Is the Woodcock-Johnson III a Test for All Seasons? Ceiling and Item Gradient Considerations in Its Use with Older Students

ERIC Educational Resources Information Center

Krasa, Nancy

2007-01-01

This study assesses the adequacy of item gradients and ceilings for the subtests of the Woodcock-Johnson III (WJ III) Cognitive and Achievement batteries, including the Diagnostic Supplement, in their use with participants ages 16 to 25 and Grades 10 to 18. Of the 52 subtests, 18 contain adequate item gradients and ceilings for the entire age and…

Obsidian hydration dating of volcanic events

USGS Publications Warehouse

Friedman, I.; Obradovich, J.

1981-01-01

Obsidian hydration dating of volcanic events had been compared with ages of the same events determined by the 14C and KAr methods at several localities. The localities, ranging in age from 1200 to over 1 million yr, include Newberry Craters, Oregon; Coso Hot Springs, California; Salton Sea, California; Yellowstone National Park, Wyoming; and Mineral Range, Utah. In most cases the agreement is quite good. A number of factors including volcanic glass composition and exposuretemperature history must be known in order to relate hydration thickness to age. The effect of composition can be determined from chemical analysis or the refractive index of the glass. Exposure-temperature history requires a number of considerations enumerated in this paper. ?? 1981.

[Psychiatry of the life span?--relevance of age in psychiatric research].

PubMed

Sikorski, Claudia; Motzek, Tom

2010-11-01

The aim of this study was to determine to what extent studies published in two German journals took the age of their sample into consideration. All publications of the two journals were viewed. Only empirical research papers were included. It was then assessed whether they included information on age of the sample and, if that was the case, the studies were further categorized as only giving descriptive sample information, reporting age-specific results of dependent variables or using age as a predictor in regression analyses. Furthermore, the age range covered was assessed. 88 % of all studies included information on age. Of those, about half only provided descriptive information on the age of the study sample, while more than one third used the age variable as a predictor in multivariate models. Few studies reported age-specific outcomes. Main focus of research was on adult populations aged 18 to 65. Only few studies concentrated on children and adolescents. In light of demographic change and age specificity of psychological disorders, it will be necessary to further differentiate and report age-specific results of psychiatric research. A change in what is considered normative aging and developmental tasks for certain age groups calls for further research in those age groups. © Georg Thieme Verlag KG Stuttgart · New York.

Atherosclerosis in epilepsy: its causes and implications.

PubMed

Hamed, Sherifa A

2014-12-01

Evidence from epidemiological, longitudinal, prospective, double-blinded clinical trials as well as case reports documents age-accelerated atherosclerosis with increased carotid artery intima media thickness (CA-IMT) in patients with epilepsy. These findings raise concern regarding their implications for age-accelerated cognitive and behavioral changes in midlife and risk of later age-related cognitive disorders including neurodegenerative processes such as Alzheimer's disease (AD). Chronic epilepsy, cerebral atherosclerosis, and age-related cognitive disorders including AD share many clinical manifestations (e.g. characteristic cognitive deficits), risk factors, and structural and pathological brain abnormalities. These shared risk factors include increased CA-IMT, hyperhomocysteinemia (HHcy), lipid abnormalities, weight gain and obesity, insulin resistance (IR), and high levels of inflammatory and oxidative stresses. The resulting brain structural and pathological abnormalities include decreased volume of the hippocampus, increased cortical thinning of the frontal lobe, ventricular expansion and increased white matter ischemic disease, total brain atrophy, and β-amyloid protein deposition in the brain. The knowledge that age-accelerated atherosclerosis may contribute to age-accelerated cognitive and behavioral abnormalities and structural brain pathologies in patients with chronic epilepsy represents an important research path to pursue future clinical and management considerations. Copyright © 2014 Elsevier Inc. All rights reserved.

Nutritional Considerations for Healthy Aging and Reduction in Age-Related Chronic Disease12

PubMed Central

Shlisky, Julie; Bloom, David E; Beaudreault, Amy R; Tucker, Katherine L; Keller, Heather H; Freund-Levi, Yvonne; Fielding, Roger A; Cheng, Feon W; Jensen, Gordon L; Wu, Dayong; Meydani, Simin N

2017-01-01

A projected doubling in the global population of people aged ≥60 y by the year 2050 has major health and economic implications, especially in developing regions. Burdens of unhealthy aging associated with chronic noncommunicable and other age-related diseases may be largely preventable with lifestyle modification, including diet. However, as adults age they become at risk of “nutritional frailty,” which can compromise their ability to meet nutritional requirements at a time when specific nutrient needs may be high. This review highlights the role of nutrition science in promoting healthy aging and in improving the prognosis in cases of age-related diseases. It serves to identify key knowledge gaps and implementation challenges to support adequate nutrition for healthy aging, including applicability of metrics used in body-composition and diet adequacy for older adults and mechanisms to reduce nutritional frailty and to promote diet resilience. This review also discusses management recommendations for several leading chronic conditions common in aging populations, including cognitive decline and dementia, sarcopenia, and compromised immunity to infectious disease. The role of health systems in incorporating nutrition care routinely for those aged ≥60 y and living independently and current actions to address nutritional status before hospitalization and the development of disease are discussed. PMID:28096124

Nutritional Considerations for Healthy Aging and Reduction in Age-Related Chronic Disease.

PubMed

Shlisky, Julie; Bloom, David E; Beaudreault, Amy R; Tucker, Katherine L; Keller, Heather H; Freund-Levi, Yvonne; Fielding, Roger A; Cheng, Feon W; Jensen, Gordon L; Wu, Dayong; Meydani, Simin N

2017-01-01

A projected doubling in the global population of people aged ≥60 y by the year 2050 has major health and economic implications, especially in developing regions. Burdens of unhealthy aging associated with chronic noncommunicable and other age-related diseases may be largely preventable with lifestyle modification, including diet. However, as adults age they become at risk of "nutritional frailty," which can compromise their ability to meet nutritional requirements at a time when specific nutrient needs may be high. This review highlights the role of nutrition science in promoting healthy aging and in improving the prognosis in cases of age-related diseases. It serves to identify key knowledge gaps and implementation challenges to support adequate nutrition for healthy aging, including applicability of metrics used in body-composition and diet adequacy for older adults and mechanisms to reduce nutritional frailty and to promote diet resilience. This review also discusses management recommendations for several leading chronic conditions common in aging populations, including cognitive decline and dementia, sarcopenia, and compromised immunity to infectious disease. The role of health systems in incorporating nutrition care routinely for those aged ≥60 y and living independently and current actions to address nutritional status before hospitalization and the development of disease are discussed. © 2017 American Society for Nutrition.

Penile size and penile enlargement surgery: a review.

PubMed

Dillon, B E; Chama, N B; Honig, S C

2008-01-01

Penile size is a considerable concern for men of all ages. Herein, we review the data on penile size and conditions that will result in penile shortening. Penile augmentation procedures are discussed, including indications, procedures and complications of penile lengthening procedures, penile girth enhancement procedures and penile skin reconstruction.

76 FR 1504 - Pipeline Safety: Establishing Maximum Allowable Operating Pressure or Maximum Operating Pressure...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-10

... profile that is dependent upon the pipelines attributes, its geographical location, design, operating... type of threats posed by the pipeline segment, including consideration of the age, design, pipe... calculation. There are several methods available for establishing MAOP or MOP. A hydrostatic pressure test...

The Coming Enrollment Crisis: What Every Trustee Must Know.

ERIC Educational Resources Information Center

Breneman, David W.

1982-01-01

Enrollment projections and the economic environment of higher education are analyzed, along with questions that trustees should ask. Factors that affect enrollment projections are addressed, and trend data at the national, regional, and state levels are presented. Demographic considerations include: future age distribution of the population, past…

Generation Changes over the Period of 1986-2006 in the Physical Fitness of Boys Aged 7-19 from Eastern Poland at Particular Stages of Education

ERIC Educational Resources Information Center

Saczuk, Jerzy; Wasiluk, Agnieszka; Zalech, Miroslaw

2012-01-01

Study aim: To assess the size of secular trends in the physical fitness of boys from eastern Poland taking into consideration stages of education. Material and methods: The physical fitness results of boys aged 7-19 years living in eastern regions of Poland were analyzed: 3188 students were examined in 1986 while in 2006 the research included 10…

Constitutional and acquired autosomal aneuploidy.

PubMed

Jackson-Cook, Colleen

2011-12-01

Chromosomal imbalances can result from numerical or structural anomalies. Numerical chromosomal abnormalities are often referred to as aneuploid conditions. This article focuses on the occurrence of constitutional and acquired autosomal aneuploidy in humans. Topics covered include frequency, mosaicism, phenotypic findings, and etiology. The article concludes with a consideration of anticipated advances that might allow for the development of screening tests and/or lead to improvements in our understanding and management of the role that aneuploidy plays in the aging process and acquisition of age-related and constitutional conditions.

Aging in Place vs. Relocation for Older Adults with a Neurocognitive Disorder: Applications of Wiseman’s Behavioral Model

PubMed Central

Kaplan, Daniel; Andersen, Troy; Lehning, Amanda; Perry, Tam Elisabeth

2015-01-01

Some older adults are more vulnerable to housing concerns due to physical and cognitive challenges, including those with a neurocognitive disorder who need extensive support. Environmental gerontology frameworks, including Wiseman’s (1980) Behavioral Model of Elderly Migration, have informed scholarship on aging in place and relocation. It remains unclear, however, the extent to which this conceptual work informs services and supports for older adults, and the Wiseman model has not been applied to people with a neurocognitive disorder. Understanding Wiseman’s model, including considerations for working with families confronting a neurocognitive disorder, can help practitioners ensure that older clients live in settings that best meet their wants and needs. PMID:26016530

The Effect of Cleft Lip on Socio-Emotional Functioning in School-Aged Children

ERIC Educational Resources Information Center

Murray, Lynne; Arteche, Adriane; Bingley, Caroline; Hentges, Francoise; Bishop, Dorothy V. M.; Dalton, Louise; Goodacre, Tim; Hill, Jonathan

2010-01-01

Background: Children with cleft lip are known to be at raised risk for socio-emotional difficulties, but the nature of these problems and their causes are incompletely understood; longitudinal studies are required that include comprehensive assessment of child functioning, and consideration of developmental mechanisms. Method: Children with cleft…

Themes from a Camp Maintenance Network: Camp Maintenance and Property Personnel Share Their Insights and Challenges.

ERIC Educational Resources Information Center

Whyman, Wynne

2003-01-01

A camp maintenance survey was completed by maintenance personnel from 99 camps. Results highlighted several important considerations: ensuring sufficient maintenance funds for aging infrastructure, including camp/property personnel in decision making, publicizing completed maintenance projects, examining long-term needs of the land, and adopting…

Application of Research to the Teaching of Basketball at the Elementary School Level.

ERIC Educational Resources Information Center

Turkington, H. David

This paper explores what has been reported by several researchers in an attempt to make recommendations on the most effective method of introducing basketball to elementary school age children. Based on this review the following observations are brought forward for consideration. Factors which significantly affected student success include: height…

Practicing uneven age management: does it pay? Some economic considerations

Treesearch

Gary W. Miller

1991-01-01

Unevenage silvicultural practices can be used to regenerate and manage many eastern hardwood stands. Single-tree cutting methods are feasible in stands where a desirable shade tolerant commercial species can be regenerated following periodic harvests. A variety of partial harvest practices, including single-tree selection and diameterlimit cutting have been used for 30...

Five Steps for Developing Effective Transition Plans for High School Students with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Szidon, Katherine; Ruppar, Andrea; Smith, Leann

2015-01-01

The Individuals With Disabilities Education Act (IDEA; 2006) requires schools to develop transition plans for students with disabilities, beginning at age 16, if not before. For students with autism spectrum disorder (ASD), the transition planning process includes unique considerations. This article describes five steps for developing effective…

Practical Considerations When Supporting Transitions for Pupils with Speech, Language and Communication Needs

ERIC Educational Resources Information Center

Perfitt, Ruth

2013-01-01

This article investigates the impact of transitions upon pupils aged 11-14 with speech, language and communication needs, including specific language impairment and autism. The aim is to identify stress factors, examine whether these affect any subgroups in particular and suggest practical strategies to support pupils through transitions. Stress…

Culturally Responsive Instruction for Students with Multiple or Severe Physical Impairments

ERIC Educational Resources Information Center

Glimps, Blanche Jackson; Ford, Theron

2006-01-01

Are there students with physical disabilities who are so severely impaired that their culture can not be taken into consideration? Growing numbers of preschool and school age children with such disabilities are from non-European countries including Africa, South America, East Asia, and the Caribbean Islands. In addition, children who are American…

A control-oriented lithium-ion battery pack model for plug-in hybrid electric vehicle cycle-life studies and system design with consideration of health management

NASA Astrophysics Data System (ADS)

Cordoba-Arenas, Andrea; Onori, Simona; Rizzoni, Giorgio

2015-04-01

A crucial step towards the large-scale introduction of plug-in hybrid electric vehicles (PHEVs) in the market is to reduce the cost of its battery systems. Currently, battery cycle- and calendar-life represents one of the greatest uncertainties in the total life-cycle cost of battery systems. The field of battery aging modeling and prognosis has seen progress with respect to model-based and data-driven approaches to describe the aging of battery cells. However, in real world applications cells are interconnected and aging propagates. The propagation of aging from one cell to others exhibits itself in a reduced battery system life. This paper proposes a control-oriented battery pack model that describes the propagation of aging and its effect on the life span of battery systems. The modeling approach is such that it is able to predict pack aging, thermal, and electrical dynamics under actual PHEV operation, and includes consideration of random variability of the cells, electrical topology and thermal management. The modeling approach is based on the interaction between dynamic system models of the electrical and thermal dynamics, and dynamic models of cell aging. The system-level state-of-health (SOH) is assessed based on knowledge of individual cells SOH, pack electrical topology and voltage equalization approach.

Incorporating Mobile Phone Technologies to Expand Evidence-Based Care

PubMed Central

Jones, Deborah J.; Anton, Margaret; Gonzalez, Michelle; Honeycutt, Amanda; Khavjou, Olga; Forehand, Rex; Parent, Justin

2014-01-01

Ownership of mobile phones is on the rise, a trend in uptake that transcends age, region, race, and ethnicity, as well as income. It is precisely the emerging ubiquity of mobile phones that has sparked enthusiasm regarding their capacity to increase the reach and impact of health care, including mental health care. Community-based clinicians charged with transporting evidence-based interventions beyond research and training clinics are in turn, ideally and uniquely situated to capitalize on mobile phone uptake and functionality to bridge the efficacy to effectiveness gap. As such, this article delineates key considerations to guide these frontline clinicians in mobile phone-enhanced clinical practice, including an overview of industry data on the uptake of and evolution in the functionality of mobile phone platforms, conceptual considerations relevant to the integration of mobile phones into practice, representative empirical illustrations of mobile-phone enhanced assessment and treatment, and practical considerations relevant to ensuring the feasibility and sustainability of such an approach. PMID:26213458

Incorporating Mobile Phone Technologies to Expand Evidence-Based Care.

PubMed

Jones, Deborah J; Anton, Margaret; Gonzalez, Michelle; Honeycutt, Amanda; Khavjou, Olga; Forehand, Rex; Parent, Justin

2015-08-01

Ownership of mobile phones is on the rise, a trend in uptake that transcends age, region, race, and ethnicity, as well as income. It is precisely the emerging ubiquity of mobile phones that has sparked enthusiasm regarding their capacity to increase the reach and impact of health care, including mental health care. Community-based clinicians charged with transporting evidence-based interventions beyond research and training clinics are in turn, ideally and uniquely situated to capitalize on mobile phone uptake and functionality to bridge the efficacy to effectiveness gap. As such, this article delineates key considerations to guide these frontline clinicians in mobile phone-enhanced clinical practice, including an overview of industry data on the uptake of and evolution in the functionality of mobile phone platforms, conceptual considerations relevant to the integration of mobile phones into practice, representative empirical illustrations of mobile-phone enhanced assessment and treatment, and practical considerations relevant to ensuring the feasibility and sustainability of such an approach.

An analysis of dental development in Pleistocene Homo using skeletal growth and chronological age.

PubMed

Šešelj, Maja

2017-07-01

This study takes a new approach to interpreting dental development in Pleistocene Homo in comparison with recent modern humans. As rates of dental development and skeletal growth are correlated given age in modern humans, using age and skeletal growth in tandem yields more accurate dental development estimates. Here, I apply these models to fossil Homo to obtain more individualized predictions and interpretations of their dental development relative to recent modern humans. Proportional odds logistic regression models based on three recent modern human samples (N = 181) were used to predict permanent mandibular tooth development scores in five Pleistocene subadults: Homo erectus/ergaster, Neanderthals, and anatomically modern humans (AMHs). Explanatory variables include a skeletal growth indicator (i.e., diaphyseal femoral length), and chronological age. AMHs Lagar Velho 1 and Qafzeh 10 share delayed incisor development, but exhibit considerable idiosyncratic variation within and across tooth types, relative to each other and to the reference samples. Neanderthals Dederiyeh 1 and Le Moustier 1 exhibit delayed incisor coupled with advanced molar development, but differences are reduced when femoral diaphysis length is considered. Dental development in KNM-WT 15,000 Homo erectus/ergaster, while advanced for his age, almost exactly matches the predictions once femoral length is included in the models. This study provides a new interpretation of dental development in KNM-WT 15000 as primarily reflecting his faster rates of skeletal growth. While the two AMH specimens exhibit considerable individual variation, the Neanderthals exhibit delayed incisor development early and advanced molar development later in ontogeny. © 2017 Wiley Periodicals, Inc.

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

PubMed

Mone, Iris; Bulo, Anyla

2012-01-01

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

The quest for a general theory of aging and longevity.

PubMed

Gavrilov, Leonid A; Gavrilova, Natalia S

2003-07-16

Extensive studies of phenomena related to aging have produced many diverse findings, which require a general theoretical framework to be organized into a comprehensive body of knowledge. As demonstrated by the success of evolutionary theories of aging, quite general theoretical considerations can be very useful when applied to research on aging. In this theoretical study, we attempt to gain insight into aging by applying a general theory of systems failure known as reliability theory. Considerations of this theory lead to the following conclusions: (i) Redundancy is a concept of crucial importance for understanding aging, particularly the systemic nature of aging. Systems that are redundant in numbers of irreplaceable elements deteriorate (that is, age) over time, even if they are built of elements that do not themselves age. (ii) An apparent aging rate or expression of aging is higher for systems that have higher levels of redundancy. (iii) Redundancy exhaustion over the life course explains a number of observations about mortality, including mortality convergence at later life (when death rates are becoming relatively similar at advanced ages for different populations of the same species) as well as late-life mortality deceleration, leveling off, and mortality plateaus. (iv) Living organisms apparently contain a high load of initial damage from the early stages of development, and therefore their life span and aging patterns may be sensitive to early-life conditions that determine this initial damage load. Thus, the reliability theory provides a parsimonious explanation for many important aging-related phenomena and suggests a number of interesting testable predictions. We therefore suggest adding the reliability theory to the arsenal of methodological approaches applied to research on aging.

Characterizing liability for cranial nerve injuries: a detailed analysis of 209 malpractice trials.

PubMed

Svider, Peter F; Sunaryo, Peter L; Keeley, Brieze R; Kovalerchik, Olga; Mauro, Andrew C; Eloy, Jean Anderson

2013-05-01

The potential for adverse events with lasting functional effects makes cranial nerve (CN) injury a target for litigation. Our objective was to comprehensively examine records of malpractice trials and detail issues influencing outcomes. Retrospective analysis. The Westlaw database (Thomson Reuters, New York, NY) was searched for jury verdict reports related to medical malpractice and CN injury. After excluding nonrelevant cases, we examined 209 trials for characteristics including nerve(s) injured, alleged causes of malpractice, demographic information, specialty, and outcome. The most commonly litigated CNs were VII (24.4%) and II (19.6%). Sixty-nine (33.0%) trials resulted in damages awarded. Outcomes varied, ranging from a 29.2% plaintiff success rate for CN XI injury to 48.4% for CN II injury. Plaintiffs had less success with increasing age. Average damages awarded were $1.7 million. The most commonly named defendants were otolaryngologists and general surgeons. Individual considerations varied but commonly included alleged deficits in informed consent (25.4%), unnecessary procedures (14.8%), undergoing additional surgery (25.8%), and untimely recognition of complications (23.9%). Malpractice trials were resolved in the defendant's favor the majority of the time. In cases where plaintiffs were successful, however, awards were considerable, averaging nearly $2 million. Factors influencing case outcome included age, location, perceived deficits in informed consent, allegedly unnecessary surgery, requiring additional surgery to repair a complication, and untimely recognition of complications. Although specific factors should be taken into consideration with each procedure, providing detailed informed consent and communicating with patients regarding expectations may minimize liability. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Graves' Disease Pharmacotherapy in Women of Reproductive Age.

PubMed

Prunty, Jeremy J; Heise, Crystal D; Chaffin, David G

2016-01-01

Graves' disease is an autoimmune disorder in which inappropriate stimulation of the thyroid gland results in unregulated secretion of thyroid hormones resulting in hyperthyroidism. Graves' disease is the most common cause of autoimmune hyperthyroidism during pregnancy. Treatment options for Graves' disease include thioamide therapy, partial or total thyroidectomy, and radioactive iodine. In this article, we review guideline recommendations for Graves' disease treatment in women of reproductive age including the recent guideline from the American College of Obstetricians and Gynecologists. Controversy regarding appropriate thioamide therapy before, during, and after pregnancy is reviewed. Surgical and radioactive iodine therapy considerations in this patient population are also reviewed. In patients who may find themselves pregnant during therapy or develop Graves' disease during their pregnancy, consideration should be given to the most appropriate treatment course for the mother and fetus. Thioamide therapy should be used with either propylthiouracil or methimazole at appropriate doses that target the upper range of normal to slightly hyperthyroid to avoid creating hypothyroidism in the fetus. Consideration should also be given to the adverse effects of thioamide, such as agranulocytosis and hepatotoxicity, with appropriate patient consultation regarding signs and symptoms. Individuals who wish to breastfeed their infants while taking thioamide should receive the lowest effective dose. Surgery should be reserved for extreme cases and limited to the second trimester, if possible. Radioactive iodine therapy may be used in nonpregnant individuals, with limited harm to future fertility. Radioactive iodine therapy should be withheld in pregnant women and those who are actively breastfeeding. Clinicians should keep abreast of developments in clinical trials and evidence-based recommendations regarding Graves' disease in reproductive-age women for any changes in evidence-based practice. © 2016 Pharmacotherapy Publications, Inc.

Personality measures in the National Social Life, Health, and Aging Project.

PubMed

Iveniuk, James; Laumann, Edward O; Waite, Linda J; McClintock, Martha K; Tiedt, Andrew

2014-11-01

Provide recommendations for researchers on the use of the Big Five personality battery in the National Social Life, Health, and Aging Project (NSHAP), and ensure that the battery does proxy the Big Five. Also, describe the levels of Big Five traits across gender and age. We used an Exploratory Structural Equation Model (ESEM) to analyze NHSAP's personality battery, comparing NSHAP with the National Longitudinal Study of Midlife in the United States (MIDUS) and the Health and Retirement Study (HRS). ESEM revealed a 5-factor structure in the NSHAP battery, but with considerable cross-loadings. When these cross-loadings were not included in the model, model fit notably worsened. Reliabilities of Big Five scales were comparable to the HRS and MIDUS, even though NSHAP's battery is shorter. Women were considerably more Agreeable than men, although this gender gap closed among the oldest in the sample (80 years or older). Researchers will be able to make use of NSHAP's personality battery to examine a range of social, biological, and psychological factors at older ages, in light of individuals' general traits. We recommend models which allow for cross-loadings. Published by Oxford University Press on behalf of the Gerontological Society of America 2014.

Economic and fiscal implications of aging for subnational American governments.

PubMed

Serow, W J

2001-01-01

This article begins with a brief review of the extensive literature dealing with the macroeconomic consequences of population aging in industrialized societies and places the question in the context of the political and economic framework of the United States. Next, we move to the fiscal ramifications of population aging for subnational units of government. The varying demographic sources of aging are then introduced and their economic implications are reviewed. The role of population aging within the context of subnational fiscal impacts is first examined by reviewing patterns of change in demand for state-government-provided public goods and services associated with an older population. These include primarily health care and income security. These considerations on the expenditure side are then extended to substate government, where primary and secondary education are easily the largest component of public budgets. Finally, the implications of demographic change on the revenue side of state and local public finances are considered, including potential impacts on sales, property, and income tax receipts.

Psychoanalysis and the nuclear threat

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

Levine, H.B.; Jacobs, D.; Rubin, L.J.

1988-01-01

{ital Psychoanalysis and the Nuclear Threat} provides coverage of the dynamic and clinical considerations that follow from life in the nuclear age. Of special clinical interest are chapters dealing with the developmental consequences of the nuclear threat in childhood, adolescence, and adulthood, and those exploring the technical issues raised by the occurrence in analytic and psychotherapeutic hours of material related to the nuclear threat. Additional chapters bring a psychoanalytic perspective to bear on such issues as the need to have enemies, silence as the real crime, love, work, and survival in the nuclear age, the relationship of the nuclear threatmore » to issues of mourning and melancholia, apocalyptic fantasies, the paranoid process, considerations of the possible impact of gender on the nuclear threat, and the application of psychoanalytic thinking to nuclear arms strategy. Finally, the volume includes the first case report in the English language---albeit a brief psychotherapy---involving the treatment of a Hiroshima survivor.« less

At what age do biomedical scientists do their best work?

PubMed

Falagas, Matthew E; Ierodiakonou, Vrettos; Alexiou, Vangelis G

2008-12-01

Several human characteristics that influence scientific research performance, including set goals, mental and physical abilities, education, and experience, may vary considerably during the life cycle of scientists. We sought to answer the question of whether high-quality research productivity is associated with investigator's age. We randomly selected 300 highly cited scientists (50 from each of 6 different biomedical fields, specifically immunology, microbiology, neuroscience, psychology-psychiatry, clinical medicine, and biology-biochemistry). Then, we identified the top 5 highly cited articles (within 10 yr after publication adjusted for the expansion of the literature) as first author of each of them. Subsequently, we plotted the distribution of the 1500 analyzed articles of the 300 studied scientists in the eight 5-year intervals of investigator's age during the year of article publication (21-25 to 55-60 yr of age), adjusted for person-years of contribution of each scientist in the various age groups. Highly cited research productivity plotted a curve that peaked at the age group of 31-35 yr of age and then gradually decreased with advancing age. However, a considerable proportion of this highly cited research was produced by older scientists (in almost 20% of the analyzed articles, researchers were older than 50 yr). The results were similar in another analysis of the single most cited article of each studied scientist. In conclusion, high-quality scientific productivity in the biomedical fields as a function of investigator's age plots an inverted U-shaped curve, in which significant decreases take place from around 40 yr of age and beyond.

Service Providers' Perceptions of Active Ageing among Older Adults with Lifelong Intellectual Disabilities

ERIC Educational Resources Information Center

Buys, L.; Aird, R.; Miller, E.

2012-01-01

Background: Considerable attention is currently being directed towards both active ageing and the revising of standards for disability services within Australia and internationally. Yet, to date, no consideration appears to have been given to ways to promote active ageing among older adults with intellectual disabilities (IDs). Methods:…

Nuclear energy center site survey reactor plant considerations

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

Harty, H.

The Energy Reorganization Act of 1974 required the Nuclear Regulatory Commission (NRC) to make a nuclear energy center site survey (NECSS). Background information for the NECSS report was developed in a series of tasks which include: socioeconomic inpacts; environmental impact (reactor facilities); emergency response capability (reactor facilities); aging of nuclear energy centers; and dry cooled nuclear energy centers.

Water Worlds. 4-H Member's Guide M-5-18; 4-H Leaders Guide L-5-18.

ERIC Educational Resources Information Center

Hawkes, Janet E.; And Others

This pocket folder of materials is designed to provide children aged 9 to 12 with an opportunity to explore and observe aquatic environments. The package includes a 4-H Leader's guide, member's guide, and supplementary materials. The leader's guide contains safety considerations, tips and techniques, and additional activities for getting started…

Setting the Research and Practice Agenda for Anxiety in Children and Adolescence: A Topic Comes of Age

ERIC Educational Resources Information Center

Kendall, Philip C.; Ollendick, Thomas H.

2004-01-01

Select research and practice issues that merit further attention are described. Specifically, we argue that the pathways for profitable research include studies of normative development, assessment and diagnostic considerations, the role of parents, and the ways to optimize the conduct and evaluation of treatment. At present, the field is too…

Unsterblicher Robin Hood--Eine literaturdidaktische Betrachtung und Wertung von zwoelf Lektueretexten (Immortal Robin Hood--A Pedagogical Consideration and Evaluation of Twelve Reading Texts).

ERIC Educational Resources Information Center

Hoegel, Rolf

1979-01-01

Examines 12 reading texts about Robin Hood, with regard to their content, suitability for various age levels, and language difficulty. The texts are found to be best suited for grades 5 and 6. An evaluation of each text is included. (IFS/WGA)

Bilateral Cochlear Implantation in Children: Experiences and Considerations

ERIC Educational Resources Information Center

Bohnert, Andrea; Spitzlei, Vera; Lippert, Karl L.; Keilmann, Annerose

2006-01-01

Between 2000 and 2006, the University Clinic for Ear Nose and Throat and Communication Disorders in Mainz, Germany, performed 41 bilateral cochlear implantations in children. This article addresses some of the factors to be considered in a decision to bilaterally implant a child, including the age of the child at the first implant, the length of…

Imaging of thymic disorders

PubMed Central

Bogot, Naama R; Quint, Leslie E

2005-01-01

Evaluation of the thymus poses a challenge to the radiologist. In addition to age-related changes in thymic size, shape, and tissue composition, there is considerable variability in the normal adult thymic appearance within any age group. Many different types of disorders may affect the thymus, including hyperplasia, cysts, and benign and malignant neoplasms, both primary and secondary; clinical and imaging findings typical for each disease process are described in this article. Whereas computed tomography is the mainstay for imaging the thymus, other imaging modalities may occasionally provide additional structural or functional information. PMID:16361143

Age-related differences in brain activity in the subsequent memory paradigm: a meta-analysis.

PubMed

Maillet, David; Rajah, M Natasha

2014-09-01

Healthy aging is associated with declines in episodic memory. This reduction is thought to be due in part to age-related differences in encoding-related processes. In the current study, we performed an activation likelihood estimation meta-analysis of functional magnetic resonance imaging (fMRI) studies assessing age-related differences in the neural correlates of episodic encoding. Only studies using the subsequent memory paradigm were included. We found age-related under-recruitment of occipital and fusiform cortex, but over-recruitment in a set of regions including bilateral middle/superior frontal gyri, anterior medial frontal gyrus, precuneus and left inferior parietal lobe. We demonstrate that all of the regions consistently over-recruited by older adults during successful encoding exhibit either direct overlap, or occur in close vicinity to regions consistently involved in unsuccessful encoding in young adults. We discuss the possibility that this overall pattern of age-related differences represents an age-related shift in focus: away from perceptual details, and toward evaluative and personal thoughts and feelings during memory tasks. We discuss whether these age-related differences in brain activation benefit performance in older adults, and additional considerations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Safety and ergonomic considerations for an aging workforce in the US construction industry.

PubMed

Choi, Sang D

2009-01-01

The US construction workforce is aging as millions of baby boomers move toward retirement age. Older workers make a substantial contribution to construction in terms of skills and experience. However, construction is still one of the most physically demanding occupations, hence the health implications for older workers. Descriptions of injuries, illnesses and fatalities among older workers in the US construction industry from recent literature are presented along with the practical health and safety interventions that have been proposed including: ergonomic interventions, wellness programs, worksite housekeeping, training, and safety climate. Understanding the risks and hazards in specific industries could help identify training and intervention requirements to meet the challenges facing aging workers in these occupational groups.

Aging Research Using Mouse Models

PubMed Central

Ackert-Bicknell, Cheryl L.; Anderson, Laura; Sheehan, Susan; Hill, Warren G.; Chang, Bo; Churchill, Gary A.; Chesler, Elissa J.; Korstanje, Ron; Peters, Luanne L.

2015-01-01

Despite the dramatic increase in human lifespan over the past century, there remains pronounced variability in “health-span”, or the period of time in which one is generally healthy and free of disease. Much of the variability in health-span and lifespan is thought to be genetic in origin. Understanding the genetic mechanisms of aging and identifying ways to boost longevity is a primary goal in aging research. Here, we describe a pipeline of phenotypic assays for assessing mouse models of aging. This pipeline includes behavior/cognition testing, body composition analysis, and tests of kidney function, hematopoiesis, immune function and physical parameters. We also describe study design methods for assessing lifespan and health-span, and other important considerations when conducting aging research in the laboratory mouse. The tools and assays provided can assist researchers with understanding the correlative relationships between age-associated phenotypes and, ultimately, the role of specific genes in the aging process. PMID:26069080

The personal and national costs of lost labour force participation due to arthritis: an economic study

PubMed Central

2013-01-01

Background The costs of arthritis to the individuals and the state are considerable. Methods Cross-sectional analysis of the base population of Health&WealthMOD, a microsimulation model of 45 to 64 year old Australians built on data from the Australian Bureau of Statistics’ Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model. Results Individuals aged 45 to 64 years who had retired early due to arthritis had a median value of AU$260 in total weekly income whereas those who were employed full time were likely to average more than five times this. The large national aggregate impact of early retirement due to arthritis includes AU$9.4 billion in lost GDP, attributable to arthritis through its impact on labour force participation. When looking at the ongoing impact of being out of the labour force those who retired from the labour force early due to arthritis were estimated to have a median value of total savings by the time they are 65 of as little as $300 (for males aged 45–54). This is far lower than the median value of savings for those males aged 45–54 who remained in the labour force full time, who would have an estimated $339 100 of savings at age 65. Conclusions The costs of arthritis to the individuals and the state are considerable. The impacts on the state include loss of productivity from reduced workforce participation, lost income taxation revenue, and increased government support payments – in addition to direct health care costs. Individuals bear the economic costs of lost income and the reduction of their savings over the long term. PMID:23452565

Cutting Edge Books: The Impact of Digital Books on Public Library Acquisitions

ERIC Educational Resources Information Center

Taylor, Lisa

2008-01-01

The book has made the transition to the digital age; that much is certain. However, the jury is still out on what form or forms the book of the future will take and how libraries will adapt. This article is a look at the impact of digital books on public library acquisitions, including available formats, purchasing considerations, functional…

Assessment of Asphalt Concrete Reinforcement Grid in Flexible Pavements

DTIC Science & Technology

2016-05-01

Guide for the Design of Pavement Structures (1993) remains in use and describes in detail the accepted procedures for both the design and maintenance...of pavement structures. Design considerations include pavement perfor- mance, traffic, subgrade soil, construction materials, environment, drain- age...Association of State Highway and Transportation Officials). 1993. Guide for the Design of Pavement Structures. Washington, DC: American Association of

The National Cross-Site Evaluation of High-Risk Youth Programs: Understanding Risk, Protection, and Substance Use among High-Risk Youth. Monograph Series.

ERIC Educational Resources Information Center

Springer, J. Fred; Sambrano, Soledad; Sale, Elizabeth; Kasim, Rafa; Hermann, Jack

This document summarizes findings from the Center for Substance Abuse Prevention's National Cross-Site Evaluation of High-Risk Youth Programs, which identified characteristics associated with strong substance abuse prevention outcomes in 48 prevention programs. Major findings include: as youth age, levels of risk and protection shift considerably,…

Injury severity analysis of commercially-licensed drivers in single-vehicle crashes: Accounting for unobserved heterogeneity and age group differences.

PubMed

Osman, Mohamed; Mishra, Sabyasachee; Paleti, Rajesh

2018-05-18

This study analyzes the injury severity of commercially-licensed drivers involved in single-vehicle crashes. Considering the discrete ordinal nature of injury severity data, the ordered response modeling framework was adopted. The moderating effect of driver's age on all other factors was examined by segmenting the parameters by driver's age group. Additional effects of the different drivers' age groups are taken into consideration through interaction terms. Unobserved heterogeneity of the different covariates was investigated using the Mixed Generalized Ordered Response Probit (MGORP) model. The empirical analysis was conducted using four years of the Highway Safety Information System (HSIS) data that included 6247 commercially-licensed drivers involved in single-vehicle crashes in the state of Minnesota. The MGORP model elasticity effects indicate that key factors that increase the likelihood of severe crashes for commercially-licensed drivers across all age groups include: lack of seatbelt usage, collision with a fixed object, speeding, vehicle age of 11 years or more, wind, night time, weekday, and female drivers. Also, the effects of several covariates were found to vary across different age groups. Copyright © 2018 Elsevier Ltd. All rights reserved.

Measurement of ageing effect on chloride diffusion coefficients in cementitious matrices

NASA Astrophysics Data System (ADS)

Andrade, C.; Castellote, M.; d'Andrea, R.

2011-05-01

Most of the low-level nuclear waste disposal facilities are based in engineered multi barrier systems where reinforced concrete is one of the basic materials. The calculation of the time until steel reinforcement depassivation is a need due to the demand of prediction of the service life of concrete structures in radioactive repositories. In doing that, one of the main steps is the transport of chloride ions towards the reinforcement, as one of the most aggressive agents for the rebars in concrete is chloride ions. Ageing of concrete related to chloride penetration leads to significant decrease of the "apparent diffusion" coefficient with time. If this effect is not considered, considerable bias can be introduced when predicting service life of reinforced concrete of repositories. Several effects have been addressed on their influence on the ageing of concrete, including the evolution with time of the concrete pore refinement, the binding of chlorides to the cement phases and to the changes of chloride "surface concentration". These effects have been studied in specimens made with different mixes trying to represent a wide range of mineral addition proportions. The analysis of their evolution with time has shown that the resistivity alone or the joint consideration of resistivity and binding capacity ( Cb/ Cf), are appropriate parameters to appraise the diffusivity ageing. For practical reasons, an accelerated procedure is proposed in order to calculate ageing for short periods of time.

Prior hospitalization and age as predictors of mental health resource utilization in Israel.

PubMed

Ginsberg, G; Lerner, Y; Mark, M; Popper, M

1997-03-01

A two-part demand model based on data from a psychiatric case registry was estimated in order to search for predictors of hospital-based psychiatric care utilization. Using only age as an independent variable, explanation of future resource utilization is considerably weaker than when number of cumulative days of psychiatric hospital-based service use during the previous five years is also included. Only a small marginal gain is achieved by also adding diagnoses. Prospective remuneration by capitating sick funds according to age and past hospital-based service utilization records is recommended to avoid the twin pitfalls of cream-skimming and a distorted allocation of resources for psychiatric services.

Ontogenetic and diel variation in stream habitat use by brook trout (Salvelinus fontinalis) in a headwater stream

USGS Publications Warehouse

Johnson, J. H.; Ross, R.M.; Dropkin, D.S.; Redell, L.A.

2011-01-01

Although considerable information exists on habitat use by stream salmonids, only a small portion has quantitatively examined diurnal and nocturnal habitat variation. We examined diel variation in habitat use by age-0 and age-1+ brook trout (Salvelinus fontinalis) during summer and autumn in a headwater stream in northern Pennsylvania. Habitat variables measured included cover, depth, substrate, and velocity. The most pronounced diel variation occurred in the use of cover during both seasons. Both age-0 brook trout and age-1+ trout were associated with less cover at night. Age-0 brook trout occupied swifter water during the day than at night during both seasons, but the difference was not significant. Increased cover, depth, and substrate size governed the habitat of age-1+ brook trout. Our findings support the need for a better understanding of diel differences in habitat use of stream salmonids when considering habitat enhancement and protection.

Biomarkers of Aging: From Function to Molecular Biology

PubMed Central

Wagner, Karl-Heinz; Cameron-Smith, David; Wessner, Barbara; Franzke, Bernhard

2016-01-01

Aging is a major risk factor for most chronic diseases and functional impairments. Within a homogeneous age sample there is a considerable variation in the extent of disease and functional impairment risk, revealing a need for valid biomarkers to aid in characterizing the complex aging processes. The identification of biomarkers is further complicated by the diversity of biological living situations, lifestyle activities and medical treatments. Thus, there has been no identification of a single biomarker or gold standard tool that can monitor successful or healthy aging. Within this short review the current knowledge of putative biomarkers is presented, focusing on their application to the major physiological mechanisms affected by the aging process including physical capability, nutritional status, body composition, endocrine and immune function. This review emphasizes molecular and DNA-based biomarkers, as well as recent advances in other biomarkers such as microRNAs, bilirubin or advanced glycation end products. PMID:27271660

[Distribution of Enterobius vermicularis among the schoolchildren of two primary schools with different social-economic status in the Ankara province].

PubMed

Hazir, Canan; Gündeşli, Hülya; Ozkirim, Asli; Keskin, Nevin

2009-01-01

In this study, 207 cellophane-tape specimens were taken from children at two different primary schools in Ankara province. Twenty two out of 207 samples were positive for Enterobius vermicularis (10.6%). A questionnaire including the major factors affecting the distribution of E. vermicularis such as the students' ages, genders and socio-economic status was made. No relationship was found between children's gender and E. vermicularis infection, whereas a higher infection rate was seen in the low-income families. When the 6-9 age group was taken into consideration, the incidence of E. vermicularis was higher for the 8-9 age group than for the 6-7 age group. Abdominal pain was the most common clinical symptom among the children.

Examination of Buckling Behavior of Thin-Walled Al-Mg-Si Alloy Extrusions

NASA Astrophysics Data System (ADS)

Vazdirvanidis, Athanasios; Koumarioti, Ioanna; Pantazopoulos, George; Rikos, Andreas; Toulfatzis, Anagnostis; Kostazos, Protesilaos; Manolakos, Dimitrios

To achieve the combination of improved crash tolerance and maximum strength in aluminium automotive extrusions, a research program was carried out. The main objective was to study AA6063 alloy thin-walled square tubes' buckling behavior under axial quasi-static load after various artificial aging treatments. Variables included cooling rate after solid solution treatment, duration of the 1st stage of artificial aging and time and temperature of the 2nd stage of artificial aging. Metallography and tensile testing were employed for developing deeper knowledge on the effect of the aging process parameters. FEM analysis with the computer code LS-DYNA was supplementary applied for deformation mode investigation and crashworthiness prediction. Results showed that data from actual compression tests and numerical modeling were in considerable agreement.

What’s Age Got to do with it? A Review of Contemporary Revascularization in the Elderly

PubMed Central

Vandermolen, Sebastian; Abbott, Jane; Silva, Kalpa De

2015-01-01

Currently a quarter of all patients treated with percutanous coronary intervention (PCI) are aged >75 years, with this proportion steadily growing. This subset of patients have a number of unique characteristics, such as a greater number of cardiovascular risk factors and frequently a larger burden of coronary artery disease, when compared to younger patients, therefore potentially deriving increased benefit from revascularization. Nonetheless this population are also more likely to experience procedural complications, secondary to age-related physiological alterations, increased frailty and increased prevalence of other co-morbidities. This article reviews the various aspects and data available to clinicians pertaining to and guiding revascularization in the elderly, including the use of adjuvant pharmacotherapy, specific considerations when considering age-related physiology, and revascularization in acute coronary syndromes. PMID:25329923

Clinical and financial considerations for implementing an ICU telemedicine program.

PubMed

Kruklitis, Robert J; Tracy, Joseph A; McCambridge, Matthew M

2014-06-01

As the population in the United States increases and ages, the need to provide high-quality, safe, and cost-effective care to the most critically ill patients will be of great importance. With the projected shortage of intensivists, innovative changes to improve efficiency and increase productivity will be necessary. Telemedicine programs in the ICUs (tele-ICUs) are a successful strategy to improve intensivist access to critically ill patients. Although significant capital and maintenance costs are associated with tele-ICUs, these costs can be offset by indirect financial benefits, such as decreased length of stay. To achieve the positive clinical outcomes desired, tele-ICUs must be carefully designed and implemented. In this article, we discuss the clinical benefits of tele-ICUs. We review the financial considerations, including direct and indirect reimbursement and development and maintenance costs. Finally, we review design and implementation considerations for tele-ICUs.

To everything there is a season and a time to every purpose: retirement and the neurosurgeon.

PubMed

Rovit, Richard L

2004-06-01

Neurosurgery has designed a rigid curriculum that must be followed precisely by those who wish to enter the specialty. A similar process at the other end of the practice cycle has never been formalized except for mandatory retirement from certain administrative positions at a particular age. Basic considerations for strategic decision making about voluntary retirement from neurosurgery, especially operative neurosurgery, are investigated. Statistical data from the US Census Bureau and sources in the medical literature were reviewed regarding life expectancy and retirement ages. Age-related differences in verbal and performance intelligence quotients, attention span, verbal memory recall, and visuospatial facility were surveyed. A questionnaire was sent to 29 recently retired academic neurosurgeons about their age and reasons for retirement along with postretirement activities; 22 responses were received. Analysis of the data indicates that surgeons are now retiring at the age of approximately 60 years, whereas life expectancy is approximately 80 years. An individual thus may have 15 to 20 productive years after leaving active neurosurgical practice. Reasons for retirement among the 22 responding neurosurgeons included decreasing personal satisfaction and financial rewards, a desire to pursue other activities, local ground rules mandating age-specific retirement, the general sense that enough is enough, and, overall, a strong desire to stop performing surgery while at the top of one's game. The process of age-related competence assessment of commercial airline pilots is outlined, and a similar process of assessment of practicing surgeons may be warranted, with consideration for mandatory retirement from operative neurosurgery.

Recent and prospective population trends in Malaysia.

PubMed

Jones, G W; Tan, P C

1985-09-01

Recent population trends in Malaysia are reviewed, with the focus on Peninsular Malaysia. Separate consideration is given to population growth between 1970 and 1980; mortality trends; period and cohort fertility trends; factors affecting fertility, including changes in age structure, nuptiality, and other socioeconomic and demographic changes; and the recent development of a pro-natalist policy involving a goal of a population of 70 million by 2050.

Toward an Integrated Research Agenda for Critical Illness in Aging

PubMed Central

Milbrandt, Eric B.; Eldadah, Basil; Nayfield, Susan; Hadley, Evan; Angus, Derek C.

2010-01-01

Aging brings an increased predisposition to critical illness. Patients older than 65 years of age account for approximately half of all intensive care unit (ICU) admissions in the United States, a proportion that is expected to increase considerably with the aging of the population. Emerging research suggests that elderly survivors of intensive care suffer significant long-term sequelae, including accelerated age-related functional decline. Existing evidence-based interventions are frequently underused and their efficacy untested in older subjects. Improving ICU outcomes in the elderly will require not only better methods for translating sound science into improved ICU practice but also an enhanced understanding of the underlying molecular, physiological, and pathophysiological interactions of critical illness with the aging process itself. Yet, significant barriers to research for critical illness in aging exist. We review the state of knowledge and identify gaps in knowledge, research opportunities, and barriers to research, with the goal of promoting an integrated research agenda for critical illness in aging. PMID:20558632

ADHD in school-aged youth: Management and special treatment considerations in the primary care setting.

PubMed

Weed, Elizabeth D

Attention-deficit/hyperactivity disorder is considered one of the most common neurodevelopmental disorders of childhood. Primary care providers are in the unique position of providing comprehensive care-routine care, well child visits, immunizations, and other healthcare needs-to a majority of children and adolescents with attention-deficit/hyperactivity disorder. As such, primary care providers are pivotal in the diagnosis, management, and treatment of this population. This article will address special treatment considerations to aid in the management of attention-deficit/hyperactivity disorder in the primary care setting, including substance use disorders and diversion, cardiac issues and stimulant medication, medication holidays and follow-up monitoring. The database of PubMed was searched using keywords that included attention-deficit/hyperactivity disorder, children, prevalence, medication holidays, safety, cardiovascular, cardiac, blood pressure, substance use, diversion, adverse drug reactions; inclusion dates were January 1, 2011 to September 30, 2015. © The Author(s) 2016.

Ageing with long-standing hearing impairment and deafness.

PubMed

Gething, L

2000-09-01

Until recently, ageing with a long-standing disability had not been a major consideration for governments around the world. Policy and planning for this substantial subgroup had not kept abreast with developments in regard to the growing numbers of older people in general. Consultations held in Australia provided information and recommendations for use by governments and service agencies. The focus was on the viewpoints of consumers. This article reports results for people with long-standing deafness and hearing impairment. It is believed that disadvantages throughout life act to restrict freedom of choice and well-being in old age. Important factors perceived to underlie disadvantage include lifelong restricted access to the opportunities afforded by education and employment and their concomitant effects on the ability to develop the skills, attitudes and knowledge necessary for independence in old age; attitudes of others (including service providers); and the complexity and inflexibility of service systems. However, there are positive aspects. Comparison with published reports about people who acquired hearing loss as a result of the ageing process suggests that people with long-standing disability have learned to live with their situation. In contrast, people whose loss was associated with ageing often report emotional issues and isolation.

Management of Concurrent Pregnancy and Acute Lymphoblastic Malignancy in Teenaged Patients: Two Illustrative Cases and Review of the Literature

PubMed Central

Johnson, Liza-Marie; Church, Christopher L.; Gomez-Garcia, Wendy C.; Popescu, Marcela I.; Margolin, Judith F.; Ribeiro, Raul C.

2014-01-01

The usual age range of acute lymphoblastic malignancies (acute lymphoblastic leukemia and advanced-stage lymphoblastic lymphoma) includes teenagers and young adults (<22 years of age) and coincides with the age of fertility. Concurrence of acute lymphoblastic malignancy with pregnancy is therefore most likely to happen during the younger childbearing ages. However, the therapeutic challenges posed by the dual diagnosis of lymphoblastic malignancy and pregnancy have not specifically been studied in the context of age, and management guidelines for pregnant young patients are lacking. Inconsistency in defining the legal decision-making rights of pregnant teenaged patients adds a further level of complexity in this age group. Management of this challenging combination in the young patient therefore entails unique ethical considerations. Here we present two illustrative cases of teenage pregnancy complicated by acute lymphoblastic malignancy, review the available literature, and offer suggestions for the therapeutic management of such cases in adolescent and young adult patients. Importantly, practical management recommendations are provided in the context of clinical ethics principles that are universally applicable, including in developing countries, where the highest incidence of adolescent pregnancies has been documented. PMID:25538861

Ethical Considerations Regarding the Use of Smart Home Technologies for Older Adults: An Integrative Review.

PubMed

Chung, Jane; Demiris, George; Thompson, Hilaire J

2016-01-01

With the wide adoption and use of smart home applications, there is a need for examining ethical issues regarding smart home use at the intersection of aging, technology, and home environment. The purpose of this review is to provide an overview of ethical considerations and the evidence on these ethical issues based on an integrative literature review with regard to the utilization of smart home technologies by older adults and their family members. REVIEW DESIGN AND METHODS: We conducted an integrative literature review of the scientific literature from indexed databases (e. g., MEDLINE, CINAHL, and PsycINFO). The framework guiding this review is derived from previous work on ethical considerations related to telehealth use for older adults and smart homes for palliative care. Key ethical issues of the framework include privacy, informed consent, autonomy, obtrusiveness, equal access, reduction in human touch, and usability. Six hundred and thirty-five candidate articles were identified between the years 1990 and 2014. Sixteen articles were included in the review. Privacy and obtrusiveness issues appear to be the most important factors that can affect smart home technology adoption. In addition, this article recommends that stigmatization and reliability and maintenance of the system are additional factors to consider. When smart home technology is used appropriately, it has the potential to improve quality of life and maintain safety among older adults, ultimately supporting the desire of older adults for aging in place. The ability to respond to potential ethical concerns will be critical to the future development and application of smart home technologies that aim to enhance safety and independence.

Association of lifestyle with serum lipid levels: a study of middle-aged Japanese men.

PubMed

Nakanishi, N; Tatara, K; Nakamura, K; Suzuki, K

2000-07-01

Cross-sectional associations between lifestyle and serum lipid levels were examined in 1591 Japanese male office workers aged 35 to 59 years in Osaka, Japan. From multiple linear regression analyses, significant correlates with low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and Log triglyceride levels and the ratio of LDL cholesterol to HDL cholesterol were, in the order of relative importance: BMI, alcohol intake (negative) and age for LDL cholesterol level; BMI (negative), cigarette smoking (negative), alcohol intake, consideration for nutritional balance, hours of brisk walking, hours of walking at an ordinary pace and physical exercise for HDL cholesterol level; BMI, cigarette smoking, consideration for nutritional balance (negative), hours of work (negative), alcohol intake and coffee drinking (negative) for Log triglyceride level; and BMI, alcohol intake (negative), cigarette smoking, consideration for nutritional balance (negative), age, hours of brisk walking (negative) and the frequency of snack intake between meals for the ratio of LDL cholesterol to HDL cholesterol. Our data suggest that obesity, cigarette smoking and snack intake between meals are atherogenic whereas alcohol consumption, consideration for nutritional balance and walking long hours, especially at a brisk pace, are anti-atherogenic in middle-aged Japanese men.

Growth failure and nutrition considerations in chronic childhood wasting diseases.

PubMed

Kyle, Ursula G; Shekerdemian, Lara S; Coss-Bu, Jorge A

2015-04-01

Growth failure is a common problem in many children with chronic diseases. This article is an overview of the most common causes of growth failure/growth retardation that affect children with a number of chronic diseases. We also briefly review the nutrition considerations and treatment goals. Growth failure is multifactorial in children with chronic conditions, including patients with cystic fibrosis, chronic kidney disease, chronic liver disease, congenital heart disease, human immunodeficiency virus, inflammatory bowel disease, short bowel syndrome, and muscular dystrophies. Important contributory factors to growth failure include increased energy needs, increased energy loss, malabsorption, decreased energy intake, anorexia, pain, vomiting, intestinal obstruction, and inflammatory cytokines. Various metabolic and pathologic abnormalities that are characteristic of chronic diseases further lead to significant malnutrition and growth failure. In addition to treating disease-specific abnormalities, treatment should address the energy and protein deficits, including vitamin and mineral supplements to correct deficiencies, correct metabolic and endocrinologic abnormalities, and include long-term monitoring of weight and growth. Individualized, age-appropriate nutrition intervention will minimize the malnutrition and growth failure seen in children with chronic diseases. © 2014 American Society for Parenteral and Enteral Nutrition.

Adoption consideration and concerns among young adult female cancer survivors.

PubMed

Gorman, Jessica R; Whitcomb, Brian W; Standridge, Daniel; Malcarne, Vanessa L; Romero, Sally A D; Roberts, Samantha A; Su, H Irene

2017-02-01

We compared adoption consideration between female young adult cancer survivors and women of the same age in the general US population, hypothesizing that cancer survivors who desired children would report greater interest in adoption than an age-adjusted general population sample who desired children. After age-standardizing the cancer survivor cohort to match the age distribution of the 2006-2010 National Survey for Family Growth (NSFG), we estimated adoption consideration among women age 18-35 years who wanted a (another) child in the two cohorts overall and within age groups. We assessed characteristics and concerns related to adoption consideration among cancer survivors. Among cancer survivors, 81.6 % (95 % CI 75.7-87.6) reported that they would consider adoption compared to 40.3 % (95 % CI 40.3-40.3) of women in the general population. While over 80 % of the cancer survivor sample reported that they would consider adoption, only 15 % of cancer survivors reported no concerns about adoption. The most common concerns were desire for a biological child (48 %), expense (45 %), adoption agency candidacy (41 %), and needing more information (39 %). We observed a twofold higher interest in adoption when comparing the cancer survivor with the general population, suggesting that adoption is a consideration for many young women who have survived cancer. Adoption is an important family-building option for those who want to have a child but are unable to or choose not to have a biological child. However, young adult survivors may need more support to understand and navigate this process.

Management considerations in heifer development and puberty.

PubMed

Patterson, D J; Perry, R C; Kiracofe, G H; Bellows, R A; Staigmiller, R B; Corah, L R

1992-12-01

Management of replacement beef heifers should focus on factors that enhance physiological processes that promote puberty. Age at puberty is important as a production trait when heifers are bred to calve as 2-yr-olds and in systems that impose restricted breeding periods. Calving by 24 mo of age is necessary to obtain maximum lifetime productivity. Because the reproductive system is the last major organ system to mature, factors that influence puberty are critical. The influence of environment on the sequence of events leading to puberty in the heifer is dictated largely by the nutritional status of the animal and related effects on growth rate and development. Management strategies have been designed to ensure that heifers reach a prebreeding target weight that supports optimum reproductive performance, and consequences of inadequate or excessive development have been evaluated. Those strategies are based on evidence linking postweaning nutritional development with key reproductive events that include age at puberty and first breeding, conception, pregnancy loss, incidence and severity of dystocia, and postpartum interval to estrus. Management alternatives that ultimately affect lifetime productivity and reproductive performance of heifers begin at birth and include decisions that involve growth-promoting implants, creep-feeding, breed type and(or) species, birth date and weaning weight, social interaction, sire selection, and exogenous hormonal treatments to synchronize or induce estrus. Basic and applied future research efforts should converge to match in a realistic manner the production potential of the animal with available resources. Strategies that incorporate consideration of nutrition, genetics, and emerging management techniques will need to be tested to enable producers to make decisions that result in profit. This review evaluates the current status of knowledge relating to management of the replacement beef heifer and serves to stimulate research needed to enhance management techniques to ensure puberty at an optimal age.

Age changes and differences in personality traits and states of the old and very old.

PubMed

Martin, Peter; Long, M Valora; Poon, Leonard W

2002-03-01

The purpose of this study was to examine stability and change in personality traits and states for 3 age groups: centenarians, octogenarians, and sexagenarians. One hundred seventy-nine older adults participated in the 2-wave study. Results concerning age-group differences indicated that centenarians scored higher in Suspiciousness but lower in Intelligence and Stress when compared with the other 2 age groups. Octogenarians were lower in the personality traits Intelligence, Dominance, and Conscientiousness when compared with sexagenarians. Octogenarians were lower in the personality state Arousal, but higher on Regression. Results from the longitudinal analyses for centenarians indicated lower scores for Sensitivity, but higher scores for Radicalism (both personality traits), as well as higher scores of Fatigue and Depression (personality states) at follow-up. For the younger 2 age groups, age changes included higher scores for Sensitivity and Suspiciousness (personality traits). Stability scores for traits and states were considerably lower for centenarians when compared with the younger age groups.

Women and substance abuse: gender, age, and cultural considerations.

PubMed

Stevens, Sally J; Andrade, Rosi A C; Ruiz, Bridget S

2009-01-01

Historically, data has shown that a smaller percentage of women use alcohol and illicit substances compared to men, and that frequency of use has been lower among women compared to use among men. Although this data on usage may be true, researchers also acknowledge that substance use among women has been a hidden issue, one not realistically acknowledged by society, especially prior to the mid-1960s. Along with this, more recent data indicates that rates of substance use among women are increasing. Factors contributing to this increase in substance abuse have begun to receive considerable attention, and recent research suggests that many issues exist that are unique to substance use among women. The purpose of this article is to discuss gender specific considerations in women's substance abuse by examining the history of substance use among women; analyzing gender-specific factors, including physiological factors, trauma-related factors, mental health issues, and cultural considerations that impact on women's substance use; articulating treatment approaches for working with substance abusing women and girls; and providing recommendations for further research in this area.

Mature-age entrants to medical school: a controlled study of sociodemographic characteristics, career choice and job satisfaction.

PubMed

Harth, S C; Biggs, J S; Thong, Y H

1990-11-01

A comparison of 121 mature-age and 270 normal-age entrants who graduated from the University of Queensland Medical School between 1972 and 1987 shows that mature-age entrants are some 7 years older, are more likely to come from public (state) schools and less likely to have parents in professional/technical occupations. Otherwise, the two groups were similar in terms of gender, marital status, number of children, ethnic background and current practice location. The educational background of mature-age entrants prior to admission includes 44.6% with degrees in health-science areas and 31.4% with degrees in non-health areas. Reasons for delayed entry of mature-age entrants include late consideration of medicine as a career (34.7%), financial problems (31.4%), dissatisfaction with previous career (30.6%), poor academic results (19.8%), or a combination of the above factors. Motivations to study medicine include family influences (more so in normal-age entrants), altruistic reasons (more so in mature-age entrants) and a variety of personal/social factors such as intellectual satisfaction, prestige and financial security (similar for both groups) and parental expectations (more so in normal-age entrants). Mature-age entrants experienced greater stress throughout the medical course, especially with regard to financial difficulties, loneliness/isolation from the students and family problems (a greater proportion were married with children). While whole-course grades were similar in both groups, normal-age entrants tended to win more undergraduate honours/prizes and postgraduate diplomas/degrees, including specialist qualifications. Practice settings were similar in terms of group private practice, hospital/clinic practice or medical administration, but there was a greater proportion of mature-age entrants in solo private practice, and a smaller proportion in teaching/research. If given the time over, some two-thirds of both groups would choose medicine as a career. Reasons for job satisfaction include helping patients, intellectual stimulation and financial rewards. Reasons for dissatisfaction include pressure of work, red-tape/paperwork, 'doctor-bashing', long working hours, emotional strain, financial pressure, unfulfilled career expectations and irritation with trivial medical complaints.

Ethical issues in biological psychiatric research with children and adolescents.

PubMed

Arnold, L E; Stoff, D M; Cook, E; Cohen, D J; Kruesi, M; Wright, C; Hattab, J; Graham, P; Zametkin, A; Castellanos, F X

1995-07-01

This article reviews, discusses, and elaborates considerations and recommendations summarized by the biological research working group at the May 1993 NIMH conference on ethical issues in mental health research on children and adolescents. Notes from the conference were summarized and supplemented by a computer search of relevant literature. Drafts were circulated for comment to national and international experts, some of whom joined as coauthors. Issues addressed include possible overprotection by policy makers and institutional review boards arising out of the recognition of children's special vulnerability without equal recognition of their need for research; the definition of minimal risk, which has often been equated with no risk in the case of children; assessment of the risk-benefit ratio; procedures for minimization of risk, such as improved technology, "piggybacking" onto clinical tests, and age-appropriate preparation; the difficulty of justifying risk for normal controls; age-graded consent; special considerations about neuroimaging; "coercive" inducement, both material and psychological; disposition of unexpected or unwanted knowledge about individuals, including the subject's right not to know and parent's right not to tell; and socioeconomic status and cultural/ethnic equity. The working group adopted a position of advocacy for children's right to research access while recognizing that this advocacy must be tempered by thoughtful protections for child and adolescent subjects.

Teaching epidemiology in the digital age: considerations for academicians and their students.

PubMed

Caron, Rosemary M

2013-09-01

The way in which we prepare future public health professionals is changing because of the digital age. Online education is expanding the accessibility of public health training to students and practitioners with diverse backgrounds. Online courses offer many advantages for students, including flexible schedules, elimination of commuting time, and fostering interactions among students and the instructor. A few disadvantages of online courses for the student can include a feeling of isolation, difficulty adjusting to the time-intensive nature, and the required self-discipline to regularly tend to online course materials that immature and working students can find challenging. For faculty who are faced with teaching epidemiology in these changing times of the traditional face-to-face classroom and the virtual classroom, the core teaching principles of this science of public health remain unchanged, yet how they are delivered in the online environment adds a layer of complexity not previously encountered. This paper presents practical considerations for faculty who will be teaching online and their students who will be learning online. In addition, a framework for an online epidemiology course is presented as a model by which faculty interested in teaching epidemiology online can modify the course structure, content, and assessment tools to fit their needs. Copyright © 2013 Elsevier Inc. All rights reserved.

The endocrine-brain-aging triad where many paths meet: female reproductive hormone changes at midlife and their influence on circuits important for learning and memory.

PubMed

Koebele, Stephanie V; Bimonte-Nelson, Heather A

2017-08-01

Female mammals undergo natural fluctuations in sex steroid hormone levels throughout life. These fluctuations span from early development, to cyclic changes associated with the menstrual or estrous cycle and pregnancy, to marked hormone flux during perimenopause, and a final decline at reproductive senescence. While the transition to reproductive senescence is not yet fully understood, the vast majority of mammals experience this spontaneous, natural phenomenon with age, which has broad implications for long-lived species. Indeed, this post-reproductive life stage, and its transition, involves significant and enduring physiological changes, including considerably altered sex steroid hormone and gonadotropin profiles that impact multiple body systems, including the brain. The endocrine-brain-aging triad is especially noteworthy, as many paths meet and interact. Many of the brain regions affected by aging are also sensitive to changes in ovarian hormone levels, and aging and reproductive senescence are both associated with changes in memory performance. This review explores how menopause is related to cognitive aging, and discusses some of the key neural systems and molecular factors altered with age and reproductive hormone level changes, with an emphasis on brain regions important for learning and memory. Copyright © 2017. Published by Elsevier Inc.

The natural course of anxiety disorders in the elderly: a systematic review of longitudinal trials.

PubMed

Sami, Musa Basseer; Nilforooshan, Ramin

2015-07-01

The anxiety disorders are a prevalent mental health problem in older age with a considerable impact on quality of life. Until recently there have been few longitudinal studies on anxiety in this age group, consequently most of the evidence to date has been cross-sectional in nature. We undertook a literature search of Medline, PsycINFO, the Cochrane trials database and the TRIP medical database to identify longitudinal studies which would help elucidate natural history and prognosis of anxiety disorders in the elderly. We identified 12 papers of 10 longitudinal studies in our Review. This represented 34,691 older age participants with 5,199 with anxiety disorders including anxious depression and 3,532 individuals with depression without anxiety. Relapse rates of anxiety disorders are high over 6 year follow-up with considerable migration to mixed anxiety-depression and pure depressive mood episodes. Mixed anxiety-depression appears to be a poorer prognostic state than pure anxiety or pure depression with higher relapse rates across studies. In community settings treatment rates are low with 7-44% of the anxious elderly treated on antidepressant medications. To our knowledge this is the first Systematic Review of longitudinal trials of anxiety disorders in older people. Major longitudinal studies of the anxious elderly are establishing the high risk of relapse and persistence alongside the progression to depression and anxiety depression states. There remains considerable under-treatment in community studies. Specialist assessment and treatment and major public health awareness of the challenges of anxiety disorders in the elderly are required.

