resulting in plasma volume (PV) expansion. Incidence and long-term management of fluid retention induced by thiazolidinediones remain unclear. Design, setting, participants, & measurements In a 4-week run-in period, rosiglitazone, 4 mg twice daily, was added to a background anti-diabetic therapy in 260 South Indian patients with type 2 diabetes mellitus. Patients with PV expansion (absolute reduction in hematocrit in run-in, ≥1.5 percentage points) entered a randomized, placebo-controlled study to evaluate effects of amiloride and spironolactone on attenuating rosiglitazone-induced fluid retention. Primary endpoint was change in hematocrit in each diuretic group versus placebo (control group). Results Of the 260 patients, 70% (n=180) had PV expansion. These 180 patients (70% male; mean age, 47.8 years [range, 30–80 years]) were randomly assigned to rosiglitazone, 4 mg twice daily, plus spironolactone, 50 mg once daily; rosiglitazone, 4 mg twice daily, plus amiloride, 10 mg once daily; or rosiglitazone, 4 mg twice daily, plus placebo for 24 weeks. Hematocrit continued to decrease significantly in control and spironolactone groups (mean absolute change, −1.2 [P=0.01] and −0.7 [P=0.02] percentage points, respectively), suggesting continued PV expansion. No change occurred with amiloride (mean change, 0.0 percentage points). Amiloride, but not spironolactone, was superior to control (mean hematocrit difference [95% confidence interval] relative to control, 1.27 [0.21–2.55] and 0.49 [−0.79–1.77] percentage points [P=0.04 and P=0.61], respectively). Conclusions Prevalence of rosiglitazone-induced fluid retention in South Indian patients with type 2 diabetes is high. Amiloride, a direct ENaC blocker, but not spironolactone, prevented protracted fluid retention in these patients. PMID:23184569

Non-penetrating sham needle, is it an adequate sham control in acupuncture research?

PubMed

Lee, Hyangsook; Bang, Heejung; Kim, Youngjin; Park, Jongbae; Lee, Sangjae; Lee, Hyejung; Park, Hi-Joon

2011-01-01

This study aimed to determine whether a non-penetrating sham needle can serve as an adequate sham control. We conducted a randomised, subject-blind, sham-controlled trial in both acupuncture-naïve and experienced healthy volunteers. Participants were randomly allocated to receive either real acupuncture (n=39) or non-penetrating sham acupuncture (n=40) on the hand (LI4), abdomen (CV12) and leg (ST36). The procedures were standardised and identical for both groups. Participants rated acupuncture sensations on a 10-point scale. A blinding index was calculated based on the participants' guesses on the type of acupuncture they had received (real, sham or do not know) for each acupuncture point. The association of knowledge about and experience in acupuncture with correct guessing was also examined. The subjects in both groups were similar with respect to age, gender, experience or knowledge about acupuncture. The sham needle tended to produce less penetration, pain and soreness only at LI4. Blinding appeared to be successfully achieved for ST36. Although 41% of participants in the real acupuncture group made correct guesses for LI4, 31% guessed incorrectly for CV12, beyond chance level. People with more experience and knowledge about acupuncture were more likely to correctly guess the type of needle they received at ST36 only, compared to that at the other points. A non-penetrating sham needle may successfully blind participants and thus, may be a credible sham control. However, the small sample size, the different needle sensations, and the degree and direction of unblinding across acupuncture points warrant further studies in Korea as well as other countries to confirm our finding. Our results also justify the incorporation of formal testing of the use of sham controls in clinical trials of acupuncture. Copyright © 2010 Elsevier Ltd. All rights reserved.

Bony Pelvis Dimensions in Women With and Without Stress Urinary Incontinence

PubMed Central

Berger, Mitchell B.; Doumouchtsis, Stergios K.; DeLancey, John O.

2012-01-01

AIMS To test the null hypothesis that bony pelvis dimensions are similar in women with and without stress urinary incontinence, both in the postpartum and midlife periods. METHODS Secondary analyses were performed of two case-control studies comparing women with stress urinary incontinence to asymptomatic controls. One study examined primiparas in the first 9–12 months postpartum; the other study involved middle-aged women. Stress urinary incontinence was confirmed by full-bladder stress test. All subjects underwent pelvic magnetic resonance imaging. The interspinous and intertuberous diameters, subpubic angle and sacrococcygeal joint-to-the inferior pubic point distance were measured from the images independently by two authors. RESULTS In the young cohorts, we compared primiparas with de novo postpartum stress urinary incontinence to both continent primiparas and nulliparas. Postpartum stress urinary incontinence is associated with a wider subpubic angle. There is also a trend towards wider interspinous and intertuberous diameters in the stress-incontinent primiparas as compared to the continent cohorts, although this did not reach statistical significance with our sample sizes. By contrast, no significant differences in bony pelvis dimensions were identified when comparing middle-aged women with stress urinary incontinence and their continent controls. CONCLUSIONS Bony pelvis dimensions are different in women with stress urinary incontinence than in matched continent controls. However, these differences are only identified in young primiparas in the postpartum period, not in middle-aged women. PMID:22674676

Are you surprised to hear this? Longitudinal spectral speech exposure in older compared to middle-aged normal hearing adults.

PubMed

Giroud, Nathalie; Lemke, Ulrike; Reich, Philip; Bauer, Julia; Widmer, Susann; Meyer, Martin

2018-01-01

Cognitive abilities such as attention or working memory can support older adults during speech perception. However, cognitive abilities as well as speech perception decline with age, leading to the expenditure of effort during speech processing. This longitudinal study therefore investigated age-related differences in electrophysiological processes during speech discrimination and assessed the extent of enhancement to such cognitive auditory processes through repeated auditory exposure. For that purpose, accuracy and reaction time were compared between 13 older adults (62-76 years) and 15 middle-aged (28-52 years) controls in an active oddball paradigm which was administered at three consecutive measurement time points at an interval of 2 wk, while EEG was recorded. As a standard stimulus, the nonsense syllable /'a:ʃa/was used, while the nonsense syllable /'a:sa/ and a morphing between /'a:ʃa/ and /'a:sa/ served as deviants. N2b and P3b ERP responses were evaluated as a function of age, deviant, and measurement time point using a data-driven topographical microstate analysis. From middle age to old age, age-related decline in attentive perception (as reflected in the N2b-related microstates) and in memory updating and attentional processes (as reflected in the P3b-related microstates) was found, as indicated by both lower neural responses and later onsets of the respective cortical networks, and in age-related changes in frontal activation during attentional stimulus processing. Importantly, N2b- and P3b-related microstates changed as a function of repeated stimulus exposure in both groups. This research therefore suggests that experience with auditory stimuli can support auditory neurocognitive processes in normal hearing adults into advanced age. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Determining BMI cut points based on excess percent body fat in US children and adolescents

USDA-ARS?s Scientific Manuscript database

Current cut points for overweight were derived statistically from BMI distribution. The study aimed at determining age-, gender-, and ethnic-specific BMI cut points based on excess body fat in US children and adolescents aged 8-17 years, who participated in the National Health and Nutrition Examinat...

Reassessing the NTCTCS Staging Systems for Differentiated Thyroid Cancer, Including Age at Diagnosis

PubMed Central

McLeod, Donald S.A.; Jonklaas, Jacqueline; Brierley, James D.; Ain, Kenneth B.; Cooper, David S.; Fein, Henry G.; Haugen, Bryan R.; Ladenson, Paul W.; Magner, James; Ross, Douglas S.; Skarulis, Monica C.; Steward, David L.; Xing, Mingzhao; Litofsky, Danielle R.; Maxon, Harry R.

2015-01-01

Background: Thyroid cancer is unique for having age as a staging variable. Recently, the commonly used age cut-point of 45 years has been questioned. Objective: This study assessed alternate staging systems on the outcome of overall survival, and compared these with current National Thyroid Cancer Treatment Cooperative Study (NTCTCS) staging systems for papillary and follicular thyroid cancer. Methods: A total of 4721 patients with differentiated thyroid cancer were assessed. Five potential alternate staging systems were generated at age cut-points in five-year increments from 35 to 70 years, and tested for model discrimination (Harrell's C-statistic) and calibration (R2). The best five models for papillary and follicular cancer were further tested with bootstrap resampling and significance testing for discrimination. Results: The best five alternate papillary cancer systems had age cut-points of 45–50 years, with the highest scoring model using 50 years. No significant difference in C-statistic was found between the best alternate and current NTCTCS systems (p = 0.200). The best five alternate follicular cancer systems had age cut-points of 50–55 years, with the highest scoring model using 50 years. All five best alternate staging systems performed better compared with the current system (p = 0.003–0.035). There was no significant difference in discrimination between the best alternate system (cut-point age 50 years) and the best system of cut-point age 45 years (p = 0.197). Conclusions: No alternate papillary cancer systems assessed were significantly better than the current system. New alternate staging systems for follicular cancer appear to be better than the current NTCTCS system, although they require external validation. PMID:26203804

Participatory women's groups and counselling through home visits to improve child growth in rural eastern India: protocol for a cluster randomised controlled trial.

PubMed

Nair, Nirmala; Tripathy, Prasanta; Sachdev, Harshpal S; Bhattacharyya, Sanghita; Gope, Rajkumar; Gagrai, Sumitra; Rath, Shibanand; Rath, Suchitra; Sinha, Rajesh; Roy, Swati Sarbani; Shewale, Suhas; Singh, Vijay; Srivastava, Aradhana; Pradhan, Hemanta; Costello, Anthony; Copas, Andrew; Skordis-Worrall, Jolene; Haghparast-Bidgoli, Hassan; Saville, Naomi; Prost, Audrey

2015-04-15

Child stunting (low height-for-age) is a marker of chronic undernutrition and predicts children's subsequent physical and cognitive development. Around one third of the world's stunted children live in India. Our study aims to assess the impact, cost-effectiveness, and scalability of a community intervention with a government-proposed community-based worker to improve growth in children under two in rural India. The study is a cluster randomised controlled trial in two rural districts of Jharkhand and Odisha (eastern India). The intervention tested involves a community-based worker carrying out two activities: (a) one home visit to all pregnant women in the third trimester, followed by subsequent monthly home visits to all infants aged 0-24 months to support appropriate feeding, infection control, and care-giving; (b) a monthly women's group meeting using participatory learning and action to catalyse individual and community action for maternal and child health and nutrition. Both intervention and control clusters also receive an intervention to strengthen Village Health Sanitation and Nutrition Committees. The unit of randomisation is a purposively selected cluster of approximately 1000 population. A total of 120 geographical clusters covering an estimated population of 121,531 were randomised to two trial arms: 60 clusters in the intervention arm receive home visits, group meetings, and support to Village Health Sanitation and Nutrition Committees; 60 clusters in the control arm receive support to Committees only. The study participants are pregnant women identified in the third trimester of pregnancy and their children (n = 2520). Mothers and their children are followed up at seven time points: during pregnancy, within 72 hours of delivery, and at 3, 6, 9, 12 and 18 months after birth. The trial's primary outcome is children's mean length-for-age Z scores at 18 months. Secondary outcomes include wasting and underweight at all time points, birth weight, growth velocity, feeding, infection control, and care-giving practices. Additional qualitative and quantitative data are collected for process and economic evaluations. This trial will contribute to evidence on effective strategies to improve children's growth in India. ISRCTN register 51505201 ; Clinical Trials Registry of India number 2014/06/004664.

Determinants of food label use among supermarket shoppers: a Singaporean perspective.

PubMed

Vijaykumar, Santosh; Lwin, May O; Chao, Jiang; Au, Cyndy

2013-01-01

Examining factors influencing food label use among Singapore's supermarket shoppers using the Theory of Planned Behavior. A point-of-purchase survey among general shoppers in 2 supermarkets. Singapore, a country whose population is exposed to a wide range of food labeling formats because of the import-dependent nature of the food industry. A total of 200 shoppers (Chinese [75.5%], Malays [8.5%], and Indians [7.0%]) participated in the survey. Independent variables composed of attitudes and subjective norms (both 5-point Likert); perceived behavioral control and diet-health concern (both 5-point semantic differential); and knowledge (18-item index). Dependent variables were intention to use food labels (5-point differential scale) and actual use of food labels (19-item index). Data were analyzed using descriptive statistics, mean analysis, and multivariate linear regression. Low levels of knowledge and health literacy were found. Attitudes, subjective norms, and behavioral control differed significantly by age and ethnicity. Subjective norms and diet-health concern were significant predictors of intention to use food labels. Lack of knowledge but positive attitudes toward food labels make Singapore's consumers vulnerable to misusing or being misled by food label information. Demographic differences demonstrate the need to develop targeted educational interventions and enhance awareness of and ability to use food labels. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Performance Modeling of a Pilot in a Free Flight Mode. 1; A Free Flight Self-Separation Cancellations Due to the Requirement for Procedural Intervention

NASA Technical Reports Server (NTRS)

Ntuen, Celestine A.

1999-01-01

Developments are being made that allow pilots to have more flexibility over the control of their aircraft. This new concept is called Free Flight. Free Flight strives to move the current air traffic system into an age where space technology is used to its fullest potential. Self-separation is one part of the Free Flight system. Self-separation provides pilots the opportunity to choose their own route to reach a specified destination provided that they maintain the 'minimum required separation distance between airplanes. In the event that pilots are unable to maintain separation, controllers will need to have the aircraft separation authority passed back to them. This situation is known as a procedural intervention point. This project attempted to examine and diagnose those particular situations in an effort to avoid reaching a procedural intervention point in the near future. Crews that reached procedural intervention points were compared with crews that made similar maneuver types in the same scenario, but did not reach procedural intervention points. Results showed that there were no significant differences between crews in a high-density acute angle flight conditions. However, significant differences in maneuver times, following the detection of an intruder aircraft and following the time the intruder aircraft came into view, were found in a low-density, acute angle scenario.

Exacerbated Glial Response in the Aged Mouse Hippocampus Following Controlled Cortical Impact Injury

PubMed Central

Sandhir, Rajat; Onyszchuk, Gregory; Berman, Nancy E. J.

2008-01-01

Old age is associated with enhanced susceptibility to and poor recovery from brain injury. An exacerbated microglial and astrocyte response to brain injury might be involved in poor outcomes observed in the elderly. The present study was therefore designed to quantitate the expression of markers of microglia and astrocyte activation using real-time RT-PCR, immunoblot and immunohistochemical analysis in aging brain in response to brain injury. We examined the hippocampus, a region that undergoes secondary neuron death, in aged (21–24 month) and adult (5–6 month) mice following controlled cortical impact (CCI) injury to the sensorimotor cortex. Basal mRNA expression of CD11b and Iba1, markers of activated microglia, was higher in aged hippocampus as compared to the adult. The mRNA expression of microglial markers increased and reached maximum 3 days post injury in both adult and aged mice, but was higher in the aged mice at all time points studied, and in the aged mice the return to baseline levels was delayed. Basal mRNA expression of GFAP and S100B, markers of activated astrocytes, was higher in aged mice. Both markers increased and reached maximum 7 days post injury. The mRNA expression of astrocyte markers returned to near basal levels rapidly after injury in the adult mice, whereas again in the aged mice return to baseline was delayed. Immunochemical analysis using Iba1 and GFAP antibodies indicate accentuated glial responses in the aged hippocampus after injury. The pronounced and prolonged activation of microglia and astrocytes in hippocampus may contribute to worse cognitive outcomes in the elderly following TBI. PMID:18692046

Trends in the quality of care for elderly people with type 2 diabetes: the need for improvements in safety and quality (the 2001 and 2007 ENTRED Surveys).

PubMed

Pornet, Carole; Bourdel-Marchasson, Isabelle; Lecomte, Pierre; Eschwège, Eveline; Romon, Isabelle; Fosse, Sandrine; Assogba, Frank; Roudier, Candice; Fagot-Campagna, Anne

2011-04-01

This study aimed to characterize the sociodemographic data, health status, quality of care and 6-year trends in elderly people with type 2 diabetes. This study used two French cross-sectional representative surveys of adults of all ages with all types of diabetes (Entred 2001 and 2007), which combined medical claims, and patient and medical provider questionnaires. The 2007 data in patients with type 2 diabetes aged 65 years or over (n=1766) were described and compared with the 2001 data (n=1801). Since 2001, obesity has increased (35% in 2007; +7 points since 2001) while written nutritional advice was less often provided (59%; -6 points). Mean HbA(1c) (7.1%; -0.2%), blood pressure (135/76 mmHg; -4/-3 mmHg) and LDL cholesterol (1.04 g/L; -0.21 g/L) declined, while the use of medication increased: at least two OHAs, 34% (+4 points); OHA(s) and insulin combined, 10% (+4 points); antihypertensive treatment, 83% (+4 points); and statins 48% (+26 points). Severe hypoglycaemia remained frequent (10% had an event at least once a year). The overall prevalence of complications increased. Renal complications were not monitored carefully enough (missing value for albuminuria: 42%; -4.5 points), and 46% of those with a glomerular filtration rate less than 60 mL/min/1.73 m² were taking metformin. Elderly people with type 2 diabetes are receiving better quality of care and have better control of cardiovascular risk factors than before. However, improvement is still required, in particular by performing better screening for complications. In this patient population, it is important to carefully monitor the risks for hypoglycaemia, hypotension, malnutrition and contraindications related to renal function. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Self-control across species (Columba livia, Homo sapiens, and Rattus norvegicus).

PubMed

Tobin, H; Logue, A W

1994-06-01

Data from six previous studies of self-control behavior were compared against predictions made by the matching law and by molar maximization. The studies involved pigeons (Columba livia), rats (Rattus norvegicus), and 3-year-old, 5-year-old, and adult humans (Homo sapiens) who had received food as the reinforcer, and adult humans who had received points exchangeable for money as the reinforcer. Neither theory proved to be an accurate or better predictor for all groups. In contrast to the predictions of these theories, self-control was shown to vary according to species, human age group, and reinforcer quality. When the reinforcer was food, the self-control of different species was found to be negatively correlated with metabolic rate; that is, larger species showed greater self-control. These results suggest that allometric scaling may prove useful in describing and predicting species differences in self-control.

Transient improvements in fixational stability in strabismic amblyopes following bifoveal fixation and reduced interocular suppression.

PubMed

Raveendran, Rajkumar Nallour; Babu, Raiju J; Hess, Robert F; Bobier, William R

2014-03-01

To test the hypothesis that fixational stability of the amblyopic eye in strabismics will improve when viewing provides both bifoveal fixation and reduced inter-ocular suppression by reducing the contrast to the fellow eye. Seven strabismic amblyopes (Age: 29.2 ± 9 years; five esotropes and two exotropes) showing clinical characteristics of central suppression were recruited. Interocular suppression was measured by a global motion task. For each participant, a balance point was determined which defined contrast levels for each eye where binocular combination was optimal (interocular suppression minimal). When the balance point could not be determined, this participant was excluded. Bifoveal fixation was established by ocular alignment using a haploscope. Participants dichoptically viewed similar targets (a cross of 2.3° surrounded by a square of 11.3°) at 40 cm. Target contrasts presented to each eye were either high contrast (100% to both eyes) or balanced contrast (attenuated contrast in the fellow fixing eye). Fixation stability was measured over a 5 min period and quantified using bivariate contour ellipse areas in four different binocular conditions; unaligned/high contrast, unaligned/balance point, aligned/high contrast and aligned/balance point. Fixation stability was also measured in six control subjects (Age: 25.3 ± 4 years). Bifoveal fixation in the strabismics was transient (58.15 ± 15.7 s). Accordingly, fixational stability was analysed over the first 30 s using repeated measures anova. Post hoc analysis revealed that for the amblyopic subjects, the fixational stability of the amblyopic eye was significantly improved in aligned/high contrast (p = 0.01) and aligned/balance point (p < 0.01) conditions. Fixational stability of the fellow fixing eye was not different statistically across conditions. Bivariate contour ellipse areas of the amblyopic and fellow fixing eyes were therefore averaged for each amblyope in the four conditions and compared with normals. This averaged bivariate contour ellipse area was significantly greater (reduced fixational stability, p = 0.04) in amblyopes compared to controls except in the case of aligned and balanced contrast (aligned/balance point, p = 0.19). Fixation stability in the amblyopic eye appears to improve with bifoveal fixation and reduced interocular suppression. However, once initiated, bifoveal fixation is transient with the strabismic eye drifting away from foveal alignment, thereby increasing the angle of strabismus. © 2014 The Authors Ophthalmic & Physiological Optics © 2014 The College of Optometrists.

Pointing control for the International Comet Mission

NASA Technical Reports Server (NTRS)

Leblanc, D. R.; Schumacher, L. L.

1980-01-01

The design of the pointing control system for the proposed International Comet Mission, intended to fly by Comet Halley and rendezvous with Comet Tempel-2 is presented. Following a review of mission objectives and the spacecraft configuration, design constraints on the pointing control system controlling the two-axis gimballed scan platform supporting the science instruments are discussed in relation to the scientific requirements of the mission. The primary design options considered for the pointing control system design for the baseline spacecraft are summarized, and the design selected, which employs a target-referenced, inertially stabilized control system, is described in detail. The four basic modes of operation of the pointing control subsystem (target acquisition, inertial hold, target track and slew) are discussed as they relate to operations at Halley and Tempel-2. It is pointed that the pointing control system design represents a significant advance in the state of the art of pointing controls for planetary missions.

Time perception in patients with major depressive disorder during vagus nerve stimulation.

PubMed

Biermann, T; Kreil, S; Groemer, T W; Maihöfner, C; Richter-Schmiedinger, T; Kornhuber, J; Sperling, W

2011-07-01

Affective disorders may affect patients' time perception. Several studies have described time as a function of the frontal lobe. The activating eff ects of vagus nerve stimulation on the frontal lobe might also modulate time perception in patients with major depressive disorder (MDD). Time perception was investigated in 30 patients with MDD and in 7 patients with therapy-resistant MDD. In these 7 patients, a VNS system was implanted and time perception was assessed before and during stimulation. A time estimation task in which patients were asked "How many seconds have passed?" tested time perception at 4 defined time points (34 s, 77 s, 192 s and 230 s). The differences between the estimated and actual durations were calculated and used for subsequent analysis. Patients with MDD and healthy controls estimated the set time points relatively accurately. A general linear model revealed a significant main eff ect of group but not of age or sex. The passing of time was perceived as significantly slower in patients undergoing VNS compared to patients with MDD at all time points (T34: t = − 4.2; df = 35; p < 0.001; T77: t = − 4.8; df = 35; p < 0.001; T192: t = − 2.0; df = 35; p = 0.059; T230 t = −2.2; df = 35; p = 0.039) as well as compared to healthy controls (at only T77: t = 4.1; df = 35; p < 0.001). There were no differences in time perception with regard to age, sex or polarity of depression (uni- or bipolar). VNS is capable of changing the perception of time. This discovery furthers the basic research on circadian rhythms in patients with psychiatric disorders.

A supplemental video teaching tool enhances splinting skills.

PubMed

Mehrpour, Saeed Reza; Aghamirsalim, Mohamadreza; Motamedi, Seyed Mohammad Kalantar; Ardeshir Larijani, Fatemeh; Sorbi, Reza

2013-02-01

The ability to apply casts and splints is a technical skill that requires practice and understanding of basic principles of musculoskeletal medicine. A video in which a given procedure is simulated on a dummy can represent reality under controlled conditions. A decrease in physician competency in musculoskeletal medicine is the result of educational deficiencies at the medical school level. We asked whether (1) a supplemental video educational program enhances performance of medical students' musculoskeletal clinical skills and (2) factors such as the proportion of orthopaedic professors to students, sex, age, and previous scores of medical students affected the clinical skills of medical students. We allocated 474 medical students into one of two groups: all participants received 90 minutes of lecture instruction on how to splint and cast but one group viewed the supplemental instructional video and the other did not. There were no differences in terms of sex, age, basic science exam scores, or grade point average of the groups. Thirteen specific skills in splinting an injured limb were evaluated. We recorded grade point averages. We developed a 10-point scoring system and graded each student on their splinting skills 6 months after the lectures. The medical students who watched the video had an average score of 7.6, whereas the control group's average score was 2.0. We observed a positive association between watching the educational video and clinical exam score. A higher professor-to-student ratio was associated with lower student Objective Structured Clinical Examination score. Our observations suggest a supplemental video instructional program improved the performance of musculoskeletal clinical skills in comparison to only a traditional lecture series.

Facial asymmetry quantitative evaluation in oculoauriculovertebral spectrum.

PubMed

Manara, Renzo; Schifano, Giovanni; Brotto, Davide; Mardari, Rodica; Ghiselli, Sara; Gerunda, Antonio; Ghirotto, Cristina; Fusetti, Stefano; Piacentile, Katherine; Scienza, Renato; Ermani, Mario; Martini, Alessandro

2016-03-01

Facial asymmetries in oculoauriculovertebral spectrum (OAVS) patients might require surgical corrections that are mostly based on qualitative approach and surgeon's experience. The present study aimed to develop a quantitative 3D CT imaging-based procedure suitable for maxillo-facial surgery planning in OAVS patients. Thirteen OAVS patients (mean age 3.5 ± 4.0 years; range 0.2-14.2, 6 females) and 13 controls (mean age 7.1 ± 5.3 years; range 0.6-15.7, 5 females) who underwent head CT examination were retrospectively enrolled. Eight bilateral anatomical facial landmarks were defined on 3D CT images (porion, orbitale, most anterior point of frontozygomatic suture, most superior point of temporozygomatic suture, most posterior-lateral point of the maxilla, gonion, condylion, mental foramen) and distance from orthogonal planes (in millimeters) was used to evaluate the asymmetry on each axis and to calculate a global asymmetry index of each anatomical landmark. Mean asymmetry values and relative confidence intervals were obtained from the control group. OAVS patients showed 2.5 ± 1.8 landmarks above the confidence interval while considering the global asymmetry values; 12 patients (92%) showed at least one pathologically asymmetric landmark. Considering each axis, the mean number of pathologically asymmetric landmarks increased to 5.5 ± 2.6 (p = 0.002) and all patients presented at least one significant landmark asymmetry. Modern CT-based 3D reconstructions allow accurate assessment of facial bone asymmetries in patients affected by OAVS. The evaluation as a global score and in different orthogonal axes provides precise quantitative data suitable for maxillo-facial surgical planning. CT-based 3D reconstruction might allow a quantitative approach for planning and following-up maxillo-facial surgery in OAVS patients.

