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Sample records for age main outcome

  1. Advanced paternal age and reproductive outcome.

    PubMed

    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. 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

  3. 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…

  4. Do gravidity and age affect pregnancy outcome?

    PubMed

    Santow, G; Bracher, M

    1989-01-01

    Fetal loss has generally been found to vary with gravidity, previous experience of fetal loss, and maternal age, but the literature is divided on the reasons for these associations. In this paper we examine pregnancy histories obtained retrospectively from a nationally representative one-in-one-thousand sample of women in Australia aged 20 to 59 years. The relations of fetal loss ratios with both gravidity and previous outcome are consistent with heterogeneity of risk over the study population and a stopping rule, whereby high-risk women undertake more pregnancies than low-risk women to achieve the same number of live births. Evidence is presented that elevated loss ratios in the teens indicate not higher risk but a selection for short gestation intervals, while loss ratios beyond the mid-thirties do not point unequivocally to a substantial increase in risk at the older reproductive ages. PMID:2814570

  5. Moral Development and Life Outcomes. [Main Report and Executive Summary].

    ERIC Educational Resources Information Center

    Candee, Daniel; And Others

    Individuals who differ in moral reasoning have been found not only to achieve different stations in life but also to have considerably different values and strategies by which they conduct their lives. The nature of individuals' life outcomes was measured in this study using the status of the person's job as well as both structured and open-ended…

  6. 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.

  7. Predictors of Driving Outcomes in Advancing Age

    PubMed Central

    Emerson, Jamie L.; Johnson, Amy M.; Dawson, Jeffrey D.; Uc, Ergun Y.; Anderson, Steven W.

    2012-01-01

    This study aimed to develop predictive models for real-life driving outcomes in older drivers. Demographics, driving history, on-road driving errors, and performance on visual, motor, and neuropsychological test scores at baseline were assessed in 100 older drivers (ages 65–89 years [72.7]). These variables were used to predict time to driving cessation, first moving violation, or crash. Using Cox proportional hazards regression models, significant individual predictors for driving cessation were greater age and poorer scores on Near Visual Acuity, Contrast Sensitivity, Useful Field of View, Judgment of Line Orientation, Trail Making Test-Part A, Benton Visual Retention Test, Grooved Pegboard, and a composite index of overall cognitive ability. Greater weekly mileage, higher education, and “serious” on-road errors predicted moving violations. Poorer scores from Trail Making Test-Part B or Trail Making Test (B-A) and serious on-road errors predicted crashes. Multivariate models using “off-road” predictors revealed (1) age and Contrast Sensitivity as best predictors for driving cessation; (2) education, weekly mileage, and Auditory Verbal Learning Task-Recall for moving violations; and (3) education, number of crashes over the past year, Auditory Verbal Learning Task-Recall, and Trail Making Test (B-A) for crashes. Diminished visual, motor, and cognitive abilities in older drivers can be easily and noninvasively monitored with standardized off-road tests, and performances on these measures predict involvement in motor vehicle crashes and driving cessation, even in the absence of a neurological disorder. PMID:22182364

  8. Educational Outcomes and Indicators for Early Childhood (Age 3).

    ERIC Educational Resources Information Center

    Ysseldyke, James E.; And Others

    The National Center on Educational Outcomes (NCEO) has been working with federal and state agencies to facilitate and enhance the collection and use of data on educational outcomes for students with disabilities. The purpose of this document is to present a model of: (1) early childhood outcomes at age 3, where outcomes are defined as the results…

  9. 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.

  10. DNA Damage: A Main Determinant of Vascular Aging.

    PubMed

    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

  11. 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

  12. 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.

  13. 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

  14. Delaying childbearing: effect of age on fecundity and outcome of pregnancy.

    PubMed

    van Noord-Zaadstra, B M; Looman, C W; Alsbach, H; Habbema, J D; te Velde, E R; Karbaat, J

    1991-06-01

    This study examined the age of the start of the fall (critical age) in fecundity, the probability of a pregnancy leading to a healthy baby taking into account the age of the women, and, by combining all of the results, the determination of the age-dependent probability of getting a healthy baby. 2 fertility clinics serving a large part of the Netherlands provided the 751 women who fulfilled the selection criteria. In this cohort study of all women who entered a donor insemination program, those who fulfilled the selection criteria were married to azoospermic husbands, were nulliparous, and never received donor insemination previously. Main outcome measures studied were the number of cycles prior to a pregnancy (positive pregnancy result) or the cessation of treatment and the result of the pregnancy (successful outcome). Of 751 women, 555 became pregnant and 461 had healthy babies. The drop in fecundity was estimated to begin at around age 31 (critical age); after 12 cycles, the probability of pregnancy in a woman age 31 was 0.54 compared with 0.74 in a woman age 20-31. After 24 cycles, this difference had decreased (probability of conception 0.75 in women 31 and 0.85 in women age 20-31). The probability of having a healthy baby also decreased, by 3.5% a year after the age of 30. Combining both of these age effects, the chance of a woman age 35 having a healthy baby was about 1.2 that of a woman age 25. After the age of 31, the probability of conception falls rapidly; however, this can be compensated for partly by continuing insemination for more cycles. In addition, the probability of an adverse pregnancy outcome begins to increase at about the same age. PMID:2059713

  15. 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. PMID:18817871

  16. 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

  17. The effects of female age on fecundity and pregnancy outcome.

    PubMed

    Nugent, D; Balen, A H

    2001-01-01

    In industrialized countries worldwide, women are delaying childbearing for a variety of reasons, including pursuit of career, greater financial independence, improved and more accessible contraception and longer life expectancy. In terms of fertility and maternity, those aged > or = 35 years are considered to be of advanced maternal age and there are usually marked reductions in both the fecundity rate for spontaneous conceptions and the success rates with assisted conception. These decreases are thought to be due mainly to oocyte ageing, and the established success of oocyte donation from younger individuals to older recipients supports this contention. For those who achieve a pregnancy at an advanced maternal age there is a greater likelihood of aneuploidy (assuming conception with the woman's own oocytes), hypertensive and other medical disorders, birth by Caesarean section and maternal mortality. However, most of the complications associated with advanced maternal age are caused by age-related confounding variables, and older premenopausal women in good health should not require special attention. The data on perinatal mortality rates are encouraging and in the absence of congenital abnormalities perinatal mortality is probably not much increased, if at all, in older mothers. Pregnancy is now possible for postmenopausal women with the application of oocyte donation, but these individuals have a significantly higher likelihood of cardiovascular ageing and should be considered at increased risk of vascular complications during pregnancy. PMID:11591256

  18. 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

  19. Ethnicity, aging, and oral health outcomes: a conceptual framework.

    PubMed

    Andersen, R M; Davidson, P L

    1997-05-01

    An expanded version of Andersen's Behavioral Model of Health Services Utilization is used as the theoretical and analytical framework for the International Collaborative Study of Oral Health Outcomes (ICS-II). The conceptual framework for understanding determinants of oral health is based on a "systems" perspective. The framework posits that characteristics of the external environment, the dental care delivery system, and the personal characteristics of the population influence oral health behaviors. The expanded behavioral model conceptualizes health behaviors (oral hygiene practices and dental services utilization) as intermediate dependent variables, which in turn influence oral health outcomes (evaluated, perceived, patient satisfaction). The framework is presented with an increased focus on the effects of race-ethnicity and age cohort, the major exogenous variables used in this study for systematic assessment of the differences in the multitude of factors influencing oral health. The framework can be applied by policy analysis and health services managers to help describe, predict, and explain population-based health behaviors and health outcomes. PMID:9549985

  20. 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

  1. Siluro-Carboniferous Transpression in Central-Coastal Maine: Constraints From New Chemical Monazite Ages

    NASA Astrophysics Data System (ADS)

    Short, H.; Yates, M.; Johnson, S.

    2004-05-01

    New in-situ chemical age determinations of monazite from several different lithologic units across central and eastern Maine suggest a protracted regional history of dextral transpression, terrane exhumation, fault reactivation, and punctuated metamorphism from the Silurian through the Carboniferous. Acadian-age orogenesis in Maine is considered to be a high-temperature, low-pressure series of events during which the dominant direction of accommodation of convergence switched from orogen-perpendicular to orogen-parallel near the end of the Devonian. New chemical monazite ages suggest this orogenesis involved a significant and long-lived component of transpression at pressures high enough to produce kyanite. A kyanite-bearing schist that occurs along the boundary of the higher-strain, higher-metamorphic-grade Liberty-Orrington belt in the middle of the orogen returns preliminary Late Silurian-Early Devonian ages from both matrix monazite and monazite included in kyanite. These data suggest that the kyanite is contemporaneous with established `Acadian-age' tectonism, and that the Liberty-Orrington belt represents a higher-pressure terrane that was exhumed during Siluro-Devonian time. Late Devonian-Carboniferous monazite ages for grains included in garnet and andalusite from the Liberty-Orrington belt suggest continued metamorphism and fault reactivation. To the east of the Liberty-Orrington belt, preliminary monazite ages of 400 Ma within inclusion trails in cores of staurolite porphyroblasts, 373 Ma from monazite included in andalusite, and 358 Ma for monazite in the dextral matrix emphasizes the protracted transpressive nature of Devonian tectonism in the area. This new monazite work suggests that a geodynamic model incorporating localized exhumation during transpression is a more appropriate model for Acadian-age orogenesis in central-eastern Maine. All analyses were carried out in-situ using the Cameca SX100 electron microprobe at the Department of Earth Sciences

  2. Age-density relation of Main galaxies at fixed parameters or for different galaxy families

    NASA Astrophysics Data System (ADS)

    Deng, Xin-Fa; Song, Jun; Chen, Yi-Qing; Jiang, Peng; Ding, Ying-Ping

    2015-09-01

    Using two volume-limited Main galaxy samples of the Sloan Digital Sky Survey Data Release 10 (SDSS DR10), we examine the environmental dependence of galaxy age at fixed parameters or for different galaxy families. Statistical results show that the environmental dependence of galaxy age is stronger for late type galaxies, but can be still observed for the early types: the age of galaxies in the densest regime is preferentially older than that in the lowest density regime with the same morphological type. We also find that the environmental dependence of galaxy age for red galaxies and Low Stellar Mass (LSM) galaxies is stronger, while the one for blue galaxies and High Stellar Mass ( HSM ) galaxies is very weak.

  3. 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

  4. Microlinguistic processes that contribute to the ability to relay main events: influence of age.

    PubMed

    Capilouto, Gilson J; Wright, Heather Harris; Maddy, Katherine McComas

    2016-07-01

    The purpose of the current study was to determine the microlinguistic processes that contribute to picture description in healthy adults across the life span. Two-hundred forty healthy adults were separated into three groups, young (n = 80; 20-39), middle (n = 80; 40-69), and older (n = 80; 70-89). Participants provided language samples in response to two single and two sequential pictures analyzed for total number of words, informativeness, lexical diversity, syntactic complexity, and main events. The older group produced a significantly lower proportion of main events for the single and sequential pictures compared to the other groups. Group differences on the microlinguistic measures varied depending on the measure and the stimulus type. Further, regardless of task, total number of words significantly related to main event production for the young and middle aged groups, but not the older group. Results of the current study extend previous findings by researchers who have investigated discourse production in cognitively healthy, older adults. Using a multi-level approach, we found that linguistic processes across different levels interact; however, the relationship is age-dependent. By including a middle-aged group we identify the potential course of documented change and our results indicate that the changes in language processes with age may not be linear. PMID:26653413

  5. 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

  6. 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.

  7. Educational Outcomes and Indicators for Early Childhood (Age 6).

    ERIC Educational Resources Information Center

    Ysseldyke, James E.; And Others

    As part of its response to the current emphasis on educational reform and accountability, the National Center on Educational Outcomes (NCEO) has been working with federal and state agencies to facilitate and enhance the collection and use of data on educational outcomes for students with disabilities. In doing so, it has taken an inclusive…

  8. 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…

  9. 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…

  10. 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.

  11. 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

  12. Spinal cord injury rehabilitation outcome: the impact of age.

    PubMed

    Yarkony, G M; Roth, E J; Heinemann, A W; Lovell, L L

    1988-01-01

    The effect of age on self-care and mobility skill performance after spinal cord injury was studied using a 15-task modified Barthel Index (MBI) to score functional abilities for 708 patients aged 6 through 88 years. Analysis of covariance showed no relationship between age and discharge MBI score; however, patients with paraplegia, incomplete lesions, and greater admission functional ratings had greater discharge functional scores than did those with quadriplegia, complete lesions, and lower admission scores, respectively. Advancing age was associated with increased dependence in only seven functional skills (bathing, upper and lower body dressing, stair climbing, and transfers to chair, toilet and bath) and only for patients with complete paraplegia. Other MBI component tasks and patients with complete quadriplegia, incomplete paraplegia and incomplete quadriplegia demonstrated no relationship between age and skill performance. Results of this study support the practice of providing comprehensive rehabilitation services to all patients following spinal cord injury regardless of age. PMID:3335882

  13. Effects of main-sequence mass loss on the turnoff ages of population 1 clusters

    SciTech Connect

    Guzik, J.A.

    1989-01-01

    Willson, Bowen, and Struck-Marcell have proposed that stars of spectral types A through early-G lose a significant portion of their mass during the early main-sequence phase. The proposed mass loss is driven by pulsation, and facilitated by rapid rotation. One implication of this hypothesis is that the main-sequence turnoff is an invalid indicator of cluster age, as present turnoff stars may have had higher projenitor masses; hence clusters appear older than they actually are. This paper presents examples of cluster HR diagrams synthesized with mass-losing stars of solar metallicity, initial masses 1-2 M/sub /circ dot//, and exponentially-decreasing mass-loss rates with e-folding times 1-2 Gyr. The increases in apparent turnoff age of Pop. I clusters, and the potential of the hypothesis to account for blue stragglers as normal stars that have not lost mass (or lost mass more slowly) are discussed. 9 refs., 6 figs.

  14. 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.…

  15. 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…

  16. 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.

  17. The Stereotype-Matching Effect: Greater Influence on Functioning When Age Stereotypes Correspond to Outcomes

    PubMed Central

    Levy, Becca R.; Leifheit-Limson, Erica

    2009-01-01

    Older individuals assimilate, and are targeted by, contradictory positive and negative age stereotypes. It was unknown whether the influence of stereotype valence is stronger when the stereotype content corresponds to the outcome domain. We randomly assigned older individuals to either positive-cognitive, negative-cognitive, positive-physical, or negative-physical subliminal-age-stereotype groups and assessed cognitive and physical outcomes. As predicted, when the age stereotypes corresponded to the outcome domains, their valence had a significantly greater impact on cognitive and physical performance. This suggests that if a match occurs, it is more likely to generate expectations that become self-fulfilling prophecies. PMID:19290757

  18. Knowledge discovery in ophthalmology: analysis of wet form of age-related macular degeneration treatment outcomes

    NASA Astrophysics Data System (ADS)

    Ulińska, Magdalena; Tataj, Emanuel; Mulawka, Jan J.; Szaflik, Jerzy

    2009-06-01

    Age-related Macular Degeneration (AMD), according to epidemiological data, is a main reason of social blindness among elderly people in developed countries. There are two forms of AMD: dry and wet. The first one is of good prognosis with low possibility of serious visual deterioration, while the second one usually leads to quick and severe visual impairment. The aim of our investigations is to analyse results of so called real-life treatment of wet AMD. We analysed outcomes of our patients treated with intravitreal injections of anti-VEGF drugs: Lucentis (61 patients) and Avastin (78 patients). We analysed changes in visual acuity (functional effect) and central retinal thickness (anatomic effect). Both drugs occurred to be efficient in treatment of wet form of AMD, however results were more satisfying in patients with better baseline visual acuity. In our approach we used R environment - an integrated suite of software facilities for data analysis and graphics.

  19. Parents as Scholars: Education Works. Outcomes for Maine Families and Implications for TANF Reauthorization.

    ERIC Educational Resources Information Center

    Smith, Rebekah J.; Deprez, Luisa S.; Butler, Sandra S.

    Maine's Parents as Scholars (PaS) program provides parents who are eligible for Temporary Assistance for Needy Families (TANF) with cash assistance and support services while they attend a two-year or four-year postsecondary degree program. PaS participants receive the same cash benefits and access to support services as TANF recipients receive.…

  20. Diagnosis and treatment of tracheal basal cell carcinoma in a Maine coon and long-term outcome.

    PubMed

    Green, Michael L; Smith, Julie; Fineman, Linda; Proulx, David

    2012-01-01

    A 6 yr old castrated male Maine coon presented with a 2 wk history of progressive dyspnea. Thoracic radiographs revealed a 2 cm diameter intratracheal mass at the level of the fourth rib. The tracheal mass was marginally excised via a combination of resection and anastomosis. Infiltrative basal cell carcinoma (BCC) with nodular osseous metaplasia was diagnosed. The thoracic trachea was then irradiated postoperatively for definitive treatment. The cat remained asymptomatic following surgical excision and radiation therapy for 32 mo when this report was written. The purpose of this report is to describe the treatment and long-term outcome of a Maine coon diagnosed with, and treated for, tracheal BCC. PMID:22611213

  1. 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.

  2. 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

  3. 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. PMID:25170434

  4. 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…

  5. 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…

  6. 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

  7. 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

  8. 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

  9. Maine Department of Education Regulation 180: Early Intervention and Special Education for Children Age Birth to under Age Six.

    ERIC Educational Resources Information Center

    Maine State Dept. of Education, Augusta.

    This document contains regulations governing the administration of the Childfind system for children age birth to under age 6, the provision of early intervention services to eligible children birth through two with disabilities and their families, and the provision of special education and related services to eligible children age 3 to under 6…

  10. Neurological outcome in preterm small for gestational age infants compared to appropriate for gestational age preterm at the age of 18 months: a prospective study.

    PubMed

    Karagianni, Paraskevi; Kyriakidou, Maria; Mitsiakos, Georgios; Chatzioanidis, Helias; Koumbaras, Emmanouel; Evangeliou, Athanasios; Nikolaides, Nikolaos

    2010-02-01

    The aim of this study was to investigate the neurological outcome of premature small for gestational age infants at the corrected age of 18 months by the Hammersmith Infant Neurological Examination. A prospective trial was conducted comparing 41 preterm infants being small for gestational age with 41 appropriate for gestational age infants. Birth weight was significantly lower in small for gestational age infants compared with appropriate for gestational age infants (1724.6 +/- 433 versus 1221 +/- 328 g). There were no significant differences regarding the median gestational age and Apgar scores. Median global scores differ significantly between both groups: 75 (47-78) versus 76 (72-78) for the small for gestational age and appropriate for gestational age infants, respectively. Both groups had optimal scores. In conclusion, although the small for gestational age group scored lower in the Hammersmith Infant Neurological Examination, median global score in both groups was within optimal range. PMID:19372094

  11. 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

  12. 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.

  13. 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…

  14. Extended main sequence turn-offs in low mass intermediate-age clusters

    NASA Astrophysics Data System (ADS)

    Piatti, Andrés E.; Bastian, Nate

    2016-05-01

    We present an imaging analysis of four low mass stellar clusters (≲5000 M⊙) in the outer regions of the LMC in order to shed light on the extended main sequence turn-off (eMSTO) phenomenon observed in high mass clusters. The four clusters have ages between 1-2 Gyr and two of them appear to host eMTSOs. The discovery of eMSTOs in such low mass clusters - more than 5 times less massive than the eMSTO clusters previously studied - suggests that mass is not the controlling factor in whether clusters host eMSTOs. Additionally, the narrow extent of the eMSTO in the two older clusters (~2 Gyr) is in agreement with predictions of the stellar rotation scenario, as lower mass stars are expected to be magnetically braked, meaning that their colour magnitude diagrams should be better reproduced by canonical simple stellar populations. We also performed a structural analysis on all the clusters and found that a large core radius is not a requisite for a cluster to exhibit an eMSTO. Full Table 2, and Tables 3-5 are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/590/A50

  15. 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...

  16. The Dark Ages of Education and a New Hope: Teaching Native American History in Maine Schools

    ERIC Educational Resources Information Center

    Loring, Donna

    2009-01-01

    In 2001, the author wrote legislation that required all public schools in Maine to teach Maine Indian history. On June 14 of that year, Gov. Angus King signed "An Act to Require Maine Native American History and Culture in Maine's Schools" into law--the first of its kind in the U.S. What makes the law unique is its requirement that specific topics…

  17. 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

  18. 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

  19. 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

  20. 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

  1. Combined Effect of Fetal Sex and Advanced Maternal Age on Pregnancy Outcomes

    PubMed Central

    Weissmann-Brenner, Alina; Simchen, Michal J.; Zilberberg, Eran; Kalter, Anat; Dulitzky, Mordechai

    2015-01-01

    Background Fetal sex and maternal age are each known to affect outcomes of pregnancies. The objective of the present study was to investigate the influence of the combination of maternal age and fetal sex on pregnancy outcomes in term and post-term singleton pregnancies. Material/Methods This was a retrospective study on term singleton pregnancies delivered between 2004 and 2008 at the Chaim Sheba Medical Center. Data collected included maternal age, fetal sex, and maternal and neonatal complications. The combined effect of fetal sex and maternal age on complications of pregnancy was assessed by multivariable logistic regression models. Results The study population comprised 37,327 pregnancies. The risk of operative deliveries increased with maternal age ≥40 and in pregnancies with male fetuses. The risk of maternal diabetes and of longer hospitalization increased as maternal age increased, and in women <40 carrying male fetuses. The risk of hypertensive disorders increased in pregnancies with males as maternal age advanced. The risk of shoulder dystocia and neonatal respiratory complications increased in male neonates born to women<40. The risk of neonatal hypoglycemia increased in males for all maternal ages. Conclusions Risk assessment for fetal sex and advanced maternal age were given for different pregnancy complications. Knowledge of fetal sex adds value to the risk assessment of pregnancies as maternal age increases. PMID:25892459

  2. Pathological gambling and treatment outcomes for adults age 50 or older in methadone maintenance treatment.

    PubMed

    Engel, Rafael J; Rosen, Daniel

    2015-01-01

    This study examined the relationship of pathological gambling to negative treatment outcomes for methadone maintenance patients aged 50 or older. The study included 130 methadone maintenance patients. Pathological gambling was determined using the Lie-Bet, a screen for pathological gambling; the outcomes were remaining in treatment and negative urine screens for drug use. Twenty percent of the sample identified as pathological gamblers. Pathological gambling was unrelated to remaining in treatment or negative urine screens. Although pathological gambling had no adverse influence on these treatment outcomes, the prevalence of pathological gambling suggests that screening for it may provide insights about other concerns. PMID:25202832

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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. PMID:11194251

  8. Mucosal Immune Responses Predict Clinical Outcomes during Influenza Infection Independently of Age and Viral Load

    PubMed Central

    Oshansky, Christine M.; Gartland, Andrew J.; Wong, Sook-San; Jeevan, Trushar; Wang, David; Roddam, Philippa L.; Caniza, Miguela A.; Hertz, Tomer; DeVincenzo, John P.; Webby, Richard J.

    2014-01-01

    Rationale: Children are an at-risk population for developing complications following influenza infection, but immunologic correlates of disease severity are not understood. We hypothesized that innate cellular immune responses at the site of infection would correlate with disease outcome. Objectives: To test the immunologic basis of severe illness during natural influenza virus infection of children and adults at the site of infection. Methods: An observational cohort study with longitudinal sampling of peripheral and mucosal sites in 84 naturally influenza-infected individuals, including infants. Cellular responses, viral loads, and cytokines were quantified from nasal lavages and blood, and correlated to clinical severity. Measurements and Main Results: We show for the first time that although viral loads in children and adults were similar, innate responses in the airways were stronger in children and varied considerably between plasma and site of infection. Adjusting for age and viral load, an innate immune profile characterized by increased nasal lavage monocyte chemotactic protein-3, IFN-α2, and plasma IL-10 levels at enrollment predicted progression to severe disease. Increased plasma IL-10, monocyte chemotactic protein-3, and IL-6 levels predicted hospitalization. This inflammatory cytokine production correlated significantly with monocyte localization from the blood to the site of infection, with conventional monocytes positively correlating with inflammation. Increased frequencies of CD14lo monocytes were in the airways of participants with lower inflammatory cytokine levels. Conclusions: An innate profile was identified that correlated with disease progression independent of viral dynamics and age. The airways and blood displayed dramatically different immune profiles emphasizing the importance of cellular migration and localized immune phenotypes. PMID:24308446

  9. 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

  10. 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

  11. 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.

  12. 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…

  13. 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…

  14. 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…

  15. 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.

  16. Pregnancy and Birth Outcomes Among Primiparae at Very Advanced Maternal Age: At What Price?

    PubMed

    Ben-David, Alon; Glasser, Saralee; Schiff, Eyal; Zahav, Aliza Segev; Boyko, Valentina; Lerner-Geva, Liat

    2016-04-01

    Objectives In light of the potential physical and emotional costs to both woman and child, this study was conducted to assess pregnancy complications and birth outcomes in primiparae at very advanced maternal age (VAMA, aged ≥45) compared to younger primiparae. Methods Retrospective cohort study comparing 222 VAMA primiparae and a reference group of 222 primiparae aged 30-35, delivering at Sheba Medical Center from 2008 through 2013.Results VAMA primiparae were more likely than younger primiparae to be single, to have chronic health conditions, and higher rates of gestational diabetes mellitus (GDM), gestational-hypertension (GHTN) and preeclampsia-eclampsia. VAMA primiparae conceived mostly by oocyte donation. They were more likely to be hospitalized during pregnancy, to deliver preterm and by cesarean birth. Infants of VAMA primiparae were at greater risk for low birthweight and Neonatal Intensive Care Unit admission. There were no differences in outcomes between VAMA primiparae with or without preexisting chronic conditions, or between those aged 45-49 and ≥50. In multivariable analysis VAMA was an independent risk factor for GDM, GHTN and preeclamsia-eclampsia, with adjusted odds ratio of 2.38 (95 % CI 1.32, 4.29), 5.80 (95 % CI 2.66, 12.64) and 2.45 (95 % CI 1.03, 5.85); respectively. The effect of age disappeared in multiple pregnancies. Conclusions Primiparity at VAMA holds a significant risk for adverse pregnancy and birth outcomes. The absence of chronic medical conditions or the use of a young oocyte donor does not improve these outcomes. Multiple pregnancies hold additional risk and may diminish the effect of age. Primiparity at an earlier age should be encouraged. PMID:26686195

  17. 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...

  18. 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. PMID:24827025

  19. Heroin snorters versus injectors: comparison on drug use and treatment outcome in age-matched samples.

    PubMed

    Carpenter, M J; Chutuape, M A; Stitzer, M L

    1998-12-01

    Drug use histories and treatment outcomes were compared for age, race and gender-matched samples of intravenous (IV; n = 28) versus intranasal (IN; n = 28) opiate abusers entering a 3-day inpatient detoxification unit. Data were derived from the Addiction Severity Index (ASI) interview. Both groups reported daily heroin use prior to detoxification, but IV users reported more days of alcohol and multiple drug use during the past 30 days. Despite age matching, IV users also started using alcohol at an earlier age and accumulated more lifetime months of regular alcohol, cocaine and multidrug use. IV users were more likely to enter treatment following the detox, but no significant outcome differences were noted at 1 and 3 months post-detoxification. The results show that intravenous, as compared to intranasal, opiate users have both a more severe pattern and a more extensive history of the use of non-opiate drugs. PMID:10933336

  20. 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

  1. 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...

  2. 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.

  3. Prospects for detecting decreasing exoplanet frequency with main-sequence age using PLATO

    NASA Astrophysics Data System (ADS)

    Veras, Dimitri; Brown, David J. A.; Mustill, Alexander J.; Pollacco, Don

    2015-10-01

    The space mission PLATO will usher in a new era of exoplanetary science by expanding our current inventory of transiting systems and constraining host star ages, which are currently highly uncertain. This capability might allow PLATO to detect changes in planetary system architecture with time, particularly because planetary scattering due to Lagrange instability may be triggered long after the system was formed. Here, we utilize previously published instability time-scale prescriptions to determine PLATO's capability to detect a trend of decreasing planet frequency with age for systems with equal-mass planets. For two-planet systems, our results demonstrate that PLATO may detect a trend for planet masses which are at least as massive as super-Earths. For systems with three or more planets, we link their initial compactness to potentially detectable frequency trends in order to aid future investigations when these populations will be better characterized.

  4. Executive Function Mediates Effects of Gestational Age on Functional Outcomes and Behavior in Preschoolers

    PubMed Central

    Loe, Irene M.; Feldman, Heidi M.; Huffman, Lynne C.

    2014-01-01

    Objective To investigate the role of executive function (EF) skills, measured by parent-rating and performance-based instruments, as mediators of the effects of gestational age on functional outcomes and behavior symptoms in preterm and full term preschoolers. Patients and methods Children born preterm (n=70; mean gestational age 29.6 weeks and mean birth weight 1365g) were compared to children born full term (n=79) on composite measures of EF (using the Behavior Rating Inventory of Executive Function and a performance-based EF battery), adaptive function, prereading skills, and behavior symptoms. For the entire sample, mediation analyses examined the effect of gestational age on outcomes with EF as mediator. Results Compared to children born full term, children born preterm had significantly higher parent-rated EF scores and lower performance-based EF scores, both indicating more problems; further, children born preterm had lower adaptive function and prereading scores and more problematic behavior. Gestational age contributed to adaptive function, prereading skills, and behavior symptoms for all children. EF acted as a mediator of gestational age for all three outcomes; different patterns emerged for parent-rated and performance-based EF evaluations. For adaptive function, both EF measures significantly mediated effects of gestational age; for prereading skills, only performance-based EF was significant; for behavior symptoms, only parent-rated EF was significant. Conclusions We propose standard assessment of EF, using both parent-rating and performance-based EF measures, in young preterm children and other children at risk of EF impairments. EF skills are measurable, mediate important functional outcomes, and may serve as intervention targets. PMID:24906034

  5. 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

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

    PubMed

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

    2015-05-30

    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

  7. 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).