Simultaneous measurement of NAD metabolome in aged mice tissue using liquid chromatography tandem-mass spectrometry.

PubMed

Yaku, Keisuke; Okabe, Keisuke; Nakagawa, Takashi

2018-06-01

Nicotinamide adenine dinucleotide (NAD) is a major co-factor that mediates multiple biological processes including redox reaction and gene expression. Recently, NAD metabolism has received considerable attention because administration of NAD precursors exhibited beneficial effects against aging-related metabolic disorders in animals. Although numerous studies have reported that NAD levels decline with aging in multiple animal tissues, the pathway and kinetics of NAD metabolism in aged organs are not completely understood. To determine the NAD metabolism upon aging, we developed targeted metabolomics based on an LC/MS/MS system. Our method is simple and applicable to crude biological samples, including culture cells and animal tissues. Unlike a conventional enzymatic cycling assay, our approach can determine NAD and NADH (reduced form of NAD) by performing a single sample preparation. Further, we validated our method using biological samples and investigated the alteration of the NAD metabolome during aging. Consistent with previous reports, the NAD levels in the liver and skeletal muscle decreased with aging. Further, we detected a significant increase in nicotinamide mononucleotide and nicotinamide riboside in the kidney upon aging. The LC/MS/MS-based NAD metabolomics that we have developed is extensively applicable to biomedical studies, and the results will present innovative ideas for the aging studies, especially for that of NAD metabolism. Copyright © 2018 John Wiley & Sons, Ltd.

Cardiac Physiology of Aging: Extracellular Considerations.

PubMed

Horn, Margaux A

2015-07-01

Aging is a major risk factor for the development of cardiovascular disease, with the majority of affected patients being elderly. Progressive changes to myocardial structure and function occur with aging, often in concert with underlying pathologies. However, whether chronological aging results in a remodeled "aged substrate" has yet to be established. In addition to myocyte contractility, myocardial performance relies heavily on the cardiac extracellular matrix (ECM), the roles of which are as dynamic as they are significant; including providing structural integrity, assisting in force transmission throughout the cardiac cycle and acting as a signaling medium for communication between cells and the extracellular environment. In the healthy heart, ECM homeostasis must be maintained, and matrix deposition is in balance with degradation. Consequently, alterations to, or misregulation of the cardiac ECM has been shown to occur in both aging and in pathological remodeling with disease. Mounting evidence suggests that age-induced matrix remodeling may occur at the level of ECM control; including collagen synthesis, deposition, maturation, and degradation. Furthermore, experimental studies using aged animal models not only suggest that the aged heart may respond differently to insult than the young, but the identification of key players specific to remodeling with age may hold future therapeutic potential for the treatment of cardiac dysfunction in the elderly. This review will focus on the role of the cardiac interstitium in the physiology of the aging myocardium, with particular emphasis on the implications to age-related remodeling in disease. © 2015 American Physiological Society.

Pacemakers and implantable cardioverter-defibrillators in pediatric patients.

PubMed

Silka, Michael J; Bar-Cohen, Yaniv

2006-11-01

The use of pacemakers and implantable cardioverter-defibrillators (ICDs) in infants, children, and patients with congenital heart disease presents unique challenges and considerations. They include uncommon indications for device implantation, innovative approaches to lead implantation and configuration, and age-dependent and disease-specific aspects of device programming. In this review, the current indications for pacemaker and ICD implantation in young patients are discussed, followed by consideration of the approaches to lead and device placement in very small patients and those with complex congenital heart disease, in whom unique problems may be encountered. The limitations of programmability of current pacemakers and ICDs when used in young patients are discussed, followed by an analysis of long-term device follow-up and potential late complications.

Anthropometric data collection of Portuguese children using 3D body scanning: considerations about the scanning booth

NASA Astrophysics Data System (ADS)

de Campos, R.; Carvalho, M. A.; Lopes, H. P.; Xu, B.

2017-10-01

This paper presents some considerations regarding the scanning booth used in an anthropometric study done with a 3D body scanning technology. The data collected is part of a Ph.D. study conducted in Textile Engineering at University of Minho in Portugal, which aims to develop clothing for overweight and obese Portuguese children aged 2-11 years, of both genders. The challenges faced during data collection are described, and modifications of the scanning booth are proposed. It is possible to conclude that the importance of the scanning booth is key to an efficient anthropometric data collection, including the growth of this technology in the garment industry, Universities Research Institutes involved with anthropometric studies.

Sepsis in Older Adults.

PubMed

Rowe, Theresa A; McKoy, June M

2017-12-01

Sepsis disproportionally affects older adults with more than 60% of sepsis diagnoses attributed to adults aged 65 years and older. Identifying, diagnosing, and treating sepsis in older individuals remain a challenge for clinicians, and few studies focus specifically on older adults with multiple medical comorbidities. Principles guiding management of sepsis for older adults are generally the same as in younger adults; however, unique considerations particularly pertinent to the care older adults include antimicrobial selection and dosing, delirium management, and goals of care discussions. Other factors, such as medical comorbidities, cognitive impairment, and functional status, impact outcomes more than age alone. Copyright © 2017 Elsevier Inc. All rights reserved.

Maternal trait personality and childbirth: the role of extraversion and neuroticism.

PubMed

Johnston, R G; Brown, A E

2013-11-01

anxiety during pregnancy and childbirth can increase risk of complications and interventions for both mother and infant. Although considerable work has explored fear of childbirth and anxiety during labour and subsequent birth outcomes there has been less consideration of the role of more stable maternal personality upon childbirth. Traits of neuroticism and extraversion are however predictive of health outcomes in other fields potentially through biological, psychological and social mechanisms. The aim of the current research was thus to examine the relationship between trait personality and childbirth experience. seven hundred and fifty-five mothers with an infant aged 0-6 months completed a self-report questionnaire including the Ten Item Personality Measure and descriptions of birth experience including mode of birth [vaginal vs. caesarean section] and complications [failure to progress, fetal distress, post-partum haemorrhage, assisted birth and severe tear]. personality traits were significantly associated with birth experience. Specifically mothers scoring low in extraversion and emotional stability were significantly more likely to have a caesarean section and experience a number of complications during labour and birth including an assisted birth, fetal distress, failure to progress and a severe tear. Findings were independent of maternal age, education and parity. the personality traits of extraversion and emotional stability appear to facilitate likelihood of normal birth. Potential explanations for this include biological (physiological reactivity, pain thresholds, oxytocin and dopamine release) and psychological (coping mechanisms, social support, self-efficacy) factors. The findings have important implications for antenatal education and support during labour. Copyright © 2012 Elsevier Ltd. All rights reserved.

Performance of normal females and carriers of color-vision deficiencies on standard color-vision tests.

PubMed

Dees, Elise W; Baraas, Rigmor C

2014-04-01

Carriers of red-green color-vision deficiencies are generally thought to behave like normal trichromats, although it is known that they may make errors on Ishihara plates. The aim here was to compare the performance of carriers with that of normal females on seven standard color-vision tests, including Ishihara plates. One hundred and twenty-six normal females, 14 protan carriers, and 29 deutan carriers aged 9-66 years were included in the study. Generally, deutan carriers performed worse than protan carriers and normal females on six out of the seven tests. The difference in performance between carriers and normal females was independent of age, but the proportion of carriers that made errors on pseudo-isochromatic tests increased with age. It was the youngest carriers, however, who made the most errors. There was considerable variation in performance among individuals in each group of females. The results are discussed in relation to variability in the number of different L-cone pigments.

Consideration of immediate and future consequences, smoking status, and body mass index.

PubMed

Adams, Jean

2012-03-01

Health-related behaviors often involve immediate costs to achieve long-term benefits. How one considers the future outcomes of present day behaviors (e.g., temporal orientation) may play a role in engagement in healthy behaviors. The Consideration of Future Consequences Scale (CFCS) measures temporal orientation on a unidimensional continuum. Recently, 2 subscales of the CFCS have been reported: immediate (CFC-I) and future (CFC-F) consequences. These support a multidimensional conceptualization of temporal orientation. Confirmatory factor analysis was performed on CFCS data. The associations between 2 health-related variables [smoking and body mass index (BMI)] and each subscale were then explored, controlling for sociodemographic variables. A random sample of 2,000 individuals aged 18 years or over was selected from the edited electoral role for one English city and sent a postal questionnaire, including the CFCS and questions on age, gender, socioeconomic position, and self-reported current smoking status and BMI. Complete data was provided by 800 participants (response rate = 40.0%). The 2-factor model fitted CFCS data better than the 1-factor model. In multiple linear regression, CFC-I was positively associated with BMI, B (95% confidence interval [CI]) = 0.47 (0.06 to 0.88), p = .025; and odds of being a current smoker, odds ratio (95% CI) = 1.28 (1.02 to 1.60), p = .035; CFC-F was not associated with health-related variables. These data support the multidimensional conceptualization of temporal orientation. Consideration of immediate consequences may be a more important determinant of health-related behaviors than consideration of future consequences.

Population aging and international development: addressing competing claims of distributive justice.

PubMed

Engelman, Michal; Johnson, Summer

2007-04-01

To date, bioethics and health policy scholarship has given little consideration to questions of aging and intergenerational justice in the developing world. Demographic changes are precipitating rapid population aging in developing nations, however, and ethical issues regarding older people's claim to scarce healthcare resources must be addressed. This paper posits that the traditional arguments about generational justice and age-based rationing of healthcare resources, which were developed primarily in more industrialized nations, fail to adequately address the unique challenges facing older persons in developing nations. Existing philosophical approaches to age-based resource allocation underemphasize the importance of older persons for developing countries and fail to adequately consider the rights and interests of older persons in these settings. Ultimately, the paper concludes that the most appropriate framework for thinking about generational justice in developing nations is a rights-based approach that allows for the interests of all age groups, including the oldest, to be considered in the determination of health resource allocation.

Nationwide real-world database of 20,462 patients enrolled in the Japanese Acute Myocardial Infarction Registry (JAMIR): Impact of emergency coronary intervention in a super-aging population.

PubMed

Kojima, Sunao; Nishihira, Kensaku; Takegami, Misa; Nakao, Yoko M; Honda, Satoshi; Takahashi, Jun; Takayama, Morimasa; Shimokawa, Hiroaki; Sumiyoshi, Tetsuya; Ogawa, Hisao; Kimura, Kazuo; Yasuda, Satoshi

2018-09-01

Cardiovascular diseases, including acute myocardial infarction (AMI), are leading causes of death among the Japanese, who have the longest life expectancy in the world. Over the past 50 years in Japan, the percentage of elderly individuals has increased 4-fold, from 5.7% in 1960 to 23.1% in 2010. To explore medical practices and emergency care for AMI in this aging society, the Japan Acute Myocardial Infarction Registry (JAMIR) was established as a nationwide real-world database. JAMIR conducted retrospective analysis of 20,462 AMI patients (mean age, 68.8 ± 13.3 years; 15,281 men [74.7%]) hospitalized between January 2011 and December 2013. The rates of ambulance use and emergency PCI were 78.9% and 87.9%, respectively. The median door-to-balloon time was 80 min (interquartile range, 53-143 min). Overall in-hospital mortality was 8.3%, including 6.6% due to cardiac death. JAMIR included 4837 patients aged ≥80 years (23.6%). In this age group, patients who underwent PCI (79.9%) had significantly lower in-hospital mortality than those who did not (11.1% vs. 36.9%, P  < 0.001). The large JAMIR database, with 24% of AMI patients aged ≥80 years, could provide useful information about medical care in an aging society. The reasonable in-hospital outcomes observed may justify consideration of PCI for patients with AMI aged ≥80 years.

A cost-effectiveness analysis of in-vitro fertilization by maternal age and number of treatment attempts.

PubMed

Griffiths, Alison; Dyer, Suzanne M; Lord, Sarah J; Pardy, Chris; Fraser, Ian S; Eckermann, Simon

2010-04-01

The increase in use and costs of assisted reproductive therapies including in-vitro fertilization (IVF) has led to debate over public funding. A decision analytic model was designed to estimate the incremental cost-effectiveness of IVF by additional treatment programmes and maternal age. Data from the Australian and New Zealand Assisted Reproductive Database were used to estimate incremental effects (live birth and other pregnancy outcomes) and costs for cohorts of women attempting up to three treatment programmes. A treatment programme included one fresh cycle and a variable number of frozen cycles dependent on maternal age. The incremental cost per live birth ranged from AU dollars 27 373 and AU dollars 31 986 for women aged 30-33 on their first and third programmes to AU dollars 130 951 and AU dollars 187 515 for 42-45-year-old women on their first and second attempts. Overall, these trends were not affected by inclusions of costs associated with ovarian hyperstimulation syndrome or multiple births. This study suggests that cost per live birth from IVF increases with maternal age and treatment programme number and indicates that maternal age has the much greater effect. This evidence may help decisionmakers target the use of IVF services conditional on societal willingness to pay for live births and equity considerations.

Delayed diagnosis of Birt-Hogg-Dubé syndrome due to marked intrafamilial clinical variability: a case report.

PubMed

Sattler, E C; Steinlein, O K

2018-03-16

Birt-Hogg-Dubé syndrome is a genetic syndrome caused by mutations in the FLCN gene. The main symptoms are lung bullae and pneumothorax, benign and malignant kidney tumors, and facial fibrofolliculoma. The risk of pneumothorax is considerable between ages 20-40 years, but decreases markedly after this age range and first-time pneumothorax after age 50 years is rare. Fibrofolliculomas usually occur between ages 35 and 45 years, while the risk for kidney cancer increases steadily with age, starting in young adulthood. However, we demonstrate here that within the same family patients might develop symptoms significantly before or after the usual age range, obscuring the typical clinical pattern and delaying diagnosis. The 43 year old index patient had a history of lung bullae and recurrent pneumothoraces starting 14 years earlier. His father (age 83 years) and one of the paternal uncles experienced their first pneumothorax unusually late after the age of 60 years. The uncle subsequently had four more pneumothoraces, and was diagnosed with kidney in his early 70s. Considerable differences in age of onset were also observed with regard to facial fibrofolliculomas that both paternal uncles developed very early around age 20 years, but which the father only started to show in his eighth decade. Birt-Hogg-Dubé syndrome was finally diagnosed when the index patient started to develop fibrofolliculomas within the typical age range. The family described here illustrates that Birt-Hogg-Dubé syndrome can be difficult to recognize, if presenting with considerable intrafamilial clinical variability. With a life-time kidney cancer risk of about 14-35% the consequences of delayed diagnosis might be grave for the affected family members. The possibility of Birt-Hogg-Dubé syndrome should therefore be taken into consideration in apparently sporadic patients presenting with lung bullae and pneumothorax.

Biologic Monitoring of Exposure to Environmental Chemicals throughout the Life Stages: Requirements and Issues for Consideration for the National Children’s Study

PubMed Central

Barr, Dana B.; Wang, Richard Y.; Needham, Larry L.

2005-01-01

Biomonitoring of exposure is a useful tool for assessing environmental exposures. The matrices available for analyses include blood, urine, breast milk, adipose tissue, and saliva, among others. The sampling can be staged to represent the particular time period of concern: preconceptionally from both parents, from a pregnant woman during each of the three trimesters, during and immediately after childbirth, from the mother postnatally, and from the child as it develops to 21 years of age. The appropriate sample for biomonitoring will depend upon matrix availability, the time period of concern for a particular exposure or health effect, and the different classes of environmental chemicals to be monitored. This article describes the matrices available for biomonitoring during the life stages being evaluated in the National Children’s Study; the best biologic matrices for exposure assessment for each individual chemical class, including consideration of alternative matrices; the analytical methods used for analysis, including quality control procedures and less costly alternatives; the costs of analysis; optimal storage conditions; and chemical and matrix stability during long-term storage. PMID:16079083

Cine phase-contrast MRI evaluation of normal aqueductal cerebrospinal fluid flow according to sex and age.

PubMed

Unal, Ozkan; Kartum, Alp; Avcu, Serhat; Etlik, Omer; Arslan, Halil; Bora, Aydin

2009-12-01

The aim of this study was cerebrospinal flow quantification in the cerebral aqueduct using cine phase-contrast magnetic resonance imaging (MRI) technique in both sexes and five different age groups to provide normative data. Sixty subjects with no cerebral pathology were included in this study. Subjects were divided into five age groups: < or =14 years, 15-24 years, 25-34 years, 35-44 years, and > or =45 years. Phase, rephase, and magnitude images were acquired by 1.5 T MR unit at the level of cerebral aqueduct with spoiled gradient echo through-plane, which is a cine phase-contrast sequence. At this level, peak flow velocity (cm/s), average flow rate (cm/ s), average flow (L/min), volumes in cranial and caudal directions (mL), and net volumes (mL) were studied. There was a statistically significant difference in peak flow between the age group of < or =14 years and the older age groups. There were no statistically significant differences in average velocity, cranial and caudal volume, net volume, and average flow parameters among different age groups. Statistically significant differences were not detected in flow parameters between sexes. When using cine-phase contrast MRI in the cerebral aqueduct, only the peak velocity showed a statistically significant difference between age groups; it was higher in subjects aged < or =14 years than those in older age groups. When performing age-dependent clinical studies including adolescents, this should be taken into consideration.

Self-silencing and age as risk factors for sexually acquired HIV in midlife and older women.

PubMed

Jacobs, Robin J; Thomlison, Barbara

2009-02-01

Objectives. This study explores the contribution of psychosocial factors on sex behaviors of midlife and older women. Methods. A community-based sample of ethnically diverse women (N = 572) between the ages of 50 and 93 completed standardized measures of self-silencing, self-esteem, sensation seeking behavior, HIV-related stigma behavior, sexual assertiveness, and safer sex behaviors. Results. Results from the regression analysis indicated the model significantly predicted safer sex behaviors (p < .001), with self silencing(â = -.115, p < .05) and age (â = .173, p < .001) as significant predictors.Bivariate correlation analysis indicated an inverse correlation between HIV stigma (p < .05) and safer sex behaviors. Discussion. Implications for further study and practice are discussed to include considerations for development of age- and gender-appropriate prevention interventions assisting women with interpersonal processes combined with skills for active involvement in addressing high-risk sex behaviors.

Impact of Aging and Cognition on Hearing Assistive Technology Use

PubMed Central

Jorgensen, Lindsey E.; Messersmith, Jessica J.

2015-01-01

Many factors go into appropriate recommendation and use of hearing assistive technology (HAT). The aging auditory system presents with its own complications and intricacies; there are many types of age-related hearing loss, and it is possible that the underlying cause of hearing loss can significantly impact the recommendations and performance with HATs. The audiologist should take into consideration peripheral and central auditory function when selecting HATs for the aging adult population as well as when selecting appropriate types of technology including personal sound amplification products, hearing aids, cochlear implants, and other assistive technology. The cognitive ability of the patient plays a central role in the recommendations of HAT. It is possible that the use of HATs could mitigate some of the effects of cognitive decline and thus should be considered as early as possible. Assessment of ability and appropriate recommendations are crucial to consistent use of HAT devices. PMID:27516716

Centenarians' "holy" memory: is being positive enough?

PubMed

Fairfield, Beth; Mammarella, Nicola; Di Domenico, Alberto

2013-01-01

The authors compared 18 centenarians' (M age = 100.1 years, SD = 1.8 years) recognition memory for emotional (positive, negative, and religious) pictures with 18 older adults (M age = 75.2 years, SD = 6.8 years). Participants observed a series of images that varied in emotional valence and meaning and were later asked to discriminate between old and new images in a series of pictures that included studied images as well as new images. Centenarians showed decreased recognition memory for positive and negative images items compared with older adults, F(1, 34) = 9.82, p < .01. In addition, a significant age by valence interaction was observed highlighting how centenarians remembered religious pictures better while older adults favoured positive information when only positive pictures were taken into consideration. Results are interpreted in terms of possible age-linked changes in meaningful goals that lead centenarians to focus on meaningful religious self-relevant information rather than simply on positive information.

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

Chironis, N.P.

This book contains a wealth of valuable information carefully selected and compiled from recent issues of Coal Age magazine. Much of the source material has been gathered by Coal Age Editors during their visits to coal mines, research establishments, universities and technical symposiums. Equally important are the articles and data contributed by over 50 top experts, many of whom are well known to the mining industry. Specifically, this easy-to-use handbook is divided into eleven key areas of underground mining. Here you will find the latest information on continuous mining techniques, longwall and shortwall methods and equipment, specialized mining and boringmore » systems, continuous haulage techniques, improved roof control and ventilation methods, mine communications and instrumentation, power systems, fire control methods, and new mining regulations. There is also a section on engineering and management considerations, including the modern use of computer terminals, practical techniques for picking leaders and for encouraging more safety consciousness in employees, factors affecting absenteeism, and some highly important financial considerations. All of this valuable information has been thoroughly indexed to provide immediate access to the specific data needed by the reader.« less

Applying a Lifespan Developmental Perspective to Chronic Pain: Pediatrics to Geriatrics.

PubMed

Walco, Gary A; Krane, Elliot J; Schmader, Kenneth E; Weiner, Debra K

2016-09-01

An ideal taxonomy of chronic pain would be applicable to people of all ages. Developmental sciences focus on lifespan developmental approaches, and view the trajectory of processes in the life course from birth to death. In this article we provide a review of lifespan developmental models, describe normal developmental processes that affect pain processing, and identify deviations from those processes that lead to stable individual differences of clinical interest, specifically the development of chronic pain syndromes. The goals of this review were 1) to unify what are currently separate purviews of "pediatric pain," "adult pain," and "geriatric pain," and 2) to generate models so that specific elements of the chronic pain taxonomy might include important developmental considerations. A lifespan developmental model is applied to the forthcoming Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks-American Pain Society Pain Taxonomy to ascertain the degree to which general "adult" descriptions apply to pediatric and geriatric populations, or if age- or development-related considerations need to be invoked. Copyright © 2016. Published by Elsevier Inc.

Differences in predictors of traditional and cyber-bullying: a 2-year longitudinal study in Korean school children.

PubMed

Yang, Su-Jin; Stewart, Robert; Kim, Jae-Min; Kim, Sung-Wan; Shin, Il-Seon; Dewey, Michael E; Maskey, Sean; Yoon, Jin-Sang

2013-05-01

Traditional bullying has received considerable research but the emerging phenomenon of cyber-bullying much less so. Our study aims to investigate environmental and psychological factors associated with traditional and cyber-bullying. In a school-based 2-year prospective survey, information was collected on 1,344 children aged 10 including bullying behavior/experience, depression, anxiety, coping strategies, self-esteem, and psychopathology. Parents reported demographic data, general health, and attention-deficit hyperactivity disorder (ADHD) symptoms. These were investigated in relation to traditional and cyber-bullying perpetration and victimization at age 12. Male gender and depressive symptoms were associated with all types of bullying behavior and experience. Living with a single parent was associated with perpetration of traditional bullying while higher ADHD symptoms were associated with victimization from this. Lower academic achievement and lower self esteem were associated with cyber-bullying perpetration and victimization, and anxiety symptoms with cyber-bullying perpetration. After adjustment, previous bullying perpetration was associated with victimization from cyber-bullying but not other outcomes. Cyber-bullying has differences in predictors from traditional bullying and intervention programmes need to take these into consideration.

Observational and ecological studies of dietary advanced glycation end products in national diets and Alzheimer's disease incidence and prevalence.

PubMed

Perrone, Lorena; Grant, William B

2015-01-01

Considerable evidence indicates that diet is an important risk-modifying factor for Alzheimer's disease (AD). Evidence is also mounting that dietary advanced glycation end products (AGEs) are important risk factors for AD. This study strives to determine whether estimated dietary AGEs estimated from national diets and epidemiological studies are associated with increased AD incidence. We estimated values of dietary AGEs using values in a published paper. We estimated intake of dietary AGEs from the Washington Heights-Inwood Community Aging Project (WHICAP) 1992 and 1999 cohort studies, which investigated how the Mediterranean diet (MeDi) affected AD incidence. Further, AD prevalence data came from three ecological studies and included data from 11 countries for 1977-1993, seven developing countries for 1995-2005, and Japan for 1985-2008. The analysis used dietary AGE values from 20 years before the AD prevalence data. Meat was always the food with the largest amount of AGEs. Other foods with significant AGEs included fish, cheese, vegetables, and vegetable oil. High MeDi adherence results in lower meat and dairy intake, which possess high AGE content. By using two different models to extrapolate dietary AGE intake in the WHICAP 1992 and 1999 cohort studies, we showed that reduced dietary AGE significantly correlates with reduced AD incidence. For the ecological studies, estimates of dietary AGEs in the national diets corresponded well with AD prevalence data even though the cooking methods were not well known. Dietary AGEs appear to be important risk factors for AD.

The use of pedometers for monitoring physical activity in children and adolescents: measurement considerations.

PubMed

Clemes, Stacy A; Biddle, Stuart J H

2013-02-01

Pedometers are increasingly being used to measure physical activity in children and adolescents. This review provides an overview of common measurement issues relating to their use. Studies addressing the following measurement issues in children/adolescents (aged 3-18 years) were included: pedometer validity and reliability, monitoring period, wear time, reactivity, and data treatment and reporting. Pedometer surveillance studies in children/adolescents (aged: 4-18 years) were also included to enable common measurement protocols to be highlighted. In children > 5 years, pedometers provide a valid and reliable, objective measure of ambulatory activity. Further evidence is required on pedometer validity in preschool children. Across all ages, optimal monitoring frames to detect habitual activity have yet to be determined; most surveillance studies use 7 days. It is recommended that standardized wear time criteria are established for different age groups, and that wear times are reported. As activity varies between weekdays and weekend days, researchers interested in habitual activity should include both types of day in surveillance studies. There is conflicting evidence on the presence of reactivity to pedometers. Pedometers are a suitable tool to objectively assess ambulatory activity in children (> 5 years) and adolescents. This review provides recommendations to enhance the standardization of measurement protocols.

Extracellular vesicles and their synthetic analogues in aging and age-associated brain diseases

PubMed Central

Smith, J. A.; Leonardi, T.; Huang, B.; Iraci, N.; Vega, B.; Pluchino, S.

2015-01-01

Multicellular organisms rely upon diverse and complex intercellular communications networks for a myriad of physiological processes. Disruption of these processes is implicated in the onset and propagation of disease and disorder, including the mechanisms of senescence at both cellular and organismal levels. In recent years, secreted extracellular vesicles (EVs) have been identified as a particularly novel vector by which cell-to-cell communications are enacted. EVs actively and specifically traffic bioactive proteins, nucleic acids, and metabolites between cells at local and systemic levels, modulating cellular responses in a bidirectional manner under both homeostatic and pathological conditions. EVs are being implicated not only in the generic aging process, but also as vehicles of pathology in a number of age-related diseases, including cancer and neurodegenerative and disease. Thus, circulating EVs—or specific EV cargoes—are being utilised as putative biomarkers of disease. On the other hand, EVs, as targeted intercellular shuttles of multipotent bioactive payloads, have demonstrated promising therapeutic properties, which can potentially be modulated and enhanced through cellular engineering. Furthermore, there is considerable interest in employing nanomedicinal approaches to mimic the putative therapeutic properties of EVs by employing synthetic analogues for targeted drug delivery. Herein we describe what is known about the origin and nature of EVs and subsequently review their putative roles in biology and medicine (including the use of synthetic EV analogues), with a particular focus on their role in aging and age-related brain diseases. PMID:24973266

Extracellular vesicles and their synthetic analogues in aging and age-associated brain diseases.

PubMed

Smith, J A; Leonardi, T; Huang, B; Iraci, N; Vega, B; Pluchino, S

2015-04-01

Multicellular organisms rely upon diverse and complex intercellular communications networks for a myriad of physiological processes. Disruption of these processes is implicated in the onset and propagation of disease and disorder, including the mechanisms of senescence at both cellular and organismal levels. In recent years, secreted extracellular vesicles (EVs) have been identified as a particularly novel vector by which cell-to-cell communications are enacted. EVs actively and specifically traffic bioactive proteins, nucleic acids, and metabolites between cells at local and systemic levels, modulating cellular responses in a bidirectional manner under both homeostatic and pathological conditions. EVs are being implicated not only in the generic aging process, but also as vehicles of pathology in a number of age-related diseases, including cancer and neurodegenerative and disease. Thus, circulating EVs-or specific EV cargoes-are being utilised as putative biomarkers of disease. On the other hand, EVs, as targeted intercellular shuttles of multipotent bioactive payloads, have demonstrated promising therapeutic properties, which can potentially be modulated and enhanced through cellular engineering. Furthermore, there is considerable interest in employing nanomedicinal approaches to mimic the putative therapeutic properties of EVs by employing synthetic analogues for targeted drug delivery. Herein we describe what is known about the origin and nature of EVs and subsequently review their putative roles in biology and medicine (including the use of synthetic EV analogues), with a particular focus on their role in aging and age-related brain diseases.

Primary and secondary management of pediatric soft tissue injuries.

PubMed

Hogg, Nicholas J V

2012-08-01

Injury is the most common cause of death in pediatric patients, with a large proportion related to head injury. The craniofacial region in children develops rapidly and at an early age, making the area more prominent compared with the remainder of the body, increasing the likelihood of injury. This article reviews the primary management of pediatric soft tissue injuries, including assessment, cleansing, surgical technique, anesthesia, and considerations for special wounds. The secondary management of pediatric facial injury is also discussed, including scar revision, management of scar hypertrophy/keloids, and staged surgical correction. Copyright © 2012 Elsevier Inc. All rights reserved.

The arts, health, and aging in america: 2005-2015.

PubMed

Hanna, Gay Powell; Noelker, Linda S; Bienvenu, Beth

2015-04-01

In advance of the White House Conference on Aging (WHCoA) in 1981, 1995, and 2005, the arts and aging communities held mini-conferences to ensure that arts, culture, and livability were part of larger public policy discussions. This article takes a historical look at recommendations from the 2005 WHCoA Mini-Conference on Creativity and Aging in America, including arts in health care, lifelong learning, and livability through universal design. Overarching recommendations in 2005 requested investments in research, including cost-benefit analyses; identification of best practices and model programs; program dissemination to broaden the availability of arts programs. The "Arts" is a broad term encompassing all forms of arts including music, theater, dance, visual arts, literature, multimedia and design, folk, and traditional arts to engage the participation of all older Americans; promotion of innovative public and private partnerships to support arts program development, including workforce development (e.g., artists, social workers, and health care providers); and public awareness of the importance of arts participation to healthy aging. Through the leadership of the National Endowment for the Arts and U.S. Department of Health and Human Services, thinking about the arts and aging has broadened to include greater emphasis on a whole-person approach to the health and well-being of older adults. This approach engages older adults in arts participation not only as audience members, but as vital members of their community through creative expression focusing on life stories for intergenerational as well as interprofessional collaboration. This article reviews progress made to date and identifies critical gaps in services for future consideration at a 2015 Mini-Conference on Creativity and Aging related to the WCHoA area of emphasis on healthy aging. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Defining Successful Aging: A Tangible or Elusive Concept?

PubMed Central

Martin, Peter; Kelly, Norene; Kahana, Boaz; Kahana, Eva; Willcox, Bradley J.; Willcox, D. Craig; Poon, Leonard W.

2015-01-01

Purpose of the Study: Everyone wants to age successfully; however, the definition and criteria of successful aging remain vague for laypersons, researchers, and policymakers in spite of decades of research on the topic. This paper highlights work of scholars who made significant theoretical contributions to the topic. Design and Methods: A thorough review and evaluation of the literature on successful aging was undertaken. Results: Our review includes early gerontological definitions of successful aging and related concepts. Historical perspectives reach back to philosophical and religious texts, and more recent approaches have focused on both process- and outcome-oriented models of successful aging. We elaborate on Baltes and Baltes’ theory of selective optimization with compensation [Baltes, P. B., & Baltes, M. M. (1990a). Psychological perspectives on successful aging: The model of selective optimization with compensation. In P. B. Baltes & M. M. Baltes (Eds.), Successful aging: Perspectives from the behavioral sciences (pp. 1–34). United Kingdom: Cambridge University Press], Kahana and Kahana’s preventive and corrective proactivity model [Kahana, E., & Kahana, B. (1996). Conceptual and empirical advances in understanding aging well through proactive adaptation. In V. Bengtson (Ed.), Adulthood and aging: Research on continuities and discontinuities (pp. 18–40). New York: Springer], and Rowe and Kahn’s model of successful aging [Rowe, J. W., & Kahn, R. L. (1998). Successful aging. New York: Pantheon Books], outlining their commonalities and differences. Additional views on successful aging emphasize subjective versus objective perceptions of successful aging and relate successful aging to studies on healthy and exceptional longevity. Implications: Additional theoretical work is needed to better understand successful aging, including the way it can encompass disability and death and dying. The extent of rapid social and technological change influencing views on successful aging also deserves more consideration. PMID:24840916

[Aging of the working population in the European Union].

PubMed

Ilmarinen, J; Costa, G

2000-01-01

The working population over 50 years of age will grow considerably during the next 15 years. After 2010, the number of retired people over 65 years of age will be almost double that of 1995, with a strong impact also on working conditions and the labour market. Work ability is a dynamic process that changes, through its components, throughout life and is the result of the interaction between individual resources (including health, functional capacity, education and skills), working conditions, and the surrounding society. Work ability creates the basis for the employability of an individual, which can be supported by a number of actions (e.g. legislation on work and retirement) and social attitudes (e.g. age discrimination). Consequently, the prevalence of limitations in work ability varies significantly according to how it is evaluated and the frequency of work disability can vary considerably in different times, locations and populations. The Work Ability Index, created and used in a Finnish 11-year longitudinal study, has been proved a useful practical tool for the assessment of workers' fitness and a good predictor of work disability. Measures able to restore, maintain or promote work ability depend on the current work status and the needs of the target groups, and must concentrate on work content, physical work environment and the work community. The actions targeted towards the individual, on the other hand, concentrate on strengthening the health status and functional resources of the workers and developing professional expertise and skills. Correctly targeted and integrated measures improve work ability of ageing workers and therefore lead to improved work quality, increased productivity and also improved quality of life and well-being. They also have positive long-term effects on the "third age", when the worker retires.

The New Compulsory Schooling Age Policy in NSW, Australia: Ethnicity, Ability and Gender Considerations

ERIC Educational Resources Information Center

Reid, Carol; Young, Helen

2012-01-01

The new schooling-leaving age policy in New South Wales, a state in Australia, requires all students to stay at school until they are 17 years old. The policy was introduced in January 2010, with little warning and, it appears, little consideration of its impact in complex contexts. In south-western Sydney, the most diverse region in the city, the…

The cardiovascular system and diving risk.

PubMed

Bove, Alfred A

2011-01-01

Recreational scuba diving is a sport that requires a certain physical capacity, in addition to consideration of the environmental stresses produced by increased pressure, low temperature and inert gas kinetics in tissues of the body. Factors that may influence ability to dive safely include age, physical conditioning, tolerance of cold, ability to compensate for central fluid shifts induced by water immersion, and ability to manage exercise demands when heart disease might compromise exercise capacity. Patients with coronary heart disease, valvular heart disease, congenital heart disease and cardiac arrhythmias are capable of diving, but consideration must be given to the environmental factors that might interact with the cardiac disorder. Understanding of the interaction of the diving environment with various cardiac disorders is essential to providing a safe diving environment to individual divers with known heart disease.

Vertebral Bomb Radiocarbon Suggests Extreme Longevity in White Sharks

PubMed Central

Hamady, Li Ling; Natanson, Lisa J.; Skomal, Gregory B.; Thorrold, Simon R.

2014-01-01

Conservation and management efforts for white sharks (Carcharodon carcharias) remain hampered by a lack of basic demographic information including age and growth rates. Sharks are typically aged by counting growth bands sequentially deposited in their vertebrae, but the assumption of annual deposition of these band pairs requires testing. We compared radiocarbon (Δ14C) values in vertebrae from four female and four male white sharks from the northwestern Atlantic Ocean (NWA) with reference chronologies documenting the marine uptake of 14C produced by atmospheric testing of thermonuclear devices to generate the first radiocarbon age estimates for adult white sharks. Age estimates were up to 40 years old for the largest female (fork length [FL]: 526 cm) and 73 years old for the largest male (FL: 493 cm). Our results dramatically extend the maximum age and longevity of white sharks compared to earlier studies, hint at possible sexual dimorphism in growth rates, and raise concerns that white shark populations are considerably more sensitive to human-induced mortality than previously thought. PMID:24416189

Vertebral bomb radiocarbon suggests extreme longevity in white sharks.

PubMed

Hamady, Li Ling; Natanson, Lisa J; Skomal, Gregory B; Thorrold, Simon R

2014-01-01

Conservation and management efforts for white sharks (Carcharodon carcharias) remain hampered by a lack of basic demographic information including age and growth rates. Sharks are typically aged by counting growth bands sequentially deposited in their vertebrae, but the assumption of annual deposition of these band pairs requires testing. We compared radiocarbon (Δ(14)C) values in vertebrae from four female and four male white sharks from the northwestern Atlantic Ocean (NWA) with reference chronologies documenting the marine uptake of (14)C produced by atmospheric testing of thermonuclear devices to generate the first radiocarbon age estimates for adult white sharks. Age estimates were up to 40 years old for the largest female (fork length [FL]: 526 cm) and 73 years old for the largest male (FL: 493 cm). Our results dramatically extend the maximum age and longevity of white sharks compared to earlier studies, hint at possible sexual dimorphism in growth rates, and raise concerns that white shark populations are considerably more sensitive to human-induced mortality than previously thought.

Sexual Function Across Aging.

PubMed

Clayton, Anita H; Harsh, Veronica

2016-03-01

Women experience multiple changes in social and reproductive statuses across the life span which can affect sexual functioning. Various phases of the sexual response cycle may be impacted and can lead to sexual dysfunction. Screening for sexual problems and consideration of contributing factors such as neurobiology, reproductive life events, medical problems, medication use, and depression can help guide appropriate treatment and thereby improve the sexual functioning and quality of life of affected women. Treatment options include psychotropic medications, hormone therapy, and psychotherapy.

Special Considerations in Children with Vitiligo.

PubMed

Taïeb, Alain; Seneschal, Julien; Mazereeuw-Hautier, Juliette

2017-04-01

Childhood vitiligo differs from adult-onset vitiligo for several features including increased incidence of the segmental variant, higher prevalence of halo nevi, and more common family history for autoimmune diseases and atopic diathesis. The major differential diagnoses are the postinflammatory hypomelanoses for nonsegmental vitiligo and nevus depigmentosus for segmental vitiligo. From a therapeutic standpoint, early awareness of the diagnosis seems to correlate with a good treatment outcome in this age group. Copyright © 2016 Elsevier Inc. All rights reserved.

It Is Time to Rethink Central Auditory Processing Disorder Protocols for School-Aged Children.

PubMed

DeBonis, David A

2015-06-01

The purpose of this article is to review the literature that pertains to ongoing concerns regarding the central auditory processing construct among school-aged children and to assess whether the degree of uncertainty surrounding central auditory processing disorder (CAPD) warrants a change in current protocols. Methodology on this topic included a review of relevant and recent literature through electronic search tools (e.g., ComDisDome, PsycINFO, Medline, and Cochrane databases); published texts; as well as published articles from the Journal of the American Academy of Audiology; the American Journal of Audiology; the Journal of Speech, Language, and Hearing Research; and Language, Speech, and Hearing Services in Schools. This review revealed strong support for the following: (a) Current testing of CAPD is highly influenced by nonauditory factors, including memory, attention, language, and executive function; (b) the lack of agreement regarding the performance criteria for diagnosis is concerning; (c) the contribution of auditory processing abilities to language, reading, and academic and listening abilities, as assessed by current measures, is not significant; and (d) the effectiveness of auditory interventions for improving communication abilities has not been established. Routine use of CAPD test protocols cannot be supported, and strong consideration should be given to redirecting focus on assessing overall listening abilities. Also, intervention needs to be contextualized and functional. A suggested protocol is provided for consideration. All of these issues warrant ongoing research.

Preliminary report on geology along Atlantic Continental Margin of northeastern United States

USGS Publications Warehouse

Minard, J.P.; Perry, W.J.; Weed, E.G.A.; Rhodehamel, E.C.; Robbins, E.I.; Mixon, R.B.

1974-01-01

The U.S. Geological Survey is conducting a geologic and geophysical study of the northeastern United States outer continental shelf and the adjacent slope from Georges Bank to Cape Hatteras. The study also includes the adjacent coastal plain because it is a more accessible extension of the shelf. The total study area is about 324,000 sq km, of which the shelf and slope constitute about 181,000 sq km and the coastal plain constitutes 143,000 sq km. The shelf width ranges from about 30 km at Cape Hatteras to about 195 km off Raritan Bay and on Georges Bank. Analyses of bottom samples make it possible to construct a preliminary geologic map of the shelf and slope to a water depth of 2,000 m. The oldest beds cropping out in the submarine canyons and on the slope are of early ate Cretaceous age. Beds of Early Cretaceous and Jurassic age are present in deep wells onshore and probably are present beneath the shelf in the area of this study. Such beds are reported beneath the Scotian shelf on the northeast where they include limestone, salt, and anhydrite. Preliminary conclusions suggest a considerably thicker Mesozoic sedimentary sequence than has been described previously. The region is large; the sedimentary wedge is thick; structures seem favorable; and the hydrocarbon potential may be considerable.

Contributions of GABA to alcohol responsivity during adolescence: Insights from preclinical and clinical studies

PubMed Central

Silveri, Marisa M.

2015-01-01

There is a considerable body of literature demonstrating that adolescence is a unique age period, which includes rapid and dramatic maturation of behavioral, cognitive, hormonal and neurobiological systems. Most notably, adolescence is also a period of unique responsiveness to alcohol effects, with both hyposensitivity and hypersensitivity observed to the various effects of alcohol. Multiple neurotransmitter systems are undergoing fine-tuning during this critical period of brain development, including those that contribute to the rewarding effects of drugs of abuse. The role of developmental maturation of the γ-amino-butyric acid (GABA) system, however, has received less attention in contributing to age-specific alcohol sensitivities. This review integrates GABA findings from human magnetic resonance spectroscopy studies as they may translate to understanding adolescent-specific responsiveness to alcohol effects. Better understanding of the vulnerability of the GABA system both during adolescent development, and in psychiatric conditions that include alcohol dependence, could point to a putative mechanism, boosting brain GABA, that may have increased effectiveness for treating alcohol abuse disorders. PMID:24631274

A Search for Impact Debris in the Pliocene Age Sirius Group, Transantarctic Mountains

NASA Technical Reports Server (NTRS)

Harvey, Ralph P.; Boyd, Hiram

2003-01-01

The Sirius Group is a mixed sequence of interbedded diamictite and mudstone of Pliocene age found at scattered locations along the length of the Transantarctic Mountains. Sirius Group rocks are usually considered tillites, but contain some very "un-tillite" elements. Within section and from site to site, Sirius Group rocks vary considerably in terms of texture and relative abundance of clast lithologies, recording a history that includes shifting influences of glacial, lacustrine, fluvial and wetland processes. The colorful heritage of the Sirius Group has generated a lot of interest due to its potential as a record of changes in the behavior of the East Antarctic icesheet during a climatologically interesting period.

Increasing persistency in lay and stabilising egg quality in longer laying cycles. What are the challenges?

PubMed Central

Bain, M. M.; Nys, Y.; Dunn, I.C.

2016-01-01

Abstract In the past 50 years, selection starting initially at the breed level and then using quantitative genetics coupled with a sophisticated breeding pyramid, has resulted in a very productive hybrid for a variety of traits associated with egg production.One major trait currently being developed further is persistency of lay and the concept of the “long life” layer. Persistency in lay however cannot be achieved without due consideration of how to sustain egg quality and the health and welfare of the birds in longer laying cycles. These multiple goals require knowledge and consideration of the bird’s physiology, nutritional requirements, which vary depending on age and management system, reproductive status and choice of the selection criteria applied.The recent advent of molecular genetics offers considerable hope that these multiple elements can be balanced for the good of all in the industry including the hens.The “long life” layer, which will be capable of producing 500 eggs in a laying cycle of 100 weeks, is therefore on the horizon, bringing with it the benefits of a more efficient utilisation of diminishing resources, including land, water, raw materials for feed as well as a reduction in waste, and an overall reduced carbon footprint. PMID:26982003

Increasing persistency in lay and stabilising egg quality in longer laying cycles. What are the challenges?

PubMed

Bain, M M; Nys, Y; Dunn, I C

2016-06-01

In the past 50 years, selection starting initially at the breed level and then using quantitative genetics coupled with a sophisticated breeding pyramid, has resulted in a very productive hybrid for a variety of traits associated with egg production. One major trait currently being developed further is persistency of lay and the concept of the "long life" layer. Persistency in lay however cannot be achieved without due consideration of how to sustain egg quality and the health and welfare of the birds in longer laying cycles. These multiple goals require knowledge and consideration of the bird's physiology, nutritional requirements, which vary depending on age and management system, reproductive status and choice of the selection criteria applied. The recent advent of molecular genetics offers considerable hope that these multiple elements can be balanced for the good of all in the industry including the hens. The "long life" layer, which will be capable of producing 500 eggs in a laying cycle of 100 weeks, is therefore on the horizon, bringing with it the benefits of a more efficient utilisation of diminishing resources, including land, water, raw materials for feed as well as a reduction in waste, and an overall reduced carbon footprint.

Socio-demographic patterns of disability among older adult populations of low-income and middle-income countries: results from World Health Survey.

PubMed

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Kostanjsek, Nenad; Kowal, Paul; Officer, Alana; Chatterji, Somnath

2016-04-01

Our objective was to quantify disability prevalence among older adults of low- and middle-income countries, and measure socio-demographic distribution of disability. World Health Survey data included 53,447 adults aged 50 or older from 43 low- and middle-income countries. Disability was a binary classification, based on a composite score derived from self-reported functional difficulties. Socio-demographic variables included sex, age, marital status, area of residence, education level, and household economic status. A multivariate Poisson regression model with robust variance was used to assess associations between disability and socio-demographic variables. Overall, 33.3 % (95 % CI 32.2-34.4 %) of older adults reported disability. Disability was 1.5 times more common in females, and was positively associated with increasing age. Divorced/separated/widowed respondents reported higher disability rates in all but one study country, and education and wealth levels were inversely associated with disability rates. Urban residence tended to be advantageous over rural. Country-level datasets showed disparate patterns. Effective approaches aimed at disability prevention and improved disability management are warranted, including the inclusion of equity considerations in monitoring and evaluation activities.

Care for Vulnerable Elderly in Cardiology: A Program for Daily Practice.

PubMed

Wit, Mirjam A M; Bos-Schaap, Annet J C M; Umans, Victor A W M

2017-03-01

The percentage of cardiac patients aged ≥75 has increased considerably over the past decades. To optimize multidisciplinary care for these frail elderly, a program of intensive medical and nursing care was started at Noord West Ziekenhuisgroep department of cardiology. Patients over 70 years of age, admitted to the department of cardiology, were included and treated by the advanced practice nurse according to a redesigned care process that focused on expedite mobilization and care by an advanced practice nurse-headed team including the first outpatient visit. A total of 951 patients over 70 years were included in the frail elderly project. The average length of stay of the frail elderly was 6 days (SD 5). In the first 30 days, after discharge, 12% of these patients were readmitted with heart failure and 2% with dehydration. Mortality during admission was 3%, and 11% died within 3 months after discharge. This observational study shows, during a 4-year period, the vulnerability of aged cardiac patients. They were mainly admitted for (diastolic) heart failure, usually in combination with atrial fibrillation and hypertension. Their length of stay was on average 6 days with 11% mortality at 90 days follow-up.

[Osteoarthritic changes in hip joint in patients with fractures of femoral neck].

PubMed

Kravtsov, Vladimir; Saranga, Dan; Kidron, Debora

2013-06-01

Fractures of proximal femur are common among elderly people. They are associated with considerable morbidity and mortality. Identification of etiopathogenetic factors associated with fractures might facilitate prevention. Osteoporosis is commonly present in the heads of femurs. The prevalence of osteoarthritic changes in hip joints is controversial. Some authorities report low prevalence and even speculate on the protective effect of osteoarthritis against fractures. The goal of the study was to examine the association between osteoarthritic changes (radiologic and histologic) and fractures of the neck of the femur. The patient population included 41 patients undergoing replacement of femoral head for subcapital fracture; their ages ranged from 61 - 93 years of age. Radiologic criteria for osteoarthritis included: (a)narrowing of joint space (b) subchondral sclerosis (c) deformation of head of femur (d) subchondra cysts and (e] osteophytes. Osteoarthritic changes, usually mild, were present in 22 (54%) patients, regardless of age and gender The frequency of radioLogical changes was similar to the general population. HistoLogic findings included subchondral fibrosis and subchondral cysts. Mild subchondral fibrosis was present in 78% of cases. The findings support lack of association between osteoarthritic changes in hip joint and fracture of proximal femur, without a protective effect.

The French-Canadian data set of Demirjian for dental age estimation: a systematic review and meta-analysis.

PubMed

Jayaraman, Jayakumar; Wong, Hai Ming; King, Nigel M; Roberts, Graham J

2013-07-01

Estimation of age of an individual can be performed by evaluating the pattern of dental development. A dataset for age estimation based on the dental maturity of a French-Canadian population was published over 35 years ago and has become the most widely accepted dataset. The applicability of this dataset has been tested on different population groups. To estimate the observed differences between Chronological age (CA) and Dental age (DA) when the French Canadian dataset was used to estimate the age of different population groups. A systematic search of literature for papers utilizing the French Canadian dataset for age estimation was performed. All language articles from PubMed, Embase and Cochrane databases were electronically searched for terms 'Demirjian' and 'Dental age' published between January 1973 and December 2011. A hand search of articles was also conducted. A total of 274 studies were identified from which 34 studies were included for qualitative analysis and 12 studies were included for quantitative assessment and meta-analysis. When synthesizing the estimation results from different population groups, on average, the Demirjian dataset overestimated the age of females by 0.65 years (-0.10 years to +2.82 years) and males by 0.60 years (-0.23 years to +3.04 years). The French Canadian dataset overestimates the age of the subjects by more than six months and hence this dataset should be used only with considerable caution when estimating age of group of subjects of any global population. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Size and burden of mental disorders in Europe--a critical review and appraisal of 27 studies.

PubMed

Wittchen, Hans-Ulrich; Jacobi, Frank

2005-08-01

Epidemiological data on a wide range of mental disorders from community studies conducted in European countries are presented to determine the availability and consistency of prevalence, disability and treatment findings for the EU. Using a stepwise multimethod approach, 27 eligible studies with quite variable designs and methods including over 150,000 subjects from 16 European countries were identified. Prevalence: On the basis of meta-analytic techniques as well as on reanalyses of selected data sets, it is estimated that about 27% (equals 82.7 million; 95% CI: 78.5-87.1) of the adult EU population, 18-65 of age, is or has been affected by at least one mental disorder in the past 12 months. Taking into account the considerable degree of comorbidity (about one third had more than one disorder), the most frequent disorders are anxiety disorders, depressive, somatoform and substance dependence disorders. When taking into account design, sampling and other methodological differences between studies, little evidence seems to exist for considerable cultural or country variation. Disability and treatment: despite very divergent and fairly crude assessment strategies, the available data consistently demonstrate (a) an association of all mental disorders with a considerable disability burden in terms of number of work days lost (WLD) and (b) generally low utilization and treatment rates. Only 26% of all cases had any consultation with professional health care services, a finding suggesting a considerable degree of unmet need. The paper highlights considerable future research needs for coordinated EU studies across all disorders and age groups. As prevalence estimates could not simply be equated with defined treatment needs, such studies should determine the degree of met and unmet needs for services by taking into account severity, disability and comorbidity. These needs are most pronounced for the new EU member states as well as more generally for adolescent and older populations.

Dementia in the Oldest Old

PubMed Central

Bullain, Szófia S.; Corrada, María M.

2013-01-01

Purpose of Review: This article discusses some of the unique features of dementia in the oldest old, including some of the most common diagnostic challenges, and potential strategies to overcome them. Recent Findings: Advances include new insight into the role of common risk factors and the effects of multiple underlying neuropathologic features for dementia in the oldest old. In addition, this article contains the latest age-specific normative data for commonly used neuropsychological tests for the oldest old. Summary: The oldest old—people aged 90 years and older—are the fastest-growing segment of society and have the highest rates of dementia in the population. The risk factors, diagnostic challenges, and underlying neuropathologic features of dementia are strikingly different in the 90-years-and-older population compared to younger elderly. Special consideration of these unique features of dementia is necessary when evaluating oldest-old subjects with cognitive impairment. PMID:23558489

Educational Attainment by Age, Sex, and Race, for the United States: 1970. 1970 Census of Population, Supplementary Report.

ERIC Educational Resources Information Center

Bureau of the Census (DOC), Suitland, MD. Population Div.

The 1960's witnessed considerable change in educational attainment levels. Of Americans 25 years old and over in 1970, 52 percent were at least high school graduates, as compared with 41 percent in 1960 and 34 percent in 1950. There was considerable variation in educational attainment levels in 1970 among the various age groups in the population.…

Dying in the age of choice.

PubMed

Black, Kathy; Csikai, Ellen L

2015-01-01

Due to the unprecedented increase in the United States aging demographics, many more people are living longer and reaching older ages than ever before. However, a longer life is not necessarily a better life, as the vast majority will face a period of prolonged deteriorating health prior to death. Although notable efforts have been underway that are designed to improve the end-of-life experience, increasing numbers of individuals express a desire and/or act upon an intent to end their lives precipitously. Though still limited, the options to actively participate in their own deaths are growing. Requests for a hastened death can occur among people of all ages and includes those with advanced illness as well as others wanting to die due to unbearable suffering. This article provides an overview of the ongoing discourse about the experience of dying faced by many older adults, including aspects frequently associated with "a good death." The limitations of established practices which seek to provide a "better" dying experience are identified followed by discussion of the growing availability of alternative options. Reflective considerations are presented to guide practice vis-à-vis the changing landscape surrounding options in dying.

Considerations in the treatment of tension-type headache in the elderly.

PubMed

Wrobel Goldberg, Stephanie; Silberstein, Stephen; Grosberg, Brian M

2014-11-01

Tension-type headache (TTH) is the most prevalent headache type in all age groups worldwide, including patients with advanced age. Because of its high prevalence and possible association with medical and psychiatric co-morbidities, TTH has a major socioeconomic impact. The lifetime prevalence of TTH ranges between 30 and 78 %, and the 1-year prevalence in individuals over the age of 55 years is 35.8 % (27.8 % in men, 42.4 % in women). Since the prevalence of secondary headache disorders increases in the elderly, the initial evaluation of this group of patients with a new-onset headache or a change in a pre-existing headache pattern should be directed towards their exclusion. This article reviews the diagnostic and treatment dilemmas encountered in elderly patients with tension-type headaches, highlighting both pharmacological and non-pharmacological interventions.

Association between body composition and stair negotiation ability among individuals >55 years of age: a cross-sectional study

PubMed Central

Dip, Renata Maciulis; Cabrera, Marcos AS; Prato, Sabrina Ferrari

2017-01-01

Background Loss of muscle strength exerts a considerable impact on the quality of life and mortality of older adults. The present household survey study measured body composition and muscle strength with the aim of analyzing the roles of low lean mass, low muscle strength and obesity in stair negotiation ability and the effect of comorbidities on the relationship between body composition and functional capacity. Methods Body composition was assessed using bioelectrical impedance analysis and muscle strength was assessed with a hand grip dynamometer. The study population comprised individuals >55 years of age from a medium-sized Brazilian municipality. The sample included 451 participants. Results A total of 368 subjects were interviewed; their ages varied from 56 to 91 years. Among males, low muscle strength was associated with stair negotiation difficulty independent of muscle mass, age and obesity but muscle mass was not. However, when we analyzed comorbidities and body composition jointly, chronic lower limb pain and obesity were independently associated with stair negotiation difficulty but body composition and age were not. Among women, after comorbidities were included into the model, low muscle strength and obesity remained associated with stair negotiation difficulty as chronic lower limb pain and depression. The relationship between muscle function and comorbidities is discussed in this article. PMID:28860730

Association between body composition and stair negotiation ability among individuals >55 years of age: a cross-sectional study.

PubMed

Dip, Renata Maciulis; Cabrera, Marcos As; Prato, Sabrina Ferrari

2017-01-01

Loss of muscle strength exerts a considerable impact on the quality of life and mortality of older adults. The present household survey study measured body composition and muscle strength with the aim of analyzing the roles of low lean mass, low muscle strength and obesity in stair negotiation ability and the effect of comorbidities on the relationship between body composition and functional capacity. Body composition was assessed using bioelectrical impedance analysis and muscle strength was assessed with a hand grip dynamometer. The study population comprised individuals >55 years of age from a medium-sized Brazilian municipality. The sample included 451 participants. A total of 368 subjects were interviewed; their ages varied from 56 to 91 years. Among males, low muscle strength was associated with stair negotiation difficulty independent of muscle mass, age and obesity but muscle mass was not. However, when we analyzed comorbidities and body composition jointly, chronic lower limb pain and obesity were independently associated with stair negotiation difficulty but body composition and age were not. Among women, after comorbidities were included into the model, low muscle strength and obesity remained associated with stair negotiation difficulty as chronic lower limb pain and depression. The relationship between muscle function and comorbidities is discussed in this article.

A multinational study of mental disorders, marriage, and divorce.

PubMed

Breslau, J; Miller, E; Jin, R; Sampson, N A; Alonso, J; Andrade, L H; Bromet, E J; de Girolamo, G; Demyttenaere, K; Fayyad, J; Fukao, A; Gălăon, M; Gureje, O; He, Y; Hinkov, H R; Hu, C; Kovess-Masfety, V; Matschinger, H; Medina-Mora, M E; Ormel, J; Posada-Villa, J; Sagar, R; Scott, K M; Kessler, R C

2011-12-01

Estimate predictive associations of mental disorders with marriage and divorce in a cross-national sample. Population surveys of mental disorders included assessment of age at first marriage in 19 countries (n = 46,128) and age at first divorce in a subset of 12 countries (n = 30,729). Associations between mental disorders and subsequent marriage and divorce were estimated in discrete time survival models. Fourteen of 18 premarital mental disorders are associated with lower likelihood of ever marrying (odds ratios ranging from 0.6 to 0.9), but these associations vary across ages of marriage. Associations between premarital mental disorders and marriage are generally null for early marriage (age 17 or younger), but negative associations come to predominate at later ages. All 18 mental disorders are positively associated with divorce (odds ratios ranging from 1.2 to 1.8). Three disorders, specific phobia, major depression, and alcohol abuse, are associated with the largest population attributable risk proportions for both marriage and divorce. This evidence adds to research demonstrating adverse effects of mental disorders on life course altering events across a diverse range of socioeconomic and cultural settings. These effects should be included in considerations of public health investments in preventing and treating mental disorders. © 2011 John Wiley & Sons A/S.

A multinational study of mental disorders, marriage, and divorce

PubMed Central

Breslau, J.; Miller, E.; Jin, R.; Sampson, N. A.; Alonso, J.; Andrade, L. H.; Bromet, E. J.; de Girolamo, G.; Demyttenaere, K.; Fayyad, J.; Fukao, A.; Gălăon, M.; Gureje, O.; He, Y.; Hinkov, H. R.; Hu, C.; Kovess-Masfety, V.; Matschinger, H.; Medina-Mora, M. E.; Ormel, J.; Posada-Villa, J.; Sagar, R.; Scott, K. M.; Kessler, R. C.

2014-01-01

Objective Estimate predictive associations of mental disorders with marriage and divorce in a cross-national sample. Method Population surveys of mental disorders included assessment of age at first marriage in 19 countries (n = 46 128) and age at first divorce in a subset of 12 countries (n = 30 729). Associations between mental disorders and subsequent marriage and divorce were estimated in discrete time survival models. Results Fourteen of 18 premarital mental disorders are associated with lower likelihood of ever marrying (odds ratios ranging from 0.6 to 0.9), but these associations vary across ages of marriage. Associations between premarital mental disorders and marriage are generally null for early marriage (age 17 or younger), but negative associations come to predominate at later ages. All 18 mental disorders are positively associated with divorce (odds ratios ranging from 1.2 to 1.8). Three disorders, specific phobia, major depression, and alcohol abuse, are associated with the largest population attributable risk proportions for both marriage and divorce. Conclusion This evidence adds to research demonstrating adverse effects of mental disorders on life course altering events across a diverse range of socioeconomic and cultural settings. These effects should be included in considerations of public health investments in preventing and treating mental disorders. PMID:21534936

Treatment of Urothelial Cancer in Elderly Patients: Focus on Immune Checkpoint Inhibitors.

PubMed

Jodon, Gray; Fischer, Stacy M; Kessler, Elizabeth R

2018-05-09

Urothelial carcinoma, or bladder cancer, is a malignancy that most commonly affects older patients. The median age at diagnosis is 73 years, and care of these patients requires consideration not just of the disease-related factors such as stage and histology, but also of patient-related factors. Many of these patients have concurrent medical morbidities and additional changes related to the aging process. Older patients with cancer are a unique population requiring additional considerations and assessment in treatment decision-making. It is important to look beyond chronologic age. The traditional treatment for advanced disease has relied on platinum-based chemotherapy. These multi-agent regimens require consideration of baseline organ function as well as competing conditions that may heighten toxicity. The advent of a new class of cancer therapeutics, the immune checkpoint inhibitors, has changed the care of patients with advanced disease considerably. These immunotherapeutics have been approved for treating patients with disease progression on chemotherapy, or those who are ineligible (or unfit) to receive cisplatin-based therapy. This expansion of the population of patients eligible for treatment has great applicability to the unique considerations in an older patient population. In general, these new immunotherapies are well tolerated and effective in this group of patients.

Clinical Trials Targeting Aging and Age-Related Multimorbidity

PubMed Central

Crimmins, Eileen M; Grossardt, Brandon R; Crandall, Jill P; Gelfond, Jonathan A L; Harris, Tamara B; Kritchevsky, Stephen B; Manson, JoAnn E; Robinson, Jennifer G; Rocca, Walter A; Temprosa, Marinella; Thomas, Fridtjof; Wallace, Robert; Barzilai, Nir

2017-01-01

Abstract Background There is growing interest in identifying interventions that may increase health span by targeting biological processes underlying aging. The design of efficient and rigorous clinical trials to assess these interventions requires careful consideration of eligibility criteria, outcomes, sample size, and monitoring plans. Methods Experienced geriatrics researchers and clinical trialists collaborated to provide advice on clinical trial design. Results Outcomes based on the accumulation and incidence of age-related chronic diseases are attractive for clinical trials targeting aging. Accumulation and incidence rates of multimorbidity outcomes were developed by selecting at-risk subsets of individuals from three large cohort studies of older individuals. These provide representative benchmark data for decisions on eligibility, duration, and assessment protocols. Monitoring rules should be sensitive to targeting aging-related, rather than disease-specific, outcomes. Conclusions Clinical trials targeting aging are feasible, but require careful design consideration and monitoring rules. PMID:28364543

Managing TIAA-CREF Contracts

ERIC Educational Resources Information Center

Bastable, C. W.; Brady, Gerald P.

1976-01-01

Complexities in managing TIAA-CREF contracts are reviewed. Attention is directed toward participation, period considerations, selection of retirement age, retirement income transition, estate considerations and beneficiaries, voluntary additional contributions, and supplemental retirement annuity contracts. (LBH)

The Effect of Novel Research Activities on Long-term Survival of Temporarily Captive Steller Sea Lions (Eumetopias jubatus)

PubMed Central

Shuert, Courtney; Horning, Markus; Mellish, Jo-Ann

2015-01-01

Two novel research approaches were developed to facilitate controlled access to, and long-term monitoring of, juvenile Steller sea lions for periods longer than typically afforded by traditional fieldwork. The Transient Juvenile Steller sea lion Project at the Alaska SeaLife Center facilitated nutritional, physiological, and behavioral studies on the platform of temporary captivity. Temporarily captive sea lions (TJs, n = 35) were studied, and were intraperitoneally implanted with Life History Transmitters (LHX tags) to determine causes of mortality post-release. Our goal was to evaluate the potential for long-term impacts of temporary captivity and telemetry implants on the survival of study individuals. A simple open-population Cormack-Jolly-Seber mark-recapture model was built in program MARK, incorporating resightings of uniquely branded study individuals gathered by several contributing institutions. A priori models were developed to weigh the evidence of effects of experimental treatment on survival with covariates of sex, age, capture age, cohort, and age class. We compared survival of experimental treatment to a control group of n = 27 free-ranging animals (FRs) that were sampled during capture events and immediately released. Sex has previously been show to differentially affect juvenile survival in Steller sea lions. Therefore, sex was included in all models to account for unbalanced sex ratios within the experimental group. Considerable support was identified for the effects of sex, accounting for over 71% of total weight for all a priori models with delta AICc <5, and over 91% of model weight after removal of pretending variables. Overall, most support was found for the most parsimonious model based on sex and excluding experimental treatment. Models including experimental treatment were not supported after post-hoc considerations of model selection criteria. However, given the limited sample size, alternate models including effects of experimental treatments remain possible and effects may yet become apparent in larger sample sizes. PMID:26580549

Summary of the National Advisory Committee on Immunization (NACI) Statement on Seasonal Influenza Vaccine for 2016-2017.