Enteral tube feeding of patients with acute stroke: when does the risk of diarrhoea increase?

PubMed

Arevalo-Manso, J J; Martinez-Sanchez, P; Juarez-Martin, B; Fuentes, B; Ruiz-Ares, G; Sanz-Cuesta, B E; Parrilla-Novo, P; Diez-Tejedor, E

2014-12-01

We aimed to evaluate the relationship between the length of time acute stroke patients underwent enteral tube feeding (ETF) and episodes of diarrhoea, and to investigate the temporal cut-off point at which diarrhoea risk increases. An observational, retrospective study was conducted on patients with acute stroke admitted to a Stroke Centre. Patients undergoing ETF (ETF group) and those not undergoing ETF (control group) were analysed and matched by age and stroke severity. Data regarding demographic and clinical variables were recorded. The analysis was conducted using a receiver operating characteristic (ROC) curve and multivariate analyses. A total of 130 inpatients was included (age 75.08 ± 11.53 years, 56.2% men). The ETF group had higher diarrhoea frequency (27.7% vs 6.2%, P = 0.001). The length of time on ETF was associated with diarrhoea development (odds ratio (OR), 1.12 increment per day; 95% confidence interval (CI) 1.05-1.18; P < 0.001), after adjusting for confounders. The ROC curve showed 7 days on ETF as a cut-off point for diarrhoea risk. Seven days or more on ETF was independently associated with diarrhoea (OR, 6.26; 95% CI 1.66-23.62; P = 0.007), whereas less than 7 days was not when compared with the control group (OR, 0.38; 95% CI 0.04-3.91; P = 0.413). The length of time on ETF is associated with diarrhoea development in patients with acute stroke, demonstrating a temporal cut-off point. Seven days or longer on ETF is related to the occurrence of diarrhoea, whereas less than 7 days on ETF does not show this effect. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

Nutrient intake and dietary changes during a 2-year multi-domain lifestyle intervention among older adults: secondary analysis of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) randomised controlled trial.

PubMed

Lehtisalo, Jenni; Ngandu, Tiia; Valve, Päivi; Antikainen, Riitta; Laatikainen, Tiina; Strandberg, Timo; Soininen, Hilkka; Tuomilehto, Jaakko; Kivipelto, Miia; Lindström, Jaana

2017-08-01

Advancing age increases the risk for diseases and health concerns like cognitive decline, constituting a major public health challenge. Lifestyle, especially healthy diet, affects many risk factors related to chronic diseases, and thus lifestyle interventions among older adults may be beneficial in promoting successful ageing. We completed a randomised 2-year multi-domain lifestyle intervention trial aiming at prevention of cognitive decline among 631 participants in the intervention and 629 in the control group, aged 60-77 years at baseline. Dietary counselling was one of the intervention domains together with strength exercise, cognitive training and management of CVD risk factors. The aim of this paper was to describe success of the intervention - that is, how an intervention based on national dietary recommendations affected dietary habits as a part of multi-intervention. Composite dietary intervention adherence score comprising nine distinct goals (range 0-9 points from none to achieving all goals) was 5·0 at baseline, and increased in the intervention group after the 1st (P<0·001) and 2nd (P=0·005) year. The difference in change compared with the control group was significant at both years (P<0·001 and P=0·018). Intake of several vitamins and minerals decreased in the control group but remained unchanged or increased in the intervention group during the 2 years. Well-targeted dietary counselling may prevent age-related decline in diet quality and help in preventing cognitive decline.

49 CFR 236.403 - Signals at controlled point.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Signals at controlled point. 236.403 Section 236..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Traffic Control Systems Standards § 236.403 Signals at controlled point. Signals at controlled point shall be so...

49 CFR 236.403 - Signals at controlled point.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Signals at controlled point. 236.403 Section 236..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Traffic Control Systems Standards § 236.403 Signals at controlled point. Signals at controlled point shall be so...

49 CFR 236.403 - Signals at controlled point.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Signals at controlled point. 236.403 Section 236..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Traffic Control Systems Standards § 236.403 Signals at controlled point. Signals at controlled point shall be so...

49 CFR 236.403 - Signals at controlled point.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Signals at controlled point. 236.403 Section 236..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Traffic Control Systems Standards § 236.403 Signals at controlled point. Signals at controlled point shall be so...

49 CFR 236.403 - Signals at controlled point.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Signals at controlled point. 236.403 Section 236..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Traffic Control Systems Standards § 236.403 Signals at controlled point. Signals at controlled point shall be so...

A Mind-Body Program for Older Adults With Chronic Low Back Pain: A Randomized Clinical Trial.

PubMed

Morone, Natalia E; Greco, Carol M; Moore, Charity G; Rollman, Bruce L; Lane, Bridget; Morrow, Lisa A; Glynn, Nancy W; Weiner, Debra K

2016-03-01

Treatment of chronic low back pain (LBP) in older adults is limited by the adverse effects of analgesics. Effective nonpharmacologic treatment options are needed. To determine the effectiveness of a mind-body program at increasing function and reducing pain in older adults with chronic LBP. This single-blind, randomized clinical trial compared a mind-body program (n = 140) with a health education program (n = 142). Community-dwelling older adults residing within the Pittsburgh metropolitan area were recruited from February 14, 2011, to June 30, 2014, with 6-month follow-up completed by April 9, 2015. Eligible participants were 65 years or older with functional limitations owing to their chronic LBP (≥11 points on the Roland and Morris Disability Questionnaire) and chronic pain (duration ≥3 months) of moderate intensity. Data were analyzed from March 1 to July 1, 2015. The intervention and control groups received an 8-week group program followed by 6 monthly sessions. The intervention was modeled on the Mindfulness-Based Stress Reduction program; the control program, on the "10 Keys" to Healthy Aging. Follow-up occurred at program completion and 6 months later. The score on the Roland and Morris Disability Questionnaire was the primary outcome and measured functional limitations owing to LBP. Pain (current, mean, and most severe in the past week) was measured with the Numeric Pain Rating Scale. Secondary outcomes included quality of life, pain self-efficacy, and mindfulness. Intent-to-treat analyses were conducted. Of 1160 persons who underwent screening, 282 participants enrolled in the trial (95 men [33.7%] and 187 women [66.3%]; mean [SD] age,74.5 [6.6] years). The baseline mean (SD) Roland and Morris Disability Questionnaire scores for the intervention and control groups were 15.6 (3.0) and 15.4 (3.0), respectively. Compared with the control group, intervention participants improved an additional -1.1 (mean, 12.1 vs 13.1) points at 8 weeks and -0.04 (mean, 12.2 vs 12.6) points at 6 months (effect sizes, -0.23 and -0.08, respectively) on the Roland and Morris Disability Questionnaire. By 6 months, the intervention participants improved on the Numeric Pain Rating Scale current and most severe pain measures an additional -1.8 points (95% CI, -3.1 to -0.05 points; effect size, -0.33) and -1.0 points (95% CI, -2.1 to 0.2 points; effect size, -0.19), respectively. The changes in Numeric Pain Rating Scale mean pain measure after the intervention were not significant (-0.1 [95% CI, -1.1 to 1.0] at 8 weeks and -1.1 [95% CI, -2.2 to -0.01] at 6 months; effect size, -0.01 and -0.22, respectively). A mind-body program for chronic LBP improved short-term function and long-term current and most severe pain. The functional improvement was not sustained, suggesting that future development of the intervention could focus on durability. clinicaltrials.gov Identifier: NCT01405716.

Primary and submovement control of aiming in C6 tetraplegics following posterior deltoid transfer

PubMed Central

2014-01-01

Background Upper limb motor control in fast, goal-directed aiming is altered in tetraplegics following posterior-deltoid musculotendinous transfer. Specifically, movements have similar end-point accuracy but longer duration and lower peak velocity than those of age-matched, neurotypical controls. Here, we examine in detail the interplay between primary movement and submovement phases in five C6 tetraplegic and five control participants. Methods Aiming movements were performed in two directions (20 cm away or toward), with or without vision. Trials that contained a submovement phase (i.e., discontinuity in velocity, acceleration or jerk) were identified. Discrete kinematic variables were then extracted on the primary and submovements phases. Results The presence of submovements did not differ between the tetraplegic (68%) and control (57%) groups, and almost all submovements resulted from acceleration and jerk discontinuities. Tetraplegics tended to make a smaller amplitude primary movement, which had lower peak velocity and greater spatial variability at peak velocity. This was followed by a larger amplitude and longer duration secondary submovement. Peak velocity of primary movement was not related to submovement incidence. Together, the primary and submovement phases of both groups were equally effective in reducing end-point error. Conclusions C6 tetraplegic participants exhibit some subtle differences in measures of motor behaviour compared to control participants, but importantly feedforward and feedback processes work effectively in combination to achieve accurate goal-directed aiming. PMID:25055852

Parent-child relationship disorders. Part I. Parental overprotection and the development of the Parent Protection Scale.

PubMed

Thomasgard, M; Metz, W P; Edelbrock, C; Shonkoff, J P

1995-08-01

There is a spectrum of parental protective behaviors promoting child safety and security, ranging from neglect to overprotection. This paper describes the development and psychometric properties of a new measure of parental protective behaviors toward children age 2 to 10 years, the Parent Protection Scale (PPS). Items were selected to represent key dimensions of protective behaviors. Factor analyses suggested four subscales: Supervision, Separation Problems, Dependence, and Control. The PPS has acceptable internal consistency, test-retest reliability, and clinical validity. Norms by child age in the form of cutoff points corresponding to +1 SD were determined. Clinical and research uses for the PPS are noted.

Prefrontal vulnerabilities and whole brain connectivity in aging and depression.

PubMed

Lamar, Melissa; Charlton, Rebecca A; Ajilore, Olusola; Zhang, Aifeng; Yang, Shaolin; Barrick, Thomas R; Rhodes, Emma; Kumar, Anand

2013-07-01

Studies exploring the underpinnings of age-related neurodegeneration suggest fronto-limbic alterations that are increasingly vulnerable in the presence of disease including late life depression. Less work has assessed the impact of this specific vulnerability on widespread brain circuitry. Seventy-nine older adults (healthy controls=45; late life depression=34) completed translational tasks shown in non-human primates to rely on fronto-limbic networks involving dorsolateral (Self-Ordered Pointing Task) or orbitofrontal (Object Alternation Task) cortices. A sub-sample of participants also completed diffusion tensor imaging for white matter tract quantification (uncinate and cingulum bundle; n=58) and whole brain tract-based spatial statistics (n=62). Despite task associations to specific white matter tracts across both groups, only healthy controls demonstrated significant correlations between widespread tract integrity and cognition. Thus, increasing Object Alternation Task errors were associated with decreasing fractional anisotropy in the uncinate in late life depression; however, only in healthy controls was the uncinate incorporated into a larger network of white matter vulnerability associating fractional anisotropy with Object Alternation Task errors using whole brain tract-based spatial statistics. It appears that the whole brain impact of specific fronto-limbic vulnerabilities in aging may be eclipsed in the presence of disease-specific neuropathology like that seen in late life depression. Copyright © 2013 Elsevier Ltd. All rights reserved.

Differential effects of bilingualism and culture on early attention: a longitudinal study in the U.S., Argentina, and Vietnam

PubMed Central

Tran, Crystal D.; Arredondo, Maria M.; Yoshida, Hanako

2015-01-01

A large body of literature suggests that bilingualism strongly influences attentional processes among a variety of age groups. Increasing studies, however, indicate that culture may also have measurable effects on attentional processes. Bilinguals are often exposed to multiple cultural backgrounds, therefore, it is unclear if being exposed to multiple languages and culture together influence attentional processes, or if the effect themselves are uniquely linked to different attentional processes. The present study explores the relevancy of different attentional processes—alerting, orienting, and executive control—to language and to culture. In the present study, 97 3-years-old (Mean age = 38.78 months) monolingual and bilingual children from three countries (the U.S., Argentina, and Vietnam) were longitudinally tested for a total of five time points on a commonly used non-linguistic attentional paradigm—the Attention Network Test. Results demonstrate that when other factors are controlled (e.g., socio-economic status, vocabulary knowledge, age), culture plays an important role on the development of the alerting and executive control attentional network, while language status was only significant on the executive control attentional network. The present study indicates that culture may interact with bilingualism to further explain previous reported advantages, as well as elucidate the increasing disparity surrounding cognitive advantages in bilingual literature. PMID:26150793

Executive attention impairment in first-episode schizophrenia

PubMed Central

2012-01-01

Background We compared the attention abilities of a group of first-episode schizophrenia (FES) patients and a group of healthy participants using the Attention Network Test (ANT), a standard procedure that estimates the functional state of three neural networks controlling the efficiency of three different attentional behaviors, i.e., alerting (achieving and maintaining a state of high sensitivity to incoming stimuli), orienting (ability to select information from sensory input), and executive attention (mechanisms for resolving conflict among thoughts, feelings, and actions). Methods We evaluated 22 FES patients from 17 to 29 years of age with a recent history of a single psychotic episode treated only with atypical neuroleptics, and 20 healthy persons matched with FES patients by sex, age, and educational level as the control group. Attention was estimated using the ANT in which participants indicate whether a central horizontal arrow is pointing to the left or the right. The central arrow may be preceded by spatial or temporal cues denoting where and when the arrow will appear, and may be flanked by other arrows (hereafter, flankers) pointing in the same or the opposite direction. Results The efficiency of the alerting, orienting, and executive networks was estimated by measuring how reaction time was influenced by congruency between temporal, spatial, and flanker cues. We found that the control group only demonstrated significantly greater attention efficiency than FES patients in the executive attention network. Conclusions FES patients are impaired in executive attention but not in alerting or orienting attention, suggesting that executive attention deficit may be a primary impairment during the progression of the disease. PMID:22998680

The influence of visual and tactile perception on hand control in children with Duchenne muscular dystrophy.

PubMed

Troise, Denise; Yoneyama, Simone; Resende, Maria Bernadette; Reed, Umbertina; Xavier, Gilberto Fernando; Hasue, Renata

2014-09-01

To investigate tactile perception and manual dexterity, with or without visual feedback, in males with Duchenne muscular dystrophy (DMD). Forty males with DMD (mean age 9 y 8 mo, SD 2 y 3 mo; range 5-14 y), recruited from the teaching hospital of the School of Medicine of the University of São Paulo, with disease severity graded as '1' to '6' on the Vignos Scale and '1' on Brooke's Scale, and 49 healthy males (mean age 8 y 2 mo; range 5-11 y; SD 1 y 11 mo), recruited from a local education center, participated in the study. We assessed tactile perception using two-point discrimination and stereognosis tests, and manual dexterity using the Pick-Up test with the eyes either open or closed. Analysis of variance was used to compare groups; a p value of less than 0.05 was considered statistically significant. Males with DMD exhibited no impairment in tactile perception, as measured by the two-point discrimination test and the number of objects correctly named in the stereognosis test. Manipulation during stereognosis was statistically slower with both hands (p<0.001), and manual dexterity was much worse in males with DMD when there was no visual feedback (p<0.001). Males with DMD exhibited disturbances in manipulation during stereognosis and dexterity tests. Hand control was highly dependent on visual information rather than on tactile perception. Motor dysfunction in males with DMD, therefore, might be related to altered neural control. © 2014 Mac Keith Press.

Can psychosocial work conditions protect against age-related cognitive decline? Results from a systematic review

PubMed Central

Nexø, Mette Andersen; Meng, Annette; Borg, Vilhelm

2016-01-01

According to the use it or lose it hypothesis, intellectually stimulating activities postpone age-related cognitive decline. A previous systematic review concluded that a high level of mental work demands and job control protected against cognitive decline. However, it did not distinguish between outcomes that were measured as cognitive function at one point in time or as cognitive decline. Our study aimed to systematically review which psychosocial working conditions were prospectively associated with high levels of cognitive function and/or changes in cognitive function over time. Articles were identified by a systematic literature search (MEDLINE, Web of Science (WOS), PsycNET, Occupational Safety and Health (OSH)). We included only studies with longitudinal designs examining the impact of psychosocial work conditions on outcomes defined as cognitive function or changes in cognitive function. Two independent reviewers compared title-abstract screenings, full-text screenings and quality assessment ratings. Eleven studies were included in the final synthesis and showed that high levels of mental work demands, occupational complexity or job control at one point in time were prospectively associated with higher levels of cognitive function in midlife or late life. However, the evidence to clarify whether these psychosocial factors also affected cognitive decline was insufficient, conflicting or weak. It remains speculative whether job control, job demands or occupational complexity can protect against cognitive decline. Future studies using methodological advancements can reveal whether workers gain more cognitive reserve in midlife and late life than the available evidence currently suggests. The public health implications of a previous review should thereby be redefined accordingly. PMID:27178844

White matter integrity and processing speed in sickle cell anemia.

PubMed

Stotesbury, Hanne; Kirkham, Fenella J; Kölbel, Melanie; Balfour, Philippa; Clayden, Jonathan D; Sahota, Sati; Sakaria, Simrat; Saunders, Dawn E; Howard, Jo; Kesse-Adu, Rachel; Inusa, Baba; Pelidis, Maria; Chakravorty, Subarna; Rees, David C; Awogbade, Moji; Wilkey, Olu; Layton, Mark; Clark, Christopher A; Kawadler, Jamie M

2018-05-11

The purpose of this retrospective cross-sectional study was to investigate whether changes in white matter integrity are related to slower processing speed in sickle cell anemia. Thirty-seven patients with silent cerebral infarction, 46 patients with normal MRI, and 32 sibling controls (age range 8-37 years) underwent cognitive assessment using the Wechsler scales and 3-tesla MRI. Tract-based spatial statistics analyses of diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) parameters were performed. Processing speed index (PSI) was lower in patients than controls by 9.34 points (95% confidence interval: 4.635-14.855, p = 0.0003). Full Scale IQ was lower by 4.14 scaled points (95% confidence interval: -1.066 to 9.551, p = 0.1), but this difference was abolished when PSI was included as a covariate ( p = 0.18). There were no differences in cognition between patients with and without silent cerebral infarction, and both groups had lower PSI than controls (both p < 0.001). In patients, arterial oxygen content, socioeconomic status, age, and male sex were identified as predictors of PSI, and correlations were found between PSI and DTI scalars (fractional anisotropy r = 0.614, p < 0.00001; r = -0.457, p < 0.00001; mean diffusivity r = -0.341, p = 0.0016; radial diffusivity r = -0.457, p < 0.00001) and NODDI parameters (intracellular volume fraction r = 0.364, p = 0.0007) in widespread regions. Our results extend previous reports of impairment that is independent of presence of infarction and may worsen with age. We identify processing speed as a vulnerable domain, with deficits potentially mediating difficulties across other domains, and provide evidence that reduced processing speed is related to the integrity of normal-appearing white matter using microstructure parameters from DTI and NODDI. Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Is diabetes a risk factor for a severe clinical presentation of dengue?--review and meta-analysis.

PubMed

Htun, Nan Shwe Nwe; Odermatt, Peter; Eze, Ikenna C; Boillat-Blanco, Noémie; D'Acremont, Valérie; Probst-Hensch, Nicole

2015-04-01

The mean age of acute dengue has undergone a shift towards older ages. This fact points towards the relevance of assessing the influence of age-related comorbidities, such as diabetes, on the clinical presentation of dengue episodes. Identification of factors associated with a severe presentation is of high relevance, because timely treatment is the most important intervention to avert complications and death. This review summarizes and evaluates the published evidence on the association between diabetes and the risk of a severe clinical presentation of dengue. A systematic literature review was conducted using the MEDLINE database to access any relevant association between dengue and diabetes. Five case-control studies (4 hospital-based, 1 population-based) compared the prevalence of diabetes (self-reported or abstracted from medical records) of persons with dengue (acute or past; controls) and patients with severe clinical manifestations. All except one study were conducted before 2009 and all studies collected information towards WHO 1997 classification system. The reported odds ratios were formally summarized by random-effects meta-analyses. A diagnosis of diabetes was associated with an increased risk for a severe clinical presentation of dengue (OR 1.75; 95% CI: 1.08-2.84, p = 0.022). Large prospective studies that systematically and objectively obtain relevant signs and symptoms of dengue fever episodes as well as of hyperglycemia in the past, and at the time of dengue diagnosis, are needed to properly address the effect of diabetes on the clinical presentation of an acute dengue fever episode. The currently available epidemiological evidence is very limited and only suggestive. The increasing global prevalence of both dengue and diabetes justifies further studies. At this point, confirmation of dengue infection as early as possible in diabetes patients with fever if living in dengue endemic regions seems justified. The presence of this co-morbidity may warrant closer observation for glycemic control and adapted fluid management to diminish the risk for a severe clinical presentation of dengue.

Evaluation of natural regulatory T cells in subjects with selective IgA deficiency: from senior idea to novel opportunities.

PubMed

Soheili, Habib; Abolhassani, Hassan; Arandi, Narges; Khazaei, Hossein Ali; Shahinpour, Shervin; Hirbod-Mobarakeh, Armin; Rezaei, Nima; Aghamohammadi, Asghar

2013-01-01

Selective IgA deficiency (SIgAD) is the most common primary immunodeficiency disorder, which is characterized by significantly decreased serum levels of IgA. Abnormalities of CD4+CD25(high)forkhead box P3 (FoxP3)+ regulatory T cells (T(reg)) have been shown in association with autoimmune and inflammatory disorders. In order to evaluate the relationship between autoimmunity and T(reg) in SIgAD, we studied 26 IgA-deficient patients (aged 4-17 years) with serum IgA levels <7 mg/dl, 26 age- and sex-matched healthy controls and 26 age- and sex matched idiopathic thrombocytopenic purpura cases with normal immune system. T(reg) were determined by flow cytometry using T(reg) markers, including CD4, CD25 and FoxP3. The mean percentage of CD4, CD25+FoxP3+ T(reg) from all CD4+ cells was 4.08 ± 0.86 in healthy controls, which was significantly higher than in SIgAD patients (2.93 ± 1.3; p = 0.003). We set a cutoff point (2.36%) for T(reg), which was two standard deviations lower than the mean of normal controls. According to this cutoff point and in order to assess the role of T(reg) in clinical SIgAD manifestation, we classified patients into two groups: 16 patients in G1 with T(reg) <2.36% and 10 patients in G2 with T(reg) >2.36%. Autoimmunity was recorded in 9 patients (53.3%) of G1 and only 1 patient of G2, respectively (p = 0.034). Although a defect in class switching recombination was observed in 40% of the patients in G1, none of the G2 patients had such a defect (p = 0.028). This study showed decreased proportions of T(reg) in SIgAD patients, particularly in those with signs of chronic inflammation. Copyright © 2012 S. Karger AG, Basel.

A new look at Togo through the eyes of a SLAR

NASA Technical Reports Server (NTRS)

Dellwig, L. F.

1980-01-01

Imaging of Togo in 1977 with SLAR provided the data required for the production of map controlled radar mosaics at a scale of 1:200,000 with 95 percent of all control points at that scale within + or - 4.0 millimeters of true positions. The moasics served as the base for the generation of a revised geologic map of Togo. Aided by two looks, numerous revisions resulted, not only with the addition of previously unknown structural features, a revision of age relationships, and the refinement of unit boundaries, but also with the repositioning of rock units and the reorientation of major faults.

A Longitudinal Study of Childhood ADHD and Substance Dependence Disorders in Early Adulthood

PubMed Central

Breyer, Jessie L.; Lee, Susanne; Winters, Ken; August, Gerald; Realmuto, George

2014-01-01

Attention-deficit/hyperactivity disorder (ADHD) is a childhood disorder that is associated with many behavioral and social problems. These problems may continue when an individual continues to meet criteria for ADHD as an adult. In this study, we describe the outcome patterns for three different groups: individuals who had ADHD as children, but no longer meet criteria as adults (Childhood-Limited ADHD, n = 71); individuals who met ADHD criteria as children and continue to meet criteria as young adults (Persistent ADHD n = 79); and a control group of individuals who did not meet ADHD diagnostic criteria in childhood or adulthood (n = 69). Groups were compared to examine differences in change in rates of alcohol, marijuana, and nicotine dependence over three time points in young adulthood (mean ages 18, 20 and 22 years). The method used is notable as this longitudinal study followed participants from childhood into young adulthood instead of relying on retrospective self-reports from adult participants. Results indicated that there were no significant group differences in change in rates of substance dependence over time. However, individuals whose ADHD persisted into adulthood were significantly more likely to meet DSM-IV criteria for alcohol, marijuana, and nicotine dependence across the three time points after controlling for age, sex, childhood stimulant medication use, and childhood conduct problems. Implications of these findings, as well as recommendations for future research, are discussed. PMID:24731117

Birth weight and cognitive ability in childhood among siblings and nonsiblings.

PubMed

Yang, Seungmi; Lynch, John; Susser, Ezra S; Lawlor, Debbie A

2008-08-01

The purpose of this work was to examine whether the positive association between birth weight and childhood cognitive ability is seen within siblings from the same family, as well as between nonsiblings, and to determine whether these associations vary with age. We compared the association of birth weight with cognitive ability measured at ages 5 to 6, 7 to 9, and 11 to 12 years among a total of 5402 children from different families with that among 2236 to 3083 sibships from the National Longitudinal Study of Youth 1979-Children. In the whole cohort, there were positive associations between birth weight and cognitive ability at all ages, with the association increasing with age from a 0.81-point increase at ages 5 to 6 years to 1.30 and 1.44 points at ages 7 to 9 and 11 to 12 years, respectively, per 1 SD of gestational age- and gender-adjusted birth weight z score. With adjustment for covariates, there was marked attenuation of these associations. Mean differences were 0.28 points in children aged 5 to 6 years, 0.67 points in those aged 7 to 9 years, and 0.52 points in those aged 11 to 12 years after adjusting for child's gender, race or ethnicity, year of birth, and age at test; maternal age, height, parity, education, smoking during pregnancy, and cognitive ability; and household income. Our family-based analyses that separated within- and between-family effects found that the between-family associations were much stronger than the within-family associations. However, adjustment for potential confounders attenuated the between-family associations, and there was no evidence for a difference in association comparing the between- and within-family associations. In these data, the positive association between birth weight and childhood cognitive ability at ages 5 to 12 years is explained largely by family characteristics rather than a specific intrauterine effect.