  8. 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.

  9. Younger gestational age is associated with worse neurodevelopmental outcomes after cardiac surgery in infancy

    PubMed Central

    Goff, Donna A.; Luan, Xianqun; Gerdes, Marsha; Bernbaum, Judy; D’Agostino, Jo Ann; Rychik, Jack; Wernovsky, Gil; Licht, Daniel J.; Nicolson, Susan C.; Clancy, Robert R.; Spray, Thomas L.; Gaynor, J. William

    2013-01-01

    Objective Evaluate the impact of near-term delivery on neurodevelopmental (ND) outcomes in children with congenital heart disease (CHD). Methods Secondary analysis of data from a study of genetic polymorphisms and ND outcomes after cardiac surgery in infants. The effect of gestational age (GA) as a continuous variable on ND outcomes was evaluated using general linear regression models. GA was also evaluated as a categorical variable to seek a threshold for better outcomes. ND domains tested at 4 years of age included cognition, language skills, attention, impulsivity, memory, executive function, social competence, visual-motor, and fine-motor skills. Results ND outcomes and GA were available for 378 infants. Median GA was 39 weeks (range, 28–42 weeks) with 351 born at 36 weeks or more (near-term/term). In univariate analysis of the near-term/term subgroup, older GA predicted better performance for cognition, visual-motor, and fine-motor skills. After covariate adjustment, older GA predicted better performance for fine-motor skills (P = .018). Performance for cognition, language, executive function, social skills, visual-motor, and fine-motor skills was better for those born at 39 to 40 weeks of GA or more versus those born at less than 39 weeks (all P<.05). Conclusions These findings are consistent with the hypothesis that delivery before 39 to 40 weeks of GA is associated with worse outcomes in patients with CHD. Early delivery of a child with CHD is often indicated because of maternal or fetal health issues. In the absence of these concerns, these data suggest that elective (or spontaneous) delivery at 39 to 40 weeks of GA is associated with better ND outcomes. PMID:22340027

  10. 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

  11. 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

  12. 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…

  13. 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.

  14. 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

  15. 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…

  16. Lupus anticoagulant is the main predictor of adverse pregnancy outcomes in aPL-positive patients: validation of PROMISSE study results

    PubMed Central

    Yelnik, Cecile M; Laskin, Carl A; Porter, T Flint; Branch, D Ware; Buyon, Jill P; Guerra, Marta M; Lockshin, Michael D; Petri, Michelle; Merrill, Joan T; Sammaritano, Lisa R; Kim, Mimi Y; Salmon, Jane E

    2016-01-01

    Objective We previously reported that lupus anticoagulant (LAC) is the main predictor of poor pregnancy outcome in antiphospholipid antibody (aPL)-positive patients. We sought to confirm this finding in an independent group of patients who were subsequently recruited into the PROMISSE study. Methods The PROMISSE study is a multicentre, prospective, observational study of pregnancy outcomes in women with aPL and/or systemic lupus erythematosus (SLE) that enrolled patients from 2003 to 2015. All consecutive, aPL-positive patients from the PROMISSE study who completed their pregnancy between April 2011 and January 2015 (after the previous PROMISSE report) are included in the current report. Patients were followed monthly until delivery, and aPL was tested at first, second and third trimesters of pregnancy and at 12 weeks post partum. Adverse pregnancy outcomes (APOs) were defined as fetal death after 12 weeks of gestation, neonatal death, delivery prior to 36 weeks of gestation due to pre-eclampsia or placental insufficiency or small-for-gestational age (birth weight <5th percentile). Results Forty-four aPL-positive patients are included in this paper. Thirteen patients had APOs, which occurred in 80% of cases during the second trimester of pregnancy. LAC was present in 69% of patients with APOs compared with 27% of patients without APOs (p=0.01). No association was found between anticardiolipin antibodies (aCL) or anti-β2 glycoprotein I antibodies (aβ2GPI) IgG or IgM positivity and APOs. Definite antiphospholipid syndrome (history of thrombosis and/or pregnancy morbidity and aPL) was found in 92% of patients with any APOs compared with 45% of patients without APOs (p=0.004). Conversely, the frequency of SLE was not statistically different between those with and without APOs (30% vs 39%). Conclusions Our findings, in an independent group of aPL-positive patients from the PROMISSE study, confirm that LAC, but not aCL and aβ2GPI, is predictive of poor pregnancy

  17. Functional Outcomes by Age for Inpatient Cancer Rehabilitation: A Retrospective Chart Review

    PubMed Central

    Hunter, Elizabeth G.; Baltisberger, Julie

    2013-01-01

    Cancer-related impairments result in disabilities similar to those typically encountered in inpatient rehabilitation settings; however, the use of rehabilitation services by cancer survivors is low. This is particularly important for older adults as they are at higher risk for cancer. This retrospective study collected data from medical records from 215 charts of patients admitted to an inpatient physical rehabilitation hospital, within a 5-year period, with a primary diagnosis of cancer. Mean age was 61 years (SD = 15.7) for 109 (51%) females and 106 (49%) males. Regardless of age, patients achieved significant functional improvement, as shown by their FIM scores (t = 23.06, p < .0001), from admission to discharge. The results have several important implications related to cancer survivorship among older adults. With a push toward aging in place, maintaining optimal physical functioning is crucial. Physical rehabilitation benefited the functional outcomes of this group of cancer survivors regardless of age. PMID:23908563

  18. Association between maternal age and pregnancy outcome: implications for the Pakistani society.

    PubMed

    Hanif, Hafsa Muhammad

    2011-03-01

    Maternal age at conception has long been demonstrated to have a significant correlation with pregnancy outcome and maternal health. Classically, very young (<20 years old) and old (= or >35 years) women have been classified as high-risk categories for child bearing. Recently, career, education, financial, and other goals have coerced women to delay childbearing all over the world. This trend is also becoming apparent in Pakistan, especially in the upper middle class, wealthy and educated women, as they become increasingly empowered. This review presents the association between maternal age and pregnancy outcome, particularly in the context of statistics of Pakistan, and its possible repercussions. On one hand, physicians need to develop effective counseling strategies for their patients in this regard, and on the other, more studies are required to ascertain the attitudes of Pakistani women, particularly those belonging to the upper and middle classes, regarding delayed childbearing, that can aid physicians in formulating effective counseling strategies. PMID:21465960

  19. 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

  20. 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

  1. 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. PMID:26451968

  2. Pre-School Quality and Educational Outcomes at Age 11: Low Quality Has Little Benefit

    ERIC Educational Resources Information Center

    Sylva, Kathy; Melhuish, Edward; Sammons, Pam; Siraj-Blatchford, Iram; Taggart, Brenda

    2011-01-01

    This article reports the effects of pre-school quality on children's cognitive and behavioural outcomes at age 11 using a large-scale longitudinal study of 3000+ children in England (EPPE/EPPSE). The ECERS-R and a curricular extension to it (ECERS-E) were used to assess the quality of provision in 141 pre-school settings attended by the children.…

  3. Bright Start: Description and main outcomes from a group-randomized obesity prevention trial in American Indian children

    PubMed Central

    Story, Mary; Hannan, Peter J; Fulkerson, Jayne A.; Rock, Bonnie Holy; Smyth, Mary; Arcan, Chrisa; Himes, John H.

    2012-01-01

    The aim of the Bright Start study was to develop and test the effectiveness of a school environment intervention, supplemented with family involvement, to reduce excessive weight gain by increasing physical activity and healthy eating practices among kindergarten and first grade American Indian children. Bright Start was a group-randomized, school-based trial involving 454 children attending 14 schools on the Pine Ridge Reservation in South Dakota. Children were followed from the beginning of their kindergarten year through the end of first grade. Main outcome variables were mean BMI, mean percent body fat, and prevalence of overweight/obese children. The goals of the intervention were to: increase physical activity at school to at least 60 min/day; modify school meals and snacks; and involve families in making behavioral and environmental changes at home. At baseline, 32% of boys and 25% of girls were overweight/obese. While the intervention was not associated with statistically significant change in mean levels of BMI, BMI-Z, skinfolds or percentage body fat, the intervention was associated with a statistically significant net decrease of 10% in the prevalence of overweight. Intervention children experienced a 13.4% incidence of overweight, while the control children experienced a corresponding incidence of 24.8%; a difference of −11.4% (p=0.033). The intervention significantly reduced parent reported mean child intakes of sugar-sweetened beverages, whole milk and chocolate milk. Changes in duration of school physical activity were not significant. Because obesity is the most daunting health challenge facing American Indian children today, more intervention research is needed to identify effective approaches. PMID:22513491

  4. 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.

  5. 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. PMID:26803373

  6. 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

  7. Perinatal Factors Associated with Poor Neurocognitive Outcome in Early School Age Congenital Diaphragmatic Hernia Survivors

    PubMed Central

    Benjamin, Jennifer R.; Gustafson, Kathryn E.; Smith, P. Brian; Ellingsen, Kirsten M.; Tompkins, K. Brooke; Goldberg, Ronald N.; Cotten, C. Michael; Goldstein, Ricki F.

    2013-01-01

    Objective Determine predictors of neurocognitive outcome in early school age congenital diaphragmatic hernia (CDH) survivors. Study design Prospective study of infants with CDH at Duke University Medical Center. Neurocognitive delay (NCD) at school age (4 to 7 years) was defined as a score < 80 in any of the following areas: Verbal Scale IQ, Performance Scale IQ, Expressive Language, or Receptive Language. Logistic regression, Fisher’s exact, and the Wilcoxon rank sum test were used to examine the relationship between NCD at early school age and 6 demographic and 18 medical variables. Results Of 43 infants with CDH, twenty seven (63%) survived to hospital discharge, and 16 (59%) returned for school age testing at a median age of 4.9 years. Seven (44%) of the children evaluated had NCD. Patch repair (p=0.01), extracorporeal membrane oxygenation (ECMO; p=0.02), days on ECMO (p=0.01), days of mechanical ventilation (p=0.049), and post-operative use of inhaled nitric oxide (p=0.02) were found to be associated with NCD at early school age. Conclusions CDH survivors are at risk for neurocognitive delay persisting into school age. Perinatal factors such as patch repair and ECMO treatment may aid in identifying CDH survivors at high risk for continued learning difficulties throughout childhood. PMID:23583126

  8. 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

  9. Trends in Outcomes for Out-of-Hospital Cardiac Arrest by Age in Japan: An Observational Study.

    PubMed

    Fukuda, Tatsuma; Ohashi-Fukuda, Naoko; Matsubara, Takehiro; Doi, Kent; Kitsuta, Yoichi; Nakajima, Susumu; Yahagi, Naoki

    2015-12-01

    Population aging has rapidly advanced throughout the world and the elderly accounting for out-of-hospital cardiac arrest (OHCA) has increased yearly.We identified all adults who experienced an out-of-hospital cardiac arrest in the All-Japan Utstein Registry of the Fire and Disaster Management Agency, a prospective, population-based clinical registry, between 2005 and 2010. Using multivariable regression, we examined temporal trends in outcomes for OHCA patients by age, as well as the influence of advanced age on outcomes. The primary outcome was a favorable neurological outcome at 1 month after OHCA.Among 605,505 patients, 454,755 (75.1%) were the elderly (≥65 years), and 154,785 (25.6%) were the oldest old (≥85 years). Although neurological outcomes were worse as the age group was older (P < 0.0001 for trend), there was a significant trend toward improved neurological outcomes during the study period by any age group (P < 0.005 for trend). After adjustment for temporal trends in various confounding variables, neurological outcomes improved yearly in all age groups (18-64 years: adjusted OR per year 1.15 [95% CI 1.13-1.18]; 65-84 years: adjusted OR per year 1.12 [95% CI 1.10-1.15]; and ≥85 years: adjusted OR per year 1.08 [95% CI 1.04-1.13]). Similar trends were found in the secondary outcomes.Although neurological outcomes from OHCA ware worse as the age group was older, the rates of favorable neurological outcomes have substantially improved since 2005 even in the elderly, including the oldest old. Careful consideration may be necessary in limiting treatment on OHCA solely for the reason of advanced age. PMID:26656330

  10. 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

  11. Do infant vocabulary skills predict school-age language and literacy outcomes?

    PubMed Central

    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 reading. However, evidence to date suggests predictive ability from infant vocabulary to later language and literacy is low. This study provides an investigation into, and interpretation of, the magnitude of such infant to school-age relationships. Methods Three hundred British infants whose vocabularies were assessed by parent report in the 2nd year of life (between 16 and 24 months) were followed up on average 5 years later (ages ranged from 4 to 9 years), when their vocabulary, phonological and reading skills were measured. Results Structural equation modelling of age-regressed scores was used to assess the strength of longitudinal relationships. Infant vocabulary (a latent factor of receptive and expressive vocabulary) was a statistically significant predictor of later vocabulary, phonological awareness, reading accuracy and reading comprehension (accounting for between 4% and 18% of variance). Family risk for language or literacy difficulties explained additional variance in reading (approximately 10%) but not language outcomes. Conclusions Significant longitudinal relationships between preliteracy vocabulary knowledge and subsequent reading support the theory that vocabulary is a cognitive foundation of both reading accuracy and reading comprehension. Importantly however, the stability of vocabulary skills from infancy to later childhood is too low to be sufficiently predictive of language outcomes at an individual level – a finding that fits well with the observation that the majority of ‘late talkers’ resolve their early language difficulties. For reading outcomes, prediction of future difficulties is likely to

  12. 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

  13. 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

  14. 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

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

    PubMed

    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

  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. PMID:26170291

  20. 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

  1. 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

  2. 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

  3. No Association Between Apoε4 Alleles, HIV Infection, Age, Neuropsychological Outcome or Death

    PubMed Central

    Becker, James T.; Martinson, Jeremy J.; Penugonda, Sudhir; Kingsley, Lawrence; Molsberry, Samantha; Wolinsky, Steven; Reynolds, Sandra; Aronow, Aaron; Goodkin, Karl; Levine, Andrew; Martin, Eileen; Miller, Eric N.; Munro, Cynthia A.; Ragin, Ann; Sacktor, Ned

    2014-01-01

    The ε4 allele of the ApoE gene may have important interactions with physical health and cognitive function among individuals with HIV disease. The purpose of this study is to examine the relationships between ε4, HIV disease, age, neuropsychological impairment and death in a large, well-characterized study sample. 2,846 men participating in the Multicenter AIDS Cohort Study had ApoE genotyping and neuropsychological test data available for analysis. We found a significant association between HIV infection and time to death (from any cause), as well as older age, race, and education. But, ApoE status was not significantly associated with time to death. Similarly, we found a significant association between HIV infection and time to incident cognitive impairment, as well as age, education, and HIV serostatus; Apoε4 status was not related to incident cognitive impairment. There were no significant interactions between ApoE, HIV infection, and age on cognitive impairment. These data replicate and strengthen prior findings of the lack of association between ApoE ε4 and cognitive outcomes in HIV disease. We conclude that within the specific constraints of an exclusively male study in which the majority of participants were less than 65 years of age (range: 22-87 years), it appears reasonable to conclude that the ε4 allele is not significantly interacting with HIV serostatus. PMID:25388225

  4. No association between Apoε4 alleles, HIV infection, age, neuropsychological outcome, or death.

    PubMed

    Becker, James T; Martinson, Jeremy J; Penugonda, Sudhir; Kingsley, Lawrence; Molsberry, Samantha; Reynolds, Sandra; Aronow, Aaron; Goodkin, Karl; Levine, Andrew; Martin, Eileen; Miller, Eric N; Munro, Cynthia A; Ragin, Ann; Sacktor, Ned

    2015-02-01

    The ε4 allele of the apolipoprotein E (ApoE) gene may have important interactions with physical health and cognitive function among individuals with HIV disease. The purpose of this study is to examine the relationships between ε4, HIV disease, age, neuropsychological impairment, and death in a large, well-characterized study sample. A total of 2846 men participating in the Multicenter AIDS Cohort Study had ApoE genotyping and neuropsychological test data available for analysis. We found a significant association between HIV infection and time to death (from any cause), as well as older age, race, and education. But, ApoE status was not significantly associated with time to death. Similarly, we found a significant association between HIV infection and time to incident cognitive impairment, as well as age, education, and HIV serostatus; Apoε4 status was not related to incident cognitive impairment. There were no significant interactions between ApoE, HIV infection, and age on cognitive impairment. These data replicate and strengthen prior findings of the lack of association between ApoE ε4 and cognitive outcomes in HIV disease. We conclude that within the specific constraints of an exclusively male study in which the majority of participants were less than 65 years of age (range 22-87 years), it appears reasonable to conclude that the ε4 allele is not significantly interacting with HIV serostatus. PMID:25388225

  5. The Effects of Technological Advances on Outcomes for Elderly Persons with Exudative Age-Related Macular Degeneration

    PubMed Central

    Sloan, Frank A.; Hanrahan, Brian W.

    2014-01-01

    Importance Exudative age-related macular degeneration (AMD) is the major cause of blindness among U.S. elderly. Developing effective therapies for this disease has been difficult. Objective This study assessed the impacts of introducing new therapies for treating exudative AMD on vision of the affected population and other outcomes among newly diagnosed Medicare beneficiaries. Design The study used data from a 5% sample of Medicare claims and enrollment data with a combination of a regression continuity design and propensity score matching (PSM) to assess the impacts on introduction/receipt of new technologies on study outcomes during a two-year follow-up period. Setting The analysis was based on longitudinal data for the U.S., 1994–2011, for Medicare beneficiaries with fee-for-service coverage. Participants The sample was limited to beneficiaries aged 68+ newly diagnosed with exudative AMD as indicated by beneficiaries having no claims with this diagnosis in a three-year look-back period. Exposures The comparisons with vision outcomes were after versus before introduction of photodynamic therapy (PDT) and anti-VEGF therapy. The comparisons for depression and long-term care facility admission were between beneficiaries newly diagnosed with exudative AMD who received PDT or anti-VEGF therapy compared to beneficiaries with the diagnosis receiving no therapy for this disease. Main Outcome and Measure Onset of decrease in vision, vision loss or blindness, depression, and admission to long term care facilities. Results Introduction of anti-VEGF therapy reduced vision loss and onset of severe vision loss and blindness of beneficiaries newly diagnosed with exudative AMD by 43% [0.50 0.66] on average. Such beneficiaries who received anti-VEGF therapy and were not admitted to a long-term care facility during the look-back period were 19% less likely on average to be admitted to a long-term care facility during follow-up. Conclusions and Relevance This study demonstrates

  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

    2016-07-01

    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

  7. 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.

  8. 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. PMID:25250886

  9. 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…

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

    PubMed Central

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

    2016-01-01

    Abstract 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 ± 261cells/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

  11. Predictors of visual and anatomical outcomes for neovascular age-related macular degeneration treated with bevacizumab

    PubMed Central

    MA, CHAORAN; BAI, LIANG; LEI, CHUNLING; WU, CHANGRUI; SHI, QIANG; HU, FENG; HAO, ZHENXUAN; MA, LE

    2015-01-01

    The present study aimed to evaluate the predictive factors for visual and anatomical outcomes in neovascular age-related macular degeneration (AMD) patients treated with intravitreal bevacizumab (IVB). A total of 113 patients with neovascular AMD received IVB treatment. The best corrected visual acuity (BCVA), central retinal thickness (CRT) and total macular volume (TMV) were assessed before the injection, and at 1, 2, 3 and 9 months after surgery. Changes in BCVA and these optical coherence tomography (OCT) outcomes from baseline were compared, and independent predictors were evaluated by logistic regression models. During the treatment, logarithm of the minimum angle of resolution (logMAR) significantly decreased from 1.12 to 0.83, and reductions in OCT parameters were earlier and larger. Baseline BCVA was associated with the changes in BCVA and CRT, whereas baseline OCT features significantly affected their own changes. Larger baseline logMAR and OCT features were more likely to experience a greater proportion of ≥50 µm reduction in CRT (P<0.05). The BCVA decreases were positively associated with the reductions in CRT (r=0.34, P<0.01) and TMV (r=0.41, P<0.01). Among patients with neovascular AMD, IVB resulted in earlier significant decreases in TMV and CRT, suggesting that these OCT anatomical outcomes may be considered as more sensitive responders to evaluate the treatment effects of bevacizumab. PMID:26171156

  12. 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. PMID:25749486

  13. 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

  14. Radiocarbon evidence for decomposition of aged organic matter in the vadose zone as the main source of speleothem carbon

    NASA Astrophysics Data System (ADS)

    Noronha, Alexandra L.; Johnson, Kathleen R.; Southon, John R.; Hu, Chaoyong; Ruan, Jiaoyang; McCabe-Glynn, Staryl

    2015-11-01

    Several recent studies have used records of the radiocarbon (14C) bomb peak in speleothems to inversely model the soil a14CO2 and the age distribution of soil organic material (SOM) above caves, in part to investigate the potential of speleothems as sensitive records of past SOM dynamics. The results of these modeling studies have suggested that soil CO2 at karst sites is derived primarily from the decomposition of SOM with turnover times on the order of decades to centuries. This result is in stark contrast with observations of soil a14CO2 at non-karst sites, which indicate that soil CO2 is derived primarily from root respiration and decomposition of SOM with much shorter turnover times. This discrepancy suggests that SOM in karst settings may have a very different age distribution than sites that have been studied previously and/or that soil CO2 is not the main source of speleothem carbon. To help resolve this discrepancy, we present an improved inverse model which we use to estimate the age of CO2 above several caves. We also present results from a detailed case study of soil carbon dynamics at Heshang Cave, China. This work demonstrates that SOM in karst sites may be much older than SOM in non-karst soils that have been studied previously, but that CO2 produced in the shallow soil zone is unlikely to be the main source of speleothem carbon. A review of the literature suggests that the most likely explanation for the aforementioned discrepancy is that decomposition of down-washed SOM in the vadose zone is the dominant source of speleothem carbon.

  15. 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

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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…

  3. 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…

  4. 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.

  5. 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.

  6. Adiabatic Mass Loss in Binary Stars. II. From Zero-age Main Sequence to the Base of the Giant Branch

    NASA Astrophysics Data System (ADS)

    Ge, Hongwei; Webbink, Ronald F.; Chen, Xuefei; Han, Zhanwen

    2015-10-01

    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⊙-100 M⊙ 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 qad (throughout this paper, we follow the convention of defining the binary mass ratio as q ≡ Mdonor/Maccretor) 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, qad 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 qad declining with decreasing mass, and asymptotically approaching qad = 2/3, appropriate to a classical isentropic n = 3/2 polytrope. Our calculated qad values agree well with the behavior of time-dependent models by Chen & Han of intermediate-mass stars initiating mass transfer in the Hertzsprung gap. Application of our results to cataclysmic variables, as systems that must be stable against rapid mass transfer, nicely

  7. Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable

    PubMed Central

    Julious, Steven A; Cooper, Cindy L; Campbell, Michael J

    2015-01-01

    Sample size justification is an important consideration when planning a clinical trial, not only for the main trial but also for any preliminary pilot trial. When the outcome is a continuous variable, the sample size calculation requires an accurate estimate of the standard deviation of the outcome measure. A pilot trial can be used to get an estimate of the standard deviation, which could then be used to anticipate what may be observed in the main trial. However, an important consideration is that pilot trials often estimate the standard deviation parameter imprecisely. This paper looks at how we can choose an external pilot trial sample size in order to minimise the sample size of the overall clinical trial programme, that is, the pilot and the main trial together. We produce a method of calculating the optimal solution to the required pilot trial sample size when the standardised effect size for the main trial is known. However, as it may not be possible to know the standardised effect size to be used prior to the pilot trial, approximate rules are also presented. For a main trial designed with 90% power and two-sided 5% significance, we recommend pilot trial sample sizes per treatment arm of 75, 25, 15 and 10 for standardised effect sizes that are extra small (≤0.1), small (0.2), medium (0.5) or large (0.8), respectively. PMID:26092476

  8. Developmental Outcomes of School-Age Children with Duarte Galactosemia: A Pilot Study.

    PubMed

    Lynch, Mary Ellen; Potter, Nancy L; Coles, Claire D; Fridovich-Keil, Judith L

    2015-01-01

    Duarte galactosemia (DG) is a mild allelic variant of classic galactosemia that results from partial impairment of galactose-1P uridylyltransferase (GALT). Although infants with DG are detected by newborn screening in some US states at close to 1/4,000 live births, most are discharged from follow-up very early in life and there is no consensus on whether these children are at increased risk for any of the long-term developmental delays seen in classic galactosemia. There is also no consensus on whether infants with DG benefit from dietary restriction of galactose. Reflecting the current uncertainty, some states choose to identify infants with DG by newborn screening and others do not. As a first step toward characterizing the developmental outcomes of school-age children with DG, we conducted a pilot study, testing 10 children with DG and 5 unaffected siblings from the same group of families. All children tested were between 6 and 11 years old. We used standardized direct assessments and parent-response surveys to collect information regarding cognition, communication, socio-emotional, adaptive behavior, and physical development for each child. Despite the small sample size, our data demonstrated some notable differences between cases and controls in socio-emotional development, in delayed recall, and in auditory processing speed. These results confirm that direct assessment of school-age children with DG can detect subtle but potentially problematic developmental deficits, and underscore the need for a larger study which has sufficient power to evaluate these outcomes while controlling for potentially confounding factors. PMID:25681083

  9. 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

  10. 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

  11. Neuropsychological, Behavioral, and Academic Sequelae of Cleft: Early Developmental, School Age, and Adolescent/Young Adult Outcomes

    PubMed Central

    Richman, Lynn C; McCoy, Thomasin E; Conrad, Amy L; Nopoulos, Peg C

    2012-01-01

    This article reviews behavioral, neuropsychological, and academic outcomes of individuals with cleft across three age levels: 1) infancy/early development, 2) school age, and 3) adolescence/young adulthood. The review points out that attachment, neurocognitive functioning, academic performance/learning, and adjustment outcomes are the result of a complex interaction between biological and environmental factors and vary with developmental level, sex, and craniofacial anomaly diagnosis. The degree to which associated genetic or neurodevelopmental conditions may explain inconsistent findings is unknown and suggests the need for caution in generalizing from group data on cleft. PMID:21905907

  12. 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

  13. 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

  14. 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

  15. Impact of donor age on outcome after allogeneic hematopoietic cell transplantation.

    PubMed

    Rezvani, Andrew R; Storer, Barry E; Guthrie, Katherine A; Schoch, H Gary; Maloney, David G; Sandmaier, Brenda M; Storb, Rainer

    2015-01-01

    As older patients are eligible for allogeneic hematopoietic cell transplantation (HCT), older siblings are increasingly proposed as donors. We studied the impact of donor age on the tempo of hematopoietic engraftment and donor chimerism, acute and chronic graft-versus-host disease (GVHD), and nonrelapse mortality (NRM) among 1174 consecutive patients undergoing myeloablative and 367 patients undergoing nonmyeloablative HCT from HLA-matched related or unrelated donors with granulocyte colony-stimulating factor-mobilized peripheral blood mononuclear cell allografts. Sustained engraftment rates were 97% and 98% in patients undergoing myeloablative and nonmyeloablative conditioning, respectively, for grafts from donors < 60 years old (younger; n = 1416) and 98% and 100%, respectively, for those from donors ≥ 60 years old (older; n = 125). No significant differences were seen in the tempo of neutrophil and platelet recoveries and donor chimerism except for an average 1.3-day delay in neutrophil recovery among myeloablative patients with older donors (P = .04). CD34(+) cell dose had an independent effect on the tempo of engraftment. Aged stem cells did not convey an increased risk of donor-derived clonal disorders after HCT. Myeloablative and nonmyeloablative recipients with older sibling donors had significantly less grade II to IV acute GVHD than recipients with grafts from younger unrelated donors. Rates of grade III and IV acute GVHD, chronic GVHD, and NRM for recipients with older donors were not significantly different from recipients with younger donors. In conclusion, grafts from donors ≥ 60 years old do not adversely affect outcomes of allogeneic HCT compared with grafts from younger donors. PMID:25278458

  16. 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

  17. Duration of periventricular densities in preterm infants and neurological outcome at 6 years of age.

    PubMed Central

    Jongmans, M; Henderson, S; de Vries, L; Dubowitz, L

    1993-01-01

    Parenchymal echogenicities that break down into extensive cystic lesions are generally followed by severe motor deficit. However, the effect of echodensities in the periventricular white matter, so called 'flares', on later development is less well documented. The aim of the present study was to investigate the impact of neonatal flares in preterm infants on neurological status and motor competence at 6 years of age and to see to what extent outcome was related to duration of flares. Forty four children with flares, subdivided into three groups according to the duration of flares, and 62 children with normal scans were assessed on Touwen's neurological examination, the Movement ABC, and the British Ability Scales. No differences in cognitive abilities were found between the groups. The results of the motor assessments showed that performance decreased significantly with increasing duration of flares. In addition, there was a suggestion that this trend was stronger in measures assessing lower limb function than those of upper limb. Teachers were also able to identify differences between the groups of children on the basis of their motor performance in school. PMID:8346967

  18. 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. PMID:24077437

  19. Dietary patterns and relationship to obesity-related health outcomes and mortality in adults 75 years of age or greater

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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-relat...