PubMed

Gemmill, I; Zhao, L; Cochrane, L

2016-09-01

Influenza is a respiratory infection caused primarily by influenza A and B viruses. Vaccination is the most effective way to prevent influenza and its complications. The National Advisory Committee on Immunization (NACI) provides recommendations regarding seasonal influenza vaccines annually to the Public Health Agency of Canada (the Agency). To summarize the NACI recommendations regarding the use of seasonal influenza vaccines for the 2016-2017 influenza season. Annual influenza vaccine recommendations are developed by NACI's Influenza Working Group for consideration and approval by NACI, based on NACI's evidence-based process for developing recommendations, and include a consideration of the burden of influenza illness and the target populations for vaccination; efficacy and effectiveness, immunogenicity and safety of influenza vaccines; vaccine schedules; and other aspects of influenza immunization. These recommendations are published annually on the Agency's website in the NACI Advisory Committee Statement: Canadian Immunization Guide Chapter on Influenza and Statement on Seasonal Influenza Vaccine (the Statement). The annual NACI seasonal influenza vaccine recommendations have been updated for the 2016-2017 influenza season to include adults with neurologic or neurodevelopment conditions among the groups for whom influenza vaccination is particularly recommended; to include the new high-dose, trivalent inactivated influenza vaccine for use in adults 65 years of age and over; to recommend that egg-allergic individuals may also be vaccinated against influenza using the low ovalbumin-containing live attenuated influenza vaccine (LAIV) licensed for use in Canada (NACI has previously recommended that egg-allergic individuals may be vaccinated using inactivated influenza vaccines); and to remove the preferential recommendation for the use of LAIV in children 2-17 years of age. Two addenda to the 2016-2017 Statement address these new LAIV recommendations. NACI continues to recommend annual influenza vaccination for all individuals aged six months and older, with particular focus on people at high risk of influenza-related complications or hospitalization, people capable of transmitting influenza to those at high risk and others as indicated.

Interventions to Reduce Harm from Smoking with Families in Infancy and Early Childhood: A Systematic Review

PubMed Central

Brown, Nicola; Luckett, Tim; Davidson, Patricia M.; Di Giacomo, Michelle

2015-01-01

Exposure to adult smoking can have deleterious effects on children. Interventions that assist families with smoking cessation/reduction and environmental tobacco smoke (ETS) avoidance can improve child health outcomes and reduce the risk of smoking initiation. The purpose of this review was to describe the state of the science of interventions with families to promote smoke-free home environments for infants and young children, including parent smoking reduction and cessation interventions, ETS reduction, and anti-smoking socialisation interventions, using the socio-ecological framework as a guide. A systematic review of peer-reviewed articles identified from journal databases from 2000 to 2014 was undertaken. Of 921 articles identified, 28 were included in the review. Considerable heterogeneity characterised target populations, intervention types, complexity and intensity, precluding meta-analysis. Few studies used socio-ecological approaches, such as family theories or concepts. Studies in early parenthood (child age newborn to one year) tended to focus on parent smoking cessation, where studies of families with children aged 1–5 years were more likely to target household SHSe reduction. Results suggest that interventions for reduction in ETS may be more successful than for smoking cessation and relapse prevention in families of children aged less than 5 years. There is a need for a range of interventions to support families in creating a smoke free home environment that are both tailored and targeted to specific populations. Interventions that target the social and psychodynamics of the family should be considered further, particularly in reaching vulnerable populations. Consideration is also required for approaches to interventions that may further stigmatise families containing smokers. Further research is required to identify successful elements of interventions and the contexts in which they are most effective. PMID:25785496

[Age of puberty and western young women sexuality].

PubMed

Tresch, C; Ohl, J

2015-02-01

The onset of menarche and age of first sexual experience have both lowered over the past century. Does the age of puberty influence the sexuality of the girl/young occidental woman? If so, to what degree? Besides, is the acquisition of reproductive function, regardless of age, a sign of sufficient maturity to engage in sexual activity? Studies show that early puberty, early sex, unprotected sexual intercourse in adolescence and number of sexual partners in early adulthood are closely related. These early sexual experiences could be stimulated by early drug use as well as by depressive disorders. The age of puberty has a real influence on sexuality but this link will be modulated by a number of social behavioral factors and it is not sustainable. The age of puberty is not a good indicator of maturity for teenage sexuality; early maturation and early sexual activity are usually associated with risky behaviors. However, other studies on the subject are required, including a consideration of the issues associated with delayed puberty, a subject virtually absent from the literature. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Life history context of reproductive aging in a wild primate model

PubMed Central

Altmann, Jeanne; Gesquiere, Laurence; Galbany, Jordi; Onyango, Patrick O.; Alberts, Susan C.

2012-01-01

The pace of reproductive aging has been of considerable interest, especially in regard to the long postreproductive period in modern women. Here we use data for both sexes from a 37-year longitudinal study of a wild baboon population to place reproductive aging within a life history context for this species, a primate relative of humans that evolved in the same savannah habitat as humans did. We examine the patterns and pace of reproductive aging, including birth rates and reproductive hormones for both sexes, and compare reproductive aging to age-related changes in several other traits. Reproductive senescence occurs later in baboon females than males. Delayed senescence in females relative to males is also found in several other traits, such as dominance status and body condition, but not in molar wear or glucocorticoid profiles. Survival, health, and well-being are the product of risk factors in morphological, physiological, and behavioral traits that differ in rate of senescence and in dependence on social or ecological conditions; some will be very sensitive to differences in circumstances and others less so. PMID:20738283

Getting to compliance in forced exercise in rodents: a critical standard to evaluate exercise impact in aging-related disorders and disease.

PubMed

Arnold, Jennifer C; Salvatore, Michael F

2014-08-22

There is a major increase in the awareness of the positive impact of exercise on improving several disease states with neurobiological basis; these include improving cognitive function and physical performance. As a result, there is an increase in the number of animal studies employing exercise. It is argued that one intrinsic value of forced exercise is that the investigator has control over the factors that can influence the impact of exercise on behavioral outcomes, notably exercise frequency, duration, and intensity of the exercise regimen. However, compliance in forced exercise regimens may be an issue, particularly if potential confounds of employing foot-shock are to be avoided. It is also important to consider that since most cognitive and locomotor impairments strike in the aged individual, determining impact of exercise on these impairments should consider using aged rodents with a highest possible level of compliance to ensure minimal need for test subjects. Here, the pertinent steps and considerations necessary to achieve nearly 100% compliance to treadmill exercise in an aged rodent model will be presented and discussed. Notwithstanding the particular exercise regimen being employed by the investigator, our protocol should be of use to investigators that are particularly interested in the potential impact of forced exercise on aging-related impairments, including aging-related Parkinsonism and Parkinson's disease.

Long-Term Clinical and Electroencephalography (EEG) Consequences of Idiopathic Partial Epilepsies.

PubMed

Dörtcan, Nimet; Tekin Guveli, Betul; Dervent, Aysin

2016-05-03

BACKGROUND Idiopathic partial epilepsies of childhood (IPE) affect a considerable proportion of children. Three main electroclinical syndromes of IPE are the Benign Childhood Epilepsy with Centro-temporal Spikes (BECTS), Panayiotopoulos Syndrome (PS), and Childhood Epilepsy with Occipital Paroxysms (CEOP). In this study we investigated the long-term prognosis of patients with IPE and discussed the semiological and electroencephalography (EEG) data in terms of syndromic characteristics. MATERIAL AND METHODS This study included a group of consecutive patients with IPE who had been followed since 1990. Demographic and clinical variables were investigated. Patients were divided into 3 groups - A: Cases suitable for a single IPE (BECTS, PS and CEOP); B: cases with intermediate characteristics within IPEs; and C: cases with both IPE and IGE characteristics. Long-term data regarding the individual seizure types and EEG findings were re-evaluated. RESULTS A total of 61 patients were included in the study. Mean follow-up duration was 7.8 ± 4.50 years. The mean age at onset of seizures was 7.7 years. There were 40 patients in group A 40, 14 in group B, and 7 in group C. Seizure and EEG characteristics were also explored independently from the syndromic approach. Incidence of autonomic seizures is considerably high at 2-5 years and incidence of oromotor seizures is high at age 9-11 years. The EEG is most abnormal at 6-8 years. The vast majority (86%) of epileptic activity (EA) with parietooccipital is present at 2-5 years, whereas EA with fronto-temporal or multiple sites become more abundant between ages 6 and 11. CONCLUSIONS Results of the present study provide support for the age-related characteristics of the seizures and EEGs in IPE syndromes. Acknowledgement of those phenomena may improve the management of IPEs and give a better estimate of the future consequences.

Improving nutrition to support healthy ageing: what are the opportunities for intervention?

PubMed

Robinson, Sian M

2017-11-27

Alongside declining activity levels, energy needs fall in older age and eating less is expected. However, as total food consumption declines, intakes of many nutrients are also likely to fall; while energy requirements may be met, other nutrient needs may not. Although this highlights the importance of nutrient-dense foods and overall diet quality in older age to ensure nutrient intakes are sufficient, maintaining or increasing diet quality may be difficult at a time when food access and preparation are becoming more challenging, and diets may be more monotonous. Poor nutrition, even in developed settings, is common. Older malnourished adults are more likely to have poorer health outcomes, longer hospital stays and increased mortality. Thus, apart from the evident personal costs, the economic burden of disease-related malnutrition is significant, and effective preventive strategies to promote good nutrition among older populations are needed. In particular, there is a need for wider recognition of malnutrition risk among older adults, including implementation of routine screening of nutritional status and early diagnosis. Design of future interventions to support older community-dwelling adults requires a clear understanding of the personal and contextual influences that affect patterns of food choice and consumption, including consideration of the importance of social and psychological factors. In addition, there are opportunities to intervene earlier in the lifecourse; the most effective preventive efforts to promote good nutrition in older age may need to start ahead of age-related changes in physiology and function, including younger adulthood and at the retirement transition.

Nutritional considerations for healthy aging and reduction in age-related chronic disease

USDA-ARS?s Scientific Manuscript database

A projected doubling in the global population of people aged >/= 60 y by the year 2050 has major health and economic implications, especially in developing regions. Burdens of unhealthy aging associated with chronic noncommunicable and other age-related diseases may be largely preventable with lifes...

Psychosocial Challenges/Transition to Adulthood.

PubMed

Frederick, Carla

2016-08-01

Advances in the health care of individuals with cystic fibrosis have resulted in more than half of the population older than the age of 18 living longer, fuller lives. This success brings about the need for new areas of improvement and development including the mastery of transitioning from pediatric to adult health care and attention to psychosocial needs. This article reviews key components of the process of transitioning to adult care and some important psychosocial considerations. Copyright © 2016 Elsevier Inc. All rights reserved.

Selecting and implementing scientific objectives. [for Voyager 1 and 2 planetary encounters

NASA Technical Reports Server (NTRS)

Miner, E. D.; Stembridge, C. H.; Doms, P. E.

1985-01-01

The procedures used to select and implement scientific objectives for the Voyager 1 and 2 planetary encounters are described. Attention is given to the scientific tradeoffs and engineering considerations must be addressed at various stages in the mission planning process, including: the limitations of ground and spacecraft communications systems, ageing of instruments in flight, and instrument calibration over long distances. The contribution of planetary science workshops to the definition of scientific objectives for deep space missions is emphasized.

Determination of N epsilon-(carboxymethyl)lysine in foods and related systems.

PubMed

Ames, Jennifer M

2008-04-01

The sensitive and specific determination of advanced glycation end products (AGEs) is of considerable interest because these compounds have been associated with pro-oxidative and proinflammatory effects in vivo. AGEs form when carbonyl compounds, such as glucose and its oxidation products, glyoxal and methylglyoxal, react with the epsilon-amino group of lysine and the guanidino group of arginine to give structures including N epsilon-(carboxymethyl)lysine (CML), N epsilon-(carboxyethyl)lysine, and hydroimidazolones. CML is frequently used as a marker for AGEs in general. It exists in both the free or peptide-bound forms. Analysis of CML involves its extraction from the food (including protein hydrolysis to release any peptide-bound adduct) and determination by immunochemical or instrumental means. Various factors must be considered at each step of the analysis. Extraction, hydrolysis, and sample clean-up are all less straight forward for food samples, compared to plasma and tissue. The immunochemical and instrumental methods all have their advantages and disadvantages, and no perfect method exists. Currently, different procedures are being used in different laboratories, and there is an urgent need to compare, improve, and validate methods.

Weather and age-gender effects on the projection of future emergency ambulance demand in Hong Kong.

PubMed

Lai, Poh-Chin; Wong, Ho-Ting

2015-03-01

An accurate projection for ambulance demand is essential to enable better resource planning for the future that strives to either maintain current levels of services or reconsider future standards and expectations. More than 2 million cases of emergency room attendance in 2008 were obtained from the Hong Kong Hospital Authority to project the demand for its ambulance services in 2036. The projection of ambulance demand in 2036 was computed in consideration of changes in the age-gender structure between 2008 and 2036. The quadratic relation between average daily temperature and daily ambulance demand in 2036 was further explored by including and excluding age-gender demographic changes. Without accounting for changes in the age-gender structure, the 2036 ambulance demand for age groups of 65 and above were consistently underestimated (by 38%-65%), whereas those of younger age groups were overestimated (by 6%-37%). Moreover, changes in the 2008 to 2036 age-gender structure also shift upward and emphasize relationships between average daily temperature and daily ambulance demand at both ends of the quadratic U-shaped curve. Our study reveals a potential societal implication of ageing population on the demand for ambulance services. © 2012 APJPH.

A new gender-specific model for skin autofluorescence risk stratification

PubMed Central

Ahmad, Muhammad S.; Damanhouri, Zoheir A.; Kimhofer, Torben; Mosli, Hala H.; Holmes, Elaine

2015-01-01

Advanced glycation endproducts (AGEs) are believed to play a significant role in the pathophysiology of a variety of diseases including diabetes and cardiovascular diseases. Non-invasive skin autofluorescence (SAF) measurement serves as a proxy for tissue accumulation of AGEs. We assessed reference SAF and skin reflectance (SR) values in a Saudi population (n = 1,999) and evaluated the existing risk stratification scale. The mean SAF of the study cohort was 2.06 (SD = 0.57) arbitrary units (AU), which is considerably higher than the values reported for other populations. We show a previously unreported and significant difference in SAF values between men and women, with median (range) values of 1.77 AU (0.79–4.84 AU) and 2.20 AU (0.75–4.59 AU) respectively (p-value « 0.01). Age, presence of diabetes and BMI were the most influential variables in determining SAF values in men, whilst in female participants, SR was also highly correlated with SAF. Diabetes, hypertension and obesity all showed strong association with SAF, particularly when gender differences were taken into account. We propose an adjusted, gender-specific disease risk stratification scheme for Middle Eastern populations. SAF is a potentially valuable clinical screening tool for cardiovascular risk assessment but risk scores should take gender and ethnicity into consideration for accurate diagnosis. PMID:25974028

The contribution of executive skills to reading comprehension.

PubMed

Sesma, Heather Whitney; Mahone, E Mark; Levine, Terry; Eason, Sarah H; Cutting, Laurie E

2009-05-01

Although word recognition deficits (WRD) are a known cause of reading comprehension deficits (RCD), other contributions to RCD, including executive function (EF), have not been fully explored. We examined the contribution of EF (working memory and planning), along with attention, decoding, fluency, and vocabulary to reading comprehension in 60 children (including 16 WRD and 10 RCD), ages 9-15 years. After controlling for commonly accepted contributors to reading comprehension (i.e., attention, decoding skills, fluency, and vocabulary), EF continued to make a significant contribution to reading comprehension but not to word recognition skills. These findings highlight the need for consideration of the role of EF in RCD.

THE CONTRIBUTION OF EXECUTIVE SKILLS TO READING COMPREHENSION

PubMed Central

Sesma, Heather Whitney; Mahone, E. Mark; Levine, Terry; Eason, Sarah H.; Cutting, Laurie E.

2009-01-01

Although word recognition deficits (WRD) are a known cause of reading comprehension deficits (RCD), other contributions to RCD, including executive function (EF), have not been fully explored. We examined the contribution of EF (working memory and planning), along with attention, decoding, fluency, and vocabulary to reading comprehension in 60 children (including 16 WRD and 10 RCD), ages 9–15 years. After controlling for commonly accepted contributors to reading comprehension (i.e., attention, decoding skills, fluency, and vocabulary), EF continued to make a significant contribution to reading comprehension but not to word recognition skills. These findings highlight the need for consideration of the role of EF in RCD. PMID:18629674

The prevalence of foot problems in older women: a cause for concern.

PubMed

Dawson, Jill; Thorogood, Margaret; Marks, Sally-Anne; Juszczak, Ed; Dodd, Chris; Lavis, Grahame; Fitzpatrick, Ray

2002-06-01

Painful feet are an extremely common problem amongst older women. Such problems increase the risk of falls and hamper mobility. The aetiology of painful and deformed feet is poorly understood. Data were obtained during a pilot case-control study about past high heel usage in women, in relation to osteoarthritis of the knee. A total of 127 women aged 50-70 were interviewed (31 cases, 96 controls); case-control sets were matched for age. The following information was obtained about footwear: (1) age when first wore shoes with heels 1, 2 and 3 inches high; (2) height of heels worn for work; (3) maximum height of heels worn regularly for work, going out socially and for dancing, in 10-year age bands. Information about work-related activities and lifetime occupational history was gathered using a Life-Grid. The interview included a foot inspection. Foot problems, particularly foot arthritis, affected considerably more cases than controls (45 per cent versus 16 per cent, p = 0.001) and was considered a confounder. Cases were therefore excluded from subsequent analyses. Amongst controls, the prevalence of any foot problems was very high (83 per cent). All women had regularly worn one inch heels and few (8 per cent) had never worn 2 inch heels. Foot problems were significantly associated with a history of wearing relatively lower heels. Few work activities were related to foot problems; regular lifting was associated with foot pain (p = 0.03). Most women in this age-group have been exposed to high-heeled shoes over many years, making aetiological research difficult in this area. Foot pain and deformities are widespread. The relationship between footwear, occupational activities and foot problems is a complex one that deserves considerably more research.

Long-term socio-economic consequences and health care costs of poliomyelitis: a historical cohort study involving 3606 polio patients.

PubMed

Nielsen, Nete Munk; Kay, Lise; Wanscher, Benedikte; Ibsen, Rikke; Kjellberg, Jakob; Jennum, Poul

2016-06-01

Worldwide 10-20 million individuals are living with disabilities after acute poliomyelitis. However, very little is known about the socio-economic consequences and health care costs of poliomyelitis. We carried out a historical register-based study including 3606 individuals hospitalised for poliomyelitis in Copenhagen, Denmark 1940-1954, and 13,795 age and gender-matched Danes. Participants were followed from 1980 until 2012, and family, socio-economic conditions and health care costs were evaluated in different age groups using chi-squared tests, boot-strapped t tests or hazard ratios (HR) calculated in Cox-regression models. The analyses were performed separately for paralytic and non-paralytic polio survivors and their controls, respectively. Compared with controls a higher percentage of paralytic polio survivors remained childless, whereas no difference was observed for non-paralytic polio survivors. The educational level among paralytic as well as non-paralytic polio survivors was higher than that among their controls, employment rate at the ages of 40, 50 and 60 years was slightly lower, whereas total income in the age intervals of 31-40, 41-50 and 51-60 years were similar to controls. Paralytic and non-paralytic polio survivors had a 2.5 [HR = 2.52 (95 % confidence interval (CI); 2.29-2.77)] and 1.4 [HR = 1.35 (95 % CI; 1.23-1.49)]-fold higher risk, respectively, of receiving disability pension compared with controls. Personal health care costs were considerably higher in all age groups in both groups of polio survivors. Individuals with a history of poliomyelitis are well educated, have a slightly lower employment rate, an income similar to controls, but a considerably higher cost in the health care system.

Assessment of Adolescent Neurotoxicity: Rationale and Methodological Considerations

PubMed Central

Spear, Linda Patia

2007-01-01

This introduction to the special issue of Neurotoxicology and Teratology on “Risk of neurobehavioral toxicity in adolescence” begins by broadly considering the ontogeny and phylogeny of adolescence, and the potential value of animal models of adolescence. Major findings from the emerging neuroscience of adolescence are then highlighted to establish the importance of studies of adolescent neurotoxicity. A variety of methodological issues that are of particular relevance to adolescent exposures are then discussed. These include consideration of pharmacokinetic factors, inclusion of other-aged comparison group(s), and issues involving timing, route of administration, and exposure-induced alterations in growth rate. Despite such methodological challenges, research to determine whether adolescence is a time of increased vulnerability (or greater resiliency) to specific drugs and environmental toxicants is progressing rapidly, as exemplified by the work presented in the articles of this special issue. PMID:17222532

Sugar maple height-diameter and age-diameter relationships in an uneven-aged northern hardwood stand

Treesearch

Laura S. Kenefic; R.D. Nyland

1999-01-01

Sugar maple (Acer saccharum Marsh.) height-diameter and age-diameter relationships are explored in a balanced uneven-aged northern hardwood stand in central New York. Results show that although both height and age vary considerably with diameter, these relationships can be described by statistically valid equations. The age-diameter relationship...

20 CFR 220.128 - Age as a vocational factor.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Age as a vocational factor. 220.128 Section... DETERMINING DISABILITY Vocational Considerations § 220.128 Age as a vocational factor. (a) General. (1) Age refers to how old the claimaint is (chronological age) and the extent to which his or her age affects his...

20 CFR 220.128 - Age as a vocational factor.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Age as a vocational factor. 220.128 Section... DETERMINING DISABILITY Vocational Considerations § 220.128 Age as a vocational factor. (a) General. (1) Age refers to how old the claimaint is (chronological age) and the extent to which his or her age affects his...

20 CFR 220.128 - Age as a vocational factor.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Age as a vocational factor. 220.128 Section... DETERMINING DISABILITY Vocational Considerations § 220.128 Age as a vocational factor. (a) General. (1) Age refers to how old the claimaint is (chronological age) and the extent to which his or her age affects his...

20 CFR 220.128 - Age as a vocational factor.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Age as a vocational factor. 220.128 Section... DETERMINING DISABILITY Vocational Considerations § 220.128 Age as a vocational factor. (a) General. (1) Age refers to how old the claimaint is (chronological age) and the extent to which his or her age affects his...

Gender issues in the pharmacotherapy of opioid-addicted women: buprenorphine.

PubMed

Unger, Annemarie; Jung, Erika; Winklbaur, Bernadette; Fischer, Gabriele

2010-04-01

Gender, a biological determinant of mental health and illness, plays a critical role in determining patients' susceptibility, exposure to mental health risks, and related outcomes. Regarding sex differences in the epidemiology of opioid dependence, one third of the patients are women of childbearing age. Women have an earlier age of initiation of substance use and a more rapid progression to drug involvement and dependence than men. Generally few studies exist which focus on the special needs of women in opioid maintenance therapy. The aim of this paper is to provide an overview of treatment options for opioid-dependent women, with a special focus on buprenorphine, and to look at recent findings related to other factors that should be taken into consideration in optimizing the treatment of opioid-dependent women. Issues addressed include the role of gender in the choice of medication assisted treatment, sex differences in pharmacodynamics and pharmacokinetics of buprenorphine drug interactions, cardiac interactions, induction of buprenorphine in pregnant patients, the neonatal abstinence syndrome and breastfeeding. This paper aims to heighten the awareness for the need to take gender into consideration when making treatment decisions in an effort to optimize services and enhance the quality of life of women suffering from substance abuse.

Cellular changes in the enteric nervous system during ageing.

PubMed

Saffrey, M Jill

2013-10-01

The intrinsic neurons of the gut, enteric neurons, have an essential role in gastrointestinal functions. The enteric nervous system is plastic and continues to undergo changes throughout life, as the gut grows and responds to dietary and other environmental changes. Detailed analysis of changes in the ENS during ageing suggests that enteric neurons are more vulnerable to age-related degeneration and cell death than neurons in other parts of the nervous system, although there is considerable variation in the extent and time course of age-related enteric neuronal loss reported in different studies. Specific neuronal subpopulations, particularly cholinergic myenteric neurons, may be more vulnerable than others to age-associated loss or damage. Enteric degeneration and other age-related neuronal changes may contribute to gastrointestinal dysfunction that is common in the elderly population. Evidence suggests that caloric restriction protects against age-associated loss of enteric neurons, but recent advances in the understanding of the effects of the microbiota and the complex interactions between enteric ganglion cells, mucosal immune system and intestinal epithelium indicate that other factors may well influence ageing of enteric neurons. Much remains to be understood about the mechanisms of neuronal loss and damage in the gut, although there is evidence that reactive oxygen species, neurotrophic factor dysregulation and/or activation of a senescence associated phenotype may be involved. To date, there is no evidence for ongoing neurogenesis that might replace dying neurons in the ageing gut, although small local sites of neurogenesis would be difficult to detect. Finally, despite the considerable evidence for enteric neurodegeneration during ageing, and evidence for some physiological changes in animal models, the ageing gut appears to maintain its function remarkably well in animals that exhibit major neuronal loss, indicating that the ENS has considerable functional reserve. © 2013 Elsevier Inc. All rights reserved.

Epidemiology and economic burden of measles, mumps, pertussis, and varicella in Germany: a systematic review.

PubMed

Damm, Oliver; Witte, Julian; Wetzka, Stefanie; Prosser, Christine; Braun, Sebastian; Welte, Robert; Greiner, Wolfgang

2016-09-01

Despite the availability of vaccines and the existence of public vaccination recommendations, outbreaks of vaccine-preventable childhood diseases still cause public health debate. The objective of this systematic review was to provide an overview of the current epidemiology and economic burden of measles, mumps, pertussis, and varicella in Germany. We systematically reviewed studies published since 2000. The literature search was conducted using PubMed and EMBASE. Also, we used German notification data to give an up-to-date overview of the epidemiology of the four diseases under consideration. Thirty-six studies were included in our review. Results suggest that there is still considerable morbidity due to childhood diseases in Germany. Studies providing cost estimates are scarce. Comparative analyses of different data sources (notification data vs. claims data) revealed a potential underestimation of incidence estimates when using notification data. Furthermore, several studies showed regional differences in incidence of some of the diseases under consideration. Our findings underline the need for improved vaccination and communication strategies targeting all susceptible age and risk groups on a national and local level.

Orthodontic Treatment Consideration in Diabetic Patients.

PubMed

Almadih, Ahmed; Al-Zayer, Maryam; Dabel, Sukainh; Alkhalaf, Ahmed; Al Mayyad, Ali; Bardisi, Wajdi; Alshammari, Shouq; Alsihati, Zainab

2018-02-01

Although orthodontic treatment is commonly indicated for young healthy individuals, recent trends showed an increase in number of older individuals undergoing orthodontic interventions. The increased age resulted in a proportionate increase in the prevalence of systemic diseases facing dentists during orthodontic procedures, especially diabetes mellitus. This necessitates that dentists should be aware of the diagnosis of diabetes mellitus and its early signs particularly in teeth and oral cavity. It is also essential for them to understand the implications of diabetes on orthodontic treatment and the measures to be considered during managing those patients. In this review, we focused on the impact of diabetes mellitus on orthodontic treatment. We also summarized the data from previous studies that had explained the measures required to be taken into consideration during managing those patients. We included both human and animal studies to review in depth the pathophysiological mechanisms by which diabetes affects orthodontic treatment outcome. In conclusion, this review emphasizes the need to carefully identify early signs and symptoms of diabetes mellitus in patients demanding orthodontic treatment and to understand the considerations to be adopted before and during treating these patients.

Contraception and mental health: a commentary on the evidence and principles for practice.

PubMed

Hall, Kelli Stidham; Steinberg, Julia R; Cwiak, Carrie A; Allen, Rebecca H; Marcus, Sheila M

2015-06-01

Among the most prevalent and disabling chronic diseases affecting reproductive-aged women worldwide, depression and anxiety can contribute to adverse reproductive health outcomes, including an increased risk of unintended pregnancy and its health and social consequences. For women with these common mental health conditions who want to avoid an unintended pregnancy, effective contraception can be an important strategy to maintain and even improve health and well-being. Reproductive health clinicians play a critical role in providing and managing contraception to help women with mental health considerations achieve their desired fertility. In this commentary, we review the literature on relationships between mental health and contraception and describe considerations for the clinical management of contraception among women with depression and anxiety. We discuss issues related to contraceptive method effectiveness and adherence concerns, mental health-specific contraceptive method safety and drug interaction considerations, and clinical counseling and management strategies. Given important gaps in current scientific knowledge of mental health and contraception, we highlight areas for future research. Copyright © 2015 Elsevier Inc. All rights reserved.

Education and trajectories of cognitive decline over 9 years in very old people: methods and risk analysis.

PubMed

Muniz-Terrera, Graciela; Matthews, Fiona; Dening, Tom; Huppert, Felicia A; Brayne, Carol

2009-05-01

the investigation of cognitive decline in the older population has been hampered by analytical considerations. Most studies of older people over prolonged periods suffer from loss to follow-up, yet this has seldom been investigated fully to date. Such considerations limit our understanding of how basic variables such as education can affect cognitive trajectories. we examined cognitive trajectories in a population-based cohort study in Cambridge, UK, of people aged 75 and over in whom multiple interviews were conducted over time. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Socio-demographic variables were measured, including educational level and social class. An age-based quadratic latent growth model was fitted to cognitive scores. The effect of socio-demographic variables was examined on all latent variables and the probability of death and dropout. at baseline, age, education, social class and mobility were associated with cognitive performance. Education and social class were not related to decline or its rate of change. In contrast, poor mobility was associated with lower cognitive performance, increased cognitive decline and increased rate of change of cognitive decline. Gender, age, mobility and cognitive ability predicted death and dropout contrary to much of the current literature, education was not related to rate of cognitive decline or change in this rate as measured by MMSE. Higher levels of education do not appear to protect against cognitive decline, though if the MMSE is used in the diagnostic process, individuals with less education may be diagnosed as having dementia somewhat earlier.

[Hypercholesterolemia: a therapeutic approach].

PubMed

Moráis López, A; Lama More, R A; Dalmau Serra, J

2009-05-01

High blood cholesterol levels represent an important cardiovascular risk factor. Hypercholesterolemia is defined as levels of total cholesterol and low-density lipoprotein cholesterol above 95th percentile for age and gender. For the paediatric population, selective screening is recommended in children older than 2 years who are overweight, with a family history of early cardiovascular disease or whose parents have high cholesterol levels. Initial therapeutic approach includes diet therapy, appropriate physical activity and healthy lifestyle changes. Drug treatment should be considered in children from the age of 10 who, after having followed appropriate diet recommendations, still have very high LDL-cholesterol levels or moderately high levels with concomitant risk factors. In case of extremely high LDL-cholesterol levels, drug treatment should be taken into consideration at earlier ages (8 years old). Modest response is usually observed with bile acid-binding resins. Statins can be considered first-choice drugs, once evidence on their efficacy and safety has been shown.

The aging African-American face.

PubMed

Brissett, Anthony E; Naylor, Michelle C

2010-05-01

With the desire to create a more youthful appearance, patients of all races and ethnicities are increasingly seeking nonsurgical and surgical rejuvenation. In particular, facial rejuvenation procedures have grown significantly within the African-American population. This increase has resulted in a paradigm shift in facial plastic surgery as one considers rejuvenation procedures in those of African descent, as the aging process of various racial groups differs from traditional models. The purpose of this article is to draw attention to the facial features unique to those of African descent and the role these features play in the aging process, taking care to highlight the differences from traditional models of facial aging. In addition, this article will briefly describe the nonsurgical and surgical options for facial rejuvenation taking into consideration the previously discussed facial aging differences and postoperative considerations. Thieme Medical Publishers.

Evidence for sex differences in cardiovascular aging and adaptive responses to physical activity.

PubMed

Parker, Beth A; Kalasky, Martha J; Proctor, David N

2010-09-01

There are considerable data addressing sex-related differences in cardiovascular system aging and disease risk/progression. Sex differences in cardiovascular aging are evident during resting conditions, exercise, and other acute physiological challenges (e.g., orthostasis). In conjunction with these sex-related differences-or perhaps even as an underlying cause-the impact of cardiorespiratory fitness and/or physical activity on the aging cardiovascular system also appears to be sex-specific. Potential mechanisms contributing to sex-related differences in cardiovascular aging and adaptability include changes in sex hormones with age as well as sex differences in baseline fitness and the dose of activity needed to elicit cardiovascular adaptations. The purpose of the present paper is thus to review the primary research regarding sex-specific plasticity of the cardiovascular system to fitness and physical activity in older adults. Specifically, the paper will (1) briefly review known sex differences in cardiovascular aging, (2) detail emerging evidence regarding observed cardiovascular outcomes in investigations of exercise and physical activity in older men versus women, (3) explore mechanisms underlying the differing adaptations to exercise and habitual activity in men versus women, and (4) discuss implications of these findings with respect to chronic disease risk and exercise prescription.

Evidence for sex differences in cardiovascular aging and adaptive responses to physical activity

PubMed Central

Parker, Beth A.; Kalasky, Martha J.; Proctor, David N.

2010-01-01

There are considerable data addressing sex-related differences in cardiovascular system aging and disease risk/progression. Sex differences in cardiovascular aging are evident during resting conditions, exercise, and other acute physiological challenges (e.g., orthostasis). In conjunction with these sex-related differences—or perhaps even as an underlying cause—the impact of cardiorespiratory fitness and/or physical activity on the aging cardiovascular system also appears to be sex-specific. Potential mechanisms contributing to sex-related differences in cardiovascular aging and adaptability include changes in sex hormones with age as well as sex differences in baseline fitness and the dose of activity needed to elicit cardiovascular adaptations. The purpose of the present paper is thus to review the primary research regarding sex-specific plasticity of the cardiovascular system to fitness and physical activity in older adults. Specifically, the paper will (1) briefly review known sex differences in cardiovascular aging, (2) detail emerging evidence regarding observed cardiovascular outcomes in investigations of exercise and physical activity in older men versus women, (3) explore mechanisms underlying the differing adaptations to exercise and habitual activity in men versus women, and (4) discuss implications of these findings with respect to chronic disease risk and exercise prescription. PMID:20480371

Clostridium difficile Infection in Older Adults: Systematic Review of Efforts to Reduce Occurrence and Improve Outcomes.

PubMed

Marshall, Leisa L; Peasah, Samuel; Stevens, Gregg A

2017-01-01

Provide a systematic review of the primary literature on efforts to reduce Clostridium difficile infection (CDI) occurrence and improve outcomes in older adults. PubMed and CINAHL databases were searched for research studies using search terms CDI, CDI prevention, reduction, control, management, geriatric, elderly, adults 65 years of age and older. The MeSH categories Aged and Aged, 80 and older, were used. A second search of PubMed, CINAHL, National Guideline Clearinghouse, and TRIP databases was conducted for primary, secondary, and tertiary literature for CDI epidemiology, burden, and management in adults of all ages, and prevention and management guidelines. Of the 2,263 articles located, 105 were selected for full review: 55 primary and 50 secondary, tertiary. Primary literature selected for full review included studies of interventions to prevent, reduce occurrence, control, manage, or improve outcomes in adults 65 years of age and older. Patient settings included the community, assisted living, nursing facility, subacute care, or hospital. The main outcome measures for research studies were whether the studied intervention prevented, reduced occurrence, controlled, managed, or improved outcomes. Studies were conducted in acute or long-term hospitals, with a few in nursing facilities. Interventions that prevented or reduced CDI included antibiotic policy changes, education, procedure changes, infection control, and multi-intervention approaches. There were few management studies for adults 65 years of age and older or for all adults with results stratified by age. Treatments studied included efficacy of fidaxomicin, metronidazole, vancomycin, and fecal microbiota transplant. Though clinical outcomes were slightly less robust in those 65 years of age and older, age was not an independent predictor of success or failure. The current prevention and management guidelines for adults of all ages, as well as special considerations in skilled nursing facilities, extracted from the secondary/tertiary literature selected, are summarized. There are a limited number of studies designed for older adults. Our findings suggest that guideline recommendations for adults are adequate and appropriate for older adults. Exposure to antibiotics and Clostridium difficile remain the two major risk factors for CDI, reinforcing the importance of antibiotic stewardship and infection control.

Accounting for Age Uncertainty in Growth Modeling, the Case Study of Yellowfin Tuna (Thunnus albacares) of the Indian Ocean

PubMed Central

Dortel, Emmanuelle; Massiot-Granier, Félix; Rivot, Etienne; Million, Julien; Hallier, Jean-Pierre; Morize, Eric; Munaron, Jean-Marie; Bousquet, Nicolas; Chassot, Emmanuel

2013-01-01

Age estimates, typically determined by counting periodic growth increments in calcified structures of vertebrates, are the basis of population dynamics models used for managing exploited or threatened species. In fisheries research, the use of otolith growth rings as an indicator of fish age has increased considerably in recent decades. However, otolith readings include various sources of uncertainty. Current ageing methods, which converts an average count of rings into age, only provide periodic age estimates in which the range of uncertainty is fully ignored. In this study, we describe a hierarchical model for estimating individual ages from repeated otolith readings. The model was developed within a Bayesian framework to explicitly represent the sources of uncertainty associated with age estimation, to allow for individual variations and to include knowledge on parameters from expertise. The performance of the proposed model was examined through simulations, and then it was coupled to a two-stanza somatic growth model to evaluate the impact of the age estimation method on the age composition of commercial fisheries catches. We illustrate our approach using the saggital otoliths of yellowfin tuna of the Indian Ocean collected through large-scale mark-recapture experiments. The simulation performance suggested that the ageing error model was able to estimate the ageing biases and provide accurate age estimates, regardless of the age of the fish. Coupled with the growth model, this approach appeared suitable for modeling the growth of Indian Ocean yellowfin and is consistent with findings of previous studies. The simulations showed that the choice of the ageing method can strongly affect growth estimates with subsequent implications for age-structured data used as inputs for population models. Finally, our modeling approach revealed particularly useful to reflect uncertainty around age estimates into the process of growth estimation and it can be applied to any study relying on age estimation. PMID:23637773

Reoperation for refractory epilepsy in childhood: a second chance for selected patients.

PubMed

Ramantani, Georgia; Strobl, Karl; Stathi, Angeliki; Brandt, Armin; Schubert-Bast, Susanne; Wiegand, Gert; Korinthenberg, Rudolf; Stephani, Ulrich; van Velthoven, Vera; Zentner, Josef; Schulze-Bonhage, Andreas; Bast, Thomas

2013-10-01

Reoperations account for >10% in pediatric epilepsy surgery cohorts, and they are especially relevant in young children with catastrophic epilepsy. To determine surgical outcomes and their predictive factors in reoperations for refractory epilepsy in childhood. We retrospectively analyzed presurgical findings, resections, and outcomes of 23 consecutive children who underwent reoperations from 2000 to 2011. Etiology included cortical dysplasia with/without glioneuronal tumor in 19 patients (83%), sole glioneuronal tumor in 2, and tuberous sclerosis and Rasmussen encephalitis in 1 each. The reasons for the failure of the initial surgery were functional considerations in 8 (35%), incorrect delineation of the epileptogenic zone in 8 (35%), and resection not performed as initially planned in 7 (30%) cases. Final procedures included 8 (35%) intralobar, 8 (35%) multilobar resections, and 7 (30%) hemispherotomies. Following reoperations, 14 (61%) patients were seizure free, 6 (26%) showed significant or worthwhile improvement, and 3 (13%) did not respond to surgery. Six of 8 patients who underwent the first resection before the age of 3 years, 6 of 8 whose first resection was limited by functional considerations, and all 7 with hemispherotomy as the final resection achieved seizure freedom after reoperation. Reoperation is particularly beneficial for selected children with refractory epilepsy associated with cortical dysplasia that did not respond to an initial limited and/or early resection but achieved seizure freedom after extensive procedures. When indicated, reoperation should be performed at the youngest possible age to profit from higher functional plasticity in compensating for neurological deficit.

Basic Science Considerations in Primary Total Hip Replacement Arthroplasty

PubMed Central

Mirza, Saqeb B; Dunlop, Douglas G; Panesar, Sukhmeet S; Naqvi, Syed G; Gangoo, Shafat; Salih, Saif

2010-01-01

Total Hip Replacement is one of the most common operations performed in the developed world today. An increasingly ageing population means that the numbers of people undergoing this operation is set to rise. There are a numerous number of prosthesis on the market and it is often difficult to choose between them. It is therefore necessary to have a good understanding of the basic scientific principles in Total Hip Replacement and the evidence base underpinning them. This paper reviews the relevant anatomical and biomechanical principles in THA. It goes on to elaborate on the structural properties of materials used in modern implants and looks at the evidence base for different types of fixation including cemented and uncemented components. Modern bearing surfaces are discussed in addition to the scientific basis of various surface engineering modifications in THA prostheses. The basic science considerations in component alignment and abductor tension are also discussed. A brief discussion on modular and custom designs of THR is also included. This article reviews basic science concepts and the rationale underpinning the use of the femoral and acetabular component in total hip replacement. PMID:20582240

Type 1 Diabetes in Young Adulthood

PubMed Central

Monaghan, Maureen; Helgeson, Vicki; Wiebe, Deborah

2015-01-01

Type 1 diabetes has traditionally been studied as a chronic illness of childhood. However, young adulthood is a critical time for the development and integration of lifelong diabetes management skills, and research is starting to identify unique challenges faced by youth with diabetes as they age into adulthood. Most young adults experience multiple transitions during this unstable developmental period, including changes in lifestyle (e.g., education, occupation, living situation), changes in health care, and shifting relationships with family members, friends, and intimate others. Young adults with type 1 diabetes must navigate these transitions while also assuming increasing responsibility for their diabetes care and overall health. Despite these critical health and psychosocial concerns, there is a notable lack of evidence-based clinical services and supports for young adults with type 1 diabetes. We review relevant evolving concerns for young adults with type 1 diabetes, including lifestyle considerations, health care transitions, psychosocial needs, and changes in supportive networks, and how type 1 diabetes impacts and is impacted by these key developmental considerations. Specific avenues for intervention and future research are offered. PMID:25901502

IMPROVING OUR UNDERSTANDING OF SUSCEPTIBILITY IN THE AGING POPULATION TO ENVIRONMENTAL EXPOSURES.

EPA Science Inventory

A radical demographic shift is taking place in America, with aging adults being the fastest-growing segment of the population. Considerable research is underway on the biology of aging and on remedies for treating the diseases of aging. Remarkably little is known, however, about ...

Human T cell immunosenescence and inflammation in aging.

PubMed

Bektas, Arsun; Schurman, Shepherd H; Sen, Ranjan; Ferrucci, Luigi

2017-10-01

The aging process is driven by a finite number of inter-related mechanisms that ultimately lead to the emergence of characteristic phenotypes, including increased susceptibility to multiple chronic diseases, disability, and death. New assays and analytical tools have become available that start to unravel some of these mechanisms. A prevailing view is that aging leads to an imbalance between stressors and stress-buffering mechanisms that causes loss of compensatory reserve and accumulation of unrepaired damage. Central to this paradigm are changes in the immune system and the chronic low-grade proinflammatory state that affect many older individuals, even when they are apparently healthy and free of risk factors. Independent of chronological age, high circulating levels of proinflammatory markers are associated with a high risk of multiple adverse health outcomes in older persons. In this review, we discuss current theories about causes and consequences of the proinflammatory state of aging, with a focus on changes in T cell function. We examine the role of NF-κB activation and its dysregulation and how NF-κB activity differs among subgroups of T cells. We explore emerging hypotheses about immunosenescence and changes in T cell behavior with age, including consideration of the T cell antigen receptor and regulatory T cells (T regs ). We conclude by illustrating how research using advanced technology is uncovering clues at the core of inflammation and aging. Some of the preliminary work in this field is already improving our understanding of the complex mechanisms by which immunosenescence of T cells is intertwined during human aging. © Society for Leukocyte Biology.

Characterization of the urinary microbiota of elderly women and the effects of type 2 diabetes and urinary tract infections on the microbiota

PubMed Central

Liu, Fengping; Ling, Zongxin; Xiao, Yonghong; Yang, Qing; Zheng, Li; Jiang, Ping; Li, Lanjuan; Wang, Wei

2017-01-01

Evidence shows that urine has complex bacterial profiles with considerable variation between individuals. Aging and age-related conditions can lead to the changes to the composition of urine, which means that the available nutrition for bacteria in the bladder changes with age. We explored the characteristics of the urinary microbiota of elderly women and whether these are associated with age-related conditions such as diabetes and urinary tract infections. An elderly and a non-elderly cohort of women were included. Magnetic beads were used to isolate bacterial genomic DNA, which was analyzed based on the V3-V4 hypervariable region of the 16S rRNA gene. There were significant differences between the elderly and non-elderly regarding thirteen genera of bacteria. For example, the relative abundance of Lactobacillus was dramatically reduced in the elderly compared with the non-elderly; it also decreased with age in the elderly cohort and it was not correlated with urine pH. The relative abundance of Peptococcus increased with age in the elderly while the abundance of Bifidobacteria decreased with age. The abundance of Escherichia coli was the same in the two cohorts, and it increased with water intake and was not associated with urinary tract infection events. Higher levels of Lactobacillus (including Lactobacillus iners) in the elderly were associated with diabetes, and lower levels of Peptoniphilus and Dialister were correlated with asymptomatic bacteriuria. The urinary microbiota of women is affected by ageing, type 2 diabetes mellitus and asymtomatic bacteriuria. PMID:29246012

Defining successful aging: a tangible or elusive concept?

PubMed

Martin, Peter; Kelly, Norene; Kahana, Boaz; Kahana, Eva; Willcox, Bradley J; Willcox, D Craig; Poon, Leonard W

2015-02-01

Everyone wants to age successfully; however, the definition and criteria of successful aging remain vague for laypersons, researchers, and policymakers in spite of decades of research on the topic. This paper highlights work of scholars who made significant theoretical contributions to the topic. A thorough review and evaluation of the literature on successful aging was undertaken. Our review includes early gerontological definitions of successful aging and related concepts. Historical perspectives reach back to philosophical and religious texts, and more recent approaches have focused on both process- and outcome-oriented models of successful aging. We elaborate on Baltes and Baltes' theory of selective optimization with compensation [Baltes, P. B., & Baltes, M. M. (1990a). Psychological perspectives on successful aging: The model of selective optimization with compensation. In P. B. Baltes & M. M. Baltes (Eds.), Successful aging: Perspectives from the behavioral sciences (pp. 1-34). United Kingdom: Cambridge University Press], Kahana and Kahana's preventive and corrective proactivity model [Kahana, E., & Kahana, B. (1996). Conceptual and empirical advances in understanding aging well through proactive adaptation. In V. Bengtson (Ed.), Adulthood and aging: Research on continuities and discontinuities (pp. 18-40). New York: Springer], and Rowe and Kahn's model of successful aging [Rowe, J. W., & Kahn, R. L. (1998). Successful aging. New York: Pantheon Books], outlining their commonalities and differences. Additional views on successful aging emphasize subjective versus objective perceptions of successful aging and relate successful aging to studies on healthy and exceptional longevity. Additional theoretical work is needed to better understand successful aging, including the way it can encompass disability and death and dying. The extent of rapid social and technological change influencing views on successful aging also deserves more consideration. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Tactical Miniature Crystal Oscillator.

DTIC Science & Technology

1980-08-01

manufactured by this process are expected to require 30 days to achieve minimum aging rates. (4) FUNDEMENTAL CRYSTAL RETRACE MEASUREMENT. An important crystal...considerable measurement time to detect differences and characterize components. Before investing considerable time in a candidate reactive element, a

Characterization of bone marrow-derived mesenchymal stem cells in aging.

PubMed

Baker, Natasha; Boyette, Lisa B; Tuan, Rocky S

2015-01-01

Adult mesenchymal stem cells are a resource for autologous and allogeneic cell therapies for immune-modulation and regenerative medicine. However, patients most in need of such therapies are often of advanced age. Therefore, the effects of the aged milieu on these cells and their intrinsic aging in vivo are important considerations. Furthermore, these cells may require expansion in vitro before use as well as for future research. Their aging in vitro is thus also an important consideration. Here, we focus on bone marrow mesenchymal stem cells (BMSCs), which are unique compared to other stem cells due to their support of hematopoietic cells in addition to contributing to bone formation. BMSCs may be sensitive to age-related diseases and could perpetuate degenerative diseases in which bone remodeling is a contributory factor. Here, we review (1) the characterization of BMSCs, (2) the characterization of in vivo-aged BMSCs, (3) the characterization of in vitro-aged BMSCs, and (4) potential approaches to optimize the performance of aged BMSCs. This article is part of a Special Issue entitled "Stem Cells and Bone". Copyright © 2014 Elsevier Inc. All rights reserved.

Age Estimation Based on Children's Voice: A Fuzzy-Based Decision Fusion Strategy

PubMed Central

Ting, Hua-Nong

2014-01-01

Automatic estimation of a speaker's age is a challenging research topic in the area of speech analysis. In this paper, a novel approach to estimate a speaker's age is presented. The method features a “divide and conquer” strategy wherein the speech data are divided into six groups based on the vowel classes. There are two reasons behind this strategy. First, reduction in the complicated distribution of the processing data improves the classifier's learning performance. Second, different vowel classes contain complementary information for age estimation. Mel-frequency cepstral coefficients are computed for each group and single layer feed-forward neural networks based on self-adaptive extreme learning machine are applied to the features to make a primary decision. Subsequently, fuzzy data fusion is employed to provide an overall decision by aggregating the classifier's outputs. The results are then compared with a number of state-of-the-art age estimation methods. Experiments conducted based on six age groups including children aged between 7 and 12 years revealed that fuzzy fusion of the classifier's outputs resulted in considerable improvement of up to 53.33% in age estimation accuracy. Moreover, the fuzzy fusion of decisions aggregated the complementary information of a speaker's age from various speech sources. PMID:25006595

The aging musculoskeletal system and obesity-related considerations with exercise

PubMed Central

Vincent, Heather K.; Raiser, Sara N.; Vincent, Kevin R.

2012-01-01

Advancing age and adiposity contribute to musculoskeletal degenerative diseases and the development of sarcopenic obesity. The etiology of muscle loss is multifactorial, and includes inflammation, oxidative stress and hormonal changes, and is worsened by activity avoidance due to fear of pain. The risk for mobility disability and functional impairment rises with severity of obesity in the older adult. Performance measures of walking distance, walking speed, chair rise, stair climb, body transfers and ability to navigate obstacles on a course are adversely affected in this population, and this reflects decline in daily physical functioning. Exercise training is an ideal intervention to counteract the effects of aging and obesity. The 18 randomized controlled trials of exercise studies with or without diet components reviewed here indicate that 3–18 month programs that included aerobic and strengthening exercise (2–3 days per week) with caloric restriction (typically 750 kcal deficit/day), induced the greatest change in functional performance measures compared with exercise or diet alone. Importantly, resistance exercise attenuates muscle mass loss with the interventions. These interventions can also combat factors that invoke sarcopenia, including inflammation, oxidative stress and insulin resistance. Therefore, regular multimodal exercise coupled with diet appears to be very effective for counteracting sarocpenic obesity and improving mobility and function in the older, obese adult. PMID:22440321

Workforce training and education gaps in gerontology and geriatrics: what we found in New York State.

PubMed

Maiden, Robert J; Horowitz, Beverly P; Howe, Judith L

2010-01-01

This article summarizes data from the 2008 Symposium Charting the Future for New York State Workforce Training and Education in Aging: The Stakeholder Perspective and the 2009 report Workforce Training and Education: The Challenge for Academic Institutions. This research is the outcome of a collaborative State Society on Aging of New York and New York State Office for the Aging study on New York State's workforce training and education needs. Eight Listening Sessions were held across New York State to obtain input on topics including training, gerontology education, and credentialing and certification. Individual sessions highlighted the needs of urban, rural, and suburban communities. Key themes identified through content analysis included the need for education about aging in agencies serving older adults, education on human development, positive aspects of aging, disabilities, developmental disabilities, and greater opportunities for training and education for service providers. Lack of incentives was identified as a barrier to credentialing or certification. Education about growing older beginning in grade school was recommended. Lack of funding was identified as a barrier that limited support for employee education/training. Disconnects were identified between employers and academic institutions and state government and providers regarding gerontology/geriatric training and education. Consideration to how these themes may be addressed by the Association of Gerontology in Higher Education is offered.

How much does it cost to care for survivors of colorectal cancer? Caregiver's time, travel and out-of-pocket costs.

PubMed

Hanly, Paul; Céilleachair, Alan Ó; Skally, Mairead; O'Leary, Eamonn; Kapur, Kanika; Fitzpatrick, Patricia; Staines, Anthony; Sharp, Linda

2013-09-01

Cancer treatment is increasingly delivered in an outpatient setting. This may entail a considerable economic burden for family members and friends who support patients/survivors. We estimated financial and time costs associated with informal care for colorectal cancer. Two hundred twenty-eight carers of colorectal cancer survivors diagnosed on October 2007-September 2009 were sent a questionnaire. Informal care costs included hospital- and domestic-based foregone caregiver time, travel expenses and out-of-pocket (OOP) costs during two phases: diagnosis and treatment and ongoing care (previous 30 days). Multiple regression was used to determine cost predictors. One hundred fifty-four completed questionnaires were received (response rate = 68%). In the diagnosis and treatment phase, weekly informal care costs per person were: hospital-based costs, incurred by 99% of carers, mean = €393 (interquartile range (IQR), €131-€541); domestic-based time costs, incurred by 85%, mean = €609 (IQR, €170-€976); and domestic-based OOP costs, incurred by 68%, mean = €69 (IQR, €0-€110). Ongoing costs included domestic-based time costs incurred by 66% (mean = €66; IQR, €0-€594) and domestic-based OOP costs incurred by 52% (mean = €52; IQR, €0-€64). The approximate average first year informal care cost was €29,842, of which 85 % was time costs, 13% OOP costs and 2% travel costs. Significant cost predictors included carer age, disease stage, and survivor age. Informal caregiving associated with colorectal cancer entails considerable time and OOP costs. This burden is largely unrecognised by policymakers, service providers and society in general. These types of studies may facilitate health decision-makers in better assessing the consequences of changes in cancer care organisation and delivery.

Mini-Mental State Exam performance of older African Americans: effect of age, gender, education, hypertension, diabetes, and the inclusion of serial 7s subtraction versus "world" backward on score.

PubMed

Hawkins, Keith A; Cromer, Jennifer R; Piotrowski, Andrea S; Pearlson, Godfrey D

2011-11-01

The Mini-Mental State Exam (MMSE) is a clinically ubiquitous yet incompletely standardized instrument. Though the test offers considerable examiner leeway, little data exist on the normative consequences of common administration variations. We sought to: (a) determine the effects of education, age, gender, health status, and a common administration variation (serial 7s subtraction vs. "world" spelled backward) on MMSE score within a minority sample, (b) provide normative data stratified on the most empirically relevant bases, and (c) briefly address item failure rates. African American citizens (N = 298) aged 55-87 living independently in the community were recruited by advertisement, community recruitment, and word of mouth. Total score with "world" spelled backward exceeded total score with serial 7s subtraction across all levels of education, replicating findings in Caucasian samples. Education is the primary source of variance on MMSE score, followed by age. In this cohort, women out-performed men when "world" spelled backward was included, but there was no gender effect when serial 7s subtraction was included in MMSE total score. To ensure an appropriate interpretation of MMSE scores, reports, whether clinical or in publications of research findings, should be explicit regarding the administration method. Stratified normative data are provided.

Is graduate entry education a solution to increasing numbers of men in nursing?

PubMed

McKenna, Lisa; Vanderheide, Rebecca; Brooks, Ingrid

2016-03-01

Males have traditionally constituted a very small proportion of the nursing workforce in many countries, including Australia. Together with a need to address the gender imbalance, nursing workforce shortages require strategies for recruiting new nurses, including males. This study examined characteristics of males entering one accelerated graduate entry masters pre-registration nursing program in Victoria, Australia. A quantitative survey gathered a variety of demographic data and factors relating to participants' decisions to undertake nursing. Data were analysed using descriptive statistics including frequencies and distributions. Forty-three male nursing students from four cohorts of the Master of Nursing Practice (MNP) course from 2009 to 2011 completed the survey. The proportion of males (30%) was considerably greater than traditional nursing courses and the profession generally. Participants demonstrated wide distributions in age ranges, professional backgrounds and previous years in the workforce. Graduate entry appears attractive to males of varying ages, personal and professional backgrounds. More research is needed to examine this phenomenon on a larger scale. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Socioeconomic and Cultural Correlates of Diet Quality in the Canadian Arctic: Results from the 2007-2008 Inuit Health Survey.

PubMed

Galloway, Tracey; Johnson-Down, Louise; Egeland, Grace M

2015-09-01

We examined the impact of socioeconomic and cultural factors on dietary quality in adult Inuit living in the Canadian Arctic. Interviews and a 24-h dietary recall were administered to 805 men and 1292 women from Inuit regions in the Canadian Arctic. We examined the effect of age, sex, education, income, employment, and cultural variables on respondents' energy, macronutrient intake, sodium/potassium ratio, and healthy eating index. Logistic regression was used to assess the impact of socioeconomic status (SES) on diet quality indicators. Age was positively associated with traditional food (TF) consumption and greater energy from protein but negatively associated with total energy and fibre intake. Associations between SES and diet quality differed considerably between men and women and there was considerable regional variability in diet quality measures. Age and cultural variables were significant predictors of diet quality in logistic regression. Increased age and use of the Inuit language in the home were the most significant predictors of TF consumption. Our findings are consistent with studies reporting a nutrition transition in circumpolar Inuit. We found considerable variability in diet quality and complex interaction between SES and cultural variables producing mixed effects that differ by age and gender.

[Dental age in the relation with nutrition model of school children from swimming classes of championship school].

PubMed

Dyras, Marta; Lyszczarz, Justyna; Wójtowicz, Barbara; Jankowska, Katarzyna

2002-01-01

The aim of this work was the comparison of calendar age with dental age in the aspect of basic nutritional ingredients intake with precise taking into consideration microelements, macroelements and vitamins. 79 schoolchildren from swimming classes of championship school in Cracow aged 10-13 were included in the examination. Among this group of pupils 24-hour recall and complex dental examination including the estimation of dental status, the hygienic status of oral cavity were conducted and the presence of dental and occlusion defects were estimated. 24-hour recall including 3 following days contained the number of products in every meal, the number of meals and the time of their consumption. The schoolchildren were divided into 3 groups on the ground of the difference between dental and calendar age. Dentition on time (no more than 5 months difference between dental and calendar age) was stated by 25 pupils--group I. Accelerated dentition of fixed teeth was observed by 36 pupils--group II and delayed dentition by 18 persons--group III. In all groups lower than safe calcium intake (80% of pupils from these groups) and iron intake (55%) was noticed. In the range of left micro- and macroelements the disturbances in nutritional status were mainly stated bypersons with delayed dentition. The shortages in Magnesium intake concerned 67% of school children and in Zinc intake--72%. In the group of schoolchildren with accelerated dentition these shortages were about 40%. In the range of vitamins intake low niacin intake (39% of schoolchildren) and riboflavin intake (25%) were stated. The differences among these groups were observed only in thiamine intake (33% from group II and 19% from group III). In the group III more often low energetic value of daily nutrient intake was stated.

The paradox of age: Tectites and tectite showers

NASA Technical Reports Server (NTRS)

Izokh, E. P.

1987-01-01

When discussing the problem of tectite origin, the age of the tectites themselves (actual glasses) must be distinguished from the date of their fall on the earth's surface, i.e., the geological age of tectite fields. The considerable difference between their two ages is the essence of the paradox which will be discussed here.

METABOLIC RATE AS A FUNCTION OF AGE IN BROWN NORWAY AND LONG-EVANS RATS.

EPA Science Inventory

Brown Norway (BN) rats are commonly used in aging studies but relatively little is known on their metabolism as it varies with age. In fact, there is considerable disagreement on the wholebody metabolism of aging rats with some studies indicating a decrease and others showing an...

Why older nurses leave the workforce and the implications of them staying.

PubMed

Duffield, Christine; Graham, Elizabeth; Donoghue, Judith; Griffiths, Rhonda; Bichel-Findlay, Jen; Dimitrelis, Sofia

2015-03-01

To identify factors that motivate older nurses to leave the workforce. As many older nurses are now reaching retirement age and will be eligible for government-funded pensions, governments are concerned about the impending financial burden. To prepare for this scenario, many are looking at increasing the age of retirement to 67 or 70 years. Little is known about how this will affect the continuing employment of older nurses and the consequences for employers and the nurses themselves if they remain longer in the workforce. Prospective randomised quantitative survey study. The Mature Age Workers Questionnaire, Job Descriptive Index and Job in General Scale were used to measure job satisfaction, intention to retire and factors encouraging retirement in registered nurses aged 45 years and over (n = 352) in Australia (July-August 2007). There were 319 respondents. The mean age proposed for leaving the workforce was 61·7 years. Key motivators were: financial considerations (40·1%), primarily financial security; nurse health (17·4%) and retirement age of partner (13·3%). Older nurses are leaving the workforce prior to retirement or pension age, primarily for financial, social and health reasons, taking with them significant experience and knowledge. As financial considerations are important in older nurses decisions to continue to work, increasing the age of retirement may retain them. However, consideration will need to be given to ensure that they continue to experience job satisfaction and are physically and mentally able to undertake demanding work. Increasing retirement age may retain older nurses in the workforce, however, the impact on the health of older nurses is not known, nor is the impact for employers of older nurses continuing to work known. Employers must facilitate workplace changes to accommodate older nurses. © 2014 John Wiley & Sons Ltd.

Dynamic regulation of genetic pathways and targets during aging in Caenorhabditis elegans.

PubMed

He, Kan; Zhou, Tao; Shao, Jiaofang; Ren, Xiaoliang; Zhao, Zhongying; Liu, Dahai

2014-03-01

Numerous genetic targets and some individual pathways associated with aging have been identified using the worm model. However, less is known about the genetic mechanisms of aging in genome wide, particularly at the level of multiple pathways as well as the regulatory networks during aging. Here, we employed the gene expression datasets of three time points during aging in Caenorhabditis elegans (C. elegans) and performed the approach of gene set enrichment analysis (GSEA) on each dataset between adjacent stages. As a result, multiple genetic pathways and targets were identified as significantly down- or up-regulated. Among them, 5 truly aging-dependent signaling pathways including MAPK signaling pathway, mTOR signaling pathway, Wnt signaling pathway, TGF-beta signaling pathway and ErbB signaling pathway as well as 12 significantly associated genes were identified with dynamic expression pattern during aging. On the other hand, the continued declines in the regulation of several metabolic pathways have been demonstrated to display age-related changes. Furthermore, the reconstructed regulatory networks based on three of aging related Chromatin immunoprecipitation experiments followed by sequencing (ChIP-seq) datasets and the expression matrices of 154 involved genes in above signaling pathways provide new insights into aging at the multiple pathways level. The combination of multiple genetic pathways and targets needs to be taken into consideration in future studies of aging, in which the dynamic regulation would be uncovered.

Interval Female Sterilization.

PubMed

Stuart, Gretchen S; Ramesh, Shanthi S

2018-01-01

Female sterilization is relied on by nearly one in three women aged 35-44 years in the United States. Sterilization procedures are among the most common procedures that obstetrician-gynecologists perform. The most frequent sterilization procedures include postpartum tubal ligation, laparoscopic tubal disruption or salpingectomy, and hysteroscopic tubal occlusion. The informed consent process for sterilization is crucial and requires shared decision-making between the patient and the health care provider. Counseling should include the specific risks and benefits of the specific surgical approaches. Additionally, women should be counseled on the alternatives to sterilization, including intrauterine contraceptives and subdermal contraceptive implants. Complications, including unplanned pregnancy after successful female sterilization, are rare. The objectives of this Clinical Expert Series are to describe the epidemiology of female sterilization, access to postpartum sterilization, advances in interval sterilization techniques, and clinical considerations in caring for women requesting sterilization.

Prevalence of otitis media with effusion among school age children in rural parts of Konya province, Turkey.

PubMed

Varsak, Yasin Kürsad; Gül, Zuhal; Eryılmaz, Mehmet Akif; Arbağ, Hamdi

2015-01-01

This study aims to evaluate the current prevalence of serous otitis media (SOM) among school age children living in rural areas of Konya province located in southern Turkey. This cross sectional study which was conducted between October 2012 and January 2013 included 2,352 children (1,179 males, 1,173 females; mean age 8.9±2.8 years; range 4 to 15 years) who attended 36 different primary schools in rural parts of the Konya province. Otologic complaints, findings, and tympanometry results were recorded. Diagnosis of SOM was obtained based on history, symptoms, abnormal otoscopy and tympanogram findings. The overall prevalence of SOM was 4.6%. The highest prevalence was at the age of four (11.2%). There was a significantly higher prevalence of SOM at the age of six (11.1%). The overall prevalence was higher in males (6.17%) compared to females (3.16%) in all age groups (p<0.05). Compared to the literature, overall prevalence of SOM in our study was lower. Development of preventive and therapeutic strategies in the first step health care service may have a considerable effect on this low rate.

Adaptive-filtering of trisomy 21: risk of Down syndrome depends on family size and age of previous child

NASA Astrophysics Data System (ADS)

Neuhäuser, Markus; Krackow, Sven

2007-02-01

The neonatal incidence rate of Down syndrome (DS) is well-known to accelerate strongly with maternal age. This non-linearity renders mere accumulation of defects at recombination during prolonged first meiotic prophase implausible as an explanation for DS rate increase with maternal age, but might be anticipated from chromosomal drive (CD) for trisomy 21. Alternatively, as there is selection against genetically disadvantaged embryos, the screening system that eliminates embryos with trisomy 21 might decay with maternal age. In this paper, we provide the first evidence for relaxed filtering stringency (RFS) to represent an adaptive maternal response that could explain accelerating DS rates with maternal age. Using historical data, we show that the proportion of aberrant live births decrease with increased family size in older mothers, that inter-birth intervals are longer before affected neonates than before normal ones, and that primiparae exhibit elevated levels of DS incidence at higher age. These findings are predicted by adaptive RFS but cannot be explained by the currently available alternative non-adaptive hypotheses, including CD. The identification of the relaxation control mechanism and therapeutic restoration of a stringent screen may have considerable medical implications.