49 CFR 236.103 - Switch circuit controller or point detector.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Switch circuit controller or point detector. 236.103 Section 236.103 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL... controller or point detector. Switch circuit controller, circuit controller, or point detector operated by...

49 CFR 236.103 - Switch circuit controller or point detector.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Switch circuit controller or point detector. 236.103 Section 236.103 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL... controller or point detector. Switch circuit controller, circuit controller, or point detector operated by...

49 CFR 236.103 - Switch circuit controller or point detector.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Switch circuit controller or point detector. 236.103 Section 236.103 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL... controller or point detector. Switch circuit controller, circuit controller, or point detector operated by...

49 CFR 236.103 - Switch circuit controller or point detector.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Switch circuit controller or point detector. 236.103 Section 236.103 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL... controller or point detector. Switch circuit controller, circuit controller, or point detector operated by...

49 CFR 236.103 - Switch circuit controller or point detector.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Switch circuit controller or point detector. 236.103 Section 236.103 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL... controller or point detector. Switch circuit controller, circuit controller, or point detector operated by...

Attention parameters in visual search tasks in different age groups.

PubMed

Baranov-Krylov, I N; Kuznetsova, T G; Ratnikova, V K

2009-06-01

Attention processes were studied using a model based on visual searches for a specified element in grids of size 3 x 3 and 7 x 7 cm displayed on a monitor screen. Five age groups took part in the experimental studies: children of five and seven years, a group of 15-year-old adolescents, a group aged 20-35 years, and a group aged over 60 years; a total of 62 subjects took part. Statistical analysis showed that the latter three groups were not different from each other and were used as an adult control group for comparison with results from children. Five types of search were used: one difficult, in which the target was similar to the distractors, and four easy (for adults but not for children), involving seeking a red or a white element in an empty grid and seeking a target markedly different in shape or color from the distractors. The following measures were analyzed: search time, errors (false alarms and misses), and corrected search times allowing for errors. Children performed significantly worse on all measures: they found all types of search difficult, even the search for a single element. The larger number of false alarms (reactions to nonmeaningful signals) was evidence for a deficiency of inhibitory processes in children, these being controlled by the frontal lobes. The larger number of misses in children may be evidence of weakness of selective attention, which is controlled by the parietal and temporal areas of the cortex. These points may indicate that children have an immature attention system, though this would appear to mature completely by age 15 years.

Behavioral Adjustment of Toddler and Preschool-Aged Children with Single-Suture Craniosynostosis*

PubMed Central

Kapp-Simon, Kathleen A; Collett, Brent R; Barr-Schinzel, Michael A; Cradock, Mary M; Buono, Lauren A; Pietila, Kristen E; Speltz, Matthew L

2012-01-01

Background The purpose of this study was to confirm initial reports of elevated behavior problems in children with single-suture craniosynostosis (SSC), using multiple informants, longitudinal analyses and a control group. We hypothesized higher levels of maladjustment for children with SSC than comparison children, particularly at the older age and in selected areas of previously observed vulnerability: attention and social adjustment. Method A Child Behavior Checklist (CBCL) was completed when children were ~19 months by 436 mothers (219 with SSC) and 371 fathers (177 with SSC); and at ~37 months by 361 mothers (175 with SSC) and 303 fathers (142 with SSC). A minimum of one caregiver/teacher report was available for 169 of these children (74 with SSC) using the Caregiver-Teacher Report Form (CTRF). Results Average CBCL/CTRF externalizing, internalizing and total scores for all informants were consistently higher (worse) for children with SSC than control group children, but most differences were small and statistically non-significant. No differences associated with suture site were found. At the oldest age point, both mothers and fathers (but not teachers) generated higher average scores for patients than for controls on scales measuring attention and social problems, with small to medium effects sizes (0.20 to 0.32). Conclusion On average toddlers/preschoolers with SSC show behavioral development that is largely indistinguishable from same-aged peers of similar socioeconomic background. The predictive significance of small group differences in attention and social adjustment will be assessed in a follow-up of this cohort at age 7. PMID:22929249

Parkinson disease and musculoskeletal pain: an 8-year population-based cohort study.

PubMed

Lien, Wei-Hung; Lien, Wei-Chih; Kuan, Ta-Shen; Wu, Shang-Te; Chen, Yi-Ting; Chiu, Ching-Ju

2017-07-01

The aim of this study was to evaluate the incidence and clinical features of musculoskeletal pain (MSP) in patients with Parkinson disease (PD) compared with a control group without the disease. The retrospective cohort study used a subset of the Taiwan National Health Insurance Research Database (NHIRD) comprising information on 1 million beneficiaries randomly sampled from the entire population of Taiwan. A total of 490 patients aged 50 and above with newly diagnosed Parkinson disease were identified during a period from 2000 to 2005. Among them, 199 developed MSP after PD. The control group consisted of 1960 participants without PD over the study period randomly selected by matching PD cases according to the date of PD incidence, age, and sex. The study groups were then followed to the end of 2007. Musculoskeletal pain was the end point. The incidence rate ratios of MSP were higher in the PD group than in the control group, representing an adjusted hazard ratio of 1.31 (95% confidence interval 1.09 to 1.58). PD was associated with a significantly elevated risk of MSP in all sex and age stratifications, with the highest hazard ratio noted for middle-aged male patients with PD, followed by older male patients with PD. This study showed that the PD may significantly increase the risk of developing MSP. The risk of developing MSP seems to be greatest for middle-aged male patients with PD. Clinicians should be more alert for MSP in patients with PD, and early intervention should be considered.

Risk of mild head injury in preschool children: relationship to attention deficit hyperactivity disorder symptoms.

PubMed

Altun, Hatice; Altun, İdiris

2018-04-25

To investigate whether there is an association between mild head injury (MHI) and attention deficit hyperactivity disorder (ADHD) symptoms in preschool children. The study included a patient group of 30 children aged 3-6 years with mild head trauma and a control group of 30 healthy and age- and sex-matched children. The symptoms of ADHD were evaluated using the Conners' Parent Rating Scale-Revised Long (CPRS-RL) form. The mean age was 4.73 ± 1.13 years in the patient group and 4.65 ± 0.99 years in the control group. No significant differences were determined between the groups in terms of age, gender, parents' age and education (p > 0.05). The total subscale points as reported by the parents of the children with MHI were significantly higher than those for the control group in terms of the following subscales: oppositional, cognitive problems/inattention, hyperactivity, social problems, ADHD index, Conners' Global Index (CGI)-Irritability-Impulsiveness, CGI-Emotional Lability, CGI-Total and DSM-IV ADHD symptoms (p < 0.05). A history of previous trauma treated in emergency services was determined in eight of the 30 patients (26.7%). The findings of this study suggest that preschool children with MHI have more pre-injury ADHD symptoms and oppositional and emotional-behavioural symptoms than healthy children without trauma. Clinicians should screen children with MHI for ADHD symptoms and refer them for treatment when necessary. Evaluation of children presenting with MHI by a child psychiatrist may prevent repetition of injuries.

Effect of one anesthetic exposure on long-term behavioral changes in children.

PubMed

Chemaly, Maen; El-Rajab, Mariam A; Ziade, Fouad M; Naja, Zoher M

2014-11-01

To determine the association between one anesthetic exposure and behavioral outcome at age 10 to 12 years. Retrospective comparative study. University-affiliated pediatrics department. The medical records of children who underwent anesthesia between January 2004 and December 2005 at our institution were reviewed. The records of 292 children were included in the study group and 300 children in the control group. The study group involved children who had one anesthetic exposure before age of 4 years and the control group had children who were not exposed to anesthesia. The primary outcome was behavioral change as assessed by the Eyberg Child Behavior Inventory (ECBI) questionnaire. The rate of behavioral abnormalities before the age of 11 years was 28.4% in the study group (P<0.001) and 5.7% in the control group. The risk of developing behavioral abnormalities was prominent in children being exposed to surgery versus those exposed during a diagnostic procedure (32.4% vs 4.8%; P<0.0001). Eighty-three point nine percent of the children who were exposed to longer duration anesthesia (more than 3 hrs) had behavioral abnormalities (P<0.0001), while 48.8% of children who received anesthesia at younger ages (0 - 6 mos) had behavioral abnormalities (P<0.0001). Exposure to multiple anesthetic agents versus one anesthetic agent was a significant risk factor for development of behavioral abnormalities (P<0.0001). The incidence of behavioral abnormalities increased when anesthesia and surgery were accompanied by younger age, longer duration of surgery, and use of multiple anesthetic agents. Copyright © 2014 Elsevier Inc. All rights reserved.

Movie smoking and urge to smoke among adult smokers.

PubMed

Sargent, James D; Morgenstern, Matthis; Isensee, Barbara; Hanewinkel, Reiner

2009-09-01

Few studies have assessed the association between exposure to movie smoking and urge to smoke under real-world conditions. We conducted exit interviews with 4,073 movie patrons, of whom 2,817 were aged 18 years or older. Some 536 were smokers and had complete data. Subjects had exited 26 movies, of which 12 contained smoking. We used least squares regression to assess the association between exposure to movie smoking and urge to smoke (scale range 0-10), controlling for movie rating, age, sex, heaviness of smoking index (HSI, range 0-6), and time since last cigarette smoked. Median age was 27 years and 52% were female. Median urge to smoke level at movie exit was 7. The dose-response between higher categories of movie smoking and median urge to smoke was one point for two lower categories (1-11 and 11-54 s) and two for the highest category (>or=55 s), but these differences were not statistically significant. In the multivariate analysis, attendance of a movie with smoking was associated with a 0.81-point increase (95% CI = 0.46-1.16) in urge to smoke. For comparison, an HSI score of 3 (vs. 0) was associated with a 2-point increase in urge to smoke. In this sample of adult smokers, exposure to movie smoking was associated with higher urge to smoke after the movie, independent of movie rating. The effect size was consistent with responses seen in cue reactivity experiments. Exposure to movie smoking may affect urge to smoke among adult smokers.

Movie smoking and urge to smoke among adult smokers

PubMed Central

Sargent, James D.; Morgenstern, Matthis; Isensee, Barbara

2009-01-01

Introduction Few studies have assessed the association between exposure to movie smoking and urge to smoke under real-world conditions. Methods We conducted exit interviews with 4,073 movie patrons, of whom 2,817 were aged 18 years or older. Some 536 were smokers and had complete data. Subjects had exited 26 movies, of which 12 contained smoking. We used least squares regression to assess the association between exposure to movie smoking and urge to smoke (scale range 0–10), controlling for movie rating, age, sex, heaviness of smoking index (HSI, range 0–6), and time since last cigarette smoked. Results Median age was 27 years and 52% were female. Median urge to smoke level at movie exit was 7. The dose–response between higher categories of movie smoking and median urge to smoke was one point for two lower categories (1–11 and 11–54 s) and two for the highest category (≥55 s), but these differences were not statistically significant. In the multivariate analysis, attendance of a movie with smoking was associated with a 0.81-point increase (95% CI = 0.46–1.16) in urge to smoke. For comparison, an HSI score of 3 (vs. 0) was associated with a 2-point increase in urge to smoke. Discussion In this sample of adult smokers, exposure to movie smoking was associated with higher urge to smoke after the movie, independent of movie rating. The effect size was consistent with responses seen in cue reactivity experiments. Exposure to movie smoking may affect urge to smoke among adult smokers. PMID:19542516

Return-to-Sport and Performance After Anterior Cruciate Ligament Reconstruction in National Basketball Association Players.

PubMed

Harris, Joshua D; Erickson, Brandon J; Bach, Bernard R; Abrams, Geoffrey D; Cvetanovich, Gregory L; Forsythe, Brian; McCormick, Frank M; Gupta, Anil K; Cole, Brian J

2013-11-01

Anterior cruciate ligament (ACL) rupture is a significant injury in National Basketball Association (NBA) players. NBA players undergoing ACL reconstruction (ACLR) have high rates of return to sport (RTS), with RTS the season following surgery, no difference in performance between pre- and postsurgery, and no difference in RTS rate or performance between cases (ACLR) and controls (no ACL tear). Case-control. NBA players undergoing ACLR were evaluated. Matched controls for age, body mass index (BMI), position, and NBA experience were selected during the same years as those undergoing ACLR. RTS and performance were compared between cases and controls. Paired-sample Student t tests, chi-square, and linear regression analyses were performed for comparison of within- and between-group variables. Fifty-eight NBA players underwent ACLR while in the NBA. Mean player age was 25.7 ± 3.5 years. Forty percent of ACL tears occurred in the fourth quarter. Fifty players (86%) RTS in the NBA, and 7 players (12%) RTS in the International Basketball Federation (FIBA) or D-league. Ninety-eight percent of players RTS in the NBA the season following ACLR (11.6 ± 4.1 months from injury). Two players (3.1%) required revision ACLR. Career length following ACLR was 4.3 ± 3.4 years. Performance upon RTS following surgery declined significantly (P < 0.05) regarding games per season; minutes, points, and rebounds per game; and field goal percentage. However, following the index year, controls' performances declined significantly in games per season; points, rebounds, assists, blocks, and steals per game; and field goal and free throw percentage. Other than games per season, there was no significant difference between cases and controls. There is a high RTS rate in the NBA following ACLR. Nearly all players RTS the season following surgery. Performance significantly declined from preinjury level; however, this was not significantly different from controls. ACL re-tear rate was low. There is a high RTS rate in the NBA after ACLR, with no difference in performance upon RTS compared with controls.

When can I go home? A prospective case control study to improve communication with patients regarding their diagnosis, treatment plan and likely discharge date.

PubMed

Murphy, David; Crowley, Rebecca; Spencer, Anthony; Birch, Mark

2015-04-17

This study aimed to improve our ability to communicate with patients with regard to four key issues. Their diagnosis, treatment plan, clinical criteria for discharge and estimated discharge date. This was a prospective case control study. It involved 200 general medical patients admitted to Christchurch Public Hospital. Each day there were two general medical admitting teams. One team formed the control group and the other team the intervention group. The 100 patients in the control group had their consultant ward round as normal. The 100 patients in the intervention group had a consultant ward round and were provided with additional written information answering the following four points: (1) their diagnosis (2) management plan for the day (3) clinical criteria for discharge and (4) estimated date of discharge. This was a laminated sheet that remained attached to their bedside locker. At four or more hours after the ward round every new patient would undergo a questionnaire based interview addressing their ability to correctly answer the points listed above. A comparison was then made between the intervention and control groups. A subgroup (n=30) were selected to obtain feedback on the initiative. 90% of respondents from the intervention group knew their diagnosis versus 59% of the control group (p<0.01). 76% knew their treatment plan for the day versus 41% (p<0.01). 76% knew some of the clinical criteria for safe discharge versus 25% (p<0.01) and 83% of the intervention group knew their estimated discharge date versus 52% of the control group (p<0.01). The median age of the patients in the intervention group was 78 years of age and 74 for the control group (p>0.05). Of those that gave feedback 70% believed the intervention was helpful in helping them understand their diagnosis and 70% believed knowing their likely discharge date was useful. The use of a card with written information for the patient regarding their diagnosis, treatment plan, clinical criteria for safe discharge and estimated discharge date at the bedside helped improve the patients understanding of their care and aided effective communication.

21 CFR 123.6 - Hazard analysis and Hazard Analysis Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2013 CFR

2013-04-01

... identified food safety hazards, including as appropriate: (i) Critical control points designed to control... control points designed to control food safety hazards introduced outside the processing plant environment... Control Point (HACCP) plan. 123.6 Section 123.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF...

21 CFR 123.6 - Hazard analysis and Hazard Analysis Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... identified food safety hazards, including as appropriate: (i) Critical control points designed to control... control points designed to control food safety hazards introduced outside the processing plant environment... Control Point (HACCP) plan. 123.6 Section 123.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF...

21 CFR 123.6 - Hazard analysis and Hazard Analysis Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2014 CFR

2014-04-01

... identified food safety hazards, including as appropriate: (i) Critical control points designed to control... control points designed to control food safety hazards introduced outside the processing plant environment... Control Point (HACCP) plan. 123.6 Section 123.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF...

Trends in mouth cancer incidence in Mumbai, India (1995-2009): An age-period-cohort analysis.

PubMed

Shridhar, Krithiga; Rajaraman, Preetha; Koyande, Shravani; Parikh, Purvish M; Chaturvedi, Pankaj; Dhillon, Preet K; Dikshit, Rajesh P

2016-06-01

Despite tobacco control and health promotion efforts, the incidence rates of mouth cancer are increasing across most regions in India. Analysing the influence of age, time period and birth cohort on these secular trends can point towards underlying factors and help identify high-risk populations for improved cancer control programmes. We evaluated secular changes in mouth cancer incidence among men and women aged 25-74 years in Mumbai between 1995 and 2009 by calculating age-specific and age-standardized incidence rates (ASR). We estimated the age-adjusted linear trend for annual percent change (EAPC) using the drift parameter, and conducted an age-period-cohort (APC) analysis to quantify recent time trends and to evaluate the significance of birth cohort and calendar period effects. Over the 15-year period, age-standardized incidence rates of mouth cancer in men in Mumbai increased by 2.7% annually (95% CI:1.9 to 3.4), p<0.0001) while rates among women decreased (EAPC=-0.01% (95% CI:-0.02 to -0.002), p=0.03). APC analysis revealed significant non-linear positive period and cohort effects in men, with higher effects among younger men (25-49 years). Non-significant increasing trends were observed in younger women (25-49 years). APC analyses from the Mumbai cancer registry indicate a significant linear increase of mouth cancer incidence from 1995 to 2009 in men, which was driven by younger men aged 25-49 years, and a non-significant upward trend in similarly aged younger women. Health promotion efforts should more effectively target younger cohorts. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effects of personality on self-rated health in a 1-year randomized controlled trial of chronic illness self-management

PubMed Central

Jerant, Anthony; Chapman, Benjamin; Duberstein, Paul; Franks, Peter

2010-01-01

Objective Personality factors moderate self-efficacy enhancing effects of some illness self-management interventions, but their influence on self-rated health is unclear This study examined whether high neuroticism and low conscientiousness, extraversion, and agreeableness (the distressed personality profile) moderated the effects of the homing in on health (HIOH) illness self-management intervention on mental and physical health status. Design Analysis of data from 384 subjects completing a randomized controlled trial of HIOH. Methods Regression analyses examined effects of NEO-five factor inventory scores on SF-36 mental component summary (MCS-36) and physical component summar (PCS-36) scores (baseline; 2, 4, and 6 weeks; 6 months; 1 year), adjusting for age gender, and study group. Results Baseline MCS-36 scores were worse in those with the distressed personality profile relative to others: high neuroticism (13.3 points worse, 95% confidence interval (CI) = 11.0, 15.7) and low conscientiousness (6.6 points worse, 95% CI = 4.1, 9.2), extraversion (10.1 points worse, 95% CI = 7.7, 12.5) and agreeableness (4.2 points worse, 95% CI = 1.6, 6.8). Intervention subjects had better MCS-36 scores at 4 and 6 weeks, and benefits were confined to participants with low conscientiousness (4 weeks – 3.7 points better, 95% CI = 0.2, 71; 6 weeks – 5.0 points better, 95% CI = 1.57, 8.4). There were no intervention or personality effects on PCS-36 scores. Conclusions Chronically ill self-management intervention recipients with the distressed personality profile had worse self-rated mental health, and conscientiousness moderated the short-term effects of the intervention on self-rated mental health. Measuring personality may help identify individuals more likely to benefit from self-management interventions. PMID:19594988

A Novel Technique to Measure In Vivo Uterine Suspensory Ligament Stiffness

PubMed Central

Smith, Tovia M.; Luo, Jiajia; Hsu, Yvonne; Ashton-Miller, James A.; Delancey, John O.L.

2013-01-01

Objective To describe a new computer-controlled research apparatus for measuring in vivo uterine ligament force-displacement behavior and stiffness and to present pilot data in women with and without prolapse. Study Design Seventeen women with varying uterine support underwent testing in the operating room (OR) after anesthetic induction. A tripod-mounted computer-controlled linear servoactuator was used to quantify force-displacement behavior of the cervix and supporting ligaments. The servoactuator applied a caudally-directed force to a tenaculum at 4 mm/s velocity until the traction force reached 17.8N (4 lbs.). Cervix location on POP-Q in clinic, in the OR at rest, and with minimal force (<1.1N), and maximum force (17.8N) was recorded. Ligament “stiffness” between minimum and maximum force was calculated. Results The mean (SD) subject age was 54.5 (12.7) years, parity 2.9 (1.1), BMI 29.0 (4.3) kg/m2, and POP-Q point C −3.1 (3.9) cm. POP-Q point C was most strongly correlated with cervix location at maximum force (r=+0.68, p=.003) and at rest (r=+0.62, p=.009). Associations between cervix location at minimum force (r=+0.46, p=.059) and ligament stiffness (r= −0.44,p=.079) were not statistically significant. Cervix location in the OR with minimal traction lay below the lowest point found on POP-Q for 13 women. Conclusions POP-Q point C was strongly correlated with cervix location at rest and at maximum traction force; however only 19% of the variation in POP-Q point C location was explained by ligament stiffness. The cervix location in the OR at minimal traction lay below POP-Q point C value in ¾ of women. PMID:23747493

Reducing environmental tobacco smoke exposure of preschool children: a randomized controlled trial of class-based health education and smoking cessation counseling for caregivers.

PubMed

Wang, Yun; Huang, Zhiqiang; Yang, Mei; Wang, Fuzhi; Xiao, Shuiyuan

2015-01-13

To assess counseling to caregivers and classroom health education interventions to reduce environmental tobacco smoke exposure of children aged 5-6 years in China. In a randomized controlled trial in two preschools in Changsha, China, 65 children aged 5-6 years old and their smoker caregivers (65) were randomly assigned to intervention (n = 33) and control (no intervention) groups (n = 32). In the intervention group, caregivers received self-help materials and smoking cessation counseling from a trained counselor, while their children were given classroom-based participatory health education. Children's urinary cotinine level and the point prevalence of caregiver quitting were measured at baseline and after 6 months. At the 6-month follow-up, children's urinary cotinine was significantly lower (Z = -3.136; p = 0.002) and caregivers' 7-day quit rate was significantly higher (34.4% versus 0%) (p < 0.001; adjusted OR = 1.13; 95% CI: 1.02-1.26) in the intervention than control group. Helping caregivers quitting smoke combined with classroom-based health education was effective in reducing children's environmental tobacco smoke exposure. Larger-scale trials are warranted.

Aging: Molecular Pathways and Implications on the Cardiovascular System.

PubMed

de Almeida, Arthur José Pontes Oliveira; Ribeiro, Thaís Porto; de Medeiros, Isac Almeida

2017-01-01

The world's population over 60 years is growing rapidly, reaching 22% of the global population in the next decades. Despite the increase in global longevity, individual healthspan needs to follow this growth. Several diseases have their prevalence increased by age, such as cardiovascular diseases, the leading cause of morbidity and mortality worldwide. Understanding the aging biology mechanisms is fundamental to the pursuit of cardiovascular health. In this way, aging is characterized by a gradual decline in physiological functions, involving the increased number in senescent cells into the body. Several pathways lead to senescence, including oxidative stress and persistent inflammation, as well as energy failure such as mitochondrial dysfunction and deregulated autophagy, being ROS, AMPK, SIRTs, mTOR, IGF-1, and p53 key regulators of the metabolic control, connecting aging to the pathways which drive towards diseases. In addition, senescence can be induced by cellular replication, which resulted from telomere shortening. Taken together, it is possible to draw a common pathway unifying aging to cardiovascular diseases, and the central point of this process, senescence, can be the target for new therapies, which may result in the healthspan matching the lifespan.

Microsurgeons do better--tactile training might prevent the age-dependent decline of the sensibility of the hand.

PubMed

Schmauss, Daniel; Megerle, Kai; Weinzierl, Andrea; Agua, Kariem; Cerny, Michael; Schmauss, Verena; Lohmeyer, Joern A; Machens, Hans-Guenther; Erne, Holger

2015-12-01

Recent data demonstrate that the normal sensibility of the hand seems to be age-dependent with the best values in the third decade and a consecutive deterioration afterwards. However, it is not clear if long-term tactile training might prevent this age-dependent decline. We evaluated sensibility of the hand in 125 surgeons aged between 26 and 75 years who perform microsurgical operations, thereby undergoing regular tactile training. We examined sensibility of the radial digital nerve of the index finger (N3) and the ulnar digital nerve of the small finger (N10) using static and moving two-point discrimination (2PD) tests and compared the results to 154 age-matched individuals without specific long-term tactile training. We found significantly lower static and moving 2PD values for the sixth, seventh, and eighth decade of life in the microsurgery group compared to the control group (p < 0.05). This study demonstrates that long-term tactile training might prevent the known age-dependent decline of the sensibility of the hand. © 2015 Peripheral Nerve Society.

Basilar artery angulation in association with aging and pontine lacunar infarction: a multicenter observational study.