  20. 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…

  1. 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…

  2. Intensity of Supervision and Outcome for Preschool Aged Children Receiving Early and Intensive Behavioral Interventions: A Preliminary Study

    ERIC Educational Resources Information Center

    Eikeseth, Svein; Hayward, Diane; Gale, Catherine; Gitlesen, Jens-Petter; Eldevik, Sigmund

    2009-01-01

    We asked whether intensity of supervision is associated with outcome in preschool aged children with autism (N = 20) who received intensive and early behavioral intervention. Intensity of supervision ranged from 2.9 to 7.8 h per month per child. A significant correlation was found between intensity of supervision and improvement scores in IQ.…

  3. Non-Resident Fathers' Relationships with Their Secondary School Age Children: Determinants and Children's Mental Health Outcomes

    ERIC Educational Resources Information Center

    Flouri, Eirini

    2006-01-01

    Data from 520 British secondary school age children were used to explore determinants of and mental health outcomes (measured with the Strengths and Difficulties Questionnaire) from their non-resident fathers' relationships (child-reported father's involvement and frequency of contact) with them. Frequency of contact was negatively related to time…

  4. 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…

  5. Does Age of Onset of Risk Behaviors Mediate the Relationship between Child Abuse and Neglect and Outcomes in Middle Adulthood?

    PubMed Central

    Horan, Jacqueline M.; Widom, Cathy Spatz

    2014-01-01

    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. PMID:25104419

  6. Epstein-Barr virus positive diffuse large B-cell lymphoma predict poor outcome, regardless of the age.

    PubMed

    Lu, Ting-Xun; Liang, Jin-Hua; Miao, Yi; Fan, Lei; Wang, Li; Qu, Xiao-Yan; Cao, Lei; Gong, Qi-Xing; Wang, Zhen; Zhang, Zhi-Hong; Xu, Wei; Li, Jian-Yong

    2015-01-01

    Epstein-Barr virus (EBV) positive diffuse large B-cell lymphoma (DLBCL) of the elderly is defined as patients older than 50 years alone. However, recent studies showed young patients with sound immune status could also be affected. In this study, we investigated the clinical features and outcomes of patients with EBV positive DLBCL in the different age groups using different EBER cut-off values. The prevalence of EBV positive DLBCL was 14.0% (35/250) and 10.4% (26/250) for EBER cut-off of 20% and 50%, respectively. With both EBER cut-off values, patients with EBV DLBCL shared many unfavorable prognostic characteristics, regardless of age. EBV positive patients, both in the elderly and young groups, showed significantly worse overall survival and progression-free survival than negative cases. Moreover, no significant differences of outcomes were identified between different age groups with EBV positive DLBCL. In conclusion, EBV positive DLBCL patients, regardless of age, shared similar poor prognostic features and showed worse outcome than negative cases. We suggest that the age criterion of EBV positive DLBCL of the elderly, and possibly the name itself, be modified in future. PMID:26202875

  7. Predicting language and social outcomes at age 5 for later-born siblings of children with autism spectrum disorders.

    PubMed

    Malesa, Elizabeth; Foss-Feig, Jennifer; Yoder, Paul; Warren, Zachary; Walden, Tedra; Stone, Wendy L

    2013-09-01

    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 attention (at a mean age of 15 months) as well as growth in levels of joint attention (between 15 months and 34 months) were used as potential predictors of outcomes at age 5. The results revealed that initial levels of initiating joint attention (IJA) were associated with language skills at outcome. In addition, growth of responding to joint attention (RJA) was associated with social skills at age 5. These patterns of associations were not significantly different between the Sibs-TD and Sibs-ASD groups. Although the Sibs-ASD group had lower joint attention scores than the Sibs-TD group at younger ages, significant group differences were not found for most measures at age 5. PMID:22751752

  8. Need for Supplemental Oxygen at Discharge in Infants with Bronchopulmonary Dysplasia Is Not Associated with Worse Neurodevelopmental Outcomes at 3 Years Corrected Age

    PubMed Central

    Lodha, Abhay; Sauvé, Reg; Bhandari, Vineet; Tang, Selphee; Christianson, Heather; Bhandari, Anita; Amin, Harish; Singhal, Nalini

    2014-01-01

    Objectives To determine if chronic oxygen dependency (discharge home on supplemental oxygen) in children with bronchopulmonary dysplasia (BPD; defined as requirement for supplemental O2 at 36 weeks postmenstrual age) predicts neurodevelopmental disability rates and growth outcomes at 36 months corrected age (CA). Study Design Longitudinal cohort study. Setting Southern Alberta regional center located at high altitude. Participants Preterm infants weighing ≤1250 grams with no BPD, BPD, and BPD with chronic oxygen dependency. Main outcome measures Neurodevelopmental and growth outcomes. Results Of 1563 preterm infants admitted from 1995–2007, 1212 survived. Complete follow-up data were available for 1030 (85%) children. Children in BPD and BPD with chronic oxygen dependency groups had significantly lower birth weights, gestational ages, prolonged mechanical ventilation and oxygen supplementation and received more postnatal steroids, compared to those without BPD. Children with BPD and BPD with chronic oxygen dependency were more likely to be below the 5th centile in weight and height compared to those without BPD but there was little difference between the BPD and BPD with chronic oxygen dependency groups. After controlling for confounding variables, children who had BPD and BPD with chronic oxygen dependency had higher odds of neurodevelopmental disability compared to those without BPD [OR (odds ratio) 1.9 (95%CI 1.1 to 3.5) and OR 1.8 (1.1 to 2.9), respectively], with no significant difference between BPD and BPD with chronic oxygen dependency [OR 0.9 (95% CI 0.6 to 1.5)]. Conclusions BPD and BPD with chronic oxygen dependency in children predicts abnormal neurodevelopmental outcomes at 36 months CA. However, the neurodevelopmental disability rates were not significantly higher in BPD with chronic oxygen dependency children compared to children with BPD only. Compared to those without BPD, growth is impaired in children with BPD and BPD with chronic oxygen

  9. Conflict-Specific Aging Effects Mainly Manifest in Early Information Processing Stages—An ERP Study with Different Conflict Types

    PubMed Central

    Korsch, Margarethe; Frühholz, Sascha; Herrmann, Manfred

    2016-01-01

    Aging is usually accompanied by alterations of cognitive control functions such as conflict processing. Recent research suggests that aging effects on cognitive control seem to vary with degree and source of conflict, and conflict specific aging effects on performance measures as well as neural activation patterns have been shown. However, there is sparse information whether and how aging affects different stages of conflict processing as indicated by event related potentials (ERPs) such as the P2, N2 and P3 components. In the present study, 19 young and 23 elderly adults performed a combined Flanker conflict and stimulus-response-conflict (SRC) task. Analysis of the reaction times (RTs) revealed an increased SRC related conflict effect in elderly. ERP analysis furthermore demonstrated an age-related increase of the P2 amplitude in response to the SRC task. In addition, elderly adults exhibited an increased P3 amplitude modulation induced by incongruent SRC and Flanker conflict trials. PMID:27014059

  10. One-Year Outcomes of Aflibercept in Recurrent or Persistent Neovascular Age-Related Macular Degeneration

    PubMed Central

    Arcinue, Cheryl A.; Ma, Feiyan; Barteselli, Giulio; Sharpsten, Lucie; Gomez, Maria Laura; Freeman, William R.

    2014-01-01

    Purpose To evaluate 6-month and 1-year outcomes of every 8 weeks (Q8W) aflibercept in patients with resistant neovascular age-related macular degeneration (AMD). Design Retrospective, interventional, consecutive case series. Methods Retrospective review of patients with resistance (multiple recurrences or persistent exudation) to every 4 weeks (Q4W) ranibizumab or bevacizumab that were switched to Q8W aflibercept. Results Sixty-three eyes of 58 patients had a median of 13 (interquartile range (IQR), 7-22) previous anti Vascular Endothelial Growth Factor (anti-VEGF) injections. At 6-months after changing to aflibercept, 60.3% of eyes were completely dry, which was maintained up to one-year. The median maximum retinal thickness improved from 355 microns to 269 microns at 6 months (p<0.0001) and 248 microns at one year (p<0.0001). There was no significant improvement in ETDRS visual acuity at 6 months (p=0.2559) and one-year follow-up (p=0.1081) compared with baseline. The mean difference in ETDRS visual acuity compared to baseline at 6 months was −0.05 logMAR (+2.5 letters) and 0.04 logMAR at 1 year (−2 letters). Conclusion Sixty percent of eyes with resistant AMD while on Q4W ranibizumab or bevacizumab were completely dry after changing to Q8W aflibercept at the 6-month and 1-year follow-ups, but visual acuity did not significantly improve. Only a third of eyes needed to be switched from Q8W to Q4W aflibercept due to persistence of fluid; Q8W dosing of aflibercept without the initial 3 monthly loading doses may be a good alternative in a select group of patients who may have developed ranibizumab or bevacizumab resistance. PMID:25461263

  11. 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.

  12. 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.

  13. 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

  14. Examining methodological variation in response inhibition: The effects of outcome measures and task characteristics on age-related differences.

    PubMed

    Klenberg, Liisa; Närhi, Vesa; Korkman, Marit; Hokkanen, Laura

    2015-01-01

    This study addressed methodological issues common to developmental studies on response inhibition. Age-related differences were investigated using two Stroop-like tasks with different levels of complexity and comparing different outcome measures in a sample of 340 children and adolescents aged 7-15 years. First, speed and accuracy of task performance were examined; the results showing that improvement in speed continued until age 13 in both the basic naming task and the two inhibition tasks. Improvement in accuracy was less consistent and continued until age 9 or 13 years. Second, two different algorithms were employed to control for the effects of basic processes in inhibition tasks. The difference algorithm indicated age-related differences similar to those for speed. The ratio algorithm, however, suggested earlier deceleration of development of response inhibition at 9 or 11 years of age. Factors related to the cognitive requirements and presented stimuli also had an effect on the results. The present findings shed light on the inconsistencies in the developmental studies of response inhibition and demonstrated that the selection of outcome measures and task characteristics are critical because they affect the way development is depicted. PMID:25175830

  15. 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

  16. 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.

  17. 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

  18. Gestational age at delivery and neonatal outcome in uncomplicated twin pregnancies: what is the optimal gestational age for delivery according to chorionicity?

    PubMed Central

    Lee, Hye-Jung; Kim, Soo Hyun; Chang, Kylie Hae-Jin; Sung, Ji-Hee; Oh, Soo-young; Roh, Cheong-Rae; Kim, Jong-Hwa

    2016-01-01

    Objective To investigate the neonatal outcome according to the gestational age at delivery and to determine the optimal timing for delivery in uncomplicated monochorionic and dichorionic twin pregnancies. Methods This is a retrospective cohort study of women with uncomplicated twin pregnancies delivered at or beyond 35 weeks of gestation from 1995 to 2013. The primary outcome was neonatal composite morbidity, which was defined as when either one or both twins have one or more of the followings: fetal death after 35 weeks gestation, admission to neonatal intensive care unit, mechanical ventilator requirement, respiratory distress syndrome and neonatal death. To determine the optimal gestational age for delivery according to chorionicity, we compared the neonatal composite morbidity rate between women who delivered and women who remained undelivered at each gestational week in both monochorionic and dichorionic twin pregnancies. Results A total of 697 twin pregnancies were included (171 monochorionic and 526 dichorionic twins). The neonatal composite morbidity rate significantly decreased with advancing gestational age at delivery and its nadir was observed at 38 and ≥39 weeks of gestation in monochorionic and dichorionic twins, respectively. However, the composite morbidity rate did not differ between women who delivered and women who remained undelivered ≥36 and ≥37 weeks in monochorionic and dichorionic twins, respectively. Conclusion Our data suggest that the optimal gestational age for delivery was at ≥36 and ≥37 weeks in uncomplicated monochorionic and dichorionic twin pregnancies, respectively. PMID:26866030

  19. 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

  20. The predictability of serum anti-Müllerian level in IVF/ICSI outcomes for patients of advanced reproductive age

    PubMed Central

    2011-01-01

    Background The role of serum anti-Müllerian hormone (AMH) as predictor of in-vitro fertilization outcomes has been much debated. The aim of the present study is to investigate the practicability of combining serum AMH level with biological age as a simple screening method for counseling IVF candidates of advanced reproductive age with potential poor outcomes prior to treatment initiation. Methods A total of 1,538 reference patients and 116 infertile patients aged greater than or equal to 40 years enrolled in IVF/ICSI cycles were recruited in this retrospective analysis. A reference chart of the age-related distribution of serum AMH level for Asian population was first created. IVF/ICSI patients aged greater than or equal to 40 years were then divided into three groups according to the low, middle and high tertiles the serum AMH tertiles derived from the reference population of matching age. The cycle outcomes were analyzed and compared among each individual group. Results For reference subjects aged greater than or equal to 40 years, the serum AMH of the low, middle and high tertiles were equal or lesser than 0.48, 0.49-1.22 and equal or greater than 1.23 ng/mL respectively. IVF/ICSI patients aged greater than or equal to 40 years with AMH levels in the low tertile had the highest cycle cancellation rate (47.6%) with zero clinical pregnancy. The nadir AMH level that has achieved live birth was 0.56 ng/mL, which was equivalent to the 36.4th percentile of AMH level from the age-matched reference group. The optimum cut-off levels of AMH for the prediction of nonpregnancy and cycle cancellation were 1.05 and 0.68 ng/mL, respectively. Conclusions Two criteria: (1) age greater than or equal to 40 years and (2) serum AMH level in the lowest tertile (equal or lesser than 33.3rd percentile) of the matching age group, may be used as markers of futility for counseling IVF/ICSI candidates. PMID:21843363

  1. The post‐infection outcomes of influenza and acute respiratory infection in patients above 50 years of age in Japan: an observational study

    PubMed Central

    Ikematsu, Hideyuki; Takeuchi, Yuriko; Rosenlund, Mats; Kawai, Naoki; Shimamura, Ryuji; Hirata, Miki; Iwaki, Norio

    2011-01-01

    Please cite this paper as: Ikematsu et al. (2011) The post‐infection outcomes of influenza and acute respiratory infection in patients above 50 years of age in Japan: an observational study. Influenza and Other Respiratory Viruses 6(3), 211–217. Objectives  Influenza can be a serious illness, especially for older people, and reducing the impact of influenza in elderly is important. The objective of this study was to estimate the prevalence and postinfection outcomes of influenza among the over‐50 population in Japan. Design  An observational study was designed to ascertain the proportion of influenza cases in a population aged ≥50 years with acute respiratory infection (ARI) and to determine the postinfection outcomes of their illness during the 2008–09 influenza season in Japan. Respiratory specimens obtained from a total of 401 patients were tested by PCR for influenza viruses, respiratory syncytial virus (RSV) and human metapneumovirus (hMPV). The effectiveness of the seasonal trivalent influenza vaccine was estimated by a test‐negative case control analysis. Setting  Seventeen outpatient clinics located in four separate areas of Japan. Sample  Respiratory swab specimens from the ARI patients aged ≥50 years. Main outcome measures  Laboratory confirmed influenza in patients presenting with ARI. Results  In all, 89 (22.2%) of the patients were positive for one of the tested viruses; 70 (78.7%) with influenza, 17 (19.1%) with RSV, and 2 (2.2%) with hMPV. Cough (95.7% vs 73.4%), loss of appetite (67.1% vs 35.5%), absence from work (50.0% vs 23.0%), impact on daily activity (90.0% vs 62.5%), and caregiver absence from work (5.7% vs 0.6%) were observed higher in influenza patients. The duration of feeling weakness (6.3 ± 5.4 vs 3.6 ± 1.9 days) and average days of reduced activity (5.2 vs 3.6 days) were longer for influenza patients. Vaccine effectiveness was estimated to be 32.1% (95% CI: −14.9, 59.9%). Conclusions  Influenza

  2. 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

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

    PubMed Central

    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. PMID:24917792

  4. Maternal age as a factor in determining the reproductive and behavioral outcome of rats prenatally exposed to ethanol.

    PubMed

    Vorhees, C V

    1988-01-01

    reproduction. Here the combination of the two factors increased maternal mortality, the number of early pregnancy losses, and the number of litters where all members were dead or resorbed. It was concluded that short-term prenatal ethanol combined with advanced maternal age produces additive interactions on pregnancy success without affecting longer-term outcomes, while young maternal age showed no clear detrimental effects compared to the middle maternal age reference group. PMID:3352565

  5. 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…

  6. 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. PMID:27268570

  7. 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. PMID:26214226

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

    PubMed Central

    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 psychosocial outcomes as CD. However, relatively little work has examined whether forms of psychopathology (e.g., externalizing and/or internalizing disorders) mediates the relationship between youth CD and adult psychosocial outcomes. The present study examined associations between youth CD and adult psychosocial outcomes and sought to identify forms of psychopathology that may potentially mediate this relationship. Participants completed self-report measures of psychosocial functioning and semi-structured diagnostic interviews during adolescence and young adulthood. Analyses found that most domains of adult psychosocial functioning were associated with youth CD. Adult antisocial behavior was the only form of psychopathology predicted by CD. Adult antisocial behavior appeared to mediate the relationship between CD and marital status, life satisfaction, and being in jail and partially mediated the relationship between CD and family support and global functioning. These data suggest that reducing the progression to adult antisocial behavior may improve multiple psychosocial outcomes among those with a history of CD. PMID:20521096

  9. 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

  10. 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

  11. Comparison in Outcomes at Two-Years of Age of Very Preterm Infants Born in 2000, 2005 and 2010

    PubMed Central

    Abily-Donval, Lénaïg; Pinto-Cardoso, Gaëlle; Chadie, Alexandra; Guerrot, Anne-Marie; Torre, Stéphanie; Rondeau, Stéphane; Marret, Stéphane

    2015-01-01

    Objective To investigate alteration in 2-year neurological/behavioral outcomes of very preterm infants born in a French level three neonatal intensive care unit. Methods We conducted a prospective, comparative study of very preterm infants born before 33 weeks’ gestation at 5-year intervals in 2000, 2005 and 2010 at Rouen University Hospital. Neonatal mortality/morbidities, ante- and neonatal treatments, and at age 2 years motor, cognitive and behavioral data were collected by standardized questionnaires. Results We included 536 very preterm infants. Follow-up rates at two years old were 78% in 2000, 93% in 2005 and 92% in 2010 respectively. No difference in gestational age, birthweight, neonatal mortality/morbidities was observed except a decrease in low grade subependymal/intraventricular hemorrhages. Care modifications concerned use of antenatal magnesium sulfate, breast-feeding and post-natal corticosteroid therapy. Significant improvement in motor outcome and dramatic decrease in cerebral palsy rates (12% in 2000, 6% in 2005, 1% in 2010, p<0.001) were observed, as were improvements in feeding behavior. Although a non significant difference to better psychosocial behavior was reported, there was no difference in cognitive outcome. Conclusions Improvement in neuromotor outcome and behavior was reported. This could be due to multiple modifications in care: including administration of magnesium sulfate to women at risk of preterm birth, increase in breast-feeding, decrease in low grade subependymal/intraventricular hemorrhages, and decrease in post-natal corticosteroid therapy, all of which require further investigation in other studies. Extended follow-up until school age is mandatory for better detection of cognitive, learning and behavioral disorders. PMID:25658321

  12. 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…

  13. 40K- 40Ar dating of the Main Deccan large igneous province: Further evidence of KTB age and short duration

    NASA Astrophysics Data System (ADS)

    Chenet, Anne-Lise; Quidelleur, Xavier; Fluteau, Frédéric; Courtillot, Vincent; Bajpai, Sunil

    2007-11-01

    Most mass extinctions coincide in time with outpourings of continental flood basalts (CFB). Some 20 years ago, it was shown [Courtillot, V., Besse, J., Vandamme, D., Montigny, R., Jaeger, J.-J., Cappetta, H., 1986. Deccan flood basalts at the Cretaceous/Tertiary boundary? Earth Planet. Sci. Lett. 80, 361-374; Courtillot, V., Feraud, G., Maluski, H., Vandamme, D., Moreau, M.G., Besse, J., 1988. Deccan flood basalts and the Cretaceous/Tertiary boundary. Nature 333, 843-846; Duncan, R.A., Pyle, D.G., 1988. Rapid eruption of the Deccan flood basalts at the Cretaceous/Tertiary boundary. Nature 333 841-843] that the age of the Deccan traps was close to the Cretaceous-Tertiary (KT) boundary and its duration under 1 Myr. We have undertaken a new geochronological study, using the (unconventional) 40K- 40Ar Cassignol-Gillot technique which is particularly well suited to the potassium-poor Deccan lavas. The mean of 4 determinations from the topmost (Ambenali and Mahabaleshwar) Formations is 64.5 ± 0.6 Ma. They straddle the C29r/C29n reversal boundary for which they provide a new constraint. The mean age of 3 determinations from the oldest (Jawhar) Formation is 64.8 ± 0.6 Ma. The difference in age between top and bottom of a 3500 m composite section, probably comprising 80% of the total Deccan volume, is statistically insignificant, with the overall mean age being 64.7 ± 0.6 Ma ( N = 7). Our results are consistent with the most recent 40Ar/ 39Ar determinations [Knight, K.B., Renne, P.R., Halkett, A., White, N., 2003. 40Ar/ 39Ar dating of the Rajahmundry Traps, eastern India and their relationship to the Deccan traps. Earth Planet. Sci. Lett. 208, 85-99; Knight, K.B., Renne, P.R., Baker, J., Waight, T., White, N., 2005. Reply to '40Ar/39Ar dating of the Rajahmundry Traps, Eastern India and their relationship to the Deccan Traps: Discussion' by A.K. Baksi. Earth Planet. Sci. Lett. 239, 374-382], confirming that there should be no systematic difference between the two methods

  14. The Home Environment and Disability-Related Outcomes in Aging Individuals: What Is the Empirical Evidence?

    ERIC Educational Resources Information Center

    Wahl, Hans-Werner; Fange, Agneta; Oswald, Frank; Gitlin, Laura N.; Iwarsson, Susanne

    2009-01-01

    Purpose: Building on the disablement process model and the concept of person-environment fit (p-e fit), this review article examines 2 critical questions concerning the role of home environments: (a) What is the recent evidence supporting a relationship between home environments and disability-related outcomes? and (b) What is the recent evidence…

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

    ERIC Educational Resources Information Center

    Tirella, Linda Grey; Chan, Wilma; Miller, Laurie C.

    2006-01-01

    More than 230,000 children have been adopted from other countries by American parents since 1989, including more than 72,000 from Eastern Europe. Many arrive with growth and development delays, and medical problems. Yet, little is known about the long-term outcomes for these children. Therefore, we assessed long-term developmental,…

  16. 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…

  17. 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…

  18. Distance Learning for Gifted Students: Outcomes for Elementary, Middle, and High School Aged Students

    ERIC Educational Resources Information Center

    Wallace, Patricia

    2009-01-01

    Although distance learning often is cited as a potentially useful strategy to provide appropriately challenging academic coursework to gifted students, little research has been conducted on its use or effectiveness with this population, particularly with younger students in elementary school. In this study, distance learning outcomes for gifted…

  19. 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…

  20. 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.

  1. 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.

  2. Incidence and Effects of Polypharmacy on Clinical Outcome among Patients Aged 80+: A Five-Year Follow-Up Study

    PubMed Central

    Fan, Li; Gao, Dewei; Liang, Zhiru; He, Jing; Gong, Weiqin; Gao, Linggen

    2015-01-01

    Objectives Polypharmacy is a problem of growing interest in geriatrics with the increase in drug consumption in recent years, is defined according to the WHO criteria as the, ‘‘concurrent use of five or more different prescription medication”. We investigated the clinical characteristics of polypharmacy and identified the effects of polypharmacy on clinical outcome among patients aged 80+ admitted to Chinese PLA general hospital. Methods Older men aged ≥80 years (n = 1562) were included in this study. The included participants attended a structured clinical examination and an interview carried out by a geriatrician and trained nurses. A follow-up survey in 2014 was carried out on survivors in the same way as in 2009. The clinical outcome measured were adverse drug reactions, falls, frailty, disability, cognitive impairment, mortality. The association between polypharmacy and clinical outcome was assessed by logistic regression. Results The mean (range) age of the included participants was 85.2 (80–104) years. Medication exposure was reported by 100% of the population. Mean number of medications reported in this population was 9.56±5.68. The prevalence of polypharmacy (≥6 medications) in the present study was 70%. At the time of the follow-up survey, an increase in the number of taken medicines had occurred among half of the survivors. The risk of different outcomes in relation to number of medications rises significantly, the odds ratios were 1.21 (95% confidence interval [CI]1.17–1.28) for adverse drug reactions, 1.18 (95% CI 1.10–1.26) for falls, 1.16 (95% CI 1.09–1.24) for disability, and 1.19 (95% CI 1.12–1.23) for mortality. There was no association between increasing number of medications and cognitive impairment. Conclusions Our study demonstrates that polypharmacy is very common in the very old patients, and observed that number of medications was a factor associated with difference clinical outcome independently of the age, type of

  3. 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

  4. Have splenectomy rate and main outcomes of ITP changed after the introduction of new treatments? A monocentric study in the outpatient setting during 35 years.

    PubMed

    Palandri, Francesca; Polverelli, Nicola; Sollazzo, Daria; Romano, Marco; Catani, Lucia; Cavo, Michele; Vianelli, Nicola

    2016-06-01

    In the last years, rituximab (RTX) and agonists of the thrombopoietin receptor (TPO-R) eltrombopag and romiplostim have provided new treatment options in persistent and chronic immune thrombocytopenia (ITP). Here, we analyzed the changes in therapeutic choices over time and their impact on clinical outcomes in a cohort of 557 ITP outpatients followed at the "L. and A. Seràgnoli" Institute of Hematology, Bologna, Italy, from 1980 to 2015. Overall 397 patients (71%) required front-line corticosteroids, mainly prednisone. Over the decades, splenectomy was delayed from second to third-line, but was steadily used in around 15-25% of patients refractory or relapsing after first-line treatment. Consensually, RTX and TPO-R agonists emerged as second and third-line therapy of choice, respectively. Splenectomy was associated with the best response rates and the lower incidences of relapse, while the relapse rate after RTX was comparable to that observed with corticosteroids and other immunosuppressive agents. The introduction of TPO-R agonists gave an alternative to the administration of immunosuppressive drugs and probably contributed to moderate the incidence of infectious complications that remained stable over the decades, despite an increasing use of RTX from the 2000s onwards. Overall responses were similar over time, with over 97% achieving a response in all time-periods. However, the cumulative risk of bleeding significantly decreased [14.3% (1980-89) vs. 7% (1990-99) vs. 5.6% (2000-09) vs. 0.2% (2010-15)] (P < 0.001), mainly thanks to the optimization of front-line corticosteroids therapy and to the wider availability of second and third-line therapies. PMID:26799593

  5. 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)

  6. Age differences in the role of cognitive versus somatic arousal in sleep outcomes.

    PubMed

    Shoji, Kristy D; McCrae, Christina S; Dautovich, Natalie D

    2014-01-01

    The purpose of this study is twofold: (a) to determine whether daily or overall cognitive and somatic arousal better predict sleep and (b) to investigate age differences in the arousal-sleep relation. Fifty younger and 50 older adults completed the Pre-Sleep Arousal Scale and sleep diaries for 14 consecutive days. Analyses revealed mean arousal may better predict sleep regardless of age. However, daily arousal represents an important avenue of research as it may uncover lagged or coupling effects in the arousal-sleep relation. Significant age differences in the arousal-sleep relation suggest age-dependent associations between the type of arousal and sleep. Implications for assessment of sleep in older and younger adults are discussed. PMID:23746053

  7. 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

  8. 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

  9. Routine outcome monitoring: Coming of age--With the usual developmental challenges.

    PubMed

    Wampold, Bruce E

    2015-12-01

    The articles in this series present a variety of systems that involve routine outcome monitoring and the provision of feedback to therapists and/or patients with the goal of improving the quality of mental health care. Sufficient evidence exists for the adopting 1 of these systems (or 1 that was not discussed in this series); nevertheless, a number of challenges exist. Issues related to identifying the efficacious components, implementation, utilization, scientific inquiry, and the next generation are discussed. PMID:26641376

  10. Outcomes of population based language promotion for slow to talk toddlers at ages 2 and 3 years: Let’s Learn Language cluster randomised controlled trial

    PubMed Central

    Tobin, Sherryn; Girolametto, Luigi; Ukoumunne, Obioha C; Gold, Lisa; Levickis, Penny; Sheehan, Jane; Goldfeld, Sharon; Reilly, Sheena

    2011-01-01

    Objective To determine the benefits of a low intensity parent-toddler language promotion programme delivered to toddlers identified as slow to talk on screening in universal services. Design Cluster randomised trial nested in a population based survey. Setting Three local government areas in Melbourne, Australia. Participants Parents attending 12 month well child checks over a six month period completed a baseline questionnaire. At 18 months, children at or below the 20th centile on an expressive vocabulary checklist entered the trial. Intervention Maternal and child health centres (clusters) were randomly allocated to intervention (modified “You Make the Difference” programme over six weekly sessions) or control (“usual care”) arms. Main outcome measures The primary outcome was expressive language (Preschool Language Scale-4) at 2 and 3 years; secondary outcomes were receptive language at 2 and 3 years, vocabulary checklist raw score at 2 and 3 years, Expressive Vocabulary Test at 3 years, and Child Behavior Checklist/1.5-5 raw score at 2 and 3 years. Results 1217 parents completed the baseline survey; 1138 (93.5%) completed the 18 month checklist, when 301 (26.4%) children had vocabulary scores at or below the 20th centile and were randomised (158 intervention, 143 control). 115 (73%) intervention parents attended at least one session (mean 4.5 sessions), and most reported high satisfaction with the programme. Interim outcomes at age 2 years were similar in the two groups. Similarly, at age 3 years, adjusted mean differences (intervention−control) were −2.4 (95% confidence interval −6.2 to 1.4; P=0.21) for expressive language; −0.3 (−4.2 to 3.7; P=0.90) for receptive language; 4.1 (−2.3 to 10.6; P=0.21) for vocabulary checklist; −0.5 (−4.4 to 3.4; P=0.80) for Expressive Vocabulary Test; −0.1 (−1.6 to 1.4; P=0.86) for externalising behaviour problems; and −0.1 (−1.3 to 1.2; P=0. 92) for internalising behaviour problems. Conclusion

  11. Psychiatric outcomes at age seven for very preterm children: rates and predictors

    PubMed Central

    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 diagnoses in VPT children. Methods Participants were 177 VPT and 65 term born children. Perinatal medical data were collected, which included brain abnormalities detected using magnetic resonance imaging. The Infant-Toddler Social-Emotional Assessment (ITSEA) and Strengths and Difficulties Questionnaire (SDQ) were administered at 2 and 5 years respectively. At 7 years of age, the Developmental and Well-being Assessment (DAWBA) was used to indicate psychiatric diagnoses. Results Compared with term born children, VPT children had three times the odds of meeting criteria for any psychiatric diagnosis at age 7 years (odds ratio 3.03; 95% confidence interval 1.23, 7.47, p = .02). The most common diagnoses were anxiety disorders (11% VPT, 8% term), attention-deficit/hyperactivity disorder (10% VPT, 3% term) and autism spectrum disorder (4.5% VPT, 0% term). For VPT children, those with severe global brain abnormalities (p = .02), those who displayed social-emotional problems at age 5 (p = .000) and those with higher social risk at age 7 (p = .001) were more likely to meet criteria for a psychiatric illness at age 7. Conclusions Compared with term born children, VPT children have higher rates of psychiatric diagnoses at early school age, predicted by neonatal brain abnormalities, prior social-emotional problems and social factors. PMID:23347471

  12. Dietary intake and main food sources of vitamin D as a function of age, sex, vitamin D status, body composition, and income in an elderly German cohort

    PubMed Central

    Jungert, Alexandra; Spinneker, Andre; Nagel, Anja; Neuhäuser-Berthold, Monika

    2014-01-01

    Background Elderly subjects are at risk of insufficient vitamin D status mainly because of diminished capacity for cutaneous vitamin D synthesis. In cases of insufficient endogenous production, vitamin D status depends on vitamin D intake. Objective The purpose of this study is to identify the main food sources of vitamin D in elderly subjects and to analyse whether contributing food sources differ by sex, age, vitamin D status, body mass index (BMI), or household income. In addition, we analysed the factors that influence dietary vitamin D intake in the elderly. Design and subjects This is a cross-sectional study in 235 independently living German elderly aged 66–96 years (BMI=27±4 kg/m2). Vitamin D intake was assessed by a 3-day estimated dietary record. Results The main sources of dietary vitamin D were fish/fish products followed by eggs, fats/oils, bread/bakery products, and milk/dairy products. Differences in contributing food groups by sex, age, vitamin D status, and BMI were not found. Fish contributed more to vitamin D intake in subjects with a household income of <1,500 €/month compared to subjects with higher income. In multiple regression analysis, fat intake and frequency of fish consumption were positive determinants of dietary vitamin D intake, whereas household income and percentage total body fat negatively affected vitamin D intake. Other parameters, including age, sex, physical activity, smoking, intake of energy, milk, eggs and alcohol, showed no significant association with vitamin D intake. Conclusion Low habitual dietary vitamin D intake does not affect vitamin D status in summer, and fish is the major contributor to vitamin D intake independent of sex, age, vitamin D status, BMI, and the income of subjects. PMID:25317118

  13. 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.