[Complex stimulation of the locomotor and psycholingual develop- ment of children with perinatal lesions of the central nervous system].

PubMed

Skvortsov, I A; Khavkhun, L A; Ustinova, E V; I'lin, L B

1989-01-01

In 121 children with perinatal CNS damage a combined therapy was performed including, besides routine drug treatment, imitation stimulation of age-matched posture-++-tonic attitudes and motor skills, metameric reflexotherapy aimed at the CNS region lesioned, magnetotherapy, electric laser puncture targeted at correction of dysfunctioning brain structures. Treatment efficiency was controlled by the brain "development profile" derived from formalized neurological and neuropsychological investigations, and electroneuromyography. The efficiency of the therapy was considerably decreased by the 3rd semester of life.

Assessing the potential effects and cost-effectiveness of programmatic herpes zoster vaccination of elderly in the Netherlands

PubMed Central

2010-01-01

Background Herpes zoster (HZ) is a painful disease affecting a considerable part of the elderly. Programmatic HZ vaccination of elderly people may considerably reduce HZ morbidity and its related costs, but the extent of these effects is unknown. In this article, the potential effects and cost-effectiveness of programmatic HZ vaccination of elderly in the Netherlands have been assessed according to a framework that was developed to support evidence-based decision making regarding inclusion of new vaccines in the Dutch National Immunization Program. Methods An analytical framework was used combining a checklist, which structured relevant data on the vaccine, pathogen and disease, and a cost-effectiveness analysis. The cost-effectiveness analysis was performed from a societal perspective, using a Markov-cohort-model. Simultaneous vaccination with influenza was assumed. Results Due to the combination of waning immunity after vaccination and a reduced efficacy of vaccination at high ages, the most optimal cost-effectiveness ratio (€21716 per QALY) for HZ vaccination in the Netherlands was found for 70-year olds. This estimated ratio is just above the socially accepted threshold in the Netherlands of €20000 per QALY. If additional reduction of postherpetic neuralgia was included, the cost-effectiveness ratio improved (~€10000 per QALY) but uncertainty for this scenario is high. Conclusions Vaccination against HZ at the age of 70 years seems marginally cost-effective in the Netherlands. Due to limited vaccine efficacy a considerable part of the disease burden caused by HZ will remain, even with optimal acceptance of programmatic vaccination. PMID:20707884

Assessing the potential effects and cost-effectiveness of programmatic herpes zoster vaccination of elderly in the Netherlands.

PubMed

van Lier, Alies; van Hoek, Albert Jan; Opstelten, Wim; Boot, Hein J; de Melker, Hester E

2010-08-13

Herpes zoster (HZ) is a painful disease affecting a considerable part of the elderly. Programmatic HZ vaccination of elderly people may considerably reduce HZ morbidity and its related costs, but the extent of these effects is unknown. In this article, the potential effects and cost-effectiveness of programmatic HZ vaccination of elderly in the Netherlands have been assessed according to a framework that was developed to support evidence-based decision making regarding inclusion of new vaccines in the Dutch National Immunization Program. An analytical framework was used combining a checklist, which structured relevant data on the vaccine, pathogen and disease, and a cost-effectiveness analysis. The cost-effectiveness analysis was performed from a societal perspective, using a Markov-cohort-model. Simultaneous vaccination with influenza was assumed. Due to the combination of waning immunity after vaccination and a reduced efficacy of vaccination at high ages, the most optimal cost-effectiveness ratio (21716 euro per QALY) for HZ vaccination in the Netherlands was found for 70-year olds. This estimated ratio is just above the socially accepted threshold in the Netherlands of 20000 euro per QALY. If additional reduction of postherpetic neuralgia was included, the cost-effectiveness ratio improved (approximately 10000 euro per QALY) but uncertainty for this scenario is high. Vaccination against HZ at the age of 70 years seems marginally cost-effective in the Netherlands. Due to limited vaccine efficacy a considerable part of the disease burden caused by HZ will remain, even with optimal acceptance of programmatic vaccination.

Aging of Diesel and Wood Burning Emissions in Smogchamber Experiments

NASA Astrophysics Data System (ADS)

Prevot, Andre S. H.

2010-05-01

Photochemical aging experiments were performed for emissions of a diesel passenger car and logwood-burner at the smogchamber at the Paul Scherrer Institute in Switzerland. The measurements include black carbon measurements (with Aethalometer, Multi-Angle Absorption Photometer, Single Particle Soot Photometer (SP-2), and Photoacoustic Spectrometer), organic mass measurements with the Aerodyne high-resolution Aerosol mass spectrometer and off-line GC-MS measurements. Single particle composition was measured with the TSI-Aerosol time-of-flight mass spectrometer. The size distribution is characterized with a scanning mobility particle sizer, and the hygroscopicity with a hygroscopicity tandem differential mobility analyzer. The given overview of the results of experiments during the last 1.5 years will focus on the formation secondary organic aerosol and include the oxidation of primary organic aerosols and the change of optical and hygroscopic properties. A considerable variability of most results is found for different after treatment systems of diesel cars and for different burning conditions of the log-wood burner which will be discussed in detail.

A minimal dose approach to resistance training for the older adult; the prophylactic for aging.

PubMed

Fisher, James P; Steele, James; Gentil, Paulo; Giessing, Jürgen; Westcott, Wayne L

2017-12-01

A plethora of research has supported the numerous health benefits of resistance training as we age, including positive relationships between muscular strength, muscle mass and reduced all-cause mortality. As such, resistance training has been referred to as medicine. However, participation and adherence remains low, with time constraints and perceived difficulty often cited as barriers to resistance training. With this in mind, we aimed to summarise the benefits which might be obtained as a product of a minimal dose approach. In this sense, participation in resistance training might serve as a prophylactic to delay or prevent the onset of biological aging. A short review of studies reporting considerable health benefits resulting from low volume resistance training participation is presented, specifically considering the training time, frequency, intensity of effort, and exercises performed. Research supports the considerable physiological and psychological health benefits from resistance training and suggests that these can be obtained using a minimal dose approach (e.g. ≤60min, 2d-wk -1 ), using uncomplicated equipment/methods (e.g. weight stack machines). Our hope is that discussion of these specific recommendations, and provision of an example minimal dose workout, will promote resistance training participation by persons who might otherwise have not engaged. We also encourage medical professionals to use this information to prescribe resistance exercise like a drug whilst having an awareness of the health benefits and uncomplicated methods. Copyright © 2017 Elsevier Inc. All rights reserved.

Individualized assessment of driving fitness for older individuals with health, disability, and age-related concerns.

PubMed

Wheatley, Carol J; Di Stefano, Marilyn

2008-08-01

Driver licensing agencies are faced with an increasing population of drivers who are seeking to maintain driving privileges whilst coping with functional changes associated with health, disability, or aging-related issues. Some of these changes impact upon the motor, sensory, and cognitive capacities essential for safe motor vehicle operation. The driver assessment process, as provided by occupational therapists and other professionals trained in the techniques of driver rehabilitation, can provide objective data to identify driver strengths and limitations and options available to increase mobility independence via consideration of adaptive mobility equipment, vehicle choice, driver training, or alternative transportation if necessary. This article provides an overview of the driver rehabilitation specialist's assessment and training process, with an analysis of the key issues related to this form of assessment and the need for further research. The basic driver rehabilitation process is outlined including examples of common deficits, assessment considerations, and intervention approaches. The clinical and on-road assessment procedures are described, with illustrations of the reasoning process that leads to a determination of the person's overall driving competence and rehabilitation recommendations. A review of the literature is provided that examines the currently available documentation that supports this assessment and rehabilitation process. The article concludes with a review of current literature that examines the claim that detailed clinical and on-road assessment, as provided by driver rehabilitation specialists, is currently the best method for assisting drivers with complex health, disability, or aging-related issues to resume or retain driving privileges.

The Aging Male Homosexual: Myth and Reality

ERIC Educational Resources Information Center

Kelly, Jim

1977-01-01

There is little evidence to suggest that being gay causes problems in old age but there is considerable evidence to suggest that societal stigma may cause problems for aging gays. Presented at the 28th Annual Scientific Meeting of Gerontological Society, Louisville, Oct., 1975. (Author)

Prevalence of upper gastrointestinal bleeding risk factors among the general population and osteoarthritis patients.

PubMed

Kim, Sang Hyuck; Yun, Jae Moon; Chang, Chong Bum; Piao, Heng; Yu, Su Jong; Shin, Dong Wook

2016-12-28

To assess the prevalence of possible risk factors of upper gastrointestinal bleeding (UGIB) and their age-group specific trend among the general population and osteoarthritis patients. We utilized data from the National Health Insurance Service that included claims data and results of the national health check-up program. Comorbid conditions (peptic ulcer, diabetes, liver disease, chronic renal failure, and gastroesophageal reflux disease), concomitant drugs (aspirin, clopidogrel, cilostazol, non-steroidal anti-inflammatory drugs, steroid, anticoagulants, and SSRI), personal habits (smoking, and alcohol consumption) were considered as possible UGIB risk factors. We randomly imputed the prevalence of infection in the data considering the age-specific prevalence of Helicobacter pylori ( H. pylori ) infection in Korea. The prevalence of various UGIB risk factors and the age-group specific trend of the prevalence were identified. Prevalence was compared between osteoarthritis patients and others. A total of 801926 subjects (93855 osteoarthritis patients) aged 20 and above were included. The prevalence of individual and concurrent multiple risk factors became higher as the age increased. The prevalence of each comorbid condition and concomitant drug were higher in osteoarthritis patients. Thirty-five point zero two percent of the overall population and 68.50% of osteoarthritis patients had at least one or more risk factors of UGIB. The prevalence of individual and concurrent multiple risk factors in younger age groups were also substantial. Furthermore, when personal habits (smoking, and alcohol consumption) and H. pylori infection were included, the prevalence of concurrent multiple risk factors increased greatly even in younger age groups. Prevalence of UGIB risk factors was high in elderly population, but was also considerable in younger population. Patient with osteoarthritis was at higher UGIB risk than those without osteoarthritis. Physicians should consider individualized risk assessment regardless of age when prescribing drugs or performing procedures that may increase the risk of UGIB, and take necessary measures to reduce modifiable risk factors such as H. pylori eradication or lifestyle counseling.

Oncofertility for gynecologic and non-gynecologic cancers: fertility sparing in young women of reproductive age.

PubMed

Dursun, Polat; Doğan, N Utku; Ayhan, Ali

2014-12-01

About ten percent of all female cancer survivors is younger than 40 years of age. For these young women the primary goal is to ensure the highest possibility of cure and to maintain the reproductive functions as well. Oncofertility is a new concept including both oncology and reproductive medicine. By this recently defined concept young women will have maximal chance to make an optimal decision without any significant impact and delay in oncologic outcome. Oncofertility concept could be applied for genital cancer as well as non-genital cancer of reproductive age. Currently sperm and embryo banking are the standard methods used for young patients with cancer whose future fertility is under risk. In contrary oocyte banking, ovarian tissue cryopreservation are all controversial procedures and still accepted as experimental by many authors although American Society of Reproductive Medicine (ASRM) consideres oocyte cryopreservation "no longer experimental". For genital cancers procedures for oncofertility depends on the type of the cancer and the treatment of choice. In this review the current data and concepts regarding oncofertility concept including the gynecologic oncologic perspective is reviewed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Induction of labor in elderly nulliparous women.

PubMed

Hadar, Eran; Hiersch, Liran; Ashwal, Eran; Chen, Rony; Wiznitzer, Arnon; Gabbay-Benziv, Rinat

2017-09-01

Maternal age is an important consideration for antenatal care, labor and delivery. We aimed to evaluate the induction of labor (IoL) failure rates among elderly nulliparous women. We conducted a retrospective analysis of all nulliparous women at 34 + 0 to 41 + 6 weeks, undergoing cervical ripening by prostaglandin E2 (PGE2) vaginal insert. Study group included elderly (≥35 years) nulliparous and control group included non-elderly (<35 years) nulliparous women. Primary outcome was IoL failure rate and secondary outcome was cesarean delivery rate. Outcomes were compared between the groups by univariate analysis followed by regression analysis to adjust results to potential confounders. Of 537 women undergoing IoL, 69 (12.8%) were elderly. The univariate analysis demonstrated no difference in IoL failure rate (26.5% versus 34.8%, p = 0.502) between groups. However, elderly nulliparous women had higher rates of cesarean delivery (36.2% versus 21.4%, p = 0.009). This difference was no longer significant after adjustment for maternal body mass index, indication for delivery, birth weight and gestational age at delivery. Among nulliparous women, older maternal age is not associated with higher rates of IoL failure or cesarean deliveries.

Chronic daily headache in the elderly.

PubMed

Özge, Aynur

2013-12-01

Disabling headache disorders are ubiquitous in all age groups, including the elderly, yet they are under-recognized, underdiagnosed and undertreated worldwide. Surveys and clinic-based research reports on headache disorders in elderly populations are extremely limited in number. Chronic daily headache (CDH) is an important and growing subtype of primary headache disorders, associated with increased burden and disruption to quality of life. CDH can be divided into two forms, based on headache duration. Common forms of primary headache disorders of long duration (>4 hours) were comprehensively defined in the third edition of the International Classification of Headache Disorders (ICHD-3 beta). These include chronic migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua. Rarer short-duration (<4 hours) forms of CDH are chronic cluster headache, chronic paroxysmal hemicrania, SUNCT, and hypnic headache. Accurate diagnosis, management, and relief of the burden of CDH in the elderly population present numerous unique challenges as the "aging world" continues to grow. In order to implement appropriate coping strategies for the elderly, it is essential to establish the correct diagnosis at each step and to exercise caution in differentiating from secondary causes, while always taking into consideration the unique needs and limitations of the aged body.

The effects of age and education on executive functioning and oral naming performance in greek cypriot adults: the neurocognitive study for the aging.

PubMed

Constantinidou, Fofi; Christodoulou, Marianna; Prokopiou, Juliana

2012-01-01

Age, educational experiences, language and culture can affect linguistic-cognitive performance. This is the first systematic study investigating linguistic-cognitive aging in Greek Cypriot adults focusing on executive functioning (EF) and oral naming performance. Three hundred and fifty-nine participants were included, a group of young-old, aged 60-75 years (n = 231), and a group of old-old participants, aged 76 years and older (n = 128). Participants in each age group were divided into three education groups: 0-4 years (n = 50), 5-9 years (n = 198), and 10 years of education and higher (n = 111). Participants were administered 5 measures of EF along with measures of receptive vocabulary and confrontational naming. There was a significant relationship between the EF composite score and all language measures. MANOVA (α = 0.05) indicated significant age and education effects on most measures of EF and language. Performance on receptive vocabulary and cognitive shift remained stable across age groups, but was mediated by education. Education plays a significant role on all measures requiring semantic organization, speed of information processing, cognitive shift, mental flexibility, receptive vocabulary and confrontational naming. Furthermore, strategic thinking has a role in semantic knowledge, word retrieval and semantic access in healthy aging. We conclude with clinical implications and assessment considerations in aphasia. Copyright © 2012 S. Karger AG, Basel.

Creativity in the Later Years: Optimistic Prospects for Achievement.

ERIC Educational Resources Information Center

Simonton, Dean Keith

1990-01-01

Claims that, despite apparent decline in productivity in final years of life, seven considerations suggest a far more favorable outlook: role of extrinsic influences; contingency on career age; impact of individual differences in creative potential; interdisciplinary variation in age curves; absence of age decrement on…

First-Line Matched Related Donor Hematopoietic Stem Cell Transplantation Compared to Immunosuppressive Therapy in Acquired Severe Aplastic Anemia

PubMed Central

Peinemann, Frank; Grouven, Ulrich; Kröger, Nicolaus; Bartel, Carmen; Pittler, Max H.; Lange, Stefan

2011-01-01

Introduction Acquired severe aplastic anemia (SAA) is a rare and progressive disease characterized by an immune-mediated functional impairment of hematopoietic stem cells. Transplantation of these cells is a first-line treatment option if HLA-matched related donors are available. First-line immunosuppressive therapy may be offered as alternative. The aim was to compare the outcome of these patients in controlled trials. Methods A systematic search was performed in the bibliographic databases MEDLINE, EMBASE, and The Cochrane Library. To show an overview of various outcomes by treatment group we conducted a meta-analysis on overall survival. We evaluated whether studies reported statistically significant factors for improved survival. Results 26 non-randomized controlled trials (7,955 patients enrolled from 1970 to 2001) were identified. We did not identify any RCTs. Risk of bias was high except in 4 studies. Young age and recent year of treatment were identified as factors for improved survival in the HSCT group. Advanced age, SAA without very severe aplastic anemia, and combination of anti-lymphocyte globulin with cyclosporine A were factors for improved survival in the IST group. In 19 studies (4,855 patients), summary statistics were sufficient to be included in meta-analysis. Considerable heterogeneity did not justify a pooled estimate. Adverse events were inconsistently reported and varied significantly across studies. Conclusions Young age and recent year of treatment were identified as factors for improved survival in the transplant group. Advanced age, SAA without very severe aplastic anemia, and combination of anti-lymphocyte globulin with cyclosporine A were factors for improved survival in the immunosuppressive group. Considerable heterogeneity of non-randomized controlled studies did not justify a pooled estimate. Adverse events were inconsistently reported and varied significantly across studies. PMID:21541024

Comparison of pathogens and their antimicrobial resistance patterns in paediatric, adult and elderly patients in Canadian hospitals.

PubMed

Adam, Heather J; Baxter, Melanie R; Davidson, Ross J; Rubinstein, Ethan; Fanella, Sergio; Karlowsky, James A; Lagacé-Wiens, Philippe R S; Hoban, Daryl J; Zhanel, George G

2013-05-01

The purpose of this study was to describe the association between age groups and antimicrobial resistance in the most commonly identified pathogens in Canadian hospitals. Between 2007 and 2011, 27,123 clinically significant isolates, comprising 3580 isolates from children ≤ 18 years old, 12,119 isolates from adults 19-64 years old and 11,424 isolates from elderly patients aged ≥ 65 years old, were collected as part of the CANWARD surveillance study from tertiary-care centres across Canada. Antimicrobial susceptibility testing was performed according to CLSI guidelines. A multifactorial logistic regression model was used to determine the impact of demographic factors, including age groups, on antimicrobial resistance. Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae and Pseudomonas aeruginosa were in the top five organisms for all of the age groups. The proportions of S. aureus that were methicillin resistant, enterococci that were vancomycin resistant and E. coli that produced extended-spectrum β-lactamases were 11.2%, 0.7% and 1.0% for children, 22.8%, 4.6% and 4.3% for adults, and 28.0%, 3.8% and 4.9% for the elderly, respectively. Notable age-related differences in antimicrobial resistance patterns included the following: significantly less methicillin, clindamycin, clarithromycin and trimethoprim/sulfamethoxazole resistance in S. aureus from children; for E. coli, higher cefazolin and ciprofloxacin resistance in the elderly and less ceftriaxone, ciprofloxacin and gentamicin resistance in isolates from children; more S. pneumoniae isolates with penicillin MICs >1 mg/L in children; and for P. aeruginosa, higher resistance rates for meropenem, ciprofloxacin and levofloxacin in adults. The assessment of antimicrobial susceptibility patterns by age group revealed that resistance rates are often higher in the older age groups; however, considerable variability in age-specific resistance trends for different pathogen-antimicrobial combinations was noted.

Elderly postmenopausal patients with breast cancer are at increased risk for distant recurrence: a tamoxifen exemestane adjuvant multinational study analysis.

PubMed

van de Water, Willemien; Seynaeve, Caroline; Bastiaannet, Esther; Markopoulos, Christos; Jones, Steve E; Rea, Daniel; Hasenburg, Annette; Putter, Hein; Hille, Elysée T M; Paridaens, Robert; de Craen, Anton J M; Westendorp, Rudi G J; van de Velde, Cornelis J H; Liefers, Gerrit-Jan

2013-01-01

For postmenopausal patients with hormone-sensitive breast cancer, outcome is worse with increasing age at diagnosis. The aim of this study was to assess the incidence of breast cancer recurrence (locoregional and distant), and contralateral breast cancer by age at diagnosis. Patients enrolled in the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial were included. Primary endpoints were locoregional recurrence, distant recurrence, and contralateral breast cancer. Age at diagnosis was categorized as younger than 65 years, 65-74 years, and 75 years or older. Overall, 9,766 patients were included, of which 5,349 were younger than 65 years (reference group), 3,060 were 65-74 years, and 1,357 were 75 years or older. With increasing age, a decreased administration of radiotherapy after breast conserving surgery (94%, 92%, and 88%, respectively) and adjuvant chemotherapy (51%, 23%, and 5%, respectively) was observed. Risk of distant recurrence increased with age at diagnosis; multivariable hazard ratio for patients aged 65-74 years was 1.20 (95% confidence interval [CI]: 1.00-1.44), hazard ratio for patients aged 75 years or older was 1.39 (95% CI: 1.08-1.79). Risks of locoregional recurrence and contralateral breast cancer were not significantly different across age groups. Elderly patients with breast cancer were at increased risk for distant recurrence. Other studies have shown that the risk of distant recurrence is mainly affected by adjuvant systemic therapy. All TEAM patients received adjuvant endocrine treatment; however, chemotherapy was administered less often in elderly patients. These findings are suggestive for consideration of chemotherapy in relatively fit elderly breast cancer patients with hormone-sensitive disease.

Elderly Postmenopausal Patients With Breast Cancer Are at Increased Risk for Distant Recurrence: A Tamoxifen Exemestane Adjuvant Multinational Study Analysis

PubMed Central

van de Water, Willemien; Seynaeve, Caroline; Bastiaannet, Esther; Markopoulos, Christos; Jones, Steve E.; Rea, Daniel; Hasenburg, Annette; Putter, Hein; Hille, Elysée T.M.; Paridaens, Robert; de Craen, Anton J.M.; Westendorp, Rudi G.J.; Liefers, Gerrit-Jan

2013-01-01

Introduction. For postmenopausal patients with hormone-sensitive breast cancer, outcome is worse with increasing age at diagnosis. The aim of this study was to assess the incidence of breast cancer recurrence (locoregional and distant), and contralateral breast cancer by age at diagnosis. Methods. Patients enrolled in the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial were included. Primary endpoints were locoregional recurrence, distant recurrence, and contralateral breast cancer. Age at diagnosis was categorized as younger than 65 years, 65–74 years, and 75 years or older. Results. Overall, 9,766 patients were included, of which 5,349 were younger than 65 years (reference group), 3,060 were 65–74 years, and 1,357 were 75 years or older. With increasing age, a decreased administration of radiotherapy after breast conserving surgery (94%, 92%, and 88%, respectively) and adjuvant chemotherapy (51%, 23%, and 5%, respectively) was observed. Risk of distant recurrence increased with age at diagnosis; multivariable hazard ratio for patients aged 65–74 years was 1.20 (95% confidence interval [CI]: 1.00–1.44), hazard ratio for patients aged 75 years or older was 1.39 (95% CI: 1.08–1.79). Risks of locoregional recurrence and contralateral breast cancer were not significantly different across age groups. Conclusion. Elderly patients with breast cancer were at increased risk for distant recurrence. Other studies have shown that the risk of distant recurrence is mainly affected by adjuvant systemic therapy. All TEAM patients received adjuvant endocrine treatment; however, chemotherapy was administered less often in elderly patients. These findings are suggestive for consideration of chemotherapy in relatively fit elderly breast cancer patients with hormone-sensitive disease. PMID:23263290

An overview of age estimation in forensic anthropology: perspectives and practical considerations.

PubMed

Márquez-Grant, Nicholas

2015-01-01

Information on methods of age estimation in physical anthropology, in particular with regard to age-at-death from human skeletal remains, is widely available in the literature. However, the practicalities and real challenges faced in forensic casework are not always highlighted. To provide a practitioner's perspective, regarding age estimation in forensic anthropology (both in the living as well as the dead), with an emphasis on the types of cases, the value of such work and its challenges and limitations. The paper reviews the current literature on age estimation with a focus on forensic anthropology, but it also brings the author's personal perspective derived from a number of forensic cases. Although much is known about what methods to use, but not always how to apply them, little attention has been given in the literature to the real practicalities faced by forensic anthropologists, for example: the challenges in different types of scenarios; how to report age estimations; responsibilities; and ethical concerns. This paper gathers some of these aspects into one overview which includes the value of such work and the practical challenges, not necessarily with the methods themselves, but also with regard to how these are applied in the different cases where age estimation is required.

A new metric of inclusive fitness predicts the human mortality profile.

PubMed

Newman, Saul J; Easteal, Simon

2015-01-01

Biological species have evolved characteristic patterns of age-specific mortality across their life spans. If these mortality profiles are shaped by natural selection they should reflect underlying variation in the fitness effect of mortality with age. Direct fitness models, however, do not accurately predict the mortality profiles of many species. For several species, including humans, mortality rates vary considerably before and after reproductive ages, during life-stages when no variation in direct fitness is possible. Variation in mortality rates at these ages may reflect indirect effects of natural selection acting through kin. To test this possibility we developed a new two-variable measure of inclusive fitness, which we term the extended genomic output or EGO. Using EGO, we estimate the inclusive fitness effect of mortality at different ages in a small hunter-gatherer population with a typical human mortality profile. EGO in this population predicts 90% of the variation in age-specific mortality. This result represents the first empirical measurement of inclusive fitness of a trait in any species. It shows that the pattern of human survival can largely be explained by variation in the inclusive fitness cost of mortality at different ages. More generally, our approach can be used to estimate the inclusive fitness of any trait or genotype from population data on birth dates and relatedness.

How applicable is even-aged silviculture in the northeast?

Treesearch

Ralph H. Griffin

1977-01-01

The applicability of even-aged silviculture in the management of forest stands in the Northeast is examined through consideration of the forest stand, stand development, intermediate cuttings, and regeneration methods. It is concluded that even-aged silviculture is quite applicable in the management of forest stands in the Northeast.

Reimagining the self at late-career transitions: how identity threat influences academic physicians' retirement considerations.

PubMed

Onyura, Betty; Bohnen, John; Wasylenki, Don; Jarvis, Anna; Giblon, Barney; Hyland, Robert; Silver, Ivan; Leslie, Karen

2015-06-01

There is scant empirical work exploring academic physicians' psychosocial adjustment during late-career transitions or on the factors that influence their retirement decisions. The authors examine these issues through the lens of sociopsychological identity theory, specifically examining how identity threat influences academic physicians' decisions about retirement. Participants were academic physicians at a Canadian medical school and were recruited via e-mail requests for clinical faculty interested in discussing late-career and retirement planning issues. Participants included 15 males and 6 females (N = 21; mean age = 63, standard deviation = 7.54), representing eight specialties (clinical and surgical). Data were collected in October and November 2012 via facilitated focus groups, which were digitally recorded, transcribed verbatim, and anonymized, then analyzed using thematic analysis. Four primary themes were identified: centrality of occupational identity, experiences of identity threat, experiences of aging in an indifferent system, and coping with late-career transitions. Identity threats were manifested in apprehensions about self-esteem after retirement, practice continuity, and clinical competence, as well as in a loss of meaning and belonging. These identity challenges influenced decisions on whether to retire. Organizational and system support was perceived as wanting. Coping strategies included reimagining and revaluing various aspects of the self through assimilating new activities and reprioritizing others. Identity-related struggles are a significant feature of academic physicians' considerations about late-career transitions. Understanding these challenges, their antecedents, and their consequences can prepare faculty, and their institutions, to better manage late-career transitions. Individual- and institution-level implications are discussed.

[Impact of out-of-home activities, neighborhood and urban-related identity on well-being in old age].

PubMed

Oswald, F; Konopik, N

2015-07-01

Aging in a neighborhood environment is considered to be important for well-being particularly in very old age. The project "This is my place" - On the importance of a place in the neighborhood for healthy aging (German acronym BEWOHNT) emphasises the role of out of home activities, neighborhood experiences and urban-related identity on well-being. The aim of this paper is to test the impact of person-environment exchange processes of "agency" (e.g., out-of-home activity) and "belonging" (e.g., urban related identity, social cohesion) on well-being (valuation of life) in addition to health effects Data are based on domestic diaries, mobility diaries and a survey including 595 community-dwelling elderly people from 3 urban districts of Frankfurt (Germany) stratified by age (70-79 years vs. 80-89 years) and household situation (e.g. living alone versus living with partner). The findings indicate substantial associations for "agency" and "belonging" indicators on well-being and differentiated effects for both age groups. Multigroup analyses show that particularly in very old age, out of home activities, social cohesion and urban-related identity considerably buffer the negative impacts of health on well-being. The findings underline the need for an age-differentiated understanding of person-environment interchange processes in later life and in particular the importance of the neighborhood in very old age in this respect.

Considerations for conducting qualitative research with pediatric patients for the purpose of PRO development.

PubMed

Patel, Zabin S; Jensen, Sally E; Lai, Jin-Shei

2016-09-01

To provide an overview of methodological considerations when conducting qualitative research with pediatric patients for the purpose of patient-reported outcome measure development A literature review of qualitative methods in pediatric measure development was completed. Eight clinicians providing care to pediatric patients were interviewed for their expert input. Thematic analysis of the literature and clinician interviews was used to identify themes for consideration. Findings from the literature and expert interviews emphasized the way in which cognitive, linguistic, and social developmental factors affect pediatric patients' understanding of their condition and ability to communicate about their experiences in an interview. There was consensus among the experts that traditional semi-structured interviews with children younger than eight lack characteristics necessary to yield meaningful information about condition and symptom report because they may fail to capture children's understanding and awareness of their condition and may limit their ability to express themselves comfortably. Our findings include recommended strategies to optimize data collected in qualitative interviews with pediatric patients, including modifications to the interview process to establish rapport, construction of interview questions to ensure they are developmentally appropriate, and the use of supplementary techniques to facilitate communication. When employing qualitative methods in pediatric measure development, interview guides, methods, and length require careful tailoring to ensure the child's perspectives are captured. This may be best achieved through research performed with narrow age bands that employs flexibility in methods to allow children a comfortable way in which to communicate about their experiences.

Ethical considerations in the prevention and management of genetic disorders with special emphasis on religious considerations.

PubMed

Albar, Mohammed A

2002-06-01

Genetic diseases include not only single gene disorders, but multifactorial, somatic cell genetic disorders, mitochondrial and even chromosomal. One in 4 adults will suffer from a multifactorial or a somatic cell genetic disease. The common diseases in the community have a hereditary component namely diabetes mellitus, hypertension, ischemic heart diseases and many types of cancer. Even monogenic diseases which affect a small number of the newborns (2%-3%), have a greater impact on childhood diseases up to age 15 years. Therefore, it is imperative to scrutinize the available methods of prevention and management of genetic disorders, their ethical implications, and since east Mediterranean region is mainly occupied by Arabs and muslims, religious considerations become of paramount importance. Islam differs from many other religions in providing a complete code of life, which encompasses the secular with spiritual, the mundane with the celestial and hence forms the basis of the ethical, moral and even juridical attitudes and laws towards any problem or situation. Islamic teachings carry a great deal of instructions for health promotion and disease prevention including hereditary and genetic disorders. This review discusses how the Islamic teachings play an important role in the prevention and management of genetic disorders and the type of ethical implications involved in such management namely premarital medical examination, the question of consanguinity, the genetic counseling, the question of preimplantation diagnosis, the question of abortion and the offering of alternative ways of reproduction.

Perceptions of Sex, Gender, and Puberty Suppression: A Qualitative Analysis of Transgender Youth.

PubMed

Vrouenraets, Lieke Josephina Jeanne Johanna; Fredriks, A Miranda; Hannema, Sabine E; Cohen-Kettenis, Peggy T; de Vries, Martine C

2016-10-01

International guidelines recommend the use of Gonadotropin-Releasing Hormone (GnRH) agonists in adolescents with gender dysphoria (GD) to suppress puberty. Little is known about the way gender dysphoric adolescents themselves think about this early medical intervention. The purpose of the present study was (1) to explicate the considerations of gender dysphoric adolescents in the Netherlands concerning the use of puberty suppression; (2) to explore whether the considerations of gender dysphoric adolescents differ from those of professionals working in treatment teams, and if so in what sense. This was a qualitative study designed to identify considerations of gender dysphoric adolescents regarding early treatment. All 13 adolescents, except for one, were treated with puberty suppression; five adolescents were trans girls and eight were trans boys. Their ages ranged between 13 and 18 years, with an average age of 16 years and 11 months, and a median age of 17 years and 4 months. Subsequently, the considerations of the adolescents were compared with views of clinicians treating youth with GD. From the interviews with the gender dysphoric adolescents, three themes emerged: (1) the difficulty of determining what is an appropriate lower age limit for starting puberty suppression. Most adolescents found it difficult to define an appropriate age limit and saw it as a dilemma; (2) the lack of data on the long-term effects of puberty suppression. Most adolescents stated that the lack of long-term data did not and would not stop them from wanting puberty suppression; (3) the role of the social context, for which there were two subthemes: (a) increased media-attention, on television, and on the Internet; (b) an imposed stereotype. Some adolescents were positive about the role of the social context, but others raised doubts about it. Compared to clinicians, adolescents were often more cautious in their treatment views. It is important to give voice to gender dysphoric adolescents when discussing the use of puberty suppression in GD. Otherwise, professionals might act based on assumptions about adolescents' opinions instead of their actual considerations. We encourage gathering more qualitative research data from gender dysphoric adolescents in other countries.

Dysphagia in the elderly: management and nutritional considerations

PubMed Central

Sura, Livia; Madhavan, Aarthi; Carnaby, Giselle; Crary, Michael A

2012-01-01

Dysphagia is a prevalent difficulty among aging adults. Though increasing age facilitates subtle physiologic changes in swallow function, age-related diseases are significant factors in the presence and severity of dysphagia. Among elderly diseases and health complications, stroke and dementia reflect high rates of dysphagia. In both conditions, dysphagia is associated with nutritional deficits and increased risk of pneumonia. Recent efforts have suggested that elderly community dwellers are also at risk for dysphagia and associated deficits in nutritional status and increased pneumonia risk. Swallowing rehabilitation is an effective approach to increase safe oral intake in these populations and recent research has demonstrated extended benefits related to improved nutritional status and reduced pneumonia rates. In this manuscript, we review data describing age related changes in swallowing and discuss the relationship of dysphagia in patients following stroke, those with dementia, and in community dwelling elderly. Subsequently, we review basic approaches to dysphagia intervention including both compensatory and rehabilitative approaches. We conclude with a discussion on the positive impact of swallowing rehabilitation on malnutrition and pneumonia in elderly who either present with dysphagia or are at risk for dysphagia. PMID:22956864

Recycling of aged refuse from a closed landfill.

PubMed

Zhao, Youcai; Song, Liyan; Huang, Renhua; Song, Lijie; Li, Xiong

2007-04-01

In this study, refuse excavated from a typical refuse landfill in Shanghai after 8-10 years of placement was characterized in terms of particle size, total nitrogen, total phosphorus, and biodegradable matter. The refuse contained a large and diverse population of micro-organisms with a high capacity for decomposing refractory organic matter present in some wastewaters, including leachate. It was found that the aged refuse was quite stable after about a decade of decomposition in the warm, humid climate of southern China. The fine fractions resembled and had the properties of black soil, a medium that is suitable for green construction, organic fertilizer, or as bioreactor media for biological treatment of organic wastewaters. Excavation of the aged refuse would make about 50% of the space available for fresh refuse. The plastics, glass, textiles, and cans can be readily mechanically separated and recycled after cleaning. It is estimated that at least 200 millions tonnes of such aged refuse are available in China alone, and at least 10 times that much is buried worldwide. Hence, the evaluation of mined landfill waste and consideration of its potential uses is of great significance.

Tg and Structural Recovery of Single Ultrathin Films

NASA Astrophysics Data System (ADS)

Simon, Sindee

The behavior of materials confined at the nanoscale has been of considerable interest over the past two decades. Here, the focus is on recent results for single polystyrene ultrathin films studied with ultrafast scanning chip calorimetry. The Tg depression of a 20 nm-thick high-molecular-weight polystyrene film is found to be a function of cooling rate, decreasing with increasing cooling rate; whereas, at high enough cooling rates (e.g., 1000 K/s), Tg is the same as the bulk within the error of the measurements. Structural recovery is also performed with chip calorimetry as a function of aging time and temperature, and the evolution of the fictive temperature is followed. The advantages of the Flash DSC include sufficient sensitivity to measure enthalpy recovery for a single 20 nm-thick film, as well as extension of the measurements to aging temperatures as high as 15 K above nominal Tg and to aging times as short as 0.01 s. The aging behavior and relaxation time-temperature map for single ultrathin films are compared to those for bulk material. Comparison to behavior in other geometries will also be discussed.

Occupational and leisure time physical activity and the risk of nonfatal acute myocardial infarction in Italy.

PubMed

Altieri, Andrea; Tavani, Alessandra; Gallus, Silvano; La Vecchia, Carlo

2004-08-01

Physical activity has long been related to a reduced risk of coronary heart disease (CHD), including acute myocardial infarction (AMI). However, the quantitative estimates of the possible protective role of physical activity appear to vary across studies and populations. A case-control study conducted in Italy between 1995 and 1999, including 507 incident cases below 79 years (378 men, 129 women) with a first episode of AMI, and 478 controls (297 men, 181 women) admitted to hospitals for acute conditions. Compared with the lowest level of occupational physical activity, the multivariate odds ratios (OR) of AMI for the highest level were 0.61 (95% confidence interval [CI], 0.38-0.97) at age 15 to 19 years, 0.57 (95% CI, 0.34-0.95) at age 30 to 39 years, and 0.51 (95% CI, 0.29-0.90) at age 50 to 59 years. The corresponding values for leisure time activity were 0.54 (95% CI, 0.38-0.77), 0.86 (95% CI, 0.57-1.30), and 1.00 (95% CI, 0.57-1.74), respectively. The association was consistent across strata of age, sex, education, smoking, and other selected covariates. The attributable risk for low occupational exercise at age 30 to 39 years was over 10%, indicating the scope for further intervention on this modifiable risk factor in this Italian population, particularly in consideration of the public health importance of CHD.

42 CFR 405.357 - Notice of right to waiver consideration.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Notice of right to waiver consideration. 405.357 Section 405.357 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

42 CFR 405.357 - Notice of right to waiver consideration.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Notice of right to waiver consideration. 405.357 Section 405.357 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

The aging musculoskeletal system and obesity-related considerations with exercise.

PubMed

Vincent, Heather K; Raiser, Sara N; Vincent, Kevin R

2012-07-01

Advancing age and adiposity contribute to musculoskeletal degenerative diseases and the development of sarcopenic obesity. The etiology of muscle loss is multifactorial, and includes inflammation, oxidative stress and hormonal changes, and is worsened by activity avoidance due to fear of pain. The risk for mobility disability and functional impairment rises with severity of obesity in the older adult. Performance measures of walking distance, walking speed, chair rise, stair climb, body transfers and ability to navigate obstacles on a course are adversely affected in this population, and this reflects decline in daily physical functioning. Exercise training is an ideal intervention to counteract the effects of aging and obesity. The 18 randomized controlled trials of exercise studies with or without diet components reviewed here indicate that 3-18 month programs that included aerobic and strengthening exercise (2-3 days per week) with caloric restriction (typically 750 kcal deficit/day), induced the greatest change in functional performance measures compared with exercise or diet alone. Importantly, resistance exercise attenuates muscle mass loss with the interventions. These interventions can also combat factors that invoke sarcopenia, including inflammation, oxidative stress and insulin resistance. Therefore, regular multimodal exercise coupled with diet appears to be very effective for counteracting sarocpenic obesity and improving mobility and function in the older, obese adult. Copyright © 2012 Elsevier B.V. All rights reserved.

Clinical implications of aging with HIV infection: perspectives and the future medical care agenda.

PubMed

Guaraldi, Giovanni; Palella, Frank J

2017-06-01

: The increasing number of aging HIV-infected (HIV+) persons comprises a unique population at risk for illnesses and syndromes traditionally associated with the elderly. As a result, similar to the current need for primary care providers to manage chronic noninfectious comorbidities among aging persons with well controlled HIV infection, HIV clinical care will need to routinely involve geriatric medicine in a new HIV-geriatric discipline. The objective of this article is to provide a conceptual framework in which HIV and geriatric management considerations for healthcare professionals caring for HIV+ persons are integrated. The provision of contemporary HIV clinical care extends well beyond the achievement of HIV virologic suppression and antiretroviral therapy management and includes a need for careful characterization of geriatric syndromes based upon functional capacity and extent of disability. Screening for geriatric syndromes is both a multidisciplinary and multidimensional process, designed to evaluate an older person's functional ability, physical health, cognition, overall mental health, and socio-environmental circumstances. Although routine incorporation of geriatric assessment into clinical trials involving HIV+ persons is feasible, a current challenge is the availability of a consensus clinical definition of frailty or vulnerability. To maximize the efficiency, value, and convenience of outpatient care visits for older HIV+ persons, these visits should include encounters with multiple providers, including primary care clinicians, social workers, and geriatricians. Challenges may exist in the routine provision of these assessments to older HIV+ persons, but clearly such cross-disciplinary collaboration will not only markedly enhance the care of aging HIV+ persons but may also constitute a model of successful healthcare management that can be applied to all aging persons with changing healthcare needs.

Frequency of debridements and time to heal: a retrospective cohort study of 312 744 wounds.

PubMed

Wilcox, James R; Carter, Marissa J; Covington, Scott

2013-09-01

Chronic wounds usually get trapped in the inflammatory stage of wound healing; however, aggressive debridement transforms chronic wounds to acute wounds and therefore complete healing. To investigate healing outcomes and debridement frequency in a large wound data set. Retrospective cohort study. Data collected from 525 wound care centers from June 1, 2008, through June 31, 2012, using a web-based clinical management system. Referred sample of 154 644 patients with 312 744 wounds of all causes (of an initial data set of 364 534 wounds) participated. A total of 47.1% were male. Median age was 69 years (age range, 19-112 years), with 59.2% having one wound. Eligibility criteria included age older than 18 years, receiving at least 1 debridement, and having been discharged from the system. Advanced therapeutic treatment was ineligible. Because of incomplete, questionable, or ineligible data, 57 190 wounds were not included. Most wounds were diabetic foot ulcers (19.0%), venous leg ulcers (26.1%), and pressure ulcers (16.2%). Debridement (removal of necrotic tissue and foreign bodies from the wound) at different frequencies. Wound healing (completely epithelialized with dimensions at 0 × 0 × 0 cm). A total of 70.8% of wounds healed. The median number of debridements was 2 (range, 1-138). Frequent debridement healed more wounds in a shorter time (P <  .001). In regression analysis, significant variables included male sex, physician category, wound type, increased patient age, and increased wound age, area, and depth. The odds ratio varied considerably for each variable. The more frequent the debridements, the better the healing outcome. Although limited by retrospective data, this study's strength was the analysis of the largest wound data set to date.

The prevalence of osteoarthritis of the sternoclavicular joint on computed tomography.

PubMed

Lawrence, Christopher R; East, Benjamin; Rashid, Abbas; Tytherleigh-Strong, Graham M

2017-01-01

Symptomatic disorders around the sternoclavicular joint (SCJ) are relatively uncommon. Previous cadaveric and radiographic studies have suggested that asymptomatic osteoarthritic changes are relatively common, progressively increasing with age. The purpose of this study was to determine the prevalence of SCJ osteoarthritis in the general population using computed tomography (CT) scans. We assessed 464 SCJs in 232 patients undergoing a standardized axial CT scan of the thorax including both SCJs, across a range of ages from the second to tenth decade. The scans were undertaken for multiple clinical indications; however, none were obtained to investigate SCJ pathology. The predominant changes investigated were for the features associated with osteoarthritis including the presence of osteophytes, subchondral cysts, and subcortical sclerosis. The CT scans of 244 SCJs (53%) in 137 patients (59%) showed at least 1 sign of osteoarthritis. No patients younger than 35 years had any features of osteoarthritis. Osteoarthritic changes were present in 89.6% of patients older than 50 years compared with 9.1% younger than this age. All patients above the age of 61 had at least 1 feature of osteoarthritic changes on at least 1 side of the SCJ. Increasing prevalence was noted with increasing age both in the percentage of SCJs showing any positive signs of osteoarthritis and in the severity of osteoarthritis. SCJ osteoarthritis is a very common incidental finding on CT scans, particularly with increasing age. This should be taken into consideration when using a CT scan to assess a patient with symptomatic SCJ pathology. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Pulmonary function test in healthy school children of 8 to 14 years age in south Gujarat region, India

PubMed Central

Doctor, Tahera H.; Trivedi, Sangeeta S.; Chudasama, Rajesh K.

2010-01-01

Objective: To obtain reference values for FEV1, FVC, FEV1% and PEFR among children aged 8-14 years in south Gujarat region of India. Materials and Methods: This cross-sectional study was conducted among 655 normal healthy school children (408 boys and 247 girls) of Surat city aged 8 to 14 years studying in V to VII standard during November 2007 to April 2008. Height, weight, body surface area were measured. All included children were tested in a sitting position with the head straight after taking written consent from parents. Spirometry was done using the spirometer “Spirolab II” MIR 010. Spirometer used in the study facilitates the total valuation of lung function including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory volume ratio in one second (FEV1%) and peak expiratory flow rate (PEFR). Results: FVC, FEV1 and PEFR were found to be statistically significant in the study groups. For FVC and FEV1, highest correlation was found with age in girls and height in boys. For FEV1%, significant negative correlation was found with age and height in both sexes, but positive correlation was found with surface area. Similarly, PEFR showed highest correlation with surface area in boys and girls. Conclusion: Variables such as FVC, FEV1 and PEFR show good positive correlation with height, age and body surface area in both sexes. There is a need to have regional values for the prediction of normal spirometric parameters in a country like India with considerable diversity. PMID:20931033

Impact of sunlight on the age of onset of bipolar disorder

PubMed Central

Bauer, Michael; Glenn, Tasha; Alda, Martin; Andreassen, Ole A; Ardau, Raffaella; Bellivier, Frank; Berk, Michael; Bjella, Thomas D; Bossini, Letizia; Zompo, Maria Del; Dodd, Seetal; Fagiolini, Andrea; Frye, Mark A; Gonzalez-Pinto, Ana; Henry, Chantal; Kapczinski, Flávio; Kliwicki, Sebastian; König, Barbara; Kunz, Mauricio; Lafer, Beny; Lopez-Jaramillo, Carlos; Manchia, Mirko; Marsh, Wendy; Martinez-Cengotitabengoa, Mónica; Melle, Ingrid; Morken, Gunnar; Munoz, Rodrigo; Nery, Fabiano G; O’Donovan, Claire; Pfennig, Andrea; Quiroz, Danilo; Rasgon, Natalie; Reif, Andreas; Rybakowski, Janusz; Sagduyu, Kemal; Simhandl, Christian; Torrent, Carla; Vieta, Eduard; Zetin, Mark; Whybrow, Peter C

2012-01-01

Objective Although bipolar disorder has high heritability, the onset occurs during several decades of life, suggesting that social and environmental factors may have considerable influence on disease onset. This study examined the association between the age of onset and sunlight at the location of onset. Method Data were obtained from 2414 patients with a diagnosis of bipolar I disorder, according to DSM-IV criteria. Data were collected at 24 sites in 13 countries spanning latitudes 6.3 to 63.4 degrees from the equator, including data from both hemispheres. The age of onset and location of onset were obtained retrospectively, from patient records and/or direct interviews. Solar insolation data, or the amount of electromagnetic energy striking the surface of the earth, were obtained from the NASA Surface Meteorology and Solar Energy (SSE) database for each location of onset. Results The larger the maximum monthly increase in solar insolation at the location of onset, the younger the age of onset (coefficient= −4.724, 95% CI: −8.124 to −1.323, p = 0.006), controlling for each country’s median age. The maximum monthly increase in solar insolation occurred in springtime. No relationships were found between the age of onset and latitude, yearly total solar insolation, and the maximum monthly decrease in solar insolation. The largest maximum monthly increases in solar insolation occurred in diverse environments, including Norway, arid areas in California, and Chile. Conclusion The large maximum monthly increase in sunlight in springtime may have an important influence on the onset of bipolar disorder. PMID:22612720

Emotion word comprehension from 4 to 16 years old: a developmental survey.

PubMed

Baron-Cohen, Simon; Golan, Ofer; Wheelwright, Sally; Granader, Yael; Hill, Jacqueline

2010-01-01

Whilst previous studies have examined comprehension of the emotional lexicon at different ages in typically developing children, no survey has been conducted looking at this across different ages from childhood to adolescence. To report how the emotion lexicon grows with age. Comprehension of 336 emotion words was tested in n = 377 children and adolescents, aged 4-16 years old, divided into 6 age-bands. Parents or teachers of children under 12, or adolescents themselves, were asked to indicate which words they knew the meaning of. Between 4 and 11 years old, the size of the emotional lexicon doubled every 2 years, but between 12 and 16 years old, developmental rate of growth of the emotional lexicon leveled off. This survey also allows emotion words to be ordered in terms of difficulty. Studies using emotion terms in English need to be developmentally sensitive, since during childhood there is considerable change. The absence of change after adolescence may be an artifact of the words included in this study. This normative developmental data-set for emotion vocabulary comprehension may be useful when testing for delays in this ability, as might arise for environmental or neurodevelopmental reasons.

Abortion index and mortality of offspring among women of different age, caste and population groups of north Indian Muslims.

PubMed

Ara, Gulshan; Siddique, Yasir Hasan; Beg, Tanveer; Afzal, Mohammad

2008-05-01

The Muslims of Aligarh city are predominantly Sunnis, although there are also a considerable number of Shias. Among the Sunnis, approximately a quarter belong to Syed, Sheikh, Moghal and Pathan groups, and three-quarters belong to various lower biradaris. In the present study, 304 women attending the Primary Health Centre of the J. N. Medical College and Hospital, Aligarh Muslim University, Uttar Pradesh, were surveyed and the following recorded among Muslim women of high-rank (Ashraf) and low-rank (Ajlaf) castes: incidence of marriage, age of the mother at the time of marriage, present age of the mother, abortions, still births, pre-reproductive mortality and overall mortality. The Ashraf are comprised of the Sheikh, Syed and Pathan, whereas the Ajlafs have Qureshi, Saifi and Ansari biradaris. Maternal age was scored as above and below 45 years in each biradari. Significant effects of maternal age were seen on mortality of offspring, whereas populations did not show consistent differences, except when Ashrafs and Ajlafs were considered separately. The results show higher mortality and abortions for various groups. This may be due to various biological and socio-cultural factors, including hidden inbreeding in the remote past.

Nutrient intake, nutritional status, and cognitive function with aging.

PubMed

Tucker, Katherine L

2016-03-01

With the demographic aging of populations worldwide, diseases associated with aging are becoming more prevalent and costly to individuals, families, and healthcare systems. Among aging-related impairments, a decline in cognitive function is of particular concern, as it erodes memory and processing abilities and eventually leads to the need for institutionalized care. Accumulating evidence suggests that nutritional status is a key factor in the loss of cognitive abilities with aging. This is of tremendous importance, as dietary intake is a modifiable risk factor that can be improved to help reduce the burden of cognitive impairment. With respect to nutrients, there is evidence to support the critical role of several B vitamins in particular, but also of vitamin D, antioxidant vitamins (including vitamin E), and omega-3 fatty acids, which are preferentially taken up by brain tissue. On the other hand, high intakes of nutrients that contribute to hypertension, atherosclerosis, and poor glycemic control may have negative effects on cognition through these conditions. Collectively, the evidence suggests that considerable slowing and reduction of cognitive decline may be achieved by following a healthy dietary pattern, which limits intake of added sugars, while maximizing intakes of fish, fruits, vegetables, nuts, and seeds. © 2016 New York Academy of Sciences.

Differential association of socio-economic status with gender- and age-defined suicidal ideation among adult and elderly individuals in South Korea.

PubMed

Lee, Hoo-Yeon; Hahm, Myung-Il; Park, Eun-Cheol

2013-11-30

South Korea has the highest suicide rate among countries in the Organisation for Economic Co-operation and Development (OECD), with a rising trend that contrasts with the trend in most other OECD countries. This study assessed differential associations of socio-demographic factors with suicidal ideation in South Korea. We used five waves of data from the 2010 Korea National Health and Nutrition Examination Survey. Study subjects included 5803 men and women aged >25 years. We analysed weighted percentages with consideration of the complex survey sample design and unequal weights. Surveylogistic regressions were applied. Protective effects against suicidal ideation were found for higher household income, higher educational attainment, and being married. Functional limitations and depressive symptoms were risk factors for suicidal ideation. However, these significant factors may exert different effects on vulnerability for suicidal ideation among different genders and age groups. Thus, household income was mainly protective for women and subjects aged 25-44 years, and educational attainment was protective for individuals aged >65 years. Our findings suggest the need for extended social protection policies for the less privileged population and special strategies for different groups. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Effects of Age, Sex, and Body Position on Orofacial Muscle Tone in Healthy Adults.

PubMed

Dietsch, Angela M; Clark, Heather M; Steiner, Jessica N; Solomon, Nancy Pearl

2015-08-01

Quantification of tissue stiffness may facilitate identification of abnormalities in orofacial muscle tone and thus contribute to differential diagnosis of dysarthria. Tissue stiffness is affected by muscle tone as well as age-related changes in muscle and connective tissue. The Myoton-3 measured tissue stiffness in 40 healthy adults, including equal numbers of men and women in each of two age groups: 18-40 years and 60+ years. Data were collected from relaxed muscles at the masseter, cheek, and lateral tongue surfaces in two positions: reclined on the side and seated with head tilted. Tissue stiffness differed across age, sex, and measurement site with multiple interaction effects. Overall, older subjects exhibited higher stiffness coefficients and oscillation frequency measures than younger subjects whereas sex differences varied by tissue site. Effects of body position were inconsistent across tissue site and measurement. Although older subjects were expected to have lower muscle tone, age-related nonmuscular tissue changes may have contributed to yield a net effect of higher stiffness. These data raise several considerations for the development of accurate normative data and for future diagnostic applications of tissue stiffness assessment.

Do gender and age moderate the symptom structure of PTSD? Findings from a national clinical sample of children and adolescents.

PubMed

Contractor, Ateka A; Layne, Christopher M; Steinberg, Alan M; Ostrowski, Sarah A; Ford, Julian D; Elhai, Jon D

2013-12-30

A substantial body of evidence documents that the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms are linked to such demographic variables as female sex (e.g., Kaplow et al., 2005) and age (e.g., Meiser-Stedman et al., 2008). Considerably less is known about relations between biological sex and age with PTSD's latent factor structure. This study systematically examined the roles that sex and age may play as candidate moderators of the full range of factor structure parameters of an empirically supported five-factor PTSD model (Elhai et al., 2011). The sample included 6591 trauma-exposed children and adolescents selected from the National Child Traumatic Stress Network's Core Data Set. Confirmatory factor analysis using invariance testing (Gregorich, 2006) and comparative fit index difference values (Cheung and Rensvold, 2002) reflected a mixed pattern of test item intercepts across age groups. The adolescent subsample produced lower residual error variances, reflecting less measurement error than the child subsample. Sex did not show a robust moderating effect. We conclude by discussing implications for clinical assessment, theory building, and future research. © 2013 Elsevier Ireland Ltd. All rights reserved.

Elderly Learners and Massive Open Online Courses: A Review

PubMed Central

Williams, Shirley Ann

2016-01-01

Background Massive open online courses (MOOCs) have become commonplace in the e-learning landscape. Thousands of elderly learners are participating in courses offered by various institutions on a multitude of platforms in many different languages. However, there is very little research into understanding elderly learners in MOOCs. Objective We aim to show that a considerable proportion of elderly learners are participating in MOOCs and that there is a lack of research in this area. We hope this assertion of the wide gap in research on elderly learners in MOOCs will pave the way for more research in this area. Methods Pre-course survey data for 10 University of Reading courses on the FutureLearn platform were analyzed to show the level of participation of elderly learners in MOOCs. Two MOOC aggregator sites (Class Central and MOOC List) were consulted to gather data on MOOC offerings that include topics relating to aging. In parallel, a selected set of MOOC platform catalogues, along with a recently published review on health and medicine-related MOOCs, were searched to find courses relating to aging. A systematic literature search was then employed to identify research articles on elderly learners in MOOCs. Results The 10 courses reviewed had a considerable proportion of elderly learners participating in them. For the over-66 age group, this varied from 0.5% (on the course “Managing people”) to 16.3% (on the course “Our changing climate”), while for the over-56 age group it ranged from 3.0% (on “A beginners guide to writing in English”) to 39.5% (on “Heart health”). Only six MOOCs were found to include topics related to aging: three were on the Coursera platform, two on the FutureLearn platform, and one on the Open2Study platform. Just three scholarly articles relating to MOOCs and elderly learners were retrieved from the literature search. Conclusions This review presents evidence to suggest that elderly learners are already participating in MOOCs. Despite this, there has been very little research into their engagement with MOOCs. Similarly, there has been little research into exploiting the scope of MOOCs for delivering topics that would be of interest to elderly learners. We believe there is potential to use MOOCs as a way of tackling the issue of loneliness among older adults by engaging them as either resource personnel or learners. PMID:26742809

Elderly Learners and Massive Open Online Courses: A Review.

PubMed

Liyanagunawardena, Tharindu Rekha; Williams, Shirley Ann

2016-01-07

Massive open online courses (MOOCs) have become commonplace in the e-learning landscape. Thousands of elderly learners are participating in courses offered by various institutions on a multitude of platforms in many different languages. However, there is very little research into understanding elderly learners in MOOCs. We aim to show that a considerable proportion of elderly learners are participating in MOOCs and that there is a lack of research in this area. We hope this assertion of the wide gap in research on elderly learners in MOOCs will pave the way for more research in this area. Pre-course survey data for 10 University of Reading courses on the FutureLearn platform were analyzed to show the level of participation of elderly learners in MOOCs. Two MOOC aggregator sites (Class Central and MOOC List) were consulted to gather data on MOOC offerings that include topics relating to aging. In parallel, a selected set of MOOC platform catalogues, along with a recently published review on health and medicine-related MOOCs, were searched to find courses relating to aging. A systematic literature search was then employed to identify research articles on elderly learners in MOOCs. The 10 courses reviewed had a considerable proportion of elderly learners participating in them. For the over-66 age group, this varied from 0.5% (on the course "Managing people") to 16.3% (on the course "Our changing climate"), while for the over-56 age group it ranged from 3.0% (on "A beginners guide to writing in English") to 39.5% (on "Heart health"). Only six MOOCs were found to include topics related to aging: three were on the Coursera platform, two on the FutureLearn platform, and one on the Open2Study platform. Just three scholarly articles relating to MOOCs and elderly learners were retrieved from the literature search. This review presents evidence to suggest that elderly learners are already participating in MOOCs. Despite this, there has been very little research into their engagement with MOOCs. Similarly, there has been little research into exploiting the scope of MOOCs for delivering topics that would be of interest to elderly learners. We believe there is potential to use MOOCs as a way of tackling the issue of loneliness among older adults by engaging them as either resource personnel or learners.

The 2015 US Food and Drug Administration Pregnancy and Lactation Labeling Rule.

PubMed

Brucker, Mary C; King, Tekoa L

2017-05-01

As of 2015, the US Food and Drug Administration (FDA) discontinued the pregnancy risk categories (ABCDX) that had been used to denote the putative safety of drugs for use among pregnant women. The ABCDX system has been replaced by the FDA Pregnancy and Lactation Labeling Rule (PLLR) that requires narrative text to describe risk information, clinical considerations, and background data for the drug. The new rule includes 3 overarching categories: 1) pregnancy, which includes labor and birth; 2) lactation; and 3) females and males of reproductive potential. This article reviews the key components of the PLLR and clinical implications, and provides resources for clinicians who prescribe drugs for women of reproductive age. © 2017 by the American College of Nurse-Midwives.

Perspectives on mealtime management in residential aged care: insights from a cross-disciplinary investigation.

PubMed

Bennett, Michelle K; Ward, Elizabeth; Scarinci, Nerina; Waite, Monique

2014-01-01

Meeting the medical, nutritional, and psychosocial mealtime needs of aged care residents requires a holistic, multidisciplinary approach. To date the perspectives of this multidisciplinary team have not been adequately explored. The aim of this study was to explore the perspectives of a range of service providers involved in mealtime management in residential aged care. In-depth semistructured interviews were conducted with 61 participants from five service disciplines. Four themes emerged: ( 1 ) mealtimes are highly valued; ( 2 ) service providers face common barriers to mealtime management; ( 3 ) communication among service providers is challenging; and ( 4 ) education in mealtime management is limited. Data indicated service providers acknowledge the importance of mealtimes but recognize numerous shortfalls in current care. The need for interdisciplinary training and increased communication and collaboration among providers was emphasized, including the need for clarification of provider roles. Limited consideration of mealtimes in policy and funding documents was identified as a primary barrier in further prioritizing mealtime management and advancing mealtime care.

Ageing management program for the Spanish low and intermediate level waste disposal and spent fuel and high-level waste centralised storage facilities

NASA Astrophysics Data System (ADS)

Zuloaga, P.; Ordoñez, M.; Andrade, C.; Castellote, M.

2011-04-01

The generic design of the centralised spent fuel storage facility was approved by the Spanish Safety Authority in 2006. The planned operational life is 60 years, while the design service life is 100 years. Durability studies and surveillance of the behaviour have been considered from the initial design steps, taking into account the accessibility limitations and temperatures involved. The paper presents an overview of the ageing management program set in support of the Performance Assessment and Safety Review of El Cabril low and intermediate level waste (LILW) disposal facility. Based on the experience gained for LILW, ENRESA has developed a preliminary definition of the Ageing Management Plan for the Centralised Interim Storage Facility of spent Fuel and High Level Waste (HLW), which addresses the behaviour of spent fuel, its retrievability, the confinement system and the reinforced concrete structure. It includes tests plans and surveillance design considerations, based on the El Cabril LILW disposal facility.

Temperament and Early Stuttering Development: Cross-Sectional Findings From a Community Cohort.

PubMed

Kefalianos, Elaina; Onslow, Mark; Ukoumunne, Obioha C; Block, Susan; Reilly, Sheena

2017-04-14

The purpose of this study was to ascertain if there is an association between stuttering severity and behaviors and the expression of temperament characteristics, including precursors of anxiety. We studied temperament characteristics of a prospectively recruited community cohort of children who stutter (N = 173) at ages 3, 4, and 6 years using the Short Temperament Scale STS (Prior, Sanson, Smart & Oberklaid, 2000). Six of 131 statistical tests of association between stuttering severity and behaviors and temperament traits were statistically significant at the 5% level, which was no more than expected by chance alone. On the basis of parent responses to the STS, preschoolers who exhibited different levels of stuttering severity and behaviors did not generally express temperament traits differently from one another. Stuttering severity and stuttering behaviors were not associated with the precursors of anxiety. Overall, taking multiple tests into consideration, results show little evidence of association between stuttering severity and temperament up to 4 years of age or between stuttering behaviors and temperament up to 6 years of age.

Prolonged CT urography in duplex kidney.

PubMed

Gong, Honghan; Gao, Lei; Dai, Xi-Jian; Zhou, Fuqing; Zhang, Ning; Zeng, Xianjun; Jiang, Jian; He, Laichang

2016-05-13

Duplex kidney is a common anomaly that is frequently associated with multiple complications. Typical computed tomography urography (CTU) includes four phases (unenhanced, arterial, parenchymal and excretory) and has been suggested to considerably aid in the duplex kidney diagnosi. Unfortunately, regarding duplex kidney with prolonged dilatation, the affected parenchyma and tortuous ureters demonstrate a lack of or delayed excretory opacification. We used prolonged-delay CTU, which consists of another prolonged-delay phase (1- to 72-h delay; mean delay: 24 h) to opacify the duplicated ureters and affected parenchyma. Seventeen patients (9 males and 8 females; age range: 2.5-56 y; mean age: 40.4 y) with duplex kidney were included in this study. Unenhanced scans did not find typical characteristics of duplex kidney, except for irregular perirenal morphology. Duplex kidney could not be confirmed on typical four-phase CTU, whereas it could be easily diagnosed in axial and CT-3D reconstruction using prolonged CTU (prolonged-delay phase). Between January 2005 and October 2010, in this review board-approved study (with waived informed consent), 17 patients (9 males and 8 females; age range: 2.5 ~ 56 y; mean age: 40.4 y) with suspicious duplex kidney underwent prolonged CTU to opacify the duplicated ureters and confirm the diagnosis. Our results suggest the validity of prolonged CTU to aid in the evaluation of the function of the affected parenchyma and in the demonstration of urinary tract malformations.

Older people's adoption of e-learning services: a qualitative study of facilitators and barriers.

PubMed

Bai, Xue; He, Yiqin; Kohlbacher, Florian

2018-05-14

This research investigates the facilitators and barriers for older people to adopt e-learning services using qualitative data of older people in a Chinese city. A qualitative approach was applied to explore the perceived facilitators and obstacles toward e-learning adoption with 10 older Chinese aged over 50. The results indicate the following: (1a) Age-related changes and cohort effects were found to be the internal barriers for the adoption of e-learning. (1b) Equipment problems, lack of time, and the availability of alternatives were found to have negative effects on the acceptance of e-learning services. It is notable that alternatives including the University of the Third Age (U3A) were found to be more attractive for older Chinese. (2a) Work requirements and flexibility of e-learning services were found to have direct effects on the acceptance of services. (2b) User-friendly design and stimulation from family would facilitate older people to adopt. Practical implications of this research include that policymakers should consider investing more in education in later life and introducing e-learning services in public lectures and tutorials and that the age-related barrier should be taken into consideration in the design phase of e-learning services. U3As should consider integrating e-learning approaches and cooperating with the community.

