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Sample records for age main outcome

  1. Advanced paternal age and reproductive outcome

    PubMed Central

    Wiener-Megnazi, Zofnat; Auslender, Ron; Dirnfeld, Martha

    2012-01-01

    Women have been increasingly delaying the start of motherhood in recent decades. The same trend is seen also for men. The influence of maternal age on fertility, chromosomal anomalies, pregnancy complications, and impaired perinatal and post-natal outcome of offspring, has been thoroughly investigated, and these aspects are clinically applied during fertility and pregestational counseling. Male aging and reproductive outcome has gained relatively less attention. The purpose of this review is to evaluate updated and relevant literature on the effect of paternal age on reproductive outcome. PMID:22157982

  2. Will Interventions Targeting Conscientiousness Improve Aging Outcomes?

    ERIC Educational Resources Information Center

    English, Tammy; Carstensen, Laura L.

    2014-01-01

    The articles appearing in this special section discuss the role that conscientiousness may play in healthy aging. Growing evidence suggests that conscientious individuals live longer and healthier lives. However, the question remains whether this personality trait can be leveraged to improve long-term health outcomes. We argue that even though it…

  3. Manchester Triage System: main flowcharts, discriminators and outcomes of a pediatric emergency care 1

    PubMed Central

    Amthauer, Camila; da Cunha, Maria Luzia Chollopetz

    2016-01-01

    ABSTRACT Objetive: to characterize the care services performed through risk rating by the Manchester Triage System, identifying demographics (age, gender), main flowcharts, discriminators and outcomes in pediatric emergency Method: cross-sectional quantitative study. Data on risk classification were obtained through a search of computerized registration data from medical records of patients treated in the pediatric emergency within one year. Descriptive statistics with absolute and relative frequencies was used for the analysis. Results: 10,921 visits were conducted in the pediatric emergency, mostly male (54.4%), aged between 29 days and two years (44.5%). There was a prevalence of the urgent risk category (43.6%). The main flowchart used in the care was worried parents (22.4%) and the most prevalent discriminator was recent event (15.3%). The hospitalization outcome occurred in 10.4% of care performed in the pediatric emergency, however 61.8% of care needed to stay under observation and / or being under the health team care in the pediatric emergency. Conclusion: worried parents was the main flowchart used and recent events the most prevalent discriminator, comprising the hospitalization outcomes and permanency in observation in the pediatric emergency before discharge from the hospital. PMID:27579934

  4. Reinterpretation of age and correlation between tectonostratigraphic units, southwestern Maine

    SciTech Connect

    Hussey, A.M. . Geology Dept.); Aleinikoff, J. ); Marvinney, R. )

    1993-03-01

    Tectonostratigraphic sequence within the Coastal Lithotectonic Belt of southwestern Maine include the Merrimack Group (MG), Casco Bay Group (CBG), Falmouth-Brunswick sequence (FBS), and Central Maine sequence (CMS). Formations of FBS (Nehumkeag Pond, Mt. Ararat, Torrey Hill, and Richmond Corner), all west of the Norumbega Fault Zone, constitute a separate sequence unrelated to the Casco Bay Group east of the Fault. The age of these rocks is uncertain. The Mt. Ararat and Nehumkeag Pond Fms. are tentatively correlated with lithically similar parts of the Massabesic Gneiss in New Hampshire, and with the Monson Gneiss in Massachusetts. The Mt. Ararat and Nehumkeag Pond Formations, now no longer correlated with the Cushing Fm. may form a basement to the CMS. The CBG, a package of metamorphosed volcanic and pelitic rocks crops out only east of the Norumbega Fault. Felsic metavolcanic rocks of the Cushing Fm. at the base of the CBG give a 471[+-]3 MA U/Pb age on zircons, indicating a Middle Ordovician age for the base of the CBG. The Sebascodegan Fm., an easterly felspathic and calcareous volcaniclastic facies of the upper part of the Cushing Fm., is correlated with the Bucksport Fm. of southeastern coastal Maine, suggesting a Middle Ordovician age for that formation. The Sebascodegan Fm may be equivalent to the Kittery Formation of the MG. The Macworth Fm. of the CBG is equivalent to the Elliot Fm. of the MG, and the Cape Elizabeth Fm. stratigraphically above the Cushing Fm in the CBG, may be equivalent in part to the Elliot Fm. Units of the CBG above the Cape Elizabeth Fm. are not present to the south in the MG due either to faulting or stratigraphic pinchout.

  5. Main sequence mass loss and the ages of stars

    NASA Technical Reports Server (NTRS)

    Willson, L. A.

    1989-01-01

    The potentially observable consequences of the pulsation/rotation-induced mass loss from main-sequence A and F stars proposed by Willson et al. (1987) are discussed, reviewing the results of recent investigations. Particular attention is given to (1) evidence for a deficiency in A stars and an excess of F and G stars, as predicted by the theory, (2) cluster HR diagrams and age estimates, and (3) modifications to standard models of solar-system evolution. It is pointed out that the time scales and mass-loss rates required to explain the observed properties of clusters and field stars in this theory are the same as those needed to account for the early development of the solar system.

  6. Disuse and aging: same problem, different outcomes.

    PubMed

    Timiras, P S

    1994-05-01

    Many of the changes that accompany physical inactivity coincide with those that occur during aging. These changes are generally grouped under the term of 'disuse' (or "lack of use" or "inappropriately modulated stimulation"). Studies of long-term space travel have revealed that weightlessness in space also induces changes resembling those of aging and physical inactivity. The relationship between disuse (due to bed rest, insufficient exercise, or lack of gravity) and aging has some definite practical implications. As life expectancy is lenghtened in all populations worldwide, the number of elderly with varying degrees of disability leading to reduced physical activity also increases. Changes induced by bed rest as a consequence of disease may also be superimposed on aging changes and further diminish physiologic reserves and accelerate pathology. Therefore, the study of disuse, irrespective of its etiology, may serve as a model for understanding not only some of the functional changes induced by lack of activity and/or gravity but also some of the disabilities of old age. Indeed, a better understanding of disuse phenomena will make it possible to establish programs of prevention and rehabilitation that will ameliorate both disuse and aging deficits.

  7. School-Aged Outcomes After Neonatal Arterial Ischemic Stroke.

    PubMed

    Czech, Theresa; Pardo, Andrea C

    2016-02-01

    Investigators from the Accident Vasculaire Cérébral de nouveau-né (AVCnn) Study Group, a multicenter registry in France, examined outcomes at 7 years of age in children previously identified with neonatal arterial ischemic stroke (NAIS).

  8. DNA Damage: A Main Determinant of Vascular Aging

    PubMed Central

    Bautista-Niño, Paula K.; Portilla-Fernandez, Eliana; Vaughan, Douglas E.; Danser, A. H. Jan; Roks, Anton J. M.

    2016-01-01

    Vascular aging plays a central role in health problems and mortality in older people. Apart from the impact of several classical cardiovascular risk factors on the vasculature, chronological aging remains the single most important determinant of cardiovascular problems. The causative mechanisms by which chronological aging mediates its impact, independently from classical risk factors, remain to be elucidated. In recent years evidence has accumulated that unrepaired DNA damage may play an important role. Observations in animal models and in humans indicate that under conditions during which DNA damage accumulates in an accelerated rate, functional decline of the vasculature takes place in a similar but more rapid or more exaggerated way than occurs in the absence of such conditions. Also epidemiological studies suggest a relationship between DNA maintenance and age-related cardiovascular disease. Accordingly, mouse models of defective DNA repair are means to study the mechanisms involved in biological aging of the vasculature. We here review the evidence of the role of DNA damage in vascular aging, and present mechanisms by which genomic instability interferes with regulation of the vascular tone. In addition, we present potential remedies against vascular aging induced by genomic instability. Central to this review is the role of diverse types of DNA damage (telomeric, non-telomeric and mitochondrial), of cellular changes (apoptosis, senescence, autophagy), mediators of senescence and cell growth (plasminogen activator inhibitor-1 (PAI-1), cyclin-dependent kinase inhibitors, senescence-associated secretory phenotype (SASP)/senescence-messaging secretome (SMS), insulin and insulin-like growth factor 1 (IGF-1) signaling), the adenosine monophosphate-activated protein kinase (AMPK)-mammalian target of rapamycin (mTOR)-nuclear factor kappa B (NFκB) axis, reactive oxygen species (ROS) vs. endothelial nitric oxide synthase (eNOS)-cyclic guanosine monophosphate (c

  9. Stellar evolution from the zero-age main sequence

    NASA Technical Reports Server (NTRS)

    Mengel, J. G.; Demarque, P.; Sweigart, A. V.; Gross, P. G.

    1979-01-01

    A consistent set of 247 evolutionary sequences extending from the ZAMS to the red-giant branch is presented for Y from 0.10 to 0.40, Z from 0.00001 to 0.10, and masses of 0.55 to 6.90 solar masses. Each sequence is started from a homogeneous ZAMS model, and almost all are evolved to the base of the red-giant branch. It is shown that: (1) the relative position of the main sequence can be determined as a function of composition; (2) theoretical luminosity functions can be derived from the relative evolutionary time scales; (3) a dip in luminosity sometimes occurs at the base of the red-giant branch and is most pronounced at larger Z values; (4) metal-poor stars evolve farther up along the main sequence before turning off toward the red-giant branch; and (5) the onset of helium burning halts the evolution across the Hertzsprung gap for the most massive and most metal-poor models, so that the star remains blue during its phase of core-helium burning.

  10. Cognitive outcomes in school-age children born prematurely.

    PubMed

    Davis, Deborah Winders

    2003-01-01

    The purpose of this article is to discuss findings in the literature regarding long-term developmental outcomes of infants born prematurely, to examine potential causes of individual differences in these outcomes, and to explore directions for future research. An extensive table summarizes recent (1996-2002) international studies of developmental outcomes among children of school age and older who were born with low birth weight, especially as the studies relate to cognitive development and academic performance. The discussion then examines how characteristics of the child and the environment may interact to produce individual differences in outcomes. Processes of attention regulation within the context of the psychosocial environment are examined as an important possible direction for future research. When designing and implementing interventions aimed at improving outcomes in this and other groups of children at risk for delays and deficits, it is important to consider how various factors affect development. PMID:12795506

  11. Pregnancy Outcome of Multiparous Women Aged over 40 Years.

    PubMed

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

    2013-01-01

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

  12. Left Main Coronary Artery Disease: Secular Trends in Patient Characteristics, Treatments, and Outcomes.

    PubMed

    Lee, Pil Hyung; Ahn, Jung-Min; Chang, Mineok; Baek, Seunghee; Yoon, Sung-Han; Kang, Soo-Jin; Lee, Seung-Whan; Kim, Young-Hak; Lee, Cheol Whan; Park, Seong-Wook; Park, Duk-Woo; Park, Seung-Jung

    2016-09-13

    Left main coronary artery (LMCA) disease is the highest-risk lesion subset of ischemic heart disease, and has traditionally been an indication for coronary artery bypass grafting (CABG). Recent evidence suggests comparable clinical outcomes between percutaneous coronary intervention (PCI) and CABG for LMCA disease, with similar rates of mortality and serious composite outcomes, a higher rate of stroke with CABG, and a higher rate of repeat revascularization with PCI. These results have been translated to the current guideline recommendation that PCI is a reasonable alternative to CABG in patients with low to intermediate anatomic complexity. However, how the characteristics, treatment, and clinical outcomes of patients with unprotected LMCA disease have evolved over time has not yet been fully evaluated. We therefore described secular trends in the characteristics and long-term outcomes of unprotected LMCA disease using "real-world" clinical experience from the IRIS-MAIN (Interventional Research Incorporation Society-Left MAIN Revascularization) registry together with a broad review of this topic. PMID:27609687

  13. The ages of globular cluster stars - Effects of rotation on pre-main-sequence, main-sequence, and turnoff evolution

    NASA Technical Reports Server (NTRS)

    Deliyannis, Constantine P.; Demarque, Pierre; Pinsonneault, Marc H.

    1989-01-01

    Evolutionary sequences for low-metallicity stars (Z ranging from 0.001 to 0.0001) to study the effects of internal stellar rotation on the evolutionary time scales in the pre-main sequence, the main sequence (MS), and around the MS turnoff. Although a substantial amount of angular momentum remains in the interior, rotation is only a minor perturbation on the structure and ages of globular cluster stars. Even models with large initial angular momenta have MS lifetimes that are within 1 percent of those of standard models of the same mass and composition. Therefore, rotation does not affect age estimates of globular clusters from isochrone fitting. Furthermore, the models suggest that because rotation is not likely to affect horizontal-branch (HB) morphology, it does not affect significantly age estimates from the Delta-V method. Nevertheless, the internal angular momentum in the models is consistent with observations of surface rotational velocities on the HB, which require the preservation of a large reservoir of internal angular momentum.

  14. Effect of recipient age on the outcome of kidney transplantation.

    PubMed

    Abou-Jaoude, Maroun M; Khoury, Mansour; Nawfal, Naji; Shaheen, Joseph; Almawi, Wassim Y

    2009-01-01

    We investigated the effect of recipient age (RA) on kidney transplantation outcome in 107 transplant patients, with a follow-up of 1 year. Patients were divided in 3 groups: Group A (RA<50 years; 72 patients), Group B (RA 50-60 years, 19 patients), and Group C (RA>60 years; 16 patients). The rate and severity of acute rejection, infection rate and type, delayed graft function, hospital stay, creatinine levels (3, 6, 12 months), incidence at 1 year of post-transplant hypertension, cholesterol and triglycerides blood levels, and the rate of post-transplant surgical complications, and 1-year graft and patient survival were comparable between the 3 groups. However, creatinine blood level at 1 month and the 1-year fasting blood sugar were significantly higher in Group B. The RA does not seem to be of a significant predictive value, good selection and pre-transplant patient workout are important factors for a better outcome.

  15. Neurodevelopmental Outcomes of Extremely Low Gestational Age Neonates with Low Grade Periventricular-Intraventricular Hemorrhage

    PubMed Central

    Payne, Allison H.; Hintz, Susan R.; Hibbs, Anna Maria; Walsh, Michele C.; Vohr, Betty R.; Bann, Carla M.; Wilson-Costello, Deanne E.

    2014-01-01

    Objective To compare neurodevelopmental outcomes at 18–22 months corrected age for extremely low gestational age infants with low grade (Grade 1 or 2) periventricular-intraventricular hemorrhage to infants with either no hemorrhage or severe (Grade 3 or 4) hemorrhage on cranial ultrasound. Design Longitudinal observational study Setting Sixteen centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Participants 1472 infants born at <27 weeks gestational age between 2006–2008 with ultrasound results within the first 28 days of life and surviving to 18–22 months with complete follow-up assessments were eligible. Main Exposure Low grade periventricular-intraventricular hemorrhage Outcome Measures Outcomes included cerebral palsy, gross motor functional limitation, Bayley III cognitive and language scores, and composite measures of neurodevelopmental impairment. Regression modeling evaluated the association of hemorrhage severity with adverse outcomes while controlling for potentially confounding variables and center differences. Results Low grade hemorrhage was not associated with significant differences in unadjusted or adjusted risk of any adverse neurodevelopmental outcome compared to infants without hemorrhage. Compared with low grade hemorrhage, severe hemorrhage was associated with decrease in adjusted continuous cognitive (−3.91, [95% Confidence Interval [CI]: −6.41, −1.42]) and language (−3.19 [−6.19, −0.19]) scores as well as increased odds of each adjusted categorical outcome except severe cognitive impairment (OR: 1.46 [0.74, 2.88]) and mild language impairment (OR: 1.35 [0.88, 2.06]). Conclusion At 18–22 months, the neurodevelopmental outcomes of extremely low gestational age infants with low grade periventricular-intraventricular hemorrhage are not significantly different from those without hemorrhage. PMID:23460139

  16. Chorioamnionitis and Early Childhood Outcomes among Extremely Low-Gestational-Age Neonates

    PubMed Central

    Pappas, Athina; Kendrick, Douglas E.; Shankaran, Seetha; Stoll, Barbara J.; Bell, Edward F.; Laptook, Abbott R.; Walsh, Michele C.; Das, Abhik; Hale, Ellen C.; Newman, Nancy S.; Higgins, Rosemary D.

    2014-01-01

    Importance Chorioamnionitis is strongly linked to preterm birth and to neonatal infection. The association between histological and clinical chorioamnionitis and cognitive, behavioral and neurodevelopmental outcomes among extremely preterm neonates is less clear. We evaluated the impact of chorioamnionitis on 18-22 month neurodevelopmental outcomes in a contemporary cohort of extremely preterm neonates. Objective To compare the neonatal and neurodevelopmental outcomes of three groups of extremely-low-gestational-age infants with increasing exposure to perinatal inflammation: no chorioamnionitis, histological chorioamnionitis alone, or histological plus clinical chorioamnionitis. Design Longitudinal observational study. Setting Sixteen centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Participants 2390 extremely preterm infants born <27 weeks' gestational age between January 1, 2006 and December 31, 2008 with placental histopathology and 18-22 months' corrected age follow-up data were eligible. Main exposure Chorioamnionitis Main Outcome Measures Outcomes included cerebral palsy, gross motor functional limitation, behavioral scores (according to the Brief Infant-Toddler Social and Emotional Assessment), cognitive and language scores (according to the Bayley Scales of Infant Development, 3rd-Edition) and composite measures of death/neurodevelopmental impairment. Multivariable logistic and linear regression models were developed to assess the association between chorioamnionitis and outcomes while controlling for important variables known at birth. Results Neonates exposed to chorioamnionitis had a lower gestational age (GA) and had higher rates of early-onset sepsis and severe periventricular-intraventricular hemorrhage as compared with unexposed neonates. In multivariable models evaluating death and neurodevelopmental outcomes, inclusion of gestational age in the model diminished the association

  17. Outcomes of Small for Gestational Age Infants < 27 Weeks’ Gestation

    PubMed Central

    De Jesus, Lilia C.; Pappas, Athina; Shankaran, Seetha; Li, Lei; Das, Abhik; Bell, Edward F.; Stoll, Barbara J.; Laptook, Abbot R.; Walsh, Michele C.; Hale, Ellen C.; Newman, Nancy S.; Bara, Rebecca; Higgins, Rosemary D.

    2014-01-01

    Objective To determine whether small for gestational age (SGA) infants <27 weeks gestation is associated with mortality, morbidity, growth and neurodevelopmental impairment at 18–22 months’ corrected age (CA). Study design This was a retrospective cohort study from National Institute of Child Health and Human Development Neonatal Research Network’s Generic Database and Follow-up Studies. Infants born at <27 weeks’ gestation from January 2006 to July 2008 were included. SGA was defined as birth weight <10th percentile for gestational age by the Olsen growth curves. Infants with birth weight ≥10th percentile for gestational age were classified as non-SGA. Maternal and infant characteristics, neonatal outcomes and neurodevelopmental data were compared between the groups. Neurodevelopmental impairment was defined as any of the following: cognitive score <70 on BSID III, moderate or severe cerebral palsy, bilateral hearing loss (+/− amplification) or blindness (vision <20/200). Logistic regression analysis evaluated the association between SGA status and death or neurodevelopmental impairment. Results There were 385 SGA and 2586 non-SGA infants. Compared with the non-SGA group, mothers of SGA infants were more likely to have higher level of education, prenatal care, cesarean delivery, pregnancy-induced hypertension and antenatal corticosteroid exposure. SGA infants were more likely to have postnatal growth failure, a higher mortality and to have received prolonged mechanical ventilation and postnatal steroids. SGA status was associated with higher odds of death or neurodevelopmental impairment [OR 3.91 (95% CI: 2.91–5.25), P<0.001]. Conclusion SGA status among infants <27 weeks’ gestation was associated with an increased risk for postnatal steroid use, mortality, growth failure and neurodevelopmental impairment at 18–22 months’ CA. PMID:23415614

  18. The Chromospheric Activity and Age Relation among Main Sequence Stars in Wide Binaries

    NASA Astrophysics Data System (ADS)

    Oswalt, Terry D.; Zhao, J.

    2011-05-01

    We present a study of the chromospheric activity levels in 36 wide binary systems. Thirty one of the binaries contain a white dwarf component. In such binaries the total age can be estimated by adding the cooling age of the white dwarf to an estimate of the progenitor's main sequence lifetime. To better understand how activity correlates to stellar age, 14 cluster member stars were also observed. Our observations confirm the expectation derived from studies of single main sequence stars that activity decays with age. However, for the first time we demonstrate that this relation extends from 50 Myr to at least 8 Gyr for stars with 1.0 < V-I < 2.4 color index. We also find that little change in activity occurs for stars with V-I < 1.0 and ages between 1 Gyr and 5 Gyr. The slope of constant age lines in the activity vs. V-I plane for young stars is relatively steep, while for old stars it appears to be flatter. In addition, our sample includes five wide binaries consisting of two main sequence stars. These pairs provide a useful reality check on our activity vs. age relation. Support for this project from NSF grant AST-0807919 to Florida Institute of Technology is gratefully acknowledged.

  19. Introduction: choosing the main outcome of an infertility trial is harder than you think.

    PubMed

    Legro, Richard S; Wu, Xiaoke

    2014-05-01

    Clinical trials in infertility choose from a variety of outcomes including change in some surrogate marker of gamete quality to healthy live birth. Incomplete reporting of outcomes makes it difficult to compare studies and to determine the clinical impact of infertility treatments. In this Views and Reviews, we explore the merits of collecting various outcomes of interest in infertility trials from the vantage point of infertility specialists, an obstetrician, and a pediatrician. These articles support more complete reporting of maternal, paternal, fetal, and infant outcomes from infertility trials to improve patient care and ultimately public health.

  20. The main factors influencing canine demodicosis treatment outcome and determination of optimal therapy.

    PubMed

    Arsenović, Milica; Pezo, Lato; Vasić, Nebojša; Ćirić, Rodoljub; Stefanović, Milan

    2015-07-01

    The main idea of this research was to evaluate the efficacy of canine demodicosis conventional treatments using mathematical analyses. All available papers published between 1980 and 2014 were used in this study. One hundred six clinical trials enrolling 3414 cases of generalized demodicosis in dogs are studied. Dogs entered in the analysis were only the ones in which the disease occurred naturally, excluding the studies in which transplantation of Demodex canis mites was done from other animals. In conventional acaricide treatments, sorted according to active substances (moxidectin, amitraz, doramectin, ivermectin, and milbemycin oxime), the way of application (spot-on, dips, orally, or subcutaneous), concentration, and interval of application were used as input parameters in mathematical modeling. Data of interest were the treatment outcome, the number of dogs that went into remission, the number of animals not responding to treatment microscopically, the average duration of therapy, the follow-up period, the number of patients with disease recurrence, the number of adverse effects, and the number of animals with side effects. Dogs lost to follow-up or when the treatment was discontinued, due to various reasons not in connection with the therapy protocol, were not considered. Statistical and mathematical analyses were applied for prediction of the drugs' effectiveness. Developed mathematical models showed satisfactorily r (2), higher than 0.87. Good evidence for recommending the use of milbemycin oxime PO (0.5 mg/kg, daily) and moxidectin spot-on (Advocate®, Bayer) weekly is found. A bit less effective therapies were based on ivermectin PO (0.5 mg/kg, daily), moxidectin PO (0.35 mg/kg, daily), and amitraz dips (0.05 % solution, weekly), respectively. It is important to keep in mind that Advocate® is recommended by the manufacturer for use in milder cases. PMID:26013574

  1. The main factors influencing canine demodicosis treatment outcome and determination of optimal therapy.

    PubMed

    Arsenović, Milica; Pezo, Lato; Vasić, Nebojša; Ćirić, Rodoljub; Stefanović, Milan

    2015-07-01

    The main idea of this research was to evaluate the efficacy of canine demodicosis conventional treatments using mathematical analyses. All available papers published between 1980 and 2014 were used in this study. One hundred six clinical trials enrolling 3414 cases of generalized demodicosis in dogs are studied. Dogs entered in the analysis were only the ones in which the disease occurred naturally, excluding the studies in which transplantation of Demodex canis mites was done from other animals. In conventional acaricide treatments, sorted according to active substances (moxidectin, amitraz, doramectin, ivermectin, and milbemycin oxime), the way of application (spot-on, dips, orally, or subcutaneous), concentration, and interval of application were used as input parameters in mathematical modeling. Data of interest were the treatment outcome, the number of dogs that went into remission, the number of animals not responding to treatment microscopically, the average duration of therapy, the follow-up period, the number of patients with disease recurrence, the number of adverse effects, and the number of animals with side effects. Dogs lost to follow-up or when the treatment was discontinued, due to various reasons not in connection with the therapy protocol, were not considered. Statistical and mathematical analyses were applied for prediction of the drugs' effectiveness. Developed mathematical models showed satisfactorily r (2), higher than 0.87. Good evidence for recommending the use of milbemycin oxime PO (0.5 mg/kg, daily) and moxidectin spot-on (Advocate®, Bayer) weekly is found. A bit less effective therapies were based on ivermectin PO (0.5 mg/kg, daily), moxidectin PO (0.35 mg/kg, daily), and amitraz dips (0.05 % solution, weekly), respectively. It is important to keep in mind that Advocate® is recommended by the manufacturer for use in milder cases.

  2. Neonatal brain MRI and motor outcome at school age in children with neonatal encephalopathy: a review of personal experience.

    PubMed

    Mercuri, Eugenio; Barnett, Anna L

    2003-01-01

    The aim of this paper is to review (i) the spectrum of neuromotor function at school age in children who had been born full-term and presented with neonatal encephalopathy (NE) and low Apgar scores and (ii) the relation between the presence/absence of such difficulties and neonatal brain MRI. Motor outcome appears to be mainly related to the severity of basal ganglia and internal capsule involvement. Severe basal ganglia lesions were always associated with the most severe outcome, microcephaly, tetraplegia, and severe global delay, whereas more discrete basal ganglia lesions were associated with athetoid cerebral palsy, with normal cognitive development, or minor neuro-motor abnormalities. White matter lesions were associated with abnormal motor outcome only if the internal capsule was involved. Children with moderate white matter changes but normal internal capsule had normal motor outcome at school age. PMID:14640307

  3. The age rank of the nearest pre-main-sequence groups

    NASA Astrophysics Data System (ADS)

    Lawson, Warrick A.; Lyo, A.-Ran; Bessell, M. S.

    2009-11-01

    We address the age rank of the nearest pre-main-sequence (PMS) associations, using low-resolution spectrophotometry to measure gravity-sensitive indices in these stars. We compare spectral index-colour sequences for the PMS populations and rank them according to the strength of their gravity-sensitive features. The age rank using the gravity method is in general agreement with the ranking of these groups suggested by colour-magnitude (CM) diagram placement. Several of the groups have a kinematic origin in the Oph-Sco-Cen OB association. For three of them, their age rank is also in agreement with epochs resulting from a formation scenario for the OB association.

  4. The Impact of Starspots on Mass and Age Estimates for Pre-main Sequence Stars

    NASA Astrophysics Data System (ADS)

    Somers, Garrett; Pinsonneault, Marc H.

    2016-01-01

    We investigate the impact of starspots on the evolution of late-type stars during the pre-main sequence (pre-MS). We find that heavy spot coverage increases the radii of stars by 4-10%, consistent with inflation factors in eclipsing binary systems, and suppresses the rate of pre-MS lithium depletion, leading to a dispersion in zero-age MS Li abundance (comparable to observed spreads) if a range of spot properties exist within clusters from 3-10 Myr. This concordance with data implies that spots induce a range of radii at fixed mass during the pre-MS. These spots decrease the luminosity and T eff of stars, leading to a displacement on the HR diagram. This displacement causes isochrone derived masses and ages to be systematically under-estimated, and can lead to the spurious appearance of an age spread in a co-eval population.

  5. Effects of main-sequence mass loss on the turnoff ages of globular clusters

    SciTech Connect

    Guzik, J.A.

    1989-01-01

    Willson, Bowen, and Struck-Marcell have proposed that globular cluster main-sequence turnoff ages can be reconciled with the lower ages of the Galaxy and universe deduced from other methods by incorporating an epoch of early main-sequence mass-loss by stars of spectral types A through early-F. The proposed mass loss is pulsation-driven, and facilitated by rapid rotation. This paper presents stellar evolution calculations of Pop. II (Z = 0.001) mass-losing stars of initial mass 0.8 to 1.6 M/sub /circle dot//, with exponentially-decreasing mass loss rates of e-folding times 0.5 to 2.0 Gyr, evolving to a final mass of 0.7 M/sub /circle dot//. The calculations indicate that a globular cluster with apparent turnoff age 18 Gyr could have an actual age as low as /approximately/12 Gyr. Observational implications that may help to verify the hypothesis, e.g. low C/N abundance ratios among red giants following first dredge-up, blue stragglers, red giant deficiencies, and signatures in cluster mass/luminosity functions, are also discussed.25 refs., 4 figs., 3 tabs.

  6. The Relationship between Maine School Administrative Unit Size, Costs, and Outcomes

    ERIC Educational Resources Information Center

    Silvernail, David L.; Sloan, James E.

    2004-01-01

    Maine should be very proud of its public school system. Without question, since passage of the Sinclair Act in 1957, Maine has made great strides in the last 45 years in improving the quality of its public schools, and in expanding educational opportunities for more and more of its children. Maine citizens have increased their investment four-fold…

  7. Age of Menarche and Psychosocial Outcomes in a New Zealand Birth Cohort

    ERIC Educational Resources Information Center

    Boden, Joseph M.; Fergusson, David M.; Horwood, L. John

    2011-01-01

    Objective: This study examined associations between age of menarche and psychosocial outcomes in early adulthood, including sexual behavior, mental health, criminal behavior, and education/employment, to identify the possible causal role of earlier age of menarche in increasing risks of adverse outcomes. Method: Data were gathered from 497 female…

  8. Free Thyroxine Levels After Very Preterm Birth and Neurodevelopmental Outcomes at Age 7 Years

    PubMed Central

    Scratch, Shannon E.; Hunt, Rodney W.; Thompson, Deanne K.; Ahmadzai, Zohra M.; Doyle, Lex W.; Inder, Terrie E.

    2014-01-01

    BACKGROUND AND OBJECTIVES: Preterm infants commonly have transient hypothyroxinemia of prematurity after birth, which has been associated with deficits in general intellectual functioning, memory, attention, and academic achievement. However, research has predominantly focused on thyroxine levels in the first 2 weeks of life and outcomes are limited to the preschool period. Our objective was to evaluate the relationships between free thyroxine (fT4) levels over the first 6 weeks after very preterm (VPT) birth with cognitive functioning and brain development at age 7 years. METHODS: A total of 83 infants born VPT (<30 weeks’ gestation) had fT4 concentrations measured postnatally and 2- and 6-week area under the curve (AUC) summary measures were calculated. Follow-up at age 7 years included a neuropsychological assessment and brain MRI. Univariable and multivariable regression modeling was used where AUC for fT4 was the main predictor of neurodevelopmental outcome at age 7 years. RESULTS: Multivariable modeling revealed that higher, not lower, postnatal fT4 levels (2-week AUC) were associated with poorer cognitive performances at age 7 years on tasks of verbal learning (P = .02), verbal memory (P = .03), and simple reaction time (P < .001). A similar pattern of results was found when the 6-week AUC was examined. No significant associations between postnatal fT4 levels and brain volumes at age 7 years were identified. CONCLUSIONS: Results are contradictory to previous observations and suggest that after adjustment for confounders, higher postnatal fT4 levels in VPT infants, rather than lower levels, may be a marker of adverse neuropsychological development in childhood. PMID:24685955

  9. Age-rotation relationship for late-type main-sequence stars

    NASA Technical Reports Server (NTRS)

    Rengarajan, T. N.

    1984-01-01

    With advancing spectral type and increasing age, late main-sequence stars exhibit monotonic decrease in rotational velocity. It is of great interest to extend the rotation-age relationship to stars of later spectral type. In recent times it has become possible to measure directly the rotational periods from the photometric modulation by Ca II H and K line emission. There have also been successful attempts to relate the chromospheric activity as manifested through Ca II H and K lines to the rotation period, and it was shown that the fraction of total stellar luminosity in Ca II H and K lines, corrected for photospheric contribution, is a function of a single parameter related to P and B-V. In the present investigation, this rotation-activity relation is utilized to infer the rotation periods as a function of spectral type. The period versus B-V plot is employed as a basis to infer that the rotational period of main-sequence stars is a single-valued function of mass (B-V color) and age.

  10. The Effect of Donor Age on Corneal Transplantation Outcome: Results of the Cornea Donor Study

    PubMed Central

    2009-01-01

    Objective To determine whether graft survival over a 5-year follow-up period using corneal tissue from donors older than 65 years of age is similar to graft survival using corneas from younger donors. Design Multi-center prospective, double-masked, controlled clinical trial Participants 1090 subjects undergoing corneal transplantation for a moderate risk condition (principally Fuchs’ dystrophy or pseudophakic corneal edema); 11 subjects with ineligible diagnoses were not included Methods 43 participating eye banks provided corneas from donors in the age range of 12 to 75 with endothelial cell densities of 2300 to 3300 cells/mm2, using a random approach without respect to recipient factors. The 105 participating surgeons at 80 sites were masked to information about the donor cornea including donor age. Surgery and post-operative care were performed according to the surgeons’ usual routines. Subjects were followed for five years. Main Outcome Measures Graft failure, defined as a regraft or a cloudy cornea that was sufficiently opaque as to compromise vision for a minimum of three consecutive months. Results The 5-year cumulative probability of graft survival was 86% in both the <66.0 donor age group and the ≥66.0 donor age group (difference = 0%, upper limit of one-sided 95% confidence interval = 4%). In a statistical model with donor age as a continuous variable, there was not a significant relationship between donor age and outcome (P=0.11). Three graft failures were due to primary donor failure, 8 to uncorrectable refractive error, 48 to graft rejection, 46 to endothelial decompensation (23 of which had a prior, resolved episode of probable or definite graft rejection), and 30 to other causes. The distribution of the causes of graft failure did not differ between donor age groups. Conclusions Five-year graft survival for cornea transplants at moderate risk for failure is similar using corneas from donors ≥ 66.0 years and donors < 66.0 years. Surgeons and

  11. The Association of Kindergarten Entry Age with Early Literacy Outcomes

    ERIC Educational Resources Information Center

    Huang, Francis L.; Invernizzi, Marcia A.

    2012-01-01

    The authors investigated whether age at kindergarten entry was associated with early literacy achievement gaps and if these gaps persisted over time. Using the kindergarten age eligibility cutoff date, they created 2 groups of students who represented the oldest and youngest children in a cohort of students in high-poverty, low-performing schools.…

  12. The IAEA international conference on fast reactors and related fuel cycles: highlights and main outcomes

    SciTech Connect

    Monti, S.; Toti, A.

    2013-07-01

    The 'International Conference on Fast Reactors and Related Fuel Cycles', which is regularly held every four years, represents the main international event dealing with fast reactors technology and related fuel cycles options. Main topics of the conference were new fast reactor concepts, design and simulation capabilities, safety of fast reactors, fast reactor fuels and innovative fuel cycles, analysis of past experience, fast reactor knowledge management. Particular emphasis was put on safety aspects, considering the current need of developing and harmonizing safety standards for fast reactors at the international level, taking also into account the lessons learned from the accident occurred at the Fukushima- Daiichi nuclear power plant in March 2011. Main advances in the several key areas of technological development were presented through 208 oral presentations during 41 technical sessions which shows the importance taken by fast reactors in the future of nuclear energy.

  13. What Do Children Know about Their Futures: Do Children's Expectations Predict Outcomes in Middle Age?

    ERIC Educational Resources Information Center

    Hallerod, Bjorn

    2011-01-01

    Are children's statements about their futures related to outcomes in middle age? In 1966 almost 13,500 children ages 12-13 were asked whether they thought their futures would be worse, similar or better as compared to others of their own age. It was shown that children with low, and surprisingly high, expectations did suffer from increased…

  14. Modeling old-age wealth with endogenous early-life outcomes: The case of Mexico.

    PubMed

    DeGraff, Deborah S; Wong, Rebeca

    2014-04-01

    This paper contributes to the literature on the life course and aging by examining the association between early-life outcomes and late-life well being, using data from the Mexican Health and Aging Study. Empirical research in this area has been challenged by the potential endogeneity of the early-life outcomes of interest, an issue which most studies ignore or downplay. Our contribution takes two forms: (1) we examine in detail the potential importance of two key life-cycle outcomes, age at marriage (a measure of family formation) and years of educational attainment (a measure of human capital investment) for old-age wealth, and (2) we illustrate the empirical value of past context variables that could help model the association between early-life outcomes and late-life well being. Our illustrative approach, matching macro-level historical policy and census variables to individual records to use as instruments in modeling the endogeneity of early-life behaviors, yields a statistically identified two-stage model of old-age wealth with minimum bias. We use simulations to show that the results for the model of wealth in old age are meaningfully different when comparing the approach that accounts for endogeneity with an approach that assumes exogeneity of early-life outcomes. Furthermore, our results suggest that in the Mexican case, models which ignore the potential endogeneity of early-life outcomes are likely to under-estimate the effects of such variables on old-age wealth.

  15. Modeling old-age wealth with endogenous early-life outcomes: The case of Mexico

    PubMed Central

    DeGraff, Deborah S.; Wong, Rebeca

    2014-01-01

    This paper contributes to the literature on the life course and aging by examining the association between early-life outcomes and late-life well being, using data from the Mexican Health and Aging Study. Empirical research in this area has been challenged by the potential endogeneity of the early-life outcomes of interest, an issue which most studies ignore or downplay. Our contribution takes two forms: (1) we examine in detail the potential importance of two key life-cycle outcomes, age at marriage (a measure of family formation) and years of educational attainment (a measure of human capital investment) for old-age wealth, and (2) we illustrate the empirical value of past context variables that could help model the association between early-life outcomes and late-life well being. Our illustrative approach, matching macro-level historical policy and census variables to individual records to use as instruments in modeling the endogeneity of early-life behaviors, yields a statistically identified two-stage model of old-age wealth with minimum bias. We use simulations to show that the results for the model of wealth in old age are meaningfully different when comparing the approach that accounts for endogeneity with an approach that assumes exogeneity of early-life outcomes. Furthermore, our results suggest that in the Mexican case, models which ignore the potential endogeneity of early-life outcomes are likely to under-estimate the effects of such variables on old-age wealth. PMID:25170434

  16. ON THE MULTIPLICITY OF THE ZERO-AGE MAIN-SEQUENCE O STAR HERSCHEL 36

    SciTech Connect

    Arias, Julia I.; Barba, Rodolfo H.; Gamen, Roberto C.; Apellaniz, Jesus MaIz; Alfaro, Emilio J.; Sota, Alfredo; Bidin, Christian Moni

    2010-02-10

    We present the analysis of high-resolution optical spectroscopic observations of the zero-age main-sequence O star Herschel 36 spanning six years. This star is definitely a multiple system, with at least three components detected in its spectrum. Based on our radial-velocity (RV) study, we propose a picture of a close massive binary and a more distant companion, most probably in wide orbit about each other. The orbital solution for the binary, whose components we identify as O9 V and B0.5 V, is characterized by a period of 1.5415 {+-} 0.0006 days. With a spectral type O7.5 V, the third body is the most luminous component of the system and also presents RV variations with a period close to 498 days. Some possible hypotheses to explain the variability are briefly addressed and further observations are suggested.

  17. Does Work Contribute to Successful Aging Outcomes in Older Workers?

    ERIC Educational Resources Information Center

    Sanders, Martha J.; McCready, Jack W.

    2010-01-01

    Older workers are the fastest growing segment of the labor force, yet little is known about designing jobs for older workers that optimize their experiences relative to aging successfully. This study examined the contribution of workplace job design (opportunities for decision-making, skill variety, coworker support, supervisor support) to…

  18. Variability in Outcome for Children with an ASD Diagnosis at Age 2

    ERIC Educational Resources Information Center

    Turner, Lauren M.; Stone, Wendy L.

    2007-01-01

    Background: Few studies have examined the variability in outcomes of children diagnosed with autism spectrum disorder (ASD) at age 2. Research is needed to understand the children whose symptoms--or diagnoses--change over time. The objectives of this study were to examine the behavioral and diagnostic outcomes of a carefully defined sample of…

  19. Therapeutic effect of interventional therapy for unprotected left main coronary artery lesions in aged patients

    PubMed Central

    Wei, Zhong-Hai; Song, Jie; Wang, Lian; Zhang, Jing-Mei; Huang, Wei; Xu, Biao

    2015-01-01

    Objective To assesse the therapeutic effect of interventional therapy in aged patients with unprotected left main coronary artery (UPLM) lesions. Methods A total of 61 patients who were over 60 years and accepted interventional therapy of UPLM from January 2012 to November 2013 in our hospital were followed up for average 14.6 months by telephone call or outpatient visits. We analyzed the clinical features data of the interventional therapy and assessed the factors that likely influenced the clinical prognosis. Results The average age of the 61 patients was 73.9 years. The average left ventricular ejection fraction (LVEF) was 47.7%. The median of the estimated glomerular filtration rate (eGFR) was 52 mL/min per 1.73 mm2. The average SYNTAX score was 27.4 and the median of stent length was 36 mm. The cumulative incidence of cardiac death at 30 days and major adverse cardiac events (MACE) after one year was 6.6% and 32.5% estimated by Kaplan-Meier plots respectively. No severe hemorrhagic complications were observed during follow-up period. On multivariate regression analysis with a COX proportional hazards model, LVEF was an independent predictor of cardiac death at 30 days [Hazard ratio (HR): 0.7, P = 0.01]. As for MACE after one year, LVEF and eGFR were both independent predictors (HR: 0.91, P = 0.06 for LVEF, HR: 0.03, P = 0.097 for eGFR). Conclusions The interventional therapy for UPLM was effective and safe in aged patients. LVEF was the only predictor of cardiac death at 30 days, while LVEF and eGFR were both independent predictors of MACE after one year. PMID:26788040

  20. The COST 731 Action and the MAP D-PHASE Initiative - Overview on Main Outcomes

    NASA Astrophysics Data System (ADS)

    Rossa, A. M.

    2010-09-01

    The COST 731 Action, launched in 2005, addresses the problem of forecasting (heavy) precipitation events and the corresponding hydrological processes in connection with the uncertainty inherent in this task. The actual threat to society that potentially occurs from intense (and thus rare) events only becomes effective after the involvement of the hydrosphere. The main focus of the Action is the quantification of forecast uncertainty and its propagation through a meteo-hydrological forecast chain. COST 731 is structured in three working groups, which deal with uncertainty cascading from observation (predominantly from radar) into numerical weather prediction (NWP) models, from observation and NWP into hydrological models, and the use of uncertainty as support in decision making. The groups of scientists involved in the action therefore represent radar meteorology, NWP, hydrological modeling, as well as social scientists who deal with risk communication. MAP D-PHASE (Mesoscale Alpine Programme, Demonstration of Probabilistic Hydrological and Atmospheric Simulation of Flooding Events in the Alps) is the second WMO/WWRP Forecast Demonstration Project and constitutes an important element of COST 731. Its Operations Period (June - November 2007) was centred in the Alpine region and experienced a number of interesting weather cases. Real-time forecast information of 7 limited area ensemble prediction systems, 23 high-resolution limited area numerical weather prediction models, as well as 7 hydrological models coupled to NWP QPF and/or radar QPE input were collected, and synthetically displayed on a visualization platform. In this presentation an overview of the COST 731 main achievements of the action as well as open issues and future opportunities are given. They are put into context with the results and perspectives of D-PHASE, first verification results, end user feedback, lessons learnt. A notable number of operational groups in hydrological modeling are in the

  1. Outcome at school-age after neonatal mechanical ventilation.

    PubMed

    Gunn, T R; Lepore, E; Outerbridge, E W

    1983-06-01

    103 school-age children (5 to 12 years) who survived mechanical ventilation for neonatal respiratory failure were evaluated for growth, neurological, intellectual, psychological and school function in order to determine those children most at risk for handicap. A major handicap occurred in seven children, preventing attendance at normal school or normal classes. Neurological sequelae were significantly associated with perinatal asphyxia and with birthweights of 1500g or less, and neurological sequelae and socio-economic factors were the major determinants of ability. The effects of the Neonatal Intensive Care Unit (NICU) experience on parents and subsequent parent-child relationships were also investigated: 67 per cent of the mothers were very upset by the experience and many continue to worry excessively about the health of their child. Parents who visited their child in the NICU frequently were significantly more anxious and overprotective, restricting many activities even when the child was of school age. PMID:6873492

  2. Does age at first treatment episode make a difference in outcomes over 11 years?

    PubMed

    Chi, Felicia W; Weisner, Constance; Grella, Christine E; Hser, Yih-Ing; Moore, Charles; Mertens, Jennifer

    2014-04-01

    This study examines the associations between age at first substance use treatment entry and trajectory of outcomes over 11 years. We found significant differences in individual and treatment characteristics between adult intakes first treated during young adulthood (25 years or younger) and those first treated at an older age. Compared to their first treated older age counterparts matched on demographics and dependence type, those who entered first treatment during young adulthood had on average an earlier onset for substance use but a shorter duration between first substance use and first treatment entry; they also had worse alcohol and other drug outcomes 11 years post treatment entry. While subsequent substance use treatment and 12-step meeting attendance are important for both age groups in maintaining positive outcomes, relationships varied by age group. Findings underline the importance of different continuing care management strategies for those entering first treatment at different developmental stages. PMID:24462221

  3. The WERO group stop smoking competition: main outcomes of a pre- and post- study

    PubMed Central

    2014-01-01

    Background One potential promising strategy for increasing smoking cessation for Māori (Indigenous New Zealanders) and New Zealand resident Pacific Island people is Quit and Win competitions. The current uncontrolled pre and post study, WERO (WERO in Māori language means challenge), differs from previous studies in that it aims to investigate if a stop smoking contest, using both within team support, external support from a team coach and cessation experts, and technology, would be effective in prompting and sustaining quitting. Method Fifteen teams, recruited from urban Māori, rural Māori and urban Pacific communities, competed to win a NZ$5000 (about €3,000, £2600) prize for a charity or community group of their choice. People were eligible if they were aged 18 years and over and identified as smokers. Smoking status was biochemically validated at the start and end of the 3 month competition. At 3-months post competition self-reported smoking status was collected. Results Fourteen teams with 10 contestants and one team with eight contestants were recruited. At the end of the competition the biochemically verified quit rate was 36%. The 6 months self-reported quit rate was 26%. The Pacific and rural Māori teams had high end of competition and 6 months follow-up quit rates (46% and 44%, and 36% and 29%). Conclusion WERO appeared to be successful in prompting quitting among high smoking prevalence groups. WERO combined several promising strategies for supporting cessation: peer support, cessation provider support, incentives, competition and interactive internet and mobile tools. Though designed for Māori and Pacific people, WERO could potentially be effective for other family- and community-centred cultures. PMID:24924780

  4. The evolution of angular momentum among zero-age main-sequence solar-type stars

    NASA Technical Reports Server (NTRS)

    Soderblom, David R.; Stauffer, John R.; Macgregor, Keith B.; Jones, Burton F.

    1993-01-01

    We consider a survey of rotation among F, G, and K dwarfs of the Pleiades in the context of other young clusters (Alpha Persei and the Hyades) and pre-main-sequence (PMS) stars (in Taurus-Auriga and Orion) in order to examine how the angular momentum of a star like the sun evolves during its early life on the main sequence. The rotation of PMS stars can be evolved into distributions like those seen in the young clusters if there is only modest, rotation-independent angular momentum loss prior to the ZAMS. Even then, the ultrafast rotators (UFRs, or ZAMS G and K dwarfs with v sin i equal to or greater than 30 km/s) must owe their extra angular momentum to their conditions of formation and to different angular momentum loss rates above a threshold velocity, for it is unlikely that these stars had angular momentum added as they neared the ZAMS, nor can a spread in ages within a cluster account for the range of rotation seen. Only a fraction of solar-type stars are thus capable of becoming UFRs, and it is not a phase that all stars experience. Simple scaling relations (like the Skumanich relation) applied to the observed surface rotation rates of young solar-type stars cannot reproduce the way in which the Pleiades evolve into the Hyades. We argue that invoking internal differential rotation in these ZAMS stars can explain several aspects of the observations and thus can provide a consistent picture of ZAMS angular momentum evolution.

  5. Selection of General Growth Outcomes for Children between Birth and Age Eight. Technical Report #2.

    ERIC Educational Resources Information Center

    McConnell, Scott; McEvoy, Mary; Carta, Judith J.; Greenwood, Charles R.; Kaminski, Ruth; Good, Roland H., III; Shinn, Mark; Ysseldyke, James; Goldberg, Paula

    This document reports on development of a comprehensive system for measuring the ongoing development of children with disabilities from birth to age 8. A multi-step process was used to identify a set of general growth outcomes for children in this age range and to begin formulating individualized indicators of growth and development, as well as…

  6. Middle-School-Age Outcomes in Children with Very Low Birthweight.

    ERIC Educational Resources Information Center

    Taylor, H. Gerry; Klein, Nancy; Minich, Nori M.; Hack, Maureen

    2000-01-01

    Compared outcomes of middle-school-age children born at very low (less than 750-g) or low birthweights (750 to 1,499-g) and full-term. Found that the very-low-weight group fared less well at school age than the low weight and term groups on cognitive functioning, achievement, behavior, and academic performance. Those without neurosensory disorders…

  7. Vocational Rehabilitation Service Patterns and Outcomes for Individuals with Autism of Different Ages.

    PubMed

    Chen, June L; Sung, Connie; Pi, Sukyeong

    2015-09-01

    Young adults with autism spectrum disorders (ASD) often experience employment difficulties. Using Rehabilitation Service Administration data (RSA-911), this study investigated the service patterns and factors related to the employment outcomes of individuals with ASD in different age groups. Hierarchical logistic regression analyses were conducted to examine the effects of demographic and vocational rehabilitation (VR) service variables on employment outcomes in each age group. The results show that transition youth made up the largest portion of VR service users among the ASD population, yet they have the worst employment outcomes across all age groups. Factors that are significantly associated with increased odds for employment in each age group were identified. Implications from systemic, practical, and research perspectives are also provided.

  8. DETECTION OF GROUNDWATER AGES WITH 85 KR IN ARSENIC-BEARING, FRACTURED CRYSTALLINE BEDROCK OF THE GOOSE RIVER BASIN, MAINE

    EPA Science Inventory

    Young groundwater from various depths in crystalline bedrock of the Goose River basin, mid-coastal Maine, is documented from 85Kr isotope age analyses (1963 ? 1987) but not from 3H isotope age analyses. Elevated geogenic arsenic in drinking water from groundwater wells and sprin...

  9. Intraventricular hemorrhage and developmental outcomes at 24 months of age in extremely preterm infants.

    PubMed

    O'Shea, T Michael; Allred, Elizabeth N; Kuban, Karl C K; Hirtz, Deborah; Specter, Barbara; Durfee, Sara; Paneth, Nigel; Leviton, Alan

    2012-01-01

    Whether intraventricular hemorrhage increases the risk of adverse developmental outcome among premature infants is controversial. Using brain ultrasound, we identified intraventricular hemorrhage and white matter abnormalities among 1064 infants born before 28 weeks' gestation. We identified adverse developmental outcomes at 24 months of age using a standardized neurologic examination and the Bayley Scales of Infant Development Mental and Motor Scales. In logistic regression models that adjusted for gestational age, sex, and public insurance, isolated intraventricular hemorrhage was associated with visual fixation difficulty but no other adverse outcome. Infants who had a white matter lesion unaccompanied by intraventricular hemorrhage were at increased risk of cerebral palsy, low Mental and Motor Scores, and visual and hearing impairments. Except when accompanied or followed by a white matter lesion, intraventricular hemorrhage is associated with no more than a modest increase (and possibly no increase) in the risk of adverse developmental outcome during infancy. PMID:22232137

  10. Severe hypoxaemia can predict unfavourable clinical outcomes in individuals with pulmonary embolism aged over 40 years

    PubMed Central

    Souza, Caio Simoes; Resende, Fernanda Simoes Seabra; Rodrigues, Marcelo Palmeira

    2014-01-01

    INTRODUCTION Acute pulmonary embolism (APE) is an urgent clinical condition that can progress in a wide variety of ways. Therefore, we sought to develop an easy-to-apply algorithm, to be based on readily available clinical indicators, effective in predicting unfavourable outcomes. METHODS This was a retrospective cohort study based on systematically collected data in a database. The study included 102 patients with APE who were admitted to a tertiary care hospital. The following outcomes were defined as unfavourable shock, the need for mechanical ventilation, the use of thrombolytics, and death. Logistic regression analysis was used to explore variables significantly associated with outcome and to calculate post-test probabilities. RESULTS The prevalence of unfavourable outcomes was 25.5% (26 of the 102 patients with APE). The risk of an unfavourable outcome was reduced to 7.0% for patients with APE who were aged ≤ 40 years. In patients with APE who were aged > 40 years, the presence of hypoxaemia (i.e. peripheral oxygen saturation < 90%) alone increased the risk of an unfavourable outcome to 57.0%. A recent history of trauma and the presence of pre-existing lung or heart disease were significantly associated with unfavourable outcomes. The inclusion of those variables in the logistic regression model increased the post-test risk of an unfavourable outcome to 65.0%–86.0%. CONCLUSION Advanced age (i.e. > 40 years), the presence of hypoxaemia, a recent history of trauma and the presence of pre-existing lung or heart disease are risk factors for unfavourable outcome in patients with APE. PMID:25273933

  11. Paternal age and assisted reproductive outcomes in ICSI donor oocytes: is there an effect of older fathers?

    PubMed Central

    Beguería, R.; García, D.; Obradors, A.; Poisot, F.; Vassena, R.; Vernaeve, V.

    2014-01-01

    STUDY QUESTION Does paternal age affect semen quality and reproductive outcomes in oocyte donor cycles with ICSI? SUMMARY ANSWER Paternal age is associated with a decrease in sperm quality, however it does not affect either pregnancy or live birth rates in reproductive treatments when the oocytes come from donors <36 years old and ICSI is used. WHAT IS KNOWN ALREADY The weight of evidence suggest that paternal age is associated with decreasing sperm quality, but uncertainty remains as to whether reproductive outcomes are affected. Although developed to treat severe sperm factor infertility, ICSI is gaining popularity and is often used even in the presence of mild male factor infertility. STUDY DESIGN, SIZE, DURATION A retrospective cohort study spanning the period between February 2007 and June 2010. A total of 4887 oocyte donation cycles were included. PARTICIPANTS/MATERIALS, SETTING, METHODS Fertilization was carried out by ICSI in all cycles included, and the semen sample used was from the male partner in all cases. The association of male age with semen parameters (volume, concentration, percentage of motile spermatozoa) was analyzed by multiple analysis of covariance. The association of male age with reproductive outcomes (biochemical pregnancy, miscarriage, ongoing pregnancy and live birth rate) was modeled by logistic regression, where the following covariates were introduced: donor age, recipient age, semen state (fresh versus frozen) and number of transferred embryos (3 and 2 versus 1). MAIN RESULTS AND THE ROLE OF CHANCE We identified a significant relationship between paternal age and all sperm parameters analyzed: for every 5 years of age, sperm volume decreases by 0.22 ml (P < 0.001), concentration increases by 3.1 million sperm/ml (P = 0.003) and percentage motile spermatozoa decreases by 1.2% (P < 0.001). No differences were found in reproductive outcomes (biochemical pregnancy, miscarriage, clinical pregnancy, ongoing pregnancy and live birth) among

  12. Is groundwater age the main control for slow turnover of nitrate in a fractured groundwater system?

    NASA Astrophysics Data System (ADS)

    Osenbrück, Karsten; Schwientek, Marc; Rügner, Hermann; Grathwohl, Peter

    2015-04-01

    Slow transformation processes are known to control the chemical, isotopic, and redox evolution of large-scale aquifers (Edmunds et al., 1982; Katz et al., 1995). However, at the field scale some of the crucial biogeochemical processes governing pollutant turnover and their interrelations with hydrology are poorly understood. Particularly, only little is known about denitrification in fractured rock aquifers. Therefore, the main objective of the presented study is to assess where and how slow turnover of nitrate ans other pollutants in the deeper subsurface take place. The studied fractured and partly karstified aquifer consisting of Triassic black limestones and dolomites is located in the catchment of the Ammer river (ca. 350 km²) close to Tübingen in southern Germany. Near the recharge area, the aquifer is covered by loess allowing intensive agriculture. Further downgradient, the cover consist of a series of mudstones and sandstones of variable permeability. The aquifer is used for drinking water purposes by regional water suppliers. Land-use is dominated by agriculture with arable land covering nearly 50% of the catchment. Over the last years a variety of groundwater samples have been collected from the groundwater system including 6 water supply wells, 4 karstic springs, and 9 monitoring wells in the recharge area. This allowed to identify spatial and temporal patterns of water quality including concentrations of major ions, dissolved organic carbon (DOC), organic pollutants (e.g., pesticides), and environmental isotopes. Groundwater age distributions at most of these locations were derived from tritium, 3He, CFCs and SF6. Groundwaters in the recharge area show high concentrations of nutrients (e.g. 20-51 mg/L of nitrate and 0.2 to 0.05 µg/L of phosphate). Of special concern are disparate nitrate concentrations ranging from below 0.4 to 20 mg/L in water supply wells although screen depths of the production wells are similar. Concentrations of dissolved

  13. The "multiple hormone deficiency" theory of aging: is human senescence caused mainly by multiple hormone deficiencies?

    PubMed

    Hertoghe, T

    2005-12-01

    In the human body, the productions, levels and cell receptors of most hormones progressively decline with age, gradually putting the body into various states of endocrine deficiency. The circadian cycles of these hormones also change, sometimes profoundly, with time. In aging individuals, the well-balanced endocrine system can fall into a chaotic condition with losses, phase-advancements, phase delays, unpredictable irregularities of nycthemeral hormone cycles, in particular in very old or sick individuals. The desynchronization makes hormone activities peak at the wrong times and become inefficient, and in certain cases health threatening. The occurrence of multiple hormone deficits and spilling through desynchronization may constitute the major causes of human senescence, and they are treatable causes. Several arguments can be put forward to support the view that senescence is mainly a multiple hormone deficiency syndrome: First, many if not most of the signs, symptoms and diseases (including cardiovascular diseases, cancer, obesity, diabetes, osteoporosis, dementia) of senescence are similar to physical consequences of hormone deficiencies and may be caused by hormone deficiencies. Second, most of the presumed causes of senescence such as excessive free radical formation, glycation, cross-linking of proteins, imbalanced apoptosis system, accumulation of waste products, failure of repair systems, deficient immune system, may be caused or favored by hormone deficiencies. Even genetic causes such as limits to cell proliferation (such as the Hayflick limit of cell division), poor gene polymorphisms, premature telomere shortening and activation of possible genetic "dead programs" may have links with hormone deficiencies, being either the consequence, the cause, or the major favoring factor of hormone deficiencies. Third, well-dosed and -balanced hormone supplements may slow down or stop the progression of signs, symptoms, or diseases of senescence and may often

  14. Age differences in IDA savings outcomes: findings from the American Dream Demonstration.

    PubMed

    Putnam, Michelle; Sherraden, Michael; Zhang, Lin; Morrow-Howell, Nancy

    2008-01-01

    This study aims to develop a greater understanding of age differences in savings outcomes within Individual Development Accounts (IDAs). Participant data from the American Dream Demonstration (ADD) are examined for age differences in accumulated net deposits, average monthly net deposits, and deposit frequency. ADDprogram data are examined for savings match rates, monthly savings targets, direct deposit, and hours of financial education offered. Results indicate that, on average, older IDA participants have better savings outcomes than younger participants. Findings from this study suggest that impoverished middleaged and older adults can save if provided an opportunity and incentives. However, success will depend on the characteristics of the programs. PMID:18198159

  15. Outcome of carpal tunnel decompression: the influence of age, gender, and occupation

    PubMed Central

    Majid, I.; Clarke, M.; Kershaw, C. J.

    2008-01-01

    The aim of this study was to investigate the effect of age, gender, and occupation on the outcome of carpal tunnel decompression. A total of 479 patients (342 females, 137 males) with a mean age of 56 years undergoing 608 carpal tunnel decompressions were prospectively studied. Outcome was assessed using the Brigham Hospital carpal tunnel questionnaire at two weeks pre-operatively and six months post-operatively. Cases were divided into four age categories (less than 40 years of age, 40–59, 60–79, and over 80 years of age) and two occupation (repetitive and non-repetitive) groups. The mean differences for both the symptom-severity and functional-status scores amongst the four age categories were similar and no significant difference was found. The mean differences for both the symptom-severity and functional-status scores between females and males and the two occupation groups were similar and no significant differences were found. The majority of the patient’s symptoms improved following carpal tunnel decompression. However, we found no influence of age, gender, or occupation on the outcome of carpal tunnel decompression in our series of patients. PMID:18923831

  16. Nuclear power plant Generic Aging Lessons Learned (GALL). Main report and appendix A

    SciTech Connect

    Kaza, K.E.; Diercks, D.R.; Holland, J.W.; Choi, S.U.

    1996-12-01

    The purpose of this generic aging lessons learned (GALL) review is to provide a systematic review of plant aging information in order to assess materials and component aging issues related to continued operation and license renewal of operating reactors. Literature on mechanical, structural, and thermal-hydraulic components and systems reviewed consisted of 97 Nuclear Plant Aging Research (NPAR) reports, 23 NRC Generic Letters, 154 Information Notices, 29 Licensee Event Reports (LERs), 4 Bulletins, and 9 Nuclear Management and Resources Council Industry Reports (NUMARC IRs) and literature on electrical components and systems reviewed consisted of 66 NPAR reports, 8 NRC Generic Letters, 111 Information Notices, 53 LERs, 1 Bulletin, and 1 NUMARC IR. More than 550 documents were reviewed. The results of these reviews were systematized using a standardized GALL tabular format and standardized definitions of aging-related degradation mechanisms and effects. The tables are included in volume s 1 and 2 of this report. A computerized data base has also been developed for all review tables and can be used to expedite the search for desired information on structures, components, and relevant aging effects. A survey of the GALL tables reveals that all ongoing significant component aging issues are currently being addressed by the regulatory process. However, the aging of what are termed passive components has been highlighted for continued scrutiny. This document is Volume 1, consisting of the executive summary, summary and observations, and an appendix listing the GALL literature review tables.

  17. Effect of sex and age interactions on functional outcome after stroke.

    PubMed

    Kim, Tae-Hee; Vemuganti, Raghu

    2015-04-01

    Stroke is one of the leading causes of death and disability worldwide. Experimental and clinical studies showed that sex and age play an important role in deciding the outcome after stroke. At younger ages, males were shown to have a higher risk for stroke than females. However, this trend reverses in older ages particularly when females reach menopause. Many preclinical studies indicate that steroid hormones modulate the age-dependent differential stroke outcome. In addition, patterns of cell death pathways activated following cerebral ischemia are distinct between males and females, but independent of steroid hormones. Recent studies also indicate that microRNAs play important roles in mediating sex-specific stroke outcome by regulating stroke-related genes. This review discusses the contribution of sex and age to outcome after stroke with particular emphasis on the experimental studies that examined the effects of steroid hormones, differential cell death pathways, and involvement of sex-specific microRNAs following cerebral ischemia. Current understanding of the role of thrombolytic agents in stroke therapy is also discussed.

  18. Effect of Paternal Age on Reproductive Outcomes of In Vitro Fertilization.

    PubMed

    Wu, Yixuan; Kang, Xiangjin; Zheng, Haiyan; Liu, Haiying; Liu, Jianqiao

    2015-01-01

    Although the adverse effects of maternal aging on reproductive outcomes have been investigated widely, there is no consensus on the impact of paternal age. Therefore, we investigated the effect of paternal age on reproductive outcomes in a retrospective analysis of 9,991 in vitro fertilization (IVF) cycles performed at the Reproductive Medicine Center of the Third Affiliated Hospital of Guangzhou Medical University (China) between January 2007 and October 2013. Samples were grouped according to maternal age [<30 (3,327 cycles), 30-34 (4,587 cycles), and 35-38 (2,077 cycles)] and then subgrouped according to paternal age (<30, 30-32, 33-35, 36-38, 39-41, and ≥42). The groups did not differ in terms of fertilization rate, numbers of viable and high-quality embryos and miscarriage rate when controlling maternal age (P >0.05). Chi-squared analysis revealed that there were no differences in implantation and pregnancy rates among the different paternal age groups when maternal age was <30 and 35-38 years (P >0.05). However, implantation and pregnancy rates decreased with paternal age in the 31-34 y maternal age group (P <0.05). Our study indicates that paternal age has no impact on fertilization rate, embryo quality at the cleavage stage and miscarriage rate. For the 30-34 y maternal age group, the implantation rate decreased with increased paternal age, with the pregnancy rate in this group being significantly higher in the paternal <30 y and 30-32 y age groups, compared with those in the 36-38 y and 39-41 y groups.

  19. Effect of Paternal Age on Reproductive Outcomes of In Vitro Fertilization

    PubMed Central

    Zheng, Haiyan; Liu, Haiying; Liu, Jianqiao

    2015-01-01

    Although the adverse effects of maternal aging on reproductive outcomes have been investigated widely, there is no consensus on the impact of paternal age. Therefore, we investigated the effect of paternal age on reproductive outcomes in a retrospective analysis of 9,991 in vitro fertilization (IVF) cycles performed at the Reproductive Medicine Center of the Third Affiliated Hospital of Guangzhou Medical University (China) between January 2007 and October 2013. Samples were grouped according to maternal age [<30 (3,327 cycles), 30–34 (4,587 cycles), and 35–38 (2,077 cycles)] and then subgrouped according to paternal age (<30, 30–32, 33–35, 36–38, 39–41, and ≥42). The groups did not differ in terms of fertilization rate, numbers of viable and high-quality embryos and miscarriage rate when controlling maternal age (P >0.05). Chi-squared analysis revealed that there were no differences in implantation and pregnancy rates among the different paternal age groups when maternal age was <30 and 35–38 years (P >0.05). However, implantation and pregnancy rates decreased with paternal age in the 31–34 y maternal age group (P <0.05). Our study indicates that paternal age has no impact on fertilization rate, embryo quality at the cleavage stage and miscarriage rate. For the 30–34 y maternal age group, the implantation rate decreased with increased paternal age, with the pregnancy rate in this group being significantly higher in the paternal <30 y and 30–32 y age groups, compared with those in the 36–38 y and 39–41 y groups. PMID:26352861

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

    PubMed Central

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

    2015-01-01

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

  1. The impact of advancing age on postoperative outcomes in plastic surgery.

    PubMed

    Shih, Kevin; De Oliveira, Gildasio S; Qin, Charles; Kim, John Y

    2015-11-01

    Age has been shown to be an independent predictor of complications in general surgery patients. In contrast, the effect of age on outcomes after plastic surgery has yet to be confirmed or refuted. The objective of the current investigation was to evaluate a possible association between age and postoperative outcomes after plastic surgery. The 2005-2012 NSQIP database was retrospectively reviewed for all patients undergoing plastic surgery. Patients ≥60 years with procedures under the category of plastic surgery in NSQIP were selected for analysis. The primary outcome of interest was 30-day overall complication rates. Multivariate regression models were constructed to control for potential perioperative confounders. Of the 2,320,920 patients captured in the NSQIP database, 36,819 patients underwent plastic surgery and met inclusion criteria. The incidence of unadjusted overall complications increased with age with an overall complication rate of 9.0% in patients <60 years, 11.6% in patients 60-69 years, 13.2% in patients 70-79 years, and 15.9% in patients 80 or more years (p < 0.001). After adjusting for potential confounders, age was not independently associated with increased overall complications rates in patients 60-69 years (OR = 1.026; 95% CI = 0.927-1.135; p = 0.619) and 70-79 years (OR = 0.933; 95% CI = 0.797-0.919; p = 0.393), although patients 80 years and older experienced more medical complications (OR = 1.626; 95% CI = 1.218-2.172; p = 0.001). Age is not independently associated with overall worse outcomes in patients undergoing plastic surgery. Medical complications and mortality were more likely in extremes of age (>80 years). Age alone should not be included as a decisional factor in patients <80 years old considering plastic surgery.

  2. Some aspects of cool main sequence star ages derived from stellar rotation (gyrochronology)

    NASA Astrophysics Data System (ADS)

    Barnes, S. A.; Spada, F.; Weingrill, J.

    2016-09-01

    Rotation periods for cool stars can be measured with good precision by monitoring starspot light modulation. Observations have shown that the rotation periods of dwarf stars of roughly solar metallicity have such systematic dependencies on stellar age and mass that they can be used to derive reliable ages, a procedure called gyrochronology. We review the method and show illustrative cases, including recent ground- and space-based data. The age uncertainties approach 10 % in the best cases, making them a valuable complement to, and constraint on, asteroseismic or other ages. Edited, updated, and refereed version of a presentation at the WE-Heraeus-Seminar in Bad Honnef, Germany: Reconstructing the Milky Way's History: Spectroscopic Surveys, Asteroseismology and Chemodynamical Models

  3. Maternal age and intracytoplasmic sperm injection outcome in infertile couples at Khartoum, Sudan

    PubMed Central

    Ahmed, Mohamed; Shareef, Osama; Adam, Ishag; Rayis, Duria

    2015-01-01

    Background Intracytoplasmic sperm injection (ICSI) was considered as the mainstay of treatment for male infertility. Nowadays, the scope of ICSI has been widened to include other causes of infertility. There are few published data on ICSI in countries with low incomes. Aims A cross-sectional study was conducted at Saad AbuAlla and Banoun Centers, Khartoum, Sudan to investigate outcomes of ICSI and to determine the parameters that might predict pregnancy success rate following ICSI. Methods The study included 191 infertile couples who underwent 296 ICSI cycles between 1st April 2013 and 31 March 2014. Results One hundred and ninety one couples (comprising 296 cycles of ICSI) were enrolled to the study. The mean (SD) number of retrieved oocytes was 9.7 (7.5).  The mean (SD) number of transferred embryos was 2.9 (1.0). Out of these, 50 (26.2%) and 40 (20.9%) had chemical and clinical pregnancy, respectively. Thirty–six couples (18.8%) and five couples (2.6%) had miscarriage and had ectopic pregnancy, respectively. Under logistic regression, younger age (OR = 0.8, 95% CI= 0.81 ─ 0.96, P = 0.004) and endometrial thickness (OR = 1.3, 95% CI= 1.07─1.60, P = 0.009) were the significant predictors for the success of ICSI in inducing pregnancy. Conclusion                 The rates of successful fertilisation and pregnancy-to-term rates in this setting depend mainly on the maternal age. PMID:27347370

  4. Middle-school-age outcomes in children with very low birthweight.

    PubMed

    Taylor, H G; Klein, N; Minich, N M; Hack, M

    2000-01-01

    Most previous studies of children with birthweight <750 g have focused on early childhood sequelae. To evaluate later outcomes, a regional sample of 60 <750-g birthweight children was compared at middle school age (M = 11 years) to 55 children with birthweight 750-1,499 g and 49 term controls. The groups were matched on age, gender, and demographic variables at the time of an early-school-age assessment (mean age 7 years). The <750-g birthweight group fared less well at middle school age than the term group on measures of cognitive function, achievement, behavior, and academic performance. In many instances, outcomes were less favorable for the <750-g children than for the 750 to 1,499-g group. Children in the <750-g group who were free of neurosensory disorders and global cognitive impairment performed more poorly on several tests than their term counterparts. Group differences in this subsample on tests of motor skills, math, and the ability to copy and recall a complex drawing remained significant even after controlling for IQ. Disparities between the <750-g and term groups increased with age for some measures. Despite favorable outcomes for many children in the <750-g group, this population is at risk for long-term developmental problems.

  5. Predictors of early school age outcomes in very low birth weight children.

    PubMed

    Taylor, H G; Klein, N; Schatschneider, C; Hack, M

    1998-08-01

    The purpose of this study was to examine predictors of outcome in very low birth weight (< 1500 g) children. The very low birth weight sample consisted of 68 children weighing less than 750 g at birth and 65 children weighing 750 to 1499 g at birth who had been matched to the less than 750 g birth weight children in terms of hospital of birth, age, sex, and race. Mean ages for these two groups were 6.7 and 6.9 years, respectively. Outcomes were measured in terms of tests of cognitive function, neuropsychological abilities, and academic achievement and parent and teacher ratings of child behavior and school performance. A weighted sum of the number of major neonatal medical complications (Neonatal Risk Index) provided a composite measure of biological risk. Social risks were also assessed. Results indicated that the Neonatal Risk Index was the most consistent predictor of outcomes. Even after taking social risks into account, neonatal risk predicted overall cognitive ability and other achievement, neuropsychological, and behavior outcomes. Individual neonatal complications that predicted outcomes included severe cerebral ultrasonographic abnormality, chronic lung disease, necrotizing enterocolitis, and apnea of prematurity. Research and therapy to prevent or reduce neonatal complications and amelioration of social risks are of critical importance in improving outcomes of very low birth weight.

  6. Factors influencing the outcome of intrauterine insemination (IUI): age, clinical variables and significant thresholds.

    PubMed

    Speyer, B E; Abramov, B; Saab, W; Doshi, A; Sarna, U; Harper, J C; Serhal, P

    2013-10-01

    The aim was to investigate the influence of various biological factors upon the outcome of intrauterine insemination (IUI). The total IUI history (856 cycles) of 352 couples was studied. Live-birth showed a strong negative correlation with female age but no correlation with male age. Antimüllerian hormone (AMH) and antral follicle count (AFC) correlated negatively with female age, and follicle stimulating hormone (FSH) correlated positively. Significant thresholds were found for all three variables, and also for total motile count (TMC) in the prepared sperm. Calculating pregnancy losses per positive pregnancy showed a strong correlation with increasing female age. This was highly significant for biochemical losses but not for fetal heart miscarriages. Male age had no effect on rate of pregnancy loss. In conclusion, female age, FSH, AMH and TMC are good predictive factors for live-birth and therefore relate to essential in vivo steps in the reproductive process. PMID:24127958

  7. Maternal Age, Parity, and Reproductive Outcome in Captive Chimpanzees (Pan troglodytes)

    PubMed Central

    ROOF, KATHERINE A.; HOPKINS, WILLIAM D.; IZARD, M. KAY; HOOK, MICHELLE; SCHAPIRO, STEVEN J.

    2007-01-01

    As early as the 1970s, it was suggested that nonhuman primates may serve as models of human reproductive senescence. In the present study, the reproductive outcomes of 1,255 pregnancies in captive chimpanzees (Pan troglodytes) were examined in relation to parity and its covariate, maternal age. The results show that the percentage of positive pregnancy outcomes was negatively correlated with increasing parity. In addition, spontaneous abortions, stillbirths, and caesarian sections (C-sections) were positively correlated with increasing parity. Maternal age, rather than parity, was found to be the most important predictor of negative birth outcome. This study supports research demonstrating reproductive decline and termination in nonhuman primates, and is the first to quantitatively account for this phenomenon in captive female chimpanzees. PMID:16229006

  8. Vocational Rehabilitation Service Patterns and Outcomes for Individuals with Autism of Different Ages

    ERIC Educational Resources Information Center

    Chen, June L.; Sung, Connie; Pi, Sukyeong

    2015-01-01

    Young adults with autism spectrum disorders (ASD) often experience employment difficulties. Using Rehabilitation Service Administration data (RSA-911), this study investigated the service patterns and factors related to the employment outcomes of individuals with ASD in different age groups. Hierarchical logistic regression analyses were conducted…

  9. Choosing Assessment Instruments for Anxiety Practice and Outcome Research with School-Aged Youth

    ERIC Educational Resources Information Center

    Erford, Bradley T.; Lutz, Julie A.

    2015-01-01

    Using effect size results from our meta-analysis for the treatment of anxiety in school-aged youth, the practical and technical aspects of five commonly used anxiety instruments were analyzed, and effect size estimates compared to indicate the best choices for use in anxiety outcome research.

  10. Does Providing Transition Services by Age 14 Produce Better Vocational Outcomes for Students with Intellectual Disability?

    ERIC Educational Resources Information Center

    Cimera, Robert Evert; Burgess, Sloane; Bedesem, Peña L.

    2014-01-01

    This study examined the potential impact providing transition services early had on the vocational outcomes achieved by young adults with intellectual disability. Two groups were compared: 7,520 individuals from states requiring transition services be addressed in individualized educational programs (IEPs) by age 14 and 7,520 individuals from…

  11. Neurocognitive and Behavioral Outcomes of Younger Siblings of Children with Autism Spectrum Disorder at Age Five

    ERIC Educational Resources Information Center

    Warren, Zachary E.; Foss-Feig, Jennifer H.; Malesa, Elizabeth E.; Lee, Evon Batey; Taylor, Julie Lounds; Newsom, Cassandra R.; Crittendon, Julie; Stone, Wendy L.