PubMed

Jeong, Seul-Ki; Lee, Ju-Hee; Nam, Do-Hyun; Kim, Joon-Tae; Ha, Yeon Soo; Oh, Sun-Young; Park, Se-Hyoung; Lee, Sang Hyuk; Hur, Nahmkeon; Kwak, Hyo-Sung; Chung, Gyung-Ho

2015-01-01

Deep pontine lacunar infarction (DPLI) not involving the basal pial surface of the medial part of the pons, is known to be a small vessel disease in the territory of the basilar artery (BA). In the present study, we examined whether morphological features of the BA differ in individuals with an advanced age and may be associated with DPLI. This study included 338 healthy subjects and 78 patients with DPLI treated at the stroke centers of three university hospitals in Korea. Time-Of-Flight magnetic resonance angiographic images were transported to a central lab and analyzed blind to obtain the clinical data. For the quantitative analysis, the BA was projected two-dimensionally in the anteroposterior and lateral views and perceived as triangles of the vertebrobasilar junction, angulation point and BA division. The angles and triangular areas were summated into angulation indexes and used to quantify the degree of BA tortuosity. The BA showed a more acute angle at the angulation point in the elderly patients than in the healthy subjects. Compared to the healthy subjects, the DPLI patients exhibited significantly larger angles at the vertebrobasilar junction, in addition to the acute angles noted at the angulation point. A unit increase in the BA angle indexes at the vertebrobasilar junction and angulation points for DPLI was found to have an odds ratio of 1.15 (95% confidence interval, 1.05-1.26) and 0.95 (95% CI, 0.91-0.99), respectively, even after adjusting for potential confounders. The angulation point of the BA becomes more acute in elderly individuals. In this study, the vertebrobasilar junction showed a larger angle in the patients with DPLI than in the healthy controls.

Parental knowledge and metabolic control of children and young adults with type 1 diabetes

PubMed Central

Mysliwiec, Malgorzata; Adamkiewicz-Drozynska, Elzbieta

2016-01-01

Introduction The authors aimed to answer the following questions: 1) What level of knowledge of type 1 diabetes do the parents of children and young adults with this disease have? 2) Will this level of knowledge increase after 1 year of observation? 3) Does improving the knowledge of young adults and their parents result in better metabolic control of the patients? Material and methods This study included 227 patients between the ages of 5 and 20 years with type 1 diabetes. The research was conducted from March 2009 to June 2011. The following two time points were examined: the beginning of the study (test 1a) and one year later (test 1b). The knowledge levels of the patients and parents were obtained using a survey and a knowledge test. Results Comparison of the results from the two study time points showed that the respondents had a significantly higher level of knowledge after 1 year (p = 0.001). The comparison of glycated hemoglobin levels between the two time points in patients with type 1 diabetes revealed that the levels were significantly higher at test 1b compared to test 1a (p = 0.0005). Conclusions The parents of children and young adults with type 1 diabetes demonstrate a satisfactory level of theoretical knowledge of therapeutic conduct and self-monitoring principles. The test 1b results demonstrated a higher level of theoretical knowledge in all respondents and poorer metabolic control. Poorer metabolic control in some patients suggests that metabolic control in type 1 diabetes depends on factors other than education. Further research is necessary to determine these additional factors. PMID:29379532

Control of oral malodour by dentifrices measured by gas chromatography.

PubMed

Newby, Evelyn E; Hickling, Jenneth M; Hughes, Francis J; Proskin, Howard M; Bosma, Marylynn P

2008-04-01

To evaluate the effect of toothpaste treatments on levels of oral volatile sulphur compounds (VSCs) measured by gas chromatography in two clinical studies. These were blinded, randomised, controlled, crossover studies with 16 (study A) or 20 (study B) healthy volunteers between the ages of 19-54. Study A: breath samples were collected at baseline, immediately and lhr after brushing. Four dentifrices (Zinc A, Zinc B, commercially available triclosan dentifrice and zinc free control) were evaluated. Study B: breath samples were collected at baseline, immediately, 1, 2, 3 and 7 hours after treatment. Subjects consumed a light breakfast then provided an additional breath sample between baseline assessment and treatment. Two dentifrices (gel-to-foam and a commercially available triclosan dentrifrice) were evaluated. Breath samples were collected in syringes and analysed for VSCs (hydrogen sulphide, methyl mercaptan and Total VSCs) utilising gas chromatography (GC) with flame photometric detection. Study A: immediately after treatment, a statistically significant reduction in VSCs from baseline was observed for Zinc A product only. A statistically significant reduction in VSCs from baseline was observed after 1 hour for all products. Both zinc products exhibited a significantly greater reduction from baseline VSCs than Colgate Total and Control at all time points. Study B: a statistically significant reduction in VSCs from baseline was observed at all time points for both products. The gel-to-foam product exhibited significantly greater reduction from baseline Total VSC concentration than Colgate Total at all time points from 1 hour post-treatment. Control of oral malodour by toothpaste treatment, evaluated as VSC levels using GC, has been demonstrated. Zinc is effective at reducing VSCs and the efficacy of zinc is formulation dependent. A gel-to-foam dentifrice was more effective at reducing VSCs than Colgate Total up to 7 hours.

Cognitive remediation therapy (CRT) in a specialist inpatient eating disorder service for children and adolescents: CAN-CRT study protocol for a pilot randomised controlled trial.

PubMed

Giombini, Lucia; Nesbitt, Sophie; Cox, Hannah; Foxall, Anna; Sharia, Teo; Easter, Abigail; Tchanturia, Kate

2018-03-26

Research on treatments for young people (YP) with anorexia nervosa (AN) is scarce. Evidence supports the use of cognitive remediation therapy (CRT) to improve central coherence and set-shifting, inefficiencies that can negatively impact on prognosis. The study aims to evaluate the feasibility of individual CRT in an inpatient setting for YP aged 10-18 years with AN and to qualitatively examine YP's and their parents experiences. In a single-centre, pilot, randomised controlled trial, 80 patients aged 10-18 years with AN will be randomly allocated to the immediate or delayed CRT group, in addition to standard treatment. A repeated measures design will be conducted across 3 time points. The data will provide evidence regarding the feasibility of individual CRT in YP with AN, informing directions of further development of CRT. The study is in preparation for a definitive randomised controlled trial. The aim of this manuscript is to describe the study protocol. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.

Early thyroxine treatment in Down syndrome and thyroid function later in life.

PubMed

Zwaveling-Soonawala, Nitash; Witteveen, M Emma; Marchal, Jan Pieter; Klouwer, Femke C C; Ikelaar, Nadine A; Smets, Anne M J B; van Rijn, Rick R; Endert, Erik; Fliers, Eric; van Trotsenburg, A S Paul

2017-05-01

The hypothalamus-pituitary-thyroid (HPT) axis set point develops during the fetal period and first two years of life. We hypothesized that thyroxine treatment during these first two years, in the context of a randomized controlled trial (RCT) in children with Down syndrome, may have influenced the HPT axis set point and may also have influenced the development of Down syndrome-associated autoimmune thyroiditis. We included 123 children with Down syndrome 8.7 years after the end of an RCT comparing thyroxine treatment vs placebo and performed thyroid function tests and thyroid ultrasound. We analyzed TSH and FT4 concentrations in the subgroup of 71 children who were currently not on thyroid medication and had no evidence of autoimmune thyroiditis. TSH concentrations did not differ, but FT4 was significantly higher in the thyroxine-treated group than that in the placebo group (14.1 vs 13.0 pmol/L; P  = 0.02). There was an increase in anti-TPO positivity, from 1% at age 12 months to 6% at age 24 months and 25% at age 10.7 years with a greater percentage of children with anti-TPO positivity in the placebo group (32%) compared with the thyroxine-treated group (18.5%) ( P  = 0.12). Thyroid volume at age 10.7 years (mean: 3.4 mL; range: 0.5-7.5 mL) was significantly lower ( P  < 0.01) compared with reference values (5.5 mL; range: 3-9 mL) and was similar in the thyroxine and placebo group. Thyroxine treatment during the first two years of life led to a mild increase in FT4 almost 9 years later on and may point to an interesting new mechanism influencing the maturing HPT axis set point. Furthermore, there was a trend toward less development of thyroid autoimmunity in the thyroxine treatment group, suggesting a protective effect of the early thyroxine treatment. Lastly, thyroid volume was low possibly reflecting Down-specific thyroid hypoplasia. © 2017 European Society of Endocrinology.

A pilot randomised clinical trial of physiotherapy (manual therapy, exercise, and education) for early-onset hip osteoarthritis post-hip arthroscopy.

PubMed

Kemp, Joanne; Moore, Kate; Fransen, Marlene; Russell, Trevor; Freke, Matthew; Crossley, Kay M

2018-01-01

Despite the increasing use of hip arthroscopy for hip pain, there is no level 1 evidence to support physiotherapy rehabilitation programs following this procedure. The aims of this study were to determine (i) what is the feasibility of a randomised controlled trial (RCT) investigating a targeted physiotherapy intervention for early-onset hip osteoarthritis (OA) post-hip arthroscopy? and (ii) what are the within-group treatment effects of the physiotherapy intervention and a health-education control group? This study was a pilot single-blind RCT conducted in a private physiotherapy clinic in Hobart, Australia. Patients included 17 volunteers (nine women; age 32 ± 8 years; body mass index = 25.6 ± 5.1 kg/m 2 ) who were recruited 4-14 months post-hip arthroscopy, with chondropathy and/or labral pathology at the time of surgery. Interventions included a physiotherapy treatment program that was semi-standardised and consisted of (i) manual therapy; (ii) hip strengthening and functional retraining; and (iii) health education. Control treatment encompassed individualised health education sessions. The primary outcome measure was feasibility, which was reported as percentage of eligible participants enrolled, adherence with the intervention, and losses to follow-up. The research process was evaluated using interviews, and an estimated sample size for a definitive study is offered. Secondary outcomes included the Hip disability and Osteoarthritis Outcome Score (HOOS) and the International Hip Outcome Tool (IHOT-33) patient-reported outcomes. Seventeen out of 48 eligible patients (35%) were randomised. Adherence to the intervention was 100%, with no losses to follow-up. The estimated sample size for a full-scale RCT was 142 patients. The within-group (95% confidence intervals) change scores for the physiotherapy group were HOOS-Symptoms 6 points (-4 to 16); HOOS-Pain 10 points (-2 to 22); HOOS-Activity of Daily Living 8 points (0 to 16); HOOS-Sport 3 points (-12 to 19); HOOS-Quality of Life 3 points (-7 to 13); and IHOT-33 7 points (-10 to 25). The within-group (95% confidence intervals) change scores for the control group were HOOS-Symptoms -4 points (-17 to 9); HOOS-Pain -2 points (-18 to 13); HOOS-Activity of Daily Living -7 points (-17 to 4); HOOS-Sport 4 points (-16 to 23); HOOS-Quality of Life -5 points (-18 to 9); and IHOT-33 -4 points (-27 to 19). Suggestions to improve study design included greater supervision of exercises and increased access to physiotherapy appointments. Results support the feasibility of a full-scale RCT, and recommendations for an adequately powered and improved study to determine the efficacy of this physiotherapy intervention post-hip arthroscopy to reduce pain and improve function are provided. Australian Clinical Trials Registry, ACTRN12614000426684.

NutrimiRAging: Micromanaging Nutrient Sensing Pathways through Nutrition to Promote Healthy Aging.

PubMed

Micó, Víctor; Berninches, Laura; Tapia, Javier; Daimiel, Lidia

2017-04-26

Current sociodemographic predictions point to a demographic shift in developed and developing countries that will result in an unprecedented increase of the elderly population. This will be accompanied by an increase in age-related conditions that will strongly impair human health and quality of life. For this reason, aging is a major concern worldwide. Healthy aging depends on a combination of individual genetic factors and external environmental factors. Diet has been proved to be a powerful tool to modulate aging and caloric restriction has emerged as a valuable intervention in this regard. However, many questions about how a controlled caloric restriction intervention affects aging-related processes are still unanswered. Nutrient sensing pathways become deregulated with age and lose effectiveness with age. These pathways are a link between diet and aging. Thus, fully understanding this link is a mandatory step before bringing caloric restriction into practice. MicroRNAs have emerged as important regulators of cellular functions and can be modified by diet. Some microRNAs target genes encoding proteins and enzymes belonging to the nutrient sensing pathways and, therefore, may play key roles in the modulation of the aging process. In this review, we aimed to show the relationship between diet, nutrient sensing pathways and microRNAs in the context of aging.

Codon 219 polymorphism of PRNP in healthy caucasians and Creutzfeldt-Jakob disease patients

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

Petraroli, R.; Pocchiari, M.

1996-04-01

A number of point and insert mutations of the PrP gene (PRNP) have been linked to familial Creutzfeldt-Jakob disease (CJD) and Gerstmann-Straussler-Scheinker disease (GSS). Moreover, the methionine/valine homozygosity at the polymorphic codon 129 of PRNP may cause a predisposition to sporadic and iatrogenic CJD or may control the age at onset of familial cases carrying either the 144-bp insertion or codon 178, codon 198, and codon 210 pathogenic mutations in PRNP. In addition, the association of methionine or valine at codon 129 and the point mutation at codon 178 on the same allele seem to play an important role inmore » determining either fatal familial insomnia or CJD. However, it is noteworthy that a relationship between codon 129 polymorphism and accelerated pathogenesis (early age at onset or shorter duration of the disease) has not been seen in familial CJD patients with codon 200 mutation or in GSS patients with codon 102 mutation, arguing that other, as yet unidentified, gene products or environmental factors, or both, may influence the clinical expression of these diseases. 17 refs.« less

[Attention deficit and understanding of non-literal meanings: the interpretation of indirect speech acts and idioms].

PubMed

Crespo, N; Manghi, D; García, G; Cáceres, P

To report on the oral comprehension of the non-literal meanings of indirect speech acts and idioms in everyday speech by children with attention deficit hyperactivity disorder (ADHD). The subjects in this study consisted of a sample of 29 Chilean schoolchildren aged between 6 and 13 with ADHD and a control group of children without ADHD sharing similar socio-demographic characteristics. A quantitative method was utilised: comprehension was measured individually by means of an interactive instrument. The children listened to a dialogue taken from a cartoon series that included indirect speech acts and idioms and they had to choose one of the three options they were given: literal, non-literal or distracter. The children without ADHD identified the non-literal meaning more often, especially in idioms. Likewise, it should be pointed out that whereas the children without ADHD increased their scores as their ages went up, those with ADHD remained at the same point. ADHD not only interferes in the inferential comprehension of non-literal meanings but also inhibits the development of this skill in subjects affected by it.

Unpacking the associations between heterogeneous externalising symptom development and academic attainment in middle childhood.

PubMed

Patalay, Praveetha; Fink, Elian; Fonagy, Peter; Deighton, Jessica

2016-05-01

This study explores children's externalising symptom development pathways between 8 and 11 years of age (three time points across 2 years) and examines their sociodemographic correlates and associations with change in academic attainment. Externalising symptoms were assessed for 5485 children across three consecutive years (M age = 8.7 years, SD = 0.30 at time 1). National standardised test scores served as an index of academic attainment. Using latent class growth analysis, six distinct trajectories of externalising symptom development were identified. Children who showed increasing externalising symptomatology across the three time points were more likely to be male or have special educational needs. These derived trajectories differentially predicted children's subsequent academic attainment (controlling for earlier attainment). Children with increasing externalising symptomatology were significantly more likely to demonstrate negative change in academic achievement compared with children with consistently low externalising problems. The study helps to clarify the longitudinal association between externalising symptom development and academic attainment, and highlights the importance of early intervention for children with increasing externalising symptoms across middle childhood.

Does postponement of first pregnancy increase gender differences in sickness absence? A register based analysis of Norwegian employees in 1993-2007.

PubMed

Ariansen, Anja M S; Mykletun, Arnstein

2014-01-01

From 1970-2012, the average age at first delivery increased from 23.2-28.5 in Norway. Postponement of first pregnancy increases risks of medical complications both during and after pregnancy. Sickness absence during pregnancy has over the last two decades increased considerably more than in non-pregnant women. The aim of this paper is twofold: Firstly to investigate if postponement of pregnancy is related to increased sickness absence and thus contributing to the increased gender difference in sickness absence; and secondly, to estimate how much of the increased gender difference in sickness absence that can be accounted for by increased sickness absence amongst pregnant women. We employed registry-data to analyse sickness absence among all Norwegian employees with income equivalent to full-time work in the period 1993-2007. After control for age, education, and income, pregnant women's sickness absence (age 20-44) increased on average 0.94 percentage points each year, compared to 0.29 in non-pregnant women and 0.14 in men. In pregnant women aged 20-24, sickness absence during pregnancy increased by 0.96 percent points per calendar year, compared to 0.60 in age-group 30-34. Sickness absence during pregnancy accounted for 25% of the increased gender gap in sickness absence, accounting for changes in education, income and age. Postponement of first pregnancy does not explain the increase in pregnant women's sickness absence during the period 1993-2007 as both the highest level and increase in sickness absence is seen in the younger women. Reasons are poorly understood, but still important as it accounts for 25% of the increased gender gap in sickness absence.

Does Postponement of First Pregnancy Increase Gender Differences in Sickness Absence? A Register Based Analysis of Norwegian Employees in 1993–2007

PubMed Central

Ariansen, Anja M. S.; Mykletun, Arnstein

2014-01-01

Background From 1970–2012, the average age at first delivery increased from 23.2–28.5 in Norway. Postponement of first pregnancy increases risks of medical complications both during and after pregnancy. Sickness absence during pregnancy has over the last two decades increased considerably more than in non-pregnant women. The aim of this paper is twofold: Firstly to investigate if postponement of pregnancy is related to increased sickness absence and thus contributing to the increased gender difference in sickness absence; and secondly, to estimate how much of the increased gender difference in sickness absence that can be accounted for by increased sickness absence amongst pregnant women. Methods We employed registry-data to analyse sickness absence among all Norwegian employees with income equivalent to full-time work in the period 1993–2007. Results After control for age, education, and income, pregnant women's sickness absence (age 20–44) increased on average 0.94 percentage points each year, compared to 0.29 in non-pregnant women and 0.14 in men. In pregnant women aged 20–24, sickness absence during pregnancy increased by 0.96 percent points per calendar year, compared to 0.60 in age-group 30–34. Sickness absence during pregnancy accounted for 25% of the increased gender gap in sickness absence, accounting for changes in education, income and age. Conclusions Postponement of first pregnancy does not explain the increase in pregnant women's sickness absence during the period 1993–2007 as both the highest level and increase in sickness absence is seen in the younger women. Reasons are poorly understood, but still important as it accounts for 25% of the increased gender gap in sickness absence. PMID:24667483

A quantitative comparison of Soil Development in four climatic regimes

USGS Publications Warehouse

Harden, J.W.; Taylor, E.M.

1983-01-01

A new quantitative Soil Development Index based on field data has been applied to chronosequences formed under different climatic regimes. The four soil chronosequences, developed primarily on sandy deposits, have some numeric age control and are located in xeric-inland (Merced, Calif.), xeric-coastal (Ventura, Calif.), aridic (Las Cruces, N. Mex.), and udic (Susquehanna Valley, Pa.) soil-moisture regimes. To quantify field properties, points are assigned for developmental increases in soil properties in comparison to the parent material. Currently ten soil-field properties are quantified and normalized for each horizon in a given chronosequence, including two new properties for carbonate-rich soils in addition to the eight properties previously defined. When individual properties or the combined indexes are plotted as a function of numeric age, rates of soil development can be compared in different climates. The results demonstrate that (1) the Soil Development Index can be applied to very different soil types, (2) many field properties develop systematically in different climatic regimes, (3) certain properties appear to have similar rates of development in different climates, and (4) the Profile Index that combines different field properties increases significantly with age and appears to develop at similar rates in different climates. The Soil Development Index can serve as a preliminary guide to soil age where other age control is lacking and can be used to correlate deposits of different geographical and climatic regions. ?? 1983.

Musical practice and cognitive aging: two cross-sectional studies point to phonemic fluency as a potential candidate for a use-dependent adaptation.

PubMed

Fauvel, Baptiste; Groussard, Mathilde; Mutlu, Justine; Arenaza-Urquijo, Eider M; Eustache, Francis; Desgranges, Béatrice; Platel, Hervé

2014-01-01

Because of permanent use-dependent brain plasticity, all lifelong individuals' experiences are believed to influence the cognitive aging quality. In older individuals, both former and current musical practices have been associated with better verbal skills, visual memory, processing speed, and planning function. This work sought for an interaction between musical practice and cognitive aging by comparing musician and non-musician individuals for two lifetime periods (middle and late adulthood). Long-term memory, auditory-verbal short-term memory, processing speed, non-verbal reasoning, and verbal fluencies were assessed. In Study 1, measures of processing speed and auditory-verbal short-term memory were significantly better performed by musicians compared with controls, but both groups displayed the same age-related differences. For verbal fluencies, musicians scored higher than controls and displayed different age effects. In Study 2, we found that lifetime period at training onset (childhood vs. adulthood) was associated with phonemic, but not semantic, fluency performances (musicians who had started to practice in adulthood did not perform better on phonemic fluency than non-musicians). Current frequency of training did not account for musicians' scores on either of these two measures. These patterns of results are discussed by setting the hypothesis of a transformative effect of musical practice against a non-causal explanation.

Socioeconomic position, psychosocial work environment and disability in an ageing workforce: a longitudinal analysis of SHARE data from 11 European countries.

PubMed

Reinhardt, Jan D; Wahrendorf, Morten; Siegrist, Johannes

2013-03-01

Prevention of disability in the ageing workforce is essential for sustaining economic growth in Europe. In order to provide information on entry points for preventive measures, it is important to better understand sociodemographic, socioeconomic and work-related determinants of disability in older employees. We aimed to test the hypothesis that low socioeconomic position and exposure to a stressful psychosocial work environment at baseline contribute to later disability. We further assumed that the association of socioeconomic position with disability is partly mediated by exposure to adverse working conditions. We studied longitudinal data from the first two waves of the Survey on Health, Ageing and Retirement in Europe comprising 11 European countries. Sociodemographic, socioeconomic and work-related factors (low control, effort-reward imbalance) and baseline disability of 2665 male and 2209 female employees aged between 50 and 64 years were used to predict disability 2 years later. Following the International Classification of Functioning (ICF), disability was subdivided into the components 'impairment' and 'restriction in activities and participation'. Two multilevel Poisson regressions were fitted to the data. After adjusting for baseline disability and relevant confounding variables, low socioeconomic position and chronic stress at work exerted significant effects on disability scores 2 years later. We found some support for the hypothesis that the association of socioeconomic position with disability is partly mediated by work stress. Investing in reduction of work stress and reducing social inequalities in health functioning are relevant entry points of policies that aim at maintaining work ability in early old age.

Hyperglycosylated hCG and Placenta Accreta Spectrum.

PubMed

Einerson, Brett D; Straubhar, Alli; Soisson, Sean; Szczotka, Kathryn; Dodson, Mark K; Silver, Robert M; Soisson, Andrew P

2018-02-28

 We aimed to evaluate the relationship between hyperglycosylated human chorionic gonadotropin (hCG-H) and placenta accreta spectrum (PAS) in the second and third trimesters of pregnancy.  This was a case-control study of PAS and controls. hCG-H was measured in the second and third trimesters of pregnancy in women with pathologically confirmed cases of PAS and in gestational age-matched controls without PAS. We compared serum hCG-H levels in cases and controls, calculated summary statistics for diagnostic accuracy, and used receiver operating characteristic (ROC) curves to define an optimal cut-point for diagnosis of PAS using hCG-H.  Thirty case samples and 30 control samples were evaluated for hCG-H. Mean hCG-H was lower in the case compared with control group (7.8 ± 5.9 μg/L vs. 11.8 ± 8.8 μg/L, p  = 0.03). At an optimal cut-point for hCG-H of ≤7.6 μg/L, the sensitivity, specificity, positive likelihood ratios, negative likelihood ratios, and area under the ROC curve were 66.7%, 69.7%, 2.20%, 0.48%, and 0.68%, respectively.  Hyperglycosylated hCG levels in the second and third trimesters of pregnancy were lower in patients with PAS than in controls, but hCG-H showed only modest capability as a diagnostic test for PAS. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Relationship between fatigue, perfectionism, and functional dysphonia.

PubMed

O'Hara, James; Miller, Tracey; Carding, Paul; Wilson, Janet; Deary, Vincent

2011-06-01

Increased levels of fatigue and perfectionism were noted during evaluation of cognitive behavioral therapy for the treatment of functional dysphonia. The investigators thus aimed to explore levels of general fatigue and perfectionism in patients with functional dysphonia and controls. Case-control study. Teaching hospital, United Kingdom. Patients recruited through speech therapy were asked to recruit a friend as a control, of the same sex and within 5 years of their age. An 11-point fatigue questionnaire, previously validated on a normal population, was analyzed using both Likert (0123) and bimodal (0011) systems, with a score greater than 4 on the bimodal system implying substantial fatigue. A 35-point perfectionism questionnaire was also completed and analyzed for "healthy" and "unhealthy" perfectionist traits. There were 75 cases and 62 controls. The mean fatigue score in patients with functional dysphonia was 17.0 and 14.4 for the controls (Likert, P = .009). Under the bimodal scoring system, the mean fatigue scores in functional dysphonia (5.10) and controls (3.01) were also significantly different (P = .003). The mean perfectionism scores were 98.9 for patients with functional dysphonia and 91.2 for controls (P = 0.043). To the investigators' knowledge, this is the first substantial report that fatigue and perfectionism scores are significantly elevated in functional dysphonia. Functional dysphonia is shown to be analogous to other medically unexplained physical symptoms that are also marked by generic somatopsychic distress and for which multiple factors are implicated in their onset and maintenance. This has implications for both research and treatment.

Relation between biochemical severity and intelligence in early treated congenital hypothyroidism: a threshold effect.

PubMed Central

Tillotson, S. L.; Fuggle, P. W.; Smith, I.; Ades, A. E.; Grant, D. B.