  14. The Efficacy of Familias Unidas on Drug and Alcohol Outcomes for Hispanic Delinquent Youth: Main Effects and Interaction Effects by Parental Stress and Social Support

    PubMed Central

    Prado, Guillermo; Cordova, David; Huang, Shi; Estrada, Yannine; Rosen, Alexa; Bacio, Guadalupe A.; Jimenez, Giselle Leon; Pantin, Hilda; Brown, C. Hendricks; Velazquez, Maria-Rosa; Villamar, Juan; Freitas, Derek; Tapia, Maria I.; McCollister, Kathryn

    2012-01-01

    INTRODUCTION Drug and alcohol use disproportionately affect Hispanic youth. Despite these disparities, few empirically supported preventive interventions are available to ameliorate this public health concern among Hispanic youth. This study examined the effects of Familias Unidas, relative to Community Practice, in reducing past 90-day substance use, alcohol and marijuana dependence, and having sex while under the influence of alcohol or drugs. Additionally, this study explored whether Familias Unidas’ effects varied by environmental context, namely parental stress and social support for parents. METHODS A total of 242 delinquent Hispanic youth aged 12 – 17 years and their primary caregivers were randomized to either Familias Unidas or Community Practice and assessed at three time points. RESULTS Familias Unidas was efficacious in reducing past 90-day substance use, illicit drug use, and in reducing the proportion of youth with an alcohol dependence diagnosis, relative to Community Practice. Results also showed a reduction in the proportion of youth who reported having sex while under the influence of alcohol or drugs. No differences between conditions were observed in past 90-day alcohol use or marijuana dependence. Intervention effects on illicit drug use and alcohol dependence varied by environmental context. For example, Familias Unidas was most efficacious for adolescents with parents exhibiting high stress and lower levels of social support. CONCLUSIONS Familias Unidas was efficacious in reducing some drug and alcohol related outcomes. The findings also support the concept of targeting family-based interventions, such as Familias Unidas, for adolescents with parents exhibiting high stress and low levels of social support. PMID:22776441

  15. 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

  16. 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

  17. 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

  18. 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.

  19. 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

  20. 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…

  1. 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…

  2. 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…

  3. 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…

  4. 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…

  5. 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…

  6. 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…

  7. 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…

  8. Language Outcomes of School-Aged Internationally Adopted Children: A Systematic Review of the Literature

    ERIC Educational Resources Information Center

    Scott, Kathleen A.

    2009-01-01

    Growing evidence suggests that, as a group, many internationally adopted children catch up to their peers in terms of their language development by the time they reach their school-age years. Although this appears to be particularly true for children adopted during the first few years of life, it is not true for all internationally adopted…

  9. 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…

  10. 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…

  11. 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

  12. Comparison of Rehabilitation Outcomes for Long Term Neurological Conditions: A Cohort Analysis of the Australian Rehabilitation Outcomes Centre Dataset for Adults of Working Age

    PubMed Central

    Turner-Stokes, Lynne; Vanderstay, Roxana; Stevermuer, Tara; Simmonds, Frances; Khan, Fary; Eagar, Kathy

    2015-01-01

    Objective To describe and compare outcomes from in-patient rehabilitation (IPR) in working-aged adults across different groups of long-term neurological conditions, as defined by the UK National Service Framework. Design Analysis of a large Australian prospectively collected dataset for completed IPR episodes (n = 28,596) from 2003-2012. Methods De-identified data for adults (16–65 years) with specified neurological impairment codes were extracted, cleaned and divided into ‘Sudden-onset’ conditions: (Stroke (n = 12527), brain injury (n = 7565), spinal cord injury (SCI) (n = 3753), Guillain-Barré syndrome (GBS) (n = 805)) and ‘Progressive/stable’ conditions (Progressive (n = 3750) and Cerebral palsy (n = 196)). Key outcomes included Functional Independence Measure (FIM) scores, length of stay (LOS), and discharge destination. Results Mean LOS ranged from 21–57 days with significant group differences in gender, source of admission and discharge destination. All six groups showed significant change (p<0.001) between admission and discharge that was likely to be clinically important across a range of items. Significant between-group differences were observed for FIM Motor and Cognitive change scores (Kruskal-Wallis p<0.001), and item-by-item analysis confirmed distinct patterns for each of the six groups. SCI and GBS patients were generally at the ceiling of the cognitive subscale. The ‘Progressive/stable’ conditions made smaller improvements in FIM score than the ‘Sudden-onset conditions’, but also had shorter LOS. Conclusion All groups made gains in independence during admission, although pattern of change varied between conditions, and ceiling effects were observed in the FIM-cognitive subscale. Relative cost-efficiency between groups can only be indirectly inferred. Limitations of the current dataset are discussed, together with opportunities for expansion and further development. PMID:26167877

  13. The relation between speed environment, age and injury outcome for bicyclists struck by a motorized vehicle - a comparison with pedestrians.

    PubMed

    Kröyer, Höskuldur R G

    2015-03-01

    This study analyzes (a) the relation between injury severities, the age of the bicyclist and the speed environment at accident locations (mean travel speed of the traffic flow involved in the accident) where a bicyclist was struck by a motorized vehicle and (b) how these relations differ from those for struck pedestrians. Accident data from Sweden for the years 2004-2008 was used to identify accident locations to analyze the relations between speed environment, age and injury outcome. Seventy-seven accident sites were used for field measurements and further analysis. The results show that both speed environment and age have considerable correlation with injury severity. There was a statistically significant relation between injury severity and the speed environment, and large proportion of the serious bicycle accidents occur at locations with speeds below 30km/h. Also, the risk of serious injuries or fatalities seems to increase after the age of 45. To our knowledge this is the first study that uses the mean travel speed in this manner for analyzing injury severity of struck bicyclists. PMID:25616032

  14. Impact of the presence of auditory neuropathy spectrum disorder (ANSD) on outcomes of children at three years of age

    PubMed Central

    Ching, Teresa Y. C.; Day, Julia; Dillon, Harvey; Gardner-Berry, Kirsty; Hou, Sanna; Seeto, Mark; Wong, Angela; Zhang, Vicky

    2013-01-01

    Objective To determine the influence of the presence of auditory neuropathy spectrum disorder (ANSD) on speech, language, and psycho-social development of children at three years of age. Design A population-based, longitudinal study was performed on outcomes of children with hearing impairment (LOCHI) in Australia. The demographic characteristics of the children were described, and their developmental outcomes were evaluated at three years of age. Performance of children with ANSD was compared with that of children without ANSD in the LOCHI study. Study sample There were 47 children with ANSD in the study sample. Results Sixty-four percent of children with ANSD have hearing sensitivity loss ranging from mild to severe degree, and the remaining have profound hearing loss. At three years, 27 children used hearing aids, 19 used cochlear implants, and one child did not use any hearing device. Thirty percent of children have disabilities in addition to hearing loss. On average, there were no significant differences in performance level between children with and without ANSD. Also, the variability of scores was not significantly different between the two groups. Conclusions There was no significant difference in performance levels or variability between children with and without ANSD, both for children who use hearing aids, and children who use cochlear implants. PMID:24350696

  15. 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

  16. 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

  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. 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

  19. Female Gender and Differences in Outcome after Isolated Coronary Artery Bypass Graft Surgery: Does Age Play a Role?

    PubMed Central

    Arif, Rawa; Farag, Mina; Gertner, Victor; Szabó, Gabor; Weymann, Alexander; Veres, Gabor; Ruhparwar, Arjang; Bekeredjian, Raffi; Bruckner, Tom; Karck, Matthias; Kallenbach, Klaus; Beller, Carsten J.

    2016-01-01

    Introduction Female gender is a known risk factor for early and late mortality after coronary artery bypass graft surgery (CABG). Higher age of women at operation may influence outcome, since age per se is also an important risk factor. The purpose of our study was to analyze possible gender differences in outcome after isolated CABG in different age groups to delineate the impact of female gender and age. Methods All patients over 60 years of age undergoing isolated CABG at our department during 2001 and 2011 were included and categorized by age into sexagenarians (2266, 16.6% women), septuagenarians (2332, 25.4% women) and octogenarians (374, 32% women) and assessed by gender for 30-day and 180-day mortality. Results Thirty-day mortality was significantly higher in women only amongst septuagenarians (7.1 vs. 4.7%, p = 0.033). Same differences apply for 180-day mortality (12.3 vs. 8.2%, p = 0.033) and estimated one-year survival (81.6 ± 4.2 vs. 86.9 ± 2.2%, p = 0.001). Predictive factors for 30-day mortality of septuagenarian were logistic EuroSCORE (ES) (p = 0.003), perioperative myocardial infarction (MI) (p<0.001), pneumonia (p<0.001), abnormal LV-function (p<0.04) and use of LIMA graft (p<0.001), but not female gender. However, female gender was found to be an independent predictor for 180-day mortality (HR 1.632, p = 0.001) in addition to ES, use of LIMA graft, perioperative MI, pneumonia and abnormal LV function (HR 1.013, p = 0.004; HR 0.523, p<0.001; HR 2.710, p<0.001; HR 3.238, p<0.001; HR 2.013, p<0.001). Conclusion Women have a higher observed probability of early death after CABG in septuagenarians. However, female gender was not found to be an independent risk factor for 30-day, but for 180-day survival. Therefore, reduction of high impact risk factors such as perioperative MI and enhancement of LIMA use should be future goals. In view of our findings, decision for surgical revascularization should not be based on gender. PMID:26845158

  20. 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

  1. An evidence-based program to improve analgesic practice and pain outcomes in residential aged care facilities.

    PubMed

    Savvas, Steven M; Toye, Chris M; Beattie, Elizabeth R A; Gibson, Stephen J

    2014-08-01

    Pain is common in individuals living in residential aged care facilities (RACFs), and a number of obstacles have been identified as recurring barriers to adequate pain management. To address this, the Australian Pain Society developed 27 recommendations for comprehensive good practice in the identification, assessment, and management of pain. This study reviewed preexisting pain management practice at five Australian RACFs and identified changes needed to implement the recommendations and then implemented an evidence-based program that aimed to facilitate better pain management. The program involved staff training and education and revised in-house pain-management procedures. Reviews occurred before and after the program and included the assessment of 282 residents for analgesic use and pain status. Analgesic use improved after the program (P<.001), with a decrease in residents receiving no analgesics (from 15% to 6%) and an increase in residents receiving around-the-clock plus as-needed analgesics (from 24% to 43%). There were improvements in pain relief for residents with scores indicative of pain, with Abbey pain scale (P=.005), Pain Assessment in Advanced Dementia Scale (P=.001), and Non-communicative Patient's Pain Assessment Instrument scale (P<.001) scores all improving. Although physical function declined as expected, Medical Outcomes Study 36-item Short-Form Survey bodily pain scores also showed improvement (P=.001). Better evidence-based practice and outcomes in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce using this program improved analgesic practice and pain relief in participating sites. Further attention to the continued targeted pain management training of aged care staff is likely to improve pain-focused care for residents. PMID:25040607

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. Estimating Geriatric Mortality after Injury Using Age, Injury Severity, and Performance of a Transfusion: The Geriatric Trauma Outcome Score

    PubMed Central

    Zhao, Frank Z.; Wolf, Steven E.; Nakonezny, Paul A.; Minhajuddin, Abu; Rhodes, Ramona L.; Paulk, M. Elizabeth

    2015-01-01

    Abstract Background: A tool to determine the probability of mortality for severely injured geriatric patients is needed. Objective: We sought to create an easily calculated geriatric trauma prognostic score based on parameters available at the bedside to aid in mortality probability determination. Methods: All patients ≥65 years of age were identified from our Level I trauma center's registry between January 1, 2000 and December 31, 2013. Measurements included age, Injury Severity score (ISS), units of packed red blood cells (PRBCs) transfused in the first 24 hours, and patients' mortality status at the end of their index hospitalization. As a first step, a logistic regression model with maximum likelihood estimation and robust standard errors was used to estimate the odds of mortality from age, ISS, and PRBCs after dichotomizing PRBCs as yes/no. We then constructed a Geriatric Trauma Outcome (GTO) score that became the sole predictor in the re-specified logistic regression model. Results: The sample (n=3841) mean age was 76.5±8.1 years and the mean ISS was 12.4±9.8. In-hospital mortality was 10.8%, and 11.9% received a transfusion by 24 hours. Based on the logistic regression model, the equation with the highest discriminatory ability to estimate probability of mortality was GTO Score=age+(2.5×ISS)+22 (if given PRBCs). The area under the receiver operating characteristic curve (AUC) for this model was 0.82. Selected GTO scores and their related probability of dying were: 205=75%, 233=90%, 252=95%, 310=99%. The range of GTO scores was 67.5 (survivor) to 275.1 (died). Conclusion: The GTO model accurately estimates the probability of dying, and can be calculated at bedside by those possessing a working knowledge of ISS calculation. PMID:25974408

  7. Very Long-term Outcomes and Predictors of Percutaneous Coronary Intervention with Drug-eluting Stents Versus Coronary Artery Bypass Grafting for Patients with Unprotected Left Main Coronary Artery Disease

    PubMed Central

    Yu, Xian-Peng; Wu, Chang-Yan; Ren, Xue-Jun; Yuan, Fei; Song, Xian-Tao; Luo, Ya-Wei; He, Ji-Qiang; Gao, Yue-Chun; Huang, Fang-Jiong; Gu, Cheng-Xiong; Sun, Li-Zhong; Lyu, Shu-Zheng; Chen, Fang

    2016-01-01

    Background: There are limited data on longer-term outcomes (>5 years) for patients with unprotected left main coronary artery (ULMCA) disease who underwent percutaneous coronary intervention (PCI) in the drug-eluting stents (DES) era. This study aimed at comparing the long-term (>5 years) outcomes of patients with ULMCA disease underwent PCI with DES and coronary artery bypass grafting (CABG) and the predictors of adverse events. Methods: All consecutive patients with ULMCA disease treated with DES implantation versus CABG in our center, between January 2003 and July 2009, were screened for analyzing. A propensity score analysis was carried out to adjust for potential confounding between the two groups. Results: Nine hundred and twenty-two patients with ULMCA disease were enrolled for the analyses (DES = 465 vs. CABG = 457). During the median follow-up of 7.1 years (interquartile range 5.3–8.2 years), no difference was found between PCI and CABG in the occurrence of death (P = 0.282) and the composite endpoint of cardiac death, myocardial infarction (MI) and stroke (P = 0.294). Rates of major adverse cardiac and cerebrovascular events were significantly higher in the PCI group (P = 0.014) in large part because of the significantly higher rate of repeat revascularization (P < 0.001). PCI was correlated with the lower occurrence of stroke (P = 0.004). Multivariate analysis showed ejection fraction (EF) (P = 0.012), creatinine (P = 0.016), and prior stroke (P = 0.031) were independent predictors of the composite endpoint of cardiac death, MI, and stroke in the DES group, while age (P = 0.026) and EF (P = 0.002) were independent predictors in the CABG group. Conclusions: During a median follow-up of 7.1 years, there was no difference in the rate of death between PCI with DES implantation and CABG in ULMCA lesions in the patient cohort. CABG group was observed to have significantly lower rates of repeat revascularization but higher stroke rates compared with PCI. EF

  8. Maternal psychological distress in primary care and association with child behavioural outcomes at age three.

    PubMed

    Prady, Stephanie L; Pickett, Kate E; Croudace, Tim; Mason, Dan; Petherick, Emily S; McEachan, Rosie R C; Gilbody, Simon; Wright, John

    2016-06-01

    Observational studies indicate children whose mothers have poor mental health are at increased risk of socio-emotional behavioural difficulties, but it is unknown whether these outcomes vary by the mothers' mental health recognition and treatment status. To examine this question, we analysed linked longitudinal primary care and research data from 1078 women enrolled in the Born in Bradford cohort. A latent class analysis of treatment status and self-reported distress broadly categorised women as (a) not having a common mental disorder (CMD) that persisted through pregnancy and the first 2 years after delivery (N = 756, 70.1 %), (b) treated for CMD (N = 67, 6.2 %), or (c) untreated (N = 255, 23.7 %). Compared to children of mothers without CMD, 3-year-old children with mothers classified as having untreated CMD had higher standardised factor scores on the Strengths and Difficulties Questionnaire (d = 0.32), as did children with mothers classified as having treated CMD (d = 0.27). Results were only slightly attenuated in adjusted analyses. Children of mothers with CMD may be at risk for socio-emotional and behavioural difficulties. The development of effective treatments for CMD needs to be balanced by greater attempts to identify and treat women. PMID:26415597

  9. 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…

  10. 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. PMID:25148555

  11. 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

  12. 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

  13. 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

    SciTech Connect

    Goudfrooij, Paul; Kozhurina-Platais, Vera; Puzia, Thomas H.; Chandar, Rupali E-mail: verap@stsci.edu E-mail: rupali.chandar@utoledo.edu

    2011-08-10

    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 x 10{sup 4} M{sub sun} to 2 x 10{sup 5} M{sub 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{sub esc} {approx}> 15 km s{sup -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{sub esc} {approx}< 10 km s{sup -1} at an age of 10 Myr. We argue that the wide MSTO region of such clusters is caused mainly by a {approx}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.

  14. 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

  15. Medication Underuse in Aging Outpatients with Cardiovascular Disease: Prevalence, Determinants, and Outcomes in a Prospective Cohort Study

    PubMed Central

    Meid, Andreas D.; Quinzler, Renate; Freigofas, Julia; Saum, Kai-Uwe; Schöttker, Ben; Holleczek, Bernd; Heider, Dirk; König, Hans-Helmut; Brenner, Hermann; Haefeli, Walter E.

    2015-01-01

    Background Cardiovascular disease is a leading cause of death in older people, and the impact of being exposed or not exposed to preventive cardiovascular medicines is accordingly high. Underutilization of beneficial drugs is common, but prevalence estimates differ across settings, knowledge on predictors is limited, and clinical consequences are rarely investigated. Methods Using data from a prospective population-based cohort study, we assessed the prevalence, determinants, and outcomes of medication underuse based on cardiovascular criteria from Screening Tool To Alert to Right Treatment (START). Results Medication underuse was present in 69.1% of 1454 included participants (mean age 71.1 ± 6.1 years) and was significantly associated with frailty (odds ratio: 2.11 [95% confidence interval: 1.24–3.63]), body mass index (1.03 [1.01–1.07] per kg/m2), and inversely with the number of prescribed drugs (0.84 [0.79–0.88] per drug). Using this information for adjustment in a follow-up evaluation (mean follow-up time 2.24 years) on cardiovascular and competing outcomes, we found no association of medication underuse with cardiovascular events (fatal and non-fatal) (hazard ratio: 1.00 [0.65–1.56]), but observed a significant association of medication underuse with competing deaths from non-cardiovascular causes (2.52 [1.01–6.30]). Conclusion Medication underuse was associated with frailty and adverse non-cardiovascular clinical outcomes. This may suggest that cardiovascular drugs were withheld because of serious co-morbidity or that concurrent illness can preclude benefit from cardiovascular prevention. In the latter case, adapted prescribing criteria should be developed and evaluated in those patients. PMID:26288222

  16. The outcomes of family haploidentical hematopoietic stem cell transplantation in hematological malignancies are not associated with patient age

    PubMed Central

    Dong, Lujia; Wu, Tong; Gao, Zhi-Yong; Zhang, Mei-Jie; Kan, Fangyu; Spellman, Stephen R.; Tan, Xi-You; Zhao, Yan-Li; Wang, Jing-Bo; Lu, Dao-Pei; Miklos, David; Petersdorf, Effie; Fernandez-Vina, Marcelo; Lee, Stephanie J.

    2011-01-01

    Haploidentical hematopoietic cell transplantation (HCT) has been used to treat hematologic malignancies but it is unknown whether the procedure is more effective in adults or children. To address this question, we analyzed patients aged 1–65 years old receiving myeloablative conditioning regimens followed by family 2 to 3 antigen HLA-mismatched HCT and reported to the Center for International Blood and Marrow Transplant Research (CIBMTR, n=137) or performed in Dao-Pei Hospital in Beijing, China (n=181). The Dao-Pei cohort had more acute and chronic GVHD, less relapse, lower transplant related mortality (TRM) and better leukemia-free survival (LFS) than the CIBMTR cohort. Overall survival (OS) and outcomes were similar between adults and children. In the CIBMTR cohort receiving ex vivo T cell depletion (TCD), adults had higher TRM (RR 2.71, 95% CI 1.29–5.69, p=0.008) and lower overall survival (RR 1.75, 95%CI 1.08–2.84, p=0.023) than children. In the CIBMTR subset that did not receive ex vivo TCD, relapse was lower in adults compared to children (RR 0.24, 95% CI 0.07–0.80, p=0.020) but TRM, LFS and OS were similar. We conclude that outcomes in adults and children are similar overall, although children have better survival than adults if ex vivo TCD is used. PMID:21193055

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

    PubMed Central

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

    2013-01-01

    Summary 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

  18. 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

  19. 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

  20. Cosmogenic exposure age evidence for rapid Laurentide deglaciation of the Katahdin area, west-central Maine, USA, 16 to 15 ka

    NASA Astrophysics Data System (ADS)

    Davis, P. Thompson; Bierman, Paul R.; Corbett, Lee B.; Finkel, Robert C.

    2015-05-01

    Katahdin, the highest peak in Maine and part of the second highest mountain range in New England, provides an opportunity to assess the timing and style of continental ice sheet surface lowering during deglaciation. We collected 14 samples from boulders on the adjacent Basin Ponds moraine, from bedrock and boulders on the upper part of the mountain, and from boulders in the surrounding area to estimate the age at which they were exposed by deglaciation of the Laurentide Ice Sheet. Measurements of in situ produced 10Be, which are consistent with measurements of 26Al, indicate that the Katahdin edifice became exposed from under ice by 15.3 ± 2.1 ka (n = 6), an age indistinguishable from the adjacent Basin Ponds moraine (16.1 ± 1.2 ka, n = 5). A boulder in the lowlands several km south of the moraine dates to 14.5 ± 0.8 ka, and a boulder deposited at Pineo Ridge, about 170 km SE of Katahdin, dates to 17.5 ± 1.1 ka. These data show that samples collected over an elevation range of 1.6 km and a distance of >170 km all have exposure ages that are indistinguishable within uncertainties. Together these data suggest that the Laurentide Ice Sheet surface dropped rapidly and the ice sheet margin retreated quickly across Maine between about 16 and 15 ka, perhaps influenced by calving of the marine-based ice sheet in the St. Lawrence Lowlands to the north and the Penobscot basin to the south.

  1. 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.

  2. 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

  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. 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. PMID:26429570

  5. Visual outcome and complications in Ab-externo scleral fixation IOL in aphakia in pediatric age group

    PubMed Central

    Ahmed Bhutto, Isra; Qadir Kazi, Ghulam; Mahar, P.S; Ahmed Qidwai, Umair

    2013-01-01

    Objective: To assess the visual outcome and complications in patients after Ab-externo scleral fixation of intraocular lens in pediatric age group (15 years or less). Methods: This quasi experimental study was conducted at Isra Postgraduate Institute of Ophthalmology, Al-Ibrahim Eye Hospital, Karachi, from January 2012 to December 2012. All cases included were worked up according to the protocol. All patients underwent Ab-externo scleral fixation of IOL under general anesthesia. Patients were followed up at 1stday, 1stweek, 1stmonth, 2ndmonth and 3rdmonth. Complete eye examination including best-corrected visual acuity and complications were noted on each visit. Results: Thirty patients were included in the study, with mean age of 8.6 years (±3.93569). Most of the patients, 20 (66.7%), had visual acuities of 6/18 or better. No complication was seen in 18 (60%) of the patients intra operatively while soft eye was observed in 7 (23.3%) of the patients. Another complication noted was vitreous hemorrhage, which was seen in 5 (16.7%) patients. Most common post-operative complication was Uveitis followed by astigmatism. Lens dislocation and iris abnormalities were seen in only one patient. Most of the patients showed significant visual improvement after surgery. Conclusion: Ab-externo scleral fixation of an IOL was found to be safe and showed favorable postoperative results with fewer complications. PMID:24353665

  6. 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

  7. 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.