    2012-01-01

    Later-born siblings of children with Autism Spectrum Disorders (ASD) are at increased risk for ASD as well as qualitatively similar traits not meeting clinical cutoffs for the disorder. This study examined age five neurocognitive and behavioral outcomes of 39 younger siblings of children with ASD (Sibs-ASD) and 22 younger siblings of typically…

  12. Lithium and age of pre-main sequence stars: the case of Parenago 1802

    NASA Astrophysics Data System (ADS)

    Giarrusso, M.; Tognelli, E.; Catanzaro, G.; Degl'Innocenti, S.; Dell'Omodarme, M.; Lamia, L.; Leone, F.; Pizzone, R. G.; Prada Moroni, P. G.; Romano, S.; Spitaleri, C.

    2016-04-01

    With the aim to test the present capability of the stellar surface lithium abundance in providing an estimation for the age of PMS stars, we analyze the case of the detached, double-lined, eclipsing binary system PAR 1802. For this system, the lithium age has been compared with the theoretical one, as estimated by applying a Bayesian analysis method on a large grid of stellar evolutionary models. The models have been computed for several values of chemical composition and mixing length, by means of the code FRANEC updated with the Trojan Horse reaction rates involving lithium burning.

  13. Childhood physical punishment or maltreatment and partnership outcomes at age 30.

    PubMed

    McLeod, Geraldine F H; Fergusson, David M; Horwood, L John

    2014-05-01

    Childhood physical abuse is known to be associated with impaired outcomes in adulthood (e.g., particularly for mental and physical health). However, relatively little is known about adult partnership outcomes for those exposed to childhood physical punishment or maltreatment. This study aims to examine the associations between childhood physical punishment or maltreatment and partnership outcomes at age 30. This investigation analyzed data from a birth cohort of more than 900 New Zealand adults studied to age 30. At ages 18 and 21, cohort members reported on the extent of exposure to childhood physical punishment or maltreatment prior to age 16. Measures of partner relations were collected up to age 30. After adjustment for childhood social, family, and related factors, increasing exposure to childhood physical punishment or maltreatment was associated with greater negative partner relationships (p=.002), partner social adjustment problems (p=.006), interpartner violence victimization (p=.010), and interpartner violence perpetration (p=.019). However, after adjustment, the association between childhood physical punishment or maltreatment and the number of cohabiting relationships was no longer statistically significant (p=.151). Interactions between childhood physical punishment or maltreatment and gender were tested for each of the outcomes. This analysis showed an interactive relationship between childhood physical punishment or maltreatment and partner social adjustment problems in which childhood physical punishment or maltreatment for females, but not males, was associated with partner social adjustment problems. These findings suggest that increasing exposure to childhood physical punishment or maltreatment is associated with impaired partnership outcomes: more negative partner relations, increased reports of a partner with social adjustment problems, and higher levels of interpartner violence.

  14. ENHANCED RECOVERY METHODS FOR 85KR AGE-DATING GROUNDWATER: ROYAL WATERSHED, MAINE

    EPA Science Inventory

    Potential widespread use of 85Kr, having a constant input function in the northern hemisphere, for groundwater age-dating would advance watershed investigations. The current input function of tritium is not sufficient to estimate young modern recharge waters. While tri...

  15. Influence of age, previous health status, and severity of acute illness on outcome from intensive care.

    PubMed

    Le Gall, J R; Brun-Buisson, C; Trunet, P; Latournerie, J; Chantereau, S; Rapin, M

    1982-09-01

    Age, previous health status (HS), and severity of acute illness were assessed prospectively on 228 unselected patients admitted over 1 yr to the multidisciplinary ICU, to determine their influence on outcome. One hundred and fifty patients (66%) were discharged from the ICU, but the survival rate fell to 50% at 6 months, and was similar after 1 yr (49%). Over a 6-month period, there was improved HS in survivors which gradually leveled off. Compared to prior HS, the final HS was worsened in 37% of survivors. Three factors were important predictors of late survival: age under 50, good previous HS, and less than two visceral failures. We conclude that evaluation of ICU outcome should provide information on 6-month survival and HS and include important variables as age, previous HS, and severity of acute illness. PMID:7105766

  16. Social Determinants, Race, and Brain Health Outcomes: Findings from the Chicago Health and Aging Project.

    PubMed

    Aggarwal, Neelum T; Everson-Rose, Susan A; Evans, Denis A

    2015-01-01

    The broad spectrum of economic and cultural diversity in the U.S. population correlates with and affects the study of behavioral aspects of health. The purpose of this article is to provide a selective overview of research findings from the Chicago Health and Aging Project (CHAP), which covers a socio-demographically diverse population in Chicago, with a focus on role-related psychosocial factors and observed racial/ethnic differences in aging outcomes. CHAP is a longitudinal, epidemiological study of common chronic conditions of aging with an emphasis on medical, psychosocial, and environmental risk factors for the decline in cognitive function across the older adult lifespan. We briefly summarize the study design and methods used in the CHAP study and characterize the study population and describe the psychosocial data, noting black-white associations as they relate to three common brain health outcomes: cognitive function and Alzheimer's Disease, stroke, and subclinical vascular disease as noted on neuroimaging. PMID:26239039

  17. Social Determinants, Race, and Brain Health Outcomes: Findings from the Chicago Health and Aging Project.

    PubMed

    Aggarwal, Neelum T; Everson-Rose, Susan A; Evans, Denis A

    2015-01-01

    The broad spectrum of economic and cultural diversity in the U.S. population correlates with and affects the study of behavioral aspects of health. The purpose of this article is to provide a selective overview of research findings from the Chicago Health and Aging Project (CHAP), which covers a socio-demographically diverse population in Chicago, with a focus on role-related psychosocial factors and observed racial/ethnic differences in aging outcomes. CHAP is a longitudinal, epidemiological study of common chronic conditions of aging with an emphasis on medical, psychosocial, and environmental risk factors for the decline in cognitive function across the older adult lifespan. We briefly summarize the study design and methods used in the CHAP study and characterize the study population and describe the psychosocial data, noting black-white associations as they relate to three common brain health outcomes: cognitive function and Alzheimer's Disease, stroke, and subclinical vascular disease as noted on neuroimaging.

  18. Age 13 language and reading outcomes in late-talking toddlers.

    PubMed

    Rescorla, Leslie

    2005-04-01

    Language and reading outcomes at 13 years of age were examined in 28 children identified at 24 to 31 months as late talkers, all of whom came from middle- to upper-class socioeconomic status (SES) families and had normal nonverbal ability and age-adequate receptive language at intake. Late talkers were compared with a group of 25 typically developing children matched at intake on age, SES, and nonverbal ability. As a group, late talkers performed in the average range on all standardized language and reading tasks at age 13. However, they scored significantly lower than SES-matched peers on aggregate measures of vocabulary, grammar, and verbal memory, as well as on reading comprehension. They were similar to comparison peers in reading mechanics and writing aggregates. Intercorrelations between outcome measures were moderately high, suggesting considerable shared variance. Regression analyses indicated that age 2 Language Development Survey vocabulary score was a significant predictor of age 13 vocabulary, grammar, verbal memory, and reading comprehension. Findings suggest that slow language development at age 2-2 1/2 is associated with a weakness in language-related skills into adolescence relative to typically developing peers.

  19. Effects of Age and Life Transitions on Alcohol and Drug Treatment Outcome Over Nine Years

    PubMed Central

    Satre, Derek D.; Chi, Felicia W.; Mertens, Jennifer R.; Weisner, Constance M.

    2012-01-01

    Objective: The purpose of this study was to examine the effects of age, common life transitions, treatment, and social support on outcomes 5–9 years after alcohol and other drug (AOD) treatment intake. Method: Participants were patients from a large outpatient AOD treatment program in an integrated health plan. There were 1,951 participants interviewed at intake, of whom 1,646 (84%) completed one or more telephone follow-up interviews at 5, 7, and 9 years. Measures included AOD use based on the Addiction Severity Index; treatment; and changes in marital, employment, and health status in the years between each follow-up. We compared participants by age group (18–39, 40–54, and >55 years old at intake) and examined factors (time invariant and time varying) associated with outcomes at 5, 7, and 9 years by fitting mixed-effects logistic random intercept models. Results: Changes in marital, employment, and health status varied significantly by age. Factors associated with remission across Years 5–9 included being in the middle-aged versus younger group (p < .001); female gender (p < .001); not losing a partner to separation, divorce, or death (p < .001); not experiencing a decline in health (p = .021); having any close friends supportive of recovery (p < .001); and not having any close friends who encourage AOD use (p < .001). Additional predictors, including employment changes, varied by drug versus alcohol abstinence outcome measures. Conclusions: Negative life transitions vary by age and are associated with worse outcomes. Older age and social support are associated with long-term AOD remission and abstinence. Findings inform treatment strategies to enhance recovery across the life span. PMID:22456251

  20. APPARENT 85KRYPTON AGES OF GROUNDWATER WITHIN THE ROYAL WATERSHED, MAINE, USA

    EPA Science Inventory

    85Kr activities were determined in 264 domestic and municipal wells from 2002-2004 in the Royal watershed (361 km2), Maine. Gas extraction for 85Kr from wells was effected directly via a well-head methodology permitting efficient widespread analys...

  1. Carboniferous U-Pb age of the Sebago batholith, southwestern Maine: metamorphic and tectonic implications.

    USGS Publications Warehouse

    Aleinikoff, J.H.; Moench, R.H.; Lyons, J.B.

    1985-01-01

    Two phases (pink and white granite) of the Sebago batholith have been dated by the U/Pb zircon method. The age of both phases is 325 m.y. Zircon in the pink phase has been reset in intrusion of the Pleasant Mountain stock approx 114 m.y. ago. Zircon in the white phase lost lead only recently. Metamorphic isograds in the vicinity of the batholith approximately parallel its shape, and may be at least partly Hercynian in age. Cooling and uplift of the Sebago batholith appear to have followed a complicated path involving little or no uplift in the Middle Carboniferous to Middle Permian, rapid cooling from 275 to 225 m.y. ago, and a slow cooling since Middle Triassic. Different rates of cooling may be related to changes in the tectonic regime.-L.C.H.

  2. Energy excess is the main cause of accelerated aging of mammals

    PubMed Central

    Biliński, Tomasz; Paszkiewicz, Tadeusz; Zadrag-Tecza, Renata

    2015-01-01

    The analysis of cases of unusually high longevity of naked mole rats and an alternative explanation of the phenomenon of calorie restriction effects in monkeys allowed for postulating that any factor preventing an excess of energy consumed, leads to increased lifespan, both in evolutionary and an individual lifetime scale. It is postulated that in mammals the most destructive processes resulting in shortening of life are not restricted to the phenomena explained by the hyperfunction theory of Mikhail Blagosklonny. Hyperfunction, understood as unnecessary or even adverse syntheses of cell components, can be to some extent prevented by lowered intake of nutrients when body growth ceases. We postulate also the contribution of glyco/lipotoxicity to aging, resulting from the excess of energy. Besides two other factors seem to participate in aging. One of them is lack of telomerase activity in some somatic cells. The second factor concerns epigenetic phenomena. Excessive activity of epigenetic maintenance system probably turns off some crucial organismal functions. Another epigenetic factor playing important role could be the micro RNA system deciding on expression of numerous age-related diseases. However, low extrinsic mortality from predation is a conditio sine qua non of the expression of all longevity phenotypes in animals. Among all long-lived animals, naked mole rats are unique in the elimination of neoplasia, which is accompanied by delayed functional symptoms of senescence. The question whether simultaneous disappearance of neoplasia and delayed senescence is accidental or not remains open. PMID:26079722

  3. Lifestyle, nutrient intake, iron status, and pregnancy outcome in pregnant women of advanced maternal age.

    PubMed

    Bae, Hyun Sook

    2011-02-01

    The purpose of this study was to investigate how advanced maternal age influences lifestyle, nutrient intake, iron status, and pregnancy outcomes in pregnant women. The subjects of this study were 112 pregnant women who were receiving prenatal care at gynecologists located in Seoul. The subjects were divided into two groups according to their ages: those over age 35 were the advanced age group of pregnant women (AP) and those under age 35 were the young age group of pregnant women (YP). General factors, nutrient intakes, iron status, and pregnancy outcomes of the two groups were then compared. It was found that 72.5% of the YP group and 51.2% of the AP group had pre-pregnancy alcohol drinking experience; indicating that the YP group had more pre-pregnancy alcohol consumption than the AP group (P < 0.05). The only difference found in nutrient intake between the two groups was their niacin intakes which were 16.83 ± 8.20 mg/day and 13.76 ± 5.28 mg/day, respectively. When gestational age was shorter than 38.7 weeks, the average infant birth weight was 2.95 ± 0.08 kg, and when gestational age was longer than 40 weeks, it averaged at about 3.42 ± 0.08 kg. In other words, as gestational age increased, infant birth weight increased (P < 0.0001), and when maternal weight increased more than 15 kg, the infant birth weight increased significantly (P < 0.05). In conclusion, in order to secure healthy human resources, with respect to advanced aged women, it is necessary to intervene by promoting daily habits that consist of strategic increases in folate and calcium intake along with appropriate amounts of exercise.

  4. The age-metallicity relation in the solar neighbourhood from a pilot sample of white dwarf-main sequence binaries

    NASA Astrophysics Data System (ADS)

    Rebassa-Mansergas, A.; Anguiano, B.; García-Berro, E.; Freeman, K. C.; Cojocaru, R.; Manser, C. J.; Pala, A. F.; Gänsicke, B. T.; Liu, X.-W.

    2016-08-01

    The age-metallicity relation (AMR) is a fundamental observational constraint for understanding how the Galactic disc formed and evolved chemically in time. However, there is not yet an agreement on the observational properties of the AMR for the solar neighborhood, primarily due to the difficulty in obtaining accurate stellar ages for individual field stars. We have started an observational campaign for providing the much needed observational input by using wide white dwarf-main sequence (WDMS) binaries. White dwarfs are "natural" clocks and can be used to derive accurate ages. Metallicities can be obtained from the main sequence companions. Since the progenitors of white dwarfs and the main sequence stars were born at the same time, WDMS binaries provide a unique opportunity to observationally constrain in a robust way the properties of the AMR. In this work we present the AMR derived from analysing a pilot sample of 23 WDMS binaries and provide clear observational evidence for the lack of correlation between age and metallicity at young and intermediate ages (0-7 Gyrs).

  5. Rotating Stellar Models Can Account for the Extended Main-sequence Turnoffs in Intermediate-age Clusters

    NASA Astrophysics Data System (ADS)

    Brandt, Timothy D.; Huang, Chelsea X.

    2015-07-01

    We show that the extended main-sequence turnoffs seen in intermediate-age Large Magellanic Cloud (LMC) clusters, often attributed to age spreads of several 100 Myr, may be easily accounted for by variable stellar rotation in a coeval population. We compute synthetic photometry for grids of rotating stellar evolution models and interpolate them to produce isochrones at a variety of rotation rates and orientations. An extended main-sequence turnoff naturally appears in color-magnitude diagrams at ages just under 1 Gyr, peaks in extent between ˜1 and 1.5 Gyr, and gradually disappears by around 2 Gyr in age. We then fit our interpolated isochrones by eye to four LMC clusters with very extended main-sequence turnoffs: NGC 1783, 1806, 1846, and 1987. In each case, stellar populations with a single age and metallicity can comfortably account for the observed extent of the turnoff region. The new stellar models predict almost no correlation of turnoff color with rotational v{sin}i. The red part of the turnoff is populated by a combination of slow rotators and edge-on rapid rotators, while the blue part contains rapid rotators at lower inclinations.

  6. Effect of Paternal Age on Reproductive Outcomes of Intracytoplasmic Sperm Injection

    PubMed Central

    Zheng, Haiyan; Liu, Haiying; Huang, Qing; Liu, Jianqiao

    2016-01-01

    The impact of paternal age on reproduction, especially using assisted reproductive technologies, has not been well studied to date. To investigate the effect of paternal age on reproductive outcomes, here we performed a retrospective analysis of 2,627 intracytoplasmic sperm injection (ICSI) cycles performed at the Reproductive Medicine Center of the Third Affiliated Hospital of Guangzhou Medical University (China) between January 2007 and May 2015. Effect of paternal age on embryo quality [number of fertilized oocytes, 2 pronucleus zygotes (2PNs), viable embryos, and high-quality embryos] was analyzed by multiple linear regression. Relationships between paternal age and pregnancy outcomes were analyzed by binary logistic regression. After adjusting for female age, no association between paternal age and the following parameters of embryo quality was observed: number of fertilized oocytes (B = -0.032; 95% CI -0.069–0.005; P = 0.088), number of 2PNs (B = -0.005; 95% CI -0.044–0.034; P = 0.806), and number of viable embryos (B = -0.025; 95% CI -0.052–0.001; P = 0.062). However, paternal age negatively influenced the number of high-quality embryos (B = -0.020; 95% CI -0.040–0.000; P = 0.045). Moreover, paternal age had no effect on pregnancy outcomes (OR for a 5-year interval), including the rates of clinical pregnancy (OR 0.919; 95% CI 0.839–1.006; P = 0.067), ongoing pregnancy (OR 0.914; 95% CI 0.833–1.003; P = 0.058), early pregnancy loss (OR 1.019; 95% CI 0.823–1.263; P = 0.861), live births (OR 0.916; 95% CI 0.833–1.007; P = 0.070), and preterm births (OR 1.061; 95% CI 0.898–1.254; P = 0.485). Therefore, increased paternal age negatively influences the number of high-quality embryos, but has no effect on pregnancy outcomes in couples undergoing ICSI cycles. However, more studies including men aged over 60 years with a longer-term follow-up are needed. PMID:26901529

  7. Older Age Does Not Affect Healing Time and Functional Outcomes After Fracture Nonunion Surgery

    PubMed Central

    Taormina, David P.; Shulman, Brandon S.; Karia, Raj; Spitzer, Allison B.; Konda, Sanjit R.

    2014-01-01

    Introduction: Elderly patients are at risk of fracture nonunion, given the potential setting of osteopenia, poorer fracture biology, and comorbid medical conditions. Risk factors predicting fracture nonunion may compromise the success of fracture nonunion surgery. The purpose of this study was to investigate the effect of patient age on clinical and functional outcome following long bone fracture nonunion surgery. Materials and Methods: A retrospective analysis of prospectively collected data identified 288 patients (aged 18-91) who were indicated for long bone nonunion surgery. Two-hundred and seventy-two patients satisfied study inclusion criteria and analyses were performed comparing elderly patients aged ≥65 years (n = 48) with patients <65 years (n = 224) for postoperative wound complications, Short Musculoskeletal Functional Assessment (SMFA) functional status, healing, and surgical revision. Regression analyses were performed to look for associations between age, smoking status, and history of previous nonunion surgery with healing and functional outcome. Twelve-month follow-up was obtained on 91.5% (249 of 272) of patients. Results: Despite demographic differences in the aged population, including a predominance of medical comorbidities (P < .01) and osteopenia (P = .02), there was no statistical differences in the healing rate of elderly patients (95.8% vs 95.1%, P = .6) or time to union (6.2 ± 4.1 months vs. 7.2 ± 6.6, P = .3). Rates of postoperative wound complications and surgical revision did not statistically differ. Elderly patients reported similar levels of function up to 12 months after surgery. Regression analyses failed to show any significant association between age and final union or time to union. There was a strong positive association between smoking and history of previous nonunion surgery with time to union. Age was associated (positively) with 12-month SMFA activity score. Conclusions: Smoking and failure of previous surgical

  8. Academic Outcomes for School-Aged Children with Severe-Profound Hearing Loss and Early Unilateral and Bilateral Cochlear Implants

    ERIC Educational Resources Information Center

    Sarant, Julia Z.; Harris, David C.; Bennet, Lisa A.

    2015-01-01

    Purpose: This study sought to (a) determine whether academic outcomes for children who received early cochlear implants (CIs) are age appropriate, (b) determine whether bilateral CI use significantly improves academic outcomes, and (c) identify other factors that are predictive of these outcomes. Method: Forty-four 8-year-old children with…

  9. Controversial age spreads from the main sequence turn-off and red clump in intermediate-age clusters in the LMC

    NASA Astrophysics Data System (ADS)

    Niederhofer, F.; Bastian, N.; Kozhurina-Platais, V.; Hilker, M.; de Mink, S. E.; Cabrera-Ziri, I.; Li, C.; Ercolano, B.

    2016-02-01

    Most star clusters at an intermediate age (1-2 Gyr) in the Large and Small Magellanic Clouds show a puzzling feature in their color-magnitude diagrams (CMD) that is not in agreement with a simple stellar population. The main sequence turn-off of these clusters is much broader than expected from photometric uncertainties. One interpretation of this feature is that age spreads of the order of 200-500 Myr exist within individual clusters, although this interpretation is highly debated. Such large age spreads should affect other parts of the CMD, which are sensitive to age, as well. In this study, we analyze the CMDs of a sample of 12 intermediate-age clusters in the Large Magellanic Cloud that all show an extended turn-off using archival optical data taken with the Hubble Space Telescope. We fit the star formation history of the turn-off region and the red clump region independently. We find that in most cases, the age spreads inferred from the red clumps are smaller than those that result from the turn-off region. However, the age ranges that result from the red clump region are broader than expected for a single age. Only two out of 12 clusters in our sample show a red clump which seems to be consistent with a single age. As our results are ambiguous, by fitting the star formation histories to the red clump regions, we cannot ultimately tell if the extended main sequence turn-off feature is the result of an age spread or not. However, we do find that the width of the extended main sequence turn-off feature is correlated with the age of the clusters in a way which would be unexplained in the so-called age spread interpretation, but which may be expected if stellar rotation is the cause of the spread at the turn-off. Based on observations made with the NASA/ESA Hubble Space Telescope, and obtained from the Hubble Legacy Archive, which is a collaboration between the Space Telescope Science Institute (STScI/NASA), the Space Telescope European Coordinating Facility (ST

  10. Incorporating Age-Specific Plans of Care to Achieve Optimal Perioperative Outcomes.

    PubMed

    Mower, Juliana

    2015-10-01

    When developing a nursing plan of care, a perioperative nurse identifies nursing diagnoses during the preoperative patient assessment. The ability to identify age-specific outcomes (ie, infant/child, adolescent, adult, elderly adult) in addition to those that are universally applicable is a major responsibility of the perioperative RN. Having an individualized plan of care is one of the best ways to determine whether desired patient outcomes have been successfully attained. Nursing care plans address intraoperative and postoperative risks and allow for a smooth transfer of care throughout the perioperative experience. A good nursing care plan also includes education for the patient and his or her caregiver. Within an overall plan of care, the use of methods such as a concept or mind map can visually demonstrate the relationships between systems, nursing diagnoses, nursing interventions, and desirable outcomes.

  11. Employment Outcomes of Transition-Aged Adults with Autism Spectrum Disorders: A State of the States Report

    ERIC Educational Resources Information Center

    Burgess, Sloane; Cimera, Robert E.

    2014-01-01

    The primary purpose of this study was to evaluate the employment outcomes of transition-aged adults with autism spectrum disorders (ASD) served by vocational rehabilitation services (VR) over the last 10 years by state. A secondary purpose was to compare employment outcomes of individuals with ASD to those of the overall transition-aged population…

  12. THE EFFECTS OF ROTATION ON THE MAIN-SEQUENCE TURNOFF OF INTERMEDIATE-AGE MASSIVE STAR CLUSTERS

    SciTech Connect

    Yang, Wuming; Bi, Shaolan; Liu, Zhie; Meng, Xiangcun E-mail: yangwuming@ynao.ac.cn

    2013-10-20

    The double or extended main-sequence turnoffs (MSTOs) in the color-magnitude diagram (CMD) of intermediate-age massive star clusters in the Large Magellanic Cloud are generally interpreted as age spreads of a few hundred Myr. However, such age spreads do not exist in younger clusters (i.e., 40-300 Myr), which challenges this interpretation. The effects of rotation on the MSTOs of star clusters have been studied in previous works, but the results obtained are conflicting. Compared with previous works, we consider the effects of rotation on the main-sequence lifetime of stars. Our calculations show that rotating models have a fainter and redder MSTO with respect to non-rotating counterparts with ages between about 0.8 and 2.2 Gyr, but have a brighter and bluer MSTO when age is larger than 2.4 Gyr. The spread of the MSTO caused by a typical rotation rate is equivalent to the effect of an age spread of about 200 Myr. Rotation could lead to the double or extended MSTOs in the CMD of the star clusters with ages between about 0.8 and 2.2 Gyr. However, the extension is not significant, and it does not even exist in younger clusters. If the efficiency of the mixing were high enough, the effects of the mixing would counteract the effect of the centrifugal support in the late stage of evolution, and the rotationally induced extension would disappear in the old intermediate-age star clusters, but younger clusters would have an extended MSTO. Moreover, the effects of rotation might aid in understanding the formation of some 'multiple populations' in globular clusters.

  13. Diet, age, and prior injury status differentially alter behavioral outcomes following concussion in rats.

    PubMed

    Mychasiuk, Richelle; Hehar, Harleen; van Waes, Linda; Esser, Michael J

    2015-01-01

    Mild traumatic brain injury (mTBI) or concussion affects a large portion of the population and although many of these individuals recover completely, a small subset of people experience lingering symptomology and poor outcomes. Little is known about the factors that affect individual susceptibility or resilience to poor outcomes after mTBI and there are currently no biomarkers to delineate mTBI diagnosis or prognosis. Based upon the growing literature associated with caloric intake and altered neurological aging and the ambiguous link between repetitive mTBI and progressive neurodegeneration, the current study was designed to examine the effect of a high fat diet (HFD), developmental age, and repetitive mTBI on behavioral outcomes following a mTBI. In addition, telomere length was examined before and after experimental mTBI. Sprague Dawley rats were maintained on a HFD or standard rat chow throughout life (including the prenatal period) and then experienced an mTBI/concussion at P30, P30 and P60, or only at P60. Behavioral outcomes were examined using a test battery that was administered between P61-P80 and included; beam-walking, open field, elevated plus maze, novel context mismatch, Morris water task, and forced swim task. Animals with a P30 mTBI often demonstrated lingering symptomology that was still present during testing at P80. Injuries at P30 and P60 rarely produced cumulative effects, and in some tests (i.e., beam walking), the first injury may have protected the brain from the second injury. Exposure to the high fat diet exacerbated many of the behavioral deficits associated with concussion. Finally, telomere length was shortened following mTBI and was influenced by the animal's dietary intake. Diet, age at the time of injury, and the number of prior concussion incidents differentially contribute to behavioral deficits and may help explain individual variations in susceptibility and resilience to poor outcomes following an mTBI.

  14. A pint for a pound? Minimum drinking age laws and birth outcomes.

    PubMed

    Barreca, Alan; Page, Marianne

    2015-04-01

    Minimum legal drinking age (MLDA) laws are known to reduce alcohol consumption among young adults. One additional benefit of higher MLDAs may be that they improve health outcomes among infants born to young mothers. We estimate the impact of MLDAs on infant health in the USA by comparing birth outcomes among 14-20 year old mothers who were exposed to different MLDAs because of when and where they gave birth. Infants born to mothers who were between the ages of 21 and 24 years are included as a control group. We find that low MLDAs are associated with very small birth weight reductions, but have a little relationship with other traditional measures of infant health. We find compelling evidence, however, that a low MLDA increases the probability of a female birth, which suggests that restricting alcohol access to young mothers may reduce fetal deaths. PMID:24375521

  15. Age or stage structure? A comparison of dynamic outcomes from discrete age- and stage-structured population models.

    PubMed

    Wikan, Arild

    2012-06-01

    Discrete stage-structured density-dependent and discrete age-structured density-dependent population models are considered. Regarding the former, we prove that the model at hand is permanent (i.e., that the population will neither go extinct nor exhibit explosive oscillations) and given density dependent fecundity terms we also show that species with delayed semelparous life histories tend to be more stable than species which possess precocious semelparous life histories. Moreover, our findings together with results obtained from other stage-structured models seem to illustrate a fairly general ecological principle, namely that iteroparous species are more stable than semelparous species. Our analysis of various age-structured models does not necessarily support the conclusions above. In fact, species with precocious life histories now appear to possess better stability properties than species with delayed life histories, especially in the iteroparous case. We also show that there are dynamical outcomes from semelparous age-structured models which we are not able to capture in corresponding stage-structured cases. Finally, both age- and stage-structured population models may generate periodic dynamics of low period (either exact or approximate). The important prerequisite is to assume density-dependent survival probabilities. PMID:22297621

  16. Intraventricular Hemorrhage and Developmental Outcomes at 24 months of age in Extremely Preterm Infants

    PubMed Central

    O'Shea, T. Michael; Allred, Elizabeth N.; Kuban, Karl C. K.; Hirtz, Deborah; Specter, Barbara; Durfee, Sara; Paneth, Nigel; Leviton, Alan

    2013-01-01

    Whether intraventricular hemorrhage increases the risk of adverse developmental outcome among premature infants is controversial. Using brain ultrasound, we identified IVH and white matter abnormalities among 1064 infants born before 28 weeks gestation. We identified adverse developmental outcomes at 24 months of age using a standardized neurological examination and the Bayley Scales of Infant Development Mental and Motor Scales. In logistic regression models that adjusted for gestational age, sex, and public insurance, isolated intraventricular hemorrhage was associated with visual fixation difficulty (odds ratio: 2.5 (95% confidence limits: 1.2, 5.1)) but no other adverse outcome. Infants who had a white matter lesion unaccompanied by intraventricular hemorrhage were at increased risk of cerebral palsy, low Mental and Motor Scores, and visual and hearing impairments. Except when accompanied or followed by a white matter lesion, intraventricular hemorrhage is associated with no more than a mild increase (and possibly no increase) in the risk of adverse developmental outcome during infancy. PMID:22232137

  17. Early blood pressure, anti-hypotensive therapy and outcomes at 18 to 22 month corrected age in extremely preterm infants

    PubMed Central

    Batton, Beau; Li, Lei; Newman, Nancy S.; Das, Abhik; Watterberg, Kristi L.; Yoder, Bradley A.; Faix, Roger G.; Laughon, Matthew M.; Stoll, Barbara J.; Higgins, Rosemary D.; Walsh, Michele C.

    2016-01-01

    Objective Investigate relationships between early blood pressure (BP) changes, receipt of anti-hypotensive therapy, and 18 – 22 month corrected age (CA) outcomes for extremely preterm infants. Design Prospective observational study of infants 230/7 – 266/7 weeks gestational age (GA). Hourly BP values and anti-hypotensive therapy exposure in the first 24 hours were recorded. Four groups were defined: infants who did or did not receive anti-hypotensive therapy in whom BP did or did not rise at the expected rate (defined as an increase in the mean arterial BP of ≥5 mmHg/day). Random-intercept logistic modeling controlling for center clustering, GA, and illness severity was used to investigate the relationship between BP, anti-hypotensive therapies, and infant outcomes. Setting Sixteen academic centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Main Outcome Measures Death or neurodevelopmental impairment / developmental delay (NIDD) at 18 – 22 months CA. Results Of 367 infants, 203 (55%) received an anti-hypotensive therapy, 272 (74%) survived to discharge, and 331 (90%) had a known outcome at 18 – 22 months CA. With logistic regression, there was an increased risk of death/NIDD with anti-hypotensive therapy versus no treatment (odds ratio: 1.836, 95% confidence interval: 1.092 – 3.086), but not NIDD alone (odds ratio: 1.53, 95% confidence interval: 0.708 – 3.307). Conclusion Independent of early BP changes, anti-hypotensive therapy exposure was associated with an increased risk of death/NIDD at 18 to 22 months CA when controlling for risk factors known to affect survival and neurodevelopment. PMID:26567120

  18. School-age outcomes of infants at risk for autism spectrum disorder.

    PubMed

    Miller, Meghan; Iosif, Ana-Maria; Young, Gregory S; Hill, Monique; Phelps Hanzel, Elise; Hutman, Ted; Johnson, Scott; Ozonoff, Sally

    2016-06-01

    Studies of infants at risk for autism spectrum disorder (ASD) have proliferated, but few of these samples have been followed longer-term. We conducted a follow-up study, at age 5.5-9 years, of younger siblings of children with ASD (high-risk group, n = 79) or typical development (low-risk group, n = 60), originally recruited as infants. Children with ASD were excluded because of the focus on understanding the range of non-ASD outcomes among high-risk siblings. Using examiner ratings, parent ratings, and standardized assessments, we evaluated differences in clinical outcomes, psychopathology symptoms, autism symptoms, language skills, and nonverbal cognitive abilities. After adjusting for covariates, the high-risk group had increased odds of any clinically elevated/impaired score across measures relative to the low-risk group (43% vs. 12%, respectively). The high-risk group also had increased odds of examiner-rated Clinical Concerns (CC) outcomes (e.g., ADHD concerns, broader autism phenotype, speech-language difficulties, anxiety/mood problems, learning problems) relative to the low-risk group (38% vs. 13%, respectively). The high-risk group with CC outcomes had higher parent-reported psychopathology and autism symptoms, and lower directly-assessed language skills, than the Low-Risk Typically Developing (TD) and High-Risk TD groups, which did not differ. There were no differences in nonverbal cognitive skills. For some in the high-risk group, clinical concerns persisted from early childhood, whereas for others clinical concerns were first evident at school-age. Results suggest continued vulnerability in at least a subgroup of school-age children with a family history of ASD and suggest that this population may benefit from continued screening and monitoring into the school-age years. Autism Res 2016, 9: 632-642. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

  19. Does obesity influence labour market outcomes among working-age adults? Evidence from Canadian longitudinal data.

    PubMed

    Larose, Samantha L; Kpelitse, Koffi A; Campbell, M Karen; Zaric, Gregory S; Sarma, Sisira

    2016-03-01

    Although a negative association between obesity and labour market outcomes is commonly reported in many studies, the causal nature of this relationship remains unclear. Using nationally representative longitudinal data from the last six confidential master files (2000/2001-2010/2011) of the National Population Health Survey, we examine the association between obesity and employment participation and earnings among working-age adults in Canada. After controlling for demographic and socioeconomic characteristics, lifestyle factors and time-invariant individual heterogeneity, our results show that obesity is not significantly associated with employment participation but is associated with reduced hourly wage rate and annual income among women by about 4% and 4.5%, respectively. The corresponding results for men show that obesity is associated with about 2% reduction in wage rate and income, but significant at 10% level. However, after controlling for the potential reverse causality bias using the lagged measure of obesity, the effect of obesity on wage rate and income became positive or statistically non-significant. Our findings suggest that obesity is not causally associated with negative labour market outcomes among working-age men in Canada. For working-age women, we find limited evidence of negative labour market outcomes. PMID:26650919

  20. Does obesity influence labour market outcomes among working-age adults? Evidence from Canadian longitudinal data.

    PubMed

    Larose, Samantha L; Kpelitse, Koffi A; Campbell, M Karen; Zaric, Gregory S; Sarma, Sisira

    2016-03-01

    Although a negative association between obesity and labour market outcomes is commonly reported in many studies, the causal nature of this relationship remains unclear. Using nationally representative longitudinal data from the last six confidential master files (2000/2001-2010/2011) of the National Population Health Survey, we examine the association between obesity and employment participation and earnings among working-age adults in Canada. After controlling for demographic and socioeconomic characteristics, lifestyle factors and time-invariant individual heterogeneity, our results show that obesity is not significantly associated with employment participation but is associated with reduced hourly wage rate and annual income among women by about 4% and 4.5%, respectively. The corresponding results for men show that obesity is associated with about 2% reduction in wage rate and income, but significant at 10% level. However, after controlling for the potential reverse causality bias using the lagged measure of obesity, the effect of obesity on wage rate and income became positive or statistically non-significant. Our findings suggest that obesity is not causally associated with negative labour market outcomes among working-age men in Canada. For working-age women, we find limited evidence of negative labour market outcomes.

  1. [sup 40]Ar/[sup 39]Ar mineral ages from southwestern Penobscot Bay, Maine: Evidence for Silurian metamorphism

    SciTech Connect

    West, D.P. Jr.; Guidotti, C.V.; Lux, D.R. . Dept. of Geological Sciences)

    1992-01-01

    The nature and timing of metamorphic events in the Coastal Lithotectonic Block of Maine remain poorly understood. Immediately west and southwest of Penobscot Bay the rocks are polymetamorphic showing evidence for at least two episodes of amphibolite facies metamorphism and later, perhaps regionally extensive, retrograde events. Hornblende mineral separates from two amphibolites din the Port Clyde area have identical Ar-40/Ar-39 plateau ages of 414.0 [+-] 3.3 and 414.0 [+-] 3.9 Ma. These ages are interpreted to reflect the time of cooling following the last significant thermal event in this area. Biotite from an amphibolite in the Port Clyde area gives a total gas age of 346.5 [+-] 3.2 Ma. Hornblende from an amphibolite 7 km to the west near Friendship gives a nearly concordant release spectrum with a plateau age of 369.0 [+-] 3.7 Ma. Coexisting biotite from this amphibolite gives a total gas age of 289.2 [+-] 2.7 Ma. Muscovite from the Waldoboro pluton has a nearly concordant release spectrum with a plateau age of 306.3 [+-] 2.2 Ma. Biotite from this sample gives a total gas age of 288.9 [+-] 2.2 Ma. The 414.0 Ma hornblende cooling ages from the Port Clyde area reflect cooling following a significant high grade Silurian thermal event. This Silurian metamorphism is the same age as tectonothermal events in the Nashoba Terrane in eastern Massachusetts, the Kingston Complex in southern New Brunswick, the Aspy Terrane in Cape Breton island, Nova Scotia, and the Hermitage Flexure in southern Newfoundland.d Thus a distinctive Silurian tectonothermal province located along the western edge of the Avalon Zone appears to extend discontinuously from Massachusetts to Newfoundland.

  2. Impact of Increasing Age on Outcomes of Spinal Fusion in Adult Idiopathic Scoliosis

    PubMed Central

    Verla, Terence; Adogwa, Owoicho; Toche, Ulysses; Farber, S. Harrison; Petraglia, Frank; Murphy, Kelly R.; Thomas, Steven; Fatemi, Parastou; Gottfried, Oren; Bagley, Carlos A.; Lad, Shivanand P.

    2016-01-01

    Objective To investigate the role of advancing age on postoperative complications and revision surgery after fusion for scoliosis. Methods A retrospective, cohort study was performed using the Thomson Reuters MarketScan database, examining patients with adult scoliosis who underwent spinal fusion from 2000 to 2009. Primary outcomes included infection, hemorrhage and pulmonary embolism (PE) within 90 days of surgery, and refusion. The effect of increasing age was estimated using the odds ratio (OR) of complications in a multivariate logistic regression analysis, and a Cox proportional hazard model estimated the hazard ratio of refusion. Results A total of 8432 patients were included in this study. Overall, the average age was 53.3 years, with 26.90% males and 39% with a Charlson Comorbidity Score of ≥1. Most patients had commercial insurance (66.81%), with 26.03% and 7.16% covered by Medicare and Medicaid, respectively. Increasing age (per 5-year increment) was a significant predictor of hemorrhagic complication (OR, 1.06; confidence interval [CI], 1.01–1.11; P = 0.0196), PE (OR, 1.09; CI, 1.03–1.16; P = 0.0031), infection (OR, 1.04; CI, 1.01–1.07; P = 0.0053), and refusion (hazard ratio, 1.07; CI, 1.02–1.13; P = 0.0103). Conclusions In this study, age was associated with increased risk of hemorrhage, PE, infection, and refusion. With the aging population, the role of patient age on postoperative healing and outcomes deserves deeper investigation after repair of adult idiopathic scoliosis. PMID:26546999

  3. Threshold age and burn size associated with poor outcomes in the elderly after burn injury.

    PubMed

    Jeschke, Marc G; Pinto, Ruxandra; Costford, Sheila R; Amini-Nik, Saeid

    2016-03-01

    Elderly burn care represents a vast challenge. The elderly are one of the most susceptible populations to burn injuries, but also one of the fastest growing demographics, indicating a substantial increase in patient numbers in the near future. Despite the need and importance of elderly burn care, survival of elderly burn patients is poor. Additionally, little is known about the responses of elderly patients after burn. One central question that has not been answered is what age defines an elderly patient. The current study was conducted to determine whether there is a cut-off age for elderly burn patients that is correlated with an increased risk for mortality and to determine the burn size in modern burn care that is associated with increased mortality. To answer these questions, we applied appropriate statistical analyses to the Ross Tilley Burn Centre and the Inflammatory and Host Response to Injury databases. We could not find a clear cut-off age that differentiates or predicts between survival and death. Risk of death increased linearly with increasing age. Additionally, we found that the LD50 decreases from 45% total body surface area (TBSA) to 25% TBSA from the age of 55 years to the age of 70 years, indicating that even small burns lead to poor outcome in the elderly. We therefore concluded that age is not an ideal to predictor of burn outcome, but we strongly suggest that burn care providers be aware that if an elderly patient sustains even a 25% TBSA burn, the risk of mortality is 50% despite the implementation of modern protocolized burn care.

  4. Age and the Head-Up Tilt Test Outcome in Syncope Patients

    PubMed Central

    Noormand, Rezvan; Shafiee, Akbar; Davoodi, Gholamreza; Tavakoli, Fatemeh; Gheini, Alireza; Yaminisharif, Ahmad; Jalali, Arash; Sadeghian, Saeed

    2015-01-01

    Background: The head-up tilt test (HUTT) is a useful diagnostic tool for syncope. Objectives: We sought to investigate the outcome of the HUTT in syncope patients and identify the relationship between age and different hemodynamic outcomes. Patients and Methods: In this cross-sectional study, we prospectively enrolled consecutive patients who presented with syncope and underwent the HUTT with a clinical suspicion of neurocardiogenic syncope after the exclusion of orthostatic hypotension cases. The HUTT consisted of consecutive passive and active phases. In the passive phase, the patients were tilted at 70 degrees for 20 minutes; and if negative, the test was repeated with 400 micrograms of sublingual nitroglycerin for another 20 minutes. Positive responses were classified according to the classification of the vasovagal syncope international study (VASIS) and compared for age and gender. Results: A total of 498 patients were enrolled (age = 44.93 ± 18.77 years; male = 271 [54.4%]). Overall, 291 (58.4%) patients had a positive HUTT, while 256 (88.5%) patients had a positive result during the active phase. The test results were as follows: 107 (36.7%) mixed type (VASIS I), 103 (35.3%) cardioinhibitory (VASIS IIA = 44 [15.1%]; VASIS IIB = 59 [20.2%]), and 80 (27.4%) vasodepressive (VASIS III). There was no relationship between gender and syncope type. The trend of the HUTT result significantly changed with age, and the rate of cardioinhibitory syncope decreased after middle ages (P value for trend = 0.02). Conclusions: Hemodynamic response to the HUTT was associated with age. Cardioinhibitory response became less frequent with age due to exaggerated vagal activity in the younger patients as compared with the older subjects. PMID:26528449

  5. Acute post-traumatic stress symptoms and age predict outcome in military blast concussion.

    PubMed

    Mac Donald, Christine L; Adam, Octavian R; Johnson, Ann M; Nelson, Elliot C; Werner, Nicole J; Rivet, Dennis J; Brody, David L

    2015-05-01

    High rates of adverse outcomes have been reported following blast-related concussive traumatic brain injury in US military personnel, but the extent to which such adverse outcomes can be predicted acutely after injury is unknown. We performed a prospective, observational study of US military personnel with blast-related concussive traumatic brain injury (n = 38) and controls (n = 34) enrolled between March and September 2012. Importantly all subjects returned to duty and did not require evacuation. Subjects were evaluated acutely 0-7 days after injury at two sites in Afghanistan and again 6-12 months later in the United States. Acute assessments revealed heightened post-concussive, post-traumatic stress, and depressive symptoms along with worse cognitive performance in subjects with traumatic brain injury. At 6-12 months follow-up, 63% of subjects with traumatic brain injury and 20% of controls had moderate overall disability. Subjects with traumatic brain injury showed more severe neurobehavioural, post-traumatic stress and depression symptoms along with more frequent cognitive performance deficits and more substantial headache impairment than control subjects. Logistic regression modelling using only acute measures identified that a diagnosis of traumatic brain injury, older age, and more severe post-traumatic stress symptoms provided a good prediction of later adverse global outcomes (area under the receiver-operating characteristic curve = 0.84). Thus, US military personnel with concussive blast-related traumatic brain injury in Afghanistan who returned to duty still fared quite poorly on many clinical outcome measures 6-12 months after injury. Poor global outcome seems to be largely driven by psychological health measures, age, and traumatic brain injury status. The effects of early interventions and longer term implications of these findings are unknown.

  6. Childhood predictors and age 48 outcomes of self-reports and official records of offending

    PubMed Central

    DUBOW, ERIC F.; HUESMANN, L. ROWELL; BOXER, PAUL; SMITH, CATHY

    2014-01-01

    Background The key question is: are self-reports and official records equally valid indicators of criminal offending? Aims We examine the correspondence between self-reports and official records of offending, the similarity of childhood and adolescent individual and contextual predictors of both measures of offending, and the similarity of age 48 correlates of both measures of offending. Methods Men (N = 436) from the Columbia County Longitudinal Study, a sample of all 3rd graders in Columbia County, New York, in 1959–60, participated. The youth, their peers and their parents were interviewed when the youth were age 8; the youth were later interviewed at ages 19, 30 and 48. Results We found moderate to high correspondence between self-reports of having been in trouble with the law and official arrest records. Lifetime self-reports and official records of offending were generally predicted by the same childhood and adolescent variables, and were correlated with many of the same adult outcome measures. By age 48, life-course non-offenders defined by either self-reports or official records had better outcomes than offenders. Conclusions The results validate the use of adolescent and adult self-reports of offending, and the early identification of individuals at risk for adult criminal behaviour through childhood parent and peer reports and adolescent self and peer reports. PMID:25294162

  7. Extended main sequence turnoffs in intermediate-age star clusters: a correlation between turnoff width and early escape velocity

    SciTech Connect

    Goudfrooij, Paul; Kozhurina-Platais, Vera; Kalirai, Jason S.; Correnti, Matteo E-mail: verap@stsci.edu E-mail: correnti@stsci.edu; and others

    2014-12-10

    We present a color-magnitude diagram analysis of deep Hubble Space Telescope imaging of a mass-limited sample of 18 intermediate-age (1-2 Gyr old) star clusters in the Magellanic Clouds, including eight clusters for which new data were obtained. We find that all star clusters in our sample feature extended main-sequence turnoff (eMSTO) regions that are wider than can be accounted for by a simple stellar population (including unresolved binary stars). FWHM widths of the MSTOs indicate age spreads of 200-550 Myr. We evaluate the dynamical evolution of clusters with and without initial mass segregation. Our main results are (1) the fraction of red clump (RC) stars in secondary RCs in eMSTO clusters scales with the fraction of MSTO stars having pseudo-ages of ≲1.35 Gyr; (2) the width of the pseudo-age distributions of eMSTO clusters is correlated with their central escape velocity v {sub esc}, both currently and at an age of 10 Myr. We find that these two results are unlikely to be reproduced by the effects of interactive binary stars or a range of stellar rotation velocities. We therefore argue that the eMSTO phenomenon is mainly caused by extended star formation within the clusters; and (3) we find that v {sub esc} ≥ 15 km s{sup –1} out to ages of at least 100 Myr for all clusters featuring eMSTOs, and v {sub esc} ≤ 12 km s{sup –1} at all ages for two lower-mass clusters in the same age range that do not show eMSTOs. We argue that eMSTOs only occur for clusters whose early escape velocities are higher than the wind velocities of stars that provide material from which second-generation stars can form. The threshold of 12-15 km s{sup –1} is consistent with wind velocities of intermediate-mass asymptotic giant branch stars and massive binary stars in the literature.

  8. Conscientiousness and (un)healthy eating: the role of impulsive eating and age in the consumption of daily main meals.

    PubMed

    Olsen, Svein Ottar; Tuu, Ho Huy; Honkanen, Pirjo; Verplanken, Bas

    2015-08-01

    The present study aims to explore the relationship between conscientiousness and the consumption of healthy versus unhealthy main meals. Impulsive eating was tested as a mediator in this relationship, as well as direct effects of age on those constructs. A nationwide representative sample of 1,006 Norwegian adults (18-70 years) within a prospective design was used to test a theoretical model. The structural equation model (SEM), in combination with bootstrapping procedures in AMOS, was the principal analytical method. Conscientiousness was negatively associated with unhealthy and impulsive eating. Impulsive eating was a partial mediator between conscientiousness and unhealthy eating and a full mediator between conscientiousness and healthy eating. Age was positively correlated with conscientiousness and this relationship had an inverted U-shape form. Finally, age was negatively associated with unhealthy and impulsive eating, and positively associated with healthy eating. This study confirmed the relevance of conscientiousness for healthy, unhealthy, and impulsive eating.

  9. Age-Dependent Effects of Haptoglobin Deletion in Neurobehavioral and Anatomical Outcomes Following Traumatic Brain Injury

    PubMed Central

    Glushakov, Alexander V.; Arias, Rodrigo A.; Tolosano, Emanuela; Doré, Sylvain

    2016-01-01

    Cerebral hemorrhages are common features of traumatic brain injury (TBI) and their presence is associated with chronic disabilities. Recent clinical and experimental evidence suggests that haptoglobin (Hp), an endogenous hemoglobin-binding protein most abundant in blood plasma, is involved in the intrinsic molecular defensive mechanism, though its role in TBI is poorly understood. The aim of this study was to investigate the effects of Hp deletion on the anatomical and behavioral outcomes in the controlled cortical impact model using wildtype (WT) C57BL/6 mice and genetically modified mice lacking the Hp gene (Hp−∕−) in two age cohorts [2–4 mo-old (young adult) and 7–8 mo-old (older adult)]. The data obtained suggest age-dependent significant effects on behavioral and anatomical TBI outcomes and recovery from injury. Moreover, in the adult cohort, neurological deficits in Hp−∕− mice at 24 h were significantly improved compared to WT, whereas there were no significant differences in brain pathology between these genotypes. In contrast, in the older adult cohort, Hp−∕− mice had significantly larger lesion volumes compared to WT, but neurological deficits were not significantly different. Immunohistochemistry for ionized calcium-binding adapter molecule 1 (Iba1) and glial fibrillary acidic protein (GFAP) revealed significant differences in microglial and astrocytic reactivity between Hp−∕− and WT in selected brain regions of the adult but not the older adult-aged cohort. In conclusion, the data obtained in the study provide clarification on the age-dependent aspects of the intrinsic defensive mechanisms involving Hp that might be involved in complex pathways differentially affecting acute brain trauma outcomes. PMID:27486583

  10. Cognitive outcome varies in adolescents born preterm, depending on gestational age, intrauterine growth and neonatal complications

    PubMed Central

    Lundequist, Aiko; Böhm, Birgitta; Lagercrantz, Hugo; Forssberg, Hans; Smedler, Ann-Charlotte

    2015-01-01

    Aim The aim of this study was to investigate long-term cognitive outcome in a cohort of 18-year-olds born preterm and previously assessed at the age of 5.5. Methods We tested 134 adolescents born preterm with a very low birthweight of <1500 g and 94 term-born controls with a comprehensive cognitive battery at 18 years of age. The cohort was subdivided into 73 extremely preterm, 42 very preterm and 19 moderately preterm infants with gestational ages of 23–27, 28–31 and 32–36 weeks, respectively. The moderately preterm group was dominated by adolescents born small for gestational age. Results Very preterm adolescents performed on a par with term-born controls. In contrast, extremely preterm adolescents displayed inferior results on all cognitive tests, more so if they had suffered neonatal complications. Moderately preterm adolescents scored lower than very preterm and full-term born adolescents, particularly on complex cognitive tasks. Conclusion Adolescents born at 28 weeks of gestation or later, with appropriate birthweight and no perinatal complications, functioned like term-born peers at 18 years of age. Extremely preterm birth per se posed a risk for long-term cognitive deficits, particularly executive deficits. Adolescents born moderately preterm but small for gestational age were at risk of general cognitive deficits. PMID:25394225

  11. Age of red blood cells and outcome in acute kidney injury

    PubMed Central

    2013-01-01

    Introduction Transfusion of red blood cells (RBCs) and, in particular, older RBCs has been associated with increased short-term mortality in critically ill patients. We evaluated the association between age of transfused RBCs and acute kidney injury (AKI), hospital, and 90-day mortality in critically ill patients. Methods We conducted a prospective, observational, predefined sub-study within the FINNish Acute Kidney Injury (FINNAKI) study. This study included all elective ICU admissions with expected ICU stay of more than 24 hours and all emergency admissions from September to November 2011. To study the age of RBCs, we classified transfused patients into quartiles according to the age of oldest transfused RBC unit in the ICU. AKI was defined according to KDIGO (Kidney Disease: Improving Global Outcomes) criteria. Results Out of 1798 patients, 652 received at least one RBC unit. The median [interquartile range] age of the oldest RBC unit transfused was 12 [11-13] days in the freshest quartile and 21 [17-27] days in the quartiles 2 to 4. On logistic regression, RBC age was not associated with the development of KDIGO stage 3 AKI. Patients in the quartile of freshest RBCs had lower crude hospital and 90-day mortality rates compared to those in the quartiles of older blood. After adjustments, older RBC age was associated with significantly increased risk for hospital mortality. Age, Simplified Acute Physiology Score II (SAPS II)-score without age points, maximum Sequental Organ Failure Assessment (SOFA) score and the total number of transfused RBC units were independently associated with 90-day mortality. Conclusions The age of transfused RBC units was independently associated with hospital mortality but not with 90-day mortality or KDIGO stage 3 AKI. The number of transfused RBC units was an independent risk factor for 90-day mortality. PMID:24093554

  12. Prenatal exposure to binge pattern of alcohol consumption: mental health and learning outcomes at age 11.

    PubMed

    Sayal, Kapil; Heron, Jon; Draper, Elizabeth; Alati, Rosa; Lewis, Sarah J; Fraser, Robert; Barrow, Margaret; Golding, Jean; Emond, Alan; Davey Smith, George; Gray, Ron

    2014-10-01

    The objective of the study is to investigate whether episodic binge pattern of alcohol consumption during pregnancy is independently associated with child mental health and academic outcomes. Using data from the prospective, population-based Avon Longitudinal Study of Parents and Children (ALSPAC), we investigated the associations between binge patterns of alcohol consumption during pregnancy (≥4 drinks per day) and child mental health [as rated by both parent (n = 4,610) and teacher (n = 4,274)] and academic outcomes [based on examination results (n = 6,939)] at age 11 years. After adjusting for prenatal and postnatal risk factors, binge pattern of alcohol consumption (≥4 drinks in a day on at least one occasion) during pregnancy was associated with higher levels of mental health problems (especially hyperactivity/inattention) in girls at age 11 years, according to parental report. After disentangling binge-pattern and daily drinking, binge-pattern drinking was independently associated with teacher-rated hyperactivity/inattention and lower academic scores in both genders. Episodic drinking involving ≥4 drinks per day during pregnancy may increase risk for child mental health problems and lower academic attainment even if daily average levels of alcohol consumption are low. Episodic binge pattern of drinking appears to be a risk factor for these outcomes, especially hyperactivity and inattention problems, in the absence of daily drinking.

  13. Adverse Geriatric Outcomes Secondary to Polypharmacy in a Mouse Model: The Influence of Aging.

    PubMed

    Huizer-Pajkos, Aniko; Kane, Alice E; Howlett, Susan E; Mach, John; Mitchell, Sarah J; de Cabo, Rafael; Le Couteur, David G; Hilmer, Sarah N

    2016-05-01

    We aimed to develop a mouse model of polypharmacy, primarily to establish whether short-term exposure to polypharmacy causes adverse geriatric outcomes. We also investigated whether old age increased susceptibility to any adverse geriatric outcomes of polypharmacy. Young (n= 10) and old (n= 21) male C57BL/6 mice were administered control diet or polypharmacy diet containing therapeutic doses of five commonly used medicines (simvastatin, metoprolol, omeprazole, acetaminophen, and citalopram). Mice were assessed before and after the 2- to 4-week intervention. Over the intervention period, we observed no mortality and no change in food intake, body weight, or serum biochemistry in any age or treatment group. In old mice, polypharmacy caused significant declines in locomotor activity (pre minus postintervention values in control 2 ± 13 counts, polypharmacy 32 ± 7 counts,p< .05) and front paw wire holding impulse (control -2.45 ± 1.02 N s, polypharmacy +1.99 ± 1.19 N s,p< .05), loss of improvement in rotarod latency (control -59 ± 11 s, polypharmacy -1.7 ± 17 s,p< .05), and lowered blood pressure (control -0.2 ± 3 mmHg, polypharmacy 11 ± 4 mmHg,p< .05). In young mice, changes in outcomes over the intervention period did not differ between control and polypharmacy groups. This novel model of polypharmacy is feasible. Even short-term polypharmacy impairs mobility, balance, and strength in old male mice. PMID:25940962

  14. Reporting outcome measures of functional constipation in children from 0 to 4 years of age.

    PubMed

    Kuizenga-Wessel, Sophie; Benninga, Marc A; Tabbers, Merit M

    2015-04-01

    Functional constipation (FC) often begins in the first year of life. Although standard definitions and criteria have been formulated to describe FC, these are rarely used in research and clinical practice. The aim of the study is to systematically assess how definitions and outcome measures are defined in therapeutic randomized controlled trials (RCTs) of infants with FC. PubMed, EMBASE, and Cochrane databases were searched. Studies were included if it was a (systematic review of) therapeutic RCT, children ≤4 years old, they had FC, a clear definition of constipation was provided, and were written in English. Quality was assessed using the Delphi list. A total of 1115 articles were found; only 5 studies fulfilled the inclusion criteria. Four different definitions were used, of which only 2 used the internationally accepted Rome III criteria. Defecation frequency was used as primary outcome in all included trials and stool consistency in 3 trials. Two trials involving infants investigated new infant formulas, whereas the third RCT evaluated the efficacy of a probiotic strain. The 2 trials including infants up to 4 years of age compared polyethylene glycol without electrolytes (PEG4000) with lactulose and milk of magnesia. All of the trials used nonvalidated parental diaries. Different definitions and outcome measures for FC in infants are used in RCTs. Disappointingly, there is a lack of well-designed therapeutic trials in infants with constipation. To make comparison between future trials possible, standard definitions, core outcomes, and validated instruments are needed.

  15. The Role of Birthweight Discordance in the Intellectual and Motor Outcome for Triplets at Early School Age

    ERIC Educational Resources Information Center

    Natalucci, Giancarlo; Seitz, Jochen; Von Siebenthal, Kurt; Bucher, Hans U.; Milinari, Luciano; Jenni, Oskar G.; Latal, Beatrice

    2011-01-01

    Aim: We assessed motor and intellectual outcome in triplets at school age and investigated the predictive value of perinatal and demographic factors. Methods: Seventy-one live-born newborn infants (24 triplet pregnancies) were prospectively enrolled at birth. At the age of 6 years, 58 children (31 males, 27 females; mean gestational age 31.2wks…

  16. The National Anesthesia Clinical Outcomes Registry: A Sustainable Model for the Information Age?

    PubMed Central

    Dutton, Richard P.

    2014-01-01

    Anesthesiologists care for patients of all ages, with all conceivable comorbidities, in every kind of health care facility. This leads to a significant challenge in the collection of data to describe the specialty, and in the development of evidence-based performance measures for anesthesiologists. Whereas narrowly defined medical specialties have developed registries based on manual abstraction of clinical data from the medical record (e.g., cardiac surgery), this approach would be prohibitively expensive for anesthesiology, and is unlikely to generate statistically useful data when major adverse outcomes occur a handful of times in tens of thousands of cases. The American Society of Anesthesiologists (ASA) addressed this challenge in 2008 by funding a related organization, the Anesthesia Quality Institute (AQI), to develop the National Anesthesia Clinical Outcomes Registry (NACOR). The technical development of this registry and the approach taken to define the specialty of anesthesiology and the performance of anesthesiologists may serve as a model for other specialty society efforts. PMID:25848607

  17. Demonstrating successful aging using the International Collaborative Study for Oral Health Outcomes.

    PubMed

    Atchison, K A; Andersen, R M

    2000-01-01

    As the lifespan increases and people are faced with 15 to 20 years of "old age," we ask what one considers successful aging with respect to oral health. We propose a comprehensive combination of outcome variables, maintenance of teeth, manageable periodontal condition, positive perceived oral health, satisfaction with their access to and receipt of dental services, and minimal functional problems, that together comprise a definition of successful aging. The International Collaborative Study for Oral Health Outcomes provides a data set for exploring the oral health of a diverse sample of older adults in US and international sites using the modified Andersen Behavioral Model. The percent of adults who report no natural teeth ranged from 16 percent in San Antonio to 59 percent in New Zealand. Seventy percent or more of the adults from each site rated their oral health as good/fair or better except in Poland. The current cohort of older adults is faring better on some indicators than others; nevertheless, ethnic minorities and poorer countries still demonstrate inequities. Dentistry must attempt to educate individuals early in their lifespan that a combination of personal oral health practices and current dental techniques offers the potential for successful oral health throughout one's lifetime.

  18. Correlation of serum KL-6 and CC16 levels with neurodevelopmental outcome in premature infants at 12 months corrected age

    PubMed Central

    Zhang, Zhiqun; Lu, Hui; Zhu, Yunxia; Xiang, Junhua; Huang, Xianmei

    2015-01-01

    The aim of this study was to evaluate KL-6 and CC16 levels and their correlation with neurodevelopmental outcome among very low birth weight pre-term infants at 12 months corrected age. This prospective cohort study was performed from 2011 to 2013 by enrolling pre-term neonates of gestational age ≤ 32 weeks and birth weight ≤ 1500 g. Serum KL-6 and CC16 levels were determined 7 days after birth and their correlation with neurodevelopment was evaluated using Gesell Mental Developmental Scales. Of the 86 eligible pre-term infants, 63 completed follow-up, of which 15 had bronchopulmonary dysplasia. At 12 months corrected age, 49 infants had favorable outcomes and 14 infants had poor neurodevelopmental outcome. KL-6 levels were higher and CC16 levels were lower in infants with poor neurodevelopmental outcome compared with those infants who had favourable neurodevelopmental outcome. Serum KL-6 levels less than 90.0 ng/ml and CC16 levels greater than 320.0 pg/ml at 7 days of life were found to be predictive of a favourable outcome at 12 months corrected age. These biological markers could predict neurodevelopmental outcome at 12 months corrected age in very low birth weight premature infants, and help the clinician plan early therapeutic interventions to minimize or avoid poor neurodevelopmental outcome. PMID:25631862

  19. Self-control forecasts better psychosocial outcomes but faster epigenetic aging in low-SES youth.

    PubMed

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

    2015-08-18

    There are persistent socioeconomic disparities in many aspects of child development in America. Relative to their affluent peers, children of low socioeconomic status (SES) complete fewer years of education, have a higher prevalence of health problems, and are convicted of more criminal offenses. Based on research indicating that low self-control underlies some of these disparities, policymakers have begun incorporating character-skills training into school curricula and social services. However, emerging data suggest that for low-SES youth, self-control may act as a "double-edged sword," facilitating academic success and psychosocial adjustment, while at the same time undermining physical health. Here, we examine this hypothesis in a five-wave study of 292 African American teenagers from rural Georgia. From ages 17 to 20 y, we assessed SES and self-control annually, along with depressive symptoms, substance use, aggressive behavior, and internalizing problems. At age 22 y, we obtained DNA methylation profiles of subjects' peripheral blood mononuclear cells. These data were used to measure epigenetic aging, a methylation-derived biomarker reflecting the disparity between biological and chronological aging. Among high-SES youth, better mid-adolescent self-control presaged favorable psychological and methylation outcomes. However, among low-SES youth, self-control had divergent associations with these outcomes. Self-control forecasted lower rates of depressive symptoms, substance use, aggressive behavior, and internalizing problems but faster epigenetic aging. These patterns suggest that for low-SES youth, resilience is a "skin-deep" phenomenon, wherein outward indicators of success can mask emerging problems with health. These findings have conceptual implications for models of resilience, and practical implications for interventions aimed at ameliorating social and racial disparities.

  20. Self-control forecasts better psychosocial outcomes but faster epigenetic aging in low-SES youth.

    PubMed

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

    2015-08-18

    There are persistent socioeconomic disparities in many aspects of child development in America. Relative to their affluent peers, children of low socioeconomic status (SES) complete fewer years of education, have a higher prevalence of health problems, and are convicted of more criminal offenses. Based on research indicating that low self-control underlies some of these disparities, policymakers have begun incorporating character-skills training into school curricula and social services. However, emerging data suggest that for low-SES youth, self-control may act as a "double-edged sword," facilitating academic success and psychosocial adjustment, while at the same time undermining physical health. Here, we examine this hypothesis in a five-wave study of 292 African American teenagers from rural Georgia. From ages 17 to 20 y, we assessed SES and self-control annually, along with depressive symptoms, substance use, aggressive behavior, and internalizing problems. At age 22 y, we obtained DNA methylation profiles of subjects' peripheral blood mononuclear cells. These data were used to measure epigenetic aging, a methylation-derived biomarker reflecting the disparity between biological and chronological aging. Among high-SES youth, better mid-adolescent self-control presaged favorable psychological and methylation outcomes. However, among low-SES youth, self-control had divergent associations with these outcomes. Self-control forecasted lower rates of depressive symptoms, substance use, aggressive behavior, and internalizing problems but faster epigenetic aging. These patterns suggest that for low-SES youth, resilience is a "skin-deep" phenomenon, wherein outward indicators of success can mask emerging problems with health. These findings have conceptual implications for models of resilience, and practical implications for interventions aimed at ameliorating social and racial disparities. PMID:26170291

  1. Self-control forecasts better psychosocial outcomes but faster epigenetic aging in low-SES youth

    PubMed Central

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

    2015-01-01

    There are persistent socioeconomic disparities in many aspects of child development in America. Relative to their affluent peers, children of low socioeconomic status (SES) complete fewer years of education, have a higher prevalence of health problems, and are convicted of more criminal offenses. Based on research indicating that low self-control underlies some of these disparities, policymakers have begun incorporating character-skills training into school curricula and social services. However, emerging data suggest that for low-SES youth, self-control may act as a “double-edged sword,” facilitating academic success and psychosocial adjustment, while at the same time undermining physical health. Here, we examine this hypothesis in a five-wave study of 292 African American teenagers from rural Georgia. From ages 17 to 20 y, we assessed SES and self-control annually, along with depressive symptoms, substance use, aggressive behavior, and internalizing problems. At age 22 y, we obtained DNA methylation profiles of subjects’ peripheral blood mononuclear cells. These data were used to measure epigenetic aging, a methylation-derived biomarker reflecting the disparity between biological and chronological aging. Among high-SES youth, better mid-adolescent self-control presaged favorable psychological and methylation outcomes. However, among low-SES youth, self-control had divergent associations with these outcomes. Self-control forecasted lower rates of depressive symptoms, substance use, aggressive behavior, and internalizing problems but faster epigenetic aging. These patterns suggest that for low-SES youth, resilience is a “skin-deep” phenomenon, wherein outward indicators of success can mask emerging problems with health. These findings have conceptual implications for models of resilience, and practical implications for interventions aimed at ameliorating social and racial disparities. PMID:26170291

  2. Effect of older age on treatment decisions and outcomes among patients with traumatic spinal cord injury

    PubMed Central

    Ahn, Henry; Bailey, Christopher S.; Rivers, Carly S.; Noonan, Vanessa K.; Tsai, Eve C.; Fourney, Daryl R.; Attabib, Najmedden; Kwon, Brian K.; Christie, Sean D.; Fehlings, Michael G.; Finkelstein, Joel; Hurlbert, R. John; Townson, Andrea; Parent, Stefan; Drew, Brian; Chen, Jason; Dvorak, Marcel F.

    2015-01-01

    Background: Older people are at increased risk of traumatic spinal cord injury from falls. We evaluated the impact of older age (≥ 70 yr) on treatment decisions and outcomes. Methods: We identified patients with traumatic spinal cord injury for whom consent and detailed data were available from among patients recruited (2004–2013) at any of the 31 acute care and rehabilitation hospitals participating in the Rick Hansen Spinal Cord Injury Registry. Patients were assessed by age group (< 70 v. ≥ 70 yr). The primary outcome was the rate of acute surgical treatment. We used bivariate and multivariate regression models to assess patient and injury-related factors associated with receiving surgical treatment and with the timing of surgery after arrival to a participating centre. Results: Of the 1440 patients included in our study cohort, 167 (11.6%) were 70 years or older at the time of injury. Older patients were more likely than younger patients to be injured by falling (83.1% v. 37.4%; p < 0.001), to have a cervical injury (78.0% v. 61.6%; p = 0.001), to have less severe injuries on admission (American Spinal Injury Association Impairment Scale grade C or D: 70.5% v. 46.9%; p < 0.001), to have a longer stay in an acute care hospital (median 35 v. 28 d; p < 0.005) and to have a higher in-hospital mortality (4.2% v. 0.6%; p < 0.001). Multivariate analysis did not show that age of 70 years or more at injury was associated with a decreased likelihood of surgical treatment (adjusted odds ratio [OR] 0.48, 95% confidence interval [CI] 0.22–1.07). An unplanned sensitivity analysis with different age thresholds showed that a threshold of 65 years was associated with a decreased chance of surgical treatment (OR 0.39, 95% CI 0.19–0.80). Older patients who underwent surgical treatment had a significantly longer wait time from admission to surgery than younger patients (37 v. 19 h; p < 0.001). Interpretation: We found chronological age to be a factor influencing

  3. Diet, age, and prior injury status differentially alter behavioral outcomes following concussion in rats.

    PubMed

    Mychasiuk, Richelle; Hehar, Harleen; van Waes, Linda; Esser, Michael J

    2015-01-01

    Mild traumatic brain injury (mTBI) or concussion affects a large portion of the population and although many of these individuals recover completely, a small subset of people experience lingering symptomology and poor outcomes. Little is known about the factors that affect individual susceptibility or resilience to poor outcomes after mTBI and there are currently no biomarkers to delineate mTBI diagnosis or prognosis. Based upon the growing literature associated with caloric intake and altered neurological aging and the ambiguous link between repetitive mTBI and progressive neurodegeneration, the current study was designed to examine the effect of a high fat diet (HFD), developmental age, and repetitive mTBI on behavioral outcomes following a mTBI. In addition, telomere length was examined before and after experimental mTBI. Sprague Dawley rats were maintained on a HFD or standard rat chow throughout life (including the prenatal period) and then experienced an mTBI/concussion at P30, P30 and P60, or only at P60. Behavioral outcomes were examined using a test battery that was administered between P61-P80 and included; beam-walking, open field, elevated plus maze, novel context mismatch, Morris water task, and forced swim task. Animals with a P30 mTBI often demonstrated lingering symptomology that was still present during testing at P80. Injuries at P30 and P60 rarely produced cumulative effects, and in some tests (i.e., beam walking), the first injury may have protected the brain from the second injury. Exposure to the high fat diet exacerbated many of the behavioral deficits associated with concussion. Finally, telomere length was shortened following mTBI and was influenced by the animal's dietary intake. Diet, age at the time of injury, and the number of prior concussion incidents differentially contribute to behavioral deficits and may help explain individual variations in susceptibility and resilience to poor outcomes following an mTBI. PMID:25270295

  4. Repeated Course Antenatal Steroids, Inflammation Gene Polymorphisms and Neurodevelopmental Outcomes at Age 2

    PubMed Central

    CLARK, Erin A. S.; MELE, Lisa; WAPNER, Ronald J.; SPONG, Catherine Y.; SOROKIN, Yoram; PEACEMAN, Alan; IAMS, Jay D.; LEVENO, Kenneth J.; HARPER, Margaret; CARITIS, Steve N.; MERCER, Brian M.; THORP, John M.; RAMIN, Susan M.; CARPENTER, Marshall; ROUSE, Dwight J.

    2013-01-01

    OBJECTIVE Evaluate the interaction between repeated course antenatal corticosteroids and inflammation gene polymorphisms with neurodevelopmental outcomes at age 2. STUDY DESIGN Nested case-control analysis of a randomized controlled trial of single versus repeated course antenatal corticosteroids. Cases had mental and/or psychomotor delay at age 2. Controls had normal neurodevelopment. Previous analyses of 125 cases and 147 controls identified 4 inflammation gene polymorphisms associated with neurodevelopmental delay at age 2. RESULTS The interaction between repeated course corticosteroids and the IL6 -174 genotype with neurodevelopmental delay was significant (P=0.046). The IL6 -174 GG genotype was associated with neurodevelopmental delay at age 2 in the single course corticosteroid group (OR 6.47; 95%CI 1.86-22.50). Exposure to repeated course antenatal corticosteroids abrogated this genotype effect (OR 1.30; 95%CI 0.48-3.54). Results were unchanged after controlling for potential confounders. CONCLUSION Repeated course antenatal steroids may reduce the increased risk of neurodevelopmental delay at age 2 associated with IL6 -174 GG genotype. PMID:21529753

  5. Outcome of community-acquired pneumonia: influence of age, residence status and antimicrobial treatment.

    PubMed

    Kothe, H; Bauer, T; Marre, R; Suttorp, N; Welte, T; Dalhoff, K

    2008-07-01

    Community-acquired pneumonia remains a major cause of mortality in developed countries. There is much discrepancy in the literature regarding factors influencing the outcome in the elderly population. Data were derived from a multicentre prospective study initiated by the German Competence Network for Community-Acquired Pneumonia. Patients with community-acquired pneumonia (n = 2,647; 1,298 aged < 65 yrs and 1,349 aged > or = 65 yrs) were evaluated, of whom 72.3% were hospitalised and 27.7% treated in the community. Clinical history, residence status, course of disease and antimicrobial treatment were prospectively documented. Microbiological investigations included cultures and PCR of respiratory samples and blood cultures. Factors related to mortality were included in multivariate analyses. The overall 30-day mortality was 6.3%. Elderly patients exhibited a significantly higher mortality rate that was independently associated with the following: age; residence status; confusion, urea, respiratory frequency and blood pressure (CURB) score; comorbid conditions; and failure of initial therapy. Increasing age remained predictive of death in the elderly. Nursing home residents showed a four-fold increased mortality rate and an increased rate of gram-negative bacillary infections compared with patients dwelling in the community. The CURB score and cerebrovascular disease were confirmed as independent predictors of death in this subgroup. Age and residence status are independent risk factors for mortality after controlling for comorbid conditions and disease severity. Failure of initial therapy was the only modifiable prognostic factor.

  6. The influence of age, playing position, anthropometry and fitness on career attainment outcomes in rugby league.

    PubMed

    Till, Kevin; Cobley, Steve; Morley, David; O'hara, John; Chapman, Chris; Cooke, Carlton

    2016-01-01

    This study evaluated the influence of annual-age category, relative age, playing position, anthropometry and fitness on the career attainment outcomes of junior rugby league players originally selected for a talent identification and development (TID) programme. Junior rugby league players (N = 580) were grouped retrospectively according to their career attainment level (i.e., amateur, academy and professional). Anthropometric (height, sitting height, body mass, sum of four skinfolds), maturational (age at peak height velocity; PHV) and fitness (power, speed, change of direction speed, estimated[Formula: see text]) characteristics were assessed at the Under 13s, 14s and 15s annual-age categories. Relative age (Q2 = 8.5% vs. Q4 = 25.5%) and playing position (Pivots = 19.5% vs. Props = 5.8%) influenced the percentage of players attaining professional status. Anthropometry and fitness had a significant effect on career attainment at the Under 14 (P = 0.002, η(2) = 0.16) and 15 (P = 0.01, η(2) = 0.12) annual-age categories. Findings at the Under 14s showed future professional players were significantly later maturing compared to academy and amateur players. Findings suggest that relative age, playing position, anthropometry and fitness can influence the career attainment of junior rugby league players. TID programmes within rugby league, and other related team sports, should be aware and acknowledge the factors influencing long-term career attainment, and not delimit development opportunities during early adolescence.