1994-01-01

OBJECTIVES--To assess whether early treatment of congenital hypothyroidism fully prevents intellectual impairment. DESIGN--A national register of children with congenital hypothyroidism who were compared with unaffected children from the same school classes and matched for age, sex, social class, and first language. SETTING--First three years (1982-4) of a neonatal screening programme in England, Wales, and Northern Ireland. SUBJECTS--361 children with congenital hypothyroidism given early treatment and 315 control children. MAIN OUTCOME MEASURES--Intelligence quotient (IQ) measured at school entry at 5 years of age with the Wechsler preschool and primary scale of intelligence. RESULTS--There was a discontinuous relation between IQ and plasma thyroxine concentration at diagnosis, with a threshold at 42.8 nmol/l (95% confidence interval 35.2 to 47.1 nmol/l). Hypothyroid children with thyroxine values below 42.8 nmol/l had a mean IQ 10.3 points (6.9 to 13.7 points) lower than those with higher values and than controls. None of the measures of quality of treatment (age at start of treatment (range 1-173 days), average thyroxine dose (12-76 micrograms in the first year), average thyroxine concentration during treatment (79-234 nmol/l in the first year), and thyroxine concentration less than 103 nmol/l at least once during the first year) influenced IQ at age 5. CONCLUSIONS--Despite early treatment in congenital hypothyroidism the disease severity has a threshold effect on brain development, probably determined prenatally. The 55% of infants with more severe disease continue to show clinically significant intellectual impairment; infants with milder disease show no such impairment. The findings predict that 10% of early treated infants with severe hypothyroidism, compared with around 40% of those who presented with symptoms in the period before screening began, are likely to require special education. PMID:7920127

Leukocyte telomere length and personality: associations with the Big Five and Type D personality traits.

PubMed

Schoormans, D; Verhoeven, J E; Denollet, J; van de Poll-Franse, L; Penninx, B W J H

2018-04-01

Backgrounds Accelerated cellular ageing, which can be examined by telomere length (TL), may be an overarching mechanism underlying the association between personality and adverse health outcomes. This 6-year longitudinal study examined the relation between personality and leukocyte telomere length (LTL) across time among adults with a wide age-range. Data from the Netherlands Study of Depression and Anxiety were used and included patients with a depression and/or anxiety disorder and healthy controls. Overall, 2936 persons (18-65 years, 66% female) had data on LTL at baseline and 1883 persons had LTL at 6-year follow-up. The Big Five personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness) and Type D personality were assessed. Neuroticism was negatively (B = -2.11, p = 0.03) and agreeableness was positively (B = 3.84, p = 0.03) related to LTL measured across two time points, which became just non-significant after adjusting for somatic health, lifestyle factors, and recent life stress (B = -1.99, p = 0.06; and B = 3.01, p = 0.10). Type D personality was negatively (B = -50.16, p < 0.01) related to LTL across two time points, which still remained statistically significant after full adjustment (B = -47.37, p = 0.01). Associations did not differ by age, gender, and current psychiatric status. The Big Five traits high neuroticism and low agreeableness, and Type D personality were associated with shorter LTL measured across a 6-year period. Associations with the Big Five traits became non-significant after controlling for somatic health, lifestyle factors, and recent life stress, yet similar trends were observed. Type D personality remained independently associated with shorter LTL after full adjustment.

[Cut-off point of epicardial adipose tissue thickness for predicting metabolic syndrome in Venezuelan population].

PubMed

Lima-Martínez, Marcos M; Paoli, Mariela; Donis, José H; Odreman, Rodolfo; Torres, Christopher; Iacobellis, Gianluca

2013-12-01

To define an echocardiographically-assessed cut-off point for epicardial adipose tissue (EAT) thickness associated to metabolic syndrome (MS) components in Venezuelan subjects. Fifty-two subjects aged 20-65 years diagnosed with MS according to International Diabetes Federation criteria and 45 sex- and age-matched controls were selected. Blood glucose and plasma lipids were tested; EAT thickness and left ventricular mass were measured by echocardiography. No significant age and sex differences were found between the two groups. Body weight, body mass index, waist circumference, and systolic and diastolic blood pressure were significantly higher (P=.0001) in the MS group. This group showed significantly higher levels of fasting blood glucose (P=.0001), total cholesterol (P=.002), LDL-C (P=.007), non-HDL-C (P=.0001), triglycerides (P=.0001), Tg-HDL-C ratio (P=.0001), and lower HDL-C levels (P=.0001) as compared to the control group. EAT thickness (P=.0001) and left ventricular mass (P=.017) were significantly higher in the MS group. The ROC curve showed an AUC of 0.852 (P=.0001) with a power of the test of 0.99. A 5-mm EAT thickness showed a sensitivity of 84.62% (95%CI: 71.9-93.1) and a specificity of 71.11% (95%CI: 55.7-83.6) for predicting MS. The odds ratio of this population for experiencing MS due to an EAT ≥ 5 mm was 8.25 (95%CI: 3.15-21.56; P=.0001). An EAT value ≥ 5 mm has good sensitivity and specificity for predicting MS in the Venezuelan population. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

Tobacco Use Among Students Aged 13-15 Years in South Korea: The 2013 Global Youth Tobacco Survey

PubMed Central

Kim, Yoonjung; Lee, Jihye; Kashiwabara, Mina

2017-01-01

Objectives We examined the prevalence of tobacco use and exposure to secondhand smoke among middle-school students in Korea using the Global Youth Tobacco Survey (GYTS) in 2013. Methods The GYTS in Korea was conducted between July and August 2013 by the Korea Centers for Disease Control and Prevention. Data were collected using a self-administered anonymous questionnaire from a nationally representative sample of middle-school students aged 13-15 years in sampled classrooms. Results The GYTS in Korea was completed by 4235 students aged 13-15 years in 43 middle schools. Approximately one in five of the students (17.8%) reported that they had tried cigarettes in the past, while 5.2% reported currently being cigarette smokers. Current cigarette smoking was higher in boys (7.5%) than in girls (2.6%). Of the students, 29.7% had been exposed to secondhand smoke at home, 47.4% inside enclosed public places, and 53.9% in outdoor public places. Of the current cigarette smokers, 25.7% bought their cigarettes from a store despite a law prohibiting this. Additionally, 58.0% of students noticed point-of-sale tobacco advertisements or promotions, 66.8% of current cigarette smokers wanted to stop smoking, and 70.9% of students had been taught about the dangers of tobacco use in school. Conclusions These findings provide an opportunity to develop, implement, and evaluate a comprehensive tobacco control policy. The results suggest that youth have relatively easy access to cigarettes and are regularly exposed to secondhand smoke in public places, as well as to point-of-sale tobacco advertisements and promotions. Strict enforcement of the ban on tobacco sales to youth, expanding smoke-free areas, and advertising bans are needed to reduce tobacco use among youth. PMID:28173685

Childhood Self-Control and Unemployment Throughout the Life Span

PubMed Central

Delaney, Liam; Egan, Mark; Baumeister, Roy F.

2015-01-01

The capacity for self-control may underlie successful labor-force entry and job retention, particularly in times of economic uncertainty. Analyzing unemployment data from two nationally representative British cohorts (N = 16,780), we found that low self-control in childhood was associated with the emergence and persistence of unemployment across four decades. On average, a 1-SD increase in self-control was associated with a reduction in the probability of unemployment of 1.4 percentage points after adjustment for intelligence, social class, and gender. From labor-market entry to middle age, individuals with low self-control experienced 1.6 times as many months of unemployment as those with high self-control. Analysis of monthly unemployment data before and during the 1980s recession showed that individuals with low self-control experienced the greatest increases in unemployment during the recession. Our results underscore the critical role of self-control in shaping life-span trajectories of occupational success and in affecting how macroeconomic conditions affect unemployment levels in the population. PMID:25870404

Elevated levels of neural recognition molecule L1 in the cerebrospinal fluid of patients with Alzheimer disease and other dementia syndromes.

PubMed

Strekalova, Helen; Buhmann, Carsten; Kleene, Ralf; Eggers, Christian; Saffell, Jane; Hemperly, John; Weiller, Cornelius; Müller-Thomsen, Tomas; Schachner, Melitta

2006-01-01

In this study we surveyed a total of 218 cerebrospinal fluid (CSF) samples from patients with different neurological diseases including Alzheimer disease, non-Alzheimer forms of dementia, other neurodegenerative diseases without dementia and normal controls to quantitate by capture ELISA the concentrations of the immunoglobulin superfamily adhesion molecules L1 and NCAM, and characterized by immunoblot analysis the molecular forms of L1 and NCAM. We found a significant increase of L1 and a strong tendency for increase of the soluble fragments of NCAM in the CSF of Alzheimer patients compared to the normal control group. The proteolytic fragments of L1, but not NCAM were also elevated in patients with vascular dementia and dementia of mixed type. Higher L1 concentrations were observed irrespective of age and gender. NCAM concentrations were independent of gender, but positively correlated with age and, surprisingly, also with incidence of multiple sclerosis. Thus, there was an influence of Alzheimer and non-Alzheimer dementias and neurodegeneration on L1, whereas age and neurodegeneration influenced NCAM concentrations. These observations point to an abnormal processing and/or shedding of L1 and NCAM in dementia-related neurodegeneration and age, respectively, reflecting changes in adhesion molecule-related cell interactions.

Effects of regular exercise on asthma control in young adults.

PubMed

Heikkinen, Sirpa A M; Mäkikyrö, Elina M S; Hugg, Timo T; Jaakkola, Maritta S; Jaakkola, Jouni J K

2017-08-28

According to our systematic literature review, no previous study has assessed potential effects of regular exercise on asthma control among young adults. We hypothesized that regular exercise improves asthma control among young adults. We studied 162 subjects with current asthma recruited from a population-based cohort study of 1,623 young adults 20-27 years of age. Asthma control was assessed by the occurrence of asthma-related symptoms, including wheezing, shortness of breath, cough, and phlegm production, during the past 12 months. Asthma symptom score was calculated based on reported frequencies of these symptoms (range: 0-12). Exercise was assessed as hours/week. In Poisson regression, adjusting for gender, age, smoking, environmental tobacco smoke exposure, and education, the asthma symptom score reduced by 0.09 points per 1 hour of exercise/week (95% CI: 0.00 to 0.17). Applying the "Low exercise" quartile as the reference, "Medium exercise" reduced the asthma symptom score by 0.66 (-0.39 to 1.72), and "High exercise" reduced it significantly by 1.13 (0.03 to 2.22). The effect was strongest among overweight subjects. Our results provide new evidence that regular exercising among young adults improves their asthma control. Thus, advising about exercise should be included as an important part of asthma self-management in clinical practice.

Intertester and intratester reliability of a movement control test battery for patients with knee osteoarthritis and controls

PubMed Central

Kaukinen, P.T.; Arokoski, J.P.; Huber, E.O.; Luomajoki, H.A.

2017-01-01

Objectives: To develop a test battery of movement control (MC) tests and assess its intertester and intratester reliability. Methods: 29 subjects with knee OA with mean age of 64.7 (SD 8.7) years and 12 controls without either knee pain or previous diagnosis of OA (mean age 36.6 (SD 16.2) years) were included. Two experienced physiotherapists rated the filmed test performance of six MC tests blinded to the patients and to each other on 3-point scale as correct, incorrect or failed. Weighted kappa coefficient (wK) with 95% confidence interval (95%CI) and the percentage of agreement were calculated for each test. Results: One-leg stance, one-leg squat 30 degrees and step down tests showed moderate to excellent inter- and intratester reliability with wK ranging between 0.43-0.85 for intertester and 0.51-0.80 for intratester reliability. The reliability of the 90 degrees squat test, small squat and step up tests was poor (wK ranging between 0.09-0.50). Conclusions: One-leg stance test, one-leg squat 30 degrees and step down test are reliable in the subjects with knee OA and controls. Further studies are needed to evaluate the discriminative validity of the reliable tests. PMID:28860422

Frontal lobe morphometry with MRI in a normal age group of 6-17 year-olds.

PubMed

Ilkay Koşar, M; Otağ, Ilhan; Sabancıoğulları, Vedat; Atalar, Mehmet; Tetiker, Hasan; Otağ, Aynur; Cimen, Mehmet

2012-12-01

Morphometric data of the frontal lobe are important for surgical planning of lesions in the frontal lobe and its surroundings. Magnetic resonance imaging (MRI) techniques provide suitable data for this purpose. In our study, the morphometric data of mid-sagittal MRI of the frontal lobe in certain age and gender groups of children have been presented. In a normal age group of 6-17-year-old participants, the length of the line passing through predetermined different points, including the frontal pole (FP), commissura anterior (AC), commissura posterior (PC), the outermost point of corpus callosum genu (AGCC), the innermost point of corpus callosum genu (IGCC), tuberculum sella (TS), AGCC and IGCC points parallel to AC-PC line and the point such line crosses at the frontal lobe surface (FCS) were measured in three age groups (6-9, 10-13 and 14-17 years) for each gender. The frontal lobe morphometric data were higher in males than females. Frontal lobe measurements peak at the age group of 10-13 in the male and at the age group of 6-13 in the female. In boys, the length of FP-AC increases 4.1% in the 10-13 age group compared with the 6-9-year-old group, while this increase is 2.3% in girls. Differences in age and gender groups were determined. While the length of AGCC-IGCC increases 10.4% in adults, in children aged 6-17, the length of AC-PC is 11.5% greater than adults. These data will contribute to the preliminary assessment for developing a surgical plan in fine interventions in the frontal lobe and its surroundings in children.

Racial and ethnic differences in cognitive function among older adults in the USA

PubMed Central

Díaz-Venegas, Carlos; Downer, Brian; Langa, Kenneth M.; Wong, Rebeca

2016-01-01

Objective Examine differences in cognition between Hispanic, non-Hispanic black (NHB), and non-Hispanic white (NHW) older adults in the United States. Data/Methods The final sample includes 18 982 participants aged 51 or older who received a modified version of the Telephone Interview for Cognitive Status during the 2010 Health and Retirement Study follow-up. Ordinary least squares will be used to examine differences in overall cognition according to race/ethnicity. Results Hispanics and NHB had lower cognition than NHW for all age groups (51–59, 60–69, 70–79, 80+). Hispanics had higher cognition than NHB for all age groups but these differences were all within one point. The lower cognition among NHB compared to NHW remained significant after controlling for age, gender, and education, whereas the differences in cognition between Hispanics and NHW were no longer significant after controlling for these covariates. Cognitive scores increased with greater educational attainment for all race/ethnic groups, but Hispanics exhibited the least benefit. Discussion Our results highlight the role of education in race/ethnic differences in cognitive function during old age. Education seems beneficial for cognition in old age for all race/ethnic groups, but Hispanics appear to receive a lower benefit compared to other race/ethnic groups. Further research is needed on the racial and ethnic differences in the pathways of the benefits of educational attainment for late-life cognitive function. PMID:26766788

21 CFR 120.8 - Hazard Analysis and Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

...: (i) Critical control points designed to control food hazards that are reasonably likely to occur and could be introduced inside the processing plant environment; and (ii) Critical control points designed... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Hazard Analysis and Critical Control Point (HACCP...

21 CFR 120.8 - Hazard Analysis and Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2012 CFR

2012-04-01

...: (i) Critical control points designed to control food hazards that are reasonably likely to occur and could be introduced inside the processing plant environment; and (ii) Critical control points designed... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Hazard Analysis and Critical Control Point (HACCP...

21 CFR 120.8 - Hazard Analysis and Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2013 CFR

2013-04-01

...: (i) Critical control points designed to control food hazards that are reasonably likely to occur and could be introduced inside the processing plant environment; and (ii) Critical control points designed... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Hazard Analysis and Critical Control Point (HACCP...

21 CFR 120.8 - Hazard Analysis and Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2014 CFR

2014-04-01

...: (i) Critical control points designed to control food hazards that are reasonably likely to occur and could be introduced inside the processing plant environment; and (ii) Critical control points designed... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Hazard Analysis and Critical Control Point (HACCP...

21 CFR 120.8 - Hazard Analysis and Critical Control Point (HACCP) plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

...: (i) Critical control points designed to control food hazards that are reasonably likely to occur and could be introduced inside the processing plant environment; and (ii) Critical control points designed... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Hazard Analysis and Critical Control Point (HACCP...

Alcohol consumption during adolescence is associated with reduced grey matter volumes.

PubMed

Heikkinen, Noora; Niskanen, Eini; Könönen, Mervi; Tolmunen, Tommi; Kekkonen, Virve; Kivimäki, Petri; Tanila, Heikki; Laukkanen, Eila; Vanninen, Ritva

2017-04-01

Cognitive impairment has been associated with excessive alcohol use, but its neural basis is poorly understood. Chronic excessive alcohol use in adolescence may lead to neuronal loss and volumetric changes in the brain. Our objective was to compare the grey matter volumes of heavy- and light-drinking adolescents. This was a longitudinal study: heavy-drinking adolescents without an alcohol use disorder and their light-drinking controls were followed-up for 10 years using questionnaires at three time-points. Magnetic resonance imaging was conducted at the last time-point. The area near Kuopio University Hospital, Finland. The 62 participants were aged 22-28 years and included 35 alcohol users and 27 controls who had been followed-up for approximately 10 years. Alcohol use was measured by the Alcohol Use Disorders Identification Test (AUDIT)-C at three time-points during 10 years. Participants were selected based on their AUDIT-C score. Magnetic resonance imaging was conducted at the last time-point. Grey matter volume was determined and compared between heavy- and light-drinking groups using voxel-based morphometry on three-dimensional T1-weighted magnetic resonance images using predefined regions of interest and a threshold of P < 0.05, with small volume correction applied on cluster level. Grey matter volumes were significantly smaller among heavy-drinking participants in the bilateral anterior cingulate cortex, right orbitofrontal and frontopolar cortex, right superior temporal gyrus and right insular cortex compared to the control group (P < 0.05, family-wise error-corrected cluster level). Excessive alcohol use during adolescence appears to be associated with an abnormal development of the brain grey matter. Moreover, the structural changes detected in the insula of alcohol users may reflect a reduced sensitivity to alcohol's negative subjective effects. © 2016 Society for the Study of Addiction.

The effect of intranasal sodium citrate on olfaction in post-infectious loss: results from a prospective, placebo-controlled trial in 49 patients.

PubMed

Whitcroft, K L; Ezzat, M; Cuevas, M; Andrews, P; Hummel, T

2017-06-01

Free calcium plays an integral role in peripheral olfactory processing, including feedback inhibition. It has therefore been suggested that reduction of intranasal free calcium with buffer solutions such as sodium citrate may improve olfactory function in patients with smell impairment. Several previous studies have supported this hypothesis, particularly in post-infectious olfactory loss. We therefore aimed to determine whether treatment with intranasal sodium citrate improves olfactory function in patients with post-infectious impairment. Prospective, single-blind, placebo-controlled trial. Interdisciplinary Smell and Taste Clinic, TU Dresden (tertiary referral centre). Forty-nine adult participants with post-infectious olfactory impairment (M : F = 11 : 38, mean age 58.71 ± 11.03 years). Olfactory function (odour threshold and identification) before and after treatment as determined using "Sniffin' Sticks". Patients were treated monorhinally with 1 mL sodium citrate solution. The contralateral nasal cavity was treated with 1 mL physiological sodium chloride solution, which acted as internal control. Clinical improvement was assumed where threshold or identification score increased by ≥2.5 or 3 points, respectively, or ≥5.5 points together. We demonstrated a statistically significant improvement in composite threshold + identification scores following treatment with sodium citrate, compared with placebo. This was true for all patients (mean improvement 0.87 ± 2.68 points, P = 0.04), and on subgroup analysis in those with hyposmia (mean improvement 1.15 ± 2.37 points, P = 0.02). However, the effect size did not reach clinical significance. Further basic and clinical work is required to fully delineate the effect of intranasal sodium citrate in the treatment of post-infectious olfactory loss. © 2016 John Wiley & Sons Ltd.

Coastal geology and recent origins for Sand Point, Lake Superior

USGS Publications Warehouse

Fisher, Timothy G.; Krantz, David E.; Castaneda, Mario R.; Loope, Walter L.; Jol, Harry M.; Goble, Ronald J.; Higley, Melinda C.; DeWald, Samantha; Hansen, Paul

2014-01-01

Sand Point is a small cuspate foreland located along the southeastern shore of Lake Superior within Pictured Rocks National Lakeshore near Munising, Michigan. Park managers’ concerns for the integrity of historic buildings at the northern periphery of the point during the rising lake levels in the mid-1980s greatly elevated the priority of research into the geomorphic history and age of Sand Point. To pursue this priority, we recovered sediment cores from four ponds on Sand Point, assessed subsurface stratigraphy onshore and offshore using geophysical techniques, and interpreted the chronology of events using radiocarbon and luminescence dating. Sand Point formed at the southwest edge of a subaqueous platform whose base is probably constructed of glacial diamicton and outwash. During the post-glacial Nipissing Transgression, the base was mantled with sand derived from erosion of adjacent sandstone cliffs. An aerial photograph time sequence, 1939–present, shows that the periphery of the platform has evolved considerably during historical time, infl uenced by transport of sediment into adjacent South Bay. Shallow seismic refl ections suggest slump blocks along the leading edge of the platform. Light detection and ranging (LiDAR) and shallow seismic refl ections to the northwest of the platform reveal large sand waves within a deep (12 m) channel produced by currents fl owing episodically to the northeast into Lake Superior. Ground-penetrating radar profi les show transport and deposition of sand across the upper surface of the platform. Basal radiocarbon dates from ponds between subaerial beach ridges range in age from 540 to 910 cal yr B.P., suggesting that Sand Point became emergent during the last ~1000 years, upon the separation of Lake Superior from Lakes Huron and Michigan. However, optically stimulated luminescence (OSL) ages from the beach ridges were two to three times as old as the radiocarbon ages, implying that emergence of Sand Point may have begun earlier, ~2000 years ago. The age discrepancy appears to be the result of incomplete bleaching of the quartz grains and an exceptionally low paleodose rate for the OSL samples. Given the available data, the younger ages from the radiocarbon analyses are preferred, but further work is necessary to test the two age models.

Effect of the Age Cross-Link Breaker Alagebrium on Anterior Segment Physiology, Morphology, and Ocular Age and Rage

PubMed Central

Kiland, Julie A.; Gabelt, B’Ann T.; Tezel, Gülgün; Lütjen-Drecoll, Elke; Kaufman, Paul L.

2009-01-01

Purpose: To determine the effects of the advanced glycation end product (AGE) cross-link breaker alagebrium on intraocular pressure (IOP), accommodation (ACC), outflow facility (OF), anterior segment morphology, and ocular AGE and receptors for AGE (RAGE) in older rhesus monkeys. Methods: Six rhesus monkeys (aged 19 to 20 years) received 3 or 4 intracameral and intravitreal (final concentration, 1 mM) injections of alagebrium to one eye over 2.5 to 3 weeks and vehicle to the opposite eye. ACC and OF responses to intramuscular or intravenous pilocarpine were measured at baseline and at 1 to 2 weeks and 2, 4, and 6 months postinjection. IOP was measured prior to all injections, ACC, and OF measurements. Monkeys were euthanized 3 to 6 months after the last injection, the eyes were enucleated, and anterior and posterior segments were examined by electron microscopy or immunohistochemistry. Results: No significant differences were found in ACC or IOP at any time point after alagebrium treatment. Baseline OF was higher (37.0 ± 6.0%; P ≤ .005) in alagebrium-treated vs control eyes at 6 months postinjection. In 3 monkeys, alagebrium-treated eyes, compared to control eyes, showed greater focal plaque formation, similar to that seen in primary open-angle glaucoma, in the juxtacanalicular meshwork/inner wall of Schlemm’s canal. No changes in anterior segment AGE or RAGE were detectable. However, some areas of the retina and optic nerve head exhibited decreased AGE and increased RAGE immunostaining. Conclusions: Intraocular injection of AGE cross-link breakers is an unlikely approach for glaucoma therapy. However, it may generate a model for further study of glaucomatous-like plaque formation. Immunohistochemical changes in the posterior segment in response to alagebrium warrant further functional studies. PMID:20126491

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

PubMed

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

2017-02-01

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

Weren't Asked, Didn't Tell: Prevalence of Communication of Suicidal Ideation in Suicide Decedents During the Last Year of Life.

PubMed

Bommersbach, Tanner J; Chock, Megan M; Geske, Jennifer L; Bostwick, J Michael

2018-06-01

To explore what percentage of suicide decedents (SDs) vs controls were assessed for suicidality at medical appointments in the year before death. Using the Rochester Epidemiology Project, 66 SDs dying in Olmsted County, Minnesota, between January 1, 2000, and December 31, 2009, were identified and matched with 141 age- and sex-matched controls. Blinded chart review determined how often providers screened and subjects endorsed suicidal ideation (SI). Positive indicators included chart notes recording SI and/or Patient Health Questionnaire-9 scored more than 0 on question 9. We found that only 29 of 66 (43.9%) SDs and 14 of 141 (9.9%) controls had been screened at any point by any means (P < .001). Only 25.8% (17 of 66) of SDs expressed SI, whereas 58.6% of screened SDs (17 of 29) did so, though none at final appointments before death. No control ever expressed SI. While the majority of both cases and controls went unscreened, providers were more likely to screen SDs (P < .001; odds ratio [OR], 9.0; 95% CI, 3.6-22.0), even with controlling for mental health diagnoses (P = .02; OR, 3.6; 95% CI, 1.2-10.6). With providers screening less than half of SDs at any point in the year before death, and less than 60% of SDs ever endorsing SI, including none at final appointments, the findings of this naturalistic study bring into question both current screening practices and screening effectiveness. Nonetheless, when SDs were screened, they were significantly more likely to endorse SI than were controls, not 1 of whom ever expressed SI. Taken together, these data suggest that patients expressing SI at any point are at elevated risk for eventual suicide. Copyright © 2018 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

On the behavior of certain ink aging curves.

PubMed

Cantú, Antonio A

2017-09-01

This work treats writing inks, particularly ballpoint pen inks. It reviews those ink aging methods that are based on the analysis (measurement) of ink solvents (e.g., 2-phenoxyethanol, which is the most common among ballpoint pen inks). Each method involves measurements that are components of an ink aging parameter associated with the method. Only mass independent parameters are considered. An ink solvent from an ink that is on an air-exposed substrate will evaporate at a decreasing rate and is never constant as the ink ages. An ink aging parameter should reflect this behavior. That is, the graph of a parameter's experimentally-determined values plotted against ink age (which yields the ink aging curve) should show this behavior. However, some experimentally-determined aging curves contain outlying points that are below or above where they should be or points corresponding to different ages that have the same ordinate (parameter value). Such curves, unfortunately, are useless since such curves show that an ink can appear older or younger than what it should be in one or more of its points or have the same age in two or more of its points. This work explains that one cause of this unexpected behavior is that the parameter values were improperly determined such as when a measurement is made of an ink solvent that is not completely extracted (removed) from an ink sample with a chosen extractor such as dry heat or a solvent. Copyright © 2017 Elsevier B.V. All rights reserved.