  8. 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

  9. The effect of age on clinical outcomes and health status in the Bypass Angioplasty Revascularization Investigation 2 Diabetes Trial (BARI 2D)

    PubMed Central

    Chung, Sheng-Chia; Hlatky, Mark A.; Faxon, David; Ramanathan, Kodangudi; Adler, Dale; Mooradian, Arshag; Rihal, Charanjit; Stone, Roslyn A.; Bromberger, Joyce T.; Kelsey, Sheryl F.; Brooks, Maria Mori

    2011-01-01

    Objective The objective was to determine the extent to which effectiveness of cardiac and diabetes treatment strategies varies by patient age. Background The impact of age on the effectiveness of revascularization and hyperglycemia treatments has not been thoroughly investigated. Methods In BARI 2D, 2368 patients with documented stable heart disease and type 2 diabetes were randomized to receive prompt revascularization versus initial medical therapy with deferred revascularization and insulin-sensitization versus insulin-provision for hyperglycemia treatment. Patients were followed for an average of 5.3 years. Cox regression and mixed models were used to investigate the effect of age and randomized treatment assignment on clinical and health status outcomes. Results The effect of prompt revascularization versus medical therapy did not differ by age for death (interaction p=0.99), major cardiovascular events (interaction p=0.081), angina (interaction p=0.98) or health status outcomes. After intervention, participants of all ages had significant angina and health status improvement. Younger participants experienced a smaller decline in health status during follow-up than older participants (age by time interaction p<0.01). The effect of the randomized glycemia treatment on clinical and health status outcomes was similar for patients of different ages. Conclusion Among patients with stable heart disease and type 2 diabetes, relative beneficial effects of a strategy of prompt revascularization versus initial medical therapy, and insulin-sensitizing versus insulin-providing therapy on clinical endpoints, symptom relief, and perceived health status outcomes do not vary by age. Health status improved significantly after treatment for all ages, and this improvement was sustained longer among younger patients. PMID:21835316

  10. Outcomes of Early- and Late-identified Children at 3 Years of Age: Findings from a Prospective Population-based Study

    PubMed Central

    Ching, Teresa Y.C.; Dillon, Harvey; Marnane, Vivienne; Hou, Sanna; Day, Julia; Seeto, Mark; Crowe, Kathryn; Street, Laura; Thomson, Jessica; Van Buynder, Patricia; Zhang, Vicky; Wong, Angela; Burns, Lauren; Flynn, Christopher; Cupples, Linda; Cowan, Robert S.C.; Leigh, Greg; Sjahalam-King, Jessica; Yeh, Angel

    2013-01-01

    Objectives To address the question of whether, on a population level, early detection and amplification improve outcomes of children with hearing impairment. Design All families of children who were born between 2002 and 2007, and who presented for hearing services below 3 years of age at Australian Hearing pediatric centers in New South Wales, Victoria and Southern Queensland were invited to participate in a prospective study on outcomes. Children’s speech, language, functional and social outcomes were assessed at 3 years of age, using a battery of age-appropriate tests. Demographic information relating to the child, family, and educational intervention was solicited through the use of custom-designed questionnaires. Audiological data were collected from the national database of Australian Hearing and records held at educational intervention agencies for children. Regression analysis was used to investigate the effects of each of 15 predictor variables, including age of amplification, on outcomes. Results Four hundred and fifty-one children enrolled in the study, 56% of whom received their first hearing-aid fitting before 6 months of age. Based on clinical records, 44 children (10%) were diagnosed with auditory neuropathy spectrum disorder. There were 107 children (24%) reported to have additional disabilities. At 3 years of age, 317 children (70%) were hearing-aid users and 134 children (30%) used cochlear implants. Based on parent reports, about 71% used an aural/oral mode of communication, and about 79% used English as the spoken language at home. Children’s performance scores on standardized tests administered at 3 years of age were used in a factor analysis to derive a global development factor score. On average, the global score of hearing-impaired children was more than one standard deviation (SD) below the mean of normal-hearing children at the same age. Regression analysis revealed that five factors, including female gender, absence of additional

  11. The Pisa pre-main sequence tracks and isochrones. A database covering a wide range of Z, Y, mass, and age values

    NASA Astrophysics Data System (ADS)

    Tognelli, E.; Prada Moroni, P. G.; Degl'Innocenti, S.

    2011-09-01

    Context. In recent years new observations of pre-main sequence stars (pre-MS) with Z ≤ Z⊙ have been made available. To take full advantage of the continuously growing amount of data of pre-MS stars in different environments, we need to develop updated pre-MS models for a wide range of metallicity to assign reliable ages and masses to the observed stars. Aims: We present updated evolutionary pre-MS models and isochrones for a fine grid of mass, age, metallicity, and helium values. Methods: We use a standard and well-tested stellar evolutionary code (i.e. FRANEC), that adopts outer boundary conditions from detailed and realistic atmosphere models. In this code, we incorporate additional improvements to the physical inputs related to the equation of state and the low temperature radiative opacities essential to computing low-mass stellar models. Results: We make available via internet a large database of pre-MS tracks and isochrones for a wide range of chemical compositions (Z = 0.0002-0.03), masses (M = 0.2-7.0 M⊙), and ages (1-100 Myr) for a solar-calibrated mixing length parameter α (i.e. 1.68). For each chemical composition, additional models were computed with two different mixing length values, namely α = 1.2 and 1.9. Moreover, for Z ≥ 0.008, we also provided models with two different initial deuterium abundances. The characteristics of the models have been discussed in detail and compared with other work in the literature. The main uncertainties affecting theoretical predictions have been critically discussed. Comparisons with selected data indicate that there is close agreement between theory and observation. Tracks and isochrones are available on the web at the http://astro.df.unipi.it/stellar-models/Tracks and isochrones are also available in electronic form at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/533/A109

  12. Febrile seizures in one-five aged infants in tropical practice: Frequency, etiology and outcome of hospitalization

    PubMed Central

    Assogba, Komi; Balaka, Bahoura; Touglo, Fidato A.; Apetsè, Kossivi M.; Kombaté, Damelan

    2015-01-01

    Background: Convulsive seizures are the common neurological emergencies in developing regions. Objectives: The aim was to determine the prevalence, causes and outcome of seizures in childhood. Patients and Methods: Participants were children aged 1–5 years old, admitted consecutively with a history of febrile convulsions or were presented seizures with fever during hospitalization, in two pediatric university hospitals. The prospective study covered a period from January to December 2013. At admission, emergency care and resuscitation procedures were provided according to the national guidelines. The history included the number and a parental description of seizures. Children with epilepsy, any central nervous system infections and other disease were excluded. Results: We have recorded 3647 children. Among them, 308 (8.4%) infants had presented with febrile seizures including 174 males and 134 females admitted to both pediatric hospitals (Tokoin University Teaching Hospitals: 206/3070, Campus University Teaching Hospitals: 102/577). Infants from 1 to 3 years age were the most common affected and constituted 65.9% of all patients. The months of September, December and January had recorded the high frequency of admission due to seizures. Regarding the seizures type, generalized tonic-clonic seizures were predominant (46.4%) followed by tonic seizures (17.2%) and status epilepticus in 9%. The etiologies were marked by falciparum malaria (52.3%), and other infections in 47.7%. At discharge, we have noted 11% (34/308) with neurodevelopmental disabilities, 6.7% of epilepsy and 9.7% (30/308) of death. Conclusion: The febrile seizure in child younger 5 years is an indicator of severe malaria in tropical nations. The campaign for “roll back malaria” must continue in developing countries to avoid long-term gross neurological deficits. PMID:25878734

  13. 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

  14. 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

  15. 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…

  16. Aging.

    PubMed

    Park, Dong Choon; Yeo, Seung Geun

    2013-09-01

    Aging is initiated based on genetic and environmental factors that operate from the time of birth of organisms. Aging induces physiological phenomena such as reduction of cell counts, deterioration of tissue proteins, tissue atrophy, a decrease of the metabolic rate, reduction of body fluids, and calcium metabolism abnormalities, with final progression onto pathological aging. Despite the efforts from many researchers, the progression and the mechanisms of aging are not clearly understood yet. Therefore, the authors would like to introduce several theories which have gained attentions among the published theories up to date; genetic program theory, wear-and-tear theory, telomere theory, endocrine theory, DNA damage hypothesis, error catastrophe theory, the rate of living theory, mitochondrial theory, and free radical theory. Although there have been many studies that have tried to prevent aging and prolong life, here we introduce a couple of theories which have been proven more or less; food, exercise, and diet restriction. PMID:24653904

  17. Aging

    PubMed Central

    Park, Dong Choon

    2013-01-01

    Aging is initiated based on genetic and environmental factors that operate from the time of birth of organisms. Aging induces physiological phenomena such as reduction of cell counts, deterioration of tissue proteins, tissue atrophy, a decrease of the metabolic rate, reduction of body fluids, and calcium metabolism abnormalities, with final progression onto pathological aging. Despite the efforts from many researchers, the progression and the mechanisms of aging are not clearly understood yet. Therefore, the authors would like to introduce several theories which have gained attentions among the published theories up to date; genetic program theory, wear-and-tear theory, telomere theory, endocrine theory, DNA damage hypothesis, error catastrophe theory, the rate of living theory, mitochondrial theory, and free radical theory. Although there have been many studies that have tried to prevent aging and prolong life, here we introduce a couple of theories which have been proven more or less; food, exercise, and diet restriction. PMID:24653904

  18. Visual and Anatomical Outcomes of Intravitreal Aflibercept for Treatment-Resistant Neovascular Age-Related Macular Degeneration

    PubMed Central

    Gharbiya, Magda; Mungo, Maria Laura

    2014-01-01

    A retrospective chart review of patients with persistent subretinal and/or intraretinal fluid, despite previous treatment with intravitreal ranibizumab (0.5 mg), who were switched to aflibercept injections, was performed. Treatment was three monthly aflibercept (2 mg) injections followed by dosing on pro re nata basis. Main outcome measures included changes in best corrected visual acuity (BCVA), 1 mm central subfield (CSF) retinal thickness, the height of the pigment epithelial detachment (PED), and subfoveal choroidal thickness on optical coherence tomography at 6 months. Thirty-one eyes of 30 patients were analyzed. The mean number of injections before aflibercept conversion was 34.4 ± 11.9. After an average of 4.5 aflibercept injections (range 3 to 6) over 6 months, no significant change in BCVA was observed (P > 0.05). Compared with baseline, there was a significant reduction of the CSF retinal thickness (449 ± 179 versus 269 ± 145 μm, P < 0.001), maximum PED height (262 ± 134 versus 183 ± 100 μm, P < 0.001), and choroidal thickness (192 ± 67 versus 167 ± 51 μm, P < 0.01). Stable visual acuity and anatomical improvement were obtained for up to 6 months after aflibercept conversion. However, choroidal thinning related to treatment was observed. PMID:24895562

  19. MAINE POPULATION

    EPA Science Inventory

    MEPOP250 depicts Maine's 1950-1990 population data by town or Census in unorganized territories. Populations were compiled from US Census Bureau data where available or from Maine Municipal Information (mainly for older records). Unorganized towns with very low or zero pop...

  20. Theoretical studies of massive stars. I - Evolution of a 15-solar-mass star from the zero-age main sequence to neon ignition

    NASA Technical Reports Server (NTRS)

    Endal, A. S.

    1975-01-01

    The evolution of a star with mass 15 times that of the sun from the zero-age main sequence to neon ignition has been computed by the Henyey method. The hydrogen-rich envelope and all shell sources were explicitly included in the models. An algorithm has been developed for approximating the results of carbon burning, including the branching ratio for the C-12 + C-12 reaction and taking some secondary reactions into account. Penetration of the convective envelope into the core is found to be unimportant during the stages covered by the models. Energy transfer from the carbon-burning shell to the core by degenerate electron conduction becomes important after the core carbon-burning stage. Neon ignition will occur in a semidegenerate core and will lead to a mild 'flash.' Detailed numerical results are given in an appendix. Continuation of the calculations into later stages and variations with the total mass of the star will be discussed in later papers.

  1. 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

  2. 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

  3. 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

  4. Comparing outcomes of asteroid impact simulations to observed main-belt families: Exploring the effects of parent body size and internal structure

    NASA Astrophysics Data System (ADS)

    Benavidez, P.; Durda, D.; Enke, B.; Richardson, D.; Asphaug, E.; Campo Bagatin, A.

    2014-07-01

    Some previous works focused on reproducing the size frequency distribution (SFD) of asteroid families through impact simulations, following the same strategy to compare the SFDs. This strategy, firstly applied by Durda et al. (2007), can also be used to estimate the parent-body diameter of observed asteroid families by plotting the (morphologically matching) modeled SFD and the observed family SFD to the same scale on the same plot. This strategy assumes that impact outcomes based on numerical simulations for targets of a particular fixed size are scalable to the observed families that originated from parent bodies perhaps significantly larger or smaller than those that have been modeled. This approximation appears to be reasonable (to zeroth order) for most observed families. However, it may well break down when the gravitational acceleration of the family's parent body is significantly larger or smaller than our modeled parent body. In this work, we study the range of applicability of such technique comparing the modeled SFDs from impacts simulations for parent bodies with different sizes and internal structures. We performed new SPH and N-body simulations for targets of 400 km. Here we used the same numerical technique as that in Benavidez et al. (2012) and Durda et al. (2004). Thus, we have a large set of impact simulations for two different sizes (100 and 400 km) and internal structures (monolithic and rubble-pile). These simulations comprise a homogenous set of 600 simulations covering a wide range of impactor diameters, impact speeds, and impact angles. We will present our preliminary results of this study, addressing the differences presented by cratering events and super-catastrophic impacts. Also, we will include a comparison with asteroid families with large progenitors.

  5. Developmental interplay between children’s biobehavioral risk and the parenting environment from toddler to early school age: Prediction of socialization outcomes in preadolescence

    PubMed Central

    Kochanska, Grazyna; Boldt, Lea J.; Kim, Sanghag; Yoon, Jeung Eun; Philibert, Robert A.

    2014-01-01

    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 hours per 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 (CU) tendencies. Children who carried a short 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 CU 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. PMID:25154427

  6. 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. PMID:25154427

  7. A randomized controlled comparison of NAL and DSL prescriptions for young children: Hearing-aid characteristics and performance outcomes at three years of age

    PubMed Central

    Ching, Teresa YC; Dillon, Harvey; Hou, Sanna; Zhang, Vicky; Day, Julia; Crowe, Kathryn; Marnane, Vivienne; Street, Laura; Burns, Lauren; Van Buynder, Patricia; Flynn, Christopher; Thomson, Jessica

    2013-01-01

    Objective To determine the influence of choice of prescription and other child-, family- and intervention-related factors on speech, language, and functional performance of hearing-impaired children by three years of age. Design and study sample A randomized controlled design was implemented as part of a population-based, longitudinal study on outcomes of children with hearing impairment (LOCHI) in Australia. Two hundred and eighteen children were randomly assigned to either the NAL or the DSL prescription for first fitting of hearing aids. Their performance outcomes were evaluated. Results Prescriptive targets were closely matched in children's hearing aids. There were not significant differences in children's language, speech production, or functional performance between prescriptions. Parents' ratings of children's device usage and loudness discomfort were not significantly different between prescription groups. Functional performance within the first year of fitting together with degree of hearing loss, presence of additional disabilities, and maternal education explained 44% of variation in language ability of children by three years of age. Conclusions There was no significant association between choice of hearing-aid prescription and variance in children's outcomes at three years of age. In contrast, additional disability, maternal educational level, and early functional performance were significant predictive factors of children's outcomes. PMID:22934930

  8. The IVF Outcome Counseling Based on the Model Combining DHEAS and Age in Patients with Low AMH Prior to the First Cycle of GnRH Antagonist Protocol of Ovarian Stimulation

    PubMed Central

    Alebić, Miro Šimun; Žuvić-Butorac, Marta

    2013-01-01

    Objective. To investigate the endocrine and/or clinical characteristics of women with low anti-Müllerian hormone (AMH) that could improve the accuracy of IVF outcome prediction based on the female age alone prior to the first GnRH antagonist IVF cycle. Methods. Medical records of 129 patients with low AMH level (<6.5 pmol/L) who underwent their first GnRH antagonist ovarian stimulation protocol for IVF/ICSI were retrospectively analyzed. The main outcome measure was the area under the ROC curve (AUC-ROC) for the models combining age and other potential predictive factors for the clinical pregnancy. Results. Clinical pregnancy rate (CPR) per initiated cycles was 11.6%. For the prediction of clinical pregnancy, DHEAS and age showed AUC-ROC of 0.726 (95%CI 0.641–0.801) and 0.662 (95%CI 0.573–0.743), respectively (P = 0.522). The predictive accuracy of the model combining age and DHEAS (AUC-ROC 0.796; 95%CI 0.716–0.862) was significantly higher compared to that of age alone (P = 0.013). In patients <37.5 years with DHEAS >5.7 pmol/L, 60% (9/15) of all pregnancies were achieved with CPR of 37.5%. Conclusions. DHEAS appears to be predictive for clinical pregnancy in younger women (<37.5 years) with low AMH after the first GnRH antagonist IVF cycle. Therefore, DHEAS-age model could refine the pretreatment counseling on pregnancy prospects following IVF. PMID:23509455

  9. 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

  10. Women have a poorer very long-term functional outcome after stroke among adults aged 18-50 years: the FUTURE study.

    PubMed

    Synhaeve, Nathalie E; Arntz, Renate M; van Alebeek, Mayte E; van Pamelen, Jeske; Maaijwee, Noortje A M; Rutten-Jacobs, Loes C A; Schoonderwaldt, Henny C; de Kort, Paul L M; van Dijk, Ewoud J; de Leeuw, Frank-Erik

    2016-06-01

    Due to their young age young stroke survivors have to cope with a dramatic impact on their life for the decades to come. We investigated the sex-specific very long-term functional outcome after transient ischemic attack (TIA) and ischemic stroke (IS) in adults aged 18-50 years. This study is part of a cohort study among 619 first-ever young ischemic stroke patients, admitted to our department between January 1, 1980 and November 1, 2010. Functional outcome was assessed during follow-up in 2009-2011 and in 2014-2015 with the modified Rankin Scale (mRS) and instrumental Activities of Daily Living scale (iADL). Risk factors for a poor functional outcome (mRS > 2 and iADL < 8) were calculated by logistic regression analysis. After a mean follow-up of 13.9 (SD 8.2) years, 24.5 % of TIA patients and 44.7 % of IS patients had a poor functional outcome (mRS > 2). When assessing the survivors, 15.2 % of TIA patients and 22.9 % of IS patients had a poor outcome as assessed by iADL. The strongest baseline predictors of poor outcome were female sex (OR 2.7, 95 % CI 1.5-5.0) and baseline NIHSS (OR 1.1, 95 % CI 1.1-1.2 per point increase). In conclusion, 14 years after an ischemic cerebrovascular event in young adults, one out of five IS survivors and one out of ten TIA survivors is still dependent in daily life, with a two to threefold higher risk of a poor outcome in women. This includes a period of life, during which important decisions regarding work and family life have to be made. PMID:27039389

  11. Defining the Effects of Age and Gender on Immune Response and Outcomes to Melanoma Vaccination: A Retrospective Analysis of a Single-Institution Clinical Trials’ Experience

    PubMed Central

    Ramirez, Adriana G; Wages, Nolan A; Hu, Yinin; Smolkin, Mark E; Slingluff, Craig L

    2015-01-01

    Background The impacts of patient age and gender on immune response (IR) and clinical outcome after cancer vaccines are not known. We hypothesized younger and female patients would have higher IR rates and better survival. Methods Patients with resected stage IIB-IV melanoma in three clinical trials (Mel43, Mel44, Mel48) were vaccinated with 12 melanoma-associated peptides restricted by Class I MHC. The cumulative incidence rate of CD8+ T cell responses (direct Interferon-gamma ELIspot assay) by week 7 was compared by age and gender. Overall survival (OS) and disease-free survival (DFS) landmark analyses were compared by Kaplan-Meier estimates and in multivariate analyses. Results T cell responses were evaluated in 327 patients, and detected in 50% of males and 48% of females, with no difference in IR by gender or menopausal status. Males had trends toward longer DFS (p=0.12) and OS (p=0.09). Cumulative incidence of IR was higher in patients < 64 years of age versus older patients (p=0.03). OS and DFS were similar by age group (p> 0.50). In multivariate modeling, younger age was associated with better IR (OR 0.40, p-value 0.003), without an impact of age or gender on clinical outcomes. Conclusion These data support the hypothesis that older patients are less likely to develop T cell responses to a cancer vaccine. Nonetheless, significant proportions of older patients mount immune responses with comparable survival outcomes. Thus, these data support including older patients in cancer vaccine trials, but suggest value in stratifying patients by age < / > 64 years. PMID:26392296

  12. MAINE AQUIFERS

    EPA Science Inventory

    AQFRS24 contains polygons of significant aquifers in Maine (glacial deposits that are a significant ground water resource) mapped at a scale 1:24,000. This statewide coverage was derived from aquifer boundaries delineated and digitized by the Maine Geological Survey from data com...

  13. 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

  14. Effect of Age on Outcome of Reduced-Intensity Hematopoietic Cell Transplantation for Older Patients With Acute Myeloid Leukemia in First Complete Remission or With Myelodysplastic Syndrome

    PubMed Central

    McClune, Brian L.; Weisdorf, Daniel J.; Pedersen, Tanya L.; Tunes da Silva, Gisela; Tallman, Martin S.; Sierra, Jorge; DiPersio, John; Keating, Armand; Gale, Robert P.; George, Biju; Gupta, Vikas; Hahn, Theresa; Isola, Luis; Jagasia, Madan; Lazarus, Hillard; Marks, David; Maziarz, Richard; Waller, Edmund K.; Bredeson, Chris; Giralt, Sergio

    2010-01-01

    Purpose Acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) primarily afflict older individuals. Hematopoietic cell transplantation (HCT) is generally not offered because of concerns of excess morbidity and mortality. Reduced-intensity conditioning (RIC) regimens allow increased use of allogeneic HCT for older patients. To define prognostic factors impacting long-term outcomes of RIC regimens in patients older than age 40 years with AML in first complete remission or MDS and to determine the impact of age, we analyzed data from the Center for International Blood and Marrow Transplant Research (CIBMTR). Patients and Methods We reviewed data reported to the CIBMTR (1995 to 2005) on 1,080 patients undergoing RIC HCT. Outcomes analyzed included neutrophil recovery, incidence of acute or chronic graft-versus-host disease (GVHD), nonrelapse mortality (NRM), relapse, disease-free survival (DFS), and overall survival (OS). Results Univariate analyses demonstrated no age group differences in NRM, grade 2 to 4 acute GVHD, chronic GVHD, or relapse. Patients age 40 to 54, 55 to 59, 60 to 64, and ≥ 65 years had 2-year survival rates as follows: 44% (95% CI, 37% to 52%), 50% (95% CI, 41% to 59%), 34% (95% CI, 25% to 43%), and 36% (95% CI, 24% to 49%), respectively, for patients with AML (P = .06); and 42% (95% CI, 35% to 49%), 35% (95% CI, 27% to 43%), 45% (95% CI, 36% to 54%), and 38% (95% CI, 25% to 51%), respectively, for patients with MDS (P = .37). Multivariate analysis revealed no significant impact of age on NRM, relapse, DFS, or OS (all P > .3). Greater HLA disparity adversely affected 2-year NRM, DFS, and OS. Unfavorable cytogenetics adversely impacted relapse, DFS, and OS. Better pre-HCT performance status predicted improved 2-year OS. Conclusion With these similar outcomes observed in older patients, we conclude that older age alone should not be considered a contraindication to HCT. PMID:20212255

  15. 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;…

  16. Effects of case management in community aged care on client and carer outcomes: a systematic review of randomized trials and comparative observational studies

    PubMed Central

    2012-01-01

    Background Case management has been applied in community aged care to meet frail older people’s holistic needs and promote cost-effectiveness. This systematic review aims to evaluate the effects of case management in community aged care on client and carer outcomes. Methods We searched Web of Science, Scopus, Medline, CINAHL (EBSCO) and PsycINFO (CSA) from inception to 2011 July. Inclusion criteria were: no restriction on date, English language, community-dwelling older people and/or carers, case management in community aged care, published in refereed journals, randomized control trials (RCTs) or comparative observational studies, examining client or carer outcomes. Quality of studies was assessed by using such indicators as quality control, randomization, comparability, follow-up rate, dropout, blinding assessors, and intention-to-treat analysis. Two reviewers independently screened potentially relevant studies, extracted information and assessed study quality. A narrative summary of findings were presented. Results Ten RCTs and five comparative observational studies were identified. One RCT was rated high quality. Client outcomes included mortality (7 studies), physical or cognitive functioning (6 studies), medical conditions (2 studies), behavioral problems (2 studies) , unmet service needs (3 studies), psychological health or well-being (7 studies) , and satisfaction with care (4 studies), while carer outcomes included stress or burden (6 studies), satisfaction with care (2 studies), psychological health or well-being (5 studies), and social consequences (such as social support and relationships with clients) (2 studies). Five of the seven studies reported that case management in community aged care interventions significantly improved psychological health or well-being in the intervention group, while all the three studies consistently reported fewer unmet service needs among the intervention participants. In contrast, available studies reported mixed

  17. "I learned that the aging population isn't that much different from me": the final outcomes of a Gero-Ed BEL Project.

    PubMed

    Masciadrelli, Brian Paul

    2014-01-01

    This article describes a Council on Social Work Education (CSWE) Gero-Ed Center BEL Project's activities and reports its final outcomes. An oral history interview in paired human behavior and practice skills courses addressed gerontological social work competencies focused on assessing and addressing values and biases regarding aging, and the ability to relate concepts and theories of aging to practice. Significant increases in perceived proficiency in these competencies occurred, as did significant decreases in negative attitudes toward older people and working with older adults. Qualitative data supported these results. Findings suggest social work educators utilize a combination of classroom-based and experiential learning to maximize student development. PMID:24377721

  18. Urinary tract infections in children younger than 5 years of age: epidemiology, diagnosis, treatment, outcomes and prevention.

    PubMed

    Schlager, T A

    2001-01-01

    recommended following the first UTI in all children aged <6 years. Patients with significant urinary tract abnormalities and/or frequent symptomatic UTI may benefit from prophylactic antibacterials. The main long term consequence of UTI is renal scarring which may lead to hypertension and end-stage renal disease. Prevention of recurrent UTI focuses on detection, and correction if possible, of urinary tract abnormalities. Interventions that have been associated with a decrease in symptomatic UTI in children with a history of recurrent UTI include relief of constipation and voiding dysfunction. PMID:11310718

  19. MAINE HYDROGRAPHY

    EPA Science Inventory

    Hydronet_me24 and Hydropoly_me24 depict Maine's hydrography data, based on 8-digit hydrological unit codes (HUC's) at the 1:24,000 scale. Some New Hampshire and New Brunswick hydrography data are also included. The NHD hydrography data was compiled from previous ArcIn...

  20. MAINE WOODLOTS

    EPA Science Inventory

    MEOWN250 describes industrial, non-industrial, and public woodlot ownership in Maine at 1:250,000 scale. Industrial owners are those having at least one primary wood processing facility. Non-industrial owners are those with no primary wood processing facility. Public ownership...

  1. 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…

  2. 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

  3. The effectiveness of an aged care specific leadership and management program on workforce, work environment, and care quality outcomes: design of a cluster randomised controlled trial

    PubMed Central

    2013-01-01

    Background A plethora of observational evidence exists concerning the impact of management and leadership on workforce, work environment, and care quality. Yet, no randomised controlled trial has been conducted to test the effectiveness of leadership and management interventions in aged care. An innovative aged care clinical leadership program (Clinical Leadership in Aged Care − CLiAC) was developed to improve managers’ leadership capacities to support the delivery of quality care in Australia. This paper describes the study design of the cluster randomised controlled trial testing the effectiveness of the program. Methods Twenty-four residential and community aged care sites were recruited as managers at each site agreed in writing to participate in the study and ensure that leaders allocated to the control arm would not be offered the intervention program. Sites undergoing major managerial or structural changes were excluded. The 24 sites were randomly allocated to receive the CLiAC program (intervention) or usual care (control), stratified by type (residential vs. community, six each for each arm). Treatment allocation was masked to assessors and staff of all participating sites. The objective is to establish the effectiveness of the CLiAC program in improving work environment, workforce retention, as well as care safety and quality, when compared to usual care. The primary outcomes are measures of work environment, care quality and safety, and staff turnover rates. Secondary outcomes include manager leadership capacity, staff absenteeism, intention to leave, stress levels, and job satisfaction. Differences between intervention and control groups will be analysed by researchers blinded to treatment allocation using linear regression of individual results adjusted for stratification and clustering by site (primary analysis), and additionally for baseline values and potential confounders (secondary analysis). Outcomes measured at the site level will be

  4. 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. PMID:22474915

  5. Impact of New York Heart Association classification, advanced age and patient-prosthesis mismatch on outcomes in aortic valve replacement surgery.

    PubMed

    Zapolanski, Alex; Mak, Andrew W C; Ferrari, Giovanni; Johnson, Christopher; Shaw, Richard E; Brizzio, Mariano E; Sperling, Jason S; Grau, Juan B

    2012-09-01

    OBJECTIVES More elderly patients (>80 years of age) are being referred for aortic valve replacement (AVR) with or without CABG. Current risk stratification models may not accurately predict the preoperative risk in these patients. We sought to determine which perioperative variables were relevant in determining short-term (30-day to in-hospital) outcomes in our intuition's series of consecutive AVR and AVR+CABG surgeries. We constructed a novel variable, patient-prosthesis mismatch (PPM) in the presence of diminished functional status (NYHA) classification, and studied its role as a predictor of mortality risk. METHODS From 2006 to 2010, 509 patients undergoing AVR or AVR+CABG were evaluated. We created four groups based on the age and procedure (AVR >80, AVR+CABG >80, AVR <80 and AVR+CABG <80). PPM was defined as a calculated effective orifice area index value of ≤ 0.85, and it was calculated from manufacturer-generated charts. In-hospital and 30-day outcomes were assessed using the Chi-square and logistic regression analyses. RESULTS Overall observed 30-day mortality for all groups was lower (n = 8, 1.6%) than the STS-predicted mortality. Reoperation and PPM+NYHA class III-IV were associated with short-term mortality, but age >80 years was not. Octogenarians referred for surgery often had advanced heart failure. CONCLUSIONS Overall, short-term outcomes after AVR with or without CABG were excellent and lower than predicted by the STS model. The low risk of AVR with CABG supports the consideration for earlier surgical referral and intervention for patients with a high likelihood of aortic stenosis progression before the onset of advanced heart failure ensues, regardless of the age. This should help further decrease the already very low mortality observed in these series. Efforts to avoid PPM in the setting of advanced heart failure may improve short-term results in this subset of patients. PMID:22665381

  6. 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…

  7. 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…

  8. 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…

  9. 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

  10. Impact of maternal age on birth outcomes: a population-based study of primiparous Brazilian women in the city of São Paulo.

    PubMed

    Machado, Carla Jorge

    2006-07-01

    The aim of this study is to analyse the impact of maternal age at first birth on low birth weight, preterm birth and low Apgar scores at one minute and at five minutes among live births delivered to primiparous Brazilian women in the city of São Paulo. Analyses were based on 73,820 birth records from the 1998 birth cohort. Logistic regression was used to assess the association between maternal age and each outcome variable, controlling for the following risk factors: delivery mode, plurality, sex, maternal education, number of prior losses, prenatal care, race, parity and community development. Maternal ages below 20 and above 30 years were significantly associated with the risks of low birth weight and preterm birth, but no association was found between maternal ages and Apgar score, with the exception that ages 15-19 reduced the odds of a low one-minute score. Even though this result seems to be inconsistent, low birth weight, preterm birth and low Apgar scores measure different dimensions of newborn well-being, and the association of each measure with maternal age is expected to diverge. PMID:16762088

  11. 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…

  12. 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

  13. 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

  14. 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...