Treatment considerations in hutchinson-gilford progeria syndrome: a case report.

PubMed

Hazan-Molina, H; Aizenbud, D; Dror, Aizenbud D

2015-01-01

Hutchinson-Guilford progeria syndrome is an extremely rare condition classified as one of the premature ageing syndromes. This case presents a 16-year-old Israeli female patient, suffering from a variant of Hutchinson-Guilford progeria with a history of treatment with oral biphosphnates. The patient presented with typical cranial and facial features of the syndrome including delayed teeth eruption and root development probably due to insufficient jaw growth and severs retrognatic position of the maxilla and mandible. Orthodontic treatment considerations are described along with those required in light of the previous treatment by oral biphosphonates.All primary teeth were extracted in three appointments while creating as minimal trauma as possible to the surrounding tissue and alveolar bone. For now, the patient refuses to begin the orthodontic treatment course. There are no limitations to conduct any dental procedures in progeria patients, however, extreme caution must be exercised during oral surgery due to the inelasticity of tissues and dermal atrophy. Orthodontic procedure commencement should be early enough to manage the delayed development and eruption of teeth. Patients taking oral biphosphonates should be advised of this potential complication. If orthodontic treatment is considered appropriate, plans should be assessed and modified to include compromises.

Family-Based Treatment for Adolescents with Anorexia Nervosa: A Dissemination Study

PubMed Central

Couturier, Jennifer; Isserlin, Leanna; Lock, James

2010-01-01

Objective This open trial of Family-Based Treatment for Anorexia Nervosa was completed in order to assess the dissemination of this treatment, including effectiveness, fidelity, and acceptability. Method Fourteen adolescents with Anorexia Nervosa were recruited with mean age 14.0±1.5 years (range 12–17 years). Therapists were trained using a workshop, manual and weekly supervision. Sessions were videotaped and rated for treatment fidelity. Pre- and post-treatment assessments were compared. Results Weight was significantly increased by an average of 7.8 kg. Dietary restraint showed significant improvement, as did interoceptive deficits and maturity fears. Of the 9 participants who had secondary amenorrhea at baseline, 8 had regained menstrual function. Treatment fidelity was rated as at least considerable 72% of the time in phase I of the treatment. Adolescents and parents found the treatment to be acceptable. Discussion This preliminary investigation of the dissemination of Family-Based Treatment for adolescents with Anorexia Nervosa indicates that this treatment is effective not only for weight restoration, but also in improving some psychological symptoms including dietary restraint, interoceptive deficits, and maturity fears. In addition, this treatment was adopted with considerable fidelity and was acceptable to adolescents and parents. PMID:20419524

Romanticism and self-esteem among teen mothers.

PubMed

Medora, N P; von der Hellen, C

1997-01-01

This study examined teen mothers' romanticism and self-esteem. The Dean Romanticism Scale and the Bachman Self-esteem Scale were administered to 94 mothers between the ages of 13 and 18 in Southern California. The study also investigated the relationship between the dependent variables--romanticism and self-esteem--and ten independent variables--age, age of mother when first child was born, incidence of sexual abuse, incidence of abortion, current sexual activity, adoption considerations, current use of birth control, whether paternity was denied by the baby's father, whether the mother's parents were living together, and the quality of the relationship between the mother's parents. Results indicated that five variables were significantly related to romanticism--whether the teenager had a previous abortion, adoption considerations, current sexual activity, whether the parents were living together, and the quality of the relationship between the parents. Two variables were significantly related to self-esteem--age and current use of birth control.

Variables related to romanticism and self-esteem in pregnant teenagers.

PubMed

Medora, N P; Goldstein, A; von der Hellen, C

1993-01-01

In this study, the Dean Romanticism Scale and the Bachman Self-esteem Scale were administered to 121 teenagers between the ages of 12 and 19 in Southern California to investigate their degree of romanticism and self-esteem. The study also explored whether there was any relationship between the dependent variables of romanticism and self-esteem and ten independent variables--age, race, place of residence during pregnancy, age when first sexual intercourse occurred, age when pregnancy occurred, incidence of sexual abuse, incidence of abortion, adoption considerations, whether the subject was currently sexually active, and whether the teenager planned to have a child with the father of the baby. The results indicated that two variables were significantly related to feelings of romanticism--adoption considerations and whether the adolescent planned to have a child with the baby's father. In addition, two variables were significantly related to self-esteem--the incidence of sexual abuse and the incidence of abortion.

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

PubMed

Wang, Zhiqiang; Peng, Yang; Liu, Meina

2017-12-01

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

Subjective Age Bias: A Motivational and Information Processing Approach

ERIC Educational Resources Information Center

Teuscher, Ursina

2009-01-01

There is broad empirical evidence, but still a lack of theoretical explanations, for the phenomenon that most older people feel considerably younger than their real age. In this article, a measurement model of subjective age was assessed, and two independent theoretical approaches are proposed: (1) a motivational approach assuming that the age…

Regeneration results using two-aged management

Treesearch

Arlyn W. Perkey; Gary W. Miller; Thomas M. Schuler

1999-01-01

Two-aged management is receiving increasing consideration by central Appalachian hardwood managers as a tool to accomplish multiple landowner goals. On non-industrial private forests where aesthetics are often important, two-aged management has the attribute of retaining some relatively large trees on the area at all times. For many landowners this is critical....

Chemistry of 5,8-dihydroxy-[1,4]-naphtoquinone, a key chromophore in aged cellulosics

USDA-ARS?s Scientific Manuscript database

5,8-Dihydroxy-[1,4]-naphthoquinone (DHNQ) is one of the key chromophores found in aged cellulosics. Cellulose aging and yellowing as well as bleaching of cellulosic materials are key processes in the pulp and paper industries and have considerable economic importance: the knowledge of the general re...

Using the World Wide Web as a Teaching Tool: Analyzing Images of Aging and the Visual Needs of an Aging Society.

ERIC Educational Resources Information Center

Jakobi, Patricia

1999-01-01

Analysis of Web site images of aging to identify positive and negative representations can help teach students about social perceptions of older adults. Another learning experience involves consideration of the needs of older adults in Web site design. (SK)

Structure and regrowth of longleaf pine forests following uneven-aged silviculture and hurricane disturbance at the Escambia Experimental Forest

Treesearch

Kimberly Bohn; Christel Chancy; Dale Brockway

2015-01-01

In recent decades, considerable attention has been placed on restoring and managing longleaf pine (Pinus palustris Mill.) ecosystems across the southeastern United States. Although, historically, these forests have been successfully regenerated following even-aged shelterwood reproduction methods, uneven-aged silviculture has received increasing...

Incidence and outcome of acquired aplastic anemia: real-world data from patients diagnosed in Sweden from 2000–2011

PubMed Central

Vaht, Krista; Göransson, Magnus; Carlson, Kristina; Isaksson, Cecilia; Lenhoff, Stig; Sandstedt, Anna; Uggla, Bertil; Winiarski, Jacek; Ljungman, Per; Brune, Mats; Andersson, Per-Ola

2017-01-01

A plastic anemia is a rare life-threatening disease. However, since the introduction of immunosuppressive therapy and allogeneic stem cell transplantation, the outcome has improved considerably, and the 5-year survival is reported to be 70–80% in selected patient cohorts. Yet, contemporary population-based data on incidence and survival are lacking. We performed a national retrospective study to determine the incidence, treatment, and survival of patients with aplastic anemia diagnosed in Sweden from 2000–2011. Patients were included via the National Patient Registry, and diagnosed according to the Camitta criteria. In total, 257 confirmed cases were identified, with an overall incidence of 2.35 (95% CI: 2.06–2.64) cases per million inhabitants per year. Median age was 60 years (range: 2–92), and median follow up was 76 (0–193) months. Primary treatments included immunosuppressive therapy (63%), allogenic stem cell transplantation (10%), or single-agent cyclosporine/no specific therapy (27%). The 5-year survival was 90.7% in patients aged 0–18 years, 90.5% in patients aged 19–39 years, 70.7% in patients aged 40–59 years, and 38.1% in patients aged ≥60 years. Multivariate analysis showed that age (both 40–59 and ≥60 age groups), very severe aplastic anemia and single-agent cyclosporine/no specific therapy were independent risk factors for inferior survival. In conclusion, younger aplastic anemia patients experience a very good long-term survival, while that of patients ≥60 years in particular remains poor. Apparently, the challenge today is to improve the management of older aplastic anemia patients, and prospective studies to address this medical need are warranted. PMID:28751565

Incidence and outcome of acquired aplastic anemia: real-world data from patients diagnosed in Sweden from 2000-2011.

PubMed

Vaht, Krista; Göransson, Magnus; Carlson, Kristina; Isaksson, Cecilia; Lenhoff, Stig; Sandstedt, Anna; Uggla, Bertil; Winiarski, Jacek; Ljungman, Per; Brune, Mats; Andersson, Per-Ola

2017-10-01

A plastic anemia is a rare life-threatening disease. However, since the introduction of immunosuppressive therapy and allogeneic stem cell transplantation, the outcome has improved considerably, and the 5-year survival is reported to be 70-80% in selected patient cohorts. Yet, contemporary population-based data on incidence and survival are lacking. We performed a national retrospective study to determine the incidence, treatment, and survival of patients with aplastic anemia diagnosed in Sweden from 2000-2011. Patients were included via the National Patient Registry, and diagnosed according to the Camitta criteria. In total, 257 confirmed cases were identified, with an overall incidence of 2.35 (95% CI: 2.06-2.64) cases per million inhabitants per year. Median age was 60 years (range: 2-92), and median follow up was 76 (0-193) months. Primary treatments included immunosuppressive therapy (63%), allogenic stem cell transplantation (10%), or single-agent cyclosporine/no specific therapy (27%). The 5-year survival was 90.7% in patients aged 0-18 years, 90.5% in patients aged 19-39 years, 70.7% in patients aged 40-59 years, and 38.1% in patients aged ≥60 years. Multivariate analysis showed that age (both 40-59 and ≥60 age groups), very severe aplastic anemia and single-agent cyclosporine/no specific therapy were independent risk factors for inferior survival. In conclusion, younger aplastic anemia patients experience a very good long-term survival, while that of patients ≥60 years in particular remains poor. Apparently, the challenge today is to improve the management of older aplastic anemia patients, and prospective studies to address this medical need are warranted. Copyright© 2017 Ferrata Storti Foundation.

Under-utilisation of preventive medication in patients with cardiovascular disease is greatest in younger age groups (PREDICT-CVD 15).

PubMed

Mehta, Suneela; Wells, Sue; Riddell, Tania; Kerr, Andrew; Pylypchuk, Romana; Marshall, Roger; Ameratunga, Shanthi; Chan, Wing Cheuk; Thornley, Simon; Crengle, Sue; Harrison, Jeff; Drury, Paul; Elley, C Raina; Bell, Fionna; Jackson, Rod

2011-06-01

Blood pressure-lowering (BPL) and lipid-lowering (LL) medications together reduce estimated absolute five-year cardiovascular disease (CVD) risk by >40%. International studies indicate that the proportion of people with CVD receiving pharmacotherapy increases with advancing age. To compare BPL and LL medications, by sociodemographic characteristics, for patients with known CVD in primary care settings. The study population included patients aged 35-74 with known CVD assessed in primary care from July 2006 to October 2009 using a web-based computerised decision support system (PREDICT) for risk assessment and management. Clinical data linked anonymously to national sociodemographic and pharmaceutical dispensing databases. Differences in dispensing BPL and LL medications in six months before first PREDICT assessment was analysed according to age, sex, ethnicity and deprivation. Of 7622 people with CVD, 1625 <55 years old, 2862 were women and 4609 lived in deprived areas (NZDep quintiles 4/5). The study population included 4249 European, 1556 Maori, 1151 Pacific and 329 Indian peoples. BPL medications were dispensed to 81%, LL medications to 73%, both BPL and LL medications to 67%, and 87% received either class of medication. Compared with people aged 65-75, people aged 35-44 were 30-40% less likely and those aged 45-54 were 10-15% less likely to be dispensed BPL, LL medications or both. There were minimal differences in likelihood of dispensing according to sex, ethnicity or deprivation. BPL and LL medications are under-utilised in patients with known CVD in New Zealand. Only two-thirds of patients in this cohort are on both. Younger patients are considerably less likely to be on recommended medications.

Emerging nondestructive inspection methods for aging aircraft

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

Beattie, A; Dahlke, L; Gieske, J

This report identifies and describes emerging nondestructive inspection (NDI) methods that can potentially be used to inspect commercial transport and commuter aircraft for structural damage. The nine categories of emerging NDI techniques are: acoustic emission, x-ray computed tomography, backscatter radiation, reverse geometry x-ray, advanced electromagnetics, including magnetooptic imaging and advanced eddy current techniques, coherent optics, advanced ultrasonics, advanced visual, and infrared thermography. The physical principles, generalized performance characteristics, and typical applications associated with each method are described. In addition, aircraft inspection applications are discussed along with the associated technical considerations. Finally, the status of each technique is presented, with amore » discussion on when it may be available for use in actual aircraft maintenance programs. It should be noted that this is a companion document to DOT/FAA/CT-91/5, Current Nondestructive Inspection Methods for Aging Aircraft.« less

Language and theory of mind: meta-analysis of the relation between language ability and false-belief understanding.

PubMed

Milligan, Karen; Astington, Janet Wilde; Dack, Lisa Ain

2007-01-01

Numerous studies show that children's language ability is related to false-belief understanding. However, there is considerable variation in the size of the correlation reported. Using data from 104 studies (N=8,891), this meta-analysis determines the strength of the relation in children under age 7 and examines moderators that may account for the variability across studies--including aspect of language ability assessed, type of false-belief task used, and direction of effect. The results indicate a moderate to large effect size overall that remains significant when age is controlled. Receptive vocabulary measures had weaker relations than measures of general language. Stronger effects were found from earlier language to later false belief than the reverse. Significant differences were not found among types of false-belief task.

Eating disorders during pregnancy.

PubMed

Cardwell, Michael S

2013-04-01

Eating disorders during pregnancy, once thought to be rare, occur in a significant number of women. The incidences of the major eating disorders-anorexia nervosa and bulimia nervosa-are increasing because of cultural pressures on the drive for thinness. Because the age range for these major eating disorders overlaps with the age range for reproductive function, it is not unusual for a clinician to encounter a pregnant patient with a major eating disorder. Eating disorders attributable to the pregnant state include pregnancy sickness, pica, and ptyalism. The diagnostic criteria, etiology, nutritional behavioral influences, evolutionary psychological considerations where elucidated, and treatment of these disorders will be presented. Obstetricians and gynecologists, family physicians After completing this CME activity, physicians should be better able to review how the major eating disorders impact pregnancy, to diagnose eating disorders during pregnancy using the diagnostic criteria, and to treat eating disorders during pregnancy.

Effect of Americium-241 Content on Plutonium Radiation Source Terms

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

Rainisch, R.

1998-12-28

The management of excess plutonium by the US Department of Energy includes a number of storage and disposition alternatives. Savannah River Site (SRS) is supporting DOE with plutonium disposition efforts, including the immobilization of certain plutonium materials in a borosilicate glass matrix. Surplus plutonium inventories slated for vitrification include materials with elevated levels of Americium-241. The Am-241 content of plutonium materials generally reflects in-growth of the isotope due to decay of plutonium and is age-dependent. However, select plutonium inventories have Am-241 levels considerably above the age-based levels. Elevated levels of americium significantly impact radiation source terms of plutonium materials andmore » will make handling of the materials more difficult. Plutonium materials are normally handled in shielded glove boxes, and the work entails both extremity and whole body exposures. This paper reports results of an SRS analysis of plutonium materials source terms vs. the Americium-241 content of the materials. Data with respect to dependence and magnitude of source terms on/vs. Am-241 levels are presented and discussed. The investigation encompasses both vitrified and un-vitrified plutonium oxide (PuO2) batches.« less

Perceived mental stress in relation to oral health over time in middle-aged Swedish women.

PubMed

Wennström, A; Boman, U Wide; Ahlqwist, M; Björkelund, C; Hakeberg, M

2015-12-01

To study perceived mental stress in relation to oral health among Swedish middle-aged women over a 36-year period, including considerations concerning smoking and socioeconomic status (SES). This combined medical and dental study includes three cross-sectional (1968/9 N = 746, 1980/1 N = 432, 2004/5 N = 500) surveys of 38- and 50-year-old women included in the Prospective Population Study of Women in Gothenburg, Sweden. Panoramic radiography was used to register the number of teeth, filled teeth and decayed teeth and the level of periodontal bone loss. The information concerning perceived mental stress, smoking and education (chosen to represent SES) was questionnaire-based. Perceived mental stress increased over the 36-year period, but was not related to oral health. The time of examination year had a protective effect on oral health, with a larger number of remaining teeth, fewer decayed teeth and less periodontal bone loss in the later examination year, 2004/5, compared with 1968/9. Risk factors for poor oral health were smoking, greater age (50 vs. 38 years) and low educational level. Smokers had fewer filled teeth than non-smokers except in 2004/5, and there was a shift over time towards fewer filled teeth among highly educated women. A remarkable increase in perceived mental stress was seen among the women over time, but was not associated with oral health. Smoking, greater age and low educational were risk factors for poor oral health, whereas a later examination year was a protective factor.

Systematic review of proposed definitions of nocturnal polyuria and population-based evidence of their diagnostic accuracy.

PubMed

Olesen, Tine Kold; Denys, Marie-Astrid; Vande Walle, Johan; Everaert, Karel

2018-02-06

Background Evidence of diagnostic accuracy for proposed definitions of nocturnal polyuria is currently unclear. Purpose Systematic review to determine population-based evidence of the diagnostic accuracy of proposed definitions of nocturnal polyuria based on data from frequency-volume charts. Methods Seventeen pre-specified search terms identified 351 unique investigations published from 1990 to 2016 in BIOSIS, Embase, Embase Alerts, International Pharmaceutical Abstract, Medline, and Cochrane. Thirteen original communications were included in this review based on pre-specified exclusion criteria. Data were extracted from each paper regarding subject age, sex, ethnicity, health status, sample size, data collection methods, and diagnostic discrimination of proposed definitions including sensitivity, specificity, positive and negative predictive value. Results The sample size of study cohorts, participant age, sex, ethnicity, and health status varied considerably in 13 studies reporting on the diagnostic performance of seven different definitions of nocturnal polyuria using frequency-volume chart data from 4968 participants. Most study cohorts were small, mono-ethnic, including only Caucasian males aged 50 or higher with primary or secondary polyuria that were compared to a control group of healthy men without nocturia in prospective or retrospective settings. Proposed definitions had poor discriminatory accuracy in evaluations based on data from subjects independent from the original study cohorts with findings being similar regarding the most widely evaluated definition endorsed by ICS. Conclusions Diagnostic performance characteristics for proposed definitions of nocturnal polyuria show poor to modest discrimination and are not based on sufficient level of evidence from representative, multi-ethnic population-based data from both females and males of all adult ages.

Clinical study of symbrachydactyly of the foot.

PubMed

Uchida, T; Kojima, T; Hirakawa, M

1995-07-01

Seventeen patients with symbrachydactyly of the foot are described. Patient characteristics including sex, the side of the affected foot, age at first medical examination, and condition of the nails were recorded. Compared with the unaffected side, the lengths of the proximal phalangeal and metatarsal bones were significantly shorter. The abnormalities of the feet were classified into four types: typical axial, atypical axial, medial ray, and rudimentary. The anomaly progresses from hypoplasia of the central rays to a deformity of the great toe, but rarely involves the fifth toe. The fact that this differs from symbrachydactyly of the hand is of considerable interest.

Precision medicine in the age of big data: The present and future role of large-scale unbiased sequencing in drug discovery and development.

PubMed

Vicini, P; Fields, O; Lai, E; Litwack, E D; Martin, A-M; Morgan, T M; Pacanowski, M A; Papaluca, M; Perez, O D; Ringel, M S; Robson, M; Sakul, H; Vockley, J; Zaks, T; Dolsten, M; Søgaard, M

2016-02-01

High throughput molecular and functional profiling of patients is a key driver of precision medicine. DNA and RNA characterization has been enabled at unprecedented cost and scale through rapid, disruptive progress in sequencing technology, but challenges persist in data management and interpretation. We analyze the state-of-the-art of large-scale unbiased sequencing in drug discovery and development, including technology, application, ethical, regulatory, policy and commercial considerations, and discuss issues of LUS implementation in clinical and regulatory practice. © 2015 American Society for Clinical Pharmacology and Therapeutics.

On the confounds among retest gains and age-cohort differences in the estimation of within-person change in longitudinal studies: a simulation study.

PubMed

Hoffman, Lesa; Hofer, Scott M; Sliwinski, Martin J

2011-12-01

Although longitudinal designs are the only way in which age changes can be directly observed, a recurrent criticism involves to what extent retest effects may downwardly bias estimates of true age-related cognitive change. Considerable attention has been given to the problem of retest effects within mixed effects models that include separate parameters for longitudinal change over time (usually specified as a function of age) and for the impact of retest (specified as a function of number of exposures). Because time (i.e., intervals between assessment) and number of exposures are highly correlated (and are perfectly correlated in equal interval designs) in most longitudinal studies, the separation of effects of within-person change from effects of retest gains is only possible given certain assumptions (e.g., age convergence). To the extent that cross-sectional and longitudinal effects of age differ, obtained estimates of aging and retest may not be informative. The current simulation study investigated the recovery of within-person change (i.e., aging) and retest effects from repeated cognitive testing as a function of number of waves, age range at baseline, and size and direction of age-cohort differences on the intercept and age slope in age-based models of change. Significant bias and Type I error rates in the estimated effects of retest were observed when these convergence assumptions were not met. These simulation results suggest that retest effects may not be distinguishable from effects of aging-related change and age-cohort differences in typical long-term traditional longitudinal designs.

Coeducational Self-Defense

ERIC Educational Resources Information Center

McGrath, Alice; Tegner, Bruce

1977-01-01

Self-defense is a useful method for correcting stereotyped feelings of submissiveness and dominance for all age groups and both sexes, yet teachers must take into consideration the forms and strengths of these stereotypes at each age level in order to teach effectively. (MB)

Ageing and Skills: A Review and Analysis of Skill Gain and Skill Loss over the Lifespan and over Time. OECD Education Working Papers, No. 72

ERIC Educational Resources Information Center

Desjardins, Richard; Warnke, Arne Jonas

2012-01-01

The relationship between ageing and skills is becoming an important policy issue, not least in the context of population ageing. Data from the Programme for the International Assessment of Adult Competencies (PIAAC) will potentially add considerably to the understanding of the relationship between ageing and foundation skills. In particular, the…

Determinants of Awareness, Consideration, and Choice Set Size in University Choice.

ERIC Educational Resources Information Center

Dawes, Philip L.; Brown, Jennifer

2002-01-01

Developed and tested a model of students' university "brand" choice using five individual-level variables (ethnic group, age, gender, number of parents going to university, and academic ability) and one situational variable (duration of search) to explain variation in the sizes of awareness, consideration, and choice decision sets. (EV)

20 CFR 404.502a - Notice of right to waiver consideration.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Notice of right to waiver consideration. 404.502a Section 404.502a Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... and the individual is receiving another type of payment from SSA (language about cross-program...

Considerations Influencing Hispanic-American Mothers' Intergenerational Language Practices with Their Children with Autism

ERIC Educational Resources Information Center

Niles, Gloria Y.

2013-01-01

Using basic qualitative research methodology, the purpose for this dissertation study was to explore the language, social and learning considerations and subsequent actions taken by eight, bilingual, Hispanic-American mothers of children with autism between the ages of four and eight-years-old regarding speaking Spanish, English or both languages…

Tertiary Student Transitions: Sectors, Fields, Impacts of and Reasons for Study--Support Document

ERIC Educational Resources Information Center

Fredman, Nick

2012-01-01

This paper examines the relationships between post-school educational fields and sectors and labour market considerations that appear to shape students' study decisions. It was found that pathways taken vary considerably by age, suggesting changes over time to patterns in tertiary education towards greater participation overall, a greater extent…

An assessment study of CVD related risk factors in a tribal population of India.

PubMed

Kandpal, Vani; Sachdeva, M P; Saraswathy, K N

2016-05-25

Non communicable diseases (NCDs) have become a major concern for global health. Cardiovascular diseases (CVDs) contribute 48 % towards the deaths due to NCDs in India. Though studies have been conducted in urban and rural areas, data related to tribal communities is limited. The present study aims to examine various CVD related risk factors including hypertension, elevated fasting blood glucose, obesity and metabolic syndrome among a tribal population. The present study was an observational, cross- sectional study conducted on Rang Bhotias, a tribal population of India. The participants were adults of age between 20 and 60 years. Prior to blood sample collection, interview schedule was administered which included relevant information like age, lifestyle, socio-economic status, education and occupation In addition to this, various anthropometric and physiological measurements were taken. Logistic regression was used to examine the association of the various health disorders related to CVDs with age, gender and behavioural factors (smoking, alcohol consumption and physical activity). A total of 288 participants were surveyed for the study including 104 males and 184 females. High BMI (56.6 %), hypertension (43.4 %), metabolic syndrome (39.2 %) and abdominal obesity (33.7 %) were the most prevalent CVD risk factors observed in the population. The multivariate logistic regression analysis, conducted to examine the contribution of risk factors including behavioural risk factors on the studied abnormalities, revealed age to be a significant risk factor for all the abnormalities except elevated fasting blood glucose. Gender and physical inactivity contributed significantly towards development of hypertension. Physical inactivity was also found to be associated with high BMI levels. In the present study, hypertension, high BMI levels, MS and abdominal obesity have been found to be high among the studied population. The status of the population with respect to these abnormalities implicates susceptibility of the community towards various common disorders. The prevention and treatment intervention programs should be implemented taking into consideration age and gender.

Coming of Age: Considerations in the Prescription of Exercise for Older Adults.

PubMed

Zaleski, Amanda L; Taylor, Beth A; Panza, Gregory A; Wu, Yin; Pescatello, Linda S; Thompson, Paul D; Fernandez, Antonio B

2016-01-01

Older adults represent the fastest-growing age demographic of the population. Physiological changes associated with primary aging and concurrent chronic disease adversely impact functional capacity, health outcomes, and quality of life. For these reasons, there is a national emphasis for healthcare providers to improve the health, function, and quality of life of older adults to preserve independent living and psychological well-being. The benefits of regular physical activity or exercise with regard to aging and disease are indisputable, yet many clinicians do not prescribe exercise to older adults. This reluctance may be attributable to a lack of knowledge regarding appropriate exercise prescription for older adults in light of the potential risks and benefits of various doses and types of exercise. In addition, clinicians and patients may have concerns about potential health considerations relevant to older adults such as comprehensive pre-exercise screening and exercise-drug interactions. In light of this, the following review presents (1) guidelines for exercise prescription in older adults and modification of these guidelines for patients with the most common age-associated comorbidities; (2) recommendations for pre-exercise screening prior to initiating an exercise program in older adults; (3) considerations for older adults on one or more medications; and (4) common barriers to adopting and maintaining exercise in an older population. Our goal is to provide a framework that clinicians can follow when prescribing exercise in older adults while considering the unique characteristics and concerns present in this population.

Characterization of gas-phase organics using proton transfer reaction time-of-flight mass spectrometry: fresh and aged residential wood combustion emissions

NASA Astrophysics Data System (ADS)

Bruns, Emily A.; Slowik, Jay G.; El Haddad, Imad; Kilic, Dogushan; Klein, Felix; Dommen, Josef; Temime-Roussel, Brice; Marchand, Nicolas; Baltensperger, Urs; Prévôt, André S. H.

2017-01-01

Organic gases emitted during the flaming phase of residential wood combustion are characterized individually and by functionality using proton transfer reaction time-of-flight mass spectrometry. The evolution of the organic gases is monitored during photochemical aging. Primary gaseous emissions are dominated by oxygenated species (e.g., acetic acid, acetaldehyde, phenol and methanol), many of which have deleterious health effects and play an important role in atmospheric processes such as secondary organic aerosol formation and ozone production. Residential wood combustion emissions differ considerably from open biomass burning in both absolute magnitude and relative composition. Ratios of acetonitrile, a potential biomass burning marker, to CO are considerably lower ( ˜ 0.09 pptv ppbv-1) than those observed in air masses influenced by open burning ( ˜ 1-2 pptv ppbv-1), which may make differentiation from background levels difficult, even in regions heavily impacted by residential wood burning. A considerable amount of formic acid forms during aging ( ˜ 200-600 mg kg-1 at an OH exposure of (4.5-5.5) × 107 molec cm-3 h), indicating residential wood combustion can be an important local source for this acid, the quantities of which are currently underestimated in models. Phthalic anhydride, a naphthalene oxidation product, is also formed in considerable quantities with aging ( ˜ 55-75 mg kg-1 at an OH exposure of (4.5-5.5) × 107 molec cm-3 h). Although total NMOG emissions vary by up to a factor of ˜ 9 between burns, SOA formation potential does not scale with total NMOG emissions and is similar in all experiments. This study is the first thorough characterization of both primary and aged organic gases from residential wood combustion and provides a benchmark for comparison of emissions generated under different burn parameters.

Pilot vision considerations : the effect of age on binocular fusion time.

DOT National Transportation Integrated Search

1966-10-01

The study provides data regarding the relationship between vision performance and age of the individual. It has direct application to pilot visual tasks with respect to instrument panel displays, and to controller visual tasks in association with rad...

Proposing a Center on Aging and Well-Being: Research, Education, and Practice Considerations

ERIC Educational Resources Information Center

Lindenbach, Jeannette M.; Jessup-Falcioni, Heather

2016-01-01

This environmental scan aimed to discover research interests and educational needs of faculty, graduate, and undergraduate students to inspire research, education, and practice in the development of a center on aging and well-being for older adults. The scan consisted of a search of university faculty and researchers regarding research on aging; a…

Talking Relative Age Effects: A Fictional Analysis Based on Scientific Evidence

ERIC Educational Resources Information Center

Roberts, Simon J.

2014-01-01

During the past 30 years, there has been a considerable amount of scientific attention dedicated to the reported age discrimination which occurs in youth and elite sport. The purpose of this paper is to examine the notion of relative age effects (RAEs) through a slightly different lens. This paper therefore presents a fictional conversation…

Differences in Affective and Behavioral Health-Related Variables Associated with Age.

ERIC Educational Resources Information Center

Bausell, R. Barker; Soeken, Karen L.

Although considerable data exist linking individual lifestyle variables to health outcomes, little is known about how the elderly differ from younger adults with respect to both their health seeking behavior and their beliefs about health. A national survey contrasted 155 persons aged 65 years of age or older with 1100 younger adults in order to…

Trajectories of depressive symptoms in foster youth transitioning into adulthood: the roles of emotion dysregulation and PTSD.

PubMed

Valdez, Christine E; Bailey, Brenda E; Santuzzi, Alecia M; Lilly, Michelle M

2014-01-01

Foster youth often experience considerable adversity both in and out of foster care, including histories of abuse and/or neglect, and further stressors within the foster system. These adverse experiences often occur at key developmental periods that can compromise emotional functioning and lead to posttraumatic symptomatology, including posttraumatic stress disorder (PTSD) and emotion dysregulation. In the face of difficult histories and ongoing mental health challenges, youth transitioning into adulthood may be particularly vulnerable to increases in depressive symptoms. We explored the trajectory of depressive symptoms in foster youth from age 17 to 19 using a piecewise linear growth model, examining the effects of PTSD and emotion dysregulation on youth's depressive symptoms over time. Results revealed depressive symptoms decreased from age 17 to 18 but increased from 18 to 19. PTSD and emotion dysregulation predicted greater baseline depressive symptoms and decreases in symptoms from age 17 to 18, whereas only PTSD predicted increases in depressive symptoms from 18 to 19. Females reported higher levels of depressive symptoms compared to males. Additionally, emotion dysregulation was a stronger predictor of depressive symptoms for females than males. Implications for service delivery for foster youth transitioning into adulthood are discussed. © The Author(s) 2014.

The Effects of Tai Chi Practice With Asynchronous Music on Compliance and Fall-Related Risk Factors in Middle-Aged and Older Women: A Pilot Study.

PubMed

Du, Yan; Roberts, Penny; Xu, Qingwen

2016-03-07

This study examined whether practicing Tai Chi (TC) along with music can maximize the effects of TC on compliance and fall-related risk factors (Dynamic Gait Index and fear of falling). A convenient sample was recruited in a community senior center. Eighteen women aged 50 to 84 years (9 White, 9 Black) were block randomly assigned to a TC in silence (TC + S; n = 6) or a TC with music (TC + M; n = 12) class. Thirteen participants (4 in TC + S group, 9 in TC + M group) with completed pre- and posttests were included in the final analysis. Paired t tests were conducted to examine changes within groups over time and analysis of covariance was used to assess group differences. After 15 weeks of intervention, balance increased in both groups with significantly higher benefits in the TC + M group (p < .05). Fear of falling scores improved in TC + M group and compliance rate was higher in this group. Practicing TC + M may help increase adherence in White and Black middle-aged and older women, and maximize the effects of TC on fall-related risk factors. Studies with more rigorous study design, including musical considerations, are warranted. © The Author(s) 2016.

24 CFR 1.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., and the term State means any one of the foregoing. (e) The term Federal financial assistance includes... without consideration or at a nominal consideration, or at a consideration which is reduced for the... of its purposes the provision of assistance. The term Federal financial assistance does not include a...

Standpoints of traditional Persian physicians on geriatric nutrition.

PubMed

Emami, Morteza; Nazarinia, Mohammad Ali; Rezaeizadeh, Hussein; Zarshenas, Mohammad M

2014-10-01

The present article aimed to compile information on the nutritional management for geriatric people. Popular textbooks of Persian medicine from 10th to 18th century were studied to derive relative viewpoints and considerations. The temperament, which is defined as the combination of 4 main elements (fire, air, water, and soil) and 4 humors made subsequently (black bile, yellow bile, phlegm, and blood), changes during age periods. Imbalance in proportional amounts of humors in elderly should be corrected with food and medicaments having opposite nature to the current condition. Traditional foods included mostly well-cooked soups, pottages, and porridges containing fresh sheep or chicken meat. Mono-ingredient foods were also administered according to their medical properties. Nutritional recommendations were also concerned with geriatrics' physiological conditions such as constipation, sleep disorders, and memory deficits. Many of traditional geriatric nutritional requirements are relevant in the present day. However, there are still notes that may be beneficial for consideration. © The Author(s) 2014.

Investigating legal aspects of cyberbullying.

PubMed

Paul, Simone; Smith, Peter K; Blumberg, Herbert H

2012-11-01

In the UK schools are required by law to protect students from bullying; the responsibility of teachers to govern such behaviour has been extended outside the school setting to include cyberbullying. In this investigation, cyberbullying in secondary education is explored from the student perspective using a qualitative method of enquiry. Reported awareness and understanding about the legal aspects of cyberbullying are investigated; consideration is given to legislation, cybercrime, children's rights, school sanctions and safeguarding responsibilities. A total of 197 male and female students aged between 11 and 14 years old participated. Despite the availability of information on guidelines and legislation at national, local, and school level, this does not appear to have reached ground level of the individual student. There is a considerable gap between what students should know and what they report to be aware of with regard to legal aspects of cyberbullying. To address concerns of keeping up with the pace of change in cyberbullying, a collaborative approach is required with young people and adults sharing expertise.

The attitudes of nursing students to euthanasia.

PubMed

Naseh, Ladan; Heidari, Mohammad

2017-01-01

One of the most common morally controversial issues in endof-life care is euthanasia. Examining the attitudes of nursing students to this issue is important because they may encounter situations related to euthanasia during their clinical courses. The aim of our study was to examine nursing students' attitudes to euthanasia in Shahrekord city in western Iran. This was done using the Euthanasia Attitude Scale. The scale is divided into four categories, ie ethical considerations, practical considerations, treasuring life and naturalistic beliefs. Of 132 nursing students, 120 participated in the study (response rate 93.1%). According to the study's findings, 52.5%, 2.5% and 45% of the students reported a negative, neutral and positive attitude to euthanasia, respectively. There was a significant correlation between the nursing students' attitudes to euthanasia and some demographic characteristics, including sex, age and religious beliefs. Iranian Muslim nursing students participating in the study had a negative attitude to euthanasia. Further studies are recommended among nursing students from different cultures and of different religious faiths.

Older Asian Indians resettled in America: narratives about households, culture and generation.

PubMed

Kalavar, Jyotsna M; Van Willigen, John

2005-09-01

Immigration in late life can be a complex experience. Older adults who have spent a considerable part of their life in one cultural milieu face several challenges in adapting to a new societal framework. Demographically speaking, the numbers of immigrants of Asian Indian origin continue to rise phenomenally in the United States. In this project, the experience of Asian Indian elderly immigrants to the United States was recorded through home visits and personal interviews. Parents of adult immigrants often choose to immigrate late in life primarily for purposes of family reunification. Providing assistance with raising grandchildren was also an important consideration. This article explores various aspects that surfaced from the analysis of interviews; these include personal investment in adult children, language/cultural barriers, use of formal services, acculturative experience, aging in India, intergenerational relationships, and expectations for the future. The findings highlight the need for gerontological research that is culturally attuned to the needs of these elders so service delivery may be optimally provided.

Ascertaining serum levels of trace elements in melanoma patients using PIXE and HR-ICPMS

NASA Astrophysics Data System (ADS)

Bernardes, S.; Tabacniks, M. H.; Santos, I. D. A. O.; Oliveira, A. F.; Shie, J. N.; Sarkis, J. E. S.; Oliveira, T.

2014-01-01

Melanoma is a serious and deadly form of skin cancer. However, patients' chances of survival and recovery are considerably increased when it is diagnosed and treated in its early stages. In this study, trace element concentrations in serum samples from patients with melanoma were measured using PIXE (Proton Induced X-ray Emission) and HR-ICPMS (High-Resolution Inductively Coupled Plasma Mass Spectrometry), with the purpose of correlating these concentrations with the disease. Blood samples from 30 melanoma patients and 116 healthy donors were collected at São Paulo Hospital (protocol CEP 1036/08 UNIFESP). Relevant clinical information on the patients has also been included in the statistical analysis. Analysis of the control group showed different P and Mg concentrations in individuals above and below 40 years of age. P, S, Ca, Cu and Zn concentrations in healthy individuals differed according to gender, highlighting the necessity to include age and gender variables in the case-control analysis. There were also differences in K, S, Ca and Se concentrations between the control and melanoma groups.

Splenic artery aneurysms encountered in the ED: 10 years' experience.

PubMed

Liu, Chu-Feng; Kung, Chia-Te; Liu, Ber-Ming; Ng, Shu-Hang; Huang, Chung-Cheng; Ko, Sheung-Fat

2007-05-01

Our objective was to report 7 cases of splenic artery aneurysm (SAA) encountered in the emergency department (ED). A retrospective survey of our ED database revealed 7 cases of SAA (6 men, 1 woman; mean age, 56 years) of 651,347 ED visits over the last decade. Their clinical and imaging features, management, and outcomes were evaluated. Splenic artery aneurysm in the ED was rare (prevalence, 0.011%). Common presentations included acute abdomen (n = 5) and shock (n = 2). Five cases had liver cirrhosis and portal hypertension. Abdominal radiographs (n = 7) revealed 2 atherosclerotic patients with SAA. Abdominal computed tomography (n = 7) depicted all SAAs (size, 1.5-8 cm; mean, 3.8 cm). Four ruptured SAAs were successfully managed with coils embolization. Among them, 1 patient with ruptured mycotic SAA also received surgery, but the patient died of Klebsiella sepsis 3 months later. In the ED, ruptured SAA should be included as a rare differential consideration of acute abdomen, especially in middle-aged men with liver cirrhosis and portal hypertension. Although SAA may be an unexpected computed tomographic finding, once diagnosed, endovascular treatment is recommended.

Initiation and continuation of smoking in iran: a qualitative content analysis.

PubMed

Ebrahimi, Hossein; Sahebihagh, Mohammad Hasan; Ghofranipour, Fazlollah; Sadegh Tabrizi, Jafar

2014-10-01

Smoking is the cause for many preventable deaths worldwide. The rate of smoking has not increased in Iran in the past two decades, but its increase among adolescents and young adults is a concern. This study investigates the risk factors of initiation and continuation of smoking in Iran using a qualitative approach. This is a qualitative content analysis study conducted on 12 smokers and 6 non-smokers in 4 selected cities in Iran. Data were collected with deep and semi-structured interviews, verbatim transcription and simultaneously coding. Then, they were analyzed through content analysis. Three themes and 16 subcategories emerged. The themes were personal inefficacy with 6 subgroups included inadequate information, low age, curiosity, consideration of smoking not as a major problem, wrong beliefs, and making reasons. Family inefficacy with 4 subgroups included poor authority, lack of reaction, existence of stressors, and history of smoking. Vulnerable social environment with 6 subgroups included poverty, social stressors, magnification of smoking, network of cigarette smoking, smoking as a norm and convenience of access. Recognition of smoking among children, modification of wrong beliefs about smoking, empowerment of the individuals against smoking from the very childhood, consideration of familial stress and crisis, and ultimately, paying attention to the role of social variables will play a major role in prevention of smoking and encouraging individuals to quit smoking.

Wilderness Preparticipation Evaluation and Considerations for Special Populations.

PubMed

Joy, Elizabeth; Van Baak, Karin; Dec, Katherine L; Semakula, Barbara; Cardin, Ashlea D; Lemery, Jay; Wortley, George C; Yaron, Michael; Madden, Christopher

2015-12-01

Children, older adults, disabled and special needs athletes, and female athletes who participate in outdoor and wilderness sports and activities each face unique risks. For children and adolescents traveling to high altitude, the preparticipation physical evaluation should focus on risk assessment, prevention strategies, early recognition of altitude-related symptoms, management plans, and appropriate follow-up. As the risk and prevalence of chronic disease increases with age, both older patients and providers need to be aware of disease and medication-specific risks relative to wilderness sport and activity participation. Disabled and special needs athletes benefit from careful pre-event planning for the potential medical issues and equipment modifications that may affect their health in wilderness environments. Issues that demand special consideration for female adventurers include pregnancy, contraceptive use, menses, and ferritin levels at altitude. A careful preparticipation evaluation that factors in unique, population- specific risks will help special populations stay healthy and safe on wilderness adventures. The PubMed and SportDiscus databases were searched in 2014 using both MeSH terms and text words and include peer-reviewed English language articles from 1977 to 2014. Additional information was accessed from Web-based sources to produce this narrative review on preparticipation evaluation for special populations undertaking wilderness adventures. Key words include children, adolescent, pediatric, seniors, elderly, disabled, special needs, female, athlete, preparticipiation examination, wilderness medicine, and sports. Copyright © 2015. Published by Elsevier Inc.

The nutritional status of school-aged children: why should we care?

PubMed

Best, Cora; Neufingerl, Nicole; van Geel, Laura; van den Briel, Tina; Osendarp, Saskia

2010-09-01

The nutritional status of school-aged children impacts their health, cognition, and subsequently their educational achievement. The school is an opportune setting to provide health and nutrition services to disadvantaged children. Yet, school-aged children are not commonly included in health and nutrition surveys. An up-to-date overview of their nutritional status across the world is not available. To provide a summary of the recent data on the nutritional status of school-aged children in developing countries and countries in transition and identify issues of public health concern. A review of literature published from 2002 to 2009 on the nutritional status of children aged 6 to 12 years from Latin America, Africa, Asia, and the Eastern Mediterranean region was performed. Eligible studies determined the prevalence of micronutrient deficiencies or child under- and overnutrition using biochemical markers and internationally accepted growth references. A total of 369 studies from 76 different countries were included. The available data indicate that the nutritional status of school-aged children in the reviewed regions is considerably inadequate. Underweight and thinness were most prominent in populations from South-East Asia and Africa, whereas in Latin America the prevalence of underweight or thinness was generally below 10%. More than half of the studies on anemia reported moderate (> 20%) or severe (> 40%) prevalence of anemia. Prevalences of 20% to 30% were commonly reported for deficiencies of iron, iodine, zinc, and vitamin A. The prevalence of overweight was highest in Latin American countries (20% to 35%). In Africa, Asia, and the Eastern Mediterranean, the prevalence of overweight was generally below 15%. The available data indicate that malnutrition is a public health issue in school-aged children in developing countries and countries in transition. However, the available data, especially data on micronutrient status, are limited. These findings emphasize the need for nutrition interventions in school-aged children and more high-quality research to assess nutritional status in this age group.

Feasibility of an Assessment Tool for Children's Competence to Consent to Predictive Genetic Testing: a Pilot Study.

PubMed

Hein, Irma M; Troost, Pieter W; Lindeboom, Robert; Christiaans, Imke; Grisso, Thomas; van Goudoever, Johannes B; Lindauer, Ramón J L

2015-12-01

Knowledge on children's capacities to consent to medical treatment is limited. Also, age limits for asking children's consent vary considerably between countries. Decision-making on predictive genetic testing (PGT) is especially complicated, considering the ongoing ethical debate. In order to examine just age limits for alleged competence to consent in children, we evaluated feasibility of a standardized assessment tool, and investigated cutoff ages for children's competence to consent to PGT. We performed a pilot study, including 17 pediatric outpatients between 6 and 18 years at risk for an autosomal dominantly inherited cardiac disease, eligible for predictive genetic testing. The reference standard for competence was established by experts trained in the relevant criteria for competent decision-making. The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) served as index test. Data analysis included raw agreement between competence classifications, difference in mean ages between children judged competent and judged incompetent, and estimation of cutoff ages for judgments of competence. Twelve (71 %) children were considered competent by the reference standard, and 16 (94 %) by the MacCAT-T, with an overall agreement of 76 %. The expert judgments disagreed in most cases, while the MacCAT-T judgments agreed in 65 %. Mean age of children judged incompetent was 9.3 years and of children judged competent 12.1 years (p = .035). With 90 % sensitivity, children younger than 10.0 years were judged incompetent, with 90 % specificity children older than 11.8 years were judged competent. Feasibility of the MacCAT-T in children is confirmed. Initial findings on age cutoffs are indicative for children between the age of 12 and 18 to be judged competent for involvement in the informed consent process. Future research on appropriate age-limits for children's alleged competence to consent is needed.

Guidance on Selecting Age Groups for Monitoring and Assessing Childhood Exposures to Environmental Contaminants

EPA Pesticide Factsheets

This document recommends a set of age groupings based on current understanding of differences in lifestage behavior and anatomy and physiology that can serve as a starting set for consideration by Agency risk assessors and researchers.

ESTIMATES OF AGE-SPECIFIC URINARY EXCRETION RATES FOR CREATININE AMONG CHILDREN

EPA Science Inventory

The results of this study suggest that naïve adjustment by creatinine concentration, without consideration of the age-dependence of the physiological mechanisms controlling its excretion, may introduce sizeable error and is inappropriate when comparing metabolite concentrations a...

Mimetic Theory and Scapegoating in the Age of Cyberbullying: The Case of Phoebe Prince

ERIC Educational Resources Information Center

Norman, James O'Higgins; Connolly, Justin

2011-01-01

Whilst traditional forms of bullying have and continue to receive considerable attention in the literature, research on technology-enabled bullying remains in an embryonic stage and considerable deficits exist in our understanding of the nature, extent, dynamics and consequents of this new form of bullying. Of the limited studies that exist on…

78 FR 76636 - Agency Information Collection Activities: Consideration of Deferred Action for Childhood Arrivals...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-18

...-0124] Agency Information Collection Activities: Consideration of Deferred Action for Childhood Arrivals... Deferred Action for Childhood Arrivals. (3) Agency form number, if any, and the applicable component of the... childhood arrivals: 1. Were under the age of 31 as of June 15, 2012; 2. Came to the United States before...

Secondary Students' Considerations of Variability in Measurement Activities Based on Authentic Practices

ERIC Educational Resources Information Center

Dierdorp, Adri; Bakker, Arthur; Ben-Zvi, Dani; Makar, Katie

2017-01-01

Measurement activities were designed in this study on the basis of authentic professional practices in which linear regression is used, to study considerations of variability by students in Grade 12 (aged 17-18). The question addressed in this article is: In what ways do secondary students consider variability within these measurement activities?…

Multimorbidity in chronic disease: impact on health care resources and costs

PubMed Central

McPhail, Steven M

2016-01-01

Effective and resource-efficient long-term management of multimorbidity is one of the greatest health-related challenges facing patients, health professionals, and society more broadly. The purpose of this review was to provide a synthesis of literature examining multimorbidity and resource utilization, including implications for cost-effectiveness estimates and resource allocation decision making. In summary, previous literature has reported substantially greater, near exponential, increases in health care costs and resource utilization when additional chronic comorbid conditions are present. Increased health care costs have been linked to elevated rates of primary care and specialist physician occasions of service, medication use, emergency department presentations, and hospital admissions (both frequency of admissions and bed days occupied). There is currently a paucity of cost-effectiveness information for chronic disease interventions originating from patient samples with multimorbidity. The scarcity of robust economic evaluations in the field represents a considerable challenge for resource allocation decision making intended to reduce the burden of multimorbidity in resource-constrained health care systems. Nonetheless, the few cost-effectiveness studies that are available provide valuable insight into the potential positive and cost-effective impact that interventions may have among patients with multiple comorbidities. These studies also highlight some of the pragmatic and methodological challenges underlying the conduct of economic evaluations among people who may have advanced age, frailty, and disadvantageous socioeconomic circumstances, and where long-term follow-up may be required to directly observe sustained and measurable health and quality of life benefits. Research in the field has indicated that the impact of multimorbidity on health care costs and resources will likely differ across health systems, regions, disease combinations, and person-specific factors (including social disadvantage and age), which represent important considerations for health service planning. Important priorities for research include economic evaluations of interventions, services, or health system approaches that can remediate the burden of multimorbidity in safe and cost-effective ways. PMID:27462182

A retrospective study of recurrent chlamydia infection in men and women: is there a role for targeted screening for those at risk?

PubMed

Evans, C; Das, C; Kinghorn, G

2009-03-01

Chalmydia trachomatis remains the commonest sexually transmitted infection (STI) in the UK. This study identifies those at risk of recurrent infection (RI) attending a central genitourinary clinic, time to subsequent reinfection and duration of at-risk behaviour for the consideration of targeted chlamydia screening. From 1995 to 2005, a total of 14,011 patients' were diagnosed with chlamydia and 1743 (12.4%) had RI, classified as a repeat infection greater than three months after initial diagnosis. Individual risk factors for both sexes include young age <25, two or more partners and failure to attend for test of cure (TOC) and previous STI. Men of non-White ethnicity, symptoms and those self-referred were also at risk. Combined risk factors for both sexes were non-White ethnicity, symptoms, young age, previous STI and two or more partners. Attendance for TOC considerably reduced RI rates in men (odds ratio [OR] = 0.549; 95% confidence interval [CI] 0.359-0.840). Mean time to first and last reinfection in men was 1.91 and 2.49 years, in women 1.76 and 1.92 years. One in eight individuals with chlamydia infection are at risk of RI, the majority of which will occur within two years of initial presentation. These individuals have identifiable risk factors facilitating targeted re-screening, enhanced follow-up and support for behavioural change.

The nutritional status and factors contributing to malnutrition in children with chronic pancreatitis.

PubMed

Kolodziejczyk, E; Wejnarska, K; Dadalski, M; Kierkus, J; Ryzko, J; Oracz, G

2014-01-01

The present study was undertaken to determine the prevalence of malnutrition among children with chronic pancreatitis (CP). Furthermore, we aimed to evaluate the relationship between etiological factors of CP, its clinical characteristics, and the severity of malnutrition. The study included 208 children with CP (113 girls and 95 boys; mean age: 10.8 years, range: 1.6-18 years), hospitalized at our center between 1988 and 2012. The severity of malnutrition was graded on the basis of Cole's ratios, and its prevalence was analyzed according to the etiological factors of pancreatitis. Moreover, the analysis of discrimination was performed to identify the factors contributing to malnutrition among the following variables: age at CP onset, duration of CP, number of CP exacerbations, the number of ERCPs performed, the grade of pancreatic damage documented on imaging, co-occurrence of diabetes, and the results of 72-h fecal fat quantification. We documented features of malnutrition in 52 (25%) children with CP, including 36 (17.3%) patients with moderate malnutrition, and 2 (0.96%) with severe malnutrition. There was no significant difference in the prevalence of malnutrition between groups of patients with various etiological factors of chronic pancreatitis. The age at CP onset showed the best discrimination ability of malnourished patients: the mean age at disease onset in a subgroup of malnourished children was significantly higher than in children with Cole's index >85%. A considerable percentage of children with CP can suffer from clinically significant malnutrition. Later age at CP onset predisposes to development of malnutrition. Copyright © 2014 IAP and EPC. Published by Elsevier B.V. All rights reserved.

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

PubMed

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

2017-02-01

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

GPs' considerations in multimorbidity management: a qualitative study.

PubMed

Luijks, Hilde D; Loeffen, Maartje J W; Lagro-Janssen, Antoine L; van Weel, Chris; Lucassen, Peter L; Schermer, Tjard R

2012-07-01

Scientific evidence on how to manage multimorbidity is limited, but GPs have extensive practical experience with multimorbidity management. To explore GPs' considerations and main objectives in the management of multimorbidity and to explore factors influencing their management of multimorbidity. Focus group study of Dutch GPs; with heterogeneity in characteristics such as sex, age and urbanisation. The moderator used an interview guide in conducting the interviews. Two researchers performed the analysis as an iterative process, based on verbatim transcripts and by applying the technique of constant comparative analysis. Data collection proceeded until saturation was reached. Five focus groups were conducted with 25 participating GPs. The main themes concerning multimorbidity management were individualisation, applying an integrated approach, medical considerations placed in perspective, and sharing decision making and responsibility. A personal patient-doctor relationship was considered a major factor positively influencing the management of multimorbidity. Mental-health problems and interacting conditions were regarded as major barriers in this respect and participants experienced several practical problems. The concept of patient-centredness overarches the participants' main objectives. GPs' main objective in multimorbidity management is applying a patient-centred approach. This approach is welcomed since it counteracts some potential pitfalls of multimorbidity. Further research should include a similar design in a different setting and should aim at developing best practice in multimorbidity management.

Tourette syndrome in children and adolescents: special considerations.

PubMed

Eapen, Valsamma; Crncec, Rudi

2009-12-01

Tourette syndrome (TS) affects people of all ages, with onset in early childhood and continuing through the different stages of the life cycle into adolescence and adults. This review focuses on barriers to diagnosis and challenges in the management of young patients with TS. Barriers to identification occur at multiple levels, including detection in the community setting (including schools), parents' help-seeking behavior, and cultural influences on such behavior, as well as diagnosis by the medical provider. Challenges to management include unfamiliarity of primary care providers, inconsistencies in the diagnosis and management plan, and failure to recognize comorbid conditions, as well as inadequate knowledge and lack of resources to effectively deal with comorbidities. In addition to the complexities posed by pharmacological interactions, there are unique psychosocial challenges experienced by young people with TS and their families. Effective communication and collaboration between families, health care providers, and school personnel, as well as supportive communities, are essential components of comprehensive management.

Body fluid levels of neuroactive amino acids in autism spectrum disorders: a review of the literature.

PubMed

Zheng, Hui-Fei; Wang, Wen-Qiang; Li, Xin-Min; Rauw, Gail; Baker, Glen B

2017-01-01

A review of studies on the body fluid levels of neuroactive amino acids, including glutamate, glutamine, taurine, gamma-aminobutyric acid (GABA), glycine, tryptophan, D-serine, and others, in autism spectrum disorders (ASD) is given. The results reported in the literature are generally inconclusive and contradictory, but there has been considerable variation among the previous studies in terms of factors such as age, gender, number of subjects, intelligence quotient, and psychoactive medication being taken. Future studies should include simultaneous analyses of a large number of amino acids [including D-serine and branched-chain amino acids (BCAAs)] and standardization of the factors mentioned above. It may also be appropriate to use saliva sampling to detect amino acids in ASD patients in the future-this is noninvasive testing that can be done easily more frequently than other sampling, thus providing more dynamic monitoring.

ABCC6 mutations and early onset stroke: Two cases of a typical Pseudoxanthoma Elasticum.

PubMed

Bertamino, Marta; Severino, Mariasavina; Grossi, Alice; Rusmini, Marta; Tortora, Domenico; Gandolfo, Carlo; Pederzoli, Silvia; Malattia, Clara; Picco, Paolo; Striano, Pasquale; Ceccherini, Isabella; Di Rocco, Maja

2018-04-12

Pseudoxanthoma elasticum (PXE) is a rare genetic disorder characterized by fragmented and mineralized elastic fibers in the mid-dermis of the skin, eye, digestive tract and cardiovascular system. Clinical presentation includes typical skin lesions, ocular angioid streaks, and multisystem vasculopathy. The age of onset varies considerably from infancy to old age, but the diagnosis is usually made in young adults due to frequent absence of pathognomonic skin and ocular manifestations in early childhood. We report two children with PXE presenting with isolated multisystem vasculopathy and early-onset stroke. In the first patient, diagnosis was delayed until typical dermatologic alterations appeared; in the second patient, next-generation sequencing (NGS) study led to early diagnosis and specific follow-up, underlying the crucial role in idiopathic pediatric stroke of early genetic testing using NGS-based panels. Copyright © 2018 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

U.S. Social Security at 75 years: an international perspective.

PubMed

Hoskins, Dalmer D

2010-01-01

Is the historical development of the Old-Age, Survivors, and Disability Insurance (OASDI) program unique or similar to the development of social security programs in other industrialized countries? The U.S. Social Security program was adopted some 40 to 50 years after those of most Western European nations. The United States thus had the opportunity to choose from a number of models and clearly chose to follow the classic social insurance path of such countries as Austria, France, and Germany, which in 1935 already had considerable experience administering earnings-related, employer/worker-financed old-age pension programs. Although based on the traditional social insurance model, OASDI evolved in certain unique ways, including the rejection over the course of succeeding decades of any reliance on general revenue financing, the importance attached to long-range (75-year) actuarial projections, and the relative generosity of benefits for survivors and dependents.

Getting a head start: the importance of personal genetics education in high schools.

PubMed

Kung, Johnny T; Gelbart, Marnie E

2012-03-01

With advances in sequencing technology, widespread and affordable genome sequencing will soon be a reality. However, studies suggest that "genetic literacy" of the general public is inadequate to prepare our society for this unprecedented access to our genetic information. As the current generation of high school students will come of age in an era when personal genetic information is increasingly utilized in health care, it is of vital importance to ensure these students understand the genetic concepts necessary to make informed medical decisions. These concepts include not only basic scientific knowledge, but also considerations of the ethical, legal, and social issues that will arise in the age of personal genomics. In this article, we review the current state of genetics education, highlight issues that we believe need to be addressed in a comprehensive genetics education curriculum, and describe our education efforts at the Harvard Medical School-based Personal Genetics Education Project.

[Psychiatric disturbances in five patients with MELAS syndrome].

PubMed

Magner, Martin; Honzik, Tomas; Tesarova, Marketa; Dvorakova, Veronika; Hansiková, Hana; Raboch, Jiři; Zeman, Jiři

2014-01-01

Mitochondrial disorders of energetic metabolism (MD) represent a heterogeneous group of diseases manifesting at any age with a broad spectrum of clinical symptoms, including psychiatric disorders. The aim of the study was to characterize psychiatric symptoms and diagnoses in five patients with MELAS syndrome between the ages of 17 and 53 years. Four of MELAS patients them harbored the prevalent mitochondrial DNA (mtDNA) mutation 3243A>G, and one patient had the mtDNA mutation 12706T>C. Three patients had positive family histories for MELAS syndrome. In one patient, depression was diagnosedas the first symptom ofMELAS syndrome. Depression also preceded a stroke-like episode in one patient. Four patients had disturbed cognitive functions, confusional states occurred in three patients. One patient manifested psychotic (schizophrenia-like) symptoms. Mitochondrial disorders deserve consideration as part of the differential diagnosis, especially, if there is suspected involvement of other organ groups or positive family history of MD.

Causes of Early-Age Thermal Cracking of Concrete Foundation Slabs and their Reinforcement to Control the Cracking

NASA Astrophysics Data System (ADS)

Bilčík, Juraj; Sonnenschein, Róbert; Gažovičová, Natália

2017-09-01

This paper focuses on the causes and consequences of early-age cracking of mass concrete foundation slabs due to restrained volume changes. Considering the importance of water leaking through cracks in terms of the serviceability, durability and environmental impact of watertight concrete structures, emphasis is placed on the effect of temperature loads on foundation slabs. Foundation slabs are usually restrained to some degree externally or internally. To evaluate the effect of external restraints on foundation slabs, friction and interaction models are introduced. The reinforcement of concrete cannot prevent the initiation of cracking, but when cracking has occurred, it may act to reduce the spacing and width of cracks. According to EN 1992-1-1, results of calculating crack widths with local variations included in National Annexes (NAs) vary considerably. A comparison of the required reinforcement areas according to different NAs is presented.

[A case of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episode/Leigh overlap syndrome].

PubMed

Matsui, Jun; Takano, Tomoyuki; Ryujin, Fukiko; Anzai, Yuko; Yoshioka, Seiichiro; Takeuchi, Yoshihiro; Goto, Yuichi

2014-09-01

We experienced a case in which mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) was identified as complications following the onset of Leigh syndrome along with a 10191 T>C mutation of the mitochondrial gene. The case pertains to a 26-year-old woman. The disease appeared when she was 11 years old due to divergent strabismus, at which point a diagnosis of juvenile Leigh syndrome was made. Many infraction images not conforming to the vessel region were observed upon a brain MRI which was performed at 26 years of age, thus leading to her being diagnosed with MELAS as a complication. Upoon bibliographical consideration, it was speculated that the clinical features of MELAS/Leigh overlap syndrome clearly differ from Leigh syndrome in terms of age of onset, symptoms, and prognosis. Pleiotropic genetic factors including heteroplasmy were presumed to be involved in the diverse phenotype of overlap syndrome.

Social Network, Activity Participation, and Cognition: A Complex Relationship.

PubMed

Litwin, Howard; Stoeckel, Kimberly J

2016-01-01

This study examined how two domains of engagement-social network and activity participation-associate with objective and subjective cognitive function in later life. Specific consideration was given as to how these two spheres intersect in regard to recall and memory. The analytic sample included Europeans aged 60 and older drawn from the fourth wave of the Survey of Health Ageing and Retirement in Europe in which a new name-generated social network inventory was implemented. Multivariate analyses revealed that activity participation yielded stronger positive associations with word recall and self-rated memory than social network alone. However, the interactions indicate that this association lessened in strength for both the objective and subjective cognitive outcome measures as social network resources increased. The findings suggest that the social component of activity participation may be partially contributing to the positive role that such engagement has on cognitive well-being in later life. © The Author(s) 2015.

The burden of mental disorders: a comparison of methods between the Australian burden of disease studies and the Global Burden of Disease study.

PubMed Central

Vos, T.; Mathers, C. D.

2000-01-01

The national and Victorian burden of disease studies in Australia set out to examine critically the methods used in the Global Burden of Disease study to estimate the burden of mental disorders. The main differences include the use of a different set of disability weights allowing estimates in greater detail by level of severity, adjustments for comorbidity between mental disorders, a greater number of mental disorders measured, and modelling of substance use disorders, anxiety disorders and bipolar disorder as chronic conditions. Uniform age-weighting in the Australian studies produces considerably lower estimates of the burden due to mental disorders in comparison with age-weighted disability-adjusted life years. A lack of follow-up data on people with mental disorders who are identified in cross-sectional surveys poses the greatest challenge in determining the burden of mental disorders more accurately. PMID:10885161

Physical activity patterns in adults who are blind as assessed by accelerometry.

PubMed

Marmeleira, José; Laranjo, Luis; Marques, Olga; Pereira, Catarina

2014-07-01

The main purpose of our study was to quantify, by using accelerometry, daily physical activity (PA) in adults with visual impairments. Sixty-three adults (34.9% women) who are blind (18-65 years) wore an accelerometer for at least 3 days (minimum of 10 hr per day), including 1 weekend day. Nineteen participants (~30%) reached the recommendation of 30 min per day of PA, when counting every minute of moderate or greater intensity. No one achieved that goal when considering bouts of at least 10 min. No differences were found between genders in PA measures. Chronological age, age of blindness onset, and body mass index were not associated with PA. We conclude that adults who are blind have low levels of PA and are considerably less active compared with the general population. Health promotion strategies should be implemented to increase daily PA for people with visual impairments.

MANAGEMENT OF ANOREXIA IN ELDERLY AS REMARKED BY MEDIEVAL PERSIAN PHYSICIANS.

PubMed

Nimrouzi, Majid; Zarshenas, Mohammad M

2015-01-01

Normal ageing is often accompanied by loss of appetite and decrease in food intake. Weight loss of senescence is called anorexia of ageing. As an outstanding scientist and physician of Traditional Persian Medicine, Avicenna has introduced an unconventional approach to seniors. He also believed that the elderly should consider special schemes in order to maintain their health. These schemes include consideration of nutrition, mental states, sleep, bathing, and physical activities, and even choosing some appropriate hobbies. The elderly should consume foods and fruits with laxative and stool-softening properties to prevent constipation. They would also do better to decrease the amount of food eaten at meals, but at the same time increasing the number of meals to compensate for low food intake. Moreover, they should maintain their vital force and avoid any activities that tax the body. Furthermore, considering the principles of hifz-al-sehah can help secure long and healthy lives for the elderly.