Active aging is associated with low prevalence of depressive symptoms among Brazilian older adults.

PubMed

Galli, Rosangela; Moriguchi, Emílio Hideyuki; Bruscato, Neide Maria; Horta, Rogerio Lessa; Pattussi, Marcos Pascoal

2016-01-01

Active aging is the process of optimizing opportunities for health, participation and security, aiming to improve quality of life as people age. A series of studies had demonstrated that a lower prevalence of depression is found among more active elderly. To evaluate the association between indicators of active aging and depressive symptoms among the elderly (aged 60 years or more). A population-based cross-sectional study was conducted with 1,006 elderly people (aged 60 years or over) from a small-sized Brazilian municipality. Depressive symptoms were assessed using the Geriatric Depression Scale - 15, with cutoff point ≥ 6 symptoms. Active aging was evaluated using indicators such as: active occupational situation, manual work, reading and physical activities. Data analyses used modified Poisson regression to obtain crude and adjusted prevalence ratios (PR). Most of the elderly people were: white, women and aged between 60 and 74 years. All the indicators of active aging were associated with the outcome. After controlling for socioeconomic, demographic and health variables, elderly people who worked, participated in groups, did manual work and maintained interests such as reading and talking to friends had lower prevalence of depressive symptoms compared to those not doing these activities. Active aging approaches may serve as a valuable mental health promotion strategy aimed at the elderly.

Delay and reward choice in ADHD: an experimental test of the role of delay aversion.

PubMed

Marco, Rafaela; Miranda, Ana; Schlotz, Wolff; Melia, Amanda; Mulligan, Aisling; Müller, Ueli; Andreou, Penny; Butler, Louise; Christiansen, Hanna; Gabriels, Isabel; Medad, Sheera; Albrecht, Bjorn; Uebel, Henrik; Asherson, Phillip; Banaschewski, Tobias; Gill, Michael; Kuntsi, Jonna; Mulas, Fernando; Oades, Robert; Roeyers, Herbert; Steinhausen, Hans-Christoph; Rothenberger, Aribert; Faraone, Stephen V; Sonuga-Barke, Edmund J S

2009-05-01

Children with attention deficit/hyperactivity disorder (ADHD) choose smaller sooner (SS) over larger later (LL) rewards more than controls. Here we assess the contributions of impulsive drive for immediate rewards (IDIR) and delay aversion (DAv) to this pattern. We also explore the characteristics of, and the degree of familiality in, ADHD SS responders. We had 360 ADHD probands; 349 siblings and 112 controls (aged between 6 to 17 years) chose between SS (1 point after 2 s) and LL reward (2 points after 30 s) outcomes on the Maudsley Index of Delay Aversion (Kuntsi, Oosterlaan, & Stevenson, 2001): Under one condition SS choice led to less overall trial delay under another it did not. ADHD participants chose SS more than controls under both conditions. This effect was larger when SS choice reduced trial delay. ADHD SS responders were younger, had lower IQ, more conduct disorder and had siblings who were more likely to be SS responders themselves. The results support a dual component model in which both IDIR and DAv contribute to SS choice in ADHD. SS choice may be a marker of an ADHD motivational subtype.

Registration of opthalmic images using control points

NASA Astrophysics Data System (ADS)

Heneghan, Conor; Maguire, Paul

2003-03-01

A method for registering pairs of digital ophthalmic images of the retina is presented using anatomical features as control points present in both images. The anatomical features chosen are blood vessel crossings and bifurcations. These control points are identified by a combination of local contrast enhancement, and morphological processing. In general, the matching between control points is unknown, however, so an automated algorithm is used to determine the matching pairs of control points in the two images as follows. Using two control points from each image, rigid global transform (RGT) coefficients are calculated for all possible combinations of control point pairs, and the set of RGT coefficients is identified. Once control point pairs are established, registration of two images can be achieved by using linear regression to optimize an RGT, bilinear or second order polynomial global transform. An example of cross-modal image registration using an optical image and a fluorescein angiogram of an eye is presented to illustrate the technique.

Return-to-Sport and Performance After Anterior Cruciate Ligament Reconstruction in National Basketball Association Players

PubMed Central

Harris, Joshua D.; Erickson, Brandon J.; Bach, Bernard R.; Abrams, Geoffrey D.; Cvetanovich, Gregory L.; Forsythe, Brian; McCormick, Frank M.; Gupta, Anil K.; Cole, Brian J.

2013-01-01

Background: Anterior cruciate ligament (ACL) rupture is a significant injury in National Basketball Association (NBA) players. Hypotheses: NBA players undergoing ACL reconstruction (ACLR) have high rates of return to sport (RTS), with RTS the season following surgery, no difference in performance between pre- and postsurgery, and no difference in RTS rate or performance between cases (ACLR) and controls (no ACL tear). Study Design: Case-control. Methods: NBA players undergoing ACLR were evaluated. Matched controls for age, body mass index (BMI), position, and NBA experience were selected during the same years as those undergoing ACLR. RTS and performance were compared between cases and controls. Paired-sample Student t tests, chi-square, and linear regression analyses were performed for comparison of within- and between-group variables. Results: Fifty-eight NBA players underwent ACLR while in the NBA. Mean player age was 25.7 ± 3.5 years. Forty percent of ACL tears occurred in the fourth quarter. Fifty players (86%) RTS in the NBA, and 7 players (12%) RTS in the International Basketball Federation (FIBA) or D-league. Ninety-eight percent of players RTS in the NBA the season following ACLR (11.6 ± 4.1 months from injury). Two players (3.1%) required revision ACLR. Career length following ACLR was 4.3 ± 3.4 years. Performance upon RTS following surgery declined significantly (P < 0.05) regarding games per season; minutes, points, and rebounds per game; and field goal percentage. However, following the index year, controls’ performances declined significantly in games per season; points, rebounds, assists, blocks, and steals per game; and field goal and free throw percentage. Other than games per season, there was no significant difference between cases and controls. Conclusion: There is a high RTS rate in the NBA following ACLR. Nearly all players RTS the season following surgery. Performance significantly declined from preinjury level; however, this was not significantly different from controls. ACL re-tear rate was low. Clinical Relevance: There is a high RTS rate in the NBA after ACLR, with no difference in performance upon RTS compared with controls. PMID:24427434

Subsidising artemisinin-based combination therapy in the private retail sector.

PubMed

Opiyo, Newton; Yamey, Gavin; Garner, Paul

2016-03-09

Malaria causes ill health and death in Africa. Treating illness promptly with artemisinin-based combination therapy (ACT) is likely to cure people and avoid the disease progressing to more severe forms and death. In many countries, ACT use remains low. Part of the problem is that most people seek treatment from the retail sector where ACTs are expensive; this expense is a barrier to their use.The Global Fund and other international organisations are subsidising the cost of ACTs for private retail providers to improve access to ACTs. The subsidy was initially organised through a stand-alone initiative, called the Affordable Medicines Facility-malaria (AMFm), but has since been integrated into the Global Fund core grant management and financial processes. To assess the effect of programmes that include ACT price subsidies for private retailers on ACT use, availability, price and market share. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 1, The Cochrane Library, including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register); MEDLINE (OvidSP), EMBASE (OvidSP), CINAHL (EbscoHost), EconLit (ProQuest), Global Health (OvidSP), Regional Indexes (Global Health Library, WHO), LILACS (Global Health Library, WHO), Science Citation Index and Social Sciences Citation Index (ISI Web of Science) and Health Management (ProQuest). All databases were searched February 2015, except for Health Management which was searched November 2013, without any date, language or publication status restrictions. We also searched the International Clinical Trials Registry Platform (ICTRP; WHO), ClinicalTrials.gov (NIH) and various grey literature sources. We also conducted a cited reference search for all included studies in ISI Web of Knowledge, checked references of identified articles and contacted authors to identify additional studies. Randomised trials, non-randomised trials, controlled before-after studies and interrupted-time-series studies that compared the effects of ACT price subsidies for private retailers to no subsidies or alternative ACT financing mechanisms were eligible for inclusion. Two authors independently screened and selected studies for inclusion. Two review authors independently extracted data, assessed study risk of bias and confidence in effect estimates (certainty of evidence) using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). We included four trials (two cluster-randomised trials reported in three articles and two non-randomised cluster trials). Three trials assessed retail sector ACT subsidies combined with supportive interventions (retail outlet provider training, community awareness and mass media campaigns). One trial assessed vouchers provided to households to purchase subsidised ACTs. Price subsidies ranged from 80% to 95%. One trial enrolled children under five years of age; the other three trials studied people of all age groups. The studies were done in rural districts in East Africa (Kenya, Uganda and Tanzania).In this East Africa setting, these ACT subsidy programmes increased the percentage of children under five years of age receiving ACTs on the day, or following day, of fever onset by 25 percentage points (95% confidence interval (CI) 14.1 to 35.9 percentage points; 1 study, high certainty evidence). This suggests that in practice, among febrile children under five years of age with an ACT usage rate of 5% without a subsidy, subsidy programmes would increase usage by between 19% and 41% over a one year period.The ACT subsidy programmes increased the percentage of retail outlets stocking ACTs for children under five years of age by 31.9 percentage points (95% CI 26.3 to 37.5 percentage points; 1 study, high certainty evidence). Effects on ACT stocking for patients of any age is unknown because the certainty of evidence was very low.The ACT subsidy programmes decreased the median cost of ACTs for children under five years of age by US$ 0.84 (median cost per ACT course without subsidy: US$ 1.08 versus with subsidy: US$ 0.24; 1 study, high certainty evidence).The ACT subsidy programmes increased the market share of ACTs for children under five years of age by between 23.6 and 63.0 percentage points (1 study, high certainty evidence).The ACT subsidy programmes decreased the use of older antimalarial drugs (such as amodiaquine and sulphadoxine-pyrimethamine) among children under five years of age by 10.4 percentage points (95% CI 3.9 to 16.9 percentage points; 1 study, high certainty evidence).None of the three studies of ACT subsidies reported the number of patients treated who had confirmed malaria.Vouchers increased the likelihood that an illness is treated with an ACT by 16 to 23 percentage points; however, vouchers were associated with a high rate of over-treatment of malaria (only 56% of patients taking ACTs from the drug shop tested positive for malaria under the 92% subsidy; 1 study, high certainty evidence). Programmes that include substantive subsidies for private sector retailers combined with training of providers and social marketing improved use and availability of ACTs for children under five years of age with suspected malaria in research studies from three countries in East Africa. These programmes also reduced prices of ACTs, improved market share of ACTs and reduced the use of older antimalarial drugs among febrile children under five years of age. The research evaluates drug delivery but does not assess whether the patients had confirmed (parasite-diagnosed) malaria. None of the included studies assessed patient outcomes; it is therefore not known whether the effects seen in the studies would translate to an impact on health.

A Proposed Mechanism of Neuronal Injury in Pilots and Aircrew Personnel with Hypobaric Exposure

DTIC Science & Technology

2017-04-22

Technical Information Center (DTIC). DATE March 14, 2017 14. 59 MOW PRIMARY POINT OF CONTACT (Last Name, First Name, M.I., email) 15. DUTY PHONE/PAGER...will appear in the manuscript. LAST NAME, FIRST NAME AND M.I. GRADE/RANK SQUADRON/GROUP/OFFICE SYMBOL INSTITUTION (If not 59 MOW) a. Primary ...34,·" ••• • • U-2 pilots display an increased incidence of white-matter hyperintensities (WMH) on MRI compared to healthy age -matched controls (non-pilots

Time Reparametrization Group and the Long Time Behavior in Quantum Glassy Systems

NASA Astrophysics Data System (ADS)

Kennett, Malcolm P.; Chamon, Claudio

2001-02-01

We study the long time dynamics of a quantum version of the Sherrington-Kirkpatrick model. Time reparametrizations of the dynamical equations have a parallel with renormalization group transformations; in this language the long time behavior of this model is controlled by a reparametrization group ( RpG) fixed point of the classical dynamics. The irrelevance of quantum terms in the dynamical equations in the aging regime explains the classical nature of the out of equilibrium fluctuation-dissipation relation.

On the long-term stability of calibration standards in different matrices.

PubMed

Kandić, A; Vukanac, I; Djurašević, M; Novković, D; Šešlak, B; Milošević, Z

2012-09-01

In order to assure Quality Control in accordance with ISO/IEC 17025, it was important, from metrological point of view, to examine the long-term stability of calibration standards previously prepared. Comprehensive reconsideration on efficiency curves with respect to the ageing of calibration standards is presented in this paper. The calibration standards were re-used after a period of 5 years and analysis of the results showed discrepancies in efficiency values. Copyright © 2012 Elsevier Ltd. All rights reserved.

Pupillometry and Saccades as Objective mTBI Biomark

DTIC Science & Technology

2017-06-01

pupillometers, King-Devick (KD) test and near point of convergence (NPC) rule, respectively. Hundred acute mTBI (≤72 hrs post injury) and 100 age-matched... test  and NPC are also significantly effected in mTBI group.  Task 3: Data Analysis and Report Writing mTBI Control 6/28/2017 1 Medical Research and...U.S. Army Aeromedical Research Laboratory Fort Rucker, Alabama UNCLASSIFIED King-Devick Test 10 *P < 0.0001 Medical Research and Materiel Command U.S

Terminal decline and practice effects in older adults without dementia: the MoVIES project.

PubMed

Dodge, Hiroko H; Wang, Chia-Ning; Chang, Chung-Chou H; Ganguli, Mary

2011-08-23

To track cognitive change over time in dementia-free older adults and to examine terminal cognitive decline. A total of 1,230 subjects who remained free from dementia over 14 years of follow-up were included in a population-based epidemiologic cohort study. First, we compared survivors and decedents on their trajectories of 5 cognitive functions (learning, memory, language, psychomotor speed, executive functions), dissociating practice effects which can mask clinically significant decline from age-associated cognitive decline. We used longitudinal mixed-effects models with penalized linear spline. Second, limiting the sample to 613 subjects who died during follow-up, we identified the inflection points at which the rate of cognitive decline accelerated, in relation to time of death, controlling for practice effects. We used mixed-effects model with a change point. Age-associated cognitive trajectories were similar between decedents and survivors without dementia. However, substantial differences were observed between the trajectories of practice effects of survivors and decedents, resembling those usually observed between normal and mildly cognitively impaired elderly. Executive and language functions showed the earliest terminal declines, more than 9 years prior to death, independent of practice effects. Terminal cognitive decline in older adults without dementia may reflect presymptomatic disease which does not cross the clinical threshold during life. Alternatively, cognitive decline attributed to normal aging may itself represent underlying neurodegenerative or vascular pathology. Although we cannot conclude definitively from this study, the separation of practice effects from age-associated decline could help identify preclinical dementia.

Bayesian Model Averaging with Change Points to Assess the Impact of Vaccination and Public Health Interventions

PubMed Central

Warren, Joshua L.; Schuck-Paim, Cynthia; Lustig, Roger; Lewnard, Joseph A.; Fuentes, Rodrigo; Bruhn, Christian A. W.; Taylor, Robert J.; Simonsen, Lone; Weinberger, Daniel M.

2017-01-01

Background: Pneumococcal conjugate vaccines (PCVs) prevent invasive pneumococcal disease and pneumonia. However, some low-and middle-income countries have yet to introduce PCV into their immunization programs due, in part, to lack of certainty about the potential impact. Assessing PCV benefits is challenging because specific data on pneumococcal disease are often lacking, and it can be difficult to separate the effects of factors other than the vaccine that could also affect pneumococcal disease rates. Methods: We assess PCV impact by combining Bayesian model averaging with change-point models to estimate the timing and magnitude of vaccine-associated changes, while controlling for seasonality and other covariates. We applied our approach to monthly time series of age-stratified hospitalizations related to pneumococcal infection in children younger 5 years of age in the United States, Brazil, and Chile. Results: Our method accurately detected changes in data in which we knew true and noteworthy changes occurred, i.e., in simulated data and for invasive pneumococcal disease. Moreover, 24 months after the vaccine introduction, we detected reductions of 14%, 9%, and 9% in the United States, Brazil, and Chile, respectively, in all-cause pneumonia (ACP) hospitalizations for age group 0 to <1 years of age. Conclusions: Our approach provides a flexible and sensitive method to detect changes in disease incidence that occur after the introduction of a vaccine or other intervention, while avoiding biases that exist in current approaches to time-trend analyses. PMID:28767518

Developmental Scores at 1 Year With Increasing Gestational Age, 37–41 Weeks

PubMed Central

Rose, Olga; Blanco, Estela; Martinez, Suzanna M.; Sim, Eastern Kang; Castillo, Marcela; Lozoff, Betsy; Vaucher, Yvonne E.

2013-01-01

OBJECTIVE: To examine the relationship between gestational age and mental and psychomotor development scores in healthy infants born between 37 and 41 weeks. METHODS: The cohort included 1562 participants enrolled during infancy in an iron deficiency anemia preventive trial in Santiago, Chile. All participants were healthy, full-term (37–41 weeks) infants who weighed 3 kg or more at birth. Development at 12 months was assessed using the Bayley Scales of Infant Development. Using generalized linear modeling, we analyzed the association between gestational age and 1-year-old developmental status, taking into account potential confounders including birth weight percentile, gender, socioeconomic status, the home environment, iron status, and iron supplementation. RESULTS: For each additional week of gestation, the Mental Development Index increased by 0.8 points (95% confidence interval = 0.2–1.4), and the Psychomotor Development Index increased by 1.4 points (95% confidence interval = 0.6–2.1) controlling for birth weight percentile, gender, socioeconomic status, and home environment. CONCLUSIONS: In a large sample of healthy full-term infants, developmental scores obtained using the Bayley Scales of Infant Development at 12 months increased with gestational age (37–41 weeks). There is increasing evidence that birth at 39 to 41 weeks provides developmental advantages compared with birth at 37 to 38 weeks. Because cesarean deliveries and early-term inductions have increased to 40% of all births, consideration of ongoing brain development during the full-term period is an important medical and policy issue. PMID:23589812

The effects of a 12-week strength-training program on strength and functionality in women with fibromyalgia.

PubMed

Kingsley, J Derek; Panton, Lynn B; Toole, Tonya; Sirithienthad, Prawee; Mathis, Reed; McMillan, Victor

2005-09-01

To determine whether women with fibromyalgia benefit from strength training. Randomized controlled trial. Testing was completed at the university and training was completed at a local community wellness facility. Twenty-nine women (age range, 18-54 y) with fibromyalgia participated. Subjects were randomly assigned to a control (n=14; wait-listed for exercise) or strength (n=15) group. After the first 4 weeks, 7 (47%) women dropped from the strength group. Subjects underwent 12 weeks of training on 11 exercises, 2 times a week, performing 1 set of 8 to 12 repetitions at 40% to 60% of their maximal lifts and were progressed to 60% to 80%. Subjects were measured for strength, functionality, tender point sensitivity, and fibromyalgia impact. The strength group significantly (P< or =.05) improved upper- (strength, 39+/-11 to 42+/-12 kg; control, 38+/-13 to 38+/-12 kg) and lower- (strength, 68+/-28 to 82+/-25 kg; control, 61+/-25 to 61+/-26 kg) body strength. Upper-body functionality measured by the Continuous-Scale Physical Functional Performance test improved significantly (strength, 44+/-11 to 50+/-16U; control, 51+/-11 to 49+/-13U) after training. Tender point sensitivity and fibromyalgia impact did not change. Strength training improved strength and some functionality in women with fibromyalgia. Interventions with resistance have important implications on independence and quality of life issues for women with fibromyalgia.

Do elite athletes experience low back, pelvic girdle and pelvic floor complaints during and after pregnancy?

PubMed

Bø, K; Backe-Hansen, K L

2007-10-01

The aim of the present investigation was to study prevalence of low back pain, pelvic girdle pain (PGP) and pelvic floor disorders during pregnancy and after childbirth in elite athletes. A postal questionnaire was sent to all elite athletes who had given birth registered with The Norwegian Olympic Committee and Confederation of Sports (n=40). Eighty age-matched women served as the control group. The response rates were 77.5% and 57.5% in the elite athletes and control groups, respectively. There were no significant differences in the prevalence of low back and PGP, urinary or fecal incontinence among elite athletes and controls at any time point. The prevalence of low back pain without radiation to the leg in elite athletes was 25.8%, 18.5%, 9.7% and 29% the year before pregnancy, during pregnancy, 6 weeks postpartum and at the time of completing the questionnaire, respectively. The prevalence of PGP was 0, 29.6%, 12.9% and 19.4%. Prevalence of stress urinary incontinence was 12.9%, 18.5%, 29% and 35.5%. None of the elite athletes had fecal incontinence at any time point. There were no differences in mode of delivery or birthweight between elite athletes and controls. The elite athletes had a significantly lower body mass index at 6 weeks postpartum and at present compared with the control group.

Reliability, validity, and responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index for elderly patients with a femoral neck fracture.

PubMed

Burgers, Paul T P W; Poolman, Rudolf W; Van Bakel, Theodorus M J; Tuinebreijer, Wim E; Zielinski, Stephanie M; Bhandari, Mohit; Patka, Peter; Van Lieshout, Esther M M

2015-05-06

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been extensively evaluated in groups of patients with osteoarthritis, yet not in patients with a femoral neck fracture. This study aimed to determine the reliability, construct validity, and responsiveness of the WOMAC compared with the Short Form-12 (SF-12) and the EuroQol 5D (EQ-5D) questionnaires for the assessment of elderly patients with a femoral neck fracture. Reliability was tested by assessing the Cronbach alpha. Construct validity was determined with the Pearson correlation coefficient. Change scores were calculated from ten weeks to twelve months of follow-up. Standardized response means and floor and ceiling effects were determined. Analyses were performed to compare the results for patients less than eighty years old with those for patients eighty years of age or older. The mean WOMAC total score was 89 points before the fracture in the younger patients and increased from 70 points at ten weeks to 81 points at two years postoperatively. In the older age group, these scores were 86, 75, and 78 points. The mean WOMAC pain scores before the fracture and at ten weeks and two years postoperatively were 92, 76, and 87 points, respectively, in the younger age group and 92, 84, and 93 points in the older age group. Function scores were 89, 68, and 79 points for the younger age group and 84, 71, and 73 points for the older age group. The Cronbach alpha for pain, stiffness, function, and the total scale ranged from 0.83 to 0.98 for the younger age group and from 0.79 to 0.97 for the older age group. Construct validity was good, with 82% and 79% of predefined hypotheses confirmed in the younger and older age groups, respectively. Responsiveness was moderate. No floor effects were found. Moderate to large ceiling effects were found for pain and stiffness scales at ten weeks and twelve months in younger patients (18% to 36%) and in the older age group (38% to 53%). The WOMAC showed good reliability, construct validity, and responsiveness in both age groups of elderly patients with a femoral neck fracture who had been physically and mentally fit before the fracture. The instrument is suitable for use in future clinical studies in these populations. The results are based on two clinical trials. The questionnaires used concern pure, clinically relevant issues (ability to walk, climb stairs, etc.). Moreover, the results can be used for future research comparing clinical outcomes (or treatments) for populations with a femoral neck fracture. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Earth observing system instrument pointing control modeling for polar orbiting platforms

NASA Technical Reports Server (NTRS)

Briggs, H. C.; Kia, T.; Mccabe, S. A.; Bell, C. E.

1987-01-01

An approach to instrument pointing control performance assessment for large multi-instrument platforms is described. First, instrument pointing requirements and reference platform control systems for the Eos Polar Platforms are reviewed. Performance modeling tools including NASTRAN models of two large platforms, a modal selection procedure utilizing a balanced realization method, and reduced order platform models with core and instrument pointing control loops added are then described. Time history simulations of instrument pointing and stability performance in response to commanded slewing of adjacent instruments demonstrates the limits of tolerable slew activity. Simplified models of rigid body responses are also developed for comparison. Instrument pointing control methods required in addition to the core platform control system to meet instrument pointing requirements are considered.

Improving the management of warfarin in aged-care facilities utilising innovative technology: a proof-of-concept study.

PubMed

Bereznicki, Luke R E; Jackson, Shane L; Kromdijk, Wiete; Gee, Peter; Fitzmaurice, Kimbra; Bereznicki, Bonnie J; Peterson, Gregory M

2014-02-01

In aged-care facilities (ACFs) monitoring of warfarin can be logistically challenging and International Normalised Ratio (INR control) is often suboptimal. We aimed to determine whether an integrated information and communications technology system and the use of point-of-care (POC) monitors by nursing staff could improve the INR control of aged-care facility residents who take warfarin. Nursing staff identified residents who were prescribed warfarin in participating ACFs. A computer program (MedePOC) was developed to store and transmit INR results from the ACFs to general practitioners (GPs) for dosage adjustment. Nursing staff received training in the use of the CoaguChek XS point-of-care INR monitor and the MedePOC software. Following a run-in phase, eligible patients were monitored weekly for up to 12 weeks. The primary outcome was the change in the time in therapeutic range (TTR) in the intervention phase compared to the TTR in the 12 months preceding the study. All GPs, nursing staff and patients were surveyed for their experiences and opinions of the project. Twenty-four patients and 19 GPs completed the trial across six ACFs. The mean TTR for all patients improved non-significantly from 58.9 to 60.6% (P=0.79) and the proportion of INR tests in range improved non-significantly from 57.1 to 64.1% (P=0.21). The mean TTR improved in 14 patients (58%) and in these patients the mean absolute improvement in TTR was 23.1%. A post hoc analysis of the INR data using modified therapeutic INR ranges to reflect the dosage adjustment practices of GPs suggested that the intervention did lead to improved INR control. The MedePOC program and POC monitoring was well received by nursing staff. Weekly POC INR monitoring conducted in ACFs and electronic communication of the results and warfarin doses resulted in non-significant improvements in INR control in a small cohort of elderly residents. Further research involving modification to the communication strategy and a longer follow-up period is warranted to investigate whether this strategy can improve INR control and clinical outcomes in this vulnerable population. © 2013 The Authors. IJPP © 2013 Royal Pharmaceutical Society.