  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. 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

  18. Feasibility of robot-assisted radical prostatectomy for very-high risk prostate cancer: surgical and oncological outcomes in men aged ≥70 years

    PubMed Central

    Koo, Kyo Chul; Jung, Dae Chul; Lee, Seung Hwan; Choi, Young Deuk; Chung, Byung Ha; Hong, Sung Joon; Rha, Koon Ho

    2014-01-01

    Purpose Robot-assisted radical prostatectomy with pelvic lymph node dissection (RALP-PLND) is a feasible treatment option for high-risk prostate cancer (HPCa), but remains controversial for very high-risk prostate cancer (VHPCa). We aimed to assess the feasibility of RALP-PLND in men ≥70 years with VHPCa features by comparing outcomes to those of HPCa. Methods Among patients aged ≥70 years who underwent RALP-PLND between 2005 and 2012, 101 HPCa patients (31%) (PSA≥20 ng/mL or biopsy Gleason 8–10 or cT3a) and 53 VHPCa patients (16%) (≥cT3b or cN1) were identified. Perioperative, functional, and oncological outcomes were compared between groups. Results Perioperative outcomes including operative time (P=0.917), estimated blood loss (P=0.181), and complications (P=0.239) were comparable. Due to Gleason score downgrading, 19% of HPCa and 4% of VHPCa were actually of intermediate risk. VHPCa revealed higher LN involvements (P=0.002). Discrepancy between clinical and pathological nodal status was more frequent in VHPCa (36% vs. 7%, P<0.01). Nodal metastasis would have been missed in 23% patients without PLND, while 13% of cN1 patients were shown to be metastasis-free by PLND. Continence rates were lower for VHPCa (32% vs. 56%, P=0.013). Although biochemical recurrence-free survival rates were comparable (P=0.648), risk for later adjuvant treatments was higher for VHPCa patients (14% vs. 34%, P<0.01). Conclusions RALP-PLND is a feasible option for VHPCa in elderly patients with satisfactory oncologic outcomes; however, functional outcomes were not as favorable. Patients who are unable to accept the risk of adjuvant therapy and its side effects or incontinence should be deterred from surgical treatment, and other options such as radiation therapy could be an alternative. PMID:25325024

  19. 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

  20. Outcome from a Prospective, Longitudinal Study of Prenatal Cocaine Use: Preschool Development at 3 Years of Age

    PubMed Central

    Behnke, Marylou; Eyler, Fonda Davis; Warner, Tamara Duckworth; Garvan, Cynthia Wilson; Hou, Wei; Wobie, Kathleen

    2011-01-01

    Objective To determine the effects of prenatal cocaine exposure on child development. Methods This prospective, longitudinal study recruited 154 pregnant cocaine users who were matched on race, parity, socioeconomic status, and perinatal risk to 154 noncocaine users. Drug use status was determined by maternal history and urine screening. At 3 years of age, the child subjects were assessed by an evaluator blinded to maternal drug use history. During a home visit at age 3, caregiver, family, and home assessments were administered. Results Structural equation modeling showed a direct effect of the amount of prenatal cocaine exposure on the adjusted birth head circumference which in turn directly affected preschool development. Conclusions We could not demonstrate a direct effect of prenatal cocaine exposure on preschool development, a result that is consistent with that of earlier work and now extending findings to age 3. However, cocaine continued to exert an indirect effect on development through its direct effect on the head circumference at birth. PMID:15827349

  1. 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

  2. The Age of Entry into High-Quality Preschool, Child and Family Factors, and Developmental Outcomes in Early Childhood

    ERIC Educational Resources Information Center

    Zupancic, Maja; Kavcic, Tina

    2006-01-01

    Three blocks of factors were considered as predictors of four year old children's (N = 286) personality, non-verbal intelligence and social behaviour in preschool: (a) personality characteristics at time 1 (T1) when the participants were three years old; (b) parental education and parenting practices measured at T1; and (c) age of child's entry to…

  3. 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…

  4. Neurodevelopmental Outcome of ECMO Survivors at Five Years of Age: The Potential for Academic and Motor Difficulties.

    ERIC Educational Resources Information Center

    Langenbacher, Deborah; Nield, Toni; Poulsen, Marie Kanne

    2001-01-01

    This study examined the cognitive and motor functioning of 52 survivors of neonatal extracorporeal membrane oxygenation (ECMO) at age 5. Ten percent were diagnosed with mental retardation, while an additional 12 percent presented other disabilities. A common pattern of specific vulnerabilities in cognitive, gross motor, fine motor, and motor…

  5. "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…

  6. 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…

  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. Variability in ESL Outcomes: The Influence of Age on Arrival and Length of Residence on Achievement in High School

    ERIC Educational Resources Information Center

    Roessingh, Hetty

    2008-01-01

    This article integrates findings from earlier research (Roessingh & Kover, 2003; Roessingh, Kover, & Watt, 2005) linking distinct patterns of achievement for diverse age-on-arrival (AOA) cohorts of ESL learners on the grade 12 Alberta English language arts (ELA) examination to their vocabulary and reading comprehension scores on a standardized…

  9. 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…

  10. Different antivascular endothelial growth factor treatments and regimens and their outcomes in neovascular age-related macular degeneration: a literature review.

    PubMed

    Lanzetta, Paolo; Mitchell, Paul; Wolf, Sebastian; Veritti, Daniele

    2013-12-01

    Antivascular endothelial growth factor (anti-VEGF) therapy has revolutionised the treatment of wet age-related macular degeneration (wAMD). Recent research has focused on evaluating competing agents and alternative dosage regimens, providing evidence to help determine optimal treatment strategies. We therefore conducted a review of clinical research studies in wAMD published since 2008 that compared anti-VEGF dosing regimens and therapies; seven studies met our inclusion criteria. Data on baseline disease characteristics, disease outcomes, safety (ocular and systemic) and treatment burden (injection and visit frequencies) were extracted on patients treated with ranibizumab 0.5 mg, bevacizumab 1.25 mg or aflibercept 2.0 mg for up to 2 years. For ranibizumab and bevacizumab, visual and anatomical outcomes at 1 and 2 years were superior using scheduled monthly (or 4 weekly (q4w)) compared with as needed or scheduled quarterly dosing regimens. Treatment outcomes were generally better for both drugs when more aggressive retreatment criteria were used, which resulted in more frequent injections. Bevacizumab, however, was associated with a 30-35% elevated rate of serious systemic adverse events compared with ranibizumab, regardless of dosing interval; further study in larger patient populations will be required to determine the validity of this finding. Intravitreal aflibercept injection every 8 weeks was non-inferior to ranibizumab q4w on all visual and anatomical endpoints at week 52, had a similar safety profile and required five fewer anti-VEGF injections. PMID:23929309

  11. 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

  12. 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

  13. 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

  14. Online Calculator to Improve Counseling of Short-Term Neonatal Morbidity and Mortality Outcomes at Extremely Low Gestational Age (23-28 Weeks).

    PubMed

    King, Carol P; da Silva, Orlando; Filler, Guido; Lopes, Laudelino M

    2016-07-01

    Objective Extremely low gestational age (ELGA) infants are at high risk of perinatal and neonatal morbidity and mortality. Accurate and relevant data are essential for developing a health care plan and providing realistic estimates of infants' outcomes. Study Design Retrospective analysis of all infants delivered between 23(0/7) and 28(6/7) weeks' gestation over 11 years at a single center. Using logistic regression analysis, gestational age (GA)-specific mortality and morbidity rates, and the effects of gender, antenatal corticosteroids, multiple gestation, and birth weight (BW) were determined. Results Of the 766 study infants, 644 (84.1%) were admitted to the neonatal intensive care unit, of which 502 (75.8%) survived to discharge. GA, antenatal corticosteroids, and BW were significant predictors of survival (GA: odds ratio [OR] = 1.83, 95% confidence interval [CI] = 1.64-2.04; corticosteroids: OR = 7.62, 95% CI = 5.19-11.18; BW: OR = 1.56, 95% CI = 1.44-1.69). Increasing BW correlated with a decreasing mortality rate. Conclusion This study provides recent outcome data of ELGA infants delivered at a tertiary level center. The results have been translated into an online counseling tool (http://murmuring-brook-6600.herokuapp.com/ELGA.html). PMID:27057769

  15. 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

  16. Delay to Treatment and Visual Outcomes in Patients Treated With Anti-Vascular Endothelial Growth Factor for Age-Related Macular Degeneration

    PubMed Central

    LIM, JONATHAN H.; WICKREMASINGHE, SANJEEWA S.; XIE, JING; CHAUHAN, DEVINDER S.; BAIRD, PAUL N.; ROBMAN, LUBA D.; HAGEMAN, GREGORY; GUYMER, ROBYN H.

    2016-01-01

    PURPOSE To investigate the potential influences that affect visual acuity (VA) outcome in a clinic-based cohort of age-related macular degeneration (AMD) patients undergoing anti–vascular endothelial growth factor (anti-VEGF) treatment for choroidal neovascularization. DESIGN Prospective interventional case series. METHODS Patients with subfoveal choroidal neovascularization (CNV) secondary to AMD were prospectively recruited. A detailed questionnaire was given to patients at time of enrollment, to collect information relating to demographics, history of visual symptoms, visual acuity (VA), and treatment scheduling. Delay from symptoms to treatment (“Treatment delay”) was measured in terms of weeks and analyzed in tertiles. Information pertaining to treatment outcomes was collected over a 6-month period. RESULTS One hundred eighty-five eyes of 185 patients were recruited into the study. Longer delay from first symptoms suggestive of CNV to first injection was a significant predictor (P = .015) of poorer treatment outcome, when controlling for age, sex, and baseline VA. Patients with a delay in treatment of 21 weeks or more compared to a delay of 7 weeks or less had an odds ratio of 2.62 (1.20, 5.68) for worsening vision after treatment. CONCLUSIONS Patients experiencing a longer delay between their first symptoms of CNV and their first anti-VEGF treatment have a significantly lower chance of improving vision at 6 months following anti-VEGF therapy. It is critical that this information reach those at potential vision loss from AMD, in order that prompt treatment may be instituted, to maximize the benefits of anti-VEGF treatment. PMID:22245460

  17. The importance of neighborhood ecological assets in community dwelling old people aging outcomes: A study in Northern Portugal

    PubMed Central

    Bastos, Alice M.; Faria, Carla G.; Moreira, Emília; Morais, Diana; Melo-de-Carvalho, José M.; Paul, M. Constança

    2015-01-01

    Human development is a bidirectional, person-context relational process, but scarce evidence is available about the relation between the individual variability across the life-span and the neighborhood ecological assets. Therefore, it is important that research focus not only on personal characteristics but on ecological assets as well. This way this study aims to analyze the association between neighborhood ecological assets categorized into four dimensions: human, physical or institutional, social or collective activity, accessibility, and the individual functioning. A 3% sample of residents aged 65 years and older in two downtown and three uptown parishes stratified by age and sex was interviewed at home using a protocol that included the Portuguese version of the Barthel Index in basic activities of daily living (BADL), the Lawton Instrumental Activities of Daily Living Scale (IADL), the Mini Mental State Examination (MMSE), and the Geriatric Depression Scale-15 items (GDS) for evaluating functionality, cognitive performance, and depression. The 162 participants were aged on average 75 years (sd = 7.0), 54% were women and 90% had less than 7 years of education. The majority of participants were independent in BADL (M = 90; sd = 17.7) and moderately dependent in IADL (M = 13, sd = 6.0), 20% showed cognitive impairment and a mean score of 8 (sd = 2.1) in GDS-15. After controlling for the effect of socio-demographic characteristics, functionality, and cognitive performance decreases in persons with worst outdoor mobility. On the other hand depressive symptoms are less common as the number of recreation opportunities, namely associative groups (cultural, educative, professional), increases. These results suggest that aging policies and practices must be ecologically embedded. PMID:26388765

  18. The importance of neighborhood ecological assets in community dwelling old people aging outcomes: A study in Northern Portugal.

    PubMed

    Bastos, Alice M; Faria, Carla G; Moreira, Emília; Morais, Diana; Melo-de-Carvalho, José M; Paul, M Constança

    2015-01-01

    Human development is a bidirectional, person-context relational process, but scarce evidence is available about the relation between the individual variability across the life-span and the neighborhood ecological assets. Therefore, it is important that research focus not only on personal characteristics but on ecological assets as well. This way this study aims to analyze the association between neighborhood ecological assets categorized into four dimensions: human, physical or institutional, social or collective activity, accessibility, and the individual functioning. A 3% sample of residents aged 65 years and older in two downtown and three uptown parishes stratified by age and sex was interviewed at home using a protocol that included the Portuguese version of the Barthel Index in basic activities of daily living (BADL), the Lawton Instrumental Activities of Daily Living Scale (IADL), the Mini Mental State Examination (MMSE), and the Geriatric Depression Scale-15 items (GDS) for evaluating functionality, cognitive performance, and depression. The 162 participants were aged on average 75 years (sd = 7.0), 54% were women and 90% had less than 7 years of education. The majority of participants were independent in BADL (M = 90; sd = 17.7) and moderately dependent in IADL (M = 13, sd = 6.0), 20% showed cognitive impairment and a mean score of 8 (sd = 2.1) in GDS-15. After controlling for the effect of socio-demographic characteristics, functionality, and cognitive performance decreases in persons with worst outdoor mobility. On the other hand depressive symptoms are less common as the number of recreation opportunities, namely associative groups (cultural, educative, professional), increases. These results suggest that aging policies and practices must be ecologically embedded. PMID:26388765

  19. 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

  20. Young people's use of NHS Direct: a national study of symptoms and outcome of calls for children aged 0–15

    PubMed Central

    Cook, E J; Randhawa, G; Large, S; Guppy, A; Chater, A M; Pang, D

    2013-01-01

    Objectives National Health Service (NHS) Direct provides 24/7 expert telephone-based healthcare information and advice to the public in England. However, limited research has explored the reasons to why calls are made on behalf of young people, as such this study aimed to examine call rate (CR) patterns in younger people to enable a better understanding of the needs of this population in England. Setting NHS Direct, England, UK. Participants and methods CRs (expressed as calls/100 persons/annum) were calculated for all calls (N=358 503) made to NHS Direct by, or on behalf of, children aged 0–15 during the combined four ‘1-month’ periods within a year (July 2010, October 2010, January 2011 and April 2011). χ² Analysis was used to determine the differences between symptom, outcome and date/time of call. Results For infants aged <1, highest CRs were found for ‘crying’ for male (n=14, 440, CR=13.61) and female (n=13 654, CR=13.46) babies, which is used as a universal assessment applied to all babies. High CRs were also found for symptoms relating to ‘skin/hair/nails’ and ‘colds/flu/sickness’ for all age groups, whereby NHS Direct was able to support patients to self-manage and provide health information for these symptoms for 59.7% and 51.4% of all cases, respectively. Variations in CRs were found for time and age, with highest peaks found for children aged 4–15 in the 15:00–23:00 period and in children aged <1 in the 7:00–15:00 period. Conclusions This is the first study to examine the symptoms and outcome of calls made to NHS Direct for and on behalf of young children. The findings revealed how NHS Direct has supported a range of symptoms through the provision of health information and self-care support which provides important information about service planning and support for similar telephone-based services. PMID:24327365

  1. Does age affect surgical outcomes in patients with degenerative cervical myelopathy? Results from the prospective multicenter AOSpine International study on 479 patients

    PubMed Central

    Nakashima, Hiroaki; Tetreault, Lindsay A; Nagoshi, Narihito; Nouri, Aria; Kopjar, Branko; Arnold, Paul M; Bartels, Ronald; Defino, Helton; Kale, Shashank; Zhou, Qiang; Fehlings, Michael G

    2016-01-01

    Background In general, older patients with degenerative cervical myelopathy (DCM) are felt to have lower recovery potential following surgery due to increased degenerative pathology, comorbidities, reduced physiological reserves and age-related changes to the spinal cord. This study aims to determine whether age truly is an independent predictor of surgical outcome and to provide evidence to guide practice and decision-making. Methods A total of 479 patients with DCM were prospectively enrolled in the CSM-International study at 16 centres. Our sample was divided into a younger group (<65 years) and an elderly (≥65 years) group. A mixed model analytic approach was used to evaluate differences in the modified Japanese Orthopaedic Association (mJOA), Nurick, Short Form-36 (SF-36) and Neck Disability Index (NDI) scores between groups. We first created an unadjusted model between age and surgical outcome and then developed two adjusted models that accounted for variations in (1) baseline characteristics and (2) both baseline and surgical factors. Results Of the 479 patients, 360 (75.16%) were <65 years and 119 (24.84%) were ≥65 years. Elderly patients had a worse preoperative health status (p<0.0001) and were functionally more severe (p<0.0001). The majority of younger patients (64.96%) underwent anterior surgery, whereas the preferred approach in the elderly group was posterior (58.62%, p<0.0001). Elderly patients had a greater number of decompressed levels than younger patients (p<0.0001). At 24 months after surgery, younger patients achieved a higher postoperative mJOA (p<0.0001) and a lower Nurick score (p<0.0001) than elderly patients. After adjustments for patient and surgical characteristics, these differences in postoperative outcome scores decreased but remained significant. Conclusions Older age is an independent predictor of functional status in patients with DCM. However, patients over 65 with DCM still achieve functionally significant

  2. Extra-nodal natural killer/T cell lymphoma in elderly patients: the impact of aging on clinical outcomes and treatment tolerability.

    PubMed

    Kim, Sung Min; Park, Silvia; Oh, Dong Ryul; Ahn, Yong Chan; Ko, Young Hyeh; Kim, Seok Jin; Kim, Won Seog

    2016-03-01

    Extra-nodal natural killer/T cell lymphoma (ENKTL) is rare in elderly patients, and its clinical course is unclear. The efficacy and tolerability of non-anthracycline-based treatments as a standard regimen in elderly patients have not been fully investigated. This study assessed the impact of aging on clinical outcomes and treatment tolerability. We retrospectively analyzed 51 patients aged ≥60 years who were diagnosed with ENKTL from January 1998 to December 2012. We defined new treatments as non-anthracycline regimens (etoposide, ifosfamide, mesna, cisplatin, and dexamethasone (VIPD); etoposide, ifosfamide, mesna, dexamethasone, and L-asparaginase (VIDL); methotrexate, leucovorin, etoposide, ifosfamide, mesna, dexamethasone, and L-asparaginase (MIDLE); ifosfamide, methotrexate, etoposide, and prednisolone (IMVP16/PD); or methotrexate, leucovorin, etoposide, ifosfamide, mesna, dexamethasone, and L-asparaginase (SMILE), with or without radiation therapy). The median age was 66 years (60-83 years). Twenty patients were diagnosed at advanced stage, and 18 had poor performance status. The overall survival and progression-free survival were 6.7 and 5.2 months, respectively. Clinical outcomes of patients with early disease were superior to those of patients with advanced disease. Among patients who received new treatments, concurrent chemoradiation therapy (CCRT) for localized disease was tolerable, although 37.5 % of patients with advanced disease who received SMILE discontinued chemotherapy due to intolerability. Elderly patients with ENKTL have poor prognostic factors compared to younger patients. In particular, patients with advanced disease have extremely poor prognosis due to inability to tolerate treatment and rapid progression of disease. PMID:26729202

  3. Hospital Based Prospective Observational Study to Audit the Prescription Practices and Outcomes of Paediatric Patients (6 months to 5 years age group) Presenting with Acute Diarrhea

    PubMed Central

    Kondekar, Santosh; Rathi, Surbhi

    2016-01-01

    Introduction Diarrhea is a leading killer of children, accounting for 9% of all deaths among under-five children worldwide. WHO protocol deviation in management of diarrheas in children is likely due to various reasons. Aim To study the prescription practices, regarding adherence to WHO protocol and deviations, in the management of acute diarrhea in children presenting at a tertiary care hospital and its impact on the outcome. Materials and Methods This was a prospective observational hospital based study at a tertiary care carried out over a 12-month period including all cases of acute diarrhea (defined as 3 or more loose stools in last 24 hours) in children belonging to the age group of 6 months to 5 years. Patients were followed up on day 3,7,14 and 28 from the day of presentation. Software SPSS Version 17.0 was used for analysis. Correlation regression analysis was used to study predictiveness of different variables affecting outcome. Results In this study, 447 children aged between 6 months and 5 years were enrolled, of which 45 cases were lost in follow-up and excluded. The median age was 14 months. Some deviation from WHO protocol was noted in 78.4% of the cases. Most common deviations from WHO protocol were addition of probiotics (78.1% of cases) and addition of race cadotril (15.9% of cases). Inadvertent use of antibiotics in diarrhea was noted in 12.2% of cases. Presence of fever was strong predictor for use of antibiotics. Cases of early recovery within 3 days of presentation were higher in WHO protocol deviation group. Use of probiotics had statistically significant association with early recovery. Conclusion In diarrhea management, WHO protocol deviation is common. Probiotics are likely to help in early recovery. PMID:27437317

  4. 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

  5. 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. PMID:25801548

  6. 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

  7. 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.

  8. Progesterone exerts neuroprotective effects and improves long-term neurologic outcome after intracerebral hemorrhage in middle-aged mice.

    PubMed

    Jiang, Chao; Zuo, Fangfang; Wang, Yuejuan; Wan, Jieru; Yang, Zengjin; Lu, Hong; Chen, Wenwu; Zang, Weidong; Yang, Qingwu; Wang, Jian

    2016-06-01

    In this study, we examined the effect of progesterone on histopathologic and functional outcomes of intracerebral hemorrhage (ICH) in 10- to 12-month-old mice. Progesterone or vehicle was administered by intraperitoneal injection 1 hour after collagenase-induced ICH and then by subcutaneous injections at 6, 24, and 48 hours. Oxidative and nitrosative stress were assayed at 12 hours post-ICH. Injury markers were examined on day 1, and lesion was examined on day 3. Neurologic deficits were examined for 28 days. Progesterone posttreatment reduced lesion volume, brain swelling, edema, and cell degeneration and improved long-term neurologic function. These protective effects were associated with reductions in protein carbonyl formation, protein nitrosylation, and matrix metalloproteinase-9 activity and attenuated cellular and molecular inflammatory responses. Progesterone also reduced vascular endothelial growth factor expression, increased neuronal-specific Na(+)/K(+) ATPase ɑ3 subunit expression, and reduced protein kinase C-dependent Na(+)/K(+) ATPase phosphorylation. Furthermore, progesterone reduced glial scar thickness, myelin loss, brain atrophy, and residual injury volume on day 28 after ICH. With multiple brain targets, progesterone warrants further investigation for its potential use in ICH therapy. PMID:27143417

  9. 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. PMID:24524368

  10. 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

  11. 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.

  12. 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

  13. 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

  14. 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

  15. Exploring outcomes through narrative: the long-term impacts of Better Beginnings, Better Futures on the turning point stories of youth at ages 18-19.

    PubMed

    Nelson, Geoffrey; Van Andel, Ashley K; Curwood, Susan Eckerle; Hasford, Julian; Love, Norah; Pancer, S Mark; Loomis, Colleen

    2012-03-01

    This study examined the long-term effects of the Better Beginnings, Better Futures project, a community-based early childhood development program, on 18-19 year-old youths' narratives about turning points in their lives. The sample consisted of youth who participated in Better Beginnings from ages 4-8 (n = 62) and youth from a comparison community who did not participate in Better Beginnings (n = 34). Controlling for covariates, significant differences favoring youth from the Better Beginnings sites were found on several dimensions of the turning point stories: ending resolution, personal growth, meaning-making, coherence, and affect transformation. Effect sizes ranged from .45 to .76 for these outcome dimensions, indicating moderate to large effects. Also, turning point story dimensions were found to be significantly correlated with two standardized measures of well-being: youths' self-esteem and community involvement. Youths' self-esteem was directly related to story ending resolution, personal growth, and meaning making, and youths' community involvement was directly related to story specificity, meaning making, and coherence. Family functioning was also examined in relation to these narrative dimensions but was not found to be significantly related to them. The findings suggest the utility of a narrative approach for the evaluation of the long-term outcomes of early childhood development programs. PMID:21792737

  16. 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

  17. 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

  18. 6-weekly bevacizumab versus 4-weekly ranibizumab for neovascular age-related macular degeneration: a 2-year outcome

    PubMed Central

    Chiam, Patrick J; Ho, Vivian W; Hickley, Nicholas M; Kotamarthi, Venkat

    2016-01-01

    AIM To compare visual acuity and central macular thickness (CMT) changes in neovascular age related macular degeneration patients treated with either 6 weekly bevacizumab regimen or 4 weekly ranibizumab on an as required basis. METHODS Patients made an informed choice between bevacizumab 1.25 mg or ranibizumab 0.5 mg. The selected treatment was administered in the first 3 visits. Bevacizumab patients were followed-up 6 weekly and ranibizumab 4 weekly. Retreatment criteria was based on the reduction of >5 letters in the best-corrected visual acuity (BCVA), the presence of retinal fluid on optical coherence tomography (OCT) or new retinal haemorrhage. RESULTS Visual acuity at 2y bevacizumab patients gained 7.0 letters and ranibizumab 9.2 (P=0.31, 95% CI -6.4 to 2.0). At 2y 86% of bevacizumab and 94% ranibizumab patients had not lost 15 letters or more (P=0.13). Mean CMT decreased at 2y bevacizumab by 146 µm, ranibizumab 160 µm (P=0.72). Mean number of injections was at 2y bevacizumzb 11.9, ranibizumab 10.3 (P=0.023). CONCLUSION Bevacizumab 6 weekly on an as required basis was not demonstrably non-inferior to ranibizumab 4 weekly pro re nata (prn) in terms of BCVA and change in CMT. In the bevacizumab group, one more injection was required in the second year compared to the ranibizumab group. PMID:27162727

  19. 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

  20. Main roads to melanoma

    PubMed Central

    Palmieri, Giuseppe; Capone, Mariaelena; Ascierto, Maria Libera; Gentilcore, Giusy; Stroncek, David F; Casula, Milena; Sini, Maria Cristina; Palla, Marco; Mozzillo, Nicola; Ascierto, Paolo A

    2009-01-01

    The characterization of the molecular mechanisms involved in development and progression of melanoma could be helpful to identify the molecular profiles underlying aggressiveness, clinical behavior, and response to therapy as well as to better classify the subsets of melanoma patients with different prognosis and/or clinical outcome. Actually, some aspects regarding the main molecular changes responsible for the onset as well as the progression of melanoma toward a more aggressive phenotype have been described. Genes and molecules which control either cell proliferation, apoptosis, or cell senescence have been implicated. Here we provided an overview of the main molecular changes underlying the pathogenesis of melanoma. All evidence clearly indicates the existence of a complex molecular machinery that provides checks and balances in normal melanocytes. Progression from normal melanocytes to malignant metastatic cells in melanoma patients is the result of a combination of down- or up-regulation of various effectors acting on different molecular pathways. PMID:19828018

  1. Main roads to melanoma.

    PubMed

    Palmieri, Giuseppe; Capone, Mariaelena; Ascierto, Maria Libera; Gentilcore, Giusy; Stroncek, David F; Casula, Milena; Sini, Maria Cristina; Palla, Marco; Mozzillo, Nicola; Ascierto, Paolo A

    2009-01-01

    The characterization of the molecular mechanisms involved in development and progression of melanoma could be helpful to identify the molecular profiles underlying aggressiveness, clinical behavior, and response to therapy as well as to better classify the subsets of melanoma patients with different prognosis and/or clinical outcome. Actually, some aspects regarding the main molecular changes responsible for the onset as well as the progression of melanoma toward a more aggressive phenotype have been described. Genes and molecules which control either cell proliferation, apoptosis, or cell senescence have been implicated. Here we provided an overview of the main molecular changes underlying the pathogenesis of melanoma. All evidence clearly indicates the existence of a complex molecular machinery that provides checks and balances in normal melanocytes. Progression from normal melanocytes to malignant metastatic cells in melanoma patients is the result of a combination of down- or up-regulation of various effectors acting on different molecular pathways. PMID:19828018

  2. 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

  3. 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

  4. 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

  5. Sex offender treatment outcome, actuarial risk, and the aging sex offender in Canadian corrections: a long-term follow-up.