American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology Screening Guidelines for the Prevention and Early Detection of Cervical Cancer

PubMed Central

Saslow, Debbie; Solomon, Diane; Lawson, Herschel W.; Killackey, Maureen; Kulasingam, Shalini; Cain, Joanna; Garcia, Francisco A. R.; Moriarty, Ann; Waxman, Alan; Wilbur, David; Wentzensen, Nicolas; Downs, Levi; Spitzer, Mark; Moscicki, Anna-Barbara; Saraiya, Mona; Franco, Eduardo L.; Stoler, Mark H.; Schiffman, Mark; Castle, Philip E.; Myers, Evan R.

2013-01-01

An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from six working groups, and a recent symposium co-sponsored by the ACS, American Society for Colposcopy and Cervical Pathology (ASCCP), and American Society for Clinical Pathology (ASCP), which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (e.g., management of screen positives and screening interval for screen negatives) of women after screening, age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16 and HPV18 infections. PMID:22418039

American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology Screening Guidelines for the Prevention and Early Detection of Cervical Cancer

PubMed Central

Saslow, Debbie; Solomon, Diane; Lawson, Herschel W.; Killackey, Maureen; Kulasingam, Shalini; Cain, Joanna; Garcia, Francisco A. R.; Moriarty, Ann; Waxman, Alan; Wilbur, David; Wentzensen, Nicolas; Downs, Levi; Spitzer, Mark; Moscicki, Anna-Barbara; Franco, Eduardo L.; Stoler, Mark H.; Schiffman, Mark; Castle, Philip E.; Myers, Evan R.

2013-01-01

An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from six working groups, and a recent symposium cosponsored by the ACS, American Society for Colposcopy and Cervical Pathology (ASCCP), and American Society for Clinical Pathology (ASCP), which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (e.g., management of screen positives and screening interval for screen negatives) of women after screening, age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16 and HPV18 infections. PMID:22422631

Management of locally advanced and metastatic colon cancer in elderly patients.

PubMed

Kurniali, Peter C; Hrinczenko, Borys; Al-Janadi, Anas

2014-02-28

Colon cancer is the second leading cause of cancer mortality in the United States with a median age at diagnosis of 69 years. Sixty percent are diagnosed over the age of 65 years and 36% are 75 years or older. At diagnosis, approximately 58% of patients will have locally advanced and metastatic disease, for which systemic chemotherapy has been shown to improve survival. Treatment of cancer in elderly patients is more challenging due to multiple factors, including disabling co-morbidities as well as a decline in organ function. Cancer treatment of elderly patients is often associated with more toxicities that may lead to frequent hospitalizations. In locally advanced disease, fewer older patients receive adjuvant chemotherapy despite survival benefit and similar toxicity when compared to their younger counterparts. A survival benefit is also observed in the palliative chemotherapy setting for elderly patients with metastatic disease. When treating elderly patients with colon cancer, one has to consider drug pharmacokinetics and pharmacodynamics. Since chronological age is a poor marker of a patient's functional status, several methods of functional assessment including performance status and activities of daily living (ADL) or instrumental ADL, or even a comprehensive geriatric assessment, may be used. There is no ideal chemotherapy regimen that fits all elderly patients and so a regimen needs to be tailored for each individual. Important considerations when treating elderly patients include convenience and tolerability. This review will discuss approaches to the management of elderly patients with locally advanced and metastatic colon cancer.

Autonomy and Citizenship in the Late Third Age

ERIC Educational Resources Information Center

Luppi, Elena

2010-01-01

The research presented in this paper is focused on the concept of active citizenship in the third age. This topic has been investigated within a group of elderly people in the second phase of the third age. The research was monitored by the social services of Bologna (Italy) in a support-care project. The results gathered led to considerations on…

Setting Up CD-ROM Work Areas. Part I: Ergonomic Considerations, User Furniture, Location.

ERIC Educational Resources Information Center

Vasi, John; LaGuardia, Cheryl

1992-01-01

The first of a two-part series on design of CD-ROM work areas in libraries discusses (1) space and location considerations; (2) ergonomics, including work surface, chairs, lighting, printers, other accessories, and security; and (3) other considerations, including staff assistance, reference tools, literature racks, and promotional materials. (MES)

[The human life cycle from a theoretical viewpoint].

PubMed

Beier, W

1976-02-15

In the view of theoretical considerations the human course of life is regarded as a generalized motion. It is made an attempt to define terms, such as chronological age, biological age and ageing. In the model of ageing irreversible alterations affecting the organism are described by a complex variable, called vitality, which represents the state of systems. The rate of vitality dV/dt and the biomorphosis of systems are equivalent terms.

Mitochondrial dysfunction and sarcopenia of aging: from signaling pathways to clinical trials

PubMed Central

Marzetti, Emanuele; Calvani, Riccardo; Cesari, Matteo; Buford, Thomas W.; Lorenzi, Maria; Behnke, Bradley J.; Leeuwenburgh, Christiaan

2013-01-01

Sarcopenia, the age-related loss of muscle mass and function, imposes a dramatic burden on individuals and society. The development of preventive and therapeutic strategies against sarcopenia is therefore perceived as an urgent need by health professionals and has instigated intensive research on the pathophysiology of this syndrome. The pathogenesis of sarcopenia is multifaceted and encompasses lifestyle habits, systemic factors (e.g., chronic inflammation and hormonal alterations), local environment perturbations (e.g., vascular dysfunction), and intramuscular specific processes. In this scenario, derangements in skeletal myocyte mitochondrial function are recognized as major factors contributing to the age-dependent muscle degeneration. In this review, we summarize prominent findings and controversial issues on the contribution of specific mitochondrial processes – including oxidative stress, quality control mechanisms and apoptotic signaling – on the development of sarcopenia. Extramuscular alterations accompanying the aging process with a potential impact on myocyte mitochondrial function are also discussed. We conclude with presenting methodological and safety considerations for the design of clinical trials targeting mitochondrial dysfunction to treat sarcopenia. Special emphasis is placed on the importance of monitoring the effects of an intervention on muscle mitochondrial function and identifying the optimal target population for the trial. PMID:23845738

Does tinnitus distress depend on age of onset?

PubMed

Schlee, Winfried; Kleinjung, Tobias; Hiller, Wolfgang; Goebel, Gerhard; Kolassa, Iris-Tatjana; Langguth, Berthold

2011-01-01

Tinnitus is the perception of a sound in the absence of any physical source of it. About 5-15% of the population report hearing such a tinnitus and about 1-2% suffer from their tinnitus leading to anxiety, sleep disorders or depression. It is currently not completely understood why some people feel distressed by their tinnitus, while others don't. Several studies indicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depression, personality, the psychosocial situation, the amount of the related hearing loss and the loudness of the tinnitus. Furthermore, theoretical considerations suggest an impact of the age at tinnitus onset influencing tinnitus distress. Based on a sample of 755 normal hearing tinnitus patients we tested this assumption. All participants answered a questionnaire on the amount of tinnitus distress together with a large variety of clinical and demographic data. Patients with an earlier onset of tinnitus suffer significantly less than patients with an onset later in life. Furthermore, patients with a later onset of tinnitus describe their course of tinnitus distress as more abrupt and distressing right from the beginning. We argue that a decline of compensatory brain plasticity in older age accounts for this age-dependent tinnitus decompensation.

Isokinetic and isometric lifting capacity of Chinese in relation to the physical demand of job.

PubMed

Luk, K D K; Lu, W W; Kwan, W W; Hu, Y; Wong, Y W; Law, K K P; Leong, J C Y

2003-03-01

The aim of the study was to formulate normative data for the lifting capacities of a normal Chinese population, in order to establish a basic foundation for further studies and to investigate the relationship between individual attributes including age, gender, height, weight, job physical demand and each type of lifting capacity. Isokinetic and isometric lifting strength at low, waist and shoulder assessment levels were measured using the LIDO Workset II based on a sample of 93 normal Chinese adults (63 men and 30 women) between the ages of 21-51. The 50th percentile score for adult Chinese female's lifting strength was 17.71% lower than the American female while the adult Chinese male's lifting strength was 14.94% lower than the American male. Lifting forces were higher in the 20-40 year age group. The isometric work mode had considerable impact on the lifting capacities, with shoulder level having the highest lifting capacities. The gender and body weight had a significant positive correlation to lifting capacity while job physical demand had a moderate correlation. Age and body heights were weakly correlated to lifting capacity. Copyright 2003 Elsevier Science Ltd.

High-quality Italian rice cultivars: chemical indices of ageing and aroma quality.

PubMed

Griglione, Alessandra; Liberto, Erica; Cordero, Chiara; Bressanello, Davide; Cagliero, Cecilia; Rubiolo, Patrizia; Bicchi, Carlo; Sgorbini, Barbara

2015-04-01

The volatile fractions of six Italian high-quality rice cultivars were investigated by HS-SPME-GC-MS to define fingerprinting and identify chemical markers and/or indices of ageing and aroma quality. In particular, four non-aromatic (Carnaroli, Carnise, Cerere and Antares) and two aromatic (Apollo and Venere) rices, harvested in 2010 and 2011, were monitored over 12months. Twenty-five aroma components were considered and, despite considerable inter-annual variability, some of them showed similar trends over time, including 2-(E)-octenal as a marker of ageing for all cultivars, and heptanal, octanal and 2-ethyl hexanol as cultivar-specific indicators. The area ratios 2-acetyl-1-pyrroline/1-octen-3-ol, for Venere, and 3-methyl-1-butanol/2-methyl-1-butanol, for Apollo, were also found to act as ageing indices. Additional information on release of key-aroma compounds was also obtained from quantitation and its dependence on grain shape and chemical composition. Heptanal/1-octen-3-ol and heptanal/octanal ratios were also defined as characterising the aroma quality indices of the six Italian rice cultivars investigated. Copyright © 2014 Elsevier Ltd. All rights reserved.

Adolescent social cognitive and affective neuroscience: past, present, and future

PubMed Central

Blakemore, Sarah-Jayne

2012-01-01

In this article, we review three areas of research within adolescent social cognitive and affective neuroscience: (i) emotion reactivity and regulation, (ii) mentalizing and (iii) peer relations, including social rejection or acceptance as well as peer influence. The review provides a context for current contributions to the special issue of Social Cognitive and Affective Neuroscience on Adolescence, and highlights three important themes that emerge from the special issue, which are relevant to future research. First, the age of participants studied (and labels for these age groups) is a critical design consideration. We suggest that it might be logical to reduce the reliance on convenience samples of undergraduates to represent adults in psychology and cognitive neuroscience studies, since there is substantial evidence that the brain is still developing within this age range. Second, developmental researchers are broadening their scope of inquiry by testing for non-linear effects, via increased use of longitudinal strategies or much wider age ranges and larger samples. Third, there is increasing appreciation for the interrelatedness of the three areas of focus in this special issue (emotion reactivity and regulation, mentalizing, and peer relations), as well as with other areas of interest in adolescent development. PMID:22228750

Impact of the age of stored blood on trauma patient mortality: a systematic review

PubMed Central

Sowers, Nicholas; Froese, Patrick C.; Erdogan, Mete; Green, Robert S.

2015-01-01

Background The impact of the age of stored red blood cells on mortality in patients sustaining traumatic injuries requiring transfusion of blood products is unknown. The objective of this systematic review was to identify and describe the available literature on the use of older versus newer blood in trauma patient populations. Methods We searched PubMed, Embase, Lilac and the Cochrane Database for published studies comparing the transfusion of newer versus older red blood cells in adult patients sustaining traumatic injuries. Studies included for review reported on trauma patients receiving transfusions of packed red blood cells, identified the age of stored blood that was transfused and reported patient mortality as an end point. We extracted data using a standardized form and assessed study quality using the Newcastle–Ottawa Scale. Results Seven studies were identified (6780 patients) from 3936 initial search results. Four studies reported that transfusion of older blood was independently associated with increased mortality in trauma patients, while 3 studies did not observe any increase in patient mortality with the use of older versus newer blood. Three studies associated the transfusion of older blood with adverse patient outcomes, including longer stay in the intensive care unit, complicated sepsis, pneumonia and renal dysfunction. Studies varied considerably in design, volumes of blood transfused and definitions applied for old and new blood. Conclusion The impact of the age of stored packed red blood cells on mortality in trauma patients is inconclusive. Future investigations are warranted. PMID:26384149

Developmental Scores at 1 Year With Increasing Gestational Age, 37–41 Weeks

PubMed Central

Rose, Olga; Blanco, Estela; Martinez, Suzanna M.; Sim, Eastern Kang; Castillo, Marcela; Lozoff, Betsy; Vaucher, Yvonne E.

2013-01-01

OBJECTIVE: To examine the relationship between gestational age and mental and psychomotor development scores in healthy infants born between 37 and 41 weeks. METHODS: The cohort included 1562 participants enrolled during infancy in an iron deficiency anemia preventive trial in Santiago, Chile. All participants were healthy, full-term (37–41 weeks) infants who weighed 3 kg or more at birth. Development at 12 months was assessed using the Bayley Scales of Infant Development. Using generalized linear modeling, we analyzed the association between gestational age and 1-year-old developmental status, taking into account potential confounders including birth weight percentile, gender, socioeconomic status, the home environment, iron status, and iron supplementation. RESULTS: For each additional week of gestation, the Mental Development Index increased by 0.8 points (95% confidence interval = 0.2–1.4), and the Psychomotor Development Index increased by 1.4 points (95% confidence interval = 0.6–2.1) controlling for birth weight percentile, gender, socioeconomic status, and home environment. CONCLUSIONS: In a large sample of healthy full-term infants, developmental scores obtained using the Bayley Scales of Infant Development at 12 months increased with gestational age (37–41 weeks). There is increasing evidence that birth at 39 to 41 weeks provides developmental advantages compared with birth at 37 to 38 weeks. Because cesarean deliveries and early-term inductions have increased to 40% of all births, consideration of ongoing brain development during the full-term period is an important medical and policy issue. PMID:23589812

Factors related to fatigue after paediatric acquired brain injury (ABI).

PubMed

van Markus-Doornbosch, F; de Kloet, A J; Berger, M A M; Lambregts, S A M; Wolterbeek, R; Vliet Vlieland, T P M

2016-01-01

To assess the degree of fatigue in children and youth after traumatic and non-traumatic brain injury (TBI and NTBI) and related factors. Follow-up study including patients with a hospital-based diagnosis of acquired brain injury (ABI), aged 4-20 years at onset and their parents. Parents and children (dependent on age) completed the Paediatric Quality of Life Inventory™ Multidimensional Fatigue Scale (PedsQL™ MFS), which measures general fatigue (GF), sleep/rest fatigue (SRF) and cognitive fatigue (CF). Additional assessments included the Child & Family Follow-up Survey (CFFS) and PedsQL™ 4.0 General Core Scales and sociodemographic and disease characteristics. Eighty-eight parents completed the PedsQL™ MFS 24-30 months after diagnosis, with 49/88 patients (56%) completing the child version. The median age of the patients was 11 years (interquartile range [IQR] = 7). There were 69 patients with TBI (16% moderate/severe TBI) and 19 patients with NTBI (16% moderate/severe NTBI). The median parent-reported and child-reported PedsQL™ MFS Total Scale Scores were 76.5 (SD = 16.4) and 78.5 (12.9), respectively (Spearman r = 0.450, p = 0.001). Apart from NTBI, increasing age and a single-parent household were significantly associated with more fatigue according to the parent-reported PedsQL™ MFS Total Score (and/or one or more sub-scale scores). Two years after onset, in particular, the parent-reported fatigue after NTBI was considerable. Moreover, older children and children from a single-parent household were found to have higher fatigue levels.

Otological diagnoses and probable age-related auditory neuropathy in "younger" and "older" elderly persons.

PubMed

Rosenhall, Ulf; Hederstierna, Christina; Idrizbegovic, Esma

2011-09-01

Audiological data from a population based epidemiological investigation were studied on elderly persons. Specific diagnoses of otological and audiological disorders, which can result in hearing loss, were searched for. A retrospective register study. Three age cohorts, 474 70- and 75-year olds ("younger"), and 252 85-year olds ("older"), were studied. Clinical pure tone and speech audiometry was used. Data from medical files were included. Conductive hearing loss was diagnosed in 6.1% of the "younger" elderly persons, and in 10.3% of the "older" ones. Specific diagnoses (chronic otitis media and otosclerosis) were established in about half of the cases. Sensorineural hearing loss, other than age-related hearing loss and noise induced hearing loss, was diagnosed in 3.4 % and 5.2% respectively. Severely impaired speech recognition, possibly reflecting age-related auditory neuropathy, was found in 0.4% in the "younger" group, and in 10% in the "older" group. Bilateral functional deafness was present in 3.2% of the 85-year-old persons, but was not present in the 70-75-year group. The incidence of probable age-related auditory neuropathy increases considerably from 70-75 to 85 years. There are marked differences between "younger" and "older" elderly persons regarding hearing loss that severely affects oral communication.

Fertility and sexual life of men after their forties and in older age.

PubMed

Schill, W B

2001-03-01

Owing to the demographic development, the aging male will require more consideration in future. In contrast to a rapid decline of estradiol during menopause in women, the process of aging in the male is retarded and subject to high individual variations. Impairment of spermatogenesis is observed as a continuous process occurring over decades. However, only about 50 % of men in their eighties show complete loss of fertility. In principle, spermatogenesis may be retained well into senescence. Of importance for the individual health condition is the fact that the number of Leydig cells declines with advancing age. Thus, altered sex hormone concentrations in aging men result from both functional disturbances and a gradual reduction in Leydig cells. Furthermore, an impaired feed-back mechanism of the pituitary-gonadal axis occurs, with disappearance of the circadian testosterone (T) rhythm. LH and FSH levels are increased, and a reduced bioavailability of sex hormones is observed. Lower total testosterone concentrations in men over 60 years are accompanied by clinical signs of reduced virility, such as decreased muscle mass and strength as well as reduced sexual hair growth and libido. An age-related decline in androgen secretion and plasma testosterone levels therefore suggests the use of androgen supplementation. However, there is a lack of risk-benefit long-term studies. Increased research in the male is mandatory to meet the requirements of the aging population. This should include the availability of precise epidemiological data about the frequency of partial androgen deficiency in aging males (PADAM).

Impact of age cutoffs on a lynch syndrome screening program.

PubMed

Gudgeon, James M; Belnap, Thomas W; Williams, Janet L; Williams, Marc S

2013-07-01

To determine the impact of applying an age cutoff to tumor-based Lynch syndrome (LS) screening, specifically focusing on changes in relative effectiveness, efficiency, and cost. The project was undertaken to answer questions about implementation of the LS screening program in an integrated health care delivery system. Clinical data extracted from an internal cancer registry, previous modeling efforts, published literature, and gray data were used to populate decision models designed to answer questions about the impact of age cutoffs in LS screening. Patients with colorectal cancer (CRC) were stratified at 10-year intervals from ages 50 to 80 years and compared with no age cutoff. Outcomes are reported for a cohort of 325 patients screened and includes total cost to screen, LS cases present in the cutoff category, number of LS cases expected to be identified by screening, cost per LS case detected, and total number and percentage of LS cases missed. Applying an age cutoff to an LS screening program has considerable potential for decreasing total screening costs and increasing efficiency, but at a loss of effectiveness. Imposing an age cutoff of 50 years reduces the cost of the screening program to 16% of a program with no age cutoff, but at the expense of missing more than half of the cases. Failure to identify LS cases is magnified by a cascade effect in family members. The results of this analysis influenced the final policy in our system.

Autism spectrum disorder in adults: diagnosis, management, and health services development

PubMed Central

Murphy, Clodagh M; Wilson, C Ellie; Robertson, Dene M; Ecker, Christine; Daly, Eileen M; Hammond, Neil; Galanopoulos, Anastasios; Dud, Iulia; Murphy, Declan G; McAlonan, Grainne M

2016-01-01

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by pervasive difficulties since early childhood across reciprocal social communication and restricted, repetitive interests and behaviors. Although early ASD research focused primarily on children, there is increasing recognition that ASD is a lifelong neurodevelopmental disorder. However, although health and education services for children with ASD are relatively well established, service provision for adults with ASD is in its infancy. There is a lack of health services research for adults with ASD, including identification of comorbid health difficulties, rigorous treatment trials (pharmacological and psychological), development of new pharmacotherapies, investigation of transition and aging across the lifespan, and consideration of sex differences and the views of people with ASD. This article reviews available evidence regarding the etiology, legislation, diagnosis, management, and service provision for adults with ASD and considers what is needed to support adults with ASD as they age. We conclude that health services research for adults with ASD is urgently warranted. In particular, research is required to better understand the needs of adults with ASD, including health, aging, service development, transition, treatment options across the lifespan, sex, and the views of people with ASD. Additionally, the outcomes of recent international legislative efforts to raise awareness of ASD and service provision for adults with ASD are to be determined. Future research is required to identify high-quality, evidence-based, and cost-effective models of care. Furthermore, future health services research is also required at the beginning and end of adulthood, including improved transition from youth to adult health care and increased understanding of aging and health in older adults with ASD. PMID:27462160

Exploring the Link Between Cognitive Abilities and Speech Recognition in the Elderly Under Different Listening Conditions

PubMed Central

Nuesse, Theresa; Steenken, Rike; Neher, Tobias; Holube, Inga

2018-01-01

Elderly listeners are known to differ considerably in their ability to understand speech in noise. Several studies have addressed the underlying factors that contribute to these differences. These factors include audibility, and age-related changes in supra-threshold auditory processing abilities, and it has been suggested that differences in cognitive abilities may also be important. The objective of this study was to investigate associations between performance in cognitive tasks and speech recognition under different listening conditions in older adults with either age appropriate hearing or hearing-impairment. To that end, speech recognition threshold (SRT) measurements were performed under several masking conditions that varied along the perceptual dimensions of dip listening, spatial separation, and informational masking. In addition, a neuropsychological test battery was administered, which included measures of verbal working and short-term memory, executive functioning, selective and divided attention, and lexical and semantic abilities. Age-matched groups of older adults with either age-appropriate hearing (ENH, n = 20) or aided hearing impairment (EHI, n = 21) participated. In repeated linear regression analyses, composite scores of cognitive test outcomes (evaluated using PCA) were included to predict SRTs. These associations were different for the two groups. When hearing thresholds were controlled for, composed cognitive factors were significantly associated with the SRTs for the ENH listeners. Whereas better lexical and semantic abilities were associated with lower (better) SRTs in this group, there was a negative association between attentional abilities and speech recognition in the presence of spatially separated speech-like maskers. For the EHI group, the pure-tone thresholds (averaged across 0.5, 1, 2, and 4 kHz) were significantly associated with the SRTs, despite the fact that all signals were amplified and therefore in principle audible. PMID:29867654

Family pet ownership during childhood: findings from a UK birth cohort and implications for public health research.

PubMed

Westgarth, Carri; Heron, Jon; Ness, Andy R; Bundred, Peter; Gaskell, Rosalind M; Coyne, Karen P; German, Alexander J; McCune, Sandra; Dawson, Susan

2010-10-01

In developed nations, approximately half of household environments contain pets. Studies of Human-Animal Interaction (HAI) have proposed that there are health benefits and risks associated with pet ownership. However, accurately demonstrating and understanding these relationships first requires a better knowledge of factors associated with ownership of different pet types. A UK birth cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC), were used to collect pet ownership data from the mothers, from gestation to child age 10 years old. 14,663 children were included in the study, of which mothers of 13,557 reported pet information at gestation, and 7,800 by age 10. Pet types recorded include cat, dog, rabbit, rodent, bird, fish and tortoise/turtle. The dataset also contains a number of demographic, socioeconomic and behavioural variables relevant to human health behaviour. Logistic regression was used to build multivariable models for ownership of each pet type at age 7 years. Family pet ownership increased during childhood, in particular rabbits, rodents and fish. A number of socioeconomic and demographic factors were associated with ownership of different pet types and the effects differed depending on the pet type studied. Variables which require consideration by researchers include gender, presence of older siblings, ethnicity, maternal and paternal education, maternal and paternal social class, maternal age, number of people in the household, house type, and concurrent ownership of other pets. Whether the mother had pets during her childhood was a strong predictor of pet ownership in all models. In HAI studies, care should be taken to control for confounding factors, and to treat each pet type individually. ALSPAC and other similar birth cohorts can be considered a potential resource for research into the effects of pet ownership during childhood.

Family Pet Ownership during Childhood: Findings from a UK Birth Cohort and Implications for Public Health Research

PubMed Central

Westgarth, Carri; Heron, Jon; Ness, Andy R.; Bundred, Peter; Gaskell, Rosalind M.; Coyne, Karen P.; German, Alexander J.; McCune, Sandra; Dawson, Susan

2010-01-01

In developed nations, approximately half of household environments contain pets. Studies of Human-Animal Interaction (HAI) have proposed that there are health benefits and risks associated with pet ownership. However, accurately demonstrating and understanding these relationships first requires a better knowledge of factors associated with ownership of different pet types. A UK birth cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC), were used to collect pet ownership data from the mothers, from gestation to child age 10 years old. 14,663 children were included in the study, of which mothers of 13,557 reported pet information at gestation, and 7,800 by age 10. Pet types recorded include cat, dog, rabbit, rodent, bird, fish and tortoise/turtle. The dataset also contains a number of demographic, socioeconomic and behavioural variables relevant to human health behaviour. Logistic regression was used to build multivariable models for ownership of each pet type at age 7 years. Family pet ownership increased during childhood, in particular rabbits, rodents and fish. A number of socioeconomic and demographic factors were associated with ownership of different pet types and the effects differed depending on the pet type studied. Variables which require consideration by researchers include gender, presence of older siblings, ethnicity, maternal and paternal education, maternal and paternal social class, maternal age, number of people in the household, house type, and concurrent ownership of other pets. Whether the mother had pets during her childhood was a strong predictor of pet ownership in all models. In HAI studies, care should be taken to control for confounding factors, and to treat each pet type individually. ALSPAC and other similar birth cohorts can be considered a potential resource for research into the effects of pet ownership during childhood. PMID:21139856

Stratigraphy, correlation, and age estimates for fossils from Area 123, Koobi Fora.

PubMed

Feibel, Craig S; Lepre, Christopher J; Quinn, Rhonda L

2009-08-01

Geological data from the Bura Hasuma region at Koobi Fora provide important constraints for estimating the ages of hominin fossils recovered there, including the cranium KNM-ER 1813. Strata of the upper Burgi, KBS, and Okote members in this part of Koobi Fora reflect three depositional regimes driven by changing paleogeography through time. The upper Burgi and lowermost KBS sequence in the southern Bura Hasuma region accumulated in a lacustrine to delta front setting, with highly localized depositional patterns, limiting the lateral extent of lithostratigraphic markers. Farther north, uppermost upper Burgi through KBS member strata document a fluctuating lake margin, with complex facies patterns. This interval is marked by laterally extensive lithostratigraphic markers, including molluscan packstones, beach sandstones, and stromatolite beds. The uppermost KBS and Okote members show a transition to dominantly fluvial character, with localized and discontinuous accumulation. An age model for the richly fossiliferous Area 123 sequence demonstrates the complexity of terrestrial accumulation patterns. Early lacustrine and delta front accumulation is marked by fairly continuous sedimentation, and high accumulation rates (up to ca. 91 cm/k.yr.). The fluctuating lake margin interval reflects lower sedimentation rates coupled with intervals of exposure, decreasing accumulation significantly (to ca. 13 cm/k.yr.). The capping fluvial interval is marked by significant erosion surfaces, breaks which may drop the overall accumulation rate even lower (ca. 0.3 cm/k.yr.). The data provided here establish a geological framework at odds with a recent proposal of ages considerably younger (by ca. 250 k.yr.) for many of the fossils from Area 123 and elsewhere. Tests of age models demonstrate that the younger ages are not possible. While minor refinements to age estimates for fossils are indicated by improved chronostratigraphic control, in the case of KNM-ER 1813, an age of younger than 1.78 Ma is precluded on magnetostratigraphic grounds.

The Aging Mind: Potential and Limits.

ERIC Educational Resources Information Center

Baltes, Paul B.

1993-01-01

Notes that research on aging mind has moved from simple growth versus decline view to conception of joint consideration of potential and limits. Sees this development illustrated by research on two categories of cognitive functioning: the cognitive mechanics (comparable to fluid intelligence) and cognitive pragmatics (comparable to crystallized…

METHODS FOR MODELING PARTICLE DEPOSITION AS A FUNCTION OF AGE. (R827352C004)

EPA Science Inventory

The purpose of this paper is to review the application of mathematical models of inhaled particle deposition to people of various ages. The basic considerations of aerosol physics, biological characteristics and model structure are presented along with limitations inherent in ...

Old Age and Literature: An Overview

ERIC Educational Resources Information Center

Ansello, Edward F.

1977-01-01

Analysis of old age and literature provides some support for the position that cultural stereotypes regarding growing older, biases with considerable history, continue to be reflected in the printed word. It seems most apparent that earlier developmental stages--historically and chronologically--are more subject to constricted representations of…

Is age a factor in crashes at channelized right-turn lanes? an exploration of potential relationships.

DOT National Transportation Integrated Search

2016-10-01

The objective of this research was to determine if a relationship exists between crashes and right-turn lane design : characteristics with specific consideration of the age of the driver. The research team used crash data of selected : intersections ...

Childhood immunization: one HMO's experience in benchmarking and improving plan performance.

PubMed

Keitel, C

1995-01-01

In 1994, Health Net initiated a childhood immunization campaign and research project to improve health plan member immunization rates by motivating and educating parents of children 20-32 months old as to the importance of fully immunizing their child. The findings indicate that 88 percent of those parents with children who were not fully immunized believed their child had been fully immunized by age two. This lack of awareness may explain the unreliability of self-reported immunization status. Future immunization campaigns must include ongoing member reminder systems, educate members as to the immunization schedule, and must take into consideration the barriers, real and perceived, that block full immunization.

Pattern identification in time-course gene expression data with the CoGAPS matrix factorization.

PubMed

Fertig, Elana J; Stein-O'Brien, Genevieve; Jaffe, Andrew; Colantuoni, Carlo

2014-01-01

Patterns in time-course gene expression data can represent the biological processes that are active over the measured time period. However, the orthogonality constraint in standard pattern-finding algorithms, including notably principal components analysis (PCA), confounds expression changes resulting from simultaneous, non-orthogonal biological processes. Previously, we have shown that Markov chain Monte Carlo nonnegative matrix factorization algorithms are particularly adept at distinguishing such concurrent patterns. One such matrix factorization is implemented in the software package CoGAPS. We describe the application of this software and several technical considerations for identification of age-related patterns in a public, prefrontal cortex gene expression dataset.

Inhalant allergies in children.

PubMed

Mims, James W; Veling, Maria C

2011-06-01

Children with chronic or recurrent upper respiratory inflammatory disease (rhinitis) should be considered for inhalant allergies. Risk factors for inhalant allergies in children include a first-degree relative with allergies, food allergy in infancy, and atopic dermatitis. Although inhalant allergies are rare in infancy, inhalant allergies are common in older children and impair quality of life and productivity. Differentiating between viral and allergic rhinitis can be challenging in children, but the child's age, history, and risk factors can provide helpful information. Allergic rhinitis is a risk factor for asthma, and if one is present, medical consideration of the other is warranted. Copyright © 2011 Elsevier Inc. All rights reserved.

Global warming and neurodegenerative disorders: speculations on their linkage.

PubMed

Habibi, Laleh; Perry, George; Mahmoudi, Morteza

2014-01-01

Climate change is having considerable impact on biological systems. Eras of ice ages and warming shaped the contemporary earth and origin of creatures including humans. Warming forces stress conditions on cells. Therefore, cells evolved elaborate defense mechanisms, such as creation of heat shock proteins, to combat heat stress. Global warming is becoming a crisis and this process would yield an undefined increasing rate of neurodegenerative disorders in future decades. Since heat stress is known to have a degenerative effects on neurons and, conversely, cold conditions have protective effect on these cells, we hypothesize that persistent heat stress forced by global warming might play a crucial role in increasing neurodegenerative disorders.

Youths as partners in a community participatory project for substance use prevention.

PubMed

Kulbok, Pamela A; Meszaros, Peggy S; Bond, Donna C; Thatcher, Esther; Park, Eunhee; Kimbrell, Monica; Smith-Gregory, Tracey

2015-01-01

This community-based participatory research project aimed to develop strategies to prevent youth substance use in a rural county. This article (1) describes the project phases, (2) examines unique contributions and considerations of youth involvement, and (3) explores the youths' perspective. Twelve youths, aged 16 to 18 years, joined parents, community leaders, and research specialists on the community-based participatory research team. The youths were integrally involved in all phases including the community assessment, community leader interviews, selection of a substance use prevention program, and program implementation. Youths reported sustained enthusiasm, experiences of authentic leadership, development of research skills, and greater awareness of their community.

Homeopathic approach in the treatment of patients with mental disability.

PubMed

Dolce Filho, R

2006-01-01

The author describes his experience assisting mentally disabled patients with homeopathy. In these patients' anamneses, common traits shared by some syndromes, pathologies and behaviour, were taken into consideration, mainly to choose the most characteristic symptoms in each case. The study includes 58 cases of patients suffering from this pathology: 28 females and 30 males, ages ranging from 1 to 49 years (mean 20). Forty-seven had some improvement. Homeopathy is a useful alternative to relieve pathologies associated with mental disability. In those cases in which there were similarities between remedy and whole symptomatology, improvements in adaptation skills and in overall health were observed.

Factors associated with female provider preference among African American women, and implications for breast cancer screening.

PubMed

Casciotti, Dana M; Klassen, Ann C

2011-07-01

Globally, breast cancer incidence is increasing. Early detection remains important for addressing disparities, including among U.S. minorities. Seeing a female physician increases screening, but the effects of unmet provider gender preference among underserved populations remain unexplored. Among 576 urban African American women age 45-93, we examined predictors of gender preference and how met and unmet preference influenced screening. We conclude that provider gender is a "double-edged sword." We saw a female provider screening benefit, but also that gender preference was associated with past disadvantage and attitudes inconsistent with health maintenance. Provider gender preference merits further consideration in women's health research.

Acute Neurological Issues in Pregnancy and the Peripartum

PubMed Central

Hosley, Catherine M.; McCullough, Louise D.

2011-01-01

Acute neurological diseases requiring hospitalization are relatively rare in women of childbearing age. However, during pregnancy and the postpartum period, several diseases increase in prevalence. Some are unique to the pregnant/postpartum state including preeclampsia and delivery-associated neuropathies. Others, although indirectly related to pregnancy, such as cerebral venous thrombosis, ischemic stroke, and intracerebral hemorrhage, increase in frequency and carry considerable risk of morbidity and mortality. In addition, treatment options are often limited. This review discusses the diseases more commonly seen during pregnancy and the postpartum period, with a focus on emergent neurological diseases and their management. Interventional therapies will also be discussed. PMID:23983844

The international growth standard for preadolescent and adolescent children: statistical considerations.

PubMed

Cole, T J

2006-12-01

This article discusses statistical considerations for the design of a new study intended to provide an International Growth Standard for Preadolescent and Adolescent Children, including issues such as cross-sectional, longitudinal, and mixed designs; sample-size derivation for the number of populations and number of children per population; modeling of growth centiles of height, weight, and other measurements; and modeling of the adolescent growth spurt. The conclusions are that a mixed longitudinal design will provide information on both growth distance and velocity; samples of children from 5 to 10 sites should be suitable for an international standard (based on political rather than statistical arguments); the samples should be broadly uniform across age but oversampled during puberty, and should include data into adulthood. The LMS method is recommended for constructing measurement centiles, and parametric or semiparametric approaches are available to estimate the timing of the adolescent growth spurt in individuals. If the new standard is to be grafted onto the 2006 World Health Organization (WHO) reference, caution is needed at the join point of 5 years, where children from the new standard are likely to be appreciably more obese than those from the WHO reference, due to the rising trends in obesity and the time gap in data collection between the two surveys.

Pharmacotherapy for Parkinson's disease.

PubMed

Chen, Jack J; Swope, David M

2007-12-01

The available pharmacotherapies for Parkinson's disease address symptomatology because no agent has been demonstrated to provide definite neuroprotection against the disease. Choice of pharmacotherapy must include consideration of short-term benefits as well as long-term consequences. Patients with mild Parkinson's disease often function adequately without symptomatic treatment. However, recent data suggest that initiation of treatment with a well-tolerated agent (e.g., the monoamine oxidase [MAO]-B inhibitor rasagiline) in the absence of functional impairment is associated with improved long-term outcomes. Consideration should also be given to many patient-specific factors, including patient expectations, level of disability, employment status, functional as well as chronologic age, expected efficacy and tolerability of drugs, and response to previous Parkinson's disease therapies. Increasingly, initial monotherapy begins with a nondopaminergic agent or, if the patient is considered functionally young, a dopamine agonist. Since Parkinson's disease is a progressive disorder, adjustments to pharmacotherapy must be expected over time. When greater symptomatic relief is desired, or in the more frail elderly patient, levodopa therapy should be considered. If motor fluctuations develop, addition of a catechol-O-methyltransferase inhibitor or MAO-B inhibitor should be considered. For management of levodopa-induced dyskinesias, addition of amantadine is an option. Surgery may be considered when patients need additional symptomatic control or are experiencing severe motor complications despite pharmacologically optimized therapy.

Evaluation of the Coca-Cola company travel health kit.

PubMed

Harper, Lynne A; Bettinger, Julie; Dismukes, Roberta; Kozarsky, Phyllis E

2002-01-01

The Coca-Cola travel health kit has been used for about one decade for international travelers and required evaluation to see if the items contained were appropriate for the employees. Two hundred thirty-four travelers were sampled and filled out a voluntary survey including questions about demographic information, travel history, and usage and value of the contents of the travel health kit. One hundred eighty-one surveys were returned; 65% of the respondents were male, and the majority of travelers were between the ages of 36 and 45 years. The most useful items were analgesics and medications used for gastrointestinal problems. In general, the items identified as being the least useful were those requiring specialized use by a medical practitioner, such as needles and syringes. Suggestions of items to be added to the kit included vitamins, cough drops, sleep aids, and eye drops. A surprising result that Coca-Cola employees expressed the desire for brand name rather than generic items. Evaluation of the Coca-Cola Company travel health kit revealed it to be very useful to most corporate travelers. Suggestions that were made will be taken into consideration in designing a new kit, and consideration is being given to whether a basic travel health kit should be provided to which travelers can add other items depending on their personal needs.

Considerations in using linkage analysis as a presymptomatic test for Huntington's disease.

PubMed

Farrer, L A; Myers, R H; Cupples, L A; Conneally, P M

1988-09-01

The polymorphic locus D4S10 that is genetically linked to the locus for Huntington's disease (HD) has made possible a presymptomatic test for those at risk. Because the symptoms of this progressively debilitating and fatal illness are not usually manifest until adulthood, the outcome of the test will influence major decisions about career, marriage, and procreation. Several differential diagnoses must be considered before using the test if HD is not confirmed in at least one family member. Review of a large number of pedigrees has shown that 40% of persons at risk do not have appropriate family structure for a linkage test. Furthermore, uncooperative or inaccessible relatives may make this test infeasible for many others who wish to be tested. Linkage phase, which must be known in the affected parent for an informative test, can be determined using one or more of 12 probe-enzyme combinations for D4S10. Although the polymorphism information content (PIC) value for any one RFLP is less than 40%, the PIC value for the haplotype of the two G8 HindIII, pK083 EcoRI, and R7 BglII RFLPs is greater than 88%. We have developed a scheme to incorporate linkage data and age at onset information adjusted for censored observations, sex of affected parent, and familial correlation for age at onset, using the computer program MLINK for calculation of risk of having HD. Simulated experiments showed that proper age at onset adjustment is crucial to the calculation of the probability of risk. A formal presymptomatic testing protocol, including pre- and post-test counselling, psychological testing, and paternity testing is recommended. Many of these considerations are illustrated in several actual test cases.

Hepatitis E virus: Western Cape, South Africa

PubMed Central

Madden, Richie G; Wallace, Sebastian; Sonderup, Mark; Korsman, Stephen; Chivese, Tawanda; Gavine, Bronwyn; Edem, Aniefiok; Govender, Roxy; English, Nathan; Kaiyamo, Christy; Lutchman, Odelia; van der Eijk, Annemiek A; Pas, Suzan D; Webb, Glynn W; Palmer, Joanne; Goddard, Elizabeth; Wasserman, Sean; Dalton, Harry R; Spearman, C Wendy

2016-01-01

AIM To conduct a prospective assessment of anti-hepatitis E virus (HEV) IgG seroprevalence in the Western Cape Province of South Africa in conjunction with evaluating risk factors for exposure. METHODS Consenting participants attending clinics and wards of Groote Schuur, Red Cross Children’s Hospital and their affiliated teaching hospitals in Cape Town, South Africa, were sampled. Healthy adults attending blood donor clinics were also recruited. Patients with known liver disease were excluded and all major ethnic/race groups were included to broadly represent local demographics. Relevant demographic data was captured at the time of sampling using an interviewer-administered confidential questionnaire. Human immunodeficiency virus (HIV) status was self-disclosed. HEV IgG testing was performed using the Wantai® assay. RESULTS HEV is endemic in the region with a seroprevalence of 27.9% (n = 324/1161) 95%CI: 25.3%-30.5% (21.9% when age-adjusted) with no significant differences between ethnic groups or HIV status. Seroprevalence in children is low but rapidly increases in early adulthood. With univariate analysis, age ≥ 30 years old, pork and bacon/ham consumption suggested risk. In the multivariate analysis, the highest risk factor for HEV IgG seropositivity (OR = 7.679, 95%CI: 5.38-10.96, P < 0.001) was being 30 years or older followed by pork consumption (OR = 2.052, 95%CI: 1.39-3.03, P < 0.001). A recent clinical case demonstrates that HEV genotype 3 may be currently circulating in the Western Cape. CONCLUSION Hepatitis E seroprevalence was considerably higher than previously thought suggesting that hepatitis E warrants consideration in any patient presenting with an unexplained hepatitis in the Western Cape, irrespective of travel history, age or ethnicity. PMID:27956810

[Employment, family and health in men of working age in Germany : Results of the GEDA studies 2009-2012].

PubMed

Kroll, Lars Eric; Müters, Stephan; Rattay, Petra; Lampert, Thomas

2016-08-01

Today's men want to participate in their children's upbringing more than in the past, but they are heavily involved in their occupation at the same time. This article describes the significance of parenthood, partnership and occupation in relation to health and health behaviours among men of working age in Germany. We summarised data from the "German Health Update" (GEDA) studies conducted in 2009, 2010 and 2012. Data on 18,465 men aged 18-64 years were available, 11,429 of which were living with children. We included mental health problems, general health awareness, sports activity and smoking as outcomes. Full-time employees working more than 48 h per week and unemployed persons had mental health problems more frequently (OR 1.44 and 2.35, p < 0.05) than full-time employees working 48 h or fewer. Similar associations can be shown for health awareness, physical activity and smoking. Concerning partnership and parenthood, the associations were considerably weaker: men living together with children and a partner in the household were overall less burdened and their behaviour was also healthier than single men without children. After simultaneous consideration of employment status, parenthood and partnership, our results show that the unemployed and employees with long working hours were the most burdened. The results provide supporting evidence regarding health problems of men in Germany due to unemployment and long working hours that are of importance for their health whether they are living with a partner and/or with children or not. The association between health and occupation was stronger than between health and fatherhood or partnership.

Epidemiology of hypospadias in Europe: a registry-based study.

PubMed

Bergman, Jorieke E H; Loane, Maria; Vrijheid, Martine; Pierini, Anna; Nijman, Rien J M; Addor, Marie-Claude; Barisic, Ingeborg; Béres, Judit; Braz, Paula; Budd, Judith; Delaney, Virginia; Gatt, Miriam; Khoshnood, Babak; Klungsøyr, Kari; Martos, Carmen; Mullaney, Carmel; Nelen, Vera; Neville, Amanda J; O'Mahony, Mary; Queisser-Luft, Annette; Randrianaivo, Hanitra; Rissmann, Anke; Rounding, Catherine; Tucker, David; Wellesley, Diana; Zymak-Zakutnia, Natalya; Bakker, Marian K; de Walle, Hermien E K

2015-12-01

Hypospadias is a common congenital malformation. The prevalence of hypospadias has a large geographical variation, and recent studies have reported both increasing and decreasing temporal trends. It is unclear whether hypospadias prevalence is associated with maternal age. To analyze the prevalence and trends of total hypospadias, isolated hypospadias, hypospadias with multiple congenital anomalies, hypospadias with a known cause, and hypospadias severity subtypes in Europe over a 10-year period and to investigate whether maternal age is associated with hypospadias. We included all children with hypospadias born from 2001 to 2010 who were registered in 23 EUROCAT registries. Information on the total number of births and maternal age distribution for the registry population was also provided. We analyzed the total prevalence of hypospadias and relative risks by maternal age. From 2001 to 2010, 10,929 hypospadias cases were registered in 5,871,855 births, yielding a total prevalence of 18.61 per 10,000 births. Prevalence varied considerably between different registries, probably due to differences in ascertainment of hypospadias cases. No significant temporal trends were observed with the exceptions of an increasing trend for anterior and posterior hypospadias and a decreasing trend for unspecified hypospadias. After adjusting for registry effects, maternal age was not significantly associated with hypospadias. Total hypospadias prevalence was stable in 23 EUROCAT registries from 2001 to 2010 and was not significantly influenced by maternal age.

Discrepancies between cognition and decision making in older adults

PubMed Central

Boyle, Patricia A.; James, Bryan D.; Yu, Lei; Barnes, Lisa L.; Bennett, David A.

2015-01-01

Background and aims There is increasing clinical and legal interest in discrepancies between decision-making ability and cognition in old age, a stage of life when decisions have major ramifications. We investigated the frequency and correlates of such discrepancies in non-demented older adults participating in a large community-based cohort study of aging, the Rush Memory and Aging Project. Methods Participants [n = 689, mean age 81.8 (SD 7.6), mean education 15.2 (SD 3.1), 76.8 % female and 93.3 % white] completed a measure of financial and healthcare decision making (DM) and a battery of 19 neuropsychological tests from which a composite measure of global cognition (COG) was derived. Results Results indicated that 23.9 % of the sample showed a significant discrepancy between DM and COG abilities. Of these, 12.9 % showed DM < COG, while 11.0 % showed DM > COG. Logistic regression models showed older age, being non-white, greater temporal discounting, and greater risk aversion were associated with higher odds of being in the DM < COG group. Being male was associated with higher odds of being in the DM > COG group. Education, income, depressive symptoms, and impulsivity were not associated with a discrepancy. Only demographic associations (age, sex, and race) remained significant in a fully adjusted model with terms included for all factors. Conclusion These results support the consideration of decision making and cognition as potentially separate constructs. PMID:25995167

Discrepancies between cognition and decision making in older adults.

PubMed

Han, S Duke; Boyle, Patricia A; James, Bryan D; Yu, Lei; Barnes, Lisa L; Bennett, David A

2016-02-01

There is increasing clinical and legal interest in discrepancies between decision-making ability and cognition in old age, a stage of life when decisions have major ramifications. We investigated the frequency and correlates of such discrepancies in non-demented older adults participating in a large community-based cohort study of aging, the Rush Memory and Aging Project. Participants [n = 689, mean age 81.8 (SD 7.6), mean education 15.2 (SD 3.1), 76.8 % female and 93.3 % white] completed a measure of financial and healthcare decision making (DM) and a battery of 19 neuropsychological tests from which a composite measure of global cognition (COG) was derived. Results indicated that 23.9 % of the sample showed a significant discrepancy between DM and COG abilities. Of these, 12.9 % showed DM < COG, while 11.0 % showed DM > COG. Logistic regression models showed older age, being non-white, greater temporal discounting, and greater risk aversion were associated with higher odds of being in the DM < COG group. Being male was associated with higher odds of being in the DM > COG group. Education, income, depressive symptoms, and impulsivity were not associated with a discrepancy. Only demographic associations (age, sex, and race) remained significant in a fully adjusted model with terms included for all factors. These results support the consideration of decision making and cognition as potentially separate constructs.

Longitudinal impact of frequent geographic relocation from adolescence to adulthood on psychosocial stress and vital exhaustion at ages 32 and 42 years: the Amsterdam growth and health longitudinal study.

PubMed

Lin, Kuan-Chia; Twisk, J W R; Huang, Hui-Chuan

2012-01-01

We assessed mobility in different life stages over a 29-year period from adolescence through adulthood and its correlation with psychosocial stress and vital exhaustion at ages 32 and 42 years. Data were derived from the Amsterdam Growth and Health Longitudinal Study, an observational longitudinal study of 420 boys and girls from age 13 to 42 years. Measurements included cumulative frequency of geographic relocation (CFGR), psychosocial stress (measured by a Dutch scale of experienced stress, VOEG-13), vital exhaustion (measured by the Maastricht Questionnaire, MQ), demographics, socioeconomic status, and other background characteristics. From 1976 to 2006, total CFGR was 3.56 ± 1.89 (range 0-13). Frequent geographic relocation during 2 life stages (age 22-32 years and 33-42 years) was significantly interrelated; however, this was not evident at age 13 to 21 years, which suggests a unique exposure to relocation during adolescence and youth. After adjusting for anticipated confounders, higher cumulative frequencies of residential changes during adolescence and youth were markedly associated with psychosocial stress and vital exhaustion at ages 32 and 42 years. Frequent geographic relocation during adolescence and youth was an indicator of psychosocial stress and vital exhaustion in the transition to middle adulthood. Further consideration of the pathways in this web of causation may aid in stress prevention and minimize negative consequences.

Calorie restriction in rodents: Caveats to consider.

PubMed

Ingram, Donald K; de Cabo, Rafael

2017-10-01

The calorie restriction paradigm has provided one of the most widely used and most useful tools for investigating mechanisms of aging and longevity. By far, rodent models have been employed most often in these endeavors. Over decades of investigation, claims have been made that the paradigm produces the most robust demonstration that aging is malleable. In the current review of the rodent literature, we present arguments that question the robustness of the paradigm to increase lifespan and healthspan. Specifically, there are several questions to consider as follows: (1) At what age does CR no longer produce benefits? (2) Does CR attenuate cognitive decline? (3) Are there negative effects of CR, including effects on bone health, wound healing, and response to infection? (4) How important is schedule of feeding? (5) How long does CR need to be imposed to be effective? (6) How do genotype and gender influence CR? (7) What role does dietary composition play? Consideration of these questions produce many caveats that should guide future investigations to move the field forward. Published by Elsevier B.V.

A systematic review and meta-analysis of structural magnetic resonance imaging studies investigating cognitive and social activity levels in older adults.

PubMed

Anatürk, M; Demnitz, N; Ebmeier, K P; Sexton, C E

2018-06-22

Population aging has prompted considerable interest in identifying modifiable factors that may help protect the brain and its functions. Collectively, epidemiological studies show that leisure activities with high mental and social demands are linked with better cognition in old age. The extent to which socio-intellectual activities relate to the brain's structure is, however, not yet fully understood. This systematic review and meta-analysis summarizes magnetic resonance imaging studies that have investigated whether cognitive and social activities correlate with measures of gray and white matter volume, white matter microstructure and white matter lesions. Across eighteen included studies (total n = 8429), activity levels were associated with whole-brain white matter volume, white matter lesions and regional gray matter volume, although effect sizes were small. No associations were found for global gray matter volume and the evidence concerning white matter microstructure was inconclusive. While the causality of the reviewed associations needs to be established, our findings implicate socio-intellectual activity levels as promising targets for interventions aimed at promoting healthy brain aging. Copyright © 2018. Published by Elsevier Ltd.

Early neurodevelopmental outcomes of extremely preterm infants.

PubMed

Rogers, Elizabeth E; Hintz, Susan R

2016-12-01

Infants born at extreme preterm gestation are at risk for both death and disability. Although rates of survival have improved for this population, and some evidence suggests a trend toward decreased neuromotor impairment over the past decades, a significant improvement in overall early neurodevelopmental outcome has not yet been realized. This review will examine the rates and types of neurodevelopmental impairment seen after extremely preterm birth, including neurosensory, motor, cognitive, and behavioral outcomes. We focus on early outcomes in the first 18-36 months of life, as the majority of large neonatal studies examining neurodevelopmental outcomes stop at this age. However, this early age is clearly just a first glimpse into lifetime outcomes; the neurodevelopmental effects of extreme prematurity may last through school age, adolescence, and beyond. Importantly, prematurity appears to be an independent risk factor for adverse development, but this population demonstrates considerable variability in the types and severity of impairments. Understanding both the nature and prevalence of neurodevelopmental impairment among extremely preterm infants is important because it can lead to targeted interventions that in turn may lead to improved outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Violence, television and the health of American youth.

PubMed

Somers, A R

1976-04-08

In 1973, 18,032 young Americans, 15 to 24 years of age, died in motor-vehicle accidents, 5182 were murdered, and 4098 committed suicide. The death rate, for this age group, was 19 per cent higher in 1973-74 than it had been in 1960-61, owing entirely to deaths by violence. The largest rise in deaths from homicide during the past two decades was at the ages of one to four. For a considerable proportion of American children and youth, the "culture of violence" is now both a major health threat and a way of life. One contributing factor is television's massive daily diet of symbolic crime and violence in "entertainment" programs. After numerous studies of televsion influence on real-life violence, including two major government commissions, the industry is experimenting with a 7 to 9 p.m. "Family Hour" (6 to 8 p.m. Central Time) from which violence, along with sex, has been largely banished. Three industry unions claim censorship and are suing. The medical profession is urged to concern itself with this serious and complex health hazard.

Hitting a Moving Target: Basic Mechanisms of Recovery from Acquired Developmental Brain Injury

PubMed Central

Giza, Christopher C.; Kolb, Bryan; Harris, Neil G.; Asarnow, Robert F.; Prins, Mayumi L.

2009-01-01

Acquired brain injuries represent a major cause of disability in the pediatric population. Understanding responses to developmental acquired brain injuries requires knowledge of the neurobiology of normal development, age-at-injury effects and experience-dependent neuroplasticity. In the developing brain, full recovery cannot be considered as a return to the premorbid baseline, since ongoing maturation means that cerebral functioning in normal individuals will continue to advance. Thus, the recovering immature brain has to ‘hit a moving target’ to achieve full functional recovery, defined as parity with age-matched uninjured peers. This review will discuss the consequences of developmental injuries such as focal lesions, diffuse hypoxia and traumatic brain injury (TBI). Underlying cellular and physiological mechanisms relevant to age-at-injury effects will be described in considerable detail, including but not limited to alterations in neurotransmission, connectivity/network functioning, the extracellular matrix, response to oxidative stress and changes in cerebral metabolism. Finally, mechanisms of experience-dependent plasticity will be reviewed in conjunction with their effects on neural repair and recovery. PMID:19956795

Age, Gender, and Fine-Grained Ethnicity Prediction using Convolutional Neural Networks for the East Asian Face Dataset

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

Srinivas, Nisha; Rose, Derek C; Bolme, David S

This paper examines the difficulty associated with performing machine-based automatic demographic prediction on a sub-population of Asian faces. We introduce the Wild East Asian Face dataset (WEAFD), a new and unique dataset to the research community. This dataset consists primarily of labeled face images of individuals from East Asian countries, including Vietnam, Burma, Thailand, China, Korea, Japan, Indonesia, and Malaysia. East Asian turk annotators were uniquely used to judge the age and fine grain ethnicity attributes to reduce the impact of the other race effect and improve quality of annotations. We focus on predicting age, gender and fine-grained ethnicity ofmore » an individual by providing baseline results with a convolutional neural network (CNN). Finegrained ethnicity prediction refers to predicting ethnicity of an individual by country or sub-region (Chinese, Japanese, Korean, etc.) of the East Asian continent. Performance for two CNN architectures is presented, highlighting the difficulty of these tasks and showcasing potential design considerations that ease network optimization by promoting region based feature extraction.« less

Epidemiological Considerations Regarding the Health and Effectiveness of Women in the Armed Forces

DTIC Science & Technology

1984-06-21

of age beyond the early teens. Since the Army consists mainly of young adults in the age range of low death rates , relatively few deaths are expected...extend to a very advanced age but only reflects the percentage of enlisted soldiers older than 39. The sex-specific death rates and the indirectly age...would have lower death rates than the overall civilian population with the exception of military-specific occupational hazards. The military

A latent class analysis of substance use and culture among gay, bisexual and other men who have sex with men.

PubMed

Card, Kiffer G; Armstrong, Heather L; Carter, Allison; Cui, Zishan; Wang, Lu; Zhu, Julia; Lachowsky, Nathan J; Moore, David M; Hogg, Robert S; Roth, Eric A

2018-03-28

Assessments of gay and bisexual men's substance use often obscures salient sociocultural and identity-related experiences related to how they use drugs. Latent class analysis was used to examine how patterns of substance use represent the social, economic and identity-related experiences of this population. Participants were sexually active gay and bisexual men (including other men who have sex with men), aged ≥ 16 years, living in Metro Vancouver (n = 774). LCA indicators included all substances used in the past six months self-reported by more than 30 men. Model selection was made with consideration to model parsimony, interpretability and optimisation of statistical criteria. Multinomial regression identified factors associated with class membership. A six-class solution was identified representing: 'assorted drug use' (4.5%); 'club drug use' (9.5%); 'street drug use' (12.1%); 'sex drug use' (11.4%); 'conventional drug use' (i.e. tobacco, alcohol, marijuana; 25.9%); and 'limited drug use' (36.7%). Factors associated with class membership included age, sexual orientation, annual income, occupation, income from drug sales, housing stability, group sex event participation, gay bars/clubs attendance, sensation seeking and escape motivation. These results highlight the need for programmes and policies that seek to lessen social disparities and account for social distinctions among this population.

Characteristics of Older Adults and the Aging: Some Comments.

ERIC Educational Resources Information Center

Kowalski, Cash J.; Cangemi, Joseph P.

1978-01-01

Asserting that both humanistic and manpower considerations dictate that we address the aging process, this article describes the characteristics of older adults and illustrates the way in which they may be allowed to remain productive. Maslow's "Need Hierarchy" and Thorndike's "Theory of Developmental Tasks" are applied to the…

Oral Discourse and Reading Comprehension Abilities of African American School-Age Children

ERIC Educational Resources Information Center

Koonce, Nicole M.

2012-01-01

The reading underachievement of African American (AA) school-age children has received considerable attention in educational circles. Unfortunately, there are relatively few studies designed to uncover the source or sources of these reading achievement differences, especially in children beyond early elementary grades. Some studies suggest that…

Age-Related Differences in Academic Burnout of Korean Adolescents

ERIC Educational Resources Information Center

Lee, Jayoung; Puig, Ana; Lea, Eunkyoung; Lee, Sang Min

2013-01-01

Korean adolescents experience considerable stress because of an educational system that focuses primarily on college entrance examinations, pressure for academic achievement, and a competitive atmosphere in school. The main purpose of this study was to explore age differences in the construct of Korean adolescents' academic burnout. Once…

Linkage of the Canadian Study of Health and Aging to provincial administrative health care databases in Nova Scotia.

PubMed

Yip, A M; Kephart, G; Rockwood, K

2001-01-01

The Canadian Study of Health and Aging (CSHA) was a cohort study that included 528 Nova Scotian community-dwelling participants. Linkage of CSHA and provincial Medical Services Insurance (MSI) data enabled examination of health care utilization in this subsample. This article discusses methodological and ethical issues of database linkage and explores variation in the use of health services by demographic variables and health status. Utilization over 24 months following baseline was extracted from MSI's physician claims, hospital discharge abstracts, and Pharmacare claims databases. Twenty-nine subjects refused consent for access to their MSI file; health card numbers for three others could not be retrieved. A significant difference in healthcare use by age and self-rated health was revealed. Linkage of population-based data with provincial administrative health care databases has the potential to guide health care planning and resource allocation. This process must include steps to ensure protection of confidentiality. Standard practices for linkage consent and routine follow-up should be adopted. The Canadian Study of Health and Aging (CSHA) began in 1991-92 to explore dementia, frailty, and adverse health outcomes (Canadian Study of Health and Aging Working Group, 1994). The original CSHA proposal included linkage to provincial administrative health care databases by the individual CSHA study centers to enhance information on health care utilization and outcomes of study participants. In Nova Scotia, the Medical Services Insurance (MSI) administration, which drew the sampling frame for the original CSHA, did not retain the list of corresponding health card numbers. Furthermore, consent for this access was not asked of participants at the time of the first interview. The objectives of this study reported here were to examine the feasibility and ethical considerations of linking data from the CSHA to MSI utilization data, and to explore variation in health services use by demographic and health status characteristics in the Nova Scotia community cohort.

Seismic Fragility Analysis of a Condensate Storage Tank with Age-Related Degradations

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

Nie, J.; Braverman, J.; Hofmayer, C

2011-04-01

The Korea Atomic Energy Research Institute (KAERI) is conducting a five-year research project to develop a realistic seismic risk evaluation system which includes the consideration of aging of structures and components in nuclear power plants (NPPs). The KAERI research project includes three specific areas that are essential to seismic probabilistic risk assessment (PRA): (1) probabilistic seismic hazard analysis, (2) seismic fragility analysis including the effects of aging, and (3) a plant seismic risk analysis. Since 2007, Brookhaven National Laboratory (BNL) has entered into a collaboration agreement with KAERI to support its development of seismic capability evaluation technology for degraded structuresmore » and components. The collaborative research effort is intended to continue over a five year period. The goal of this collaboration endeavor is to assist KAERI to develop seismic fragility analysis methods that consider the potential effects of age-related degradation of structures, systems, and components (SSCs). The research results of this multi-year collaboration will be utilized as input to seismic PRAs. This report describes the research effort performed by BNL for the Year 4 scope of work. This report was developed as an update to the Year 3 report by incorporating a major supplement to the Year 3 fragility analysis. In the Year 4 research scope, an additional study was carried out to consider an additional degradation scenario, in which the three basic degradation scenarios, i.e., degraded tank shell, degraded anchor bolts, and cracked anchorage concrete, are combined in a non-perfect correlation manner. A representative operational water level is used for this effort. Building on the same CDFM procedure implemented for the Year 3 Tasks, a simulation method was applied using optimum Latin Hypercube samples to characterize the deterioration behavior of the fragility capacity as a function of age-related degradations. The results are summarized in Section 5 and Appendices G through I.« less

The Sleep-Time Cost of Parenting: Sleep Duration and Sleepiness Among Employed Parents in the Wisconsin Sleep Cohort Study

PubMed Central

Hagen, Erika W.; Mirer, Anna G.; Palta, Mari; Peppard, Paul E.

2013-01-01

Insufficient sleep is associated with poor health and increased mortality. Studies on whether parenthood (including consideration of number and ages of children) is associated with sleep duration or sleep problems are scant and inconclusive. Using data collected in the Wisconsin Sleep Cohort Study (n = 4,809) between 1989 and 2008, we examined cross-sectional associations of number and ages of children with self-reported parental sleep duration, daytime sleepiness, and dozing among employed adults. Longitudinal change in sleep duration over 19 years was examined to evaluate changes in parental sleep associated with children transitioning into adulthood (n = 833). Each child under age 2 years was associated with 13 fewer minutes of parental sleep per day (95% confidence interval (CI): 5, 21); each child aged 2–5 years was associated with 9 fewer minutes of sleep (95% CI: 5, 13); and each child aged 6–18 years was associated with 4 fewer minutes (95% CI: 2, 6). Adult children were not associated with shorter parental sleep duration. Parents of children over age 2 years were significantly more likely to experience daytime sleepiness and dozing during daytime activities. Parents of minor children at baseline had significantly greater increases in sleep duration over 19 years of follow-up. Parenting minor children is associated with shorter sleep duration. As children age into adulthood, the sleep duration of parents with more children approaches that of parents with fewer children. PMID:23378502

The WITS Atlas: A Black Southern African dental atlas for permanent tooth formation and emergence.

PubMed

Esan, Temitope A; Schepartz, Lynne A

2018-05-01

Current dental maturity charts, such as the widely applied London atlas, do not take into consideration advanced tooth emergence and formation patterns observed in children of African ancestry. The result is inaccurate age estimation in Southern Africa, a region where there is great forensic and anthropological need for reliable age estimation. To develop a population-specific atlas of permanent tooth emergence and formation for age estimation of Black Southern Africans. Using data from a cross-sectional study of 642 school children aged 5-20 years, panoramic radiographs taken during routine dental examination in a mobile treatment van were analyzed using the Demirjian method of eight (A-H) tooth formation stages. Tables of the stages of tooth development for each tooth, including the third molars, were generated separately for age cohorts and by sex. The most frequently occurring (modal) stage of tooth formation was considered the signature developmental stage for the age. The relationship of the third molar occlusal surfaces with occlusal tables on the radiographs were checked and compared with the findings recorded during intra oral examination. Comparison with the London atlas shows that at age 9.5 years, the canine and premolar emergence are at least one year ahead and the third molar formation completes four years earlier in the WITS Atlas. Similarities in advancement in tooth formation and emergence across sub-Saharan Africa suggest that the WITS Atlas can be used for those populations as well. © 2018 Wiley Periodicals, Inc.

Radioactive dating of the elements

NASA Technical Reports Server (NTRS)

Cowan, John J.; Thielemann, Friedrich-Karl; Truran, James W.

1991-01-01

The extent to which an accurate determination of the age of the Galaxy, and thus a lower bound on the age of the universe, can be obtained from radioactive dating is discussed. Emphasis is given to the use of the long-lived radioactive nuclei Re-187, Th-232, U-238, and U-235. The nature of the production sites of these and other potential Galactic chronometers is examined along with their production ratios. Age determinations from models of nucleocosmochronology are reviewed and compared with age determination from stellar sources and age constraints form cosmological considerations.

Emotional experience in the mornings and the evenings: consideration of age differences in specific emotions by time of day.