Validation of Accelerometer Cut-Points in Children With Cerebral Palsy Aged 4 to 5 Years.

PubMed

Keawutan, Piyapa; Bell, Kristie L; Oftedal, Stina; Davies, Peter S W; Boyd, Roslyn N

2016-01-01

To derive and validate triaxial accelerometer cut-points in children with cerebral palsy (CP) and compare these with previously established cut-points in children with typical development. Eighty-four children with CP aged 4 to 5 years wore the ActiGraph during a play-based gross motor function measure assessment that was video-taped for direct observation. Receiver operating characteristic and Bland-Altman plots were used for analyses. The ActiGraph had good classification accuracy in Gross Motor Function Classification System (GMFCS) levels III and V and fair classification accuracy in GMFCS levels I, II, and IV. These results support the use of the previously established cut-points for sedentary time of 820 counts per minute in children with CP aged 4 to 5 years across all functional abilities. The cut-point provides an objective measure of sedentary and active time in children with CP. The cut-point is applicable to group data but not for individual children.

Realtime control of multiple-focus phased array heating patterns based on noninvasive ultrasound thermography.

PubMed

Casper, Andrew; Liu, Dalong; Ebbini, Emad S

2012-01-01

A system for the realtime generation and control of multiple-focus ultrasound phased-array heating patterns is presented. The system employs a 1-MHz, 64-element array and driving electronics capable of fine spatial and temporal control of the heating pattern. The driver is integrated with a realtime 2-D temperature imaging system implemented on a commercial scanner. The coordinates of the temperature control points are defined on B-mode guidance images from the scanner, together with the temperature set points and controller parameters. The temperature at each point is controlled by an independent proportional, integral, and derivative controller that determines the focal intensity at that point. Optimal multiple-focus synthesis is applied to generate the desired heating pattern at the control points. The controller dynamically reallocates the power available among the foci from the shared power supply upon reaching the desired temperature at each control point. Furthermore, anti-windup compensation is implemented at each control point to improve the system dynamics. In vitro experiments in tissue-mimicking phantom demonstrate the robustness of the controllers for short (2-5 s) and longer multiple-focus high-intensity focused ultrasound exposures. Thermocouple measurements in the vicinity of the control points confirm the dynamics of the temperature variations obtained through noninvasive feedback. © 2011 IEEE

Hiatus hernia in healthy volunteers is associated with intrasphincteric reflux and cardiac mucosal lengthening without traditional reflux.

PubMed

Robertson, Elaine V; Derakhshan, Mohammad H; Wirz, Angela A; Mitchell, David R; Going, James J; Kelman, Andrew W; Ballantyne, Stuart A; McColl, Kenneth E L

2017-07-01

Hiatus hernia (HH) is a key mediator of gastro-oesophageal reflux disease but little is known about its significance in the general population. We studied the structure and function of the gastro-oesophageal junction in healthy volunteers with and without HH. We compared 15 volunteers with HH, detected by endoscopy or MRI scan, but without gastro-oesophageal reflux disease with 15 controls matched for age, gender and body weight. Jumbo biopsies were taken across the squamocolumnar junction (SCJ). High-resolution pH metry (12 sensors) and manometry (36 sensors) were performed upright and supine, before and after a meal. The SCJ was marked with an endoscopically placed clip and visualised fluoroscopically. Cardiac mucosa was longer in volunteers with HH (3.5 vs 2.5 mm, p=0.01). There was no excessive acid reflux 5 cm above the upper border of the lower oesophageal sphincter (LOS) in either group but those with HH had short segment reflux 11 mm above the pH transition point after the meal when supine (pH<4 for 5.5% vs 0.3% of time, p=0.01). The SCJ and pH transition point were proximally displaced within the gastro-oesophageal junction in those with HH versus controls (p<0.05). The pH transition point was proximal to the peak LOS pressure point in HH subjects but distal to it in controls after the meal (p<0.05). When supine, the postprandial pH transition point crossed the SCJ in those with HH (p=0.03). Healthy volunteers with HH have increased intrasphincteric reflux and lengthening of cardiac mucosa in the absence of traditional transsphincteric reflux. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Acupuncture point injection treatment of primary dysmenorrhoea: a randomised, double blind, controlled study.

PubMed

Wade, C; Wang, L; Zhao, W J; Cardini, F; Kronenberg, F; Gui, S Q; Ying, Z; Zhao, N Q; Chao, M T; Yu, J

2016-01-05

To determine if injection of vitamin K3 in an acupuncture point is optimal for the treatment of primary dysmenorrhoea, when compared with 2 other injection treatments. A Menstrual Disorder Centre at a public hospital in Shanghai, China. Chinese women aged 14-25 years with severe primary dysmenorrhoea for at least 6 months not relieved by any other treatment were recruited. Exclusion criteria were the use of oral contraceptives, intrauterine devices or anticoagulant drugs, pregnancy, history of abdominal surgery, participation in other therapies for pain and diagnosis of secondary dysmenorrhoea. Eighty patients with primary dysmenorrhoea, as defined on a 4-grade scale, completed the study. Two patients withdrew after randomisation. A double-blind, double-dummy, randomised controlled trial compared vitamin K3 acupuncture point injection to saline acupuncture point injection and vitamin K3 deep muscle injection. Patients in each group received 3 injections at a single treatment visit. The primary outcome was the difference in subjective perception of pain as measured by an 11 unit Numeric Rating Scale (NRS). Secondary measurements were Cox Pain Intensity and Duration scales and the consumption of analgesic tablets before and after treatment and during 6 following cycles. Patients in all 3 groups experienced pain relief from the injection treatments. Differences in NRS measured mean pain scores between the 2 active control groups were less than 1 unit (-0.71, CI -1.37 to -0.05) and not significant, but the differences in average scores between the treatment hypothesised to be optimal and both active control groups (1.11, CI 0.45 to 1.78) and (1.82, CI 1.45 to 2.49) were statistically significant in adjusted mixed-effects models. Menstrual distress and use of analgesics were diminished for 6 months post-treatment. Acupuncture point injection of vitamin K3 relieves menstrual pain rapidly and is a useful treatment in an urban outpatient clinic. NCT00104546; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Acupuncture point injection treatment of primary dysmenorrhoea: a randomised, double blind, controlled study

PubMed Central

Wade, C; Wang, L; Zhao, W J; Cardini, F; Kronenberg, F; Gui, S Q; Ying, Z; Zhao, N Q; Chao, M T; Yu, J

2016-01-01

Objective To determine if injection of vitamin K3 in an acupuncture point is optimal for the treatment of primary dysmenorrhoea, when compared with 2 other injection treatments. Setting A Menstrual Disorder Centre at a public hospital in Shanghai, China. Participants Chinese women aged 14–25 years with severe primary dysmenorrhoea for at least 6 months not relieved by any other treatment were recruited. Exclusion criteria were the use of oral contraceptives, intrauterine devices or anticoagulant drugs, pregnancy, history of abdominal surgery, participation in other therapies for pain and diagnosis of secondary dysmenorrhoea. Eighty patients with primary dysmenorrhoea, as defined on a 4-grade scale, completed the study. Two patients withdrew after randomisation. Interventions A double-blind, double-dummy, randomised controlled trial compared vitamin K3 acupuncture point injection to saline acupuncture point injection and vitamin K3 deep muscle injection. Patients in each group received 3 injections at a single treatment visit. Primary and secondary outcome measures The primary outcome was the difference in subjective perception of pain as measured by an 11 unit Numeric Rating Scale (NRS). Secondary measurements were Cox Pain Intensity and Duration scales and the consumption of analgesic tablets before and after treatment and during 6 following cycles. Results Patients in all 3 groups experienced pain relief from the injection treatments. Differences in NRS measured mean pain scores between the 2 active control groups were less than 1 unit (−0.71, CI −1.37 to −0.05) and not significant, but the differences in average scores between the treatment hypothesised to be optimal and both active control groups (1.11, CI 0.45 to 1.78) and (1.82, CI 1.45 to 2.49) were statistically significant in adjusted mixed-effects models. Menstrual distress and use of analgesics were diminished for 6 months post-treatment. Conclusions Acupuncture point injection of vitamin K3 relieves menstrual pain rapidly and is a useful treatment in an urban outpatient clinic. Trial registration number NCT00104546; Results. PMID:26733563

Surgical Correction of Metopic Craniosynostosis: A 3-D Photogrammetric Analysis of Cranial Vault Outcomes.

PubMed

Linden, Olivia E; Baratta, Vanessa M; Gonzalez, Jose A; Byrne, Margaret E; Klinge, Petra M; Sullivan, Stephen R; Taylor, Helena O

2018-01-01

To evaluate 3-dimensional (3-D) photogrammetry as a tool for assessing the postoperative head shape of patients who had undergone cranial vault remodeling for metopic synostosis. We prospectively analyzed images of patients with metopic craniosynostosis who had undergone anterior cranial vault remodeling and age-matched controls. To ensure standardized facial orientation, each 3-D image was positioned to "best fit" the preoperative face by aligning 6 soft tissue landmarks. Forehead measurements were taken from a standardized position behind the surface of the face to landmarks placed in a ray configuration across the forehead. Academic teaching hospital. Thirteen pediatric patients with metopic craniosynostosis who had undergone anterior cranial vault remodeling and age-matched controls. Images were taken preoperatively, immediately postoperatively, and over 1-year postoperatively. Forehead contours preoperatively and postoperatively, with statistics performed using a multivariate analysis of variance shape analysis. Mean postoperative follow-up was 1.8 (0.6) years. The average distance from the origin to forehead landmarks was 55.1 (3.4) mm preoperatively, 59.3 (0.7) mm immediate postoperatively, 59.1 (1.0) mm 1-year postoperatively, and 59.4 (0.6) mm in controls. Postoperative metopic forehead contours varied significantly from preoperative contours ( P < .01), while there was no statistical difference between the 2 postoperative time points ( P = .70). One-year postoperative patients were not significantly different from their age-matched controls ( P > .99). Preoperative metopic forehead contours varied significantly from postoperative contours. Cranial reconstructions approximated the foreheads of normal controls, and reconstructions were stable at more than 1-year follow-up.

The development of control processes supporting source memory discrimination as revealed by event-related potentials.

PubMed

de Chastelaine, Marianne; Friedman, David; Cycowicz, Yael M

2007-08-01

Improvement in source memory performance throughout childhood is thought to be mediated by the development of executive control. As postretrieval control processes may be better time-locked to the recognition response rather than the retrieval cue, the development of processes underlying source memory was investigated with both stimulus- and response-locked event-related potentials (ERPs). These were recorded in children, adolescents, and adults during a recognition memory exclusion task. Green- and red-outlined pictures were studied, but were tested in black outline. The test requirement was to endorse old items shown in one study color ("targets") and to reject new items along with old items shown in the alternative study color ("nontargets"). Source memory improved with age. All age groups retrieved target and nontarget memories as reflected by reliable parietal episodic memory (EM) effects, a stimulus-locked ERP correlate of recollection. Response-locked ERPs to targets and nontargets diverged in all groups prior to the response, although this occurred at an increasingly earlier time point with age. We suggest these findings reflect the implementation of attentional control mechanisms to enhance target memories and facilitate response selection with the greatest and least success, respectively, in adults and children. In adults only, response-locked ERPs revealed an early-onsetting parietal negativity for nontargets, but not for targets. This was suggested to reflect adults' ability to consistently inhibit prepotent target responses for nontargets. The findings support the notion that the development of source memory relies on the maturation of control processes that serve to enhance accurate selection of task-relevant memories.

Reliability and Validity of Computerized Force Platform Measures of Balance Function in Healthy Older Adults.

PubMed

Harro, Cathy C; Garascia, Chelsea

2018-01-10

Postural control declines with aging and is an independent risk factor for falls in older adults. Objective examination of balance function is warranted to direct fall prevention strategies. Force platform (FP) systems provide quantitative measures of postural control and analysis of different aspects of balance. The purpose of this study was to examine the reliability and validity of FP measures in healthy older adults. This study enrolled 46 healthy elderly adults, mean age 67.67 (5.1) years, who had no history of falls. They were assessed on 3 standardized tests on the NeuroCom Equitest FP system: limits of stability (LOS), motor control test (MCT), and sensory organization test (SOT). The test battery was administered twice within a 10-day period for test-retest reliability; intraclass correlation coefficients (ICCs), standard error of measurement (SEM), and minimal detectable change based on a 95% confidence interval (MDC95) were calculated. FP measures were compared with criterion clinical balance (Mini-BESTest and Functional Gait Assessment) and gait (10-m walk and 6-minute walk) measures to examine concurrent validity using Pearson correlation coefficients. Multiple linear regression analysis examined whether age and activity level were associated with FP performance. The α level was set at P < .05. SOT composite equilibrium scores, MCT average latency, and LOS end point excursion measures all demonstrated excellent test-retest reliability (ICC = 0.90, 0.85, and 0.77, respectively), whereas moderate to good reliability was found for SOT vestibular ratio score (ICC = 0.71). There was large variability in performance in this healthy elderly cohort, resulting in relatively large MDC95 for these measures, especially for the LOS test. Fair correlations were found between LOS end point excursion and clinical balance and gait measures (r = 0.31-0.49), and between MCT average latency and gait measures only (r = -0.32). No correlations were found between SOT measures and clinical balance and gait measures. Age was only marginally significantly (P = .055) associated with LOS end point excursion but was not associated with SOT or MCT measures, and activity level was not associated with any of the FP measures. FP measures provided reliable information on balance function in healthy older adults; however, small learning effects were evident, particularly for the SOT. The SEM and MDC95 for the LOS and SOT measures were relatively large for this healthy elderly cohort. A relationship between FP measures, which assess underlying balance mechanisms, and clinical balance and gait measures was not strongly supported in this study. Further research is needed to justify the value of adding FP measures to a test battery for balance assessment in older adults without a history of falls.

Depression treatment for impoverished mothers by point-of-care providers: A randomized controlled trial.

PubMed

Segre, Lisa S; Brock, Rebecca L; O'Hara, Michael W

2015-04-01

Depression in low-income, ethnic-minority women of childbearing age is prevalent and compromises infant and child development. Yet numerous barriers prevent treatment delivery. Listening Visits (LV), an empirically supported intervention developed for delivery by British home-visiting nurses, could address this unmet mental health need. This randomized controlled trial (RCT) evaluated the effectiveness of LV delivered at a woman's usual point-of-care, including home visits or an ob-gyn office. Listening Visits were delivered to depressed pregnant women or mothers of young children by their point-of-care provider (e.g., home visitor or physician's assistant), all of whom had low levels of prior counseling experience. Three quarters of the study's participants were low-income. Of those who reported ethnicity, all identified themselves as minorities. Participants from 4 study sites (N = 66) were randomized in a 2:1 ratio, to LV or a wait-list control group (WLC). Assessments, conducted at baseline and 8 weeks, evaluated depression, quality of life, and treatment satisfaction. Depressive severity, depressive symptoms, and quality of life significantly improved among LV recipients as compared with women receiving standard social/health services. Women valued LV as evidenced by their high attendance rates and treatment satisfaction ratings. In a stepped model of depression care, LV can provide an accessible, acceptable, and effective first-line treatment option for at-risk women who otherwise are unlikely to receive treatment. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Conflict and performance monitoring throughout the lifespan: An event-related potential (ERP) and temporospatial component analysis.

PubMed

Clawson, Ann; Clayson, Peter E; Keith, Cierra M; Catron, Christina; Larson, Michael J

2017-03-01

Cognitive control includes higher-level cognitive processes used to evaluate environmental conflict. Given the importance of cognitive control in regulating behavior, understanding the developmental course of these processes may contribute to a greater understanding of normal and abnormal development. We examined behavioral (response times [RTs], error rates) and event-related potential data (N2, error-related negativity [ERN], correct-response negativity [CRN], error positivity [Pe]) during a flanker task in cross-sectional groups of 45 youth (ages 8-18), 52 younger adults (ages 20-28), and 58 older adults (ages 56-91). Younger adults displayed the most efficient processing, including significantly reduced CRN and N2 amplitude, increased Pe amplitude, and significantly better task performance than youth or older adults (e.g., faster RTs, fewer errors). Youth displayed larger CRN and N2, attenuated Pe, and significantly worse task performance than younger adults. Older adults fell either between youth and younger adults (e.g., CRN amplitudes, N2 amplitudes) or displayed neural and behavioral performance that was similar to youth (e.g., Pe amplitudes, error rates). These findings point to underdeveloped neural and cognitive processes early in life and reduced efficiency in older adulthood, contributing to poor implementation and modulation of cognitive control in response to conflict. Thus, cognitive control processing appears to reach peak performance and efficiency in younger adulthood, marked by improved task performance with less neural activation. Copyright © 2017 Elsevier B.V. All rights reserved.

A nation-wide study of the family aggregation and risk factors in anorexia nervosa over three generations.

PubMed

Steinhausen, Hans-Christoph; Jakobsen, Helle; Helenius, Dorte; Munk-Jørgensen, Povl; Strober, Michael

2015-01-01

This nation-wide register-based study investigated how often anorexia nervosa (AN) and co-morbid disorders occur in affected families compared with control families. Furthermore, the study addressed the impact of sex, year of birth, and degree of urbanization in terms of risk factors. A total of N = 2,370 child and adolescent psychiatric subjects born between 1951 and 1996 and registered in the Danish Psychiatric Central Research Register (DPCRR) had any mental disorder before the age of 18 and developed AN at some point during their life-time. In addition, N = 7,035 controls without any psychiatric diagnosis before age 18 and matched for age, sex, and residential region were included. Psychiatric diagnoses were also obtained on the first-degree relatives as a part of the Danish Three Generation Study (3GS). A family load component was obtained by using various mixed regression models. AN occurred significantly more often in case than in control families. AN Risk factors included having a sibling with AN, affective disorders in family members, and co-morbid affective, anxiety, obsessive-compulsive, personality, or substance use disorders. Furthermore, female sex, and ascending year of birth were significantly associated with having AN. Urbanization was not related to the family load of AN and case-relatives did not develop AN earlier than control relatives. These findings based on a very large and representative dataset provide evidence for the family aggregation and further risk factors in AN. © 2014 Wiley Periodicals, Inc.

Hippocampal and prefrontal cortex contributions to learning and memory: analysis of lesion and aging effects on maze learning in rats.

PubMed

Winocur, G; Moscovitch, M

1990-08-01

Young adult rats with bilateral lesions to the hippocampus or prefrontal cortex, young operated controls, and normal old rats were tested on two complex mazes in the Hebb-Williams series. Approximately half the animals were previously trained on one of the mazes; the remainder received no previous training. The trained hippocampal rats showed sparing of memory for the general skill of maze learning but poor recall of the specific maze on which they had been previously trained. The opposite pattern was observed in trained prefrontal rats. In contrast, the aged rats' memory for maze-specific and maze-general information was impaired. The results confirmed the importance of the hippocampus for recalling highly specific information and pointed to a possible role for the frontal lobes in learning and remembering nonspecific skill-related information. The generalized deficit of the aged rats indicates that both types of memory were compromised and offers further evidence of frontal lobe and hippocampal dysfunction in normal aging.

Parenting, corpus callosum, and executive function in preschool children.

PubMed

Kok, Rianne; Lucassen, Nicole; Bakermans-Kranenburg, Marian J; van IJzendoorn, Marinus H; Ghassabian, Akhgar; Roza, Sabine J; Govaert, Paul; Jaddoe, Vincent W; Hofman, Albert; Verhulst, Frank C; Tiemeier, Henning

2014-01-01

In this longitudinal population-based study (N = 544), we investigated whether early parenting and corpus callosum length predict child executive function abilities at 4 years of age. The length of the corpus callosum in infancy was measured using postnatal cranial ultrasounds at 6 weeks of age. At 3 years, two aspects of parenting were observed: maternal sensitivity during a teaching task and maternal discipline style during a discipline task. Parents rated executive function problems at 4 years of age in five domains of inhibition, shifting, emotional control, working memory, and planning/organizing, using the Behavior Rating Inventory of Executive Function-Preschool Version. Maternal sensitivity predicted less executive function problems at preschool age. A significant interaction was found between corpus callosum length in infancy and maternal use of positive discipline to determine child inhibition problems: The association between a relatively shorter corpus callosum in infancy and child inhibition problems was reduced in children who experienced more positive discipline. Our results point to the buffering potential of positive parenting for children with biological vulnerability.

[Indications for relaxation in geriatrics].

PubMed

Richard, J; Picot, A; de Bus, P; Andreoli, A; Dalakaki, X

1975-11-01

On a three years base experience in the geriatiic department of Geneva's University Psychiatric Clinic the paper studies the problem of selecting aged patients to be treated by relaxation according to the method of J. De Ajuriaguerra et M. Cahen. Observations are presented in an attempt to define three main points: a) the role played by relaxation when there is an objective [corrected] impairment of the body's integrity; b) relaxation effect on aged persons neurotic states evolution; c) the reality of considering dementia as a counter-indication of relaxation therapy. These remarks complete those presented previously about the training of therapists in relaxation, the type of control to be organized for them and their patients, the technical management of the cure, the place of relaxation in the post graduate psychiatric training, the effects of the therapy on the patients human environnement behavior in and out of the hospital, the way body is perceived through relaxation by the aged patients and it's consequences on the adjustment of an aging person.

Individual Test Point Fluctuations of Macular Sensitivity in Healthy Eyes and Eyes With Age-Related Macular Degeneration Measured With Microperimetry.

PubMed

Barboni, Mirella Telles Salgueiro; Szepessy, Zsuzsanna; Ventura, Dora Fix; Németh, János

2018-04-01

To establish fluctuation limits, it was considered that not only overall macular sensitivity but also fluctuations of individual test points in the macula might have clinical value. Three repeated measurements of microperimetry were performed using the Standard Expert test of Macular Integrity Assessment (MAIA) in healthy subjects ( N = 12, age = 23.8 ± 1.5 years old) and in patients with age-related macular degeneration (AMD) ( N = 11, age = 68.5 ± 7.4 years old). A total of 37 macular points arranged in four concentric rings and in four quadrants were analyzed individually and in groups. The data show low fluctuation of macular sensitivity of individual test points in healthy subjects (average = 1.38 ± 0.28 dB) and AMD patients (average = 2.12 ± 0.60 dB). Lower sensitivity points are more related to higher fluctuation than to the distance from the central point. Fixation stability showed no effect on the sensitivity fluctuation. The 95th percentile of the standard deviations of healthy subjects was, on average, 2.7 dB, ranging from 1.2 to 4 dB, depending on the point tested. Point analysis and regional analysis might be considered prior to evaluating macular sensitivity fluctuation in order to distinguish between normal variation and a clinical change. S tatistical methods were used to compare repeated microperimetry measurements and to establish fluctuation limits of the macular sensitivity. This analysis could add information regarding the integrity of different macular areas and provide new insights into fixation points prior to the biofeedback fixation training.

Effect of adding systematic family history enquiry to cardiovascular disease risk assessment in primary care: a matched-pair, cluster randomized trial.

PubMed

Qureshi, Nadeem; Armstrong, Sarah; Dhiman, Paula; Saukko, Paula; Middlemass, Joan; Evans, Philip H; Kai, Joe

2012-02-21

Evidence of the value of systematically collecting family history in primary care is limited. To evaluate the feasibility of systematically collecting family history of coronary heart disease in primary care and the effect of incorporating these data into cardiovascular risk assessment. Pragmatic, matched-pair, cluster randomized, controlled trial. (International Standardized Randomized Controlled Trial Number Register: ISRCTN 17943542). 24 family practices in the United Kingdom. 748 persons aged 30 to 65 years with no previously diagnosed cardiovascular risk, seen between July 2007 and March 2009. Participants in control practices had the usual Framingham-based cardiovascular risk assessment with and without use of existing family history information in their medical records. Participants in intervention practices also completed a questionnaire to systematically collect their family history. All participants were informed of their risk status. Participants with high cardiovascular risk were invited for a consultation. The primary outcome was the proportion of participants with high cardiovascular risk (10-year risk ≥ 20%). Other measures included questionnaire completion rate and anxiety score. 98% of participants completed the family history questionnaire. The mean increase in proportion of participants classified as having high cardiovascular risk was 4.8 percentage points in the intervention practices, compared with 0.3 percentage point in control practices when family history from patient records was incorporated. The 4.5-percentage point difference between groups (95% CI, 1.7 to 7.2 percentage points) remained significant after adjustment for participant and practice characteristics (P = 0.007). Anxiety scores were similar between groups. Relatively few participants were from ethnic minority or less-educated groups. The potential to explore behavioral change and clinical outcomes was limited. Many data were missing for anxiety scores. Systematically collecting family history increases the proportion of persons identified as having high cardiovascular risk for further targeted prevention and seems to have little or no effect on anxiety. Genetics Health Services Research program of the United Kingdom Department of Health.

Sexual function of premature ejaculation patients assayed with Chinese Index of Premature Ejaculation.

PubMed

Yuan, Yi-Ming; Xin, Zhong-Cheng; Jiang, Hui; Guo, Yan-Jie; Liu, Wu-Jiang; Tian, Long; Zhu, Ji-Chuan

2004-06-01

To assess the psychometric properties of the Chinese Index of Premature Ejaculation (CIPE). The sexual function of 167 patients with and 114 normal controls without premature ejaculation (PE) were evaluated with CIPE. All subjects were married and had regular sexual activity. The CIPE has 10 questions, focusing on libido, erectile function, ejaculatory latency, sexual satisfaction and difficulty in delaying ejaculation, self-confidence and depression. Each question was responded to on a 5 point Likert-type scale. The individual question score and the total scale score were analyzed between the two groups. There were no significant differences between the age, duration of marriage and educational level (P> 0.05) of patients with and without PE and normal controls. The mean latency of patients with PE and normal controls were 1.6 +/- 1.2 and 10.2 +/- 9.5 minutes, respectively. Significant differences between patients with (26.7 +/- 4.6) PE and normal controls (41.9 +/- 4.0) were observed on the total score of CIPE (P< 0.01). Using binary logistic regression analysis, PE was significantly related to five questions of the original measure. They are the so-called the CIPE-5 and include: ejaculatory latency, sexual satisfaction of patients and sexual partner, difficulty in delaying ejaculation, anxiety and depression. Receiver Operating Characteristic (ROC) curve analysis of CIPE-5 questionnaire indicated that the sensitivity and specificity of CIPE were 97.60 % and 94.74 %, respectively. Employing the total score of CIPE-5, patients with PE could be divided into three groups: mild (>15 point) 19.8 %, moderate (10-14 point) 62.8 % and severe (< 9 point) 16.7 %. The CIPE-5 is a useful method for the evaluation of sexual function of patients with PE and can be used as a clinical endpoint for clinical trials studying the efficacy of pharmacological intervention.