  7. The influence of age, playing position, anthropometry and fitness on career attainment outcomes in rugby league.

    PubMed

    Till, Kevin; Cobley, Steve; Morley, David; O'hara, John; Chapman, Chris; Cooke, Carlton

    2016-01-01

    This study evaluated the influence of annual-age category, relative age, playing position, anthropometry and fitness on the career attainment outcomes of junior rugby league players originally selected for a talent identification and development (TID) programme. Junior rugby league players (N = 580) were grouped retrospectively according to their career attainment level (i.e., amateur, academy and professional). Anthropometric (height, sitting height, body mass, sum of four skinfolds), maturational (age at peak height velocity; PHV) and fitness (power, speed, change of direction speed, estimated[Formula: see text]) characteristics were assessed at the Under 13s, 14s and 15s annual-age categories. Relative age (Q2 = 8.5% vs. Q4 = 25.5%) and playing position (Pivots = 19.5% vs. Props = 5.8%) influenced the percentage of players attaining professional status. Anthropometry and fitness had a significant effect on career attainment at the Under 14 (P = 0.002, η(2) = 0.16) and 15 (P = 0.01, η(2) = 0.12) annual-age categories. Findings at the Under 14s showed future professional players were significantly later maturing compared to academy and amateur players. Findings suggest that relative age, playing position, anthropometry and fitness can influence the career attainment of junior rugby league players. TID programmes within rugby league, and other related team sports, should be aware and acknowledge the factors influencing long-term career attainment, and not delimit development opportunities during early adolescence. PMID:26512761

  8. Small-for-gestational age and large-for-gestational age thresholds to predict infants at risk of adverse delivery and neonatal outcomes: are current charts adequate? An observational study from the Born in Bradford cohort

    PubMed Central

    Norris, T; Johnson, W; Farrar, D; Tuffnell, D; Wright, J; Cameron, N

    2015-01-01

    Objectives Construct an ethnic-specific chart and compare the prediction of adverse outcomes using this chart with the clinically recommended UK-WHO and customised birth weight charts using cut-offs for small-for-gestational age (SGA: birth weight <10th centile) and large-for-gestational age (LGA: birth weight >90th centile). Design Prospective cohort study. Setting Born in Bradford (BiB) study, UK. Participants 3980 White British and 4448 Pakistani infants with complete data for gestational age, birth weight, ethnicity, maternal height, weight and parity. Main outcome measures Prevalence of SGA and LGA, using the three charts and indicators of diagnostic utility (sensitivity, specificity and area under the receiver operating characteristic (AUROC)) of these chart-specific cut-offs to predict delivery and neonatal outcomes and a composite outcome. Results In White British and Pakistani infants, the prevalence of SGA and LGA differed depending on the chart used. Increased risk of SGA was observed when using the UK-WHO and customised charts as opposed to the ethnic-specific chart, while the opposite was apparent when classifying LGA infants. However, the predictive utility of all three charts to identify adverse clinical outcomes was poor, with only the prediction of shoulder dystocia achieving an AUROC>0.62 on all three charts. Conclusions Despite being recommended in national clinical guidelines, the UK-WHO and customised birth weight charts perform poorly at identifying infants at risk of adverse neonatal outcomes. Being small or large may increase the risk of an adverse outcome; however, size alone is not sensitive or specific enough with current detection to be useful. However, a significant amount of missing data for some of the outcomes may have limited the power needed to determine true associations. PMID:25783424

  9. The impact of frailty in the elderly on the outcome of surgery in the aged.

    PubMed

    Brown, Nefertiti A; Zenilman, Michael E

    2010-01-01

    As the population continues to age, we will continue to encounter issues involving aging and the elderly. Despite these issues, knowledge is expanding and evolving with new solutions to ongoing problems. Mechanistically, frailty at its root is a symptom of growing old, with cascades and circuitous feedback between organ systems at all levels. Clinically, frailty is as equally dynamic and its multifactorial nature represents a unique challenge to the surgical community and warrants the integration of geriatric assessment into clinical practice. Integration within clinical practice includes using an interdisciplinary approach, where surgeons work with anesthesiologists, geriatricians, nursing, rehabilitation, nutritionists, and other support staff to provide holistic assessment, efficient delivery, and higher quality of care. This in hand, recognition of frailty can occur in a timely fashion to initiate treatment, decreasing the risk of morbidity and mortality for improved surgical outcomes.

  10. How do groups work? Age differences in performance and the social outcomes of peer collaboration.

    PubMed

    Leman, Patrick J

    2015-05-01

    Do children derive different benefits from group collaboration at different ages? In the present study, 183 children from two age groups (8.8 and 13.4 years) took part in a class quiz as members of a group, or individually. In some groups, cohesiveness was made salient by awarding prizes to the top performing groups. In other groups, prizes were awarded to the best performing individuals. Findings, both in terms of social outcomes and performance in the quiz, indicated that the 8-year olds viewed the benefits of group membership in terms of the opportunities to receive information from other members. The 13-year olds, in contrast, viewed group collaboration as a constructive process where success was connected with group cohesiveness.

  11. Liver Function Parameters in Hip Fracture Patients: Relations to Age, Adipokines, Comorbidities and Outcomes

    PubMed Central

    Fisher, Leon; Srikusalanukul, Wichat; Fisher, Alexander; Smith, Paul

    2015-01-01

    Aim: To asses liver markers in older patients with hip fracture (HF) in relation to age, comorbidities, metabolic characteristics and short-term outcomes. Methods: In 294 patients with HF (mean age 82.0±7.9 years, 72.1% women) serum alanine aminotransferase (ALT), gammaglutamyltransferase (GGT), alkaline phosphatase (ALP), albumin, bilirubin, 25(OH)vitaminD, PTH, calcium, phosphate, magnesium, adiponectin, leptin, resistin, thyroid function and cardiac troponin I were measured. Results: Elevated ALT, GGT, ALP or bilirubin levels on admission were observed in 1.7% - 9.9% of patients. With age GGT, ALT and leptin decrease, while PTH and adiponectin concentrations increase. Higher GGT (>30U/L, median level) was associated with coronary artery disease (CAD), diabetes mellitus (DM), and alcohol overuse; lower ALT (≤20U/L, median level) with dementia; total bilirubin >20μmol/L with CAD and alcohol overuse; and albumin >33g/L with CAD. Multivariate adjusted regression analyses revealed ALT, ALP, adiponectin, alcohol overuse and DM as independent and significant determinants of GGT (as continuous or categorical variable); GGT for each other liver marker; and PTH for adiponectin. The risk of prolonged hospital stay (>20 days) was about two times higher in patients with GGT>30U/L or adiponectin >17.14 ng/L (median level) and 4.7 times higher if both conditions coexisted. The risk of in-hospital death was 3 times higher if albumin was <33g/L. Conclusions: In older HF patients liver markers even within the normal range are associated with age-related disorders and outcomes. Adiponectin (but not 25(OH)vitaminD, PTH, leptin or resistin) is an independent contributor to higher GGT. Serum GGT and albumin predict prolonged hospital stay and in-hospital death, respectively. A unifying hypothesis of the findings presented. PMID:25589886

  12. Characteristics and Outcome of Patients Diagnosed With HIV at Older Age.

    PubMed

    Asher, Ilan; Guri, Keren Mahlab; Elbirt, Daniel; Bezalel, Shira Rosenberg; Maldarelli, Frank; Mor, Orna; Grossman, Zehava; Sthoeger, Zev M

    2016-01-01

    To characterize the clinical, virological, and immunological status at presentation as well as the outcome of patients diagnosed with HIV above the age of 50. A retrospective study of 418 patients newly diagnosed with HIV in 1 Israeli center, between the years 2004 and 2013. Patients with new HIV diagnosis ≥ 50 years of age defined as "older' and < 50 defined as "younger.' Patients were evaluated every 1 to 3 months (mean follow-up 53 ± 33 months). Patients with < 2 CD4/viral-load measurements or with < 1 year of follow-up were excluded. Time of HIV infection was estimated by HIV sequence ambiguity assay. Ambiguity index ≤ 0.43 indicated recent (≤ 1 year) HIV infection. Eighty nine (21%) patients were diagnosed with HIV at an older age. Those older patients presented with significant lower CD4 cell counts and higher viral-load compared with the younger patients. At the end of the study, the older patients had higher mortality rate (21% vs 3.5%; P < 0.001) and lower CD4 cell counts (381 ± 228 vs 483 ± 26 cells/μL; P < 0.001) compared with the younger patients. This difference was also observed between older and younger patients with similar CD4 cell counts and viral load at the time of HIV diagnosis and among patients with a recent (≤ 1 year) HIV infection. One-fifth of HIV patients are diagnosed at older age (≥ 50 years). Those older patients have less favorable outcome compared with the younger patients. This point to the need of educational and screening programs within older populations and for a closer follow-up of older HIV patients. PMID:26735534

  13. Neonatal cranial ultrasound versus MRI and neurodevelopmental outcome at school age in children born preterm

    PubMed Central

    Rademaker, K; Uiterwaal, C; Beek, F; van Haastert, I C; Lieftink, A; Groenendaal, F; Grobbee, D; de Vries, L S

    2005-01-01

    Aim: To examine the correlation between neonatal cranial ultrasound and school age magnetic resonance imaging (MRI) and neurodevelopmental outcome. Methods: In a prospective 2 year cohort study, 221 children (gestational age ⩽32 weeks and/or birth weight ⩽1500 g) participated at a median age of 8.1 years (inclusion percentage 78%). Conventional MRI, IQ (subtests of the WISC), and motor performance (Movement Assessment Battery for Children) at school age were primary outcome measurements. Results: Overall, there was poor correspondence between ultrasound group classifications and MRI group classifications, except for the severe group (over 70% agreement). There was only a 1% chance of the children with a normal cranial ultrasound having a major lesion on MRI. Mean IQ (standard deviation) was significantly lower in children with major ultrasound or MRI lesions, but was also lower in children with minor lesions on MRI compared to children with a normal MRI (91±16, 100±13, 104±13 for major lesions, minor lesions, and normal MRI, respectively). Median total impairment score (TIS) was significantly higher in children with major lesions on ultrasound or MRI as well as in children with minor lesions on MRI (TIS 4.0 and 6.25 for normal and minor lesions on MRI, respectively; p<0.0001). Conclusions: A normal neonatal cranial ultrasound excluded a severe lesion on MRI in 99% of cases. MRI correlated more strongly with mean IQ and median TIS than ultrasound. Subtle white matter lesions are better detected with MRI which could explain the stronger correlation of MRI with IQ and motor performance. PMID:15956095

  14. Early Developmental and Psychosocial Risks and Longitudinal Behavioral Adjustment Outcomes for Preschool-Age Girls Adopted from China

    ERIC Educational Resources Information Center

    Tan, Tony Xing; Marfo, Kofi; Dedrick, Robert F.

    2010-01-01

    The central goal of this longitudinal study was to examine behavioral adjustment outcomes in a sample of preschool-age adopted Chinese girls. Research examining the effects of institutional deprivation on post-adoption behavioral outcomes for internationally adopted children has been constrained by the frequent unavailability of data on the…

  15. The Associations of Prenatal Substance Use To Birth Outcomes and Infant Death: Do They Vary by Maternal Age and Race?

    ERIC Educational Resources Information Center

    Hellerstedt, Wendy L.; Johnson, Pamela Jo; Oswald, John W.

    2002-01-01

    Examined whether associations between prenatal substance use and birth and infant outcomes varied by maternal age and race. Data on all singleton live births in Minnesota from 1990-98 indicated that poor birth outcomes and infant death were generally lower for whites than for African Americans and American Indians. Prenatal substance use varied by…

  16. On the interpretation of sub-giant branch morphologies of intermediate-age star clusters with extended main sequence turnoffs

    NASA Astrophysics Data System (ADS)

    Goudfrooij, Paul; Girardi, Léo; Rosenfield, Philip; Bressan, Alessandro; Marigo, Paola; Correnti, Matteo; Puzia, Thomas H.

    2015-06-01

    High-quality photometry of many star clusters in the Magellanic Clouds with ages of 1-2 Gyr revealed main sequence turnoffs (MSTOs) that are significantly wider than can be accounted for by a simple stellar population (SSP). Such extended MSTOs (eMSTOs) are often interpreted in terms of an age spread of several 108 yr, challenging the traditional view of star clusters as being formed in a single star formation episode. Li et al. and Bastian & Niederhofer recently investigated the sub-giant branches (SGBs) of NGC 1651, NGC 1806, and NGC 1846, three star clusters in the Large Magellanic Cloud (LMC) that exhibit an eMSTO. They argued that the SGB of these star clusters can be explained only by an SSP. We study these and two other similar star clusters in the LMC, using extensive simulations of SSPs including unresolved binaries. We find that the shapes of the cross-SGB profiles of all star clusters in our sample are in fact consistent with their cross-MSTO profiles when the latter are interpreted as age distributions. Conversely, SGB morphologies of star clusters with eMSTOs are found to be inconsistent with those of simulated SSPs. Finally, we create PARSEC isochrones from tracks featuring a grid of convective overshoot levels and a very fine grid of stellar masses. A comparison of the observed photometry with these isochrones shows that the morphology of the red clump (RC) of such star clusters is also consistent with that implied by their MSTO in the age spread scenario. We conclude that the SGB and RC morphologies of star clusters featuring eMSTOs are consistent with the scenario in which the eMSTOs are caused by a distribution of stellar ages.

  17. Age at migration, language proficiency, and socioeconomic outcomes: evidence from Australia.

    PubMed

    Guven, Cahit; Islam, Asadul

    2015-04-01

    This study estimates the causal effects of language proficiency on the economic and social integration of Australian immigrants. Identifying the effects of languages on socioeconomic outcomes is inherently difficult owing to the endogeneity of language skills. Using the phenomenon that younger children learn languages more easily than older children, we construct an instrumental variable for language proficiency. To achieve this, we consider the age at arrival of immigrants who came as children from Anglophone and non-Anglophone countries. We find a significant positive effect of English proficiency on wages and promotions among adults who immigrated to Australia as children. Higher levels of English proficiency are associated with increased risk-taking, more smoking, and more exercise for men, but have considerable health benefits for women. English language proficiency has a significant influence on partner choice and a number of social outcomes, as well as on children's outcomes, including their levels of academic achievement. The results are robust to alternative specifications, including accounting for between-sibling differences and alternative measures of English skills.

  18. Severity of necrotizing enterocolitis: influence on outcome at 2 years of age.

    PubMed

    Walsh, M C; Kliegman, R M; Hack, M

    1989-11-01

    The long-term outcome of very low birth weight (VLBW) infants with necrotizing enterocolitis has been reported to be similar to that of other VLBW infants. To examine the influence of disease severity on outcome, the growth and neurodevelopment of survivors of necrotizing enterocolitis were evaluated when the babies were 20 months' corrected age. Between 1975 and 1983, 1506 VLBW infants were admitted to the hospital, and necrotizing enterocolitis developed in 84 (5.6%). Forty infants (48%) survived to be 20 months' corrected age, and complete follow-up data were available for 36. Survivors were classified by modified Bell's criteria into four groups by increasing severity of disease; 13 had mild necrotizing enterocolitis (stage IIA, IIB), and 23 had severe necrotizing enterocolitis (stage IIIA, IIIB). The 36 survivors were compared with 766 surviving VLBW infants without necrotizing enterocolitis. There were no perinatal or socioeconomic differences between groups. Compared with infants with stage II necrotizing enterocolitis at 20 months, infants with stage III necrotizing enterocolitis had a higher rate of subnormal body weight (39% vs 15%) and subnormal head circumference (30% vs 0%). Thirty-three percent of necrotizing enterocolitis survivors had significant neurodevelopmental impairment; the majority of impaired infants (10 of 12) were survivors of stage III necrotizing enterocolitis. These findings highlight the importance of continued evaluations for medical and neurodevelopmental sequelae.

  19. Comorbidities, Alcohol Use Disorder, and Age Predict Outcomes after Autologous Hematopoietic Cell Transplantation for Lymphoma.

    PubMed

    Graf, Solomon A; Vaughn, Jennifer E; Chauncey, Thomas R; Storer, Barry E; Gopal, Ajay K; Holmberg, Leona A; McCune, Jeannine S; Bensinger, William I; Maloney, David G; Press, Oliver W; Storb, Rainer; Sorror, Mohamed L

    2016-09-01

    Autologous hematopoietic cell transplantation (HCT) is a treatment option for many patients diagnosed with lymphoma. The effects of patient-specific factors on outcomes after autologous HCT are not well characterized. Here, we studied a sequential cohort of 754 patients with lymphoma treated with autologous HCT between 2000 and 2010. In multivariate analysis, patient-specific factors that were statistically significantly associated with nonrelapse mortality (NRM) included HCT-specific comorbidity index (HCT-CI) scores  ≥ 3 (HR, 1.94; P = .05), a history of alcohol use disorder (AUD) (HR, 2.17; P = .004), and older age stratified by decade (HR, 1.29; P = .02). HCT-CI ≥ 3, a history of AUD, and age > 50 were combined into a composite risk model: NRM and overall mortality rates at 5 years increased from 6% to 30% and 32% to 58%, respectively, in patients with 0 versus all 3 risk factors. The HCT-CI is a valid tool in predicting mortality risks after autologous HCT for lymphoma. AUD and older age exert independent prognostic impact on outcomes. Whether AUD indicates additional organ dysfunction or sociobehavioral abnormality warrants further investigation. The composite model may improve risk stratification before autologous HCT. PMID:27311969

  20. Seat Belt Usage in Injured Car Occupants: Injury Patterns, Severity and Outcome After Two Main Car Accident Mechanisms in Kashan, Iran, 2012

    PubMed Central

    Mohammadzadeh, Mahdi; Paravar, Mohammad; Mirzadeh, Azadeh Sadat; Mohammadzadeh, Javad; Mahdian, Soroush

    2015-01-01

    Background: Road traffic accidents (RTAs) are the main public health problems in Iran. The seat belts, which are vehicle safety devices, are imperative to reduce the risk of severe injuries and mortality. Objectives: The aim of the study was to evaluate injury patterns, severity and outcome among belted and unbelted car occupants who were injured in car accidents. Patients and Methods: This cross-sectional prospective study was performed on all car occupants injured in RTAs (n = 822) who were transported to hospital and hospitalized for more than 24 hours from March 2012 to March 2013. Demographic profile of the patients, including age, gender, position in the vehicle, the use of seat belts, type of car crashes, injured body regions, revised trauma score (RTS), Glasgow coma score (GCS), duration of hospital stay and mortality rate were analyzed by descriptive analysis, chi-square and independent t-test. P < 0.05 was considered significant. Results: A total of 560 patients used seat belts (68.1%). The unbelted occupants were younger (28 years vs. 38 years) and had more frequently sustained head, abdomen and multiple injuries (P = 0.01, P = 0.01 and P = 0.009, respectively). Also, these patients had significantly lower GCS and elongated hospitalization and higher death rate (P = 0.001, P = 0.001 and P = 0.05, respectively). Tendency of severe head trauma and low RTS and death were increased in unbelted occupants in car rollover accident mechanisms (P = 0.001, P = 0.01 and P = 0.008, respectively). Conclusions: During car crashes, especially car rollover, unbelted occupants are more likely to sustain multiple severe injuries and death. Law enforcement of the seat belt usage for all occupants (front and rear seat) is obligatory to reduce severe injuries sustained as a result of car accidents, especially in vehicles with low safety. PMID:26064867

  1. Older and colder: The impact of starspots on stellar masses, ages, and lithium during the pre-main sequence

    NASA Astrophysics Data System (ADS)

    Somers, Garrett

    2016-01-01

    Starspots are ubiquitously found on young, active stars on the pre-main sequence (pre-MS), and may cover up to ~50% of their surfaces, but their effects on early stellar evolution have never been fully explored. I study the impact of such extreme spot coverage on pre-MS stellar evolution by modifying an existing stellar evolution code to account for spot effects on both the surface boundary conditions and the transport of energy in the interior. I show that heavy spot coverage systematically increases the radii of young stars, while reducing their luminosity and average surface temperature. Such increased radii may underlie the well-known radius inflation of some young, active stars, while the decreased luminosity and effective temperature displace stars on the HR diagram, leading to systematic under-estimation of stellar masses by up to 2x, and of stellar ages by up to 10x, if spotted stars are interpreted with un-spotted isochrones. The inhomogeneous surfaces of spotted stars also distort the emission spectrum, and can thus explain the anomalous colors of the rapidly rotating K dwarfs of the Pleiades, a young open cluster. I further find that spots reduce the central temperature of stars, leading to a suppression of lithium burning during the pre-MS. As a result, pre-MS stars of equal mass but differing spot properties reach the zero-age main sequence with different surface lithium abundances. I show that this effect can account for the previously unexplained lithium abundance dispersions observed at fixed Teff in the Pleiades, and other young clusters.Synthesizing these results, I argue that the inclusion of spots, a prominent phenomenon on the pre-MS, can explain several outstanding mysteries associated with young stars: inflated radii, age spreads in young clusters, the anomalous colors of rapid rotators, and the lithium abundance dispersions in young star clusters. I discuss implications of under-estimated masses and ages for measuring age spreads in young

  2. STELLAR AGES AND CONVECTIVE CORES IN FIELD MAIN-SEQUENCE STARS: FIRST ASTEROSEISMIC APPLICATION TO TWO KEPLER TARGETS

    SciTech Connect

    Silva Aguirre, V.; Christensen-Dalsgaard, J.; Chaplin, W. J.; Basu, S.; Deheuvels, S.; Brandao, I. M.; Cunha, M. S.; Sousa, S. G.; Dogan, G.; Metcalfe, T. S.; Serenelli, A. M.; Garcia, R. A.; Ballot, J.; Weiss, A.; Appourchaux, T.; Casagrande, L.; Cassisi, S.; Creevey, O. L.; Lebreton, Y.; Noels, A.; and others

    2013-06-01

    Using asteroseismic data and stellar evolution models we obtain the first detection of a convective core in a Kepler field main-sequence star, putting a stringent constraint on the total size of the mixed zone and showing that extra mixing beyond the formal convective boundary exists. In a slightly less massive target the presence of a convective core cannot be conclusively discarded, and thus its remaining main-sequence lifetime is uncertain. Our results reveal that best-fit models found solely by matching individual frequencies of oscillations corrected for surface effects do not always properly reproduce frequency combinations. Moreover, slightly different criteria to define what the best-fit model is can lead to solutions with similar global properties but very different interior structures. We argue that the use of frequency ratios is a more reliable way to obtain accurate stellar parameters, and show that our analysis in field main-sequence stars can yield an overall precision of 1.5%, 4%, and 10% in radius, mass, and age, respectively. We compare our results with those obtained from global oscillation properties, and discuss the possible sources of uncertainties in asteroseismic stellar modeling where further studies are still needed.

  3. Schizophrenia and delusional disorder in older age: community prevalence, incidence, comorbidity, and outcome.

    PubMed

    Copeland, J R; Dewey, M E; Scott, A; Gilmore, C; Larkin, B A; Cleave, N; McCracken, C F; McKibbin, P E

    1998-01-01

    The opportunity to assess prevalence, incidence, and outcome of schizophrenia and delusional disorder was provided by an age- and sex-stratified random sample of 5,222 persons age 65 years and over. This sample was chosen from general practitioner lists, and interviewed by psychiatric nurses trained to use the Geriatric Mental State (GMS)-AGECAT computerized diagnostic system. GMS-AGECAT ensured the reliability of the selection of cases between the two waves of the study. A subsample was interviewed by a research psychiatrist. The sample was followed up 2 years later using the same method by interviewers blind to the initial findings. The protocols of all nominated cases and subcases of schizophrenia/paranoid disorder diagnosed by AGECAT were reviewed by a clinician and DSM-III-R diagnoses were made. Refusal rate was 13 percent for initial interviews (wave 1) and 15 percent for reinterview 2 years later (wave 2). The prevalence of DSM-III-R schizophrenia was 0.12 percent (95% confidence interval [CI] 0.04-0.25) and delusional disorder 0.04 percent (95% CI 0.00-0.14). The minimum incidence of schizophrenia for new cases was 3.0 (95% CI 0.00 to 110.70); for new and relapsed cases, 45.0 (95% CI 3.54-186.20); and for delusional disorder, 15.6 (95% CI 0.02-135.10) per 100,000 per year. Two of the five cases with schizophrenia were known to have been first diagnosed before age 65. After 2 years, none of the cases of schizophrenia had recovered fully, but none was deluded at followup. Two had developed dementia. The outcome was bad because they remained cases of some type of psychiatric illness but good because of the improvement in their schizophrenia/delusion disorder symptoms.

  4. Outcomes and Tolerability of Chemoradiation Therapy for Pancreatic Cancer Patients Aged 75 Years or Older

    SciTech Connect

    Miyamoto, David T.; Mamon, Harvey J.

    2010-07-15

    Purpose: To review the outcomes and tolerability of full-dose chemoradiation in elderly patients aged 75 years or older with localized pancreatic cancer. Methods and Materials: We retrospectively reviewed patients aged 75 years or older with nonmetastatic pancreatic cancer treated with chemoradiation therapy at two institutions from 2002 to 2007. Patients were analyzed for treatment toxicity, local recurrences, distant metastases, and survival. Results: A total of 42 patients with a median age of 78 years (range, 75-90 years) who received chemoradiation therapy for pancreatic cancer were identified. Of the patients, 24 had locally advanced disease treated with definitive chemoradiation, and 18 had disease treated with surgery and chemoradiation. Before chemoradiotherapy, the mean Eastern Cooperative Oncology Group performance status was 1.0 {+-} 0.8, and the mean 6-month weight loss was 5.3 {+-} 3.8 kg. The mean radiation dose delivered was 48.1 {+-} 9.2 Gy. All patients received fluoropyrimidine-based chemotherapy concurrently with radiotherapy. In all, 8 patients (19%) were hospitalized, 7 (17%) had an emergency room visit, 15 (36%) required a radiation treatment break, 3 (7%) required a chemotherapy break, 9 (21%) did not complete therapy, and 22 (49%) had at least one of these adverse events. The most common toxicities were nausea, pain, and failure to thrive. Median overall survival was 8.6 months (95% confidence interval, 7.2-13.1) in patients who received definitive chemoradiation therapy and 20.6 months (95% confidence interval, 9.5-{infinity}) in patients who underwent resection and chemoradiation therapy. Conclusions: In this dataset of very elderly patients with pancreatic cancer and good Eastern Cooperative Oncology Group performance status, outcomes after chemoradiotherapy were similar to those among historic controls for patients with locally advanced and resected pancreatic cancer, although many patients experienced substantial treatment

  5. Age at the time of sulfonylurea initiation influences treatment outcomes in KCNJ11-related neonatal diabetes

    PubMed Central

    Thurber, Brian W.; Carmody, David; Tadie, Elizabeth C.; Pastore, Ashley N.; Dickens, Jazzmyne T.; Wroblewski, Kristen E.; Naylor, Rochelle N.; Philipson, Louis H.; Greeley, Siri Atma W.

    2015-01-01

    Aims/hypothesis Individuals with heterozygous activating mutations of the KCNJ11 gene encoding a subunit of the ATP-sensitive potassium channel (KATP) can usually be treated with oral sulfonylurea (SU) pills in lieu of insulin injections. The aim of this study was to test our hypothesis that younger age at the time of initiation of SU therapy is correlated with lower required doses of SU therapy, shorter transition time and decreased likelihood of requiring additional diabetes medications. Methods We performed a retrospective cohort study using data on 58 individuals with neonatal diabetes due to KCNJ11mutations identified through the University of Chicago Monogenic Diabetes Registry (http://monogenicdiabetes.uchicago.edu/registry). We assessed the influence of age at initiation of SU therapy on treatment outcomes. Results HbA1c fell from an average of 8.5% (69 mmol/mol) before transition to 6.2% (44 mmol/mol) after SU therapy (p < 0.001). Age of initiation of SU correlated with the dose (mg kg−1 day−1) of SU required at follow-up (r = 0.80, p < 0.001). Similar associations were observed across mutation subtypes. Ten participants required additional glucose-lowering medications and all had initiated SU at age 13 years or older. No serious adverse events were reported. Conclusions/interpretation Earlier age at initiation of SU treatment is associated with improved response to SU therapy. Declining sensitivity to SU may be due to loss of beta cell mass over time in those treated with insulin. Our data support the need for early genetic diagnosis and appropriate personalised treatment in all cases of neonatal diabetes. PMID:25877689

  6. Treatment outcome in Hodgkin's disease in patients above the age of 60: a population-based study.

    PubMed

    Enblad, G; Glimelius, B; Sundström, C

    1991-04-01

    All persons in three Swedish counties afflicted with Hodgkin's disease between 1979 and 1988 were traced. The objective was to analyze, in unselected, population-based material, whether an assumed worse prognosis in the elderly could be due to differences in staging procedures, treatment intensity, decreased tolerance to therapy or to a more aggressive disease. After histopathological revision, 163 of 202 patients (autopsy cases excluded) were accepted as HD, 61 (37%) of them above the age of 60. Although staging procedures had been more intense in the young, the elderly patients had a more advanced stage at diagnosis, and tended more often to have B-symptoms. The intensity of staging procedures did not seem to influence survival. The 5-yr relative survival was 37% above and 85% below the age of 60. Radiotherapy was the primary treatment in 12 (20%) above and 41 (41%) below the age of 60 with 5-yr relative survival figures of 84% and 85%, respectively. Thirty-seven patients (61%) above and 61 (59%) below 60 were treated with combination chemotherapy (MOPP/ABVD, MOPP, ChlVPP/OPEC) with curative intent. The 5-yr relative survival was 33% and 86%, respectively. The majority of the elderly patients (54%) received less than 40% of the planned chemotherapy dose. The main reason for this pronounced reduction was intolerance to therapy, with 8 treatment-related deaths. We conclude that tolerance to combination chemotherapy in the elderly patients with HD is poor and could be the major reason for poor treatment outcome in this age group. PMID:1714293

  7. Age and therapeutic outcome of experimental Pseudomonas aeruginosa keratitis treated with ciprofloxacin, prednisolone, and flurbiprofen.

    PubMed Central

    Hobden, J A; Hill, J M; Engel, L S; O'Callaghan, R J

    1993-01-01

    This study was conducted to determine whether the age of the host influences the pathogenesis and therapeutic outcome of drug-treated Pseudomonas aeruginosa keratitis. Young (3- to 5-month-old) and old (1.5- to 3-year-old) rabbits were intrastromally infected with P. aeruginosa ATCC 27853. Sixteen hours later, rabbits in both age subpopulations were divided into three groups and treated topically as follows: group 1, phosphate-buffered saline; group 2, 0.3% ciprofloxacin; and group 3, 0.3% ciprofloxacin, 1.0% prednisolone, and 0.03% flurbiprofen. Drops were given every 15 min for 1 h and then every 30 min for 9 h. At 27 h postinfection, ocular pathology was graded with a slit lamp examination (SLE) scoring system. Aqueous humor was collected for ciprofloxacin quantitation, and corneas were harvested for bacterial enumeration and estimation of polymorphonuclear leukocytes. Young rabbits had more severe inflammation and pathology than old rabbits. At 27 h postinfection, SLE scores and polymorphonuclear leukocyte numbers were significantly higher for young rabbits than old rabbits (P < 0.02), regardless of treatment. Prednisolone and flurbiprofen significantly reduced SLE scores in both age groups (P < 0.03) without affecting the antimicrobial efficacy of ciprofloxacin. PMID:8239596

  8. The Effect of Age upon Care and Outcomes in Patients Hospitalized for Congestive Heart Failure in Alberta, Canada

    ERIC Educational Resources Information Center

    Cujec, Bibiana; Quan, Hude; Jin, Yan; Johnson, David

    2004-01-01

    We describe the age-specific outcomes for patients hospitalized with newly diagnosed congestive heart failure using administrative hospital abstracts from Alberta, Canada, from April 1, 1994, to March 31, 2000. Seniors (aged 65 years and older) constituted about 85 per cent of the 16,162 patients. Both co-morbidity and severity of illness tended…

  9. Antecedents and Outcomes of Level and Rates of Change in Perceived Control: The Moderating Role of Age

    ERIC Educational Resources Information Center

    Infurna, Frank J.; Okun, Morris A.

    2015-01-01

    Perceived control is interrelated with aging-related outcomes across adulthood and old age. Relatively little is known, however, about resources as antecedents of longitudinal change in perceived control and the role of perceived control as a buffer against mortality risk when these resources are low. We examined functional limitations, depressive…

  10. Consumer-directed personal care: comparing aged and non-aged adult recipient health-related outcomes among those with paid family versus non-relative providers.

    PubMed

    Newcomer, Robert; Kang, Taewoon; Faucett, Julia

    2011-10-01

    Risk factors associated with the incidence of recipient injuries, bedsores and contractures, and health care use (i.e., emergency department and hospital use) among aged and non-aged adult personal care recipients are investigated. Data are from a statewide survey of aged and non-aged adult personal assistance service (PAS) recipients (n = 913) in California's In-Home Supportive Services (IHSS) program. This is a consumer-directed PAS program. Outcomes among recipients using relatives (other than spouses or parents) as paid providers are compared with those of recipients having non-relatives as providers. No differences were found by provider-recipient relationships. Non-aged recipients, those in poorer health, those with more than three activities of daily living (ADL) limitations, and those changing providers during the year were all at greater risk for adverse health outcomes. African American, Hispanic, and Asian recipients were at lower risk for injuries and hospital stays than were White recipients. PMID:22106901

  11. Evidence for a Significant Intermediate-Age Population in the M31 Halo from Main Sequence Photometry

    NASA Technical Reports Server (NTRS)

    Brown, Thomas M.; Ferguson, Henry C.; Smith, Ed; Kimble, Randy A.; Sweigart, Allen V.; Renzini, Alvio; Rich, R. Michael; Vandenberg, Don A.

    2003-01-01

    We present a color-magnitude diagram (CMD) for a minor-axis field in the halo of the Andromeda galaxy (M3l), 51 arcmin (11 kpc) from the nucleus. These observations, taken with the Advanced Camera for Surveys (ACS) on the Hubble Space Telescope, are the deepest optical images yet obtained, attaining 50% completeness at m(sub v) = 30.7 mag. The CMD, constructed from approx. 3 x 10(exp 5) stars, reaches more than 1.5 mag fainter than the old main-sequence turnoff. Our analysis is based on direct comparisons to ACS observations of four globular clusters through the same filters, as well as chi square fitting to a finely-spaced grid of calibrated stellar-population models. We find that the M31 halo contains a major (approx. 30% by mass) intermediate-age (6-8 Gyr) metal-rich ([Fe/H] greater than -0.5) population, as well as a significant globular-cluster age (11-13.5 Gyr) metal-poor population. These findings support the idea that galaxy mergers played an important role in the formation of the M31 halo.

  12. Core-Halo Structure of a Chemically Homogeneous Massive Star and Bending of the Zero-Age Main Sequence

    NASA Astrophysics Data System (ADS)

    Ishii, Mie; Ueno, Munetaka; Kato, Mariko

    1999-08-01

    We have recalculated the interior structure of very massive stars of uniform chemical composition with the OPAL opacity. Very massive stars are found to develop a core-halo structure with an extended radiative-envelope. With the core-halo structure, because a more massive star has a more extended envelope, the track of the upper zero-age main-sequence (ZAMS) curves redward in the H-R diagram at > 100 MO (Z=0.02), >70 MO (Z=0.05), and > 15 MO for helium ZAMS (X=0, Z=0.02). Therefore, the effective temperatures of very massive ZAMS stars are rather low: e.g., for a 200 MO star, log T_eff=4.75 (Z=0.004), 4.60 (Z=0.02), 4.46 (Z=0.05), and 4.32 (Z=0.10). The effective temperatures of very luminous stars (> 120 MO ) found in the LMC, the SMC, and the Galaxy are discussed in relation to this metal dependence of a curving upper main-sequence.

  13. Effects of neonatal enteral glutamine supplementation on cognitive, motor and behavioural outcomes in very preterm and/or very low birth weight children at school age.

    PubMed

    de Kieviet, Jorrit F; Oosterlaan, Jaap; van Zwol, Annelies; Boehm, Guenther; Lafeber, Harrie N; van Elburg, Ruurd M

    2012-12-28

    In very preterm ( < 32 weeks of gestation) and/or very low birth weight (VLBW, < 1500 g birth weight) children, serious neonatal infections are among the main causes of poor developmental outcomes later in childhood. The amino acid glutamine has been shown to reduce the incidence of serious neonatal infections in very preterm and/or VLBW children, while developmental effects beyond 24 months are unknown. We determined the cognitive, motor and behavioural outcomes at school age of a cohort of sixty-four very preterm and/or VLBW children (aged 7·5 (sd 0·4) years) who participated in a randomised placebo-controlled trial using enteral glutamine between day 3 and day 30 of life. Cognitive and motor outcomes were studied using the Wechsler Intelligence Scale for Children-III, the Movement Assessment Battery for Children (MABC), the Attention Network Test and a visual working memory task. Behavioural outcomes were evaluated using parent- and teacher-rated questionnaires. Intelligence quotient, processing speed, attentional functioning, working memory and parent- and teacher-rated behavioural outcomes were not different between children treated with glutamine or placebo; only visuomotor abilities as measured by the Ball Skills scale of the MABC (P = 0·002; d = 0·67) were poorer in the glutamine group. This effect persisted after taking into account the beneficial effects of lower serious neonatal infections rates in children treated with glutamine (P = 0·005). In conclusion, glutamine supplementation between day 3 and day 30 of life had neither beneficial nor detrimental effects on long-term cognitive, motor and behavioural outcomes of very preterm and/or VLBW children at school age, although visuomotor abilities were poorer in children that received glutamine.

  14. ADIABATIC MASS LOSS IN BINARY STARS. II. FROM ZERO-AGE MAIN SEQUENCE TO THE BASE OF THE GIANT BRANCH

    SciTech Connect

    Ge, Hongwei; Chen, Xuefei; Han, Zhanwen; Webbink, Ronald F. E-mail: rwebbink@illinois.edu

    2015-10-10

    In the limit of extremely rapid mass transfer, the response of a donor star in an interacting binary becomes asymptotically one of adiabatic expansion. We survey here adiabatic mass loss from Population I stars (Z = 0.02) of mass 0.10 M{sub ⊙}–100 M{sub ⊙} from the zero-age main sequence to the base of the giant branch, or to central hydrogen exhaustion for lower main sequence stars. The logarithmic derivatives of radius with respect to mass along adiabatic mass-loss sequences translate into critical mass ratios for runaway (dynamical timescale) mass transfer, evaluated here under the assumption of conservative mass transfer. For intermediate- and high-mass stars, dynamical mass transfer is preceded by an extended phase of thermal timescale mass transfer as the star is stripped of most of its envelope mass. The critical mass ratio q{sub ad} (throughout this paper, we follow the convention of defining the binary mass ratio as q ≡ M{sub donor}/M{sub accretor}) above which this delayed dynamical instability occurs increases with advancing evolutionary age of the donor star, by ever-increasing factors for more massive donors. Most intermediate- or high-mass binaries with nondegenerate accretors probably evolve into contact before manifesting this instability. As they approach the base of the giant branch, however, and begin developing a convective envelope, q{sub ad} plummets dramatically among intermediate-mass stars, to values of order unity, and a prompt dynamical instability occurs. Among low-mass stars, the prompt instability prevails throughout main sequence evolution, with q{sub ad} declining with decreasing mass, and asymptotically approaching q{sub ad} = 2/3, appropriate to a classical isentropic n = 3/2 polytrope. Our calculated q{sub ad} values agree well with the behavior of time-dependent models by Chen and Han of intermediate-mass stars initiating mass transfer in the Hertzsprung gap. Application of our results to cataclysmic variables, as systems

  15. The Impact of Maternal Obesity and Excessive Gestational Weight Gain on Maternal and Infant Outcomes in Maine: Analysis of Pregnancy Risk Assessment Monitoring System Results from 2000 to 2010

    PubMed Central

    Sarton, Cheryl; Lichter, Erika

    2016-01-01

    The objective of this study is to understand the relationships between prepregnancy obesity and excessive gestational weight gain (GWG) and adverse maternal and fetal outcomes. Pregnancy risk assessment monitoring system (PRAMS) data from Maine for 2000–2010 were used to determine associations between demographic, socioeconomic, and health behavioral variables and maternal and infant outcomes. Multivariate logistic regression analysis was performed on the independent variables of age, race, smoking, previous live births, marital status, education, BMI, income, rurality, alcohol use, and GWG. Dependent variables included maternal hypertension, premature birth, birth weight, infant admission to the intensive care unit (ICU), and length of hospital stay of the infant. Excessive prepregnancy BMI and excessive GWG independently predicted maternal hypertension. A high prepregnancy BMI increased the risk of the infant being born prematurely, having a longer hospital stay, and having an excessive birth weight. Excessive GWG predicted a longer infant hospital stay and excessive birth weight. A low pregnancy BMI and a lower than recommended GWG were also associated with poor outcomes: prematurity, low birth weight, and an increased risk of the infant admitted to ICU. These findings support the importance of preconception care that promotes achievement of a healthy weight to enhance optimal reproductive outcomes. PMID:27747104

  16. The Effects of Antenatal Corticosteroids on Short- and Long-Term Outcomes in Small-for-Gestational-Age Infants

    PubMed Central

    Ishikawa, Hiroshi; Miyazaki, Ken; Ikeda, Tomoaki; Murabayashi, Nao; Hayashi, Kazutoshi; Kai, Akihiko; Ishikawa, Kaoru; Miyamoto, Yoshihiro; Nishimura, Kunihiro; Kono, Yumi; Kusuda, Satoshi; Fujimura, Masanori

    2015-01-01

    Aim: To evaluate the effect of antenatal corticosteroids (ANS) on short- and long-term outcomes in small-for-gestational age (SGA) infants. Methods: A retrospective database analysis was performed. A total of 1,931 single infants (birth weight <1,500 g) born at a gestational age between 22 weeks and 33 weeks 6 days who were determined to be SGA registered in the Neonatal Research Network Database in Japan between 2003 and 2007 were evaluated for short-term outcome and long-term outcome. Results: ANS was administered to a total of 719 infants (37%) in the short-term outcome evaluation group and 344 infants (36%) in the long-term outcome evaluation group. There were no significant differences between the ANS group and the no-ANS group for primary short-term outcome (adjusted odds ratio (OR) 0.73; 95% confidence interval (CI) 0.45-1.20; P-value 0.22) or primary long-term outcome (adjusted OR 0.69; 95% CI 0.40-1.17; P-value 0.17). Conclusions: Our results show that ANS does not affect short- or long-term outcome in SGA infants when the birth weight is less than 1500 g. This study strongly suggests that administration of ANS resulted in few benefits for preterm FGR fetuses. PMID:25897289

  17. Body Mass Index Trajectories among Middle-Aged and Elderly Canadians and Associated Health Outcomes

    PubMed Central

    Wang, Meng; Yi, Yanqing; Roebothan, Barbara; Colbourne, Jennifer; Maddalena, Victor; Wang, Peizhong Peter; Sun, Guang

    2016-01-01

    Background. Whether there is heterogeneity in the development of BMI from middle-age onward is still unknown. The primary aim of this study is to analyze long-term obesity and how BMI trajectories are associated with health outcomes in midlife. Methods. Latent Class Growth Modelling was used to capture the changes in BMI over time. In this study, 3070 individuals from the National Population Health Survey (NPHS), aged 40–55 years at baseline, were included. Results. Four BMI trajectory groups, “Normal-Stable” (N-S), “Overweight-Stable” (OV-S), “Obese I-Stable” (OB I-S), and “Obese II-Stable” (OB II-S), were identified. Men, persons of White ancestry, and individuals who had no postsecondary education had higher odds of being in the latter three groups. Moreover, members of the OV-S, OB I-S, and OB II-S groups experienced more asthma, arthritis, hypertension, diabetes, heart disease, cognitive impairment, and reduced self-rated overall health. Individuals in the OB II-S group were at greater risk for back problems, chronic bronchitis or emphysema, and emotional issues when compared to the N-S group. Conclusion. Understanding different BMI trajectories is important in order to identify people who are at the highest risk of developing comorbidities due to obesity and to establish programs to intervene appropriately. PMID:26925112

  18. Liver Transplantation Outcomes Using Grafts From Donors Older Than the Age of 80 Years.

    PubMed

    Rabelo, A V; Alvarez, M J; Méndez, C S M; Villegas, M T; MGraneroa, K; Becerra, A; Dominguez, M; Raya, A M; Exposito, M; Suárez, Y F

    2015-11-01

    We performed a retrospective cohort study between 2002 and 2014 to compare liver transplantation outcomes between recipients of grafts from donors older than and younger than the age of 80 years. Numerical variables were compared with the Student t test when their distribution was normal and the Mann-Whitney test when it was not, whereas categorical variables were compared with Pearson chi-squared test or Fisher test, as appropriate; P < .05 was considered significant. The study included 312 patients with organs from donors younger than 80 years of age and 17 with organs from older donors. The 2 recipient groups did not significantly differ in weight, height, gender, body mass index (BMI), CHILD or MELD score, intensive care unit (ICU) or hospital stay, need for intraoperative hemoderivatives, postreperfusion syndrome, biliary or vascular complications, ischemic cholangiopathy, number of repeat surgeries, graft rejection, retransplantation, or survival at 6 months. Although earlier studies considered livers from elderly donors to be suboptimal, our results support the proposition that octogenarian donors can be an excellent source of liver grafts.

  19. Liver Transplantation Outcomes Using Grafts From Donors Older Than the Age of 80 Years.

    PubMed

    Rabelo, A V; Alvarez, M J; Méndez, C S M; Villegas, M T; MGraneroa, K; Becerra, A; Dominguez, M; Raya, A M; Exposito, M; Suárez, Y F

    2015-11-01

    We performed a retrospective cohort study between 2002 and 2014 to compare liver transplantation outcomes between recipients of grafts from donors older than and younger than the age of 80 years. Numerical variables were compared with the Student t test when their distribution was normal and the Mann-Whitney test when it was not, whereas categorical variables were compared with Pearson chi-squared test or Fisher test, as appropriate; P < .05 was considered significant. The study included 312 patients with organs from donors younger than 80 years of age and 17 with organs from older donors. The 2 recipient groups did not significantly differ in weight, height, gender, body mass index (BMI), CHILD or MELD score, intensive care unit (ICU) or hospital stay, need for intraoperative hemoderivatives, postreperfusion syndrome, biliary or vascular complications, ischemic cholangiopathy, number of repeat surgeries, graft rejection, retransplantation, or survival at 6 months. Although earlier studies considered livers from elderly donors to be suboptimal, our results support the proposition that octogenarian donors can be an excellent source of liver grafts. PMID:26680060

  20. Long-Term Outcomes of External Dacryocystorhinostomy in the Age of Transcanalicular Microendoscopic Techniques

    PubMed Central

    Alnawaiseh, M.; Mihailovic, N.; Wieneke, A. C.; Prokosch, V.; Rosentreter, A.; Merté, R. L.; Eter, N.

    2016-01-01

    Purpose. This study aimed to evaluate long-term results of external dacryocystorhinostomy (DCR) at a tertiary eye care center specializing in lacrimal duct surgery in Germany. Methods. The medical records of 1010 patients with acquired nasolacrimal duct obstruction (NLDO), who had undergone lacrimal duct surgery at a tertiary eye care center, were reviewed. Only adult patients who had undergone external DCR were included. The evaluation included the following parameters: age, gender, duration of symptoms, patient satisfaction, previous dacryocystitis, complication rates, and surgical outcome. Results. 154 eyes of 146 patients (14.5%) could be included in the study. The average age was 64.1 ± 29.7 years. 66.4% of patients were females and 33.6% were males. Acute or chronic dacryocystitis was found in 81 patients (55.5%). Overall, 82.8% of patients had full resolution of symptoms. The success rate of external DCR for patients with previous episodes of dacryocystitis was 82.7% compared to 83.4% for patients without dacryocystitis in their medical history. Conclusion. In cases in which transcanalicular microendoscopic techniques are contraindicated (e.g., after dacryocystitis) or in complex cases where microendoscopic procedures have failed (revision surgery), external DCR is still the surgical treatment of choice with very good postoperative success. PMID:27110391

  1. The effects of technological advances on outcomes for elderly persons with exudative age-related macular degeneration.

    PubMed

    Sloan, Frank A; Hanrahan, Brian W

    2014-04-01

    IMPORTANCE Exudative age-related macular degeneration (ARMD) is the major cause of blindness among US elderly. Developing effective therapies for this disease has been difficult. OBJECTIVES To assess the effects of introducing new therapies for treating exudative ARMD on vision of the affected population and other outcomes among Medicare beneficiaries newly diagnosed as having ARMD. DESIGN The study used data from a 5% sample of Medicare claims and enrollment data with a combination of a regression discontinuity design and propensity score matching to assess the effects on the introduction or receipt of new technologies on study outcomes during a 2-year follow-up period. SETTING AND PARTICIPANTS The analysis was based on longitudinal data for the United States, January 1, 1994, to December 31, 2011, for Medicare beneficiaries with fee-for-service coverage. The sample was limited to beneficiaries 68 years or older newly diagnosed as having exudative ARMD as indicated by beneficiaries having no claims with this diagnosis in a 3-year look-back period. EXPOSURES The comparisons with vision outcomes were after vs before the introduction of photodynamic therapy and anti-vascular endothelial growth factor (VEGF) therapy. The comparisons for depression and long-term care facility admission were between beneficiaries newly diagnosed as having exudative ARMD who received photodynamic therapy or anti-VEGF therapy compared with beneficiaries having the diagnosis who received no therapy for this disease. MAIN OUTCOMES AND MEASURES Onset of decrease in vision, vision loss or blindness, depression, and admission to a long-term care facility. RESULTS Among beneficiaries newly diagnosed as having exudative ARMD, the introduction of anti-VEGF therapy reduced vision loss by 41% (95% CI, 52%-68%) and onset of severe vision loss and blindness by 46% (95% CI, 47%-63%). Such beneficiaries who received anti-VEGF therapy and were not admitted to a long-term care facility during the look

  2. Comparison of outcomes in patients ≤85 versus >85 years of age undergoing transcatheter aortic-valve implantation.

    PubMed

    Havakuk, Ofer; Finkelstein, Ariel; Steinvil, Arie; Halkin, Amir; Arbel, Yaron; Abramowitz, Yigal; Ben Assa, Eyal; Konigstein, Maayan; Keren, Gad; Banai, Shmuel

    2014-01-01

    The impact of age on baseline characteristics and outcomes in patients with severe aortic stenosis who undergo transcatheter aortic valve implantation (TAVI) has not been thoroughly investigated. To describe the baseline clinical profile of TAVI patients aged >85 and ≤85 years and to evaluate the influence of age differences on outcomes, we evaluated a consecutive cohort of 293 patients who underwent transfemoral TAVI at the Tel Aviv Medical Center. The cohort was divided into 2 groups: patients aged >85 years (n = 93) and patients aged ≤85 years (n = 200). Mean age was 83 ± 5.3 years (range 63 to 98) for the entire cohort. Women comprised 70% of the older group and 57.5% of the younger age group (p = 0.043). Baseline clinical profile, including EuroSCORE index and preprocedural aortic valve area were similar in both age groups. Thirty-day mortality, major vascular complications, need for permanent pacemaker implantation, length of hospital stay, and improvement in functional class after the procedure showed no differences between the 2 groups. Adjustment for baseline clinical differences between groups did not change the results. In conclusion, among patients who underwent transfemoral TAVI, older patients (>85 years) experience similar benefits and outcomes regarding functional status, complication rates, and 30-day mortality. PMID:24210675

  3. Neurocognitive outcomes at kindergarten entry after liver transplantation at <3 yr of age.

    PubMed

    Robertson, Charlene M T; Dinu, Irina A; Joffe, Ari R; Alton, Gwen Y; Yap, Jason Y K; Asthana, Sonel; Acton, Bryan V; Sauve, Reg S; Martin, Steven R; Kneteman, Norman M; Gilmour, Susan M

    2013-11-01

    This prospective inception cohort study determines kindergarten-entry neurocognitive abilities and explores their predictors following liver transplantation at age <3 yr. Of 52 children transplanted (1999-2008), 33 (89.2%) of 37 eligible survivors had psychological assessment at age 54.7 (8.4) months: 21 with biliary atresia, seven chronic cholestasis, and five acute liver failure. Neurocognitive scores (mean [s.d.], 100 [15]) as tested by a pediatric-experienced psychologist did not differ in relation to age group at transplant (≤12 months and >12 months): FSIQ, 93.9 (17.1); verbal (VIQ), 95.3 (16.5); performance (PIQ), 94.3 (18.1); and VMI, 90.5 (15.9), with >70% having scores ≥85, average or above. Adverse predictors from the pretransplant, transplant, and post-transplant (30 days) periods using univariate linear regressions for FSIQ were post-transplant use of inotropes, p = 0.029; longer transplant warm ischemia time, p = 0.035; and post-transplant highest serum creatinine, (p = 0.04). For PIQ, they were pretransplant encephalopathy, p = 0.027; post-transplant highest serum creatinine, p = 0.034; and post-transplant inotrope use, p = 0.037. For VMI, they were number of post-transplant infections, p = 0.019; post-transplant highest serum creatinine, p = 0.025; and lower family socioeconomic index, p = 0.039. Changes in care addressing modifiable predictors, including reducing acute post-transplant illness, pretransplant encephalopathy, transplant warm ischemia times, and preserving renal function, may improve neurocognitive outcomes. PMID:23961979

  4. Impact of SYNTAX score on 1-year clinical outcomes in patients undergoing percutaneous coronary intervention for unprotected left main coronary artery.

    PubMed

    Nozue, Tsuyoshi; Kamijima, Ryo; Iwaki, Taku; Michishita, Ichiro

    2012-01-01

    SYNTAX score is an angiographic scoring system that was developed to quantify the number, complexity, and location of lesions in patients undergoing coronary revascularization. Up to now, the impact of SYNTAX score on clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) for unprotected left main coronary artery (LMCA) lesions has not been fully examined. Therefore, we evaluate the usefulness of the SYNTAX score and identify the cutoff value of this score to predict 1-year clinical outcomes in patients undergoing PCI for unprotected LMCA lesions. This was a single-center retrospective study that included 49 consecutive patients undergoing elective PCI for unprotected LMCA lesions. We calculated the SYNTAX score and examined the correlations between this score and 1-year clinical outcomes. Major adverse cardiac events (MACE) occurred in 12 patients (24%): target lesion revascularization in 9 patients (18%), myocardial infarction in 2 (4%), and cardiac death in 1 (2%). The frequency of MACE was significantly higher in the intermediate (47%) or high score group (50%) than in the low score group (4%). Furthermore, the SYNTAX score was significantly higher in the MACE group than in the non-MACE group (31 vs. 22, p = 0.008). Receiver-operating characteristic curve showed that the SYNTAX score exhibited 83% sensitivity and 76% specificity for predicting the development of MACE at a cutoff value 26. These results demonstrate that the SYNTAX score could be a useful tool to predict 1-year clinical outcomes in patients undergoing elective PCI for unprotected LMCA lesions.

  5. Infant Aphakia Treatment Study: Effects of persistent fetal vasculature on outcome at 1 year of age

    PubMed Central

    Morrison, David G.; Wilson, M. Edward; Trivedi, Rupal H.; Lambert, Scott R.; Lynn, Michael J.

    2011-01-01

    Background The Infant Aphakia Treatment Study (IATS) is a randomized trial comparing the treatment of unilateral congenital cataract with primary intraocular lens (IOL) implantation versus aphakic contact lens (CL). The purpose of this study was to compare the outcomes for infants with lens opacity associated with persistent fetal vasculature (PFV) to those without. Methods Retrospective subgroup analysis of grating visual acuity at 1 year of age and adverse events up to 1 year after surgery in eyes identified intraoperatively as having evidence of mild PFV from the IATS. Results Of 83 infants, 18 (22%: 11 CL, 7 IOL) had PFV. Median logMAR visual acuity was 0.88 for patients with PFV and 0.80 for patients without PFV (P = 0.46). One or more adverse events up to one year after surgery occurred in 12 infants (67%) with PFV and 30 infants (46%) without PFV (P = 0.18). The incidence of adverse events was significantly higher in patients with PFV compared to patients without PFV in the CL group (55% vs 20%, P = 0.049) but not in the IOL group (86% vs 71%, P = 0.65), possibly because all children receiving IOLs had higher rates of adverse events when compared to aphakic children (73% vs 29%, P < 0.001). Conclusions Aphakic infants with mild PFV treated with CL had a higher incidence of adverse events following lensectomy compared to children with other forms of unilateral congenital cataract; nevertheless, similar visual outcomes at one year after surgery were obtained. PMID:22108353

  6. Etiological Subgroups of Small-for-Gestational-Age: Differential Neurodevelopmental Outcomes

    PubMed Central

    Li, Xiuhong; Eiden, Rina D.; Epstein, Leonard H.; Shenassa, Edmond D.; Xie, Chuanbo; Wen, Xiaozhong

    2016-01-01

    Objectives It remains unclear why substantial variations in neurodevelopmental outcomes exist within small-for-gestational-age (SGA) children. We prospectively compared 5-y neurodevelopmental outcomes across SGA etiological subgroups. Methods Children born SGA (N = 1050) from U.S. Early Childhood Longitudinal Study-Birth Cohort (2001–2007) was divided into etiological subgroups by each of 7 well-established prenatal risk factors. We fit linear regression models to compare 5-y reading, math, gross motor and fine motor scores across SGA subgroups, adjusting for socio-demographic confounders. Results Compared to singleton SGA subgroup, multiple-birth SGA subgroup had lower mean reading (adjusted mean difference, -4.08 [95% confidence interval, -6.10, -2.06]) and math (-2.22 [-3.61, -0.84]) scores. These disadvantages in reading and math existed only among multiple-birth SGA subgroup without ovulation stimulation (reading, -4.50 [-6.64, -2.36]; math, -2.91 [-4.37, -1.44]), but not among those with ovulation stimulation (reading, -2.33 [-6.24, 1.57]; math 0.63 [-1.86, 3.12]). Compared to singleton SGA subgroup without maternal smoking and inadequate gestational weight gain, singleton SGA subgroup with co-occurrence of maternal smoking and inadequate gestational weight gain (GWG) had lower mean reading (-4.81 [-8.50, -1.12]) and math (-2.95 [-5.51, -0.38]) scores. These differences were not mediated by Apgar score. Conclusions Multiple-birth SGA subgroups (vs. singleton SGA) or singleton SGA subgroup with co-occurrence of smoking and inadequate GWG (vs. singleton SGA subgroup without maternal smoking and inadequate gestational weight gain) have poorer cognitive development up to 5 y. PMID:27501456

  7. Impact of age on transcatheter aortic valve implantation outcomes: a comparison of patients aged ≤ 80 years versus patients > 80 years

    PubMed Central

    van der Kley, Frank; van Rosendael, Philippe J; Katsanos, Spyridon; Kamperidis, Vasileios; Marsan, Nina A; Karalis, Ioannis; de Weger, Arend; Palmen, Meindert; Bax, Jeroen J; Schalij, Martin J; Delgado, Victoria

    2016-01-01

    Objective To investigate the procedural outcomes and the long-term survival of patients undergoing transcatheter aortic valve implantation (TAVI) and compare study results of patients ≤ 80 years and patients > 80 years old. Methods A total of 240 patients treated with TAVI were divided into two groups according to age ≤ 80 years (n = 105; 43.8%) and > 80 years (n = 135; 56.2%). The baseline characteristics and the procedural outcomes were compared between these two groups of patients. Results With the exception of peripheral artery disease and hypercholesterolemia, which were more frequently observed in the older age group, baseline characteristics were comparable between groups. Complication rates did not differ significantly between patients ≤ 80 years and patients > 80 years. There were no differences in 30-day mortality rates between patients aged ≤ 80 years and patients > 80 years old (9.5% vs. 7.4%, respectively; P = 0.557). After a median follow-up of 28 months (interquartile range: 16–42 months), 50 (47.6%) patients aged ≤ 80 years died compared to 57 (42%) deaths in the group of patients > 80 years old (P = 0.404). Conclusion The results of the present single center study showed that age did not significantly impact the outcomes of TAVI. PMID:26918010

  8. Early end-tidal carbon monoxide levels and neurodevelopmental outcome at 3 years 6 months of age in preterm infants

    PubMed Central

    Blok, Cornelie A; Krediet, Tannette G; Kavelaars, Annemiek; Koopman-Esseboom, Corine; Vreman, Hendrik J; Van Bel, Frank

    2011-01-01

    Aim Increased end-tidal carbon monoxide (ETCOc) and cytokines in preterm infants are related to bronchopulmonary dysplasia and intraventricular haemorrhages. The aim was to study the predictive value of ETCOc and cytokine levels for long-term outcome. Methods This study comprised 105 very preterm infants (57 males, 48 females; gestational age range 25wk 5d–31wk 4d; birthweight 610–2100g) who were admitted to a neonatal intensive care unit between 1 February and 31 December 2002. ETCOc, plasma tumour necrosis factor alpha (TNF-α) and interleukins (IL) 6 and 8, and malondialdehyde (MDA, a marker of lipid peroxidation), were measured at days 1, 3, and 5 of life and related to outcome at 3 years 6 months of age (Griffiths Mental Developmental Scales). Results Of the 105 infants, 69 were eligible for follow-up (37 male; 32 female; bronchopulmonary dysplasia, n=12). ETCOc at 0 to 24 hours was higher in infants with adverse outcome (Griffiths developmental quotient <85, n=15) compared with favourable outcome (2.7 SD 0.7 vs 2.0 SD 0.5; p<0.05). MDA and cytokines did not differ between groups. Regression analysis with bootstrapping of independent variables (gestational age, birthweight, ETCOc, TNF-α, IL-6, IL-8, and bronchopulmonary dysplasia) showed that ETCOc was the only parameter that correlated with outcome. The sensitivity and negative predictive value of ETCOc for adverse outcome were 93% and 85% respectively. Interpretation Adverse neurodevelopmental outcome is associated with increased endogenous carbon monoxide. ETCOc less than 2.0ppm during the first day indicates a favourable outcome. PMID:21933176

  9. The influence of maternal age on the outcomes of pregnancies complicated by bleeding at less than 12 weeks.

    PubMed

    Mbugua Gitau, Godfrey; Liversedge, Helen; Goffey, Dawn; Hawton, Annemarie; Liversedge, Neil; Taylor, Myles

    2009-01-01

    The effect of maternal age on the outcome of threatened miscarriage after ultrasound has confirmed fetal heart (FH) pulsation was assessed. At a university teaching hospital, 138 women presenting with bleeding before 12 weeks' gestation were followed up until delivery or pregnancy loss. Those with multiple or ectopic pregnancy, social termination of pregnancy, assisted conception and temporary residence were excluded. Outcome measures were pregnancy loss, fetal abnormalities, preterm delivery, low birthweight and cesarean delivery. Age over 35 years was significantly associated with reduced live-birth and increased miscarriage rates. Women over 35 years of age had higher cesarean section and pregnancy loss rates than the younger women. The combination of bleeding in early pregnancy and advanced age increases risk of pregnancy loss even after ultrasound has confirmed FH pulsation. PMID:19140048

  10. The Effect of Age on Technique Variability and Outcome Variability during a Leg Press

    PubMed Central

    Wilson, Cassie; Perkin, Oliver J.; McGuigan, Miranda P.; Stokes, Keith A.

    2016-01-01

    The aim of this study was to determine the effect of aging on power generation and joint coordination during a leg press, in order to increase understanding of how functional movements are affected during the aging process. 44 older and 24 younger adults performed eight sub-maximal power repetitions on a seated leg press dynamometer. Peak power and velocity (at 40% maximum resistance) were measured along with the coordination (coupling angle) of the lower limb joints using the vector coding technique. The younger adults produced significantly greater peak power than the older adults (mean ± SD; 762 W ± 245 vs 361 W ± 162, p < 0.01) and at higher peak velocities (mean ± SD; 1.37 m/s ± 0.05 vs 1.00 m/s ± 0.06, p < 0.01). The older adults produced less consistent values of peak power than younger adults, evidenced by a higher coefficient of variation (mean ± SD; 7.6% ± 5.2 vs 5.0% ± 3.0, p < 0.01), however, there was significantly less variability in the coupling angles displayed by the older adults compared to the younger adults (mean ± SD; 2.0° ± 1.1 vs 3.5° ± 2.7, p < 0.01 (ankle-knee); 1.7° ± 0.6 vs 4.1° ± 3.0, p < 0.01 (knee-hip)). The results of this study demonstrate that older adults display higher outcome variability but lower variability in technique (coordination). The more rigid movement strategies displayed by the older adults potentially reflects an increased risk of overuse injury due to repetitive demands on the same structures, or the reduced ability to respond to unexpected situations due to a lack of flexibility in joint control. PMID:27701431

  11. Neonatal Gram Negative and Candida Sepsis Survival and Neurodevelopmental Outcome at the Corrected Age of 24 Months

    PubMed Central

    de Haan, Timo R.; Beckers, Loes; de Jonge, Rogier C. J.; Spanjaard, Lodewijk; van Toledo, Letty; Pajkrt, Dasja; van Wassenaer-Leemhuis, Aleid G.; van der Lee, Johanna H.

    2013-01-01

    Objectives To evaluate the long term neurodevelopmental outcome of premature infants exposed to either gram- negative sepsis (GNS) or neonatal Candida sepsis (NCS), and to compare their outcome with premature infants without sepsis. Methods Historical cohort study in a population of infants born at <30 weeks gestation and admitted to the Neonatal Intensive Care Unit (NICU) of the Academic Medical Center in Amsterdam during the period 1997–2007. Outcome of infants exposed to GNS or NCS and 120 randomly chosen uncomplicated controls (UC) from the same NICU were compared. Clinical data during hospitalization and neurodevelopmental outcome data (clinical neurological status; Bayley –test results and vision/hearing test results) at the corrected age of 24 months were collected. An association model with sepsis as the central determinant of either good or adverse outcome (death or severe developmental delay) was made, corrected for confounders using multiple logistic regression analysis. Results Of 1362 patients, 55 suffered from GNS and 29 suffered from NCS; cumulative incidence 4.2% and 2.2%, respectively. During the follow-up period the mortality rate was 34% for both GNS and NCS and 5% for UC. The adjusted Odds Ratio (OR) [95% CI] for adverse outcome in the GNS group compared to the NCS group was 1.4 [0.4–4.9]. The adjusted ORs [95% CI] for adverse outcome in the GNS and NCS groups compared to the UC group were 4.8 [1.5–15.9] and 3.2 [0.7–14.7], respectively. Conclusions We found no statistically significant difference in outcome at the corrected age of 24 months between neonatal GNS and NCS cases. Suffering from either gram –negative or Candida sepsis increased the odds for adverse outcome compared with an uncomplicated neonatal period. PMID:23527140

  12. Diagnostics in a digital age: an opportunity to strengthen health systems and improve health outcomes.

    PubMed

    Peeling, Rosanna W

    2015-11-01

    Diagnostics play a critical role in clinical decision making, and in disease control and prevention. Rapid point-of-care (POC) tests for infectious diseases can improve access to diagnosis and patient management, but the quality of these tests vary, quality of testing is often not assured and there are few mechanisms to capture test results for surveillance when the testing is so decentralised. A new generation of POC molecular tests that are highly sensitive and specific, robust and easy to use are now available for deployment in low resource settings. Decentralisation of testing outside of the laboratory can put tremendous stress on the healthcare system and presents challenges for training and quality assurance. A feature of many of these POC molecular devices is that they are equipped with data transmission capacities. In a digital age, it is possible to link data from diagnostic laboratories and POC test readers and devices to provide data on testing coverage, disease trends and timely information for early warning of infectious disease outbreaks to inform design or optimisation of disease control and elimination programmes. Data connectivity also allows control programmes to monitor the quality of tests and testing, and optimise supply chain management; thus, increasing the efficiency of healthcare systems and improving patient outcomes. PMID:26553825

  13. Diagnostics in a digital age: an opportunity to strengthen health systems and improve health outcomes.

    PubMed

    Peeling, Rosanna W

    2015-11-01

    Diagnostics play a critical role in clinical decision making, and in disease control and prevention. Rapid point-of-care (POC) tests for infectious diseases can improve access to diagnosis and patient management, but the quality of these tests vary, quality of testing is often not assured and there are few mechanisms to capture test results for surveillance when the testing is so decentralised. A new generation of POC molecular tests that are highly sensitive and specific, robust and easy to use are now available for deployment in low resource settings. Decentralisation of testing outside of the laboratory can put tremendous stress on the healthcare system and presents challenges for training and quality assurance. A feature of many of these POC molecular devices is that they are equipped with data transmission capacities. In a digital age, it is possible to link data from diagnostic laboratories and POC test readers and devices to provide data on testing coverage, disease trends and timely information for early warning of infectious disease outbreaks to inform design or optimisation of disease control and elimination programmes. Data connectivity also allows control programmes to monitor the quality of tests and testing, and optimise supply chain management; thus, increasing the efficiency of healthcare systems and improving patient outcomes.

  14. Employment outcomes of transition-aged adults with autism spectrum disorders: a state of the States report.

    PubMed

    Burgess, Sloane; Cimera, Robert E

    2014-01-01

    The primary purpose of this study was to evaluate the employment outcomes of transition-aged adults with autism spectrum disorders (ASD) served by vocational rehabilitation services (VR) over the last 10 years by state. A secondary purpose was to compare employment outcomes of individuals with ASD to those of the overall transition-aged population served by VR for the same time period. Although there was variability both within and among states, the results of this study indicate that, over time, the number of young adults with ASD seeking VR services has increased; however, employment outcomes including the percent of adults with ASD achieving employment, the number of hours worked, and wages earned have not improved for this group. The cost to provide VR services to transition-aged adults with ASD was relatively stable over time. Transition-aged adults with ASD were more likely to become successfully employed as a result of receiving VR services than the overall population of transition-aged adults served by VR. However, the employed transition-aged adults consistently worked fewer hours and earned lower wages than those in the overall population. Factors that may influence variability within and among states, and between groups, and implications for research and practice are discussed.

  15. Outcomes of children of extremely low birthweight and gestational age in the 1990's.

    PubMed

    Hack, M; Fanaroff, A A

    1999-01-01

    Advances in perinatal care have improved the chances for survival of extremely low birthweight (< 800 g) and gestational age (< 26 weeks) infants. A review of the world literature and our own experience reveals that at 23 weeks gestation survival ranges from 2% to 35%. At 24 weeks gestation the range is 17% to 58%, and at 25 weeks gestation 35% to 85%. Differences in population descriptors, in the initiation and withdrawal of treatment and the duration of survival considered may account for the wide variations in the reported ranges of survival. Major neonatal morbidity increases with decreasing gestational age and birthweight. The rates of severe cerebral ultrasound abnormality range at 23 weeks gestation from 10% to 83%, at 24 weeks from 17% to 64% and at 25 weeks gestation from 10% to 22%. At 23 weeks gestation, chronic lung disease occurs in 57% to 70% of survivors, at 24 weeks in 33% to 89%, and at 25 weeks gestation in 16% to 71% of survivors. When compared to children born prior to the 1990's, the rates of neurodevelopmental disability have, in general, remained unchanged. Of 30 survivors reported at 23 weeks gestation nine (30%) are severely disabled. At 24 weeks gestation the rates of severe neurodevelopmental disability (including subnormal cognitive function, cerebral palsy, blindness and deafness) range from 17% to 45%, and at 25 weeks gestation 12% to 35% are similarly affected. In Cleveland, Ohio, we compared the outcomes of 114 children with birthweight 500-749 g born 1990-1992 to 112 infants born 1993-1995. Twenty month survival was similar (43% vs 38%). The use of antenatal and postnatal steroids increased (10% vs 54% and 43% vs 84%, respectively, P< 0.001), however the rates of chronic lung disease increased from 41% to 63% (P = 0.06). There was a significant increase in the rate of subnormal cognitive function at 20 months corrected age (20% vs 48%, P < 0.02) and a trend to an increase in the rate of cerebral palsy (10% vs 16%) and

  16. Acute Coronary Syndrome Does Not Have a Negative Impact on Outcomes after Coronary Artery Bypass Grafting in Patients with Left Main Disease

    PubMed Central

    Takanashi, Shuichiro

    2015-01-01

    Purpose: Early and long-term outcomes of coronary artery bypass grafting (CABG) in patients with left main disease (LMD) with acute coronary syndrome (ACS) have never been assessed. Methods: Between September 2004 and April 2012, 459 patients with LMD underwent first-time isolated CABG. Of those, 191 patients had ACS and 268 did not. Early and late postoperative outcomes were compared between two groups. Results: Patients in the LMD+ACS group were older and more likely to be female. Left ventricular ejection fraction was lower in the LMD+ACS group. In both groups, bilateral internal thoracic artery grafts were used in over 90% of patients and off-pump technique in over 95%. Operative death rate was not significantly different between the groups (LMD+ACS: 2.1% vs. LMD–ACS: 0.4%). Log-rank test revealed that the actuarial survival rate (79.2 ± 3.7% vs. 81.5 ± 3.5%) and freedom from major adverse cardiac and cerebrovascular events (MACCE) (69.2 ± 4.2% vs. 67.0 ± 4.1%) were similar between groups at 7 years. Multivariate analyses demonstrated that ACS was not identified as an independent predictor of operative death, late mortality, and late MACCE. Conclusion: ACS did not have a negative impact on early and late outcomes of CABG in patients with LMD. PMID:25641028

  17. Maternal Schooling and Children's Relative Inequalities in Developmental Outcomes: Evidence from the 1947 School Leaving Age Reform in Britain

    ERIC Educational Resources Information Center

    Sabates, Ricardo; Duckworth, Kathryn

    2010-01-01

    This paper investigates whether mothers' participation in post-compulsory education impacts on children's relative inequalities across four developmental outcomes. The empirical analysis uses information from children born in 1958 in Britain. Mothers of the 1958 British cohort were affected by the 1947 school leaving age reform, which increased…

  18. The Relationship between Perceived Computer Competence and the Employment Outcomes of Transition-Aged Youths with Visual Impairments

    ERIC Educational Resources Information Center

    Zhou, Li; Smith, Derrick W.; Parker, Amy T.; Griffin-Shirley, Nora

    2013-01-01

    Introduction: The study reported here explored the relationship between the self-perceived computer competence and employment outcomes of transition-aged youths with visual impairments. Methods: Data on 200 in-school youths and 190 out-of-school youths with a primary disability of visual impairment were retrieved from the database of the first…

  19. Evidence-Based Systematic Review: Effects of Different Service Delivery Models on Communication Outcomes for Elementary School-Age Children

    ERIC Educational Resources Information Center

    Cirrin, Frank M.; Schooling, Tracy L.; Nelson, Nickola W.; Diehl, Sylvia F.; Flynn, Perry F.; Staskowski, Maureen; Torrey, T. Zoann; Adamczyk, Deborah F.

    2010-01-01

    Purpose: The purpose of this investigation was to conduct an evidence-based systematic review (EBSR) of peer-reviewed articles from the last 30 years about the effect of different service delivery models on speech-language intervention outcomes for elementary school-age students. Method: A computer search of electronic databases was conducted to…

  20. Does age of onset of risk behaviors mediate the relationship between child abuse and neglect and outcomes in middle adulthood?

    PubMed

    Horan, Jacqueline M; Widom, Cathy Spatz

    2015-03-01

    Child maltreatment has been linked with a number of risk behaviors that are associated with long-lasting maladaptive outcomes across multiple domains of functioning. This study examines whether the ages of onset of four risk behaviors-sexual intercourse, alcohol use, drug use, and criminal behavior-mediate the relationship between child maltreatment and outcomes in middle adulthood among a sample of court-documented victims of child abuse/neglect and matched controls (N = 1,196; 51.7% female; 66.2% White, 32.6% Black). Adult outcomes included employment status, welfare receipt, internalizing symptoms of anxiety and depressive symptoms, substance use problems, and criminal arrests. The results indicated gender differences in these relationships. For females, age of onset of sexual intercourse mediated the relationship between child abuse/neglect and both internalizing symptoms and substance use problems in middle adulthood. For males, age at first criminal arrest mediated the relationship between child abuse/neglect and extensive involvement in the justice system in middle adulthood. Age of onset of alcohol use and drug use did not mediate the relationship between child abuse/neglect and middle adult outcomes. This study expands current knowledge by identifying associations between early initiation of risk behavior in one domain and later, continuing problems in different domains. Thus, early initiation of specific risk behaviors may have more wide-ranging negative consequences than are typically considered during intervention or treatment and strategies may need to target multiple domains of functioning.

  1. What is the main driver of ageing in long-lived winter honeybees: antioxidant enzymes, innate immunity, or vitellogenin?

    PubMed

    Aurori, Cristian M; Buttstedt, Anja; Dezmirean, Daniel S; Mărghitaş, Liviu A; Moritz, Robin F A; Erler, Silvio

    2014-06-01

    To date five different theories compete in explaining the biological mechanisms of senescence or ageing in invertebrates. Physiological, genetical, and environmental mechanisms form the image of ageing in individuals and groups. Social insects, especially the honeybee Apis mellifera, present exceptional model systems to study developmentally related ageing. The extremely high phenotypic plasticity for life expectancy resulting from the female caste system provides a most useful system to study open questions with respect to ageing. Here, we used long-lived winter worker honeybees and measured transcriptional changes of 14 antioxidative enzyme, immunity, and ageing-related (insulin/insulin-like growth factor signaling pathway) genes at two time points during hibernation. Additionally, worker bees were challenged with a bacterial infection to test ageing- and infection-associated immunity changes. Gene expression levels for each group of target genes revealed that ageing had a much higher impact than the bacterial challenge, notably for immunity-related genes. Antimicrobial peptide and antioxidative enzyme genes were significantly upregulated in aged worker honeybees independent of bacterial infections. The known ageing markers vitellogenin and IlP-1 were opposed regulated with decreasing vitellogenin levels during ageing. The increased antioxidative enzyme and antimicrobial peptide gene expression may contribute to a retardation of senescence in long-lived hibernating worker honeybees.