PubMed

English, Tammy; Carstensen, Laura L

2014-01-01

Considerable evidence points to age-related improvements in emotional well-being with age. In order to gain a more nuanced understanding of the nature of these apparent shifts in experience, we examined age differences in a range of emotional states in the mornings and evenings in a sample of 135 community-residing participants across 10 consecutive days. Participants ranged in age from 22 to 93 years. Each participant completed a diary in the morning and again in the evening every day for the study period. During each of the assessments, participants reported the degree to which they experienced emotions sampled from all four quadrants of the affective circumplex. Overall, participants felt less positive and more negative in the evenings than in the mornings. As expected, older adults reported a relatively more positive emotional experience than younger adults at both times of day. Importantly, however, age effects varied based on emotion type and time of day. Older adults reported experiencing more positive emotion than relatively younger adults across a range of different positive states (although age differences emerged most consistently for low arousal positive states). Age-related reductions in negative experience were observed only for reports of low arousal negative emotions. There were no age differences in anger, anxiety, or sadness. For some emotions, age differences were stronger in the mornings (e.g., relaxed) whereas for other emotions age differences were more pronounced in the evenings (e.g., enthusiastic). Findings are discussed in the context of adulthood changes in motivation and emotional experience.

Emotional experience in the mornings and the evenings: consideration of age differences in specific emotions by time of day

PubMed Central

English, Tammy; Carstensen, Laura L.

2014-01-01

Considerable evidence points to age-related improvements in emotional well-being with age. In order to gain a more nuanced understanding of the nature of these apparent shifts in experience, we examined age differences in a range of emotional states in the mornings and evenings in a sample of 135 community-residing participants across 10 consecutive days. Participants ranged in age from 22 to 93 years. Each participant completed a diary in the morning and again in the evening every day for the study period. During each of the assessments, participants reported the degree to which they experienced emotions sampled from all four quadrants of the affective circumplex. Overall, participants felt less positive and more negative in the evenings than in the mornings. As expected, older adults reported a relatively more positive emotional experience than younger adults at both times of day. Importantly, however, age effects varied based on emotion type and time of day. Older adults reported experiencing more positive emotion than relatively younger adults across a range of different positive states (although age differences emerged most consistently for low arousal positive states). Age-related reductions in negative experience were observed only for reports of low arousal negative emotions. There were no age differences in anger, anxiety, or sadness. For some emotions, age differences were stronger in the mornings (e.g., relaxed) whereas for other emotions age differences were more pronounced in the evenings (e.g., enthusiastic). Findings are discussed in the context of adulthood changes in motivation and emotional experience. PMID:24639663

Attitudes, knowledge and perceptions towards whooping cough and pertussis vaccine in hospitalized adults.

PubMed

Ridda, Iman; Gao, Zhanhai; Macintyre, C Raina

2014-02-19

Whooping cough or pertussis is a major cause of morbidity and mortality for adults and children around the world. There has been a rise in pertussis-related deaths in the elderly; pertussis vaccination is not currently routinely recommended in adults, excepting new parents and other adults household members including grandparents and care-givers of young children. Currently, there is lack of clear vaccine recommendations after the age of 50 years. Given the increase in adult pertussis, adult vaccine recommendations are a policy consideration. The study surveyed a convenience sample of patients previously recruited in a case control study designed to examine the burden of influenza with and without AMI in adults aged ≥ 40 years. Our findings showed that only 9.6% had received the pertussis vaccination within the past five years and 79.4% of participants had no knowledge of the pertussis adult booster vaccine, and 30.7% of participants who had regular contact with children under the age of two years in the past 12 months. The results showed that even though there is general acceptance of prevention by vaccines, there is low awareness about pertussis vaccination. This lack of knowledge presents a barrier against pertussis vaccination thus it is imperative that any future adult immunisation policy recommendations around pertussis vaccine include awareness programs in the target population. Copyright © 2014 Elsevier Ltd. All rights reserved.

Perceived Demands of Schooling, Stress and Mental Health: Changes from Grade 6 to Grade 9 as a Function of Gender and Cognitive Ability.

PubMed

Giota, Joanna; Gustafsson, Jan-Eric

2017-08-01

The link between perceived demands of school, stress and mental health in relation to gender is complex. The study examined, with two waves of longitudinal data at age 13 and age 16, how changes in perceived academic demands relate to changes in perceived stress, taking into account gender and cognitive ability, and to investigate how these factors affect the level of psychosomatic and depressive symptoms at the age of 16. A nationally representative sample including about 9000 individuals from the Swedish longitudinal Evaluation Through Follow up database born in 1998 was included. A growth modelling approach was applied to examine relations over time. The results show girls to have a considerably higher self-reported level of mental health problems at the end of compulsory school than boys. This gender difference is entirely accounted for by perceived school demands and stress in grades 6 and 9. Students who were stronger in inductive than vocabulary ability reported lower levels of perceived academic demands and less stress in grade 6. There is a need to develop interventions for minimizing the consequences of stress among adolescents and modify those particular aspects of academic demands which cause stress and poor mental health, especially among girls. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Immune responses in age-related macular degeneration and a possible long-term therapeutic strategy for prevention.

PubMed

Nussenblatt, Robert B; Lee, Richard W J; Chew, Emily; Wei, Lai; Liu, Baoying; Sen, H Nida; Dick, Andrew D; Ferris, Frederick L

2014-07-01

To describe the immune alterations associated with age-related macular degeneration (AMD); and, based on these findings, to offer an approach to possibly prevent the expression of late disease. Perspective. Review of the existing literature dealing with epidemiology, models, and immunologic findings in patients. Significant genetic associations have been identified and reported, but environmentally induced (including epigenetic) changes are also an important consideration. Immune alterations include a strong interleukin 17 family signature as well as marked expression of these molecules in the eye. Oxidative stress as well as other homeostatic altering mechanisms occur throughout life. With this immune dysregulation there is a rationale for considering immunotherapy. Indeed, immunotherapy has been shown to affect the late stages of AMD. Immune dysregulation appears to be an underlying alteration in AMD, as in other diseases thought to be degenerative and attributable to aging. Para-inflammation and immunosenescence may importantly contribute to the development of disease. The role of complement factor H still needs to be better defined, but in light of its association with ocular inflammatory conditions such as sarcoidosis, it does not appear to be unique to AMD but rather may be a marker for retinal pigment epithelium function. With the strong interleukin 17 family signature and the need to treat early on in the disease process, oral tolerance may be considered to prevent disease progression. Published by Elsevier Inc.

Methods for recording and measuring tonic GABAA receptor-mediated inhibition

PubMed Central

Bright, Damian P.; Smart, Trevor G.

2013-01-01

Tonic inhibitory conductances mediated by GABAA receptors have now been identified and characterized in many different brain regions. Most experimental studies of tonic GABAergic inhibition have been carried out using acute brain slice preparations but tonic currents have been recorded under a variety of different conditions. This diversity of recording conditions is likely to impact upon many of the factors responsible for controlling tonic inhibition and can make comparison between different studies difficult. In this review, we will firstly consider how various experimental conditions, including age of animal, recording temperature and solution composition, are likely to influence tonic GABAA conductances. We will then consider some technical considerations related to how the tonic conductance is measured and subsequently analyzed, including how the use of current noise may provide a complementary and reliable method for quantifying changes in tonic current. PMID:24367296

Monitoring population status of sea otters (Enhydra lutris) in Glacier Bay National Park and Preserve, Alaska: options and considerations

USGS Publications Warehouse

Esslinger, George G.; Esler, Daniel N.; Howlin, S.; Starcevich, L.A.

2015-06-25

After many decades of absence from southeast Alaska, sea otters (Enhydra lutris) are recolonizing parts of their former range, including Glacier Bay, Alaska. Sea otters are well known for structuring nearshore ecosystems and causing community-level changes such as increases in kelp abundance and changes in the size and number of other consumers. Monitoring population status of sea otters in Glacier Bay will help park researchers and managers understand and interpret sea otter-induced ecosystem changes relative to other sources of variation, including potential human-induced impacts such as ocean acidification, vessel disturbance, and oil spills. This report was prepared for the National Park Service (NPS), Southeast Alaska Inventory and Monitoring Network following a request for evaluation of options for monitoring sea otter population status in Glacier Bay National Park and Preserve. To meet this request, we provide a detailed consideration of the primary method of assessment of abundance and distribution, aerial surveys, including analyses of power to detect interannual trends and designs to reduce variation around annual abundance estimates. We also describe two alternate techniques for evaluating sea otter population status—(1) quantifying sea otter diets and energy intake rates, and (2) detecting change in ages at death. In addition, we provide a brief section on directed research to identify studies that would further our understanding of sea otter population dynamics and effects on the Glacier Bay ecosystem, and provide context for interpreting results of monitoring activities.

Recent Advances and Perspectives in Liposomes for Cutaneous Drug Delivery.

PubMed

Carita, Amanda C; Eloy, Josimar O; Chorilli, Marlus; Lee, Robert J; Leonardi, Gislaine Ricci

2018-02-13

The cutaneous route is attractive for the delivery of drugs in the treatment of a wide variety of diseases. However the stratum corneum (SC) is an effective barrier that hampers skin penetration. Within this context, liposomes emerge as a potential carrier for improving topical delivery of therapeutic agents. In this review, we aimed to discuss key aspects for the topical delivery by drug-loaded liposomes. Phospholipid type and phase transition temperature have been shown to affect liposomal topical delivery. The effect of surface charge is subject to considerable variation depending on drug and composition. In addition, modified vesicles with the presence of components for permeation enhancement, such as surfactants and solvents, have been shown to have a considerable effect. These liposomes include: Transfersomes, Niosomes, Ethosomes, Transethosomes, Invasomes, coated liposomes, penetration enhancer containing vesicles (PEVs), fatty acids vesicles, Archaeosomes and Marinosomes. Furthermore, adding polymeric coating onto liposome surface could influence cutaneous delivery. Mechanisms of delivery include intact vesicular skin penetration, free drug diffusion, permeation enhancement, vesicle adsorption to and/or fusion with the SC, trans-appendageal penetration, among others. Finally, several skin conditions, including acne, melasma, skin aging, fungal infections and skin cancer, have benefited from liposomal topical delivery of drugs, with promising in vitro and in vivo results. However, despite the existence of some clinical trials, more studies are needed to be conducted in order to explore the potential of liposomes in the dermatological field. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Age model for a continuous, ca 250-ka Quaternary lacustrine record from Bear Lake, Utah-Idaho

USGS Publications Warehouse

Colman, Steven M.; Kaufman, D.S.; Bright, Jordon; Heil, C.; King, J.W.; Dean, W.E.; Rosenbaum, J.G.; Forester, R.M.; Bischoff, J.L.; Perkins, Marie; McGeehin, J.P.

2006-01-01

The Quaternary sediments sampled by continuous 120-m-long drill cores from Bear Lake (Utah-Idaho) comprise one of the longest lacustrine sequences recovered from an extant lake. The cores serve as a good case study for the construction of an age model for sequences that extend beyond the range of radiocarbon dating. From a variety of potential age indicators, we selected a combination of radiocarbon ages, one magnetic excursion (correlated to a standard sequence), and a single Uranium-series age to develop an initial data set. The reliability of the excursion and U-series data require consideration of their position with respect to sediments of inferred interglacial character, but not direct correlation with other paleoclimate records. Data omitted from the age model include amino acid age estimates, which have a large amount of scatter, and tephrochronology correlations, which have relatively large uncertainties. Because the initial data set was restricted to the upper half of the BL00-1 core, we inferred additional ages by direct correlation to the independently dated paleoclimate record from Devils Hole. We developed an age model for the entire core using statistical methods that consider both the uncertainties of the original data and that of the curve-fitting process, with a combination of our initial data set and the climate correlations as control points. This age model represents our best estimate of the chronology of deposition in Bear Lake. Because the age model contains assumptions about the correlation of Bear Lake to other climate records, the model cannot be used to address some paleoclimate questions, such as phase relationships with other areas.

Gender, ageing, and injustice: social and political contexts of bioethics.

PubMed

Dodds, S

2005-05-01

There has been considerable work in bioethics addressing injustice and gender oppression in the provision of healthcare services, in the interaction between client and healthcare professional, and in allocation of healthcare services within a particular hospital or health service. There remain several sites of continued injustice that can only be addressed adequately from a broader analytical perspective, one that attends to the social and political contexts framing healthcare policy and practice. Feminist bioethicists have a strong track record in providing this kind of analysis. Using current Australian aged care and welfare policy this paper demonstrates some of the ways in which issues of gender, age, and social inequity shape bioethical debate, policy, and practice in the areas of aged care and welfare provision. The author develops an argument that demonstrates the gender injustice underlying health care and welfare policy. This argument recognises the inevitability of human dependency relations, and questions the adequacy of current political theories to address the requirements for full and equal citizenship. The author shows that an adequate analysis of the ethics of aged healthcare depends on sufficient consideration of the social and political context within which healthcare policy is framed and an adequate understanding of human dependency.

Experimental characterization of thermal and hygric properties of hemp concrete with consideration of the material age evolution

NASA Astrophysics Data System (ADS)

Bennai, F.; Issaadi, N.; Abahri, K.; Belarbi, R.; Tahakourt, A.

2018-04-01

The incorporation of plant crops in construction materials offers very good hygrothermal performance to the building, ensuring substantial environmental and ecological benefits. This paper focuses on studying the evolution of hygrothermal properties of hemp concrete over age (7, 30 and 60 days). The analysis is done with respect to two main hygric and thermal properties, respectively: sorption isotherms, water vapor permeability, thermal conductivity and heat capacity. In fact, most of these parameters are very susceptible to change function of the age of the material. This influence of the aging is mainly due to the evolution of the microstructure with the binder hydration over time and the creation of new hydrates which can reduces the porosity of the material and consequently modify its properties. All the tested hemp concrete samples presented high moisture storage capacity and high-water vapor permeability whatever the age of such hygroscopic material. These hygric parameters increase significantly for high relative humidity requiring more consideration of such variability during the modeling of coupled heat and mass transfer within the material. By the same, the thermal conductivity and heat capacity tests highlighted the impact of the temperature and hygric state of the studied material.

Height-related trends in leaf xylem anatomy and shoot hydraulic characteristics in a tall conifer: safety versus efficiency in water transport

Treesearch

D.R. Woodruff; F.C. Meinzer; B. Lachenbruch

2008-01-01

Growth and aboveground biomass accumulation follow a common pattern as tree size increases, with productivity peaking when leaf area reaches its maximum and then declining as tree age and size increase. Age- and size-related declines in forest productivity are major considerations in setting the rotational age of commercial forests, and relate to issues of carbon...

40 CFR 1505.2 - Record of decision in cases requiring environmental impact statements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... alternatives based on relevant factors including economic and technical considerations and agency statutory missions. An agency shall identify and discuss all such factors including any essential considerations of...

Accelerated aging in adults with knee osteoarthritis pain: consideration for frequency, intensity, time, and total pain sites

PubMed Central

Sibille, Kimberly T.; Chen, Huaihou; Bartley, Emily J.; Riley, Joseph; Glover, Toni L.; King, Christopher D.; Zhang, Hang; Cruz-Almeida, Yenisel; Goodin, Burel R.; Sotolongo, Adriana; Petrov, Megan E.; Herbert, Matthew; Bulls, Hailey W.; Edberg, Jeffrey C.; Staud, Roland; Redden, David; Bradley, Laurence A.; Fillingim, Roger B.

2017-01-01

Abstract Introduction: Individuals with osteoarthritis (OA) show increased morbidity and mortality. Telomere length, a measure of cellular aging, predicts increased morbidity and mortality. Telomeres shorten with persisting biological and psychosocial stress. Living with chronic OA pain is stressful. Previous research exploring telomere length in people with OA has produced inconsistent results. Considering pain severity may clarify the relationship between OA and telomeres. Objectives: We hypothesized that individuals with high OA chronic pain severity would have shorter telomeres than those with no or low chronic pain severity. Methods: One hundred thirty-six adults, ages 45 to 85 years old, with and without symptomatic knee OA were included in the analysis. Peripheral blood leukocyte telomere length was measured, and demographic, clinical, and functional data were collected. Participants were categorized into 5 pain severity groups based on an additive index of frequency, intensity, time or duration, and total number of pain sites (FITT). Covariates included age, sex, race or ethnicity, study site, and knee pain status. Results: The no or low chronic pain severity group had significantly longer telomeres compared with the high pain severity group, P = 0.025. A significant chronic pain severity dose response emerged for telomere length, P = 0.034. The FITT chronic pain severity index was highly correlated with the clinical and functional OA pain measures. However, individual clinical and functional measures were not associated with telomere length. Conclusion: Results demonstrate accelerated cellular aging with high knee OA chronic pain severity and provide evidence for the potential utility of the FITT chronic pain severity index in capturing the biological burden of chronic pain. PMID:29392207

Estimates of effective elastic thickness of oceanic lithosphere using model including surface and subsurface loads and effective elastic thickness of subduction zones

NASA Astrophysics Data System (ADS)

Yang, A.; Yongtao, F.

2016-12-01

The effective elastic thickness (Te) is an important parameter that characterizes the long term strength of the lithosphere, which has great significance on understanding the mechanical properties and evolution of the lithosphere. In contrast with many controversies regarding elastic thickness of continent lithosphere, the Te of oceanic lithosphere is thought to be in a simple way that is dependent on the age of the plate. However, rescent studies show that there is no simple relationship between Te and age at time of loading for both seamounts and subduction zones. As subsurface loading is very importand and has large influence in the estimate of Te for continent lithosphere, and many oceanic features such as subduction zones also have considerable subsurface loading. We introduce the method to estimate the effective elastic thickness of oceanic lithosphere using model including surface and subsurface loads by using free-air gravity anomaly and bathymetric data, together with a moving window admittance technique (MWAT). We use the multitaper spectral estimation method to calculate the power spectral density. Through tests with synthetic subduction zone like bathymetry and gravity data show that the Te can be recovered in an accurance similar to that in the continent and there is also a trade-off between spatial resolution and variance for different window sizes. We estimate Te of many subduction zones (Peru-Chile trench, Middle America trench, Caribbean trench, Kuril-Japan trench, Mariana trench, Tonga trench, Java trench, Ryukyu-Philippine trench) with an age range of 0-160 Myr to reassess the relationship between elastic thickness and the age of the lithosphere at the time of loading. The results do not show a simple relationship between Te and age.

Measures of fit and discomfort for elementary school children in Serbia.

PubMed

Feathers, David; Pavlovic-Veselinovic, Sonja; Hedge, Alan

2013-01-01

Assessing physical ergonomic factors within the classroom environment creates new opportunities to support designs that promote student well-being. Student-aged anthropometric data helps guide proper desk fit assessment, therefore facilitating scholastic performance through the reduction of distractions such as physical discomfort. This study reports dimensions of fit between student anthropometry and the desk environment (classroom seating conditions), for grade-school aged children in Serbia. Measurements of the children and their desks are compared to subjective reports of discomfort. Fifty-seven elementary school students, grade 2 (ages 7-8; n=29) and grade 4 (ages 9-10; n=28), were enrolled in this study. All participants were from the same elementary school in the city of Nis, Serbia. Seventeen anthropometric measurements of students were collected using standard anthropometric instruments. Eight measurements of student work desks and chairs were also collected. Students were evaluated by a physiatrist to assess health issues and completed a novel questionnaire about musculoskeletal discomfort for different body parts. Student fit to the classroom seat and desk was assessed structurally and subjectively. Data analysis included descriptive anthropometric measurements and inferential statistics including Chi square analysis. Results indicated age-related differences in body part discomfort for grade 2 and grade 4 students, arm discomfort reported over 50% of second grade students, and neck/upper back discomfort was reported as the highest of all body parts (32%) for students in the fourth grade. Anthropometric variables and preliminary analysis of fit as it relates to reported discomfort are discussed, as are external factors of backpack use and seated video/computer-game use. International comparisons of anthropometric data are discussed and serve to inform new considerations of ergonomics research for school children.

Duration of protection of pentavalent rotavirus vaccination in Nicaragua.

PubMed

Patel, Manish; Pedreira, Cristina; De Oliveira, Lucia Helena; Umaña, Jazmina; Tate, Jacqueline; Lopman, Ben; Sanchez, Edmundo; Reyes, Martha; Mercado, Juan; Gonzalez, Alcides; Perez, Maria Celina; Balmaceda, Angel; Andrus, Jon; Parashar, Umesh

2012-08-01

To evaluate the duration of protection of pentavaent rotavirus vaccine (RV5) against rotavirus hospitalizations in Nicaragua, a developing country in Central America. We conducted a case-control study at 4 hospitals from 2007 through 2010, including 1016 children hospitalized with laboratory-confirmed rotavirus diarrhea, 4930 controls with nonrotavirus diarrhea (ie, "test-negative"), and 5627 controls without diarrhea. All cases and controls were aged ≥ 6 months and born after August 2006. Outcomes included odds of antecedent vaccination between case-patients and controls, and effectiveness of vaccination (1 - adjusted odds ratio [OR] × 100). Duration of protection was assessed by comparing effectiveness among children aged <1 year compared with ≥ 1 year. Indicators of socioeconomic conditions and nonrotavirus vaccination (oral polio vaccine and diphtheria/tetanus/pertussis/hepatitis A/hepatitis B) for test-negative controls were more comparable to the rotavirus case-patients than nondiarrhea controls. RV5 vaccination was associated with a significantly lower risk of rotavirus hospitalization by using test-negative controls (OR: 0.55; 95% confidence interval [CI]: 0.41-0.74) and nondiarrhea controls (OR: 0.30; 95% CI: 0.22-0.40). Risk of rotavirus hospitalization was twofold lower among RV5 vaccinated children aged <1 year (OR: 0.36; 95% CI: 0.22-0.57) compared with RV5 vaccinated children aged ≥ 1 year (OR: 0.70; 95% CI: 0.47-1.05). RV5 provided good protection against severe rotavirus disease in Nicaragua during the first year of life, when most severe and fatal rotavirus disease in developing countries occurs. However, the decline in protection with age warrants monitoring of disease among older children and consideration of a booster dose evaluation at the end of infancy.

Atypical glandular cells in cervical smears: histological correlation and a suggested plan of management based on age of the patient in a low-resource setting.

PubMed

Adhya, A K; Mahesha, V; Srinivasan, R; Nijhawan, R; Rajwanshi, A; Suri, V; Dhaliwal, L K

2009-12-01

To perform an audit of all smears reported as atypical glandular cells (AGC) using the Bethesda system (TBS) 2001. A total of 18 376 cervical smears were screened from January 2005 to June 2007, of which 65 cases were reported as AGC. Follow-up histology was available in 31 cases (47.7%), in whom a detailed cytological/histological correlation was carried out. AGC constituted 0.35% of all Pap smears. Follow-up histology was normal or benign in 20 cases, whereas a squamous or glandular abnormality was seen in 11 cases. Squamous abnormalities included one case each of cervical intraepithelial neoplasia (CIN)1, CIN2 and CIN3 and five cases of squamous cell carcinoma. All glandular epithelial abnormalities were endometrial in origin and included two endometrial adenocarcinomas and one uterine serous carcinoma. Neither in situ nor invasive adenocarcinoma of the endocervix was observed. Review of smears and reclassification as AGC, not otherwise specified and favour neoplasia revealed a higher proportion of abnormality in the latter group, reaffirming the utility of subtyping. The median age of women with AGC was 41 years. The outcome was analysed with respect to the median age. In women aged equal or more than 40 years, AGC reflected a high-grade squamous or glandular epithelial abnormality in 50% of cases compared with none in those less than 40 years old (P = 0.010). The age of the woman as well as the subtype of atypical glandular cells influences outcome and hence must be taken into consideration while formulating an acceptable management strategy in these women in a low-resource setting.

Conflicts and dilemmas in prevention of cardiovascular disease. The new, Norwegian guidelines--a new approach to risk management.

PubMed

Gjelsvik, Bjørn

2012-03-01

Prevention of cardiovascular disease (CVD) has been debated for many years, between an organ-specialist perspective versus a public health view. As an illustration, the Wonca Europe Council decided in 2004 to withdraw its support to the 2003 European Guidelines. This paper discusses the main sources of disagreement, most important the levels of risk when treatment should be offered. The Norwegian Guideline for primary prevention of CVD (2009) introduced a new principle of age-differentiated risk levels. Pharmacological treatment should be offered to all persons aged 40-49 years with 10-year mortality risk ≥ 1%, all persons aged 50-59 years at ≥ 5% risk, and all persons aged 60-69 years at ≥ 10% risk. Lower thresholds for younger persons are based on the fact that life years lost, will be considerable if drugs are prescribed only for risk levels above 5%. For persons aged 60-69 years, age is the dominant risk factor and the benefits of treatment are smaller. The implications of the recommendation are discussed, both at an individual and a societal level. Compared to the European 2007 guidelines, the total sum of life years gained is about the same, but the number of patients treated is considerably lower.

Sinusitis: Special Considerations for Aging Patients

MedlinePlus

... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources Quality Clinical Data Registry Research Reimbursement ...

Evaluation of Amyloid Protective Factors and Alzheimer Disease Neurodegeneration Protective Factors in Elderly Individuals.

PubMed

Vemuri, Prashanthi; Knopman, David S; Lesnick, Timothy G; Przybelski, Scott A; Mielke, Michelle M; Graff-Radford, Jonathan; Murray, Melissa E; Roberts, Rosebud O; Vassilaki, Maria; Lowe, Val J; Machulda, Mary M; Jones, David T; Petersen, Ronald C; Jack, Clifford R

2017-06-01

While amyloid and neurodegeneration are viewed together as Alzheimer disease pathophysiology (ADP), the factors that influence amyloid and AD-pattern neurodegeneration may be considerably different. Protection from these ADP factors may be important for aging without significant ADP. To identify the combined and independent protective factors for amyloid and AD-pattern neurodegeneration in a population-based sample and to test the hypothesis that "exceptional agers" with advanced ages do not have significant ADP because they have protective factors for amyloid and neurodegeneration. This cohort study conducted a prospective analysis of 942 elderly individuals (70-≥90 years) with magnetic resonance imaging and Pittsburgh compound B-positron emission tomography scans enrolled in the Mayo Clinic Study of Aging, a longitudinal population-based study of cognitive aging in Olmsted County, Minnesota. We operationalized "exceptional aging" without ADP by considering individuals 85 years or older to be without significant evidence of ADP. We evaluated predictors including demographics, APOE, intellectual enrichment, midlife risk factors (physical inactivity, obesity, smoking, diabetes, hypertension, and dyslipidemia), and the total number of late-life cardiac and metabolic conditions. We used multivariate linear regression models to identify the combined and independent protective factors for amyloid and AD-pattern neurodegeneration. Using a subsample of the cohort 85 years of age or older, we computed Cohen d-based effect size estimations to compare the quantitative strength of each predictor variable in their contribution with exceptional aging without ADP. The study participants included 423 (45%) women and the average age of participants was 79.7 (5.9) years. Apart from demographics and the APOE genotype, only midlife dyslipidemia was associated with amyloid deposition. Obesity, smoking, diabetes, hypertension, and cardiac and metabolic conditions, but not intellectual enrichment, were associated with greater AD-pattern neurodegeneration. In the 85 years or older cohort, the Cohen d results showed small to moderate effects (effect sizes > 0.2) of several variables except job score and midlife hypertension in predicting exceptional aging without ADP. The protective factors that influence amyloid and AD-pattern neurodegeneration are different. "Exceptional aging" without ADP may be possible with a greater number of protective factors across the lifespan but warrants further investigation.

A low-fat, whole-food vegan diet, as well as other strategies that down-regulate IGF-I activity, may slow the human aging process.

PubMed

McCarty, Mark F

2003-06-01

A considerable amount of evidence is consistent with the proposition that systemic IGF-I activity acts as pacesetter in the aging process. A reduction in IGF-I activity is the common characteristic of rodents whose maximal lifespan has been increased by a wide range of genetic or dietary measures, including caloric restriction. The lifespans of breeds of dogs and strains of rats tend to be inversely proportional to their mature weight and IGF-I levels. The link between IGF-I and aging appears to be evolutionarily conserved; in worms and flies, lifespan is increased by reduction-of-function mutations in signaling intermediates homologous to those which mediate insulin/IGF-I activity in mammals. The fact that an increase in IGF-I activity plays a key role in the induction of sexual maturity, is consistent with a broader role for-IGF-I in aging regulation. If down-regulation of IGF-I activity could indeed slow aging in humans, a range of practical measures for achieving this may be at hand. These include a low-fat, whole-food, vegan diet, exercise training, soluble fiber, insulin sensitizers, appetite suppressants, and agents such as flax lignans, oral estrogen, or tamoxifen that decrease hepatic synthesis of IGF-I. Many of these measures would also be expected to decrease risk for common age-related diseases. Regimens combining several of these approaches might have a sufficient impact on IGF-I activity to achieve a useful retardation of the aging process. However, in light of the fact that IGF-I promotes endothelial production of nitric oxide and may be of especial importance to cerebrovascular health, additional measures for stroke prevention-most notably salt restriction-may be advisable when attempting to down-regulate IGF-I activity as a pro-longevity strategy.

[Correlation of dental age and anthropometric parametres of the overall growth and development in children].

PubMed

Triković-Janjić, Olivera; Apostolović, Mirjana; Janosević, Mirjana; Filipović, Gordana

2008-02-01

Anthropometric methods of measuring the whole body and body parts are the most commonly applied methods of analysing the growth and development of children. Anthropometric measures are interconnected, so that with growth and development the change of one of the parameters causes the change of the other. The aim of the paper was to analyse whether dental development follows the overall growth and development and what the ratio of this interdependence is. The research involved a sample of 134 participants, aged between 6 and 8 years. Dental age was determined as the average of the sum of existing permanent teeth from the participants aged 6, 7 and 8. With the aim of analysing physical growth and development, commonly accepted anthropometric indexes were applied: height, weight, circumference of the head, the chest cavity at its widest point, the upper arm, the abdomen, the thigh and thickness of the epidermis. The dimensions were measured according to the methodology of the International Biological Programme. The influence of the pertinent variables' related size on the analysed variable was deter mined by the statistical method of multivariable regression. The middle values of all the anthropometric parametres, except for the thickness of the epidermis, were slightly bigger with male participants, and the circumference of the chest cavity was statistically considerably bigger (p < 0.05). The results of anthropometric measurement showed in general a distinct homogeneity not only of the sample group but also within gender, in relation to all the dimensions, excyt for the thickness of the epidermis. The average of the dental age of the participants was 10.36, (10.42 and 10.31 for females and males respectively). Considerable correlation (R = 0.59) with high statistical significance (p < 0.001) was determined between dental age and the set of anthropometric parameters of general growth and development. There is a considerable positive correlation (R = 0.59) between dental age and anthropometric parameters of general growth and development, which confirms that dental development follows the overall growth and development of children, aged between 6 and 8 years.

42 CFR 137.329 - What environmental considerations must be included in the construction project agreement?

Code of Federal Regulations, 2010 CFR

2010-10-01

... must be included in the construction project agreement? The construction project agreement must include..., and (d) An assurance that no action will be taken on the construction phase of the project that would... 42 Public Health 1 2010-10-01 2010-10-01 false What environmental considerations must be included...

Factors affecting red blood cell storage age at the time of transfusion.

PubMed

Dzik, Walter H; Beckman, Neil; Murphy, Michael F; Delaney, Meghan; Flanagan, Peter; Fung, Mark; Germain, Marc; Haspel, Richard L; Lozano, Miguel; Sacher, Ronald; Szczepiorkowski, Zbigniew; Wendel, Silvano

2013-12-01

Clinical trials are investigating the potential benefit resulting from a reduced maximum storage interval for red blood cells (RBCs). The key drivers that determine RBC age at the time of issue vary among individual hospitals. Although progressive reduction in the maximum storage period of RBCs would be expected to result in smaller hospital inventories and reduced blood availability, the magnitude of the effect is unknown. Data on current hospital blood inventories were collected from 11 hospitals and three blood centers in five nations. A general predictive model for the age of RBCs at the time of issue was developed based on considerations of demand for RBCs in the hospital. Age of RBCs at issue is sensitive to the following factors: ABO group, storage age at the time of receipt by the hospital, the restock interval, inventory reserve, mean demand, and variation in demand. A simple model, based on hospital demand, may serve as the basis for examining factors affecting the storage age of RBCs in hospital inventories. The model suggests that the age of RBCs at the time of their issue to the patient depends on factors external to the hospital transfusion service. Any substantial change in the expiration date of stored RBCs will need to address the broad variation in demand for RBCs while attempting to balance considerations of availability and blood wastage. © 2013 American Association of Blood Banks.

A presomite human embryo of Horizon VII.

PubMed Central

Rewell, R E; Harrison, R G

1976-01-01

A presomite embryo of Horizon VII aged approximately 18 days is described and illustrated. It is compared with some other embryos of a similar age, and a considerable variation of histological characteristics within the same Horizon is noted. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 PMID:1254532

Development of understory tree vegetation after thinning naturally occurring shortleaf pine forests

Treesearch

K.C. Anup; Thomas B. Lynch; Douglas Stevenson; Duncan Wilson; James M. Guldin; Bob Heinemann; Randy Holeman; Dennis Wilson; Keith Anderson

2015-01-01

During the 25 years since establishment of more than 200 growth study plots in even-aged, naturally regenerated shortleaf pine (Pinus echinata Mill.) forests, there has been considerable development of hardwood understory trees, shrubs, and some shortleaf pine regeneration. During the period from 1985-1987, even-aged shortleaf pine growth-study...

An Attachment Model of Sibling Helping Behavior in Old Age.

ERIC Educational Resources Information Center

Cicirelli, Victor G.

Sibling relationships are not only maintained throughout life in most cases, but assume considerable importance in old age. Siblings provide psychological support for each other as well as more tangible forms of helping and caregiving. In order to investigate variables leading to sibling help in the area of psychological support, a path model…

Optimal control problems of epidemic systems with parameter uncertainties: application to a malaria two-age-classes transmission model with asymptomatic carriers.

PubMed

Mwanga, Gasper G; Haario, Heikki; Capasso, Vicenzo

2015-03-01

The main scope of this paper is to study the optimal control practices of malaria, by discussing the implementation of a catalog of optimal control strategies in presence of parameter uncertainties, which is typical of infectious diseases data. In this study we focus on a deterministic mathematical model for the transmission of malaria, including in particular asymptomatic carriers and two age classes in the human population. A partial qualitative analysis of the relevant ODE system has been carried out, leading to a realistic threshold parameter. For the deterministic model under consideration, four possible control strategies have been analyzed: the use of Long-lasting treated mosquito nets, indoor residual spraying, screening and treatment of symptomatic and asymptomatic individuals. The numerical results show that using optimal control the disease can be brought to a stable disease free equilibrium when all four controls are used. The Incremental Cost-Effectiveness Ratio (ICER) for all possible combinations of the disease-control measures is determined. The numerical simulations of the optimal control in the presence of parameter uncertainty demonstrate the robustness of the optimal control: the main conclusions of the optimal control remain unchanged, even if inevitable variability remains in the control profiles. The results provide a promising framework for the designing of cost-effective strategies for disease controls with multiple interventions, even under considerable uncertainty of model parameters. Copyright © 2014 Elsevier Inc. All rights reserved.

Illness, normality and identity: the experience of heart transplant as a young adult.

PubMed

Waldron, Rebecca; Malpus, Zoey; Shearing, Vanessa; Sanchez, Melissa; Murray, Craig D

2017-09-01

End stage heart failure and transplant present great opportunities and challenges for patients of all ages. However, young adulthood may present additional specific challenges associated with the development of identity, career and romantic relationships. Despite recognition of greater mortality rates in young adults, consideration of the experience of transplant during this life stage has been largely overlooked in the literature. The aim of this study was to explore the experience of heart transplant in young adults. Interviews were conducted with nine participants across three transplant services in the United Kingdom and the data subject to interpretative phenomenological analysis. Analysis identified three themes. "Separating from illness" and "working toward normality" involved limiting the influence of illness on identity, as well as reengaging with typical functioning in young adulthood. "Integrating transplant into identity" involved acknowledging the influence of living with a shortened life expectancy. The need for support that recognizes specific challenges of transplant as a young adult is discussed (e.g. the development of age specific end of life pathways, improved communication between transplant recipients, their families and teams), including consideration of the impact of societal discourses (e.g. gift of life) which provided additional challenges for patients. IMPLICATIONS FOR REHABILITATION Heart transplant presents specific challenges according to the recipient's life stage. The needs of young adult recipients should be considered. Transplant professionals should consider providing opportunities for peer support and addressing the identities and values of young adult transplant recipients during rehabilitation.

Barriers to rehabilitative care for young breast cancer survivors: a qualitative understanding.

PubMed

Miedema, Baukje; Easley, Julie

2012-06-01

The goal of this study was to assess the rehabilitation needs of young women breast cancer survivors under the age of 50 and to identify factors that may impact or prevent cancer rehabilitation utilization. Utilizing a grounded theory methodology, 35 young breast cancer survivors were interviewed twice in four Atlantic Canadian provinces. A considerable number of barriers exist to receiving rehabilitative care post-treatment for young breast cancer survivors. The systemic barriers include the lack of availability of services, travel issues, cost of services, and the lack of support to address the unique needs for this age group. However, the most complicated barriers to accessing rehabilitative care were personal barriers which related more to choice and circumstances, such as the lack of time due to family responsibilities and appointment fatigue. Many of these personal barriers were rooted in the complex set of gender roles of young women as patients, mothers, workers, and caregivers. The contexts of young women's lives can have a substantial impact on their decisions to seek and receive rehabilitative care after breast cancer treatment. The systemic barriers can be reduced by introducing more services or financial assistance; however, the personal barriers to rehabilitation services are difficult to ameliorate due to the complex set of roles within and outside the family for this group of young breast cancer survivors. Health care providers need to take into consideration the multiple contexts of women's lives when developing and promoting breast cancer rehabilitation services and programs.

Estimation of radiation cancer risk in CT-KUB

NASA Astrophysics Data System (ADS)

Karim, M. K. A.; Hashim, S.; Bakar, K. A.; Bradley, D. A.; Ang, W. C.; Bahrudin, N. A.; Mhareb, M. H. A.

2017-08-01

The increased demand for computed tomography (CT) in radiological scanning examinations raises the question of a potential health impact from the associated radiation exposures. Focusing on CT kidney-ureter-bladder (CT-KUB) procedures, this work was aimed at determining organ equivalent dose using a commercial CT dose calculator and providing an estimate of cancer risks. The study, which included 64 patients (32 males and 32 females, mean age 55.5 years and age range 30-80 years), involved use of a calibrated CT scanner (Siemens-Somatom Emotion 16-slice). The CT exposures parameter including tube potential, pitch factor, tube current, volume CT dose index (CTDIvol) and dose-length product (DLP) were recorded and analyzed using CT-EXPO (Version 2.3.1, Germany). Patient organ doses, including for stomach, liver, colon, bladder, red bone marrow, prostate and ovaries were calculated and converted into cancer risks using age- and sex-specific data published in the Biological Effects of Ionizing Radiation (BEIR) VII report. With a median value scan range of 36.1 cm, the CTDIvol, DLP, and effective dose were found to be 10.7 mGy, 390.3 mGy cm and 6.2 mSv, respectively. The mean cancer risks for males and females were estimated to be respectively 25 and 46 out of 100,000 procedures with effective doses between 4.2 mSv and 10.1 mSv. Given the increased cancer risks from current CT-KUB procedures compared to conventional examinations, we propose that the low dose protocols for unenhanced CT procedures be taken into consideration before establishing imaging protocols for CT-KUB.

High Rate of Alternative Diagnoses in Patients Referred for Presumed Clostridium difficile Infection

PubMed Central

Jackson, Melissa; Olefson, Sidney; Machan, Jason T.; Kelly, Colleen R.

2015-01-01

Goals We evaluated a cohort of patients referred to our center for presumed recurrent Clostridium difficile infection (CDI) to determine final diagnoses and outcomes. Background As rates of CDI have increased, more patients are diagnosed with recurrent CDI and other sequelae of the infection. Distinguishing symptomatic patients with CDI from those who are colonized with an alternative etiology of diarrheal symptoms may be challenging. Methods We performed a retrospective review of 117 patients referred to our center for recurrent CDI between January 2013 and June 2014. Data collected included demographics, referring provider, previous anti-CDI treatment, and significant medical conditions. Additionally we gathered data on atypical features of CDI and investigations obtained to investigate etiology of symptoms. Outcomes included rates of alternative diagnoses and the accuracy of CDI diagnosis by referral source. Results The mean age was 61 years and 70% were female. 29 patients (25%) were determined to have a non-CDI diagnosis. Most common alternative diagnoses included irritable bowel syndrome (18 patients: 62%) and inflammatory bowel disease (3:10 %). Age was inversely correlated with rate of non-CDI diagnosis (p=0.016). Of the remaining 88 (75%) patients with a confirmed diagnosis of CDI, 25 (28%) received medical therapy alone and 63 (72%) underwent fecal microbiota transplantation (FMT). Conclusion Among patients referred to our center for recurrent CDI, a considerable percentage did not have CDI, but rather an alternative diagnosis, most commonly IBS. The rate of alternative diagnosis correlated inversely with age. Providers should consider other etiologies of diarrhea in patients presenting with features atypical of recurrent CDI. PMID:26565971

Infantile onset progressive cerebellar atrophy and anterior horn cell degeneration--a late onset variant of PCH-1?

PubMed

Lev, Dorit; Michelson-Kerman, Marina; Vinkler, Chana; Blumkin, Lubov; Shalev, Stavit A; Lerman-Sagie, Tally

2008-03-01

Despite major recent advances in our understanding of developmental cerebellar disorders, classification and delineation of these disorders remains difficult. The term pontocerebellar hypoplasia is used when there is a structural defect, originating in utero of both pons and cerebellar hemispheres. The term olivopontocerebellar atrophy is used when the disorder starts later in life and the process is a primary degeneration of cerebellar neurons. Pontocerebellar hypoplasia type 1 is associated with spinal anterior horn cell degeneration, congenital contractures, microcephaly, polyhydramnion and respiratory insufficiency leading to early death. However, anterior horn cell degeneration has also been described in cases with later onset pontocerebellar atrophy and recently the spectrum has even been further extended to include the association of anterior horn cell degeneration and cerebellar atrophy without pontine involvement. We describe two siblings from a consanguineous Moslem Arabic family who presented with progressive degeneration of both the cerebellum and the anterior horn cells. The patients presented after 1 year of age with a slow neurodegenerative course that included both cognitive and motor functions. There is considerable phenotypic variability; the sister shows a much milder course. Both children are still alive at 6 and 9 years. The sister could still crawl and speak two word sentences at the age of 3 years while the brother was bedridden and only uttered guttural sounds at the same age. Our cases further extend the phenotype of the cerebellar syndromes with anterior horn cell involvement to include a childhood onset and protracted course and further prove that this neurodegenerative disorder may start in utero or later in life.

Predictors for additional anterior cruciate ligament reconstruction: data from the Swedish national ACL register.

PubMed

Fältström, Anne; Hägglund, Martin; Magnusson, Henrik; Forssblad, Magnus; Kvist, Joanna

2016-03-01

To identify predictors for additional anterior cruciate ligament (ACL) reconstruction. Patients from the Swedish national ACL register who underwent ACL reconstruction between January 2005 and February 2013 (follow-up duration 6-104 months) were included. Cox regression analyses included the following independent variables regarding primary injury: age, sex, time between injury and primary ACL reconstruction, activity at primary injury, concomitant injuries, injury side, graft type, and pre-surgery KOOS and EQ-5D scores. Among ACL reconstruction procedures, 93% involved hamstring tendon (HT) autografts. Graft type did not predict additional ACL reconstruction. Final regression models only included patients with HT autograft (n = 20,824). Of these, 702 had revision and 591 contralateral ACL reconstructions. The 5-year post-operative rates of revision and contralateral ACL reconstruction were 4.3 and 3.8%, respectively. Significant predictors for additional ACL reconstruction were age (fourfold increased rate for <16-year-old patients vs. >35-year-old patients), time between injury and primary surgery (two to threefold increased rate for ACL reconstruction within 0-90 days vs. >365 days), and playing football at primary injury. This study identified younger age, having ACL reconstruction early after the primary injury, and incurring the primary injury while playing football as the main predictors for revision and contralateral ACL reconstruction. This suggests that the rate of additional ACL reconstruction is increased in a selected group of young patients aiming to return to strenuous sports after primary surgery and should be taken into consideration when discussing primary ACL reconstruction, return to sports, and during post-surgery rehabilitation. II.

Considerations for management of patients with diabetic macular edema: Optimizing treatment outcomes and minimizing safety concerns through interdisciplinary collaboration.

PubMed

Strain, W David; Cos, Xavier; Prünte, Christian

2017-04-01

Diabetes is a growing worldwide epidemic and a leading cause of blindness in working-age people around the world. Diabetic retinopathy (DR) and diabetic macular edema (DME) are common causes of visual impairment in people with diabetes and often indicate the presence of diabetes-associated preclinical micro- and macrovascular complications. As such, patients with DR and DME often display complex, highly comorbid profiles. Several treatments are currently available for the treatment of DME, including anti-vascular endothelial growth factor (VEGF) agents, which are administered via intravitreal injection. While the safety profiles of approved ocular anti-VEGF therapies have been reassuring, the high-risk nature of the DME patient population means that treatment must be carefully considered and a holistic approach to disease management should be taken. This requires multidisciplinary, collaborative care involving all relevant specialties to ensure that patients not only receive prompt treatment for DME but also appropriate consideration is taken of any systemic comorbidities to evaluate and minimize potentially serious safety issues. Copyright © 2017. Published by Elsevier B.V.

Migration and psychological status of adolescents in Turkey.

PubMed

Aksel, Seyda; Gün, Zübeyit; Irmak, Türkan Yilmaz; Cengelci, Banu

2007-01-01

The aim of this study was to investigate the influence of involuntary migration on an adolescent population that had moved with their families to either one of two culturally different locations in Turkey. One of these groups had moved from a village in Eastern Turkey to a nearby town, while the other had moved a considerable distance to a large city in Western Turkey. Comparison groups included adolescents from both regions who had never migrated. Measures of self-esteem, satisfaction with life, and social support networks were used with 305 adolescents who were between the ages of 12 and 15. Adolescents who had migrated scored lower on self-esteem and life satisfaction, and had fewer people in their social support networks than those who had not. It was also found that those who had migrated tended to be more dependent on peers than family for social support. This was probably the case because school attendance was lower for migrants, particularly for males, and the probability of full time work on the street away from their families was considerably higher.

Direct-to-adolescent text messaging for vaccine reminders: What will parents permit?

PubMed

Roberts, James R; Morella, Kristen; Dawley, Erin H; Madden, Christi A; Jacobson, Robert M; Pope, Charlene; Davis, Boyd; Thompson, David; O'Brien, Elizabeth S; Darden, Paul M

2018-05-11

Direct-to-adolescent text messaging may be a consideration for vaccine reminders, including human papilloma virus (HPV), but no studies have explored the minimum age at which parents would allow adolescents to receive a text message. We distributed a survey to parents of 10-17 year olds during any office visit in two practice based research networks in South Carolina and Oklahoma. We asked about parental preference for receiving vaccine reminders for their adolescent, whether they would allow the healthcare provider to directly message their adolescent, and if so, what would be the acceptable minimum age. In 546 surveys from 11 practices, parents of females were more supportive of direct-to-teen text message reminders than were parents of males, (75% v. 60%, p < .001). The median age at which parents would allow direct text messages from physicians' offices was 14 in females compared to 15 in males, p = .049. We found a correlation between the child's age and the youngest age at which parents would allow a direct text message. Of the parents who permitted a text message directly to their adolescent, most reported an allowable age higher than their adolescent's current age until the age of 15. Our study suggests that direct-to-adolescent text messaging would be allowed by parents for older adolescents. This supports an intervention aimed at older adolescents, such as for receipt of MCV4 dose #2, delayed HPV vaccine series completion and annual influenza vaccination. Copyright © 2018 Elsevier Ltd. All rights reserved.

Body mass trajectories, diabetes mellitus, and mortality in a large cohort of Austrian adults.

PubMed

Peter, Raphael Simon; Keller, Ferdinand; Klenk, Jochen; Concin, Hans; Nagel, Gabriele

2016-12-01

There are only few studies on latent trajectories of body mass index (BMI) and their association with diabetes incidence and mortality in adults.We used data of the Vorarlberg Health Monitoring & Prevention Program and included individuals (N=24,875) with BMI measurements over a 12-year period. Trajectory classes were identified using growth mixture modeling for predefined age groups (<50, 50-65, >65 years of age) and men, women separately. Poisson models were applied to estimate incidence and prevalence of diabetes for each trajectory class. Relative all-cause mortality and diabetes-related mortality was estimated using Cox proportional hazard regression.We identified 4 trajectory classes for the age groups <50 years and 50 to 65 years, and 3 for age groups >65 years. For all age groups, a stable BMI trajectory class was the largest, with about 90% of men and 70% to 80% of women. For the low stable BMI classes, the corresponding fasting glucose levels were the lowest. The highest diabetes prevalences were observed for decreasing trajectories. During subsequent follow-up of mean 8.1 (SD 2.0) years, 2741 individuals died. For men <50 years, highest mortality was observed for steady weight gainers. For all other age-sex groups, mortality was the highest for decreasing trajectories.We found considerably heterogeneity in BMI trajectories by sex and age. Stable weight, however, was the largest class over all age and sex groups, and was associated with the lowest diabetes incidence and mortality suggesting that maintaining weight at a moderate level is an important public health goal.

Head Injury and Aging: The Importance of Bleeding Injuries

PubMed Central

Mallory, Ann

The current study analyzed 1993–2007 data from NASS/CDS (National Automotive Sampling System / Crashworthiness Data System) to explore the types of serious head injuries sustained by adult motor vehicle crash occupants and how the types of head injuries sustained shifted with age. The purpose was to determine which head injuries are most important for older occupants by identifying specific injuries that become more likely for aging occupants and taking into consideration previous reports on the potential outcome of those injuries for an older population. Results confirmed previous reports that older head injury victims in motor vehicle collisions were more likely to sustain bleeding injuries than younger head injury victims. The current study showed that, in particular, the rate of extra-axial bleeding injury (which includes epidural, subdural, and subarachnoid bleeding) increased with age. The increase in extra-axial bleeding injury rate was especially prominent in relatively low Delta-V crashes. Among the extra-axial bleeding injuries that had increased odds of injury for older occupants, subdural hematoma and subarachnoid hemorrhage were notable, with increased odds of injury for occupants age 50 to 69 as well as for occupants age 70 and older. The importance of subdural hematoma for aging occupants is emphasized by previous studies showing its high mortality rate, while the impact of subarachnoid hemorrhage is linked in previous studies to its aggravating effect on other injuries. The results highlight a need to further explore the injury mechanisms of subdural hematoma and subarachnoid hemorrhage in older occupants in order to define age-adjusted injury tolerance and develop countermeasures. PMID:21050591

An evaluation of costs and benefits of a vehicle periodic inspection scheme with six-monthly inspections compared to annual inspections.

PubMed

Keall, Michael D; Newstead, Stuart

2013-09-01

Although previous research suggests that safety benefits accrue from periodic vehicle inspection programmes, little consideration has been given to whether the benefits are sufficient to justify the often considerable costs of such schemes. Methodological barriers impede many attempts to evaluate the overall safety benefits of periodic vehicle inspection schemes, including this study, which did not attempt to evaluate the New Zealand warrant of fitness scheme as a whole. Instead, this study evaluated one aspect of the scheme: the effects of doubling the inspection frequency, from annual to biannual, when the vehicle reaches six years of age. In particular, reductions in safety-related vehicle faults were estimated together with the value of the safety benefits compared to the costs. When merged crash data, licensing data and roadworthiness inspection data were analysed, there were estimated to be improvements in injury crash involvement rates and prevalence of safety-related faults of respectively 8% (95% CI 0.4-15%) and 13.5% (95% CI 12.8-14.2%) associated with the increase from annual to 6-monthly inspections. The wide confidence interval for the drop in crash rate shows considerably statistical uncertainty about the precise size of the drop. Even assuming that this proportion of vehicle faults prevented by doubling the inspection frequency could be maintained over the vehicle age range 7-20 years, the safety benefits are very unlikely to exceed the additional costs of the 6-monthly inspections to the motorists, valued at $NZ 500 million annually excluding the overall costs of administering the scheme. The New Zealand warrant of fitness scheme as a whole cannot be robustly evaluated using the analysis approach used here, but the safety benefits would need to be substantial--yielding an unlikely 12% reduction in injury crashes--for benefits to equal costs. Copyright © 2013 Elsevier Ltd. All rights reserved.

Food choice considerations among American Indians living in rural Oklahoma: The THRIVE study.

PubMed

Wetherill, Marianna S; Williams, Mary B; Hartwell, Micah L; Salvatore, Alicia L; Jacob, Tvli; Cannady, Tamela K; Standridge, Joy; Fox, Jill; Spiegel, Jennifer; Anderson, Natia; Jernigan, Valarie Blue Bird

2018-05-17

In rural American Indian (AI) communities, access to affordable, healthy foods is often limited. Understanding AI food choice considerations when selecting foods, such as sensory appeal, cost, or health, is an important yet understudied topic for eliminating persistent AI health disparities. In partnership with the Chickasaw Nation and Choctaw Nation of Oklahoma, we administered a modified version of the Food Choice Values (FCV) Questionnaire to a cross-sectional sample of 83 AI patrons shopping at tribally-owned convenience stores ≥3 times per week. The FCV Questionnaire uses 25 items to assess eight FCV subscales related to buying and eating food, including sensory appeal; safety; accessibility; convenience; health/weight control; organic; tradition; and comfort. We compared mean scores for each FCV subscale by demographic groups using t-tests and ANOVA. We used confirmatory factor analysis (CFA) to examine how well the data from this population fit FCV subscale constructs. We then used cluster analysis, MANOVA, and discriminant analysis to characterize distinct segments of the population based on patterns of FCV endorsement. Appeal, safety, and access FCVs were most strongly endorsed across the sample. Prioritization of FCVs varied by age, gender, income, and education. Our cluster analysis identified four groups, or segments, each with distinct patterns of FCV endorsement: limited endorsement of any FCVs (23.3%); safety and sensory appeal (32.9%); health/weight control (17.8%); and broad endorsement of FCVs (26.0%). These groups varied by age and employment status. Findings from this analysis informed the design and implementation of a healthy retail intervention comprised of new healthful foods and beverages, product placement and marketing strategies within four tribally-owned and operated convenience stores. Public health interventions aimed at reducing nutrition-related disparities in rural AI populations may benefit from assessing food choice considerations. Copyright © 2018 Elsevier Ltd. All rights reserved.

Impact of technology on cytology outcome in cervical cancer screening of young and older women.

PubMed

Rask, J; Lynge, E; Franzmann, M; Hansen, B; Hjortebjerg, A; Rygaard, C; Schledermann, D; Wåhlin, A; Rebolj, M

2014-05-01

Little is known about age-dependent variation in outcomes of cervical cytology with modern technologies. This population-based study evaluated age-dependent changes after routine implementation of ThinPrep and SurePath technology in two independent laboratories, and controlled for time trends in a third laboratory using manually read conventional cytology continually. Data were collected from the Danish National Health Care Registers. For each laboratory, we compared proportions of abnormal cytology defined as atypical squamous cells of undetermined significance or worse (ASCUS+) by age and technology phase. The study included 489,960 cytological samples with no recent abnormality from women aged 23-59 years, routinely screened between 1998 and 2007. Implementation of SurePath liquid-based cytology (LBC) was followed by an increase in abnormal cytology in women aged 23-29 years from 4.6 to 6.1%, relative proportion (RP): 1.31 [95% confidence interval (CI): 1.08-1.61], and a decrease in women aged 45-59 years from 2.9 to 2.0%, RP: 0.71 (95% CI: 0.60-0.83). Implementation of ThinPrep LBC was followed by a decrease in abnormal cytology both in women aged 23-29 years from 7.7 to 6.8%, RP: 0.89 (95% CI: 0.78-1.02) and in women aged 45-59 years from 3.4 to 1.0%, RP: 0.30 (95% CI: 0.24-0.37). With implementation of imaging-assisted reading, regardless of the brand of technology, the proportion of abnormality increased by around 30% in all age groups (range from 19 to 41%). In the laboratory with unchanged technology no trends in abnormality proportions were observed. The impact of LBC implementation on cytological abnormality proportions varied considerably across age groups. © 2013 UICC.

Age-period-cohort analysis of suicides among Japanese 1950-2003: a Bayesian cohort model analysis.

PubMed

Ooe, Yosuke; Ohno, Yuko; Nakamura, Takashi

2009-07-01

The suicide rate in Japan is one of the highest in the world and presents us with a considerable challenge. Demographic statistics show that the number of suicides is on the rise, and at roughly 30,000 people per year have committed suicide since 1998. Suicide trends are not only related to economic boom and bust but also to certain generations and age groups. During the 1950s, there was a remarkably high suicide rate among people in their 20s, and this cohort was identical to that of the middle-age generation in the 1980s. It is important to separately understand both the trend of suicide rates and the numbers analyzed to determine the different factors that influence suicide. These include age, time period, cohort, interaction between age and time period, and changes in population composition. We performed an age-period-cohort analysis of annual trends of suicide rates by age group in Japan using a Bayesian cohort model. With the help of the Nakamura method, we have been able to break down the effects of age, time period, cohort, and the age-by-period interaction. The cohort comprised of people born in the 1930s demonstrated a relatively high suicide rate. Men currently in their 50s also belong to a high suicide rate cohort. Regarding the period effect, business cycles and by-period interaction effect, it became apparent that the high suicide rate among young adults in their early 20s around 1960 was slowing, especially among men. Instead, there was an obvious recent trend for men in their late 50s to have the highest suicide rate. This study confirmed that age-period-cohort analysis can describe these trends of suicide mortality of the Japanese.

Impact of age on the diagnostic performances and cut-offs of APRI and FIB-4 for significant fibrosis and cirrhosis in chronic hepatitis B.

PubMed

Li, Qiang; Lu, Chuan; Li, Weixia; Huang, Yuxian; Chen, Liang

2017-07-11

Assessing the diagnostic performances of APRI and FIB-4 using age as a categorical marker. 822 chronic hepatitis B (CHB) patients were included. Using METAVIR scoring system as a reference, the performances of APRI and FIB-4 were compared between patients aged≥30 and patients aged<30 years. The APRI AUROC in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (0.61 vs 0.70, p<0.001) and cirrhosis (0.64 vs 0.78, p<0.001). The FIB-4 AUROC in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (0.57 vs 0.65, p<0.001) and cirrhosis (0.63 vs 0.72, p<0.001). Using specificity≥90%, the APRI cut-off in patients aged<30 years was lower than patients aged≥30 years for significant fibrosis (1.0 vs 1.2) and cirrhosis (1.2 vs 1.5). Using sensitivity≥90%, the APRI cut-off in patients aged<30 years was also lower than patients aged≥30 years for significant fibrosis (0.2 vs 0.4) and cirrhosis (0.3 vs 0.5). Using specificity≥90%, the FIB-4 cut-off in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (1.2 vs 2.1) and cirrhosis (1.4 vs 2.6). Using sensitivity≥90%, the FIB-4 cut-off in patients aged<30 years was also lower than that in patients aged≥30 years for significant fibrosis (0.5 vs 0.8) and cirrhosis (0.8 vs 1.2). Evaluation of the diagnostic performances of APRI and FIB-4 should take age into consideration.

Whey peptides prevent chronic ultraviolet B radiation-induced skin aging in melanin-possessing male hairless mice.

PubMed

Kimura, Yoshiyuki; Sumiyoshi, Maho; Kobayashi, Toshiya

2014-01-01

Whey proteins or peptides exhibit various actions, including an antioxidant action, an anticancer action, and a protective action against childhood asthma and atopic syndrome. The effects of orally administered whey peptides (WPs) on chronic ultraviolet B (UVB) radiation-induced cutaneous changes, including changes in cutaneous thickness, elasticity, wrinkle formation, etc., have not been examined. In this study, we studied the preventive effects of WPs on cutaneous aging induced by chronic UVB irradiation in melanin-possessing male hairless mice (HRM). UVB (36-180 mJ/cm(2)) was irradiated to the dorsal area for 17 wk in HRM, and the measurements of cutaneous thickness and elasticity in UVB irradiated mice were performed every week. WPs (200 and 400 mg/kg, twice daily) were administered orally for 17 wk. WPs inhibited the increase in cutaneous thickness, wrinkle formation, and melanin granules and the reduction in cutaneous elasticity associated with photoaging. Furthermore, it has been reported that UVB irradiation-induced skin aging is closely associated with the increase in expression of matrix metalloproteinase (MMP), vascular endothelial growth factor (VEGF), Ki-67-, and 8-hydroxy-2'-deoxyguanosine (8-OHdG)-positive cells. WPs also prevented increases in the expression of MMP-2 and pro-MMP-9, VEGF, and Ki-67- and 8-OHdG-positive cells induced by chronic UVB irradiation. It was found that WPs prevent type IV collagen degradation, angiogenesis, proliferation, and DNA damage caused by UVB irradiation. Overall, these results demonstrate the considerable benefit of WPs for protection against solar UV-irradiated skin aging as a supplemental nutrient.

Adult dementia: history, biopsy, pathology.

PubMed

Torack, R M

1979-05-01

The historical events in the evolution of Alzheimer's disease are reviewed, including the initial description by Alois Alzheimer and the subsequent controversy regarding the nosological specificity of this entity. The similarity of senile dementia and Alzheimer's disease is emphasized. The basis for the modern concept of Alzheimer's disease as premature or accelerated aging is included in the review. The pathological correlates of the major categories of adult dementia have been described. The traditional criteria of neurofibrillary tangles and senile plaques have been re-evaluated using the current insight into these changes afforded by electron microscopy and biochemistry. The significance of amyloid has been described because it occurs within the senile plaque and also as the essential component of congophilic angiopathy. The new information regarding neuronal cell counts and the loss of choline acetyltransferase has been evaluated in terms of an indication of a pathogenic mechanism of Alzheimer's disease. The current understanding of normal pressure hydrocephalus, Creutzfeldt-Jakob disease, and multi-infarct dementia has been described. Brain biopsy in dementia has been described as having diagnostic, research, pathogenic, and prognostic value. The precautions involving the performance and handling of the biopsy have been stressed, particularly because these procedures involve conditions of possible slow virus etiology. The polemic for Alzheimer's disease as aging or slow virus infection has been summarized. At this time a consideration seems justified that Alzheimer's disease is an age-related, slow virus disease due to a hitherto unknown immune defect. Aging as an etiological agent must be clarified before Alzheimer's disease, in any form, can be considered to be an inevitable consequence of longevity.

Social Integration in Young Adulthood and the Subsequent Onset of Substance Use and Disorders among a Community Population of Urban African Americans*

PubMed Central

Green, Kerry M.; Doherty, Elaine E.; Reisinger, Heather S.; Chilcoat, Howard D.; Ensminger, Margaret

2009-01-01

Aims This article examines the association between social integration in young adulthood and the later onset of substance use and disorders through mid-adulthood. Design Data come from a community cohort of African Americans followed longitudinally from age 6–42 with four assessment periods. Setting The cohort all lived in the Woodlawn neighborhood of Chicago in 1966, an urban disadvantaged setting. Participants All Woodlawn first graders in 1966 were asked to participate; 13 families declined (N=1242). Measurement Substance use was measured via interview at age 42 and includes the onset of alcohol and drug use disorders and the onset of cocaine/heroin use between ages 32 and 42. Social integration measures were assessed via interview at age 32 and include social roles (employee, spouse, parent), participation in religious and social organizations, and a measure of overall social integration. Control variables were measured in childhood and later in the lifecourse. Findings Multivariate regression analyses suggest that unemployment, being unmarried, infrequent religious service attendance, and lower overall social integration in young adulthood predict later adult-onset drug use disorders, but not alcohol use disorders once confounders are taken into consideration. Unemployment and lower overall social integration predict onset of cocaine/heroin use later in adulthood. Conclusions Results show meaningful onset of drug use and substance use disorders during mid-adulthood and that social integration in young adulthood seems to play a role in later onset of drug use and drug disorders, but not alcohol disorders. PMID:20402992

Epidemiology of pituitary pars intermedia dysfunction: A systematic literature review of clinical presentation, disease prevalence and risk factors.

PubMed

Ireland, J L; McGowan, C M

2018-05-01

Pituitary pars intermedia dysfunction (PPID) is caused by an age-related degenerative disease of dopaminergic neurones. Despite its importance in equine practice, available information regarding its epidemiology is limited. This systematic review aimed to assess published literature to evaluate available evidence regarding the clinical presentation, prevalence and risk factors for PPID in horses and ponies. Electronic database searches were undertaken using a range of terms, and English language publications published prior to August 2016 were included. Both authors independently reviewed screened papers for inclusion, extracted data, and assessed the quality of reporting using predefined criteria. Data were extracted using modified critically appraised topic data collection forms. Meta-analysis was not undertaken due to marked between-study variations. Following removal of duplicate records, of 358 published papers yielded by the search, 97 abstracts were screened for eligibility and 29 publications meeting inclusion criteria were included in the review. Most studies reviewed were case series or cross-sectional studies, with considerable variation in study populations and PPID case definition. Hypertrichosis and/or other hair coat abnormalities, laminitis and epaxial muscle wastage or muscle atrophy are the most frequently reported clinical signs, with prevalence of these signs increasing with increasing horse age. The most robust prevalence estimates for PPID were 21.2% in horses and ponies aged ≥15 years and 2.9% amongst the general equine population. Findings regarding breed and sex predispositions were equivocal and only increasing age has been identified as a significant risk factor for PPID. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

A retrospective investigation of the oral health records of a cohort of preschool children who received extractions under general anaesthesia including cost analysis of treatment.