    PubMed

    Olver, Mark E; Nicholaichuk, Terry P; Gu, Deqiang; Wong, Stephen C P

    2013-08-01

    The present study is an examination of sex offender treatment outcome in a large national cohort of Canadian Federally incarcerated sex offenders followed up an average of 11.7 years postrelease. A brief actuarial risk scale (BARS), which predicted sexual and violent recidivism, was created for the purposes of the present study to control for risk-related differences between treated and untreated offenders. In total, 732 offenders were identified as having completed (n = 625) or not attended (n = 107) a sex offender treatment program and for whom sufficient information was available to complete the scale. Controlling for risk and individual differences in follow-up time using Cox regression survival analyses and an 8-year fixed follow-up period, treated sex offenders demonstrated significantly lower rates of violent, but not sexual, recidivism. When the treated and untreated groups were stratified by risk level, significant differences were observed only among moderate or high risk offenders. Some significant group differences also emerged on indicators of recidivism severity, with treated offenders demonstrating slower times to sexual reoffense and lower scores on a quantified metric of sexual and violent recidivism severity after controlling for risk. Differences in recidivism base rates between treated and untreated offenders were also larger in magnitude for younger offenders (i.e., under age 50 at release), than for older offenders; however, interactions between age and treatment were not found. The findings are consistent with the risk principle and have possible implications regarding the dynamic nature of sexual violence risk. PMID:23136142

  6. 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

  7. 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

  8. 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

  9. Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic ischaemic encephalopathy: synthesis and meta-analysis of trial data

    PubMed Central

    Edwards, A David; Brocklehurst, Peter; Gunn, Alistair J; Halliday, Henry; Juszczak, Edmund; Levene, Malcolm; Strohm, Brenda; Thoresen, Marianne; Whitelaw, Andrew

    2010-01-01

    Objective To determine whether moderate hypothermia after hypoxic-ischaemic encephalopathy in neonates improves survival and neurological outcome at 18 months of age. Design A meta-analysis was performed using a fixed effect model. Risk ratios, risk difference, and number needed to treat, plus 95% confidence intervals, were measured. Data sources Studies were identified from the Cochrane central register of controlled trials, the Oxford database of perinatal trials, PubMed, previous reviews, and abstracts. Review methods Reports that compared whole body cooling or selective head cooling with normal care in neonates with hypoxic-ischaemic encephalopathy and that included data on death or disability and on specific neurological outcomes of interest to patients and clinicians were selected. Results We found three trials, encompassing 767 infants, that included information on death and major neurodevelopmental disability after at least 18 months’ follow-up. We also identified seven other trials with mortality information but no appropriate neurodevelopmental data. Therapeutic hypothermia significantly reduced the combined rate of death and severe disability in the three trials with 18 month outcomes (risk ratio 0.81, 95% confidence interval 0.71 to 0.93, P=0.002; risk difference −0.11, 95% CI −0.18 to −0.04), with a number needed to treat of nine (95% CI 5 to 25). Hypothermia increased survival with normal neurological function (risk ratio 1.53, 95% CI 1.22 to 1.93, P<0.001; risk difference 0.12, 95% CI 0.06 to 0.18), with a number needed to treat of eight (95% CI 5 to 17), and in survivors reduced the rates of severe disability (P=0.006), cerebral palsy (P=0.004), and mental and the psychomotor developmental index of less than 70 (P=0.01 and P=0.02, respectively). No significant interaction between severity of encephalopathy and treatment effect was detected. Mortality was significantly reduced when we assessed all 10 trials (1320 infants; relative risk 0

  10. 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

  11. Influence of the main cereal and feed form of the rearing phase diets on performance, digestive tract, and body traits of brown-egg laying pullets from hatch to 17 weeks of age.

    PubMed

    Saldaña, B; Guzmán, P; Safaa, H M; Harzalli, R; Mateos, G G

    2015-11-01

    The effects of the main cereal and feed form of the rearing phase diets on growth performance, gastrointestinal tract characteristics, and body traits were studied in brown-egg pullets from hatch to 17 wk of age. Eight dietary treatments that were a combination of 2 main cereals (corn vs. wheat) and 4 feeding programs were used. The feeding program consisted in feeding crumbles from 0 to 5, 0 to 10, or 0 to 17 wk of age followed by mash until 17 wk, or feeding mash continuously from 0 to 17 wk. Each treatment was replicated 9 times. From hatch to 17 wk of age, pullets fed corn had similar ADG but poorer feed conversion ratio (FCR; P < 0.001) than pullets fed wheat. Also, pullets fed crumbles continuously (0 to 17 wk) had greater ADG (12.3 vs. 11.5 g; P < 0.001) and better FCR (4.21 vs. 4.36; P < 0.001) than pullets feed mash continuously, with pullets that were changed at any age of the rearing period from crumbles to mash feeding showing intermediate results. At 17 wk of age, the relative weights (% BW) of the gastrointestinal tract and gizzard were greater in pullets fed corn than in pullets fed wheat (P < 0.01) but the relative length (cm/kg full BW) of the small intestine, body, and tarsus was not affected. Pullets fed crumbles continuously had lighter gizzards (P < 0.001), higher gizzard pH (P < 0.001), and were shorter (P < 0.01) than pullets fed mash continuously, with pullets fed the other 2 treatments being intermediate. In summary, wheat can be used in substitution of corn in pullet diets without any adverse effect on growth performance. Feeding crumbles improves pullet performance but hinders gizzard and gastrointestinal tract development. Growth performance, gastrointestinal tract, and body traits of the pullets re-adapt quickly to changes in feed form of the rearing diets. PMID:26362977

  12. Clinical Outcomes of Eyes with Submacular Hemorrhage Secondary to Age-related Macular Degeneration Treated with Anti-vascular Endothelial Growth Factor

    PubMed Central

    Kim, Kun Hae; Chang, Young Suk; Lee, Tae Gon; Kim, Jong Woo; Lew, Young Ju

    2015-01-01

    Purpose To evaluate the long-term outcomes of intravitreal anti-vascular endothelial growth factor (VEGF) monotherapy for patients diagnosed with submacular hemorrhage secondary to exudative age-related macular degeneration. Methods This retrospective, observational study included 49 patients (49 eyes) who initially presented with submacular hemorrhage associated with exudative age-related macular degeneration and who were followed-up for at least 24 months. Only eyes that were treated with intravitreal anti-VEGF monotherapy were included in the study. Best-corrected visual acuity (BCVA) measurements obtained at diagnosis, six months, and the final visit were compared. The associations of BCVA at the final visit with baseline BCVA, BCVA at six months, symptom duration, hemorrhage extent, and central foveal thickness were also analyzed. Results Over the course of follow-up (mean, 32.1 ± 8.5 months), an average of 5.1 ± 2.2 anti-VEGF injections were administered. Recurrent hemorrhage was noted in 13 eyes (26.5%). The mean logarithm of the minimal angle of resolution BCVA at diagnosis, six months, and the final visit were 1.40 ± 0.52, 0.87 ± 0.64, and 1.03 ± 0.83, respectively. Both baseline BCVA (p = 0.012) and BCVA at six months (p < 0.001) were significantly associated with BCVA at the final visit. Conclusions Improved visual acuity was maintained for more than two years with intravitreal anti-VEGF monotherapy. BCVA at six months is a useful clinical index to predict long-term visual prognosis. PMID:26457037

  13. A Meta-Analysis of Studies Evaluating Visual and Anatomical Outcomes in Patients with Treatment Resistant Neovascular Age-Related Macular Degeneration following Switching to Treatment with Aflibercept

    PubMed Central

    Seguin-Greenstein, Sophie; Lightman, Sue

    2016-01-01

    With the introduction of aflibercept, eyes with neovascular age-related macular degeneration (AMD) not responding well to injections of ranibizumab or bevacizumab can be switched to treatment with aflibercept. We carried out a meta-analysis to analyze all available evidence of visual and anatomical outcomes of eyes with resistant neovascular AMD switched to aflibercept at six months. Data from seven retrospective and prospective studies looking at change in best corrected visual acuity (BCVA) and central retinal thickness (CRT) were included. Weighted mean difference (WMD) and 95% CI were estimated using the standardized mean change method. The overall results of the meta-analysis showed a small but statistically significant improvement in BCVA six months following treatment switch to aflibercept (WMD 0.142, 95% CI 0.006 to 0.28; p = 0.04), and the effect was more significant in data gathered from prospective studies (WMD 0.407, 95% CI 0.023 to 0.791, p = 0.038). There was a significant improvement in CRT following treatment switch to aflibercept (WMD −0.36, 95% CI −0.485 to −0.235; p < 0.0001). Our meta-analysis indicates that following treatment switch to aflibercept patients may have a significant improvement in CRT with stabilization or even some improvement in their visual acuity. PMID:27042342

  14. Reliability and Validity of the Telephone Administration of the Wheelchair Outcome Measure (WhOM) for Middle-Aged and Older Users of Power Mobility Devices

    PubMed Central

    Auger, Claudine; Demers, Louise; Gélinas, Isabelle; Routhier, François; Ben Mortenson, W.; Miller, William C

    2014-01-01

    Objective To examine the measurement properties of the telephone administration of the Wheelchair Outcome Measure (WhOM). Subjects Power mobility device users aged 50–89 years. Methods Two independent cohorts were recruited: 1) a prospective cohort (n=40) to estimate test-retest reliability and to determine the applicability of the telephone format, and 2) a cross-sectional cohort to examine construct validity with 3 groups: i) people waiting for a first power mobility device (n=44); ii) new users (n=35;1–6 months), and iii) long-term users (n=39;12–18 months). Results The tool demonstrated good test-retest reliability (ICCs .77–1.00), was administered in 10.9 minutes (SD=5.2) and was practical to use over the telephone. The validity testing showed moderate correlations with the Quebec User Evaluation of Satisfaction with Technology (QUEST 2.0, rS=.36–.45) and the Psychosocial Impact of Assistive Devices Scale (PIADS-10, rS=31–.43). WhOM scores could discriminate users based on duration of use (p<.001) and device type (power wheelchair vs scooter, p<.05). Conclusions The WhOM is a stable, valid and applicable measure for telephone administration with older power mobility device users. It is moderately linked to satisfaction with the device and to the psychosocial impact of the device, and therefore complements rather than replaces those measures. PMID:20549163

  15. 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.

  16. 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

  17. 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.

  18. 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

  19. Test-taking behaviors in a neurocognitive assessment: associations with school-age outcomes in a Finnish longitudinal follow-up.

    PubMed

    Heinonen, Johanna; Aro, Tuija; Ahonen, Timo; Poikkeus, Anna-Maija

    2011-03-01

    Test-taking behaviors (i.e., task focus, maintenance of attention, and cooperation) affect children's cognitive test performance, and, thus, it is critical to take test-taking behavior into account when drawing conclusions and making recommendations. Prior studies have evaluated test-taking behaviors at the end of the assessment; the present study focused on the fluctuation of cooperation and attention during a neuropsychological assessment. We examined the attention and cooperation of 5-year-old children in a test-taking situation; the associations between these aspects of their test-taking behavior and the children's concurrent neurocognitive test performance, IQ, and parent-rated behavior; and the associations with their IQ, behavioral outcomes, and academic achievement at 8 years of age. The data (for 76 boys and 63 girls) were drawn from the Jyväskylä Longitudinal Study of Dyslexia (Lyytinen et al., 2001, 2004). All the children were Caucasian and spoke Finnish as their native language. As a whole, the 5-year-old children showed high cooperation and attention, but a slight decrement in test-taking behavior toward the end of the session was rather common. Three subgroups of children with different levels of cooperation and attention were identified. Children in the subgroup with nonoptimal attention and cooperation showed decreasing neurocognitive test performance toward the end of the assessment session. They also showed more inattentive behavior 3 years later. The findings imply that the examiner's observations of waning attention and cooperation during the assessment session are highly relevant, as these provide stable and clinically meaningful information about the child's behavioral tendencies. PMID:21280960

  20. 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.

  1. 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

  2. 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…

  3. 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

  4. 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…

  5. Clinical Characteristics and Outcomes Associated with the Natural History of Early Repolarization in a Young, Biracial Cohort Followed to Middle Age: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

    PubMed Central

    Ilkhanoff, Leonard; Soliman, Elsayed Z.; Prineas, Ronald J.; Walsh, Joseph A.; Ning, Hongyan; Liu, Kiang; Carr, J. Jeffrey; Jacobs, David R.; Lloyd-Jones, Donald M.

    2014-01-01

    Background Early repolarization (ER), a common electrocardiographic phenotype, has been associated with increased mortality risk in middle-aged adults. Data are sparse on long-term follow-up and outcomes associated with ER in younger adults. Methods and Results We prospectively examined 5,039 participants (mean age 25 years at baseline, 40% black) from the CARDIA cohort over 23 years. Twelve-lead electrocardiograms were recorded and analyzed at Years 0, 7 and 20 and coded as definite or probable ER using a standardized algorithm. Cox regression was used, and models were adjusted for important baseline and clinical covariates. Kaplan-Meier curves were created for presence of ER and total mortality and cardiovascular (CV) mortality. Participants with ER were more likely to be black, male, smoke, have higher systolic blood pressure, lower heart rate, and BMI, and also higher exercise duration, and longer PR, QRS and QT intervals. ER was associated with total mortality (HR1.77, 1.38–2.28, p<0.01), and CV mortality (HR 1.59, 1.01–2.50, p=0.04) in unadjusted analyses, but adjustment for age, sex, and race attenuated associations almost completely. Sex-race stratified analyses showed no significant associations between ER and outcome for any of the subgroups except blacks. Conclusions The presence of ER at any time point over 23 years of follow-up was not associated with adverse outcomes. Black race and male sex confound the unadjusted association of ER and outcomes, with no race-sex interactions noted. Further studies are necessary to understand the factors associated with heightened risk of death in those who maintain ER into and beyond middle age. PMID:24759868

  6. Maine's Families: Poverty Despite Work.

    ERIC Educational Resources Information Center

    Lazere, Edward B.

    Children are among the poorest of Maine's residents. Nearly 1 in 5 children under the age of 18, 19.3%, lived in families below the federal poverty line in the early 1990s. Most of these poor children lived in working families. The working poor are often missing from policy debates, but their numbers are likely to increase with welfare reform…

  7. The Influence of the Epsilon4 Allele of the Apolipoprotein E Gene on Childhood IQ, Nonverbal Reasoning in Old Age, and Lifetime Cognitive Change.

    ERIC Educational Resources Information Center

    Deary, Ian J.; Whalley, Lawrence J.; St. Clair, David; Breen, Gerome; Leaper, Steve; Lemmon, Helen; Hayward, Caroline; Starr, John M.

    2003-01-01

    Examines the influence of apolipoprotein E gene states on three cognitive outcomes in 173 people at age 11 and in the same people at age 77 and examined the change in IQ between these ages. There was no significant main effect of gene status on IQ in youth or old age, nor in cognitive change across the lifespan. (SLD)

  8. 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

  9. 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…

  10. INFLUENCE OF AGE AND HISTOLOGY ON OUTCOME IN ADULT NON-HODGKIN’S LYMPHOMA PATIENTS UNDERGOING AUTOLOGOUS HCT: A REPORT FROM THE CENTER FOR INTERNATIONAL BLOOD & MARROW TRANSPLANT RESEARCH (CIBMTR)

    PubMed Central

    Lazarus, Hillard M.; Carreras, Jeanette; Boudreau, Christian; Loberiza, Fausto R.; Armitage, James O.; Bolwell, Brian J.; Freytes, César O.; Gale, Robert Peter; Gibson, John; Hale, Gregory A.; Inwards, David J.; LeMaistre, Charles F.; Maharaj, Dipnarine; Marks, David I.; Miller, Alan M.; Pavlovsky, Santiago; Schouten, Harry C.; van Besien, Koen; Vose, Julie M.; Bitran, Jacob D.; Khouri, Issa F.; McCarthy, Philip L.; Yu, Hongmei; Rowlings, Philip; Serna, Derek S.; Horowitz, Mary M.; Rizzo, J. Douglas

    2009-01-01

    To compare the clinical outcomes of older (age ≥ 55 years) non-Hodgkin’s lymphoma (NHL) patients with younger NHL patients (< 55 years) receiving autologous hematopoietic cell transplantation (HCT) while adjusting for patient-, disease-, and treatment-related variables. We compared autologous HCT outcomes in 805 NHL patients age ≥ 55 years to 1,949 NHL patients < 55 years during the years 1990–2000 using data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). In multivariate analysis, older patients with aggressive histologies were 1.86 times [95% confidence interval (CI) 1.43–2.43, p<0.001] more likely than younger patients to experience treatment-related mortality. Relative death risks were 1.33 times (CI 1.04–1.71, p=0.024) and 1.50 times (CI 1.33–169, p<0.001) higher in older compared to younger patients with follicular grade I/II and aggressive histologies, respectively. Autologous HCT in older NHL patients is feasible but most disease-related outcomes are statistically inferior to younger patients. Studies addressing supportive care particular to older patients who are most likely to benefit from this approach are recommended. PMID:19041053

  11. Corporal punishment and child behavioral and cognitive outcomes through 5 years-of-age: Evidence from a contemporary urban birth cohort study

    PubMed Central

    MacKenzie, Michael J.; Nicklas, Eric; Waldfogel, Jane; Brooks-Gunn, Jeanne

    2013-01-01

    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. PMID:24839402

  12. 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. PMID:24839402

  13. 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

  14. 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

  15. 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 Central

    2013-01-01

    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. PMID:23385442

  16. Circulating miRNA profiles provide a biomarker for severity of stroke outcomes associated with age and sex in a rat model

    PubMed Central

    Selvamani, Amutha; Williams, Madison H.; Miranda, Rajesh C.; Sohrabji, Farida

    2015-01-01

    Small non-coding RNA [miRNA (microRNA)] found in the circulation have been used successfully as biomarkers and mechanistic targets for chronic and acute disease. The present study investigated the impact of age and sex on miRNA expression following ischaemic stroke in an animal model. Adult (6 month) and middle-aged (11–12 months) female and male rats were subject to MCAo (middle cerebral artery occlusion) using ET-1 (endothelin-1). Circulating miRNAs were analysed in blood samples at 2 and 5 days post-stroke, and brain miRNAs were analysed at 5 days post-stroke. Although stroke-associated infarction was observed in all groups, infarct volume and sensory-motor deficits were significantly reduced in adult females compared with middle-aged females, adult males or middle-aged males. At 2 days post-stroke, 21 circulating miRNAs were differentially regulated and PCA (principal component analysis) confirmed that most of the variance was due to age. At 5 days post-stroke, 78 circulating miRNAs exhibited significantly different regulation, and most of the variance was associated with sex. A small cohort (five) of miRNAs, miR-15a, miR-19b, miR-32 miR-136 and miR-199a-3p, were found to be highly expressed exclusively in adult females compared with middle-aged females, adult males and middle-aged males. Predicted gene targets for these five miRNAs analysed for KEGG (Kyoto Encyclopedia of Genes and Genomes) pathways revealed that the top ten KEGG pathways were related to growth factor signalling, cell structure and PI3K (phosphoinositide 3-kinase)/Akt and mTOR (mammalian target of rapamycin) signalling. Overall, the pattern of circulating miRNA expression suggests an early influence of age in stroke pathology, with a later emergence of sex as a factor for stroke severity. PMID:24428837

  17. 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

  18. 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…

  19. 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…

  20. 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…

  1. 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

    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…

  2. 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…

  3. Examining the Relationship between Treatment Outcomes for Academic Achievement and Social Skills in School-Age Children with Attention-Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Rutherford, Laura E.; DuPaul, George J.; Jitendra, Asha K.

    2008-01-01

    The purpose of this study was to determine the relationship between treatment-induced changes in academic achievement and social skills in elementary school-age children with attention-deficit hyperactivity disorder. A sample of 123 children in grades 1 through 4 with symptoms of inattention, impulsivity and/or hyperactivity, and significant…

  4. Neonatal Mortality and Long-Term Outcome of Infants Born between 27 and 32 Weeks of Gestational Age in Breech Presentation: The EPIPAGE Cohort Study

    PubMed Central

    Azria, Elie; Kayem, Gilles; Langer, Bruno; Marchand-Martin, Laetitia; Marret, Stephane; Fresson, Jeanne; Pierrat, Véronique; Arnaud, Catherine; Goffinet, François; Kaminski, Monique; Ancel, Pierre-Yves

    2016-01-01

    Objective To determine whether breech presentation is an independent risk factor for neonatal morbidity, mortality, or long-term neurologic morbidity in very preterm infants. Design Prospective population-based cohort. Population Singletons infants without congenital malformations born from 27 to 32 completed weeks of gestation enrolled in France in 1997 in the EPIPAGE cohort. Methods The neonatal and long-term follow-up outcomes of preterm infants were compared between those in breech presentation and those in vertex presentation. The relation of fetal presentation with neonatal mortality and neurodevelopmental outcomes was assessed using multiple logistic regression models. Results Among the 1518 infants alive at onset of labor included in this analysis (351 in breech presentation), 1392 were alive at discharge. Among those eligible to follow up and alive at 8 years, follow-up data were available for 1188 children. Neonatal mortality was significantly higher among breech than vertex infants (10.8% vs. 7.5%, P = 0.05). However the differences were not significant after controlling for potential confounders. Neonatal morbidity did not differ significantly according to fetal presentation. Severe cerebral palsy was less frequent in the group born in breech compared to vertex presentation but there was no difference after adjustment. There was no difference according to fetal presentation in cognitive deficiencies/learning disabilities or overall deficiencies. Conclusion Our data suggest that breech presentation is not an independent risk factor for neonatal mortality or long-term neurologic deficiencies among very preterm infants. PMID:26744838

  5. 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

  6. 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.

  7. Interaction effects of age and contingency management treatments in cocaine-dependent outpatients.

    PubMed

    Weiss, Lindsay M; Petry, Nancy M

    2011-04-01

    As the American population ages, older adults are accounting for a larger percentage of the drug-abusing population, but little attention has been given to this age group especially in regards to evaluating responsivity to different treatment modalities. Contingency management (CM) is a highly effective behavioral treatment that provides positive tangible reinforcers for objective evidence of behavior change. The purpose of this study was to examine main and interactive effects of age on outcomes in cocaine-dependent patients receiving CM with standard care (SC) or SC alone. Patients (N = 393) participating in 1 of 3 randomized trials of CM for cocaine dependence were divided into young, middle, and older age cohorts. Baseline characteristics and outcomes were compared across the age groups. The oldest age group had more medical problems than the youngest and middle age groups but had fewer legal difficulties and psychiatric symptoms. The oldest age group remained in treatment significantly longer than the other age groups, regardless of the type of treatment received. Although all age groups benefited from CM in terms of retention and longest duration of abstinence achieved, a significant age by treatment interaction effect emerged, with the older cohort improving relatively less from CM than the younger age groups. These findings demonstrate that age may play a role in moderating intervention outcomes, and tailoring CM to the needs of older and middle-aged substance abusers may be important for improving outcomes in this growing population. PMID:21463074

  8. 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

  9. Midterm Outcomes of the Recently FDA Approved Ceramic on Ceramic Bearing in Total Hip Arthroplasty Patients Under 65 Years of Age.

    PubMed

    Aoude, Ahmed A; Antoniou, John; Epure, Laura M; Huk, Olga L; Zukor, David J; Tanzer, Michael

    2015-08-01

    The present study aimed to evaluate the mid-term results of the fourth generation of ceramic on ceramic (CC) bearing. Demographics, surgical technique, complications, clinical and radiologic outcomes were analyzed in a series of 133 consecutive CC total hip arthroplasties (THAs) with a newest generation CC bearings to determine if these provide safe and well performing bearings. At the last follow-up, there were no cases of ceramic fracture or chipping and no revision surgery necessary for bearing related complication. One hip underwent two staged revision for infection and another underwent revision for dislocation, resulting in an overall 98.5% survival rate at a mean of 6 years. The newest generation of CC bearings provides a reliable and safe bearing in young, active patients undergoing THA. PMID:25869588

  10. 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

  11. 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…

  12. The Maine Event

    ERIC Educational Resources Information Center

    McHale, Tom

    2007-01-01

    In this article, the author describes the successful laptop program employed at Mt. Abram High School in Strong, Maine. Through the Maine Learning Technology Initiative, the school has issued laptops to all 36,000 teachers and students in grades 7-8. This program has helped level the playing field for a student population that is 50 percent to 55…

  13. MAINE MARINE WORM HABITAT

    EPA Science Inventory

    WORM provides a generalized representation at 1:24,000 scale of commercially harvested marine worm habitat in Maine, based on Maine Department of Marine Resources data from 1970's. Original maps were created by MDMR and published by USF&WS as part of the ""&quo...

  14. 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

  15. Early caregiving stress exposure moderates the relation between respiratory sinus arrhythmia reactivity at 1 month and biobehavioral outcomes at age 3.

    PubMed

    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

  16. 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)

  17. MAINE WEIRS 1990

    EPA Science Inventory

    WEIR90 shows point locations of herring weirs in Maine based on 1990 overflight by MDMR Marine Patrol, mapped at an approximate scale of 1:100,000. Data were screen digitized from paper maps used during the overflight.

  18. FCC main fractionator revamps

    SciTech Connect

    Golden, S.W.; Martin, G.R.; Sloley, A.W. )

    1993-03-01

    Structured packing use in fluid catalytic cracker (FCC) main fractionators significantly impacts unit pressure profile. Unit pressure balance links the FCC main fractionator, reactor, regenerator, air compressor and wet gas compressor. Unit pressure balance should be viewed as a design variable when evaluating FCC unit revamps. Depending upon limitations of the particular FCC unit, capacity increases of 12.5% to 22.5% have been achieved without modifications to major rotating equipment, by revamping FCC main fractionators with structured packing. An examination of three FCC main fractionator revamps show improvements to pressure profiles and unit capacity. The three revamps described included a wet gas compressor volume limit; an air blower limitation; and a wet gas compressor motor limitation.

  19. 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…

  20. Management of neovascular age-related macular degeneration: current state-of-the-art care for optimizing visual outcomes and therapies in development

    PubMed Central

    Agarwal, Aniruddha; Rhoades, William R; Hanout, Mostafa; Soliman, Mohamed Kamel; Sarwar, Salman; Sadiq, Mohammad Ali; Sepah, Yasir Jamal; Do, Diana V; Nguyen, Quan Dong

    2015-01-01

    Contemporary management of neovascular age-related macular degeneration (AMD) has evolved significantly over the last few years. The goal of treatment is shifting from merely salvaging vision to maintaining a high quality of life. There have been significant breakthroughs in the identification of viable drug targets and gene therapies. Imaging tools with near-histological precision have enhanced our knowledge about pathophysiological mechanisms that play a role in vision loss due to AMD. Visual, social, and vocational rehabilitation are all important treatment goals. In this review, evidence from landmark clinical trials is summarized to elucidate the optimum modern-day management of neovascular AMD. Therapeutic strategies currently under development, such as gene therapy and personalized medicine, are also described. PMID:26089632

  1. Management of neovascular age-related macular degeneration: current state-of-the-art care for optimizing visual outcomes and therapies in development.

    PubMed

    Agarwal, Aniruddha; Rhoades, William R; Hanout, Mostafa; Soliman, Mohamed Kamel; Sarwar, Salman; Sadiq, Mohammad Ali; Sepah, Yasir Jamal; Do, Diana V; Nguyen, Quan Dong

    2015-01-01

    Contemporary management of neovascular age-related macular degeneration (AMD) has evolved significantly over the last few years. The goal of treatment is shifting from merely salvaging vision to maintaining a high quality of life. There have been significant breakthroughs in the identification of viable drug targets and gene therapies. Imaging tools with near-histological precision have enhanced our knowledge about pathophysiological mechanisms that play a role in vision loss due to AMD. Visual, social, and vocational rehabilitation are all important treatment goals. In this review, evidence from landmark clinical trials is summarized to elucidate the optimum modern-day management of neovascular AMD. Therapeutic strategies currently under development, such as gene therapy and personalized medicine, are also described. PMID:26089632

  2. Outcome following surgical treatment for regional metastases from cutaneous cancers of the head and neck in patients aged 80 and over

    PubMed Central

    Khandavilli, Sunil D; Lloyd, Christopher J; Jones, Huw B

    2011-01-01

    INTRODUCTION Population demographics and disease epidemiology is resulting in more elderly patients presenting with regional metastases from cutaneous malignancy of the head and neck region. Surgery remains the most appropriate primary treatment option. PATIENTS AND METHODS We analysed consecutive patients aged 80 and over who developed regional metastases from cutaneous cancers of head and neck and underwent a neck dissection over a two-and-a-half-year period. Data were obtained from the cancer database and patients’ notes. A Kaplan-Meier survival graph was constructed. RESULTS Our study demonstrated a low postoperative morbidity but one patient died from medical complications with in the first 30 days post surgery. The median survival time following surgery is nearly two years. CONCLUSIONS We continue to advocate primary surgery for cutaneous metastatic malignancy from the head and neck area but patients need multidisciplinary team discussions, thorough assessment and counselling. PMID:21477435

  3. 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

  4. 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

  5. [Main data on refugees].

    PubMed

    Lakatos, M; Meszaros, A

    1991-02-01

    Data on refugees coming to Hungary between January 1, 1988, and March 31, 1990, are presented. The data concern refugee characteristics by country of origin, age, sex, language, occupation, and intended country of final destination. (SUMMARY IN ENG AND RUS) PMID:12283684

  6. 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

  7. 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

  8. 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. PMID:20884847

  9. Tract-specific fractional anisotropy predicts cognitive outcome in a community sample of middle-aged participants with white matter lesions

    PubMed Central

    Soriano-Raya, Juan José; Miralbell, Júlia; López-Cancio, Elena; Bargalló, Núria; Arenillas, Juan Francisco; Barrios, Maite; Cáceres, Cynthia; Toran, Pere; Alzamora, Maite; Dávalos, Antoni; Mataró, Maria

    2014-01-01

    Cerebral white matter lesions (WMLs) have been consistently related to cognitive dysfunction but the role of white matter (WM) damage in cognitive impairment is not fully determined. Diffusion tensor imaging is a promising tool to explain impaired cognition related to WMLs. We investigated the separate association of high-grade periventricular hyperintensities (PVHs) and deep white matter hyperintensities (DWMHs) with fractional anisotropy (FA) in middle-aged individuals. We also assessed the predictive value to cognition of FA within specific WM tracts associated with high-grade WMLs. One hundred participants from the Barcelona-AsIA Neuropsychology Study were divided into groups based on low- and high-grade WMLs. Voxel-by-voxel FA were compared between groups, with separate analyses for high-grade PVHs and DWMHs. The mean FA within areas showing differences between groups was extracted in each tract for linear regression analyses. Participants with high-grade PVHs and participants with high-grade DWMHs showed lower FA in different areas of specific tracts. Areas showing decreased FA in high-grade DWMHs predicted lower cognition, whereas areas with decreased FA in high-grade PVHs did not. The predictive value to cognition of specific WM tracts supports the involvement of cortico-subcortical circuits in cognitive deficits only in DWMHs. PMID:24549185

  10. The main cubioid

    NASA Astrophysics Data System (ADS)

    Blokh, Alexander; Oversteegen, Lex; Ptacek, Ross; Timorin, Vladlen

    2014-08-01

    The connectedness locus in the parameter space of quadratic polynomials is called the Mandelbrot set. A good combinatorial model of this set is due to Thurston. By definition, the principal hyperbolic domain of the Mandelbrot set consists of parameter values, for which the corresponding quadratic polynomials have an attracting fixed point. The closure of the principal hyperbolic domain of the Mandelbrot set is called the main cardioid. Its topology is completely described by Thurston's model. Less is known about the connectedness locus in the parameter space of cubic polynomials. In this paper, we discuss cubic analogues of the main cardioid and establish relationships between them.