  2. Does neonatal morphine use affect neuropsychological outcomes at 8 to 9 years of age?

    PubMed

    de Graaf, Joke; van Lingen, Richard A; Valkenburg, Abraham J; Weisglas-Kuperus, Nynke; Groot Jebbink, Liesbeth; Wijnberg-Williams, Barbara; Anand, Kanwaljeet J S; Tibboel, Dick; van Dijk, Monique

    2013-03-01

    Morphine is widely used to treat severe pain in neonatal intensive care unit patients. Animal studies suggest adverse long-term side effects of neonatal morphine, but a follow-up study of 5-year-old children who participated in a morphine-placebo controlled trial as newborns found no such effects on the child's general functioning. This study indicated that morphine may negatively affect response inhibition, a domain of executive functions. Therefore, we performed a second follow-up study in the same population at the age of 8 to 9 years, focused on the child's general functioning in terms of intelligence, visual motor integration, and behavior and on executive functions. Children in the morphine group showed significantly less externalizing problems according to the parents but more internalizing behavior according to the teachers, but only after adjustment for intelligence quotient (IQ), potential confounders using a propensity score, and additional open-label morphine. Morphine-treated children showed significantly fewer problems with executive functions in daily life as rated by parents for the subscales inhibition and organization of materials and for planning/organizing as rated by the teachers. After adjustment for IQ and the propensity score, executive functioning as rated by the parents remained statistically significantly better in the morphine-treated group. The influence of the additional morphine given was not of a significant influence for any of the outcome variables. Overall, the present study demonstrates that continuous morphine infusion of 10 μg/kg/h during the neonatal period does not harm general functioning and may even have a positive influence on executive functions at 8 to 9 years.

  3. Mental Health Outcomes of Cocaine-Exposed Children at 6 Years of Age

    PubMed Central

    Linares, Teresa J.; Singer, Lynn T.; Kirchner, H. Lester; Short, Elizabeth J.; Min, Meeyoung O.; Hussey, Patrick; Minnes, Sonia

    2008-01-01

    Objective To assess 6-year-old cocaine- and noncocaine-exposed children's mental health outcomes controlling for potential confounders. Methods The sample consisted of 322 children [169 cocaine exposed (CE) and 153 noncocaine exposed (NCE)] enrolled in a longitudinal study since birth. At age 6, children were assessed for mental health symptoms using the Dominic Interactive (DI), a child self-report measure, and the Child Behavior Checklist (CBCL), a caregiver report of behavioral problems. Results CE children were more likely to self-report symptoms in the probable clinical range for oppositional defiant disorder (ODD) and attention deficit hyperactivity disorder (ADHD). In contrast, prenatal cocaine exposure was not related to child behavior based on the CBCL. After control for exposure, CE children in adoptive or foster care were rated as having more problems with aggression, externalizing behaviors, and total behavioral problems than NCE children and CE children in maternal or relative care. Also, CE children in adoptive or foster care self-reported more externalizing symptoms than CE children in maternal or relative care and NCE children. Findings could not be attributed to caregiver intelligence or depressive symptoms, or to the quality of the home environment. Conclusions CE children report more symptoms of ODD and ADHD than nonexposed children. Adoptive or foster caregivers rated their CE children as having more behavioral problems than did maternal or relative caregivers of CE children or parents of NCE children. Although further studies are needed to understand the basis for the more negative ratings by adoptive or foster caregivers of their CE children, the self-report of CE children indicates a need for psychological interventions. PMID:15802608

  4. School-aged functioning of children diagnosed with autism spectrum disorder before age three: parent-reported diagnostic, adaptive, medication, and school placement outcomes.

    PubMed

    Towle, Patricia O; Vacanti-Shova, Karyn; Shah, Shristi; Higgins-D'alessandro, Ann

    2014-06-01

    Eighty children with early autism spectrum disorder (ASD) diagnoses (under 36 months) were identified using a chart abstraction protocol applied to early intervention charts. Parents filled out questionnaires by mail when the children were school-aged (ages 6-16 years). Similar to previous studies, approximately 20% no longer had ASD diagnoses; the other participants were assigned to Moderate/Severe versus Mild ASD outcome groups. These three groups were compared across several variables, including diagnostic features and functional features including adaptive behavior, social experiences, medication use, and school placement. The findings expand our knowledge about outcomes in longitudinal studies of children with ASD, as well as provide support for using relatively indirect methods (chart review, parent questionnaire) to gather this type of information.

  5. Preliminary fission track ages for samples from western Maine: Implications for the low temperature thermal history of the region

    SciTech Connect

    Lux, D.R. . Dept. of Geological Sciences); Johnson, K. )

    1992-01-01

    In order to elucidate the low temperature cooling history of the region, 12 preliminary samples from a N-S traverse from the central Sebago batholith to the Chain of Ponds pluton were selected for fission track dating. The range of Ar-40/Ar-39 ages from the selected samples is 140 Ma (371--231 Ma) for biotites, 63 Ma (304--241 Ma) for muscovites and 61 Ma (375--304 Ma) for hornblendes. Twelve samples were dated by the external detector method and yield ages between 114 and 79 Ma. The southern most samples from the Sebago batholith and Songo pluton, within the highest metamorphic zones, are the youngest and range from 101 to 79 Ma. Those from the Mooselookmeguntic and Chain of Ponds plutons, within lower metamorphic zones, vary between 114 and 92 Ma. This general discordance trend is similar but of much smaller magnitude than the regional pattern of Ar-40/Ar-39 cooling ages. The much smaller range of apatite ages than biotite ages suggests that large differences in the thermal regime across of the region during Late Paleozoic time had largely been erased by the Early Cretaceous. The new fission track ages are interpreted to represent regional cooling through the apatite closure temperature, assumed to be ca 100 C. Young apatite ages may be the result of a regional thermal disturbance related to the intrusion of magmas of the White Mountains Plutonic Suite, as the youngest plutons are similar in age to the apatites. Alternatively, they could be the result of regional exhumation of the Acadian orogen. The authors conclude that the latter interpretation is more consistent with their data and attribute the ages to time of regional exhumation and uplift through the apatite closure temperature.

  6. New [sup 40]Ar/[sup 39]Ar mica ages from eastern New Hampshire and southern Maine: Implications for the exhumation history of the region

    SciTech Connect

    Lux, D.R.; West, D.P. Jr. . Dept. of Geological Science)

    1993-03-01

    It has long been recognized that micas from the high-grade metamorphic terrane of Maine and New Hampshire have anomalously young K-Ar ages. Furthermore, ages show systematic spatial patterns. Samples from western New Hampshire are youngest and become progressively older towards the east. In the Kearsarge-Central Maine Synclinorium (KCMS) of western Maine, ages are oldest along the northern terminus of high grade metamorphism and become progressively younger towards the southwest. In order to understand this peculiar relationship, micas from 20 sites in eastern New Hampshire and southern Maine were dated by the [sup 40]Ar/[sup 39]Ar method. The following relationships are observed: (1) Micas from the KCMS of southern New Hampshire have Permo-Carboniferous ages and coexisting micas are highly discordant, (2) micas from within or very near the Massabesic Gneiss Complex have young ages ([approximately]240--250 Ma) and show little to no discordance, (3) with one exception, micas from south of the Sebago batholith in Maine are also young ([approximately]240--250 Ma) and show little to no discordance. North of the Sebago batholith the transition to older micas is gradual. Mica ages from the Massabesic Gneiss Complex are younger than in surrounding regions and the transition to older ages roughly coincides with the Campbell Hill and Flint Hill faults. Outside the zone of young micas, cooling curves are concave upward for the same temperature interval. The young micas are concordant indicating rapid cooling but they are [approximately]40 Ma younger than the time of Late Paleozoic metamorphism. Therefore the young ages cannot be explained by rapid post-metamorphic cooling. The authors believe the accelerated cooling is the result of regional tectonic exhumation related to the earliest stages of rifting associated with opening of the Atlantic.

  7. Prediction of Preadolescent Overweight and Poor Cardiometabolic Outcome in Children up to 6 Years of Age: Research Protocol

    PubMed Central

    Wijga, Alet; Vergouwe, Yvonne; Heijmans, Martijn W; Jaddoe, Vincent WV; Twisk, Jos WR; Raat, Hein

    2016-01-01

    Background Dynamic risk estimations may enable targeting primary prevention of overweight and overweight-related adverse cardiometabolic outcome in later life, potentially serving as a valuable addition to universal primary prevention. This approach seems particularly promising in young children, as body mass index (BMI) changes at a young age are highly predictive of these outcomes, and parental lifestyle interventions at a young age are associated with improved long-term outcome. Objective This paper describes the design of our study, which aims to develop digitized tools that can be implemented in the Dutch Child Health Care (CHC) system or by pediatricians for children up to 6 years of age. These tools will enable (1) dynamically predicting the development of overweight, hypertension or prehypertension, low high-density lipoprotein cholesterol (HDL-C) values, and high total cholesterol to HDL-C ratio by early adolescence and (2) identifying children who are likely to have poor cardiometabolic outcome by the age of 5-6 years and by the age of 10 years. Methods Data will be obtained from the Generation R (n=7893) and Prevention and Incidence of Asthma and Mite Allergy (PIAMA; n=3963) cohorts, two Dutch prenatally recruited cohorts. We will select candidate predictors that can be assessed during the first visit and/or during subsequent visits to the CHC center or pediatrician, including sex; parental age, education level, and BMI; smoking exposure; ethnicity; birth weight; gestational age; breastfeeding versus formula feeding; and growth data through the age of 6 years. We will design dynamic prediction models that can be updated with new information obtained during subsequent CHC visits, allowing each measurement to be added to the model. Performance of the model will be assessed in terms of discrimination and calibration. Finally, the model will be validated both internally and externally using the combined cohort data and then converted into a computer

  8. Effect of Young Maternal Age on Obstetric and Perinatal Outcomes: Results from the Tertiary Center in Turkey

    PubMed Central

    Demirci, Oya; Yılmaz, Ertuğrul; Tosun, Özgür; Kumru, Pınar; Arınkan, Arzu; Mahmutoğlu, Didar; Selçuk, Selçuk; Dolgun, Zehra Nihal; Arısoy, Resul; Erdoğdu, Emre; Tarhan, Nazan

    2016-01-01

    Background: Young maternal age is variously defined in studies of its effect on obstetrics and perinatal outcomes. Also, pregnancy has been reported as the leading cause of death in adolescent girls in low- and middle-income countries. Aims: The aim of the study was to evaluate whether young maternal age was associated with an increased risk of obstetrics and perinatal adverse outcomes. Study Design: Case-control study. Methods: This case-control study was derived from a database of the medical records between January 2008 and December 2012. In the present study, 1374 teenage pregnancy and 1294 adult pregnancy cases were included. After restriction of analyses to singleton primiparous women, 1282 teenage pregnancy and 735 adult pregnancy cases were analyzed. Maternal age was separated into three groups: 15 and less, 16–19, and 20–34 years. Adjusted odds ratios (ORs) were derived through logistic regression models for the potential confounding factors. Results: Adolescents aged 15 years and younger had higher risks of preterm delivery, early preterm delivery, intrauterine fetal death and neonatal death compared with women aged 20 to 34 years after adjustment for confounding factors. In addition, both groups of adolescents had higher risks for anemia and episiotomy and lower risk of cesarean delivery. The rates of preeclampsia, gestational diabetes, chronic diseases, intrauterine growth restriction (IUGR) were higher in the adult group. Conclusion: Younger maternal age was correlated with increased risks of preterm delivery, fetal and neonatal death and anemia. PMID:27308080

  9. [Cleaning and disinfection in nursing homes. Data on quality of structure, process and outcome in nursing homes in Frankfurt am Main, Germany, 2011].

    PubMed

    Heudorf, U; Gasteyer, S; Samoiski, Y; Voigt, K

    2012-08-01

    Due to the Infectious Disease Prevention Act, public health services in Germany are obliged to check the infection prevention in hospitals and other medical facilities as well as in nursing homes. In Frankfurt/Main, Germany, standardized control visits have been performed for many years. In 2011 focus was laid on cleaning and disinfection of surfaces. All 41 nursing homes were checked according to a standardized checklist covering quality of structure (i.e. staffing, hygiene concept), quality of process (observation of the cleaning processes in the homes) and quality of output, which was monitored by checking the cleaning of fluorescent marks which had been applied some days before and should have been removed via cleaning in the following days before the final check. In more than two thirds of the homes, cleaning personnel were salaried, in one third external personnel were hired. Of the homes 85% provided service clothing and all of them offered protective clothing. All homes had established hygiene and cleaning concepts, however, in 15% of the homes concepts for the handling of Norovirus and in 30% concepts for the handling of Clostridium difficile were missing. Regarding process quality only half of the processes observed, i.e. cleaning of hand contact surfaces, such as handrails, washing areas and bins, were correct. Only 44% of the cleaning controls were correct with enormous differences between the homes (0-100%). The correlation between quality of process and quality of output was significant. There was good quality of structure in the homes but regarding quality of process and outcome there was great need for improvement. This was especially due to faults in communication and coordination between cleaning personnel and nursing personnel. Quality outcome was neither associated with the number of the places for residents nor with staffing. Thus, not only quality of structure but also quality of process and outcome should be checked by the public health

  10. Artificial Aging Effects on Cryogenic Fracture Toughness of the Main Structural Alloy for the Super Lightweight Tank

    NASA Technical Reports Server (NTRS)

    Chen, P. S.; Stanton, W. P.

    2002-01-01

    In 1996, Marshall Space Flight Center developed a multistep heating rate-controlled (MSRC) aging technique that significantly enhanced cryogenic fracture toughness (CFT) and reduced the statistical spread of fracture toughness values in alloy 2195 by controlling the location and size of strengthening precipitate T1. However, it could not be readily applied to flight-related hardware production, primarily because large-scale production furnaces are unable to maintain a heating rate of 0.6 C (1 F)/hr. In August 1996, a new program was initiated to determine whether the MSRC aging treatment could be further modified to facilitate its implementation to flight hardware production. It was successfully redesigned into a simplified two-step aging treatment consisting of 132 C (270 F)/20 hr + 138 C (280 F)/40 hr. Results indicated that two-step aging can achieve the same yield strength levels as those produced by conventional aging while providing greatly improved ductility. Two-step aging proved to be very effective at enhancing CFT, enabling previously rejected materials to meet simulated service requirements. Cryogenic properties are improved by controlling T1 nucleation and growth so that they are promoted in the matrix and suppressed in the subgrain boundaries.

  11. A New Aging Treatment for Improving Cryogenic Toughness of the Main Structural Alloy of the Super Lightweight Tank

    NASA Technical Reports Server (NTRS)

    Chen, P. S.; Stanton, W. P.

    1996-01-01

    Marshall Space Flight Center (MSFC) has developed a new technique that can enhance cryogenic fracture toughness and reduce the statistical spread of toughness values in alloy 2195. This aging treatment can control the location and size of strengthening precipitate T1, making improvements possible in cryogenic fracture toughness (CFT) and fracture toughness ratio (FTR). At the start of this program, design of experiments (DOE) ingot No. 10 was used as a baseline for aging process development and optimization. The new aging treatment was found to be very effective, improving CFT by approximately 15 to 20 percent for DOE ingot No. 10. To further evaluate the repeatability and effectiveness of this new treatment, the investigators selected and tested three more lots of alloy 2195, using 1.75-in-thick gauge plates with FTR values ranging from 0.85 to 1.07. The new aging treatment effectively enhanced CFT and FTR values for all three lots. In one instance, the material was considered rejectable because it did not meet the minimum FTR value (1.0) of the super lightweight tank (SLWT). The new aging treatment improved its FTR from 0.85 to 1.01, making this material acceptable for use in the SLWT.

  12. Therapeutics with SPION-labeled stem cells for the main diseases related to brain aging: a systematic review

    PubMed Central

    Alvarim, Larissa T; Nucci, Leopoldo P; Mamani, Javier B; Marti, Luciana C; Aguiar, Marina F; Silva, Helio R; Silva, Gisele S; Nucci-da-Silva, Mariana P; DelBel, Elaine A; Gamarra, Lionel F

    2014-01-01

    The increase in clinical trials assessing the efficacy of cell therapy for structural and functional regeneration of the nervous system in diseases related to the aging brain is well known. However, the results are inconclusive as to the best cell type to be used or the best methodology for the homing of these stem cells. This systematic review analyzed published data on SPION (superparamagnetic iron oxide nanoparticle)-labeled stem cells as a therapy for brain diseases, such as ischemic stroke, Parkinson’s disease, amyotrophic lateral sclerosis, and dementia. This review highlights the therapeutic role of stem cells in reversing the aging process and the pathophysiology of brain aging, as well as emphasizing nanotechnology as an important tool to monitor stem cell migration in affected regions of the brain. PMID:25143726

  13. Dating slate belts using 40Ar/39Ar geochronology and zircon ages from crosscutting plutons: A case study from east-central Maine, USA

    NASA Astrophysics Data System (ADS)

    Ghanem, Hind; Kunk, Michael; Ludman, Allan; Bish, David; Wintsch, Robert

    2016-04-01

    Determining the tectonic significance of slate belts is a persistent problem in many orogenic belts because of the lack of time constraints on the age of deposition and the age(s) of cleavages. We have solved this problem in east-central Maine where the ages of the regional Acadian cleavage (S1) and local ductile fault zone cleavage (S2) were both constrained using 40Ar/39Ar geochronology and the ages of crosscutting plutons. Applying 40Ar/39Ar geochronology to rocks with multiple generations of muscovite was possible because each cleavage-forming muscovite records a crystallization age rather than a cooling age due to the low grade of regional metamorphism. Evidence for metamorphic crystallization in rocks dominated by regional Acadian cleavage (S1) comes from the truncations of detrital and authigenic muscovite and chlorite grains by new muscovite and chlorite grains that define the S1 foliation. In rocks that display two foliations, the evidence comes from the truncations of chlorite and muscovite grains defining all earlier fabrics by new muscovite grains in the younger folia (S2). Step-heating experiments using the 40Ar/39Ar technique on twelve samples all yielded sigmoidal age spectra. The low-temperature steps produced a hump in the age spectra, indicating 39Ar recoil into adjacent interlayered chlorite grains, the latter interlayering confirmed by back-scattered electron imaging. Continuing steps climbed steadily from those with minimum apparent ages as young as ~381 Ma to steps with maximum ages as old as 466 Ma. The samples with the lowest minimum apparent age steps are those in which the S2 cleavage-forming mica population dominates. In contrast, the oldest apparent age steps are from samples that have the highest modal abundance of detrital micas. The Middle Ordovician age of the maximum age steps is interpreted to be the minimum cooling age of the detrital micas. The minimum 40Ar/39Ar age steps of muscovite in the samples that display only S1 cleavage

  14. Launching an Interdisciplinary "International Summer School on Ageing" (ISSA): Aims, Methodology, and Outcomes

    ERIC Educational Resources Information Center

    Barbabella, F.; Chiatti, C.; Di Rosa, M.; Lamura, G.; Martin-Matthews, A.; Papa, R.; Svensson, T.

    2016-01-01

    Despite the increasing availability of gerontological training programs, knowledge of their contents, characteristics, methods, and outcomes remains limited. However, the transition from multidisciplinarity to interdisciplinary orientations is now fundamental to such training, providing participants from diverse academic orientations and…

  15. Dietary Patterns and Relationship to Obesity-Related Health Outcomes and Mortality in Adults 75 Years of Age or Greater

    PubMed Central

    Hsiao, P.Y.; Mitchell, D.C.; Coffman, D.L.; Wood, G. Craig; Hartman, T.J.; Still, C.; Jensen, G.L.

    2015-01-01

    Background The prevalence of obesity-related adverse health outcomes is increasing among older adults. Because it is thought that nutrition plays an important role in successful aging, there has been considerable interest in the association between dietary patterns of older adults and obesity-related health outcomes. Objective This study examined the association between dietary patterns and mortality and prevalence of obesity-related health outcomes, namely cardiovascular disease (CVD), type 2 diabetes mellitus, hypertension, and metabolic syndrome (MetSyn), over a 5-year follow-up period in adults aged 75 years or greater. Design A longitudinal observational study with cross-sectional dietary assessment. Setting Rural Central Pennsylvania. Participants Community-dwelling older adults (N = 449; 76.5 years old; 57% female). Measurements Multiple, unannounced, 24-hour dietary recalls were used to collect dietary intake. Cluster analysis was used to derive dietary patterns. Prevalence of CVD, diabetes mellitus, hypertension, and MetSyn was extracted from outpatient electronic medical records. Logistic regression was used to examine the associations between dietary patterns and health outcomes and mortality. Results ‘Sweets and Dairy’, ‘Health-Conscious’ and ‘Western’ dietary patterns were identified. Compared to the ‘Health-Conscious’ pattern, those in the ‘Sweets and Dairy’ pattern had increased odds of hypertension over the follow-up period; adjusted odds ratio (95% CI) was 2.18 (1.11-4.30). No significant associations were found for CVD, diabetes mellitus, MetSyn or mortality with dietary patterns. Conclusions These findings support the potential value of healthy dietary patterns in the management of hypertension in older adults. We did not observe any other strong associations between dietary patterns and health outcomes or mortality in persons ≥ 75 years of age; thus failing to support the use of overly restrictive diet prescriptions for

  16. Trajectory of the main GABAergic interneuron populations from early development to old age in the rat primary auditory cortex.

    PubMed

    Ouellet, Lydia; de Villers-Sidani, Etienne

    2014-01-01

    In both humans and rodents, decline in cognitive function is a hallmark of the aging process; the basis for this decrease has yet to be fully characterized. However, using aged rodent models, deficits in auditory processing have been associated with significant decreases in inhibitory signaling attributed to a loss of GABAergic interneurons. Not only are these interneurons crucial for pattern detection and other large-scale population dynamics, but they have also been linked to mechanisms mediating plasticity and learning, making them a prime candidate for study and modeling of modifications to cortical communication pathways in neurodegenerative diseases. Using the rat primary auditory cortex (A1) as a model, we probed the known markers of GABAergic interneurons with immunohistological methods, using antibodies against gamma aminobutyric acid (GABA), parvalbumin (PV), somatostatin (SOM), calretinin (CR), vasoactive intestinal peptide (VIP), choline acetyltransferase (ChAT), neuropeptide Y (NPY), and cholecystokinin (CCK) to document the changes observed in interneuron populations across the rat's lifespan. This analysis provided strong evidence that several but not all GABAergic neurons were affected by the aging process, showing most dramatic changes in expression of parvalbumin (PV) and somatostatin (SOM) expression. With this evidence, we show how understanding these trajectories of cell counts may be factored into a simple model to quantify changes in inhibitory signaling across the course of life, which may be applied as a framework for creating more advanced simulations of interneuronal implication in normal cerebral processing, normal aging, or pathological processes.

  17. Effect of age on the outcome of renal transplantation: A single-center experience

    PubMed Central

    Ozkul, Faruk; Erbis, Halil; Yilmaz, Vural Taner; Kocak, Huseyin; Osmanoglu, Ibrahim Ali; Dinckan, Ayhan

    2016-01-01

    Objectives: To analyze the effects of old age on renal transplantation (Tx) results and graft survival, and compared elderly patient population with the young patients. Methods: A total of 1946 renal transplant were performed from 1537 living and 409 cadaveric donors between 2003 and 2014. The recipients were divided into two groups according to their age at the time of transplantation. The young age group consisted of 18-59-year-old, and the elderly group consisted of the ones ≥ 60 years. Results: Acute rejection was seen in 19.5% of the young age group while this rate was 16.7% in the old age group (p=0.535). DGF was seen in 6.3% of the young age group, and in 13.5% of the old age group (p<0.001). Analysis of the overall survival rates demonstrated that 1.6% of the patients in the young age group and 6.8% of the patients in the old age groups died (p=0.003). Conclusions: Renal transplant had high graft survival rates in the elderly as in the young patients. However, the risks for complications were higher in the older age group compared to the younger age group. Thus, it is important to make a careful selection among elderly candidates for renal transplantation. PMID:27648022

  18. Does psychotherapy work with school-aged youth? A meta-analytic examination of moderator variables that influence therapeutic outcomes.

    PubMed

    Fedewa, Alicia L; Ahn, Soyeon; Reese, Robert J; Suarez, Marietta M; Macquoid, Ahjane; Davis, Matthew C; Prout, H Thompson

    2016-06-01

    The present study is a quantitative synthesis of the available literature to investigate the efficacy of psychotherapy for children's mental health outcomes. In particular, this study focuses on potential moderating variables-study design, treatment, client, and therapist characteristics-that may influence therapeutic outcomes for youth but have not been thoroughly accounted for in prior meta-analytic studies. An electronic search of relevant databases resulted in 190 unpublished and published studies that met criteria for inclusion in the analysis. Effect sizes differed by study design. Pre-post-test designs resulted in absolute magnitudes of treatment effects ranging from |-0.02| to |-0.76| while treatment versus control group comparison designs resulted in absolute magnitudes of treatment effects ranging from |-0.14| to |-2.39|. Changes in youth outcomes larger than 20% were found, irrespective of study design, for outcomes focused on psychosomatization (29% reduction), school attendance (25% increase), and stress (48% reduction). The magnitude of changes after psychotherapy ranged from 6% (externalizing problems) to 48% (stress). Several moderator variables significantly influenced psychotherapy treatment effect sizes, including frequency and length of treatment as well as treatment format. However, results did not support the superiority of a single type of intervention for most outcomes. Implications for therapy with school-aged youth and future research are discussed.

  19. Relations between Preschool Attention Span-Persistence and Age 25 Educational Outcomes.

    PubMed

    McClelland, Megan M; Acock, Alan C; Piccinin, Andrea; Rhea, Sally Ann; Stallings, Michael C

    2013-04-01

    This study examined relations between children's attention span-persistence in preschool and later school achievement and college completion. Children were drawn from the Colorado Adoption Project using adopted and non-adopted children (N = 430). Results of structural equation modeling indicated that children's age 4 attention span-persistence significantly predicted math and reading achievement at age 21 after controlling for achievement levels at age 7, adopted status, child vocabulary skills, gender, and maternal education level. Relations between attention span-persistence and later achievement were not fully mediated by age 7 achievement levels. Logistic regressions also revealed that age 4 attention span-persistence skills significantly predicted the odds of completing college by age 25. The majority of this relationship was direct and was not significantly mediated by math or reading skills at age 7 or age 21. Specifically, children who were rated one standard deviation higher on attention span-persistence at age 4 had 48.7% greater odds of completing college by age 25. Discussion focuses on the importance of children's early attention span-persistence for later school achievement and educational attainment.

  20. Relations between Preschool Attention Span-Persistence and Age 25 Educational Outcomes

    PubMed Central

    McClelland, Megan M.; Acock, Alan C.; Piccinin, Andrea; Rhea, Sally Ann; Stallings, Michael C.

    2012-01-01

    This study examined relations between children’s attention span-persistence in preschool and later school achievement and college completion. Children were drawn from the Colorado Adoption Project using adopted and non-adopted children (N = 430). Results of structural equation modeling indicated that children’s age 4 attention span-persistence significantly predicted math and reading achievement at age 21 after controlling for achievement levels at age 7, adopted status, child vocabulary skills, gender, and maternal education level. Relations between attention span-persistence and later achievement were not fully mediated by age 7 achievement levels. Logistic regressions also revealed that age 4 attention span-persistence skills significantly predicted the odds of completing college by age 25. The majority of this relationship was direct and was not significantly mediated by math or reading skills at age 7 or age 21. Specifically, children who were rated one standard deviation higher on attention span-persistence at age 4 had 48.7% greater odds of completing college by age 25. Discussion focuses on the importance of children’s early attention span-persistence for later school achievement and educational attainment. PMID:23543916

  1. Antecedents and outcomes of level and rates of change in perceived control: The moderating role of age.

    PubMed

    Infurna, Frank J; Okun, Morris A

    2015-10-01

    Perceived control is interrelated with aging-related outcomes across adulthood and old age. Relatively little is known, however, about resources as antecedents of longitudinal change in perceived control and the role of perceived control as a buffer against mortality risk when these resources are low. We examined functional limitations, depressive symptoms, and emotional support as antecedents of level and rates of change in perceived control and whether level and rates of change in perceived control buffer the relations between high functional limitations and depressive symptoms and lack of emotional support and mortality risk. In addition, age was investigated as a moderator of these associations. To do so, we used 16-year longitudinal data from participants in the Americans' Changing Lives (ACL) Study who were at least 40 years old at Wave 1 (N = 2,540; mean age = 62.85, SD = 12.15; 65% women). With respect to the antecedents of perceived control, results indicated that more functional limitations and depressive symptoms, as well as having less emotional support, were each associated with lower levels of and stronger declines in perceived control over time. Additionally, more functional limitations and less emotional support were more detrimental to levels of perceived control in midlife compared to old age. Focusing on outcomes of perceived control, more positive rates of change in perceived control protected against mortality risk for those with fewer functional limitations and depressive symptoms and more emotional support, and this was more pronounced for functional limitations and depressive symptoms in old age as compared to midlife. Our discussion focuses on the complex interplay among perceived control, functional limitations, depressive symptoms, and emotional support; how they vary with age; and the implications of our findings for interventions.

  2. Age-related differences in outcome and severity of DIC in children with septic shock and purpura.

    PubMed

    Hazelzet, J A; Risseeuw-Appel, I M; Kornelisse, R F; Hop, W C; Dekker, I; Joosten, K F; de Groot, R; Hack, C E

    1996-12-01

    We studied the influence of age on mortality and severity of clotting abnormalities in 79 children (median age: 3.1 years) with meningococcal sepsis. Parameters of coagulation and fibrinolysis and plasma levels of cytokines were prospectively measured on admission. The mortality rate was 27%. The age of survivors was significantly different from that of non-survivors (p = 0.013). With the exception of FVII, vWF and t-PA, parameters of coagulation and fibrinolysis, as well as plasma cytokine levels were related to outcome. Patients were divided in two groups: younger and older than median age. The mortality in children < or = 3.1 years was 40% versus 13% in children > 3.1 years (p = 0.006). In contrast to cytokine levels, which were not different between the two age groups, fibrinogen, prothrombin, factors V, VII, VIII, vWF, protein C, antithrombin, FDP, and the ratio PA1-1/t-PA were related to age, indicating a more severe coagulopathy in children < or = 3.1 years despite a similar degree of inflammatory response. A relative deficiency of coagulation factors due to an immature state of the clotting system, as well as an inadequate fibrinolytic response, both related to age may have caused this more severe coagulative response in younger children, and may have contributed to the higher mortality rate.

  3. Outcome of Silicone Ring Vertical Gastroplasty in Patients Aged 50 Years and Older.

    PubMed

    Kyzer; Ramadan; Avraham; Belavsky; Hopp; Chaimoff

    1996-08-01

    BACKGROUND: The authors studied the results Of silicone ring vertical gastroplasty (SRVG) in Patients aged 50 years and older. METHODS: The early and late Postoperative results in 28 patients aged.50 Years or older undergoing SRVG were reviewed retrospectively, The results were compared to those of 370 Patients Younger than 50 years operated during the same period. RESULTS: There was no Postoperative mortality among patients aged 50 years and older. There was a significantly higher incidence Of Pulmonary embolus and wound infection among patients aged 50 years and older (P < 0.05). The weight loss did not differ significantly between the two studied age groups. CONCLUSION: SRVG may performed on patients aged 50 years or older with acceptable complication rate and favorable postoperative results. PMID:10729875

  4. Antidepressant use and risk of cardiovascular outcomes in people aged 20 to 64: cohort study using primary care database

    PubMed Central

    Hill, Trevor; Morriss, Richard; Moore, Michael; Arthur, Antony; Hippisley-Cox, Julia

    2016-01-01

    Objective To assess associations between different antidepressant treatments and rates of three cardiovascular outcomes (myocardial infarction, stroke or transient ischaemic attack, and arrhythmia) in people with depression. Design Cohort study. Setting UK general practices contributing to the QResearch primary care database. Participants 238 963 patients aged 20 to 64 years with a first diagnosis of depression between 1 January 2000 and 31 July 2011. Exposures Antidepressant class (tricyclic and related antidepressants, selective serotonin reuptake inhibitors, other antidepressants), dose, duration of use, and commonly prescribed individual antidepressant drugs. Main outcome measures First diagnoses of myocardial infarction, stroke or transient ischaemic attack, and arrhythmia during five years’ follow-up. Cox proportional hazards models were used to estimate hazard ratios, adjusting for potential confounding variables. Results During five years of follow-up, 772 patients had a myocardial infarction, 1106 had a stroke or transient ischaemic attack, and 1452 were diagnosed as having arrhythmia. No significant associations were found between antidepressant class and myocardial infarction over five years’ follow-up. In the first year of follow-up, patients treated with selective serotonin reuptake inhibitors had a significantly reduced risk of myocardial infarction (adjusted hazard ratio 0.58, 95% confidence interval 0.42 to 0.79) compared with no use of antidepressants; among individual drugs, fluoxetine was associated with a significantly reduced risk (0.44, 0.27 to 0.72) and lofepramine with a significantly increased risk (3.07, 1.50 to 6.26). No significant associations were found between antidepressant class or individual drugs and risk of stroke or transient ischaemic attack. Antidepressant class was not significantly associated with arrhythmia over five years’ follow-up, although the risk was significantly increased during the first 28 days of

  5. Introduction to patient-reported outcome item banks: issues in minority aging research.

    PubMed

    Templin, Thomas N; Hays, Ron D; Gershon, Richard C; Rothrock, Nan; Jones, Richard N; Teresi, Jeanne A; Stewart, Anita; Weech-Maldonado, Robert; Wallace, Steve

    2013-04-01

    Pre-Conference Workshop in conjunction with the Annual Meeting of the Geriatrics Society of America San Diego Convention Center, San Diego, CA, USA, 14 November 2012 In 2004, the NIH awarded contracts to initiate the development of high-quality psychological and neuropsychological outcome measures for the improved assessment of health-related outcomes. The workshop introduced these measurement development initiatives, the measures created and the NIH-supported resource (Assessment Center) for internet or tablet-based test administration and scoring. Presentations covered item response theory and assessment of test bias, construction of item banks and computerized adaptive testing, and the different ways in which qualitative analyses contribute to the definition of construct domains and the refinement of outcome constructs. The panel discussion included questions about representativeness of samples and the assessment of cultural bias. PMID:23570428

  6. Associations between Charlson Comorbidity Index and surgical risk severity and the surgical outcomes in advanced-age patients.

    PubMed

    Larson, Kelly J; Hamlin, Ryan J; Sprung, Juraj; Schroeder, Darrell R; Weingarten, Toby N

    2014-06-01

    The Charlson Comorbidity Index (CCI) has not been assessed for elderly (95 years of age or older) surgical patients. We examined the association between the CCI and life-threatening complications and 30-day mortality rate. Medical records of patients 95 years old or older from 2004 through 2008 were reviewed for major postoperative morbidity or death. Logistic regression analyses of age, sex, the CCI, American College of Cardiology/American Heart Association Surgical Risk Stratification, and surgical urgency were performed to identify associations with poor surgical outcome. One hundred eighty-seven patients were identified (mean [standard deviation] age, 96.6 [1.9] years; median [interquartile range] CCI, 4 [2 to 6]). Ninety patients (48.1%) underwent moderate-risk and 20 (10.7%) underwent high-risk surgical procedures. Twenty patients (10.7%) died within 30 postoperative days and 20 others had major morbidity. Only moderate-risk (P = 0.045) and high-risk surgical procedures (P = 0.001) were associated with poor outcome. Patients of advanced age have high rates of morbidity and death after surgical procedures. These events are associated with surgical risk stratification and are independent of patient comorbidities. Risks, benefits, and alternatives must be considered carefully and discussed with patients and their families before deciding to proceed with high-risk surgery.

  7. How Do Groups Work? Age Differences in Performance and the Social Outcomes of Peer Collaboration

    ERIC Educational Resources Information Center

    Leman, Patrick J.

    2015-01-01

    Do children derive different benefits from group collaboration at different ages? In the present study, 183 children from two age groups (8.8 and 13.4 years) took part in a class quiz as members of a group, or individually. In some groups, cohesiveness was made salient by awarding prizes to the top performing groups. In other groups, prizes were…

  8. Childhood Brain Insult: Can Age at Insult Help Us Predict Outcome?

    ERIC Educational Resources Information Center

    Anderson, Vicki; Spencer-Smith, Megan; Leventer, Rick; Coleman, Lee; Anderson, Peter; Williams, Jackie; Greenham, Mardee; Jacobs, Rani

    2009-01-01

    Until recently, the impact of early brain insult (EBI) has been considered to be less significant than for later brain injuries, consistent with the notion that the young brain is more flexible and able to reorganize in the context of brain insult. This study aimed to evaluate this notion by comparing cognitive and behavioural outcomes for…

  9. Social-Emotional Factors and Academic Outcomes among Elementary-Aged Children

    ERIC Educational Resources Information Center

    McKown, Clark; Russo-Ponsaran, Nicole M.; Allen, Adelaide; Johnson, Jason K.; Warren-Khot, Heather K.

    2016-01-01

    Social-emotional comprehension involves encoding, interpreting, and reasoning about social-emotional information, and self-regulating. This study examined the mediating pathways through which social-emotional comprehension and social behaviour are related to academic outcomes in two ethnically and socioeconomically heterogeneous samples totaling…

  10. Traumatic Brain Injury in School-Age Children: Academic and Social Outcome.

    ERIC Educational Resources Information Center

    Arroyos-Jurado, Elsa; Paulsen, Jane S.; Merrell, Kenneth W.; Lindgren, Scott D.; Max, Jeffrey E.

    2000-01-01

    Examines the academic, behavioral, and social outcomes of a cohort of children and adolescents (N=43) following a traumatic brain injury. Findings reveal that premorbid functions were significant predictors of reading and spelling achievement and adaptive functioning. Discusses implications of results including program development, reintegration…

  11. Educational Outcomes of Children Adopted from Eastern Europe, Now Ages 8-12

    ERIC Educational Resources Information Center

    Neuharth-Pritchett, Stacey

    2006-01-01

    Longitudinal data on the cognitive and physical outcomes of children adopted from Eastern Europe by American families is limited. While there is clear evidence that many children adopted from Eastern European countries are more at risk for medical concerns and developmental delay, research that follows these children into their elementary school…

  12. Conduct Disorder and Psychosocial Outcomes at Age 30: Early Adult Psychopathology as a Potential Mediator

    ERIC Educational Resources Information Center

    Olino, Thomas M.; Seeley, John R.; Lewinsohn, Peter M.

    2010-01-01

    Conduct disorder (CD) is associated with a number of adverse psychosocial outcomes in adulthood. There is consistent evidence that CD is predictive of antisocial behavior, but mixed evidence that CD is predictive of other externalizing and internalizing disorders. Further, externalizing and internalizing disorders are often associated with similar…

  13. Lumbar Interbody Fusion Outcomes in Degenerative Lumbar Disease : Comparison of Results between Patients Over and Under 65 Years of Age

    PubMed Central

    Jo, Dae-Jean; Jun, Jae-Kyun; Kim, Ki-Tack

    2010-01-01

    Objective To evaluate the clinical and radiological outcomes of lumbar interbody fusion and its correlation with various factors (e.g., age, comorbidities, fusion level, bone quality) in patients over and under 65 years of age who underwent lumbar fusion surgery for degenerative lumbar disease. Methods One-hundred-thirty-three patients with lumbar degenerative disease underwent lumbar fusion surgery between June 2006 and June 2007 and were followed for more than one year. Forty-eight (36.1%) were older than 65 years of age (group A) and 85 (63.9%) were under 65 years of age (group B). Diagnosis, comorbidities, length of hospital stay, and perioperative complications were recorded. The analysis of clinical outcomes was based on the visual analogue scale (VAS). Radiological results were evaluated using plain radiographs. Clinical outcomes, radiological outcomes, length of hospital stay, and complication rates were analyzed in relation to lumbar fusion level, the number of comorbidities, bone mineral density (BMD), and age. Results The mean age of the patients was 61.2 years (range, 33-86 years) and the mean BMD was -2.2 (range, -4.8 to -2.8). The mean length of hospital stay was 15.0 days (range, 5-60 days) and the mean follow-up was 23.0 months (range, 18-30 months). Eighty-five (64.0%) patients had more than one preoperative comorbidities. Perioperative complications occurred in 27 of 133 patients (20.3%). The incidence of overall complication was 22.9% in group A, and 18.8% in group B but there was no statistical difference between the two groups. The mean VAS scores for the back and leg were significantly decreased in both groups (p < 0.05), and bony fusion was achieved in 125 of 133 patients (94.0%). There was no significant difference in bony union rates between groups A and B (91.7% in group A vs. 95.3% in group B, p = 0.398). In group A, perioperative complications were more common with the increase in fusion level (p = 0.027). Perioperative complications in

  14. Association between Birth Interval and Cardiovascular Outcomes at 30 Years of Age: A Prospective Cohort Study from Brazil

    PubMed Central

    Devakumar, D.; Hallal, P. C.; Horta, B. L.; Barros, F. C.; Wells, J. C. K.

    2016-01-01

    Background Birth interval is an important and potentially modifiable factor that is associated with child health. Whether an association exists with longer-term outcomes in adults is less well known. Methods Using the 1982 Pelotas (Brazil) Birth Cohort Study, the association of birth interval with markers of cardiovascular health at 30 years of age was examined. Multivariable linear regression was used with birth interval as a continuous variable and categorical variable, and effect modification by gender was explored. Results Birth interval and cardiovascular data were present for 2,239 individuals. With birth interval as a continuous variable, no association was found but stratification by gender tended to show stronger associations for girls. When compared to birth intervals of <18 months, as binary variable, longer intervals were associated with increases in height (1.6 cm; 95% CI: 0.5, 2.8) and lean mass (1.7 kg; 95% CI: 0.2, 3.2). No difference was seen with other cardiovascular outcomes. Conclusions An association was generally not found between birth interval and cardiovascular outcomes at 30 years of age, though some evidence existed for differences between males and females and for an association with height and lean mass for birth intervals of 18 months and longer. PMID:26890250

  15. Clinical and oncological outcomes after surgical excision of parotid gland tumours in patients aged over 80 years.

    PubMed

    Fakhry, N; Aldosari, B; Michel, J; Giorgi, R; Collet, C; Santini, L; Giovanni, A; Dessi, P

    2013-11-01

    The objective of this study was to evaluate the surgical and long-term outcomes of a series of patients aged over 80 years, operated on for parotid neoplasms. Among 614 parotidectomies for neoplasms performed between 1998 and 2008, 34 patients (5.5%) aged over 80 years were identified retrospectively. Pathological examination showed a malignant tumour in 24 and a benign tumour in 10 cases. Overall survival (OS) and disease-free survival (DFS) were determined by Kaplan-Meier analysis. A search for parameters that could influence the postoperative complication rate and long-term outcomes was carried out by univariate analysis. There was no postoperative death. Eight patients (24%) had postoperative complications. Malignant histopathology (P=0.05) and radical resection (P=0.033) were found to have a significant negative impact on the postoperative course. Focusing on malignant tumours, only histopathological type (metastasis vs primary tumour) was found to have a negative impact on OS. The 2- and 5-year OS rates were 86% and 86%, respectively, for primary tumours, and 67% and 29%, respectively, for metastasis (P=0.05). Malignant or benign histopathology had no impact on OS. Our results showed acceptable clinical and long-term oncological outcomes in very elderly patients operated on for parotid tumours, including malignant tumours.

  16. Associated terrestrial and marine fossils in the late-glacial Presumpscot Formation, southern Maine, USA, and the marine reservoir effect on radiocarbon ages

    USGS Publications Warehouse

    Thompson, W.B.; Griggs, C.B.; Miller, N.G.; Nelson, R.E.; Weddle, T.K.; Kilian, T.M.

    2011-01-01

    Excavations in the late-glacial Presumpscot Formation at Portland, Maine, uncovered tree remains and other terrestrial organics associated with marine invertebrate shells in a landslide deposit. Buds of Populus balsamifera (balsam poplar) occurred with twigs of Picea glauca (white spruce) in the Presumpscot clay. Tree rings in Picea logs indicate that the trees all died during winter dormancy in the same year. Ring widths show patterns of variation indicating responses to environmental changes. Fossil mosses and insects represent a variety of species and wet to dry microsites. The late-glacial environment at the site was similar to that of today's Maine coast. Radiocarbon ages of 14 tree samples are 11,907??31 to 11,650??5014C yr BP. Wiggle matching of dated tree-ring segments to radiocarbon calibration data sets dates the landslide occurrence at ca. 13,520+95/??20calyr BP. Ages of shells juxtaposed with the logs are 12,850??6514C yr BP (Mytilus edulis) and 12,800??5514C yr BP (Balanus sp.), indicating a marine reservoir age of about 1000yr. Using this value to correct previously published radiocarbon ages reduces the discrepancy between the Maine deglaciation chronology and the varve-based chronology elsewhere in New England. ?? 2011 University of Washington.

  17. Associated terrestrial and marine fossils in the late-glacial Presumpscot Formation, southern Maine, USA, and the marine reservoir effect on radiocarbon ages

    NASA Astrophysics Data System (ADS)

    Thompson, Woodrow B.; Griggs, Carol B.; Miller, Norton G.; Nelson, Robert E.; Weddle, Thomas K.; Kilian, Taylor M.

    2011-05-01

    Excavations in the late-glacial Presumpscot Formation at Portland, Maine, uncovered tree remains and other terrestrial organics associated with marine invertebrate shells in a landslide deposit. Buds of Populus balsamifera (balsam poplar) occurred with twigs of Picea glauca (white spruce) in the Presumpscot clay. Tree rings in Picea logs indicate that the trees all died during winter dormancy in the same year. Ring widths show patterns of variation indicating responses to environmental changes. Fossil mosses and insects represent a variety of species and wet to dry microsites. The late-glacial environment at the site was similar to that of today's Maine coast. Radiocarbon ages of 14 tree samples are 11,907 ± 31 to 11,650 ± 50 14C yr BP. Wiggle matching of dated tree-ring segments to radiocarbon calibration data sets dates the landslide occurrence at ca. 13,520 + 95/-20 cal yr BP. Ages of shells juxtaposed with the logs are 12,850 ± 65 14C yr BP ( Mytilus edulis) and 12,800 ± 55 14C yr BP ( Balanus sp.), indicating a marine reservoir age of about 1000 yr. Using this value to correct previously published radiocarbon ages reduces the discrepancy between the Maine deglaciation chronology and the varve-based chronology elsewhere in New England.

  18. Attributing heart attack and stroke to "Old Age": Implications for subsequent health outcomes among older adults.

    PubMed

    Stewart, Tara L; Chipperfield, Judith G; Perry, Raymond P; Hamm, Jeremy M

    2016-01-01

    This study assessed the extent to which older adults attribute a recent heart attack/stroke to "old age," and examined consequences for subsequent lifestyle behavior and health-care service utilization. Community-dwelling adults (N = 57, ages 73-98 years) were interviewed about their heart attack/stroke, and an objective health registry provided data on health-care utilization over a 3-year period. Endorsement of "old age" as a cause of heart attack/stroke negatively predicted lifestyle behavior change, and positively predicted frequency of physician visits and likelihood of hospitalization over the subsequent 3 years. Findings suggest the importance of considering "old age" attributions in the context of cardiovascular health events.

  19. Optimal Developmental Outcomes for the Child Aged Six to Twelve: Social, Moral, Cognitive, and Emotional Dimensions.

    ERIC Educational Resources Information Center

    Baker, Kay

    2001-01-01

    Discusses Montessori theories for development of social, moral, cognitive, and emotional dimensions of the human personality during the second plane of development--age six to puberty--as these theories relate to the theory of optimal experience. (JPB)

  20. Childhood Symptoms of ADHD Overrule Comorbidity in Relation to Psychosocial Outcome at Age 15: A Longitudinal Study

    PubMed Central

    Norén Selinus, Eva; Molero, Yasmina; Lichtenstein, Paul; Larson, Tomas; Lundström, Sebastian; Anckarsäter, Henrik; Gumpert, Clara Hellner

    2015-01-01

    Objective Neurodevelopmental problems (NDPs) may influence the transition from childhood to adolescence. Our aim was to study long-term psychosocial outcomes of NDPs, focusing on ADHD. Method Data was collected through a telephone interview with parents of twins at ages 9 or 12 years. NDP screen-positive children were clinically assessed at age 15; N = 450. Psychosocial outcome concerning peers, school, internalizing problems, antisocial behavior, alcohol misuse, drug misuse, and impaired daily functioning was examined. Results Even after controlling for other NDP comorbidity, screen-positivity for ADHD doubled or tripled the odds of later psychosocial problems. When controlling for parental education level, the significant effect of ADHD remained only for antisocial behavior and impaired daily functioning. Conclusions Signs of NDPs as well as other psychiatric diagnoses at ages 9 or 12 years are associated with a more problematic adolescence. However, despite the presence of comorbidity, early ADHD symptoms stand out as the most important risk factor for later antisocial development and impaired daily functioning. PMID:26360378

  1. Is Age a Determinant Factor in EVAR as a Predictor of Outcomes or in the Selection Procedure? Our Experience

    PubMed Central

    Machado, Rui; Teixeira, Gabriela; Oliveira, Pedro; Loureiro, Luís; Pereira, Carlos; Almeida, Rui

    2016-01-01

    Introduction Endovascular aneurysm repair (EVAR) is the therapy of choice in high risk patients with abdominal aortic aneurysm. The good results described are leading to the broadening of clinical indications to younger patients. However, reintervention rates seem higher and even with successful treatment sometimes there is growth of the aneurysm sac and rupture, meaning a failure of the therapeutic goal. This study proposes to analyse the impact of age in patients' selection and post-EVAR results. Methods The clinical records of consecutive patients undergoing endovascular aneurysm repair, between 2001 and 2013, were retrospectively reviewed. Patients were divided according to age groups (<70, 70-80 and >80 years). Gender, body mass index, aneurysm anatomic features, neck characteristics, iliac morphology, surgical indication, endograft type, anesthesic risk classification, length of stay, reinterventions and mortality were analysed and compared. Results The study included 171 patients, 161 (94.1%) men, and mean age 74.1±8.9 years. The age group under 70 had 32% of the patients. Only three characteristics were found different among age groups: 1) body mass index was higher in younger patients, with a considerable trend toward significance (P=0.06); 2) surgical indication, in the younger group, surgeon's and the patient's option were more proeminent (P<0.05); 3) erectile dysfunction was higher in elderly group (P<0.05). No other clinical and anatomical characteristics or final outcomes were found statisticaly different among age groups. Conclusion The absence of statistically differences in mortality and reinterventions among age groups suggests that age by itself is not a relevant factor in endovascular aneurysm repair. Indeed, the three characteristics different in younger (obesity, sexual function and patient's choice) favor endovascular aneurysm repair. PMID:27556312

  2. Impacts of sources and aging on submicrometer aerosol properties in the marine boundary layer across the Gulf of Maine

    NASA Astrophysics Data System (ADS)

    Quinn, P. K.; Bates, T. S.; Coffman, D.; Onasch, T. B.; Worsnop, D.; Baynard, T.; de Gouw, J. A.; Goldan, P. D.; Kuster, W. C.; Williams, E.; Roberts, J. M.; Lerner, B.; Stohl, A.; Pettersson, A.; Lovejoy, E. R.

    2006-12-01

    Measurements were made on board the NOAA RV Ronald H. Brown during the second New England Air Quality Study (NEAQS 2004) to determine the source of the aerosol in the region and how sources and aging processes affect submicrometer aerosol chemical composition and optical properties. Using the Lagrangian particle dispersion model FLEXPART in combination with gas phase tracer compounds, local (urban), regional (NE U.S. urban corridor of Washington, D.C.; New York; and Boston), and distant (midwest industries and North American forest fires) sources were identified. Submicrometer aerosol measured near the source region (Boston Harbor) had a molar equivalence ratio near one with respect to NH4+, NO3-, and SO4=, had a large mass fraction of particulate organic matter (POM) relative to SO4=, and had relatively unoxidized POM. As distance from the source region increased, the submicrometer aerosol measured in the marine boundary layer became more acidic and had a lower POM mass fraction, and the POM became more oxidized. The relative humidity dependence of light extinction reflected the change in aerosol composition being lower for the near-source aerosol and higher for the more processed aerosol. A factor analysis performed on a combined data set of aerosol and gas phase parameters showed that the POM measured during the experiment was predominantly of secondary anthropogenic origin.

  3. A 22-year follow-up of the nonsurgical expansion of maxillary and mandibular arches in a young adult: Are the outcomes stable, relapsed, or unstable with aging?

    PubMed

    Valladares-Neto, José; Evangelista, Karine; Miranda de Torres, Hianne; Melo Pithon, Matheus; Alves Garcia Santos Silva, Maria

    2016-09-01

    Adult maxillary and mandible arch expansion without a surgical approach can be uncertain when long-term stability is considered. This case report describes the treatment of a 19-year-old woman with an Angle Class I malocclusion with constricted maxillary and mandibular arches. The patient's main complaint was mandibular anterior crowding. The treatment plan included expansion of the mandibular arch concurrent with semirapid maxillary expansion. An edgewise appliance was used to adjust the final occlusion. Smile esthetics and dental alignment were improved without straightening the profile. This outcome was followed up with serial dental casts for 22 years after treatment. At the end of that period, the occlusion and tooth alignment were clinically satisfactory, further supported by mandibular fixed retention. However, the transverse widths were continuously and gradually reduced over time, superposing orthodontic transverse relapse and natural arch constriction caused by aging. PMID:27585782

  4. The role of age and comorbidities in postoperative outcome of mitral valve repair

    PubMed Central

    Bonnet, Vincent; Boisselier, Clément; Saplacan, Vladimir; Belin, Annette; Gérard, Jean-Louis; Fellahi, Jean-Luc; Hanouz, Jean-Luc; Fischer, Marc-Olivier

    2016-01-01

    Abstract The average age of patients undergoing mitral valve repair is increasing each year. This retrospective study aimed to compare postoperative complications of mitral valve repair (known to be especially high-risk) between 2 age groups: under and over the age of 80. Patients who underwent mitral valve repair were divided into 2 groups: group 1 (<80 years old) and group 2 (≥80 years old). Baseline characteristics, pre- and postoperative hemodynamic data, surgical characteristics, and postoperative follow-up data until hospital discharge were collected. A total of 308 patients were included: 264 in group 1 (age 63 ± 13 years) and 44 in group 2 (age 83 ± 2 years). Older patients had more comorbidities (atrial fibrillation, history of cardiac decompensation, systemic hypertension, pulmonary hypertension, and chronic kidney disease) and they presented more postoperative complications (50.0% vs 33.7%; P = 0.043), with a longer hospital stay (8.9 ± 6.9 vs 6.6 ± 4.6 days; P = 0.005). To assess the burden of age, a propensity score was awarded to postoperative complications. Active smoking, chronic pulmonary disease, chronic kidney disease, associated ischemic heart disease, obesity, and cardio pulmonary by-pass duration were described as independent risk factors. When matched on this propensity score, there was no difference in morbidity or mortality between group 1 and group 2. Older patients suffered more postoperative complications, which were related to their comorbidities and not only to their age. PMID:27336886

  5. Mammography outcomes in a practice setting by age: prognostic factors, sensitivity, and positive biopsy rate.

    PubMed

    Linver, M N; Paster, S B

    1997-01-01

    The separate unplanned analysis of women ages 40-49 in population-based randomized controlled trials has resulted in demonstration of statistically significant breast cancer mortality reduction due to screening mammography in only two of the individual trials, and in all such trials only through meta-analysis. Therefore, many researchers have utilized the surrogate endpoints of tumor size and axillary lymph node status to evaluate screening efficacy. For the present study, these endpoints were evaluated in an audit of 854 screen-detected cancers found in 147,125 mammographic examinations performed in women over 40 between 1988 and 1994 in a community practice setting. The concerns that mammography in the 40-49 group has a lower sensitivity and higher biopsy rate were also addressed. Median invasive tumor size and lymph node positivity were found to be equally small (1.0-1.1 cm and 13.5-12.2%, respectively), and the sensitivity and overall biopsy rate were found to be constant over all ages 40 and above. Positive biopsy rate (PBR) varied directly with increasing age, paralleling the measured cancer detection rate in each decade, with no abrupt change at age 50. We conclude that modern mammography in a community practice setting can successfully detect breast cancers with favorable prognostic factors and achieve constant sensitivity and acceptable PBRs in all women over 40. Our data also suggest that many of the large differences seen by inappropriately dividing data at age 50 decrease or disappear when analysis is performed by decade.

  6. The baboon model (Papio hamadryas) of fetal loss: Maternal weight, age, reproductive history and pregnancy outcome

    PubMed Central

    Schlabritz-Loutsevitch, Natalia; Moore, Charleen M.; Lopez-Alvarenga, Juan Carlos; Dunn, Betty G.; Dudley, Donald; Hubbard, Gene B.

    2010-01-01

    Background Several risk factors are associated with the incidence of human stillbirths. The prevention of stillbirths in women is a pressing clinical problem. Methods We reviewed 402 pathology records of fetal loss occurring in a large baboon (Papio spp.) colony during a 15-year period. Clinical histories of 565 female baboons with one or more fetal losses during a 20-year period were analyzed for weight, age, and reproductive history. Results Fetal loss was most common at term (35.57%) and preterm (28.61%) and less common in the first half of gestation (11.20%) and post-term (5.22%). Greater maternal weight, older age, history of stillbirth and higher parity were independent predictors for stillbirth. An exponential increase in the incidence of fetal loss was observed beginning at age 14 years in baboons. Conclusion Fetal loss and maternal risk factors associated with stillbirths in baboons were similar to those documented in women. PMID:19017195

  7. The Influence of Age and Gender on Rehabilitation Outcomes in Nontraumatic Spinal Cord Injury

    PubMed Central

    New, Peter W; Epi, M Clin

    2007-01-01

    Study Design: Retrospective, 3-year case series. Objective: To investigate the relationship between gender and age and a range variables in patients with nontraumatic spinal cord injury (SCI). Setting: Tertiary medical unit specializing in rehabilitation of patients with nontraumatic SCI. Method: Participants were a consecutive series of 70 adult inpatients with nontraumatic SCI undergoing initial rehabilitation. The variables of interest were demographic characteristics, clinical features, complications, mortality, length of stay (LOS), mobility, bladder and bowel continence, and Functional Independence Measure (FIM) scores. Results: Men were younger than women, but the difference was not statistically significant (median 64 years vs 72.5 years, P =0.2). There was no statistically significant relationship between age or gender and the following: American Spinal Injury Association grade, level of injury, many SCI complications, mortality, LOS, walking ability, bladder management, and fecal continence. The only SCI complication that was related to age was pressure ulcers (<65 years = 20% vs ≥65 years = 50%, P = 0.04). Patients discharged home were more likely to be younger (P = 0.01) and male (P = 0.03). There was a significant negative correlation between patients' age and the discharge Rasch-transformed FIM motor (Spearman's ρ =−0.30, P = 0.015) and cognitive (Spearman's ρ =−0.25, P = 0.04) subscores. There were no significant relationships between gender and FIM subscale scores. Conclusions: Gender and age do not significantly influence most aspects of rehabilitation in patients with nontraumatic SCI. Age alone should not be used as a discriminator of ability to benefit from nontraumatic SCI rehabilitation. PMID:17684888

  8. Relative-age effect on competition outcomes at the World Youth and World Junior Athletics Championships.

    PubMed

    Hollings, Stephen C; Hume, Patria A; Hopkins, Will G

    2014-01-01

    The relative-age effect refers to a higher frequency of athletes with birthdates earlier in the competitive year. Track and field athletics has a 2-year competitive cycle at youth and junior levels that could make it particularly susceptible to the effect. We have therefore investigated the effect in athletics event finalists (first to eighth place) at the 2008 Junior Championships (men and women aged ≤ 19 years; n=1479) and the 2009 Youth Championships (boys and girls aged 16-17 years; n=1445). Counts of finalists differing in age by 1 year were estimated with Poisson regression and compared as factor effects (with ×/÷ 90% confidence limits and assessment of magnitude). The factor effects were: junior men 2.1 (×/÷ 1.4, large); junior women 1.7 (×/÷ 1.4, moderate); youth boys 3.7 (×/÷ 1.4, very large); youth girls 2.1 (×/÷ 1.3, large). Analysis by event group indicated the age effect was greatest in youth boys' sprints & hurdles (4.0, ×/÷ 1.7, very large), throws (7.2, ×/÷ 2.3, very large) and jumps (5.6, ×/÷ 1.9, very large), whereas it was smallest in junior men's throws (1.4, ×/÷ 1.4, small) and youth girls' jumps (1.4, ×/÷ 1.4, small). In conclusion, the marked relative-age effects in athletics must exclude some talented younger athletes from youth and junior championships and presumably discourage them from continuing to senior championships. The consequences are a lower overall standard of performance and, for some athletes, termination of involvement in athletics before realising their full potential. An alternative structure and calendar is needed to make youth and junior athletics championships more equitable.

  9. Comparative clinicopathological and outcome analysis of differentiated thyroid cancer in Saudi patients aged below 60 years and above 60 years

    PubMed Central

    AL-Qahtani, Khalid Hussain; Tunio, Mutahir A; Asiri, Mushabbab Al; Bayoumi, Yasser; Balbaid, Ali; Aljohani, Naji J; Fatani, Hanadi

    2016-01-01

    Introduction The aim of this study was to evaluate the treatment outcomes of differentiated thyroid cancer in Saudi patients aged above 60 years. Materials and methods Comparative analysis was performed in 252 patients aged 46–60 years (Group A) and 118 patients aged above 60 years (Group B), who had thyroidectomy, radioactive iodine-131, and thyroid-stimulating hormone suppression therapy between July 2000 and December 2012. Different clinicopathological features, treatment, complications, disease-free survival, and overall survival rates were compared. Results Mean age of patients in Group A was 51.9 years (range: 46–60), and mean age of those in Group B was 68.6 years (range: 62–97). Group B patients had higher positive lymph nodes (43.2%), P=0.011. The frequency of extrathyroidal extension, multifocality, and lymphovascular space invasion was seen more in Group B than in Group A. Postsurgical complications (permanent hypoparathyroidism, bleeding, and wound infections) were also seen more in Group B (P=0.043, P=0.011, and P=0.021, respectively). Group B patients experienced more locoregional recurrences (11.0%, P=0.025); similarly, more distant metastases were observed in Group B (15.3%, P=0.003). The 10-year disease-free survival rates were 87.6% in Group A and 70.8% in Group B (P<0.0001). Conclusion Differentiated thyroid cancer in patients aged above 60 years are more aggressive biologically and associated with a worse prognosis, and the morbidity is significantly high as compared to patients aged below 60 years. PMID:27621604

  10. Comparative clinicopathological and outcome analysis of differentiated thyroid cancer in Saudi patients aged below 60 years and above 60 years

    PubMed Central

    AL-Qahtani, Khalid Hussain; Tunio, Mutahir A; Asiri, Mushabbab Al; Bayoumi, Yasser; Balbaid, Ali; Aljohani, Naji J; Fatani, Hanadi

    2016-01-01

    Introduction The aim of this study was to evaluate the treatment outcomes of differentiated thyroid cancer in Saudi patients aged above 60 years. Materials and methods Comparative analysis was performed in 252 patients aged 46–60 years (Group A) and 118 patients aged above 60 years (Group B), who had thyroidectomy, radioactive iodine-131, and thyroid-stimulating hormone suppression therapy between July 2000 and December 2012. Different clinicopathological features, treatment, complications, disease-free survival, and overall survival rates were compared. Results Mean age of patients in Group A was 51.9 years (range: 46–60), and mean age of those in Group B was 68.6 years (range: 62–97). Group B patients had higher positive lymph nodes (43.2%), P=0.011. The frequency of extrathyroidal extension, multifocality, and lymphovascular space invasion was seen more in Group B than in Group A. Postsurgical complications (permanent hypoparathyroidism, bleeding, and wound infections) were also seen more in Group B (P=0.043, P=0.011, and P=0.021, respectively). Group B patients experienced more locoregional recurrences (11.0%, P=0.025); similarly, more distant metastases were observed in Group B (15.3%, P=0.003). The 10-year disease-free survival rates were 87.6% in Group A and 70.8% in Group B (P<0.0001). Conclusion Differentiated thyroid cancer in patients aged above 60 years are more aggressive biologically and associated with a worse prognosis, and the morbidity is significantly high as compared to patients aged below 60 years.

  11. Slip rate, magnitudes and ages of surface-rupturing events along the Main Frontal Thrust in Bhutan (Himalaya)

    NASA Astrophysics Data System (ADS)

    Ritz, J.; Berthet, T.; Ferry, M. A.; Pelgay, P.; Cattin, R.; Drukpa, D.; Braucher, R.; Chophel, J.; Thinley, K.; Hetényi, G.

    2013-12-01

    The Himalayas absorb about 20 mm.yr-1 of the convergence between India and Eurasia plate. Morphotectonics studies East of Bhutan yielded a Holocene shortening rate of 23 × 6.2 mm/yr consistent with the 21 × 1.5 mm/yr estimated in Nepal. Most of this crustal shortening is accommodated along the Main Frontal Thrust by major earthquakes (M≥8) that occurred in the past 1000 years. Between 89°E and 92°E, the MFT runs along the southern border of the Kingdom of Bhutan where no reliable historical record of major earthquakes exists (one strong historical earthquake would have occurred in 1713 after a Tibetan eyewitness reports). However, recent paleoseismic investigations in Nepal and on both side of Bhutan border suggest that a great earthquake may have ruptured a 700 to 800 km long section of the MFT during a single event around AD 1100. In December 2012, we carried out a first morphotectonic and paleosismologic study within two sites (Sarpang, Gelephu) along the MFT in central Bhutan. We identified several sequences of abandoned fluvial terraces that have been uplifted along the fault. From a kinematic GPS survey, we estimated that the oldest terrace sequence (T2) has a cumulative offset of 53.6 × 2.3 m. A younger sequence (T1) shows offsets of 4.5 × 0.5 m on the lower terrace (T1a) and 7.9 × 0.5 m on the upper one (T1b). The uplift on T1b may cumulate the vertical components of the two last seismic events that would have produced each a vertical offset of several meters. These preliminary observations suggest that the latest seismic event as well as the penultimate event correspond to two major seismic events with magnitudes greater than M8. After 14C dating (charcoals in sands on top of T1 terraces sequence), these two last seismic events occurred after 1000 AD. The youngest event may correspond to the historical event reported in 1713 AD, while the penultimate event could correspond the great medieval earthquake observed in trenches East and West of Bhutan

  12. THE CONTRIBUTIONS OF INTERACTIVE BINARY STARS TO DOUBLE MAIN-SEQUENCE TURNOFFS AND DUAL RED CLUMP OF INTERMEDIATE-AGE STAR CLUSTERS

    SciTech Connect

    Yang Wuming; Bi Shaolan; Tian Zhijia; Li Tanda; Liu Kang; Meng Xiangcun E-mail: woomyang@gmail.com

    2011-04-20

    Double or extended main-sequence turnoffs (DMSTOs) and dual red clump (RC) were observed in intermediate-age clusters, such as in NGC 1846 and 419. The DMSTOs are interpreted as that the cluster has two distinct stellar populations with differences in age of about 200-300 Myr but with the same metallicity. The dual RC is interpreted as a result of a prolonged star formation. Using a stellar population-synthesis method, we calculated the evolution of a binary-star stellar population. We found that binary interactions and merging can reproduce the dual RC in the color-magnitude diagrams of an intermediate-age cluster, whereas in actuality only a single population exists. Moreover, the binary interactions can lead to an extended main-sequence turnoff (MSTO) rather than DMSTOs. However, the rest of the main sequence, subgiant branch, and first giant branch are hardly spread by the binary interactions. Part of the observed dual RC and extended MSTO may be the results of binary interactions and mergers.

  13. Outcome Differences Across Age Groups. Data Notes. Volume 3, Number 2, March/April 2008

    ERIC Educational Resources Information Center

    Clery, Sue

    2008-01-01

    Using data from Achieving the Dream: Community College Count, this issue examines the differing developmental needs and enrollment and persistence patterns of Achieving the Dream students across different age groups. The data show older students in Achieving the Dream colleges tended to achieve higher grades and perform better academically than…

  14. Does Raising the State Compulsory School Attendance Age Achieve the Intended Outcomes? REL 2014-005

    ERIC Educational Resources Information Center

    Mackey, Philip E.; Duncan, Teresa G.

    2013-01-01

    Maryland recently raised its compulsory school attendance age from 16 to 18 in two stages: from 16 to 17 at the beginning of the 2014-15 school year and from 17 to 18 at the beginning of the 2016-17 school year (Maryland Senate Bill 362, 2012). The Maryland State Department of Education, a member of Regional Educational Laboratory…

  15. Psychiatric Outcomes at Age Seven for Very Preterm Children: Rates and Predictors

    ERIC Educational Resources Information Center

    Treyvaud, Karli; Ure, Alexandra; Doyle, Lex W.; Lee, Katherine J.; Rogers, Cynthia E.; Kidokoro, Hiroyuki; Inder, Terrie E.; Anderson, Peter J.

    2013-01-01

    Background: Uncertainty remains about the rate of specific psychiatric disorders and associated predictive factors for very preterm (VPT) children. The aims of this study were to document rates of psychiatric disorders in VPT children aged 7 years compared with term born children, and to examine potential predictive factors for psychiatric…

  16. Do Infant Vocabulary Skills Predict School-Age Language and Literacy Outcomes?

    ERIC Educational Resources Information Center

    Duff, Fiona J.; Reen, Gurpreet; Plunkett, Kim; Nation, Kate

    2015-01-01

    Background: Strong associations between infant vocabulary and school-age language and literacy skills would have important practical and theoretical implications: Preschool assessment of vocabulary skills could be used to identify children at risk of reading and language difficulties, and vocabulary could be viewed as a cognitive foundation for…

  17. A Narrative Review of Problem-Based Learning with School-Aged Children: Implementation and Outcomes

    ERIC Educational Resources Information Center

    Jerzembek, Gabi; Murphy, Simon

    2013-01-01

    This paper reviews empirical studies that have evaluated the impact of problem-based learning (PBL) on school-aged pupils, in order to summarise how it has been implemented and to assess its effects on academic and personal development. Following electronic searches of PsychINFO, the British Education Index and the Cochrane review database, six…

  18. Similar degrees of obesity induced by diet or aging cause strikingly different immunologic and metabolic outcomes.

    PubMed

    Krishna, Kanthi B; Stefanovic-Racic, Maja; Dedousis, Nikolaos; Sipula, Ian; O'Doherty, Robert M

    2016-03-01

    In obesity, adipose tissue (AT) and liver are infiltrated with Th-1 polarized immune cells, which are proposed to play an important role in the pathogenesis of the metabolic abnormalities of obesity. Aging is also associated with increased adiposity, but the effects of this increase on inflammation and associated metabolic dysfunction are poorly understood. To address this issue, we assessed insulin resistance (IR) andATand liver immunophenotype in aged, lean (AL) and aged, obese (AO) mice, all of whom were maintained on a standard chow diet (11% fat diet) throughout their lives. For comparison, these variables were also assessed in young, lean (YL) and young diet-induced obese mice (41% fat diet,YO). Despite similar body weight and fat accumulation,YOmice were substantially moreIRand had greater liver steatosis compared toAOmice.YOalso had elevated infiltration of macrophages/dendritic cells inATand liver, but these increases were absent inAO Furthermore, liver immune cells ofYOwere more Th-1 polarized thenAO Notably, aging was associated with accumulation of T cells, but this occurred independent of obesity. Together, the data suggest that reduced inflammation inAOunderlies the improved insulin sensitivity and lowered steatosis compared toYO.

  19. Relations between Preschool Attention Span-Persistence and Age 25 Educational Outcomes

    ERIC Educational Resources Information Center

    McClelland, Megan M.; Acock, Alan C.; Piccinin, Andrea; Rhea, Sally Ann; Stallings, Michael C.

    2013-01-01

    This study examined relations between children's attention span-persistence in preschool and later school achievement and college completion. Children were drawn from the Colorado Adoption Project using adopted and non-adopted children (N = 430). Results of structural equation modeling indicated that children's age 4 attention span-persistence…

  20. Choosing Assessment Instruments for Depression Outcome Research with School-Age Youth

    ERIC Educational Resources Information Center

    Muller, Brooke E.; Erford, Bradley T.

    2012-01-01

    Using effect size results from Erford et al.'s (2011) meta-analysis for treatment of depression in school-age youth, the authors analyzed 6 commonly used instruments for practical and technical strengths and weaknesses. Effect size estimates from these 6 instruments were compared to indicate likely results when used in future depression outcome…

  1. Treatment Moderators and Predictors of Outcome in the Treatment of Early Age Mania (TEAM) Study

    ERIC Educational Resources Information Center

    Vitiello, Benedetto; Riddle, Mark A.; Yenokyan, Gayane; Axelson, David A.; Wagner, Karen D.; Joshi, Paramjit; Walkup, John T.; Luby, Joan; Birmaher, Boris; Ryan, Neal D.; Emslie, Graham; Robb, Adelaide; Tillman, Rebecca

    2012-01-01

    Objective: Both the diagnosis and treatment of bipolar disorder in youth remain the subject of debate. In the Treatment of Early Age Mania (TEAM) study, risperidone was more effective than lithium or divalproex in children diagnosed with bipolar mania and highly comorbid with attention-deficit/hyperactivity disorder (ADHD). We searched for…

  2. Adult Learning in the Digital Age: Perspectives on Online Technologies and Outcomes

    ERIC Educational Resources Information Center

    Kidd, Terry T., Ed.; Keengwe, Jared, Ed.