PubMed

McAuliffe, Una; Kinirons, Martin; Woods, Noel; Harding, Mairead

2017-02-01

Internationally, a considerable proportion of children aged five years and younger require extraction of teeth due to dental caries and frequently dental general anaesthesia (DGA) is the treatment of choice. To investigate the records of a cohort of preschool children (aged five years and younger) referred to the public dental service provided at Cork University Hospital (CUH), Cork, Ireland, for extractions under DGA between the years 2000 and 2002. To determine the characteristics of the sample: disadvantage; the presence of a significant medical history; and, fluoride status. To establish the pattern of appointments and care, before, during and after DGA, and the pattern of dental treatment required up to sixth class (aged 11 to 12 years). A retrospective review of dental records of a cohort of preschool-aged children referred for DGA in CUH during the years 2000-2002 was completed. Demographic and clinical data were collated and analysed using Statistical Packages for Social Sciences (SPSS). Costs were provided by CUH and the Health Service Executive (HSE). Data on costs relating to preventive programmes were obtained from information presented in the Irish Oral Health Services Guideline Initiative 2009.1 Results: A total of 347 children were included with a median age of.fQur years and a range of one to five years. Children with a disadvantage were more likely to require extractions under DGA than their- counterparts (50%, n=175). In total, 73% (n=253)~ of patients had a fluoridated water supply and 91% (n=316) had no adverse medical history. For 88% (n=306), their first dental visit was an emergency appointment. The primary indication for DGA was treatment of dental caries. A recall appointment was provided for 18% (n=63). One-quarter (n=86) required an extraction, antibiotic or referral for a second DGA at their first visit following DGA. In first class, referral for a second DGA or extraction under local anaesthetic (LA) was required for 23% (n=79) of patients. Over 60% (n=21 1) required either an extraction or a restoration in third class. In excess of 20% (n=69) of patients did not attend the sixth class dental inspection, the final assessment appointment in the public services. A considerable number of preschool children require extractions under DGA due to dental caries. The results of this study indicate that such children progress to adolescence with poor oral health, as evidenced by the need for further restorations, extractions and repeat DGA. The average cost of DGA was E819 per child. This figure has been shown to be as much as eight times the cost of a preventive/oral health promotion prograrnme operating within a similar cohort. An integrated preventive programme targeting preschool-aged children should be considered in attempting to manage the hicih levels of dental caries within this age group.

Ageing, cognitive disorders and professional practice.

PubMed

FitzGerald, Deirdre; Keane, Ruth-Anne; Reid, Alex; O'Neill, Desmond

2013-09-01

the workforce is ageing. The contribution of older workers is considerable. Their occupational health profiles differ from those of younger workers. we wished to establish whether consideration has been given by regulatory and professional bodies of the impact of ageing-related conditions such as dementia on professional practice. We e-mailed a questionnaire to 22 regulatory and professional bodies in the UK and the Republic of Ireland. We asked whether there are supports for their practitioners should they develop age-related diseases, (particularly cognitive disorders),whether the body considered that the practitioner was responsible for their own health, and whether the body has resources to arrange for medical review for their professionals if concerns arose regarding competence. Where bodies did not respond, information relating to the questions was extracted from their on-line resources. thirteen bodies responded. None of these had specific supports to assist older workers. Some knew of other supports (occupational health, employee assistance supports, benevolent funds or counselling services). All of the bodies who responded either have or are developing structures to deal with concerns regarding their practitioners. The absence of specific policies for age-related diseases, (particularly dementia), among professional and regulatory bodies is a challenge for an ageing workforce in the liberal professions. Closer working between geriatric medicine, old age psychiatry, occupational health and professional bodies is recommended to develop age-attuned policies and systems which protect the public while supporting the professionals in both work and timely transition from work.

Trend analysis of mortality rates and causes of death in children under 5 years old in Beijing, China from 1992 to 2015 and forecast of mortality into the future: an entire population-based epidemiological study.

PubMed

Cao, Han; Wang, Jing; Li, Yichen; Li, Dongyang; Guo, Jin; Hu, Yifei; Meng, Kai; He, Dian; Liu, Bin; Liu, Zheng; Qi, Han; Zhang, Ling

2017-09-18

To analyse trends in mortality and causes of death among children aged under 5 years in Beijing, China between 1992 and 2015 and to forecast under-5 mortality rates (U5MRs) for the period 2016-2020. An entire population-based epidemiological study was conducted. Data collection was based on the Child Death Reporting Card of the Beijing Under-5 Mortality Rate Surveillance Network. Trends in mortality and leading causes of death were analysed using the χ 2 test and SPSS 19.0 software. An autoregressive integrated moving average (ARIMA) model was fitted to forecast U5MRs between 2016 and 2020 using the EViews 8.0 software. Mortality in neonates, infants and children aged under 5 years decreased by 84.06%, 80.04% and 80.17% from 1992 to 2015, respectively. However, the U5MR increased by 7.20% from 2013 to 2015. Birth asphyxia, congenital heart disease, preterm/low birth weight and other congenital abnormalities comprised the top five causes of death. The greatest, most rapid reduction was that of pneumonia by 92.26%, with an annual average rate of reduction of 10.53%. The distribution of causes of death differed among children of different ages. Accidental asphyxia and sepsis were among the top five causes of death in children aged 28 days to 1 year and accident was among the top five causes in children aged 1-4 years. The U5MRs in Beijing are projected to be 2.88‰, 2.87‰, 2.90‰, 2.97‰ and 3.09‰ for the period 2016-2020, based on the predictive model. Beijing has made considerable progress in reducing U5MRs from 1992 to 2015. However, U5MRs could show a slight upward trend from 2016 to 2020. Future considerations for child healthcare include the management of birth asphyxia, congenital heart disease, preterm/low birth weight and other congenital abnormalities. Specific preventative measures should be implemented for children of various age groups. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Trend analysis of mortality rates and causes of death in children under 5 years old in Beijing, China from 1992 to 2015 and forecast of mortality into the future: an entire population-based epidemiological study

PubMed Central

Cao, Han; Wang, Jing; Li, Yichen; Li, Dongyang; Guo, Jin; Hu, Yifei; Meng, Kai; He, Dian; Liu, Bin; Liu, Zheng; Qi, Han; Zhang, Ling

2017-01-01

Objectives To analyse trends in mortality and causes of death among children aged under 5 years in Beijing, China between 1992 and 2015 and to forecast under-5 mortality rates (U5MRs) for the period 2016–2020. Methods An entire population-based epidemiological study was conducted. Data collection was based on the Child Death Reporting Card of the Beijing Under-5 Mortality Rate Surveillance Network. Trends in mortality and leading causes of death were analysed using the χ2 test and SPSS 19.0 software. An autoregressive integrated moving average (ARIMA) model was fitted to forecast U5MRs between 2016 and 2020 using the EViews 8.0 software. Results Mortality in neonates, infants and children aged under 5 years decreased by 84.06%, 80.04% and 80.17% from 1992 to 2015, respectively. However, the U5MR increased by 7.20% from 2013 to 2015. Birth asphyxia, congenital heart disease, preterm/low birth weight and other congenital abnormalities comprised the top five causes of death. The greatest, most rapid reduction was that of pneumonia by 92.26%, with an annual average rate of reduction of 10.53%. The distribution of causes of death differed among children of different ages. Accidental asphyxia and sepsis were among the top five causes of death in children aged 28 days to 1 year and accident was among the top five causes in children aged 1–4 years. The U5MRs in Beijing are projected to be 2.88‰, 2.87‰, 2.90‰, 2.97‰ and 3.09‰ for the period 2016–2020, based on the predictive model. Conclusion Beijing has made considerable progress in reducing U5MRs from 1992 to 2015. However, U5MRs could show a slight upward trend from 2016 to 2020. Future considerations for child healthcare include the management of birth asphyxia, congenital heart disease, preterm/low birth weight and other congenital abnormalities. Specific preventative measures should be implemented for children of various age groups. PMID:28928178

Empirical evaluation of grouping of lower urinary tract symptoms: principal component analysis of Tampere Ageing Male Urological Study data.

PubMed

Pöyhönen, Antti; Häkkinen, Jukka T; Koskimäki, Juha; Hakama, Matti; Tammela, Teuvo L J; Auvinen, Anssi

2013-03-01

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: The ICS has divided LUTS into three groups: storage, voiding and post-micturition symptoms. The classification is based on anatomical, physiological and urodynamic considerations of a theoretical nature. We used principal component analysis (PCA) to determine the inter-correlations of various LUTS, which is a novel approach to research and can strengthen existing knowledge of the phenomenology of LUTS. After we had completed our analyses, another study was published that used a similar approach and results were very similar to those of the present study. We evaluated the constellation of LUTS using PCA of the data from a population-based study that included >4000 men. In our analysis, three components emerged from the 12 LUTS: voiding, storage and incontinence components. Our results indicated that incontinence may be separate from the other storage symptoms and post-micturition symptoms should perhaps be regarded as voiding symptoms. To determine how lower urinary tract symptoms (LUTS) relate to each other and assess if the classification proposed by the International Continence Society (ICS) is consistent with empirical findings. The information on urinary symptoms for this population-based study was collected using a self-administered postal questionnaire in 2004. The questionnaire was sent to 7470 men, aged 30-80 years, from Pirkanmaa County (Finland), of whom 4384 (58.7%) returned the questionnaire. The Danish Prostatic Symptom Score-1 questionnaire was used to evaluate urinary symptoms. Principal component analysis (PCA) was used to evaluate the inter-correlations among various urinary symptoms. The PCA produced a grouping of 12 LUTS into three categories consisting of voiding, storage and incontinence symptoms. Post-micturition symptoms were related to voiding symptoms, but incontinence symptoms were separate from storage symptoms. In the analyses by age group, similar categorization was found at ages 40, 50, 60 and 80 years, but only two groups of symptoms emerged among men aged 70 years. The prevalence among men aged 30 was too low for meaningful analysis. This population-based study suggests that LUTS can be divided into three subgroups consisting of voiding, storage and incontinence symptoms based on their inter-correlations. Our empirical findings suggest an alternative grouping of LUTS. The potential utility of such an approach requires careful consideration. © 2012 BJU International.

Prevalence of Invalid Performance on Baseline Testing for Sport-Related Concussion by Age and Validity Indicator.

PubMed

Abeare, Christopher A; Messa, Isabelle; Zuccato, Brandon G; Merker, Bradley; Erdodi, Laszlo

2018-03-12

Estimated base rates of invalid performance on baseline testing (base rates of failure) for the management of sport-related concussion range from 6.1% to 40.0%, depending on the validity indicator used. The instability of this key measure represents a challenge in the clinical interpretation of test results that could undermine the utility of baseline testing. To determine the prevalence of invalid performance on baseline testing and to assess whether the prevalence varies as a function of age and validity indicator. This retrospective, cross-sectional study included data collected between January 1, 2012, and December 31, 2016, from a clinical referral center in the Midwestern United States. Participants included 7897 consecutively tested, equivalently proportioned male and female athletes aged 10 to 21 years, who completed baseline neurocognitive testing for the purpose of concussion management. Baseline assessment was conducted with the Immediate Postconcussion Assessment and Cognitive Testing (ImPACT), a computerized neurocognitive test designed for assessment of concussion. Base rates of failure on published ImPACT validity indicators were compared within and across age groups. Hypotheses were developed after data collection but prior to analyses. Of the 7897 study participants, 4086 (51.7%) were male, mean (SD) age was 14.71 (1.78) years, 7820 (99.0%) were primarily English speaking, and the mean (SD) educational level was 8.79 (1.68) years. The base rate of failure ranged from 6.4% to 47.6% across individual indicators. Most of the sample (55.7%) failed at least 1 of 4 validity indicators. The base rate of failure varied considerably across age groups (117 of 140 [83.6%] for those aged 10 years to 14 of 48 [29.2%] for those aged 21 years), representing a risk ratio of 2.86 (95% CI, 2.60-3.16; P < .001). The results for base rate of failure were surprisingly high overall and varied widely depending on the specific validity indicator and the age of the examinee. The strong age association, with 3 of 4 participants aged 10 to 12 years failing validity indicators, suggests that the clinical interpretation and utility of baseline testing in this age group is questionable. These findings underscore the need for close scrutiny of performance validity indicators on baseline testing across age groups.

Click-evoked auditory brainstem responses and autism spectrum disorder: A meta-analytic review.

PubMed

Talge, Nicole M; Tudor, Brooke M; Kileny, Paul R

2018-06-01

Behavior does not differentiate ASD risk prior to 12 months of age, but biomarkers may inform risk before symptoms emerge. Click-evoked auditory brainstem responses (ABRs) may be worth consideration due to their measurement properties (noninvasiveness; reliability) and conceptual features (well-characterized neural generators), but participant characteristics and assessment protocols vary considerably across studies. Our goal is to perform a meta-analysis of the association between ABRs and ASD. Following an electronic database search (PubMed, Medline, PsycInfo, PsycArticles), we included papers that were written in English, included ASD and typically-developing (TD) groups, and reported the information needed to calculate standardized mean differences (Hedges's g) for at least one ABR latency component (I, III, V, I-III, III-V, I-V). We weighted and averaged effect sizes across conditions and subsets of participants to yield one estimate per component per study. We then performed random-effects regressions to generate component-specific estimates. ASD was associated with longer ABR latencies for Waves III (g = 0.5, 95% CI 0.1, 0.9), V (g = 0.7, 95% CI 0.3, 1.1), I-III (g = 0.7, 95% CI 0.2, 1.2), and I-V (g = 0.6, 95% CI 0.2, 1.0). All components showed significant heterogeneity. Associations were strongest among participants ≤8 years of age and those without middle ear abnormalities or elevated auditory thresholds. In sum, associations between ABRs and ASD are medium-to-large in size, but exhibit heterogeneity. Identifying sources of heterogeneity is challenging, however, due to power limitations and co-occurrence of sample/design characteristics across studies. Research addressing the above limitations is crucial to determining the etiologic and/or prognostic value of ABRs for ASD. Autism Res 2018, 11: 916-927. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. Auditory brainstem responses (ABR) may be associated with ASD, but participant characteristics and assessment protocols vary considerably across individual studies. Our goal is to combine the results across these studies to facilitate clarity on the topic. Doing so represents a first step in evaluating whether ABRs yield potential for informing the etiology of ASD risk and/or ASD symptom profiles. © 2018 International Society for Autism Research, Wiley Periodicals, Inc.

Relationships of Disability with Age Among Adults Aged 50 to 85: Evidence from the United States, England and Continental Europe

PubMed Central

Wahrendorf, Morten; Reinhardt, Jan D.; Siegrist, Johannes

2013-01-01

Objectives To extend existing research on the US health disadvantage relative to Europe by studying the relationships of disability with age from midlife to old age in the US and four European regions (England/Northern and Western Europe/Southern Europe/Eastern Europe) including their wealth-related differences, using a flexible statistical approach to model the age-functions. Methods We used data from three studies on aging, with nationally representative samples of adults aged 50 to 85 from 15 countries (N = 48225): the US-American Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA) and the Survey of Health, Ageing and Retirement in Europe (SHARE). Outcomes were mobility limitations and limitations in instrumental activities of daily living. We applied fractional polynomials of age to determine best fitting functional forms for age on disability in each region, while controlling for socio-demographic characteristics and important risk factors (hypertension, diabetes, obesity, smoking, physical inactivity). Results Findings showed high levels of disability in the US with small age-related changes between 50 and 85. Levels of disability were generally lower in Eastern Europe, followed by England and Southern Europe and lowest in Northern and Western Europe. In these latter countries age-related increases of disability, though, were steeper than in the US, especially in Eastern and Southern Europe. For all countries and at all ages, disability levels were higher among adults with low wealth compared to those with high wealth, with largest wealth-related differences among those in early old age in the USA. Conclusions This paper illustrates considerable variations of disability and its relationship with age. It supports the hypothesis that less developed social policies and more pronounced socioeconomic inequalities are related to higher levels of disability and an earlier onset of disability. PMID:23977172

Modified Maturity Offset Prediction Equations: Validation in Independent Longitudinal Samples of Boys and Girls.

PubMed

Kozieł, Sławomir M; Malina, Robert M

2018-01-01

Predicted maturity offset and age at peak height velocity are increasingly used with youth athletes, although validation studies of the equations indicated major limitations. The equations have since been modified and simplified. The objective of this study was to validate the new maturity offset prediction equations in independent longitudinal samples of boys and girls. Two new equations for boys with chronological age and sitting height and chronological age and stature as predictors, and one equation for girls with chronological age and stature as predictors were evaluated in serial data from the Wrocław Growth Study, 193 boys (aged 8-18 years) and 198 girls (aged 8-16 years). Observed age at peak height velocity for each youth was estimated with the Preece-Baines Model 1. The original prediction equations were included for comparison. Predicted age at peak height velocity was the difference between chronological age at prediction and maturity offset. Predicted ages at peak height velocity with the new equations approximated observed ages at peak height velocity in average maturing boys near the time of peak height velocity; a corresponding window for average maturing girls was not apparent. Compared with observed age at peak height velocity, predicted ages at peak height velocity with the new and original equations were consistently later in early maturing youth and earlier in late maturing youth of both sexes. Predicted ages at peak height velocity with the new equations had reduced variation compared with the original equations and especially observed ages at peak height velocity. Intra-individual variation in predicted ages at peak height velocity with all equations was considerable. The new equations are useful for average maturing boys close to the time of peak height velocity; there does not appear to be a clear window for average maturing girls. The new and original equations have major limitations with early and late maturing boys and girls.

[Employment and married women's health in Korea; beneficial or harmful?].

PubMed

Kim, Il Ho; Chun, Heeran

2009-09-01

The aim of this study was to investigate whether working married women in different occupational classes affected diverse health outcomes. We used data for married women aged 25-59 (N=2,273) from the 2005 National Health and Nutritional Examination Survey. Outcome measures included physical/mental and subjective/objective indicators (self-rated poor health, chronic diseases, depression, and suicidal ideation from reported results; metabolic syndrome and dyslipidemia from health examination results). Age-standardized prevalence and logistic regression were employed to assess health status according to three types of working groups (housewives, married women in manual jobs, married women in non-manual jobs). Sociodemographic factors (age, numbers of children under 7, education, household income) and health behaviors (health examination, sleep, rest, exercise, smoking, drinking) and a psychological factor (stress) were considered as covariates. Non-manual married female workers in Korea showed better health status in all five health outcomes than housewives. The positive health effect for the non-manual group persisted in absolute (age-adjusted prevalence) and relative (odds ratio) measures, but multivariate analyses showed an insignificant association of the non-manual group with dyslipidemia. Manual female workers showed significantly higher age-adjusted prevalence of almost all health outcomes than housewives except chronic disease, but the associations disappeared after further adjustment for covariates regarding sleep, rest, and stress. Our results suggest that examining the health impact of work on married women requires the consideration of occupational class.

The assessment of cortisol in human hair: associations with sociodemographic variables and potential confounders.

PubMed

Dettenborn, L; Tietze, A; Kirschbaum, C; Stalder, T

2012-11-01

To inform the future use of hair cortisol measurement, we have investigated influences of potential confounding variables (natural hair colour, frequency of hair washes, age, sex, oral contraceptive (OC) use and smoking status) on hair cortisol levels. The main study sample comprised 360 participants (172 women) covering a wide range of ages (1-91 years; mean = 25.95). In addition, to more closely examine influences of natural hair colour and young age on hair cortisol levels, two additional samples comprising 69 participants with natural blond or dark brown hair (hair colour sample) as well as 28 young children and 34 adults (young age sample) were recruited. Results revealed a lack of an effect for natural hair colour, OC use, and smoking status on hair cortisol levels (all p's >0.10). No influence of frequency of hair washes was seen for proximal hair segments (p = 0.335) but for the third hair segment indicating lower cortisol content (p = 0.008). We found elevated hair cortisol levels in young children and older adults (p < 0.001). Finally, men showed higher hair cortisol levels than women (p = 0.002). The present data indicate that hair cortisol measurement provides a useful tool in stress-related psychobiological research when applied with the consideration of possible confounders including age and sex.

Spending by California’s Department of Developmental Services for Persons with Autism across Demographic and Expenditure Categories

PubMed Central

Leigh, J. Paul; Grosse, Scott D.; Cassady, Diana; Melnikow, Joy; Hertz-Picciotto, Irva

2016-01-01

Background Few autism spectrum disorder (ASD) studies have estimated non-medical costs for treatment or addressed possible differences in provision of services across gender, race-ethnic, age or demographic or expenditure categories, especially among adults. Methods The California Department of Developmental Services (CDDS) provides services to residents with developmental disabilities. CDDS provided aggregate data on primarily non-medical spending for fiscal year 2012–2013 for persons with ASD with or without intellectual disability (ID) (main sample, n = 42,274), and two sub-samples: ASD only (n = 30,164), and ASD+ID (n = 12,110). Demographic variables included sex, age and race-ethnicity. Spending categories included Employment Support, Community Care Facilities, Day Care, Transportation, and in-home and out-of-home Respite. Results Per-person spending for males and females were approximately the same: $10,488 and $10,791 for males and females for ages 3–17 and $26,491 and $26,627 for ages 18+. Among race/ethnicity categories, the ranking from highest to lowest among ages 3–17 was white non-Hispanics ($11,480), Asian non-Hispanics ($11,036), “Others” ($11,031), Hispanics ($9,571), and African-American non-Hispanics ($9,482). For ages 18+, the ranking was whites ($31,008), African-Americans ($26,831), “Others” ($25,395), Asians ($22,993), and Hispanics ($18,083). The ASD+ID sub-sample exerted disproportionate influence on findings from the main sample for persons 18+. Combining all ages, the top two expenditure categories for per-person spending were Community Care Facilities ($43,867) and Day Care ($11,244). For most adult age groups, the percentage of recipients participating were highest for Day Care (44.9% - 62.4%) and Transportation (38.6% - 50.9%). Per-person spending for Day Care, Transportation, and Employment Support was relatively low for children but relatively high for adults. Conclusion White non-Hispanics received the highest per-person spending and Hispanics among the least. Amounts within spending categories varied considerably across age groups. Our estimates may be useful as baseline measures for stakeholders preparing for increasing ASD prevalence, especially among adults. PMID:27015098

Mortality attributable to diabetes: estimates for the year 2010.

PubMed

Roglic, Gojka; Unwin, Nigel

2010-01-01

Country and global health statistics underestimate the number of excess deaths due to diabetes. The aim of the study was to provide a more accurate estimate of the number of deaths attributable to diabetes for the year 2010. A computerized disease model was used to obtain the estimates. The baseline input data included the population structure, estimates of diabetes prevalence, estimates of underlying mortality and estimates of the relative risk of death for people with diabetes compared to people without diabetes. The total number of excess deaths attributable to diabetes worldwide was estimated to be 3.96 million in the age group 20-79 years, 6.8% of global (all ages) mortality. Diabetes accounted for 6% of deaths in adults in the African Region, to 15.7% in the North American Region. Beyond 49 years of age diabetes constituted a higher proportion of deaths in females than in males in all regions, reaching over 25% in some regions and age groups. Thus, diabetes is a considerable cause of premature mortality, a situation that is likely to worsen, particularly in low and middle income countries as diabetes prevalence increases. Investments in primary and secondary prevention are urgently required to reduce this burden. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Attention and memory evaluation across the life span: heterogeneous effects of age and education.

PubMed

Gómez-Pérez, Esther; Ostrosky-Solís, Feggy

2006-05-01

The developmental sequences of attention and memory were studied by utilizing normative data derived from the neuropsychological battery named NEUROPSI ATTENTION AND MEMORY. A sample of 521 Spanish-speaking individuals, aged 6 to 85 years, participated in this study. In the adult sample, educational level ranged from 0 to 22 years of education. Data from subtests measuring orientation, attention and concentration, executive functions, working memory, immediate and delayed verbal memory, and immediate and delayed visual memory were included. The factor structure of the analyzed battery is presented. The effects of age and education on this structure were analyzed. Results suggested that although attention and memory are related, their developmental sequences are separated from one another. During childhood, the development of selective and sustained attention, attentional-working memory, and executive functions showed a fast improvement in performance. Development of verbal memory and place and person orientation showed a slower increment in scores. In the adult sample it was found that factors related to memory are sensitive to age, whereas those related to attention and executive functions are sensitive to education. The consideration of both the developmental sequence, as well as differential effects of education, can improve the sensitivity and specificity of neuropsychological measures, allowing early diagnosis of cognitive dysfunction and implementation of adequate rehabilitation programs.

Does Tinnitus Distress Depend on Age of Onset?

PubMed Central

Schlee, Winfried; Kleinjung, Tobias; Hiller, Wolfgang; Goebel, Gerhard; Kolassa, Iris-Tatjana; Langguth, Berthold

2011-01-01

Objectives Tinnitus is the perception of a sound in the absence of any physical source of it. About 5–15% of the population report hearing such a tinnitus and about 1–2% suffer from their tinnitus leading to anxiety, sleep disorders or depression. It is currently not completely understood why some people feel distressed by their tinnitus, while others don't. Several studies indicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depression, personality, the psychosocial situation, the amount of the related hearing loss and the loudness of the tinnitus. Furthermore, theoretical considerations suggest an impact of the age at tinnitus onset influencing tinnitus distress. Methods Based on a sample of 755 normal hearing tinnitus patients we tested this assumption. All participants answered a questionnaire on the amount of tinnitus distress together with a large variety of clinical and demographic data. Results Patients with an earlier onset of tinnitus suffer significantly less than patients with an onset later in life. Furthermore, patients with a later onset of tinnitus describe their course of tinnitus distress as more abrupt and distressing right from the beginning. Conclusion We argue that a decline of compensatory brain plasticity in older age accounts for this age-dependent tinnitus decompensation. PMID:22125612

Health care prioritization in ageing societies: influence of age, education, health literacy and culture.

PubMed

Mak, Benise; Woo, Jean; Bowling, Ann; Wong, Florens; Chau, Pui Hing

2011-05-01

To examine how Chinese people in Hong Kong view health care prioritization and to compare the findings with those from a United Kingdom survey. A cross-sectional opinion survey was conducted in Hong Kong and 1512 participants were interviewed. Data show that the highest rankings were accorded to "treatment for children" and "high technology services." Services for the elderly, whether in the community or in hospitals, and including end-of-life care, were ranked among the lowest. This view was also shared by healthcare professionals. Compared with the UK findings, there are stark contrasts in the low ranking of end-of-life care and the high ranking of high technology services among the HK population. It is evident that most people would give priority to the young over the old in distributing a given amount of healthcare services. To meet the needs of ageing societies and to meet the needs of all users equitably, health care policy needs to acknowledge constraints and the needs for prioritization. Both the public and professionals should engage with policy makers in formulating a policy based on cost benefit considerations as well as overall societal view of prioritization that is not based on age alone. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Grandparenting predicts late-life cognition: Results from the Women's Healthy Ageing Project.

PubMed

Burn, Katherine; Szoeke, Cassandra

2015-06-01

Social engagement provides dynamic stimulation for older individuals that influences cognition. Grandparenting is an increasingly popular form of childcare that provides social activity for older adults. To investigate the relationship between grandparenting, as a form of social engagement, and cognitive function in adults aged over 65, a decade after our previous work. Participants were 224 Australian women (mean age=70) from the longitudinal prospective Women's Healthy Ageing Project (WHAP). Cognitive function was assessed using a neuropsychological battery consisting of previously validated measures including the California Verbal Learning Test, Digit Span task, and Controlled Oral Word Association Test. Individual test scores were combined using factor analysis into executive function and episodic memory scores. Grandmothers minding grandchildren had higher executive function than those who were not minding grandchildren or who did not have grandchildren (p<0.05). Minding grandchildren for one day per week predicted better executive function performance than more frequent grandparenting (p<0.05), consistent with previous findings. While grandparenting is associated with better executive function overall, highly frequent grandparenting is associated with lower executive function, which may be due to demands. Social engagement comprises various aspects which need to be taken into consideration when studying cognition. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The genetic and environmental etiology of antisocial behavior from childhood to emerging adulthood.

PubMed

Tuvblad, Catherine; Narusyte, Jurgita; Grann, Martin; Sarnecki, Jerzy; Lichtenstein, Paul

2011-09-01

Previous research suggests that both genetic and environmental influences are important for antisocial behavior across the life span, even though the prevalence and incidence of antisocial behavior varies considerably across ages. However, little is known of how genetic and environmental effects influence the development of antisocial behavior. A total of 2,600 male and female twins from the population-based Swedish Twin Registry were included in the present study. Antisocial behavior was measured on four occasions, when twins were 8-9, 13-14, 16-17, and 19-20 years old. Longitudinal analyses of the data were conducted using structural equation modeling. The stability of antisocial behavior over time was explained by a common latent persistent antisocial behavior factor. A common genetic influence accounted for 67% of the total variance in this latent factor, the shared environment explained 26%, and the remaining 7% was due to the non-shared environment. Significant age-specific shared environmental factors were found at ages 13-14 years, suggesting that common experiences (e.g., peers) are important for antisocial behavior at this age. Results from this study show that genetic as well as shared environmental influences are important in antisocial behavior that persists from childhood to emerging adulthood.

Development and Reliability of the Basic Skill Assessment Tool for Adolescents with Autism Spectrum Disorder

PubMed Central

Lersilp, Suchitporn; Suchart, Sumana

2017-01-01

The purpose of this study was to improve upon the first version of the basic work skills assessment tool for adolescents with autism spectrum disorder (ASD) and examine interrater and intrarater reliability using Intraclass Correlation Coefficient (ICC). The modified tool includes 2 components: (1) three tasks measuring work abilities and work attitudes and (2) a form to record the number of verbal and nonverbal prompts. 26 participants were selected by purposive sampling and divided into 3 groups—group 1 (10 subjects, aged 11–13 years), group 2 (10, aged 14–16 years), and group 3 (6, aged 17–19 years). The results show that interrater reliabilities of work abilities and work attitudes were high in all groups except that the work attitude in group 1 was moderate. Intrarater reliabilities of work abilities in group 1 and group 2 were high. Group 3 was moderate. Intrarater reliabilities of work attitudes in group 1 and group 3 were high but not in group 2 in which they were moderate. Nevertheless, interrater and intrarater reliabilities in the total scores of all groups were high, which implies that this tool is applicable for adolescents aged 11–19 years with consideration of relevance for each group. PMID:28280769

Eusocial insects as emerging models for behavioural epigenetics.

PubMed

Yan, Hua; Simola, Daniel F; Bonasio, Roberto; Liebig, Jürgen; Berger, Shelley L; Reinberg, Danny

2014-10-01

Understanding the molecular basis of how behavioural states are established, maintained and altered by environmental cues is an area of considerable and growing interest. Epigenetic processes, including methylation of DNA and post-translational modification of histones, dynamically modulate activity-dependent gene expression in neurons and can therefore have important regulatory roles in shaping behavioural responses to environmental cues. Several eusocial insect species - with their unique displays of behavioural plasticity due to age, morphology and social context - have emerged as models to investigate the genetic and epigenetic underpinnings of animal social behaviour. This Review summarizes recent studies in the epigenetics of social behaviour and offers perspectives on emerging trends and prospects for establishing genetic tools in eusocial insects.

Regulatory and Economic Considerations of Retinal Drugs.

PubMed

Shah, Ankoor R; Williams, George A

2016-01-01

The advent of anti-VEGF therapy for neovascular age-related macular degeneration and macular edema secondary to retinal vein occlusion and diabetes mellitus has prevented blindness in tens of thousands of people. However, the costs of these drugs are without precedent in ophthalmic drug therapeutics. An analysis of the financial implications of retinal drugs and the impact of the Food and Drug Administration on treatment of retinal disease must include not only an evaluation of the direct costs of the drugs and the costs associated with their administration, but also the cost savings which accrue from their clinical benefit. This chapter will discuss the financial and regulatory issues associated with retinal drugs. © 2016 S. Karger AG, Basel.

Dismantling the Active Ingredients of an Intervention for Children with Autism.

PubMed

Pellecchia, Melanie; Connell, James E; Beidas, Rinad S; Xie, Ming; Marcus, Steven C; Mandell, David S

2015-09-01

This study evaluated the association of fidelity to each of the components of the Strategies for Teaching based on Autism Research (STAR) program, a comprehensive treatment package for children with autism that includes discrete trial training, pivotal response training, and teaching in functional routines, on outcomes for 191 students ages 5-8 years in a large public school district. Fidelity to all components was relatively low, despite considerable training and support, suggesting the need to develop new implementation strategies. Fidelity to pivotal response training, but not discrete trial training or functional routines, was positively associated with gains in cognitive ability despite low levels of fidelity, and may be an effective intervention choice in under-resourced settings.

On the Use of Accelerated Test Methods for Characterization of Advanced Composite Materials

NASA Technical Reports Server (NTRS)

Gates, Thomas S.

2003-01-01

A rational approach to the problem of accelerated testing for material characterization of advanced polymer matrix composites is discussed. The experimental and analytical methods provided should be viewed as a set of tools useful in the screening of material systems for long-term engineering properties in aerospace applications. Consideration is given to long-term exposure in extreme environments that include elevated temperature, reduced temperature, moisture, oxygen, and mechanical load. Analytical formulations useful for predictive models that are based on the principles of time-based superposition are presented. The need for reproducible mechanisms, indicator properties, and real-time data are outlined as well as the methodologies for determining specific aging mechanisms.

Is Geriatric Medicine Possible in a Middle-Income Country? The Case of Costa Rica.

PubMed

Morales-Martínez, Fernando

2017-08-01

This article outlines the current and future-projected demographic data, organization, networks for the care of older people, and perspectives in Costa Rica in relation to the challenges resulting from exponential growth of the older adult population, most notably those aged 80 and older. It includes consideration of the Norms of Integrated Care of the Older Adult of Costa Rica's national social security system and contributions from other public and private institutions. It also makes note of commentaries on the need for ever-increasing efforts to manage the care of Costa Rica's burgeoning older adult population. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Sinusitis: Special Considerations for Aging Patients

MedlinePlus

... Humanitarian Efforts International Outreach Advocacy Board of Governors Industry Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources ...

Strategies influence neural activity for feedback learning across child and adolescent development.

PubMed

Peters, Sabine; Koolschijn, P Cédric M P; Crone, Eveline A; Van Duijvenvoorde, Anna C K; Raijmakers, Maartje E J

2014-09-01

Learning from feedback is an important aspect of executive functioning that shows profound improvements during childhood and adolescence. This is accompanied by neural changes in the feedback-learning network, which includes pre-supplementary motor area (pre- SMA)/anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (DLPFC), superior parietal cortex (SPC), and the basal ganglia. However, there can be considerable differences within age ranges in performance that are ascribed to differences in strategy use. This is problematic for traditional approaches of analyzing developmental data, in which age groups are assumed to be homogenous in strategy use. In this study, we used latent variable models to investigate if underlying strategy groups could be detected for a feedback-learning task and whether there were differences in neural activation patterns between strategies. In a sample of 268 participants between ages 8 to 25 years, we observed four underlying strategy groups, which were cut across age groups and varied in the optimality of executive functioning. These strategy groups also differed in neural activity during learning; especially the most optimal performing group showed more activity in DLPFC, SPC and pre-SMA/ACC compared to the other groups. However, age differences remained an important contributor to neural activation, even when correcting for strategy. These findings contribute to the debate of age versus performance predictors of neural development, and highlight the importance of studying individual differences in strategy use when studying development. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Effect of Age and Type of Noise on Speech Perception under Conditions of Changing Context and Noise Levels.

PubMed

Taitelbaum-Swead, Riki; Fostick, Leah

2016-01-01

Everyday life includes fluctuating noise levels, resulting in continuously changing speech intelligibility. The study aims were: (1) to quantify the amount of decrease in age-related speech perception, as a result of increasing noise level, and (2) to test the effect of age on context usage at the word level (smaller amount of contextual cues). A total of 24 young adults (age 20-30 years) and 20 older adults (age 60-75 years) were tested. Meaningful and nonsense one-syllable consonant-vowel-consonant words were presented with the background noise types of speech noise (SpN), babble noise (BN), and white noise (WN), with a signal-to-noise ratio (SNR) of 0 and -5 dB. Older adults had lower accuracy in SNR = 0, with WN being the most difficult condition for all participants. Measuring the change in speech perception when SNR decreased showed a reduction of 18.6-61.5% in intelligibility, with age effect only for BN. Both young and older adults used less phonemic context with WN, as compared to other conditions. Older adults are more affected by an increasing noise level of fluctuating informational noise as compared to steady-state noise. They also use less contextual cues when perceiving monosyllabic words. Further studies should take into consideration that when presenting the stimulus differently (change in noise level, less contextual cues), other perceptual and cognitive processes are involved. © 2016 S. Karger AG, Basel.

Different incidences of knee arthroplasty in the Nordic countries.

PubMed

NiemeläInen, Mika J; MäKelä, Keijo T; Robertsson, Otto; W-Dahl, Annette; Furnes, Ove; Fenstad, Anne M; Pedersen, Alma B; Schrøder, Henrik M; Huhtala, Heini; Eskelinen, Antti

2017-04-01

Background and purpose - The annual number of total knee arthroplasties (TKAs) has increased worldwide in recent years. To make projections regarding future needs for primaries and revisions, additional knowledge is important. We analyzed and compared the incidences among 4 Nordic countries Patients and methods - Using Nordic Arthroplasty Register Association (NARA) data from 4 countries, we analyzed differences between age and sex groups. We included patients over 30 years of age who were operated with TKA or unicompartmental knee arthroplasty (UKA) during the period 1997-2012. The negative binomial regression model was used to analyze changes in general trends and in sex and age groups. Results - The average annual increase in the incidence of TKA was statistically significant in all countries. The incidence of TKA was higher in women than in men in all 4 countries. It was highest in Finland in patients aged 65 years or more. At the end of the study period in 2012, Finland's total incidence was double that of Norway, 1.3 times that of Sweden and 1.4 times that of Denmark. The incidence was lowest in the youngest age groups (< 65 years) in all 4 countries. The proportional increase in incidence was highest in patients who were younger than 65 years. Interpretation - The incidence of knee arthroplasty steadily increased in the 4 countries over the study period. The differences between the countries were considerable, with the highest incidence in Finland. Patients aged 65 years or more contributed to most of the total incidence of knee arthroplasty.

Age, circadian rhythms, and sleep loss in flight crews

NASA Technical Reports Server (NTRS)

Gander, Philippa H.; Nguyen, DE; Rosekind, Mark R.; Connell, Linda J.

1993-01-01

Age-related changes in trip-induced sleep loss, personality, and the preduty temperature rhythm were analyzed in crews from various flight operations. Eveningness decreased with age. The minimum of the baseline temperature rhythm occurred earlier with age. The amplitude of the baseline temperature rhythm declined with age. Average daily percentage sleep loss during trips increased with age. Among crewmembers flying longhaul flight operations, subjects aged 50-60 averaged 3.5 times more sleep loss per day than subjects aged 20-30. These studies support previous findings that evening types and subjects with later peaking temperature rhythms adapt better to shift work and time zone changes. Age and circadian type may be important considerations for duty schedules and fatigue countermeasures.

28 CFR 544.32 - Goals.

Code of Federal Regulations, 2013 CFR

2013-07-01

... activities are designed to attract inmate participation regardless of ethnic, racial, age, or sex difference, or handicap considerations, and to enhance the potential for post-release involvement. (b) Leisure...

28 CFR 544.32 - Goals.

Code of Federal Regulations, 2011 CFR

2011-07-01

... activities are designed to attract inmate participation regardless of ethnic, racial, age, or sex difference, or handicap considerations, and to enhance the potential for post-release involvement. (b) Leisure...

28 CFR 544.32 - Goals.

Code of Federal Regulations, 2014 CFR

2014-07-01

... activities are designed to attract inmate participation regardless of ethnic, racial, age, or sex difference, or handicap considerations, and to enhance the potential for post-release involvement. (b) Leisure...

28 CFR 544.32 - Goals.

Code of Federal Regulations, 2010 CFR

2010-07-01

... activities are designed to attract inmate participation regardless of ethnic, racial, age, or sex difference, or handicap considerations, and to enhance the potential for post-release involvement. (b) Leisure...

28 CFR 544.32 - Goals.

Code of Federal Regulations, 2012 CFR

2012-07-01

... activities are designed to attract inmate participation regardless of ethnic, racial, age, or sex difference, or handicap considerations, and to enhance the potential for post-release involvement. (b) Leisure...

The heat treatment of duralumin

NASA Technical Reports Server (NTRS)

Nelson, WM

1927-01-01

When certain light aluminum alloys are heat-treated, quenched and aged, there is considerable improvement in their tensile properties. This paper presents different methods of accomplishing these heat treatments.

Patterns of Adolescent Depression to Age 20: The Role of Maternal Depression and Youth Interpersonal Dysfunction

ERIC Educational Resources Information Center

Hammen, Constance; Brennan, Patricia A.; Keenan-Miller, Danielle

2008-01-01

Considerable research has focused on youth depression, but further information is needed to characterize different patterns of onset and recurrence during adolescence. Four outcome groups by age 20 were defined (early onset-recurrent, early-onset-desisting, later-onset, never depressed) and compared on three variables predictive of youth…

The Student Returns: Challenges of the Returning Student.

ERIC Educational Resources Information Center

Marino, Carrie A.

According to a 1994 analysis of returning students, as many as 43% of all college students are currently over the age of 24. This influx of returning students demands a new look at existing pedagogical practices. The changing demographics of the classroom turn age and life experience into a consideration for pedagogy alongside race, class, and…

The Parent as Naive Psychologist: Analyses of Parental Deliberations.

ERIC Educational Resources Information Center

Holden, George W.; West, Meredith J.

Two groups of l4 mothers were interviewed to study how parents reason about their children's behavior. The two samples differed considerably in terms of education, age, race, and socioeconomic status. The first group, high school educated, averaged 24 years of age, and, if married, had spouses with blue-collar jobs. The second group, college…

Learning through the Ages? Generational Inequalities and Inter-Generational Dynamics of Lifelong Learning

ERIC Educational Resources Information Center

Field, John

2013-01-01

This exploratory paper considers the concept of generation in the context of learning across the life course. Although researchers have often found considerable inequalities in participation by age, as well as strongly articulated attitudinal differences, there have so far been only a handful of studies that have explored these patterns through…

Psychosocial Correlates of Shape and Weight Concerns in Overweight Pre-Adolescents

ERIC Educational Resources Information Center

Sinton, Meghan M.; Goldschmidt, Andrea B.; Aspen, Vandana; Theim, Kelly R.; Stein, Richard I.; Saelens, Brian E.; Epstein, Leonard H.; Wilfley, Denise E.

2012-01-01

Shape and weight concerns among overweight pre-adolescents heighten risk for eating disorders and weight gain. Treatment and prevention efforts require consideration of psychosocial factors that co-occur with these concerns. This study involved 200 overweight pre-adolescents, aged 7-12 years (M age = 9.8; SD = 1.4), presenting for family-based…

Age-Related Cognitive Impairments in Mice with a Conditional Ablation of the Neural Cell Adhesion Molecule

ERIC Educational Resources Information Center

Bisaz, Reto; Boadas-Vaello, Pere; Genoux, David; Sandi, Carmen

2013-01-01

Most of the mechanisms involved in neural plasticity support cognition, and aging has a considerable effect on some of these processes. The neural cell adhesion molecule (NCAM) of the immunoglobulin superfamily plays a pivotal role in structural and functional plasticity and is required to modulate cognitive and emotional behaviors. However,…

Spirituality: An Affective Facet for Curriculum Consideration.

ERIC Educational Resources Information Center

Dickmann, Leonore W.

1980-01-01

The current age has been characterized as an Age of Materialism in which personal goals are material aims and pleasures. The need for getting back to a spiritual culture is considered foundational. It is the duty of educators to provide for the spiritual or affective domain of a learner's development. To neglect this aspect of a person's being is…

Elderly adults and skin disorders: common problems for nondermatologists.

PubMed

Na, Chang R; Wang, Steven; Kirsner, Robert S; Federman, Daniel G

2012-11-01

Diseases of elderly adults are becoming increasingly important as life expectancy gradually rises worldwide. To promote healthy aging, it is important to understand the skin changes associated with aging. This review focuses on the special considerations for some of the more common dermatological disorders in elderly adults and examines presentation, contributing factors, and association with systemic diseases.

Gender and the Division of Household Labor in Older Couples: A European Perspective

ERIC Educational Resources Information Center

Hank, Karsten; Jurges, Hendrik

2007-01-01

Using microdata from the 2004 Survey of Health, Ageing and Retirement in Europe (SHARE), this study takes a cross-national perspective to investigate the division of household labor among older couples (aged 50 years or more). Across nine continental European countries, the authors find considerable variation in the overall distribution of…

Variables and Methodological Considerations Associated with Children's Sex Role Preferences.

ERIC Educational Resources Information Center

Cappella, Roseann

Several key variables in the development and assessment of young children's sex role preference are examined in this study. A sample of 257 pre-kindergarten children (mean age, 59 months) and their mothers participated in this study. After obtaining information on each child's age, IQ, and his/her mother's employment status the It Scale for…

Economic considerations of uneven-age hardwood management

Treesearch

H. Clay Smith; Gary W. Miller

1987-01-01

Uneven-age management or partial cutting methods as described in this paper allow foresters to manage eastern hardwood stands and harvest forest products without clearcutting. These methods can involve regular periodic harvests, at least for the short term, based on stand conditions and growing-site capabilities. We are not going to make the decision as to which is the...

Problematic Smartphone Use: Investigating Contemporary Experiences Using a Convergent Design

PubMed Central

Harkin, Lydia

2018-01-01

Internet-enabled smartphones are increasingly ubiquitous in the Western world. Research suggests a number of problems can result from mobile phone overuse, including dependence, dangerous and prohibited use. For over a decade, this has been measured by the Problematic Mobile Phone Use Questionnaire (PMPU-Q). Given the rapid developments in mobile technologies, changes of use patterns and possible problematic and addictive use, the aim of the present study was to investigate and validate an updated contemporary version of the PMPU-Q (PMPU-Q-R). A mixed methods convergent design was employed, including a psychometric survey (N = 512) alongside qualitative focus groups (N = 21), to elicit experiences and perceptions of problematic smartphone use. The results suggest the PMPU-Q-R factor structure can be updated to include smartphone dependence, dangerous driving, and antisocial smartphone use factors. Theories of problematic mobile phone use require consideration of the ubiquity and indispensability of smartphones in the present day and age, particularly regarding use whilst driving and in social interactions. PMID:29337883

Problematic Smartphone Use: Investigating Contemporary Experiences Using a Convergent Design.

PubMed

Kuss, Daria J; Harkin, Lydia; Kanjo, Eiman; Billieux, Joel

2018-01-16

Internet-enabled smartphones are increasingly ubiquitous in the Western world. Research suggests a number of problems can result from mobile phone overuse, including dependence, dangerous and prohibited use. For over a decade, this has been measured by the Problematic Mobile Phone Use Questionnaire (PMPU-Q). Given the rapid developments in mobile technologies, changes of use patterns and possible problematic and addictive use, the aim of the present study was to investigate and validate an updated contemporary version of the PMPU-Q (PMPU-Q-R). A mixed methods convergent design was employed, including a psychometric survey ( N = 512) alongside qualitative focus groups ( N = 21), to elicit experiences and perceptions of problematic smartphone use. The results suggest the PMPU-Q-R factor structure can be updated to include smartphone dependence, dangerous driving, and antisocial smartphone use factors. Theories of problematic mobile phone use require consideration of the ubiquity and indispensability of smartphones in the present day and age, particularly regarding use whilst driving and in social interactions.

Irritable bowel syndrome

PubMed Central

Enck, Paul; Aziz, Qasim; Barbara, Giovanni; Farmer, Adam D.; Fukudo, Shin; Mayer, Emeran A.; Niesler, Beate; Quigley, Eamonn M. M.; Rajilić-Stojanović, Mirjana; Schemann, Michael; Schwille-Kiuntke, Juliane; Simren, Magnus; Zipfel, Stephan; Spiller, Robin C.

2016-01-01

Irritable bowel syndrome (IBS) is a functional gastrointestinal disease with a high population prevalence. The disorder can be debilitating in some patients, whereas others may have mild or moderate symptoms. The most important single risk factors are female sex, younger age and preceding gastrointestinal infections. Clinical symptoms of IBS include abdominal pain or discomfort, stool irregularities and bloating, as well as other somatic, visceral and psychiatric comorbidities. Currently, the diagnosis of IBS is based on symptoms and the exclusion of other organic diseases, and therapy includes drug treatment of the predominant symptoms, nutrition and psychotherapy. Although the underlying pathogenesis is far from understood, aetiological factors include increased epithelial hyperpermeability, dysbiosis, inflammation, visceral hypersensitivity, epigenetics and genetics, and altered brain–gut interactions. IBS considerably affects quality of life and imposes a profound burden on patients, physicians and the health-care system. The past decade has seen remarkable progress in our understanding of functional bowel disorders such as IBS that will be summarized in this Primer. PMID:27159638

Accuracy of the MacArthur competence assessment tool for clinical research (MacCAT-CR) for measuring children's competence to consent to clinical research.

PubMed

Hein, Irma M; Troost, Pieter W; Lindeboom, Robert; Benninga, Marc A; Zwaan, C Michel; van Goudoever, Johannes B; Lindauer, Ramón J L

2014-12-01

An objective assessment of children's competence to consent to research participation is currently not possible. Age limits for asking children's consent vary considerably between countries, and, to our knowledge, the correlation between competence and children's age has never been systematically investigated. To test a standardized competence assessment instrument for children by modifying the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), to investigate its reliability and validity, and to examine the correlation of its assessment with age and estimate cutoff ages. This prospective study included children and adolescents aged 6 to 18 years in the inpatient and outpatient departments of allergology, gastroenterology, oncology, ophthalmology, and pulmonology from January 1, 2012, through January 1, 2014. Participants were eligible for clinical research studies, including observational studies and randomized clinical trials. Competence judgments by experts aware of the 4 relevant criteria-understanding, appreciation, reasoning, and choice-were used to establish the reference standard. The index test was the MacCAT-CR, which used a semistructured interview format. Interrater reliability, validity, and dimensionality of the MacCAT-CR and estimated cutoff ages for competence. Of 209 eligible patients, we included 161 (mean age, 10.6 years; 47.2% male). Good reproducibility of MacCAT-CR total and subscale scores was observed (intraclass correlation coefficient range, 0.68-0.92). We confirmed unidimensionality of the MacCAT-CR. By the reference standard, we judged 54 children (33.5%) to be incompetent; by the MacCAT-CR, 61 children (37.9%). Criterion-related validity of MacCAT-CR scores was supported by high overall accuracy in correctly classifying children as competent against the reference standard (area under the receiver operating characteristics curve, 0.78). Age was a good predictor of competence on the MacCAT-CR (area under the receiver operating characteristics curve, 0.90). In children younger than 9.6 years, competence was unlikely (sensitivity, 90%); in those older than 11.2 years, competence was probable (specificity, 90%). The optimal cutoff age was 10.4 years (sensitivity, 81%; specificity, 84%). The MacCAT-CR demonstrated strong psychometric properties. In children aged 9.6 to 11.2 years, consent may be justified when competence can be demonstrated in individual cases by the MacCAT-CR. The results contribute to a scientific underpinning of regulations for clinical research directed toward children.

Early vs late age at onset frontotemporal dementia and frontotemporal lobar degeneration.

PubMed

Seo, Sang Won; Thibodeau, Marie-Pierre; Perry, David C; Hua, Alice; Sidhu, Manu; Sible, Isabel; Vargas, Jose Norberto S; Gaus, Stephanie E; Rabinovici, Gil D; Rankin, Katherine D; Boxer, Adam L; Kramer, Joel H; Rosen, Howard J; Gorno-Tempini, Maria Luisa; Grinberg, Lea T; Huang, Eric J; DeArmond, Stephen J; Trojanowski, John Q; Miller, Bruce L; Seeley, William W

2018-03-20

To examine clinicopathologic correlations in early vs late age at onset frontotemporal dementia (FTD) and frontotemporal lobar degeneration (FTLD). All patients were clinically evaluated and prospectively diagnosed at the UCSF Memory and Aging Center. Two consecutive series were included: (1) patients with a clinically diagnosed FTD syndrome who underwent autopsy (cohort 1) and (2) patients with a primary pathologic diagnosis of FTLD, regardless of the clinical syndrome (cohort 2). These series were divided by age at symptom onset (cutoff 65 years). In cohort 1, 48 (25.3%) were 65 years or older at symptom onset. Pathologic causes of behavioral variant FTD (bvFTD) were similar in the early age at onset (EO) and late age at onset (LO) bvFTD groups. In corticobasal syndrome (CBS), however, the most common pathologic substrate differed according to age at onset: progressive supranuclear palsy (42.9%) in LO-CBS and Alzheimer disease (AD; 40.7%) in EO-CBS. In cohort 2, 57 (28.4%) were classified as LO-FTLD. Regarding FTLD major molecular classes, FTLD with transactive response DNA-binding protein of 43 kDa was most common in EO-FTLD (44.4%), whereas FTLD-tau (58.3%) was most common in LO-FTLD. Antemortem diagnosis of a non-FTD syndrome, usually AD-type dementia, was more frequent in LO-FTLD than EO-FTLD (19.3% vs 7.7%, p = 0.017). LO-FTLD was also associated with more prevalent comorbid pathologic changes. Of these, moderate to severe AD neuropathologic change and argyrophilic grain disease were overrepresented among patients who received an antemortem diagnosis of AD-type dementia. Patients with FTD and FTLD often develop symptoms after age 65, and age at onset represents an important consideration when making antemortem neuropathologic predictions. © 2018 American Academy of Neurology.

Vitamin E Supplementation Reduces Cellular Loss in the Brain of a Premature Aging Mouse Model.

PubMed

La Fata, G; van Vliet, N; Barnhoorn, S; Brandt, R M C; Etheve, S; Chenal, E; Grunenwald, C; Seifert, N; Weber, P; Hoeijmakers, J H J; Mohajeri, M H; Vermeij, W P

2017-01-01

Aging is a highly complex biological process driven by multiple factors. Its progression can partially be influenced by nutritional interventions. Vitamin E is a lipid-soluble anti-oxidant that is investigated as nutritional supplement for its ability to prevent or delay the onset of specific aging pathologies, including neurodegenerative disorders. We aimed here to investigate the effect of vitamin E during aging progression in a well characterized mouse model for premature aging. Xpg-/- animals received diets with low (~2.5 mg/kg feed), medium (75 mg/kg feed) or high (375 mg/kg feed) vitamin E concentration and their phenotype was monitored during aging progression. Vitamin E content was analyzed in the feed, for stability reasons, and in mouse plasma, brain, and liver, for effectiveness of the treatment. Subsequent age-related changes were monitored for improvement by increased vitamin E or worsening by depletion in both liver and nervous system, organs sensitive to oxidative stress. Mice supplemented with high levels of vitamin E showed a delayed onset of age-related body weight decline and appearance of tremors when compared to mice with a low dietary vitamin E intake. DNA damage resulting in liver abnormalities such as changes in polyploidy, was considerably prevented by elevated amounts of vitamin E. Additionally, immunohistochemical analyses revealed that high intake of vitamin E, when compared with low and medium levels of vitamin E in the diet, reduces the number of p53-positive cells throughout the brain, indicative of a lower number of cells dying due to DNA damage accumulated over time. Our data underline a neuroprotective role of vitamin E in the premature aging animal model used in this study, likely via a reduction of oxidative stress, and implies the importance of improved nutrition to sustain health.

What happened to life expectancy in Spain in the 1980s?

PubMed Central

Chenet, L; McKee, M; Otero, A; Ausin, I

1997-01-01

BACKGROUND: Life expectancy at birth in Spain improved between 1972 and 1982, by 2.5 years for males and 3.2 years for females. This slowed considerably in the following decade, with increases of only 0.5 and 1.7 years respectively. OBJECTIVE: To determine the causes of death that have been responsible for the failure by Spain to maintain in the 1980s and 1990s the rate of improvement in life expectancy seen during the 1970s. DESIGN: Data from WHO mortality tapes grouped in a series of clinically meaningful categories were used to calculate the contribution of each category, in five year age groups, to the changing life expectancy at birth in the two periods. SETTING: Spain. RESULTS: The trend in life expectancy at birth in Spain over this 20 year period can be considered to have two components, both with important consequences for public health policy. Underlying trends include a steady negative contribution from respiratory cancer in men and a reduction in cardiovascular disease. More recent trends include a considerable deterioration in deaths among young adults, most notably from accidents and, possibly, AIDS. CONCLUSION: The failure to maintain the rate of earlier gains in life expectancy in Spain can be attributed largely to a few conditions, although these may indicate less obvious underlying problems. These findings have important consequences for prioritising public health policies. PMID:9425460

Does consideration of either psychological or material disadvantage improve coronary risk prediction? Prospective observational study of Scottish men.

PubMed

Macleod, John; Metcalfe, Chris; Smith, George Davey; Hart, Carole

2007-09-01

To assess the value of psychosocial risk factors in discriminating between individuals at higher and lower risk of coronary heart disease, using risk prediction equations. Prospective observational study. Scotland. 5191 employed men aged 35 to 64 years and free of coronary heart disease at study enrollment Area under receiver operating characteristic (ROC) curves for risk prediction equations including different risk factors for coronary heart disease. During the first 10 years of follow up, 203 men died of coronary heart disease and a further 200 were admitted to hospital with this diagnosis. Area under the ROC curve for the standard Framingham coronary risk factors was 74.5%. Addition of "vital exhaustion" and psychological stress led to areas under the ROC curve of 74.5% and 74.6%, respectively. Addition of current social class and lifetime social class to the standard Framingham equation gave areas under the ROC curve of 74.6% and 74.9%, respectively. In no case was there strong evidence for improved discrimination of the model containing the novel risk factor over the standard model. Consideration of psychosocial risk factors, including those that are strong independent predictors of heart disease, does not substantially influence the ability of risk prediction tools to discriminate between individuals at higher and lower risk of coronary heart disease.

The impact of aging physiology in critical care.

PubMed

Walker, Mandi; Spivak, Mark; Sebastian, Mary

2014-03-01

Aging physiology greatly impacts care delivery in the geriatric patient population. Consideration should be given to addressing the patient-specific needs regarding the systemic changes seen in the aging patient. Each major body system presents its own unique challenges to the critical care practitioner, and a comprehensive understanding of these changes is necessary to effectively care for this patient population. This article summarizes these changes and provides key points for the practitioner to consider when caring for the aging patient in the critical care arena. Copyright © 2014 Elsevier Inc. All rights reserved.

Octogenarian and centenarian performance on the Fuld Object Memory Evaluation.

PubMed

Rahman-Filipiak, Annalise; Woodard, John L; Miller, L Stephen; Martin, Peter; Davey, Adam; Poon, Leonard W

2015-01-01

The Fuld Object Memory Evaluation (FOME) has considerable utility for cognitive assessment in older adults, but there are few normative data, particularly for the oldest old. In this study, 80 octogenarians and 244 centenarians from the Georgia Centenarian Study completed the FOME. Total and trial-to-trial performance on the storage, retrieval, repeated retrieval, and ineffective reminder indices were assessed. Additional data stratified by age group, education, and cognitive impairment are provided in the Supplemental data. Octogenarians performed significantly better than centenarians on all FOME measures. Neither age group benefitted from additional learning trials beyond Trial 3 for storage and Trial 2 for retention and retrieval. Ineffective reminders showed no change across learning trials for octogenarians, while centenarians improved only between Trials 1 and 2. This minimal improvement past Trial 2 indicates that older adults might benefit from a truncated version of the test that does not include trials three through five, with the added benefit of reducing testing burden in this population.

[Psychological aspects of treating staghorn nephrolithiasis using percutaneous and retrograde nephrolithotripsy].

PubMed

Podoinitsyn, A A; Dutov, V V

2016-11-01

To investigate the level of anxiety and the severity of asthenic state in patients with staghorn nephrolithiasis treated by of minimally invasive therapies - percutaneous nephrolithotripsy (PNLT) and retrograde nephrolithotripsy (RNLT). This study analyzed the psychological state of 150 patients with staghorn nephrolithiasis aged 25 to 75 years before and after PNLT and RNLT. Testing was performed at baseline, at 5-7 day of hospital stay (average time of preparing for surgery) and after treatment with the use of various questionnaires: Anxiety Scale, Asthenic conditions scale and Pain questionnaire. The follow-up findings shower positive changes, including reduction in the level of anxiety and severity of asthenia in patients of different age groups. The decrease in anxiety level and severity of fatigue was associated with decreased rates of neuropathic component of pain. The psychological state of patients with staghorn nephrolithiasis depends on the characteristics of minimally invasive methods of treatment and requires attending physicians and medical personnel to take into consideration the mental and emotional state of patients.

Pediatric Issues in Sports Concussions

PubMed Central

Giza, Christopher C.

2014-01-01

Purpose of Review: Sports-related concussions are receiving increasing attention in both the lay press and medical literature. While most media attention has been on high-profile collegiate or professional athletes, the vast majority of individuals participating in contact and collision sports are adolescents and children. This review provides a practical approach toward youth sports-related concussion with a foundation in the recent guidelines, but including specific considerations when applying these management principles to children and adolescents. Recent Findings: Objective measurement of early signs and symptoms is challenging in younger patients, and many commonly used assessment tools await rigorous validation for younger patients. Excellent evidence-based guidelines exist for CT evaluation of mild traumatic brain injury presenting to the emergency department. Evidence suggests that recovery from sports-related concussion takes longer in high school athletes compared with collegiate or professionals; however, rigorous studies below high school age are still lacking. Summary: Proper care for concussion in youth requires a delicate balance of clinical skills, age-appropriate assessment, and individualized management to achieve optimal outcomes. PMID:25470161

Decision-Making for Induced Abortion in the Accra Metropolis, Ghana.

PubMed

Gbagbo, Fred Yao; Amo-Adjei, Joshua; Laar, Amos

2015-06-01

Decision-making for induced abortion can be influenced by various circumstances including those surrounding onset of a pregnancy. There are various dimensions to induced abortion decision-making among women who had an elective induced abortion in a cosmopolitan urban setting in Ghana, which this paper examined. A cross-sectional mixed method study was conducted between January and December 2011 with 401 women who had undergone an abortion procedure in the preceding 12 months. Whereas the quantitative data were analysed with descriptive statistics, thematic analysis was applied to the qualitative data. The study found that women of various profiles have different reasons for undergoing abortion. Women considered the circumstances surrounding onset of pregnancy, person responsible for the pregnancy, gestational age at decision to terminate, and social, economic and medical considerations. Pressures from partners, career progression and reproductive intentions of women reinforced these reasons. First time pregnancies were mostly aborted regardless of gestational ages and partners' consent. Policies and programmes targeted at safe abortion care are needed to guide informed decisions on induced abortions.

A Cautionary Tale: Examining the Interplay of Culturally Specific Risk and Resilience Factors in Indigenous Communities

PubMed Central

Walls, Melissa L.; Whitbeck, Les; Armenta, Brian

2016-01-01

Efforts to build empirical evidence for the protective effects of Indigenous cultural factors on psychological health have yielded mixed findings. We examine the interplay of previously hypothesized culturally relevant risk (discrimination, historical loss) and protective (spiritual activities) factors among Indigenous people. The sample includes 569 Indigenous adolescents (M age = 17.23, SD = 0.88; 51.0% girls) and 563 Indigenous adult caregivers (M age = 44.66, SD = 9.18; 77.4% women). Our central finding was that indigenous spirituality was associated with poorer psychological outcomes across several domains (depressive symptoms, anger, anxiety, somatization and interpersonal difficulties), but observed effects were attenuated once perceived discrimination and historical losses were added to statistical models. Thus, consideration of relevant stressors drastically changed our conclusions, underscoring the uncertain dynamics through which specific Indigenous cultural factors impact mental health. Researchers should work in collaboration with Indigenous communities to improve measurement and empirical investigation of these complex constructs. PMID:28138417

Inequalities in Dental Attendance throughout the Life-course

PubMed Central

2012-01-01

The purpose of this study was to identify socio-economic inequalities in regular dental attendance throughout the life-course. The analyses relied on data from SHARE (waves 1 to 3 of the Survey of Health, Ageing, and Retirement in Europe), which includes retrospective information on life-course dental attendance of 26,525 persons currently aged 50 years or greater from 13 European countries (Austria, Poland, Spain, Italy, the Netherlands, Belgium, Greece, the Czech Republic, France, Denmark, Switzerland, Germany, and Sweden). Inequalities in dental attendance were assessed by means of Concentration Indices. Socio-economic disparities in regular dental attendance were identified as early as childhood. Moreover, higher educational attainment resulted in increased probabilities of regular dental attendance throughout subsequent life-years in all nations. In most countries, inequality levels remained relatively inelastic throughout the life-course. These findings suggest that a considerable proportion of inequalities in dental care use is already established at childhood and persists throughout the life-course. PMID:22699676

Prevalence of oral malodour and its relationship with oral parameters in Indian children aged 7-15 years.

PubMed

Patil, P S; Pujar, P; Poornima, S; Subbareddy, V V

2014-08-01

To determine the prevalence of oral malodour in Indian children and also to assess the relationship of oral malodour with oral hygiene, gingival health, dental caries, tongue coating, mouth breathing and frequency of tooth brushing. A total number of 900 school children (7-15 years) were included in the study. Children were assessed for the oral malodour, oral hygiene, gingival health, dental caries, tongue coating, mouth breathing and frequency of tooth brushing. The prevalence of oral malodour in Davangere school children was found to be 40.9%. Oral malodour was significantly (p < 0.001) associated with age, mouth breathing, tongue coating, oral hygiene status, gingival status and tooth brushing frequency. Oral malodour was not significantly correlated with gender and caries status. The prevalence of malodour in the population studied was 40.9% and oral health status and oral malodour were associated with one another. The prevalence of oral malodour was considerably high and should not be neglected in children.