Explaining Dog Wolf Differences in Utilizing Human Pointing Gestures: Selection for Synergistic Shifts in the Development of Some Social Skills

PubMed Central

Gácsi, Márta; Gyoöri, Borbála; Virányi, Zsófia; Kubinyi, Enikö; Range, Friederike; Belényi, Beatrix; Miklósi, Ádám

2009-01-01

Background The comparison of human related communication skills of socialized canids may help to understand the evolution and the epigenesis of gesture comprehension in humans. To reconcile previously contradicting views on the origin of dogs' outstanding performance in utilizing human gestures, we suggest that dog-wolf differences should be studied in a more complex way. Methodology/Principal Findings We present data both on the performance and the behaviour of dogs and wolves of different ages in a two-way object choice test. Characteristic behavioural differences showed that for wolves it took longer to establish eye contact with the pointing experimenter, they struggled more with the handler, and pups also bit her more before focusing on the human's signal. The performance of similarly hand-reared 8-week-old dogs and wolves did not differ in utilizing the simpler proximal momentary pointing. However, when tested with the distal momentary pointing, 4-month-old pet dogs outperformed the same aged hand reared wolves. Thus early and intensive socialisation does not diminish differences between young dogs and wolves in behaviour and performance. Socialised adult wolves performed similarly well as dogs in this task without pretraining. The success of adult wolves was accompanied with increased willingness to cooperate. Conclusion/Significance Thus, we provide evidence for the first time that socialised adult wolves are as successful in relying on distal momentary pointing as adult pet dogs. However, the delayed emergence of utilising human distal momentary pointing in wolves shows that these wild canines react to a lesser degree to intensive socialisation in contrast to dogs, which are able to control agonistic behaviours and inhibition of actions in a food related task early in development. We suggest a “synergistic” hypothesis, claiming that positive feedback processes (both evolutionary and epigenetic) have increased the readiness of dogs to attend to humans, providing the basis for dog-human communication. PMID:19714197

Explaining dog wolf differences in utilizing human pointing gestures: selection for synergistic shifts in the development of some social skills.

PubMed

Gácsi, Márta; Györi, Borbála; Gyoöri, Borbála; Virányi, Zsófia; Kubinyi, Enikö; Range, Friederike; Belényi, Beatrix; Miklósi, Adám

2009-08-28

The comparison of human related communication skills of socialized canids may help to understand the evolution and the epigenesis of gesture comprehension in humans. To reconcile previously contradicting views on the origin of dogs' outstanding performance in utilizing human gestures, we suggest that dog-wolf differences should be studied in a more complex way. We present data both on the performance and the behaviour of dogs and wolves of different ages in a two-way object choice test. Characteristic behavioural differences showed that for wolves it took longer to establish eye contact with the pointing experimenter, they struggled more with the handler, and pups also bit her more before focusing on the human's signal. The performance of similarly hand-reared 8-week-old dogs and wolves did not differ in utilizing the simpler proximal momentary pointing. However, when tested with the distal momentary pointing, 4-month-old pet dogs outperformed the same aged hand reared wolves. Thus early and intensive socialisation does not diminish differences between young dogs and wolves in behaviour and performance. Socialised adult wolves performed similarly well as dogs in this task without pretraining. The success of adult wolves was accompanied with increased willingness to cooperate. Thus, we provide evidence for the first time that socialised adult wolves are as successful in relying on distal momentary pointing as adult pet dogs. However, the delayed emergence of utilising human distal momentary pointing in wolves shows that these wild canines react to a lesser degree to intensive socialisation in contrast to dogs, which are able to control agonistic behaviours and inhibition of actions in a food related task early in development. We suggest a "synergistic" hypothesis, claiming that positive feedback processes (both evolutionary and epigenetic) have increased the readiness of dogs to attend to humans, providing the basis for dog-human communication.

Pointing at targets by children with congenital and transient blindness.

PubMed

Gaunet, Florence; Ittyerah, Miriam; Rossetti, Yves

2007-04-01

The study investigated pointing at memorized targets in reachable space in congenitally blind (CB) and blindfolded sighted (BS) children (6, 8, 10 and 12 years; ten children in each group). The target locations were presented on a sagittal plane by passive positioning of the left index finger. A go signal for matching the target location with the right index finger was provided 0 or 4 s after demonstration. An age effect was found only for absolute distance errors and the surface area of pointing was smaller for the CB children. Results indicate that early visual experience and age are not predictive factors for pointing in children. The delay was an important factor at all ages and for both groups, indicating distinct spatial representations such as egocentric and allocentric frames of reference, for immediate and delayed pointing, respectively. Therefore, the CB like the BS children are able to use both ego- and allocentric frames of reference.

47 CFR 22.325 - Control points.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Control points. 22.325 Section 22.325... Operational and Technical Requirements Operational Requirements § 22.325 Control points. Each station in the Public Mobile Services must have at least one control point and a person on duty who is responsible for...

47 CFR 22.325 - Control points.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Control points. 22.325 Section 22.325... Operational and Technical Requirements Operational Requirements § 22.325 Control points. Each station in the Public Mobile Services must have at least one control point and a person on duty who is responsible for...

47 CFR 22.325 - Control points.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Control points. 22.325 Section 22.325... Operational and Technical Requirements Operational Requirements § 22.325 Control points. Each station in the Public Mobile Services must have at least one control point and a person on duty who is responsible for...

47 CFR 22.325 - Control points.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Control points. 22.325 Section 22.325... Operational and Technical Requirements Operational Requirements § 22.325 Control points. Each station in the Public Mobile Services must have at least one control point and a person on duty who is responsible for...

47 CFR 22.325 - Control points.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Control points. 22.325 Section 22.325... Operational and Technical Requirements Operational Requirements § 22.325 Control points. Each station in the Public Mobile Services must have at least one control point and a person on duty who is responsible for...

Randomized control trial of computer-based training targeting alertness in older adults: the ALERT trial protocol.

PubMed

VanVleet, Thomas; Voss, Michelle; Dabit, Sawsan; Mitko, Alex; DeGutis, Joseph

2018-05-03

Healthy aging is associated with a decline in multiple functional domains including perception, attention, short and long-term memory, reasoning, decision-making, as well as cognitive and motor control functions; all of which are significantly modulated by an individual's level of alertness. The control of alertness also significantly declines with age and contributes to increased lapses of attention in everyday life, ranging from minor memory slips to a lack of vigilance and increased risk of falls or motor-vehicle accidents. Several experimental behavioral therapies designed to remediate age-related cognitive decline have been developed, but differ widely in content, method and dose. Preliminary studies demonstrate that Tonic and Phasic Alertness Training (TAPAT) can improve executive functions in older adults and may be a useful adjunct treatment to enhance benefits gained in other clinically validated treatments. The purpose of the current trial (referred to as the Attention training for Learning Enhancement and Resilience Trial or ALERT) is to compare TAPAT to an active control training condition, include a larger sample of patients, and assess both cognitive and functional outcomes. We will employ a multi-site, longitudinal, blinded randomized controlled trial (RCT) design with a target sample of 120 patients with age-related cognitive decline. Patients will be asked to complete 36 training sessions remotely (30 min/day, 5 days a week, over 3 months) of either the experimental TAPAT training program or an active control computer games condition. Patients will be assessed on a battery of cognitive and functional outcomes at four time points, including: a) immediately before training, b) halfway through training, c) within forty-eight hours post completion of total training, and d) after a three-month no-contact period post completion of total training, to assess the longevity of potential training effects. The strengths of this protocol are that it tests an innovative, in-home administered treatment that targets a fundamental deficit in adults with age-related cognitive decline; employs highly sensitive computer-based assessments of cognition as well as functional abilities, and incorporates a large sample size in an RCT design. ClinicalTrials.gov identifier: NCT02416401.

Neurodevelopmental outcomes at 5 years in children exposed prenatally to maternal dental amalgam: the Seychelles Child Development Nutrition Study.

PubMed

Watson, Gene E; van Wijngaarden, Edwin; Love, Tanzy M T; McSorley, Emeir M; Bonham, Maxine P; Mulhern, Maria S; Yeates, Alison J; Davidson, Philip W; Shamlaye, Conrad F; Strain, J J; Thurston, Sally W; Harrington, Donald; Zareba, Grazyna; Wallace, Julie M W; Myers, Gary J

2013-01-01

Limited human data are available to assess the association between prenatal mercury vapor (Hg⁰)) exposure from maternal dental amalgam restorations and neurodevelopment of children. We evaluated the association between maternal dental amalgam status during gestation and children's neurodevelopmental outcomes at 5 years in the Seychelles Child Development Nutrition Study (SCDNS). Maternal amalgam status was determined prospectively in a longitudinal cohort study examining the associations of prenatal exposure to nutrients and methylmercury (MeHg) with neurodevelopment. A total of 236 mother-child pairs initially enrolled in the SCDNS in 2001 were eligible to participate. Maternal amalgam status was measured as number of amalgam surfaces (the primary metric) and number of occlusal points. The neurodevelopmental assessment battery was comprised of age-appropriate tests of cognitive, language, and perceptual functions, and scholastic achievement. Linear regression analysis controlled for MeHg exposure, maternal fatty acid status, and other covariates relevant to child development. Maternal amalgam status evaluation yielded an average of 7.0 surfaces (range 0-28) and 11.0 occlusal points (range 0-40) during pregnancy. Neither the number of maternal amalgam surfaces nor occlusal points were associated with any outcome. Our findings do not provide evidence to support a relationship between prenatal exposure to Hg⁰ from maternal dental amalgam and neurodevelopmental outcomes in children at 5 years of age. © 2013.

Neurodevelopmental Outcomes at 5 Years in Children Exposed Prenatally to Maternal Dental Amalgam: The Seychelles Child Development Nutrition Study

PubMed Central

Watson, Gene E.; van Wijngaarden, Edwin; Love, Tanzy M.T.; McSorley, Emeir M.; Bonham, Maxine P.; Mulhern, Maria S.; Yeates, Alison J.; Davidson, Philip W.; Shamlaye, Conrad F.; Strain, J.J.; Thurston, Sally W.; Harrington, Donald; Zareba, Grazyna; Wallace, Julie M.W.; Myers, Gary J.

2013-01-01

Limited human data are available to assess the association between prenatal mercury vapor (Hg0) exposure from maternal dental amalgam restorations and neurodevelopment of children. We evaluated the association between maternal dental amalgam status during gestation and children’s neurodevelopmental outcomes at 5 years in the Seychelles Child Development Nutrition Study (SCDNS). Maternal amalgam status was determined prospectively in a longitudinal cohort study examining the associations of prenatal exposure to nutrients and methylmercury (MeHg) with neurodevelopment. A total of 236 mother-child pairs initially enrolled in the SCDNS in 2001 were eligible to participate. Maternal amalgam status was measured as number of amalgam surfaces (the primary metric) and number of occlusal points. The neurodevelopmental assessment battery was comprised of age-appropriate tests of cognitive, language, and perceptual functions, and scholastic achievement. Linear regression analysis controlled for MeHg exposure, maternal fatty acid status, and other covariates relevant to child development. Maternal amalgam status evaluation yielded an average of 7.0 surfaces (range 0–28) and 11.0 occlusal points (range 0–40) during pregnancy. Neither the number of maternal amalgam surfaces nor occlusal points were associated with any outcome. Our findings do not provide evidence to support a relationship between prenatal exposure to Hg0 from maternal dental amalgam and neurodevelopmental outcomes in children at 5 years of age. PMID:23856391

Response of tibialis anterior tendon to a chronic exposure of stretch-shortening cycles: age effects

PubMed Central

Ensey, James S; Hollander, Melinda S; Wu, John Z; Kashon, Michael L; Baker, Brent B; Cutlip, Robert G

2009-01-01

Background The purpose of the current study was to investigate the effects of aging on tendon response to repetitive exposures of stretch-shortening cycles (SSC's). Methods The left hind limb from young (3 mo, N = 4) and old (30 mo, N = 9) male Fisher 344 × Brown Norway rats were exposed to 80 maximal SSCs (60 deg/s, 50 deg range of motion) 3x/week for 4.5 weeks in vivo. After the last exposure, tendons from the tibialis anterior muscle were isolated, stored at -80°C, and then tested using a micro-mechanical testing machine. Deformation of each tendon was evaluated using both relative grip-to-grip displacements and reference marks via a video system. Results At failure, the young control tendons had higher strain magnitude than the young exposed (p < 0.01) and the old control tendons (p < .0001). Total load at inflection was affected by age only (p < 0.01). Old exposed and control tendons exhibited significantly higher loads at the inflection point than their young counterparts (p < 0.05 for both comparisons). At failure, the old exposed tendons carried higher loads than the young exposed tendons (p < 0.05). Stiffness was affected by age only at failure where the old tendons exhibited higher stiffness in both exposed and control tendons than their young counterparts (p < 0.05 and p < 0.01, respectively). Conclusion The chronic protocol enhanced the elastic stiffness of young tendon and the loads in both the young and old tendons. The old exposed tendons were found to exhibit higher load capacity than their younger counterparts, which differed from our initial hypothesis. PMID:19563638

Tobacco point of sale advertising increases positive brand user imagery

PubMed Central

Donovan, R; Jancey, J; Jones, S

2002-01-01

Objectives: To determine the potential impact of point of sale advertising on adolescents so as to inform changes to the Tobacco Control Act. Design: Participants were randomly assigned to one of two conditions. In the control condition, students were exposed to a photograph of a packet of cigarettes; in the intervention condition, students were exposed to an ad for cigarettes, typical of point of sale advertising posters. All students then rated the brand user on a set of 12 bipolar adjectives. Two brands were used in the study: Benson & Hedges, and Marlboro. Subjects: One hundred year (grade) 6 and 7 students (age range 10–12 years), from four Western Australian metropolitan primary schools, participated in the study. Results: In a majority of the brand user descriptions, the cigarette advertisements increased brand user imagery in a positive way, especially for Benson & Hedges. For example, participants viewing the Benson & Hedges advertisement, as distinct from those viewing the Benson & Hedges pack only, were more likely to describe the Benson & Hedges user as relaxed, interesting, cool, rich, adventurous, and classy. Relative to the Marlboro pack only, the Marlboro ad increased positive perceptions of the Marlboro user on adventurous, interesting, and relaxed. Conclusions: The results presented here support restrictions being placed on advertising at point of sale, since such ads have the potential to increase positive brand user imagery directly in the situation where a product purchase can take place, and hence the potential to increase the likelihood of impulse purchasing. PMID:12198267

Tobacco point of sale advertising increases positive brand user imagery.

PubMed

Donovan, R J; Jancey, J; Jones, S

2002-09-01

To determine the potential impact of point of sale advertising on adolescents so as to inform changes to the Tobacco Control Act. Participants were randomly assigned to one of two conditions. In the control condition, students were exposed to a photograph of a packet of cigarettes; in the intervention condition, students were exposed to an ad for cigarettes, typical of point of sale advertising posters. All students then rated the brand user on a set of 12 bipolar adjectives. Two brands were used in the study: Benson & Hedges, and Marlboro. One hundred year (grade) 6 and 7 students (age range 10-12 years), from four Western Australian metropolitan primary schools, participated in the study. In a majority of the brand user descriptions, the cigarette advertisements increased brand user imagery in a positive way, especially for Benson & Hedges. For example, participants viewing the Benson & Hedges advertisement, as distinct from those viewing the Benson & Hedges pack only, were more likely to describe the Benson & Hedges user as relaxed, interesting, cool, rich, adventurous, and classy. Relative to the Marlboro pack only, the Marlboro ad increased positive perceptions of the Marlboro user on adventurous, interesting, and relaxed. The results presented here support restrictions being placed on advertising at point of sale, since such ads have the potential to increase positive brand user imagery directly in the situation where a product purchase can take place, and hence the potential to increase the likelihood of impulse purchasing.

[Analysis on death causes of residents in Anhui province, 2013].

PubMed

He, Qin; Chen, Yeji; Dai, Dan; Xu, Wei; Xing, Xiuya; Liu, Zhirong

2015-09-01

To analyze the demographic characteristics and the death causes of the residents in Anhui province, and provide evidence for the disease prevention and control. Using descriptive epidemiological analysis, the demographic characteristics and death data of the national disease surveillance points (DSPs) in Anhui province in 2013 were analyed by areas. The aging of the population was observed in all the areas in Anhui, which was most obvious in Jianghuai, followed by Wannan and Huaibei. The overall mortality was 627.10/100 000. The mortalities of diseases varied with sex, area and age. Among the 3 areas, the overall mortality, chronic disease mortality and injury mortality were highest in Huaibei and lowest in Wannan. The area specific difference in mortality of infectious diseases was small. Regardless of areas or the types of diseases, the mortality was higher in males than in females. Deaths caused by diseases with unknown origins were common in residents aged >65 years. The mortality of chronic diseases was higher in residents aged >45 years, especially in those aged 65-84 years. The mortality of injuries was higher in age groups >15 years and >45 years. The mortality of infectious diseases peaked at both young age group and old age group. The top five death causes were cerebrovascular diseases, malignant tumors, heart diseases, respiratory diseases and injuries. Regardless of sex or area, the major death causes were similar, but the ranks were slightly different. The major death causes varied in different age groups, but they were similar in same age group in different areas. The major death causes were diseases originated in perinatal period, and congenital malformations, deformations and chromosomal abnormalities in children aged <1 year. The major death causes in children aged 1-14 years were injuries, diseases originated in perinatal period, congenital malformations, deformations and chromosomal abnormalities. Injuries and malignant tumors were the first and second death causes in residents aged 15-44 years. Malignant tumors, injuries, cerebrovascular diseases and heart diseases were the major death causes in residents aged 45-64 years. The major death causes were cerebrovascular diseases, malignant tumors, heart diseases and respiratory diseases in residents aged 65-84 years and heart diseases, cerebrovascular diseases, respiratory diseases and malign tumors in residents aged≥85 years. The major death causes in residents in Anhui province were cerebrovascular diseases, malignant tumors and injuries. Close attention should be paid to the prevention and control of cerebrovascular diseases, malignant tumors and heart diseases in age group≥45 years. It is necessary to strengthen the prevention and control of injuries in age group 15-44 years. Huaibei is a key area of disease prevention and control in Anhui, especially chronic disease and injury preventions.

Instrument Pointing Control System for the Stellar Interferometry Mission - Planet Quest

NASA Technical Reports Server (NTRS)

Brugarolas, Paul B.; Kang, Bryan

2006-01-01

This paper describes the high precision Instrument Pointing Control System (PCS) for the Stellar Interferometry Mission (SIM) - Planet Quest. The PCS system provides front-end pointing, compensation for spacecraft motion, and feedforward stabilization, which are needed for proper interference. Optical interferometric measurements require very precise pointing (0.03 as, 1-(sigma) radial) for maximizing the interference pattern visibility. This requirement is achieved by fine pointing control of articulating pointing mirrors with feedback from angle tracking cameras. The overall pointing system design concept is presentcd. Functional requirements and an acquisition concept are given. Guide and Science pointing control loops are discussed. Simulation analyses demonstrate the feasibility of the design.

Heading perception in patients with advanced retinitis pigmentosa

NASA Technical Reports Server (NTRS)

Li, Li; Peli, Eli; Warren, William H.

2002-01-01

PURPOSE: We investigated whether retinis pigmentosa (RP) patients with residual visual field of < 100 degrees could perceive heading from optic flow. METHODS: Four RP patients and four age-matched normally sighted control subjects viewed displays simulating an observer walking over a ground. In experiment 1, subjects viewed either the entire display with free fixation (full-field condition) or through an aperture with a fixation point at the center (aperture condition). In experiment 2, patients viewed displays of different durations. RESULTS: RP patients' performance was comparable to that of the age-matched control subjects: heading judgment was better in the full-field condition than in the aperture condition. Increasing display duration from 0.5 s to 1 s improved patients' heading performance, but giving them more time (3 s) to gather more visual information did not consistently further improve their performance. CONCLUSIONS: RP patients use active scanning eye movements to compensate for their visual field loss in heading perception; they might be able to gather sufficient optic flow information for heading perception in about 1 s.

Heading perception in patients with advanced retinitis pigmentosa.

PubMed

Li, Li; Peli, Eli; Warren, William H

2002-09-01

We investigated whether retinis pigmentosa (RP) patients with residual visual field of < 100 degrees could perceive heading from optic flow. Four RP patients and four age-matched normally sighted control subjects viewed displays simulating an observer walking over a ground. In experiment 1, subjects viewed either the entire display with free fixation (full-field condition) or through an aperture with a fixation point at the center (aperture condition). In experiment 2, patients viewed displays of different durations. RP patients' performance was comparable to that of the age-matched control subjects: heading judgment was better in the full-field condition than in the aperture condition. Increasing display duration from 0.5 s to 1 s improved patients' heading performance, but giving them more time (3 s) to gather more visual information did not consistently further improve their performance. RP patients use active scanning eye movements to compensate for their visual field loss in heading perception; they might be able to gather sufficient optic flow information for heading perception in about 1 s.

Typhoid fever in young children in Bangladesh: clinical findings, antibiotic susceptibility pattern and immune responses.

PubMed

Khanam, Farhana; Sayeed, Md Abu; Choudhury, Feroza Kaneez; Sheikh, Alaullah; Ahmed, Dilruba; Goswami, Doli; Hossain, Md Lokman; Brooks, Abdullah; Calderwood, Stephen B; Charles, Richelle C; Cravioto, Alejandro; Ryan, Edward T; Qadri, Firdausi

2015-04-01

Children bear a large burden of typhoid fever caused by Salmonella enterica serotype Typhi (S. Typhi) in endemic areas. However, immune responses and clinical findings in children are not well defined. Here, we describe clinical and immunological characteristics of young children with S. Typhi bacteremia, and antimicrobial susceptibility patterns of isolated strains. As a marker of recent infection, we have previously characterized antibody-in-lymphocyte secretion (TPTest) during acute typhoid fever in adults. We similarly assessed membrane preparation (MP) IgA responses in young children at clinical presentation, and then 7-10 days and 21-28 days later. We also assessed plasma IgA, IgG and IgM responses and T cell proliferation responses to MP at these time points. We compared responses in young children (1-5 years) with those seen in older children (6-17 years), adults (18-59 years), and age-matched healthy controls. We found that, compared to age-matched controls patients in all age cohorts had significantly more MP-IgA responses in lymphocyte secretion at clinical presentation, and the values fell in all groups by late convalescence. Similarly, plasma IgA responses in patients were elevated at presentation compared to controls, with acute and convalescent IgA and IgG responses being highest in adults. T cell proliferative responses increased in all age cohorts by late convalescence. Clinical characteristics were similar in all age cohorts, although younger children were more likely to present with loss of appetite, less likely to complain of headache compared to older cohorts, and adults were more likely to have ingested antibiotics. Multi-drug resistant strains were present in approximately 15% of each age cohort, and 97% strains had resistance to nalidixic acid. This study demonstrates that S. Typhi bacteremia is associated with comparable clinical courses, immunologic responses in various age cohorts, including in young children, and that TPTest can be used as marker of recent typhoid fever, even in young children.

Mismatch Negativity in essential tremor: role of age at onset in pre-attentive auditory discrimination.

PubMed

Pauletti, C; Mannarelli, D; Locuratolo, N; Vanacore, N; De Lucia, M C; Fattapposta, F

2014-04-01

To investigate whether pre-attentive auditory discrimination is impaired in patients with essential tremor (ET) and to evaluate the role of age at onset in this function. Seventeen non-demented patients with ET and seventeen age- and sex-matched healthy controls underwent an EEG recording during a classical auditory MMN paradigm. MMN latency was significantly prolonged in patients with elderly-onset ET (>65 years) (p=0.046), while no differences emerged in either latency or amplitude between young-onset ET patients and controls. This study represents a tentative indication of a dysfunction of auditory automatic change detection in elderly-onset ET patients, pointing to a selective attentive deficit in this subgroup of ET patients. The delay in pre-attentive auditory discrimination, which affects elderly-onset ET patients alone, further supports the hypothesis that ET represents a heterogeneous family of diseases united by tremor; these diseases are characterized by cognitive differences that may range from a disturbance in a selective cognitive function, such as the automatic part of the orienting response, to more widespread and complex cognitive dysfunctions. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Expressive drawing ability in children with autism.

PubMed

Jolley, Richard P; O'Kelly, Rachael; Barlow, Claire M; Jarrold, Christopher

2013-03-01

The autistic impairments in emotional and social competence, imagination and generating ideas predict qualitative differences in expressive drawings by children with autism beyond that accounted by any general learning difficulties. In a sample of 60 5-19-year-olds, happy and sad drawings were requested from 15 participants with non-savant autism and compared with those drawn by three control groups matched on either degree of learning difficulty (MLD), mental age (MA) or chronological age (CA). All drawings were rated by two artists on a 7-point quality of expression scale. Contrary to our predictions, the drawings from the autistic group were rated similar to those of the MA and MLD groups. Analysis of the people and social content of the drawings revealed that although children with autism did not draw fewer people, they did draw more immature forms than mental age controls. Furthermore, there was tentative evidence that fewer social scenes were produced by the autism sample. We conclude that the overall merit of expressive drawing in autism is commensurate with their general learning difficulties, but the social/emotional impairment in autism affects their drawings of people and social scenes. © 2013 The British Psychological Society.