    2010-01-01

    As instructors move further into the incorporation of 21st century technologies in adult education, a new paradigm of digitally-enriched mediated learning has emerged. This book provides a comprehensive framework of trends and issues related to adult learning for the facilitation of authentic learning in the age of digital technology. This…

  3. Longitudinal Analysis of Factors Associated with Successful Outcomes for Transition-Age Youths with Visual Impairments

    ERIC Educational Resources Information Center

    Connors, Elyse; Curtis, Amy; Emerson, Robert Wall; Dormitorio, Benedict

    2014-01-01

    Introduction: Transition-age youths with visual impairments have higher rates of unemployment than their peers without impairment, and factors associated with success after graduation have been examined; however, it is unknown whether these factors remain influential across the first decade after exiting high school. Methods: Five waves of the…

  4. Joint and Maternal Custody: The Outcome for Boys Aged 6-11 and Their Parents.

    ERIC Educational Resources Information Center

    Shiller, Virginia

    Although divorcing parents have a variety of child custody arrangements from which to choose, opinions are mixed as to which children benefit from which arrangements. To compare the adjustment of boys in joint and maternal physical custody and to investigate factors related to their adjustment, 20 joint custody families with a boy aged 6-11 and a…

  5. Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study

    PubMed Central

    Meador, Kimford J; Baker, Gus A; Browning, Nancy; Cohen, Morris J; Bromley, Rebecca L; Clayton-Smith, Jill; Kalayjian, Laura A; Kanner, Andres; Liporace, Joyce D; Pennell, Page B; Privitera, Michael; Loring, David W

    2013-01-01

    Summary Background Many women of childbearing potential take antiepileptic drugs, but the cognitive effects of fetal exposure are uncertain. We aimed to assess effects of commonly used antiepileptic drugs on cognitive outcomes in children up to 6 years of age. Methods In this prospective, observational, assessor-masked, multicentre study, we enrolled pregnant women with epilepsy on antiepileptic drug monotherapy (carbamazepine, lamotrigine, phenytoin, or valproate) between October, 1999, and February, 2004, at 25 epilepsy centres in the UK and the USA. Our primary outcome was intelligence quotient (IQ) at 6 years of age (age-6 IQ) in all children, assessed with linear regression adjusted for maternal IQ, antiepileptic drug type, standardised dose, gestational birth age, and use of periconceptional folate. We also assessed multiple cognitive domains and compared findings with outcomes at younger ages. This study is registered with ClinicalTrials.gov, number NCT00021866. Findings We included 305 mothers and 311 children (six twin pairs) in the primary analysis. 224 children completed 6 years of follow-up (6-year-completer sample). Multivariate analysis of all children showed that age-6 IQ was lower after exposure to valproate (mean 97, 95% CI 94–101) than to carbamazepine (105, 102–108; p=0·0015), lamotrigine (108, 105–110; p=0·0003), or phenytoin (108, 104–112; p=0·0006). Children exposed to valproate did poorly on measures of verbal and memory abilities compared with those exposed to the other antiepileptic drugs and on non-verbal and executive functions compared with lamotrigine (but not carbamazepine or phenytoin). High doses of valproate were negatively associated with IQ (r=−0·56, p<0·0001), verbal ability (r=−0·40, p=0·0045), non-verbal ability (r=−0·42, p=0·0028), memory (r=−0·30, p=0·0434), and executive function (r=−0·42, p=0·0004), but other antiepileptic drugs were not. Age-6 IQ correlated with IQs at younger ages, and IQ

  6. Phonological skills of children with specific expressive language impairment (SLI-E): outcome at age 3.

    PubMed

    Roberts, J; Rescorla, L; Giroux, J; Stevens, L

    1998-04-01

    Naturalistic speech samples of 29 3-year-olds diagnosed with specific expressive language delay (SU-E) were compared to those produced by 19 age-matched normally developing peers in order to determine their improvement in phonological skills since age 2, when Rescorla and Ratner (1996) studied them. Specifically, the groups were compared with regard to vocalization rate, verbalizations, fully intelligible utterances, phonetic inventories, percentages of consonants correct (PCC), phonological processes, and mean length of utterance (MLU). Results revealed that there was no significant difference between the groups in their numbers of vocalizations (as there had been at age 2), although there continued to be differences in their phonetic inventories, PCC scores, and overall intelligibility. These findings suggest that at age 2 the children with SU-E were not only less phonologically skilled but less talkative, whereas by age 3 they were equally vocal. Analysis of the phonetic inventories of the children demonstrated that for most consonants, the SLI-E group followed the some pattern of development as the comparison children, but more of the normally developing group had productive control of each consonant, consistent with findings of Rescorla and Ratner. There continued to be differences in intelligibility as measured by rates of verbalization (those utterances with at least one intelligible word) and fully intelligible utterances. Using these measures, we found that approximately half the SU-E children had caught up with their normally developing peers in terms of articulation, whereas half of them continued to be significantly delayed. Finally, although some of the late-bloomer group had caught up to the comparison children in language skills, as measured by MLU, many had not, suggesting that there was a tendency for the children to catch up in some articulation skills before catching up in language abilities. PMID:9570589

  7. Acute rejection in the elderly recipient: influence of age in the outcome of kidney transplantation.

    PubMed

    Palomar, Rosa; Ruiz, Juan C; Zubimendi, José A; Cotorruelo, Julio G; de Francisco, Angel L M; Rodrigo, Emilio; Sanz, Saturnino; Fernández-Fresnedo, Gema; Arias, Manuel

    2002-01-01

    Since the immune response in older recipients is weaker they should be less likely to reject a transplanted organ and should need less aggressive immunosuppressive treatment. Our aim was to record the incidence and severity of episodes of acute rejection (AR), estimate the influence of these events on graft survival of elderly recipients (> or = 60) and to compare these with that in younger ones. We performed 363 kidney transplants between 1/94 and 12/98, and recorded clinical and immunological data, incidence-severity of AR and cause of graft loss. Patients were divided into two groups, according to the age at transplantation: A (<60, n = 281/77.4%) and B (> 60, n = 82/22.6%). The percentage of aging recipients and mean age of donors and recipients increased throughout the period. Although the incidence of ATN was higher in the older group (29% vs.19%, p < 0.0001) the number of graft biopsies was equal in both groups. The incidence of AR was similar, 33.4% vs. 26.8%, pNS. The number of AR episodes per patient was 0.44 and 0.41 respectively. The severity of AR was: Banff grade I: A (40.3%)/B (45.7%) pNS; grade II: A (44.1%)/B (48.57) pNS; grade III: A (15.5%)/B (5.7%) pNS. Younger recipients presented a higher level of panel-reactive antibodies (PRA) (4.3% vs. 2.07%, p = 0.01). One-yearpatient survival was 96%/91% (p < 0.05) and graft survival was 81%/78% (pNS) respectively. The age of recipient does not seem to have influenced the incidence-severity of AR or the graft survival. Thus immunosuppression should be individualized for each patient and should not depend on the age at transplantation.

  8. Age, Predisposing Diseases, and Ultrasonographic Findings in Determining Clinical Outcome of Acute Acalculous Inflammatory Gallbladder Diseases in Children

    PubMed Central

    2016-01-01

    We evaluated clinical factors such as age, gender, predisposing diseases and ultrasonographic findings that determine clinical outcome of acute acalculous inflammatory gallbladder diseases in children. The patients were divided into the four age groups. From March 2004 through February 2014, clinical data from 131 children diagnosed as acute acalculous inflammatory gallbladder disease by ultrasonography were retrospectively reviewed. Systemic infectious diseases were the most common etiology of acute inflammatory gallbladder disease in children and were identified in 50 patients (38.2%). Kawasaki disease was the most common predisposing disease (28 patients, 21.4%). The incidence was highest in infancy and lowest in adolescence. The age groups were associated with different predisposing diseases; noninfectious systemic disease was the most common etiology in infancy and early childhood, whereas systemic infectious disease was the most common in middle childhood and adolescence (P = 0.001). Gallbladder wall thickening was more commonly found in malignancy (100%) and systemic infection (94.0%) (P = 0.002), whereas gallbladder distension was more frequent in noninfectious systemic diseases (60%) (P = 0.000). Ascites seen on ultrasonography was associated with a worse clinical course compared with no ascites (77.9% vs. 37.7%, P = 0.030), and the duration of hospitalization was longer in patients with ascites (11.6 ± 10.7 vs. 8.0 ± 6.6 days, P = 0.020). In conclusion, consideration of age and predisposing disease in addition to ultrasonographic gallbladder findings in children suspected of acute acalculous inflammatory gallbladder disease might result in better outcomes. PMID:27550491

  9. Heart valve disease in elderly Chinese population: effect of advanced age and comorbidities on treatment decision-making and outcomes

    PubMed Central

    Hu, Kui; Li, Jun; Wan, Yun; Hong, Tao; Lu, Shu-Yang; Guo, Chang-Fa; Wang, Chun-Sheng

    2016-01-01

    Background A considerable proportion of elderly patients with symptomatic severe heart valve disease are treated conservatively despite clear indications for surgical intervention. However, little is known about how advanced age and comorbidities affect treatment decision-making and therapeutic outcomes. Methods Patients (n = 234, mean age: 78.5 ± 3.7 years) with symptomatic severe heart valve disease hospitalized in our center were included. One hundred and fifty-one patients (65%) were treated surgically (surgical group) and 83 (35%) were treated conservatively (conservative group). Factors that affected therapeutic decision-making and treatment outcomes were investigated and long-term survival was explored. Results Isolated aortic valve disease, female sex, chronic renal insufficiency, aged ≥ 80 years, pneumonia, and emergent status were independent factors associated with therapeutic decision-making. In-hospital mortality for the surgical group was 5.3% (8/151). Three patients (3.6%) in the conservative group died during initial hospitalization. Low cardiac output syndrome and chronic renal insufficiency were identified as predictors of in-hospital mortality in the surgical group. Conservative treatment was identified as the single risk factor for late death in the entire study population. The surgical group had better 5-year (77.2% vs. 45.4%, P < 0.0001) and 10-year (34.5% vs. 8.9%, P < 0.0001) survival rates than the conservative group, even when adjusted by propensity score-matched analysis. Conclusions Advanced age and geriatric comorbidities profoundly affect treatment decision-making for severe heart valve disease. Valve surgery in the elderly was not only safe but was also associated with good long-term survival while conservative treatment was unfavorable for patients with symptomatic severe valve disease. PMID:27605940

  10. Age, Predisposing Diseases, and Ultrasonographic Findings in Determining Clinical Outcome of Acute Acalculous Inflammatory Gallbladder Diseases in Children.

    PubMed

    Yi, Dae Yong; Chang, Eun Jae; Kim, Ji Young; Lee, Eun Hye; Yang, Hye Ran

    2016-10-01

    We evaluated clinical factors such as age, gender, predisposing diseases and ultrasonographic findings that determine clinical outcome of acute acalculous inflammatory gallbladder diseases in children. The patients were divided into the four age groups. From March 2004 through February 2014, clinical data from 131 children diagnosed as acute acalculous inflammatory gallbladder disease by ultrasonography were retrospectively reviewed. Systemic infectious diseases were the most common etiology of acute inflammatory gallbladder disease in children and were identified in 50 patients (38.2%). Kawasaki disease was the most common predisposing disease (28 patients, 21.4%). The incidence was highest in infancy and lowest in adolescence. The age groups were associated with different predisposing diseases; noninfectious systemic disease was the most common etiology in infancy and early childhood, whereas systemic infectious disease was the most common in middle childhood and adolescence (P = 0.001). Gallbladder wall thickening was more commonly found in malignancy (100%) and systemic infection (94.0%) (P = 0.002), whereas gallbladder distension was more frequent in noninfectious systemic diseases (60%) (P = 0.000). Ascites seen on ultrasonography was associated with a worse clinical course compared with no ascites (77.9% vs. 37.7%, P = 0.030), and the duration of hospitalization was longer in patients with ascites (11.6 ± 10.7 vs. 8.0 ± 6.6 days, P = 0.020). In conclusion, consideration of age and predisposing disease in addition to ultrasonographic gallbladder findings in children suspected of acute acalculous inflammatory gallbladder disease might result in better outcomes. PMID:27550491

  11. Labour and Neonatal Outcome in Small for Gestational Age Babies Delivered Beyond 36+0 Weeks: A Retrospective Cohort Study

    PubMed Central

    Boers, K. E.; van der Post, J. A. M.; Mol, Ben W. J.; van Lith, J. M. M.; Scherjon, S. A.

    2011-01-01

    Objective. Small for gestational age (SGA) is associated with increased neonatal morbidity and mortality. At present, evidence on whether these pregnancies should be managed expectantly or by induction is lacking. To get insight in current policy we analysed data of the National Dutch Perinatal Registry (PRN). Methods. We used data of all nulliparae between 2000 and 2005 with a singleton in cephalic presentation beyond 36+0 weeks, with a birth weight below the 10th percentile. We analysed two groups of pregnancies: (I) with isolated SGA and (II) with both SGA and hypertensive disorders. Onset of labour was related to route of delivery and neonatal outcome. Results. Induction was associated with a higher risk of emergency caesarean section (CS), without improvement in neonatal outcome. For women with isolated SGA the relative risk of emergency CS after induction was 2.3 (95% Confidence Interval [CI] 2.1 to 2.5) and for women with both SGA and hypertensive disorders the relative risk was 2.7 (95% CI 2.3 to 3.1). Conclusion. Induction in pregnancies complicated by SGA at term is associated with a higher risk of instrumental deliveries without improvement of neonatal outcome. Prospective studies are needed to determine the best strategy in suspected IUGR at term. PMID:21490789

  12. Appraisal, Social Support, and Life Events: Predicting Outcome Behavior in School-Age Children.

    ERIC Educational Resources Information Center

    Jackson, Yo; Warren, Jared S.

    2000-01-01

    Examined relationship between social support and appraisal of life events in predicting adaptive, externalizing, and internalizing behavior in 265 seven- to 13-year-olds. Found support for both the main effects and moderator models of the association between life events and global social support. Gender differences were found. Appraisal of life…

  13. Effects of maternal ageing on ICSI outcomes and embryo development in relation to oocytes morphological characteristics of birefringent structures.

    PubMed

    Korkmaz, Cem; Tekin, Yesim Bayoglu; Sakinci, Mehmet; Ercan, Cihangir Mutlu

    2015-08-01

    The aim of this study was to determine the morphological characteristics of the older reproductive aged women's oocytes and to reveal the influence of these characteristics on intra-cytoplasmic sperm injection (ICSI) outcomes. The oocytes of women older than 35 years of age were evaluated retrospectively. Non-invasive polarization microscopy (PolScope) examinations of mature oocytes were performed by measurement of meiotic spindles' length, area and retardance and zona pellucida thickness and retardance. Fertilization and conception competence and the correlation with the birefringent structures were assessed. Two hundred and thirteen mature oocytes from 54 women were evaluated with a PolScope. Length of the meiotic spindle was shown to be related to fertilization success of women with advanced maternal age. In conclusion, the PolScope is a useful device used to identify the oocyte quality. Quantitative measurements of meiotic spindle parameters may be valuable for the selection of high-quality oocytes that have the potential for embryo development in the in vitro fertilization (IVF) laboratory of women older than 35 years of age who are mostly poor responders.

  14. Long-term Outcomes of Military Service in Aging and the Life Course: A Positive Re-envisioning.

    PubMed

    Spiro, Avron; Settersten, Richard A; Aldwin, Carolyn M

    2016-02-01

    Most research on military service focuses on its short-term negative consequences, especially the mental and physical injuries of those deployed in warzones. However, studies of long-term outcomes reveal surprisingly positive effects of military service--both those early in adulthood that grow over time and others that can emerge later in life. These multidomain effects have been found in veterans of World War II and the Korean War and are now being seen in veterans of the Vietnam War. Although some are directly attributable to public policies such as the GI Bill, which facilitate educational and economic gains, there are personal developmental gains as well, including autonomy, emotional maturity and resilience, mastery, and leadership skills, that lead to better health and well-being in later life. These long-term effects vary across persons, change over time within persons, and often reflect processes of cumulative advantage and disadvantage. We propose a life-span model of the effects of military service that provides a perspective for probing both long-term positive and negative outcomes for aging veterans. We further explicate the model by focusing on both sociocultural dynamics and individual processes. We identify public-use data that can be examined to evaluate this model, and offer a set of questions that can be used to assess military service. Finally, we outline an agenda for dedicated inquiry into such effects and consider policy implications for the health and well-being of aging veterans in later life. PMID:26655859

  15. Long-term Outcomes of Military Service in Aging and the Life Course: A Positive Re-envisioning.

    PubMed

    Spiro, Avron; Settersten, Richard A; Aldwin, Carolyn M

    2016-02-01

    Most research on military service focuses on its short-term negative consequences, especially the mental and physical injuries of those deployed in warzones. However, studies of long-term outcomes reveal surprisingly positive effects of military service--both those early in adulthood that grow over time and others that can emerge later in life. These multidomain effects have been found in veterans of World War II and the Korean War and are now being seen in veterans of the Vietnam War. Although some are directly attributable to public policies such as the GI Bill, which facilitate educational and economic gains, there are personal developmental gains as well, including autonomy, emotional maturity and resilience, mastery, and leadership skills, that lead to better health and well-being in later life. These long-term effects vary across persons, change over time within persons, and often reflect processes of cumulative advantage and disadvantage. We propose a life-span model of the effects of military service that provides a perspective for probing both long-term positive and negative outcomes for aging veterans. We further explicate the model by focusing on both sociocultural dynamics and individual processes. We identify public-use data that can be examined to evaluate this model, and offer a set of questions that can be used to assess military service. Finally, we outline an agenda for dedicated inquiry into such effects and consider policy implications for the health and well-being of aging veterans in later life.

  16. Brain Responses to Words in 2-Year-Olds with Autism Predict Developmental Outcomes at Age 6

    PubMed Central

    Kuhl, Patricia K.; Coffey-Corina, Sharon; Padden, Denise; Munson, Jeffrey; Estes, Annette; Dawson, Geraldine

    2013-01-01

    Autism Spectrum Disorder (ASD) is a developmental disability that affects social behavior and language acquisition. ASD exhibits great variability in outcomes, with some individuals remaining nonverbal and others exhibiting average or above average function. Cognitive ability contributes to heterogeneity in autism and serves as a modest predictor of later function. We show that a brain measure (event-related potentials, ERPs) of word processing in children with ASD, assessed at the age of 2 years (N = 24), is a broad and robust predictor of receptive language, cognitive ability, and adaptive behavior at ages 4 and 6 years, regardless of the form of intensive clinical treatment during the intervening years. The predictive strength of this brain measure increases over time, and exceeds the predictive strength of a measure of cognitive ability, used here for comparison. These findings have theoretical implications and may eventually lead to neural measures that allow early prediction of developmental outcomes as well as more individually tailored clinical interventions, with the potential for greater effectiveness in treating children with ASD. PMID:23734230

  17. Vitamin D and Age-Related Health Outcomes: Movement, Mood, and Memory

    PubMed Central

    2015-01-01

    It has long been recognized that vitamin D plays an important role in calcium homeostasis and musculoskeletal health. More recent evidence supports a role of vitamin D in physical and cognitive function and depressive symptoms through direct effects on skeletal muscle and the brain as well as indirectly through its reported roles in chronic conditions such as cardiovascular disease and diabetes, conditions that frequently lead to declines in physical and cognitive function and depressed mood. The purpose of this review is to summarize the prospective cohort and randomized controlled trial evidence for vitamin D on physical and cognitive function and depressed mood in older adults. Results from both prospective cohort studies and randomized controlled trials of vitamin D supplementation are mixed. Thus, controversy remains over the optimal vitamin D concentration for physical and cognitive function and depressed mood and whether vitamin D supplementation is beneficial for these outcomes. PMID:26779391

  18. Children with cerebral palsy and periventricular white matter injury: does gestational age affect functional outcome?

    PubMed

    Harvey, Adrienne R; Randall, Melinda; Reid, Susan M; Lee, Katherine J; Imms, Christine; Rodda, Jillian; Eldridge, Beverley; Orsini, Francesca; Reddihough, Dinah

    2013-09-01

    This study aimed to determine differences in functional profiles and movement disorder patterns in children aged 4-12 years with cerebral palsy (CP) and periventricular white matter injury (PWMI) born >34 weeks gestation compared with those born earlier. Eligible children born between 1999 and 2006 were recruited through the Victorian CP register. Functional profiles were determined using the Gross Motor Function Classification System (GMFCS), Manual Abilities Classification System (MACS), Communication Function Classification System (CFCS), Functional Mobility Scale (FMS) and Bimanual Fine Motor Function (BFMF). Movement disorder and topography were classified using the Surveillance of Cerebral Palsy in Europe (SCPE) classification. 49 children born >34 weeks (65% males, mean age 8 y 9 mo [standard deviation (SD) 2 y 2 mo]) and 60 children born ≤ 34 weeks (62% males, mean age 8 y 2 mo [SD 2 y 2 mo]) were recruited. There was evidence of differences between the groups for the GMFCS (p=0.003), FMS 5, 50 and 500 (p=0.003, 0.002 and 0.012), MACS (p=0.04) and CFCS (p=0.035), with a greater number of children born ≤ 34 weeks more severely impaired compared with children born later. Children with CP and PWMI born >34 weeks gestation had milder limitations in gross motor function, mobility, manual ability and communication compared with those born earlier.

  19. Effects of inter-alpha inhibitor proteins on neonatal brain injury: Age, task and treatment dependent neurobehavioral outcomes.

    PubMed

    Threlkeld, Steven W; Gaudet, Cynthia M; La Rue, Molly E; Dugas, Ethan; Hill, Courtney A; Lim, Yow-Pin; Stonestreet, Barbara S

    2014-11-01

    Hypoxic-ischemic (HI) brain injury is frequently associated with premature and/or full term birth related complications. HI injury often results in learning and processing deficits that reflect widespread damage to an extensive range of cortical and sub-cortical brain structures. Further, inflammation has been implicated in the long-term progression and severity of HI injury. Recently, inter-alpha inhibitor proteins (IAIPs) have been shown to attenuate inflammation in models of systemic infection. Importantly, preclinical studies of neonatal HI injury and neuroprotection often focus on single time windows of assessment or single behavioral domains. This approach limits translational validity, given evidence for a diverse spectrum of neurobehavioral deficits that may change across developmental windows following neonatal brain injury. Therefore, the aims of this research were to assess the effects of human IAIPs on early neocortical cell death (72h post-insult), adult regional brain volume measurements (cerebral cortex, hippocampus, striatum, corpus callosum) and long-term behavioral outcomes in juvenile (P38-50) and adult (P80+) periods across two independent learning domains (spatial and non-spatial learning), after postnatal day 7 HI injury in rats. Here, for the first time, we show that IAIPs reduce acute neocortical neuronal cell death and improve brain weight outcome 72h following HI injury in the neonatal rat. Further, these longitudinal studies are the first to show age, task and treatment dependent improvements in behavioral outcome for both spatial and non-spatial learning following systemic administration of IAIPs in neonatal HI injured rats. Finally, results also show sparing of brain regions critical for spatial and non-spatial learning in adult animals treated with IAIPs at the time of injury onset. These data support the proposal that inter-alpha inhibitor proteins may serve as novel therapeutics for brain injury associated with premature birth and

  20. Effects of Age, Sex, and Comorbidities on the Pediatric Outcomes Data Collection Instrument (PODCI) in the General Population

    PubMed Central

    Campbell, Susan R.

    2015-01-01

    Background: The Pediatric Outcomes Data Collection Instrument (PODCI) is an outcomes assessment tool developed to allow measurement of health-related quality of life in children with disorders having musculoskeletal impact. The instrument was tested by Hunsaker and colleagues on a large population-based sample of children (n=5300), and partial results of that survey were published in 2002. Further publication of the findings did not occur. The PODCI was designed to collect data on age, sex, comorbidities, race and ethnicity, makeup of the household, and other demographic data that could have an impact on function and psychosocial issues. This retrospective study evaluated the impact of age, sex, and health/comorbid conditions on the subscales of the PODCI. Methods: Using the database that was developed by Hunsaker and colleagues for the American Academy of Orthopaedic Surgeons, a 1-way multivariate analysis of variance was conducted to determine effects of prior comorbid condition versus no prior comorbid condition on the dependent variables of the PODCI Upper Extremity Function, Transfers and Basic Mobility, Sports and Physical Function, Comfort, and Happiness scales by parent respondent. A follow-up analysis of the health/comorbid condition, age, and sex of the child on the PODCI subscales using independent samples t tests was performed. Results: Significant differences in the PODCI subscales of Transfers and Basic Mobility, Sports and Physical Function, Comfort, and Happiness occurred between children with a prior comorbid condition versus no prior reported comorbid condition. The sex of the child with a comorbid condition versus without a comorbidity appears to affect the PODCI subscale scores except for the Upper Extremity Function subscale. PODCI scales show an initial increase with age. Age at plateau varies, as do patterns of scores after plateau, with gradual decreases in quality-of-life scales. Conclusions: With further exploration of the population

  1. Severity of brain injury following neonatal extracorporeal membrane oxygenation and outcome at age 5 years.

    PubMed

    Glass, P; Bulas, D I; Wagner, A E; Rajasingham, S R; Civitello, L A; Papero, P H; Coffman, C E; Short, B L

    1997-07-01

    Neurodevelopmental evaluation in childhood provides an opportunity to study complex neurological compensation following documented neonatal brain injury, and furnishes important clinical information which may have an impact on patient care. We studied 152 term children treated with extracorporeal membrane oxygenation (ECMO) as neonates and who received routine neonatal neuroimaging and comprehensive neurodevelopmental evaluation at age 5 years. The cohort was divided into four groups based on an independent neuroimaging score: No lesion, N=88; Mild lesion, N=38; Moderate lesion, N=12; and Severe lesion, N=14. Standardized testing at age 5 included complete neuropsychological assessment, neurological evaluation, and assessment of motor function. All testing was conducted without knowledge of the neuroimaging score. The occurrence of disability by severity of neuroimaging was: No lesion=10%; Mild=13%; Moderate=33%; Severe=57%. The relative risk within the ECMO population for disability at age 5 after moderate or severe neonatal lesion was 4.3 (CI=1.0 to 17.5) and 11.7 (CI=3.3 to 41.3), respectively. The remaining non-disabled children who had moderate to severe lesions functioned within normal limits. Severity of neonatal neuroimaging was inversely associated with IQ scores, pre-academic skills, and neuromotor function. The effect size was small but the rank order was predictable. Our data identify in 5-year-old children an impact of brain lesion severity demonstrated on routine neonatal neuroimaging. The results indicate potential compensation following moderate and severe lesions, and suggest a subtle but consistent influence of even mild neonatal brain injury.

  2. Alcohol Involvement in Sexual Behaviour and Adverse Sexual Health Outcomes from 26 to 38 Years of Age

    PubMed Central

    Connor, Jennie L.; Kydd, Robyn M.; Dickson, Nigel P.

    2015-01-01

    Background Research on alcohol and sexual behaviour has focused on young adults or high-risk groups, showing alcohol use contributing to riskier sexual choices. Adults now in their late thirties have been exposed to heavier drinking norms than previously, raising questions about effects on sexual wellbeing. We examined self-reported use and consequences of alcohol in sexual contexts, and its association with usual drinking pattern at age 38, and also associations of heavy drinking occasion (HDO) frequency with number of sexual partners, sexually transmitted infections (STIs), and terminations of pregnancy (TOPs), from 26–32 and 32–38 years of age. Methods Members of the Dunedin Study birth cohort answered computer-presented questions about sexual behaviour and outcomes, and interviewer-administered alcohol consumption questions, at age 26, 32 and 38 years. Results Response level was >90% at each assessment. At 38, drinking before or during sex in the previous year was common (8.2% of men; 14.6% of women reported “usually/always”), and unwanted consequences were reported by 13.5% of men and 11.9% of women, including regretted sex or failure to use contraception or condoms. Frequent heavy drinkers were more likely to “use alcohol to make it easier to have sex” and regret partner choice, particularly women. Heavy drinking frequency was strongly associated with partner numbers for men and women at 32, but only for women at 38. Significantly higher odds of STIs amongst the heaviest drinking men, and TOPs amongst the heaviest drinking women were seen at 32–38. Conclusions Alcohol involvement in sex continues beyond young adulthood where it has been well documented, and is common at 38. Women appear to be more affected than men, and heavy drinking is associated with poorer outcomes for both. Improving sexual health and wellbeing throughout the life course needs to take account of the role of alcohol in sexual behaviour. PMID:26267272

  3. National Trends in Main Causes of Hospitalization: A Multi-Cohort Register Study of the Finnish Working-Age Population, 1976–2010

    PubMed Central

    Kouvonen, Anne; Koskinen, Aki; Varje, Pekka; Kokkinen, Lauri; De Vogli, Roberto; Väänänen, Ari

    2014-01-01

    Background The health transition theory argues that societal changes produce proportional changes in causes of disability and death. The aim of this study was to identify long-term changes in main causes of hospitalization in working-age population within a nation that has experienced considerable societal change. Methodology National trends in all-cause hospitalization and hospitalizations for the five main diagnostic categories were investigated in the data obtained from the Finnish Hospital Discharge Register. The seven-cohort sample covered the period from 1976 to 2010 and consisted of 3,769,356 randomly selected Finnish residents, each cohort representing 25% sample of population aged 18 to 64 years. Principal Findings Over the period of 35 years, the risk of hospitalization for cardiovascular diseases and respiratory diseases decreased. Hospitalization for musculoskeletal diseases increased whereas mental and behavioral hospitalizations slightly decreased. The risk of cancer hospitalization decreased marginally in men, whereas in women an upward trend was observed. Conclusions/Significance A considerable health transition related to hospitalizations and a shift in the utilization of health care services of working-age men and women took place in Finland between 1976 and 2010. PMID:25379723

  4. Social context and outcomes for the ageing breast cancer patient: considerations for clinical practitioners.

    PubMed

    Ballantyne, Peri J

    2004-03-01

    Current incidence, prevalence and survival rates determine that breast cancer is primarily a disease of older women. This integrative essay provides an extensive review of the literature on (i). the social and psychological factors that influence adjustment to breast cancer and survival from it, (ii). the social and health status of older women, and (iii). the medical treatment of older breast cancer patients. It is concluded that while psychological orientation to the disease, coping strategies and functional continuities of breast cancer patients are important for disease outcome, adjustment to and survival from breast cancer by older women may be compromised by the social context - with respect to marriage and intimate ties, social participation, socio-economic status, and mental and physical health. The paper concludes with the suggestion that clinical practitioners need to be aware of the both the resources of, and limitations facing the older breast cancer patient, and with the provision of specific recommendations about the clinical management of this population for nurses and other health professionals.

  5. CsA-based post-graft immunosuppression: the main factor for improving outcome of allografted patients with acquired aplastic anemia. A retrospective survey by the Spanish Group of Hematopoietic Transplantation.

    PubMed

    Arranz, R; Conde, E; Rodriguez-Salvanés, F; Pajuelo, F J; Cabrera, R; Sanz, M A; Petit, J; Bueno, J; Maldonado, J; Odriozola, J; Conde, J G; Brunet, S; Carreras, E; Iriondo, A; Fernández-Rañada, J M; Marín, P

    2002-02-01

    A retrospective multicenter study was performed to assess the clinical results in patients with acquired aplastic anemia (AA) allografted over a 19 year period and to identify prognostic factors influencing survival. From April 1978 to December 1997, 176 patients were transplanted. Records from 160 receiving related matched bone marrow transplantation (BMT) were reviewed. Fifty-two percent of the patients were older than 20 years, 5% older than 40; 6.3% were untransfused at BMT and 56.2% had received prior treatments. Conditioning regimens were with chemotherapy in 43.7% of the procedures and with additional irradiation in 56.3%. Graft-versus-host disease (GVHD) prophylaxis was based on cyclosporin A (CsA) in 58.1% of the patients while methotrexate (MTX) was administered to 41.9%. Transplantation earlier on, a longer interval from diagnosis to BMT, GVHD prophylaxis with MTX, graft failure/rejection and acute severe GVHD were adverse factors for survival. The use of CsA emerged as the main factor for the improvement, inducing a significant decrease in graft failure/rejection rate and severe acute GVHD when compared with MTX alone. Radiation-containing regimens decreased the graft failure/rejection rate without improving survival due to the increased risk of acute GVHD. Age and number of transfusions pretransplant did not influence outcome. Survival achieved since 1991 is 79.79%, and graft failure and acute severe GVHD rates are 6.0% and 11.8%, respectively. In conclusion, CsA-based post-graft immunosuppression has been crucial in achieving improved survival in patients with acquired AA up to 40 years of age. Regardless of CsA use, further improvement in survival was apparent with time, probably due to better skills in patient care. PMID:11859392

  6. New clues to the cause of extended main-sequence turnoffs in intermediate-age star clusters in the Magellanic Clouds

    SciTech Connect

    Correnti, Matteo; Goudfrooij, Paul; Kalirai, Jason S.; Girardi, Leo; Puzia, Thomas H.; Kerber, Leandro E-mail: goudfroo@stsci.edu E-mail: leo.girardi@oapd.inaf.it E-mail: lkerber@gmail.com

    2014-10-01

    We use the Wide Field Camera 3 on board the Hubble Space Telescope (HST) to obtain deep, high-resolution images of two intermediate-age star clusters in the Large Magellanic Cloud of relatively low mass (≈10{sup 4} M {sub ☉}) and significantly different core radii, namely NGC 2209 and NGC 2249. For comparison purposes, we also reanalyzed archival HST images of NGC 1795 and IC 2146, two other relatively low-mass star clusters. From the comparison of the observed color-magnitude diagrams with Monte Carlo simulations, we find that the main-sequence turnoff (MSTO) regions in NGC 2209 and NGC 2249 are significantly wider than that derived from simulations of simple stellar populations, while those in NGC 1795 and IC 2146 are not. We determine the evolution of the clusters' masses and escape velocities from an age of 10 Myr to the present age. We find that differences among these clusters can be explained by dynamical evolution arguments if the currently extended clusters (NGC 2209 and IC 2146) experienced stronger levels of initial mass segregation than the currently compact ones (NGC 2249 and NGC 1795). Under this assumption, we find that NGC 2209 and NGC 2249 have estimated escape velocities, V {sub esc} ≳ 15 km s{sup –1} at an age of 10 Myr, large enough to retain material ejected by slow winds of first-generation stars, while the two clusters that do not feature extended MSTOs have V {sub esc} ≲ 12 km s{sup –1} at that age. These results suggest that the extended MSTO phenomenon can be better explained by a range of stellar ages rather than a range of stellar rotation velocities or interacting binaries.

  7. Evaluating gyrochronology on the zero-age-main-sequence: rotation periods in the southern open cluster Blanco 1 from the Kelt-South survey

    SciTech Connect

    Cargile, P. A.; Pepper, J.; Siverd, R.; Stassun, K. G.; James, D. J.; Kuhn, R. B.

    2014-02-10

    We report periods for 33 members of Blanco 1 as measured from Kilodegree Extremely Little Telescope-South light curves, the first reported rotation periods for this benchmark zero-age-main-sequence open cluster. The distribution of these stars spans from late-A or early-F dwarfs to mid-K with periods ranging from less than a day to ∼8 days. The rotation period distribution has a morphology similar to the coeval Pleiades cluster, suggesting the universal nature of stellar rotation distributions. Employing two different gyrochronology methods, we find an age of 146{sub −14}{sup +13} Myr for the cluster. Using the same techniques, we infer an age of 134{sub −10}{sup +9} Myr for the Pleiades measured from existing literature rotation periods. These rotation-derived ages agree with independently determined cluster ages based on the lithium depletion boundary technique. Additionally, we evaluate different gyrochronology models and quantify levels of agreement between the models and the Blanco 1/Pleiades rotation period distributions, including incorporating the rotation distributions of clusters at ages up to 1.1 Gyr. We find the Skumanich-like spin-down rate sufficiently describes the rotation evolution of stars hotter than the Sun; however, we find cooler stars rotating faster than predicted by a Skumanich law, suggesting a mass dependence in the efficiency of stellar angular momentum loss rate. Finally, we compare the Blanco 1 and Pleiades rotation period distributions to available nonlinear angular momentum evolution models. We find they require a significant mass dependence on the initial rotation rate of solar-type stars to reproduce the observed range of rotation periods at a given stellar mass and are furthermore unable to predict the observed over-density of stars along the upper envelope of the clusters' rotation distributions.

  8. Cochlear Implants in Subjects Over Age 65: Quality of Life and Audiological Outcomes.

    PubMed

    Aimoni, Claudia; Ciorba, Andrea; Hatzopoulos, Stavros; Ramacciotti, Giulia; Mazzoli, Manuela; Bianchini, Chiara; Rosignoli, Monica; Skarżyński, Henryk; Skarżyński, Piotr H

    2016-01-01

    BACKGROUND Cochlear implants (CIs) have been recognized as a safe and effective means for profound hearing loss rehabilitation in children and adults and recently their use has been extended to subjects over 65 years of age. The aim of this paper was to assess indices related to changes in the quality of life (QoL) in elderly CI recipients. MATERIAL AND METHODS A case-control paradigm was used to assess the effects of CIs on the QoL. Forty-two subjects were assigned to the Case group and 15 subjects to the Control group. All 57 subjects were affected by profound hearing loss and had received a CI. Audiological data were collected from both groups at: (i) 1 month pre-implantation [T1]; (ii) 1 day pre- implantation [T2]; (iii) 30 days post-implantation, with CI used in free field [T3]; and (iv) 12 months post-implantation, with CI used in a free field [T4]. The QoL was assessed via a Glasgow Benefit Inventory (GBI) questionnaire, adapted to otolaryngology. To compare subjects across different ages with varying degrees of speech development, a perception parameter was used from the Speech Perception Categories test developed by Geers and Moog. RESULTS Hearing performance was considerably improved after CI. In relation to the hearing performance at time T1, statistically significant threshold gains were observed in both groups in the T3 and T4 observation windows. At time T4, a threshold gain of 70 dB HL in the Case group and a gain of 84 dB HL in the Control group were observed. With speech therapy rehabilitation, a perception level of 6 was reached by 80.0% of patients in the Case group and by 100% of patients in the Control group. In terms of QoL, both groups showed improved post-CI scores. Statistical differences were observed between the 2 groups, with the Control group outperforming the Case group in all but the social section. CONCLUSIONS Despite age-related changes in auditory system and prolonged hearing deprivation, CIs offer audiological and QoL benefits in

  9. Cochlear Implants in Subjects Over Age 65: Quality of Life and Audiological Outcomes

    PubMed Central

    Aimoni, Claudia; Ciorba, Andrea; Hatzopoulos, Stavros; Ramacciotti, Giulia; Mazzoli, Manuela; Bianchini, Chiara; Rosignoli, Monica; Skarżyński, Henryk; Skarżyński, Piotr H.

    2016-01-01

    Background Cochlear implants (CIs) have been recognized as a safe and effective means for profound hearing loss rehabilitation in children and adults and recently their use has been extended to subjects over 65 years of age. The aim of this paper was to assess indices related to changes in the quality of life (QoL) in elderly CI recipients. Material/Methods A case-control paradigm was used to assess the effects of CIs on the QoL. Forty-two subjects were assigned to the Case group and 15 subjects to the Control group. All 57 subjects were affected by profound hearing loss and had received a CI. Audiological data were collected from both groups at: (i) 1 month pre-implantation [T1]; (ii) 1 day pre- implantation [T2]; (iii) 30 days post-implantation, with CI used in free field [T3]; and (iv) 12 months post-implantation, with CI used in a free field [T4]. The QoL was assessed via a Glasgow Benefit Inventory (GBI) questionnaire, adapted to otolaryngology. To compare subjects across different ages with varying degrees of speech development, a perception parameter was used from the Speech Perception Categories test developed by Geers and Moog. Results Hearing performance was considerably improved after CI. In relation to the hearing performance at time T1, statistically significant threshold gains were observed in both groups in the T3 and T4 observation windows. At time T4, a threshold gain of 70 dB HL in the Case group and a gain of 84 dB HL in the Control group were observed. With speech therapy rehabilitation, a perception level of 6 was reached by 80.0% of patients in the Case group and by 100% of patients in the Control group. In terms of QoL, both groups showed improved post-CI scores. Statistical differences were observed between the 2 groups, with the Control group outperforming the Case group in all but the social section. Conclusions Despite age-related changes in auditory system and prolonged hearing deprivation, CIs offer audiological and QoL benefits in the

  10. A Nation of Immigrants: Assimilation and Economic Outcomes in the Age of Mass Migration

    PubMed Central

    Abramitzky, Ran; Boustan, Leah Platt; Eriksson, Katherine

    2015-01-01

    During the Age of Mass Migration (1850–1913), the United States maintained an open border, absorbing 30 million European immigrants. Prior cross-sectional work finds that immigrants initially held lower-paid occupations than natives but converged over time. In newly assembled panel data, we show that, in fact, the average immigrant did not face a substantial occupation-based earnings penalty upon first arrival and experienced occupational advancement at the same rate as natives. Cross-sectional patterns are driven by biases from declining arrival cohort skill level and departures of negatively selected return migrants. We show that assimilation patterns vary substantially across sending countries and persist in the second generation. PMID:26609186

  11. Radiocarbon Ages from Two Submerged Strandline Features in the Western Gulf of Maine and a Sea-Level Curve for the Northeastern Massachusetts Coastal Region

    USGS Publications Warehouse

    Oldale, R.N.; Colman, Steven M.; Jones, Glenn A.

    1993-01-01

    New radiocarbon dates provide ages for two submerged strandline features on the Massachusetts inner shelf. These ages provide limited control on a relative sea-level (RSL) curve for the late Wisconsinan and Holocene. The curve indicates a late Wisconsinan high stand of RSL of +33 m about 14,000 yr ago and a very short-lived relative low stand of about -43 m at about 12,000 yr ago followed by a rise to present sea level. Rapid changes of RSL around 12,000 yr ago may be related to changes in global glacial meltwater discharge and eustatic sea-level change shown by dated corals off Barbados. Variations in the magnitude and timing of RSL change from south to north along the coast of the western Gulf of Maine are due to greater crustal depression and later deglaciation to the north.

  12. Outcomes of children of extremely low birthweight and gestational age in the 1990s.

    PubMed

    Hack, M; Fanaroff, A A

    2000-05-01

    Advances in perinatal care have improved the chances for survival of extremely low birthweight (<800 grams) and gestational age (<26 weeks) infants. A review of the world literature reveals that among regional populations, survival at 23 weeks' gestation ranges from 2 to 35%, at 24 weeks' gestation 17 to 62% and at 25 weeks' gestation 35 to 72%. These wide variations may be accounted for by differences in population descriptors, in the criteria used for starting or withdrawing treatment, in the reported duration of survival and differences in care. Major neonatal morbidity increases with decreasing gestational age and birthweight. At 23 weeks' gestation, chronic lung disease occurs in 57 to 86% of survivors, at 24 weeks in 33 to 89% and at 25 weeks' gestation in 16 to 71% of survivors. The rates of severe cerebral ultrasound abnormality range from 10 to 83% at 23 weeks' gestation, 9 to 64% at 24 weeks and 7 to 22% at 25 weeks' gestation Of 77 survivors at 23 weeks' gestation, 26 (34%) have severe disability (defined as subnormal cognitive function, cerebral palsy, blindness and/or deafness). At 24 weeks' gestation, the rates of severe neurodevelopmental disability range from 22 to 45%, and at 25 weeks' gestation 12 to 35%. When compared with children born prior to the 1990s, the rates of neurodevelopmental disability have, in general, remained unchanged. We conclude that, with current methods of care, the limits of viability have been reached. The continuing toll of major neonatal morbidity and neurodevelopmental handicap are of serious concern.

  13. Childlessness and Psychological Well-Being in Midlife and Old Age: An Examination of Parental Status Effects across a Range of Outcomes

    ERIC Educational Resources Information Center

    Hansen, Thomas; Slagsvold, Britt; Moum, Torbjorn

    2009-01-01

    The study explores and distinguishes links between parental status (childless persons, parents with residential children, and empty nest parents) and a range of psychological well-being outcomes in midlife and old age. Data are from the first wave of the Norwegian Life Course, Ageing and Generation (NorLAG) study (n = 5,189). We separate outcomes…

  14. Five years of interdisciplinary research on ageing and technology: Outcomes of the Lower Saxony Research Network Design of Environments for Ageing (GAL)--an introduction to this Special Issue on Ageing and Technology.

    PubMed

    Haux, Reinhold; Hein, Andreas; Kolb, Gerald; Künemund, Harald; Eichelberg, Marco

    2014-01-01

    This Special Issue of Informatics for Health and Social Care is presenting outcomes of the Lower Saxony Research Network Design of Environments for Ageing (abbreviated as GAL), probably one of the largest inter- and multidisciplinary research projects on aging and technology. In order to investigate and provide answers on whether new information and communication technologies can contribute to keeping, or even improving quality of life, health and self-sufficiency in ageing societies through new ways of living and new forms of care, GAL had been established as a five-year research project, running from 2008 to 2013. Ambient-assisted living technologies in personal and home environments were especially important. During the five years of research in GAL, more than seventy researchers from computer science, economics, engineering, geriatrics, gerontology, informatics, medicine, nursing science and rehabilitation pedagogy intensively collaborated in finding answers.

  15. Cryptic residual GALT activity is a potential modifier of scholastic outcome in school age children with classic galactosemia.

    PubMed

    Ryan, Emily L; Lynch, Mary Ellen; Taddeo, Elles; Gleason, Tyler J; Epstein, Michael P; Fridovich-Keil, Judith L

    2013-11-01

    Classic galactosemia is a potentially lethal disorder that results from profound deficiency of galactose-1-phosphate uridylyltransferase (GALT), the second enzyme in the Leloir pathway of galactose metabolism. Although early diagnosis and rigorous dietary restriction of galactose prevent or resolve the potentially lethal acute symptoms, patients are at markedly increased risk of long-term complications including significant cognitive, speech, and behavioral difficulties, among other problems. The mechanisms that underlie these long-term complications remain unclear, as do the factors that modify their severity. Here we explored the scholastic and behavioral outcomes experienced by a cohort of 54 school age children with classic galactosemia. Data collected included survey responses from parents and teachers, school records including standardized test scores, and GALT genotype data used to estimate predicted residual GALT activity based on a yeast expression system. As expected, many but not all of the children in our study demonstrated speech, scholastic, and behavioral difficulties. Perhaps most striking, we found that predicted cryptic residual GALT activity, often below the threshold of detection of clinical assays, appeared to modify scholastic outcome. These data raise the intriguing possibility that cryptic GALT activity might also influence the severity of other long-term complications in classic galactosemia. PMID:23319291

  16. Does the Animal Fun program improve social-emotional and behavioural outcomes in children aged 4-6 years?

    PubMed

    Piek, Jan P; Kane, Robert; Rigoli, Daniela; McLaren, Sue; Roberts, Clare M; Rooney, Rosanna; Jensen, Lynn; Dender, Alma; Packer, Tanya; Straker, Leon

    2015-10-01

    Animal Fun was designed to enhance motor and social development in young children. Its efficacy in improving motor skills was presented previously using a randomised controlled trial and a multivariate nested cohort design. Based on the Environmental Stress Hypothesis, it was argued that the program would also result in positive mental health outcomes, investigated in the current study. Pre-intervention scores were recorded for 511 children aged 4.83-6.17 years (M=5.42, SD=.30). Intervention and control groups were compared 6 months following intervention, and again in their first school year. Changes in teacher-rated prosocial behaviour and total difficulties were assessed using the Strengths and Difficulties Questionnaire, and data analysed using Generalised Linear Mixed Models. There was a significant improvement in prosocial behaviour of children in the intervention group six months after initial testing, which remained at 18-month follow-up. Total difficulties decreased at 6 months for the intervention group, with no change at 18 months. This effect was present only for the hyperactivity/inattention subscale. The only significant change for the control group was an increase in hyperactivity/inattention scores from pre-intervention to 18-month follow-up. The Animal Fun program appears to be effective in improving social and behavioural outcomes. PMID:26298689

  17. Growth outcomes for Australian Aboriginal children aged 11 years who were born with intrauterine growth retardation at term gestation.

    PubMed

    Sayers, Susan; Mackerras, Dorothy; Halpin, Stephen; Singh, Gurmeet

    2007-09-01

    Long-term poor growth outcomes are well documented for intrauterine growth-retarded babies (IUGR) in developed populations but there is a paucity of IUGR studies from disadvantaged populations where the greatest burden of IUGR occurs. Using a Northern Territory, Aboriginal cohort recruited at birth and followed up at a mean age of 11.4 years, comparisons of body size were made between children born at term who had been IUGR (n = 121) and those non-IUGR (n = 341), and between those IUGR babies who had an appropriate ponderal index at birth (n = 72) and those with a low ponderal index (n = 49). Compared with non-IUGR children, at follow-up the IUGR children were almost 2 cm shorter (P = 0.10), 4 kg lighter (P < 0.01) and their head circumferences were almost a 1 cm smaller (P < 0.01). For the 121 term IUGR children, there were no significant differences in growth outcomes according to ponderal index measures at birth. These findings from an Australian Aboriginal sample are consistent with other comparisons of IUGR and non-IUGR children in developed populations and suggest there may be no additional effects of IUGR on growth in childhood for disadvantaged populations similar to the Aboriginal population in the Northern Territory.

  18. Population Parameters of Intermediate-age Star Clusters in the Large Magellanic Cloud. III. Dynamical Evidence for a Range of Ages Being Responsible for Extended Main-sequence Turnoffs

    NASA Astrophysics Data System (ADS)

    Goudfrooij, Paul; Puzia, Thomas H.; Chandar, Rupali; Kozhurina-Platais, Vera

    2011-08-01

    We present a new analysis of 11 intermediate-age (1-2 Gyr) star clusters in the Large Magellanic Cloud based on Hubble Space Telescope imaging data. Seven of the clusters feature main-sequence turnoff (MSTO) regions that are wider than can be accounted for by a simple stellar population, whereas their red giant branches (RGBs) indicate a single value of [Fe/H]. The star clusters cover a range in present-day mass from about 1 × 104 M sun to 2 × 105 M sun. We compare radial distributions of stars in the upper and lower parts of the MSTO region, and calculate cluster masses and escape velocities from the present time back to a cluster age of 10 Myr. Our main result is that for all clusters in our sample with estimated escape velocities v esc >~ 15 km s-1 at an age of 10 Myr, the stars in the brightest half of the MSTO region are significantly more centrally concentrated than the stars in the faintest half and more massive RGB and asymptotic giant branch stars. This is not the case for clusters with v esc <~ 10 km s-1 at an age of 10 Myr. We argue that the wide MSTO region of such clusters is caused mainly by a ~200-500 Myr range in the ages of cluster stars due to extended star formation within the cluster from material shed by first-generation stars featuring slow stellar winds. Dilution of this enriched material by accretion of ambient interstellar matter is deemed plausible if the spread of [Fe/H] in this ambient gas was very small when the second-generation stars were formed in the cluster. Based on observations with the NASA/ESA Hubble Space Telescope, obtained at the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS5-26555.

  19. The impact of increased age on outcome from a strategy of early invasive management and revascularisation in patients with acute coronary syndromes: retrospective analysis study from the ACACIA registry

    PubMed Central

    Prakash, Roshan; Chew, Derek P

    2012-01-01

    Objective To evaluate the impact of increased age on outcome from a strategy of early invasive management and revascularisation in patients with acute coronary syndromes (ACS). Design Retrospective analysis of a national Acute Coronary Syndrome registry (ACACIA). Setting Multiple Australian (n=39) centres; 25% rural, 52% with onsite cardiac surgery. Patients Unselected consecutive patients admitted with confirmed ACS, total n=2559, median 99 per centre. Interventions Management was at the discretion of the treating physician. Analysis of outcome based on age >75 years was compared using Cox proportional hazard with a propensity model to adjust for baseline covariates. Main outcome measures Primary outcome was all-cause mortality. Secondary outcomes were bleeding and a composite of any vascular event or unplanned readmission. Results Elderly patients were more likely to present with high-risk features yet were less likely to receive evidence-based medical therapies or receive diagnostic coronary angiography (75% vs 49%, p<0.0001) and early revascularisation (50% vs 30%, p<0.0001). Multivariate analysis found early revascularisation in the elderly cohort to be associated with lower 12-month mortality hazard (0.4 (0.2–0.7)) and composite outcome (0.6 (0.5–0.8)). Propensity model suggested a greater absolute benefit in elderly patients compared to others. Conclusions Following presentation with ACS, elderly patients are less likely to receive evidence-based medical therapies, to be considered for an early invasive strategy and be revascularised. Increasing age is a significant barrier to physicians when considering early revascularisation. An early invasive strategy with revascularisation when performed was associated with substantial benefit and the absolute accrued benefit appears to be higher in elderly patients. PMID:22344538

  20. Moderating Effects of Gender on Outcomes Associated with Stressful Life Events Among Elementary School-Age Youth.

    PubMed

    Brown, Shaquanna; Fite, Paula J; Poquiz, Jonathan

    2016-08-01

    Stressful life events have been associated with child and adolescent maladjustment, including elevated levels of aggression and anxiety (Attar et al. in J Clin Child Psychol 23:391-400, 1994; Fox et al. in J Adolesc 33:43-54, 2010). However, gender specific outcomes associated with stressful life events among elementary school-age youth are less known. Accordingly, the current study examined the role of gender in the associations between stressful life events and anxiety and proactive and reactive aggression. Participants included 294 elementary school-age children (M = 8.71, SD = 1.17, 50.7 % male). Regression analyses indicated that stressful life events were positively associated with anxiety and reactive, but not proactive, aggression. There were no gender differences with regard to the associations with anxiety symptoms or proactive aggression. However, gender moderated the association between stressful life events and reactive aggression, such that stressful life events were only positively associated with reactive aggression for boys. Future directions and implications of this research are presented.

  1. Main Report

    PubMed Central

    2006-01-01

    difficult to evaluate, quantify and place in one of the three categories. In addition, many conditions were found to occur in multiple forms distinguished by age-of-onset, severity, or other features. Further, unless a condition was already included in newborn screening programs, there was a potential for bias in the information related to some criteria. In such circumstances, the quality of the studies underlying the data such as expert opinion that considered case reports and reasoning from first principles determined the placement of the conditions into particular categories. Newborn screening program optimization – Assessment of the activities of newborn screening programs, based on program reports, was done for the six program components: education; screening; follow-up; diagnostic confirmation; management; and program evaluation. Considerable variation was found between programs with regard to whether particular aspects (e.g., prenatal education program availability, tracking of specimen collection and delivery) were included and the degree to which they are provided. Newborn screening program evaluation systems also were assessed in order to determine their adequacy and uniformity with the goal being to improve interprogram evaluation and comparison to ensure that the expected outcomes from having been identified in screening are realized. Conclusions: The state of the published evidence in the fast-moving worlds of newborn screening and medical genetics has not kept up with the implementation of new technologies, thus requiring the considerable use of expert opinion to develop recommendations about a core panel of conditions for newborn screening. Twenty-nine conditions were identified as primary targets for screening from which all components of the newborn screening system should be maximized. An additional 25 conditions were listed that could be identified in the course of screening for core panel conditions. Programs are obligated to establish a diagnosis and

  2. A Systematic Study of Effects of Stellar Rotation, Age Spread, and Binaries on Color-Magnitude Diagrams with Extended Main-sequence Turnoffs

    NASA Astrophysics Data System (ADS)

    Li, Zhongmu; Mao, Caiyan; Zhang, Liyun; Zhang, Xi; Chen, Li

    2016-07-01

    Stellar rotation, age spread, and binary stars are thought to be the three most possible causes of the peculiar color-magnitude diagrams (CMDs) of some star clusters, which exhibit extended main-sequence turnoffs (eMSTOs). The answer is far from clear. This paper studies the effects of the three above causes on the CMDs of star clusters systematically. A rapid stellar evolutionary code and a recently published database of rotational effects of single stars have been used, via an advanced stellar population synthesis technique. As a result, we find a similar result for rotation to recent works, which suggests that rotation is able to explain, at least partially, the eMSTOs of clusters, if clusters are not too old (<2.0 Gyr). In addition, an age spread of 200-500 Myr reproduces extended turnoffs for all clusters younger than 2.5 Gyr, in particular, for those younger than 2.2 Gyr. Age spread also results in extended red clumps (eRCs) for clusters younger than 0.5 Gyr. The younger the clusters, the clearer the eRC structures. Moreover, it is shown that binaries (including interactive binaries) affect the spread of MSTOs slightly for old clusters, but they can contribute to the eMSTOs of clusters younger than 0.5 Gyr. Our result suggests a possible way to disentangle the roles of stellar rotation and age spread, i.e., checking the existence of CMDs with both eMSTOs and eRCs in clusters younger than 0.5 Gyr.

  3. Age-dependent metallicity gradients of the MilkyWay disk from main sequence turn-off stars in LSS-GAC

    NASA Astrophysics Data System (ADS)

    Xiang, Maosheng; Liu, Xiaowei

    2015-08-01

    The stellar metallicity gradient plays an important role on constraining the formation and assemblage history of the Galactic disk. We use 297, 042 main sequence turn-off stars from LAMOST Spectroscopic Survey of the Galactic Anti-center (LSS-GAC) to study the radial metallicity gradient, [Fe/H]/R, and the vertical metallicity gradient, [Fe/H]/|Z|, of the Galactic disk in the anti-center direction. We carry out age determination for these turnoff stars via isochrone fitting and study the age-dependent metallicity gradients. We have implemented a detailed analysis on the sample selection effect to account for the target selection in the color - magnitude diagram (CMD) and the potential bias on metallicity gradients of a magnitude limited sample. Our results show that both the radial and vertical gradients have strong spatial and temporal evolution. The radial gradients of the oldest (age > 11Gyr) stars are almost zero at all heights above the Galactic disk plane, while those of the younger stars are always negative. The vertical gradients of the oldest stars are negative and show very weak evolution with the Galactocentric distance in the disk plane, R, while those of the younger stars show strong evolution with R. At the early epoch, the radial gradient steepens as the age becomes younger, with a maximum occurs at 7 - 8Gyr, after then it becomes flatter. Similar trend with age is also presented in the vertical gradients. We infer that the formation of the Galactic disk has experienced at least two phases. The earlier phase is probably a slow, pressure-supported collapse of gas, where the gas settle down to the disk from the vertical direction. In the later phase, there is significant radial flow of gas. Transition of the gas behaviors between the two phases occurs between 8 and 11Gyr. The two phases are responsible for the formation of the Galactic thick and thin disks, respectively, and consequently, we recommend that the age is a natural, physical criterion to

  4. Treatment outcomes for substance use disorder among women of reproductive age in Massachusetts: A population-based approach

    PubMed Central

    Bernstein, Judith; Derrington, Taletha M.; Belanoff, Candice; Cabral, Howard J.; Babakhanlou-Chase, Hermik; Diop, Hafsatou; Evans, Stephen R.; Jacobs, Hilary; Kotelchuck, Milton

    2014-01-01

    Introduction Longitudinal patterns of treatment utilization and relapse among women of reproductive age with substance use disorder (SUD) are not well known. In this statewide report spanning seven years we describe SUD prevalence, SUD treatment utilization, and differences in subsequent emergency department (ED) use and post-treatment relapse rates by type of treatment: none, ‘acute only’ (detoxification/stabilization), or ‘ongoing’ services. Methods We linked a statewide dataset of hospital discharge, observation stay and ED records with SUD treatment admission records from hospitals and freestanding facilities, and birth/fetal death certificates, in Massachusetts, 2002–2008. We aggregated episodes into individual woman records, identified evidence of SUD and treatment, and tested post-treatment outcomes. Results Nearly 150,000 (8.5%) of 1.7 million Massachusetts women aged 15–49 were identified as SUD-positive. Nearly half of SUD-positive women (71,533 or 48.3%) had evidence of hospital or facility-based SUD treatment; among these, 12% received acute care/detoxification only while 88% obtained ‘ongoing’ treatment. Treatment varied by substance type; women with dual diagnosis and those with opiate use were least likely to receive ‘ongoing’ treatment. Treated women were older and less likely to have a psychiatric history or chronic illness. Women who received ‘acute only’ services were more likely to relapse (12.4% vs. 9.6%) and had a 10% higher rate of ED visits post-treatment than women receiving ‘ongoing’ treatment. Conclusions Many Massachusetts women of reproductive age need but do not receive adequate SUD treatment. ‘Ongoing’ services beyond detoxification/stabilization may reduce the likelihood of post-treatment relapse and/or reliance on the ED for subsequent medical care. PMID:25496707

  5. Spatial and seasonal patterns in abundance and age-composition of Calanus finmarchicus in the Gulf of Maine and on Georges Bank: 1977 1987

    NASA Astrophysics Data System (ADS)

    Meise, C. J.; O'Reilly, J. E.

    ubiquitously very abundant (> 10 4/10 m 2), and diverged from September to December. C. finmarchicus stage distribution in the GB-GOM area was highly negatively correlated with mean water column temperature during the stratified season. This seemed more related to the hydrography of the region, which isolates warmer well mixed Georges Bank from the Gulf of Maine and the stratified areas on the Bank, than to temperature, because Calanus abundances decline on the Bank before water temperatures exceed their preferences. A large part of the spatial and seasonal variation in C. finmarchicus abundance and age structure appears to be tightly coupled to major hydrographic regimes and to major circulation patterns in the region. There was a sharp ecotone between well-mixed Georges Bank and the Gulf of Maine as defined by C. finmarchicus abundance patterns and life history distributions. The ecotone is present year-round but is most apparent during the stratified season (May-October), when thermohaline density gradients and the near-surface current jet along the northern flank are generally strongest. The Gulf of Maine had the highest abundances of C. finmarchicus, and lowest spatial and seasonal variation in the region, while tidally mixed Georges Banks displayed the opposite pattern. This indication of stable population centers in the Gulf of Maine would make it a major source of Calanus in the region, particularly during March-April. Distributional patterns also suggest a strong Calanus influence from Scotian Shelf water in northern Gulf of Maine and on the southern flank of Georges Bank.

  6. Fixed bimonthly aflibercept in naïve and switched neovascular age-related macular degeneration patients: one year outcomes

    PubMed Central

    Warwick, Alasdair N; Leaver, Hannah H; Lotery, Andrew J; Goverdhan, Srini V

    2016-01-01

    AIM To determine real life clinical outcomes in poorly responsive and treatment-naïve neovascular age related macular degeneration (nvAMD) patients using bimonthly fixed dosing aflibercept regimen. METHODS This was a retrospective study of 165 eyes with nvAMD started on aflibercept at Southampton Eye Unit between June 2013 and June 2014. Patients were either switched from pro re nata (PRN) ranibizumab/bevacizumab due to poor response (107 eyes), or treatment-naïve (58 eyes). Patients initially received 3-monthly intravitreal aflibercept injections followed by 2-monthly fixed doses. Clinic visits were scheduled at month 0, 4, 10 and 12. Mean change in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) from baseline were assessed using the Wilcoxon signed-rank test. The proportion of patients maintaining BCVA (<15 letters loss) at 12mo was also evaluated. RESULTS Mean BCVA change at month 12 was +3.29 and +4.67 letters in the switched and naïve aflibercept groups respectively (P<0.01). BCVA was maintained in 95.3% of switched and 96.6% of naïve patients. CRT at month 12 showed a decrease of -6.16 µm in the switched group and -35.36 µm in the naïve group (P<0.01). Patients previously treated with ranibizumab/bevacizumab had on average received 7.4 ranibizumab/bevacizumab injections over 12.6mo, attending 10 clinic visits. The fixed dosing aflibercept regimen required an average of 7.1 injections (naïve group), 7.5 injections (switched group) and 4 clinic visits per year. CONCLUSION Fixed bimonthly aflibercept is effective in both treatment-naïve and poorly responsive nvAMD patients. Adopting a fixed dosing regimen can reduce patient burden without compromising on outcomes. PMID:27588271

  7. Noble gas composition and 40Ar/39Ar age in eclogites from the main hole of the Chinese Continental Scientific Drilling project

    NASA Astrophysics Data System (ADS)

    Hopp, Jens; Schwarz, Winfried H.; Trieloff, Mario; Meyer, Hans-Peter; Hanel, Michael; Altherr, Rainer

    2016-10-01

    We present the first comprehensive noble gas study on eclogites. The four eclogite samples were recovered during the Chinese Continental Scientific Drilling and are from two distinct profile depth sections differing in their degree of interaction with meteoric water, based on their δ 18O-values (surface related and of mantle-type). Hence, noble gas analyses offer the potential to further discriminate between shallow (meteoric) and deep (mantle) fluid sources. Noble gas compositions reveal typical crustal fluid compositions, characterized by a variable mixture of atmospheric gases with significant contributions of nucleogenic neon, radiogenic 4He*, radiogenic 40Ar*, fissiogenic 131-136Xe, and presumably bariogenic 131Xe, but no significant addition of mantle gases. This signature can be also considered to represent one endmember component of eclogitic diamonds. Concentrations of non-radiogenic noble gases are rather low, with depletion of light relative to the heavier noble gases. Eclogites from lower depth which experienced a higher degree of interaction with meteoric water also showed higher contributions of atmospheric gas compared with eclogites recovered from greater depth. This is interpreted to result from interaction with high-salinity fluids during ultrahigh pressure (UH P). It demonstrates that the atmospheric noble gas abundance is a proxy for interaction with surface related fluids. 40Ar/39Ar (inverse) isochron ages of two phengite separates (241.2 ± 0.4 Ma and 275.0 ± 1.8 Ma, 1 σ-errors) predate the main phase of UH P metamorphism (ca. 220 Ma). Biotite yields an integrated age of about 1100 Ma. These age values are interpreted to reflect the likely addition of excess 40Ar without any chronological meaning.

  8. Dopaminergic and Prefrontal Contributions to Reward-Based Learning and Outcome Monitoring during Child Development and Aging

    ERIC Educational Resources Information Center

    Hammerer, Dorothea; Eppinger, Ben

    2012-01-01

    In many instances, children and older adults show similar difficulties in reward-based learning and outcome monitoring. These impairments are most pronounced in situations in which reward is uncertain (e.g., probabilistic reward schedules) and if outcome information is ambiguous (e.g., the relative value of outcomes has to be learned).…

  9. Impact of cytomegalovirus infection, year of transplantation, and donor age on outcomes after liver transplantation for hepatitis C.

    PubMed

    Burak, Kelly W; Kremers, Walter K; Batts, Kenneth P; Wiesner, Russell H; Rosen, Charles B; Razonable, Raymund R; Paya, Carlos V; Charlton, Michael R

    2002-04-01

    Recurrence of hepatitis C virus (HCV) infection after liver transplantation (LT) is almost universal. However, variables that hasten the progression of allograft injury have not been fully defined. Cytomegalovirus (CMV) is a common infection post-LT, and its impact on the course of post-LT HCV infection remains unclear. We investigated the impact of CMV infection on patient and graft outcomes in 93 consecutive HCV-infected liver transplant recipients. Data were collected prospectively, with surveillance cultures for CMV and protocol liver biopsies. CMV infection (defined as isolation of CMV from blood and treatment with ganciclovir) occurred in 25 patients (26.9%). Graft failure (defined as cirrhosis, relisting for LT, re-LT, or death) was significantly more common in CMV-positive compared with CMV-negative patients (52% v 19.1%; P =.002). Fibrosis stage 2 or greater on the 4-month liver biopsy specimen was more common in CMV-infected patients (45% v 16.4%; P =.01). Patients who underwent LT in more recent years had an increased risk for graft failure. Donor and recipient age, CMV infection, and mycophenolate mofetil use were significantly associated with graft failure in a stepwise multivariate analysis. CMV infection occurs in approximately one quarter of HCV-infected liver transplant recipients and is an independent risk factor for graft failure in these patients. Whether CMV mediates this by inducing increased immunosuppression or directly enhancing HCV replication requires further study.

  10. Treatment of neovascular age-related macular degeneration with anti-VEGF agents: retrospective analysis of 5-year outcomes

    PubMed Central

    Pedrosa, Ana Catarina; Reis-Silva, Adriana; Pinheiro-Costa, João; Beato, João; Freitas-da-Costa, Paulo; Falcão, Manuel S; Falcão-Reis, Fernando; Carneiro, Ângela

    2016-01-01

    Purpose To evaluate the 5-year results obtained in clinical practice in the treatment of neovascular age-related macular degeneration (nAMD) with anti-VEGF agents. Materials and methods We retrospectively analyzed all patients with nAMD who initiated anti-VEGF treatment before October 2009. We collected data regarding visual and anatomical outcomes. Results A total of 278 patients met the selection criteria. The mean number of intravitreal injections was 5.7 in the first year and 3.7 in the fifth year. A positive mean visual acuity variation of +3.7 Early Treatment Diabetic Retinopathy Study letters occurred in the first year, but no significant differences relative to baseline were observed thereafter. The majority of patients (71%) maintained stable visual acuity throughout follow-up. At 5 years, mean central macular thickness remained substantially inferior to baseline (−96.6 μm), and 56% of patients maintained dry retinas. Conclusion Anti-VEGF therapy leads to long-term visual stabilization in the great majority of patients. PMID:27099460

  11. Development of a web-based tool for the assessment of health and economic outcomes of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA)

    PubMed Central

    2015-01-01

    Background The European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) is a European Commission led policy initiative to address the challenges of demographic change in Europe. For monitoring the health and economic impact of the social and technological innovations carried out by more than 500 stakeholder's groups ('commitments') participating in the EIP on AHA, a generic and flexible web-based monitoring and assessment tool is currently being developed. Aim This paper describes the approach for developing and implementing this web-based tool, its main characteristics and capability to provide specific outcomes that are of value to the developers of an intervention, as well as a series of case studies planned before wider rollout. Methods The tool builds up from a variety of surrogate endpoints commonly used across the diverse set of EIP on AHA commitments in order to estimate health and economic outcomes in terms of incremental changes in quality adjusted life years (QALYs) as well as health and social care utilisation. A highly adaptable Markov model with initially three mutually exclusive health states ('baseline health', 'deteriorated health' and 'death') provides the basis for the tool which draws from an extensive database of epidemiological, economic and effectiveness data; and also allows further customisation through remote data entry enabling more accurate and context specific estimation of intervention impact. Both probabilistic sensitivity analysis and deterministic scenario analysis allow assessing the impact of parameter uncertainty on intervention outcomes. A set of case studies, ranging from the pre-market assessment of early healthcare technologies to the retrospective analysis of established care pathways, will be carried out before public rollout, which is envisaged end 2015. Conclusion Monitoring the activities carried out within the EIP on AHA requires an approach that is both flexible and consistent in the way health and

  12. Stage IV and age over 45 years are the only prognostic factors of the International Prognostic Score for the outcome of advanced Hodgkin lymphoma in the Spanish Hodgkin Lymphoma Study Group series.

    PubMed

    Guisado-Vasco, Pablo; Arranz-Saez, Reyes; Canales, Miguel; Cánovas, Araceli; Garcia-Laraña, José; García-Sanz, Ramón; Lopez, Andrés; López, José Luis; Llanos, Marta; Moraleda, José Maria; Rodriguez, José; Rayón, Consuelo; Sabin, Pilar; Salar, Antonio; Marín-Niebla, Ana; Morente, Manuel; Sánchez-Godoy, Pedro; Tomás, José Francisco; Muriel, Alfonso; Abraira, Victor; Piris, Miguel A; Garcia, Juán F; Montalban, Carlos

    2012-05-01

    The International Prognostic Score (IPS) is the most widely used system to date for identifying risk groups for the outcome of patients with advanced Hodgkin lymphoma, although important limitations have been recognized. We analyzed the value of the IPS in a series of 311 patients with advanced classical Hodgkin lymphoma (cHL) (Ann Arbor stage III, IV or stage II with B symptoms and/or bulky masses) treated with first-line chemotherapy including adriamycin (adriamycin, bleomycin, vinblastine, dacarbazine [ABVD] or equivalent variants). In univariate and multivariate analyses, stage IV disease and age ≥ 45 years were the only factors with independent predictive significance for overall survival (OS) (p = 0.002 and p < 0.001, respectively). Stage IV was still significant for freedom from progression (FFP) (p = 0.001) and age ≥ 45 years was borderline significant (p = 0.058). IPS separates prognostic groups, as in the original publication, but this is mainly due to the high statistical significance of stage IV and age ≥ 45 years. Moreover, the combination of these two factors enables a simpler system to be constructed that separates groups with different FFP and OS. In conclusion, in our series, stage IV and age ≥ 45 years are the key prognostic factors for the outcome of advanced cHL.

  13. Effect of Supported Employment on Vocational Rehabilitation Outcomes of Transition-Age Youth with Intellectual and Developmental Disabilities: A Case Control Study

    ERIC Educational Resources Information Center

    Wehman, Paul; Chan, Fong; Ditchman, Nicole; Kang, Hyun-Ju

    2014-01-01

    The purpose of this study was to examine the effect of supported employment intervention on the employment outcomes of transition-age youth with intellectual and developmental disabilities served by the public vocational rehabilitation system using a case-control study design. Data for this study were extracted from the Rehabilitation Services…

  14. Atomic diffusion in metal poor stars. The influence on the Main Sequence fitting distance scale, subdwarfs ages and the value of Delta Y/ Delta Z

    NASA Astrophysics Data System (ADS)

    Salaris, M.; Groenewegen, M. A. T.; Weiss, A.

    2000-03-01

    The effect of atomic diffusion on the Main Sequence (MS) of metal-poor low mass stars is investigated. Since diffusion alters the stellar surface chemical abundances with respect to their initial values, one must ensure - by calibrating the initial chemical composition of the theoretical models - that the surface abundances of the models match the observed ones of the stellar population under scrutiny. When properly calibrated, our models with diffusion reproduce well within the errors the Hertzsprung-Russell diagram of Hipparcos subdwarfs with empirically determined T_eff values and high resolution spectroscopical [Fe/H] determinations. Since the observed surface abundances of subdwarfs are different from the initial ones due to the effect of diffusion, while the globular clusters stellar abundances are measured in Red Giants, which have practically recovered their initial abundances after the dredge-up, the isochrones to be employed for studying globular clusters and Halo subdwarfs with the same observational value of [Fe/H] are different and do not coincide. This is at odds with the basic assumption of the MS-fitting technique for distance determinations. However, the use of the rather large sample of Hipparcos lower MS subdwarfs with accurate parallaxes keeps at minimum the effect of these differences, for two reasons. First, it is possible to use subdwarfs with observed [Fe/H] values close to the cluster one; this minimizes the colour corrections (which are derived from the isochrones) needed to reduce all the subdwarfs to a mono-metallicity sequence having the same [Fe/H] than the cluster. Second, one can employ objects sufficiently faint so that the differences between the subdwarfs and cluster MS with the same observed value of [Fe/H] are small (they increase for increasing luminosity). We find therefore that the distances based on standard isochrones are basically unaltered when diffusion is taken properly into account. On the other hand, the absolute ages

  15. Manganese Exposure and Neurocognitive Outcomes in Rural School-Age Children: The Communities Actively Researching Exposure Study (Ohio, USA)

    PubMed Central

    Sucharew, Heidi; Kuhnell, Pierce; Alden, Jody; Barnas, Mary; Wright, Robert O.; Parsons, Patrick J.; Aldous, Kenneth M.; Praamsma, Meredith L.; Beidler, Caroline; Dietrich, Kim N.

    2015-01-01

    Haynes EN, Sucharew H, Kuhnell P, Alden J, Barnas M, Wright RO, Parsons PJ, Aldous KM, Praamsma ML, Beidler C, Dietrich KN. 2015. Manganese exposure and neurocognitive outcomes in rural school-age children: the Communities Actively Researching Exposure Study (Ohio, USA). Environ Health Perspect 123:1066–1071; http://dx.doi.org/10.1289/ehp.1408993 PMID:25902278

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

    PubMed

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

    2015-12-01

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

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

    PubMed

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

    2015-12-01

    The Hemophilia Experiences, Results and Opportunities (HERO) initiative assessed psychosocial issues reported by people with moderate to severe hemophilia and was led by a multidisciplinary international advisory board. This analysis reports data from young adult respondents (aged 18-30 years), including both US and overall global (including US respondents) results, and investigates treatment outcomes, quality of life, and impacts of hemophilia on relationships. More young adults in HERO received prophylaxis than on-demand treatment, although a majority reported not using factor products exactly as prescribed, and 50% of global respondents and 26% of US respondents reported issues with access to factor replacement therapy in the previous 5 years. Many young adults with hemophilia reported comorbidities, including bone/skeletal arthritis, chronic pain, and viral infections, and nearly half of young adults reported anxiety/depression. Most reported pain interference with daily activities in the past 4 weeks, although a majority reported participating in lower-risk activities and approximately half in intermediate-risk activities. Most young adults were very or quite satisfied with the support of partners/spouses, family, and friends, although roughly one-third reported that hemophilia affected their ability to develop close relationships with a partner. A majority of young adults reported that hemophilia has had a negative impact on employment, and 62% of global respondents and 78% of US respondents were employed at least part-time. Together these data highlight the psychosocial issues experienced by young adults with hemophilia and suggest that increased focus on these issues may improve comprehensive care during the transition to adulthood. PMID:26619194

  18. Impact of age on outcomes of allogeneic hematopoietic stem cell transplantation with reduced intensity conditioning in elderly patients with acute myeloid leukemia.

    PubMed

    Aoki, Jun; Kanamori, Heiwa; Tanaka, Masatsugu; Yamasaki, Satoshi; Fukuda, Takahiro; Ogawa, Hiroyasu; Iwato, Koji; Ohashi, Kazuteru; Okumura, Hirokazu; Onizuka, Makoto; Maesako, Yoshitomo; Teshima, Takanori; Kobayashi, Naoki; Morishima, Yasuo; Hirokawa, Makoto; Atsuta, Yoshiko; Yano, Shingo; Takami, Akiyoshi

    2016-03-01

    Previous studies have repeatedly reported that increasing age is a significant risk factor for worse outcomes after allogeneic hematopoietic stem cell transplantation (allo-HSCT) among patients with acute myeloid leukemia (AML). However, more recent studies reported conflicting results regarding the association between age and outcomes in elderly patients. Therefore, we conducted a large-scale, nationwide retrospective study to examine the impact of age on outcomes of allo-HSCT with reduced intensity conditioning (RIC) for AML patients who were older than 50 years. Of the 757 patients, 89 patients (11.8%) were 50-54, 249 patients (32.9%) were 55-59, 301 patients (39.8%) were 60-64 and 118 patients (15.6%) were ≥65 years old. The 3-year overall survival (OS) (47.8, 45.2, 37.9, and 36.6% for patients aged 50-54, 55-59, 60-64, and ≥65 years, respectively, P = 0.24) and nonrelapse mortality (NRM) (24.0, 22.8, 29.2, and 27.6% for patients aged 50-54, 55-59, 60-64, and ≥65 years, respectively, P = 0.49) were not significantly different among the four age groups. Multivariate analysis revealed that increased age had no significant effect on OS or NRM after adjusting for covariates. These results suggested that advanced patient age is not a contraindication for RIC allo-HSCT in elderly AML patients. PMID:26663096

  19. Developmental interplay between children's biobehavioral risk and the parenting environment from toddler to early school age: Prediction of socialization outcomes in preadolescence.