  11. Childhood Injuries in Maine: A Status Report.

    ERIC Educational Resources Information Center

    DiCara, Cheryl; And Others

    Purposes of this report are to: (1) describe the extent of the childhood injury problem relative to diseases and other conditions affecting children in Maine who are 1 to 19 years of age; (2) give an overview of what is known about the incidence of childhood injuries in Maine; and (3) offer recommendations to improve the state's ability to control…

  12. 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…

  13. 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...

  14. 1 Main Street, Mars

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Located outside StenniSphere, the visitor center at John C. Stennis Space Center, 1 Main Street Mars is a model of how a habitat on Mars might look. Complete with thermometers, scales and clocks set to Martian equivalents, this exhibit shows how very different life on Mars can be.

  15. Indians of Maine.

    ERIC Educational Resources Information Center

    Maine State Dept. of Health and Welfare, Augusta.

    The relationships between the Penobscot and Passamaquoddy Indian Tribes and the State of Maine began in the 1820's. Treaties have left the Penobscot tribe with ownership of 146 islands in the Penobscot River while the Passamaquoddy tribe lives on land owned by the State. Both tribes presently have trust funds derived from the sale of land, and use…

  16. 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.

  17. MAINE SCHOOLS AND LIBRARIES

    EPA Science Inventory

    SCHLIB shows point locations of libraries and educational institutions in Maine at 1:24,000 scale. Colleges, universities, technical colleges, high schools, middle schools, elementary schools, kindergarten/sub-primary and other special schools are included. The data was developed...

  18. 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.

  19. 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

  20. Late childbearing and changing risks of adverse birth outcomes in Korea.

    PubMed

    Cho, Youngtae; Hummer, Robert A; Choi, Yoon-Jung; Jung, Sung Won

    2011-05-01

    This study aimed to examine whether the relative importance of maternal age as a correlate of adverse birth outcomes has changed and to investigate if social inequalities in birth outcomes have widened during the past decade when the marriage and fertility related social environment has undergone tremendous change in Korea. Probabilities of adverse birth outcomes (prematurity and intrauterine growth retardation [IUGR]) were estimated with multinomial logistic regression models, utilizing the Korean birth registration data of 1995 and 2005. The main effects of maternal age and parental socioeconomic characteristics were compared between two study years, net of infant sex, birth order, and plurality. The association between maternal age and adverse birth outcomes, relative to the maternal and parental social characteristics, has clearly diminished between 1995 and 2005. During this period, differences in prematurity and IUGR by maternal age have also diminished, while those by parental social characteristics, particularly maternal education, have substantially widened. The intensified overall socioeconomic polarization since the economic crisis of the late 1990s is most likely responsible for the increased social inequality in adverse birth outcomes in Korea. A massive structural change in macro-economic conditions and culture during the study period may have modified the relationship between maternal age and birth outcomes. PMID:20432060

  1. 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.

  2. 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.

  3. Factors affecting outcomes in colonoscopy.

    PubMed

    Selehi, Seema; Leung, Edmund; Wong, Ling

    2008-01-01

    There are many factors that influence successful outcomes in colonoscopy. The aims of this study were to evaluate these factors and determine ways to improve outcomes. All participants (N=229) who underwent planned colonoscopy between July and September 2004 were retrospectively included. Participants included 118 men and 111 women with a mean age of 59 years. Completion rate was 92%. Reasons of failure included poor bowel preparation (2.2%, p< .025), bowel looping (2.2%, p< .025), participant discomfort (1.3%), and obstructing lesion (1.3%). Mean midazolam dose was 3.8 mg. Three participants (1.3%) had midazolam alone, and all had complete colonoscopy. One hundred thirty-three participants (60.7%) had additional meperidine, with a completion rate of 94%. Eighty three participants (37.9%) had additional meperidine and Buscopan, with a completion rate reduced to 89.2%. There was no correlation between sedatives used and completion rate. Completion rate of colonoscopy in our unit was acceptable at 92%. A combination of midazolam and meperidine gave the best completion rates (94%). The two main reasons for incompletion were poor bowel preparation and excessive bowel looping. PMID:18300826

  4. 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

  5. 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. PMID:23290558

  6. 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

  7. 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

  8. Marriage and Cohabitation Outcomes After Pregnancy Loss

    PubMed Central

    Gold, Katherine J.; Sen, Ananda; Hayward, Rodney A.

    2010-01-01

    OBJECTIVE The goal was to evaluate marriage and cohabitation outcomes for couples who experienced a live birth or fetal death at any gestational age. METHODS For married and cohabitating women who experienced live births, miscarriages, or stillbirths, we conducted a survival analysis (median follow-up period: 7.8 years), by using data from the National Survey of Family Growth, to examine the association between birth outcomes and subsequent relationship survival. The Cox proportional-hazards models controlled for multiple independent risk factors known to affect relationship outcomes. The main outcome measure was the proportion of intact marriages or cohabitations over time. RESULTS Of 7770 eligible pregnancies, 82% ended in live births, 16% in miscarriages, and 2% in stillbirths. With controlling for known risk factors, women who experienced miscarriages (hazard ratio: 1.22 [95% confidence interval: 1.08–1.38]; P = .001) or stillbirths (hazard ratio: 1.40 [95% confidence interval: 1.10–1.79]; P = .007) had a significantly greater hazard of their relationship ending, compared with women whose pregnancies ended in live births. CONCLUSIONS This is the first national study to establish that parental relationships have a higher risk of dissolving after miscarriage or stillbirth, compared with live birth. Given the frequency of pregnancy loss, these findings might have significant societal implications if causally related. PMID:20368319

  9. Aquarius main structure configuration

    NASA Astrophysics Data System (ADS)

    Eremenko, A.

    The Aquarius/SAC-D Observatory is a joint US-Argentine mission to map the salinity at the ocean surface. This information is critical to improving our understanding of two major components of Earth's climate system - the water cycle and ocean circulation. By measuring ocean salinity from space, the Aquarius/SAC-D Mission will provide new insights into how the massive natural exchange of freshwater between the ocean, atmosphere and sea ice influences ocean circulation, weather and climate. Aquarius is the primary instrument on the SAC-D spacecraft. It consists of a Passive Microwave Radiometer to detect the surface emission that is used to obtain salinity and an Active Scatterometer to measure the ocean waves that affect the precision of the salinity measurement. The Aquarius Primary Structure houses instrument electronics, feed assemblies, and supports a deployable boom with a 2.5 m Reflector, and provides the structural interface to the SAC-D Spacecraft. The key challenge for the Aquarius main structure configuration is to satisfy the needs of component accommodations, ensuring that the instrument can meet all operational, pointing, environmental, and launch vehicle requirements. This paper describes the evolution of the Aquarius main structure configuration, the challenges of balancing the conflicting requirements, and the major configuration driving decisions and compromises.

  10. Outcomes of Telephone Medical Care

    PubMed Central

    Delichatsios, Helen; Callahan, Mark; Charlson, Mary

    1998-01-01

    OBJECTIVES To document the outcomes of a telephone coverage system and identify patient characteristics that may predict these outcomes. DESIGN Telephone survey. SETTING An academic outpatient medical practice that has a physician telephone coverage service. PATIENTS All patients (483) who called during the 3-week study period to speak to a physician were evaluated, and for the 180 patients with symptoms, attempts were made to survey them by telephone 1 week after their initial telephone call. MEASUREMENTS AND MAIN RESULTS The mean age of the 180 patients was 41 years, 71% were female, and 56% belonged to commercial managed care plans. In the week after the initial telephone call, the following outcomes were reported: 27% of the patients had no further contact with the practice; 9% filled a prescription medication; 19% called the practice again; 48% kept an earlier appointment in the practice; 3% saw an internist elsewhere; 8% saw a specialist; 8% went to an emergency department; 4% were admitted to a hospital. Of the 180 patients who called with symptoms, 160 (89%) were successfully contacted for survey. Eighty-seven percent of these 160 patients rated their satisfaction with the care they received over the telephone as excellent, very good, or good. In multivariate analysis, patients' own health perception identified those most likely to have symptom relief (p = .002), and symptom relief, in turn, was a strong predictor of high patient satisfaction (p = .006). Thirty-three percent of the 160 patients reported that they would have gone to an emergency department if a physician were not available by telephone. CONCLUSIONS In the present study, younger patients, female patients, and patients in commercial managed care plans used the telephone most frequently. Also, the telephone provided a viable alternative to emergency department and walk-in visits. Overall satisfaction with telephone medicine was high, and the strongest predictors of high patient satisfaction

  11. Review and Outcome of Prolonged Cardiopulmonary Resuscitation

    PubMed Central

    Youness, Houssein; Al Halabi, Tarek; Hussein, Hussein; Awab, Ahmed; Jones, Kellie; Keddissi, Jean

    2016-01-01

    The maximal duration of cardiopulmonary resuscitation (CPR) is unknown. We report a case of prolonged CPR. We have then reviewed all published cases with CPR duration equal to or more than 20 minutes. The objective was to determine the survival rate, the neurological outcome, and the characteristics of the survivors. Measurements and Main Results. The CPR data for 82 patients was reviewed. The median duration of CPR was 75 minutes. Patients mean age was 43 ± 21 years with no significant comorbidities. The main causes of the cardiac arrests were myocardial infarction (29%), hypothermia (21%), and pulmonary emboli (12%). 74% of the arrests were witnessed, with a mean latency to CPR of 2 ± 6 minutes and good quality chest compression provided in 96% of the cases. Adjunct therapy included extracorporeal membrane oxygenation (18%), thrombolysis (15.8%), and rewarming for hypothermia (19.5%). 83% were alive at 1 year, with full neurological recovery reported in 63 patients. Conclusion. Patients undergoing prolonged CPR can survive with good outcome. Young age, myocardial infarction, and potentially reversible causes of cardiac arrest such as hypothermia and pulmonary emboli predict a favorable result, especially when the arrest is witnessed and followed by prompt and good resuscitative efforts. PMID:26885387

  12. 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…

  13. 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.

  14. 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

  15. Influence of advancing age on clinical presentation, treatment efficacy and safety, and long-term outcome of pre-excitation syndromes: a retrospective cohort study of 961 patients included over a 25-year period

    PubMed Central

    Brembilla-Perrot, Béatrice; Olivier, Arnaud; Sellal, Jean-Marc; Manenti, Vladimir; Brembilla, Alice; Villemin, Thibaut; Admant, Philippe; Beurrier, Daniel; Bozec, Erwan; Girerd, Nicolas

    2016-01-01

    Objectives There are very little data on pre-excitation syndrome (PS) in the elderly. We investigated the influence of advancing age on clinical presentation, treatment and long-term outcome of PS. Setting Single-centre retrospective study of patient files. Participants In all, 961 patients (72 patients ≥60 years (mean 68.5±6), 889 patients <60 years (mean 30.5±14)) referred for overt pre-excitation and indication for electrophysiological study (EPS) were followed for 5.3±5 years. Usual care included 24 h Holter monitoring, echocardiography and EPS. Patients underwent accessory pathway (AP) ablation if necessary. Primary and secondary outcome measures Occurrence of atrial fibrillation (AF) or procedure-induced adverse event. Results Electrophysiological data and recourse to AP ablation (43% vs 48.5%, p=0.375) did not significantly differ between the groups. Older patients more often had symptomatic forms (81% vs 63%, p=0.003), history of spontaneous AF (8% vs 3%, p=0.01) or adverse presentation (poorly tolerated arrhythmias: 18% vs 7%, p=0.0009). In multivariable analysis, patients ≥60 years had a significantly higher risk of history of AF (OR=4.2, 2.1 to 8.3, p=0.001) and poorly tolerated arrhythmias (OR=3.8, 1.8 to 8.1, p=0.001). Age ≥60 years was associated with an increased major AP ablation complication risk (10% vs 1.9%, p=0.006). During follow-up, occurrence of AF (13.9% vs 3.6%, p<0.001) and incidence of poorly tolerated tachycardia (4.2% vs 0.6%, p=0.001) were more frequent in patients ≥60 years, although frequency of ablation failure or recurrence was similar (20% vs 15.5%, p=0.52). In multivariable analysis, patients ≥60 years had a significantly higher risk of AF (OR=2.9, 1.2 to 6.8, p≤0.01). Conclusions In this retrospective monocentre study, patients ≥60 years referred for PS work up appeared at higher risk of AF and adverse presentation, both prior and after the work up. These results suggest that, in elderly

  16. Predicting 3-year outcomes of early-identified children with hearing impairment

    PubMed Central

    Ching, T.Y.C.; Day, J.; Seeto, M.; Dillon, H.; Marnane, V.; Street, L.

    2013-01-01

    Problem/Objectives Permanent childhood hearing loss has major negative impacts on children’s health and development. To improve outcomes, universal newborn hearing screening (UNHS) has been implemented widely. However, high-quality evidence on its efficacy was lacking. To address this evidence gap, we conducted the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study to directly compare outcomes of early- and late-identified children. This paper investigates whether early performance measured shortly after initial amplification predicts language development at 3 years of age. Methodology This is a prospective, population-based study. We assessed outcomes at 6- and 12-months after amplification, and then at 3 and 5 years of age. Main outcome measures included directly-assessed language, receptive vocabulary, speech production; and parent-reported functional performance in everyday life. A range of demographic and audiological information was also collected at evaluation intervals. Results About 450 children participated, and 3-year outcomes scores were available for 356 participants. Multiple regression analysis revealed that early language scores or functional performance ratings were significant predictors of 3-year outcomes. Other significant predictors included the presence or absence of additional disabilities, severity of hearing loss, and age at cochlear implant activation. Conclusions Early performance, either directly-assessed language ability (PLS-4) or parent-reported functional ratings (PEACH), were significant predictors of 3-year outcomes; along with presence or absence of additional disabilities, severity of hearing loss, and age at CI activation. Earlier implantation is possible with early detection of hearing loss via UNHS. Monitoring performance after initial amplification allows preventive strategies to be implemented early to improve outcomes. PMID:24383228

  17. HOUSEHOLD NUCLEATION, DEPENDENCY AND CHILD HEALTH OUTCOMES IN GHANA.

    PubMed

    Annim, Samuel Kobina; Awusabo-Asare, Kofi; Amo-Adjei, Joshua

    2015-09-01

    This study uses three key anthropometric measures of nutritional status among children (stunting, wasting and underweight) to explore the dual effects of household composition and dependency on nutritional outcomes of under-five children in Ghana. The objective is to examine changes in household living arrangements of under-five children to explore the interaction of dependency and nucleation on child health outcomes. The concept of nucleation refers to the changing structure and composition of household living arrangements, from highly extended with its associated socioeconomic system of production and reproduction, social behaviour and values, towards single-family households - especially the nuclear family, containing a husband and wife and their children alone. A negative relationship between levels of dependency, as measured by the number of children in the household, and child health outcomes is premised on the grounds that high dependency depletes resources, both tangible and intangible, to the disadvantage of young children. Data were drawn from the last four rounds of the Ghana Demographic and Health Surveys (GDHSs), from 1993 to 2008, for the first objective - to explore changes in household composition. For the second objective, the study used data from the 2008 GDHS. The results show that, over time, households in Ghana have been changing towards nucleation. The main finding is that in households with the same number of dependent children, in nucleated households children under age 5 have better health outcomes compared with children under age 5 in non-nucleated households. The results also indicate that the effect of dependency on child health outcomes is mediated by household nucleation and wealth status and that, as such, high levels of dependency do not necessarily translate into negative health outcomes for children under age 5, based on anthropometric measures. PMID:25167165

  18. Foreign Body in Left Main Bronchus.

    PubMed

    Dhadke, Shubhangi V; Chaudhari, Amit L; Deshpande, Neelima S; Dhadke, Vithal N; Sangle, Shashikala A

    2015-07-01

    Tracheobronchial foreign body (TFB) aspiration is rare in adults, although incidence rates increases with advancing age. We report a case of foreign body in left main bronchus in an adult female who had no risk factor. She was successfully treated with removal of betel nuts by bronchoscopy. Unusual presentation and high index of suspicion can help in proper management. PMID:26731835

  19. Maine Special Education Regulations: Chapter 101.

    ERIC Educational Resources Information Center

    Maine State Dept. of Education, Augusta. Div. of Special Services.

    This document contains regulations governing the provision of equal educational opportunities and free, appropriate public education in the least restrictive educational alternative to all Maine student residents with disabilities between the ages of 5 and 20. Twenty sections contain provisions relating to: (1) the policy and purpose of special…

  20. 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

  1. The healthy aged

    PubMed Central

    Godwin, Marshall; Pike, Andrea; McCrate, Farah; Parsons, Karen; Parsons, Wanda; Pitcher, Heather; Buehler, Sharon; Gadag, Veeresh; Miller, Robert; Sclater, Anne

    2015-01-01

    Abstract Objective To describe a population of cognitively functioning seniors aged 80 years and older who are living independently in the community. Design Descriptive cross-sectional study based on the enrolment cohort of a randomized controlled trial. Setting St John’s, Nfld. Participants A total of 236 cognitively functioning seniors aged 80 years and older living independently in the community. Main outcome measures Demographic characteristics including age, sex, marital status, and education; health status and quality of life measured by the Short Form–36 and the CASP-19 (control, autonomy, self-realization, and pleasure); use of formal and informal community services; satisfaction with family physician care as measured by the Patient Satisfaction Questionnaire–18; and use of health care resources (family physician visits, emergency department visits, hospitalizations, and laboratory and diagnostic imaging tests). Results Overall, 66.5% of those in the group were women and the average age was 85.5 years. A quarter had postsecondary diplomas or degrees; 54.7% were widowed (69.4% of women and 25.3% of men). The cohort scored well in terms of health status and quality of life, with a range of scores on the Short Form–36 from 57.5 to 93.5 out of 100, and a score of 44 out of 57 on the CASP-19; they were satisfied with the care received from family physicians, with scores between 3.8 and 4.3 out of 5 on the Patient Satisfaction Questionnaire–18; and use of health services was low—70% had no emergency department visits in the previous year and 80% had not used any laboratory or diagnostic services. Conclusion Seniors aged 80 years and older living independently are involved in the social fabric of society. They are generally well educated, slightly more than half are widowed, and two-thirds are female. They score well on scales that measure well-being and quality of life, and they use few health services. They are the healthy aged. Trial registration

  2. [Knowledge production about nursing outcomes].

    PubMed

    Seganfredo, Deborah Hein; Almeida, Miriam de Abreu

    2010-01-01

    This literature review aimed at identifying and analysing the knowledge production regarding nursing outcomes in a worldwide context. A systematized review was carried out using LILACS and MEDLINE databases. The following key words were used: outcomes, nursing and classification. No national production was identified. The main issues raised were: the use of the standardized outcomes classifications to measure changes in the patient's health condition; the use of the Nursing Outcomes Classifications (NOC) as the chosen terminology for nursing practice; the need to rank effectivity of nursing interventions by identifying the nursing-sensitive patient outcomes, as well as to make the nursing practice a profitable one to the institutions. It is important to develop and Brazilian studies addressing the issue. PMID:20339766

  3. 22. View showing main anchor arm, as viewed from main ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    22. View showing main anchor arm, as viewed from main cantilever arm looking south. Note upper chord eyebar arrangement. - Williamstown-Marietta Bridge, Spanning Ohio River between Williamstown & Marietta, Williamstown, Wood County, WV

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. MAINE MUSSEL SEED CONSERVATION AREAS

    EPA Science Inventory

    SEED shows point locations of Maine mussel seed conservation areas at 1:24,000 scale. Data for this coverage were screen digitized on a 1:24000 scale base using descriptions contained in Maine Department of Marine Resources (MDMR) rules. Coastal arcs from Maine Office of GIS 1:24...

  10. Neurological disorders presenting mainly in adolescence

    PubMed Central

    Macleod, S; Appleton, R E

    2007-01-01

    The aim of this review is to discuss some of the neurological diseases that present mainly in the adolescent period. The article focuses on the usual presentation and course of the more common, and some uncommon, epilepsies, neuromuscular disorders, neurodegenerative disorders, inflammatory disorders of the central nervous system and some other, miscellaneous conditions. The article ends with a very brief and general discussion about management issues in this age group. PMID:17264287

  11. Birthweight outcomes in Bolivia: the role of maternal height, ethnicity, and behavior.

    PubMed

    Delajara, Marcelo; Wendelspiess Chávez Juárez, Florian

    2013-01-01

    We identify maternal behavioral factors associated with birthweight in Bolivia using data from the Demographic and Health Survey (DHS) of 2003. We estimate birthweight as a function of maternal behavior and the child's sex and gestational age. We control for maternal height, ethnicity, education, and wealth, and for differences observed across Bolivian regions in educational and health outcomes, demographic indicators, and altitude. We find that maternal age, fertility record, and birth spacing behavior are the main observable behavioral factors associated with birthweight, and that maternal height is associated with gestational age, a main determinant of birthweight. We also find that after controlling for gestational age, both ethnicity and altitude have an insignificant effect on birthweight. PMID:22560303

  12. 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

  13. 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

  14. A Comparison of Functional Outcome in Patients Sustaining Major Trauma: A Multicentre, Prospective, International Study

    PubMed Central

    Rainer, Timothy H.; Yeung, Hiu Hung; Gabbe, Belinda J.; Yuen, Kai Y.; Ho, Hiu F.; Kam, Chak W.; Chang, Annice; Poon, Wai S.; Cameron, Peter A.; Graham, Colin A.

    2014-01-01

    Objectives To compare 6 month and 12 month health status and functional outcomes between regional major trauma registries in Hong Kong and Victoria, Australia. Summary Background Data Multicentres from trauma registries in Hong Kong and the Victorian State Trauma Registry (VSTR). Methods Multicentre, prospective cohort study. Major trauma patients and aged ≥18 years were included. The main outcome measures were Extended Glasgow Outcome Scale (GOSE) functional outcome and risk-adjusted Short-Form 12 (SF-12) health status at 6 and 12 months after injury. Results 261 cases from Hong Kong and 1955 cases from VSTR were included. Adjusting for age, sex, ISS, comorbid status, injury mechanism and GCS group, the odds of a better functional outcome for Hong Kong patients relative to Victorian patients at six months was 0.88 (95% CI: 0.66, 1.17), and at 12 months was 0.83 (95% CI: 0.60, 1.12). Adjusting for age, gender, ISS, GCS, injury mechanism and comorbid status, Hong Kong patients demonstrated comparable mean PCS-12 scores at 6-months (adjusted mean difference: 1.2, 95% CI: −1.2, 3.6) and 12-months (adjusted mean difference: −0.4, 95% CI: −3.2, 2.4) compared to Victorian patients. Keeping age, gender, ISS, GCS, injury mechanism and comorbid status, there was no difference in the MCS-12 scores of Hong Kong patients compared to Victorian patients at 6-months (adjusted mean difference: 0.4, 95% CI: −2.1, 2.8) or 12-months (adjusted mean difference: 1.8, 95% CI: −0.8, 4.5). Conclusion The unadjusted analyses showed better outcomes for Victorian cases compared to Hong Kong but after adjusting for key confounders, there was no difference in 6-month or 12-month functional outcomes between the jurisdictions. PMID:25157522

  15. 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

  16. 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

  17. 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…

  18. Educational Outcomes and Indicators for Grade 8.

    ERIC Educational Resources Information Center

    Ysseldyke, James E.; And Others

    This document presents a conceptual model of educational domains and outcomes for learners in Grade 8 (or approximately 13 years of age) and possible indicators for each outcome for all students, including students with disabilities or developmental delays. In the model, educational resources (inputs and contexts) influence learning opportunity…

  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. Aging Brain, Aging Mind.

    ERIC Educational Resources Information Center

    Selkoe, Dennis J.

    1992-01-01

    Discusses the aging process related to physical changes of the human neural structure involved in learning, memory, and reasoning. Presents evidence that indicates such alterations do not necessarily signal the decline in cognitive function. Vignettes provide images of brain structures involved in learning, memory, and reasoning; hippocampal…

  1. BIOMARKERS S100B AND NSE PREDICT OUTCOME IN HYPOTHERMIA-TREATED ENCEPHALOPATHIC NEWBORNS

    PubMed Central

    Massaro, An N.; Chang, Taeun; Baumgart, Stephen; McCarter, Robert; Nelson, Karin B.; Glass, Penny

    2014-01-01

    Objective To evaluate if serum S100B protein and neuron specific enolase (NSE) measured during therapeutic hypothermia are predictive of neurodevelopmental outcome at 15 months in children with neonatal encephalopathy (NE). Design Prospective longitudinal cohort study Setting A level IV neonatal intensive care unit in a free-standing children’s hospital. Patients Term newborns with moderate to severe NE referred for therapeutic hypothermia during the study period. Interventions Serum NSE and S100B were measured at 0, 12, 24 and 72 hrs of hypothermia. Measurements and Main Reseults Of the 83 infants were enrolled, fifteen (18%) died in the newborn period. Survivors were evaluated by the Bayley Scales of Infant Development (BSID-II) at 15 months of age. Outcomes were assessed in 49/68 (72%) survivors at a mean age of 15.2±2.7 months. Neurodevelopmental outcome was classified by BSID-II Mental (MDI) and Psychomotor (PDI) Developmental Index scores, reflecting cognitive and motor outcomes respectively. Four-level outcome classifications were defined a priori: normal= MDI/PDI within 1SD (>85), mild= MDI/PDI <1SD (70–85), moderate/severe= MDI/PDI <2SD (<70), or died. Elevated serum S100B and NSE levels measured during hypothermia were associated with increasing outcome severity after controlling for baseline and soceioeconomic characteristics in ordinal regression models. Adjusted odds ratios for cognitive outcome were: S100B 2.5 (95% CI 1.3–4.8) and NSE 2.1 (1.2–3.6); for motor outcome: S100B 2.6 (1.2–5.6) and NSE 2.1 (1.2–3.6). Conclusions Serum S100B and NSE levels in babies with NE are associated with neurodevelopmental outcome at 15 months. These putative biomarkers of brain injury may help direct care during therapeutic hypothermia. PMID:24777302

  2. 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,…

  3. MAINE LANDS OVER 2700 FEET

    EPA Science Inventory

    MECON2700 contains areas in Maine with elevations greater than 2700 feet, generated from USGS 1:250,000 DEMs. Areas above 2700 feet are regulated by the Maine Land Use Regulation Commission (MELURC). Areas were generated from USGS 1:250,000 scale digital elevation models using A...

  4. MAINE ATLANTIC SALMON HABITAT - GENERAL

    EPA Science Inventory

    ASDENN00 describes, at 1:24,000 scale, important Atlantic salmon habitat of the Dennys River in Maine. The coverage was developed from field surveys conducted on the Dennys River in Maine by staff of the Atlantic Salmon Authority and U.S. Fish and Wildlife Service. This survey wa...

  5. Maine Indians: A Brief Summary.

    ERIC Educational Resources Information Center

    1971

    The Indians of Maine, descendants of Algonquian linguistic stock, number approximately 1800 and reside on 3 reservations totalling 22,600 acres of land. Most of the reservation land is forested, with important economic and recreational advantages in terms of timber production and hunting and fishing opportunities. In 1965, Maine became the first…

  6. 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.

  7. 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

  8. Neonatal outcomes at a subdistrict hospital in north India.

    PubMed

    Kumar, M; Paul, V K; Kapoor, S K; Anand, K; Deoraria, A K

    2002-02-01

    Subdistrict hospitals form the first referral level facilities for essential newborn care services. However, there is a paucity of information on the pattern of neonatal admission and outcomes at this level. The objective of this study was to describe the spectrum of neonatal mortality at a subdistrict hospital. The study was conducted at a 50-bed hospital at Ballabgarh in northern India. The data of the neonates born in this hospital (inborns) and those admitted with sickness after being delivered at home (outborns) were separately analysed for the period 1994-1999. The main outcomes of interests were incidence, distribution, and primary causes of neonatal mortality. Of 6746 inborns and 385 outborns admitted (total 7,137) there were 56 deaths (0.8 per cent) and 38 (0.6 per cent) referrals among inborn and 70 deaths (18.2 per cent) and 37 (9.6 per cent) referrals among outborns. The deaths or referral rates among inborn for different weight groups were 27.7 per cent for < 1,500 g, 7.2 per cent for 1500-1999 g, 1.2 per cent for 2,000-2,499 g, and 0.6 per cent for weight > or = 2,500 g. Most deaths under 7 days of age were related to prematurity [41 per cent (28/69)] and birth asphyxia [38 per cent (26/68)], while those aged between 7 and 27 days were mostly due to sepsis [91 per cent (42/46)]. The results of this study indicate that babies with a birthweight above 1,500 g have a good outcome at this level. Deaths under 7 days of age were mostly due to birth asphyxia and prematurity, while those after 7 days were almost entirely due to sepsis. Referral is an important outcome at this level of service. PMID:11866336

  9. 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