    PubMed

    Kochanska, Grazyna; Boldt, Lea J; Kim, Sanghag; Yoon, Jeung Eun; Philibert, Robert A

    2015-08-01

    We followed 100 community families from toddler age to preadolescence. Each mother- and father-child dyad was observed at 25, 38, 52, 67, and 80 months (10 hr/child) to assess positive and power-assertive parenting. At age 10 (N = 82), we obtained parent- and child-reported outcome measures of children's acceptance of parental socialization: cooperation with parental monitoring, negative attitude toward substance use, internalization of adult values, and callous-unemotional tendencies. Children who carried a short serotonin transporter linked polymorphic region gene (5-HTTLPR) allele and were highly anger prone, based on anger observed in laboratory from 25 to 80 months, were classified as high in biobehavioral risk. The remaining children were classified as low in biobehavioral risk. Biobehavioral risk moderated links between parenting history and outcomes. For low-risk children, parenting measures were unrelated to outcomes. For children high in biobehavioral risk, variations in positive parenting predicted cooperation with monitoring and negative attitude toward substance use, and variations in power-assertive parenting predicted internalization of adult values and callous-unemotional tendencies. Suboptimal parenting combined with high biobehavioral risk resulted in the poorest outcomes. The effect for attitude toward substance use supported differential susceptibility: children high in biobehavioral risk who received optimal parenting had a more adaptive outcome than their low-risk peers. The remaining effects were consistent with diathesis-stress.

  20. Minimum age of the Neoproterozoic Seven Hundred Acre Island Formation and the tectonic setting of the Islesboro Formation, Islesboro block, Maine

    USGS Publications Warehouse

    Stewart, D.B.; Tucker, R.D.; Ayuso, R.A.; Lux, D.R.

    2001-01-01

    Two platformal stratigraphic sequences occur on Islesboro, Penobscot Bay, Maine. The older Seven Hundred Acre Island Formation is at least 200 m thick, its base is not exposed, and it makes up fault-bounded blocks of siliceous colour-banded dolomitic marble, muscovite-rich quartzite, coarse-grained splendent muscovite-garnet-staurolite-andalusite schist, and calcareous metapelite, with minor garnet amphibolite and amphibolite. It was initially metamorphosed to lower amphibolite facies and was later to lower greenschist facies. The lower amphibolite facies metamorphism is Neoproterozoic (670 to 650 Ma) as inferred from the 40Ar/39Ar high temperature release spectra of hornblende separates. A U-Pb zircon age of 646.7 ?? 2.7 Ma obtained for a pegmatite that intruded deformed rocks is taken to be the minimum age of the Formation. The platformal Islesboro Formation probably unconformably overlies the Seven Hundred Acre Island Formation. It is primarily turbiditic pelite with many beds of quartzite, impure dolomitic marble, some conglomerate, and a few feldsparrich volcaniclastic beds and is thought to be either Neoproterozoic or Cambrian. It was metamorphosed only to lower greenschist facies, possibly in the same event that retrograded the Seven Hundred Acre Island Formation. Geochemical interpretations of minor and trace element analyses of six amphibolite and four schist samples from the Seven Hundred Acre Island Formation show that the protoliths of the amphibolite samples were intermediate between tholeiitic and within-plate type basaltic flows or dikes that intruded attenuated continental crust, or were eroded from these basalts. Four amphibolite and three schist samples analyzed for Pb isotopes were found to be enriched in radiogenic Pb. The Pb isotopic compositions are similar to those in peri-Gondwanan basement rocks from Atlantic Canada. The peri-Gondwanan Islesboro block was placed against the peri-Gondwanan Middle and Late Cambrian Ellsworth terrane on the

  1. Congenital heart disease in low-birth-weight infants: effects of small for gestational age (SGA) status and maturity on postoperative outcomes.

    PubMed

    Wei, Daniel; Azen, Colleen; Bhombal, Shazia; Hastings, Laura; Paquette, Lisa

    2015-01-01

    Few studies have examined the role that small for gestational age (SGA) status plays in postoperative outcomes for low-birth-weight (LBW) infants with congenital heart disease (CHD). This study aimed to examine the effect of SGA status, gestational and chronologic age, and weight on differences in morbidities and mortalities during the immediate postoperative hospitalization period. The charts of infants with CHD weighing less than 2.5 kg who underwent operative repair during the neonatal period between 2004 and 2011 were reviewed. Infants with an isolated patent ductus arteriosus were excluded from the study. Data on hospital morbidities and mortality before discharge were collected. The study identified 136 LBW infants with a diagnosis of CHD. Among the 74 infants who underwent surgery and had complete chart records, the SGA infants had a higher gestational age at birth (36.8 vs. 32.3 weeks; p < 0.0001). The SGA and non-SGA infants did not differ in terms of survival to discharge or immediate postoperative outcomes. A lower weight at surgery was significantly associated with an increased risk of postoperative infection. In contradistinction, an older postnatal age at surgery was associated with an increased risk of preoperative infection (p < 0.0001). Additionally, lower gestational age at birth was associated with home oxygen use, higher tracheostomy rates, and discharge with a gastrostomy tube. Small for gestational age status played no protective role in the outcome for LBW infants after primary surgery for CHD. A weight of 2.4 kg or greater at the time of surgery was associated with lower rates of postoperative infections. Greater duration of time between birth and surgery was associated with a greater risk of preoperative infection. A gestational age of 32 weeks or more at birth was associated with decreased morbidities, which could influence obstetric management. PMID:24997649

  2. Age, JAK2(V617F) and SF3B1 mutations are the main predicting factors for survival in refractory anaemia with ring sideroblasts and marked thrombocytosis.

    PubMed

    Broséus, J; Alpermann, T; Wulfert, M; Florensa Brichs, L; Jeromin, S; Lippert, E; Rozman, M; Lifermann, F; Grossmann, V; Haferlach, T; Germing, U; Luño, E; Girodon, F; Schnittger, S

    2013-09-01

    Refractory anaemia with ring sideroblasts (RARS) and marked thrombocytosis (RARS-T) is a provisional entity in the World Health Organisation 2008 classification and has previously been shown to have a high proportion of JAK2(V617F) (Janus Kinase 2) and SF3B1 (Splicing Factor 3B subunit 1) mutations. The purpose of the present study was to analyse the frequency of SF3B1 mutations in a large cohort of 111 patients with RARS-T and 33 patients with RARS and to explore the prognostic impact of SF3B1 mutational status on RARS-T. The frequency of SF3B1 mutations in RARS-T (96/111, 86.5%) and RARS (28/33, 84.8%) was similar. In RARS-T, median survival was better in SF3B1-mutated patients than in SF3B1-non-mutated patients (6.9 and 3.3 years, respectively, P=0.003). RARS can be differentiated from RARS-T by the frequency of JAK2(V617F) (0% vs 48.6%). In RARS-T patients, SF3B1 (P=0.021) and JAK2 mutations (P=0.016) were independent factors for a better prognosis. Altogether, our results confirm that RARS-T is an independent entity that should be recognised by the next World Health Organisation classification. The assessment of SF3B1 mutations is of prognostic interest in RARS-T patients. Younger age, JAK2(V617F) and SF3B1 mutations are the main predicting factors for survival in RARS-T. PMID:23594705

  3. Acute Uncomplicated Febrile Illness in Children Aged 2-59 months in Zanzibar – Aetiologies, Antibiotic Treatment and Outcome

    PubMed Central

    Elfving, Kristina; Shakely, Deler; Andersson, Maria; Baltzell, Kimberly; Ali, Abdullah S.; Bachelard, Marc; Falk, Kerstin I.; Ljung, Annika; Msellem, Mwinyi I.; Omar, Rahila S.; Parola, Philippe; Xu, Weiping; Petzold, Max; Trollfors, Birger; Björkman, Anders; Lindh, Magnus; Mårtensson, Andreas

    2016-01-01

    Background Despite the fact that a large proportion of children with fever in Africa present at primary health care facilities, few studies have been designed to specifically study the causes of uncomplicated childhood febrile illness at this level of care, especially in areas like Zanzibar that has recently undergone a dramatic change from high to low malaria transmission. Methods We prospectively studied the aetiology of febrile illness in 677 children aged 2–59 months with acute uncomplicated fever managed by IMCI (Integrated Management of Childhood Illness) guidelines in Zanzibar, using point-of-care tests, urine culture, blood-PCR, chest X-ray (CXR) of IMCI-pneumonia classified patients, and multiple quantitative (q)PCR investigations of nasopharyngeal (NPH) (all patients) and rectal (GE) swabs (diarrhoea patients). For comparison, we also performed NPH and GE qPCR analyses in 167 healthy community controls. Final fever diagnoses were retrospectively established based on all clinical and laboratory data. Clinical outcome was assessed during a 14-day follow-up. The utility of IMCI for identifying infections presumed to require antibiotics was evaluated. Findings NPH-qPCR and GE-qPCR detected ≥1 pathogen in 657/672 (98%) and 153/164 (93%) of patients and 158/166 (95%) and 144/165 (87%) of controls, respectively. Overall, 57% (387/677) had IMCI-pneumonia, but only 12% (42/342) had CXR-confirmed pneumonia. Two patients were positive for Plasmodium falciparum. Respiratory syncytial virus (24.5%), influenza A/B (22.3%), rhinovirus (10.5%) and group-A streptococci (6.4%), CXR-confirmed pneumonia (6.2%), Shigella (4.3%) were the most common viral and bacterial fever diagnoses, respectively. Blood-PCR conducted in a sub-group of patients (n = 83) without defined fever diagnosis was negative for rickettsiae, chikungunya, dengue, Rift Valley fever and West Nile viruses. Antibiotics were prescribed to 500 (74%) patients, but only 152 (22%) had an infection

  4. School-Aged Functioning of Children Diagnosed with Autism Spectrum Disorder before Age Three: Parent-Reported Diagnostic, Adaptive, Medication, and School Placement Outcomes

    ERIC Educational Resources Information Center

    Towle, Patricia O.; Vacanti-Shova, Karyn; Shah, Shristi; Higgins-D'alessandro, Ann

    2014-01-01

    Eighty children with early autism spectrum disorder (ASD) diagnoses (under 36 months) were identified using a chart abstraction protocol applied to early intervention charts. Parents filled out questionnaires by mail when the children were school-aged (ages 6-16 years). Similar to previous studies, approximately 20 % no longer had ASD diagnoses;…

  5. Risk of Adverse Obstetric and Neonatal Outcomes by Maternal Age: Quantifying Individual and Population Level Risk Using Routine UK Maternity Data

    PubMed Central

    Penn, Nicole; Pipi, Maria; Oteng-Ntim, Eugene; Doyle, Pat

    2016-01-01

    Objective The objective of this study was to investigate whether moderately increased maternal age is associated with obstetric and neonatal outcome in a contemporary population, and to consider the possible role of co-morbidities in explaining any increased risk. Study Design Secondary analysis of routinely collected data from a large maternity unit in London, UK. Data were available on 51,225 singleton deliveries (≥22 weeks) occurring to women aged ≥20 between 2004 and 2012. Modified Poisson regression was used to estimate risk ratios for the association between maternal age and obstetric and neonatal outcome (delivery type, postpartum haemorrhage, stillbirth, low birthweight, preterm birth, small for gestational age, neonatal unit admission), using the reference group 20–24 years. Population attributable fractions were calculated to quantify the population impact. Results We found an association between increasing maternal age and major postpartum haemorrhage (≥1000ml blood loss) (RR 1.36 95% CI 1.18–1.57 for age 25–29 rising to 2.41 95% CI 2.02–2.88 for age ≥40). Similar trends were observed for caesarean delivery, most notably for elective caesareans (RR 1.64 95% CI 1.36–1.96 for age 25–29 rising to 4.94 95% CI 4.09–5.96 for age ≥40). There was evidence that parity modified this association, with a higher prevalence of elective caesarean delivery in older nulliparous women. Women aged ≥35 were at increased risk of low birthweight and preterm birth. We found no evidence that the risk of stillbirth, small for gestational age, or neonatal unit admission differed by maternal age. Conclusions Our results suggest a gradual increase in the risk of caesarean delivery and postpartum haemorrhage from age 25, persisting after taking into account maternal BMI, hypertension and diabetes. The risk of low birthweight and preterm birth was elevated in women over 35. Further research is needed to understand the reasons behind the high prevalence of

  6. Maine Ingredients

    ERIC Educational Resources Information Center

    Waters, John K.

    2009-01-01

    This article features Maine Learning Technology Initiative (MLTI), the nation's first-ever statewide 1-to-1 laptop program which marks its seventh birthday by expanding into high schools, providing an occasion to celebrate--and to examine the components of its success. The plan to put laptops into the hands of every teacher and student in grades 7…

  7. Relationship between office and home blood pressure with increasing age: The International Database of HOme blood pressure in relation to Cardiovascular Outcome (IDHOCO).

    PubMed

    Ntineri, Angeliki; Stergiou, George S; Thijs, Lutgarde; Asayama, Kei; Boggia, José; Boubouchairopoulou, Nadia; Hozawa, Atsushi; Imai, Yutaka; Johansson, Jouni K; Jula, Antti M; Kollias, Anastasios; Luzardo, Leonella; Niiranen, Teemu J; Nomura, Kyoko; Ohkubo, Takayoshi; Tsuji, Ichiro; Tzourio, Christophe; Wei, Fang-Fei; Staessen, Jan A

    2016-08-01

    Home blood pressure (HBP) measurements are known to be lower than conventional office blood pressure (OBP) measurements. However, this difference might not be consistent across the entire age range and has not been adequately investigated. We assessed the relationship between OBP and HBP with increasing age using the International Database of HOme blood pressure in relation to Cardiovascular Outcome (IDHOCO). OBP, HBP and their difference were assessed across different decades of age. A total of 5689 untreated subjects aged 18-97 years, who had at least two OBP and HBP measurements, were included. Systolic OBP and HBP increased across older age categories (from 112 to 142 mm Hg and from 109 to 136 mm Hg, respectively), with OBP being higher than HBP by ∼7 mm Hg in subjects aged >30 years and lesser in younger subjects (P=0.001). Both diastolic OBP and HBP increased until the age of ∼50 years (from 71 to 79 mm Hg and from 66 to 76 mm Hg, respectively), with OBP being consistently higher than HBP and a trend toward a decreased OBP-HBP difference with aging (P<0.001). Determinants of a larger OBP-HBP difference were younger age, sustained hypertension, nonsmoking and negative cardiovascular disease history. These data suggest that in the general adult population, HBP is consistently lower than OBP across all the decades, but their difference might vary between age groups. Further research is needed to confirm these findings in younger and older subjects and in hypertensive individuals. PMID:27053011

  8. Age-differences in work motivation and job satisfaction. The influence of age on the relationships between work characteristics and workers' outcomes.

    PubMed

    Boumans, Nicolle P G; de Jong, Ad H J; Janssen, Sara M

    2011-01-01

    This study investigated the influence of age on the relationship between work characteristics and workers' work motivation and job satisfaction. In total, 1036 workers of a Dutch division of a multinational organization participated. Data were collected by a digital questionnaire. Two interaction terms in the regression on work motivation were significant. The first interaction showed that the positive correlation between Motivating Potential Score (MPS) and motivation was much stronger for older than for younger employees. So, to remain motivated, older employees seem more in need of intrinsic challenging and fulfilling jobs. The second significant interaction indicated that the positive association between career opportunities and motivation was much stronger for younger employees than for older employees. This means that, especially, younger workers' motivation increases as they are offered more career opportunities. Careful career mentoring by the supervisor as part of an aging policy can contribute to the maintenance of workers of any age.

  9. The Effects of Age Composition of 12-Step Groups on Adolescent 12-Step Participation and Substance Use Outcome

    ERIC Educational Resources Information Center

    Kelly, John F.; Myers, Mark G.; Brown, Sandra A.; Myers, Mark

    2005-01-01

    Youth substance use disorder treatment programs frequently advocate integration into 12-Step fellowships to help prevent relapse. However, the effects of the predominantly adult composition of 12-step groups on adolescent involvement and substance use outcome remain unstudied. Greater knowledge could enhance the specificity of treatment…

  10. A Meta-Analysis of Morphological Interventions in English: Effects on Literacy Outcomes for School-Age Children

    ERIC Educational Resources Information Center

    Goodwin, Amanda P.; Ahn, Soyeon

    2013-01-01

    The purpose of this study is to examine the effects of morphological instruction on language and literacy outcomes by synthesizing 92 standardized mean differences (d) from 30 independent studies. Findings show a moderate overall effect of morphological instruction ([d-bar] = 0.32), suggesting that children receiving morphological instruction…

  11. Predicting Language and Social Outcomes at Age 5 for Later-Born Siblings of Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Malesa, Elizabeth; Foss-Feig, Jennifer; Yoder, Paul; Warren, Zachary; Walden, Tedra; Stone, Wendy L.

    2013-01-01

    The relation between early joint attention (in which a child coordinates attention between another person and an object or event) and later language and social outcomes was examined in younger siblings of children with autism spectrum disorder (Sibs-ASD) and younger siblings of children with typical development (Sibs-TD). Initial levels of joint…

  12. Age-related outcomes following intracranial aneurysm treatment with the Pipeline Embolization Device: a subgroup analysis of the IntrePED registry.

    PubMed

    Brinjikji, Waleed; Kallmes, David F; Cloft, Harry J; Lanzino, Giuseppe

    2016-06-01

    OBJECT The association between age and outcomes following aneurysm treatment with flow diverters such as the Pipeline Embolization Device (PED) have not been well established. Using the International Retrospective Study of the Pipeline Embolization Device (IntrePED) registry, the authors assessed the age-related clinical outcomes of patients undergoing aneurysm embolization with the PED. METHODS Patients with unruptured aneurysms in the IntrePED registry were divided into 4 age groups: ≤ 50, 51-60, 61-70, and > 70 years old. The rates of the following postoperative complications were compared between age groups using chi-square tests: spontaneous rupture, intracranial hemorrhage (ICH), ischemic stroke, parent artery stenosis, cranial neuropathy, neurological morbidity, neurological mortality, combined neurological morbidity and mortality, and all-cause mortality. The association between age and these complications was tested in a multivariate logistic regression analysis adjusted for sex, number of PEDs, and aneurysm size, location, and type. RESULTS Seven hundred eleven patients with 820 unruptured aneurysms were included in this study. Univariate analysis demonstrated no significant difference in ICH rates across age groups (lowest 1.0% for patients ≤ 50 years old and highest 5.0% for patients > 70 years old, p = 0.097). There was no difference in ischemic stroke rates (lowest 3.6% for patients ≤ 50 years old and highest 6.0% for patients 50-60 years old, p = 0.73). Age > 70 years old was associated with higher rates of neurological mortality; patients > 70 years old had neurological mortality rates of 7.4% compared with 3.3% for patients 61-70 years old, 2.7% for patients 51-60 years old, and 0.5% for patients ≤ 50 years old (p = 0.006). On multivariate logistic regression analysis, increasing age was associated with higher odds of combined neurological morbidity and mortality (odds ratio 1.02, 95% confidence interval 1.00-1.05; p = 0.03). CONCLUSIONS

  13. Age-Differences in Work Motivation and Job Satisfaction. The Influence of Age on the Relationships between Work Characteristics and Workers' Outcomes

    ERIC Educational Resources Information Center

    Boumans, Nicolle P. G.; de Jong, Ad H. J.; Janssen, Sara M.

    2011-01-01

    This study investigated the influence of age on the relationship between work characteristics and workers' work motivation and job satisfaction. In total, 1036 workers of a Dutch division of a multinational organization participated. Data were collected by a digital questionnaire. Two interaction terms in the regression on work motivation were…

  14. The movement assessment battery in Greek preschoolers: the impact of age, gender, birth order, and physical activity on motor outcome.

    PubMed

    Giagazoglou, Paraskevi; Kabitsis, Nikolaos; Kokaridas, Dimitrios; Zaragas, Charilaos; Katartzi, Ermioni; Kabitsis, Chris

    2011-01-01

    Early identification of possible risk factors that could impair the motor development is crucial, since poor motor performance may have long-term negative consequences for a child's overall development. The aim of the current study was the examination of disorders in motor coordination in Greek pre-school aged children and the detection of differences in motor performance with regards to age, gender, participation in sports and order of birth in the family. Performance profiles on the movement ABC were used to classify 412 Greek children aged 4-6 years old. It appears from the results that the occurrence rate of probable developmental coordination disorders (DCD) was 5.4%. Significant differences were observed in all independent variables except the order of birth in the family. The findings reinforce the need for the evaluation of motor performance in preschool-aged children, in order specific individual motor profiles to be established for optimizing and adapting early intervention programs.

  15. Impact of Age and Sex on Outcomes and Hospital Cost of Acute Asthma in the United States, 2011-2012

    PubMed Central

    Teague, W. Gerald; Koroukian, Siran M.; Schlitz, Nicholas K.; Bleecker, Eugene R.; Busse, William B.; Calhoun, William J.; Castro, Mario; Comhair, Suzy A.; Fitzpatrick, Anne M.; Israel, Elliot; Wenzel, Sally E.; Holguin, Fernando; Gaston, Benjamin M.

    2016-01-01

    Background Worldwide, asthma is a leading cause of morbidity, mortality and economic burden, with significant gender and racial disparities. However, little attention has been given to the independent role of age on lifetime asthma severity and hospitalization. We aimed to assess the effect of age, gender, race and ethnicity on indicators of asthma severity including asthma related hospitalization, mortality, hospital cost, and the rate of respiratory failure. Methods We analyzed the 2011 and 2012 Healthcare Cost and Utilization Project- National Inpatient Sample (NIS). We validated and extended those results using the National Heart, Lung, and Blood Institute-Severe Asthma Research Program (SARP; 2002–2011) database. Severe asthma was prospectively defined using the stringent American Thoracic Society (ATS) definition. Results Hospitalization for asthma was reported in 372,685 encounters in 2012 and 368,528 in 2011. The yearly aggregate cost exceeded $2 billion. There were distinct bimodal distributions for hospitalization age, with an initial peak at 5 years and a second at 50 years. Likewise, this bimodal age distribution of patients with severe asthma was identified using SARP. Males comprised the majority of individuals in the first peak, but women in the second. Aggregate hospital cost mirrored the bimodal peak distribution. The probability of respiratory failure increased with age until the age of 60, after which it continued to increase in men, but not in women. Conclusions Severe asthma is primarily a disease of young boys and middle age women. Greater understanding of the biology of lung aging and influence of sex hormones will allow us to plan for targeted interventions during these times in order to reduce the personal and societal burdens of asthma. PMID:27294365

  16. Cognitive and Neuropsychological Outcomes at 5 Years of Age in Preterm Children Born in the 2000s

    ERIC Educational Resources Information Center

    Lind, Annika; Korkman, Marit; Lehtonen, Liisa; Lapinleimu, Helena; Parkkola, Riitta; Matomaki, Jaakko; Haataja, Leena

    2011-01-01

    Aim: The aim of this study was to assess the cognitive level and neuropsychological performance at 5 years of age in children with a very low birthweight (VLBW; birthweight less than 1501g) born in 2001 to 2003. Method: A regional cohort of 97 children with a VLBW (mean gestational age 28wks [SD 3wks]; mean birthweight 1054g [SD 259g]; 50 male; 47…

  17. Effects of a joint supplement whose main components are resveratrol and hyaluronic acid on some biochemical parameters in aged lame horses

    PubMed Central

    EMEME, Mary U.; ABDULLAHI, Usman S.; SACKEY, Anthony K. B.; AYO, Joseph O.; MSHELIA, Wayuta P.; EDEH, Richard E.

    2016-01-01

    ABSTRACT This study aimed to evaluate the effects of a supplement that contains resveratrol and hyaluronic acid (RH supplement) in aged lame horses. A total of 16 horses of both sexes, aged between 15 and 22 years, weighing between 350–450 kg and showing lameness due to arthritis of the knee, hock, stifle, and fetlock joints and stiffness owing to ageing were used for the study. They comprised eight horses that were administered the RH supplement for three weeks and eight others that served as controls and were given only a Saccharomyces cerevisiae yeast strain used as carrier in the supplement. Blood samples were collected from each horse before supplementation (week 0) and at weekly intervals for the three weeks of the experiment. Biochemical parameters including creatine kinase, aspartate aminotransferase, urea, glucose, total cholesterol, sodium, potassium, chloride, and calcium were measured by standard methods. There was a significant (P˂0.05) reduction in values of creatine kinase and glucose in the horses administered the RH supplement. It was concluded that the RH supplement may reduce the level of these biochemical parameters and their deleterious effects especially during ageing in horses. PMID:27073333

  18. Comparison of 85KR and 3H Apparent Ground-Water Ages for Source Water Vulterability in the COLLYER RIVER CATCHMENT, MAINE

    EPA Science Inventory

    Apparent ground-water ages as determined by the noble gas isotope 85Kr and the water isotope 3H are compared. Refined gas extraction methodology at the wellhead permits efficient collection of Kr for 85Kr isotope enrichment. 85Kr isoch...

  19. Effects of a joint supplement whose main components are resveratrol and hyaluronic acid on some biochemical parameters in aged lame horses.

    PubMed

    Ememe, Mary U; Abdullahi, Usman S; Sackey, Anthony K B; Ayo, Joseph O; Mshelia, Wayuta P; Edeh, Richard E

    2016-01-01

    This study aimed to evaluate the effects of a supplement that contains resveratrol and hyaluronic acid (RH supplement) in aged lame horses. A total of 16 horses of both sexes, aged between 15 and 22 years, weighing between 350-450 kg and showing lameness due to arthritis of the knee, hock, stifle, and fetlock joints and stiffness owing to ageing were used for the study. They comprised eight horses that were administered the RH supplement for three weeks and eight others that served as controls and were given only a Saccharomyces cerevisiae yeast strain used as carrier in the supplement. Blood samples were collected from each horse before supplementation (week 0) and at weekly intervals for the three weeks of the experiment. Biochemical parameters including creatine kinase, aspartate aminotransferase, urea, glucose, total cholesterol, sodium, potassium, chloride, and calcium were measured by standard methods. There was a significant (P˂0.05) reduction in values of creatine kinase and glucose in the horses administered the RH supplement. It was concluded that the RH supplement may reduce the level of these biochemical parameters and their deleterious effects especially during ageing in horses. PMID:27073333

  20. Breast cancer screening outcomes in women ages 40-49: clinical experience with service screening using modern mammography.

    PubMed

    Sickles, E A

    1997-01-01

    The several randomized controlled trials (RCTs) of breast cancer screening among women of ages 40 to 49 now collectively show a statistically significant reduction in breast cancer mortality. However, there have been numerous recent advances in mammography, such that it now is demonstrably better than when the RCTs were conducted. The use of surrogate measures of screening efficacy (tumor size, lymph node status, cancer stage), readily derived from modern service screening programs, demonstrates how the improved mammography of the 1990s should produce a greater degree of mortality reduction among women ages 40-49 than that already demonstrated in the RCTs. Indeed, these surrogate measures of mortality reduction are as favorable for women of ages 40-49 and 65+ as they are for women of ages 50-64, strongly suggesting that, since modern service screening is accepted as effectively reducing mortality among women of ages 50-64, it should also effectively reduce mortality among women in the 40-49 and 65+ age groups.

  1. Labeling and the effect of adolescent legal system involvement on adult outcomes for foster youth aging out of care.

    PubMed

    Lee, JoAnn S; Courtney, Mark E; Harachi, Tracy W; Tajima, Emiko A

    2015-09-01

    This study uses labeling theory to examine the role that adolescent legal system involvement may play in initiating a process of social exclusion, leading to higher levels of adult criminal activities among foster youth who have aged out of care. We used data from the Midwest Evaluation of the Adult Functioning of Former Foster Youth (Midwest Study), a prospective study that sampled 732 youth from Illinois, Iowa, and Wisconsin as they were preparing to leave the foster care system at ages 17 or 18. The youth were interviewed again at ages 19, 21, and 23 or 24. We used structural equation modeling to examine pathways to self-reported adult criminal behaviors from juvenile legal system involvement. The path model indicated that legal system involvement as a juvenile was associated with a lower likelihood of having a high school diploma at age 19, which was associated with a reduced likelihood of employment and increased criminal activities at age 21. Legal system involvement is more common among foster youth aging out of care, and this legal system involvement appears to contribute to a process of social exclusion by excluding former foster youth from conventional opportunities.

  2. Adolescent mothers and their children: changes in maternal characteristics and child developmental and behavioral outcome at school age.

    PubMed

    Camp, B W

    1996-06-01

    This study examines stability and change in characteristics of adolescent mothers from their child's infancy to school age, describes cognitive and behavioral characteristics of their children at school age, and reports on the relationship between maternal characteristics and child behavior and development at school age. Cognitive status and childrearing attitudes were assessed in 43 adolescent mothers (mean age 16.3 years) when their children were infants (Time 1) and again when children were school age (Time 2). At school age, mothers also completed the Louisville Behavior Checklist, and children were administered the Slosson Intelligence Test and the Wide Range Achievement Test. Significant correlations were obtained between maternal measures at Time 1 and Time 2, and no significant differences were observed between mean scores at Time 1 and Time 2 on any measures. Children demonstrated average intelligence, but mean achievement was almost 1 SD below average. Significantly more children had high scores than expected on scales for hyperactivity and academic disability. Except for maternal vocabulary, maternal measures obtained at Time 1 were not directly related to children's IQ or behavior problems. Maternal vocabulary and authoritarian and hostile childrearing attitudes assessed at Time 1 contributed independently to prediction of achievement test scores in a positive direction. Mothers' vocabulary at Time 2 and high or increased hostile childrearing attitudes contributed positively to prediction of child IQ. Mothers who still had high scores in authoritarian childrearing attitudes or whose scores increased had children with lower IQs. Changes in attitudes or contemporary measures of attitudes were also related to behavior problems at school age.

  3. The role of age and comorbidities in postoperative outcome of mitral valve repair: A propensity-matched study.

    PubMed

    Bonnet, Vincent; Boisselier, Clément; Saplacan, Vladimir; Belin, Annette; Gérard, Jean-Louis; Fellahi, Jean-Luc; Hanouz, Jean-Luc; Fischer, Marc-Olivier

    2016-06-01

    The average age of patients undergoing mitral valve repair is increasing each year. This retrospective study aimed to compare postoperative complications of mitral valve repair (known to be especially high-risk) between 2 age groups: under and over the age of 80.Patients who underwent mitral valve repair were divided into 2 groups: group 1 (<80 years old) and group 2 (≥80 years old). Baseline characteristics, pre- and postoperative hemodynamic data, surgical characteristics, and postoperative follow-up data until hospital discharge were collected.A total of 308 patients were included: 264 in group 1 (age 63 ± 13 years) and 44 in group 2 (age 83 ± 2 years). Older patients had more comorbidities (atrial fibrillation, history of cardiac decompensation, systemic hypertension, pulmonary hypertension, and chronic kidney disease) and they presented more postoperative complications (50.0% vs 33.7%; P = 0.043), with a longer hospital stay (8.9 ± 6.9 vs 6.6 ± 4.6 days; P = 0.005). To assess the burden of age, a propensity score was awarded to postoperative complications. Active smoking, chronic pulmonary disease, chronic kidney disease, associated ischemic heart disease, obesity, and cardio pulmonary by-pass duration were described as independent risk factors. When matched on this propensity score, there was no difference in morbidity or mortality between group 1 and group 2.Older patients suffered more postoperative complications, which were related to their comorbidities and not only to their age. PMID:27336886

  4. Impact of Sleep and Breathing in Infancy on Outcomes at Three Years of Age for Children with Cleft Lip and/or Palate

    PubMed Central

    Smith, Courtney B.; Walker, Karen; Badawi, Nadia; Waters, Karen A.; MacLean, Joanna E.

    2014-01-01

    Study Objectives: To evaluate the relationship between sleep disordered breathing (SDB) in early infancy and outcomes at 3 years of age in children with cleft lip and/or palate (CL/P). Design: Observational follow-up study. Setting: Multidisciplinary CL/P clinic, tertiary centre. Participants: Children with CL/P who participated in a study of sleep and breathing in infancy. Measurements and Results: The families of 52 children were approached for this follow-up study. The children underwent neurocognitive (Bayley Scales of Infant and Toddler Development, Third Edition; BSID-III), quality of life (Infant/Toddler Quality of Life Questionnaire; ITQOL), and growth assessments at 3 years. The families of 33 children (66%) completed follow-up at 36.7 ± 1.4 months. The apnea-hypopnea index (AHI) in infancy was 23.9 ± 18.0 events/h. Mean group BSID-III scores fell within the standardized normal range (10 ± 3) for all domains; however, language scores were lower than control children. Quality of life scores and growth parameter z-scores were similar to published control data. PSG variables in infancy showed significant relationships with outcomes at 3 years of age; lower percentage of AS/REM sleep was associated with lower cognition score; more obstructive events were associated with lower global behavior ITQOL score; and higher number of respiratory events in infancy was associated with lower weight z-score. Conclusion: Neurocognition, quality of life, and growth measures from children with CL/P fall within a normal range; however, scores in the language domain are lower than controls. Sleep and respiratory elements of SDB in infancy appear to modify these outcomes at 3 years of age. Citation: Smith CB, Walker K, Badawi N, WAters KA, MacLean JE. Impact of sleep and breathing in infancy on outcomes at three years of age for children with cleft lip and/or palate. SLEEP 2014;37(5):919-925. PMID:24790270

  5. Undescended testes: incidence in 1,002 consecutive male infants and outcome at 1 year of age.

    PubMed

    Thong, M; Lim, C; Fatimah, H

    1998-01-01

    In a study of 1,002 consecutive Malaysian male newborns, 48 (4.8%) were found to have undescended testes (UDT). The rate and laterality of the UDT were associated with lower birth weight (P < 0.001) and prematurity (P < 0.001). Boys with UDT were also more likely to have other congenital abnormalities of the external genitalia, the commonest being hydrocele. No correlation between UDT and maternal age, birth order, social class, or mode of delivery was demonstrated in this study. Although 26/34 (76.5%) of UDT achieved full spontaneous descent by 1 year of age, 1.1% of all infants whose testes remained undescended required regular long-term follow-up with surgical referral and correction at an appropriate time. A premature infant with UDT is more likely to achieve full testicular descent at 1 year of age than a term infant. PMID:9391202

  6. The Movement Assessment Battery in Greek Preschoolers: The Impact of Age, Gender, Birth Order, and Physical Activity on Motor Outcome

    ERIC Educational Resources Information Center

    Giagazoglou, Paraskevi; Kabitsis, Nikolaos; Kokaridas, Dimitrios; Zaragas, Charilaos; Katartzi, Ermioni; Kabitsis, Chris

    2011-01-01

    Early identification of possible risk factors that could impair the motor development is crucial, since poor motor performance may have long-term negative consequences for a child's overall development. The aim of the current study was the examination of disorders in motor coordination in Greek pre-school aged children and the detection of…

  7. Counseling Outcomes from 1990 to 2008 for School-Age Youth with Depression: A Meta-Analysis

    ERIC Educational Resources Information Center

    Erford, Bradley T.; Erford, Breann M.; Lattanzi, Gina; Weller, Janet; Schein, Hallie; Wolf, Emily; Hughes, Meredith; Darrow, Jenna; Savin-Murphy, Janet; Peacock, Elizabeth

    2011-01-01

    Clinical trials exploring the effectiveness of counseling and psychotherapy in treatment of depression in school-age youth composed this meta-analysis. Results were synthesized using a random effects model for mean difference and mean gain effect size estimates. No effects of moderating variables were evident. Counseling and psychotherapy are…

  8. Cognitive Outcome following Unilateral Arterial Ischaemic Stroke in Childhood: Effects of Age at Stroke and Lesion Location

    ERIC Educational Resources Information Center

    Westmacott, Robyn; Askalan, Rand; MacGregor, Daune; Anderson, Peter; deVeber, Gabrielle

    2010-01-01

    Aim: Plasticity in the developing brain is a controversial issue. Although language and motor function often recover remarkably well following early brain injury, recent evidence suggests that damage to the developing brain results in significant long-term neuropsychological impairment. Our aim was to investigate the relationship among age at…

  9. Does Raising the State Compulsory School Attendance Age Achieve the Intended Outcomes? Summary. REL 2014-005

    ERIC Educational Resources Information Center

    Mackey, Philip E.; Duncan, Teresa G.

    2013-01-01

    Maryland raised its compulsory school attendance age from 16 to 18 in two stages: from 16 to 17 at the beginning of the 2014/15 school year and from 17 to 18 at the beginning of the 2016/17 school year (Maryland Senate Bill 362, 2012). The Maryland State Department of Education (MSDE) sought technical assistance from the Regional Educational…

  10. "The 1-2-3 Magic Program": Implementation Outcomes of an Australian Pilot Evaluation with School-Aged Children

    ERIC Educational Resources Information Center

    Bailey, Erin L.; van der Zwan, Rick; Phelan, Thomas W.; Brooks, Anna

    2012-01-01

    This study served as a pilot evaluation of the efficacy of the 1-2-3 Magic Program (Phelan, 2003) as a brief parenting intervention for families with a school-aged child. Nine Australian families assigned to either a wait-listed control group (n = 4) or to one that received immediate intervention (n = 5), participated in a randomized controlled…

  11. The Long-Term Outcome of Children by Birth Weight and Gestational Age. High-Risk Follow-Up Study.

    ERIC Educational Resources Information Center

    Colorado Univ., Denver. Medical Center.

    This report is comprised of three separate studies conducted at the University of Colorado Medical Center. In the first study, answers to the following questions were sought: (1) What kinds of late morbidity occur at different birth weights and gestational ages? and (2) Has a vigorous approach to metabolic support in the newborn period changed the…

  12. Serum betaine is inversely associated with low lean mass mainly in men in a Chinese middle-aged and elderly community-dwelling population.

    PubMed

    Huang, Bi-Xia; Zhu, Ying-Ying; Tan, Xu-Ying; Lan, Qiu-Ye; Li, Chun-Lei; Chen, Yu-Ming; Zhu, Hui-Lian

    2016-06-01

    Previous studies have demonstrated that betaine supplements increase lean body mass in livestock and improve muscle performance in human beings, but evidence for its effect on human lean mass is limited. Our study assessed the association of circulating betaine with lean mass and its composition in Chinese adults. A community-based study was conducted on 1996 Guangzhou residents (weight/mass: 1381/615) aged 50-75 years between 2008 and 2010. An interviewer-administered questionnaire was used to collect general baseline information. Fasting serum betaine was assessed using HPLC-MS. A total of 1590 participants completed the body composition analysis performed using dual-energy X-ray absorptiometry during a mean of 3·2 years of follow-up. After adjustment for age, regression analyses demonstrated a positive association of serum betaine with percentage of lean mass (LM%) of the entire body, trunk and limbs in men (all P<0·05) and LM% of the trunk in women (P=0·016). Each sd increase in serum betaine was associated with increases in LM% of 0·609 (whole body), 0·811 (trunk), 0·422 (limbs), 0·632 (arms) and 0·346 (legs) in men and 0·350 (trunk) in women. Multiple logistic regression analysis revealed that the prevalence of lower LM% decreased by 17 % (whole body) and 14 % (trunk) in women and 23 % (whole body), 28 % (trunk), 22 % (arms) and 26 % (percentage skeletal muscle index) in men with each sd increment in serum betaine. Elevated circulating betaine was associated with a higher LM% and lower prevalence of lower LM% in middle-aged and elderly Chinese adults, particularly men. PMID:27079329

  13. Serum betaine is inversely associated with low lean mass mainly in men in a Chinese middle-aged and elderly community-dwelling population.

    PubMed

    Huang, Bi-Xia; Zhu, Ying-Ying; Tan, Xu-Ying; Lan, Qiu-Ye; Li, Chun-Lei; Chen, Yu-Ming; Zhu, Hui-Lian

    2016-06-01

    Previous studies have demonstrated that betaine supplements increase lean body mass in livestock and improve muscle performance in human beings, but evidence for its effect on human lean mass is limited. Our study assessed the association of circulating betaine with lean mass and its composition in Chinese adults. A community-based study was conducted on 1996 Guangzhou residents (weight/mass: 1381/615) aged 50-75 years between 2008 and 2010. An interviewer-administered questionnaire was used to collect general baseline information. Fasting serum betaine was assessed using HPLC-MS. A total of 1590 participants completed the body composition analysis performed using dual-energy X-ray absorptiometry during a mean of 3·2 years of follow-up. After adjustment for age, regression analyses demonstrated a positive association of serum betaine with percentage of lean mass (LM%) of the entire body, trunk and limbs in men (all P<0·05) and LM% of the trunk in women (P=0·016). Each sd increase in serum betaine was associated with increases in LM% of 0·609 (whole body), 0·811 (trunk), 0·422 (limbs), 0·632 (arms) and 0·346 (legs) in men and 0·350 (trunk) in women. Multiple logistic regression analysis revealed that the prevalence of lower LM% decreased by 17 % (whole body) and 14 % (trunk) in women and 23 % (whole body), 28 % (trunk), 22 % (arms) and 26 % (percentage skeletal muscle index) in men with each sd increment in serum betaine. Elevated circulating betaine was associated with a higher LM% and lower prevalence of lower LM% in middle-aged and elderly Chinese adults, particularly men.

  14. Long-Term Visual Outcomes for a Treat and Extend Anti-Vascular Endothelial Growth Factor Regimen in Eyes with Neovascular Age-Related Macular Degeneration

    PubMed Central

    Mrejen, Sarah; Jung, Jesse J.; Chen, Christine; Patel, Samir N.; Gallego-Pinazo, Roberto; Yannuzzi, Nicolas; Xu, Luna; Marsiglia, Marcela; Boddu, Sucharita; Freund, K. Bailey

    2015-01-01

    With the advent of anti-vascular endothelial growth factor (VEGF) therapy, clinicians are now focused on various treatment strategies to better control neovascular age-related macular degeneration (NVAMD), a leading cause of irreversible blindness. Herein, we retrospectively reviewed consecutive patients with treatment-naïve NVAMD initially classified based on fluorescein angiography (FA) alone or with an anatomic classification utilizing both FA and optical coherence tomography (OCT) and correlated long-term visual outcomes of these patients treated with an anti-VEGF Treat-and-Extend Regimen (TER) with baseline characteristics including neovascular phenotype. Overall, 185 patients (210 eyes) were followed over an average of 3.5 years (range 1–6.6) with a retention rate of 62.9%, and visual acuity significantly improved with a TER that required a mean number of 8.3 (±1.6) (± standard deviation) intravitreal anti-VEGF injections/year (range 4–13). The number of injections and the anatomic classification were independent predictors of visual acuity at 6 months, 1, 2, 3 and 4 years. Patients with Type 1 neovascularization had better visual outcomes and received more injections than the other neovascular subtypes. There were no serious adverse events. A TER provided sustained long-term visual gains. Eyes with Type 1 neovascularization had better visual outcomes than those with other neovascular subtypes. PMID:26239682

  15. Long-Term Visual Outcomes for a Treat and Extend Anti-Vascular Endothelial Growth Factor Regimen in Eyes with Neovascular Age-Related Macular Degeneration.

    PubMed

    Mrejen, Sarah; Jung, Jesse J; Chen, Christine; Patel, Samir N; Gallego-Pinazo, Roberto; Yannuzzi, Nicolas; Xu, Luna; Marsiglia, Marcela; Boddu, Sucharita; Freund, K Bailey

    2015-01-01

    With the advent of anti-vascular endothelial growth factor (VEGF) therapy, clinicians are now focused on various treatment strategies to better control neovascular age-related macular degeneration (NVAMD), a leading cause of irreversible blindness. Herein, we retrospectively reviewed consecutive patients with treatment-naïve NVAMD initially classified based on fluorescein angiography (FA) alone or with an anatomic classification utilizing both FA and optical coherence tomography (OCT) and correlated long-term visual outcomes of these patients treated with an anti-VEGF Treat-and-Extend Regimen (TER) with baseline characteristics including neovascular phenotype. Overall, 185 patients (210 eyes) were followed over an average of 3.5 years (range 1-6.6) with a retention rate of 62.9%, and visual acuity significantly improved with a TER that required a mean number of 8.3 (±1.6) (± standard deviation) intravitreal anti-VEGF injections/year (range 4-13). The number of injections and the anatomic classification were independent predictors of visual acuity at 6 months, 1, 2, 3 and 4 years. Patients with Type 1 neovascularization had better visual outcomes and received more injections than the other neovascular subtypes. There were no serious adverse events. A TER provided sustained long-term visual gains. Eyes with Type 1 neovascularization had better visual outcomes than those with other neovascular subtypes. PMID:26239682

  16. Relationship between Proton Magnetic Resonance Spectroscopy of Frontoinsular Gray Matter and Neurodevelopmental Outcomes in Very Low Birth Weight Children at the Age of 4

    PubMed Central

    Herman-Sucharska, Izabela; Urbanik, Andrzej; Klimek, Małgorzata; Karcz, Paulina; Dutkowska, Grażyna; Nitecka, Magdalena; Kwinta, Przemko

    2016-01-01

    Very low birth weight is associated with long term neurodevelopmental complications. Macroscopic brain abnormalities in prematurity survivors have been investigated in several studies. However, there is limited data regarding local cerebral metabolic status and neurodevelopmental outcomes. The purpose of this study was to characterize the relationship between proton magnetic resonance spectra in basal ganglia, frontal white matter and frontoinsular gray matter, neurodevelopmental outcomes assessed with the Leiter scale and the Developmental Test of Visual Perception and selected socioeconomic variables in a cohort of very low birth weight children at the age of four. Children were divided in three groups based on the severity of neurodevelopmental impairment. There were no differences in spectroscopy in basal ganglia and frontal white matter between the groups. Lower concentrations of N-acetylaspartate (NAA), choline (Cho) and myoinositol (mI) were observed in the frontoinsular cortex of the left hemisphere in children with neurodevelopmental impairment compared to children with normal neurodevelopmental outcomes. Higher parental education, daycare attendance and breastfeeding after birth were associated with more favorable neurodevelopmental prognosis, whereas rural residence was more prevalent in children with moderate and severe impairment. Our study demonstrates the role of long term neurometabolic disruption in the left frontoinsular cortex and selected socioeconomic variables in determination of neurodevelopmental prognosis in prematurity survivors. PMID:27223474

  17. Prevalence of purging at age 16 and associations with negative outcomes among girls in three community-based cohorts

    PubMed Central

    Solmi, Francesca; Sonneville, Kendrin R; Easter, Abigail; Horton, Nicholas J; Crosby, Ross D; Treasure, Janet; Rodriguez, Alina; Jarvelin, Marjo-Riitta; Field, Alison E; Micali, Nadia

    2015-01-01

    Background The comorbidity of purging behaviours, such as vomiting, inappropriate use of laxatives, diuretics or slimming medications, has been examined in literature. However, most studies do not include adolescents, individuals who purge in the absence of binge eating, or those purging at subclinical frequency. This study examines the prevalence of purging among 16-year-old girls across three countries and their association with substance use and psychological comorbidity. Methods Data were obtained by questionnaire in 3 population-based cohorts (Avon Longitudinal Study of Parents and Children (ALSPAC), United Kingdom, n = 1,608; Growing Up Today Study (GUTS), USA, n = 3,504; North Finland Birth Cohort (NFBC85/86), Finland, n = 2,306). Multivariate logistic regressions were employed to estimate associations between purging and outcomes. Four models were fit adjusting for binge eating and potential confounders of these associations. Results In ALSPAC, 9.7% of girls reported purging in the 12-months prior to assessment, 7.3% in GUTS, and 3.5% in NFBC. In all 3 cohorts, purging was associated with adverse outcomes such as binge drinking (ALSPAC: odds ratio (OR) = 2.0, 95% confidence interval (CI) = 1.4–2.9; GUTS: OR = 2.5, 95% CI = 1.5–4.0; NFBC: OR = 1.7, 95% CI = 1.0–2.8), drug use (ALSPAC: OR = 2.9, 95% CI = 1.8–4.7; GUTS: OR = 4.5, 95% CI = 2.8–7.3; NFBC: OR = 4.1, 95% CI = 2.6–6.6), depressive symptoms in ALSPAC (OR = 2.2, 95% CI = 1.5–3.1) and GUTS(OR = 3.7, 95% CI = 2.2–6.3), and several psychopathology measures including clinical anxiety/depression in NFBC (OR = 11.2, 95% CI = 3.9, 31.7). Conclusions Results show a higher prevalence of purging behaviours among girls in the United Kingdom compared to those in the United States and Finland. Our findings support evidence highlighting that purging in adolescence is associated with negative outcomes, independent of its frequency and binge eating. PMID:24975817

  18. Effect of supported employment on vocational rehabilitation outcomes of transition-age youth with intellectual and developmental disabilities: a case control study.

    PubMed

    Wehman, Paul; Chan, Fong; Ditchman, Nicole; Kang, Hyun-Ju

    2014-08-01

    The purpose of this study was to examine the effect of supported employment intervention on the employment outcomes of transition-age youth with intellectual and developmental disabilities served by the public vocational rehabilitation system using a case-control study design. Data for this study were extracted from the Rehabilitation Services Administration Case Service Report (RSA-911) database for fiscal year 2009. The sample included 23,298 youth with intellectual and developmental disabilities aged between 16 and 25 years old at the time of application. The classification and regression tree (CART) method was used to estimate propensity scores and to adjust for selection bias on the basis of all prominent covariates relevant to the dependent variable (i.e., competitive employment). Results yielded six homogeneous subgroups, and receipt of supported employment was found to increase the employment rates across all of the groups. The effect of supported employment was especially strong for youth who were Social Security beneficiaries, special education students, and individuals with intellectual disabilities or autism who were high school graduates. These findings suggest that supported employment is an effective service for enhancing the vocational rehabilitation outcomes of young adults and provides valuable information for policy makers, health care providers, rehabilitation counselors, and educators. PMID:25061773

  19. Developmental outcome of school-age children born to mothers with heroin dependency: importance of environmental factors.

    PubMed

    Ornoy, A; Segal, J; Bar-Hamburger, R; Greenbaum, C

    2001-10-01

    Development of children aged 5 to 12 years born to mothers with heroin dependency raised at home or adopted was studied in comparison with: (1) children with environmental deprivation alone (i.e. low parental socioeconomic status [SES] and evidence of neglect), (2) children born to fathers with heroin dependency fathers, and (3) control individuals of average SES. One hundred and sixty children (84 males and 76 females; average age at examination 8 years) were evaluated between 1998 and 1999. All were attending mainstream schools. All participants were examined by a paediatrician and a psychologist using standard neurological and psychological age-appropriate tests, as well as tests and questionnaires to assess learning ability and attention span. The Conners and Achenbach questionnaires and the Pollack Taper test were used to assess possible presence of attention-deficit-hyperactivity disorder (ADHD). Mothers were assessed for ADHD using Wender's questionnaire. Children born to parents with heroin dependency raised at home and those of low SES exhibited intellectual impairment both on verbal and performance skills. They also had impaired reading and arithmetic skills. Children born to mothers with heroin dependency but who were adopted at a young age had normal intellectual and learning abilities, except for some reduced function on the performance Wechsler Intelligence Scale for Children-Revised. We found a high rate of ADHD among all children born to parents with heroin dependency, including those adopted, as well as in children with low parental SES. The highest rate of ADHD was in children born to mothers with heroin dependency raised at home, being twice that observed in the other groups. Mothers of these groups of children also had a high rate of ADHD.

  20. Prevalence and Health Outcomes of Functional Gastrointestinal Symptoms in Infants From Birth to 12 Months of Age

    PubMed Central

    Vandenplas, Yvan; Abkari, Abdelhak; Bellaiche, Marc; Benninga, Marc; Chouraqui, Jean Pierre; ÇokuÐraþ, FügenÇullu; Harb, Tracy; Hegar, Badriul; Lifschitz, Carlos; Ludwig, Thomas; Miqdady, Mohamed; de Morais, Mauro Batista; Osatakul, Seksit; Salvatore, Silvia; Shamir, Raanan; Staiano, Annamaria; Szajewska, Hania; Thapar, Nikhil

    2015-01-01

    ABSTRACT Objectives: The aim of the study was to review published evidence and the opinion of practising clinicians on the prevalence and long-term health consequences of functional gastrointestinal symptoms in infants younger than 12 months. Methods: PubMed was searched from inception to November 2014 to find articles reporting the prevalence and long-term health outcomes of infantile colic, regurgitation, functional constipation, functional diarrhoea, and dyschezia in infants younger than <12 months. A questionnaire was sent to practising clinicians worldwide, and a group of 15 international experts met to discuss the likely frequency and longer-term consequences of these symptoms. Results: The literature search identified 30 studies reporting the prevalence of infantile colic (2%–73%), 13 that of regurgitation (3%–87%), 8 that of functional constipation (0.05%–39.3%), 2 that of functional diarrhoea (2%–4.1%), and 3 that of dyschezia (0.9%–5.6%). The studies varied in design, populations investigated, and definition of the symptoms. Questionnaires were received from 369 respondents. The experts agreed that the likely prevalences for colic, regurgitation, and functional constipation were 20%, 30%, and 15%, respectively. The limited data in the literature for functional diarrhoea and dyschezia suggest prevalences <10%. Infantile colic may be associated with future health problems in a subset of infants. Conclusions: Functional gastrointestinal symptoms appear to occur in a significant proportion of infants younger than 12 months and may have an impact on future health outcomes. Prospective collection of data according to agreed criteria is needed to obtain more accurate estimates of the prevalence and consequences of these symptoms. PMID:26308317

  1. Spontaneous Intestinal Perforation in Extremely Low Birth Weight Infants: Association with Indometacin Therapy and Effects on Neurodevelopmental Outcomes at 18-22 months Corrected Age

    PubMed Central

    Wadhawan, Rajan; Oh, William; Vohr, Betty R.; Saha, Shampa; Das, Abhik; Bell, Edward F.; Laptook, Abbot R.; Shankaran, Seetha; Stoll, Barbara J.; Walsh, Michele C.; Higgins, Rosemary D.

    2013-01-01

    Background Spontaneous intestinal perforation (SIP) is associated with the use of postnatal glucocorticoids and indometacin in extremely low birth weight (ELBW) infants. We hypothesized: 1) an association of SIP with the use of antenatal steroids (ANS) and indometacin either as prophylaxis for IVH (P Indo) or for treatment of PDA (Indo/PDA) and 2) an increased risk of death or abnormal neurodevelopmental outcomes in infants with SIP at 18-22 months corrected age. Design/Methods We retrospectively identified ELBW infants with SIP in the Neonatal Research Network’s generic database. Unadjusted analysis identified the differences in maternal, neonatal and clinical variables between infants with and without SIP. Logistic regression analysis identified the adjusted odds ratio for SIP with reference to ANS, P Indo and Indo/PDA. Neurodevelopmental outcomes were assessed among survivors at 18 to 22 months corrected age. Results Indo/PDA was associated with an increased risk of SIP (adjusted OR 1.61; 95% CI 1.25,2.08), while P Indo and ANS were not. SIP was independently associated with an increased risk of death or NDI (adjusted OR−1.85; 95% CI 1.32,2.60) and NDI among survivors (adjusted OR−1.75, 95% CI 1.20,2.55). Conclusion Indometacin used for IVH prophylaxis and ANS were not associated with the occurrence of SIP in ELBW infants. Indometacin used for treatment of symptomatic PDA was however associated with an increased risk of SIP. ELBW infants with SIP have an increased risk of poor neurodevelopmental outcomes. PMID:22684157

  2. Age of volcanism and rifting in the Burji-Soyoma area, Amaro Horst, southern Main Ethiopian Rift: geo- and biochronologic data

    NASA Astrophysics Data System (ADS)

    WoldeGabriel, G.; Yemane, T.; Suwa, G.; White, T.; Asfaw, B.

    Late Eocene basalts capping late Mesozoic or early Tertiary basal sandstone are present in the Amaro Horst within southern sector of the Main Ethiopian Rift. This basaltic unit is time correlative to flows already reported from southwestern Ethiopia. The discovery of these lavas within the rift system proves that the oldest volcanic units of the Ethiopian volcanic province are not confined to the NW Plateau, west of the Main Ethiopian Rift as was generally believed. At the same time, the widely held notion of rift-ward migration of volcanism from the plateau is not supported by the occurrence of this Late Eocene basalt within the uplifted Amaro Horst. The Late Eocene basalt is blanketed by Early Oligocene basalt and silicic flows. Geochemical characteristics indicate that the volcanic succession consists of Late Eocene transitional tholeiitic basalt, Oligocene and Mid-Miocene hawaiites, and Mid-Miocene mildly alkaline basalt flows. The lower (Late Eocene and Early Oligocene) and upper (Mid-Miocene) basaltic sequences are separated by sedimentary strata deposited in a lacustrine environment that contains Early to Mid-Miocene fossil fauna and flora. Although the botanical study of the flora was not attempted, the Burji faunal remains appear to represent a primitive species of Choerolophodont mastodont. Biochronological evidence suggests that the proboscidean would be in the time range of 15-17 Ma. The presence of the fossil-bearing sedimentary strata suggests that a rift-related basin developed in Early to Mid-Miocene contemporaneous with the volcanic eruptions. The confinement of the Mid-Miocene basaltic units to the Amaro Horst suggests that rift-related subsidence in the southern sector of the Main Ethiopian Rift probably started in Early Miocene or Late Oligocene time, coincident with development of the sedimentary basin. The correlation of lavas of tholeiitic composition to intense tectonic activity in northcentral Ethiopia and northern Kenya implies that the

  3. Age-Related Differences in 1- and 12-Month Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation (from a Large Multicenter Data Repository).

    PubMed

    Attizzani, Guilherme F; Ohno, Yohei; Latib, Azeem; Petronio, Anna Sonia; Giannini, Cristina; Ettori, Federica; Fiorina, Claudia; Bedogni, Francesco; Brambilla, Nedy; Bruschi, Giuseppe; Colombo, Paola; Presbitero, Patrizia; Fiorilli, Rosario; Poli, Arnaldo; Barbanti, Marco; Colombo, Antonio; Tamburino, Corrado

    2016-10-01

    Scarce data are available on the impact of age on transcatheter aortic valve implantation (TAVI) outcomes. We therefore, analyzed 1,845 consecutive patients from 9 Italian centers who underwent TAVI with the Corevalve Revalving System from September 2007 to March 2014; patients were dichotomized according to their age in the date of the procedure, as follows: 75 to 85 years old and >85 years old. End points were defined according to Valve Academic Research Consortium definitions. In-hospital, 30-day, and 1-year clinical and echocardiographic data were available for 100% of the patients included. Propensity matching was performed. Procedural success rates were high (>94%) and comparable between groups. Although worse baseline renal function was observed in the older group, the incidence of acute kidney injury after procedure was comparable (17.1% and 17.4%, respectively for the 75- to 85- and >85-year-old group, p = 0.877); importantly, >99% of acute kidney injury episodes in both groups were grades 1 and 2. Procedural complications rates were low without between-group differences. In-hospital death (3.7% and 4.6%, p = 0.379) and stroke/transient ischemic attack (1.9% and 1.9%, respectively, p = 0.960) were comparable. The 1-year death rates were 14.9% and 17.2% (p = 0.197) in the 75- to 85- and >85-year-old group, respectively. Cardiovascular death was observed in 7.8% and 7% (p = 0.542), while stroke/transient ischemic attack was demonstrated in 5.2% and 4.4% (p = 0.496), respectively. Results were sustained after propensity matching. In conclusion, advanced age did not negatively impact the outcomes of TAVI through 1-year after procedure.

  4. Age-related Differential Item Functioning for the Patient-Reported Outcomes Information System (PROMIS®) Physical Functioning Items

    PubMed Central

    Paz, Sylvia H; Spritzer, Karen L; Morales, Leo S; Hays, Ron D

    2013-01-01

    Purpose To evaluate the equivalence of the PROMIS® wave 1 physical functioning item bank, by age (50 years or older versus 18-49). Materials and methods A total of 114 physical functioning items with 5 response choices were administered to English- (n=1504) and Spanish-language (n=640) adults. Item frequencies, means and standard deviations, item-scale correlations, and internal consistency reliability were estimated. Differential Item Functioning (DIF) by age was evaluated. Results Thirty of the 114 items were fagged for DIF based on an R-squared of 0.02 or above criterion. The expected total score was higher for those respondents who were 18-49 than those who were 50 or older. Conclusions Those who were 50 years or older versus 18-49 years old with the same level of physical functioning responded differently to 30 of the 114 items in the PROMIS® physical functioning item bank. This study yields essential information about the equivalence of the physical functioning items in older versus younger individuals. PMID:24052925

  5. The unexpected outcomes of anti-aging, rejuvenation, and life extension studies: an origin of modern therapies.

    PubMed

    Stambler, Ilia

    2014-06-01

    The search for life-extending interventions has been often perceived as a purely academic pursuit, or as an unorthodox medical enterprise, with little or no practical outcome. Yet, in fact, these studies, explicitly aiming to prolong human life, often constituted a formidable, though hardly ever acknowledged, motivation for biomedical research and discovery. At least several modern biomedical fields have originated directly from rejuvenation and life extension research: (1) Hormone replacement therapy was born in Charles-Edouard Brown-Séquard's rejuvenation experiments with animal gland extracts (1889). (2) Probiotic diets originated in Elie Metchnikoff's conception of radically prolonged "orthobiosis" (c. 1900). (3) The development of clinical endocrinology owed much to Eugen Steinach's "endocrine rejuvenation" operations (c. 1910s-1920s). (4) Tissue transplantations in humans (allografts and xenografts) were first widely performed in Serge Voronoff's "rejuvenation by grafting" experiments (c. 1910s-1920s). (5) Tissue engineering was pioneered during Alexis Carrel's work on cell and tissue immortalization (c. 1900-1920). (6) Cell therapy (and particularly human embryonic cell therapy) was first widely conducted by Paul Niehans for the purposes of rejuvenation as early as the 1930s. Thus, the pursuit of life extension and rejuvenation has constituted an inseparable and crucial element in the history of biomedicine. Notably, the common principle of these studies was the proactive maintenance of stable, long-term homeostasis of the entire organism.

  6. Mid- and long-term outcome of 166 premature infants weighing less than 1,000 g at birth, all small for gestational age.

    PubMed

    Monset-Couchard, M; de Bethmann, O; Kastler, B

    2002-01-01

    This longitudinal study reported the mid- and long-term neurodevelopmental outcome of 166 premature infants born with an extremely low birth weight (<1,000 g), all small for gestational age (<10th percentile birth weight for gestational age). Nine girls were lost to follow-up before 3 years of age, and 6 children were excluded a posteriori because of specific conditions diagnosed in the 1st year of life (severe abnormalities in 5). Of the remaining 151 children, 2% had cerebral palsy, 15% had lesser motor disturbances (reduced to 2% after psychomotor training), 8% had early severe developmental delays, and added mild and moderate delays and increasing cognitive gaps amounted to 28% in the 14th year. Visual deficits increased with age up to 63% of the older children. Seven children had deafness and 13 had hearing losses after otitis media. Language delays were observed at some stage in 31% of cases, as well as behavioral disturbances in 42% (severe problems in 12%). At last evaluation, 34% of the children were normal (12% of the older ones), 51% had minor deficiencies, 18% had moderate and 3% had major disabilities. Children entered the first grade in the 7th year in only 84% of cases, which dropped to 63% at proper level in the second grade; 47% entered high school at the proper age, 7/15 obtained the 'baccalauréat' in the 19th/20th year. The school performance was heavily dependent on the socioeconomic and cultural level of the family. PMID:12011568

  7. An assessment of anti-Müllerian hormone in predicting mating outcomes in female hamsters that have undergone natural and chemically-accelerated reproductive aging.

    PubMed

    Roosa, Kristen A; Zysling, Devin A; Place, Ned J

    2015-04-01

    In mammals, female fertility declines with age due in part to a progressive loss of ovarian follicles. The rate of follicle decline varies among individuals making it difficult to predict the age of onset of reproductive senescence. Serum anti-Müllerian hormone (AMH) concentrations correlate with the numbers of ovarian follicles, and therefore, AMH could be a useful predictor of female fertility. In women and some production animals, AMH is used to identify which individuals will respond best to ovarian stimulation for assisted reproductive technologies. However, few studies have evaluated AMH's predictive value in unassisted reproduction, and they have yielded conflicting results. To assess the predictive value of AMH in the context of reproductive aging, we prospectively measured serum AMH in 9-month-old Siberian hamsters shortly before breeding them. Female Siberian hamsters experience substantial declines in fertility and fecundity by 9months of age. We also measured serum AMH in 5-month-old females treated with 4-vinylcyclohexene diepoxide (VCD), which selectively destroys ovarian follicles and functionally accelerates ovarian aging. Vehicle-treated 5-month-old females served as controls. AMH concentrations were significantly reduced in VCD-treated females yet many females with low AMH reproduced successfully. On average, both young and old hamsters that littered had higher AMH concentrations than females that did not. However, some females with relatively high AMH concentrations failed to litter, whereas several with low AMH succeeded. Our results suggest that mean AMH concentration can predict mating outcomes on a population or group level, but on an individual basis, a single AMH determination is less informative.

  8. Should Women Younger Than 40 Years of Age With Invasive Breast Cancer Have a Mastectomy?: 15-Year Outcomes in a Population-Based Cohort

    SciTech Connect

    Cao, Jeffrey Q.; Truong, Pauline T.; Olivotto, Ivo A.; Olson, Robert; Coulombe, Genevieve; Keyes, Mira; Weir, Lorna; Gelmon, Karen; Bernstein, Vanessa; Woods, Ryan; Speers, Caroline; Tyldesley, Scott

    2014-11-01

    Purpose: Optimal local management for young women with early-stage breast cancer remains controversial. This study examined 15-year outcomes among women younger than 40 years treated with breast-conserving surgery plus whole-breast radiation therapy (BCT) compared with those treated with modified radical mastectomy (MRM). Methods and Materials: Women aged 20 to 39 years with early-stage breast cancer diagnosed between 1989 and 2003 were identified in a population-based database. Primary outcomes of breast cancer–specific survival (BCSS), overall survival (OS) and secondary outcomes of local relapse–free survival (LRFS), locoregional relapse–free survival (LRRFS), and distant relapse–free survival (DRFS) were calculated using Kaplan-Meier methods and compared between BCT and MRM cohorts using log-rank tests. A planned subgroup analysis was performed on patients considered “ideal” for BCT (ie, T1N0, negative margins and no extensive ductal carcinoma in situ) and in whom local therapy may have the largest impact on survival because of low systemic risk. Results: 965 patients were identified; 616 had BCT and 349 had MRM. The median follow-up time was 14.4 years (range, 8.4-23.3 years). Overall, 15-year rates of BCSS (76.0% vs 74.1%, P=.62), OS (74.2% vs 73.0%, P=.75), LRFS (85.4% vs 86.5%, P=.95), LRRFS (82.2% vs 81.6%, P=.61), and DRFS (74.4% vs 71.6%, P=.40) were similar between the BCT and MRM cohorts. In the “ideal” for BCT subgroup, there were 219 BCT and 67 MRM patients with a median follow-up time of 15.5 years. The 15-year BCSS (86.1% vs 82.9%, P=.57), OS (82.6% vs 82.9%, P=.89), LRFS (86.2% vs 84.2%, P=.50), LRRFS (83.1% vs 78.3%, P=.24), and DRFS (84.8% vs 79.1%, P=.17) were similar in the BCT and MRM cohorts. Conclusions: This population-based analysis with long-term follow-up confirmed that women younger than 40 years treated with BCT had similar 15-year outcomes compared with MRM. Young age alone is not a contraindication to BCT.

  9. Factors Associated with Streptococcal Bacteremia in Diarrheal Children under Five Years of Age and Their Outcome in an Urban Hospital in Bangladesh

    PubMed Central

    Shahid, Abu Sadat Mohammad Sayeem Bin; Ahmed, Tahmeed; Shahunja, K. M.; Kabir, Senjuti; Chowdhury, Fahmida; Faruque, Abu Syeed Golam; Das, Sumon Kumar; Sarker, Mohammad Habibur Rahman; Bardhan, Pradip Kumar; Chisti, Mohammod Jobayer

    2016-01-01

    Background Although Streptococcal bacteremia is common in diarrheal children with high morbidity and mortality, no systematic data are available on Streptococcal bacteremia in diarrheal children. We sought to evaluate the factors associated with Streptococcal bacteremia in diarrheal children under five years of age and their outcome. Methods We used an unmatched case-control design to investigate the associated factors with Streptococcal bacteremia in all the diarrheal children under five years of age through electronic medical record system of Dhaka hospital of International Centre for Diarrhoeal Disease Research, Bangladesh. We had simultaneously used a retrospective cohort design to further evaluate the outcome of our study children. All the enrolled children had their blood culture done between January 2010 and December 2012. Comparison was made among the children with (cases = 26) and without Streptococcal bacteremia (controls = 78). Controls were selected randomly from hospitalized diarrheal children under five years of age. Results Cases had proportionately higher deaths compared to controls, but it was statistically insignificant (15% vs. 10%, p = 0.49). The cases more often presented with severe dehydration, fever, respiratory distress, severe sepsis, and abnormal mental status compared to the controls (for all p<0.05). In the logistic regression analysis, after adjusting for potential confounders, it has been found that Streptococcal bacteremia in diarrheal children under five years of age was independently associated with nutritional edema (OR: 5.86, 95% CI = 1.28–26.80), hypoxemia (OR: 19.39, 95% CI = 2.14–175.91), fever (OR: 4.44, 95% CI = 1.13–17.42), delayed capillary refill time (OR: 7.00, 95% CI = 1.36–35.93), and respiratory distress (OR: 2.69, 95% CI = 1.02–7.12). Conclusions and Significance The results of our analyses suggest that diarrheal children under five years of age presenting with nutritional edema, hypoxemia, fever, delayed

  10. Comparison of Tertiary depositional sequences, age of bounding unconformities, and coastal onlap patterns in Baltimore Canyon Trough, offshore New Jersey, and Main Pass, offshore Alabama

    SciTech Connect

    Greenlee, S.M.

    1987-05-01

    Interpretation of high-quality seismic reflection profiles tied to well bores has delineated the Tertiary geologic history of the Baltimore Canyon Trough and the Main Pass area. During the Tertiary both areas subsided slowly, were in comparable paleographic position, and were the focus of primarily siliciclastic, progradational sedimentation. Because these areas are so similar geologically and have extensive seismic, log, and paleontologic data, they provide a unique opportunity to compare the character, timing, and extent of depositional sequences found on two different portions of the North American continental margin. The Cretaceous-Tertiary boundary is characterized by an erosional unconformity which is downlapped by overlying Paleocene clinoforms. This downlap surface is interpreted to be a result of the rapid rise in sea level in the late Maastrichtian and early Paleocene. Both areas remained in deep water throughout the Paleocene and Eocene and record second-order (5-10 m.y.) eustatic cycles. Following a major basinward shift of coastal onlap in the Oligocene, thick progradational deltaic wedges are found within the study areas which record the effects of third-order (approx. 1 m.y.) eustatic cycles. These depositional sequences may be grouped into second-order eustatic cycles recognized by major downward shifts in coastal onlap in the Oligocene, lower Miocene, and at the end of the middle Miocene. Landward and basinward shifts in coastal onlap patterns show a high degree of similarity among the study areas and with the global coastal onlap chart. A departure in the middle Miocene is attributed to differing subsidence histories of the two margins.

  11. Age and outcomes of primary percutaneous intervention for ST elevation myocardial infarction in a tertiary center—are we there yet?

    PubMed Central

    Sharma, Vinoda; Srinivasan, Manivannan; Smith, Dave

    2015-01-01

    Background Primary percutaneous intervention (PPCI) is the treatment of choice for ST elevation myocardial infarction (STEMI) but robust evidence in the very elderly is lacking. We compared PPCI outcomes between different age quartiles (quartile 1 < 60 years, quartile 2 ≥ 60 to < 70 years, quartile 3 ≥ 70 to < 80 years, quartile 4 ≥ 80 years). Methods Retrospective observational analysis of our Morriston Tertiary Cardiac Center (Abertawe Bro Morgannwg University Health Board) patients from 2005 to 2010 with STEMI who underwent PPCI. Results Of 434 patients, 57 (13%) were in quartile 4 (≥ 80 years). In older age quartiles, patients were less likely to receive a drug eluting stent (DES, P = 0.001) or glycoprotein IIb/IIIa inhibitor (GPI, P < 0.0001). Increase in age was associated with reduced time to survival (β-coefficient: −0.192, t: −3.70, 95%CI: −4.91 to −1.50, P < 0.0001) as was the presence of cardiogenic shock (β-coefficient: −0.194, t = 3.77, 95%CI: −5.26 to −1.65, P < 0.0001). Use of GPI was associated with increased time to survival (β-coefficient: 0.138, t = 2.82, 95%CI: 1.58–8.58, P = 0.005) but older age quartiles were less likely to receive GPI (P < 0.0001). In-hospital mortality (1.8% quartile 1, 3.6% quartile 2, 10.9% quartile 3 and 12.3% quartile 4, P = 0.002) and 1-year mortality (5.4% quartile 1, 5.5% quartile 2, 16.8% quartile 3 and 24.6% quartile 4, P < 0.0001, respectively) was significantly higher in older age quartiles. Conclusions Increased short term and intermediate term mortality is seen in the very elderly after PPCI. Age and cardiogenic shock were prognostic factors. Intervention should not be based on age alone and awareness regarding prognostic factors can help improve management. PMID:26089851

  12. Early and Long-Term Outcomes in Japanese Patients Aged 80 Years or Older Undergoing Conventional Aortic Valve Replacement

    PubMed Central

    Osaka, Shunji; Yaoita, Hiroko; Ishii, Yusuke; Arimoto, Munehito; Hata, Hiroaki; Shiono, Motomi

    2015-01-01

    In this study, we investigated the early and long-term results of conventional aortic valve replacement (AVR) in very old patients. Methods: Seventy-five patients with aortic stenosis underwent conventional AVR for patients aged 80 years.We examined early death and major adverse cardiovascular and cerebrovascular event (MACCE). Results: The operative mortality was 0% for isolated AVR and 19.2% for concomitant surgery. The postoperative survival rate and MACCE free-rate were no significant differences between the isolated AVR and the concomitant surgery. Univariate analysis confirmed that cardiac dysfunction, severe chronic kidney disease (CKD), hemodialysis, + coronary artery bypass grafting, and norepinephrine use were risk factor of early death. Univariate analysis confirmed that severe CKD, BNP >1000 pg/ml, aortic cross clamping time (ACCT) >180 min, and non-use carperitide and multivariate analysis confirmed that ACCT >180 min, and non-use carperitide were risk factor of MACCE. Conclusions: This study showed that the results of conventional AVR in very old patients were not satisfactory. However, the results obtained with isolated AVR were favorable with no operative deaths. The present study demonstrated that preoperative cardiac function, preoperative renal function, and operative factors have an important impact on early mortality and MACCE. PMID:26004118

  13. Worsening anatomic outcomes following aflibercept for neovascular age-related macular degeneration in eyes previously well controlled with ranibizumab

    PubMed Central

    Nudleman, Eric; Wolfe, Jeremy D; Woodward, Maria A; Yonekawa, Yoshihiro; Williams, George A; Hassan, Tarek S

    2016-01-01

    Purpose Antivascular endothelial growth factor injection is the mainstay of treating neovascular age-related macular degeneration (AMD). Previous studies have shown that switching treatment from ranibizumab to aflibercept led to an improvement in eyes with recalcitrant activity. Herein, we identify a unique subset of patients whose eyes with neovascular AMD were previously well controlled with ranibizumab injections were then worsened after being switched to aflibercept. Methods This is a retrospective interventional case series. Eyes with neovascular AMD, previously well controlled with monthly injections of ranibizumab, which then developed worsening of subretinal fluid after being switched to aflibercept were included. Results A total of 17 eyes were included. All eyes developed increased subretinal fluid when switched from ranibizumab to aflibercept. Fourteen patients were switched back to ranibizumab after a single injection of aflibercept and had subsequent rapid resolution of subretinal fluid. Three patients continued with monthly aflibercept injections for two subsequent months and demonstrated the persistence of the increased subretinal fluid until they were switched back to treatment with ranibizumab at which time the fluid resolved. No eye had persistent decline in visual acuity. Conclusion Switching from intravitreal ranibizumab to aflibercept in eyes with well-controlled neovascular AMD may result in worsening in a subset of patients and resolves when therapy is switched back to ranibizumab. PMID:27354759

  14. Europe’s Tired, Poor, Huddled Masses: Self-Selection and Economic Outcomes in the Age of Mass Migration†

    PubMed Central

    Abramitzky, Ran; Boustan, Leah Platt; Eriksson, Katherine

    2015-01-01

    During the age of mass migration (1850–1913), one of the largest migration episodes in history, the United States maintained a nearly open border, allowing the study of migrant decisions unhindered by entry restrictions. We estimate the return to migration while accounting for migrant selection by comparing Norway-to-US migrants with their brothers who stayed in Norway in the late nineteenth century. We also compare fathers of migrants and nonmigrants by wealth and occupation. We find that the return to migration was relatively low (70 percent) and that migrants from urban areas were negatively selected from the sending population. “Keep, ancient lands, your storied pomp!” cries she With silent lips. “Give me your tired, your poor, Your huddled masses yearning to breathe free, The wretched refuse of your teeming shore. Send these, the homeless, tempest-tost to me, I lift my lamp beside the golden door!”——Emma Lazarus (1883)1 PMID:26594052

  15. Association of caregiver quality of care with neurocognitive outcomes in HIV-affected children aged 2–5 years in Uganda

    PubMed Central

    Bass, Judith K.; Nakasujja, Noeline; Familiar-Lopez, Itziar; Sikorskii, Alla; Murray, Sarah M.; Opoka, Robert; Augustinavicius, Jura; Boivin, Michael J.

    2016-01-01

    ABSTRACT Children affected by HIV are at increased risk of developmental and neuropsychological disturbances due to direct effects of HIV on the brain and direct effects associated with living in poverty. Caregivers can play an important role, through quality caregiving, in mitigating the negative effect of these stressors. This study used baseline data from an ongoing caregiver training intervention trial to evaluate the association between quality of caregiver–child interactions and neurocognitive outcomes in rural HIV-infected and HIV-exposed but uninfected children in Uganda. We also assessed the extent to which caregiver distress moderated this relationship. Data on 329 caregiver–child dyads were collected between March 2012 and July 2014, when the children were between 2 and 5 years of age. Child outcomes include the Mullen Scales of Early Learning to assess general cognitive ability and the Color Object Association Test to assess immediate memory and total recall. Caregiving quality was assessed using the Home Observation for the Measurement of the Environment (HOME) total and subscale scores. Caregiver distress was assessed using the Hopkins Symptom Checklist. General linear regression models assessed the association between the HOME total and subscale scores and child outcomes, with interaction terms used to test moderation by caregiver distress. Total HOME scores were positively and significantly associated with Mullen scores of cognitive ability; HOME acceptance subscale scores were positively and significantly associated with immediate recall scores. No other associations were statistically significant. As hypothesized, there is a strong association between the HOME and Mullen scores of cognitive ability in our study population, such that children who were assessed as living in environments with more stimulation also presented with a higher level of general neurocognitive development. Our results support the view of program guidance for HIV

  16. Association of caregiver quality of care with neurocognitive outcomes in HIV-affected children aged 2-5 years in Uganda.

    PubMed

    Bass, Judith K; Nakasujja, Noeline; Familiar-Lopez, Itziar; Sikorskii, Alla; Murray, Sarah M; Opoka, Robert; Augustinavicius, Jura; Boivin, Michael J

    2016-01-01

    Children affected by HIV are at increased risk of developmental and neuropsychological disturbances due to direct effects of HIV on the brain and direct effects associated with living in poverty. Caregivers can play an important role, through quality caregiving, in mitigating the negative effect of these stressors. This study used baseline data from an ongoing caregiver training intervention trial to evaluate the association between quality of caregiver-child interactions and neurocognitive outcomes in rural HIV-infected and HIV-exposed but uninfected children in Uganda. We also assessed the extent to which caregiver distress moderated this relationship. Data on 329 caregiver-child dyads were collected between March 2012 and July 2014, when the children were between 2 and 5 years of age. Child outcomes include the Mullen Scales of Early Learning to assess general cognitive ability and the Color Object Association Test to assess immediate memory and total recall. Caregiving quality was assessed using the Home Observation for the Measurement of the Environment (HOME) total and subscale scores. Caregiver distress was assessed using the Hopkins Symptom Checklist. General linear regression models assessed the association between the HOME total and subscale scores and child outcomes, with interaction terms used to test moderation by caregiver distress. Total HOME scores were positively and significantly associated with Mullen scores of cognitive ability; HOME acceptance subscale scores were positively and significantly associated with immediate recall scores. No other associations were statistically significant. As hypothesized, there is a strong association between the HOME and Mullen scores of cognitive ability in our study population, such that children who were assessed as living in environments with more stimulation also presented with a higher level of general neurocognitive development. Our results support the view of program guidance for HIV-affected children

  17. Intermediate outcomes of chronic disease self-management program offered by members of the Healthy Aging Regional Collaborative in South Florida.

    PubMed

    Melchior, Michael A; Seff, Laura R; Albatineh, Ahmed N; McCoy, H Virginia; Page, Timothy F; Palmer, Richard C

    2014-07-01

    Currently, 80% of adults over the age of 65 have at least one chronic disease. The Chronic Disease Self-management Program (CDSMP) focuses on increasing self-efficacy for managing chronic disease. Few studies have evaluated the effectiveness of CDSMP when offered by multiple agencies, as a collaborative effort, in community-based settings. Seven agencies delivered 108 CDSMP workshops at 81 sites from October 1, 2008, to December 31, 2010. A total of 811 participants were eligible for analysis. Participants completed surveys at baseline and week 6, the end of instruction. Controlling for agency effect and general health at baseline, the general linear model was used to assess the significance of outcomes at 6 weeks. Outcomes showing significant improvement included self-efficacy to manage disease (p = .001), self-efficacy to manage emotions (p = .026), time spent walking (p = .008), and perceived social/role activities limitations (p = .001). Findings showed that CDSMP is an effective program at improving self-efficacy, increasing physical activity, and decreasing limitations.

  18. Effect of Age on Survival Outcome in Operated and Non-Operated Patients with Colon Cancer: A Population-Based Study

    PubMed Central

    Tan, XueMing; Fan, ZhiNing

    2016-01-01

    Objective To know the effect of age on survival outcome in operated and non-operated patients with colon cancer. Methods From the Surveillance, Epidemiology, and End Results database, we identified 123,356 patients with colon cancer who were diagnosed between 1996 and 2005, grouped them as older or younger than 40 years and analyzed their 5-year cancer-specific survival (CSS) data, along with some risk factors, using Kaplan–Meier methods and multivariable Cox regression models. Results The younger group had significantly higher pathological grades (P<0.001), more mucinous and signet-ring histology (P<0.001), advanced AJCC stage (P<0.001), and were more likely to undergo surgery (P<0.001). For surgically treated patients, age did not significantly affect 5-year CSS (younger: 66.7%; older: 67.3%; P = 0.86). Further analysis showed that age was an independent prognostic factor in stage I–IV disease (stage I: P = 0.001; P<0.001 for stages II–IV, in both uni- and multivariate analyses), but not for patients with unknown disease stage (P = 0.52). For non-surgically treated patients, age significantly affected 5-year CSS (younger: 16.2%; older: 12.9%; P<0.001) in univariate analysis; and was an independent prognostic factor (P<0.001) in multivariate analysis. Conclusion The CSS rate for younger CC patients was at least as high as for older patients, although they presented with higher proportions of unfavorable factors and more advanced disease. PMID:26789841

  19. Autogenous brachio-cephalic arterio-venousautogenous brachio-cephalic arterio-venous fistulae: effect of age, diabetes,fistulae: effect of age, diabetes, atherosclerosis, and anticoagulation on theatherosclerosis, and anticoagulation on the long-term outcomelong-term outcome.

    PubMed

    Papalois, Vassilios E; Ndzengue, Albert; Choi, Peter; Hakim, Nadey S

    2008-01-01

    Age, diabetes, and generalized atherosclerosis are thought to be limiting factors forAge, diabetes, and generalized atherosclerosis are thought to be limiting factors for creating an autogenous arterio-venous fistula (AVF) unlike the use of anticoagulants. Wecreating an autogenous arterio-venous fistula (AVF) unlike the use of anticoagulants. We retrospectively assessed the effect of these factors on the outcome of 75 autogenousretrospectively assessed the effect of these factors on the outcome of 75 autogenous brachio-cephalic AVFs created between January 1, 2002 and August 31, 2005. Differentbrachio-cephalic AVFs created between January 1, 2002 and August 31, 2005. Different groups of patients were compared and the longevity of the AVFs was calculated. Fifty-twogroups of patients were compared and the longevity of the AVFs was calculated. Fifty-two percent of the patients were >65 years old, 41.3% werepercent of the patients were >65 years old, 41.3% were diabetic, 48% were arteriopaths,diabetic, 48% were arteriopaths, and 41.3% were not using anticoagulants. The maximum follow-up was 35 months (mean,and 41.3% were not using anticoagulants. The maximum follow-up was 35 months (mean, 11.2 +/- 10.3 months; median, 7 months). The success rate of the operation was 93.3% (mean 11.2 +/- 10.3 months; median, 7 months). The success rate of the operation was 93.3% (70 patent AVFs); 79.3% of the AVFs were functioning at 35 months. Age >65 years old,patent AVFs); 79.3% of the AVFs were functioning at 35 months. Age >65 years old, diabetes, generalized atherosclerosis, and the lack of use of anticoagulants were notdiabetes, generalized atherosclerosis, and the lack of use of anticoagulants were not associated with an increased rate of technical failures or a decreased long-term patencyassociated with an increased rate of technical failures or a decreased long-term patency rate of the AVFs.rate of the AVFs. PMID:19731852

  20. Associations between Tactile Sensory Threshold and Postural Performance and Effects of Healthy Aging and Subthreshold Vibrotactile Stimulation on Postural Outcomes in a Simple Dual Task.

    PubMed

    Dettmer, Marius; Pourmoghaddam, Amir; Lee, Beom-Chan; Layne, Charles S

    2016-01-01

    Specific activities that require concurrent processing of postural and cognitive tasks may increase the risk for falls in older adults. We investigated whether peripheral receptor sensitivity was associated with postural performance in a dual-task and whether an intervention in form of subthreshold vibration could affect performance. Ten younger (age: 20-35 years) and ten older adults (70-85 years) performed repeated auditory-verbal 1-back tasks while standing quietly on a force platform. Foot sole vibration was randomly added during several trials. Several postural control and performance measures were assessed and statistically analyzed (significance set to α-levels of .05). There were moderate correlations between peripheral sensitivity and several postural performance and control measures (r = .45 to .59). Several postural performance measures differed significantly between older and younger adults (p < 0.05); addition of vibration did not affect outcome measures. Aging affects healthy older adults' performance in dual-tasks, and peripheral sensitivity may be a contributor to the observed differences. A vibration intervention may only be useful when there are more severe impairments of the sensorimotor system. Hence, future research regarding the efficacy of sensorimotor interventions in the form of vibrotactile stimulation should focus on older adults whose balance is significantly affected. PMID:27143967

  1. Associations between Tactile Sensory Threshold and Postural Performance and Effects of Healthy Aging and Subthreshold Vibrotactile Stimulation on Postural Outcomes in a Simple Dual Task

    PubMed Central

    Dettmer, Marius; Pourmoghaddam, Amir; Lee, Beom-Chan; Layne, Charles S.

    2016-01-01

    Specific activities that require concurrent processing of postural and cognitive tasks may increase the risk for falls in older adults. We investigated whether peripheral receptor sensitivity was associated with postural performance in a dual-task and whether an intervention in form of subthreshold vibration could affect performance. Ten younger (age: 20–35 years) and ten older adults (70–85 years) performed repeated auditory-verbal 1-back tasks while standing quietly on a force platform. Foot sole vibration was randomly added during several trials. Several postural control and performance measures were assessed and statistically analyzed (significance set to α-levels of .05). There were moderate correlations between peripheral sensitivity and several postural performance and control measures (r = .45 to .59). Several postural performance measures differed significantly between older and younger adults (p < 0.05); addition of vibration did not affect outcome measures. Aging affects healthy older adults' performance in dual-tasks, and peripheral sensitivity may be a contributor to the observed differences. A vibration intervention may only be useful when there are more severe impairments of the sensorimotor system. Hence, future research regarding the efficacy of sensorimotor interventions in the form of vibrotactile stimulation should focus on older adults whose balance is significantly affected. PMID:27143967

  2. Early Visual Attention in Preterm and Fullterm Infants in Relation to Cognitive and Motor Outcomes at School Age: An Exploratory Study

    PubMed Central

    Hitzert, Marrit M.; Van Braeckel, Koenraad N. J. A.; Bos, Arend F.; Hunnius, Sabine; Geuze, Reint H.

    2014-01-01

    Objective: Preterm infants are exposed to the visual environment earlier than fullterm infants, but whether early exposure affects later development is unclear. Our aim was to investigate whether the development of visual disengagement capacity during the first 6 months postterm was associated with cognitive and motor outcomes at school age, and whether associations differed between fullterms and low-risk preterms. Method: Seventeen fullterms and ten low-risk preterms were tested in a gaze shifting task every 4 weeks until 6 months postterm. The longitudinal data were converted into single continuous variables by fitting the data with an S-shaped curve (frequencies of looks) or an inverse model (latencies of looks). Neuropsychological test results at school age were converted into composite z scores. We then performed linear regression analyses for each functional domain at school age with the variables measuring infant visual attention as separate predictors and adjusting for maternal level of education and group (fullterms versus preterms). We included an interaction term, visual attention*group, to determine whether predictive relations differed between fullterms and preterms. Results: A slower development of disengagement predicted poorer performance on attention, motor skills, and handwriting, irrespective of fullterm or preterm birth. Predictive relationships differed marginally between fullterms and preterms for inhibitory attentional control (P = 0.054) and comprehensive reading (P = 0.064). Conclusion: This exploratory study yielded no indications of a clear advantage or disadvantage of the extra visual exposure in healthy preterm infants. We tentatively conclude that additional visual exposure does not interfere with the ongoing development of neuronal networks during this vulnerable period of brain development. PMID:25340045

  3. Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper.

    PubMed

    López-Sendón, José; González-Juanatey, José Ramón; Pinto, Fausto; Cuenca Castillo, José; Badimón, Lina; Dalmau, Regina; González Torrecilla, Esteban; López-Mínguez, José Ramón; Maceira, Alicia M; Pascual-Figal, Domingo; Pomar Moya-Prats, José Luis; Sionis, Alessandro; Zamorano, José Luis

    2015-11-01

    Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries. PMID:26315766

  4. Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper.

    PubMed

    López-Sendón, José; González-Juanatey, José Ramón; Pinto, Fausto; Cuenca Castillo, José; Badimón, Lina; Dalmau, Regina; González Torrecilla, Esteban; López-Mínguez, José Ramón; Maceira, Alicia M; Pascual-Figal, Domingo; Pomar Moya-Prats, José Luis; Sionis, Alessandro; Zamorano, José Luis

    2015-11-01

    Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries.

  5. Information and communication technologies for promoting and sustaining quality of life, health and self-sufficiency in ageing societies--outcomes of the Lower Saxony Research Network Design of Environments for Ageing (GAL).

    PubMed

    Haux, Reinhold; Hein, Andreas; Kolb, Gerald; Künemund, Harald; Eichelberg, Marco; Appell, Jens-E; Appelrath, H-Jürgen; Bartsch, Christian; Bauer, Jürgen M; Becker, Marcus; Bente, Petra; Bitzer, Jörg; Boll, Susanne; Büsching, Felix; Dasenbrock, Lena; Deparade, Riana; Depner, Dominic; Elbers, Katharina; Fachinger, Uwe; Felber, Juliane; Feldwieser, Florian; Forberg, Anne; Gietzelt, Matthias; Goetze, Stefan; Gövercin, Mehmet; Helmer, Axel; Herzke, Tobias; Hesselmann, Tobias; Heuten, Wilko; Huber, Rainer; Hülsken-Giesler, Manfred; Jacobs, Gerold; Kalbe, Elke; Kerling, Arno; Klingeberg, Timo; Költzsch, Yvonne; Lammel-Polchau, Christopher; Ludwig, Wolfram; Marschollek, Michael; Martens, Birger; Meis, Markus; Meyer, Eike Michael; Meyer, Jochen; Meyer Zu Schwabedissen, Hubertus; Moritz, Niko; Müller, Heiko; Nebel, Wolfgang; Neyer, Franz J; Okken, Petra-Karin; Rahe, Julia; Remmers, Hartmut; Rölker-Denker, Lars; Schilling, Meinhard; Schöpke, Birte; Schröder, Jens; Schulze, Gisela C; Schulze, Mareike; Siltmann, Sina; Song, Bianying; Spehr, Jens; Steen, Enno-Edzard; Steinhagen-Thiessen, Elisabeth; Tanschus, Nele-Marie; Tegtbur, Uwe; Thiel, Andreas; Thoben, Wilfried; van Hengel, Peter; Wabnik, Stefan; Wegel, Sandra; Wilken, Olaf; Winkelbach, Simon; Wist, Thorben; Wolf, Klaus-Hendrik; Wolf, Lars; Zokoll-van der Laan, Melanie

    2014-01-01

    Many societies across the world are confronted with demographic changes, usually related to increased life expectancy and, often, relatively low birth rates. Information and communication technologies (ICT) may contribute to adequately support senior citizens in aging societies with respect to quality of life and quality and efficiency of health care processes. For investigating and for providing answers on whether new information and communication technologies can contribute to keeping, or even improving quality of life, health and self-sufficiency in ageing societies through new ways of living and new forms of care, the Lower Saxony Research Network Design of Environments for Ageing (GAL) had been established as a five years research project, running from 2008 to 2013. Ambient-assisted living (AAL) technologies in personal and home environments were especially important. In this article we report on the GAL project, and present some of its major outcomes after five years of research. We report on major challenges and lessons learned in running and organizing such a large, inter- and multidisciplinary project and discuss GAL in the context of related research projects. With respect to research outcomes, we have, for example, learned new knowledge about multimodal and speech-based human-machine-interaction mechanisms for persons with functional restrictions, and identified new methods and developed new algorithms for identifying activities of daily life and detecting acute events, particularly falls. A total of 79 apartments of senior citizens had been equipped with specific "GAL technology", providing new insights into the use of sensor data for smart homes. Major challenges we had to face were to deal constructively with GAL's highly inter- and multidisciplinary aspects, with respect to research into GAL's application scenarios, shifting from theory and lab experimentation to field tests, and the complexity of organizing and, in our view, successfully managing

  6. Cross-cultural adaptation and linguistic validation of age-group-specific haemophilia patient-reported outcome (PRO) instruments for patients and parents.

    PubMed

    von Mackensen, S; Campos, I G; Acquadro, C; Strandberg-Larsen, M

    2013-03-01

    Currently, haemophilia care aims to provide the best possible quality of life for individuals living with this chronic disease. Many factors are known to influence treatment adherence, including treatment satisfaction. Health-related quality of life (HRQoL) and treatment satisfaction are, therefore, important outcomes in clinical trials and clinical practice. As individuals' perception of their well-being often differs from that of their physician, it is recommended that self-report instruments are used to assess patient-reported outcomes (PROs). The way that the impact of haemophilia is perceived by the patient and their family can be different, so it is important to assess how parents perceive the impact on their children. A series of PRO instruments have been developed, adapted to different age groups and parents of patients with haemophilia. To allow the instruments to be used internationally, culturally adapted and linguistically validated translations have been developed; some instruments have been translated into 61 languages. Here, we report the process used for cultural adaptation of the Haemo-QoL, Haem-A-QoL and Hemo-Sat into 28 languages. Equivalent concepts for 22 items that were difficult to adapt culturally for particular languages were identified and classed as semantic/conceptual (17 items), cultural (three items), idiomatic (one item), and grammatical (one item) problems. This has resulted in linguistically validated versions of these instruments, which can be used to assess HRQoL and treatment satisfaction in clinical trials and clinical practice. They will provide new insights into areas of haemophilia that remain poorly understood today. PMID:23167873

  7. Cancer as the main aging factor for humans: the fundamental role of 5-methoxy-tryptamine in reversal of cancer-induced aging processes in metabolic and immune reactions by non-melatonin pineal hormones.

    PubMed

    Lissoni, Paolo; Messina, Giuseppina; Rovelli, Franco

    2012-12-01

    Aging and advanced cancer are characterized by similar neuroendocrine and immune deficiencies; the most important of them consist of diminished nocturnal production of the pineal hormone melatonin (MLT) and decreased production of IL-2. At present, however, it is known that the pineal gland may produce indole hormones other than MLT. The most investigated of them is represented by 5-methoxy-tryptamine (5-MTT), which may exert antitumor, anticachectic, and immunomodulating effects under experimental conditions, in addition to those effects produced by MLT itself. In an attempt to obtain some preliminary data in human subjects about the potential therapeutic properties of 5-MTT, three different studies of 5-MTT have been carried out in advanced solid tumor patients. The first study of MLT plus 5-MTT included 14 thrombocytopenic cancer patients who did not respond to MLT alone. In the second study we have compared the clinical efficacy of MLT plus 5-MTT in a group of 25 untreatable metastatic cancer patients to the results obtained in a control group of 25 cancer patients receiving MLT alone. Finally, the third study of MLT plus 5-MTT included 14 untreatable metastatic cancer patients who did not respond to MLT alone. In all of these studies, MLT and 5-MTT were given orally at the level of 20 mg/day in the evening and at 5 mg/day during the period of maximum light. A normalization of platelet number was achieved by MLT plus 5-MTT in 5 of 14 (36%) thrombocytopenic cancer patients who did not respond to MLT alone. The percentage of disease control obtained by MLT plus 5-MTT in untreatable metastatic cancer patients was significantly higher than that achieved by MLT alone (15/25 [60%] vs. 8/25 [32%], P < 0.05). Finally, the association of 5-MTT with MLT induced disease stabilization in 4 of 14 (29%) untreatable metastatic cancer patients who did not respond to MLT alone.

  8. Novel risk markers and long-term outcomes of delirium: The Successful Aging after Elective Surgery (SAGES) Study Design and Methods

    PubMed Central

    Schmitt, Eva M.; Marcantonio, Edward R.; SM; Alsop, David C.; Jones, Richard N.; Rogers, Selwyn O.; Fong, Tamara G.; Metzger, Eran; Inouye, Sharon K.

    2012-01-01

    Objectives Delirium--a costly, life-threatening, and potentially preventable condition--is a common complication for older adults following major surgery. While the basic epidemiology of delirium after surgery has been defined, the contribution of delirium to long-term outcomes remains uncertain, and novel biomarkers from plasma and neuroimaging have yet to be examined. This program project was designed to contribute to our understanding of the complex multifactorial syndrome of delirium. Design Long-term prospective cohort study. Setting 3 academic medical centers (2 hospitals and 1 coordinating center). Participants Patients without recognized dementia (targeted cohort = 550 patients) age 70 and older scheduled to undergo elective major surgery are assessed at baseline prior to surgery, daily during their hospital stay, and for 18-36 months after discharge. Measurements The Successful Aging after Elective Surgery (SAGES) study is an innovative, interdisciplinary study that includes biomarkers, neuroimaging, cognitive reserve markers, and serial neuropsychological testing to examine the contribution of delirium to long-term cognitive and functional decline. The primary goal is to examine the contribution of delirium to long-term cognitive and functional decline. In addition, novel risk markers, for delirium are being examined, including plasma biomarkers (e.g., cytokines, proteomics), advanced neuroimaging markers (e.g., volumetric, white matter hyperintensity, noncontrast blood flow, and diffusion tensor measures) and cognitive reserve markers (e.g., education, occupation, lifetime activities). Conclusion Results from this study will contribute to a fuller understanding of the etiology and prognosis of delirium. Ultimately, we hope this project will provide the groundwork for future development of prevention and treatment strategies for delirium, designed to minimize the long-term negative impact of delirium in older adults. PMID:22999782

  9. Comparison of the Northeast Arctic cod year class strength (at the age of 3+) with the SST anomalies in main spawning ground (the Norwegian Shelf Waters) by results of analysis satellite monitoring data during last years.

    NASA Astrophysics Data System (ADS)

    Vanyushin, George

    2015-04-01

    Continuous long-term database (1998-2014) on the sea surface temperature (SST) comprising results of regional satellite monitoring (the Norwegian and the Barents seas) is used to resolve several applied problems. Authors have analyzed indirect influence the SST (the NOAA satellite data) on modern cod total stock biomass (abundance of the Northeast Arctic cod at age 3+). In this study, we went on the consideration of the relationship between the SST anomalies for March-April in the main spawning ground of the cod off the Lofoten islands in the Norwegian Shelf Waters and forecasting assessment of future cod generation success and its future abundance of 3 year old. Mean monthly SST and SST anomalies are computed for the selected area on the basis of the weekly SST maps which made by using the NOAA satellites data for the period 1998-2014. Comparison of the SST anomalies in the main spawning ground with abundance of the cod year class at age 3+ shows that survival of the cod generations was inhibited on the whole as negative (below -0,1C) well as positive SST anomalies (above +1,3C) during March and April. Finally, the results indicate that poor and low middle generations of cod at age 3+ (2002, 2004, 2010) occurred in years with negative or extremely high positive the SST anomalies in the spawning area. The SST anomalies in years which were close to normal significances provide conditions for appearance middle or strong generations of cod (2001-2003, 2005-2009, 2011-2013). So, the SST and SST anomalies (by the NOAA satellite data) characterize of increase in input of warm Atlantic waters which form numerous eddies along the main stream thus creating favorable conditions for spawning and development of the cod larvae and fry and provide them with food stock, finally direct influence on forming total stock biomass of cod and helping its population forecast. Key words: satellite monitoring of SST, the Northeast Arctic cod, spawning ground, forecast of the cod year class

  10. Impact of the mandatory age-based single-embryo transfer legislation in Turkey on outcome of in vitro fertilization: a multicentre study.

    PubMed

    Ergun, B; Bastu, E; Galandarov, R; Koksal, G; Yumru, H; Attar, E

    2013-08-01

    This study in Turkey evaluated the impact of age-based mandatory single-embryo transfer (SET) legislation with the subsequent increase in frozen-thawed embryo transfer (FT-EU) on pregnancy outcome of in vitro fertilization (IVF) patients. SET, FT-FT and double-embryo transfer were used in 5632 patients after legislation, while traditional IVF and FT-FT approach was used in 6029 patients before legislation. The cumulative pregnancy rate after legislation was slightly lower (38.2%) than before legislation (42.0%) but not significantly so. The single pregnancy rate for SET and traditional IVF were similar between the 2 groups (37.8% versus 28.7%), while multiple pregnancy rates were significantly higher before than after legislation (13.7% versus 0.3%). For FT-ET, the number of cycles was significantly higher after legislation (862 versus 616). SET yielded similar results to traditional IVF. In order to reduce multiple pregnancies without significantly decreasing pregnancy rates, SET might be a successful strategy.

  11. Prenatal coke: what's behind the smoke? Prenatal cocaine/alcohol exposure and school-age outcomes: the SCHOO-BE experience.

    PubMed

    Delaney-Black, V; Covington, C; Templin, T; Ager, J; Martier, S; Compton, S; Sokol, R

    1998-06-21

    Despite media reports and educators' concerns, little substantive data have been published to document or refute the emerging reports that children prenatally exposed to cocaine have serious behavioral problems in school. Recent pilot data from this institution have indeed demonstrated teacher-reported problem behaviors following prenatal cocaine exposure after controlling for the effects of prenatal alcohol use and cigarette exposure. Imperative in the study of prenatal exposure and child outcome is an acknowledgement of the influence of other control factors such as postnatal environment, secondary exposures, and parenting issues. We report preliminary evaluation from a large ongoing historical prospective study of prenatal cocaine exposure on school-age outcomes. The primary aim of this NIDA-funded study is to determine if a relationship exists between prenatal cocaine/alcohol exposures and school behavior and, if so, to determine if the relationship is characterized by a dose-response relationship. A secondary aim evaluates the relationship between prenatal cocaine/alcohol exposures and school achievement. Both relationships will be assessed in a black, urban sample of first grade students using multivariate statistical techniques for confounding as well as mediating and moderating prenatal and postnatal variables. A third aim is to evaluate the relationship between a general standardized classroom behavioral measure and a tool designed to tap the effects thought to be specific to prenatal cocaine exposure. This interdisciplinary research team can address these aims because of the existence of a unique, prospectively collected perinatal Database, funded in part by NIAAA and NICHD. The database includes repeated measures of cocaine, alcohol, and other substances for over 3,500 births since 1986. Information from this database is combined with information from the database of one of the largest public school systems in the nation. The final sample will be

  12. Long-term (60-month) results for the implantable miniature telescope: efficacy and safety outcomes stratified by age in patients with end-stage age-related macular degeneration

    PubMed Central

    Boyer, David; Freund, K Bailey; Regillo, Carl; Levy, Marc H; Garg, Sumit

    2015-01-01

    Background The purpose of this study was to evaluate the long-term results of an implantable miniature telescope (IMT) in patients with bilateral, end-stage, age-related macular degeneration (AMD). Methods A prospective, open-label, multicenter clinical trial with fellow eye controls enrolled 217 patients (mean age 76 years) with AMD and moderate-to-profound bilateral central visual acuity loss (20/80–20/800) resulting from untreatable geographic atrophy, disciform scars, or both. A subgroup analysis was performed with stratification for age (patient age 65 to <75 years [group 1; n=70] and patient age ≥75 years [group 2; n=127]), with a comparative evaluation of change in best-corrected distance visual acuity (BCDVA), quality of life, ocular complications from surgery, adverse events, and endothelial cell density (ECD). Follow-up in an extension study was 60 months. Results Data were available for 22, 38, and 31 patients in group 1 and 42, 46, and 32 patients in group 2 at 36, 48, and 60 months, respectively. Mean BCDVA improvement from baseline to 60 months was 2.41±2.69 lines in all patients (n=76), with 2.64±2.55 lines in group 1 and 2.09±2.88 lines in group 2. Quality of life scores were significantly higher in group 1. The most common significant surgery-related ocular complications in group 1 were iritis >30 days after surgery (7/70; 10%) and persistent corneal edema (3/70; 4.3%); and in group 2 were a decrease in BCDVA in the implanted eye or IMT removal (10/127 each; 7.9%), corneal edema >30 days after surgery (9/127; 7.1%), and persistent corneal edema (6/127; 4.7%). Significant adverse events included four corneal transplants, comprising two (2.9%) in group 1 and two (1.6%) in group 2. At 60 months, one patient in group 1 (3.2%) and three patients in group 2 (9.4%) had lost ≥2 lines of vision. The IMT was removed in one (1.4%) and ten (7.9%) patients in group 1 and group 2, respectively. Mean ECD loss was 20% at 3 months. Chronic loss was 3% per

  13. 10Be dating of the Main Terrace level in the Amblève valley (Ardennes, Belgium): new age constraint on the archaeological and palaeontological filling of the Belle-Roche palaeokarst

    NASA Astrophysics Data System (ADS)

    Rixhon, Gilles; Bourlès, Didier L.; Braucher, Régis; Siame, Lionel; Cordy, Jean-Marie; Demoulin, Alain

    2014-05-01

    It is still disputed whether very old archaeological and palaeontological remains found in the Belle-Roche palaeocave (eastern Belgium) pertain to the Early (˜1 Ma) or Middle (˜0.5 Ma) Pleistocene. Here, in situ-produced cosmogenic 10Be concentrations from a depth profile in nearby sediments of the Belle-Roche terrace (Amblève Main Terrace level) are used as an indirect solution of this chronological issue. The distribution of 10Be concentrations in the upper 3 m of this profile displays the theoretically expected exponential decrease with depth. Assuming a single exposure episode, we obtain a best fit age of 222.5±31 ka for the time of terrace abandonment. However, below 3 m, the 10Be concentrations show a marked progressive increase with depth. This distinctive cosmogenic signal is interpreted as the result of slow aggradation of the fluvial deposits over a lengthy interval. Modelling of the whole profile thus suggests that the onset of the terrace formation occurred at around 550 ka, with a sediment accumulation rate of ˜20 mm/ka. Based on two slightly different reconstructions of the geomorphic evolution of the area and a discussion of the temporal link between the cave and Main Terrace levels, we conclude that the fossil-bearing layers in the palaeokarst pertain most probably to MIS 14-13 (or possibly MIS 12-11) and the artifact-bearing layer to MIS 13 (or possibly MIS 11). This age estimate for the large mammal association identified in the Belle-Roche palaeokarst and the attribution to MIS 14-13 of a similar fauna found in the lowermost fossiliferous layers of the Caune de l'Arago (Tautavel) are in mutual support. Our results therefore confirm the status of the Belle-Roche site as a reference site for the Cromerian mammal association and the Early Palaeolithic industry in NW Europe.

  14. Relationship of Intraoperative Cerebral Oxygen Saturation to Neurodevelopmental Outcome and Brain MRI at One Year of Age in Infants Undergoing Biventricular Repair

    PubMed Central

    Kussman, Barry D.; Wypij, David; Laussen, Peter C.; Soul, Janet S.; Bellinger, David C.; DiNardo, James A.; Robertson, Richard; Pigula, Frank A.; Jonas, Richard A.; Newburger, Jane W.

    2010-01-01

    Background Near-infrared spectroscopy (NIRS) monitoring of cerebral oxygen saturation (rSO2) has become routine in many centers, but no studies have reported the relationship of intraoperative NIRS to long-term neurodevelopmental outcomes after cardiac surgery. Methods and Results Of 104 infants undergoing biventricular repair without aortic arch reconstruction, 89 (86%) returned for neurodevelopmental testing at age 1 year. The primary NIRS variable was the integrated rSO2 (area under the curve) for rSO2 ≤ 45%; secondary variables were the average and minimum rSO2 by perfusion phase and at specific time points. Psychomotor (PDI) and Mental Development Indexes of the Bayley Scales, head circumference, neurologic examination, and abnormalities on brain MRI did not differ between subjects according to a threshold level for rSO2 of 45%. Lower PDI scores were modestly associated with lower average (r=0.23; P=0.03) and minimum rSO2 (r=0.22; P=0.04) during the 60 minute period following cardiopulmonary bypass (CPB), but not with other perfusion phases. Hemosiderin foci on brain MRI were associated with lower average rSO2 from post-induction to 60 minutes post-CPB (71±10 vs. 78±6%; P=0.01), and lower average rSO2 during the rewarming phase (72±12 vs. 83±9%; P=0.003) and during the 60 minute period following CPB (65±11 vs. 75±10%; P=0.009). In regression analyses adjusting for age ≤ 30 days, PDI score (P=0.02) and brain hemosiderin (P=0.04) remained significantly associated with rSO2 during the 60 minute period following CPB. Conclusions Perioperative periods of diminished cerebral oxygen delivery, as indicated by rSO2, are associated with one-year PDI and brain MRI abnormalities among infants undergoing reparative heart surgery. Clinical Trial Registration Information http://clinicaltrials.gov/ct2/show/NCT00006183 PMID:20606124

  15. Coupling age-structured stock assessment and fish bioenergetics models: a system of time-varying models for quantifying piscivory patterns during the rapid trophic shift in the main basin of Lake Huron

    USGS Publications Warehouse

    He, Ji X.; Bence, James R.; Madenjian, Charles P.; Pothoven, Steven A.; Dobiesz, Norine E.; Fielder, David G.; Johnson, James E.; Ebener, Mark P.; Cottrill, Adam R.; Mohr, Lloyd C.; Koproski, Scott R.

    2015-01-01

    We quantified piscivory patterns in the main basin of Lake Huron during 1984–2010 and found that the biomass transfer from prey fish to piscivores remained consistently high despite the rapid major trophic shift in the food webs. We coupled age-structured stock assessment models and fish bioenergetics models for lake trout (Salvelinus namaycush), Chinook salmon (Oncorhynchus tshawytscha), walleye (Sander vitreus), and lake whitefish (Coregonus clupeaformis). The model system also included time-varying parameters or variables of growth, length–mass relations, maturity schedules, energy density, and diets. These time-varying models reflected the dynamic connections that a fish cohort responded to year-to-year ecosystem changes at different ages and body sizes. We found that the ratio of annual predation by lake trout, Chinook salmon, and walleye combined with the biomass indices of age-1 and older alewives (Alosa pseudoharengus) and rainbow smelt (Osmerus mordax) increased more than tenfold during 1987–2010, and such increases in predation pressure were structured by relatively stable biomass of the three piscivores and stepwise declines in the biomass of alewives and rainbow smelt. The piscivore stability was supported by the use of alternative energy pathways and changes in relative composition of the three piscivores. In addition, lake whitefish became a new piscivore by feeding on round goby (Neogobius melanostomus). Their total fish consumption rivaled that of the other piscivores combined, although fish were still a modest proportion of their diet. Overall, the use of alternative energy pathways by piscivores allowed the increases in predation pressure on dominant diet species.

  16. Effects of Multimedia Social Stories on Knowledge of Adult Outcomes and Opportunities among Transition-Aged Youth with Significant Cognitive Disabilities

    ERIC Educational Resources Information Center

    Richter, Sharon; Test, David

    2011-01-01

    Students with significant cognitive disabilities typically experience poor post-school outcomes as adults. Federal legislation and recent research reflect the importance of teaching self-determination skills as a strategy to improve post-school outcomes. However, the National Longitudinal Transition Study-2 (NLTS-2) reported that individuals with…

  17. Parasitological and nutritional status of school-age and preschool-age children in four villages in Southern Leyte, Philippines: Lessons for monitoring the outcome of Community-Led Total Sanitation.

    PubMed

    Belizario, Vicente Y; Liwanag, Harvy Joy C; Naig, June Rose A; Chua, Paul Lester C; Madamba, Manuel I; Dahildahil, Roy O

    2015-01-01

    While preventive chemotherapy remains to be a major strategy for the prevention and control of soil-transmitted helminthiases (STH), improvements in water, sanitation, and hygiene (WASH) comprise the long-term strategy to achieve sustained control of STH. This study examined the parasitological and nutritional status of school-age and preschool-age children in four villages in Southern Leyte, Philippines where two of the villages attained Open-Defecation-Free (ODF) status after introduction of Community-Led Total Sanitation (CLTS). A total of 341 children (89.0% of the total eligible population) submitted stool samples which were examined using the Kato-Katz technique. Results showed that 27.9% of the total stool samples examined had at least one type of STH (cumulative prevalence), while 7.9% had moderate-heavy intensity infections. Between the two villages where CLTS was introduced, Buenavista had a significantly higher cumulative prevalence of STH at 67.4% (p<0.001) and prevalence of moderate-heavy intensity STH at 23.5% (p=0.000), while Caubang had a significantly lower cumulative prevalence at 4.9% and prevalence of moderate-heavy intensity at 1.8%. On the other hand, the non-CLTS villages of Bitoon and Saub had similar rates for cumulative prevalence (16.7% and 16.8%, respectively; p=0.984) and prevalence of moderate-heavy intensity STH (2.0% and 3.1%, respectively; p=1.000). The findings may be explained by factors that include possible reversion to open defecation, non-utilization of sanitary facilities, and mass drug administration (MDA) coverage, although further studies that can accurately assess the impact of CLTS are recommended. While this study was descriptive, the data indicate no clear pattern among the parasitological and nutritional parameters, as well as the presence of CLTS in the village, suggesting the need to monitor the ODF status of villages on a regular basis even after the end of CLTS activities to ensure the sustainability of the CLTS

  18. 40Ar-39Ar age constraint on deformation and brittle-ductile transition of the Main Central Thrust and the South Tibetan Detachment zone from Dhauliganga valley, Garhwal Himalaya, India

    NASA Astrophysics Data System (ADS)

    Sen, Koushik; Chaudhury, Reetam; Pfänder, Jörg

    2015-08-01

    40Ar-39Ar data from two sets of mylonitic two-mica granites present in the Main Central Thrust (MCT) and one leucogranite from the South Tibetan Detachment (STD) of Dhauliganga valley, Garhwal Himalaya are presented. The MCT and the STD bound the High Himalayan Crystallines (HHC) and are believed to facilitate its extrusion. Field evidence of ductile deformation in the form of tight isoclinal folding and brittle deformation in the form of back thrusts and transverse fractures are observed. The STD zone shows evidence of pervasive migration of leucogranitic melt through north dipping extensional shear zones. The ∼19.5 Ma old Malari Leucogranite, present adjacent to the STD zone, experienced ductile and brittle deformation related to the tectonics of the STD. Muscovite analysis from the Malari leucogranite gives a cooling age of ∼15.2 Ma suggesting that ductile deformation in the STD zone may have ceased by ∼15 Ma. 40Ar-39Ar chronology of biotite from two mylonitic granites of the MCT yields cooling ages of 10.8 Ma and 9.7 Ma, which we correlate with activity of the MCT at ∼10 Ma that caused rapid exhumation of the HHC. 40Ar-39Ar ages of 6.4 Ma and 6.2 Ma from white mica represent newly crystallized white mica post-dating biotite cooling and indicate late stage deformation. It is inferred that, as the HHC wedge started to exhume and erode rapidly along the MCT zone at ∼10 Ma, the taper angle of the Himalayan wedge decreased to a 'sub-critical' stage. To regain the critical taper angle, the wedge underwent internal deformation in the form of back thrusts and duplex structures. Comparison of our data with earlier results from other sections of the MCT helps us envisage that the ∼6 Ma white mica ages can be correlated with this internal deformation event and also with the transition of deformation regime in the MCT zone from ductile to brittle.

  19. National Trends in Pulmonary Embolism Hospitalization Rates and Outcomes for Adults Aged ≥65 Years in the United States (1999 to 2010).

    PubMed

    Minges, Karl E; Bikdeli, Behnood; Wang, Yun; Kim, Nancy; Curtis, Jeptha P; Desai, Mayur M; Krumholz, Harlan M

    2015-11-01

    Little is known about national trends of pulmonary embolism (PE) hospitalizations and outcomes in older adults in the context of recent diagnostic and therapeutic advances. Therefore, we conducted a retrospective cohort study of 100% Medicare fee-for-service beneficiaries hospitalized from 1999 to 2010 with a principal discharge diagnosis code for PE. The adjusted PE hospitalization rate increased from 129/100,000 person-years in 1999 to 302/100,000 person-years in 2010, a relative increase of 134% (p <0.001). Black patients had the highest rate of increase (174 to 548/100,000 person-years) among all age, gender, and race categories. The mean (standard deviation) length of hospital stay decreased from 7.6 (5.7) days in 1999 to 5.8 (4.4) days in 2010, and the proportion of patients discharged to home decreased from 51.1% (95% confidence interval [CI] 50.5 to 51.6) to 44.1% (95% CI 43.7 to 44.6), whereas more patients were discharged with home health care and to skilled nursing facilities. The in-hospital mortality rate decreased from 8.3% (95% CI 8.0 to 8.6) in 1999 to 4.4% (95% CI 4.2 to 4.5) in 2010, as did adjusted 30-day (from 12.3% [95% CI 11.9 to 12.6] to 9.1% [95% CI 8.5 to 9.7]) and 6-month mortality rates (from 23.0% [95% CI 22.5 to 23.4] to 19.6% [95% CI 18.8 to 20.5]). There were no significant racial differences in mortality rates by 2010. There was no change in the adjusted 30-day all-cause readmission rate from 1999 to 2010. In conclusion, PE hospitalization rates increased substantially from 1999 to 2010, with a higher rate for black patients. All mortality rates decreased but remained high. The increase in hospitalization rates and continued high mortality and readmission rates confirm the significant burden of PE for older adults. PMID:26409636

  20. Corporal Punishment and Child Behavioural and Cognitive Outcomes through 5?Years of Age: Evidence from a Contemporary Urban Birth Cohort Study

    ERIC Educational Resources Information Center

    MacKenzie, Michael J.; Nicklas, Eric; Waldfogel, Jane; Brooks-Gunn, Jeanne

    2012-01-01

    This study examined the prevalence and determinants of spanking of children at 3?years of age and the associations between spanking and externalizing behaviour and receptive verbal ability at age 5?years. Overall, we find maternal spanking rates of 55.2% and paternal rates of 43.2% at age 3?years. Mothers facing greater stress and those who…

  1. Long-Term Outcome of Prosthetic Valve Replacement in Japanese Patients Aged 65 Years or Older: Are Guidelines for Prosthetic Valve Selection Based on Overseas Data Appropriate for Japanese Patients?

    PubMed Central

    Osaka, Shunji; Yaoita, Hiroko; Ishii, Yusuke; Arimoto, Munehito; Hata, Hiroaki; Shiono, Motomi

    2015-01-01

    Background: Based on the revised AHA/ACC guidelines, it might be necessary to take into consideration the average life expectancy of Japanese people and revise the Japanese guidelines accordingly. Accordingly, we performed the present study to compare the long-term outcome in patients aged 65 years or older who underwent prosthetic valve replacement at our hospital using mechanical valves or biological valves. Methods: We have performed valve replacement in 416 patients aged 65 years or older (mechanical: 157; biological: 244). Results: There was no significant difference between the mechanical and biological valve for the actuarial survival rate. As for the valve-related complication free rate, in the mechanical valve group, the rates were significantly higher for all patients, aortic valve replacement (AVR) patients, and mitral valve replacement (MVR) patients. Conclusions: Following revision of the AHA/ACC guidelines for selection of prosthetic valves, it is necessary to investigate whether patients aged 60–70 represent the gray zone for selecting valves as in US and European guidelines, or whether a higher age is more appropriate in view of the longer average life expectancy in Japan. Accordingly, further evaluation of the long-term outcome for mechanical and biological valves in Japanese patients is needed to obtain evidence for preparation of original Japanese guidelines on prosthetic valve selection. PMID:26004117

  2. Association between maternal age at childbirth and child and adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration)

    PubMed Central

    Fall, Caroline H D; Sachdev, Harshpal Singh; Osmond, Clive; Restrepo-Mendez, Maria Clara; Victora, Cesar; Martorell, Reynaldo; Stein, Aryeh D; Sinha, Shikha; Tandon, Nikhil; Adair, Linda; Bas, Isabelita; Norris, Shane; Richter, Linda M

    2015-01-01

    Summary Background Both young and advanced maternal age is associated with adverse birth and child outcomes. Few studies have examined these associations in low-income and middle-income countries (LMICs) and none have studied adult outcomes in the offspring. We aimed to examine both child and adult outcomes in five LMICs. Methods In this prospective study, we pooled data from COHORTS (Consortium for Health Orientated Research in Transitioning Societies)—a collaboration of five birth cohorts from LMICs (Brazil, Guatemala, India, the Philippines, and South Africa), in which mothers were recruited before or during pregnancy, and the children followed up to adulthood. We examined associations between maternal age and offspring birthweight, gestational age at birth, height-for-age and weight-for-height Z scores in childhood, attained schooling, and adult height, body composition (body-mass index, waist circumference, fat, and lean mass), and cardiometabolic risk factors (blood pressure and fasting plasma glucose concentration), along with binary variables derived from these. Analyses were unadjusted and adjusted for maternal socioeconomic status, height and parity, and breastfeeding duration. Findings We obtained data for 22 188 mothers from the five cohorts, enrolment into which took place at various times between 1969 and 1989. Data for maternal age and at least one outcome were available for 19 403 offspring (87%). In unadjusted analyses, younger (≤19 years) and older (≥35 years) maternal age were associated with lower birthweight, gestational age, child nutritional status, and schooling. After adjustment, associations with younger maternal age remained for low birthweight (odds ratio [OR] 1·18 (95% CI 1·02–1·36)], preterm birth (1·26 [1·03–1·53]), 2-year stunting (1·46 [1·25–1·70]), and failure to complete secondary schooling (1·38 [1·18–1·62]) compared with mothers aged 20–24 years. After adjustment, older maternal age remained

  3. The Influence of Age at Single-Event Multilevel Surgery on Outcome in Children with Cerebral Palsy Who Walk with Flexed Knee Gait

    ERIC Educational Resources Information Center

    Svehlik, Martin; Steinwender, Gerhard; Kraus, Tanja; Saraph, Vinay; Lehmann, Thomas; Linhart, Wolfgang E.; Zwick, Ernst B.

    2011-01-01

    Aim: Information on the timing and long-term outcome of single-event multilevel surgery in children with bilateral spastic cerebral palsy (CP) walking with flexed knee gait is limited. Based on our clinical experience, we hypothesized that older children with bilateral spastic CP would benefit more from single-event multilevel surgery than younger…

  4. Corporal punishment and child behavioral and cognitive outcomes through 5 years-of-age: Evidence from a contemporary urban birth cohort study.

    PubMed

    MacKenzie, Michael J; Nicklas, Eric; Waldfogel, Jane; Brooks-Gunn, Jeanne

    2012-01-01

    This study examined the prevalence and determinants of spanking of children at 3 years-of-age, and the associations between spanking and externalizing behavior and receptive verbal ability at age 5. Overall, we find maternal spanking rates of 55.2% and paternal rates of 43.2% at age 3. Mothers facing greater stress and those who spanked earlier are more likely to spank at age 3, whereas those who report a supportive partner during pregnancy and those who were not U.S. born were less likely to spank. Mothers and fathers in communities where spanking was more normative were more likely to spank. Fathers were less likely to spank daughters at age 3. Frequent maternal spanking at age 3 was associated with externalizing behavior and receptive vocabulary at age 5, controlling for an array of ecological risks, earlier behavior, and verbal capacity. Taking advantage of the large and diverse sample we explored potential interactions and found no evidence that race, parental warmth, normativeness, or child gender moderated the association between spanking and externalizing or receptive vocabulary. These findings add to the literature on negative consequences associated with a widely endorsed parenting practice, and highlight the need for research that explores alternative effective discipline practices and addresses parent questions of what else they could, or even should, be doing.

  5. Call to action: continuum of care for females of reproductive age to prevent obesity and ensure better health outcomes of offspring through nutrition.

    PubMed

    Zive, Michelle M; Rhee, Kyung E

    2014-09-01

    The health and nutritional status of women of reproductive age has tremendous impact on the health of future populations; therefore, special attention should be paid to promoting women's health, especially a healthy weight at this critical time period. The purpose of the paper is to provide information on the nutritional needs of women at various stages of the reproductive age spectrum, including preconception/interconception and during pregnancy to achieve and maintain a healthy weight. The Socio-Ecological Model (SEM) is presented to help practitioners understand the importance of intervening where women of reproductive age live, work, and frequent.

  6. Factors affecting intellectual outcome in pediatric brain tumor patients

    SciTech Connect

    Ellenberg, L.; McComb, J.G.; Siegel, S.E.; Stowe, S.

    1987-11-01

    A prospective study utilizing repeated intellectual testing was undertaken in 73 children with brain tumors consecutively admitted to Childrens Hospital of Los Angeles over a 3-year period to determine the effect of tumor location, extent of surgical resection, hydrocephalus, age of the child, radiation therapy, and chemotherapy on cognitive outcome. Forty-three patients were followed for at least two sequential intellectual assessments and provide the data for this study. Children with hemispheric tumors had the most general cognitive impairment. The degree of tumor resection, adequately treated hydrocephalus, and chemotherapy had no bearing on intellectual outcome. Age of the child affected outcome mainly as it related to radiation. Whole brain radiation therapy was associated with cognitive decline. This was especially true in children below 7 years of age, who experienced a very significant loss of function after whole brain radiation therapy.

  7. A Prospective Randomized Controlled Study of Laser-Assisted Hatching on the Outcome of First Fresh IVF-ET Cycle in Advanced Age Women.

    PubMed

    Shi, Wenhao; Hongwei, Tan; Zhang, Wei; Li, Na; Li, Mingzhao; Li, Wei; Shi, Juanzi

    2016-10-01

    There is no sufficient data to conclude the benefit of assisted hatching (AH) for advanced age patients. However, AH is routinely performed for advanced age patients undergoing in vitro fertilization (IVF) in China based on some retrospective evidence. It is important to assess the benefit of AH procedure for advanced age patients, especially by analyzing the data from China. This is a prospective randomized controlled trial to evaluate the effect of laser AH in the advanced age patients undergoing IVF. A total of 256 patients conformed to the inclusion criteria, and 78 were excluded by exclusion criteria. A total of 178 patients were eligible and randomized to 2 groups (82 AH group and 96 control group). Laser AH (zona thinning) was performed in the AH group. There were no statistical significance in basic clinical parameters between the 2 groups. No difference was found in implantation rate (AH vs control, 32.45% vs 39.29%) and clinical pregnancy rate (AH vs control, 48.78% vs 59.38%). Our data did not find any benefit of laser AH in improving implantation or pregnancy rates in advanced age women. Due to the potential risk and increasing financial burden, AH should not be routinely performed in first fresh IVF embryo transfer cycle for advanced age women.

  8. Outcome after Elective Percutaneous Coronary Intervention Depends on Age in Patients with Stable Coronary Artery Disease – An Analysis of Relative Survival in a Multicenter Cohort and an OCT Substudy

    PubMed Central

    Roth, Christian; Gangl, Clemens; Dalos, Daniel; Krenn, Lisa; Scherzer, Sabine; Gerken, Anna; Reinwein, Martin; Zhang, Chao; Hagmann, Michael; Wrba, Thomas; Delle-Karth, Georg; Neunteufl, Thomas; Maurer, Gerald; Vock, Paul; Mayr, Harald

    2016-01-01

    Background Age is a strong predictor of survival in patients with coronary artery disease. In elder patients with increasing co-morbidities percutaneous coronary intervention (PCI) is associated with more complications and worse outcome. The calculation of relative survival rates adjusts for the “background” mortality in the general population by correcting for age and gender. We analyzed if elder patients after elective PCI have a worse relative survival compared to younger patient groups. Methods A total of 8,342 patients who underwent elective PCI at two high volume centers between 1998 and 2009 were analyzed. Results The survival of our patients after PCI (observed survival) was slightly lower compared to the general population (expected survival) resulting in a slightly decreasing relative survival curve. In a multivariate Cox regression model age amongst others was a strong predictor of survival. Stratifying patients according to their age the relative survival curves of younger patients (Quartile 1: <58 years; 2,046 patients), elder patients (Quartile 3: 66–73 years; 2,090 patients) and very old patients (Quartile 4: >73 years; 2,307 patients) were similar. The relative survival of mid-aged patients (Quartile 2: 58–65 years; 1,899 patients) was better than that of all other patient groups. The profile of cardiovascular risk factors differs between the various groups resulting in different composition and burden of coronary plaques in an optical coherence tomography sub-study. Conclusion Patients after elective PCI have a slightly worse long-term survival compared to the age- and sex-matched general population. This is also true for different groups of age except for mid-aged patients between 58 and 63 years. Elder patients between 66 and 73 years and above 73 years have a similar relative survival compared to younger patients below 58 years, and might therefore have similar benefit from elective PCI. PMID:27105207

  9. Comparison of weight loss outcomes 1 year after sleeve gastrectomy and Roux-en-Y gastric bypass in patients aged above 50 years

    PubMed Central

    Praveenraj, Palanivelu; Gomes, Rachel M; Kumar, Saravana; Perumal, Sivalingam; Senthilnathan, Palanisamy; Parthasarathi, Ramakrishnan; Rajapandian, Subbiah; Palanivelu, Chinnusamy

    2016-01-01

    INTRODUCTION: Safe, effective weight loss with resolution of comorbidities has been convincingly demonstrated with bariatric surgery in the aged obese. They, however, lose less weight than younger individuals. It is not known if degree of weight loss is influenced by the choice of bariatric procedure. The aim of this study was to compare the degree of weight loss between laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients above the age of 50 years at 1 year after surgery. MATERIALS AND METHODS: A retrospective analysis was performed of all patients more than 50 years of age who underwent LSG or LRYGB between February 2012 and July 2013 with at least 1 year of follow-up. Data evaluated at 1 year included age, sex, weight, body mass index (BMI), mean operative time, percentage of weight loss and excess weight loss, resolution/remission of diabetes, morbidity and mortality. RESULTS: Of a total of 86 patients, 54 underwent LSG and 32 underwent LRYGB. The mean percentage of excess weight loss at the end of 1 year was 60.19 ± 17.45 % after LSG and 82.76 ± 34.26 % after LRYGB (P = 0.021). One patient developed a sleeve leak after LSG, and 2 developed iron deficiency anaemia after LRYGB. The remission/improvement in diabetes mellitus and biochemistry was similar. CONCLUSION: LRYGB may offer better results than LSG in terms of weight loss in patients over 50 years of age. PMID:27279392

  10. Screening outcomes in older US women undergoing multiple mammograms in community practice: does interval, age, or comorbidity score affect tumor characteristics or false positive rates?

    PubMed

    Braithwaite, Dejana; Zhu, Weiwei; Hubbard, Rebecca A; O'Meara, Ellen S; Miglioretti, Diana L; Geller, Berta; Dittus, Kim; Moore, Dan; Wernli, Karen J; Mandelblatt, Jeanne; Kerlikowske, Karla

    2013-03-01

    Background Uncertainty exists about the appropriate use of screening mammography among older women because comorbid illnesses may diminish the benefit of screening. We examined the risk of adverse tumor characteristics and false positive rates according to screening interval, age, and comorbidity. Methods From January 1999 to December 2006, data were collected prospectively on 2993 older women with breast cancer and 137 949 older women without breast cancer who underwent mammography at facilities that participated in a data linkage between the Breast Cancer Surveillance Consortium and Medicare claims. Women were aged 66 to 89 years at study entry to allow for measurement of 1 year of preexisting illnesses. We used logistic regression analyses to calculate the odds of advanced (IIb, III, IV) stage, large (>20 millimeters) tumors, and 10-year cumulative probability of false-positive mammography by screening frequency (1 vs 2 years), age, and comorbidity score. The comorbidity score was derived using the Klabunde approximation of the Charlson score. All statistical tests were two-sided. Results Adverse tumor characteristics did not differ statistically significantly by comorbidity, age, or interval. Cumulative probability of a false-positive mammography result was higher among annual screeners than biennial screeners irrespective of comorbidity: 48.0% (95% confidence interval [CI] = 46.1% to 49.9%) of annual screeners aged 66 to 74 years had a false-positive result compared with 29.0% (95% CI = 28.1% to 29.9%) of biennial screeners. Conclusion Women aged 66 to 89 years who undergo biennial screening mammography have similar risk of advanced-stage disease and lower cumulative risk of a false-positive recommendation than annual screeners, regardless of comorbidity.

  11. Is Presurgery and Early Postsurgery Performance Related to Speech and Language Outcomes at 3 Years of Age for Children with Cleft Palate?

    ERIC Educational Resources Information Center

    Chapman, Kathy L.

    2004-01-01

    This study examined the relationship between presurgery speech measures and speech and language performance at 39 months as well as the relationship between early postsurgery speech measures and speech and language performance at 39 months of age. Fifteen children with cleft lip and palate participated in the study. Spontaneous speech samples were…

  12. Like Mother, Like Child: Intergenerational Patterns of Age at First Birth and Associations with Childhood and Adolescent Characteristics and Adult Outcomes in the Second Generation.

    ERIC Educational Resources Information Center

    Hardy, Janet B.; Astone, Nan M.; Brooks-Gunn, Jeanne; Shapiro, Sam; Miller, Therese L.

    1998-01-01

    This study found that continuity in teenage parenting across two generations was associated with family and personal characteristics unfavorable for optimal child development; and also found that delay of first parenting till age 25 or later was associated with more favorable environmental characteristics and greater adult self-sufficiency. (BC)

  13. The North Dakota Mental Health and Aging Education Project: Curriculum Design and Training Outcomes for a Train-the-Trainer Model

    ERIC Educational Resources Information Center

    Fitzgerald, Margaret A.; Chromy, Barbara; Philbrick, Candace A.; Sanders, Gregory F.; Muske, Kara L.; Bratteli, Marlys

    2009-01-01

    A training curriculum on mental health and aging was developed and disseminated to 32 natural caregivers throughout a frontier state using a train-the-trainer model. Those certified as trainers included social workers, religious professionals, volunteers, long-term care employees, nurses, home health workers, and professional and informal…

  14. Outcomes of a School-Based Intervention (RESCATE) to Improve Physical Activity Patterns in Mexican Children Aged 8-10 Years

    ERIC Educational Resources Information Center

    Colin-Ramirez, E.; Castillo-Martinez, L.; Orea-Tejeda, A.; Vergara-Castaneda, A.; Keirns-Davis, C.; Villa-Romero, A.

    2010-01-01

    The aim of this study was to evaluate the impact of an intervention program on the patterns of physical activity in 8- to 10-year-old Mexican children from lower socioeconomic status. This study performed a randomized controlled field trial in 498 children aged 8-10 years from 10 public schools of low socioeconomic status in Mexico City. Schools…

  15. Forecasting Three-Month Outcomes in a Laboratory School Comparison of Mixed Amphetamine Salts Extended Release (Adderall XR) and Atomoxetine (Strattera) in School-Aged Children with ADHD

    ERIC Educational Resources Information Center

    Faraone, Stephen V.; Wigal, Sharon B.; Hodgkins, Paul

    2007-01-01

    Objective: Compare observed and forecasted efficacy of mixed amphetamine salts extended release (MAS-XR; Adderall) with atomoxetine (Strattera) in ADHD children. Method: The authors analyze data from a randomized, double-blind, multicenter, parallel-group, forced-dose-escalation laboratory school study of children ages 6 to 12 with ADHD combined…

  16. Preschool-Age Male Psychiatric Patients with Specific Developmental Disorders and Those Without: Do They Differ in Behavior Problems and Treatment Outcome?

    ERIC Educational Resources Information Center

    Achtergarde, Sandra; Becke, Johanna; Beyer, Thomas; Postert, Christian; Romer, Georg; Müller, Jörg Michael

    2014-01-01

    Specific developmental disorders of speech, language, and motor function in children are associated with a wide range of mental health problems. We examined whether preschool-age psychiatric patients with specific developmental disorders and those without differed in the severity of emotional and behavior problems. In addition, we examined whether…

  17. The Impact of Family Involvement on the Education of Children Ages 3 to 8: A Focus on Literacy and Math Achievement Outcomes and Social-Emotional Skills

    ERIC Educational Resources Information Center

    Van Voorhis, Frances L.; Maier, Michelle F.; Epstein, Joyce L.; Lloyd, Chrishana M.

    2013-01-01

    This report summarizes research conducted primarily over the past 10 years on how families' involvement in children's learning and development through activities at home and at school affects the literacy, mathematics, and social-emotional skills of children ages 3 to 8. A total of 95 studies of family involvement are reviewed. These…

  18. Delayed progesterone treatment reduces brain infarction and improves functional outcomes after ischemic stroke: a time-window study in middle-aged rats

    PubMed Central

    Yousuf, Seema; Sayeed, Iqbal; Atif, Fahim; Tang, Huiling; Wang, Jun; Stein, Donald G

    2014-01-01

    We evaluated the neuroprotective effects of delayed progesterone (PROG) treatment against ischemic stroke-induced neuronal death, inflammation, and functional deficits. We induced transient focal cerebral ischemia in male rats and administered PROG (8 mg/kg) or vehicle intraperitoneally at 3, 6, or 24 hours post occlusion, subcutaneously 5 hours later and then every 24 hours for 7 days. Behavioral outcomes were evaluated over 22 days. Infarct size and other biomarkers of injury were evaluated by cresyl violet staining, and matrix metalloproteinase-9 (MMP-9), glial fibrillary acidic protein (GFAP), and vascular endothelial growth factor (VEGF) by immunofluorescence. Progesterone treatment started at 3 and 6 hours post occlusion significantly (P<0.05) improved behavioral performance at all time points (74.01%) and reduced infarction volume (61.68%) compared with vehicle. No significant difference was observed between the 3 and 6 hour PROG treatment groups. Matrix metalloproteinase-9 and VEGF were upregulated in the PROG groups compared with vehicle. Glial fibrillary acidic protein expression was increased in the vehicle group but markedly lower in the PROG groups. Treatment delayed for 24 hours did not significantly improve functional outcomes or reduce infarction volume. We conclude that, under the right treatment conditions, PROG treatment delayed up to 6 hours can improve functional deficits and reduce brain infarction, possibly by modulating GFAP, VEGF, and MMP-9 expression. PMID:24301297

  19. Using a cultural framework to assess the nutrition influences in relation to birth outcomes among African American women of childbearing age: application of the PEN-3 theoretical model.

    PubMed

    Kannan, Srimathi; Webster, Dewitt; Sparks, Arlene; Acker, Charlene M; Greene-Moton, Ella; Tropiano, Elizabeth; Turner, Tonya

    2009-07-01

    The purpose is to present the process and results of focus groups conducted to access information for the design of a healthy eating curriculum to reduce maternal nutritional risks and enhance protective factors among African American women in relation to birth outcomes. Sixteen younger (19 to 25 years) and 20 older African American women (45 to 60 years), respectively, participated. The PEN-3 model, (Airhihenbuwa, 1995, 1999) guided the focus groups. Most women stated that culture and family relationships impacted their food choices. Younger women expressed creativity with recipes and presented a desire to be more involved with preparing foods. Older women expressed eagerness to teach family-centered culinary skill-building classes. Both groups of women acknowledged time and budget barriers, identified the prevalence of lactose intolerance, and recognized that large grocery stores that offered food variety were not located in their community. Health professionals are encouraged to consider these findings while designing interventions targeting young African American women's nutrition in relation to birth outcomes.

  20. The evolution of massive stars and their spectra. I. A non-rotating 60 M⊙ star from the zero-age main sequence to the pre-supernova stage

    NASA Astrophysics Data System (ADS)

    Groh, Jose H.; Meynet, Georges; Ekström, Sylvia; Georgy, Cyril

    2014-04-01

    For the first time, the interior and spectroscopic evolution of a massive star is analyzed from the zero-age main sequence (ZAMS) to the pre-supernova (SN) stage. For this purpose, we combined stellar evolution models using the Geneva code and stellar atmospheric/wind models using CMFGEN. With our approach, we were able to produce observables, such as a synthetic high-resolution spectrum and photometry, thereby aiding the comparison between evolution models and observed data. Here we analyze the evolution of a non-rotating 60 M⊙ star and its spectrum throughout its lifetime. Interestingly, the star has a supergiant appearance (luminosity class I) even at the ZAMS. We find the following evolutionary sequence of spectral types: O3 I (at the ZAMS), O4 I (middle of the H-core burning phase), B supergiant (BSG), B hypergiant (BHG), hot luminous blue variable (LBV; end of H-core burning), cool LBV (H-shell burning through the beginning of the He-core burning phase), rapid evolution through late WN and early WN, early WC (middle of He-core burning), and WO (end of He-core burning until core collapse). We find the following spectroscopic phase lifetimes: 3.22 × 106 yr for the O-type, 0.34 × 105 yr (BSG), 0.79 × 105 yr (BHG), 2.35 × 105 yr (LBV), 1.05 × 105 yr (WN), 2.57 × 105 yr (WC), and 3.80 × 104 yr (WO). Compared to previous studies, we find a much longer (shorter) duration for the early WN (late WN) phase, as well as a long-lived LBV phase. We show that LBVs arise naturally in single-star evolution models at the end of the MS when the mass-loss rate increases as a consequence of crossing the bistability limit. We discuss the evolution of the spectra, magnitudes, colors, and ionizing flux across the star's lifetime, and the way they are related to the evolution of the interior. We find that the absolute magnitude of the star typically changes by ~6 mag in optical filters across the evolution, with the star becoming significantly fainter in optical filters at

  1. Neurodevelopmental outcomes at 7 years’ corrected age in preterm infants who were fed high-dose docosahexaenoic acid to term equivalent: a follow-up of a randomised controlled trial

    PubMed Central

    Gibson, Robert A; Anderson, Peter J; McPhee, Andrew J; Sullivan, Thomas R; Gould, Jacqueline F; Ryan, Philip; Doyle, Lex W; Davis, Peter G; McMichael, Judy E; French, Noel P; Colditz, Paul B; Simmer, Karen; Morris, Scott A; Makrides, Maria

    2015-01-01

    Objective To determine if improvements in cognitive outcome detected at 18 months’ corrected age (CA) in infants born <33 weeks’ gestation receiving a high-docosahexaenoic acid (DHA) compared with standard-DHA diet were sustained in early childhood. Design Follow-up of a multicentre randomised controlled trial. Randomisation was stratified for sex, birth weight (<1250 vs ≥1250 g) and hospital. Setting Five Australian tertiary hospitals from 2008 to 2013. Participants 626 of the 657 participants randomised between 2001 and 2005 were eligible to participate. Interventions High-DHA (≈1% total fatty acids) enteral feeds compared with standard-DHA (≈0.3% total fatty acids) from age 2–4 days until term CA. Primary outcome Full Scale IQ of the Wechsler Abbreviated Scale of Intelligence (WASI) at 7 years CA. Prespecified subgroup analyses based on the randomisation strata (sex, birth weight) were conducted. Results 604 (92% of the 657 originally randomised) consented to participate (291 high-DHA, 313 standard-DHA). To address missing data in the 604 consenting participants (22 for primary outcome), multiple imputation was performed. The Full Scale IQ was not significantly different between groups (high-DHA 98.3, SD 14.0, standard-DHA 98.5, SD 14.9; mean difference adjusted for sex, birthweight strata and hospital −0.3, 95% CI −2.9 to 2.2; p=0.79). There were no significant differences in any secondary outcomes. In prespecified subgroup analyses, there was a significant sex by treatment interaction on measures of parent-reported executive function and behaviour. Scores were within the normal range but girls receiving the high-DHA diet scored significantly higher (poorer outcome) compared with girls receiving the standard-DHA diet. Conclusions Supplementing the diets of preterm infants with a DHA dose of approximately 1% total fatty acids from days 2–4 until term CA showed no evidence of benefit at 7 years’ CA. Trial registration number

  2. Evidence based medicine in clinical practice: how to advise patients on the influence of age on the outcome of surgical anterior cruciate ligament reconstruction: a review of the literature

    PubMed Central

    Sloane, P; Brazier, H; Murphy, A; Collins, T; Best, T

    2002-01-01

    Objective: To determine, using a literature search, whether patient age influences the outcome of surgical reconstruction of a torn anterior cruciate ligament. Methods: Medline (1966 to present) was searched using the PubMed interface, Embase (1974 to present) using the Datastar system, and the Cochrane Library at the Update Software web site. Papers retrieved from the three databases were independently assessed by two reviewers using preliminary inclusion criteria. Reference lists of papers satisfying the preliminary criteria were then scanned and appropriate papers reviewed. Any new papers in turn had their reference lists scanned, this process continuing until no new papers were identified. Final inclusion criteria were then applied to all papers satisfying the preliminary inclusion criteria. Results: The initial search identified 661 papers. Exclusion of duplicates produced 536 unique papers. Medline contained 445, Embase 185, and the Cochrane Library 31. Of the 536, 523 were assessed by abstract and 12 by full text; one paper was not retrieved. Application of the preliminary inclusion criteria produced 33 papers. Their reference lists contained 950 references. Scanning of these added six new papers to the dataset. These six had their reference lists assessed; no new papers were identified. Four of the 39 papers in the completed dataset satisfied the final inclusion criteria. There was wide variation in the total number of subjects in the four studies, ranging from 22 to 203 patients. The total number of different outcome measures was 17; only one measure was used by all four studies. None of the objective outcome measures showed any significant difference between age groups, and the subjective measures, which did show differences, were contradictory. A total of 108 interlibrary loans were requested, by a full time researcher, at a total cost of IR£432.00 over a 10 week period. Conclusions: When advising patients on the outcome of anterior cruciate ligament

  3. Phonological awareness, vocabulary, and word reading in children who use cochlear implants: does age of implantation explain individual variability in performance outcomes and growth?

    PubMed

    James, Deborah; Rajput, Kaukab; Brinton, Julie; Goswami, Usha

    2008-01-01

    The phonological awareness (PA), vocabulary, and word reading abilities of 19 children with cochlear implants (CI) were assessed. Nine children had an implant early (between 2 and 3.6 years) and 10 had an implant later (between 5 and 7 years). Participants were tested twice over a 12-month period on syllable, rhyme, and phoneme awareness (see James et al., 2005). Performance of CI users was compared against younger hearing children matched for reading level. Two standardized assessments of vocabulary and single word reading were administered. As a group, the children fitted early had better performance outcomes on PA, vocabulary, and reading compared to hearing benchmark groups. The early group had significant growth on rhyme awareness, whereas the late group showed no significant gains in PA over time. There was wide individual variation in performance and growth in the CI users. Two participants with the best overall development were both fitted with an implant late in childhood.

  4. Predictive value of pyramidal lobe, percentage thyroid uptake and age for ablation outcome after 15 mCi fixed dose of radioiodine-131 in Graves’ disease

    PubMed Central

    Zaman, Maseeh uz; Fatima, Nosheen; Zaman, Unaiza; Sajjad, Zafar; Zaman, Areeba; Tahseen, Rabia

    2015-01-01

    Purpose: The purpose was to find out the efficacy of fixed 15 mCi radioactive iodine-131 (RAI) dose and predictive values of various factors for inducing hypothyroidism in Graves’ disease (GD). Materials and Methods: Retrospective study conducted from January 2012 till August 2014. Patients with GD who had a technetium-99m thyroid scan, thyroid antibodies, received fixed 15 mCi RAI and did follow endocrine clinics for at least 6 months were selected. RAI was considered successful if within 6 months of RAI therapy patients developed hypothyroidism. Results: Of the 370 patients with GD who had RAI during study period, 210 (57%) qualified study criteria. Mean age of patients was 48 ± 15 years with female: male ratio of 69:31, positive thyroid antibodies in 61%, means thyroid uptake of 15.09 ± 11.23%, and presence of pyramidal lobe in 40% of total population. Hypothyroidism was achieved in 161 (77%) patients while 49 (23%) patients failed to achieve it (remained either hyperthyroid or euthyroid on antithyroid medication). Patients who became hypothyroid were significantly younger with higher proportion of presence of thyroid antibodies and pyramidal lobe and lower percentage thyroid uptake than those who failed. Multiple logistic regression analysis revealed that age (odds ratio; OR = 2.074), pyramidal lobe (OR = 3.317), thyroid antibodies (OR = 8.198), and percentage thyroid uptake (OR = 3.043) were found to be significant prognostic risk factors for post-RAI hypothyroidism. Gender was found to have nonsignificant association with the development of hypothyroidism. Receiver operating characteristic analysis revealed age <42 years and thyroid uptake <15% as threshold values for the development of post-RAI hypothyroidism. Conclusion: We conclude that fixed (15 mCi) RAI dose is highly effective in rendering hypothyroidism in patients with GD. Age (≤42 years), thyroid uptake (≤15%) and presence of pyramidal lobe are strong predictors of hypothyroidism and must be

  5. New Main Ring control system

    SciTech Connect

    Seino, K.; Anderson, L.; Ducar, R.; Franck, A.; Gomilar, J.; Hendricks, B.; Smedinghoff, J.

    1990-03-01

    The Fermilab Main Ring control system has been operational for over sixteen years. Aging and obsolescence of the equipment make the maintenance difficult. Since the advent of the Tevatron, considerable upgrades have been made to the controls of all the Fermilab accelerators except the Main Ring. Modernization of the equipment and standardization of the hardware and software have thus become inevitable. The Tevatron CAMAC serial system has been chosen as a basic foundation in order to make the Main Ring control system compatible with the rest of the accelerator complex. New hardware pieces including intelligent CAMAC modules have been designed to satisfy unique requirements. Fiber optic cable and repeaters have been installed in order to accommodate new channel requirements onto the already saturated communication medium system. 8 refs., 2 figs.

  6. Impact of the age of Biomphalaria alexandrina snails on Schistosoma mansoni transmission: modulation of the genetic outcome and the internal defence system of the snail

    PubMed Central

    Abou-El-Naga, Iman Fathy; Sadaka, Hayam Abd El-Monem; Amer, Eglal Ibrahim; Diab, Iman Hassan; Khedr, Safaa Ibrahim Abd El-Halim

    2015-01-01

    Of the approximately 34 identified Biomphalaria species,Biomphalaria alexandrina represents the intermediate host of Schistosoma mansoni in Egypt. Using parasitological and SOD1 enzyme assay, this study aimed to elucidate the impact of the age of B. alexandrina snails on their genetic variability and internal defence against S. mansoni infection. Susceptible and resistant snails were reared individually for self-reproduction; four subgroups of their progeny were used in experiment. The young susceptible subgroup showed the highest infection rate, the shortest pre-patent period, the highest total cercarial production, the highest mortality rate and the lowest SOD1 activity. Among the young and adult susceptible subgroups, 8% and 26% were found to be resistant, indicating the inheritance of resistance alleles from parents. The adult resistant subgroup, however, contained only resistant snails and showed the highest enzyme activity. The complex interaction between snail age, genetic background and internal defence resulted in great variability in compatibility patterns, with the highest significant difference between young susceptible and adult resistant snails. The results demonstrate that resistance alleles function to a greater degree in adults, with higher SOD1 activity and provide potential implications for Biomphalaria control. The identification of the most susceptible snail age enables determination of the best timing for applying molluscicides. Moreover, adult resistant snails could be beneficial in biological snail control. PMID:26061235

  7. Space Transportation Main Engine

    NASA Technical Reports Server (NTRS)

    Monk, Jan C.

    1992-01-01

    The topics are presented in viewgraph form and include the following: Space Transportation Main Engine (STME) definition, design philosophy, robust design, maximum design condition, casting vs. machined and welded forgings, operability considerations, high reliability design philosophy, engine reliability enhancement, low cost design philosophy, engine systems requirements, STME schematic, fuel turbopump, liquid oxygen turbopump, main injector, and gas generator. The major engine components of the STME and the Space Shuttle Main Engine are compared.

  8. Applying Memories of Reinforcement Outcomes Mainly to Pavlovian Conditioning

    ERIC Educational Resources Information Center

    Capaldi, E. J.; Martins, Ana P. G.

    2010-01-01

    A theory devised initially on the basis of instrumental reward schedule data, such as the PREE, was extended to deal with various Pavlovian findings. These Pavlovian findings include blocking, unblocking, relative validity, positive and negative patterning, renewal, reinstatement, reacquisition, and inhibition. In addition, the sequential model…

  9. Teaching Main Idea Comprehension.

    ERIC Educational Resources Information Center

    Baumann, James F., Ed.

    Intended to help classroom teachers, curriculum developers, and researchers, this book provides current information on theoretical and instructional aspects of main idea comprehension. Titles and authors are as follows: "The Confused World of Main Idea" (James W. Cunningham and David W. Moore); "The Comprehension of Important Information in…

  10. Early caregiving stress exposure moderates the relation between respiratory sinus arrhythmia reactivity at 1 month and biobehavioral outcomes at age 3

    PubMed Central

    CONRADT, ELISABETH; BEAUCHAINE, THEODORE; ABAR, BEAU; LAGASSE, LINDA; SHANKARAN, SEETHA; BADA, HENRIETTA; BAUER, CHARLES; WHITAKER, TONI; HAMMOND, JANE; LESTER, BARRY

    2016-01-01

    There is a growing scientific interest in the psychophysiological functioning of children living in low-socioeconomic status (SES) contexts, though this research is complicated by knowledge that physiology–behavior relations often operate differently in these environments among adults. Importantly, such research is made more difficult because SES may be a proxy for a wide range of risk factors including poor caregiving and exposure to parental substance use. We used factor analysis to organize risk-exposure data collected from 827 children—many of whom were raised in low-SES contexts and exposed to substances prenatally—into dissociable components including economic stress, caregiving stress (e.g., stress the caregiver may experience, including parental psychopathology), and postnatal substance exposure. These factors, along with respiratory sinus arrhythmia (RSA) reactivity at age 1 month, were used to predict behavior dysregulation and resting RSA at age 3 years. A significant RSA Reactivity × Caregiving Stress interaction indicated that infants who exhibited high RSA reactivity at 1 month experienced the greatest behavior dysregulation at 3 years, but only when they were exposed to high levels of caregiving stress. Among African Americans, the highest resting RSA at 3 years was found in infants with less RSA reactivity, but only if they also experienced less caregiving stress. Our work is consistent with biological sensitivity to context, adaptive calibration, and allostatic load models, and highlights the importance of studying Physiology × Environment interactions in low-SES contexts for predicting behavior and resting RSA. PMID:26681620

  11. Didacticism and Educational Outcomes

    ERIC Educational Resources Information Center

    Johnes, Geraint

    2006-01-01

    This note provides an analysis of the determinants of educational outcomes at age 16, and of subsequent pathways as school pupils transit toward the labour market. There is some evidence that examination results tend to be better where nondidactic teaching methods are used, but there is little evidence to suggest that teaching method has an…

  12. DNA methylation and genetic polymorphisms of the Leptin gene interact to influence lung function outcomes and asthma at 18 years of age

    PubMed Central

    Mukherjee, Nandini; Lockett, Gabrielle A; Merid, Simon K; Melén, Erik; Pershagen, Göran; Holloway, John W; Arshad, Syed Hasan; Ewart, Susan; Zhang, Hongmei; Karmaus, Wilfried

    2016-01-01

    The leptin gene (LEP) plays a regulatory role in satiety, inflammation, and allergy. Prior findings linking leptin to asthma motivated us to investigate whether DNA methylation (DNA-M) of CpG (cytosine-phosphate-guanine) sites in concert with single nucleotide polymorphisms (SNPs) of LEP can explain the risk of asthma and lung function. Methylation of CpG sites was assessed using the Illumina Infinium Human Methylation 450 beadchip in blood samples collected from 10- and 18-year-old boys and girls from the Isle of Wight (IOW) birth cohort (UK). Four LEP SNPs were genotyped. Linear and log linear models were used for the analysis, adjusting for false discovery rate (FDR). The analyses were repeated in the BAMSE cohort (Sweden). In the IOW study, the interaction of cg00666422 and rs11763517 (CT vs TT and CC) was associated with FEV1 (FDR-adjusted p-value: 0.03), FEV1/FVC ratio (FDR-adjusted p-value: 0.0096), and FEF25-75% (FDR-adjusted p-value: 0.00048) such that they decreased with increasing DNA-M. The interaction of the same CpG-SNP pair was also associated with increased risk of asthma at age 18. We replicated the findings for FEV1/FVC and FEF25-75% in a smaller sample of 34 participants at age 10. Regarding the BAMSE cohort, although, the interaction of cg00666422 and rs11763517 on lung function were not significant, the direction of the effect was the same as in IOW cohort. Thus, penetrance of LEP genotype seems to be modified by methylation at cg00666422 and is linked to airway obstruction and asthma. PMID:27186323

  13. Long-term outcomes of combination photodynamic therapy with ranibizumab or bevacizumab for treatment of wet age-related macular degeneration

    PubMed Central

    Rishi, Ekta; Rishi, Pukhraj; Sharma, Vishal; Koundanya, Vikram; Athanikar, Renu

    2016-01-01

    Aim: To evaluate and compare the efficacy of combination of ranibizumab or bevacizumab with photodynamic therapy (PDT) in treating choroidal neovascularization (CNV) secondary to age-related macular degeneration (ARMD) on long-term follow-up. Materials and Methods: Of 42 eyes, 18 were treated with bevacizumab (Group A) and 24 with ranibizumab (Group B) in combination with verteporfin PDT. Treatment was initiated after informed consent. Complete ophthalmic examination including optical coherence tomography (OCT) was performed at presentation, 1 month, 3 months, and subsequent follow-up visits. OCT measures used were lesion thickness (LT) of the CNV, retinal thickness above the lesion (RT), and central macular thickness (CMT). Mean follow-up period was 33 months (median 18, range 1-84). Additional treatment on follow-up was left at treating surgeon's discretion. Results: Visual acuity improved significantly from baseline by 0.3 LogMAR in Group A and 0.26 LogMAR in Group B. LT decreased significantly from 1st month onward and remained significant at all the subsequent visits, in both the groups. CMT and RT showed a decreasing trend in both the groups. No difference was seen in visual acuity (VA), LT, CMT, and RT between Group A and Group B at any of the visits. The mean number of additional anti-vascular endothelial growth factor injections given postcombination therapy were 1.5 (median 1, range 0-7) injections per eye. Conclusions: PDT in combination with either ranibizumab or bevacizumab was equally effective in preventing vision loss in eyes with wet-Age-related macular degeneration (ARMD). Such combination also reduces the economic burden of the treatment. PMID:27433034

  14. The Main Idea Organizer.

    ERIC Educational Resources Information Center

    Burke, Jim

    2003-01-01

    Presents the Main Idea Organizer (MIO) to help students who may struggle with writing, reading, and thinking--though in different ways and for different reasons. Describes many different ways the author uses the MIO. (SG)

  15. eHealth Technology Competencies for Health Professionals Working in Home Care to Support Older Adults to Age in Place: Outcomes of a Two-Day Collaborative Workshop

    PubMed Central

    Barakat, Ansam; Woolrych, Ryan D; Sixsmith, Andrew; Kearns, William D

    2013-01-01

    Background The demand for care is increasing, whereas in the near future the number of people working in professional care will not match with the demand for care. eHealth technology can help to meet the growing demand for care. Despite the apparent positive effects of eHealth technology, there are still barriers to technology adoption related to the absence of a composite set of knowledge and skills among health care professionals regarding the use of eHealth technology. Objective The objective of this paper is to discuss the competencies required by health care professionals working in home care, with eHealth technologies such as remote telecare and ambient assisted living (AAL), mobile health, and fall detection systems. Methods A two-day collaborative workshop was undertaken with academics across multiple disciplines with experience in working on funded research regarding the application and development of technologies to support older people. Results The findings revealed that health care professionals working in home care require a subset of composite skills as well as technology-specific competencies to develop the necessary aptitude in eHealth care. This paper argues that eHealth care technology skills must be instilled in health care professionals to ensure that technologies become integral components of future care delivery, especially to support older adults to age in place. Educating health care professionals with the necessary skill training in eHealth care will improve service delivery and optimise the eHealth care potential to reduce costs by improving efficiency. Moreover, embedding eHealth care competencies within training and education for health care professionals ensures that the benefits of new technologies are realized by casting them in the context of the larger system of care. These care improvements will potentially support the independent living of older persons at home. Conclusions This paper describes the health care professionals

  16. Correlates of consistent condom use with main-new and main-old sexual partners.

    PubMed

    Wiemann, Constance M; Chacko, Mariam R; Kozinetz, Claudia A; DiClemente, Ralph; Smith, Peggy B; Velasquez, Mary M; von Sternberg, Kirk

    2009-09-01

    An exploratory study identified correlates of consistent condom use for young women reporting Main-new or Main-old partners in the past 3 months: frequency of vaginal sex (across partner types); perceived likelihood of getting a STI (Main-new); age and STI history (Main-old). To enhance programmatic efficacy in community clinics, these key correlates of condom use for main partner types should be incorporated in STI risk reduction counseling. PMID:19699427

  17. Long-term outcome of 73 Zweymüller total hip prostheses with a screw cup in patients under 50 years of age.

    PubMed

    Busch, Vincentius J J F; Pouw, Martin H; Laumen, Armand M R P; van Susante, Job L C; Vervest, Antonius M J S

    2012-01-01

    Total hip arthroplasty in young patients is associated with high failure rates and the best option for this demanding group of patients remains controversial. We report the long-term results of 73 consecutive Zweymüller total hip arthroplasties with a titanium threaded cup and a polyethylene insert in 67 patients aged under 50 years at the time of surgery (mean 43 years, range 23-49). Independent assessment was performed clinically and radiographically, and Kaplan-Meier analysis was used to determine survival for different end-points. Three hips were revised for septic loosening, three cups for aseptic loosening and one hip because of a periprosthetic fracture. Three patients (3 hips) died and seven patients (8 hips) were lost to radiographic follow-up without any reoperation. The mean follow-up was 17.5 (15-21) years and the mean HHS was 90 (52-100). Survival with an end-point of revision for any reason was 89% (95% C.I. 85-93) and of revision for aseptic loosening was 94% (C.I. 95-99) at 17 years. Zweymüller total hip arthroplasty with a titanium threaded cup and a polyethylene insert showed good long-term results, even in this group of young patients. PMID:22740279

  18. Long-term outcome of 73 Zweymüller total hip prostheses with a screw cup in patients under 50 years of age.

    PubMed

    Busch, Vincentius J J F; Pouw, Martin H; Laumen, Armand M R P; van Susante, Job L C; Vervest, Antonius M J S

    2012-01-01

    Total hip arthroplasty in young patients is associated with high failure rates and the best option for this demanding group of patients remains controversial. We report the long-term results of 73 consecutive Zweymüller total hip arthroplasties with a titanium threaded cup and a polyethylene insert in 67 patients aged under 50 years at the time of surgery (mean 43 years, range 23-49). Independent assessment was performed clinically and radiographically, and Kaplan-Meier analysis was used to determine survival for different end-points. Three hips were revised for septic loosening, three cups for aseptic loosening and one hip because of a periprosthetic fracture. Three patients (3 hips) died and seven patients (8 hips) were lost to radiographic follow-up without any reoperation. The mean follow-up was 17.5 (15-21) years and the mean HHS was 90 (52-100). Survival with an end-point of revision for any reason was 89% (95% C.I. 85-93) and of revision for aseptic loosening was 94% (C.I. 95-99) at 17 years. Zweymüller total hip arthroplasty with a titanium threaded cup and a polyethylene insert showed good long-term results, even in this group of young patients.

  19. Outcomes of a school-based intervention (RESCATE) to improve physical activity patterns in Mexican children aged 8-10 years.

    PubMed

    Colín-Ramírez, E; Castillo-Martínez, L; Orea-Tejeda, A; Vergara-Castañeda, A; Keirns-Davis, C; Villa-Romero, A

    2010-12-01

    The aim of this study was to evaluate the impact of an intervention program on the patterns of physical activity in 8- to 10-year-old Mexican children from lower socioeconomic status. This study performed a randomized controlled field trial in 498 children aged 8-10 years from 10 public schools of low socioeconomic status in Mexico City. Schools were randomly assigned to intervention (n = 5) or control (n = 5) groups and followed up during 12 months. Physical and sedentary activities were assessed at the beginning of the program and after 6 and 12 months. At the end of follow-up, there was a significant increase in the performance of moderate physical activity (MPA) among children in intervention group who had not performed MPA at baseline any day of the week (40%, P = 0.04) but not in the control group (8%, P = not significant). The intervention group also showed a significant reduction in the proportion of children who spent more than 3 hours a day playing video games (from 23 to 13%, P = 0.01), while control group did not show significant changes. Given these findings, we conclude that intervention was able to modify positively physical activity and reduce time spent on such sedentary activities as video games among those at highest risk studied children.

  20. Impact of Age and Primary Disease Site on Outcome in Women With Low-Grade Serous Carcinoma of the Ovary or Peritoneum: Results of a Large Single-Institution Registry of a Rare Tumor

    PubMed Central

    Gershenson, David M.; Bodurka, Diane C.; Lu, Karen H.; Nathan, Lisa C.; Milojevic, Ljiljana; Wong, Kwong K.; Malpica, Anais; Sun, Charlotte C.

    2015-01-01

    Purpose Low-grade serous carcinoma of the ovary (LGSOC) or peritoneum (LGSPC) is a rare subtype of ovarian or peritoneal cancer characterized by young age at diagnosis and relative resistance to chemotherapy. The purpose of this study is to report our updated experience with women diagnosed with LGSOC or LGSPC to assess the validity of our original observations. Patients and Methods Eligibility criteria for patients from our database were: stage I to IV LGSOC or LGSPC, original diagnosis before January 2012, and adequate clinical information. All patients were included in progression-free survival, overall survival, and multivariable Cox regression analyses. A subset analysis was performed among patients with stage II to IV low-grade serous carcinoma treated with primary surgery followed by platinum-based chemotherapy. Results We identified 350 eligible patients. Median progression-free survival was 28.1 months; median overall survival was 101.7 months. In the multivariable analysis, compared with women age ≤ 35 years, those diagnosed at age > 35 years had a 43% reduction in likelihood of dying (hazard ratio, 0.53; 95% CI, 0.37 to 0.74; P < .001). Having disease present at completion of primary therapy was associated with a 1.78 increased hazard of dying compared with being clinically disease free (P < .001). Similar trends were noted in the smaller patient cohort. In this cohort, women with LGSPC had a 41% decreased chance of dying (hazard ratio, 0.59; 95% CI, 0.36 to 0.98; P = .04) compared with those with LGSOC. Conclusion Women age < 35 years with low-grade serous carcinoma and those with persistent disease at completion of primary therapy have the worst outcomes. Patients with LGSPC seem to have a better prognosis than those with LGSOC. PMID:26195696

  1. One-year outcome of intravitreal aflibercept injection for age-related macular degeneration resistant to ranibizumab: rapid morphologic recovery and subsequent visual improvement

    PubMed Central

    Hirakata, Toshiaki; Fujinami, Kaoru; Watanabe, Ken; Sasaki, Mariko; Noda, Toru; Akiyama, Kunihiko

    2016-01-01

    Objective To describe the 1-year efficacy of aflibercept in Japanese patients with age-related macular degeneration (AMD) who were resistant to ranibizumab treatment. Design Retrospective case series. Participants Fourteen consecutive eyes of 14 patients with AMD were enrolled who had no substantial response or developed resistance to intravitreal ranibizumab injections. Methods All patients were subcategorized into one of two subtypes of AMD: seven patients with occult choroidal neovascularization (CNV) and seven with polypoidal choroidal vasculopathy (PCV). Serial intravitreal aflibercept (IVA) injections were administered. Comprehensive ophthalmic examinations, including optical coherence tomography, were conducted at baseline and at follow-up examinations at 1, 3, 6, and 12 months after the initial IVA injection. The best-corrected visual acuity converted to logarithm of the minimum angle of resolution (logMAR) and central macular thickness (CMT) at each follow-up visit were compared with the baseline values. The anatomic response was also assessed with absorption or reduction of fluid in the subretina or subretinal pigment epithelial space. Results The logMAR best-corrected visual acuity improved significantly at 3, 6, and 12 months in the total cohort: at 3 and 6 months in patients with occult CNV and at 3 and 12 months in patients with PCV. The CMT decreased significantly at all follow-up visits in the total cohort as well as in both subtypes, except for the CMT at 6 months in PCV patients. The anatomic improvement was also demonstrated in all cases, and pigment epithelial detachments tended to be resolved more rapidly in patients with PCV than in patients with occult CNV. Conclusion Conversion to IVA was effective in patients with AMD resistant to ranibizumab, showing rapid morphologic improvement. The logMAR visual acuity was raised significantly within 12 months, and the clinical course of visual acuity improvement may differ according to the AMD subtypes

  2. Developmental Outcome of Childhood Leukemia.

    ERIC Educational Resources Information Center

    Coniglio, Susan J.; Blackman, James A.

    1995-01-01

    Literature on developmental and psychosocial outcomes of childhood leukemia is reviewed, focusing on preschool-age children. Studies are categorized in terms of outcome measures: intelligence/achievement, neuropsychological, memory/attention, and psychosocial tests. Evidence suggests that preschool children with leukemia are at high risk for…

  3. Main Parachute Test

    NASA Technical Reports Server (NTRS)

    2008-01-01

    Shown is the testing of the Main Parachute for the Ares/CLV first stage in support of the Ares/Constellation program at the Yuma Proving Ground, Arizona. This image is extracted from high definition video and is the highest resolution available.

  4. Ladybugs of Maine

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Color images are presented for the 57 species of Coccinellidae, commonly known as ladybugs, that are documented from Maine. Images are displayed in taxonomic order. Information on each species includes its genus-species name, length, and an actual-size silhouette beside a grid matched to the scale...

  5. Main features of meiosis

    SciTech Connect

    1993-12-31

    Chapter 17, outlines the main features of meiosis, beginning with its significance and proceeding through the meiotic stages. Meiosis is the most important modification of mitosis because it is the reduction division that gives rise to the haploid generation in the life cycle. 17 refs., 6 figs.

  6. Outcomes of multiplets.

    PubMed

    Shinwell, E S; Haklai, T; Eventov-Friedman, S

    2009-01-01

    Outcomes, both short and long term, differ between singletons and multiplets. Recently, a number of large, well-designed studies have clarified these differences, particularly in light of major changes in perinatal and neonatal care that have influenced changing outcomes. Accordingly, this article will review risks for singletons, twins and higher-order multiples as whole groups and also after correction for gestational age and other potential confounding variables that differ markedly between the groups. In addition, we will focus on the effects of certain factors such as antenatal steroid therapy and gender. Finally, we will detail the specific long-term risks for multiples in terms of growth and neurodevelopmental disabilities.

  7. [Main Cellular Redox Couples].

    PubMed

    Bilan, D S; Shokhina, A G; Lukyanov, S A; Belousov, V V

    2015-01-01

    Most of the living cells maintain the continuous flow of electrons, which provides them by energy. Many of the compounds are presented in a cell at the same time in the oxidized and reduced states, forming the active redox couples. Some of the redox couples, such as NAD+/NADH, NADP+/NADPH, oxidized/reduced glutathione (GSSG/GSH), are universal, as they participate in adjusting of many cellular reactions. Ratios of the oxidized and reduced forms of these compounds are important cellular redox parameters. Modern research approaches allow setting the new functions of the main redox couples in the complex organization of cellular processes. The following information is about the main cellular redox couples and their participation in various biological processes.

  8. COBRA Main Engine Project

    NASA Technical Reports Server (NTRS)

    Snoddy, Jim; Sides, Steve; Lyles, Garry M. (Technical Monitor)

    2002-01-01

    The COBRA (CO-Optimized Booster for Reusable Applications) project include the following: 1. COBRA main engine project team. 2. COBRA and RLX cycles selected. 3. COBRA proto-type engine approach enables mission success. 4. COBRA provides quick, low cost demo of cycle and technologies. 5. COBRA cycle I risk reduction supports. 6. Achieving engine safety. 6. RLX cycle I risk reduction supports. 7. Flight qualification. 9. Life extension engine testing.

  9. Maine coast winds

    SciTech Connect

    Avery, Richard

    2000-01-28

    The Maine Coast Winds Project was proposed for four possible turbine locations. Significant progress has been made at the prime location, with a lease-power purchase contract for ten years for the installation of turbine equipment having been obtained. Most of the site planning and permitting have been completed. It is expect that the turbine will be installed in early May. The other three locations are less suitable for the project, and new locations are being considered.

  10. The impact of cannabis use on age of onset and clinical characteristics in first-episode psychotic patients. Data from the Psychosis Incident Cohort Outcome Study (PICOS).

    PubMed

    Tosato, Sarah; Lasalvia, Antonio; Bonetto, Chiara; Mazzoncini, Rodolfo; Cristofalo, Doriana; De Santi, Katia; Bertani, Mariaelena; Bissoli, Sarah; Lazzarotto, Lorenza; Marrella, Giovanna; Lamonaca, Dario; Riolo, Rosanna; Gardellin, Francesco; Urbani, Anna; Tansella, Michele; Ruggeri, Mirella

    2013-04-01

    Cannabis use is frequent among first-episode psychosis (FEP) patients and has been associated with several clinical features. This study aimed in an FEP sample to determine whether cannabis use is associated with (1) a higher level of positive symptoms, a lower level of depression and a better premorbid adjustment, (2) an earlier age of onset, and a better premorbid IQ. The study was conducted within the framework of the Psychosis Incident Cohort Outcome Study (PICOS), a multisite collaborative research on FEP patients who attended the psychiatric services in Veneto Region, Italy. Standardized instruments were used to collect sociodemographic, clinical, and drug use data. A total of 555 FEP patients met the inclusion criteria, 517 of whom received an ICD-10 diagnosis of psychosis; 397 (55% males; mean age: 32 yrs ± 9.5) were assessed. Out of these, 311 patients agreed to be interviewed on drug and alcohol misuse; 20.3% was positive for drug misuse: cannabis (19.0%), cocaine (3.9%), and hallucinogens (3.9%). Cannabis use was not associated with a higher level of positive symptoms, but correlated with less severe depressive symptoms. No relationship was observed between premorbid adjustment or IQ and cannabis use. FEP patients who used cannabis had an earlier age of onset than abstinent patients, even after adjusting for gender and diagnosis. Our results suggest a possible causal role of cannabis in triggering psychosis in certain vulnerable subjects. Particular attention must be paid to this behaviour, because reducing cannabis use can delay or prevent some cases of psychosis.

  11. Surgical outcomes of the endoscopic transsphenoidal route to pituitary tumours in paediatric patients >10 years of age: 5 years of experience at a single institute

    PubMed Central

    Zhan, Rucai; Xu, Guangming; Wiebe, Timothy M; Li, Xingang

    2015-01-01

    Objective To evaluate the safety and effectiveness of the endoscopic endonasal transsphenoidal approach (EETA) for the management of pituitary adenomas in paediatric patients >10 years of age. Methods A retrospective chart review was performed to identify 56 paediatric patients between 10 and 18 years of age who underwent an endonasal endoscopic transsphenoidal approach for the resection of a pituitary adenoma during the last 5 years. The age, sex, symptoms, tumour size, extent of tumour resection, clinical outcome and surgical complications of patients were reviewed. Results Total resection was achieved in 49 (87.5%) cases, subtotal resection was achieved in 7 (12.5%) cases and no patient had a partial or insufficient resection. Of the 35 patients who experienced preoperative deterioration of vision, 33 (94.2%) achieved visual remission with rates of 34.2% and 60% for normalisation and improvement, respectively. Endocrinological normalisation was achieved in 13 (31.7%) of 41 patients who had preoperative hyperhormonal levels; hormone levels decreased in 25 (61.0%) patients, and 3 (7.3%) patients had no change in hormone level. Two (3.5%) patients incurred postoperative cerebrospinal fluid leakage, which was resolved after lumbar drainage. Four (7.1%) patients developed hypopituitarism, which required hormone therapy. Post-surgery, five (8.9%) patients incurred transient diabetes insipidus (DI), of which one (1.7%) patient developed persistent DI and was administered Minirin. Meningitis occurred in one (1.7%) patient who was cured by the administration of a third-generation antibiotic. There were no cases of intracranial haematoma, reoperation or death. Conclusions EETA allows neurosurgeons to safely and effectively remove paediatric pituitary adenomas with low morbidity and mortality. PMID:26006173

  12. Nutrient intakes and iron and vitamin D status differ depending on main milk consumed by UK children aged 12-18 months - secondary analysis from the Diet and Nutrition Survey of Infants and Young Children.

    PubMed

    Sidnell, Anne; Pigat, Sandrine; Gibson, Sigrid; O'Connor, Rosalyn; Connolly, Aileen; Sterecka, Sylwia; Stephen, Alison M

    2016-01-01

    Nutrition in the second year is important as this is a period of rapid growth and development. Milk is a major food for young children and this analysis evaluated the impact of the type of milk consumed on nutrient intakes and nutritional status. Data from the Diet and Nutrition Survey of Infants and Young Children were used to investigate the intakes of key nutrients, and Fe and vitamin D status, of children aged 12-18 months, not breastfed, and consuming >400 g/d fortified milk (n 139) or >400 g/d of whole cows' milk (n 404). Blood samples from eligible children for measurement of Hb (n 113), serum ferritin and plasma 25-hydroxyvitamin D (25(OH)D) concentrations (n 105) were available for approximately 20 % of children. Unpaired Mann-Whitney tests were used to compare nutrient intakes and status between consumers of fortified and cows' milk. Mean daily total dietary intakes of Fe, Zn, vitamin A and vitamin D were significantly higher in the fortified milk group. Mean daily total dietary intakes of energy, protein, Ca, iodine, Na and saturated fat were significantly higher in the cows' milk group. Hb was not different between groups. The fortified milk group had significantly higher serum ferritin (P = 0·049) and plasma 25(OH)D (P = 0·014). This analysis demonstrates significantly different nutrient intakes and status between infants consuming >400 g/d fortified milk v. those consuming >400 g/d whole cows' milk. These results indicate that fortified milks can play a significant role in improving the quality of young children's diets in their second year of life.

  13. Nutrient intakes and iron and vitamin D status differ depending on main milk consumed by UK children aged 12-18 months - secondary analysis from the Diet and Nutrition Survey of Infants and Young Children.

    PubMed

    Sidnell, Anne; Pigat, Sandrine; Gibson, Sigrid; O'Connor, Rosalyn; Connolly, Aileen; Sterecka, Sylwia; Stephen, Alison M

    2016-01-01

    Nutrition in the second year is important as this is a period of rapid growth and development. Milk is a major food for young children and this analysis evaluated the impact of the type of milk consumed on nutrient intakes and nutritional status. Data from the Diet and Nutrition Survey of Infants and Young Children were used to investigate the intakes of key nutrients, and Fe and vitamin D status, of children aged 12-18 months, not breastfed, and consuming >400 g/d fortified milk (n 139) or >400 g/d of whole cows' milk (n 404). Blood samples from eligible children for measurement of Hb (n 113), serum ferritin and plasma 25-hydroxyvitamin D (25(OH)D) concentrations (n 105) were available for approximately 20 % of children. Unpaired Mann-Whitney tests were used to compare nutrient intakes and status between consumers of fortified and cows' milk. Mean daily total dietary intakes of Fe, Zn, vitamin A and vitamin D were significantly higher in the fortified milk group. Mean daily total dietary intakes of energy, protein, Ca, iodine, Na and saturated fat were significantly higher in the cows' milk group. Hb was not different between groups. The fortified milk group had significantly higher serum ferritin (P = 0·049) and plasma 25(OH)D (P = 0·014). This analysis demonstrates significantly different nutrient intakes and status between infants consuming >400 g/d fortified milk v. those consuming >400 g/d whole cows' milk. These results indicate that fortified milks can play a significant role in improving the quality of young children's diets in their second year of life. PMID:27547395

  14. Some Effects of Between-Trials Variability and Initial Response Outcome on the Alternation Discrimination Learning of Mentally Retarded Adolescents. Interim Report.

    ERIC Educational Resources Information Center

    Clinton, LeRoy

    This study investigated the effects of between-trials variability on the alternation discrimination of retardates. Brightness and size were variable between trials and irrelevant. Initial response outcome and mental age were also independent variables. Neither between-trials variability nor mental age produced a significant main effect, while the…

  15. Adult outcomes of preterm children.

    PubMed

    Hack, Maureen

    2009-10-01

    The survivors of the initial years of neonatal intensive care of preterm infants reached adulthood during the last decade. Reports of their adult outcomes examined have included neurodevelopmental, behavioral and health outcomes as well as social functioning and reproduction. Despite statistically significant differences between preterm young adults and controls in most outcomes studied, the majority of preterm survivors do well and live fairly normal lives. The two major predictors of adult outcomes are lower gestational age that reflect perinatal injury and family sociodemographic status which reflects both genetic and environmental effects.

  16. Thyroid and Aging or the Aging Thyroid? An Evidence-Based Analysis of the Literature

    PubMed Central

    2013-01-01

    Thyroid hormone production, metabolism, and action change with aging. The reference ranges for serum thyrotropin and thyroid hormones are derived mainly from younger populations. Thus, the prevalence of subclinical thyroid dysfunction is increased greatly in the elderly. However, it is unclear whether mild thyroid dysfunction in the elderly is associated with adverse outcomes. In this review, we discuss current evidence-based literature on thyroid function in the elderly and whether subclinical thyroid dysfunction in the elderly should be treated. PMID:24106641

  17. Factors Associated With Gastroschisis Outcomes

    PubMed Central

    Overcash, Rachael T.; DeUgarte, Daniel A.; Stephenson, Megan L.; Gutkin, Rachel M.; Norton, Mary E.; Parmar, Sima; Porto, Manuel; Poulain, Francis R.; Schrimmer, David B.

    2014-01-01

    Objective To identify perinatal variables associated with adverse outcomes in infants prenatally diagnosed with gastroschisis. Methods A retrospective review was conducted of all inborn pregnancies complicated by gastroschisis within the five institutions of the University of California Fetal Consortium from 2007 to 2012. The primary outcome was a composite adverse neonatal outcome comprising death, re-operation, gastrostomy, and necrotizing enterocolitis. Variables collected included antenatal ultrasound findings, maternal smoking or drug use, gestational age at delivery, preterm labor, elective delivery, mode of delivery, and birth weight. Univariate and multivariate analysis was utilized to assess factors associated with adverse outcomes. We also evaluated the e association of preterm delivery with neonatal outcomes such as total parenteral nutrition (TPN) cholestasis and length of stay. Results There were 191 infants born with gastroschisis in University of California Fetal Consortium institutions at a mean gestational age of 36 3/7 ± 1.8 weeks. Within the cohort, 27 (14%) had one or more major adverse outcomes including three deaths (1.6%). Early gestational age at delivery was the only variable identified as a significant predictor of adverse outcomes on both univariate and multivariate analysis (OR 1.4; 95% CI 1.1-1.8 for each earlier week of gestation). TPN cholestasis was significantly more common in infants delivered < 37 weeks of gestational age (38/115 (33%) compared with 11/76 (15%); p<0.001). Conclusions In this contemporary cohort, earlier gestational age at delivery is associated with adverse neonatal outcomes in infants with gastroschisis. Other variables such as antenatal ultrasound findings and mode of delivery did not predict adverse neonatal outcomes. PMID:25162255

  18. Neurodevelopmental Outcome in Preterm Infants

    ERIC Educational Resources Information Center

    Bos, Arend F.; Roze, Elise

    2011-01-01

    Aim: To determine the distribution of cognitive and motor scores in preterm children, and to establish the influence of brain lesions and decreasing gestational age thereon. Method: One hundred and six very preterm children (63 males, 43 females; gestational age 24.0-31.6wk; birthweight 480-2275g) were assessed for cognition and motor outcome at 6…

  19. Main Oxidizer Valve Design

    NASA Technical Reports Server (NTRS)

    Addona, Brad; Eddleman, David

    2015-01-01

    A developmental Main Oxidizer Valve (MOV) was designed by NASA-MSFC using additive manufacturing processes. The MOV is a pneumatically actuated poppet valve to control the flow of liquid oxygen to an engine's injector. A compression spring is used to return the valve to the closed state when pneumatic pressure is removed from the valve. The valve internal parts are cylindrical in shape, which lends itself to traditional lathe and milling operations. However, the valve body represents a complicated shape and contains the majority of the mass of the valve. Additive manufacturing techniques were used to produce a part that optimized mass and allowed for design features not practical with traditional machining processes.

  20. Usability of a barcode scanning system as a means of data entry on a PDA for self-report health outcome questionnaires: a pilot study in individuals over 60 years of age

    PubMed Central

    Boissy, Patrick; Jacobs, Karen; Roy, Serge H

    2006-01-01

    Background Throughout the medical and paramedical professions, self-report health status questionnaires are used to gather patient-reported outcome measures. The objective of this pilot study was to evaluate in individuals over 60 years of age the usability of a PDA-based barcode scanning system with a text-to-speech synthesizer to collect data electronically from self-report health outcome questionnaires. Methods Usability of the system was tested on a sample of 24 community-living older adults (7 men, 17 women) ranging in age from 63 to 93 years. After receiving a brief demonstration on the use of the barcode scanner, participants were randomly assigned to complete two sets of 16 questions using the bar code wand scanner for one set and a pen for the other. Usability was assessed using directed interviews with a usability questionnaire and performance-based metrics (task times, errors, sources of errors). Results Overall, participants found barcode scanning easy to learn, easy to use, and pleasant. Participants were marginally faster in completing the 16 survey questions when using pen entry (20/24 participants). The mean response time with the barcode scanner was 31 seconds longer than traditional pen entry for a subset of 16 questions (p = 0.001). The responsiveness of the scanning system, expressed as first scan success rate, was less than perfect, with approximately one-third of first scans requiring a rescan to successfully capture the data entry. The responsiveness of the system can be explained by a combination of factors such as the location of the scanning errors, the type of barcode used as an answer field in the paper version, and the optical characteristics of the barcode scanner. Conclusion The results presented in this study offer insights regarding the feasibility, usability and effectiveness of using a barcode scanner with older adults as an electronic data entry method on a PDA. While participants in this study found their experience with the

  1. Implications of Vascular Aging

    PubMed Central

    Barodka, Viachaslau M.; Joshi, Brijen L.; Berkowitz, Dan E.; Hogue, Charles W.; Nyhan, Daniel

    2011-01-01

    Chronological age is a well established risk factor for the development of cardiovascular diseases. The changes that accumulate in the vasculature with age, though, are highly variable. It is now increasingly recognized that indices of vascular health are more reliable than age per se in predicting adverse cardiovascular outcomes. The variation in the accrual of these age-related vascular changes is a function of multiple genetic and environmental factors. In this review, we highlight some of the pathophysiological mechanisms that characterize the vascular aging phenotype. Furthermore, we provide an overview of the key outcome studies that address the value of these vascular health indices in general and discuss potential effects on perioperative cardiovascular outcomes. PMID:21474663

  2. The Cannabis Youth Treatment (CYT) Study: main findings from two randomized trials.

    PubMed

    Dennis, Michael; Godley, Susan H; Diamond, Guy; Tims, Frank M; Babor, Thomas; Donaldson, Jean; Liddle, Howard; Titus, Janet C; Kaminer, Yifrah; Webb, Charles; Hamilton, Nancy; Funk, Rod

    2004-10-01

    This article presents the main outcome findings from two inter-related randomized trials conducted at four sites to evaluate the effectiveness and cost-effectiveness of five short-term outpatient interventions for adolescents with cannabis use disorders. Trial 1 compared five sessions of Motivational Enhancement Therapy plus Cognitive Behavioral Therapy (MET/CBT) with a 12-session regimen of MET and CBT (MET/CBT12) and another that included family education and therapy components (Family Support Network [FSN]). Trial II compared the five-session MET/CBT with the Adolescent Community Reinforcement Approach (ACRA) and Multidimensional Family Therapy (MDFT). The 600 cannabis users were predominately white males, aged 15-16. All five CYT interventions demonstrated significant pre-post treatment during the 12 months after random assignment to a treatment intervention in the two main outcomes: days of abstinence and the percent of adolescents in recovery (no use or abuse/dependence problems and living in the community). Overall, the clinical outcomes were very similar across sites and conditions; however, after controlling for initial severity, the most cost-effective interventions were MET/CBT5 and MET/CBT12 in Trial 1 and ACRA and MET/CBT5 in Trial 2. It is possible that the similar results occurred because outcomes were driven more by general factors beyond the treatment approaches tested in this study; or because of shared, general helping factors across therapies that help these teens attend to and decrease their connection to cannabis and alcohol.

  3. Martian ages

    NASA Technical Reports Server (NTRS)

    Neukum, G.; Hiller, K.

    1981-01-01

    Four discussions are conducted: (1) the methodology of relative age determination by impact crater statistics, (2) a comparison of proposed Martian impact chronologies for the determination of absolute ages from crater frequencies, (3) a report on work dating Martian volcanoes and erosional features by impact crater statistics, and (4) an attempt to understand the main features of Martian history through a synthesis of crater frequency data. Two cratering chronology models are presented and used for inference of absolute ages from crater frequency data, and it is shown that the interpretation of all data available and tractable by the methodology presented leads to a global Martian geological history that is characterized by two epochs of activity. It is concluded that Mars is an ancient planet with respect to its surface features.

  4. Martian ages

    NASA Astrophysics Data System (ADS)

    Neukum, G.; Hiller, K.

    1981-04-01

    Four discussions are conducted: (1) the methodology of relative age determination by impact crater statistics, (2) a comparison of proposed Martian impact chronologies for the determination of absolute ages from crater frequencies, (3) a report on work dating Martian volcanoes and erosional features by impact crater statistics, and (4) an attempt to understand the main features of Martian history through a synthesis of crater frequency data. Two cratering chronology models are presented and used for inference of absolute ages from crater frequency data, and it is shown that the interpretation of all data available and tractable by the methodology presented leads to a global Martian geological history that is characterized by two epochs of activity. It is concluded that Mars is an ancient planet with respect to its surface features.

  5. Project MAIN: Community Collaboration Benefits Senior Citizens.

    ERIC Educational Resources Information Center

    Blake, Gerald F.

    1986-01-01

    Examines Project MAIN (Mobile Assistants in Nutrition), a 12-month demonstration project and the collaborative effort of an urban university, a high school, and a senior services agency, which employed students, ages 14 to 19, to research, plan, and operate a grocery delivery and escort service for elderly and disabled citizens. (BB)

  6. Infantile autism: adult outcome.

    PubMed

    Korkmaz, B

    2000-07-01

    Although the core features of autism do not change qualitatively, a gradual overall symptomatic improvement including an increase in adaptive skills is observed in most cases with age. Follow-up studies show that the diagnostic features, the differential diagnosis, and clinical problems of adult autistics differ substantially from that of autistic children. The differential diagnosis of older autistics include personality disorders, learning disabilities, and mood disorder. Depression, epilepsy, and behavioral problems such as aggression and agitation may be major clinical problems during adolescence. The early indicators of a better outcome include a higher level of IQ and language. Among the neuropsychological variables, measures of flexibility and cognitive shift are important as prognostic factors. Early behavioral and educational intervention may especially increase the adaptive skills of the patients and promote the in-family communication. The outcome studies of autism are particularly helpful in addressing the appropriate and most effective programs of remediation for adult autistics.

  7. Predicting mortality from burns: the need for age-group specific models.

    PubMed

    Taylor, Sandra L; Lawless, MaryBeth; Curri, Terese; Sen, Soman; Greenhalgh, David G; Palmieri, Tina L

    2014-09-01

    Traditional burn mortality models are derived using all age groups. We hypothesized that age variably impacts mortality after burn and that age-specific models for children, adults, and seniors will more accurately predict mortality than an all-ages model. We audited data from the American Burn Association (ABA) National Burn Repository (NBR) from 2000 to 2009 and used mixed effect logistic regression models to assess the influence of age, total body surface area (TBSA) burn, and inhalation injury on mortality. Mortality models were constructed for all ages and age-specific models: children (<18 years), adults (18-60 years), and seniors (>60 years). Model performance was assessed by area under the receiver operating curve (AUC). Main effect and two-way interactions were used to construct age-group specific mortality models. Each age-specific model was compared to the All Ages model. Of 286,293 records 100,051 had complete data. Overall mortality was 4% but varied by age (17% seniors, <1% children). Age, TBSA, and inhalation injury were significant mortality predictors for all models (p<0.05). Differences in predicted mortality between the All Ages model and the age-specific models occurred in children and seniors. In the age-specific pediatric model, predicted mortality decreased with age; inhalation injury had greater effect on mortality than in the All Ages model. In the senior model mortality increased with age. Seniors had greater increase in mortality per 1% increment in burn size and 1 year increase in age than other ages. The predicted mortality in seniors using the senior-specific model was higher than in the All Ages model. "One size fits all" models for predicting burn outcomes do not accurately reflect the outcomes for seniors and children. Age-specific models for children and seniors may be advisable. PMID:24846014

  8. Predicting Mortality from Burn Injuries: The need for age-group specific models

    PubMed Central

    Taylor, Sandra L.; Lawless, MaryBeth; Curri, Terese; Sen, Soman; Greenhalgh, David G.; Palmieri, Tina L.

    2014-01-01

    Traditional burn mortality models are derived using all age groups. We hypothesized that age variably impacts mortality after burn and that age-specific models for children, adults, and seniors will more accurately predict mortality than an all-ages model. We audited data from the American Burn Association (ABA) National Burn Repository (NBR) from 2000-2009 and used mixed effect logistic regression models to assess the influence of age, total body surface area (TBSA) burn, and inhalation injury on mortality. Mortality models were constructed for all ages and age-specific models: children (<18 years), adults (18-60 years), and seniors (>60 years). Model performance was assessed by area under the receiver operating curve (AUC). Main effect and two-way interactions were used to construct age-group specific mortality models. Each age-specific model was compared to the All Ages model. Of 286,293 records 100,051 had complete data. Overall mortality was 4% but varied by age (17% seniors, <1% children). Age, TBSA, and inhalation injury were significant mortality predictors for all models (p<0.05). Differences in predicted mortality between the All Ages model and the age-specific models occurred in children and seniors. In the age-specific pediatric model, predicted mortality decreased with age; inhalation injury had greater effect on mortality than in the All Ages model. In the senior model mortality increased with age. Seniors had greater increase in mortality per 1% increment in burn size and 1 year increase in age than other ages. The predicted mortality in seniors using the senior-specific model was higher than in the All Ages model. “One size fits all” models for predicting burn outcomes do not accurately reflect the outcomes for seniors and children. Age-specific models for children and seniors may be advisable. PMID:24846014

  9. Teleophthalmology: improving patient outcomes?

    PubMed Central

    Sreelatha, Omana Kesary; Ramesh, Sathyamangalam VenkataSubbu

    2016-01-01

    Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP). Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR), glaucoma, age-related macular degeneration (ARMD), and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients’ assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time. Considering the improved quality of patient care and patient satisfaction reported for these telemedicine services, this review explores how teleophthalmology helps to improve patient outcomes. PMID:26929592

  10. Teleophthalmology: improving patient outcomes?

    PubMed

    Sreelatha, Omana Kesary; Ramesh, Sathyamangalam VenkataSubbu

    2016-01-01

    Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP). Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR), glaucoma, age-related macular degeneration (ARMD), and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients' assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time. Considering the improved quality of patient care and patient satisfaction reported for these telemedicine services, this review explores how teleophthalmology helps to improve patient outcomes. PMID:26929592

  11. 28. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    28. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, LOOKING NORTH (LOCATION Q) - Shippingport Atomic Power Station, On Ohio River, 25 miles Northwest of Pittsburgh, Shippingport, Beaver County, PA

  12. 29. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    29. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, LOOKING SOUTH (LOCATION Q) - Shippingport Atomic Power Station, On Ohio River, 25 miles Northwest of Pittsburgh, Shippingport, Beaver County, PA

  13. Endoscopic ultrasonic dacryocystorhinostomy: clinical profile and outcomes.

    PubMed

    Ali, Mohammad Javed; Singh, Manpreet; Chisty, Naja; Kamal, Saurabh; Naik, Milind N

    2016-07-01

    Ultrasonic endoscopic dacryocystorhinostomy (UEnDCR) is emerging alternative modality of managing nasolacrimal duct obstructions. The aim of this study was to report the clinical profile and outcomes with a UEnDCR with mitomycin C and silicone intubation. Prospective interventional case series performed on all consecutive patients undergoing an ultrasonic endoscopic dacryocystorhinostomy over a 1-year period from September 2013 to October 2014. All surgeries were performed by a single surgeon (MJA). Data collected include demographics, presentation, indications for surgery, past interventions, intraoperative and post-operative complications and outcomes. The main outcome measures were anatomical and functional success of the surgery. 44 procedures were performed in 41 patients. The mean age was 31.6 years. Children with complex congenital nasolacrimal duct obstructions refractory to probing and intubation accounted for 17 % (7/41) of the cohort. Past history of acute dacryocystitis was noted in 35.6 % (15/41). Two patients (4.9 %, 2/41) had failed external DCR. A minimal follow-up of 6 months following surgery was taken for final analysis. Complications included intraoperative focal epithelial burn in one patient that healed spontaneously and post-operative ostium granulomas in 15.9 % (7/44) of the ostia. At the 6-month follow-up, anatomical and functional successes were noted in 93.1 % (41/44) and 88.6 % (39/44), respectively. Ultrasonic dacryocystorhinostomy is a safe and effective alternative modality in the management of nasolacrimal duct obstructions in pediatric and adult age groups. Setup was easy and no additional technical difficulties were observed. PMID:26530294

  14. Personality and adolescent pregnancy outcomes

    PubMed Central

    Harville, Emily W.; Madkour, Aubrey Spriggs; Xie, Yiqiong

    2014-01-01

    Aims To examine the relationship between personality, pregnancy and birth outcomes in adolescents Background Personality has been shown to be a strong predictor of many health outcomes. Adolescents who become pregnant have worse birth outcomes than adults. Design Cross-sectional study using data from the National Longitudinal Study of Adolescent Health (baseline, 1994-1995; follow-up, 2007-2008). Methods The study sample was 6529 girls, 820 of whom reported on pregnancy outcomes for a teenage birth. Personality data was taken from the Mini International Personality Item Pool personality tool, which measures the five-factor personality traits of neuroticism, conscientiousness, intellect/imagination, extraversion and agreeableness. Logistic regression was used to predict teen pregnancy and linear regression was used to predict birth weight and gestational age with adjustment for confounders and stratification by race. Results Agreeableness and intellect/imagination were associated with a reduced likelihood of becoming pregnant as an adolescent, while neuroticism, conscientiousness and extraversion were all associated with an increased likelihood of becoming pregnant. Higher neuroticism was associated with lower birth weight and gestational age among Black girls, but not non-Black. Conscientiousness was associated with lower gestational age among non-Black girls. No relationships were found with extraversion or agreeableness and birth outcomes. Receiving late or no prenatal care was associated with higher intellect/imagination. Conclusions Personality is understudied with respect to pregnancy and birth outcomes compared with other health outcomes. Such research could help professionals and clinicians design and target programs that best fit the characteristics of the population most likely to need them, such as those with high neuroticism. PMID:25040691

  15. Rheumatology outcomes: the patient's perspective.

    PubMed

    Carr, Alison; Hewlett, Sarah; Hughes, Rod; Mitchell, Helene; Ryan, Sarah; Carr, Maggie; Kirwan, John

    2003-04-01

    Our aim was to explore the patient's perspective of outcomes in rheumatoid arthritis (RA) to identify which outcomes are important to patients and how patients calibrate what constitutes a meaningful change in those outcomes. A qualitative study was performed using focus groups in 5 clinical centers in different geographical locations in the UK. Each group contained 6 to 9 patients with RA who were purposefully sampled to include men and women with a range of age, disease duration, functional disability, work disability, and current disease activity. Each focus group lasted around 1 h and addressed 3 questions: What outcomes from treatment are important to RA patients? What makes patients satisfied or dissatisfied with a treatment? How do patients decide that a treatment is working? Patients identified as important not only physical outcomes such as pain and disability, but also fatigue and a general feeling of wellness. The relative importance of these outcomes depended on the stage of disease and on specific situations, such as a disease flare. Satisfaction was influenced by communication, access to treatment, and treatment efficacy. Treatment efficacy was related to symptom reduction, with the magnitude of reduction necessary for efficacy dependent on the stage of disease. For example, large changes were deemed necessary with disease of long duration, while in early disease, even small changes could be important. Our data support existing knowledge of the importance of pain and mobility as treatment outcomes, but raise new and important issues: Some outcomes of importance to patients are not currently measured and there are no measures available to capture them. Existing measures need to be calibrated to take account of the differing importance of outcomes at different stages of disease and variations in the magnitude of change within the same outcome that indicate treatment efficacy. PMID:12672221

  16. Gestational age

    MedlinePlus

    Fetal age - gestational age; Gestation; Neonatal gestational age; Newborn gestational age ... Gestational age can be determined before or after birth. Before birth, your health care provider will use ultrasound to ...

  17. Comparative outcome of low birth weight babies.

    PubMed

    Das, B K; Mishra, R N; Mishra, O P; Bhargava, V; Prakash, A

    1993-01-01

    One hundred and fifty six babies with birth weight between 1500-2000 g and 103 full term-appropriate for gestational age (FT-AGA) babies delivered at University Hospital, District Hospital and village homes were included for a comparative study of mortality, morbidity and growth pattern. The low birth weight (LBW) babies from the three centres had similar birth weight and gestational age. Neonatal mortality rates for the LBW babies were similar at the three centres. The main cause of death were infections and aspiration with rates again being similar. Diarrhea and respiratory tract infections were common causes of morbidity. The mortality rates for the LBW babies were significantly higher as compared to FT-AGA babies irrespective of the place of delivery. The incidence of morbidities like diarrhea and respiratory infections were also higher in LBW babies. However, the differences were statistically significant mostly in the preterm group. The weight gain of all LBW babies was similar up to 3 months of age. The findings of an identical outcome for the LBW babies at village level to those managed at hospitals is an encouraging trend to increasing domiciliary care for LBW babies. PMID:8406701

  18. Infective endocarditis: determinants of long term outcome

    PubMed Central

    Netzer, R O M; Altwegg, S C; Zollinger, E; Täuber, M; Carrel, T; Seiler, C

    2002-01-01

    Objective: To evaluate predictors of long term prognosis in infective endocarditis. Design: Retrospective cohort study. Setting: Tertiary care centre. Patients: 212 consecutive patients with infective endocarditis between 1980 and 1995 Main outcome measures: Overall and cardiac mortality; event-free survival; and the following events: recurrence, need for late valve surgery, bleeding and embolic complications, cerebral dysfunction, congestive heart failure. Results: During a mean follow up period of 89 months (range 1–244 months), 56% of patients died. In 180 hospital survivors, overall and cardiac mortality amounted to 45% and 24%, respectively. By multivariate analysis, early surgical treatment, infection by streptococci, age < 55 years, absence of congestive heart failure, and > 6 symptoms or signs of endocarditis during active infection were predictive of improved overall long term survival. Independent determinants of event-free survival were infection by streptococci and age < 55 years. Event-free survival was 17% at the end of follow up both in medically–surgically treated patients and in medically treated patients. Conclusions: Long term survival following infective endocarditis is 50% after 10 years and is predicted by early surgical treatment, age < 55 years, lack of congestive heart failure, and the initial presence of more symptoms of endocarditis. PMID:12067947

  19. Ramadan, Fasting and Educational Outcomes

    ERIC Educational Resources Information Center

    Oosterbeek, Hessel; van der Klaauw, Bas

    2013-01-01

    Using a difference-in-differences framework, we estimate the impact of Ramadan on educational outcomes of Muslim students living in a non-Muslim country. For identification we exploit that the number of Ramadan weeks during the course that we study, varies from year to year, ranging from zero to four. Our main finding is that Ramadan observance…

  20. Outcomes of Children Adopted from Eastern Europe

    ERIC Educational Resources Information Center

    Miller, Laurie; Chan, Wilma; Tirella, Linda; Perrin, Ellen

    2009-01-01

    Behavioral problems are frequent among post-institutionalized Eastern European adoptees. However, risk factors related to outcomes have not been fully delineated. We evaluated 50 Eastern European adoptees, age 8-10 years, with their adoptive families for more than five years. Cognitive and behavioral outcomes and parenting stress were evaluated in…

  1. 18. MAIN FLOOR HOLDING TANKS Main floor, looking at ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. MAIN FLOOR - HOLDING TANKS Main floor, looking at holding tanks against the west wall, from which sluice gates are seen protruding. Right foreground-wooden holding tanks. Note narrow wooden flumes through which fish were sluiced into holding and brining tanks. - Hovden Cannery, 886 Cannery Row, Monterey, Monterey County, CA

  2. Oblique view, looking eastsoutheast, of main gatehouse, main entrance, and ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Oblique view, looking east-southeast, of main gatehouse, main entrance, and battery storage house. East side of canal wall in foreground - Grand Valley Diversion Dam, Half a mile north of intersection of I-70 & Colorado State Route 65, Cameo, Mesa County, CO

  3. View of the main interior space facing east. The main ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View of the main interior space facing east. The main entry is on the left hand side at the rear. The exit to the deck is to the right. - San Luis Yacht Club, Avila Pier, South of Front Street, Avila Beach, San Luis Obispo County, CA

  4. The yeast Saccharomyces cerevisiae- the main character in beer brewing.

    PubMed

    Lodolo, Elizabeth J; Kock, Johan L F; Axcell, Barry C; Brooks, Martin

    2008-11-01

    Historically, mankind and yeast developed a relationship that led to the discovery of fermented beverages. Numerous inventions have led to improved technologies and capabilities to optimize fermentation technology on an industrial scale. The role of brewing yeast in the beer-making process is reviewed and its importance as the main character is highlighted. On considering the various outcomes of functions in a brewery, it has been found that these functions are focused on supporting the supply of yeast requirements for fermentation and ultimately to maintain the integrity of the product. The functions/processes include: nutrient supply to the yeast (raw material supply for brewhouse wort production); utilities (supply of water, heat and cooling); quality assurance practices (hygiene practices, microbiological integrity measures and other specifications); plant automation (vessels, pipes, pumps, valves, sensors, stirrers and centrifuges); filtration and packaging (product preservation until consumption); distribution (consumer supply); and marketing (consumer awareness). Considering this value chain of beer production and the 'bottle neck' during production, the spotlight falls on fermentation, the age-old process where yeast transforms wort into beer. PMID:18795959

  5. The yeast Saccharomyces cerevisiae- the main character in beer brewing.

    PubMed

    Lodolo, Elizabeth J; Kock, Johan L F; Axcell, Barry C; Brooks, Martin

    2008-11-01

    Historically, mankind and yeast developed a relationship that led to the discovery of fermented beverages. Numerous inventions have led to improved technologies and capabilities to optimize fermentation technology on an industrial scale. The role of brewing yeast in the beer-making process is reviewed and its importance as the main character is highlighted. On considering the various outcomes of functions in a brewery, it has been found that these functions are focused on supporting the supply of yeast requirements for fermentation and ultimately to maintain the integrity of the product. The functions/processes include: nutrient supply to the yeast (raw material supply for brewhouse wort production); utilities (supply of water, heat and cooling); quality assurance practices (hygiene practices, microbiological integrity measures and other specifications); plant automation (vessels, pipes, pumps, valves, sensors, stirrers and centrifuges); filtration and packaging (product preservation until consumption); distribution (consumer supply); and marketing (consumer awareness). Considering this value chain of beer production and the 'bottle neck' during production, the spotlight falls on fermentation, the age-old process where yeast transforms wort into beer.

  6. Maine Agricultural Foods. Project SEED.

    ERIC Educational Resources Information Center

    Beaulieu, Peter; Ossenfort, Pat

    This paper describes an activity-based program that teaches students in grades 4-12 about the importance of Maine agriculture in their lives. Specifically, the goal is to increase student awareness of how the foods they eat are planted, harvested, and processed. The emphasis is on crops grown in Maine such as potatoes, broccoli, peas, blueberries,…

  7. Main Propulsion Test Article (MPTA)

    NASA Technical Reports Server (NTRS)

    Snoddy, Cynthia

    2010-01-01

    Scope: The Main Propulsion Test Article integrated the main propulsion subsystem with the clustered Space Shuttle Main Engines, the External Tank and associated GSE. The test program consisted of cryogenic tanking tests and short- and long duration static firings including gimbaling and throttling. The test program was conducted on the S1-C test stand (Position B-2) at the National Space Technology Laboratories (NSTL)/Stennis Space Center. 3 tanking tests and 20 hot fire tests conducted between December 21 1 1977 and December 17, 1980 Configuration: The main propulsion test article consisted of the three space shuttle main engines, flightweight external tank, flightweight aft fuselage, interface section and a boilerplate mid/fwd fuselage truss structure.

  8. The Impact of Prolonged Participation in a Pro-Social Cognitive Behavioral Skills Program on Elementary Age Students, with Behavior Related Disorders, Behavior Accelerative, Behavior Reductive, and Return to Regular Classroom Outcomes

    ERIC Educational Resources Information Center

    Esser, Ted H.

    2012-01-01

    Overall, pretest-posttest results indicated statistically significant pretest beginning program compared to posttest ending program percentage of behavioral improvement for on task, following directions, and positive interactions outcomes improvement for individual students who completed the elementary grades pro-social cognitive behavioral skills…

  9. Determinants of outcome in smoking cessation.

    PubMed Central

    Lennox, A S

    1992-01-01

    A large amount of research has been conducted into the factors which influence outcome in attempts to stop smoking. This article reviews the literature in two main areas: first, the effects of patient characteristics on outcome, and secondly, the effectiveness of various primary care interventions. The practical implications of this research for primary care interventions to help people stop smoking are explored. PMID:1419248

  10. EXHAUST MAIN PERSONNEL EXPOSURE CALCULATION

    SciTech Connect

    S. Su

    1999-09-29

    The purpose of this activity is to identify and determine potential radiation hazards in the service exhaust main due to a waste package leakage from an emplacement drift. This work supports the subsurface ventilation system design for the EDA II, which consists of an accessible service exhaust main for personnel, and an exhaust main for hot air flow. The objective is to provide the necessary radiation exposure calculations to determine if the service exhaust main is accessible following a waste package leak. This work includes the following items responsive to the stated purpose and objective: Calculate the limiting transient radiation exposure of personnel in the service exhaust main due to the passage of airborne radioactive material through the ventilation raise and connecting horizontal raise to the exhaust main in the event of a leaking waste package Calculate the potential exposures to maintenance workers in the service exhaust main from residual radioactive material deposited inside of the ventilation raise and connecting horizontal raise This calculation is limited to external radiation only, since the airborne and contamination sources will be contained in the ventilation raise and connecting horizontal raise.

  11. Aging, longevity and health.

    PubMed

    Rasmussen, Lene Juel; Sander, Miriam; Wewer, Ulla M; Bohr, Vilhelm A

    2011-10-01

    The IARU Congress on Aging, Longevity and Health, held on 5-7 October 2010 in Copenhagen, Denmark, was hosted by Rector Ralf Hemmingsen, University of Copenhagen and Dean Ulla Wewer, Faculty of Health Sciences, University of Copenhagen and was organized by Center for Healthy Aging (CEHA) under the leadership of CEHA Managing Director Lene Juel Rasmussen and Prof. Vilhelm Bohr, National Institute on Aging, NIH, Baltimore, USA (associated to CEHA). The Congress was attended by approximately 125 researchers interested in and/or conducting research on aging and aging-related topics. The opening Congress Session included speeches by Ralf Hemmingsen, Ulla Wewer, and Lene Juel Rasmussen and Keynote Addresses by four world renowned aging researchers: Povl Riis (The Age Forum), Bernard Jeune (University of Southern Denmark), George Martin (University of Washington, USA) and Jan Vijg (Albert Einstein School of Medicine, USA) as well as a lecture discussing the art-science interface by Thomas Söderqvist (Director, Medical Museion, University of Copenhagen). The topics of the first six Sessions of the Congress were: Neuroscience and DNA damage, Aging and Stress, Life Course, Environmental Factors and Neuroscience, Muscle and Life Span and Life Span and Mechanisms. Two additional Sessions highlighted ongoing research in the recently established Center for Healthy Aging at the University of Copenhagen. This report highlights outcomes of recent research on aging-related topics, as described at the IARU Congress on Aging, Longevity and Health.

  12. UV, stress and aging.

    PubMed

    Debacq-Chainiaux, Florence; Leduc, Cedric; Verbeke, Alix; Toussaint, Olivier

    2012-07-01

    Skin is a model of choice in studies on aging. Indeed, skin aging can be modulated by internal and external factors, reflecting its complexity. Two types of skin aging have been identified: intrinsic, mainly genetically determined and extrinsic-also called "photo-aging"-resulting on the impact of environmental stress and more precisely of UV rays. Simplified in vitro models, based on cellular senescence, have been developed to study the relationship between UV and aging. These models vary on the cell type (fibroblasts or keratinocytes, normal or immortalized) and the type of UV used (UVA or UVB). PMID:23467762

  13. UV, stress and aging.

    PubMed

    Debacq-Chainiaux, Florence; Leduc, Cedric; Verbeke, Alix; Toussaint, Olivier

    2012-07-01

    Skin is a model of choice in studies on aging. Indeed, skin aging can be modulated by internal and external factors, reflecting its complexity. Two types of skin aging have been identified: intrinsic, mainly genetically determined and extrinsic-also called "photo-aging"-resulting on the impact of environmental stress and more precisely of UV rays. Simplified in vitro models, based on cellular senescence, have been developed to study the relationship between UV and aging. These models vary on the cell type (fibroblasts or keratinocytes, normal or immortalized) and the type of UV used (UVA or UVB).

  14. Atrazine and Pregnancy Outcomes: A Systematic Review of Epidemiologic Evidence

    PubMed Central

    Goodman, Michael; Mandel, Jack S; DeSesso, John M; Scialli, Anthony R

    2014-01-01

    Atrazine (ATR) is a commonly used agricultural herbicide that has been the subject of epidemiologic studies assessing its relation to reproductive health problems. This review evaluates both the consistency and the quality of epidemiologic evidence testing the hypothesis that ATR exposure, at usually encountered levels, is a risk factor for birth defects, small for gestational age birth weight, prematurity, miscarriages, and problems of fetal growth and development. We followed the current methodological guidelines for systematic reviews by using two independent researchers to identify, retrieve, and evaluate the relevant epidemiologic literature on the relation of ATR to various adverse outcomes of birth and pregnancy. Each eligible paper was summarized with respect to its methods and results with particular attention to study design and exposure assessment, which have been cited as the main areas of weakness in ATR research. As a quantitative meta-analysis was not feasible, the study results were categorized qualitatively as positive, null, or mixed. The literature on ATR and pregnancy-related health outcomes is growing rapidly, but the quality of the data is poor with most papers using aggregate rather than individual-level information. Without good quality data, the results are difficult to assess; however, it is worth noting that none of the outcome categories demonstrated consistent positive associations across studies. Considering the poor quality of the data and the lack of robust findings across studies, conclusions about a causal link between ATR and adverse pregnancy outcomes are not warranted. PMID:24797711

  15. Should surgical outcomes be published?

    PubMed

    Chou, Evelyn; Abboudi, Hamid; Shamim Khan, Mohammed; Dasgupta, Prokar; Ahmed, Kamran

    2015-04-01

    Despite publishing surgical outcomes being a positive step forwards in the progression of England's healthcare system, it has no doubt been faced with criticism and reservations. This review article aims to discuss the pros and cons of publishing individual surgical outcomes, as well as the challenges faced. Publishing outcomes requires data from a number of sources such as national clinical audits, hospital episode statistics, patient-reported outcomes, registers and information from revalidation. As yet, eight surgical specialties have begun publishing their data, including cardiac (coronary artery bypass graft, valve and aortic surgery), endocrine (thyroidectomy, lobectomy, isthmusectomy), orthopaedic (hip and knee replacement), urological (full and partial nephrectomies, nephroureterectomy), colorectal (bowel tumour removal), upper gastrointestinal (stomach cancer and oesophageal cancer removal, bariatric surgery), ear, nose and throat surgery (larynx, oral cavity, oropharynx, hypopharynx and salivary gland cancer removal), as well as vascular surgery (abdominal aortic aneurysm, carotid endarterectomy). However, not all procedures have been addressed. Despite the controversy surrounding the topic of publishing surgical outcomes, the advantages of reporting outcomes outweigh the disadvantages, and these challenges can be overcome, to create a more reliable, trustworthy and transparent NHS. Perhaps one of the main challenges has been the difficulty in collecting large amounts of clinically significant data able to quantify the performance of surgeons.

  16. Outcome analysis of individualized vestibular rehabilitation protocols

    NASA Technical Reports Server (NTRS)

    Black, F. O.; Angel, C. R.; Pesznecker, S. C.; Gianna, C.

    2000-01-01

    OBJECTIVE: To determine the outcome of vestibular rehabilitation protocols in subjects with peripheral vestibular disorders compared with normal and abnormal control subjects. STUDY DESIGN: Prospective study using repeated measure, matched control design. Subjects were solicited consecutively according to these criteria: vestibular disorder subjects who had abnormal results of computerized dynamic posturography (CDP) sensory organization tests (SOTs) 5 and 6 and underwent rehabilitation; vestibular disorder subjects who had abnormal results of SOTs 5 and 6 and did not undergo rehabilitation; and normal subjects (normal SOTs). SETTING: Tertiary neurotology clinic. SUBJECTS: Men and women over age 18 with chronic vestibular disorders and chief complaints of unsteadiness, imbalance, and/or motion intolerance, and normal subjects. INTERVENTIONS: Pre- and post-rehabilitation assessment included CDP, vestibular disability, and activities of daily living questionnaires. Individualized rehabilitation plans were designed and implemented to address the subject's specific complaints and functional deficits. Supervised sessions were held at weekly intervals, and self-administered programs were devised for daily home use. MAIN OUTCOME MEASURES: CDP composite and SOT scores, number of falls on CDP, and self-assessment questionnaire results. RESULTS: Subjects who underwent rehabilitation (Group A) showed statistically significant improvements in SOTs, overall composite score, and reduction in falls compared with abnormal (Group B) control groups. Group A's performances after rehabilitation were not significantly different from those of normal subjects (Group C) in SOTs 3 through 6, and close to normal on SOTs 1 and 2. Subjects in Group A also reported statistically significant symptomatic improvement. CONCLUSIONS: Outcome measures of vestibular protocol physical therapy confirmed objective and subjective improvement in subjects with chronic peripheral vestibular disorders. These

  17. Space Shuttle Era: Main Engines

    NASA Video Gallery

    Producing 500,000 pounds of thrust from a package weighing only 7,500 pounds, the Space Shuttle Main Engines are one of the shining accomplishments of the shuttle program. The success did not come ...

  18. Progression of aging in Mexico: the Mexican Health and Aging Study (MHAS) 2012

    PubMed Central

    Wong, Rebeca; Michaels-Obregón, Alejandra; Palloni, Alberto; Gutiérrez-Robledo, Luis Miguel; González-González, César; López-Ortega, Mariana; Téllez-Rojo, Martha María; Mendoza-Alvarado, Laura Rosario

    2015-01-01

    Objective To describe the third wave of the Mexican Health and Aging Study (MHAS), completed in 2012, and present preliminary results. Materials and methods Descriptive analyses by gender and age group of demographic and socioeconomic characteristics, health conditions and health behaviors, as well as social support and life satisfaction measures are presented. In addition, external validations are presented by comparing MHAS 2012 indicators with other national data sources. Results For the panel of older adults in the sample, the rate of health care insurance coverage increased greatly between 2001 and 2012, a significantly higher change in rural compared to urban areas. The results for 2012 are consistent with the previous two waves for the main indicators of health and physical disability prevalence, risk factors, and behaviors. Conclusions The MHAS offers a unique opportunity to study aging in Mexico, as well as to complete cross-national comparisons. The cumulative number of deaths in the cohort should support the study of mortality and its association with health outcomes and behaviors over the life cycle. In addition, the sub-samples of objective markers will enable methodological research on self-reports and associations of biomarkers in old age with similar health outcomes and behaviors. PMID:26172238

  19. Epidemiological Risk Factors and Perinatal Outcomes of Congenital Anomalies.

    PubMed

    Almeida, Lissa Fernandes Garcia; Araujo Júnior, Edward; Crott, Gerson Claudio; Okido, Marcos Masaru; Berezowski, Aderson Tadeu; Duarte, Geraldo; Marcolin, Alessandra Cristina

    2016-07-01

    Objectives To identify the epidemiological risk factors for congenital anomalies (CAs) and the impact of these fetal malformations on the perinatal outcomes. Methods This prospective cohort study comprised 275 women whose fetuses had CAs. Maternal variables to establish potential risk factors for each group of CA and perinatal outcomes were evaluated. The primary outcome was CA. Secondary outcomes included: fetal growth restriction (FGR); fetal distress (FD); premature rupture of membranes (PROM); oligohydramnios or polyhydramnios; preterm delivery (PTD); stillbirth; cesarean section; low birth weight; Apgar score < 7 at the 1st and 5th minutes; need for assisted ventilation at birth; neonatal infection; need for surgical treatment; early neonatal death; and hospitalization time. Chi-square (χ(2)) test and multilevel regression analysis were applied to compare the groups and determine the effects of maternal characteristics on the incidence of CAs. Results The general prevalence of CAs was of 2.4%. Several maternal characteristics were associated to CAs, such as: age; skin color; level of education; parity; folic acid supplementation; tobacco use; and history of previous miscarriage. There were no significant differences among the CA groups in relation to FGR, FD, PROM, 1-minute Apgar score > 7, and need for assisted ventilation at birth. On the other hand, the prevalence of the other considered outcomes varied significantly among groups. Preterm delivery was significantly more frequent in gastrointestinal tract/abdominal wall defects. The stillbirth rate was increased in all CAs, mainly in isolated fetal hydrops (odds ratio [OR]: 27.13; 95% confidence interval [95%CI]: 2.90-253.47). Hospitalization time was higher for the urinary tract and congenital heart disease groups (p < 0.01). Neonatal death was significantly less frequent in the central nervous system anomalies group. Conclusion It was possible to identify several risk factors for CAs

  20. Predicting Language Outcomes for Internationally Adopted Children

    ERIC Educational Resources Information Center

    Glennen, Sharon L.

    2007-01-01

    Purpose: Language and speech are difficult to assess in newly arrived internationally adopted children. The purpose of this study was to determine if assessments completed when toddlers were first adopted could predict language outcomes at age 2. Local norms were used to develop early intervention guidelines that were evaluated against age 2…

  1. Origins and Outcomes of Judgments about Work

    ERIC Educational Resources Information Center

    Johnson, Monica Kirkpatrick; Mortimer, Jeylan T.

    2011-01-01

    We evaluate the importance of judgments about work for the attainment process in the "new economy." Findings show continuing links between social origins and work orientations at age 21/22, as well as significant effects of work orientations on occupational outcomes at age 31/32. Higher socio-economic status background, and stronger self-perceived…

  2. Clinical features and treatment outcome of very elderly patients over 80 years old with multiple myeloma: comparison with patients in different age groups in the era of novel agents.

    PubMed

    Matsue, Kosei; Matsue, Yuya; Fujisawa, Manabu; Fukumoto, Kota; Suehara, Yasuhito; Sugihara, Hiroki; Takeuchi, Masami

    2016-01-01

    We retrospectively analyzed the outcomes of 175 consecutive patients admitted to our hospital between April 2004 and June 2014, and identified 42 (24%), 80 (46%), and 53 (30%) patients ≥ 80, 66-79, and ≤ 65 years old, respectively. The median progression-free survival (PFS) and overall survival (OS) of the ≥ 80, 66-79, and ≤ 65 years old groups were 19.1, 26.3, and 54.3 months, and 31.9, 54.8, and 83.8 months, respectively. Patients ≥ 80 but not ≤ 79 years old with ECOG performance score (PS) ≥ 3 and/or Charlson comorbidity index (CCI) ≥ 5 showed significantly shorter survival. ECOG PS and CCI predicted the treatment outcome of patients ≥ 80 but did not predict ≤ 79 years old.

  3. Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases.

    PubMed

    Franceschi, Claudio; Campisi, Judith

    2014-06-01

    Human aging is characterized by a chronic, low-grade inflammation, and this phenomenon has been termed as "inflammaging." Inflammaging is a highly significant risk factor for both morbidity and mortality in the elderly people, as most if not all age-related diseases share an inflammatory pathogenesis. Nevertheless, the precise etiology of inflammaging and its potential causal role in contributing to adverse health outcomes remain largely unknown. The identification of pathways that control age-related inflammation across multiple systems is therefore important in order to understand whether treatments that modulate inflammaging may be beneficial in old people. The session on inflammation of the Advances in Gerosciences meeting held at the National Institutes of Health/National Institute on Aging in Bethesda on October 30 and 31, 2013 was aimed at defining these important unanswered questions about inflammaging. This article reports the main outcomes of this session.

  4. Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases.

    PubMed

    Franceschi, Claudio; Campisi, Judith

    2014-06-01

    Human aging is characterized by a chronic, low-grade inflammation, and this phenomenon has been termed as "inflammaging." Inflammaging is a highly significant risk factor for both morbidity and mortality in the elderly people, as most if not all age-related diseases share an inflammatory pathogenesis. Nevertheless, the precise etiology of inflammaging and its potential causal role in contributing to adverse health outcomes remain largely unknown. The identification of pathways that control age-related inflammation across multiple systems is therefore important in order to understand whether treatments that modulate inflammaging may be beneficial in old people. The session on inflammation of the Advances in Gerosciences meeting held at the National Institutes of Health/National Institute on Aging in Bethesda on October 30 and 31, 2013 was aimed at defining these important unanswered questions about inflammaging. This article reports the main outcomes of this session. PMID:24833586

  5. The Aging Stress Response

    PubMed Central

    Haigis, Marcia C.; Yankner, Bruce A.

    2010-01-01

    Aging is the outcome of a balance between damage and repair. The rate of aging and the appearance of age-related pathology are modulated by stress response and repair pathways that gradually decline, including the proteostasis and DNA damage repair networks and mitochondrial respiratory metabolism. Highly conserved insulin/IGF-1, TOR, and sirtuin signaling pathways in turn, control these critical cellular responses. The coordinated action of these signaling pathways maintains cellular and organismal homeostasis in the face of external perturbations, such as changes in nutrient availability, temperature and oxygen level, as well as internal perturbations, such as protein misfolding and DNA damage. Studies in model organisms suggest that changes in signaling can augment these critical stress response systems, increasing lifespan and reducing age-related pathology. The systems biology of stress response signaling thus provides a new approach to the understanding and potential treatment of age-related diseases. PMID:20965426

  6. ORFEUS-SPAS MAIN TELESCOPE

    NASA Technical Reports Server (NTRS)

    1996-01-01

    In the Multi-Payload Processing Facility (MPPF) at KSC, technicians hoist the orbiting and Retrievable Far and Extreme Ultraviolet Spectrograph-Shuttle Pallet Satellite (ORFEUS-SPAS) II main telescope to a vertical position prior to installing it atop the Astronomy Shuttle Pallet Satellite (ASTRO-SPAS) platform. Two spectrographs share the main telescope: the Extreme Ultraviolet Spectrograph (EUV) provided by the University of California at Berkeley, and the Far Ultraviolet Spectrograph (FUV) designed by German institutions the University of Tubingen and Landessternwarte Heidelberg and built by German company Kayser-Threde. The main telescope has a primary mirror approximately one yard (one meter) in diameter, coated with iridium to improve its light-gathering power in the ultraviolet. During the flight of ORFEUS-SPAS II on Space Shuttle Mission STS- 80, these two spectrographs -- along with a third installed separately on the ASTRO-SPAS -- will gather data about the life cycle of stars.

  7. Importance and Impotence? Learning, Outcomes and Research in Further Education

    ERIC Educational Resources Information Center

    James, David

    2005-01-01

    One of the defining features of the Teaching and Learning Research Programme is that it 'aims to improve outcomes for learners of all ages in teaching and learning contexts across the UK'. This article argues that, although it is possible to use the terms "outcomes for learners" and "learning outcomes" interchangeably, they have an important…

  8. Healthy Aging

    MedlinePlus

    ... About Us Contact Us Text size | Print | Healthy Aging This information in Spanish ( en español ) A healthy ... Aging email updates. Enter email address Submit Healthy Aging news Accessibility | Privacy policy | Disclaimers | FOIA | Link to ...

  9. Healthy Aging

    MedlinePlus

    ... A Change Contrast print sign up Share Healthy Aging This category offers tips on how to stay ... with Smell Problems with Taste Skin Care and Aging Sleep and Aging Taking Medicines Talking with Your ...

  10. Outcomes evaluation of the athletic elbow.

    PubMed

    Freehill, Michael T; Mannava, Sandeep; Safran, Marc R

    2014-09-01

    The high-level athletic population poses difficulty when evaluating outcomes in orthopedic surgery, given generally good overall health and high function at baseline. Subtle differences in performance following injury or orthopedic surgery are hard to detect in high-performance athletes using standard outcome metrics; however, attaining these subtle improvements after injury or surgery are key to an athletes' livelihood.